「血气为神，要在疏通」。《内经》指出：「人之所有者，血与气耳。」(《素问·调经论》)卫说：「人之血气精神者，奉生而周于性命者也。」(「灵枢·本脏》)人体一切生理功能的完成，皆赖气血充盛。所以，「气血者人之神，不可不谨养。』(《索问·八正神明论>》我认为气血是脏腑生理活动的物质基础，也是病理变化的依据。调养气血为摄生之首务，论治之中心。脏腑功能正常，不仅在于气血充盛，且贵在气血通调，如日月之行不休，「如环无端，莫知其纪，终而复始」。若外邪侵袭或脏腑失和，则气血运行失调，发生病变，并进而引起各个脏腑功能异常。《素问·调经论》说：「气血不和，百病乃变化而生。」朱丹溪也指出：「气血冲和，百病不生；一有怫郁，百病生焉。」王清任更指出：「治病之耍诀在明白气机。无论外感内伤，要知初病伤人何物……所伤者无非气血。」故凡病必有气血失调。其在表者，必是营卫失和；其在里者，则是脏腑之阴阳气血不调，轻者在气，重者入血，轻者气血不畅，重者气血瘀滞，甚则形成积聚。
诸般病症，由此而生。
基于上述认识，临证时常在八法基础上，以扶正培本、活血化瘀、清热解毒三法为习用之法。推敲揣摩，稍有所得。
扶正培本属八法中补法范畴。扶正者，扶助正气，补益气血阴阳，培本者，培补脾肾。张景岳曾说；「世未有正气复而邪不退者，也未有正气竭而命不倾者。」可见治病之关键在于扶助正气。扶正培本法在临床上主要用于虚证和虚实夹杂证。我常以扶正培本以增强抗病能力祛邪外出。对老人体弱、久病者、产后等正不足者，不可徒攻其邪，烈致邪未去而正又竭，病未除而人先危。邪势猖厥，若已伤正，也无忘顾护正气。应用时要抓住三点：①益气血重在补脾。脾为后天之本，气血化生之源，只有脾气健运，才能化源充足，益气生血。而且脾统血之功，脾虚失其统摄血脉之力，便多有出血之患。而且出血又能加重血虚。所以出血之证亦必须健脾益气，方能使血归于经。对于气血两虚或气虚不摄血，我从补脾入手，当归补血汤或归脾汤加减用之常获良效。在补益气血中还应注意气血相互依存的关系。血瘀时行气以活血，血虚时益气生血，大出血时，注意「有形之血不能速生，无形之气所当急固」，故有用独参汤之举。还应注意血对气的作用。「血不充盛则气无所藏，血失皤润则气易耗散」。李东垣创补中益气汤用当归「以和血脉』，我常在补气时佐入当归等血分药，取血为气母之意。②补阴阳应当益肾。肾为元阴元阳之所居，五脏阴阳之虚衰，皆影响肾之阴阳。故凡阴阳虚衰之证，应当注意益肾。张景岳说：「善补阳者，必于明中求阳，则阳得阴助而生化无穷}善补阴者，必予阳中求阴，阴得阳升而泉源不竭。」故肾气、右归之中，以六昧补阴，桂附温阳，所谓水中补火左归之中，熟地、山药，杞子养阴，又伍以鹿胶、菟丝之温肾，以防阴凝不解。我曾治一妇人，年三十一岁，两年前因产后大出血致乳房萎缩，经闭不行。近两月来又毛发脱落，性欲全无。兼见气短、心悸、失眠、健忘，腰酸畏寒，手足逆冷，全身痿软，舌淡胖无苔，脉沉细无力。经西医诊断为「席汉氏综合征」。我辨之以肾气虚损，气血大亏。投以扶正培本、补肾养血之剂，方用当归、熟地、五睐子，山萸肉、川芎、仙茅、菟丝子、仙灵脾、黄芪、自术、沙苑子、枸杞子、牛膝，服四十余剂而愈。本例用归、地、五味、萸肉等滋阴养血的同时，合以温阳益气=仙、黄苠以阳中求阴，求得其生化之妙，遂使虚袁火证起而复兴。我在补肾时，还特别重视肾和脑髓的关系。我依据中医理论指导，将一些脑、脊髓等中枢系统疾患归于脑髓，而将一些造血系统疾患归于骨髓，提出了补肾养脑生髓的治法，自拟「补肾养脑汤」(紫河车、龙眼肉、桑椹、熟地、当归、赤自芍、丹参、莜苓、太子参、生蒲黄、菖蒲、郁金)和「补肾生髓汤」(紫河车、熟地、龟板胶、党参、黄芪、黑桑椹、制首乌，黄精、当归、仙鹤草、砂仁、鸡血藤)，收到一定疗效。③补脏腑注意生制。调补脏腑的基本原则，即《难经·十四难》指出的：「损其肺者益其气；损其心者和其营卫；损其脾者调其饮食，适其寒温；损其肝者缓其中，损其气者益其精。」要根据各脏腑的特点及其虚衰情况进行调治。尤其应注意各脏腑间生克制化的相互关系，特别是相生的方面，即所谓「虚则补其母」的间接补法。如培土生金、扶土抑木、补火助土，滋水涵木等。相互资生中最重要莫过于先、后天之本的作用。困脏腑生机在肾，补养在脾，故临证诊病，先察脾胃是否健旺，继思气化是否正常。脏腑失调，脾肾俱虚时，先补脾以资化源，后益肾以固根本。
在应用扶正培本法时，我常常注意以下几点：
(一)明辨虚实。注意「大实有赢状，至虚有盛候」，不犯虚虚实实之戒。
(二)根据病情分别选择不同补法。如病势急迫，气血暴脱，宜用峻补，且应补足，使药效持续方能挽救于万一。否则药性一过，元气复脱，则功亏一篑。而对于慢性病，则宜用缓补之法，须日积月累，至一定时日始觅功效，不急于求成或浅尝辄止。
(三)防止补药之弊。壮阳之剂久用易生虚火，宜少佐柔润之品，滋阴之品，多用腻膈碍胃，酌加理气和胃之药。务使补气不壅中，养阴不碍胃，才能补而得效。
(四)注意「虚不受补」。虚不受补或因脾胃虚弱，补而不适；或因遣药不当，过于壅滞；或因夹有余邪痰浊一正如陈若虚所说：「受补者自无痰火内毒之相杂，不受补者，乃有阴火湿热之相攻。」(《外科正宗》)故常根据情况，或予调理脾胃，或用平补、清补、缓补之法，或先祛内停之痰浊湿热，方能奏效。
(五)注意时令剂型。《内经》有「春夏养阳，秋冬养戮?之说，诸家认识也不尽一致。但服药之时令确需注意。我认为立冬至春分的四个月中，乃万物闭藏之时，人合天地阴阳，气血固摄于内，又少化火滞气之弊，是服补剂的最好时令。而且慢性虚证，又非一汤一药所能马上奏效。故常配以膏丸之剂调理，久用方能收功。
(六)注意食养摄生。扶正培本不可专恃药饵。
「药能治病，未可能补人」「病去则养之」。《内经》提出；「谷肉果柴，食养尽之。」这是值得认真领会的。活血化瘀法是针对血失调达的「瘀血」病变提出的一种治法。活血即疏畅血流，化瘀即消散瘀滞。我体会瘀血的主要症候特点有：
病史有外伤、手术史，极易损伤脉络，形成瘀血。有出血史，各种内外出血皆可使血溢脉外，形成瘀血。病程较长，「久病入络」，由气及血，导致血行瘀滞。
症状①疼痛，刺痛样感，痛有定处，拒按，②肿块；④胸腹满闷，「欲捣其胸上」，④发热，入暮发热或身觉烦热而体温不高，但也随瘀血部位不同而各异，如「瘀血在肌肉，则翕翕发热」}⑤口燥，但欲嗽水不欲咽；⑥皮肤粗糙，甚则甲错，颜色黯黑或出现瘀点、瘀斑，或面颈部出现红丝赤缕或掌色暗红，或唇甲紫绀；⑦大便色黑而润，或如柏油样；⑧出血}③精神方面出现健忘，发狂等证，。血在下如狂，血在上善忘」，⑩月经不调，经色紫黑有块或痛经。
舌脉脉象沉细弦涩或结代；唇舌暗红或发紫，甚或紫蓝，或有瘀点、瘀斑，舌下脉络粗大，曲张色暗。以上诸症，最重视舌象的变化。因气血的微小变化从舌质上反映最早。对于本法我主要用于如下病症；④外伤后遗症。．早期采取活血化瘀法。我吸收了伤科治疗跌打损伤经验，受七厘散、紫金锭、回生第一丹等方启发，自拟「脑震荡后遗症方」，药用苏木、刘寄奴、鬼箭羽、土氅虫、菖蒲、猪莶草、鸡血藤、泽兰、，赤芍、川芎。②痛证。唐容川说：「凡是疼痛皆瘀血凝滞之故也。」举凡痹证、心腹疼痛、胃脘痛、头痛等都是不同部位的气血凝滞，故常以活血化瘀法冶之。但应注意所在脏腑及夹杂病邪的不同，配合不同方法，选择不同药物。风证。包括内风、外风，主要指肝风内动引起之眩晕。头痛、口眼歪邪，震颤抽搐，甚至突然昏仆等证。风窜经络则可引起麻木瘫痪，半身不遂。无论内风、外风，当先从血脉论治。故有「治风先治血，血行风自灭」之说。外风当兼行血活血，内风则宜养血活血。且内风多兼脏腑阴阳之失调，或夹痰浊为患，应合用它法，方能十全。血证。
指出血和发斑。唐容川说：。凡系离经之血，与养莱周身之血已睽绝而不合……此血在身，不能加于好血，而反阻新血之化机，故凡血证总以祛瘀为要。」我在治疗各种血证，如白血病、再障、血小板减少症等，并非一味补血止血，而且据证配合活血化瘀之法，选用作用较轻的活血化瘀药或祛瘀止血之品，如丹皮、赤芍、生蒲黄、茜草、三七等。⑤久病。必然会出现由气及血、由经入络的病理机转，引起血行瘀滞。叶天士在其医案中多次论道：「经几年宿病，病必在络。」周学海亦弓l叶氏之说认为；「凡大寒大热病后，脉络之中必有推荡不尽之瘀血。」许多慢性病后期多有血瘀的病理变化。如《金匮要略·血痹虚劳病脉证并治》之大黄蜜虫丸证，出现「内有干血，肌肤甲错，两目黯黑」之干血痨症，即是五脏虚劳，引起经络营卫气伤而致的瘀血现象。这既是许多慢性病出现虚宴夹杂的原因，也是一些虚证补之不当或虚不受补的原因之一。对这类病症我采用补中有消、消补结合或以消为补的治法。如大黄蜜虫丸即是一个「缓中补虚」的良方，常为我用。我认为，活血化瘀法是以通为补的方法，久病虚宴夹杂皆可用之。症瘕积聚，都是气血积滞而成，《灵枢·百病始生》指出：「凝血蕴里而不散，沣液涩渗，着而不去而积皆成矣。」王清任亦说；「结块者，必有形之血也。血受寒则凝结成块，血受热则煎熬成块。」此时，须选用祛瘀力强兼有软坚化积作用的药物，如鳖甲、丹参，王不留行、三棱、莪术等。我还特别喜用虫类药，如虻虫、水蛭、蜜虫、鼠妇等。此类药善走窜入络，通经破瘀之力甚强。这与叶氏主张「通络之法，每取虫蚁迅速飞走诸灵」其义相合。⑦妇人病。妇人以血为先天。肝藏血，若肝气郁结，失其谰达则经血不调，或经产之后，血络受损，护调失当，均可引起经带胎产诸病。如经闭、痛经、月经不凋、不孕症，慢性盆腔炎等均可用活血化瘀法，但常需与舒肝理气药合用。选药时，多选用兼有：词经作用之活血化瘀药，如当归、丹皮、赤芍、灵脂、香附、元胡、蒲黄等。
在应用活血化瘀法时，我常注意以下问题：
(一)气血关系。气为血帅，气行则血行。活血化瘀中佐入行气理气之品，虚证宜加益气之品，冀其推动血液运行。
(二)辨明虚实。血瘀一证，局部观之属实，整体又多兼虚，注意祛瘀不伤正，补虚不留瘀。
(三)分清寒热。予以温经散寒或清热凉血之法，切不可泥于「温则行之」，而一味温热，也不可拘于「遇寒则凝」而忌用寒凉。
(四)明确部位。我临床依瘀血部位不同，分别选用不同方药。。头部常用通窍活血汤或自拟「脑震荡后遗症方」』胸膈以上及两胁用血府逐瘀汤、复元活血汤及旋复花汤等，腹中用膈下逐瘀汤，脐下用少腹逐瘀汤或当归芍药散，半身用补阳还五汤，关节痹痛用身痛逐瘀汤等。
(五)瘀血轻重。一般瘀血不畅，行血活血即可；瘀血内停者，应活血祛瘀，形成症瘕痞块则应用消症破瘀通经之法。
(六)根据病情配合它法。正虚者，扶正祛瘀；出血者，止血祛瘀，兼寒者，散寒祛瘀；夹热者，清热祛麝，有痰者，化痰祛瘀；因湿者，渗利祛瘀，有肿毒者，消肿祛瘀；积块者，软坚祛瘀妇人者，通经祛瘀等。
清热解毒法包括清热和解毒两方面，两者互相渗透密切相关，应从热和毒两方面理解本法。热证，临床观察火热颇多。《内经》病机十九条中属火属热者占九条，几近一半。故河间有「六气皆从火化」之说。凡引起人体上下内外表里脏腑明阳失调，阴虚阳盛者皆可形成火热之证。毒之为病古人多指药毒、食毒及蛊毒等，以后则邪毒并称，有所谓火毒、热毒、湿毒、水毒、血毒、温毒等。今人将癌肿病因称为癌毒，可见毒的概念甚广。我体会，凡邪之甚者，重伤气血或伤及脏腑组织出现红肿、糜烂、溃疡等症，皆可谓毒。毒与火热有关，并非凡毒皆属火热。清热解毒法是指清解热毒而言的。热毒的临证特点：①一般表现。程锺龄将热证特点归纳为「口渴能消水，喜冷饮食，烦躁，溺短赤，便结，脉数。」它如身热，面红目赤，皮肤粘膜发红，头痛头晕等证也常出现。②组织损伤。火邪热毒易灼伤内外脏腑组织，引起局部红肿、糜烂、溃疡或形成哝肿。③血证。迫血妄行，引起各种出血发斑之证。④神志症状。引起心神不安，烦躁不宁，重则热毒入心，邪闭心包引起谵语，或热极生风出现痉厥抽搐之症。⑤舌脉。舌多红绎或暗红，舌苔黄腻，或光剥，或焦黑起刺，或燥裂少津，脉多疾数有力或疾促细数等。
我在临床中清热解毒法只用于三方面：
“血气为神，关键在于疏通。”《内经》指出：“人的身体中，最重要的就是血和气罢了。”（出自《素问·调经论》）卫说：“人的血、气、精神，是奉养生命并周流全身以维持性命活动的根本。”（出自《灵枢·本脏》）人体一切生理功能的完成，都依赖于气血的充盛。所以，“气血是人的神机所在，不可不谨慎调养。”（出自《素问·八正神明论》）我认为气血是脏腑生理活动的物质基础，也是病理变化的依据。调养气血是养生保健的首要任务，也是辨证论治的中心环节。脏腑功能正常，不仅在于气血充盛，更贵在气血通调，就像日月运行不停息一样，“如环无端，莫知其纪，终而复始”。如果外邪侵袭或脏腑失和，就会导致气血运行失调，发生病变，并进而引起各个脏腑功能异常。《素问·调经论》说：“气血不和，百病乃变化而生。”朱丹溪也指出：“气血冲和，百病不生；一旦有郁结阻滞，百病就产生了。”王清任更指出：“治病的关键诀窍在于明白气机。无论是外感还是内伤，要知道初病伤人的是什么……所伤害的无非是气血。”所以凡是疾病必然伴有气血失调。病在表层的，必然是营卫失和；病在内部的，则是脏腑的阴阳气血不调，轻者在气分，重者入血分，轻者气血不畅，重者气血瘀滞，甚至形成积聚。
各种病症，由此而生。
基于上述认识，我在临床诊疗时，常在中医“八法”基础上，将扶正培本、活血化瘀、清热解毒三法作为常用之法。经过反复推敲揣摩，稍有所得。
扶正培本属于“八法”中补法的范畴。扶正，即扶助正气，补益气血阴阳；培本，即培补脾肾。张景岳曾说：“世上没有正气恢复而邪气不退的，也没有正气枯竭而生命不倾覆的。”可见治病的关键在于扶助正气。扶正培本法在临床上主要用于虚证和虚实夹杂证。我常通过扶正培本来增强抗病能力，促使邪气外出。对于年老体弱、久病之人、产后等正气不足者，不可单纯攻伐邪气，否则可能导致邪气未去而正气先竭，病未除而人先危。即使邪势猖獗，若已损伤正气，也不能忘记顾护正气。应用此法时要抓住三点：①益气血重在补脾。脾为后天之本，气血化生之源，只有脾气健运，才能化源充足，益气生血。而且脾有统摄血液的功能，脾虚失去统摄血脉之力，便多有出血之患。而且出血又能加重血虚。所以出血之证也必须健脾益气，才能使血液回归脉道。对于气血两虚或气虚不能摄血的情况，我从补脾入手，使用当归补血汤或归脾汤加减，常获良效。在补益气血中还应注意气血相互依存的关系。血瘀时行气以活血，血虚时益气生血，大出血时，要注意“有形之血不能速生，无形之气所当急固”，故有用独参汤之举。还应注意血对气的作用。“血不充盛则气无所藏，血失濡润则气易耗散”。李东垣创制补中益气汤时用当归“以和血脉”，我常在补气时佐入当归等血分药，取血为气母之意。②补阴阳应当益肾。肾为元阴元阳之所居，五脏阴阳的虚衰，皆影响肾之阴阳。故凡阴阳虚衰之证，应当注意益肾。张景岳说：“善于补阳的人，必于阴中求阳，则阳得阴助而生化无穷；善于补阴的人，必于阳中求阴，阴得阳升而泉源不竭。”所以在肾气丸、右归丸之中，以六味地黄丸补阴，桂枝、附子温阳，所谓水中补火；左归丸之中，熟地、山药、杞子养阴，又伍以鹿角胶、菟丝子的温肾，以防阴凝不解。我曾治疗一位妇人，年三十一岁，两年前因产后大出血导致乳房萎缩，经闭不行。近两个月来又毛发脱落，性欲全无。兼见气短、心悸、失眠、健忘，腰酸畏寒，手足逆冷，全身痿软，舌淡胖无苔，脉沉细无力。经西医诊断为“席汉氏综合征”。我辨之为肾气虚损，气血大亏。投以扶正培本、补肾养血之剂，方用当归、熟地、五味子、山萸肉、川芎、仙茅、菟丝子、仙灵脾、黄芪、白术、沙苑子、枸杞子、牛膝，服四十余剂而愈。本例用归、地、五味、萸肉等滋阴养血的同时，合以温阳益气之仙茅、黄芪以阳中求阴，求得生化之妙，遂使虚损火证起而复兴。我在补肾时，还特别重视肾和脑髓的关系。我依据中医理论指导，将一些脑、脊髓等中枢系统疾患归于脑髓，而将一些造血系统疾患归于骨髓，提出了补肾养脑生髓的治法，自拟“补肾养脑汤”（紫河车、龙眼肉、桑椹、熟地、当归、赤芍、丹参、茯苓、太子参、生蒲黄、石菖蒲、郁金）和“补肾生髓汤”（紫河车、熟地、龟板胶、党参、黄芪、黑桑椹、制首乌、黄精、当归、仙鹤草、砂仁、鸡血藤），收到一定疗效。③补脏腑注意生克制化。调补脏腑的基本原则，即《难经·十四难》指出的：“损其肺者益其气；损其心者和其营卫；损其脾者调其饮食，适其寒温；损其肝者缓其中，损其肾者益其精。”要根据各脏腑的特点及其虚衰情况进行调治。尤其应注意各脏腑间生克制化的相互关系，特别是相生的方面，即所谓“虚则补其母”的间接补法。如培土生金、扶土抑木、补火助土，滋水涵木等。相互资生中最重要莫过于先天、后天之本的作用。因为脏腑生机在肾，补养在脾，故临证诊病，先察脾胃是否健旺，继思气化是否正常。脏腑失调，脾肾俱虚时，先补脾以资化源，后益肾以固根本。
在应用扶正培本法时，我常常注意以下几点：
(一)明辨虚实。注意“大实有羸状，至虚有盛候”，不犯虚虚实实之戒。
(二)根据病情分别选择不同补法。如病势急迫，气血暴脱，宜用峻补，且应补足，使药效持续方能挽救于万一。否则药性一过，元气复脱，则功亏一篑。而对于慢性病，则宜用缓补之法，须日积月累，至一定时日始觅功效，不急于求成或浅尝辄止。
(三)防止补药之弊。壮阳之剂久用易生虚火，宜少佐柔润之品；滋阴之品多用腻膈碍胃，酌加理气和胃之药。务使补气不壅中，养阴不碍胃，才能补而得效。
(四)注意“虚不受补”。虚不受补或因脾胃虚弱，补而不适；或因遣药不当，过于壅滞；或因夹有余邪痰浊——正如陈若虚所说：“受补者自无痰火内毒之相杂，不受补者，乃有阴火湿热之相攻。”（《外科正宗》）故常根据情况，或予调理脾胃，或用平补、清补、缓补之法，或先祛内停之痰浊湿热，方能奏效。
(五)注意时令剂型。《内经》有“春夏养阳，秋冬养阴”之说，诸家认识也不尽一致。但服药之时令确需注意。我认为立冬至春分的四个月中，乃万物闭藏之时，人合天地阴阳，气血固摄于内，又少化火滞气之弊，是服补剂的最好时令。而且慢性虚证，又非一汤一药所能马上奏效。故常配以膏丸之剂调理，久用方能收功。
(六)注意食养摄生。扶正培本不可专恃药饵。
“药能治病，未必能补人”，“病去则养之”。《内经》提出：“谷肉果菜，食养尽之。”这是值得认真领会的。活血化瘀法是针对血失调达的“瘀血”病变提出的一种治法。活血即疏畅血流，化瘀即消散瘀滞。我体会瘀血的主要症候特点有：
病史有外伤、手术史，极易损伤脉络，形成瘀血。有出血史，各种内外出血皆可使血溢脉外，形成瘀血。病程较长，“久病入络”，由气及血，导致血行瘀滞。
症状①疼痛，刺痛样感，痛有定处，拒按；②肿块；③胸腹满闷，“欲捣其胸上”；④发热，入暮发热或身觉烦热而体温不高，但也随瘀血部位不同而各异，如“瘀血在肌肉，则翕翕发热”；⑤口燥，但欲嗽水不欲咽；⑥皮肤粗糙，甚则甲错，颜色黯黑或出现瘀点、瘀斑，或面颈部出现红丝赤缕或掌色暗红，或唇甲紫绀；⑦大便色黑而润，或如柏油样；⑧出血；⑨精神方面出现健忘，发狂等证，“血在下如狂，血在上善忘”；⑩月经不调，经色紫黑有块或痛经。
舌脉脉象沉细弦涩或结代；唇舌暗红或发紫，甚或紫蓝，或有瘀点、瘀斑，舌下脉络粗大，曲张色暗。以上诸症，最重视舌象的变化。因气血的微小变化从舌质上反映最早。对于本法我主要用于如下病症：①外伤后遗症。早期采取活血化瘀法。我吸收了伤科治疗跌打损伤经验，受七厘散、紫金锭、回生第一丹等方启发，自拟“脑震荡后遗症方”，药用苏木、刘寄奴、鬼箭羽、土鳖虫、菖蒲、豨莶草、鸡血藤、泽兰、赤芍、川芎。②痛证。唐容川说：“凡是疼痛皆瘀血凝滞之故也。”举凡痹证、心腹疼痛、胃脘痛、头痛等都是不同部位的气血凝滞，故常以活血化瘀法治之。但应注意所在脏腑及夹杂病邪的不同，配合不同方法，选择不同药物。③风证。包括内风、外风，主要指肝风内动引起之眩晕、头痛、口眼歪斜，震颤抽搐，甚至突然昏仆等证。风窜经络则可引起麻木瘫痪，半身不遂。无论内风、外风，当先从血脉论治。故有“治风先治血，血行风自灭”之说。外风当兼行血活血，内风则宜养血活血。且内风多兼脏腑阴阳之失调，或夹痰浊为患，应合用它法，方能十全。④血证。指出血和发斑。唐容川说：“凡系离经之血，与营养周身之血已睽绝而不合……此血在身，不能加于好血，而反阻新血之化机，故凡血证总以祛瘀为要。”我在治疗各种血证，如白血病、再障、血小板减少症等，并非一味补血止血，而且据证配合活血化瘀之法，选用作用较轻的活血化瘀药或祛瘀止血之品，如丹皮、赤芍、生蒲黄、茜草、三七等。⑤久病。必然会出现由气及血、由经入络的病理机转，引起血行瘀滞。叶天士在其医案中多次论道：“经几年宿病，病必在络。”周学海亦引叶氏之说认为：“凡大寒大热病后，脉络之中必有推荡不尽之瘀血。”许多慢性病后期多有血瘀的病理变化。如《金匮要略·血痹虚劳病脉证并治》之大黄䗪虫丸证，出现“内有干血，肌肤甲错，两目黯黑”之干血痨症，即是五脏虚劳，引起经络营卫气伤而致的瘀血现象。这既是许多慢性病出现虚实夹杂的原因，也是一些虚证补之不当或虚不受补的原因之一。对这类病症我采用补中有消、消补结合或以消为补的治法。如大黄䗪虫丸即是一个“缓中补虚”的良方，常为我用。我认为，活血化瘀法是以通为补的方法，久病虚实夹杂皆可用之。症瘕积聚，都是气血积滞而成，《灵枢·百病始生》指出：“凝血蕴里而不散，津液涩渗，着而不去而积皆成矣。”王清任亦说：“结块者，必有形之血也。血受寒则凝结成块，血受热则煎熬成块。”此时，须选用祛瘀力强兼有软坚化积作用的药物，如鳖甲、丹参、王不留行、三棱、莪术等。我还特别喜用虫类药，如虻虫、水蛭、土鳖虫、鼠妇等。此类药善走窜入络，通经破瘀之力甚强。这与叶氏主张“通络之法，每取虫蚁迅速飞走诸灵”其义相合。⑦妇人病。妇人以血为先天。肝藏血，若肝气郁结，失其疏达则经血不调，或经产之后，血络受损，护理失当，均可引起经带胎产诸病。如经闭、痛经、月经不调、不孕症，慢性盆腔炎等均可用活血化瘀法，但常需与舒肝理气药合用。选药时，多选用兼有调经作用之活血化瘀药，如当归、丹皮、赤芍、灵脂、香附、元胡、蒲黄等。
在应用活血化瘀法时，我常注意以下问题：
(一)气血关系。气为血帅，气行则血行。活血化瘀中佐入行气理气之品，虚证宜加益气之品，冀其推动血液运行。
(二)辨明虚实。血瘀一证，局部观之属实，整体又多兼虚，注意祛瘀不伤正，补虚不留瘀。
(三)分清寒热。予以温经散寒或清热凉血之法，切不可泥于“温则行之”，而一味温热，也不可拘于“遇寒则凝”而忌用寒凉。
(四)明确部位。我临床依瘀血部位不同，分别选用不同方药。头部常用通窍活血汤或自拟“脑震荡后遗症方”；胸膈以上及两胁用血府逐瘀汤、复元活血汤及旋复花汤等，腹中用膈下逐瘀汤，脐下用少腹逐瘀汤或当归芍药散，半身用补阳还五汤，关节痹痛用身痛逐瘀汤等。
(五)瘀血轻重。一般瘀血不畅，行血活血即可；瘀血内停者，应活血祛瘀，形成症瘕痞块则应用消癥破瘀通经之法。
(六)根据病情配合它法。正虚者，扶正祛瘀；出血者，止血祛瘀，兼寒者，散寒祛瘀；夹热者，清热祛瘀，有痰者，化痰祛瘀；因湿者，渗利祛瘀，有肿毒者，消肿祛瘀；积块者，软坚祛瘀；妇人者，通经祛瘀等。
清热解毒法包括清热和解毒两方面，两者互相渗透密切相关，应从热和毒两方面理解本法。热证，临床观察火热颇多。《内经》病机十九条中属火属热者占九条，几近一半。故河间有“六气皆从火化”之说。凡引起人体上下内外表里脏腑阴阳失调，阴虚阳盛者皆可形成火热之证。毒之为病古人多指药毒、食毒及蛊毒等，以后则邪毒并称，有所谓火毒、热毒、湿毒、水毒、血毒、温毒等。今人将癌肿病因称为癌毒，可见毒的概念甚广。我体会，凡邪之甚者，重伤气血或伤及脏腑组织出现红肿、糜烂、溃疡等症，皆可谓毒。毒与火热有关，并非凡毒皆属火热。清热解毒法是指清解热毒而言的。热毒的临证特点：①一般表现。程锺龄将热证特点归纳为“口渴能消水，喜冷饮食，烦躁，溺短赤，便结，脉数。”它如身热，面红目赤，皮肤粘膜发红，头痛头晕等证也常出现。②组织损伤。火邪热毒易灼伤内外脏腑组织，引起局部红肿、糜烂、溃疡或形成脓肿。③血证。迫血妄行，引起各种出血发斑之证。④神志症状。引起心神不安，烦躁不宁，重则热毒入心，邪闭心包引起谵语，或热极生风出现痉厥抽搐之症。⑤舌脉。舌多红绛或暗红，舌苔黄腻，或光剥，或焦黑起刺，或燥裂少津，脉多疾数有力或疾促细数等。
我在临床中清热解毒法只用于三方面：
"Blood and Qi constitute the spirit, with the key lying in unblocking." The *Nei Jing* (Inner Canon of the Yellow Emperor) points out: "What belongs to man are blood and Qi alone." (*Su Wen: Tiao Jing Lun*) Wei states: "Man's blood, Qi, and spirit nourish life and circulate throughout the body to sustain existence." (*Ling Shu: Ben Zang*) The completion of all physiological functions of the human body relies on the abundance of blood and Qi. Therefore, "Blood and Qi are the spirit of man; they must not fail to be carefully nourished." (*Su Wen: Ba Zheng Shen Ming Lun*) I believe that blood and Qi are the material basis for the physiological activities of the Zang-Fu organs and the basis for pathological changes. Regulating and nourishing blood and Qi is the primary task of health preservation and the central focus of syndrome differentiation and treatment. Normal function of the Zang-Fu organs depends not only on the abundance of blood and Qi but, more importantly, on their smooth circulation, just as the sun and moon move without ceasing, "like a ring without beginning or end, unknown in its duration, ending and starting again." If external pathogens invade or the Zang-Fu organs lose harmony, the circulation of blood and Qi becomes disordered, leading to disease, which in turn causes dysfunction of various Zang-Fu organs. The *Su Wen: Tiao Jing Lun* says: "When blood and Qi are disharmonious, myriad diseases arise from changes." Zhu Danxi also pointed out: "When blood and Qi are harmonious and flowing freely, no disease arises; once there is stagnation and depression, myriad diseases are born." Wang Qingren further stated: "The crucial secret of treating disease lies in understanding the movement of Qi. Whether external contraction or internal injury, one must know what initially harms the body... what is harmed is nothing but blood and Qi." Thus, all diseases inevitably involve the disharmony of blood and Qi. Those at the exterior are necessarily disharmony of Ying (Nutrient) and Wei (Defensive); those at the interior are disharmony of Yin-Yang and blood-Qi within the Zang-Fu organs. Mild cases affect Qi, severe cases enter Blood; mild cases involve sluggish flow, severe cases involve stasis, and even accumulation and masses may form.
Various symptoms and diseases arise from this.
Based on the above understanding, in clinical practice, I often use three methods—Supporting Righteousness and Cultivating the Root (Fu Zheng Pei Ben), Invigorating Blood and Resolving Stasis (Huo Xue Hua Yu), and Clearing Heat and Detoxifying (Qing Re Jie Du)—as routine practices, building upon the Eight Methods (Ba Fa). Through repeated deliberation, I have gained some insights.
Supporting Righteousness and Cultivating the Root belongs to the category of Tonification (Bu Fa) among the Eight Methods. Supporting Righteousness means assisting the body's healthy Qi and tonifying blood, Qi, Yin, and Yang; cultivating the Root means strengthening the Spleen and Kidney. Zhang Jingyue once said: "There is no case in the world where healthy Qi recovers while pathogenic factors remain, nor is there a case where healthy Qi is exhausted yet life is not endangered." This shows that the key to treating disease lies in supporting healthy Qi. This method is mainly used clinically for deficiency syndromes and mixed deficiency-excess syndromes. I often use it to enhance resistance and expel pathogens. For the elderly, the weak, those with chronic illness, or postpartum women with insufficient righteous Qi, one should not merely attack the pathogen, lest the pathogen remain while righteous Qi is depleted, leaving the patient in danger before the disease is cured. Even if the pathogenic force is rampant, if righteous Qi has been damaged, one must not forget to protect it. When applying this method, three points must be grasped: 1) Benefiting blood and Qi focuses on tonifying the Spleen. The Spleen is the foundation of acquired constitution and the source of blood and Qi production. Only when Spleen Qi is robust can the source be sufficient to generate Qi and Blood. Moreover, the Spleen has the function of controlling blood; if Spleen deficiency loses its power to control blood vessels, bleeding disorders often occur. Bleeding can also exacerbate blood deficiency. Therefore, bleeding syndromes must also be treated by invigorating Spleen Qi to ensure blood returns to the vessels. For conditions of dual deficiency of Qi and Blood or Qi deficiency failing to control blood, I start with tonifying the Spleen, using modified Dang Gui Bu Xue Tang (Astragali Radix and Angelicae Sinensis Decoction) or Gui Pi Tang (Restore the Spleen Decoction), often achieving good results. In tonifying blood and Qi, attention must also be paid to their interdependent relationship. When blood stasis exists, moving Qi activates blood; when blood deficiency exists, benefiting Qi generates blood. In massive hemorrhage, one must note that "substantial blood cannot be quickly generated, but intangible Qi must be urgently secured," hence the use of Du Shen Tang (Single Ginseng Decoction). Attention should also be paid to the effect of blood on Qi. "If blood is not abundant, Qi has nowhere to reside; if blood fails to moisten, Qi easily dissipates." Li Dongyuan created Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) using Dang Gui (Angelicae Sinensis Radix) "to harmonize the blood vessels"; I often add Dang Gui and other blood-invigorating herbs when tonifying Qi, taking advantage of the concept that blood is the mother of Qi. 2) Tonifying Yin and Yang should benefit the Kidney. The Kidney is the residence of Primordial Yin and Primordial Yang; deficiency of Yin and Yang in the five Zang organs affects the Kidney's Yin and Yang. Therefore, for syndromes of Yin-Yang deficiency, one should pay attention to benefiting the Kidney. Zhang Jingyue said: "Those skilled in tonifying Yang must seek Yang within Yin, so that Yang receives assistance from Yin and generation is endless; those skilled in tonifying Yin must seek Yin within Yang, so that Yin receives ascent from Yang and the springhead does not dry up." Thus, in Shen Qi Wan (Kidney Qi Pill) and You Gui Wan (Restore the Left [Yin] Pill), Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) tonifies Yin, while Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Lateralis Radix Praeparata) warm Yang, known as supplementing fire in water. In Zuo Gui Wan (Restore the Left [Yin] Pill), Shu Di Huang (Prepared Rehmanniae Radix), Shan Yao (Dioscoreae Rhizoma), and Gou Qi Zi (Lycii Fructus) nourish Yin, combined with Lu Jiao Jiao (Deer Antler Glue) and Tu Si Zi (Cuscutae Semen) to warm the Kidney, preventing Yin stagnation. I once treated a woman, aged thirty-one, who suffered breast atrophy and amenorrhea due to massive postpartum hemorrhage two years prior. For the past two months, she had hair loss and complete loss of libido. She also presented with shortness of breath, palpitations, insomnia, poor memory, soreness and cold sensation in the lower back, cold extremities, general flaccidity, a pale and swollen tongue without coating, and a deep, fine, and powerless pulse. Diagnosed by Western medicine as "Sheehan's Syndrome," I differentiated it as Kidney Qi deficiency and severe depletion of blood and Qi. I prescribed a formula to support righteousness, cultivate the root, tonify the Kidney, and nourish blood, using Dang Gui, Shu Di Huang, Wu Wei Zi (Schisandrae Fructus), Shan Yu Rou (Corni Fructus), Chuan Xiong (Chuanxiong Rhizoma), Xian Mao (Curculiginis Rhizoma), Tu Si Zi, Xian Ling Pi (Epimedii Folium), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Rhizoma), Sha Yuan Zi (Astragali Complanati Semen), Gou Qi Zi, and Niu Xi (Achyranthis Bidentatae Radix). After taking over forty doses, she recovered. In this case, while using Gui, Di, Wu Wei Zi, and Yu Rou to nourish Yin and blood, I combined them with warming Yang and benefiting Qi herbs like Xian Mao and Huang Qi to seek Yin within Yang, achieving the wonder of generation, thus reviving the condition of deficiency-fire. When tonifying the Kidney, I also particularly emphasize the relationship between the Kidney and brain marrow. Guided by TCM theory, I classified certain central nervous system diseases involving the brain and spinal cord into brain marrow, and hematological system diseases into bone marrow, proposing the treatment method of tonifying the Kidney, nourishing the brain, and generating marrow. I independently formulated "Bu Shen Yang Nao Tang" (Tonify Kidney and Nourish Brain Decoction: Zi He Che, Long Yan Rou, Sang Shen, Shu Di Huang, Dang Gui, Chi Shao, Dan Shen, Fu Ling, Tai Zi Shen, Sheng Pu Huang, Shi Chang Pu, Yu Jin) and "Bu Shen Sheng Sui Tang" (Tonify Kidney and Generate Marrow Decoction: Zi He Che, Shu Di Huang, Gui Ban Jiao, Dang Shen, Huang Qi, Hei Sang Shen, Zhi Shou Wu, Huang Jing, Dang Gui, Xian He Cao, Sha Ren, Ji Xue Teng), achieving certain efficacy. 3) Tonifying Zang-Fu organs requires attention to mutual generation and restriction. The basic principle of regulating and tonifying Zang-Fu organs, as pointed out in *Nan Jing: Chapter 14*, is: "Damage to the Lung benefits Qi; damage to the Heart harmonizes Ying and Wei; damage to the Spleen regulates diet and adjusts warmth and cold; damage to the Liver soothes the middle; damage to the Kidney benefits Essence." Treatment must be based on the characteristics and degree of deficiency of each organ. Special attention should be paid to the mutual relationships of generation and restriction, especially the aspect of generation, i.e., the indirect method of "tonifying the mother when deficient." Such as strengthening Earth to generate Metal, supporting Earth to suppress Wood, supplementing Fire to assist Earth, and nourishing Water to contain Wood. Among mutual nourishment, the most important is the role of the congenital and acquired foundations. Since the vitality of Zang-Fu organs lies in the Kidney and nourishment lies in the Spleen, in clinical diagnosis, one first observes whether the Spleen and Stomach are robust, then considers whether Qi transformation is normal. When Zang-Fu dysfunction involves both Spleen and Kidney deficiency, one first tonifies the Spleen to provide the source of transformation, then benefits the Kidney to solidify the root.
When applying the method of Supporting Righteousness and Cultivating the Root, I often pay attention to the following points:
(1) Clearly distinguish deficiency and excess. Pay attention to "great excess may present with signs of deficiency, extreme deficiency may present with signs of excess," avoiding the error of worsening deficiency with tonification or worsening excess with purgation.
(2) Select different tonification methods according to the condition. If the disease is urgent and blood and Qi are suddenly depleted, strong tonification is appropriate, and it must be sufficient to maintain efficacy for rescue. Otherwise, once the drug effect passes, original Qi may deplete again, ruining the effort. For chronic diseases, gentle tonification is suitable, requiring accumulation over time to achieve effects, not seeking quick success or stopping halfway.
(3) Prevent the drawbacks of tonifying drugs. Long-term use of Yang-tonifying agents easily generates deficiency fire; it is advisable to add a small amount of moistening and softening agents. Yin-nourishing agents are often cloying and hinder the stomach; rationalizing and harmonizing the stomach should be added appropriately. Ensure that tonifying Qi does not cause stagnation in the middle, and nourishing Yin does not hinder the stomach, so that tonification can be effective.
(4) Pay attention to "deficiency unable to tolerate tonification." Deficiency unable to tolerate tonification may be due to Spleen-Stomach weakness making tonification unsuitable, improper prescription causing excessive stagnation, or the presence of residual pathogens, phlegm, and turbidity. As Chen Ruoxu said: "Those who can tolerate tonification naturally lack internal phlegm-fire and toxins; those who cannot tolerate tonification have attacking yin-fire and damp-heat." (*Wai Ke Zheng Zong*) Therefore, depending on the situation, one may regulate the Spleen and Stomach, use mild, clearing, or gentle tonification methods, or first eliminate internal phlegm-turbidity and damp-heat to achieve efficacy.
(5) Pay attention to seasonal timing and dosage forms. The *Nei Jing* states "Nourish Yang in Spring and Summer, nourish Yin in Autumn and Winter," though scholars' understandings vary. However, the timing of medication intake must indeed be noted. I believe that during the four months from Start of Winter to Spring Equinox, when all things are in hiding, humans align with Heaven and Earth's Yin-Yang, with blood and Qi secured internally, minimizing the弊端 of transforming into fire and stagnating Qi. This is the best season for taking tonics. Moreover, chronic deficiency syndromes cannot be resolved immediately with a single decoction. Therefore, I often combine them with paste or pill preparations for long-term regulation to achieve results.
(6) Pay attention to dietary nourishment and health preservation. Supporting righteousness and cultivating the root should not rely solely on medicinal herbs.
"Medicines can treat disease, but may not necessarily tonify the person"; "After the disease is gone, nourish the body." The *Nei Jing* proposes: "Grains, meats, fruits, and vegetables complete the dietary nourishment." This is worth serious comprehension.
The method of Invigorating Blood and Resolving Stasis is a treatment proposed for the pathological change of "blood stasis" caused by the failure of blood to flow smoothly. Invigorating blood means smoothing blood flow; resolving stasis means dissipating stagnation. My understanding of the main symptomatic characteristics of blood stasis includes:
Medical history: History of trauma or surgery easily damages collaterals, forming blood stasis. History of bleeding: various internal and external bleeds can cause blood to extravasate, forming stasis. Long course of disease: "Long-standing disease enters the collaterals," progressing from Qi to Blood, leading to stagnant blood flow.
Symptoms: 1) Pain, stabbing sensation, fixed location, tenderness on pressure; 2) Masses; 3) Chest and abdominal fullness/distension, "desire to pound the chest"; 4) Fever, evening fever or feeling hot internally without elevated temperature, varying by site, e.g., "if blood stasis is in the muscle, there is slight fever"; 5) Dry mouth, desire to rinse mouth but not swallow; 6) Rough skin, even chelonoid scales, dark color, petechiae, ecchymosis, red threads on face/neck, dark red palms, or cyanotic lips/nails; 7) Black and moist stool, or tarry stool; 8) Bleeding; 9) Mental symptoms such as amnesia or mania, "blood stasis below leads to mania, blood stasis above leads to amnesia"; 10) Menstrual irregularities, purple-black clots, or dysmenorrhea.
Tongue and Pulse: Pulse is deep, fine, wiry, choppy, or intermittent; lips and tongue are dark red or purple, even bluish-purple, with petechiae/ecchymosis; sublingual veins are thick, tortuous, and dark. Among these symptoms, tongue appearance is most emphasized because subtle changes in blood and Qi reflect earliest on the tongue body. I mainly apply this method to the following conditions: 1) Sequelae of trauma. Early stage adopts invigorating blood and resolving stasis. Drawing on orthopedic experience for bruises and injuries, inspired by formulas like Qi Li San, Zi Jin Ding, and Hui Sheng Di Yi Dan, I formulated "Post-Concussion Syndrome Formula" using Su Mu, Liu Ji Nu, Gui Jian Yu, Tu Bie Chong, Shi Chang Pu, Xi Xian Cao, Ji Xue Teng, Ze Lan, Chi Shao, and Chuan Xiong. 2) Pain syndromes. Tang Rongchuan said: "All pain is due to blood stasis stagnation." Bi syndrome, heart/abdominal pain, epigastric pain, headache, etc., are all qi-blood stagnations in different locations, so this method is often used. However, one must note the involved Zang-Fu organs and accompanying pathogens, combining methods and selecting drugs accordingly. 3) Wind syndromes. Including internal and external wind, mainly referring to dizziness, headache, facial paralysis, tremors, convulsions, or sudden collapse caused by internal stirring of Liver wind. Wind invading collaterals causes numbness, paralysis, or hemiplegia. Whether internal or external wind, treatment should start from the blood vessels. Hence, "To treat wind, first treat blood; when blood flows, wind extinguishes itself." External wind should be combined with moving blood; internal wind should be combined with nourishing and moving blood. Internal wind often accompanies Zang-Fu Yin-Yang disharmony or phlegm-turbidity, requiring combination with other methods for completeness. 4) Blood syndromes. Referring to bleeding and macules/petechiae. Tang Rongchuan said: "Any blood that has left its vessels is separated from the blood nourishing the body... This blood remaining in the body cannot join good blood but instead hinders the formation of new blood, so in all blood syndromes, removing stasis is essential." In treating various blood syndromes like leukemia, aplastic anemia, thrombocytopenia, etc., I do not merely tonify blood and stop bleeding, but combine invigorating blood and resolving stasis based on syndrome, selecting milder blood-invigorating or stasis-resolving hemostatic herbs like Dan Pi, Chi Shao, Sheng Pu Huang, Qian Cao, and San Qi. 5) Chronic diseases. There will inevitably be pathological progression from Qi to Blood and from meridians to collaterals, causing blood stasis. Ye Tianshi frequently discussed in his medical records: "For chronic diseases lasting years, the pathology must be in the collaterals." Zhou Xuehai also cited Ye, stating: "After severe cold or heat diseases, there must be lingering blood stasis in the collaterals." Many late-stage chronic diseases have blood stasis pathology. For example, the Da Huang Zhe Chong Wan syndrome in *Jin Gui Yao Lue: Xue Bi Xu Lao Bing Mai Zheng Bing Zhi* presents with "dry blood inside, chelonoid skin, dark eyes," a dry blood consumption syndrome caused by five-Zang deficiency damaging meridians, Ying, Wei, Qi, and Blood. This is both the reason for mixed deficiency-excess in many chronic diseases and a reason why some deficiency syndromes fail to respond to tonification or cannot tolerate it. For such conditions, I use methods of tonification with elimination, combined tonification and elimination, or elimination as tonification. Da Huang Zhe Chong Wan is a good formula for "gentle middle and tonifying deficiency," often used by me. I believe invigorating blood and resolving stasis is a method of tonification through unblocking, applicable to chronic diseases with mixed deficiency-excess. Zheng Jia Ji Ju (masses and accumulations) are formed by qi-blood stagnation. *Ling Shu: Bai Bing Shi Sheng* points out: "Coagulated blood gathers inside and does not disperse, fluids become viscous and seep, adhering and not departing, leading to the formation of masses." Wang Qingren also said: "Where there are lumps, there must be substantial blood. Blood congeals into lumps when exposed to cold; it boils into lumps when exposed to heat." At this time, drugs with strong stasis-resolving and softening-hardness effects must be selected, such as Bie Jia, Dan Shen, Wang Bu Liu Xing, San Leng, and E Zhu. I particularly favor insect drugs like Meng Chong, Shui Zhi, Tu Bie Chong, and Shu Fu. These drugs are good at penetrating collaterals and have strong power to unblock meridians and break stasis. This aligns with Ye's assertion that "the method of unblocking collaterals often uses swift, flying, walking spirits." 7) Women's diseases. Women take blood as their foundation. The Liver stores blood; if Liver Qi stagnates and fails to flow freely, menstruation becomes irregular. Or after menstruation/childbirth, blood collaterals are damaged, and improper care can cause various menstrual, leukorrhea, pregnancy, and childbirth diseases. Amenorrhea, dysmenorrhea, irregular menstruation, infertility, chronic pelvic inflammatory disease, etc., can all be treated with invigorating blood and resolving stasis, but often need to be combined with soothing Liver and regulating Qi herbs. When selecting drugs, those with menstruation-regulating effects like Dang Gui, Dan Pi, Chi Shao, Ling Zhi, Xiang Fu, Yuan Hu, and Pu Huang are often chosen.
When applying the method of Invigorating Blood and Resolving Stasis, I often pay attention to the following issues:
(1) Relationship between Qi and Blood. Qi is the commander of Blood; when Qi moves, Blood moves. In invigorating blood and resolving stasis, adding Qi-moving and Qi-regulating herbs is necessary; for deficiency syndromes, adding Qi-tonifying herbs is advisable to promote blood circulation.
(2) Distinguish deficiency and excess. Locally, blood stasis appears as excess, but overall it often accompanies deficiency. Note that removing stasis should not damage righteous Qi, and tonifying deficiency should not leave stasis behind.
(3) Differentiate cold and heat. Apply warming meridians and dispelling cold or clearing heat and cooling blood methods. Do not blindly adhere to "warmth promotes flow" and use only warming herbs, nor do not forbid cold herbs due to "cold causes coagulation."
(4) Clarify location. Clinically, I select different formulas and herbs based on the location of blood stasis. For the head, Tong Qiao Huo Xue Tang or my self-formulated "Post-Concussion Syndrome Formula" is commonly used; for the chest/diaphragm and hypochondrium, Xue Fu Zhu Yu Tang, Fu Yuan Huo Xue Tang, and Xuan Fu Hua Tang are used; for the abdomen, Ge Xia Zhu Yu Tang is used; for below the umbilicus, Shao Fu Zhu Yu Tang or Dang Gui Shao Yao San is used; for half-body, Bu Yang Huan Wu Tang is used; for joint bi-pain, Shen Tong Zhu Yu Tang is used.
(5) Severity of blood stasis. Generally, for sluggish blood flow, moving blood suffices; for internal stasis, invigorating blood and resolving stasis is needed; for formed masses, eliminating masses, breaking stasis, and unblocking meridians is required.
(6) Combine with other methods according to condition. For righteous deficiency, support righteousness and remove stasis; for bleeding, stop bleeding and remove stasis; for accompanying cold, dispel cold and remove stasis; for accompanying heat, clear heat and remove stasis; for phlegm, resolve phlegm and remove stasis; for dampness, leach dampness and remove stasis; for swelling/toxins, reduce swelling and remove stasis; for masses, soften hardness and remove stasis; for women's issues, unblock menstruation and remove stasis, etc.
The method of Clearing Heat and Detoxifying includes clearing heat and detoxifying, two aspects closely related and permeating each other. This method should be understood from both heat and toxin perspectives. Heat syndromes: clinically, fire-heat is common. Nine of the nineteen pathogenesis clauses in the *Nei Jing* belong to fire or heat, nearly half. Hence, He Jian proposed "the six qi all transform into fire." Any factor causing disharmony of Yin-Yang in the upper/lower, internal/external, surface/interior, and Zang-Fu organs, leading to Yin deficiency and Yang hyperactivity, can form fire-heat syndromes. Toxins: ancient texts mostly referred to drug toxicity, food toxicity, and gu poison, later combining evil and toxin, mentioning fire-toxin, heat-toxin, damp-toxin, water-toxin, blood-toxin, warm-toxin, etc. Modern people refer to cancer etiology as cancer-toxin, showing the broad concept of toxin. My understanding is that any severe pathogen severely damaging blood/Qi or Zang-Fu tissues, presenting with redness, swelling, erosion, ulcers, etc., can be called toxin. Toxin is related to fire-heat, but not all toxins belong to fire-heat. The method of Clearing Heat and Detoxifying refers specifically to clearing heat-toxin. Clinical characteristics of heat-toxin: 1) General manifestations. Cheng Zhongling summarized heat syndrome characteristics as "thirst with ability to drink water, preference for cold food/drink, irritability, short dark urine, constipation, rapid pulse." Other symptoms like fever, red face and eyes, red skin/mucous membranes, headache, dizziness also often appear. 2) Tissue damage. Fire-heat toxin easily burns internal/external Zang-Fu tissues, causing local redness, swelling, erosion, ulcers, or abscess formation. 3) Blood syndromes. Forcing blood to move recklessly, causing various bleeding and macule syndromes. 4) Mental symptoms. Causing heart-mind unrest, irritability; severe cases involve heat-toxin entering the Heart or Evil closing the Pericardium, leading to delirium, or extreme heat generating wind causing spasms and convulsions. 5) Tongue and Pulse. Tongue is mostly crimson or dark red, coating yellow-greasy, peeled, scorched-black with prickles, or dry-cracked with little fluid; pulse is mostly rapid-strong or rapid-fine.
In clinical practice, I only apply the method of Clearing Heat and Detoxifying in three aspects: