《素问》脉要精微论曰∶脉风成为疠风。论曰∶风寒客于脉而不去，名曰疠风。疠风者，荣卫热
，其气不清，故使鼻柱坏而色败，皮肤疡溃。又谓风气与太阳俱入，行诸脉俞，散诸分肉之间，与
卫气相干，其道不利，故使肌肉 而有疡，卫气有所凝而不行，故其肉有不仁也。长刺节论曰∶大
风骨节重，须眉堕，名曰大风。刺肌肉为故，汗出百日。王注以泄卫气之怫热。刺骨髓，汗出百日。
王注∶以泄荣气之怫热。二百日，须眉生而止。《灵枢》曰∶疠风者，数刺其肿上，已刺，以锐
针针其处，按出其恶气，肿尽乃止。常食方食，毋食他食。今观经之论治，分荣卫者如此。若古方虽
多，但混泻其风热于荣卫，又无先后之分，至东垣、丹溪始分之。《活法机要》云∶先桦皮散，从少
至多，服五七日，灸承浆穴七壮，灸疮愈，再灸再愈，三灸之后，服二圣散泄热，祛血之风邪，戒房
室，三年病愈。此先治其卫、后治其荣也。《试效方》治段库使用补气泻荣汤，此治荣多于治卫也。
丹溪云∶须分在上在下，在上者以醉仙散，取臭恶血于齿缝中出，在下者以通天再造散，取恶物蛔虫
于谷道中出。所出虽有上下道路之异，然皆不外于阳明一经而已。看其疙瘩，上先见，在上体多者，
病在上也。下先见，在下体多者，病在下也。上下同得者，病在上复在下也。阳明主胃与大肠，无物
不受，此风之入人也，气受之在上多，血受之在下多，血气俱受者，上下皆多。自非医者神手，病者
铁心，罕有免者。夫气为阳为卫，血为阴为荣，身半以上，阳先受之，身半以下，阴先受之。是故再
造散治其病在阴者，用皂角剌出风毒于荣血中。肝主血，恶血留止，其属肝也。虫亦生于厥阴，风木
所化，必用是治其脏气杀虫为主，以大黄引入肠胃荣血之分，利出瘀恶虫物。醉仙散治其病在阳者，
用鼠粘子出风毒遍身恶疮，胡麻逐风补肺润皮肤，蒺
藜主恶血身体风痒，通鼻气，防风治诸风，栝蒌根治瘀血消热 肿，枸杞消风热散疮毒，蔓荆子主贼
风，苦参治热毒风，皮肌烦躁生疮，赤癞眉脱，八味药治功固至矣，然必银粉为使，银粉乃是下膈通
大肠之要剂，所以用其驱诸药入阳明经，开其风热怫郁痞隔，逐出恶风臭秽之毒，杀所生之虫，循经
上行至牙齿软薄之分，而出其臭毒之涎水。服此药若有伤于齿，则以黄连末揩之，或先固济以解银粉
之毒。银粉在醉仙散有夺旗斩将之功，遂成此方之妙用，非他方可企及，故丹溪取二方分用之，如破
敌之先锋。至于余邪未除者，但调和荣卫药中少加驱逐剂耳。
薛新甫曰∶大抵此证，多由劳伤气血，腠理不密，或醉后房劳沐浴，或登山涉水，外邪所乘，卫
气相搏，湿热相火，血随火化而致。故淮阳闽广间多患之。眉毛先落者，毒在肺。面发紫泡者，毒在
肝。脚底先痛或穿者，毒在肾。遍身如癣者，毒在脾。目先损者，毒在心。此五脏受病之重者也。一
曰皮死，麻木不仁。二曰肉死，针刺不痛。三曰血死，烂溃。四曰筋死，指脱。五曰骨死，鼻柱坏。
此五脏受伤之不可治也。若声哑目盲，尤为难治。治当辨本证兼证，变证类证，阴阳虚实而斟酌焉。
若妄投燥热之剂，脓水淋漓，则肝血愈燥，风热愈炽，肾水愈枯，相火愈
旺，反成坏证矣。
本证治法∶疠疡所患，非止一脏，然其气血无有弗伤，兼证无有弗杂，况积岁而发现于外，须分
经络之上下，病势之虚实，不可概施攻毒之药，当先助胃壮气，使根本坚固，而后治其疮可也。疠疡
当知有变、有类之不同，而治法有汗、有下、有砭刺、攻补之不一。盖兼证当审轻重，变证当察先后，
类证当详真伪，而汗下砭刺攻补之法，又当量其人之虚实，究其病之源委而施治焉。盖虚者形气虚也，
实者病气实而形气则虚也。疠疡砭刺之法，子和张先生谓一汗抵千针，盖以砭血不如发汗之周遍也。
然发汗即出血，出血即发汗，二者一律。若恶血凝滞在肌表经络者，宜刺宜汗，取委中出血则效。若
恶毒蕴结于脏，非荡涤其内则不能瘥。若毒在外者，非砭刺遍身患处及两臂腿腕，两手足指缝各出血，
其毒必不能散。若表里俱受毒者，非外砭内泄，其毒决不能退。若上体患多，宜用醉仙散，取其内蓄
恶血于齿缝中出，及刺手指缝并臂腕以去肌表毒血。下体患多，宜用再造散，令恶血陈虫于谷道中出，
仍针足指缝并腿腕，隔一二日更刺之，以血赤为度，如有寒热头疼等证，当大补血气。疠疡服轻粉之
剂，若腹痛去后兼有脓秽之物，不可用药止之。若口舌肿痛，秽
水时流作渴，发热喜冷，此为上焦热毒，宜用泻黄散。若寒热往来，宜用小柴胡汤加知母。若口齿缝
出血，发热而大便秘结，此为热毒内淫，宜用黄连解毒汤。若大便调和，用《济生》犀角地黄汤。若
秽水虽尽，口舌不愈，或发热作渴而不饮冷，此为虚热也，宜用七味白术散。疠疡手足或腿臂或各指
拳挛者，由阴火炽盛亏损气血，当用加味逍遥散加生地黄，及换肌散兼服。疠疡生虫者，五方风邪翕
合，相火制金，木盛所化，内食五脏，而证见于外也。宜用升麻汤，送泻青丸，或桦皮散，以清肺肝
之邪，外灸承浆，以 阳明任脉，则风热息而虫不生矣。肝经虚热者，佐以加味逍遥散、六味地黄丸。
兼证治法∶
【头目眩晕】若右寸关脉浮而无力，脾肺气虚也，用补中益气汤。若左关尺脉数而无
力，肝肾气虚也，用六味地黄丸。若右寸尺脉浮大或微细，阳气虚也，用八味地黄丸。血虚者，四物
汤加参、苓、白术。气虚者，四君子汤加当归、黄 。肝经实热者，柴胡清肝散。肝经虚热者，六味
地黄丸。脾气虚弱者，补中益气汤。脾虚有痰者，半夏白术天麻汤。砭血过多者，芎归汤。发热恶寒
者，圣愈汤。大凡发热则真气伤矣，不可用苦寒药，恐复伤脾胃也。
【口 目斜】若手足牵搐，或
眉棱痒动，属肝经血虚风热，用加味逍遥散、六味地黄丸，以生肝血滋肾水。若寒热往来，或耳聋胁
痛，属肝木炽盛，先用小柴胡合四物汤，以清肝火生肝血。若筋挛骨痛，或不能动履，用六味地黄丸、
补中益气汤，以滋化源。若因服燥药而致者，用四物汤加生甘草、金银花，以解热毒益阴血。凡此俱
属肝经血燥所致，须用六味地黄丸、补中益气汤为主。若因怒气房劳而甚者，用六味地黄丸、十全大
补汤为主。若因劳伤形体而甚者，用补中益气汤、十全大补汤为主。
【夏秋湿热行令】若饮食不甘，
头目眩晕，遍身酸软，或两腿麻木，口渴自汗，气促身热，小便黄数，大便稀溏，湿热伤元气也，用
清燥汤。如在夏令，用清暑益气汤。若自汗盗汗，气高而喘，身热脉大，元气内伤也，用补中益气汤。
若呕吐少食，肚腹痞闷，大便不实，脾胃受伤也，用六君子汤。若胸腹不利，饮食少思，吐痰不止，
脾胃虚痞也，用四君子汤。若形气倦怠，肢体麻木，饮食少思，热伤元气也，用人参益气汤。
【热渴便浊】若夜安昼热者，热在气分也，用清心莲子饮。昼安夜热者，热在血分也，用四物二连汤，俱佐
以六味地黄丸。若寒热往来者，肝经血虚也，用加味逍遥散、六味地黄丸。
【小便不利】若因服燥药
而致者，用四物汤加炒黑黄柏、知母、生甘草，以滋阴血。若频数而色黄者，用四物汤加参、术、麦
门、五味子，以生气血。若短而色黄
者，用补中益气汤加山药、麦门、五味，以滋化源。
【大便不通】若血虚内热而涩滞者，用四物汤加
麦门、五味子，以生血润燥。若因燥热之药而患者，用四物汤加连翘、生甘草，以生血清热。若服克
伐之药而致者，用四君子汤加芎、归，以助气生血。若作渴饮冷者，热淫于内也，用竹叶石膏汤，以
清胃火。若作渴饮汤者，肠胃虚热也，用竹叶黄 汤，以补气生津。若内热作渴，面赤饮汤者，用四
物汤送润肠丸，以凉血润燥。若肠胃满胀，燥在直肠而不通者，用猪胆汁导之。肠胃气虚血涸而不通
者，用十全大补汤。若肝胆邪盛，脾土受侮，而不能输化者，用小柴胡汤加山栀、郁李仁、枳壳治之。
【怔忡无寐或兼衄血便血】若内热晡热，作渴饮汤，肢体倦怠，此脾血虚而火动也，用四君子加芎、
归。若思虑伤脾动火而致，用归脾汤加山栀。若发热晡热，用八珍汤加酸枣仁、茯神、远志。若因心
血虚损，用柏子仁散。大抵此证皆心脾血少所致，但调补胃气，则痰清而神自安，不必专于清热治痰。
【发热恶寒】若肢体倦怠，烦躁作渴，气高而喘，头痛自汗者，此内伤气血也，用补中益气汤加五味、
麦门。倦怠食少，大便不调，小便频数，洒淅恶寒者，此脾肺气虚也，用升阳益胃汤。烦躁作渴，体
倦少食，或食而不化者，此脾气虚热也，用六君子汤。
【发热】在午前脉数而有力者，气分热也，用
清心莲子饮。脉数而无力者，阳
气虚也，用补中益气汤。午后脉数而有力者，血分热也，用四物汤加牡丹皮。脉数而无力者，阴血虚
也，用四物汤加参、术。热从两胁起者，肝虚也，用四物汤加参、术、黄 。从脐下起者，肾虚也，
用四物汤加参、术、黄柏、知母、五味、麦门、肉桂，或六味丸。其热昼见夜伏，夜见昼止，或去来
无定时，或起作无定处，或从脚起者，此无根虚火也，须用加减八味丸，及十全大补汤加麦门、五味，
更以附子末唾津调搽涌泉穴。若形体恶寒，喜热饮食者，阳气虚寒也，急用八味丸。
【口干】若恶冷
饮食者，胃气虚而不能生津液也，用七味白术散。若喜冷冻饮料食者，胃火盛而消烁津液也，须用竹叶石
膏汤。夜间发热口渴者，肾水弱而不能上润也，当用六味地黄丸。若因汗下之后而有前患，胃气虚也，
宜用八珍汤。
【作渴】若烦躁饮冷者，属上焦实热，用凉膈散。兼大便秘结者，属下焦实热，用清凉
饮。若用克伐之药而渴者，气血虚也，急用八珍汤、六味丸。
【耳聋耳鸣】若左寸关脉弦数者，心肝
二经虚热也，用四物汤加山栀、柴胡生阴血。右寸关脉浮大者，脾肺二经虚热也，用补中益气汤加山
栀、桔梗培阳气。若因怒便作，用小柴胡汤加山栀、芎、归，清肝凉血。若午前甚，用小柴胡汤加参、
、归、术，补气清肝。午后甚，用四物汤加酒炒黑黄柏、知母、五味，补阴降火。如两足心热，属
肾虚，用六味丸以壮水之主。
两足冷属阳虚，用八味丸以益火之源。
【项强口噤腰背反张者】气血虚而发痉也。仲景云∶足太阳
病，发汗太多则痉，风病下之则痉，复发汗则加拘急，疮家发汗则痉。盖风能散气，故有汗而不恶寒
曰柔痉。寒能涩血，故无汗而恶寒曰刚痉。皆因内虚复汗，亡津血，筋无所养而然。悉属虚象，非风
证也。当大补气血为主。故产妇、溃疡、劳伤气血、湿热相火、误服克伐之剂者，多患之，其义可见。
【妇女经闭】若因郁火伤脾，以归脾汤加山栀、丹皮。气血俱虚，以八珍汤加山栀、丹皮。若因服燥
药伤血，以四物汤加生甘草。若经候过期而来者，气血虚也，八珍汤倍用参、术。先期而来者，血虚
热也，四物汤倍加参、术、牡丹皮。将来而作痛者，气虚血滞也，四物汤加茯苓、白术、香附。色紫
而成块者，血热也，四物汤加山栀、丹皮。作痛而色淡者，血气虚也，用八珍汤。其血崩之证，肝火
不能脏血者，用加味逍遥散。脾虚不能统血者，用补中益气汤。凡此皆六淫七情亏损元气所致，当审
其因而调补胃气为善。
变证治法∶
【身起疙瘩搔破脓水淋漓】若寒热往来者，肝经气血虚而有火也，用八珍散加丹皮、
柴胡。寒热内热者，血气弱而虚热也，用八珍散倍用参、术。若恶
寒形寒者，阳气虚寒也，用十全大补汤。若肌肤搔如帛隔者，气血不能外荣也，用人参养荣汤。若面
部搔之麻痒者，气血不能上荣也，用补中益气汤。若痿软筋挛者，血气不能滋养也，用补中益气汤，
佐以六味地黄丸。
【口舌生疮或咽喉作痛】若饮食喜冷，大便秘结者，实热也，用四顺清凉饮。肌热
恶热，烦渴引饮者，血虚也，用当归补血汤。饮食恶寒，大便不实者，虚热也，用十全大补汤。热从
下或从足起者，肾虚热也，用加减八味丸。若饮食难化，四肢逆冷者，命门火衰也，用八味地黄丸。
【牙齿作痛】或牙龈溃烂，若喜寒恶热，属胃火，加味清胃散为主。恶寒喜热属胃虚，补中益气汤为
主。
【自汗】属气虚，用补中益气汤送六味地黄丸。盗汗属血虚，用当归六黄汤（内芩、连、黄柏，
炒黑用。）送六味地黄丸。若因劳心而致，以归脾汤倍用茯神、酸枣仁。
【唾痰或作喘】若右寸脉浮
缓者，肺气虚也，用六君子汤加桔梗。右寸脉洪滑者，肺经有热也，用泻白散。右寸关脉浮缓迟弱者，
脾肺气虚也，用六君子汤加桔梗、黄 。右寸关脉洪滑迟缓者，脾热传肺也，用泻白、泻黄二散。右
《素问·脉要精微论》说：脉象受风邪影响而形成的病证，称为疠风（麻风病）。该篇论述道：风寒之邪侵入经脉而不离去，这种病叫做疠风。疠风患者，营卫之气郁热，体内气机浑浊不清，因此导致鼻梁塌陷、面色败坏，皮肤发生溃疡溃烂。又说风气与足太阳膀胱经一同进入人体，运行于各经脉的腧穴，散布在肌肉之间，与卫气相互干扰，导致经络通道不利，因此使肌肉溃烂生疮；卫气凝滞而不能正常运行，所以肌肉出现麻木不仁的现象。《灵枢·长刺节论》说：大风病导致骨节沉重，胡须眉毛脱落，这种病叫大风。治疗应针刺肌肉部位，令患者出汗一百天。王冰注解说：这是为了宣泄卫气的郁热。再针刺骨髓部位，令患者出汗一百天。王冰注解说：这是为了宣泄营气的郁热。经过二百天，胡须眉毛重新生长，治疗即可停止。《灵枢》说：治疗疠风，多次针刺肿胀部位，针刺后，用尖针穿刺患处，按压排出恶浊之气，直到肿胀消退为止。平时只吃常规食物，不要吃其他杂食。现在考察经典中关于治疗的论述，区分营气和卫气的方法是这样的。如果古代的方剂虽然多，但只是混杂地泻除营卫中的风热，又没有先后次序之分，直到李东垣、朱丹溪才开始进行区分。《活法机要》记载：先服用桦皮散，从少量逐渐增加到最大量，连续服用五到七天，然后灸承浆穴七壮，等灸疮愈合后，再次施灸，再次愈合，第三次施灸之后，服用二圣散以泄热，祛除血分的风邪，禁止房事，三年后病愈。这是先治卫分，后治营分的治法。《试效方》治疗段库使用补气泻荣汤，这是治疗营分多于治疗卫分的例子。朱丹溪说：必须区分病位在上还是在下，病位在上的用醉仙散，促使臭恶的血从齿缝中排出；病位在下的用通天再造散，促使恶物和蛔虫从肛门中排出。排出的途径虽然有上下道路的不同，但都不外乎阳明经这一条路径。观察其疙瘩，如果上面先出现，且上半身较多，说明病位在上；下面先出现，且下半身较多，说明病位在下；上下都有的，说明病位既在上又在下。阳明经主管胃和大肠，没有什么是不能接受的，这种风邪侵入人体，气分受邪多在上部，血分受邪多在下部，气血都受邪的，上下都多。如果不是医生手法高明，病人意志坚定，很少能免除死难。气属于阳，也就是卫；血属于阴，也就是营。身体半以上，阳气先受邪；身体半以下，阴气先受邪。所以再造散治疗病在阴分的，用皂角刺将风毒从营血中引出。肝主血，恶血留止，这属于肝脏的问题。虫也生于厥阴经，由风木之气所化，必须用这种方法来治疗脏气，以杀虫为主，配合大黄将其引入肠胃营血之分，利出瘀恶和虫物。醉仙散治疗病在阳分的，用鼠粘子（牛蒡子）将风毒遍身的恶疮引出，胡麻（黑芝麻）祛风补肺润肤，蒺藜主治恶血引起的身体风痒，通鼻气，防风治疗各种风邪，栝蒌根治疗瘀血消除热肿，枸杞消散风热散解毒疮，蔓荆子主治贼风，苦参治疗热毒风引起的皮肌烦躁生疮、赤癞眉脱，这八味药的功效已经非常完备了，然而必须用银粉作为引经药，银粉是下膈通大肠的重要药物，所以用它来驱使诸药进入阳明经，开通风热郁结痞隔，逐出恶风臭秽之毒，杀死所生的虫子，循经上行至牙齿软薄之处，排出臭毒的涎水。服用此药如果有损伤牙齿的情况，可以用黄连末擦拭，或者预先固护保护以解除银粉的毒性。银粉在醉仙散中有夺旗斩将的功效，从而成就了此方的妙用，不是其他方剂所能比及的，所以丹溪选取这两个方子分别使用，就像破敌时的先锋一样。至于残留的邪气未清除的，只是在调和营卫的药物中稍微加入驱逐邪气的药剂罢了。
薛新甫说：大抵这种病症，多因劳伤气血，腠理不紧密，或者醉酒后行房事、沐浴，或者登山涉水，外邪乘虚而入，与卫气相搏，湿热与相火交织，血液随火化热而导致。所以在淮阳、福建、广东等地多患此病。眉毛先脱落的，毒在肺。面部发紫泡的，毒在肝。脚底先痛或穿孔的，毒在肾。全身像癣一样的，毒在脾。眼睛先受损的，毒在心。这是五脏受病较重的情况。一曰皮死，表现为麻木不仁。二曰肉死，表现为针刺不痛。三曰血死，表现为腐烂溃烂。四曰筋死，表现为手指脱落。五曰骨死，表现为鼻梁塌陷。这是五脏受伤不可治愈的情况。如果声音嘶哑、眼睛失明，更是难以治疗。治疗应当辨别本证、兼证、变证、类证，根据阴阳虚实来斟酌处理。如果误投燥热性质的药物，导致脓水淋漓，那么肝血更加干燥，风热更加炽盛，肾水更加枯竭，相火更加旺盛，反而变成坏证了。
本证治法：疠疡所患，不止涉及一个脏腑，然而其气血无不受伤，兼证无不杂乱，何况积累多年才表现在外部，必须区分经络的上下，病势的虚实，不能一概施用攻毒的药物，应当先扶助胃气、壮大元气，使根本坚固，然后再治疗疮疡。疠疡应当知道有变化、有类似的不同，而治法有发汗、有攻下、有砭刺、有攻补的不同。大概兼证应当审察轻重，变证应当察看先后，类证应当详辨真伪，而汗、下、砭、刺、攻、补的方法，又应当衡量病人的虚实，探究疾病的源委来施治。所谓虚，是指形体和气机虚弱；所谓实，是指病气实而形体和气机则虚。疠疡的砭刺方法，张子和张先生说一次发汗相当于千次针刺，因为放血不如发汗那样周遍全身。然而发汗即等于出血，出血即等于发汗，这两者是一致的。如果恶血凝滞在肌表经络，适宜针刺或发汗，取委中穴放血则有效。如果恶毒蕴结在脏腑内部，不荡涤其内则不能痊愈。如果毒邪在外部，不砭刺遍身患处以及两臂腿腕、两手足指缝各处放血，其毒邪一定不能消散。如果表里都受毒邪，不外用砭刺内用攻泄，其毒邪决不能退去。如果上半身患病多，适宜用醉仙散，取其让内蓄的恶血从齿缝中排出，并针刺手指缝及手臂手腕以去除肌表的毒血。下半身患病多，适宜用再造散，令恶血和陈旧的虫物从肛门中排出，仍然针刺足指缝及腿腕，隔一两天再针刺，以血色变红为度，如果有寒热头痛等症状，应当大量补益气血。疠疡服用轻粉制剂，如果出现腹痛腹泻且伴有脓秽之物，不可用药止泻。如果口舌肿痛，秽水时常流出且口渴喜冷饮，这是上焦热毒，适宜用泻黄散。如果寒热往来，适宜用小柴胡汤加知母。如果口齿缝出血，发热且大便秘结，这是热毒内侵，适宜用黄连解毒汤。如果大便调和，用《济生方》的犀角地黄汤。如果秽水虽已排尽，口舌仍不愈合，或者发热口渴但不喜冷饮，这是虚热，适宜用七味白术散。疠疡患者手足或腿臂或各个手指屈曲挛缩，是由于阴火炽盛亏损气血，应当用加味逍遥散加生地黄，以及换肌散兼服。疠疡生虫，是由于五方风邪聚合，相火克制金气，木气过盛所化，内食五脏，而症状表现于外部。适宜用升麻汤，送服泻青丸，或桦皮散，以清肺肝之邪，外部灸承浆穴，以疏通阳明任脉，则风热平息而虫子不生。肝经虚热的，佐以加味逍遥散、六味地黄丸。
兼证治法：
【头目眩晕】如果右寸关脉浮而无力，是脾肺气虚，用补中益气汤。如果左关尺脉数而无力，是肝肾气虚，用六味地黄丸。如果右寸尺脉浮大或微细，是阳气虚，用八味地黄丸。血虚的，用四物汤加人参、茯苓、白术。气虚的，用四君子汤加当归、黄芪。肝经实热的，用柴胡清肝散。肝经虚热的，用六味地黄丸。脾气虚弱的，用补中益气汤。脾虚有痰的，用半夏白术天麻汤。砭血过多的，用芎归汤。发热恶寒的，用圣愈汤。大凡发热就会损伤真气，不可用苦寒药，恐怕再次损伤脾胃。
【口眼歪斜】如果手足抽搐，或者眉棱骨痒动，属于肝经血虚风热，用加味逍遥散、六味地黄丸，以生肝血滋肾水。如果寒热往来，或者耳聋胁痛，属于肝木炽盛，先用小柴胡汤合四物汤，以清肝火生肝血。如果筋挛骨痛，或者不能行动行走，用六味地黄丸、补中益气汤，以滋养化源。如果因服用燥药导致的，用四物汤加生甘草、金银花，以解热毒益阴血。这些都属于肝经血燥所致，必须以六味地黄丸、补中益气汤为主。如果因怒气房劳而加重的，用六味地黄丸、十全大补汤为主。如果因劳伤形体而加重的，用补中益气汤、十全大补汤为主。
【夏秋湿热行令】如果饮食无味，头目眩晕，全身酸软，或者双腿麻木，口渴自汗，气促身热，小便黄数，大便稀溏，是湿热损伤元气，用清燥汤。如果在夏季，用清暑益气汤。如果自汗盗汗，气短而喘，身热脉大，是元气内伤，用补中益气汤。如果呕吐少食，肚腹痞闷，大便不成形，是脾胃受伤，用六君子汤。如果胸腹不适，饮食减少，吐痰不止，是脾胃虚痞，用四君子汤。如果形体倦怠，肢体麻木，饮食减少，是热伤元气，用人参益气汤。
【热渴便浊】如果夜间安睡白天发热，是热在气分，用清心莲子饮。白天安睡夜间发热，是热在血分，用四物二连汤，都佐以六味地黄丸。如果寒热往来，是肝经血虚，用加味逍遥散、六味地黄丸。
【小便不利】如果因服用燥药导致的，用四物汤加炒黑黄柏、知母、生甘草，以滋阴血。如果尿频且色黄的，用四物汤加人参、白术、麦门冬、五味子，以生气血。如果尿短且色黄的，用补中益气汤加山药、麦门冬、五味子，以滋化源。
【大便不通】如果血虚内热而涩滞的，用四物汤加麦门冬、五味子，以生血润燥。如果因燥热药物导致的，用四物汤加连翘、生甘草，以生血清热。如果服用克伐药物导致的，用四君子汤加川芎、当归，以助气生血。如果口渴喜冷饮的，是热淫于内，用竹叶石膏汤，以清胃火。如果口渴喜热饮的，是肠胃虚热，用竹叶黄芪汤，以补气生津。如果内热口渴，面赤喜热饮的，用四物汤送服润肠丸，以凉血润燥。如果肠胃满胀，燥结在直肠而不通的，用猪胆汁导之。如果肠胃气虚血枯而不通的，用十全大补汤。如果肝胆邪盛，脾土受侮，而不能输化的，用小柴胡汤加山栀、郁李仁、枳壳治疗。
【怔忡无寐或兼衄血便血】如果内热午后发热，口渴喜热饮，肢体倦怠，这是脾血虚而火动，用四君子汤加川芎、当归。如果思虑伤脾动火导致的，用归脾汤加山栀。如果发热午后发热，用八珍汤加酸枣仁、茯神、远志。如果因心血虚损，用柏子仁散。大抵这些病症都是心脾血少导致的，只要调补胃气，则痰清而神自安，不必专门清热治痰。
【发热恶寒】如果肢体倦怠，烦躁口渴，气短而喘，头痛自汗，这是内伤气血，用补中益气汤加五味子、麦门冬。倦怠食少，大便不调，尿频，怕冷发抖，这是脾肺气虚，用升阳益胃汤。烦躁口渴，体倦少食，或者吃了不消化，这是脾气虚热，用六君子汤。
【发热】午前脉数有力的，是气分热，用清心莲子饮。脉数无力的，是阳气虚，用补中益气汤。午后脉数有力的，是血分热，用四物汤加牡丹皮。脉数无力的，是阴血虚，用四物汤加人参、白术。热从两胁起的，是肝虚，用四物汤加人参、白术、黄芪。从脐下起的，是肾虚，用四物汤加人参、白术、黄柏、知母、五味子、麦门冬、肉桂，或者六味丸。其热昼现夜伏，夜现昼止，或者来去无定时，或者起作无定处，或者从脚起的，这是无根虚火，须用加减八味丸，及十全大补汤加麦门冬、五味子，再用附子末唾津调匀搽涌泉穴。如果形体怕冷，喜热饮食，是阳气虚寒，急用八味丸。
【口干】如果厌恶冷饮食，是胃气虚不能生津液，用七味白术散。如果喜欢冷冻饮料食物，是胃火盛而消烁津液，须用竹叶石膏汤。夜间发热口渴，是肾水弱不能上润，当用六味地黄丸。如果因汗下之后而有前患，是胃气虚，宜用八珍汤。
【作渴】如果烦躁饮冷，属上焦实热，用凉膈散。兼大便秘结的，属下焦实热，用清凉饮。如果服用克伐药物而渴的，是气血虚，急用八珍汤、六味丸。
【耳聋耳鸣】如果左寸关脉弦数，是心肝二经虚热，用四物汤加山栀、柴胡生阴血。右寸关脉浮大的，是脾肺二经虚热，用补中益气汤加山栀、桔梗培阳气。如果因愤怒发作，用小柴胡汤加山栀、川芎、当归，清肝凉血。如果午前严重，用小柴胡汤加人参、黄芪、当归、白术，补气清肝。午后严重，用四物汤加酒炒黑黄柏、知母、五味子，补阴降火。如果两足心热，属肾虚，用六味丸以壮水之主。两足冷属阳虚，用八味丸以益火之源。
【项强口噤腰背反张者】是气血虚而发痉。张仲景说：足太阳病，发汗太多则痉，风病下之则痉，复发汗则加重拘急，疮家发汗则痉。盖风能散气，故有汗而不恶寒叫柔痉。寒能涩血，故无汗而恶寒叫刚痉。都是因为内虚复汗，亡失津血，筋无所养而然。都属于虚象，不是风证。应当以大补气血为主。所以产妇、溃疡、劳伤气血、湿热相火、误服克伐药物的人，多患此病，其中的道理可见。
【妇女经闭】如果因郁火伤脾，用归脾汤加山栀、丹皮。气血俱虚，用八珍汤加山栀、丹皮。如果因服燥药伤血，用四物汤加生甘草。如果月经过期而来的，是气血虚，八珍汤倍用人参、白术。先期而来的，是血虚热，四物汤倍加人参、白术、牡丹皮。将来而作痛的，是气虚血滞，四物汤加茯苓、白术、香附。色紫而成块的，是血热，四物汤加山栀、丹皮。作痛而色淡的，是血气虚，用八珍汤。其血崩之证，肝火不能藏血的，用加味逍遥散。脾虚不能统血的，用补中益气汤。这些都是六淫七情亏损元气导致的，应当审察原因调补胃气为好。
变证治法：
【身起疙瘩搔破脓水淋漓】如果寒热往来，是肝经气血虚而有火，用八珍散加丹皮、柴胡。寒热内热，是血气弱而虚热，用八珍散倍用人参、白术。如果恶寒形寒，是阳气虚寒，用十全大补汤。如果肌肤搔抓如帛隔感，是气血不能外荣，用人参养荣汤。如果面部搔之麻痒，是气血不能上荣，用补中益气汤。如果痿软筋挛，是血气不能滋养，用补中益气汤，佐以六味地黄丸。
【口舌生疮或咽喉作痛】如果饮食喜冷，大便秘结，是实热，用四顺清凉饮。肌热恶热，烦渴引饮，是血虚，用当归补血汤。饮食恶寒，大便不实，是虚热，用十全大补汤。热从下或从足起，是肾虚热，用加减八味丸。如果饮食难化，四肢逆冷，是命门火衰，用八味地黄丸。
【牙齿作痛】或牙龈溃烂，如果喜寒恶热，属胃火，加味清胃散为主。恶寒喜热属胃虚，补中益气汤为主。
【自汗】属气虚，用补中益气汤送六味地黄丸。盗汗属血虚，用当归六黄汤（内含金银花、黄连、黄柏，炒黑用。）送六味地黄丸。如果因劳心而致，用归脾汤倍用茯神、酸枣仁。
【唾痰或作喘】如果右寸脉浮缓，是肺气虚，用六君子汤加桔梗。右寸脉洪滑，是肺经有热，用泻白散。右寸关脉浮缓迟弱，是脾肺气虚，用六君子汤加桔梗、黄芪。右寸关脉洪滑迟缓，是脾热传肺，用泻白、泻黄二散。右
The *Suwen* (Basic Questions), chapter "Mai Yao Jing Wei Lun" (Essential Discussions on Pulse Diagnosis), states: When the pulse is affected by wind pathogen, it forms a condition called Li Feng (Leprosy/Malodorous Wind). The discussion elaborates: When cold and wind pathogens invade the vessels and do not depart, this condition is named Li Feng. In patients with Li Feng, the Ying (Nutrient) and Wei (Defensive) Qi become hot, and the internal Qi becomes turbid and unclear, thus causing the nasal bridge to collapse, the complexion to deteriorate, and the skin to ulcerate and suppurate. It is also stated that wind pathogen enters together with the Foot-Taiyang Bladder channel, travels through the Shu points of various vessels, and scatters between the muscles. It interferes with the Wei Qi, obstructing its pathways, thereby causing muscle ulcers. Since the Wei Qi coagulates and fails to circulate, the flesh becomes numb and insensible. The *Lingshu*, chapter "Chang Ci Jie Lun" (Long-Needle Section), states: Severe wind disease causes heaviness in the bones and joints, and loss of eyebrows and beard; this is called Da Feng (Great Wind). Treatment involves needling the muscles until sweating occurs for one hundred days. Wang Bing's commentary notes: This is to vent the stagnation-heat of the Wei Qi. Needling the bone marrow until sweating occurs for another one hundred days. Wang Bing's commentary notes: This is to vent the stagnation-heat of the Ying Qi. After two hundred days, the eyebrows and beard will regrow, and treatment should cease. The *Lingshu* states: For Li Feng, repeatedly needle the swollen areas. After needling, use a sharp needle to puncture the site, press to expel the foul Qi, and stop when the swelling subsides. Consume only regular foods and avoid other miscellaneous foods. Examining the classic discussions on treatment, the distinction between Ying and Wei Qi is as follows. Although ancient formulas are numerous, they merely mixedly purged wind-heat from Ying and Wei without distinguishing sequence. It was not until Li Dongyuan and Zhu Danxi that this distinction began. *Huo Fa Ji Yao* (Key to Living Methods) records: First, administer Hua Pi San (Birch Bark Powder), starting from a small dose and increasing gradually, taken for five to seven days. Then moxa the Chengjiang (CV24) acupoint seven moxibustion cones. Once the moxibustion wound heals, repeat the moxibustion and healing process. After the third moxibustion, administer Er Sheng San (Two Sages Powder) to clear heat and expel wind pathogen from the blood. Abstinence from sexual activity is required, and the disease will heal after three years. This represents treating the Wei level first, then the Ying level. *Shi Xiao Fang* (Formulas for Trial Effectiveness) treats Duan Ku using Bu Qi Xie Rong Tang (Tonify Qi and Purge Ying Decoction), which treats Ying more than Wei. Zhu Danxi said: One must distinguish whether the pathology is above or below. For pathology above, use Zui Xian San (Intoxicating Immortal Powder) to induce the discharge of foul blood from the gum margins. For pathology below, use Tong Tian Zai Zao San (Heaven-Reaching Regeneration Powder) to induce the discharge of foul matter and roundworms from the anus. Although the routes of discharge differ above and below, all fall within the Yangming channel. Observe the nodules: if they appear first on the upper body and are more prevalent there, the disease is above; if they appear first on the lower body and are more prevalent there, the disease is below; if both are present, the disease is both above and below. The Yangming channel governs the Stomach and Large Intestine, accepting everything. When wind pathogen invades, Qi is predominantly affected above, Blood below, and both above and below if both are affected. Unless the physician is skilled and the patient resolute, few escape death. Qi is Yang and Wei; Blood is Yin and Ying. Above the midpoint of the body, Yang is affected first; below the midpoint, Yin is affected first. Thus, Zai Zao San treats pathology in the Yin level by using Gao Jiao Ci (Gleditsia Spine) to draw out wind-toxin from the Ying-Blood. The Liver governs Blood; stagnant foul blood belongs to the Liver. Worms also arise in the Jueyin channel, transformed by Wind-Wood Qi. Treatment must focus on regulating the Zang-Qi and killing worms, assisted by Da Huang (Rhubarb Root) to guide the action into the intestines and stomach Ying-Blood levels, promoting the expulsion of stasis and worms. Zui Xian San treats pathology in the Yang level. It uses Niu Bang Zi (Arctii Fructus) to expel wind-toxin from widespread sores, Hu Ma (Sesamum Seed) to dispel wind, tonify Lung, and moisten skin, Ji Li (Tribulus Fruit) to treat foul blood and pruritus, open nasal passages, Fang Feng (Saposhnikoviae Radix) to treat various winds, Gua Lou Gen (Trichosanthis Radix) to resolve stasis and reduce heat-swelling, Gou Qi Zi (Lycium Fruit) to dissipate wind-heat and detoxify sores, Man Jing Zi (Vitalis Fruit) to treat thief-wind, and Ku Shen (Sophorae Flavescentis Radix) to treat heat-toxic wind causing skin irritation and sores, red leprosy, and eyebrow loss. These eight herbs have solid efficacy, but Yin Fen (Calomel) is used as an assistant drug. Yin Fen is a crucial agent for descending through the diaphragm and unblocking the Large Intestine. It drives the other herbs into the Yangming channel, opens wind-heat stagnation and obstruction, expels foul wind and toxic filth, kills worms, and ascends along the channel to the thin gums to expel foul saliva. If this medication damages the teeth, wipe them with Huang Lian (Coptidis Rhizoma) powder, or protect them beforehand to neutralize Yin Fen toxicity. Yin Fen plays a decisive role in Zui Xian San, creating its unique efficacy, unmatched by other formulas. Hence, Danxi selected these two formulas for separate use, like vanguard troops in battle. For residual pathogens not yet cleared, simply add mild expelling agents to formulas harmonizing Ying and Wei.
Xue Xinpu said: Generally, this syndrome arises from labor injuring Qi and Blood, leading to loose interstices, or from sexual activity and bathing after drunkenness, or from climbing mountains and wading through water, allowing external pathogens to invade and contend with Wei Qi. Damp-heat and Ministerial Fire interact, transforming blood, leading to the disease. Thus, it is common in Huaiyang, Fujian, and Guangdong. Loss of eyebrows first indicates toxin in the Lung. Purple blisters on the face indicate toxin in the Liver. Pain or perforation in the soles of the feet indicates toxin in the Kidney. Body-wide lesions resembling tinea indicate toxin in the Spleen. Damage to the eyes first indicates toxin in the Heart. These are severe cases of Zang involvement. Five types of death are described: Skin death presents as numbness and insensibility; Flesh death presents as insensitivity to needle prick; Blood death presents as rotting and ulceration; Tendon death presents as finger detachment; Bone death presents as nasal collapse. These represent incurable damage to the five Zang organs. Hoarseness and blindness are particularly difficult to treat. Treatment must differentiate primary syndrome, accompanying syndromes, transformed syndromes, and similar syndromes, adjusting according to Yin-Yang and deficiency-excess. Misusing drying-hot agents leads to dripping pus, further drying Liver Blood, intensifying wind-heat, depleting Kidney Water, and flaring Ministerial Fire, resulting in complicated conditions.
Treatment of Primary Syndromes: Li Yang (Leprous Ulcers) affects not just one Zang, but Qi and Blood are invariably injured, and accompanying syndromes are invariably complex. Accumulating over years before manifesting externally, one must distinguish the upper and lower meridians and the deficiency-excess of the pathological trend. Do not indiscriminately apply toxic-purgative drugs. First, support Stomach Qi and strengthen Yuan Qi to solidify the root, then treat the sores. Li Yang has variations and similarities, requiring methods such as sweating, purging, bloodletting (Bian), and tonification/purging. Accompanying syndromes require assessing severity; transformed syndromes require observing sequence; similar syndromes require distinguishing truth from falsehood. Sweating, purging, Bian, needling, tonifying, and purging methods must be applied based on the patient's deficiency-excess and the disease's origin. Deficiency refers to weak form and Qi; Excess refers to strong pathogenic Qi but weak form and Qi. Zhang Hezi stated that one sweating session equals a thousand needles, as bloodletting is less comprehensive than sweating. However, sweating is equivalent to bleeding, and bleeding is equivalent to sweating. For foul blood stagnating in muscles and meridians, needling or sweating is appropriate; bleeding at Weizhong (BL40) is effective. For toxins accumulating internally in Zang organs, internal purging is necessary for cure. For external toxins, Bian needling of affected areas, wrists, ankles, and finger webs is required to disperse the toxin. For simultaneous exterior and interior toxin, external Bian and internal purging are essential. For predominant upper body involvement, use Zui Xian San to discharge internal foul blood via gums and needle finger webs and arms to remove superficial toxin blood. For predominant lower body involvement, use Zai Zao San to discharge foul blood and old worms via the anus, and needle toe webs and legs. Repeat every one to two days until blood turns red. If chills, fever, or headache occur, heavily tonify Qi and Blood. If taking Qing Fen (Calomel) preparations causes abdominal pain with purulent diarrhea, do not use antidiarrheals. Mouth and tongue swelling, foul saliva flow, thirst, fever, and preference for cold drinks indicate Upper Jiao Heat-Toxin; use Xie Huang San. Chills and alternating fever indicate Shaoyang disorder; use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Zhi Mu (Anemarrhenae Rhizoma). Bleeding from gum margins, fever, and constipation indicate internal invasion of Heat-Toxin; use Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxins). If stool is normal, use Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) from *Jisheng Fang*. If foul drainage ceases but mouth/tongue does not heal, or fever/thirst occurs without preference for cold drinks, this is Deficient Heat; use Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder). Contracture of hands, feet, legs, arms, or fingers due to Li Yang results from flourishing Yin Fire injuring Qi and Blood; use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) plus Sheng Di Huang (Rehmanniae Radix) and Huan Ji San (Skin-Renewing Powder). Worms in Li Yang result from the convergence of wind pathogens from five directions, Ministerial Fire suppressing Metal, and excessive Wood transformation, consuming the five Zang internally and manifesting externally. Use Sheng Ma Tang (Cimicifugae Decoction) with Xie Qing Wan (Draining Green Pill) or Hua Pi San to clear Lung and Liver pathogens. External moxibustion at Chengjiang (CV24) unblocks Yangming and Renmai channels, extinguishing wind-heat and preventing worm growth. For Liver Channel Deficient Heat, assist with Jia Wei Xiao Yao San and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia).
Treatment of Accompanying Syndromes:
[Dizziness and Vertigo] If Right Cun-Guan pulse is floating and forceless, it is Spleen-Lung Qi Deficiency; use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If Left Guan-Chi pulse is rapid and forceless, it is Liver-Kidney Qi Deficiency; use Liu Wei Di Huang Wan. If Right Cun-Chi pulse is floating-large or micro-fine, it is Yang Qi Deficiency; use Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia). For Blood Deficiency, use Si Wu Tang (Four Substance Decoction) plus Ren Shen (Ginseng Radix), Fu Ling (Poria), and Bai Zhu (Atractylodis Macrocephalae Rhizoma). For Qi Deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction) plus Dang Gui (Angelicae Sinensis Radix) and Huang Qi (Astragali Radix). For Liver Channel Excess Heat, use Chai Hu Qing Gan San (Bupleurum Liver-Clearing Powder). For Liver Channel Deficient Heat, use Liu Wei Di Huang Wan. For Spleen Qi Weakness, use Bu Zhong Yi Qi Tang. For Spleen Deficiency with Phlegm, use Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes, and Gastrodia Decoction). For excessive bloodletting, use Xiong Gui Tang (Ligusticum and Angelica Decoction). For fever and aversion to cold, use Sheng Yu Tang (Sage Renewal Decoction). Fever injures True Qi; avoid bitter-cold herbs to prevent further Spleen-Stomach injury.
[Facial Paralysis] If limbs twitch or brow ridge itches, it is Liver Channel Blood Deficiency with Wind-Heat; use Jia Wei Xiao Yao San and Liu Wei Di Huang Wan to generate Liver Blood and nourish Kidney Water. If chills and alternating fever or deafness/costal pain occur, it is Flourishing Liver Wood; initially use Xiao Chai Hu Tang combined with Si Wu Tang to clear Liver Fire and generate Liver Blood. If tendon cramps and bone pain or immobility occur, use Liu Wei Di Huang Wan and Bu Zhong Yi Qi Tang to nourish the source of transformation. If caused by drying herbs, use Si Wu Tang plus Sheng Gan Cao (Raw Licorice Root) and Jin Yin Hua (Lonicerae Japonicae Flos) to resolve heat-toxin and benefit Yin Blood. All these stem from Liver Channel Blood Dryness; prioritize Liu Wei Di Huang Wan and Bu Zhong Yi Qi Tang. If exacerbated by anger or sexual fatigue, prioritize Liu Wei Di Huang Wan and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction). If exacerbated by physical labor, prioritize Bu Zhong Yi Qi Tang and Shi Quan Da Bu Tang.
[Summer-Autumn Damp-Heat Dominance] If appetite is poor, dizziness occurs, body feels sore/weak, legs are numb, thirst and spontaneous sweating occur, breathing is rapid, body is hot, urine is yellow/frequent, and stool is loose, damp-heat has injured Yuan Qi; use Qing Zao Tang (Clear Dryness Decoction). In summer, use Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction). If spontaneous/diaphoretic sweating, shortness of breath, body heat, and large pulse indicate internal Yuan Qi injury; use Bu Zhong Yi Qi Tang. If vomiting, low intake, abdominal fullness, and loose stool indicate Spleen-Stomach injury; use Liu Jun Zi Tang (Six Gentlemen Decoction). If chest/abdominal discomfort, low appetite, and incessant phlegm expectoration indicate Spleen-Stomach Deficient Fullness; use Si Jun Zi Tang. If fatigue, limb numbness, and low appetite indicate Heat injuring Yuan Qi; use Ren Shen Yi Qi Tang (Ginseng Qi-Augmenting Decoction).
[Heat, Thirst, Turbid Urine] If calm at night but hot during day, Heat is in Qi Level; use Qing Xin Lian Zi Yin (Lotus Seed Decoction for Clearing the Heart). If calm during day but hot at night, Heat is in Blood Level; use Si Wu Er Lian Tang (Four Substance and Two Continuous Decoction), assisted by Liu Wei Di Huang Wan. If chills and alternating fever occur, it is Liver Channel Blood Deficiency; use Jia Wei Xiao Yao San and Liu Wei Di Huang Wan.
[Difficulty Urinating] If caused by drying herbs, use Si Wu Tang plus Chao Hei Huang Bo (Stir-baked Phellodendri Cortex), Zhi Mu, and Sheng Gan Cao to nourish Yin Blood. If frequent and yellow, use Si Wu Tang plus Ren Shen, Bai Zhu, Mai Men Dong (Ophiopogonis Tuber), and Wu Wei Zi (Schisandrae Fructus) to generate Qi and Blood. If scanty and yellow, use Bu Zhong Yi Qi Tang plus Shan Yao (Dioscoreae Rhizoma), Mai Men Dong, and Wu Wei Zi to nourish the source of transformation.
[Constipation] If涩滞 (astringent/stagnant) due to Blood Deficiency and Internal Heat, use Si Wu Tang plus Mai Men Dong and Wu Wei Zi to generate Blood and moisten dryness. If caused by drying-hot herbs, use Si Wu Tang plus Lian Qiao (Forsythiae Fructus) and Sheng Gan Cao to generate Blood and clear Heat. If caused by purgative herbs, use Si Jun Zi Tang plus Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Dang Gui to boost Qi and generate Blood. If thirsty and preferring cold drinks, Heat invades internally; use Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) to clear Stomach Fire. If thirsty and preferring hot drinks, Intestines/Stomach Deficient Heat; use Zhu Ye Huang Qi Tang (Bamboo Leaf and Astragalus Decoction) to boost Qi and generate fluids. If internal heat, thirst, red face, and preference for hot drinks, use Si Wu Tang with Run Chang Wan (Moisten Intestines Pill) to cool Blood and moisten dryness. If abdominal distension and rectal dryness cause blockage, use Pig Gallbladder Juice for enema. If Qi Deficiency and Blood Exhaustion cause blockage, use Shi Quan Da Bu Tang. If Liver/Gallbladder Pathogen Flourishing insults Spleen Earth, impairing transport/transformation, use Xiao Chai Hu Tang plus Zhi Zi (Gardeniae Fructus), Yu Li Ren (Prunus Semen), and Zhi Ke (Aurantii Fructus Pericarpium).
[Palpitations, Insomnia, or Epistaxis/Hematochezia] If internal heat, afternoon fever, thirst preferring hot drinks, and limb fatigue occur, it is Spleen Blood Deficiency with Fire Movement; use Si Jun Zi Tang plus Chuan Xiong and Dang Gui. If caused by overthinking injuring Spleen and stirring Fire, use Gui Pi Tang (Restore the Spleen Decoction) plus Zhi Zi. If fever and afternoon fever occur, use Ba Zhen Tang (Eight Treasure Decoction) plus Suan Zao Ren (Ziziphus Seed), Fu Shen (Poria with Hostwood), and Yuan Zhi (Polygalae Radix). If due to Heart Blood Deficiency, use Bai Zi Ren San (Biota Seed Powder). Generally, these syndromes result from Heart-Spleen Blood Deficiency. Regulating Stomach Qi clears Phlegm and calms Spirit; specific heat-clearing and phlegm-resolving are unnecessary.
[Fever and Aversion to Cold] If limb fatigue, irritability, thirst, shortness of breath, headache, and spontaneous sweating occur, it is Internal Injury to Qi and Blood; use Bu Zhong Yi Qi Tang plus Wu Wei Zi and Mai Men Dong. If fatigue, low appetite, irregular stool, frequent urination, and shivering chills occur, it is Spleen-Lung Qi Deficiency; use Sheng Yang Yi Wei Tang (Raise Yang and Benefit Stomach Decoction). If irritability, thirst, fatigue, low appetite, or indigestion occur, it is Spleen Qi Deficient Heat; use Liu Jun Zi Tang.
[Fever] If pulse is rapid and forceful before noon, Heat is in Qi Level; use Qing Xin Lian Zi Yin. If pulse is rapid and forceless, Yang Qi is Deficient; use Bu Zhong Yi Qi Tang. If pulse is rapid and forceful after noon, Heat is in Blood Level; use Si Wu Tang plus Mu Dan Pi (Moutan Cortex). If pulse is rapid and forceless, Yin Blood is Deficient; use Si Wu Tang plus Ren Shen and Bai Zhu. Heat rising from hypochondrium indicates Liver Deficiency; use Si Wu Tang plus Ren Shen, Bai Zhu, and Huang Qi. Heat rising from below umbilicus indicates Kidney Deficiency; use Si Wu Tang plus Ren Shen, Bai Zhu, Huang Bo, Zhi Mu, Wu Wei Zi, Mai Men Dong, and Rou Gui (Cinnamon Bark), or Liu Wei Wan. Heat appearing by day and hiding by night, or coming/goings without fixed time/location, or rising from feet, indicates Rootless Deficient Fire; use Jia Jian Ba Wei Wan (Modified Eight-Ingredient Pill) and Shi Quan Da Bu Tang plus Mai Men Dong and Wu Wei Zi. Also apply Fu Zi (Aconiti Lateralis Radix Preparata) powder mixed with saliva to Yongquan (KI1). If aversion to cold and preference for hot drinks indicate Yang Deficiency Cold, urgently use Ba Wei Wan.
[Dry Mouth] If aversion to cold drinks, Stomach Qi is Deficient and cannot generate fluids; use Qi Wei Bai Zhu San. If preference for cold drinks/food, Stomach Fire is Flourishing and consumes fluids; use Zhu Ye Shi Gao Tang. Nighttime fever and thirst indicate Kidney Water Deficiency failing to moisten upward; use Liu Wei Di Huang Wan. If preceding symptoms occur after sweating/purging, Stomach Qi is Deficient; use Ba Zhen Tang.
[Thirst] If irritability and preference for cold drinks indicate Upper Jiao Excess Heat, use Liang Ge San (Cool the Diaphragm Powder). With constipation, Lower Jiao Excess Heat; use Qing Liang Yin (Cooling Beverage). If thirst results from purgative herbs, Qi and Blood are Deficient; urgently use Ba Zhen Tang and Liu Wei Wan.
[Deafness and Tinnitus] If Left Cun-Guan pulse is wiry-rapid, Heart-Liver Deficient Heat; use Si Wu Tang plus Zhi Zi and Chai Hu (Bupleuri Radix) to generate Yin Blood. If Right Cun-Guan pulse is floating-large, Spleen-Lung Deficient Heat; use Bu Zhong Yi Qi Tang plus Zhi Zi and Jie Geng (Platycodon Radix) to cultivate Yang Qi. If triggered by anger, use Xiao Chai Hu Tang plus Zhi Zi, Chuan Xiong, and Dang Gui to clear Liver and cool Blood. If worse before noon, use Xiao Chai Hu Tang plus Ren Shen, Huang Qi, Dang Gui, and Bai Zhu to boost Qi and clear Liver. If worse after noon, use Si Wu Tang plus Jiu Chao Hei Huang Bo, Zhi Mu, and Wu Wei Zi to tonify Yin and descend Fire. Hot solesoles indicate Kidney Deficiency; use Liu Wei Wan to strengthen the Master of Water. Cold solesoles indicate Yang Deficiency; use Ba Wei Wan to benefit the Source of Fire.
[Nuchal Rigidity, Lockjaw, Opisthotonos] Indicates Qi and Blood Deficiency leading to Spasm. Zhang Zhongjing stated: Taiyang disease with excessive sweating causes spasm; Wind disease with purging causes spasm; repeated sweating worsens stiffness; Chan Jia (wound patients) with sweating causes spasm. Wind disperses Qi, so sweating without aversion to cold is Rou Jing (Soft Spasm). Cold congeals Blood, so no sweating with aversion to cold is Gang Jing (Hard Spasm). All result from internal deficiency compounded by sweating, losing Jin-Ye and Blood, leaving tendons un-nourished. All are deficiency patterns, not Wind syndromes. Prioritize heavy tonification of Qi and Blood. Postpartum women, ulcer patients, those with labor-injured Qi/Blood, damp-heat/ministerial fire, or those misusing purgatives often suffer this, illustrating the principle.
[Women's Amenorrhea] If caused by Depressed Fire injuring Spleen, use Gui Pi Tang plus Zhi Zi and Mu Dan Pi. If Qi and Blood both Deficient, use Ba Zhen Tang plus Zhi Zi and Mu Dan Pi. If Blood injured by drying herbs, use Si Wu Tang plus Sheng Gan Cao. If menstruation arrives late, Qi and Blood are Deficient; use Ba Zhen Tang doubling Ren Shen and Bai Zhu. If arriving early, Blood Deficient Heat; use Si Wu Tang doubling Ren Shen, Bai Zhu, and Mu Dan Pi. If painful before arrival, Qi Deficiency with Blood Stasis; use Si Wu Tang plus Fu Ling, Bai Zhu, and Xiang Fu (Cyperi Rhizoma). If dark purple with clots, Blood Heat; use Si Wu Tang plus Zhi Zi and Mu Dan Pi. If painful with pale color, Qi and Blood Deficient; use Ba Zhen Tang. For Metrorrhagia due to Liver Fire failing to store Blood, use Jia Wei Xiao Yao San. For Spleen Deficiency failing to control Blood, use Bu Zhong Yi Qi Tang. All result from Six Evils and Seven Emotions injuring Yuan Qi; investigate cause and regulate Stomach Qi.
Treatment of Transformed Syndromes:
[Nodules on Body, Suppurating upon Scratching] If chills and alternating fever, Liver Channel Qi-Blood Deficiency with Fire; use Ba Zhen San plus Mu Dan Pi and Chai Hu. If internal heat with chills, Qi-Blood Weakness with Deficient Heat; use Ba Zhen San doubling Ren Shen and Bai Zhu. If aversion to cold/chills, Yang Qi Deficient Cold; use Shi Quan Da Bu Tang. If skin feels like fabric barrier upon scratching, Qi-Blood failing to nourish exterior; use Ren Shen Yang Rong Tang (Ginseng Nourishing Glory Decoction). If facial itching/numbness upon scratching, Qi-Blood failing to nourish upper body; use Bu Zhong Yi Qi Tang. If flaccidity and tendon cramps, Qi-Blood failing to nourish; use Bu Zhong Yi Qi Tang assisted by Liu Wei Di Huang Wan.
[Mouth/Tongue Ulcers or Sore Throat] If preferring cold food and constipation, Excess Heat; use Si Shun Qing Liang Yin. If muscular heat, aversion to heat, irritability, and thirst, Blood Deficiency; use Dang Gui Bu Xue Tang (Angelica Tonifying Qi Decoction). If aversion to cold food and loose stool, Deficient Heat; use Shi Quan Da Bu Tang. Heat rising from below or feet, Kidney Deficient Heat; use Jia Jian Ba Wei Wan. If difficulty digesting food and cold extremities, Mingmen Fire Decline; use Ba Wei Di Huang Wan.
[Toothache] Or gum ulceration. If preferring cold/aversion to heat, Stomach Fire; prioritize Jia Wei Qing Wei San (Modified Stomach-Clearing Powder). If aversion to cold/preference for heat, Stomach Deficiency; prioritize Bu Zhong Yi Qi Tang.
[Spontaneous Sweating] Indicates Qi Deficiency; use Bu Zhong Yi Qi Tang with Liu Wei Di Huang Wan. Night sweats indicate Blood Deficiency; use Dang Gui Liu Huang Tang (Angelica and Three Yellows Decoction - Huang Qin, Huang Lian, Huang Bo stir-baked black) with Liu Wei Di Huang Wan. If caused by mental labor, use Gui Pi Tang doubling Fu Shen and Suan Zao Ren.
[Phlegm Salivation or Wheezing] If Right Cun pulse is floating-slow, Lung Qi Deficiency; use Liu Jun Zi Tang plus Jie Geng. If Right Cun pulse is洪滑 (Surging-Slippery), Lung Channel Heat; use Xie Bai San (Drain White Powder). If Right Cun-Guan pulse is floating-slow-chi-ruo (Floating-Slow-Chi-Weak), Spleen-Lung Qi Deficiency; use Liu Jun Zi Tang plus Jie Geng and Huang Qi. If Right Cun-Guan pulse is Surging-Slippery-Slow-Chi, Spleen Heat transmitting to Lung; use Xie Bai and Xie Huang powders. Right