典藏书目

Zhishi Daozhi Wan (Immature Bitter Orange Decoction for Directing Stagnation): A mild purgative method for food stagnation. This formula is recorded in Li Mingzhi's *Pi Wei Lun* (Treatise on the Spleen and Stomach).
Xiao Zhishi (Immature Aurantium Fructus, 5 qian), Liushen Qu (Six-God Qu, 5 qian), Qing Ziqin (Scutellariae Radix, 3 qian), Chi Ling (Poria Cocos with Red Coir, 3 qian), Sheng Shai Zhu (Atractylodis Rhizoma, 3 qian), Zhi Jinwen (Rhei Radix et Rhizoma, 1 liang), Xiao Chuanlian (Coptidis Rhizoma, 3 qian), Zexie (Alismatis Rhizoma, 2 qian).

Mengshi Guntan Wan: A severe purgative method for phlegm-fire. This formula is recorded in Wang Yinjun's *Yangsheng Zhu Lun*.
Qing Mengshi (Lapis Malachitis, 1 liang, ground with Huoxiao), Chenxiang (Aquilariae Lignum Resinatum, 5 qian), Chuan Jinwen (Rhei Radix et Rhizoma, 8 liang, steamed with wine), Qing Ziqin (Scutellariae Radix, 8 liang, washed with wine).

Kongyan Dan: A severe purgative method for phlegm-fluid retention. This formula is recorded in *Danxi Xinfa*.
Baijiezi (Sinapis Semen, 1 liang), Wei Gansui (Kansui Radix, 1 liang, baked), Hongya Daji (Euphorbiae Pekinensis Radix, 1 liang), made into pills with Shengjiang Zhi (Ginger Juice).

Dai Didang Wan: A severe purgative method for blood stasis and heat. This formula is recorded in *Wangshi Zhunsheng*.
Sheng Chuanjun (Rhei Radix et Rhizoma, 4 liang, stir-fried with wine), Chao Chuanjia (Testudinis Carapax et Plastrum, 1 liang), Yuanmingfen (Natrii Sulfas, 1 liang), Guiwei (Angelicae Sinensis Radix Caulis, 1 liang), Guang Taoren (Persicae Semen, 30 pieces), Peng Ezhu (Curcumae Longae Rhizoma, 1 liang, stir-fried with vinegar), Zi Gui (Cinnamomi Ramulus, 3 qian), Xi Shengdi (Rehmanniae Radix Praeparata, 1 liang).

Danggui Longhui Wan: A severe purgative method for draining liver fire. This formula is recorded in Danxi's *Xinfa*.
Longdancao (Gentianae Radix, 1 liang), Danggui (Angelicae Sinensis Radix, 1 liang), Xiao Chuanlian (Coptidis Rhizoma, 1 liang), Chuan Huangbai (Phellodendri Chinensis Cortex, 1 liang), Lvhui (Aloe, 5 qian), Guang Muxiang (Aucklandiae Radix, 1.5 qian), Qing Ziqin (Scutellariae Radix, 1 liang), Sheng Shanzhi (Gardeniae Fructus, 1 liang), Sheng Chuanjun (Rhei Radix et Rhizoma, 5 qian), Qingdai (Indigo Naturalis, 5 qian), Shexiang (Moschus, 5 fen).

Jiaomei Wan: A mild purgative method for worm accumulation. This formula is recorded in *Zhangshi Yitong*.
Chao Chuanjiao (Zanthoxyli Pericarpium, 3 qian), Wumei Rou (Mume Fructus Pulpa, 1 qian), Xiao Chuanlian (Coptidis Rhizoma, 1 qian), made into pills with Yitang (Maltose).

Xue Geng He Gengyi Wan: A simultaneous treatment method for the Liver and Small Intestine. This is an empirical formula by Yu.
Dan Haihe (Metereae Corpus, 4 liang), Da Biqi (Dioscoreae Hypoglaucae Rhizoma, 6 pieces), Gengyi Wan (Gengyi Pill, 1.5 qian, can be swallowed or decocted in a bag).

[Commentary by Xiu] The Xue Geng formula first appeared in Wang Jinsan's *Gu Fang Xuan Zhu*. It states that Haihe tastes salty, and Biqi tastes sweet and slightly salty. Both are cold in nature and slippery in texture, possessing the wonderful effect of cooling and penetrating inward. Whenever there is liver meridian heat jue, with attacking pain in the lower abdomen, and other medicines are ineffective, using it to drain heat and relieve pain is as swift as shadow following form. However, based on my verification, its efficacy is not limited to this. For diseases such as phlegm-wheezing, chest oppression, vomiting, distension, constipation, dysentery, abdominal masses, infantile malnutrition, and jaundice caused by liver fire, they can all be used酌情 (at discretion). Even in cases where purgation is indicated, but the constitution is weak and cannot withstand Xiaoshi (Natrii Nitras) and Dahuang (Rhei Radix et Rhizoma), adding Zhishi (Immature Aurantium Fructus) and Houpo (Magnoliae Officinalis Cortex) according to the syndrome often yields silent effectiveness. Only Yu believed its power was thin, so he frequently added Gengyi Wan, achieving remarkable results repeatedly.

Juan Yin Wanling Tang: An urgent purgative method for retained fluid. This is an empirical formula by Yu.
Yuanhua (Genkwa Flos, 5 fen, stir-fried with wine), Wei Gansui (Kansui Radix, 8 fen), Jiang Banxia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine, 6 qian), Zhe Fuling (Poria Cocos, 8 qian), Daji (Euphorbiae Pekinensis Radix, 1 qian, stir-fried with wine), Da Heizao (Jujubae Fructus, 10 pieces), Chao Guangpi (Citri Reticulatae Pericarpium, 3 qian), Xian Shengjiang (Zingiberis Rhizoma Recens, 1 qian).

[Commentary by Xiu] Retained fluid causes harm; mildly it causes chest fullness and vomiting, severely it causes abdominal distension and limb edema, and even worse, it transforms into abdominal distension (鼓胀). Without severe water-draining methods, no success can be achieved. This formula uses Yuanhua's pungent and spicy nature as the sovereign drug, which is light and clear entering the Lung, directly removing stagnant and old phlegm from the highest part. It is combined with the bitter drainage of Gansui and Daji, paired with the sweet and moistening Jujube to缓和 (moderate) the attack. Thus, the retained fluid from the chest to the hypochondrium and abdomen will exit through both urine and feces. This is the function of Zhang Zhongjing's Shizao Tang (Ten Jujube Decoction). Yu supplemented it with Erchen Tang minus Gancao, following Zhang Zhongjing's principle that "phlegm-fluid should be harmonized with warm medicines." He assisted with the pungency of fresh ginger, combining with the sweetness of Shizao, so that pungent-sweet dispersal occurs; what disperses disperses, what descends descends, leaving no place for retained fluid to remain. Named Wanling (Myriad Efficacy), it truly lives up to the name.

Zhangshi Jichuan Jian: A method of increasing fluids, moistening intestines, and regulating qi. This is an empirical formula by Yu, originally recorded in *Jingyue Quanshu*.
Dan Congrong (Cynomorii Herba, 4 qian), Huai Niuxi (Achyranthis Bidentatae Radix, 2 qian, raw), Shengma (Cimicifugae Rhizoma, 5 fen, honey-fried), You Danggui (Angelicae Sinensis Radix, 3 qian), Fu Zexie (Alismatis Rhizoma, 1.5 qian), Zhiqiao (Aurantii Fructus, 7 fen, honey-fried).

[Commentary by Xiu] Constipation has three patterns: heat binding, qi stagnation, and fluid depletion. Heat binding is correctly treated with various Chengqi Decoctions, which is established. Qi stagnation requires seeking the cause of the stagnation and removing it. For example, food stagnation uses Zhishi Daozhi Wan, phlegm stagnation uses Jiawei Liangge San, blood stasis uses Tao Ren Chengqi Tang, fluid stagnation uses Juan Yin Wanling Tang, cold stagnation uses Nongpu Qiwu Tang, and heat stagnation uses Liu Mo Yinzi; all are effective. Fluid depletion often accompanies heat binding, making Yangrong Chengqi Tang the correct treatment. If fluid depletion accompanies qi stagnation, mild cases use Wuren Ju Pi Wan, and severe cases use Zhangshi Jichuan Jian. Jichuan Jian focuses on the Kidney and Liver. Since the Kidney governs the two bowels, Congrong and Niuxi are used as sovereign drugs to nourish Kidney yin and unblock the bowels. The Liver governs free flow, so Danggui and Zhiqiao are used as minister drugs; one moistens liver yin with pungency, the other drains liver qi with bitterness. The brilliance lies in Shengma ascending clear qi to transport to the Spleen, and Zexie descending turbid qi to transport to the Bladder, assisting Congrong and Niuxi to achieve moistening and lubricating effects. Zhang Jingyue said that for superficial deficiency damage with constipation, aggressive agents like Xiaoshi and Dahuang must not be used. If the situation necessitates unblocking, this formula should be used. This is a formula that uses unblocking within tonification. It is most exquisite.

[Commentary by Rongzhai] Cheng Zhongling said: "The purgative method is the attacking method, attacking evil. If the disease is in the exterior, sweat it; if half-exterior half-interior, harmonize it; if in the interior, purge it. However, there are those who err by not purging when they should; by purging when they should not; by wrongly purging when they should not purge; by purging improperly when they should not purge but must; by purging without knowing depth, distinguishing between urinary difficulty and blood stasis, or choosing between decoctions and pills; and by failing to distinguish cold-heat, accumulation, phlegm-water, worms, blood, abscesses, and pus in miscellaneous diseases. These must be examined. What is 'should purge but did not'? Zhang Zhongjing said: 'Shaoyin disease, after two or three days, with dry mouth and throat, purge urgently. Shaoyin disease after six or seven days, with abdominal fullness and inability to defecate, purge urgently. Diarrhea with slippery-rapid pulse, aversion to food, hardness under the heart upon pressure indicates retained food, purge urgently. Yangming disease, delirium and inability to eat indicate dry stool in the stomach, it can be purged. Yangming disease, with fever and profuse sweating, purge urgently. Shaoyin disease, diarrhea with clear water, pure green color, pain under the heart, and dry mouth, purge urgently. Cold injury after six or seven days, unclear vision and unfocused eyes, no exterior symptoms, difficult defecation, purge urgently.' These are all examples of when to purge. If time is lost and purging is not done, fluids will be depleted, the body will become like dead wood, and it will be hard to save. But why are there cases of purging when one should not? For example, if exterior symptoms of cold injury have not resolved, the disease is in the Yang stage; purging leads to Jie Xiong (chest knotting); although pathogenic factors have entered the interior, if they are scattered among the three Yin meridians and not yet solidified, immediate purging also leads to Pi Qi (epigastric fullness); moreover, there are Yin-Jie syndromes where stool is hard but moves with warmth, like melting ice. In miscellaneous diseases, there are elderly with dry blood stagnation, postpartum women with blood depletion, patients after illness with fluid loss, those who have lost blood, and those who haven't defecated for days without abdominal discomfort or other symptoms; if wrongly purged, complications arise! This is 'purging when one should not.' But why are there cases where one should purge but cannot? If heat pathogen transmits to the interior, forming a purgable syndrome, but there is moving qi above, below, left, or right of the navel, purging is contraindicated. The Classics say: 'Moving qi on the right cannot be purged; purging depletes internal fluids, causing dry throat, dry nose, dizziness, and palpitations. Moving qi on the left cannot be purged; purging causes abdominal tension, inability to eat, and worsened moving qi. Even with body heat and desire to curl up, moving qi above cannot be purged; purging causes hot palms, floating sweat, and desire to pour water on oneself. Moving qi below cannot be purged; purging causes abdominal fullness, dizziness, undigested food in stool, and epigastric fullness.' Also, those with throat obstruction cannot be purged; purging leads to heaviness below and lightness above, inability to drink, curled lying position, body ache, and frequent diarrhea. Those with faint pulses cannot be purged. Pulses that are floating-large but weak upon pressure cannot be purged. Slow pulses cannot be purged. Wheezing with chest fullness cannot be purged. Desire to vomit cannot be purged. Patients with inherently weak yang cannot be purged; purging causes hiccups. Patients with weak stomachs unable to eat cannot be purged. Patients who can eat during illness but have no dry stool in the stomach cannot be purged. Those with clear urine cannot be purged. Patients with intermittent abdominal fullness that returns cannot be purged. If wrongly purged, hundreds of complications arise! This is 'should purge but cannot, wrongly purging.' But why are there cases where one should purge but cannot, yet must purge? With a frail person and fine pulse, sudden heat pathogen invasion means righteous qi is deficient and evil is excessive, hardest to handle. Ancients had clearing methods, moistening methods, guiding methods, slight harmonizing methods, tonify-then-attack, attack-then-tonify methods, and simultaneous attack-tonify methods. These must be studied. Such as Sanhuang Jiedu for clearing, Mahan Lizhi for moistening, Honey suppository, Pig bile, or Tu Guagen for guiding, Liangge San and Da Chaihu for slight harmonizing. For those with empty pulses and weak constitutions unable to tolerate, tonify first then attack, or briefly attack then tonify, or send Sanhuang Zhizhu Wan down with Renshen Tang, or combine Renshen, Gualou, Zhishi for simultaneous attack and tonification without conflict. When strong agents are used, Renshen, Baizhu, Danggui, Shaoyi maintain and protect within, allowing evil to dissipate quietly and righteous qi to remain secure, worthy of being a king's army. For miscellaneous diseases with constipation, methods can be referenced; elderly, chronic patients, and new postpartum women often have constipation. Danxi used Siwu Tang, Dongyuan used Tongyou Tang. I combined them and added Congrong, Gouqi, Baiziren, Zhima, Songziren, human milk, Lizhi, Fengmi, achieving quick results. I also added Shengma and previous moistening herbs to Siwu Tang to treat elderly with blood depletion unable to defecate for weeks, often effective; these are gentle unblocking methods. If indeed deficient, even with transmitted heat pathogen, borrowing these is acceptable. Better than suddenly rushing in, destroying true yuan, leading to severe diarrhea; though called fate, is it not human error? This is 'the value of purging lies in obtaining the proper method.' But why are there cases of purging without knowing depth, distinguishing urinary difficulty/blood stasis, or choosing decoctions/pills? For example, Zhang Zhongjing's Dachengqi Tang is only for cases with Pi, Man, Zao, Shi all present. If only Pi and Man without Zao and Shi, Zhang Zhongjing uses Xiexin Tang. If Pi, Man, and Zao without Shi, Zhang Zhongjing uses Xiao Chengqi Tang, removing Mangxiao to avoid injuring lower jiao yin-blood. If Zao and Shi are below but Pi and Man are mild, Zhang Zhongjing uses Tiaowei Chengqi Tang, removing Zhipo to avoid injuring upper jiao yang-qi. For Taiyang wind-strike wrongly purged transmitting to Taiyin causing abdominal pain, use Guizhi Tang plus Shaoyao; for severe pain, Guizhi Tang plus Dahuang; this is resolving exterior while attacking interior. For pathogen from Shaoyang with unresolved chills/fever, use Da Chaihu Tang; this is harmonizing while attacking interior. For Jie Xiong syndrome with stiff neck/back, hardness/fullness/pain from chest to abdomen, untouchable, Zhang Zhongjing uses Da Xianxiong Tang/Wan; if non-tender, use Xiao Xianxiong Tang; for cold-food Jie Xiong, use Sanbai San cooling herbs to attack. For water-Jie Xiong with head sweating, use Xiao Banxia plus Fuling Tang; for water retention in hypochondrium with unbearable pain, use Shizao Tang. For all Jie Xiong yin-yang syndromes unresponsive to medication, Huoren all use Zhishi Lizhong Wan, effective immediately. *Hejian Sanshu* says: 'Severe郁热 (depressed heat) accumulation causes confusion and reversal, pulses are sluggish and choppy, appearing faint and nearly absent. Laypeople do not understand the principles of creation; administering warm medicines is incurable. Some wrongly purge, causing sudden destruction of residual yin, a critical danger whether purged or not. Use Qingge San combined with Jiedu Tang to nourish yin and retreat yang, allowing accumulated heat to disperse, harmonizing chest and heart, and gradually restoring pulses.' These are the steps of drug depth/shallowness. For example, Taiyang syndrome unresolved, thirst, short/scanty urine, normal stool, this is heat-stasis blockage, treat with Wuling San. Taiyin transmitted heat binding to Bladder, patient manic, lower abdominal hardness/fullness/pain, free urination, this is blood stasis in lower jiao, use Didang Tang/Wan. If blood stasis is mild, only lower abdominal urgency/clumping without hardness/fullness, use Taohe Chengqi Tang, or Dihuang Siwu Tang plus Jiu Xi Dahuang half-dose each, particularly safe. Urinary difficulty has normal stool, dry stool has scanty urine, blood stasis has free urine and black stool; this distinguishes urinary/stool/blood issues. Blood binding to Bladder, acute condition, use Didang Tang; milder, Didang Wan. Complete severe Jie Xiong symptoms, use Da Xianxiong Tang; milder, Xiao Xianxiong Wan. Other methods of cleansing intestines and eliminating old to generate new all use decoctions. Ancients said: "When using purgatives to attack evil, decoctions surpass pills/powders. Indeed, with heat rampant inside, using decoctions to cleanse achieves purity; this is the difference between decoctions and pills." But why do some err in miscellaneous diseases by not distinguishing cold-heat, accumulation, phlegm-water, worms, blood, abscesses, and pus? Dongyuan treated food-injury with abdominal pain, constipation, and tenderness due to cold food using Yongyuan Wan. Due to hot food, using Sanhuang Zhizhu Wan. If cold and heat mutually injure, use both pills adjusting for amount of food eaten, achieving quick results. There are also Real-Heat Old Phlegm, Guntan Wan, Edema Excess Syndrome, Shenyuan Wan, Worm Accumulation, Jianhong Wan, Blood Accumulation, Huarui Dan, Shixiao Wan, Intestinal Abscess, Mudanpi San; prescribing according to syndrome, each has its suitability. This is a good method for purging miscellaneous diseases."