有汗，用黄 蜜炙；无汗，煨用；胃虚，米泔水炒用；表畏寒，酒炒；嘈杂，乳汁制；表虚
，多。泻火，生甘草；热盛， 、草多；无汗，加干葛、防风、升麻、柴胡；久病热不退
，去表药，只用保元；血虚，加当归；脾虚，加白术；渴，加麦冬、五味；虚烦，亦加；不
睡，加酸枣仁；头痛，宜补中益气加川芎、蔓荆；小水不利，加牛膝、茯苓；心神不安，加
茯苓、远志、酸枣仁；退火，多用参、 ；虚而动火，少加炒黄柏；小便不通，或赤或白，
黄柏、知母酒浸炒各一两，肉桂一钱，为末，开水为丸，空心服百丸，小便下异物为验。腰
痛，姜汁炒杜仲；恶寒，加官桂；恶心，加干姜；自汗虚寒，加附子。内伤发热不退，莫如
补中益气加附子， 、草倍之，甘温除大热故也。腹胀，恐成中满，补中加附子、姜、桂、吴萸
、青皮、麦芽、神曲、枳壳之类，随手用之；湿痰，加羌活、防风、茯苓，风能胜湿故也。
去病之药，不可多服，恐泄真气，人无气不生。气常有余，血常不足，前药皆补血中之气，
血无气不行，须用保元。独阴不生，独阳不长。保元者，保血之元气耳。
人禀天地之气，犹恐阳陷于阴分，常使胃气有春夏之令，故宜大升大举，使清阳发腠理，浊
阴走五脏是也。盖人以血为主，胃乃生血之源，若元气不足，陷于阴分，则通身化为虚火，
变异无常，人死莫知其故，何也？人天庭属阳，下体属阴，天庭一倒，其死即速者，上阳不
生而阴气绝也。故天之阳气上升，即地之阴气不绝；人之阳气升举，即血之阳布于四肢，何
病之有？倘阳一不升，则气凝涩，诸病生焉，圣人固不过升降浮沉之法耳。
虚损诸病，久之皆属脾虚，脾虚则肺先受之。肺病，不能管摄一身；脾病，则四肢不能为用
。谨养脾气，惟以保元气为主，或前从疟、痢、吐泻变症，总从脾胃治。则保元兼温脾，勿
用血药。盖纵有杂症，火起不必去火，有痰不治痰，宜参苓白术散加减。腹痛，加干姜；腰
痛，益智、吴茱萸少许；小腹疼痛亦宜；胃不思食，加砂仁、木香；嗳气，神曲；腹胀，和
中散加六君子。久病以温补为主，病急则缓治，攻则散离。书曰∶大毒治病，十去一二；中
毒治病，十去其五；无毒治病，十去八九。
慎斋先生内伤治法，凡邪火逆行，上乘脾位，用吴茱萸炒黄连者，以黄连泻火，归于其位，
所以木沉则火降。凡内伤，清气下陷，阴火在上者，若用寒药，则阳愈陷，火愈炽，火寻窍
出，虚者受之，或目痛，或耳聋，或齿痛，从其虚而攻之也。（此所以寒遏于上阳陷于下，
而反不免有上焦热证也。肺闭则中下之气为所摄，胃闭则上下之气为所格，真阳失道，久郁
尽化为阴火，甚有令人心孔鼻窍日夜如烟熏难受者。）
有汗出症状时，使用蜜炙的黄芪；无汗出时，使用煨制的黄芪；胃气虚弱时，用米泔水炒制后使用；体表畏寒时，用酒炒制；伴有嘈杂感（胃中不适似饥非饥），用乳汁拌制；表虚且多汗时，增加黄芪用量。若要泻火，使用生甘草；若热势亢盛，则增加黄芪和甘草的用量；若无汗，加入干葛、防风、升麻、柴胡；久病发热不退，去掉解表药，只使用保元汤；血虚者，加入当归；脾虚者，加入白术；口渴者，加入麦冬、五味子；虚烦不安者，也加入黄芪；失眠不睡者，加入酸枣仁；头痛者，宜在补中益气汤基础上加入川芎、蔓荆子；小便不利者，加入牛膝、茯苓；心神不安者，加入茯苓、远志、酸枣仁；退火时，多用人参、黄芪；因虚而动火者，少量加入炒黄柏；小便不通，或尿色赤或白，可用黄柏、知母各一两经酒浸炒后研末，肉桂一钱，开水泛丸，空腹服用一百丸，以排出体内异物为见效标志。腰痛者，用姜汁炒杜仲；恶寒者，加入官桂；恶心者，加入干姜；自汗且属虚寒者，加入附子。内伤发热不退，莫过于在补中益气汤中加入附子，并将黄芪、甘草加倍，这是运用甘温药物来消除大热的道理。腹胀，担心发展成中满证，可在补中益气汤中加入附子、干姜、肉桂、吴茱萸、青皮、麦芽、神曲、枳壳等药，随症选用；若有湿痰，加入羌活、防风、茯苓，因为风能胜湿的道理。祛除病邪的药物，不可多服，恐怕会泄耗真气，人没有气就无法生存。气常有余，血常不足，前面的方药都是补血中的气，血没有气就不能运行，必须使用保元汤。独阴不能生长，独阳不能发育。保元汤，就是保护血的元气罢了。
人禀受天地之气，还担心阳气下陷于阴分，所以要常使胃气具有春夏生发之令，因此适宜大力升提举扬，使清阳发散于腠理，浊阴走注于五脏。大概人以血为主宰，胃是生血的源头，如果元气不足，下陷于阴分，那么全身都会化为虚火，变化无常，人死了也不知道原因，为什么呢？人的天庭部位属阳，下体属阴，如果天庭阳气倒陷，死亡就会迅速到来，这是因为上部阳气不生而阴气断绝的缘故。所以天的阳气上升，地的阴气就不会断绝；人的阳气升举，血的阳气就能布散于四肢，会有什么疾病呢？倘若阳气一旦不升，气就会凝滞涩阻，各种疾病就会产生，圣人治理疾病不过不过是运用升降浮沉的方法罢了。
虚损类的疾病，日久都归属于脾虚，脾虚则肺先受到波及。肺病，不能统摄一身之气；脾病，则四肢不能正常发挥作用。谨慎调养脾气，主要以保养元气为主，或者之前从疟疾、痢疾、呕吐腹泻变证而来，总归从脾胃治疗。这样保元汤兼以温脾，不要使用血分药。即使有杂症，火起不必去火，有痰不必治痰，宜用参苓白术散加减。腹痛，加入干姜；腰痛，加入少许益智仁、吴茱萸；小腹疼痛也适宜；胃不想进食，加入砂仁、木香；嗳气，加入神曲；腹胀，配合和中散及六君子汤。久病以温补为主，病急则缓治，攻伐则会使正气散离。书说：用大毒药物治疗疾病，病去十分之一二；用中毒药物治疗疾病，病去其五；用无毒药物治疗疾病，病去其八九。
慎斋先生治疗内伤的方法，凡是邪火逆行，上乘脾位，使用吴茱萸炒黄连，是因为黄连能泻火，使其归于本位，所以木气下沉则火气下降。凡是内伤，清气下陷，阴火在上者，如果使用寒凉药物，则阳气更加下陷，火势更加炽盛，火寻找孔窍而出，虚弱的身体承受攻击，或者出现眼痛，或者耳聋，或者齿痛，这是顺着其虚处进行攻伐。（这就是寒邪遏制于上，阳气下陷于下，反而不免出现上焦热证的原因。肺气闭郁则中下之气被其所摄，胃气闭郁则上下之气相互格拒，真阳失去正道，长久郁结全部化为阴火，甚至有让人心孔鼻窍日夜感觉如烟熏般难受的情况。）
If there is sweating, use *Astragali Radix* (Huangqi, 黄芪) honey-fried; if there is no sweating, use roasted *Astragali Radix*; for deficiency of the Stomach, stir-fry with rice washing water before use; for aversion to cold at the exterior, stir-fry with wine; for gastric discomfort resembling hunger but not actually hungry (Zaocao), process with milk; for exterior deficiency with profuse sweating, increase the dosage. To purge fire, use raw *Glycyrrhizae Radix et Rhizoma* (Gancao, 甘草); when heat is excessive, increase the amounts of *Astragali Radix* and *Glycyrrhizae Radix et Rhizoma*; if there is no sweating, add *Puerariae Lobatae Radix* (Gegen, 干葛), *Saposhnikoviae Radix* (Fangfeng, 防风), *Bupleuri Radix* (Chaihu, 柴胡), and *Cimicifugae Rhizoma* (Shengma, 升麻); for prolonged illness with persistent fever, remove exterior-releasing herbs and use only Baoyuan Tang (Preserve the Prime Decoction); for blood deficiency, add *Angelicae Sinensis Radix* (Danggui, 当归); for Spleen deficiency, add *Atractylodis Macrocephalae Rhizoma* (Baizhu, 白术); for thirst, add *Ophiopogonis Radix* (Maidong, 麦冬) and *Schisandrae Fructus* (Wuweizi, 五味); for deficiency-related vexation, also add *Astragali Radix*; for insomnia, add *Ziziphi Spinosae Semen* (Suanzaoren, 酸枣仁); for headache, it is appropriate to modify Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) by adding *Ligustici Chuanxiong Rhizoma* (Chuanxiong, 川芎) and *Vitex Fructus* (Manjingzi, 蔓荆); for difficult urination, add *Achyranthis Bidentatae Radix* (Niuxi, 牛膝) and *Poria* (Fuling, 茯苓); for unsettled heart-mind, add *Poria*, *Polygalae Radix* (Yuanzhi, 远志), and *Ziziphi Spinosae Semen*; to reduce fire, use more *Ginseng Radix* (Renshen, 人参) and *Astragali Radix*; for fire stirred by deficiency, add a small amount of stir-fried *Phellodendri Cortex* (Huangbai, 黄柏); for urinary retention, or urine that is red or white, take *Phellodendri Cortex* and *Anemarrhenae Rhizoma* (Zhimu, 知母), each one liang, soaked in wine and stir-fried, ground into powder, mixed with one qian of *Cinnamomi Cortex* (Rougui, 官桂), formed into pills with warm water, taken on an empty stomach (one hundred pills), with the passage of foreign matter in urine as the sign of efficacy. For lower back pain, stir-fry *Eucommiae Cortex* (Duzhong, 杜仲) with ginger juice; for aversion to cold, add *Cinnamomi Cortex* (Guigui, 官桂); for nausea, add dried ginger (*Zingiberis Rhizoma*); for spontaneous sweating due to deficiency-cold, add *Aconiti Lateralis Radix Praeparata* (Fuzi, 附子). For persistent fever due to internal injury, nothing is better than modifying Buzhong Yiqi Tang with *Aconiti Lateralis Radix Praeparata*, doubling the dosage of *Astragali Radix* and *Glycyrrhizae Radix et Rhizoma*, following the principle of using sweet-warm herbs to eliminate great heat. For abdominal distension, fearing progression to fullness in the middle jiao, add *Aconiti Lateralis Radix Praeparata*, dried ginger, *Cinnamomi Cortex*, *Evodiae Fructus* (Wuyu, 吴萸), *Citri Reticulatae Pericarpium* (Qingpi, 青皮), *Hordei Fructus Germinatus* (Maiya, 麦芽), *Crataegi Fructus* (Shenqu, 神曲), and *Aurantii Fructus Immaturus* (Zhike, 枳壳) to Buzhong Yiqi Tang, using them flexibly according to symptoms; for damp-phlegm, add *Notopterygii Rhizoma et Radix* (Qianghuo, 羌活), *Saposhnikoviae Radix*, and *Poria*, based on the principle that wind can overcome dampness. Herbs that expel pathogens should not be taken in large quantities, lest they drain true qi, as humans cannot survive without qi. Qi is often in excess, while blood is often deficient; the aforementioned formulas all tonify the qi within the blood. Since blood cannot circulate without qi, one must use Baoyuan Tang. Solitary yin does not generate, solitary yang does not grow. Baoyuan Tang preserves the prime qi of blood.
Humans inherit the qi of heaven and earth, yet we still fear yang sinking into the yin portion. Therefore, we should constantly ensure that the Stomach qi possesses the commanding influence of spring and summer, thus it is suitable to vigorously lift and raise, allowing clear yang to diffuse through the cou-li (interstices) and turbid yin to travel to the five zang organs. Generally, humans are governed by blood, and the Stomach is the source of blood generation. If yuan qi (original qi) is insufficient and sinks into the yin portion, the entire body transforms into deficient fire, changing unpredictably, and people may die without knowing the cause. Why? The upper part of the face (Tianting) belongs to yang, and the lower body belongs to yin. If the yang of the Tianting collapses, death occurs rapidly because the upper yang fails to generate and the yin qi is severed. Thus, when heavenly yang rises, earthly yin does not cease; when human yang lifts, the yang of blood distributes to the four limbs, so what disease would there be? If yang fails to rise, qi becomes stagnant and obstructed, giving rise to various diseases. The sages merely employ the methods of ascending, descending, floating, and sinking.
Various deficiency-consumption diseases, over time, all belong to Spleen deficiency. Spleen deficiency causes the Lung to be affected first. When the Lung is diseased, it cannot govern the whole body; when the Spleen is diseased, the four limbs cannot function. Carefully nourishing Spleen qi focuses primarily on preserving yuan qi. Or, regarding complications from malaria, dysentery, vomiting, and diarrhea, treatment generally targets the Spleen and Stomach. In this case, Baoyuan Tang is used to warm the Spleen, avoiding blood-invigorating or blood-tonifying herbs. Even with miscellaneous symptoms, if fire arises, do not clear it directly; if phlegm exists, do not resolve it directly. Instead, use Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) with modifications. For abdominal pain, add dried ginger; for lower back pain, add a small amount of *Alpinia Oxyphylla Fructus* (Yizhi, 益智) and *Evodiae Fructus*; for lower abdominal pain, these are also suitable; for loss of appetite, add *Amomi Fructus Rotundus* (Sharen, 砂仁) and *Aucklandiae Radix* (Muxiang, 木香); for belching, add *Crataegi Fructus*; for abdominal distension, combine with Hezhong San (Harmonize the Middle Powder) and Liujunzi Tang (Six Gentlemen Decoction). Long-standing illnesses are treated primarily with warming and tonifying. If the illness is acute, treat it gently; attacking aggressively scatters the righteous qi. The classic states: Using highly toxic drugs to treat disease removes one or two parts out of ten; using moderately toxic drugs removes five parts out of ten; using non-toxic drugs removes eight or nine parts out of ten.
Mr. Shenzhai’s method for treating internal injury: Whenever pathogenic fire rebels upward and attacks the Spleen position, use Coptidis Rhizoma (Huanglian, 黄连) stir-fried with Evodiae Fructus. This is because Huanglian purges fire, returning it to its proper position, so that when Wood qi sinks, Fire qi descends. In cases of internal injury where clear qi sinks downward and yin fire flares upward, if cold-natured herbs are used, yang will sink further and fire will blaze more intensely. Fire seeks exit through orifices, attacking the deficient areas, potentially causing eye pain, deafness, or toothache. This constitutes attacking along the path of deficiency. (This explains why cold constrains the upper yang which sinks to the lower, resulting in upper jiao heat syndromes. If Lung qi is closed, the qi of the middle and lower jiao is constrained; if Stomach qi is closed, the qi of the upper and lower jiao is blocked. True yang loses its pathway, and long-term stagnation transforms entirely into yin fire, sometimes causing unbearable sensations in the heart cavity and nasal/oral orifices as if smoked day and night.)