治一切失血。或血虚烦渴燥热睡卧不宁。五心烦热作渴等症。即四物汤加人参黄 。
柯韵伯曰。此方取参 配四物。以治阴虚血脱等症。盖阴阳互为其根。阴虚则阳无所附。
所以烦热燥渴。而阳亦亡。气血相为表里。血脱则气无所归。所以睡卧不宁。而气亦脱。然
阴虚无骤补之法。计在存阳。血脱有生血之机。必先补气。此阳生阴长血随气行之理也。故
曰。阴虚则无气。无气则死矣。前辈治阴虚。用八珍十全。卒不获效者。因甘草之甘。不达
下焦。白术之燥。不利肾阴。茯苓渗泄。碍乎生升。肉桂辛热。动其虚火。此六味皆醇浓和
平而滋润。服之则气血疏通。内外调和。合于圣度矣。
陈修园曰。此方为一切失血之良药。及血后烦热。睡卧不宁。五心烦热作渴。可以兼治。
其止血。妙在川芎一味。其退热。
妙在黄 一味。其熟睡止渴。妙在人参一味。柯韵伯以参 为气分阳药。取配四物等语。
亦未免为俗说所囿也。经云。中焦受气取汁变化而赤。是谓血。血之流行。半随冲任而行于
经络。半散于脉外而充于肌腠皮毛。凡一切失血之症。其血不能中行于经络。外散于肌腠皮
毛。故从窍道涌出不止。妙得川芎之温行。又有当归以濡之。俾血仍行于经络。得川芎之辛
散。又有黄 以鼓之。俾血仍散于肌腠皮毛。源流俱清。而血焉有不止者乎。至于血后燥热。
得黄 以微汗之。则表气和而热退。即当归补血汤意也。睡卧不宁。血后阴虚所致。五脏属
阴。唯人参能兼补之。五脏之阴长。则五心之烦热自除。烦热既除。则津液自生。燥渴自已。
诸症可以渐退矣。自宋元以后。无一人能读本草经。此方疑有神助。非制方人识力所到也。
柯韵伯卓卓不凡。但未读本草经。未免阙憾。○五脏有血。六腑无血。观剖诸兽。腹心下夹
脊包络中多血
肝内多血。心脾肺肾中各有血。六腑无血。近时以吐血多者为吐胃血。皆耳食昔医之误。
凡五脏血。吐出一丝即死。若吐血衄血下血及妇人血崩。皆是行于经络与散于肌腠之血。溢
于上为吐衄。渗于下为崩下也。
治疗各种失血证。或者因血虚导致的烦躁口渴、燥热、睡眠不安稳。以及五心烦热、口渴等症状。这个方子就是四物汤加入人参和黄芪。
柯韵伯说：此方取用人参、黄芪配合四物汤，用来治疗阴虚血脱等病症。大概因为阴阳互为根本，阴虚则阳气无所依附，所以出现烦热、燥渴，进而导致阳气也亡失。气血互为表里，血脱则气无所归依，所以出现睡眠不安稳，进而导致气也脱失。然而，对于阴虚无突然进补的方法，关键在于保存阳气；对于血脱有生血之机，必须先补气。这是“阳生阴长，血随气行”的道理。所以说：阴虚就没有气，没有气就会死亡。前辈治疗阴虚，使用八珍汤、十全大补汤，最终没有获得疗效的原因，是因为甘草的甘味不能到达下焦，白术的燥性不利于肾阴，茯苓的渗泄作用妨碍了生发之气，肉桂的辛热性质会扰动虚火。这六味药（指四物汤加参、芪中的部分药物或泛指前文提到的无效方剂组成）都是醇厚浓密、和平滋润的，服用后能使气血疏通，内外调和，符合圣人的法度。
陈修园说：此方是治疗各种失血的良药，以及失血后的烦热、睡眠不安稳、五心烦热、口渴等症状，可以兼治。它止血之妙，在于川芎这一味药；退热之妙，在于黄芪这一味药；让人熟睡并止渴之妙，在于人参这一味药。柯韵伯认为人参、黄芪是气分的阳药，取用它们配合四物汤等说法，也不免被世俗的说法所局限。《内经》说：“中焦受纳水谷之气，提取精汁，变化而成为红色，这就叫做血。”血液的运行，一半随着冲脉、任脉在经络中运行，一半散布在脉外而充盈于肌肉腠理和皮毛。凡是各种失血的病症，血液不能正常地在经络中运行，而是向外散溢到肌肉腠理和皮毛，所以从孔窍涌出而不止。巧妙地得到川芎的温通运行，又有当归来濡润它，使血液仍能行于经络；得到川芎的辛散作用，又有黄芪来鼓动它，使血液仍能散于肌肉腠理和皮毛。源头和流去都清澈通畅，那么血怎么会不止呢？至于失血后的燥热，得到黄芪微微发汗，则表气调和而热退，这就是当归补血汤的意思。睡眠不安稳，是失血后阴虚所致。五脏属阴，只有人参能兼补五脏之阴。五脏之阴增长，那么五心的烦热自然消除。烦热既除，津液自然生成，燥渴自然停止。各种症状可以逐渐消退了。自从宋元以后，没有一个人能读懂《神农本草经》，这个方子疑似有神助，不是制方者的见识和力量所能达到的。柯韵伯卓越不凡，但未读《神农本草经》，未免有缺憾。○五脏有血，六腑无血。观察剖开的野兽，腹心下方夹脊的包络中多血，肝内多血，心、脾、肺、肾中各有血，六腑无血。近时人把吐血多的人称为吐胃血，这都是听信从前医生错误观点的结果。凡是五脏的血，吐出一丝就会死。如果吐血、鼻衄、便血以及妇女血崩，这些都是行于经络与散于肌肉腠理的血液。溢出向上为吐血、鼻衄，渗漏向下为血崩、便血。
Treats all types of hemorrhage. Or symptoms such as irritability, thirst, dryness-heat, and restless sleep due to blood deficiency. As well as five-palm heat (five-center heat) and thirst. This formula is Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix).
Ke Yunbo stated: This formula utilizes Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix) combined with Siwu Tang (Four Substances Decoction) to treat conditions such as Yin deficiency and blood collapse. Generally, Yin and Yang are mutually rooted; when Yin is deficient, Yang has no attachment, resulting in irritability, heat, dryness, and thirst, leading to the loss of Yang. Qi and Blood are exterior-interior partners; when Blood collapses, Qi has no return, resulting in restless sleep, leading to the depletion of Qi. However, there is no method for sudden tonification in Yin deficiency; the strategy lies in preserving Yang. In blood collapse, there is a mechanism for generating blood, but one must first tonify Qi. This is the principle that "Yang generates Yin, and Blood follows Qi." Therefore, it is said: If Yin is deficient, there is no Qi; without Qi, death ensues. The reason why predecessors failed to achieve efficacy when treating Yin deficiency using Bazhen Tang (Eight Treasures Decoction) or Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) is that Gancao (Licorice Radix et Rhizoma)'s sweetness does not reach the Lower Jiao (Lower Burner), Baizhu (Atractylodis Macrocephalae Rhizoma)'s dryness is unfavorable to Kidney Yin, Fuling (Poria) promotes drainage and obstruction hinders generation and ascent, and Rougui (Cinnamon Bark)'s acridity and heat stir up deficient fire. These ingredients are mellow, rich, peaceful, and moistening; taking them allows Qi and Blood to flow smoothly, harmonizing the interior and exterior, conforming to the Sage's standards.
Chen Xiuyuan stated: This formula is an excellent medicine for all types of hemorrhage, and can also treat post-hemorrhagic irritability, restless sleep, five-palm heat, and thirst. Its brilliance in stopping bleeding lies in Chuanxiong (Ligustici Chuanxiong Rhizoma); its brilliance in reducing fever lies in Huangqi (Astragali Radix); its brilliance in inducing sound sleep and quenching thirst lies in Renshen (Ginseng Radix et Rhizoma). Ke Yunbo regarded Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix) as Yang herbs of the Qi level, claiming they are taken to pair with Siwu Tang (Four Substances Decoction); this view is somewhat constrained by vulgar theories. The Classic states: "The Middle Jiao receives Qi, extracts juices, transforms them into red, and this is called Blood." The circulation of Blood flows half along the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) within the meridians, and half disperses outside the vessels to fill the muscle-couplings and skin-hair. In all cases of hemorrhage, Blood cannot circulate normally within the meridians but scatters outward to the muscle-couplings and skin-hair, thus gushing out from orifices uncontrollably. It skillfully utilizes Chuanxiong (Ligustici Chuanxiong Rhizoma)'s warming movement, assisted by Danggui (Angelicae Sinensis Radix) to moisten it, so that Blood may still travel within the meridians; utilizing Chuanxiong (Ligustici Chuanxiong Rhizoma)'s acrid dispersion, assisted by Huangqi (Astragali Radix) to boost it, so that Blood may still disperse to the muscle-couplings and skin-hair. With both source and flow clear, how could bleeding continue? As for post-hemorrhagic dryness-heat, mild sweating induced by Huangqi (Astragali Radix) harmonizes the Exterior Qi and reduces fever, which is the intent of Danggui Buxue Tang (Danggui Tonifies the Blood Decoction). Restless sleep is caused by Yin deficiency after hemorrhage. The Five Zang Organs belong to Yin, and only Renshen (Ginseng Radix et Rhizoma) can tonify them all. When the Yin of the Five Zang Organs grows, the five-palm heat naturally disappears. Once the heat disappears, Body Fluids are generated, and dryness-thirst ceases. All symptoms will gradually recede. Since the Song and Yuan dynasties, no one has been able to read the Shennong Bencao Jing (Divine Farmer's Materia Medica); this formula seems divinely assisted, beyond the comprehension and power of its formulator. Ke Yunbo was outstanding, but his failure to read the Shennong Bencao Jing (Divine Farmer's Materia Medica) remains a regret. ○ The Five Zang Organs contain Blood; the Six Fu Organs do not. Observing dissected beasts, there is much blood in the pericardium surrounding the heart below the abdomen and flanking the spine, and in the Liver; each of the Heart, Spleen, Lungs, and Kidneys contains blood, while the Six Fu Organs do not. Recently, those who vomit large amounts of blood are said to be vomiting Stomach blood; this is all an error derived from listening to past physicians' mistakes. Any blood from the Five Zang Organs, if even a single thread is vomited, leads to death. Vomiting blood, epistaxis, lower bleeding, and uterine bleeding in women are all Blood circulating in the meridians and scattered in the muscle-couplings. Overflowing upward causes vomiting and epistaxis; seeping downward causes uterine bleeding and lower bleeding.