(当归四逆并加吴茱萸等汤见阴症略例)
四物汤益荣卫泫气血月水不调脐腹 痛等证并见局方 熟地黄(补血如脐下痛非此不能
除乃
通于肾经之药也)川芎(治风泄肝木也如血虚头痛非此不能除乃通肝经之药也)芍药(和血理脾
如腹中虚痛非此不能除乃通脾经之药也)当归(和血如血刺痛非此不能除刺如刀刺乃通肾
经
之药也)上为粗末水煎 加减于后 若加地骨皮牡丹皮治妇人骨蒸 若妊娠胎动不安下血不
止
者加艾十叶阿胶一片又加葱白黄 若血藏虚冷崩中去血过多亦加胶艾 若妇人尝服春倍川
芎
脉弦头痛 夏倍芍药 脉洪飧泄 秋倍地黄 脉沉涩血虚 冬倍当归 脉沉寒而不食 若
春则防风四物加防风倍川芎 若夏则黄芩四物加黄芩倍芍药 若秋则门冬四物加天门冬倍地
黄若冬则桂枝四物加桂枝倍当归 若血虚而腹痛微汗而恶风四物汤加术桂谓之腹痛六合
若风眩运加秦艽羌活谓之风六合 若气虚弱起则乏力眶然而倒加浓朴陈皮谓之气六合 若发
热
而烦不能睡卧者加黄连栀子谓之热六合 若虚寒脉微自汗气难布息清便自调加干姜附子谓之
寒六合 若中湿身沉重无力身微凉汗加白术茯苓谓之湿六合 若产后虚劳日久而脉浮疾宜柴
胡四物汤 川芎 熟地黄 当归 芍药(各一两半) 加柴胡(八钱) 人参 黄芩 甘草 半
夏曲(各三钱) 水煎服若妇人筋骨肢节痛及头痛脉弦增寒如疟宜治风六合 四物汤(四两)
防风 羌活(各一两) 若血气上冲心腹肋下满闷宜治气六合 四物汤(四两) 香术 槟榔(
各一两) 若脐下虚冷腹痛及腰脊间闷痛宜玄胡六合(小腹痛者同) 四物汤(四两) 玄胡
苦楝(各一两碎炒焦)若气充经脉故月事频并脐下多痛宜芍药六合 四物汤(四两)芍药(一两)若经
事欲行脐腹绞痛临经痛者血涩也宜八物汤 四物汤(四两)玄胡 苦楝(碎炒焦)槟榔 木香(
各一两)若经水过多别无余证宜黄芩六合 四物汤(四两)黄芩 白
术(各一两) 若经水涩少宜四物内加葵花煎(又加红花血见愁)若虚劳气弱咳嗽喘满宜浓朴六
合四物汤(四两)浓朴(姜制一两)枳实(麸炒半两)若经水暴下加黄芩一两 若腹痛加黄连如
夏月不去黄芩 若经水如黑豆汁者加黄芩黄连(各一两)若经水少而色和者四物汤加熟地黄当
归(各一两)若经水适来适断或有往来寒热者先服小柴胡汤以去其寒热后以四物汤和之若妇
人血积者四物汤内加广术 京三棱 桂枝 干膝(各一两)若妇人伤寒汗下后饮食减少血虚
者宜八物汤 四物汤(四两) 黄 甘草 茯苓 白术(各一两) 若妊娠伤寒中风表虚自汗
头痛项强身热恶寒脉浮而弱太阳经病宜表虚六合汤四物汤(四两)桂枝 地骨皮(各七钱) 若
妊娠伤寒头痛身热无汗脉浮紧太阳经病宜表实六合汤 四物汤(四两)麻黄 细辛(各半两)若
妊娠伤寒中风湿之气肢节烦痛脉浮而热头痛宜风湿六合汤太阳标病也 四物汤(四两)防风
苍术(制各七钱)若妊娠伤寒下后过经不愈温毒发 如锦纹宜升麻六合汤 四物汤(四两) 升麻
连翘(各七钱)若妊娠伤寒胸胁满痛而脉弦少阳也宜柴胡六合汤 四物汤(四两)柴胡 黄芩(
各七钱)若妊娠伤寒大便硬小便赤气满而脉沉数阳明太阳本病也急下之宜大黄六合汤 四物汤
(四两)大黄(半两)桃仁(十个去皮尖面炒)若妊娠伤寒汗下后咳嗽不止者宜人参六合汤 四物
汤(四两) 人参 五味子(各五钱) 若妇人妊娠伤寒汗下后虚痞胀满者阳明本虚也宜浓朴六
合汤 四物汤(四两) 浓朴 枳实(麸炒各半两)若妊娠伤寒汗下后不得眠者宜栀子六合汤
四物
汤(四两) 栀子 黄芩(各半两)若妊娠伤寒身热大渴蒸蒸而烦脉长而大者宜石膏六合汤 四
物
汤(四两) 石膏 知母(各半两)若妊娠伤寒小便不利太阳本病宜茯苓六合汤 四物汤(四两)
茯苓 泽泻(各半两)若妊娠伤寒太阳本病小便赤如血者宜琥珀六合汤 四物汤(四两) 琥
珀茯苓(各半两) 若妊娠伤寒汗下后血漏不止胎气损者宜胶艾六合汤 四物汤(四两) 阿
胶艾(各半两一方加甘草同上一方加干姜甘草黄 ) 若妊娠伤寒四肢拘急身凉微汗腹中痛
脉沉而迟少阴病也宜附子六合汤 四物汤(四两) 附子(炮去皮脐) 肉桂(各半两) 若赤白
带下宜香桂六合汤 四物汤(四两) 肉桂 香附子(各半两) 若妊娠伤寒蓄血证不宜堕胎药
下之宜四物大黄汤下 四物汤 生地黄 酒浸大黄 若虚热病四物与参苏饮相合名补心汤主
之若四肢肿痛不能举动四物苍术各半汤主之 若治燥结四物与调胃承气汤各半为玉烛散
若流湿润燥宜四物理中各半汤 若保胎气令人有子四物与缩砂四君子汤各半名八珍汤 若热
与血相抟口舌干渴饮水加栝蒌 麦门冬 若腹中刺痛恶物不下加当归 芍药 若血崩者加生
地黄 蒲黄 黄芩 若头昏项强者加柴胡 黄芩 若因热生风者加川芎 柴胡 防风 若藏
秘涩者加大黄 桃仁 若滑涩者加官桂 附子 若呕者加白术 人参 生姜 若大渴者加知
母石膏 若发寒热者加干姜 丹皮 芍药 柴胡若水停心下微吐逆者加猪苓 茯苓 防己
若虚寒似伤寒者加人参 柴胡 防风 若产妇诸证各随六经以四物与仲景药各半服之其效
如神 若妇人或因伤酒或因产亡血或虚劳五心烦热者宜四物二连汤 四物汤(内用生地黄)
黄连 胡黄连(真者)温饮精汁 四物与桂枝麻黄白术柴胡理中四逆茱萸承气凉膈等皆可作各
半汤此易老用药大略也 若虚烦不得睡加竹叶 人参 若妇人血虚心腹 痛不可忍者去地黄
加干姜名四神汤 若诸痛有湿者四物与白术相半加天麻 茯苓 穿山甲 酒煎 若目赤暴发
作云翳疼痛不可忍宜四物龙胆汤 四物(各半两) 羌活 防风(各三钱) 龙胆草防己(各二
钱)水煎
海藏云妇人妊娠蓄血 妇人妊娠或蓄血 抵当桃仁勿妄施 要教子母俱无损 大黄四物
对服之
海藏当归丸治三阴受邪心脐少三腹 痛气风等证
四物汤(各半两) 防风 独活 全蝎 茴香(炒) 续断(各半两) 苦楝 玄胡(各七钱)
木香 丁香(各二钱半) 上为细末酒糊丸如桐子大空心温酒下三五十丸大效
若楝丸治奔豚小腹痛神效 川苦楝 茴香 附子(一两炮去皮脐) 上三味酒二升煮尽为
度焙
干研细末每秤药末一两入玄胡半两全蝎十八个炒丁香十八个别为末和匀酒糊丸桐子大温酒下
五十丸空心痛甚加当归煎酒下
治喉闭逡巡不救方 皂荚(去皮子生半两为细末箸头点少许在痛处更以醋糊调药末浓
涂项上须臾便破血出立瘥)
极济换骨丹 海云自汗者不宜服歌曰 槐皮芎术芷 仙人防首蔓 十味各停匀 苦味
香减半 龙麝即少许 朱砂作衣缠 麻黄膏煎丸 大少如指弹 上治半身不遂口眼 斜手足
不仁言语謇涩或痛入骨髓或痹袭皮肤或中急风涎潮不语精神昏塞行止艰难筋脉拘急左瘫右痪
一切风疾并皆治之
槐荚子(生) 人参 桑白皮 苍术 川芎 何首乌 蔓荆子 葳灵仙 防风(各二两)
五味子 香附子 苦参(各一两) 香白芷(二两) 麝香(二钱另研) 上一十四味为细未入香
令匀又用麻黄十斤去节根用大河水三石三斗熬至六斗滤过去滓再熬至二升半入银石器内熬
成
膏入前药末和匀杵三五千下每一两作十丸朱砂为衣每服一丸先捣碎酒一盏自晨浸至晚食后临
卧搅匀服之神清无睡是药之验须臾隔五日服之如中风无汗宜服若体虚自汗服之是重亡津液也
风盛人于密室温卧取汗
(当归四逆加吴茱萸生姜汤,详见阴症略例章节)
四物汤用于补益营卫、调和气血,治疗月事不调、脐腹疼痛等证候。以上方剂均可见于《局方》。熟地黄(补血药,如脐下疼痛非此药不能除,乃入肾经之药),川芎(治风以泄肝木,如血虚头痛非此药不能除,乃入肝经之药),芍药(和血理脾,如腹中虚痛非此药不能除,乃入脾经之药),当归(和血,如血刺痛非此药不能除,其痛如刀刺,乃入肾经之药)。以上药材研为粗末,用水煎煮。加减法如下:若加地骨皮、牡丹皮,可治疗妇人骨蒸潮热;若妊娠期间胎动不安、下血不止者,加艾叶十片、阿胶一片,再加葱白、黄芩;若血脏虚冷、崩漏去血过多者,亦加胶艾汤;若妇人常服春令加倍用量的川芎,脉弦且头痛者,夏季加倍用量芍药,脉洪大且完谷不化泄泻者,秋季加倍用量地黄,脉沉涩且血虚者,冬季加倍用量当归,脉沉寒且不食者。若春季,则用防风四物汤(四物汤加防风,倍用川芎);若夏季,则用黄芩四物汤(四物汤加黄芩,倍用芍药);若秋季,则用门冬四物汤(四物汤加天门冬,倍用地黄);若冬季,则用桂枝四物汤(四物汤加桂枝,倍用当归)。若血虚而腹痛,微汗出且恶风者,四物汤加白术、桂枝,称为“腹痛六合汤”;若风眩眩晕,加秦艽、羌活,称为“风六合汤”;若气虚弱,起立时乏力突然跌倒,加厚朴、陈皮,称为“气六合汤”;若发热烦躁不能睡眠者,加黄连、栀子,称为“热六合汤”;若虚寒,脉微细自汗出,气息短促难续,大小便正常者,加干姜、附子,称为“寒六合汤”;若中湿,身体沉重无力,身微凉有汗,加白术、茯苓,称为“湿六合汤”。若产后虚劳日久,脉浮疾者,宜用柴胡四物汤。组成:川芎、熟地黄、当归、芍药(各一两半),加柴胡(八钱)、人参、黄芩、甘草、半夏、神曲(各三钱),水煎服。若妇人筋骨肢节疼痛及头痛,脉弦且怕冷如疟疾状者,宜用治风六合汤。组成:四物汤(四两),防风、羌活(各一两)。若血气上冲心腹,胁下满闷者,宜用治气六合汤。组成:四物汤(四两),苍术、槟榔(各一两)。若脐下虚冷腹痛及腰脊间闷痛者,宜用玄胡六合汤(小腹痛者同用)。组成:四物汤(四两),玄胡索、苦楝子(各一两,捣碎炒焦)。若气充经脉导致月经频发且脐下多痛者,宜用芍药六合汤。组成:四物汤(四两),芍药(一两)。若经期将至,脐腹绞痛,经前疼痛者,此为血涩,宜用八物汤。组成:四物汤(四两),玄胡索、苦楝子(捣碎炒焦)、槟榔、木香(各一两)。若经水过多而无其他证候者,宜用黄芩六合汤。组成:四物汤(四两),黄芩、白术(各一两)。若经水涩少者,宜在四物汤内加葵花煎(又加红花、血见愁)。若虚劳气弱,咳嗽喘满者,宜用厚朴六合汤。组成:四物汤(四两),厚朴(姜制一两),枳实(麸炒半两)。若经水暴下,加黄芩一两;若腹痛,加黄连;如夏季不去黄芩。若经水如黑豆汁色者,加黄芩、黄连(各一两)。若经水少而颜色调和者,四物汤加熟地黄、当归(各一两)。若经水适来适断,或有往来寒热者,先服小柴胡汤以去除寒热,后以四物汤调和之。若妇人血积者,四物汤内加莪术、京三棱、桂枝、干漆(各一两)。若妇人伤寒发汗或攻下后,饮食减少,血虚者,宜用八物汤。组成:四物汤(四两),黄芪、甘草、茯苓、白术(各一两)。若妊娠伤寒中风,表虚自汗,头痛项强,身热恶寒,脉浮而弱,属太阳经病者,宜用表虚六合汤。组成:四物汤(四两),桂枝、地骨皮(各七钱)。若妊娠伤寒,头痛身热无汗,脉浮紧,属太阳经病者,宜用表实六合汤。组成:四物汤(四两),麻黄、细辛(各半两)。若妊娠伤寒中风湿之气,肢节烦痛,脉浮而热,头痛者,宜用风湿六合汤,此属太阳标病。组成:四物汤(四两),防风、苍术(制各七钱)。若妊娠伤寒下后过经不愈,温毒发斑如锦纹者,宜用升麻六合汤。组成:四物汤(四两),升麻、连翘(各七钱)。若妊娠伤寒胸胁满痛而脉弦,属少阳病者,宜用柴胡六合汤。组成:四物汤(四两),柴胡、黄芩(各七钱)。若妊娠伤寒大便硬,小便赤,气满而脉沉数,属阳明、太阳本病者,急当攻下,宜用大黄六合汤。组成:四物汤(四两),大黄(半两),桃仁(十个,去皮尖面炒)。若妊娠伤寒汗下后咳嗽不止者,宜用人参六合汤。组成:四物汤(四两),人参、五味子(各五钱)。若妇人妊娠伤寒汗下后虚痞胀满者,属阳明本虚,宜用厚朴六合汤。组成:四物汤(四两),厚朴、枳实(麸炒各半两)。若妊娠伤寒汗下后不得眠者,宜用栀子六合汤。组成:四物汤(四两),栀子、黄芩(各半两)。若妊娠伤寒身热大渴,蒸蒸而烦,脉长而大者,宜用石膏六合汤。组成:四物汤(四两),石膏、知母(各半两)。若妊娠伤寒小便不利,属太阳本病者,宜用茯苓六合汤。组成:四物汤(四两),茯苓、泽泻(各半两)。若妊娠伤寒太阳本病,小便赤如血者,宜用琥珀六合汤。组成:四物汤(四两),琥珀、茯苓(各半两)。若妊娠伤寒汗下后血漏不止,胎气受损者,宜用胶艾六合汤。组成:四物汤(四两),阿胶、艾叶(各半两,一方加甘草同上一方,一方加干姜、甘草、黄芪)。若妊娠伤寒四肢拘急,身凉微汗,腹中痛,脉沉而迟,属少阴病者,宜用附子六合汤。组成:四物汤(四两),附子(炮去皮脐)、肉桂(各半两)。若赤白带下者,宜用香桂六合汤。组成:四物汤(四两),肉桂、香附子(各半两)。若妊娠伤寒蓄血证,不宜用堕胎药攻下,宜用四物大黄汤下之。组成:四物汤,生地黄,酒浸大黄。若虚热病,四物汤与参苏饮相合,名为补心汤主治之。若四肢肿痛不能举动,用四物苍术各半汤主治之。若治燥结,四物汤与调胃承气汤各半,名为玉烛散。若流湿润燥,宜用四物理中各半汤。若保胎气令人有子,四物汤与缩砂四君子汤各半,名为八珍汤。若热与血相搏,口舌干渴饮水者,加栝蒌、麦门冬。若腹中刺痛,恶露不下者,加当归、芍药。若血崩者,加生地黄、蒲黄、黄芩。若头昏项强者,加柴胡、黄芩。若因热生风者,加川芎、柴胡、防风。若脏腑秘涩者,加大黄、桃仁。若滑涩者,加官桂、附子。若呕吐者,加白术、人参、生姜。若大渴者,加知母、石膏。若发寒热者,加干姜、丹皮、芍药、柴胡。若水停心下微吐逆者,加猪苓、茯苓、防己。若虚寒似伤寒者,加人参、柴胡、防风。若产妇诸证,各随六经以四物汤与张仲景方药各半服之,其效如神。若妇人或因伤酒,或因产亡血,或虚劳五心烦热者,宜用四物二连汤。组成:四物汤(内用生地黄),黄连、胡黄连(真者),温饮精汁送服。四物汤可与桂枝汤、麻黄汤、白术散、柴胡剂、理中汤、四逆汤、吴茱萸汤、承气汤、凉膈散等皆可作各半汤使用,这是易老(李东垣)用药的大略。若虚烦不得睡,加竹叶、人参。若妇人血虚心腹疼痛不可忍者,去地黄加干姜,名为四神汤。若诸痛有湿者,四物汤与白术相半,加天麻、茯苓、穿山甲,酒煎服。若目赤暴发,作云翳疼痛不可忍,宜用四物龙胆汤。组成:四物汤(各半两),羌活、防风(各三钱),龙胆草、防己(各二钱),水煎服。海藏云:妇人妊娠蓄血,妇人妊娠或蓄血,抵当汤、桃仁承气勿妄施,要教子母俱无损,大黄四物对服之。海藏当归丸治三阴受邪,心脐少腹疼痛,气风等证。组成:四物汤(各半两),防风、独活、全蝎、茴香(炒)、续断(各半两),苦楝、玄胡索(各七钱),木香、丁香(各二钱半)。上为细末,酒糊丸如梧桐子大,空心温酒下三五十丸,大效。若楝丸治奔豚小腹痛,神效。组成:川苦楝、茴香、附子(一两,炮去皮脐)。上三味,酒二升,煮尽为度,焙干研细末,每秤药末一两入玄胡索半两、全蝎十八个炒、丁香十八个别为末,和匀酒糊丸梧桐子大,温酒下五十丸,空心服,痛甚加当归煎酒下。治喉闭逡巡不救方:皂荚(去皮子生用半两为细末,箸头点少许在痛处,更以醋糊调药末浓涂项上,须臾便破血出立瘥)。极济换骨丹:海云自汗者不宜服。歌曰:槐皮芎术芷,仙人防首蔓,十味各停匀,苦味香减半,龙麝即少许,朱砂作衣缠,麻黄膏煎丸,大少如指弹。上治半身不遂,口眼歪斜,手足不仁,言语謇涩,或痛入骨髓,或痹袭皮肤,或中急风,涎潮不语,精神昏塞,行止艰难,筋脉拘急,左瘫右痪,一切风疾并皆治之。组成:槐荚子(生)、人参、桑白皮、苍术、川芎、何首乌、蔓荆子、葳灵仙、防风(各二两),五味子、香附子、苦参(各一两),香白芷(二两),麝香(二钱另研)。上一十四味为细末,入香令匀。又用麻黄十斤去节根,用大河水三石三斗熬至六斗,滤过去滓,再熬至二升半,入银石器内熬成膏,入前药末和匀,杵三五千下,每一两作十丸,朱砂为衣。每服一丸,先捣碎,酒一盏,自晨浸至晚,食后临卧搅匀服之,神清无睡是药之验,须臾隔五日服之。如中风无汗宜服,若体虚自汗服之是重亡津液也。风盛人于密室温卧取汗。
(The formula *Danggui Sini Jia Wuzhuyu Tang* is detailed in the "General Examples of Yin Syndromes" chapter.)
*Siyu Tang* (Four-Substance Decoction) nourishes Ying and Wei (Defensive and Nutritive Qi), harmonizes Blood and Qi, and treats syndromes such as irregular menstruation and pain in the umbilical and abdominal regions. These syndromes are documented in the *Ju Fang* (Standard Formulary). Shudihuang (Prepared Rehmanniae Radix) [Shu Di Huang (Cooked Rehmannia Root): Nourishes Blood; e.g., for pain below the umbilicus, this herb is indispensable as it enters the Kidney Meridian]; Chuanxiong (Ligustici Chuanxiong Rhizoma) [Chuan Xiong (Szechwan Lovage Rhizome): Treats Wind by dispersing Liver Wood; e.g., for headache due to Blood deficiency, this herb is indispensable as it enters the Liver Meridian]; Shaoyao (Paeoniae Radix Alba/Rubra) [Bai Shao (White Peony Root): Harmonizes Blood and regulates the Spleen; e.g., for empty pain in the abdomen, this herb is indispensable as it enters the Spleen Meridian]; Danggui (Angelicae Sinensis Radix) [Dang Gui (Chinese Angelica Root): Harmonizes Blood; e.g., for stabbing blood pain, which feels like knife stabs, this herb is indispensable as it enters the Kidney Meridian]. The above herbs are coarsely powdered and decocted in water. Modifications are as follows:
If Gudupi (Cortex Lycii Radicis) and Mudanpi (Cortex Moutan Radicis) are added, it treats bone-steaming tidal fever in women;
If a pregnant woman experiences fetal restlessness and continuous bleeding, add ten leaves of Aijie (Folium Artemisiae Argyi) and one piece of Ejiao (Colla Corii Asini), plus Congbai (Scallion White) and Huangqi (Astragali Radix);
If uterine emptiness-cold causes metrorrhagia with excessive blood loss, also add Jiao'ai Tang (Gelatin and Mugwort Decoction);
If a woman frequently takes Spring-dose increased Chuanxiong, presenting with a wiry pulse and headache;
Summer-dose increased Shaoyao, presenting with a flooding pulse and undigested food diarrhea;
Autumn-dose increased Dihuang, presenting with a deep, choppy pulse and Blood deficiency;
Winter-dose increased Danggui, presenting with a deep, cold pulse and anorexia.
In Spring, use *Fengwang Siwu Tang* (Windproof Four-Substance Decoction: *Siyu Tang* plus *Fengwang*, with doubled *Chuanxiong*);
In Summer, use *Huangqin Siwu Tang* (Scutellaria Four-Substance Decoction: *Siyu Tang* plus *Huangqin*, with doubled *Shaoyao*);
In Autumn, use *Mendong Siwu Tang* (Asparagus Four-Substance Decoction: *Siyu Tang* plus *Tianmendong*, with doubled *Dihuang*);
In Winter, use *Guizhi Siwu Tang* (Cinnamon Twig Four-Substance Decoction: *Siyu Tang* plus *Guizhi*, with doubled *Danggui*).
If Blood deficiency causes abdominal pain with slight sweating and aversion to wind, use *Siyu Tang* plus Baizhu (Atractylodis Macrocephalae Rhizoma) and Guizhi (Cinnamomi Ramulus), named "Abdominal Pain Liuhe Tang" (Six-Harmony Decoction for Abdominal Pain);
If Wind-dizziness occurs, add Qinjiao (Gentianae Macrophyllae Radix) and Qianghuo (Notopterygii Rhizoma et Radix), named "Wind Liuhe";
If Qi is weak, causing fatigue upon rising and sudden fainting, add Houpo (Magnoliae Officinalis Cortex) and Chenpi (Citri Reticulatae Pericarpium), named "Qi Liuhe";
If fever, irritability, and insomnia occur, add Huanglian (Coptidis Rhizoma) and Zhizi (Gardeniae Fructus), named "Heat Liuhe";
If Empty-Cold presents with a minute pulse, spontaneous sweating, shortness of breath, but normal bowel and bladder functions, add Ganjiang (Zingiberis Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata), named "Cold Liuhe";
If dampness invades, causing heavy body, weakness, slight coolness, and sweating, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria), named "Dampness Liuhe".
If postpartum consumptive disease persists for a long time with a floating and rapid pulse, use *Chaihu Siwu Tang*. Composition: Chuanxiong, Shudihuang, Danggui, Shaoyao (each 1.5 liang), plus Chaihu (8 qian), Renshen (Ginseng Radix), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix), Banxia (Pinelliae Rhizoma), Shenqu (Massa Medicata Fermentata) (each 3 qian). Decoct in water and take orally.
If women suffer from pain in bones, sinews, limbs, and joints, along with headache, wiry pulse, and chills resembling malaria, use *Zhifeng Liuhe Tang* (Wind-Treating Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Fengwang (Saposhnikoviae Radix), Qianghuo (each 1 liang).
If Qi and Blood rush upward to the heart and abdomen, causing fullness and oppression under the ribs, use *Zhiqi Liuhe Tang* (Qi-Treating Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Cangzhu (Atractylodis Rhizoma), Binglang (Arecae Semen) (each 1 liang).
If emptiness-cold below the umbilicus causes abdominal pain and dull pain in the waist and spine, use *Xuanhu Liuhe Tang* (also for lower abdominal pain). Composition: *Siyu Tang* (4 liang), Xuanhusuo (Corydalis Rhizoma), Koushen (Toosendan Fructus) (each 1 liang, crushed and stir-fried until scorched).
If Qi fills the meridians causing frequent menstruation and much pain below the umbilicus, use *Shaoyao Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shaoyao (1 liang).
If menstrual flow approaches with cramping pain in the umbilical and abdominal regions, and severe pain during menstruation indicating stagnant Blood, use *Bawu Tang* (Eight-Substance Decoction). Composition: *Siyu Tang* (4 liang), Xuanhusuo, Koushen (crushed and stir-fried until scorched), Binglang, Muxiang (Aucklandiae Radix) (each 1 liang).
If menstrual flow is excessive without other symptoms, use *Huangqin Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Huangqin, Baizhu (each 1 liang).
If menstrual flow is scanty and stagnant, add Kuihua Decoction (Sunflower Decoction) to *Siyu Tang* (can also add Honghua [Carthami Flos] and Xuejianchou [Leonurus Japonicus Herba]).
If consumptive disease causes weak Qi, cough, wheezing, and chest fullness, use *Noupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Noupo (Magnoliae Officinalis Cortex, ginger-processed, 1 liang), Zhishi (Immature Bitter Orange Fruit, bran-fried, half liang).
If menstrual blood flows violently, add Huangqin 1 liang; if abdominal pain, add Huanglian; in summer, do not remove Huangqin.
If menstrual blood resembles black bean juice, add Huangqin and Huanglian (each 1 liang).
If menstrual blood is scanty but normal in color, add Shudihuang and Danggui (each 1 liang) to *Siyu Tang*.
If menstruation starts and stops abruptly, or there are alternating chills and fever, first administer *Xiaochaihu Tang* (Minor Bupleurum Decoction) to resolve the chills and fever, then harmonize with *Siyu Tang*.
If a woman has Blood accumulation/stasis, add Ezhu (Curcumae Rhizoma), Jingsanleng (Sparganii Rhizoma), Guizhi, and Ganxi (Drynariae Rhizoma / Drynaria root? Note: Ganxi usually refers to Drynaria or similar, context implies blood-invigorating) (each 1 liang) to *Siyu Tang*.
If a woman suffers from Cold Damage (Shanghan), and after sweating or purging treatments, diet decreases and Blood becomes deficient, use *Bawu Tang*. Composition: *Siyu Tang* (4 liang), Huangqi (Astragali Radix), Gancao, Fuling, Baizhu (each 1 liang).
If during pregnancy, Cold Damage or Wind Strike presents with exterior deficiency, spontaneous sweating, headache, neck stiffness, fever, aversion to cold, and a floating, weak pulse (Taiyang Meridian disease), use *Biaoxu Liuhe Tang* (Exterior-Deficiency Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Guizhi, Gudupi (each 7 qian).
If during pregnancy, Cold Damage presents with headache, fever, no sweat, and a floating, tight pulse (Taiyang Meridian disease), use *Biaoshi Liuhe Tang* (Exterior-Excess Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Mahuang (Ephedrae Herba), Xixin (Asari Radix et Rhizoma) (each half liang).
If during pregnancy, Cold Damage involves Wind-Dampness causing painful joints, floating and hot pulse, and headache (Taiyang Mark Disease), use *Fengshi Liuhe Tang* (Wind-Dampness Six-Harmony Decoction). Composition: *Siyu Tang* (4 liang), Fengwang, Cangzhu (processed, each 7 qian).
If during pregnancy, Cold Damage persists beyond the course after purging, and Warm-Toxin erupts like brocade patterns, use *Shengma Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shengma (Cimicifugae Rhizoma), Lianqiao (Forsythiae Fructus) (each 7 qian).
If during pregnancy, Cold Damage presents with chest and hypochondriac fullness/pain and a wiry pulse (Shaoyang disease), use *Chaihu Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Chaihu, Huangqin (each 7 qian).
If during pregnancy, Cold Damage presents with hard stool, red urine, abdominal fullness, and a deep, rapid pulse (Yangming/Taiyang Root Disease), urgent purging is required. Use *Dahuang Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Dahuang (Rhei Radix et Rhizoma, half liang), Taoren (Persicae Semen, 10 seeds, skin and tip removed, flour-fried).
If during pregnancy, Cold Damage after sweating/purging results in persistent cough, use *Renshen Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Renshen, Wuweizi (Schisandrae Fructus) (each 5 qian).
If a pregnant woman with Cold Damage, after sweating/purbing, develops empty fullness and bloating (Yangming Root Deficiency), use *Noupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Noupo, Zhishi (bran-fried, each half liang).
If during pregnancy, Cold Damage after sweating/purbing causes insomnia, use *Zhizi Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Zhizi, Huangqin (each half liang).
If during pregnancy, Cold Damage presents with high fever, great thirst, steaming irritability, and a long, large pulse, use *Shigao Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma) (each half liang).
If during pregnancy, Cold Damage causes difficult urination (Taiyang Root Disease), use *Fuling Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Fuling, Zexie (Alismatis Rhizoma) (each half liang).
If during pregnancy, Taiyang Root Disease presents with red urine resembling blood, use *Hupo Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Hupo (Amber), Fuling (each half liang).
If during pregnancy, Cold Damage after sweating/purbing causes continuous blood leakage and damages fetal Qi, use *Jiaoai Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Ejiao, Aijie (each half liang). One formula adds Gancao; another adds Ganjiang, Gancao, and Huangqi.
If during pregnancy, Cold Damage causes limb contracture, cool body with slight sweat, abdominal pain, and a deep, slow pulse (Shaoyin disease), use *Fuzi Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Fuzi (prepared, skin and脐 removed), Rougui (Cinnamomi Cortex) (each half liang).
If white and yellow leukorrhea occurs, use *Xianggui Liuhe Tang*. Composition: *Siyu Tang* (4 liang), Rougui, Xiangfu (Cyperi Rhizoma) (each half liang).
If pregnancy Cold Damage involves Blood accumulation, abortifacients should not be used. Instead, use *Siyu Dahuang Tang* to purge. Composition: *Siyu Tang*, Shengdihuang (Rehmanniae Radix), Jiujin Dahuang (Wine-soaked Rhubarb).
For Empty-Heat diseases, combine *Siyu Tang* and *Renshen Su Yin* (Ginseng and Perilla Drink) equally, named *Buxin Tang* (Heart-Nourishing Decoction).
For swollen and painful limbs unable to move, use *Siyu Cangzhu Geban Tang* (Equal-Half Four-Substance and Atractylodes Decoction).
To treat dryness constipation, combine *Siyu Tang* and *Tiaowei Chengqi Tang* equally, named *Yuzhu San* (Jade Candle Powder).
To moisten dryness, use *Siyu Lizhong Geban Tang* (Equal-Half Four-Substance and Regulate Middle Decoction).
To preserve fetal Qi and aid conception, combine *Siyu Tang* and *Suisha Sizjunzi Tang* (Amomum and Four-Gentlemen Decoction) equally, named *Bazhen Tang* (Eight-Treasure Decoction).
If Heat and Blood struggle, causing dry mouth/tongue and thirst despite drinking, add Gualou (Trichosanthis Fructus) and Maidong (Ophiopogonis Radix).
If stabbing abdominal pain and failure to expel lochia, add Danggui and Shaoyao.
For Metrorrhagia, add Shengdihuang, Puhuang (Pollen Typhae), and Huangqin.
For dizziness and neck stiffness, add Chaihu and Huangqin.
For Wind generated by Heat, add Chuanxiong, Chaihu, and Fengwang.
For organ constipation, add Dahuang and Taoren.
For slippery/stagnant irregularity, add Guanzi (Cinnamon Bark) and Fuzi.
For vomiting, add Baizhu, Renshen, and Shengjiang (Fresh Ginger).
For extreme thirst, add Zhimu and Shigao.
For chills and fever, add Ganjiang, Danpi (Moutan Cortex), Shaoyao, and Chaihu.
For Water retention under the Heart causing mild nausea/vomiting, add Zhuling (Polyporus), Fuling, and Fangji (Stephaniae Tetrandrae Radix).
For Empty-Cold resembling Cold Damage, add Renshen, Chaihu, and Fengwang.
For various postpartum syndromes, differentiate according to the Six Meridians, combining *Siyu Tang* with Zhang Zhongjing's formulas in equal halves; the effect is miraculous.
If women suffer from alcohol injury, blood loss from childbirth, or consumptive disease with five-palm heat, use *Siyu Erlian Tang*. Composition: *Siyu Tang* (using Shengdihuang), Huanglian, Hu Huanglian (True Picrorhizae Rhizoma), taken with warm essence fluid.
*Siyu Tang* can be combined in equal halves with Guizhi Tang, Mahuang Tang, Baizhu Tang, Chaihu Tang, Lizhong Tang, Sini Tang, Wuzhuyu Tang, Chengqi Tang, Liangge San, etc. This is the general principle of Yilao's medication.
For empty irritability and insomnia, add Zhuye (Bambusae Folium) and Renshen.
If a woman with Blood deficiency suffers unbearable heart/abdominal pain, remove Dihuang and add Ganjiang, named *Sishen Tang* (Four-Spirit Decoction).
For various pains with Dampness, combine *Siyu Tang* and Baizhu in equal halves, add Tianma (Gastrodiae Rhizoma), Fuling, and Chuanshanjia (Manis Squama), decoct in wine.
For sudden red eyes forming cloud-like opacity and unbearable pain, use *Siyu Longdan Tang*. Composition: *Siyu Tang* (each half liang), Qianghuo, Fengwang (each 3 qian), Longdancao (Gentianae Radix), Fangji (each 2 qian). Decoct in water.
Haizang said: For pregnant women with Blood accumulation, or if a pregnant woman has Blood accumulation, do not rashily use Didang Tang or Taoren Chengqi Tang. To ensure mother and child remain unharmed, take Dahuang and *Siyu Tang* together.
*Haizang Danggui Wan* (Haizang Angelica Pill): Treats syndromes of Heart, Umbilical, and Lower Abdominal pain, Qi, and Wind caused by pathogenic invasion of the Three Yin Meridians. Composition: *Siyu Tang* (each half liang), Fengwang, Duhuo (Angelicae Pubescentis Radix), Quanxie (Scorpio), Huixiang (Foeniculi Fructus, fried), Xuduan (Dipsaci Radix) (each half liang), Koushen, Xuanhusuo (each 7 qian), Muxiang, Dingxiang (Caryophylli Flos) (each 2.5 qian). Powder finely, make pills with wine paste, size of paulownia seeds. Take 30-50 pills with warm wine on an empty stomach for great effect.
*Koushen Wan* (Toosendan Pill): Miraculous for Ben Tun (Rushing Pig) syndrome and lower abdominal pain. Composition: Chuan Koushen, Huixiang, Fuzi (1 liang, prepared, skin and脐 removed). Boil these three ingredients in 2 sheng of wine until the wine is exhausted, dry, and powder finely. For every 1 liang of powder, add 0.5 liang Xuanhusuo, 18 Quanxie (fried), and 18 Dingxiang, all separately powdered and mixed evenly. Make pills with wine paste, size of paulownia seeds. Take 50 pills with warm wine on an empty stomach. If pain is severe, take with Danggui decocted in wine.
Formula for treating Throat Closure (Hou Bi) requiring swift rescue: Zaojiao (Gleditsiae Sinensis Spina, skin and seeds removed, raw, 0.5 liang, powdered finely). Dip the tip of a chopstick into the powder and apply to the painful area. Also, mix the powder with vinegar paste and apply thickly to the neck. Pus and blood will break out shortly, leading to immediate recovery.
*Jiji Huangu Dan* (Ultimate Salvation Bone-Changing Pill): Not suitable for those with spontaneous sweating (per Haiyun). Verse: "Sophora bark, Chuanxiong, Atractylodes, Angelica; Immortal, Windproof, Polygonum, Vitex; Ten flavors balanced equally; Bitter and fragrant halved; Dragon and Musk in small amounts; Cinnabar coating wraps them; Ephedra paste boils pills; Size like a finger bullet." The above treats hemiplegia, facial paralysis, numbness of hands/feet, slurred speech, pain penetrating to the bone marrow, bi-syndrome affecting the skin, acute wind-phlegm causing muteness, mental confusion, difficulty walking, tendon/muscle contracture, left hemiplegia/right paralysis, and all wind diseases. Composition: Huaiguazi (Sophorae Fructus, raw), Renshen, Sangbaipi (Mori Cortex), Cangzhu, Chuanxiong, Heshouwu (Polygoni Multiflori Radix), Manjingzi (Viticis Fructus), Weilingxian (Salviae Miltiorrhizae Radix? Note: Weilingxian is Saposhnikoviae Radix here, distinct from Danshen), Fengwang (each 2 liang), Wuweizi, Xiangfu, Kushen (Sophorae Flavescentis Radix) (each 1 liang), Xiangbaizhi (Angelicae Dahuricae Radix, 2 liang), Shexiang (Moschus, 2 qian, separately powdered). These 14 ingredients are powdered finely, mixed with fragrance. Then, take 10 jin of Mahuang (remove nodes and roots), boil in 3 dan 3 dou of river water until reduced to 6 dou, filter residue, boil again until reduced to 2.5 sheng, put in silver/copper vessel, boil into paste. Add the herbal powder, mix well, pound 3000-5000 times. Each 1 liang of powder makes 10 pills, coated with Cinnabar. Take 1 pill, crush first, soak in 1 cup of wine from morning to evening. Stir well and take after meal before bed. Clarity of mind and lack of sleepiness indicate efficacy. Take again after 5 days. Suitable for Wind-Stroke without sweat; if deficient with spontaneous sweat, taking it further depletes fluids. People with excess Wind should lie in a warm room to induce sweat.