凡病无不起于郁者，如气运之乖和也，则五郁之病生。经言木郁达之，宜吐。火郁发之，升散。土郁夺
之，攻下。金郁泄之，解表利小便。水郁折之，制其冲逆。此论胜复之变。情志之怫抑也，则六郁之病作。
经言怵 思虑则伤神，忧愁不解则伤意，悲哀动中则伤魂，喜乐无极则伤魄，盛怒不止则伤志，恐惧不解则伤精。
此论气血之损。又言尝贵后贱，虽不中邪，病从内生，名曰脱营。尝富后贫，名曰失精，以及病发心脾，不
得隐曲，思想无穷，所愿不得，皆情志之郁也。夫六气外来之郁，多伤经腑，如寒火湿热痰食，皆可以消散解。
若思忧悲惊怒恐之郁伤气血，多损脏阴，可徒以消散治乎！七情内起之郁，始而伤气，继必及血，终乃成劳，
主治宜苦辛凉润宣通。苦能泄热，辛能理气，凉润能濡燥，宣通能解结，用剂必气味相投，乃可取效。以郁为
燥邪，必肺气失宣，不能升降。中气日结，不能运纳，至血液日涸，肌消骨蒸，经闭失调，乳岩项 ，而郁
劳之症成，不止血嗽气膈，狂癫失志而已。今分条列治，如思郁伤脾，气结，宜郁金、贝母、当归、柏子仁、
桔梗、木香汁。思郁伤神，精滑。神伤必不摄肾，故遗精淋浊，固阴煎。思郁伤肝，潮热，逍遥散。思郁伤心
脾，失血。归脾汤去白术，加白芍。忧郁伤肺，气阻，杏仁、栝蒌皮、郁金、枳壳、枇杷叶、竹沥、姜汁、半
夏。忧郁伤中食少，七福饮去熟地，加砂仁。悲忧脏躁欲泣，甘麦大枣汤。惊郁胆怯欲迷，人参、枣仁、茯神、
龙骨、石菖蒲、南枣、小麦。惊郁神乱欲狂，清心温胆汤。怒郁肝伤气逆，解肝煎。怒郁火升动血，化肝煎。
恐郁阳消精怯，八味丸加减，或鹿角胶酒化服。诸郁久，风阳内生，眩悸咽痛，宜阿胶、生地、石斛、茯神、
牡蛎、白芍、麦冬、甘草。气郁脉沉而涩，七气汤。血郁脉涩而芤，四物化郁汤。气
郁生涎心悸，温胆汤。血郁络伤胁痛，金铃子散加桃仁、归须、郁金、降真香。肺脾郁，营损肌瘦，养营汤去
桂心，减熟地黄。心脾郁，怔忡崩漏，归脾汤。肝胆郁，血燥结核，加味逍遥散。若嘈杂吞酸，逍遥佐金汤。
脾胃郁，气噎哕呃，金匮麦门冬汤加竹茹、丁香。三焦郁，口干不食，栀子仁姜汁浸炒黑研细，以人参、麦冬、
乌梅煎汤服。若夫六气之火郁，散之。火郁汤。寒郁成热，泻之。羚羊角、山栀、生白芍、丹皮、川黄连、
川石斛。湿郁除之。除湿汤、平胃散。痰郁涤之。润下丸，或二陈汤加海石、栝蒌、贝母、竹沥。食郁消之。
保和丸。通治诸郁，用越鞠丸、六郁汤加减。阴阳壅滞，气不升降。沉香降气散。妇人咽中如有炙脔，咯不出，
咽不下，半夏浓朴汤。凡怀抱不舒，遭遇不遂，以及怨旷积想在心，莫能排解，种种郁悒，各推其原以治之。
然以情病者，当以理遣以命安。若不能怡情放怀，至积郁成劳，草本无能为挽矣，岂可借合欢捐忿，萱草忘忧
也哉！
丹溪立越鞠丸，以治六郁，用香附理气，川芎调血，苍术去湿，山栀泄火，神曲疗食，有痰加贝母。
开郁利气为主。谓气郁则湿郁，湿郁则热郁，热郁则痰郁，痰郁则血郁，血郁则食郁，相因为病。赵养葵云∶
东方生木，火气附焉。木郁则土郁，土郁则金郁，金郁则水郁，五行相因之理。与以逍遥散治木郁，诸郁皆因
而愈，甚者方中加左金丸。以黄连治心火，吴茱萸气臊，肝之气亦臊，同气相求而佐金以制木，此佐金之所
以得名也。继用六味丸加柴胡、白芍以滋水生木，木火郁舒，土亦滋润，金水相生矣。
凡是疾病，没有不是起源于郁滞的。例如五运六气失调不和，就会产生“五郁”的病证。《内经》说：木郁应当疏达，适宜用吐法；火郁应当发散，宜用升散之法；土郁应当攻夺，宜用攻下之法；金郁应当宣泄，宜解表并通利小便；水郁应当制约，宜控制其冲逆之势。这是论述五行胜复变化的规律。
如果是情志被压抑，就会产生“六郁”的病证。《内经》说：惊恐思虑会损伤心神，忧愁不解会损伤意志，悲哀触动内心会损伤魂，喜乐无节制会损伤魄，盛怒不止会损伤志，恐惧不解会损伤精。这是论述气血受损的情况。又说：曾经尊贵后来卑贱，虽然没受外邪侵袭，病从内生，名叫“脱营”；曾经富有后来贫穷，名叫“失精”，以及发病在心脾，难以启齿诉说隐曲之事，思虑无穷，愿望无法实现，这些都是情志之郁。
至于六气（风、寒、暑、湿、燥、火）外来引起的郁滞，多损伤经络和脏腑，如寒、火、湿、热、痰、食等郁滞，都可以用消散的方法治疗。如果是思、忧、悲、惊、怒、恐等七情内起引起的郁滞，多损伤脏阴，难道能只用消散法治吗！七情内起的郁滞，起初伤气，随后必然波及血，最终形成劳损，主治宜用苦、辛、凉、润、宣、通的药物。苦味能泄热，辛味能理气，凉润能濡养燥邪，宣通能解开结滞，用药必须气味相投，才能见效。因为郁滞被视为燥邪，必然导致肺气失于宣发，不能正常升降。中气日益结聚，不能运化纳谷，直到血液日渐枯竭，肌肉消瘦，骨蒸潮热，月经闭止或失调，乳房肿块（乳岩），颈部瘰疬（项瘿），从而形成郁劳之症，不仅仅是咯血、咳嗽、气膈、狂癫、神志失常而已。
现在分条列举治法：如思虑过度伤脾，气机结滞，宜用郁金、贝母、当归、柏子仁、桔梗、木香汁。思虑伤神，出现遗精滑泄。神伤必然不能固摄肾气，所以出现遗精、淋浊，用固阴煎。思虑伤肝，出现潮热，用逍遥散。思虑伤心脾，出现失血，用归脾汤去掉白术，加白芍。忧郁伤肺，气机阻滞，用杏仁、栝蒌皮、郁金、枳壳、枇杷叶、竹沥、姜汁、半夏。忧郁伤中焦，食欲不振，用七福饮去掉熟地黄，加砂仁。悲伤脏躁，想哭泣，用甘麦大枣汤。惊悸胆怯，神志迷乱，用人参、枣仁、茯神、龙骨、石菖蒲、南枣、小麦。惊悸神乱，想要发狂，用清心温胆汤。愤怒伤肝，气机上逆，用解肝煎。愤怒火升，动血，用化肝煎。恐惧阳气消减，精气怯弱，用八味丸加减，或用鹿角胶酒化服。各种郁滞日久，风阳内生，出现眩晕、心悸、咽痛，宜用阿胶、生地、石斛、茯神、牡蛎、白芍、麦冬、甘草。气郁脉象沉而涩，用七气汤。血郁脉象涩而芤，用四物化郁汤。气郁生涎伴心悸，用温胆汤。血郁络脉受伤致胁痛，用金铃子散加桃仁、归须、郁金、降真香。肺脾郁滞，营血亏损肌肉消瘦，用养营汤去掉桂心，减少熟地黄。心脾郁滞，出现怔忡、崩漏，用归脾汤。肝胆郁滞，血燥生结核，用加味逍遥散。如果有嘈杂吞酸症状，用逍遥佐金汤。脾胃郁滞，出现气噎、呃逆，用金匮麦门冬汤加竹茹、丁香。三焦郁滞，口干不食，将栀子仁用姜汁浸炒黑研细，用人参、麦冬、乌梅煎汤送服。
至于六气之火郁，用散法，用火郁汤。寒郁化热，用泻法，用羚羊角、山栀、生白芍、丹皮、川黄连、川石斛。湿郁用除法，用除湿汤、平胃散。痰郁用涤法，用润下丸，或二陈汤加海浮石、栝蒌、贝母、竹沥。食郁用消法，用保和丸。通治各种郁滞，用越鞠丸、六郁汤加减。阴阳壅滞，气机不升降，用沉香降气散。妇人咽喉中如有炙肉块，咳不出，咽不下，用半夏厚朴汤。凡是怀抱不舒畅，遭遇不顺遂，以及怨恨旷达积想在心中，无法排解，种种抑郁，各自推究其原因来治疗。然而因情志致病者，应当以理遣怀，以命运安身。如果不能怡情放怀，以致积郁成劳，草本药物也无能为力挽回，难道可以借合欢树消除忿怒，萱草忘记忧愁吗！
朱丹溪创立越鞠丸，用来治疗六郁，用香附理气，川芎调血，苍术去湿，山栀泄火，神曲疗食，有痰加贝母。以开郁利气为主。认为气郁则湿郁，湿郁则热郁，热郁则痰郁，痰郁则血郁，血郁则食郁，相互关联而成病。赵养葵说：东方生木，火气依附于木。木郁则土郁，土郁则金郁，金郁则水郁，这是五行相互关联的道理。给予逍遥散治疗木郁，诸郁都因此痊愈，严重的在方中加入左金丸。用黄连治心火，吴茱萸气味臊臭，肝的气味也臊臭，同气相求，佐金以制木，这就是“佐金”得名的原因。继用六味丸加柴胡、白芍以滋水生木，木火郁滞舒展，土也滋润，金水相生了。
All diseases originate from stagnation (Yu, 郁). For instance, when the movement of Qi and the harmony of Six Qi (Six Climate Factors: Wind, Cold, Summer-heat, Dampness, Dryness, Fire) are disordered, the pathologies of "Five Stagnations" arise. The Classics state: For Wood stagnation, promote its free flow; emesis is suitable. For Fire stagnation, diffuse it; ascending and dispersing methods are used. For Earth stagnation, purge it; purgative methods are applied. For Metal stagnation, drain it; releasing the exterior and promoting urination are indicated. For Water stagnation, restrain it; controlling its rebellious upward surge is necessary. This discusses the variations of overcoming and retaliation among the Five Phases.
When emotions are suppressed, the pathologies of "Six Stagnations" occur. The Classics state: Fear and excessive thinking damage the Shen (Spirit); unresolved sorrow damages Yi (Intellect/Intent); grief moving within damages Hun (Ethereal Soul); unbounded joy damages Po (Corporeal Soul); unremitting rage damages Zhi (Willpower); unresolved fear damages Jing (Essence). This discusses the damage to Qi and Blood. It also states: One who was once noble but became humble, though not struck by external pathogens, develops disease from within, named "Tuoying" (Depletion of Ying/Nutritive Qi). One who was once rich but became poor, is named "Shijing" (Loss of Jing/Essence), along with diseases originating in the Heart and Spleen, where one cannot speak of hidden matters, thinks endlessly, and desires remain unfulfilled—all are emotional stagnations.
Stagnations caused by the external Six Qi often damage the meridians and fu-organs; such as stagnations of Cold, Fire, Dampness, Heat, Phlegm, and Food can all be resolved by dissipating methods. However, stagnations arising internally from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) often damage the Yin of the zang-organs; can they be treated merely with dissolving methods? Stagnations from internal Seven Emotions initially damage Qi, subsequently involve Blood, and finally become consumptive disorders (Lao, 劳). The main treatment should employ bitter, acrid, cool, moistening, diffusing, and unblocking agents. Bitterness clears heat; acridity regulates Qi; cool and moistening properties nourish dryness; diffusing and unblocking properties resolve knots. Medicinals must have compatible flavors and aromas to be effective. Since stagnation is regarded as a dry pathogen, it inevitably causes Lung Qi to lose its diffusing function, failing to descend and ascend properly. Middle Jiao Qi becomes increasingly knotted, unable to transport and receive nutrients, leading to daily depletion of Blood, emaciation, bone-steaming fever, amenorrhea or irregular menstruation, breast masses (Ru Yan, 乳岩), and neck lumps (Xiang Lei, 项瘿), thereby forming symptoms of Stagnation Consumption. This goes beyond mere hemoptysis, cough, Qi obstruction, mania, epilepsy, and loss of will.
Now, treatments are listed by category:
If excessive thinking damages the Spleen and Qi knots, use Yujin (Curcuma Rhizome), Beimu (Fritillaria Bulb), Danggui (Angelica Sinensis Root), Baiziren (Biota Seed), Jiegeng (Platycodon Root), and Muxiang juice.
If thinking damages the Shen, causing seminal emission, since damaged Shen fails to control Kidney Essence, resulting in spermatorrhea and turbid urine, use Guyin Jian (Solidify Yin Decoction).
If thinking damages the Liver, causing tidal fever, use Xiaoyao San (Free Wanderer Powder).
If thinking damages the Heart and Spleen, causing blood loss, use Guipi Tang (Restore the Spleen Decoction) removing Baizhu (Atractylodes Macrocephala Rhizome), adding Baishao (White Peony Root).
If melancholy damages the Lung, causing Qi obstruction, use Xingren (Apricot Seed), Gualoupi (Trichosanthes Peel), Yujin (Curcuma Rhizome), Zhike (Bitter Orange Fruit), Pipaye (Loquat Leaf), Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), and Banxia (Pinellia Tuber).
If melancholy damages the Middle Jiao, causing poor appetite, use Qifu Yin (Seven Blessings Decoction) removing Shudi (Prepared Rehmannia Root), adding Sharen (Amomum Fruit).
For organ-zang anxiety with weeping tendency, use Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction).
For fright-induced gallbladder timidity and confusion, use Renshen (Ginseng Root), Zaoren (Ziziphus Seed), Fushen (Poria with Hostwood), Longgu (Fossilized Bone), Shichangpu (Acorus Rhizome), Nanzao (Chinese Jujube), and Xiao Mai (Wheat).
For fright-induced mental chaos and manic tendencies, use Qingxin Wendan Tang (Clear Heart and Warm Gallbladder Decoction).
For anger damaging the Liver and causing Qi rebellion, use Jiegan Jian (Resolve Liver Decoction).
For anger causing Fire rising and disturbing Blood, use Huagan Jian (Transform Liver Decoction).
For fear causing Yang decline and Jing cowardice, use Bawei Wan (Eight Ingredients Pill) modified, or Lu Jiao Jiu (Deer Antler Glue dissolved in wine).
For prolonged stagnations generating internal Wind-Yang, causing dizziness, palpitations, and sore throat, use Ejiao (Donkey-Hide Gelatin), Shengdi (Rehmannia Root), Shihu (Dendrobium Stem), Fushen (Poria with Hostwood), Muli (Oyster Shell), Baishao (White Peony Root), Maidong (Ophiopogon Tuber), and Gancao (Licorice Root).
For Qi stagnation with deep and choppy pulse, use Qiqi Tang (Seven Qi Decoction).
For Blood stagnation with choppy and hollow pulse, use Siwu Huayu Tang (Four Substances Transforming Stagnation Decoction).
For Qi stagnation producing saliva and palpitations, use Wendan Tang (Warm Gallbladder Decoction).
For Blood stagnation damaging collaterals causing hypochondriac pain, use Jinlingzi San (Jin Ling Zi Powder) plus Taoren (Peach Kernel), Guixu (Angelica Sinensis Tail), Yujin (Curcuma Rhizome), and Jiangzhenxiang (Dalbergia Odorifera Lignum).
For Lung-Spleen stagnation with Ying deficiency and emaciation, use Yangying Tang (Nourish Ying Decoction) removing Guixin (Cinnamon Twig), reducing Shudi (Prepared Rehmannia Root).
For Heart-Spleen stagnation with palpitations and metrorrhagia, use Guipi Tang (Restore the Spleen Decoction).
For Liver-Gallbladder stagnation with Blood dryness and nodules, use Jiawei Xiaoyao San (Modified Free Wanderer Powder).
For嘈杂 (sensation of hunger with discomfort) and acid regurgitation, use Xiaoyao Zuojin Tang (Free Wanderer Supporting Metal Decoction).
For Spleen-Stomach stagnation causing Qi blockage and hiccups, use Jingui Maigandong Tang (Golden Cabinet Ophiopogon Decoction) plus Zhuru (Bamboo Sap) and Dingxiang (Clove).
For Triple Burner stagnation causing dry mouth and anorexia, stir-fry Zhirenzi (Gardenia Seed) soaked in ginger juice until black, grind finely, and take with decoction of Renshen (Ginseng Root), Maidong (Ophiopogon Tuber), and Wumei (Mume Fruit).
Regarding Fire stagnation of the Six Qi, use dispersion; Huoyu Tang (Fire Stagnation Decoction).
For Cold stagnation transforming into Heat, use purgation/draining; Lingyangjiao (Antelope Horn), Shanzhi (Gardenia Fruit), Sheng Baishao (Raw White Peony Root), Danpi (Moutan Cortex), Chuanlianhuan (Coptis Rhizome), Chuanshihu (Dendrobium Stem).
For Damp stagnation, use elimination; Chushi Tang (Eliminate Dampness Decoction), Pingwei San (Calm the Stomach Powder).
For Phlegm stagnation, use scouring/clearing; Runxia Wan (Moisten and Descend Pill), or Erchen Tang (Two Aged Ingredients Decoction) plus Haishi (Flint), Gualou (Trichosanthes Fruit), Beimu (Fritillaria Bulb), Zhuli (Bamboo Sap).
For Food stagnation, use digestion/resolution; Baohe Wan (Preserve Harmony Pill).
To treat all stagnations generally, use Yueju Wan (Surpass Stagnation Pill) or Liuyu Tang (Six Stagnations Decoction) modified.
For Yin-Yang congestion and failure of Qi to ascend/descend, use Chenxiang Jiangqi San (Agarwood Descending Qi Powder).
For women feeling a lump like roasted meat in the throat, neither spittable nor swallowable, use Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction).
For those whose hearts are not at ease, encounters are unsatisfactory, and resentment or longing accumulates in the mind without release, addressing various forms of depression requires tracing their origins for treatment. However, for illnesses caused by emotions, one should dispel them with reason and find peace with destiny. If one cannot relax their feelings and open their minds, leading to accumulated stagnation becoming consumption, herbal medicine will be powerless to save them. How could one rely on Helianthus (Hehuan, 合欢) to dismiss anger or Daylily (Xuancao, 萱草) to forget sorrow?
Zhu Danxi established Yueju Wan (Surpass Stagnation Pill) to treat Six Stagnations, using Xiangfu (Cyperus Rhizome) to regulate Qi, Chuanxiong (Ligusticum Rhizome) to harmonize Blood, Cangzhu (Atractylodes Rhizome) to remove Dampness, Shanzhi (Gardenia Fruit) to clear Fire, Shenqu (Medicated Leaven) to treat Food stagnation, and adding Beimu (Fritillaria Bulb) if Phlegm is present. The primary aim is to open stagnation and benefit Qi flow. He stated that Qi stagnation leads to Damp stagnation, Damp stagnation leads to Heat stagnation, Heat stagnation leads to Phlegm stagnation, Phlegm stagnation leads to Blood stagnation, and Blood stagnation leads to Food stagnation; they cause disease mutually.
Zhao Yangkui said: The East generates Wood, and Fire Qi attaches to it. Wood stagnation leads to Earth stagnation, Earth stagnation leads to Metal stagnation, and Metal stagnation leads to Water stagnation; this is the principle of mutual influence among the Five Phases. Using Xiaoyao San (Free Wanderer Powder) to treat Wood stagnation cures all other stagnations; for severe cases, add Zuojin Wan (Support Metal Pill) to the formula. Using Huanglian (Coptis Rhizome) to treat Heart Fire, and Wu Zhu Yu (Evodia Fruit) which has a fishy odor; the Liver's Qi also has a fishy odor. Like attracts like, supporting Metal to control Wood; this is why it is named "Supporting Metal." Subsequently, using Liuwei Wan (Six Ingredients Pill) plus Chaihu (Bupleurum Root) and Baishao (White Peony Root) to nourish Water to generate Wood. When Wood and Fire stagnation are relieved, Earth becomes moistened, and Metal and Water generate each other.