十药神书。专医虚损失血。用保和汤亦佳。润肺利气。平燥解郁。前方清纯。此方活动。随宜取用。血自安静
而不动矣。有因肝经风火。鼓动煽炽。而血不能静者。则见口苦咽干。目眩耳鸣。胁痛逆气。躁怒决裂。骨蒸
妄梦。以逍遥散平剂和之。审系肝经风气鼓动。而血不宁者。再加桑寄生僵蚕玉竹枣仁牡蛎青蒿。此从
仲景白头翁汤得来。仲景治产后血痢。取白头翁平木息风。盖肝为藏血之脏。风气散而不藏。则必平之
使安。而从血乃得安也。又或肝火偏胜。横决而不可遏。致令血不能藏者。则宜加阿胶山栀胆草胡黄连
蒌仁牛膝青皮牡蛎。当归芦荟丸。尤破泻肝火之重剂。但不如逍遥散加减之稳。又有冲气上逆。其证颈
赤头晕。火逆上气。咽喉不利。乳下动脉。辟辟弹指。颈上动脉。现出皮肤。冲脉原不上头项。咽干者。以冲为
血海属肝。因肝脉而达于咽也。颈脉动面赤色者。以冲脉丽于阳明。冲气逆。则阳明之气。随逆故也。内经
谓冲为气街。又谓冲为血海。气逆血升。此血证之一大关键也。故仲景治血以治冲为要。麦门冬汤主之。
陈修园谓去粳米。加白蜜。尤能滋补其阴。予谓治冲脉独取阳明。促景既引其端。后人亦即当扩而充之。
审其冲阳太旺者。知母枳壳白芍 石膏。均可加入。以清折之。栀子黄芩木通蒌仁牛膝。利阳明之水者。
尤可加入。以分消之。此冲脉之气。上合阳明之治法也。然冲为气街。气根于肾。血海即丹田。肾气之所藏
也。若冲脉挟肾中虚阳。上逆喘急者。宜用四磨汤。调纳逆气。是仲景桂苓甘草五味汤意。但仲景用桂枝
化膀胱之寒水。谓气从少腹。上冲咽喉。面热如醉。或热流于两股。或小便难而昏冒。忽上忽下。如电光之
闪灼无定。乃阴盛格阳。而阳气飞越。故以辛温化之。今系失血。阴气既伤。再用桂枝。岂不犯阳盛则毙之
戒。故用沉香代桂。以纳浮阳。而即用人参以滋阴。沉香直走下焦。乌药治膀胱肾间之气。冲为血海。居膀
胱肾间之地。治阳明者。治其末。治膀胱肾间者。是治其本也。若肾中阴气大虚。而冲阳不能安宅。则用四
磨汤。加熟地枣皮山药五味枸杞子。滋阴配阳以安之。若其人素有水饮。格阳于上。因而动血者。仲景桂
苓甘草五味汤。又为对证。第其方。与血证本不相关。可加当归白芍丹皮阿胶。或用苏子降气汤。利痰降
气。以靖冲逆。或用小柴胡汤。加龙骨牡蛎。以导冲逆。桂苓苏子汤。是治痰饮以治冲之法。小柴胡。又是清
火以治冲之法。本方治热入血室。血室者。肝之所司也。冲脉起于血室。故又属肝。治肝即是治冲。血室。在
男子为丹田。在女子为子宫。其根系于右肾。肾中真阳寄于胞中。为生气之根。乃阴中之阳。肝木得之。发
育条达。是为相火。其火如不归根。即为雷龙之火。龙骨牡蛎。乃阳物而能蛰藏。取其同气。以潜伏阳气。此
尤治冲脉。更进一层之法。合小柴胡。大有清敛相火之功。若肾经阴虚。阳无所附。雷龙之火上腾者。用二
加龙骨汤。加阿胶麦冬五味。以引归其宅亦妙。肾气丸。麦味地黄汤。皆可酌用。二方。一以温药化气。一以
阴药滋降。肾居冲脉之下。又为冲脉之根。安肾气。即是安冲气。冲气安而血海宁。自不至于潮上矣。总而
论之。血之所以不安者。皆由气之不安故也。宁气即是宁血。以上所论各气治法。亦云详备。在临证者细
审处之。
四补血。邪之所辏。其正必虚。不独补法是顾虚。即止血消瘀。用攻治法。亦恐其久而致虚。故亟攻之。使邪
速去。以免其致虚耳。但彼时虽恐其虚。而犹未大虚。故以去邪为急。若延日已久。未有不虚怯者。即血既
循经。一如平人。而前次所吐之血。已属有去无回。其经脉脏腑。又系血所走泄之路。非用封补滋养之法。
乌能完全。补法不一。先以补肺胃为要。肺为华盖。外主皮毛。内主制节。肺虚则津液枯竭。喘嗽痿燥诸证
作焉。因其制节不得下行。故气上而血亦上。未有吐血。而不伤肺气者也。故初吐必治肺。已止。尤先要补
肺。用辛字润肺膏。滋补肺中阴液。肺既津润。则其叶下垂。气泽因之得以下降。利膀胱。传大肠。诸窍通调。
五脏受益。如肺叶枯焦。不能覆下。则翘举而气亦上逆。不得卧息。外应皮毛不荣。下则二便不调。足痿肠
燥。百病俱生。惟此膏润津。为痿燥良剂。近人黄坤载。所立地魄汤。补土生金。补金生水。于补肺之法颇得。
平时代茶。可用生脉散。黄 糯米汤。加阿胶麦冬。尤能充补肺脏。凡此皆滋补肺阴。为失血必有之证治
也。而陈修园谓血虽阴类。运以阳和。心肺之阳一宣。如日月一出。爝火无光。诸般邪热俱除。血自不扰。而
循经矣。故又有温补肺阳之法。用保元汤。甘温除大热。使肺阳布 。阴翳自消。设有痰饮咳嗽者。加五味
杏仁。或用六君汤。加炮姜五味。内经云。形寒饮冷则伤肺。上二方。为形寒者立补肺之法。凡阳虚生外寒。
及浊阴干上焦者。用以扶肺之阳。洵属良剂。然失血之人。多是阴虚。若执甘温除大热之说。妄投此等药
料。鲜不致误。故年来从修园法者。能医杂证。而不能医虚痨。以其偏于补阳故也。第以理论之。原有气不
摄血之义。故什百之中。亦有一二宜补阳者。因并列其方。使人参观。以尽其变。心为君火。主生血。血虚火
旺。虚烦不眠。怔忡健忘。淋遗秘结。神气不安。用天王补心丹。启肾之水。上交心火。火不上炎。则心得所养。
心经水火不相济者。以此补水宁心。若不关水虚。但由本脏之血虚火旺者。则但用养血清心之药而已。
朱砂安神丸。泻心火。补心血。并安心神。凡怔忡昏烦不寐之证。皆可治之。若心阳不收。汗出惊悸。以及心
火不下交于肾。而为梦遗溺赤等证者。随用上二方。再加龙骨牡蛎枣仁莲心浮麦等。以敛戢之。此为心
经血虚火旺之大法。其有心经火虚。不能生血。瘦削悸怯。六脉细弱。宜用人参养荣汤。补脾胃以补心。内
经云。中焦受气取汁。变化而赤是为血。是汤补心化血。以奉周身。名养荣者。专主以阳生阴。和畅荣血。凡
气血两虚。变见诸证。皆可服也。然女人血崩。及产后亡血过多。均以温补为主。因其血下泻。属于脱证故
也。至于吐血。乃血脉奋兴。上干阳分。是为逆证。宜温补者最少。然亦有阳不统阴。暴脱大吐。阴亡而阳亦
随亡者。温补又为要法。甚矣。医者辨证不可不详。而用药不可执一也。故近日从丹溪者。专用苦寒。从修
园者。专用温药。皆是一弊。脾主统血。营运上下。充周四体。且是后天。五脏皆受气于脾。故凡补剂。无不以
脾为主。思虑伤脾。不能摄血。健忘怔忡。惊悸盗汗。嗜卧少食。大便不调等证。归脾汤统治之。脾虚发热。加
丹皮炒栀。兼肺气燥者。加麦冬五味。胀满而水谷不健运者。加陈皮煨姜。或加阿胶以滋血。或加柴胡贝
母以解郁。或加鱼胶以固血。独于熟地不可加入。以碍其统摄营运之用。盖此乃以阳生阴。以气统血之
总方。不似四物六味。以阴益阴也。且脾与肝肾。滋阴之法。亦各不同。若脾阴虚。脉数身热。咽痛声哑。慎柔
五书。用养真汤。煎去头煎。止服二三煎。取无味之功以补脾。为得滋养脾阴之秘法。杨西山专主甲己化
土汤。亦颇简当。而人参花粉。尤滋生津液之要药。世但知砂半姜蔻。为扶脾进食之要药。不知脾阳不足。
不能熏化水谷者。砂半姜蔻。自系要药。若脾阴不足。津液不能融化水谷者。则人参花粉。又为要药。试观
回食病。水谷不下。由于胃津干枯。则知津液。尤是融化水谷之本。近日西洋医法书传中国。与内经之旨。
多有 牾。实则内经多言其神化。西洋多滞于形迹。以内经之旨通观之。神化可以该形迹。然西人逐迹
细求。未尝无一二通于神化者也。内经之旨。谓脾主消磨水谷。肝胆之气。寄在胃中。以疏泄水谷。西医则
云。谷入于胃。有甜肉汁。来注以化之。又苦胆汁注于小肠以化之。与胃津合并。化其谷食。内经所言。化谷
以气。西医所言。化谷以汁。有此气。自有此汁。今人读内经。不知经文举精以该粗。竟至得用而遗体。反不
若西医逐迹以求。尚知谷食之化。在于汁液也。但西医有此论。而用药不经。不足为训。吾于滋胃汁。每用
甘露饮。清燥养荣汤。叶氏养胃汤。滋脾汁。用人参固本汤。炙甘草汤。去桂枝。加白芍。滋胆汁。用小柴胡汤。
去半夏加花粉。生津化谷。以折衷中西之医法。而为补养脾阴要义。知此。庶可补李东垣脾胃论之所不
足。若果脾阳不旺。不能磨化水谷者。则用六君子。加香砂以燥之。如欲专意填补。则仲景小建中汤。尤胜。
补阳致阴。为虚痨圣方。今即不能恪遵。但得其意。则于归脾六君补中益气诸方。可以变化神奇。用收广
效。归脾汤。从建中汤重浊处用意。补中汤。从建中汤轻清处用意。第此方。桂枝阳燥。于血证有宜不宜。用
者审之。如命门真火。不能生土。吐利厥冷。阴火上冲。头面赤色。恶心逆满。用正元丹温补少火。而又无壮
火食气之虞。是能得小建中之遗意者也。葛可久白凤膏。化平胃散之燥。变为柔和。又用酒送。取五谷之
精。合诸药以养脾胃。治饮食不进。发热劳倦。和血顺气。功效最大。肝为藏血之脏。血所以营运周身者。赖
冲任带三脉以管领之。而血海胞中。又血所转输归宿之所。肝则司主血海。冲任带三脉。又肝所属。故补
血者。总以补肝为要。李时珍谓肝无补法。盖恐木盛侮土。故为此论。不知木之所以克土者。肝血虚。则火
扰胃中。肝气虚。则水泛脾经。其侮土也如是。非真肝经之气血有余也。且世上虚痨。多是肝虚。此理自东
垣脾胃论后。少有知者。肝血虚。则虚烦不眠。骨蒸梦遗。宜四物汤。加枣仁知母云苓柴胡阿胶牡蛎甘草。
敛戢肝魂。滋养肝血。清热除烦。为肝经阴虚滋补之法。又有肝经气虚。脏寒魂怯。精神耗散。桂甘龙牡汤。
以敛助肝阳。阳虚遗精。惊悸等证宜之。独与失血未尽合宜。以其纯用气分药故也。仁熟散。用血分药较
多。温润养肝血。功与炙甘草汤相近。若肝之血不畅和。亦可用滑氏补肝散。以酸味补肝体。以辛味补肝
用。妙独活一味。借风药以张其气。若去独活。加桑寄生。则又有宁息风气之妙。方意实从逍遥散套出。但
此方气味浓。俱纯于补肝。逍遥散气味较薄。故纯于和肝。凡肝有郁火。胸胁刺痛。头眩心悸。颊赤口苦。寒
热盗汗。少食嗜卧。无不治之。又有肝经血脉大损。虚悸脉代者。法宜大生其血。宜仲景炙甘草汤。大补中
焦。受气取汁。并借桂枝入心。化赤为血。使归于肝。以充百脉。为补血第一方。世医补血。而不得血之化源。
虽用归地千石无益。果参透此旨。则归脾汤之用远志枣仁。是入心理血之源也。逍遥散之用丹栀。是入
心清血之源也。从此一隅三反。自有许多妙用。肾为水脏。上济君火。则水火既济。上交肺金。则水天一气。
水升火降。不相射而相济。安有不戢自焚之患。设水阴之气虚。而火热之气亢。喘咳蒸灼。痰血痨瘵均作
矣。凡人后天之病。久则及于先天。寇深矣。若之何。凡治虚者。不可以不早也。地黄汤主之。补肾之阴。而兼
退热利水。退热则阴益生。利水则阴益畅。盖膀胱化气。有形之水气下泄。则无形之水阴。如露上腾而四
布矣。以济君火。则加枸杞元参。以输肺金。则加生脉散。火甚者再加黄柏知母。如小便清和。无痰气者。只
须专意滋肾。左归饮多服为佳。回龙汤滋阴降火。同气相求。视无情草木尤胜。如阴虚火旺。足痿筋焦。骨
蒸头晕。用丹溪大补阴丸。滋阴潜阳。以苦寒培生气。较地黄汤更优。以上补肾阴法。又有宜补肾阳者。肾
为水脏。而内含阳气。是为命火。此火上泛。则为雷龙之火。下敛则为元阳之气。引雷龙之火以归根。则无
上热下寒。头晕腰痛。肿喘癃闭之证。用肾气丸。从阴化阳。补火济水以治之。再加牛膝车前。或黄柏知母。
更能利水折火。如不须化水。但须补阳者。则用黄 天魂汤。是从仲景附子汤套出。虽不及附子汤力量
之浓。较附子汤药尤纯和。血家忌刚燥。间有宜补元阳者。亦以此等为佳。夫肾中之阳。达于肝。则木温而
血和。达于脾。则土敦而谷化。筋骨强健。手足不清冷。卫气固。不恶寒。皆肾阳足故也。然肾水赖阳以化。而
肾阳又赖水封之。此理不可偏废。补肾者所宜细求。以上所论补法。轻重进退。各有法度。非如张景岳辈。
多集补药而已也。总而论之。血证属虚痨门。固宜滋补。第恐瘀邪未清。骤用补法。则实以留邪为患。而正
气反不受益。历见干血痨瘵等证。皆系医人横用滋补。以致旧血不去。新血不生。不知旧血。客于经络脏
腑之间。如木之有蛀。不急去之。非木死。其蛀不止也。故仲景治干血。用大黄 虫丸。夫既成虚痨之证。而
《十药神书》专门治疗虚损导致的失血，使用保和汤效果也很好。它能润肺、利气、平燥、解郁。前面的方子性质清纯，这个方子性质灵动，应根据具体情况选择使用，血液自然就能安静而不妄行。如果是由于肝经的风火鼓动煽炽，导致血液不能安静的，就会见到口苦咽干、目眩耳鸣、胁痛、气逆、烦躁易怒、骨蒸盗汗、梦遗等症状，用逍遥散平和地调和它。如果确认为是肝经风气鼓动导致血液不宁的，再加桑寄生、僵蚕、玉竹、酸枣仁、牡蛎、青蒿。这是从张仲景的白头翁汤化裁而来。张仲景治疗产后血痢，取白头翁来平抑肝木、平息内风。因为肝是藏血的脏器，风气散乱则血不能藏，所以必须平抑风气使其安宁，血液才能安定。又或者肝火偏盛，横决而不可遏制，导致血液不能收藏的，就适宜加入阿胶、山栀、龙胆草、胡黄连、瓜蒌仁、牛膝、青皮、牡蛎。当归芦荟丸更是破泻肝火的重剂，但不如加减逍遥散稳妥。又有冲脉之气上逆，其症状表现为颈部发红、头晕、火气上逆、咽喉不利、乳下动脉搏动明显（辟辟弹指）、颈上动脉在皮肤下显现。冲脉原本不上达头项，咽喉干燥是因为冲脉为血海属肝，通过肝脉到达咽喉。颈部脉搏跳动且面色赤红，是因为冲脉依附于阳明经，冲气上逆，阳明之气随之上逆。《内经》说冲脉是气街，又说冲脉是血海，气逆血升，这是血证的一个关键所在。所以张仲景治疗血证以调理冲脉为要务，用麦门冬汤主治。陈修园认为去掉粳米，加入白蜜，更能滋补阴液。我认为治疗冲脉应独取阳明经，张仲景已经开了个头，后人应当扩展充实。如果审察到冲阳脉太旺的，知母、枳壳、白芍、石膏都可以加入，以清折火势。栀子、黄芩、木通、瓜蒌仁、牛膝，这些能利阳明之水分的药物，尤其可以加入，以分消火热。这是调理冲脉之气上合阳明经的方法。然而冲脉是气街，气根源于肾，血海即丹田，是肾气所藏之处。如果冲脉挟带肾中虚阳上逆，出现喘急，适宜用四磨汤调纳逆气，这是张仲景桂苓甘草五味汤的意思。但张仲景用桂枝来化解膀胱的寒水，针对的是气从少腹上冲咽喉，面部发热如醉，或热流于两腿，或小便困难而昏冒，忽上忽下，如电光闪烁不定，这是阴盛格阳，阳气飞越，所以用辛温药来化解它。现在是失血之证，阴气已经受伤，再用桂枝，难道不违背“阳盛则毙”的戒律吗？所以用沉香代替桂枝，以收纳浮越之阳，同时用人参来滋阴。沉香直走下焦，乌药治疗膀胱肾间之气。冲脉位于膀胱肾之间，治阳明经是治其末，治膀胱肾间是治其本。如果肾中阴气大虚，导致冲阳不能安宅，就用四磨汤加熟地黄、山茱萸、山药、五味子、枸杞子，滋阴配阳以安定它。如果其人素有水饮，格拒阳气于上，因而动血，张仲景的桂苓甘草五味汤又是对证的。只是那个方子与血证本不相关，可加入当归、白芍、丹皮、阿胶，或者用苏子降气汤，利痰降气，以平定冲逆。或者用小柴胡汤加龙骨、牡蛎，以导引冲逆。桂苓苏子汤，是治痰饮以治冲的方法；小柴胡汤，又是清火以治冲的方法。本方治疗热入血室，血室由肝所主管，冲脉起于血室，所以也属于肝。治肝即是治冲。血室，在男子称为丹田，在女子称为子宫，其根系于右肾，肾中真阳寄居在胞中，是生气的根本，属于阴中之阳。肝木得到它，发育条达，这就是相火。如果这火不能归根，就成为雷龙之火。龙骨、牡蛎是阳物却能蛰伏潜藏，取其同类之气，以潜伏阳气。这更是治疗冲脉进一层的法子。配合小柴胡汤，大有清敛相火的功效。如果肾经阴虚，阳气无所依附，雷龙之火上腾，用二加龙骨汤加阿胶、麦冬、五味子，以引导阳气回归其宅，也很妙。肾气丸、麦味地黄汤，都可以酌情使用。这两个方子，一个用温药化气，一个用阴药滋降。肾位于冲脉之下，又是冲脉的根本，安固肾气就是安固冲气。冲气安定而血海安宁，自然就不会潮涌上逆了。总而言之，血液之所以不安，都是因为气不安的缘故。宁气就是宁血。以上所论述的各种气治法，也算详细完备了，临证时要仔细审察处理。
第四种补血法：邪气聚集的地方，正气必然虚弱。不仅仅是补法是为了顾护虚损，即使是止血消瘀，使用攻治法，也担心日久导致虚弱，所以急于攻邪，使邪气速去，以免导致虚弱。但是那时虽然担心虚损，但还没有严重到极度虚弱，所以以祛除邪气为急务。如果拖延日子久了，没有不变得虚怯的。即使血液现在循经而行，像正常人一样，但之前吐出的血，已经是有去无回。经脉脏腑，又是血液流失的路径，不用封补滋养的方法，怎么能完全恢复？补法有多种，先以补肺胃为要。肺为华盖，外主皮毛，内主制节。肺虚则津液枯竭，喘嗽、痿证、燥证等各种病症发作。因为它的制节功能不能下行，所以气上逆而血也上逆。没有吐血而不伤肺气的人。所以初吐时必治肺，已止后，尤其要先补肺。用辛字润肺膏，滋补肺中阴液。肺既滋润，则其叶下垂，气泽因此得以下降，通利膀胱，传导大肠，诸窍通调，五脏受益。如果肺叶枯焦，不能覆盖下方，则翘举而上逆，不得卧息，外应皮毛不荣，下则二便不调，足痿肠燥，百病俱生。只有这种膏润津，是痿燥的良剂。近代人黄坤载所立的地魄汤，补土生金，补金生水，在补肺之法上颇有心得。平时代茶饮用，可用生脉散、黄芪糯米汤，加阿胶、麦冬，更能充补肺脏。凡此皆是滋补肺阴，是失血必定有的证治方法。而陈修园认为血虽属阴类，需以阳和运化，心肺之阳一旦宣通，如日月一出，小火无光，各种邪热俱除，血自然不扰而循经。所以又有温补肺阳的方法，用保元汤，甘温除大热，使肺阳布散，阴翳自消。如果有痰饮咳嗽的，加五味子、杏仁，或者用六君汤加炮姜、五味子。《内经》说，形寒饮冷则伤肺，上述两个方子，是为形寒者设立补肺之法。凡是阳虚生外寒，及浊阴干扰上焦的，用以扶助肺之阳，确实是良剂。然而失血之人，多是阴虚，如果执着于甘温除大热的说法，妄投此类药物，很少不致误诊的。所以近年来遵循修园法的人，能医杂证，而不能医虚劳，因为其偏于补阳的缘故。但从理论上来讲，原有气不摄血的意义，所以百个之中，也有一二个宜补阳的，因此并列其方，让人参考观摩，以穷尽其变化。心为君火，主生血。血虚火旺，虚烦不眠，怔忡健忘，淋证遗精，秘结，神气不安，用天王补心丹，启肾之水，上交心火，火不上炎，则心得所养。心经水火不相济的，以此补水宁心。如果不关水虚，仅由本脏之血虚火旺的，则只用养血清心之药而已。朱砂安神丸，泻心火，补心血，并安心神。凡是怔忡、昏烦、不寐的证候，都可治疗。如果心阳不收，汗出惊悸，以及心火不下交于肾，而为梦遗、溺赤等证，随用上二方，再加龙骨、牡蛎、枣仁、莲心、浮小麦等，以收敛它。这是心经血虚火旺的大法。有心经火虚，不能生血，身体瘦削、心悸胆怯、六脉细弱的，适宜用人参养荣汤，补脾胃以补心。《内经》说，中焦受气取汁，变化而赤是为血，此汤补心化血，以奉养周身，名为养荣，专主以阳生阴，和畅荣血。凡是气血两虚，变见各种证候，皆可服用。然而女人血崩，及产后亡血过多，均以温补为主，因其血下泻，属于脱证缘故。至于吐血，乃血脉奋兴，上干阳分，是为逆证，宜温补者最少。然而也有阳不统阴，暴脱大吐，阴亡而阳亦随亡的，温补又为要法。确实啊，医者辨证不可不详，而用药不可执一。所以近日跟随丹溪的人，专用苦寒；跟随修园的人，专用温药，都是一弊。脾主统血，营运上下，充周四体，且是后天之本，五脏皆受气于脾，所以凡补剂，无不以脾为主。思虑伤脾，不能摄血，出现健忘、怔忡、惊悸、盗汗、嗜卧、少食、大便不调等证，归脾汤统管治疗。脾虚发热，加丹皮、炒栀子；兼肺气燥的，加麦冬、五味子；胀满而水谷不健运的，加陈皮、煨姜。或加阿胶以滋血，或加柴胡、贝母以解郁，或加鱼胶以固血。唯独不可加入熟地黄，以免碍其统摄营运之用。因为这乃是“以阳生阴，以气统血”的总方，不像四物汤、六味地黄丸那样以阴益阴。而且脾与肝肾，滋阴之法，也各不相同。若脾阴虚，脉数身热，咽痛声哑，《慎柔五书》用养真汤，煎煮时去掉头煎，只服二三煎，取无味之功以补脾，这是得滋养脾阴的秘法。杨西山专主甲己化土汤，也颇简当，而人参、花粉，尤是滋生津液的要药。世人只知道砂仁、半夏、干姜、豆蔻，是扶脾进食的要药，不知道脾阳不足，不能熏化水谷的，砂仁、半夏、干姜、豆蔻，自系要药。若脾阴不足，津液不能融化水谷的，则人参、花粉，又为要药。试看回食病，水谷不下，由于胃津干枯，则知津液，尤是融化水谷之本。近日西洋医法书传入中国，与《内经》的宗旨，多有抵触，实则《内经》多言其神化，西洋医学多滞于形迹。以《内经》的宗旨通观之，神化可以涵盖形迹，然而西人逐迹细求，未尝无一二通于神化的地方。《内经》的宗旨，谓脾主消磨水谷，肝胆之气，寄在胃中，以疏泄水谷。西医则云，谷入于胃，有甜肉汁（胰液），来注以化之，又苦胆汁注于小肠以化之，与胃津合并，化其谷食。《内经》所言，化谷以气，西医所言，化谷以汁。有此气，自有此汁。今人读《内经》，不知经文举精以该粗，竟至得用而遗体，反不如西医逐迹以求，尚知谷食之化，在于汁液也。但西医有此论，而用药不经，不足为训。我在滋胃汁方面，每用甘露饮、清燥养荣汤、叶氏养胃汤；滋脾汁，用人参固本汤、炙甘草汤去桂枝加白芍；滋胆汁，用小柴胡汤去半夏加花粉，生津化谷，以折衷中西之医法，而为补养脾阴要义。知晓此理，庶可弥补李东垣《脾胃论》之所不足。如果果真是脾阳不旺，不能磨化水谷的，则用六君子汤加香附、砂仁以燥之。如欲专意填补，则张仲景的小建中汤尤为上乘。补阳致阴，为虚劳圣方。如今即不能恪守遵循，但得其意，则对于归脾汤、六君汤、补中益气汤等方，可以变化神奇，用收广效。归脾汤，是从建中汤重浊处用意；补中益气汤，是从建中汤轻清处用意。只是此方中的桂枝性阳燥，对于血证有适宜有不适宜，使用者需审慎。如果命门真火不能生土，出现吐利、厥冷、阴火上冲、头面赤色、恶心逆满，用正元丹温补少火，而又无壮火食气的忧虑，是能得小建中汤遗意的人。葛可久的白凤膏，化平胃散的燥，变为柔和，又用酒送服，取五谷之精，合诸药以养脾胃，治饮食不进、发热劳倦，和血顺气，功效最大。肝为藏血之脏，血所以营运周身者，赖冲任带三脉以管领之，而血海胞中，又是血所转输归宿之所。肝则司主血海，冲任带三脉，又属肝所主，所以补血者，总以补肝为要。李时珍谓肝无补法，大概是恐怕木盛侮土，故为此论。不知木之所以克土者，肝血虚，则火扰胃中；肝气虚，则水泛脾经，其侮土也如是，并非真肝经的气血有余。且世上虚劳，多是肝虚，此理自东垣《脾胃论》后，少有知道的人。肝血虚，则虚烦不眠、骨蒸梦遗，适宜四物汤加酸枣仁、知母、茯苓、柴胡、阿胶、牡蛎、甘草，敛戢肝魂，滋养肝血，清热除烦，为肝经阴虚滋补之法。又有肝经气虚，脏寒魂怯，精神耗散，桂甘龙牡汤，以敛助肝阳，阳虚遗精、惊悸等证适宜。唯独与失血未尽合宜，因为其纯用气分药缘故。仁熟散，用血分药较多，温润养肝血，功与炙甘草汤相近。如果肝之血不畅和，也可用滑伯仁的补肝散，以酸味补肝体，以辛味补肝用，妙在独活一味，借风药以张其气。如果去掉独活，加桑寄生，则又有宁息风气的妙处。方意实从逍遥散套出，但这个方气味浓，俱纯于补肝；逍遥散气味较薄，故纯于和肝。凡肝有郁火，胸胁刺痛、头眩心悸、颊赤口苦、寒热盗汗、少食嗜卧，无不治之。又有肝经血脉大损，虚悸脉代的，法宜大生其血，适宜张仲景的炙甘草汤，大补中焦，受气取汁，并借桂枝入心，化赤为血，使归于肝，以充百脉，为补血第一方。世医补血，而不得血之化源，虽用归地千石无益。果能参透此旨，则归脾汤之用远志、枣仁，是入心理血之源；逍遥散之用丹皮、栀子，是入心清血之源。从此一隅三反，自有许多妙用。肾为水脏，上济君火，则水火既济；上交肺金，则水天一气。水升火降，不相射而相济，安有不戢自焚之患？设若水阴之气虚，而火热之气亢，喘咳蒸灼、痰血痨瘵均作矣。凡人后天之病，久则及于先天，寇深矣，如何是好？凡治虚者，不可以不早也。地黄汤主治，补肾之阴，而兼退热利水。退热则阴益生，利水则阴益畅。盖膀胱化气，有形之水气下泄，则无形之水阴，如露上腾而四布矣，以济君火，则加枸杞、元参；以输肺金，则加生脉散；火甚者再加黄柏、知母。如小便清和，无痰气的，只须专意滋肾，左归饮多服为佳。回龙汤滋阴降火，同气相求，视无情草木尤胜。如阴虚火旺，足痿筋焦，骨蒸头晕，用丹溪大补阴丸，滋阴潜阳，以苦寒培生气，较地黄汤更优。以上补肾阴法，又有宜补肾阳者。肾为水脏，而内含阳气，是为命火。此火上泛，则为雷龙之火；下敛则为元阳之气。引雷龙之火以归根，则无上热下寒、头晕腰痛、肿喘癃闭之证，用肾气丸，从阴化阳，补火济水以治之。再加牛膝、车前，或黄柏、知母，更能利水折火。如不须化水，但须补阳的，则用黄芪天魂汤，是从张仲景附子汤套出，虽不及附子汤力量之浓，较附子汤药尤纯和。血家忌刚燥，间有宜补元阳的，也以此等为佳。夫肾中之阳，达于肝，则木温而血和；达于脾，则土敦而谷化。筋骨强健，手足不清冷，卫气固，不恶寒，皆肾阳足故也。然肾水赖阳以化，而肾阳又赖水封之，此理不可偏废，补肾者所宜细求。以上所论补法，轻重进退，各有法度，非如张景岳辈，多集补药而已也。总而言之，血证属虚劳门，固宜滋补，第恐瘀邪未清，骤用补法，则实以留邪为患，而正气反不受益。历见干血痨瘵等证，皆系医人横用滋补，以致旧血不去，新血不生。不知旧血，客于经络脏腑之间，如木之有蛀，不急去之，非木死，其蛀不止也。所以张仲景治干血，用大黄䗪虫丸。夫既成虚劳之证，而……
*Shiyao Shenshu* (Divine Book of Ten Medicines) specializes in treating deficiency-induced hemorrhage; using *Baohe Tang* (Preserve Harmony Decoction) is also excellent. It moistens the lungs, promotes qi circulation, relieves dryness, and resolves stagnation. The preceding formula is pure in nature, while this one is dynamic; choose according to circumstances, and the blood will naturally settle and cease erratic movement. If the blood cannot remain quiet due to wind-fire stirring and blazing in the Liver channel, symptoms such as bitter taste in the mouth, dry throat, vertigo, tinnitus, hypochondriac pain, rebellious qi, irritability, bone-steaming fever, and nocturnal emissions may appear. In such cases, harmonize with *Xiaoyao San* (Free and Easy Wanderer Powder). If it is confirmed that wind qi in the Liver channel is stirring and causing blood unrest, add Sangjisheng (Taxilli Herba), Jiangcan (Bombyx Batryticatus), Yuzhu (Polygonati Odorati Rhizoma), Zaoren (Ziziphi Spinosae Semen), Muli (Concha Ostreae), and Qinghao (Artemisiae Annuae Herba). This approach is derived from Zhang Zhongjing's *Baitouweng Tang* (Pulsatilla Decoction). Zhang Zhongjing treated postpartum bloody dysentery by employing Baitouweng (Pulsatillae Radix) to calm the Wood element and extinguish internal wind. Since the Liver is the organ that stores blood, when wind qi scatters and blood fails to be stored, it is necessary to pacify the wind to ensure tranquility, thereby allowing the blood to rest. Alternatively, if Liver fire is excessively strong, surging uncontrollably and preventing blood storage, it is appropriate to add Ejiao (Colla Corii Asini), Shanzhi (Gardeniae Fructus), Dancao (Genkwanatis Radix), Huhuanglian (Coptidis Rhizoma var. chinensis or Coptidis Rhizoma), Louren (Trichosanthis Fructus), Niuxi (Achyranthis Bidentatae Radix), Qingpi (Citri Reticulatae Pericarpium Viride), and Muli (Concha Ostreae). *Danggui Luyuan Wan* (Angelica and Wormwood Pill) is a heavy agent for breaking down and draining Liver fire, but it is not as stable as modified *Xiaoyao San*. Furthermore, if Chong Mai (Penetrating Vessel) qi rebels upward, symptoms include redness of the neck, dizziness, rebellious fire qi, difficulty in the throat, palpable pulsation under the breasts (described as "pipi" snapping fingers), and visible arteries on the neck. The Chong Mai originally does not ascend to the head and neck; dryness of the throat occurs because the Chong Mai, as the Sea of Blood belonging to the Liver, reaches the throat via the Liver channel. Neck pulse throbbing with facial redness occurs because the Chong Mai attaches to the Yangming channel; when Chong qi rebels, Yangming qi follows suit. The *Neijing* states that the Chong Mai is the "Street of Qi" and also the "Sea of Blood." Rebellious qi and ascending blood constitute a critical key point in blood disorders. Therefore, Zhang Zhongjing emphasized regulating the Chong Mai as essential in treating blood disorders, primarily using *Maimendong Tang* (Ophiopogon Decoction). Chen Xiuyuan suggested removing Jingmi (Oryzae Fructus Glutinosus) and adding Baimi (Mel) to better nourish yin. I believe that treating the Chong Mai requires focusing exclusively on the Yangming channel. Zhang Zhongjing initiated this approach, and later scholars should expand upon it. If the Chongyang pulse is excessively vigorous, Zhimu (Anemarrhenae Rhizoma), Zhike (Aurantii Fructus Immaturus), Baishao (Paeoniae Radix Alba), and Shigao (Gypsum Fibrosum) can be added to clear and subdue the pathogenic factor. Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Mutong (Akebiae Caulis), Louren (Trichosanthis Fructus), and Niuxi (Achyranthis Bidentatae Radix), which promote the flow of fluids in the Yangming channel, are particularly suitable for addition to dissipate heat. This constitutes the method of treating Chong Mai qi that merges with the Yangming channel. However, the Chong Mai is the Street of Qi, and Qi originates from the Kidney; the Sea of Blood is the Dantian, where Kidney qi resides. If the Chong Mai carries deficient yang from the Kidney upward, causing wheezing and urgency, *Simotu Tang* (Four-Ingredient Decoction) should be used to regulate and descend rebellious qi, reflecting the intent of Zhang Zhongjing's *Guiling Gancao Wuwei Tang* (Cinnamon Twig, Poria, Licorice, and Schisandra Decoction). However, Zhang Zhongjing used Guizhi (Cinnamomi Ramulus) to transform cold water in the Bladder, addressing conditions where qi rushes from the lower abdomen up to the throat, with a face hot as if intoxicated, or heat flowing into the thighs, or difficult urination accompanied by dizziness, fluctuating suddenly like flashing lightning. This represents Yin excess repelling Yang, with Yang flying away, thus requiring acrid-warm herbs to transform it. In cases of blood loss, Yin qi is already damaged; using Guizhi again would violate the warning against "Yang excess leading to death." Therefore, Chenxiang (Aquilariae Lignum Resinatum) is used instead of Guizhi to gather floating Yang, while Renshen (Ginseng Radix et Rhizoma) is used to nourish Yin. Chenxiang travels directly to the Lower Jiao, and Wuyao (Linderae Radix) treats qi in the region between the Bladder and Kidney. The Chong Mai resides in the area between the Bladder and Kidney; treating the Yangming channel addresses the branch, while treating the Bladder-Kidney region addresses the root. If Kidney Yin is severely deficient, failing to anchor the Chong Yang, *Simotu Tang* should be supplemented with Shudi (Rehmanniae Radix Preparata), Shanzhuyu (Corni Fructus), Shanyao (Dioscoreae Rhizoma), Wuweizi (Schisandrae Chinensis Fructus), and Gouqi (Lycii Fructus) to nourish Yin and balance Yang for stability. If the patient has chronic fluid retention that repels Yang upward, triggering bleeding, Zhang Zhongjing's *Guiling Gancao Wuwei Tang* is indicated. Although this formula is not inherently related to blood disorders, Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Danpi (Moutan Cortex), and Ejiao (Colla Corii Asini) can be added. Alternatively, *Suzi Jiangqi Tang* (Perilla Seed Descending Qi Decoction) can be used to resolve phlegm and descend qi to calm Chong rebellion. Or, *Xiaochaihu Tang* (Minor Bupleurum Decoction) with Longgu (Fossilia Ossis Mastodi) and Muli (Concha Ostreae) can be employed to guide down Chong rebellion. *Guiling Suzi Tang* treats Chong rebellion by resolving phlegm-fluids; *Xiaochaihu Tang* treats it by clearing fire. This original formula treats Heat entering the Blood Chamber (Xueshi). The Blood Chamber is governed by the Liver, and since the Chong Mai originates from the Blood Chamber, it also belongs to the Liver. Treating the Liver is equivalent to treating the Chong Mai. In men, the Blood Chamber is called the Dantian; in women, it is the uterus. Its root connects to the Right Kidney, where the True Yang of the Kidney resides in the Baozhong (Uterus/Center), serving as the root of vital energy—Yin containing Yang. Liver Wood relies on this for growth and smooth development, constituting Minister Fire (Xianghuo). If this fire fails to return to its root, it becomes Thunder-Dragon Fire (Leilong zhi Huo). Longgu (Fossilia Ossis Mastodi) and Muli (Concha Ostreae) are Yang substances capable of hibernation and storing; their similar nature is utilized to submerge Yang qi. This is an advanced method for treating the Chong Mai. Combined with *Xiaochaihu Tang*, it effectively clears and astringes Minister Fire. If Kidney channel Yin deficiency leaves Yang without attachment, causing Thunder-Dragon Fire to ascend, *Erjia Longgu Tang* (Two-Added Dragon Bone Decoction) with Ejiao (Colla Corii Asini), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Chinensis Fructus) can guide the fire back to its residence. *Shenqi Wan* (Kidney Qi Pill) and *Maiwei Dihuang Tang* (Ophiopogon and Schisandra Rehmannia Decoction) can also be considered. One uses warm herbs to transform Qi, the other uses Yin-nourishing herbs to descend; both are viable. The Kidney lies below the Chong Mai and serves as its root; stabilizing Kidney Qi stabilizes Chong Qi. When Chong Qi is calm and the Sea of Blood is peaceful, chaotic upward surging will cease. In summary, blood instability arises from Qi instability. Calming Qi calms Blood. The aforementioned methods for treating various Qi aspects are comprehensive; clinicians must examine them carefully.
Fourth method: Nourishing Blood. Where pathogenic factors accumulate, Zheng Qi (Upright Qi) is inevitably deficient. Not only do tonification methods address deficiency, but even hemostatic and blood-resolving methods, which employ attacking strategies, risk causing prolonged deficiency. Thus, urgent attack is employed to rapidly eliminate pathogens and prevent subsequent deficiency. However, at that stage, although deficiency is a concern, it is not yet severe, so eliminating pathogens takes priority. If the condition persists, deficiency inevitably develops. Even if blood now flows normally along the channels like a healthy person, previously expelled blood is lost forever. The meridians and organs, being pathways for blood loss, require sealing, tonifying, and nourishing methods to fully recover. Tonification methods vary; prioritizing Lung and Stomach tonification is essential. The Lung is the "Canopy," governing skin and hair externally, and regulation internally. Lung deficiency leads to depletion of body fluids, causing wheezing, cough, flaccidity, and dryness. Because its regulatory function fails to descend, Qi and Blood rebel upward. No case of hematemesis fails to injure Lung Qi. Therefore, initial treatment must focus on the Lung, and after cessation, Lung tonification is paramount. Use *Xinzi Runfei Gao* (Acrid Moisten-Lung Paste) to nourish Lung Yin. Once the Lung is moist, its lobes hang downward, allowing Qi and moisture to descend, benefiting the Bladder, Large Intestine, orifices, and all five Zang organs. If Lung lobes are scorched and cannot cover downward, they rise, causing Qi rebellion, inability to lie flat, external dullness of skin/hair, and internal dysfunction of bowels/bladder, leg flaccidity, and intestinal dryness, leading to myriad diseases. This paste is an excellent remedy for flaccidity and dryness. Huang Kunzai's modern *Dipo Tang* (Earth Soul Decoction), which tonifies Earth to generate Metal and Metal to generate Water, aligns well with Lung tonification. For daily tea, *Shengmai San* (Generate Pulse Powder) or Astragalus glutinous rice soup with Ejiao (Colla Corii Asini) and Maidong (Ophiopogonis Radix) further nourishes the Lung. These methods nourish Lung Yin, addressing inevitable patterns in blood loss. Chen Xiuyuan argued that although Blood is Yin, it requires Yang harmony for movement. Once Heart and Lung Yang are dispersed, like the sun rising, minor fires lose brightness, and all pathogenic heat is eliminated, allowing Blood to follow channels calmly. Thus, warming and tonifying Lung Yang is another approach, using *Baoyuan Tang* (Protect Origin Decoction) to use sweet-warm properties to remove great heat, dispersing Lung Yang and消散阴翳 (dispersing Yin shadows). For phlegm-fluids and cough, add Wuweizi (Schisandrae Chinensis Fructus) and Xingren (Pruni Armeniaci Semen); or *Liujun Tang* (Six-Gentleman Decoction) with Paojiang (Prepared Ginger) and Wuweizi. The *Neijing* states, "Cold damaging the form and cold drinks injure the Lung." These two formulas address Lung tonification for cold damage. They aid Lung Yang in cases of Yang deficiency generating exterior cold or turbid Yin interfering with the Upper Jiao. However, blood-loss patients are mostly Yin deficient; blindly applying sweet-warm heat-clearing methods often leads to error. Hence, practitioners following Chen's method treat miscellaneous diseases well but fail in consumptive diseases due to bias toward Yang tonification. Theoretically, however, Qi failing to control Blood exists, so some cases benefit from Yang tonification. Both methods are presented for reference. The Heart governs Minister Fire and Blood generation. Blood deficiency with Fire hyperactivity causes vexation, insomnia, palpitations, forgetfulness, strangury, enuresis, constipation, and spiritual unrest. *Tianwang Buxin Dan* (Heavenly Emperor Heart-Nourishing Pill) draws Kidney Water to intersect with Heart Fire. If Fire does not flare, the Heart is nourished. For Heart channel Water-Fire imbalance, this formula nourishes Water to calm the Heart. If not due to Water deficiency but intrinsic Heart Blood deficiency with Fire hyperactivity, use Blood-nourishing and Heart-clearing herbs alone. *Zhusha Anshen Wan* (Cinnabar Calming Spirit Pill) drains Heart Fire, tonifies Heart Blood, and calms the Spirit, treating palpitations, confusion, and insomnia. For unrestrained Heart Yang with sweating and fright, or Heart Fire failing to descend to the Kidney causing nocturnal emission and dark urine, use the above formulas plus Longgu (Fossilia Ossis Mastodi), Muli (Concha Ostreae), Zaoren (Ziziphi Spinosae Semen), Lianxin (Nelumbinis Plumula), and Fumai (Tritici Caput) to astringe. This is the major principle for Heart Blood deficiency and Fire hyperactivity. For Heart Fire deficiency failing to generate Blood, presenting with emaciation, palpitations, timidity, and thin-weak pulses, *Renshen Yangrong Tang* (Ginseng Nourishing Glory Decoction) tonifies the Spleen and Stomach to nourish the Heart. The *Neijing* states, "The Middle Jiao receives Qi, extracts essence, transforms it red, and this is Blood." This formula generates Blood to nourish the body, named "Nourishing Glory" for using Yang to generate Yin and harmonizing Ying Blood. It suits all Qi-Blood dual deficiencies. Women with metrorrhagia or postpartum excessive blood loss require warm tonification due to collapse syndrome. Hematemesis, however, involves vigorous blood vessels rebelling into the Yang aspect, an adverse pattern rarely suited for warm tonification. Yet, in cases of Yang failing to control Yin, sudden massive bleeding with simultaneous Yin and Yang collapse, warm tonification is crucial. Physicians must differentiate carefully and avoid rigid prescribing. Modern followers of Danxi use only bitter-cold herbs; followers of Chen use only warm herbs—both are biased. The Spleen governs Blood containment and circulation throughout the body. As the Postnatal Root, all Zang organs receive Qi from the Spleen. Thus, all tonics prioritize the Spleen. Overthinking injures the Spleen, impairing Blood containment, causing forgetfulness, palpitations, night sweats, lethargy, poor appetite, and irregular bowels. *Guipi Tang* (Restore the Spleen Decoction) treats these. For Spleen deficiency fever, add Danpi (Moutan Cortex) and Chaozhizi (Stir-fried Gardeniae Fructus); for concurrent Lung dryness, add Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Chinensis Fructus); for distension and poor digestion, add Chenpi (Citri Reticulatae Pericarpium) and Weijiang (Roasted Ginger). Add Ejiao (Colla Corii Asini) to nourish Blood, Chaihu (Bupleuri Radix) and Beimu (Fritillariae Thunbergii Bulbus) to resolve stagnation, or Yujiao (Fish Maw) to secure Blood. Avoid Shudi (Rehmanniae Radix Preparata) as it hinders Spleen transport. This formula embodies "Yang generating Yin" and "Qi controlling Blood," unlike Siwu Tang or Liuwei Dihuang Tang which "Yin supporting Yin." Spleen, Liver, and Kidney Yin tonification differ. For Spleen Yin deficiency with rapid pulse, fever, sore throat, and hoarseness, *Shenrou Wushu* recommends *Yangzhen Tang* (Nourish Truth Decoction), discarding the first decoction and taking only the second and third to utilize flavorless properties for Spleen tonification—a secret method for nourishing Spleen Yin. Yang Xishan advocates *Jiaji Hutu Tang* (Wood-Earth Transforming Earth Decoction), simple and effective. Renshen (Ginseng Radix et Rhizoma) and Huafen (Trichosanthis Radix) are key for generating fluids. While people know Sharen (Amomi Fructus), Banxia (Pinelliae Rhizoma), Jiang (Zingiberis Rhizoma), and Kouren (Amomi Fructus) aid Spleen Yang and digestion, they are insufficient for Spleen Yin deficiency where fluids fail to transform food. Renshen and Huafen are then essential. Observing "returning food disease" (dysphagia due to dry stomach fluids) confirms fluids as the basis for transforming food. Western medicine texts contradict the *Neijing*, focusing on physical traces rather than spiritual transformation. The *Neijing* emphasizes spiritual transformation encompassing physical forms; Western medicine focuses on physical details, occasionally touching upon spiritual principles. The *Neijing* states the Spleen digests food, aided by Liver/Gallbladder Qi in the Stomach. Western medicine describes pancreatic juice and bile mixing with gastric juices. The *Neijing* says digestion relies on Qi; Western medicine says it relies on fluids. Having Qi implies having fluids. Modern readers of the *Neijing* miss the essence for the gross, whereas Westerners, though detailed, recognize fluid-based digestion. However, Western herbal applications are unorthodox. To moisten Stomach fluids, I use *Ganlu Yin* (Sweet Dew Drink), *Qingzao Yangrong Tang* (Clear Dryness Nourish Glory Decoction), and Ye Tianshi's *Yangwei Tang* (Nourish Stomach Decoction). To moisten Spleen fluids, *Renshen Guben Tang* (Ginseng Root-Securing Decoction) and *Gancao Tang* (Licorice Decoction) minus Guizhi plus Baishao. To moisten bile, *Xiaochaihu Tang* minus Banxia plus Huafen. This synthesizes Chinese and Western methods for Spleen Yin tonification, supplementing Li Dongyuan's *Piwei Lun*. For Spleen Yang deficiency failing to digest, use *Liujunzi Tang* (Six-Gentlemen Decoction) with Xiangsha (Aucklandiae and Amomi). For deep tonification, Zhang Zhongjing's *Xiao Jianzhong Tang* (Minor Construct the Middle Decoction) is superior, tonifying Yang to generate Yin. Though strict adherence may be impossible, understanding its principle allows flexible application of *Guipi Tang*, *Liujunzi Tang*, and *Buzhong Yiqi Tang*. *Guipi Tang* derives from the heavy/turbid aspect of *Jianzhong Tang*; *Buzhong Yiqi Tang* from its light/clear aspect. Note Guizhi's drying nature may be unsuitable for blood disorders. For Mingmen Fire failing to warm Earth, causing vomiting, diarrhea, cold limbs, flaming fire, red face, nausea, use *Zhengyuan Dan* (Correct Origin Pill) to warm mild fire without consuming Qi, echoing *Jianzhong Tang*. Ge Kejiu's *Baifeng Gao* (White Phoenix Paste) modifies *Pingwei San* to be gentle, taken with wine to combine grain essence with herbs, nourishing Spleen/Stomach, improving appetite, reducing fever/fatigue, harmonizing Blood/Qi. The Liver stores Blood; circulation relies on Chong, Ren, and Dai vessels. The Blood Sea and Baozhong are destinations for Blood. The Liver governs the Blood Sea and these vessels; thus, tonifying Blood prioritizes the Liver. Li Shizhen claimed "Liver has no tonification method" fearing Wood overacting on Earth. However, Wood overacts because Liver Blood deficiency causes Fire disturbing the Stomach, and Liver Qi deficiency causes Water flooding the Spleen—not due to Liver excess. Consumptive diseases are often Liver deficiency, overlooked since Li Dongyuan. Liver Blood deficiency causes vexation, insomnia, bone-steaming, emissions; treat with *Siwu Tang* plus Zaoren (Ziziphi Spinosae Semen), Zhimu (Anemarrhenae Rhizoma), Fuling (Poria), Chaihu (Bupleuri Radix), Ejiao (Colla Corii Asini), Muli (Concha Ostreae), Gancao (Glycyrrhizae Radix) to calm Liver Soul, nourish Blood, clear heat. Liver Qi deficiency with cold organs and fearful Soul requires *Guigan Longmu Tang* (Licorice, Cinnamon Twig, Dragon Bone, Oyster Shell Decoction) to support Liver Yang for emission/palpitations, though less suitable for active bleeding as it uses Qi-moving herbs. *Renshu San* (Ren and Shu Powder) uses more Blood herbs, warming/nourishing Liver Blood similarly to *Gancao Tang*. For stagnant Liver Blood, *Hushi Bu Gan San* (Master Hu's Liver-Tonifying Powder) uses sour to tonify Liver Substance and acrid to tonify Liver Function. Duohuo (Angelicae Pubescentis Radix) uses wind herbs to boost Qi; replacing it with Sangjisheng (Taxilli Herba) calms wind. Derived from *Xiaoyao San*, this formula is richer/heavier than *Xiaoyao San*'s lighter/harmonizing nature. It treats Liver depression-fire with chest/flank pain, dizziness, palpitations, red cheeks, bitter taste, chills/sweats, poor appetite. For severe Liver Blood vessel damage with weak/intermittent pulses, use Zhang Zhongjing's *Gancao Tang* (Licorice Decoction) to tonify Middle Jiao, extract essence, use Guizhi (Cinnamomi Ramulus) to enter Heart, transform red Blood, return to Liver, filling all vessels—the premier Blood-tonifying formula. Physicians failing to understand Blood generation sources waste resources. Understanding this, *Guipi Tang*'s Yuanzhi (Polygalae Radix) and Zaoren target Heart Blood source; *Xiaoyao San*'s Danpi and Zhizi clear Heart Blood source. From this, many applications arise. The Kidney is the Water Organ, assisting Minister Fire and communicating with Lung Metal. Water rises, Fire descends, avoiding self-burning. If Kidney Yin is deficient and Fire hyperactive, wheezing, steaming, hemoptysis, and consumption occur. Chronic acquired diseases eventually affect congenital roots; early treatment is vital. *Dihuang Tang* (Rehmannia Decoction) tonifies Kidney Yin, reduces heat, and promotes urination. Reducing heat generates Yin; promoting urination frees Yin. Bladder Qi transformation releases有形 water, allowing无形 Yin to rise like dew to nourish Minister Fire (add Gouqi (Lycii Fructus) and Yuanshen (Scrophulariae Radix)); to transmit to Lung (add *Shengmai San*); for severe fire, add Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma). If urine is clear without phlegm, focus solely on Kidney Yin; *Zuogui Yin* (Left Restoring Drink) is best. *Huilong Tang* (Return Dragon Decoction) nourishes Yin and descends fire via sympathetic resonance, surpassing crude herbs. For Yin deficiency with Fire hyperactivity, leg flaccidity, bone-steaming, use Danxi's *Dabu Yin Wan* (Great Tonify Yin Pill) to nourish Yin, submerge Yang, and cultivate vital Qi with bitter-cold herbs, superior to *Dihuang Tang*. Among Kidney Yin tonification methods, Kidney Yang tonification is also needed. The Kidney contains Yang, called Mingmen Fire. Ascending, it becomes Thunder-Dragon Fire; descending, it is Primordial Yang. Returning this fire prevents upper heat/lower cold, dizziness, back pain, edema, and urinary retention. Use *Shenqi Wan* (Kidney Qi Pill) to transform Yin into Yang, tonify Fire to assist Water. Add Niuxi (Achyranthis Bidentatae Radix) and Cheqian (Plantaginis Semen), or Huangbai/Zhimu, to drain water and subdue fire. If water transformation isn't needed but Yang tonification is, use *Huangqi Tianhun Tang* (Astragalus Heaven-Soul Decoction), derived from Zhang Zhongjing's *Fuzi Tang* (Aconite Decoction). Though milder than *Fuzi Tang*, it is purer. Blood patients avoid acrid-dry herbs; for rare Yang tonification needs, this is suitable. Kidney Yang reaching the Liver warms Wood and harmonizes Blood; reaching the Spleen solidifies Earth and aids digestion. Strong bones/joints, warm extremities, solid Wei Qi, and aversion to cold indicate sufficient Kidney Yang. However, Kidney Water relies on Yang for transformation, and Yang relies on Water for containment. Balance is key. The discussed tonification methods have precise gradations, unlike Zhang Jingyue's mere collection of tonics. In summary, blood disorders belong to consumptive categories, requiring tonification. However, if stasis/pathogens remain, premature tonification traps pathogens and harms Zheng Qi. Dry-blood consumption often results from physicians' indiscriminate tonification, preventing old blood removal and new blood generation. Old blood lodged in meridians/organs is like woodworms;若不急去 (if not removed urgently), the wood dies, and worms persist. Thus, Zhang Zhongjing used *Dahuang Zhechong Wan* (Rhubarb and Ground Beetle Pill) for dry blood. Once consumptive disease sets in...