丹溪先生治病，不出乎气血痰，故用药之要有三∶气用四君子汤，血用四物汤，痰用二陈汤。又云
久病属郁，立治郁之方，曰越鞠丸。盖气、血、痰三病，多有兼郁者，或郁久而生病，或病久而生郁，或
误药杂乱而成郁，故余每用此方治病，时以郁法参之。气病兼郁，则用四君子加开郁药，血病、痰病皆
然。故四法者，治病用药之大要也。丹溪又云∶近世治病，多不知分气血，但见虚病，便用参、 ，属气
虚者固宜矣，若是血虚，岂不助气而反耗阴血耶？是谓血病治气，则血愈虚耗，甚而至于气血俱虚。故治
病用药，须要分别气血明白，不可混淆！
愚按经云，脾胃为气血之本。若阳气虚弱而不能生阴血者，宜用六君子汤；阳气虚寒而不能生阴血
者，亦用前汤加炮姜；若胃土燥热而不能生阴血者，宜用四物汤；若脾胃虚寒而不能生阴血者，宜用八味
丸。其余当更推五脏互相生克而调补之。
一儒者，每劳役则食少，胸痞，发热，头痛，吐痰，作渴，脉浮大。余谓此脾胃气虚而血病也。不
信，服二陈、四物、黄柏、知母之类，腹痛作呕，脉洪数而无伦次。先以六君子汤加炮姜，痛、呕渐愈，
又用补中益气汤而痊。
一儒者，素勤苦，因饮食失节，大便下血，或赤或黯，后非便血则盗汗，非恶寒则发热，六脉浮大，
心脾则涩，此思伤心脾，不能摄血归源也。盖血即汗，汗即血，其色赤黯，便血，盗汗，皆火之升降微。
牛黄抱龙丸 治风痰壅盛，或咳嗽发热，或发惊搐等症。
牛黄 雄黄 辰砂 天竺黄（各四钱） 麝香（一钱） 牛胆南星
上为末，甘草汤糊丸皂子大。每服二丸，姜汤下。
柴芍参苓散 治脾胃不和，饮食少进，或呕吐、泄泻。凡病后宜用此调理。
柴胡 芍药 人参 白术 茯苓 陈皮 当归（各五分） 甘草 丹皮 山栀（炒，各三分）
上为末，每服一钱，白汤下。或作丸服。
五味子汤 治咳嗽，皮肤干燥，唾中有血，胸膈疼痛等症。
五味子（炒） 桔梗（炒） 紫菀 甘草（炒） 续断（各五分） 竹茹（一钱） 赤小豆（一撮）
生地黄（二钱） 桑白皮（炒，二钱）
上水煎服。
人参平肺散 治心火克肺，咳嗽喘呕，痰涎壅盛，胸膈痞满。
上为末，每二钱，空心小麦汤调下。
姜附赤石脂朱砂丹 治小便数而不禁，怔忡，多忘，魇梦不已，下元虚冷，遗尿，精滑，或阳虚精
漏不止，或肾气虚寒，脾泄、肾泄等症。
附子（生） 干姜（各半两） 赤石脂（一两半，水飞）
上为细末，酒糊丸绿豆大。每十五至二、三十丸。大便不和米饮下，小便不禁茯苓汤下。
茯苓丸 治心肾俱虚，神志不守，小便淋沥不禁，或赤，或浊，或不利，并宜服之。
赤茯苓 白茯苓（等分）
上为末，以新汲水挪洗，澄去新沫，控干，别取熟地黄汁与好酒，同于银石器内，熬成膏，搜和丸弹
子大，空心盐酒嚼下一丸。
人参救肺散 治咳血、吐血等症。
升麻（一钱） 柴胡（一钱） 当归尾（二钱） 熟地黄（二钱） 白芍药（一钱） 苏木（半钱）
黄（二钱） 人参（二钱） 甘草（半钱） 苍术（一钱） 陈皮（五分）
上每服五钱，水二盏，煎至一盏，去渣，食前温服。
麦门冬饮子 治吐血久不愈，或肺气虚短气不足以息，要须识此。吾妻尝胎漏，忽日血大崩，遂晕
去，服童便而醒，少顷复晕，急煎服荆芥，随醒随晕，服止血止晕之药不效，忽然呕吐。予以童便药
汁，满于胸膈也，即以手探吐之，少间吐出米饭及齑菜碗许，询问其由，适方午饭，后着恼，故即崩而不
止。予悟曰∶因方饱食，胃气不行，故崩甚。血既大崩，胃气益虚而不能运化，宜乎服药而无效也。急宜
调理脾胃，遂用白术五钱，陈皮、麦芽各二钱，煎服之。服未半而晕止，再服而崩止，遂专理脾胃，服十
数剂胃气始还，然后加血药服之而安。若不审知食滞，而专用血崩血晕之药，岂不误哉！
愚按人以脾胃为本，纳五谷，化精液。其清者入
荣，浊者入胃，阴阳得此，是谓之橐 ，故阳则发于四肢，阴则行于五脏。土旺于四时，善载乎万物，
人得土以养百骸，身失土以枯四肢。东垣以饮食自伤，医多妄下，清气下陷，浊气不降，乃生
胀，所以胃脘之阳不能升举，其气陷入中焦，当用补中益气，使浊气得降，不治自安。窃谓饱食致
崩者，因伤脾气，下陷于肾，与相火协合，湿热下迫而致。宜用甘温之剂调补脾气，则血自归经而
止矣。若误用寒凉，复损胃气，则血无所羁，而欲其止，不亦难哉！大凡脾胃虚弱而不能摄血，宜调
补脾气为主。
一妇人崩漏，面黄或赤，时觉腹间脐下痛，四肢困倦，烦热不安，其经行先发寒热，两肋如束。
此脾胃亏损，元气下陷，与相火湿热下迫所致。用补中益气汤加防风、芍药、炒黑黄柏，煎服归
脾汤而愈。
丹溪先生治疗疾病，不外乎气、血、痰三个方面，所以用药的要点有三条：治气病用四君子汤（益气健脾的基础方），治血病用四物汤（补血调血的基础方），治痰病用二陈汤（燥湿化痰的基础方）。他又说久病多属于郁证，创立了治疗郁证的方剂，叫做越鞠丸。大概气、血、痰三种病症，大多兼有郁滞，或者因郁滞日久而生出疾病，或者因病久而导致气机郁滞，或者因误用杂乱药物而形成郁滞，所以我每次用这些方子治病时，时常参酌使用解郁的方法。如果是气病兼有郁滞，就在四君子汤中加入开郁的药物，血病和痰病也都是这样。所以这四种方法，是治病用药的大纲要领。
丹溪又说：近代人治病，大多不知道区分气血，只要见到虚证，就用人参、白术等补气药，对于气虚的病人固然适宜，但如果是血虚，难道不是助长阳气反而耗伤阴血吗？这就叫作“治血病却治气”，结果导致血更加虚弱耗损，严重到甚至气血都虚弱。所以治疗疾病用药，必须把气血分辨清楚，不可混淆！
我按：经典中说，脾胃是气血的根本。如果阳气虚弱不能化生阴血，宜用六君子汤（四君子汤加半夏、陈皮）；如果阳气虚寒不能化生阴血，也用前面的方子加炮姜；如果胃土燥热不能化生阴血，宜用四物汤；如果脾胃虚寒不能化生阴血，宜用八味丸（金匮肾气丸）。其余情况应当进一步推究五脏之间相生相克的关系来调理补益。
有一位读书人，每次劳累后饮食减少，胸中痞闷，发热，头痛，吐痰，口渴，脉象浮大。我说这是脾胃气虚而导致的血病。他不相信，服用了二陈汤、四物汤、黄柏、知母之类的药物，出现腹痛呕吐，脉象洪数且没有条理。我先用六君子汤加炮姜，疼痛和呕吐逐渐痊愈，又用补中益气汤（升阳举陷的代表方）而康复。
另一位读书人，平时勤劳刻苦，因为饮食不节制，大便下血，血色或红或暗，如果不是便血就是盗汗，如果不是恶寒就是发热，六脉浮大，心脾脉涩，这是思虑过度损伤心脾，不能统摄血液回归本源。大概血即是汗，汗即是血，其色赤暗，便血、盗汗，都是火气升降细微的表现。（此处原文插入牛黄抱龙丸方义，略去具体组成翻译，仅保留主治描述）牛黄抱龙丸治疗风痰壅盛，或咳嗽发热，或惊风抽搐等症状。
柴芍参苓散治疗脾胃不和，饮食少进，或呕吐、泄泻。凡是病后宜用此方调理。
人参平肺散治疗心火克制肺金，咳嗽气喘呕吐，痰涎壅盛，胸膈痞满。
姜附赤石脂朱砂丹治疗小便频数且不禁控，心悸怔忡，健忘，噩梦不止，下元虚冷，遗尿，滑精，或阳虚精漏不止，或肾气虚寒，脾泄、肾泄等症状。
茯苓丸治疗心肾俱虚，神志不守，小便淋沥不禁，或尿色红，或尿浊，或排尿不利，都适宜服用。
麦门冬饮子治疗吐血久不愈，或肺气虚短气不足以呼吸，必须认识这一点。我的妻子曾经胎漏，忽然一天大量出血崩漏，随即晕厥过去，服用童便（童子尿）后醒来，过了一会儿又晕倒，急忙煎服荆芥，随醒随晕，服用止血止晕的药物无效，忽然发生呕吐。我认为这是因为童便药汁充满胸膈，于是用手探喉催吐，过一会儿吐出了米饭和咸菜约一碗，询问其原因，正好刚吃过午饭，后来生气恼怒，所以导致崩漏不止。我领悟道：因为刚吃饱饭，胃气运行不畅，所以崩漏严重。血既然大量崩漏，胃气更加虚弱而不能运化，服药无效是理所当然的。急宜调理脾胃，于是用白术五钱，陈皮、麦芽各二钱，煎服。服用不到一半，晕厥停止，再服用后崩漏停止，随后专门调理脾胃，服了十几天胃气才恢复，然后加上补血药服用才安稳。如果不审察是否有食积停滞，而专用治疗血崩血晕的药物，岂不是错误了吗！
我按：人以脾胃为本，受纳五谷，化生精液。其中清轻的部分进入荣血，浑浊的部分归于胃腑，阴阳依靠这个机制运作，这就叫做橐龠（比喻呼吸或气机升降的枢纽），所以阳气发于四肢，阴气行于五脏。土旺于四季，善于承载万物，人得到土的滋养以供养全身骨骼，身体失去土的滋养则四肢枯槁。李东垣认为饮食自我伤害，医生多妄用攻下法，导致清气下陷，浊气不降，于是产生胀满，所以胃脘的阳气不能升举，其气陷入中焦，应当用补中益气汤，使浊气得以下降，不治自安。我私下认为饱食导致崩漏，是因为损伤脾气，下陷于肾，与相火结合，湿热下迫所致。宜用甘温的药剂调补脾气，则血液自然归经而停止。如果误用寒凉药物，再次损伤胃气，那么血液无所约束，想要让它停止，不也很难吗！大凡脾胃虚弱而不能统摄血液，应以调补脾气为主。
一位妇人患崩漏，面色黄或红，时常觉得腹部脐下疼痛，四肢困倦，烦热不安，月经来潮前先发寒热，两肋像被捆绑一样紧束。这是脾胃亏损，元气下陷，与相火湿热下迫所致。用补中益气汤加防风、芍药、炒黑黄柏，煎服归脾汤而痊愈。
Mr. Danxi's treatment of diseases focuses on Qi, Blood, and Phlegm; thus, the key principles of medication are threefold: for Qi disorders, use Sijunzi Tang (Four Gentlemen Decoction); for Blood disorders, use Siwu Tang (Four Substances Decoction); for Phlegm disorders, use Erchen Tang (Two Aged Decoction). He also stated that chronic diseases often belong to Yu (Stagnation), so he established a formula for treating Yu, called Yueju Wan (Yueju Pill). Generally, Qi, Blood, and Phlegm disorders frequently involve Stagnation; either Stagnation persists for a long time leading to disease, or disease persists leading to Stagnation, or improper and mixed medications cause Stagnation. Therefore, whenever I use these formulas to treat diseases, I often incorporate methods to resolve Stagnation. If Qi disorder is accompanied by Stagnation, open-Stagnation herbs are added to Sijunzi Tang; this applies similarly to Blood and Phlegm disorders. Thus, these four methods constitute the major essentials of treating diseases with medication.
Danxi further remarked: In recent times, physicians often fail to distinguish between Qi and Blood. Upon seeing deficiency patterns, they indiscriminately use tonics like Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). While this is appropriate for Qi deficiency, if it is Blood deficiency, does it not exacerbate Qi at the expense of consuming Yin-Blood? This is termed "treating Blood disease by addressing Qi," resulting in further depletion of Blood, potentially leading to simultaneous deficiency of both Qi and Blood. Therefore, when treating diseases and prescribing medication, one must clearly differentiate between Qi and Blood and avoid confusion!
I note: The Classics state that the Spleen and Stomach are the root of Qi and Blood. If Yang-Qi is weak and unable to generate Yin-Blood, Liujunzi Tang (Six Gentlemen Decoction) should be used; if Yang-Qi is deficient and cold, unable to generate Yin-Blood, the aforementioned decoction should be used with Paojiang (Prepared Ginger Rhizome); if the Stomach Earth is dry and hot, unable to generate Yin-Blood, Siwu Tang should be used; if the Spleen and Stomach are deficient and cold, unable to generate Yin-Blood, Bawei Wan (Eight-Ingredient Pill) should be used. For other cases, one should further deduce the mutual generation and restriction among the Five Zang Organs to regulate and tonify.
A scholar experienced reduced appetite, chest fullness, fever, headache, expectoration of phlegm, thirst, and a floating and large pulse after every instance of overwork. I diagnosed this as Spleen-Stomach Qi deficiency leading to Blood pathology. Disbelieving this, he took Erchen Tang, Siwu Tang, Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma), which resulted in abdominal pain, vomiting, and a surging, rapid, and irregular pulse. I first prescribed Liujunzi Tang with Paojiang, after which the pain and vomiting gradually subsided. Subsequently, using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), he recovered.
Another scholar, accustomed to hard work, suffered from hematochezia due to dietary irregularities. The blood was either bright red or dark. When not passing bloody stool, he experienced night sweats; when not feeling aversion to cold, he had fever. His six pulses were floating and large, while the Heart and Spleen pulses were choppy. This indicated that excessive thinking damaged the Heart and Spleen, failing to control the Blood and return it to its source. Essentially, Blood is Sweat, and Sweat is Blood. Their red-dark color, hematochezia, and night sweats all reflect subtle disturbances in the ascending and descending of Fire. [Note: The text inserts a description for Niuhuang Bao Long Wan here, indicating it treats Wind-Phlegm congestion, cough with fever, or convulsions.]
Chaishao Shenling San (Bupleurum, Peony, Ginseng, and Poria Powder) treats Disharmony of the Spleen and Stomach, poor appetite, vomiting, or diarrhea. It is suitable for post-illness regulation.
Wuweizi Tang (Schisandra Decoction) treats cough, dry skin, blood in saliva, and chest discomfort.
Renshen Pingfei San (Ginseng Lung-Pacifying Powder) treats Heart-Fire suppressing Lung-Jin, cough with wheezing and vomiting, copious sputum, and chest fullness.
Jiangfu Chishizhi Zhusha Dan (Ginger, Aconite, Red Kaolin, and Cinnabar Pill) treats frequent and incontinent urination, palpitations, forgetfulness, persistent nightmares, lower Yuan deficiency-cold, enuresis, seminal emission, continuous leakage of essence due to Yang-deficiency, Kidney-Qi deficiency-cold, Spleen-diarrhea, or Kidney-diarrhea.
Fuling Wan (Poria Pill) treats dual deficiency of the Heart and Kidney, unsettled spirit, dribbling and incontinence of urine, whether red, turbid, or difficult to pass.
Renshen Jiufei San (Ginseng Lung-Saving Powder) treats hemoptysis and hematemesis.
Maimendong Yinzi (Ophiopogon Drink) treats persistent hematemesis or shortness of breath due to Lung-Qi deficiency. One must understand this principle. My wife once suffered from fetal leakage, suddenly experiencing a massive hemorrhage and fainting. After waking up from drinking Tongbian (Child's Urine), she fainted again shortly. Urgently brewing Jingjie (Schizonepetae Herba) provided only temporary relief before fainting returned. Hemostatic and anti-fainting medicines were ineffective, followed by sudden vomiting. I reasoned that the Tongbian medicine filled the chest and diaphragm, so I induced vomiting by stimulating the throat. She vomited about a bowl of rice and pickles. Upon inquiry, she had just finished lunch and became angry, causing the hemorrhage to persist. I realized: because she ate a full meal, Stomach-Qi failed to move, exacerbating the hemorrhage. With massive bleeding, Stomach-Qi became too weak to transform and transport, making medication ineffective. I urgently regulated the Spleen and Stomach, prescribing Baizhu (5 qian), Chenpi (2 qian), and Maiya (2 qian). Before finishing half the dose, the fainting stopped; after another dose, the bleeding ceased. I then focused solely on regulating the Spleen and Stomach. After more than ten doses, Stomach-Qi recovered, after which I added Blood-tonifying herbs, leading to stability. Had I not assessed food stagnation and exclusively used medicines for hemorrhage and fainting, would it not have been a mistake!
I note: Humans rely on the Spleen and Stomach as the root, receiving five grains and transforming them into essences. The clear portion enters Ying (Nutritive) Blood, while the turbid portion remains in the Stomach. Yin and Yang utilize this mechanism, termed Tuoyue (Bellows), allowing Yang to manifest in the four limbs and Yin to circulate within the Five Zang Organs. Earth thrives in all four seasons, bearing all things. Humans receive Earth's nourishment to sustain their bones; losing Earth's support causes the limbs to wither. Li Dongyuan argued that self-inflicted dietary injury, combined with physicians' reckless purgation, causes Clear-Qi to sink and Turbid-Qi to fail to descend, leading to distension. Consequently, the Yang of the Epigastrium cannot ascend, sinking into the Middle Jiao. One should use Buzhong Yiqi Tang to allow Turbid-Qi to descend, achieving recovery without direct intervention. I privately believe that hemorrhage caused by overeating stems from damaging Spleen-Qi, which sinks into the Kidney, combining with Ministerial Fire to create Damp-Heat forcing downward. One should use sweet-warm agents to tonify Spleen-Qi, allowing Blood to return to its vessels and stop naturally. If cold-cooling agents are mistakenly used, further damaging Stomach-Qi, the Blood will have no restraint, making cessation difficult. Generally, for Spleen-Stomach weakness failing to control Blood, the primary approach should be tonifying Spleen-Qi.
A woman suffered from metrorrhagia and metrostaxis, with a yellow or red complexion, occasional pain below the umbilicus, limb fatigue, irritability, and heat. Her menstruation began with alternating chills and fever, and her hypochondrium felt bound. This was caused by Spleen-Stomach damage, sinking of Original-Qi, and downward pressure from Ministerial Fire and Damp-Heat. Using Buzhong Yiqi Tang with Fangfeng (Saposhnikoviae Radix), Shaoyao (Paeoniae Radix Alba), and fried Hei Huangbai (Phellodendri Cortex), followed by Guipi Tang (Restore the Spleen Decoction), she recovered.