一条 师曰。夫脉。当取太过不及。阳微阴弦。即胸痹而痛。所以然者。责其极虚也。今阳虚。知在上焦。所
以胸痹心痛者。以其阴弦故也。
脉有伦类。盛则俱盛。衰则俱衰。此大较也。故凡诊脉者。当取其既有太过处。又有不及处。则不及者自为病。
而有余者将乘之。而尤为不及者之病矣。即如其脉。关以前之阳部得微。关以后之阴部得弦。夫关前之阳
脉微。则自胃脘上至胸中。其真阳卑弱而不能奋鼓。故病名曰痹。关后之阴脉弦。则自胃腑下至肝脏。其浊
邪弦急而从上弹射。故症则见痛。所以然者。责在胸中阳位之极虚。故招下焦之上凌耳。二句。就主一边说。
即后文栝蒌薤白及人参诸汤。填阳之案也。关前应胸分。关前之脉微。故知胸分之阳虚而病痹也。二句是
自注。所以知其为胸痹之故。弦脉。于脏为肝。于气为阴。于邪为寒。于症为痛。病胸痹而心痛者。正弦脉以肝
脏阴寒之邪。上乘阳虚之所致也。二句就客一边说。即后文栝蒌薤白加半夏。及薏苡附子等汤。并乌头赤
石脂丸。兼责中下二焦逆阴之案也。此与腹满寒疝第一条。寸口脉微弦。文虽同而大有分别。彼处之微
弦。在寸口一部上见。盖浮之得微。而沉之得弦也。此处之微弦。是寸口与关上。或下与尺中两部分见。故三
条曰寸口脉云云。关上脉云云。九条乌头赤石脂丸一症。虽未尝言脉。然就其症与方意细审之。又确为尺
弦之候故也。又彼处心肺间。其无形之宗气虚馁。与此处同。而胸痹一症。多在当心之膈膜。其有形血肉中
之气虚。故痹着而痛。且从孙络而痛彻于背也。大概无形之宗气。虚于大惊大吐。或忧戚所致。其病顿。略久
而上不能御下者。则成惊悸。或便难而见吐衄等血。其不能提下者。又成半产漏淋。亡血失精诸候。并传变
为本门之胸痹者亦有之。当心之膈膜。其有形血肉中之气。又虚于形寒饮冷。及伤心诸事者居多。其病渐
而在心后之脉络。故其曰心痛者。谓当心而痛。非心脏中之自痛也。
二条 平人无寒热。短气不足以息者。实也。
短气者。宗气上虚。而逆阴凑之。则吸气艰于深入。入浅则出亦浅。故殊觉短而不足以息也。寒则肺卷。热则
气闭。俱能短气。今外则似无病之平人。既无寒热之症。则其所以短气者。岂非上虚而邪凑之。以致气机不
能深入之故乎。夫邪之所凑。其气必虚。留而不去。其病乃实。即第五条所谓留气结在胸中者是也。故曰实
也。上照前条之极虚。故使客邪逗留而反实。下伏后方之攻实。故用橘枳浓朴以散痞也。
三条 胸痹之病。喘息咳唾。胸背痛。短气。寸口脉沉而迟。关上小紧数。栝蒌薤白白酒汤主之。
栝蒌薤白白酒汤方 栝蒌实（一枚） 薤白（半斤） 白酒（七升）
上三味。同煮。取二升。分温再服。
此言胸痹之全症也。喘息及短气者。胸中之本气虚。而胃邪实之。以致呼吸之气不能深入远出之义。肺气
逆。故咳。肺液与气俱逆。故咳而且唾也。胸背痛者。胸中阴维阴跷之脉。其孙络与督脉。及阳维阳跷之在背
者相贯。其痛从胸透背。故胸背阴沁而切痛也。寸口二句。又即首条阳微阴弦而深细言之。盖寸口为胸之
应。沉为阳不能上鼓。迟为气不能连续。是沉迟为微脉之根蒂。寸口外微而内沉迟。故知胸中之阳气极虚
而病痹也。关上为胃之应。紧即首条之弦脉。与伤寒之紧脉不同。伤寒之紧脉。因寒气凝敛。脉从两头中缩
而紧。其体常短。故曰形如转索。转索者。以中缩而紧也。弦脉之紧。因阴弛阳急。脉从两头扯拔而紧。其体较
长。故曰状如弓弦。弓弦者。以绷急而紧也。胸膈上虚下吸有力。以致中焦之气奔之。吸张乘两就之势。故其
脉数也。小紧数。犹言略略紧数之谓。盖终不比有余者之上射也。关上小紧数。故知胸病虚痹。胃以阴弛阳
急之气赴之。而致痛矣。夫胸膈象天。常喜轻清。薤白气味俱薄。而性辛温。薄则应在天之气而走胸分。辛温
则能迎导其阳气而发越之。佐以蔓生甘润。而善于通窍之栝蒌。蔓生则走经络。甘润而通窍。则又能入络
脉。而行其阴中之气矣。然后以浮缓之酒托之。取气味俱薄之白酒者。一则以轻清应天。再则以少火生气。
将阳回春满。从胸温络。而痹自愈矣。薤独取白者。以白具上行之性故也。且南方种之以供蔬。尝留白而就
地刈之。不数天而苗长如故。则尤见其上行之最速者矣。此胸痹之正病正方。单责胸分之阳虚。而未责
中下者也。
四条 胸痹不得卧。心痛彻背者。栝蒌薤白半夏汤主之。
栝蒌薤白半夏汤方 栝蒌实（一枚） 薤白（三两） 半夏（半升） 白酒（一斗）
上四味。同煎。取四升。温服一升。日三服。（以四升日三服计之。当缺夜一服三字。）
胸痹二字。包上条之脉症在内。后仿此。前条之症。因胸中自虚。下吸胃气。胃家本无上犯之意。犹胸中之谩
藏冶容。诲其淫盗耳。故以填阳通气之外。略无余议下及者。此也。本条之症。胸中之虚未甚。却以胃家之浊
邪方实。以盛凌衰而贯注之。浊气上浮而不下伏。故不得卧。且胸分虚而客气上乘。犹之盗贼所经。于墙垣
门径之低小残缺者。则一往趋之。心后之络。外通于背。阳虚而痹。墙垣之低小。门径之残缺是也。浊气从胸
之心后而贯痹。故痛如在心。又从痹之络脉而贯背。故痛彻背矣。于前汤中。减辛温填气之薤白过半。故知
胸中之虚未甚。君平胃降气之半夏而用至半升。故知以盛凌衰。为胃中之邪过实也。是此汤即第一条太
过不及而两责之者。盖以栝蒌薤白本汤。责胸分之阳虚者十之三。加半夏为君。而责胃中之气实者十之
七也。岐黄论卧与不卧。明明说是气伏于阴分。则神明收藏。故得卧。气出于阳分。则灵醒发越。故不得卧。
半夏粳米汤治之。覆杯即卧者。以半夏乘春发生。入夏将半。即归根复命而苗便枯。故名。是圣人取半夏之
性降。能伏其气以入于阴分故也。佐粳米者。滋胃中之阴液以覆庇阳神。犹之衣被之用而已。李氏旧注。引
甲乙本灵枢之意。而以半夏治不眠。谓半夏入少阳经。已乖仲景用在阳明之旨。至其谓为转运阴阳之药。
阴阳得通。其卧立至。则平人之白日不欲卧者。其阴阳俱不通者耶。冤哉。
五条 胸痹。心中痞。留气结在胸。胸满。胁下逆抢心。枳实薤白桂枝汤主之。人参汤亦主之。
枳实薤白桂枝汤方
枳实（四枚） 薤白（半斤） 桂枝（一两） 浓朴（四两） 栝蒌实（一枚捣）
上五味。以水五升。先煮枳实、浓朴。取二升。内诸药。煮数沸。分温三服。
人参汤方 人参 白术 甘草 干姜（各三两）
上四味。以水八升。煮取三升。温服一升。日三服。
胸分之阳虚。而下阴上凑。故心中痞。但痞之为病。常随阳气之起伏以为消长。故腹满时减者。痞之候也。今
其气逗留而结在胸。以致胸满不减者。此留气也。譬之天地。寒云断脚。冷雾横拖。逗留于太虚。而不收不散
之象。是从胃脘中路上浮。而已据胸中矣。加之胁下以肝胆之逆。从旁抢心。而争趋空处。此虽胸中阳虚之
所招致。填膈之品。固宜首重。以降逆阴。然其留气结胸。犹之贼据城郭。扫除之法。不得不与抚绥兼施矣。故
以散气之枳实。开痞之浓朴为主。而先煮之者。其意以微风荡云雾而去留气也。然后以薤白、桂枝之辛温
而甘者。填胸阳以引其气。以栝蒌实之甘寒而润者。走络脉以入其痹。犹之人尿、猪胆及柏叶等之反佐也。
于是留气散而胸阳上复。则不治逆而逆将自靖矣。至于枳实、浓朴。欲并用其苦味以泄土邪。故久煮之以
取其重浊。薤桂二味。欲单用其温阳以通天气。故略煮之以取其轻清耳。人参汤亦主之者。盖人参补气。白
术填胸。干姜散结开痞。甘草浮缓上托。使一团太和之气。氤氲胸中。上则旁导阳气而治痹。下则照临阴氛
而消逆。其于留气之结胸者。舞干羽而有苗格化矣。或曰。前汤是治全症之方。后汤是单治胁下逆抢之
方。又曰。服前汤而留气已散。痞结已开。后汤所以愈痹。而为善后之剂也。二说虽与仲景一条。而主两汤之
文例不合。然皆近理。故俱存之。以俟有识者之鉴定焉。
六条 胸痹。胸中气塞。短气。茯苓杏仁甘草汤主之。橘枳生姜汤亦主之。
茯苓杏仁甘草汤方 茯苓（三两） 杏仁（五十个） 甘草（一两）
上三味。以水一斗。煮取五升。温服一升。日三服。不瘥。更服。（以煮五升。服一升按之。则日三服之下。当缺
夜二服一语。盖不瘥更服。是更作一服之谓。若谓即服此二升。金匮前后诸汤。并无一剂分作数服。今日
服一半。至明日服完。为更服之例也。）
橘枳生姜汤方 橘皮（一斤） 枳实（三两） 生姜（半斤）
上三味。以水五升。煮取二升。分温再服。
胸痹上虚而中下之逆邪有二。湿与寒是也。肺性恶湿复恶寒。湿则肺滞。寒则肺敛。俱能使膈膜之痹处作
痛外。而又能令其气塞且短也。湿气上逆者。以茯苓之温胸燥湿者为主。佐杏仁以利肺窍。而以浮缓之甘
草。托之上行而留恋之。则湿去滞通。而气之塞且短者可愈矣。故主之。寒气上逆者。以辛温之橘皮为君。温
则暖膈。辛则散结也。生姜祛寒止逆。而性复宣通。与犀利之橘皮相济。则成和风爽气之象。然后佐以破留
气之枳实。则寒去而肺畅。气之塞且短者亦愈。故曰亦主之。然二汤皆微弦两责之方也。
七条 胸痹。缓急者。薏苡附子散主之。
薏苡附子散方 薏苡仁（十五两） 大附子（十枚炮）
上二味。杵为散。服方寸匕。日三服。
此即前条茯苓杏仁。及橘枳汤之合症合方也。缓急统胸痹之全症而言。凡喘息咳唾。背痛短气。及不得卧
等候。有时而缓。有时而急者。以其人之脾胃。素有客湿客寒之邪。上冲下伏之所致也。夫阴阳五行。生扶囚
谢之化。人身之脏腑。与天地准。故火土之气衰。而水木为妖者。得丙丁戊己而持。得壬癸甲乙而甚。持则病
缓。而甚则病急者。一也。且湿气浸淫。寒气劲迫。是湿邪为害尚缓。而寒邪为害则急者。又一也。故其谓病痹
之人。其诸痹症。或缓或急。此湿寒之气在中焦。以上窥胸阳之往复。而为更迭入寇之象。故主祛湿利水之
薏苡者。即上条茯苓甘草杏仁汤之义。配温中行阳之附子者。即上条橘枳生姜汤之义。而进之者也。至杵
为散而连服其渣质。则留连胃中。使寒湿既去。而其干温之化。还浮于太虚。则填胸贯络。而痹自愈。此虽似
乎单责阴弦之脉。注意在讨贼一边。不知荡平之后。阳微大振。而贺太平者。却正在朝廷也。噫、神矣哉。
八条 心中痞。诸逆。心悬痛。桂枝生姜枳实汤主之。
桂枝生姜枳实汤方 桂枝 生姜（各三两） 枳实（五枚）
上三味。以水六升。煮取三升。分温三服。
痞及诸逆之由于胸阳虚馁者。详已见。心之所以如有根据辅者。真气为之旁薄故也。真气上虚。则心无凭借。
有如空悬之状。故曰心悬。胸为阳位。阴邪留之。则阴阳不相宜。而阴沁作痛。故曰心悬痛也。以辛温之桂枝
生姜填真气者。所以治其心之虚悬。以苦温开痞之枳实破留气者。所以除其痛耳。大概即五条枳实薤白
之汤意而变易之者也。此及下文二条。又就胸痹之症而推展言之。盖谓胸痹者。见种种等候。固宜主此。
然不必执定胸痹。凡上虚而下气上犯。以致留而不散者。俱主之。故于条端。既不冠胸痹字。而且曰诸逆云尔。
九条 心痛彻背。背痛彻心。乌头赤石脂丸主之。
乌头赤石脂丸方
乌头（一分炮） 赤石脂（一两） 附子（半两炮） 干姜（一两） 蜀椒（一两）
上五味。末之。蜜丸如梧子大。先食服一丸。三服不知。稍加服。（梧子大者服一丸。恐有误。）
细按症治。其脉亦当阳微阴弦。但微脉固在寸口。而阴弦之脉。当在关以下之尺中耳。人身心胸中之真阳。
外为周身卫气之根。内为中下二焦之主。真阳上虚。而脾胃之邪。就近犯之。则为四、五、六、七等条之症。若夫
肾为牡脏。肝居至阴之下。其虚寒之邪。比之吴楚诸夷。周室既衰。而泽国蛮荆。亦来远窥王室矣。然肝肾之
阴邪上犯。较之中土之逆为尤甚。故心痛彻背。与四条之症既同。而胸阳内亏。卫气衰薄。寒从背入。且与下
阴之逆。起而贯痹者。同类而两相感召。故背痛而又内彻于心也。夫三焦之化。阳从底生。盖以命门之温热。
蒸熟水谷。而化悍气。然后上熏如雾。而贮为胸阳者也。况本症又属下焦之寒逆乎。是非温下以温上不可
也。故以乌头之老阳。壮先天之元气。以附子之生阳。发后天之化气。取蜀椒之辛敛者。所以补其阳而封之
固之也。取干姜之辛散者。又所以种其根而升之举之也。总交于气重色赤之石中脂髓。以为使者。气重、易
致下行。色赤、偏宜阴脏。石中之脂髓。岂非欲其入精血中。而温资始之化源乎。丸非汤散之仅行上中者可
第一条 老师说：诊脉时，应当辨别脉象的“太过”（亢盛）与“不及”（虚弱）。如果寸部脉微（阳气微弱），尺部脉弦（阴寒内盛），这就是胸痹并伴有疼痛的原因。之所以这样，是因为病根在于极度的虚损。如今知道是上焦阳气虚弱，导致胸痹心痛的原因，正是因为下焦阴寒之邪上乘的缘故。
脉象是有规律可循的，盛的时候两者都盛，衰的时候两者都衰，这是大概的情况。所以凡是诊脉的人，应当寻找既有太过之处，又有不及之处的脉象。那么不及的一方自然成为病患，而有余的一方就会乘虚侵袭，从而更加重了不及一方的病症。就像这种脉象：关前（寸部）的阳脉表现为微，关后（尺部）的阴脉表现为弦。关前的阳脉微，说明从胃脘向上至胸中，其真阳卑弱而不能振奋鼓动，所以疾病命名为“痹”。关后的阴脉弦，说明从胃腑向下至肝脏，其浊邪弦急并从上方弹射冲击，所以症状表现为痛。之所以这样，责任在于胸中阳位的极度虚弱，所以招致了下焦阴寒的上凌。这两句是从主要矛盾（本虚）方面说的，即后文栝蒌薤白汤及人参诸汤，是填补阳气的案例。关前应分属胸部，关前脉微，所以知道胸部的阳气虚弱而患痹证。这两句是自注，解释之所以知道这是胸痹的原因。弦脉，在五脏对应肝，在六气对应阴，在邪气对应寒，在症状对应痛。患胸痹且心痛，正是由于弦脉所代表的肝脏阴寒之邪，上乘于阳气虚弱所致。这两句是从次要矛盾（标实/客邪）方面说的，即后文栝蒌薤白加半夏汤、薏苡附子散等方，以及乌头赤石脂丸，是同时责治中下二焦逆乱阴寒的案例。这与《腹满寒疝宿食病脉证治》第一条中“寸口脉微弦”的文句虽然相同，但大有区别。彼处的微弦，是在寸口这一部位上显现，即浮取得微，沉取得弦。此处的微弦，是在寸口与关上，或者下部与尺中两个部分显现。所以第三条说“寸口脉……”，“关上脉……”。第九条乌头赤石脂丸一症，虽然没有明言脉象，但就其症状和方义仔细审察，确实符合尺脉弦的征候。另外，彼处心肺之间，是无形的宗气虚馁，与此处相同；而胸痹这一症，多在当心部位的膈膜，是有形血肉中的气虚，所以痹阻而痛，并且通过孙络疼痛放射到背部。大抵无形的宗气，因大惊、大吐或忧戚所致而虚损，其病发作急骤，若时间久了，上不能御下，则形成惊悸；或大便困难并出现吐血、衄血等出血症状；若不能提摄下部，又形成半产、漏淋、亡血、失精等各种候证，并传变为本篇的胸痹病的也有这种情况。当心部位的膈膜，其有形血肉中的气，又多因形寒饮冷及伤心之事而虚损，其病势缓慢，在心后的脉络，所以说“心痛”，是指当心部位疼痛，并非心脏内部自痛。
第二条 平素健康的人，没有恶寒发热的症状，却感到短气、呼吸不足以接续，这是实证。
短气，是因为宗气上部虚弱，而逆上的阴寒之气凑聚，导致吸气艰难深入。吸入浅则呼出也浅，所以特别觉得气短而不足以息。寒邪会使肺叶卷缩，热邪会使气机闭塞，都能导致短气。现在外观看起来像无病的正常人，既没有寒热症状，那么他之所以短气，难道不是因为上焦虚而邪气凑聚，导致气机不能深入吗？邪气所凑聚的地方，正气必然虚弱；邪气停留不去，病情就转为实证。这就是第五条所说的“留气结在胸中”。所以说这是实证。这呼应了前条的“极虚”，使得客邪逗留反而呈现实证；这也伏应后方的攻逐实证之法，所以使用橘皮、枳实、厚朴来消散痞结。
第三条 胸痹病，表现为喘息、咳嗽、吐唾沫、胸背疼痛、短气。寸口脉沉而迟，关上脉小紧数。用栝蒌薤白白酒汤主治。
栝蒌薤白白酒汤方：栝蒌实（一枚）、薤白（半斤）、白酒（七升）。
以上三味药，同煮，取药液二升，分两次温服。
这段话讲的是胸痹的全部症状。喘息及短气，是因为胸中本气虚弱，而胃中邪气实盛，导致呼吸之气不能深入远出。肺气上逆，所以咳嗽；肺液与气一起上逆，所以咳而且吐唾沫。胸背痛，是因为胸中的阴维脉、阴跷脉，其孙络与督脉，以及背部阳维脉、阳跷脉相互贯通，疼痛从胸部透达背部，所以胸部和背部感觉阴冷且剧烈疼痛。寸口脉沉迟两句，又是就首条“阳微阴弦”进行详细阐述。盖因寸口对应胸部，沉表示阳气不能上鼓，迟表示气不能连续，所以沉迟是微脉的根本。寸口脉外微内沉迟，所以知道胸中阳气极虚而患痹证。关上对应胃，紧就是首条所说的弦脉，但与伤寒病的紧脉不同。伤寒病的紧脉，是因为寒气凝敛，脉管从两头向中间收缩而紧，脉体通常较短，所以说“形如转索”，转索就是因为中间收缩而紧。弦脉的紧，是因为阴弛阳急，脉管从两头拉扯而紧，脉体较长，所以说“状如弓弦”，弓弦就是因为绷急而紧。胸膈上部虚而下部吸力有力，导致中焦之气奔涌而上，吸气张开乘两就之势，所以脉象数。小紧数，意思是略微紧数。终究不像有余之邪向上冲射那样剧烈。关上脉小紧数，所以知道胸病为虚痹，胃中以阴弛阳急之气赴之，从而导致疼痛。胸膈象天，喜欢轻清。薤白气味俱薄，性味辛温，薄则作用于天之气而走胸部，辛温则能迎导阳气而发散它。佐以蔓生、甘润且善于通窍的栝蒌，蔓生则走经络，甘润通窍则能入络脉，运行其中的阴中之气。然后用浮缓的酒来托举它，选用气味俱薄的白酒，一是以轻清应合天道，二是以少火生气，使阳气回复如春满，从胸部温通络脉，痹证自然痊愈。薤独取白色，是因为白色具有上行的性质。况且南方种植它作为蔬菜，常常保留白色部分就地收割，没过几天苗又长得一样高，这就更见到它上行速度最快的特性了。这是胸痹的正病正方，只责治胸分的阳气虚弱，而未责治中下焦。
第四条 胸痹不能平卧，心痛放射到背部，用栝蒌薤白半夏汤主治。
栝蒌薤白半夏汤方：栝蒌实（一枚）、薤白（三两）、半夏（半升）、白酒（一斗）。
以上四味药，同煎，取药液四升，温服一升，每日三次。（按四升分三次服计算，应当缺少“夜一服”三个字。）
“胸痹”二字包含了上一条的脉症在内，后文仿照此例。上一条的症状，是因为胸中自虚，下部吸入胃气，胃家本来没有上犯的意思，就像胸中修饰容貌，引诱淫盗一样。所以在填阳通气之外，没有多余的议论涉及下部。本条的症状，胸中的虚损不严重，却是胃家的浊邪正盛，以盛凌衰而贯注进来。浊气上浮而不下降，所以不能平卧。而且胸分虚而客气上乘，就像盗贼经过墙垣门径低小残缺的地方，就往那里去。心后的络脉，外部通向背部，阳虚而痹，就是墙垣低小、门径残缺的表现。浊气从胸中心后贯穿痹阻之处，所以痛感像在心，又从痹阻的络脉贯穿到背部，所以疼痛放射到背部。在前一方中，减去辛温填气的薤白过半，所以知道胸中的虚损不严重；君药改为平胃降气的半夏并用至半升，所以知道是以盛凌衰，是胃中的邪气过实。这个方子就是第一条中“太过”与“不及”两方面都责治的。大概是栝蒌薤白本汤，责治胸分阳虚占十分之三，加入半夏为君药，而责治胃中气实占十分之七。岐伯和黄帝讨论卧与不卧，明明说是气伏于阴分，则神明收藏，所以能卧；气出于阳分，则灵醒发越，所以不能卧。半夏粳米汤治疗失眠，喝下杯子就睡着，是因为半夏乘着春天发生、夏天将半时归根复命而苗枯的特性，名叫半夏，所以圣人取半夏的性质沉降，能使气伏入阴分。佐以粳米，是滋润胃中的阴液以覆盖保护阳神，就像衣被的作用一样。李氏旧注引用《甲乙经》和《灵枢》的意思，认为半夏治疗失眠，说半夏入少阳经，已经违背了仲景用在阳明经的本意。至于他说半夏是转运阴阳的药，阴阳通畅，睡眠立刻到来，那么普通人白天不想睡觉，难道是阴阳都不通吗？真是冤枉啊。
第五条 胸痹，心中痞塞，留气结在胸中，胸满，胁下有气逆抢心。用枳实薤白桂枝汤主治。人参汤也可以主治。
枳实薤白桂枝汤方：枳实（四枚）、薤白（半斤）、桂枝（一两）、厚朴（四两）、栝蒌实（一枚，捣碎）。
以上五味药，用水五升，先煮枳实、厚朴，取药液二升，加入其他药物，煮几沸，分三次温服。
人参汤方：人参、白术、甘草、干姜（各三两）。
以上四味药，用水八升，煮取药液三升，温服一升，每日三次。
胸分的阳气虚弱，而下部阴寒之气上凑，所以心中痞塞。但痞塞这种病，常随着阳气的起伏而消长，所以腹满时减，是痞的征候。现在气逗留而结在胸，导致胸满不减，这就是留气。好比天地之间，寒云断脚，冷雾横拖，停留在太空中不散不收的样子，这是从胃脘中路浮上来，已经占据胸中了。再加上胁下肝胆之气逆乱，从旁边抢心，争趋空处。这虽然是胸中阳气虚弱招致的，填补膈膜的药品固然应该首选，以降低逆上的阴寒，但是留气结在胸中，就像贼人占据城池，扫除的方法，不得不与安抚兼施。所以用散气的枳实、开痞的厚朴为主药，先煮它们，用意是用微风荡涤云雾以去除留气。然后用薤白、桂枝的辛温而甘，填补胸阳以引导气机，用栝蒌实的甘寒而润，走络脉以进入痹阻之处，就像人尿、猪胆及柏叶等的反佐作用。于是留气散而胸阳上复，则不治逆气而逆气将自然平静。至于枳实、厚朴，想要并用它们的苦味以泄土邪，所以久煮以取其重浊；薤白、桂枝两味，想要单用它们的温阳以通天气，所以略煮以取其轻清。人参汤也可以主治，是因为人参补气，白术填胸，干姜散结开痞，甘草浮缓上托，使一团太和之气，氤氲胸中，向上则旁导阳气而治痹，向下则照临阴氛而消除逆气。对于留气结胸者，如同舞干羽而有苗格化一样。有人说：前汤是治疗全症的方子，后汤是单独治疗胁下逆抢心的方子。又说：服用前汤后留气已散，痞结已开，后汤是用来治愈痹证，作为善后的药剂。这两种说法虽然符合仲景的一条经文，但不符合主两汤的文体例，然而都接近事理，所以都保存下来，以待有见识的人鉴定。
第六条 胸痹，胸中气塞，短气。用茯苓杏仁甘草汤主治。橘皮枳实生姜汤也可以主治。
茯苓杏仁甘草汤方：茯苓（三两）、杏仁（五十个）、甘草（一两）。
以上三味药，用水一斗，煮取药液五升，温服一升，每日三次。如果不愈，继续服用。（按煮五升，服一升计算，则在“日三服”之下，应当缺少“夜二服”一句话。大概“不瘥更服”是指再作一服的意思。如果说就是服完这二升，《金匮》前后诸汤，没有一剂分作数服的例子，今天服一半，到明天服完，作为“更服”的条例吗？）
橘皮枳实生姜汤方：橘皮（一斤）、枳实（三两）、生姜（半斤）。
以上三味药，用水五升，煮取药液二升，分两次温服。
胸痹上虚而中下的逆邪有两种，湿与寒。肺性厌恶湿又厌恶寒，湿则肺滞，寒则肺敛，都能使膈膜痹阻处作痛，另外还能使其气塞且短。湿气上逆，以茯苓温胸燥湿为主药，佐杏仁以利肺窍，以浮缓的甘草，托之上行而留恋之，则湿去滞通，气之塞且短者可愈。所以主治。寒气上逆，以辛温的橘皮为君药，温则暖膈，辛则散结。生姜祛寒止逆，且性质宣通，与犀利的橘皮相辅相成，则形成和风爽气之象。然后佐以破留气的枳实，则寒去而肺畅，气之塞且短者也痊愈。所以说“亦主之”。然而这两个方子都是微弦（太少两责）的方子。
薏苡附子散方：薏苡仁（十五两）、大附子（十枚，炮制）。
以上两味药，捣成散剂，每次服方寸匕，每日三次。
这就是前条茯苓杏仁汤及橘皮枳实汤的合症合方。“缓急”统括胸痹的全部症状而言。凡是喘息咳唾、背痛短气及不能平卧等候，有时缓解，有时紧急的，是因为人的脾胃素有客湿客寒之邪，上冲下伏所致。阴阳五行，有生扶囚谢的变化，人身脏腑与天地相准。所以火土之气衰，而水木为妖者，得到丙丁戊己（火土）而持，得到壬癸甲乙（水木）而甚。持则病缓，甚则病急，这是一点。而且湿气浸淫，寒气劲迫，湿邪为害尚缓，而寒邪为害则急，这是另一点。所以说患痹病的人，各种痹症，或缓或急，这是湿寒之气在中焦，以上窥胸阳的往复，而为更迭入侵的现象。所以主治祛湿利水的薏苡，即上条茯苓甘草杏仁汤的意义；配伍温中行阳的附子，即上条橘皮枳实生姜汤的意义，并进而加强之。至于捣成散剂并连渣滓服用，则留恋胃中，使寒湿既去，而其干温的变化，还浮于太虚，则填胸贯络，痹证自然痊愈。这虽然看似只责治阴弦之脉，注意在讨贼（祛邪）一边，不知道荡平之后，阳气大振，而庆祝太平的，却正是在朝廷（扶正）啊。唉，神妙啊！
桂枝生姜枳实汤方：桂枝、生姜（各三两）、枳实（五枚）。
以上三味药，用水六升，煮取药液三升，分三次温服。
痞塞及各种逆气由于胸阳虚馁的原因，详情已在前面见到。心之所以如有依托辅佐，是因为真气在其中旁礴。真气上部虚弱，则心无凭借，有如空悬的状态，所以说“心悬”。胸为阳位，阴邪留滞其中，则阴阳不相宜，而阴寒沁入作痛，所以说“心悬痛”。用辛温的桂枝、生姜填补真气，所以治疗心的虚悬；用苦温开痞的枳实破除留气，所以消除疼痛。大抵就是第五条枳实薤白汤的意旨而变易的。此条及下文两条，又是就胸痹的症状而推展言之。大概说胸痹，见种种候证，固然适宜主治此方，然而不必拘泥于胸痹，凡是上虚而下气上犯，导致留而不散的，都主治此方。所以在条文开头，既不冠以“胸痹”二字，而且说“诸逆”。
乌头赤石脂丸方：乌头（一分，炮制）、赤石脂（一两）、附子（半两，炮制）、干姜（一两）、蜀椒（一两）。
以上五味药，研末，蜜丸如梧桐子大。饭前服一丸，三次服药后无明显效果，稍增加剂量服用。（梧桐子大的药丸服一丸，恐怕有误。）
仔细分析症状和治疗，其脉象也应当是阳微阴弦。但微脉固在寸口，而阴弦之脉，应当在关以下的尺中。人心身胸中的真阳，外部是周身卫气的根本，内部是中下二焦的主宰。真阳上部虚弱，而脾胃的邪气就近侵犯，就形成第四、五、六、七条的症状。至于肾为牡脏，肝居至阴之下，其虚寒之邪，比之吴楚各地的蛮夷，周室既衰，泽国蛮荆也来远窥王室。然而肝肾的阴邪上犯，比之中土的逆气更为严重，所以心痛放射到背部，与第四条的症状既相同，而胸阳内亏，卫气衰薄，寒从背入，且与下阴之逆起而贯穿痹阻之处，同类而相互感召，所以背痛而又向内彻于心。三焦的化生，阳气从底部产生，大概以命门的温热，蒸熟水谷，而化生悍气，然后上熏如雾，而贮积为胸阳。何况本症又属于下焦的寒逆呢？这不是温下以温上不可。所以用乌头的老阳，壮先天之元气；用附子的生阳，发后天之化气；取蜀椒的辛敛，所以补其阳而封固之；取干姜的辛散，又所以种其根而升举之。总归于气重色赤的石中脂髓，作为使者。气重，易致下行；色赤，偏宜阴脏。石中的脂髓，岂不是想让它进入精血中，而温养资始的化源吗？丸药不是汤散仅能行于上中焦的……
Article 1 The Master said: "When taking the pulse, one should assess both excess (Tai Guo) and deficiency (Bu Ji). If the Yang portion (Cun/Guan) is micro (Wei) and the Yin portion (Chi) is wiry (Xian), this indicates Chest Bi with pain. The reason for this is attributed to extreme deficiency. Now, knowing that Yang Qi is deficient in the Upper Jiao, the cause of Chest Bi and heart pain lies in the Wiry Yin pulse."
Pulses have their categories; when excessive, both are excessive; when deficient, both are deficient. This is the general rule. Therefore, whenever diagnosing the pulse, one should identify areas of both excess and deficiency. The deficient part naturally becomes diseased, and the excess part will exploit it, causing even greater disease to the deficient part. Consider this pulse: the Yang portion before the Guan (Cun) presents as Micro, and the Yin portion after the Guan (Chi) presents as Wiry. A Micro Yang pulse before the Guan indicates that from the epigastrium up to the chest, the True Yang is weak and unable to stir and propel. Thus, the disease is named Bi (Obstruction). A Wiry Yin pulse after the Guan indicates that from the stomach fu down to the Liver, turbid pathogens are wiry and urgent, shooting upwards from above. Thus, the symptom is pain. The reason is that the responsibility lies in the extreme deficiency of the Yang position in the chest, which attracts the upward encroachment of the Lower Jiao's Yin. These two sentences focus on the primary aspect (root deficiency), corresponding to later formulas like Gualou Xiebai Baijiu Tang and Ren Shen Tang, which fill Yang. The area before the Guan corresponds to the chest; a Micro pulse there indicates Yang deficiency in the chest leading to Bi. These two sentences are self-annotations explaining why it is known as Chest Bi. The Wiry pulse corresponds to the Liver among Zang organs, to Yin among Qi, to Cold among pathogens, and to Pain among symptoms. Chest Bi with heart pain is caused by the Liver's Yin-Cold pathogen, represented by the Wiry pulse, encroaching upon the Yang-deficient state. These two sentences focus on the secondary aspect (branch/excess), corresponding to later formulas like Gualou Xiebai Banxia Tang, Yiyi Fuzi San, and Wutou Chishizhi Wan, which address both Middle and Lower Jiao rebellious Yin. This differs significantly from Article 1 of the Abdominal Fullness, Cold Cramps, and Parasitic Disease chapter, which also mentions "Cunkou pulse Micro and Wiry." There, the Micro-Wiry appears in the Cunkou section alone (Micro on superficial pressure, Wiry on deep pressure). Here, the Micro-Wiry appears in two parts: Cunkou/Guan or Lower/Chi. Hence, Article 3 says "Cunkou pulse..." and "Guan pulse...". Although Article 9 (Wutou Chishizhi Wan) does not explicitly mention the pulse, careful examination of its symptoms and formula intent confirms it fits the Chi-Wiry pattern. Furthermore, while both conditions involve deficiency of formless Zong Qi between the Heart and Lungs, Chest Bi often occurs in the diaphragm at the center of the heart, involving deficiency of Qi within the form-flesh-blood tissues, leading to obstruction and pain that radiates through collateral vessels to the back. Generally, formless Zong Qi becomes deficient due to great fright, severe vomiting, or sorrow, resulting in acute onset. If prolonged and unable to control the lower, it leads to palpitations; if it cannot lift the lower, it leads to spontaneous abortion, dripping leukorrhea, blood loss, and essence loss, which may transform into Chest Bi. Deficiency of Qi in the form-flesh-blood tissues at the central diaphragm is mostly caused by external cold, cold drinks, and emotional injury to the Heart. The disease progresses slowly in the meridians behind the heart. Thus, "heart pain" refers to pain at the center of the heart, not pain originating within the Heart organ itself.
Article 2 A healthy person without chills or fever who experiences shortness of breath and insufficient respiration has an Excess condition.
Shortness of breath occurs when Zong Qi is deficient in the upper part and rebellious Yin gathers, making deep inhalation difficult. Shallow inhalation leads to shallow exhalation, feeling particularly short and insufficient. Cold causes lung contraction; heat causes Qi closure; both lead to shortness of breath. Now, externally appearing as a healthy person without chills or fever, the cause of shortness of breath must be upper deficiency allowing pathogens to gather, preventing Qi from penetrating deeply. Where pathogens gather, Qi is necessarily deficient; if they remain and do not depart, the condition becomes Excess. This is what Article 5 calls "stagnant Qi knotting in the chest." Hence, it is called Excess. This echoes the previous article's "extreme deficiency," causing guest pathogens to linger and appear as Excess; it also foreshadows the subsequent treatment attacking Excess, using Ju Pi, Zhi Shi, and Hou Po to dissipate stagnation.
Article 3 In Chest Bi disease, symptoms include panting, coughing, spitting, chest and back pain, and shortness of breath. The Cunkou pulse is Deep and Slow; the Guan pulse is slightly Tight and Rapid. Treat with Gualou Xiebai Baijiu Tang.
Formula: Gualou Fruit (one piece), Allii Macrostemonis Bulbus (half jin), White Wine (seven sheng).
Boil the three ingredients together, obtain two sheng, divide into two warm doses.
This describes the full syndrome of Chest Bi. Panting and shortness of breath result from deficiency of original Qi in the chest and excess of Stomach pathogens, preventing respiratory Qi from penetrating deeply and extending far. Lung Qi rebels, causing cough; lung fluids rebel with Qi, causing cough and spitting. Chest and back pain occur because the Yin Wei and Yin Qiao meridians in the chest connect via collateral vessels to the Du Mai and the Yang Wei and Yang Qiao meridians in the back. Pain penetrates from chest to back, causing cold and cutting pain in both regions. The Deep-Slow Cunkou pulse elaborates on the "Yang Micro, Yin Wiry" from Article 1. Cunkou corresponds to the chest; Deep indicates Yang cannot ascend and stir; Slow indicates Qi cannot connect continuously. Thus, Deep-Slow is the root of the Micro pulse. External Micro with internal Deep-Slow indicates extreme Yang deficiency in the chest leading to Bi. Guan corresponds to the Stomach; Tight here refers to the Wiry pulse mentioned in Article 1, but differs from the Tight pulse in Cold Damage. The Cold Damage Tight pulse arises from cold condensation, contracting from both ends inward, usually short, described as "like a turning rope." The Wiry pulse's tightness arises from Yin relaxation and Yang urgency, stretching from both ends, usually longer, described as "like a bowstring." Upper chest deficiency with strong lower suction causes Middle Jiao Qi to surge upward, creating a Rapid pulse. "Slightly Tight-Rapid" means mildly tight and rapid, not as forceful as excess pathogens shooting upward. Guan Slightly Tight-Rapid indicates Chest Bi due to deficiency, with Stomach Qi of Yin-relaxation/Yang-urgency rushing in, causing pain. The chest/diaphragm resembles Heaven, preferring lightness and clarity. Xiebai is thin in aroma and flavor, acrid and warm; thinness acts on Heavenly Qi moving to the chest; acrid-warm guides and disperses Yang Qi. Combined with Gua Lou, which grows vines, is sweet-moist, and opens orifices, it enters collaterals to move Yin-Qi. Then, floating-slow wine supports it. Using thin-aroma white wine responds to Heaven with lightness and generates Qi with mild fire, restoring Yang like spring, warming collaterals from the chest, curing Bi. Xiebai is chosen for its white color because white has ascending nature. Southern cultivation for vegetables shows rapid regrowth after cutting, demonstrating its swift ascending property. This is the standard formula for Chest Bi, addressing only Upper Jiao Yang deficiency, not Middle/Lower Jiao.
Article 4 In Chest Bi, inability to lie flat, and heart pain radiating to the back, treat with Gualou Xiebai Banxia Tang.
Formula: Gualou Fruit (one piece), Allii Macrostemonis Bulbus (three liang), Pinelliae Rhizoma Preparatum (half sheng), White Wine (one dou).
Decoct the four ingredients, obtain four sheng, take one sheng warm, three times daily. (Calculation suggests missing "night dose").
"Chest Bi" encompasses the pulse and symptoms of the previous article. In the previous article, symptoms arose from internal chest deficiency sucking in Stomach Qi; the Stomach had no intention to rebel, akin to inviting theft by improper conduct. Thus, besides filling Yang and unblocking Qi, no other measures were needed. In this article, chest deficiency is less severe, but Stomach turbid pathogens are strong, overwhelming weakness and penetrating. Turbid Qi floats up instead of descending, causing inability to lie flat. Chest deficiency allows guest Qi to attack, like thieves entering through low walls or broken gates. Collaterals behind the heart connect externally to the back; Yang deficiency and Bi are like low walls and broken gates. Turbid Qi penetrates from chest-heart through Bi to back, causing pain felt in the heart and radiating to the back. Reducing Xiebai by more than half indicates less severe chest deficiency. Making Banxia the chief herb at half sheng indicates Stomach excess overwhelming weakness. This formula addresses both Excess and Deficiency from Article 1. Gualou Xiebai Tang addresses chest Yang deficiency (30%); adding Banxia as chief addresses Stomach Qi excess (70%). Huangdi Neijing states Qi resting in Yin allows spirit storage and sleep; Qi emerging in Yang causes alertness and wakefulness. Banxia-Ji Mi Tang cures insomnia quickly because Banxia, rooting in summer, descends Qi into Yin. Ji Mi nourishes Stomach Yin to cover Yang Spirit. Li's commentary citing Jia Yi Ben Ling Shu claims Banxia treats insomnia by entering Shaoyang, contradicting Zhong Jing's use in Yangming. Claiming it transports Yin-Yang so sleep comes instantly implies those awake during day have blocked Yin-Yang, which is unjust.
Article 5 In Chest Bi, epigastric stuffiness, stagnant Qi knotting in chest, chest fullness, and rebellious Qi seizing the heart from hypochondrium, treat with Zhishi Xiebai Guizhi Tang. Renshen Tang is also effective.
Formula: Zhishi (four pieces), Allii Macrostemonis Bulbus (half jin), Guizhi (one liang), Houpo (four liang), Gualou Fruit (one piece, crushed).
Boil Zhishi and Houpo in five sheng water to two sheng, add others, boil briefly, divide into three warm doses.
Renshen Tang Formula: Renshen, Baizhu, Gancao, Ganjiang (each three liang).
Boil in eight sheng water to three sheng, take one sheng warm, three times daily.
Chest Yang deficiency attracting Lower Yin causes epigastric stuffiness. Stuffiness varies with Yang Qi fluctuations; abdominal fullness that decreases intermittently is a sign of stuffiness. Here, Qi lingers and knots in chest, causing constant fullness—this is stagnant Qi. Like cold clouds and fog lingering in the void, rising from epigastrium to occupy chest. Plus rebellious Qi from Liver/Gallbladder in hypochondrium seizing heart towards empty space. Although caused by chest Yang deficiency, filling agents are primary to subdue rebellious Yin. However, since Qi knots in chest like thieves occupying a city, sweeping methods must combine with pacification. Use Zhishi to disperse Qi and Houpo to open stuffiness as main herbs, boiled first to act like wind clearing fog. Then use acrid-warm Gancao-Guizhi to fill chest Yang and guide Qi, and sweet-cool Gualou to enter collaterals and resolve Bi, acting like counter-agents such as human urine or pig bile. Thus, stagnant Qi disperses, chest Yang restores, and rebellion calms without direct treatment. Long boiling of Zhishi/Houpo extracts heavy-turbid bitter flavors to drain Earth pathogens; brief boiling of Xiebai/Guizhi extracts light-clear warm Yang to connect with Heaven. Renshen Tang works because Renshen tonifies Qi, Baizhu fills chest, Ganjiang scatters knots and opens stuffiness, Gancao floats-slowly lifts, creating harmonious Qi in chest. Upward, it guides Yang to treat Bi; downward, it illuminates Yin to eliminate rebellion. It transforms stagnant Qi knotting like dancing with shield and feather. Some say former formula treats full syndrome, latter treats hypochondriac seizure; or latter is follow-up care. Both interpretations fit logic, so both are preserved for expert judgment.
Article 6 In Chest Bi, chest Qi obstruction and shortness of breath, treat with Fuling Xingren Gancao Tang. Ju Pi Zhishi Shengjiang Tang is also effective.
Formula: Fuling (three liang), Xingren (fifty kernels), Gancao (one liang).
Boil in ten sheng water to five sheng, take one sheng warm, three times daily. If not cured, continue. (Implies night doses missing).
Ju Pi Zhishi Shengjiang Tang Formula: Ju Pi (one jin), Zhishi (three liang), Shengjiang (half jin).
Boil in five sheng water to two sheng, divide into two warm doses.
Upper deficiency in Chest Bi with Middle/Lower rebellious pathogens involves Dampness and Cold. Lung dislikes Dampness and Cold; Dampness stagnates Lung, Cold contracts Lung, both causing pain in diaphragmatic Bi and Qi obstruction/shortness. For upward-rebellious Dampness, use warm-drying Fuling as chief, assist with Xingren to benefit Lung orifices, and floating-slow Gancao to lift and retain, resolving Dampness and stagnation to cure obstruction/shortness. Hence, it is chief. For upward-rebellious Cold, use acrid-warm Ju Pi as chief; warmth warms diaphragm, acridity scatters knots. Shengjiang dispels cold, stops rebellion, and is diffusing; combined with sharp Ju Pi, creates gentle breeze and fresh air. Assist with Zhishi to break stagnant Qi, resolving Cold and unblocking Lung to cure obstruction/shortness. Hence, "also effective." Both formulas address slight Wiry (Excess/Deficiency balance).
Article 7 In Chest Bi, alternating severity, treat with Yiyi Fuzi San.
Formula: Yiyiren (fifteen liang), Da Fuzi (ten pieces, processed).
Pound into powder, take one fangcun bi, three times daily.
This combines symptoms and formulas of previous articles. "Alternating severity" covers all Chest Bi symptoms: panting, coughing, spitting, back pain, shortness of breath, inability to lie flat, varying in intensity. This is due to Guest Dampness/Cold in Spleen/Stomach surging up and sinking down. Yin-Yang Five Elements undergo growth, support, imprisonment, and decline transformations. Human organs mirror heaven and earth. When Fire/Earth Qi declines, Water/Wood become demons; supported by Bing/Ding/Wu/Ji (Fire/Earth), they hold; strengthened by Ren/Gui/Jia/Yi (Water/Wood), they intensify. Holding brings缓 (slowness/mildness); intensifying brings ji (urgency/severity). Also, Dampness infiltrates slowly; Cold forces urgently. Damp harm is slower; Cold harm is faster. Thus, Bi symptoms vary in severity due to Damp-Cold in Middle Jiao peeking at Chest Yang cycles, invading alternately. Use Yiyi for damp-draining (meaning of Fuling Xingren Gancao Tang) and Fuzi for warming-middle-moving-Yang (meaning of Ju Pi Zhishi Shengjiang Tang), enhancing them. Powdering and consuming dregs retains them in Stomach; after Damp-Cold leaves, dry-warm transformation floats to Tai Xu, filling chest and penetrating collaterals to cure Bi. Though seemingly focusing only on Yin-Wiry pulse (attacking bandits), after pacification, Yang Qi revives greatly, celebrating peace through court (tonifying Zheng). Ah, how divine!
Article 8 Epigastric stuffiness, various rebellions, hanging heart pain, treat with Guizhi Shengjiang Zhishi Tang.
Formula: Guizhi, Shengjiang (each three liang), Zhishi (five pieces).
Boil in six sheng water to three sheng, divide into three warm doses.
Stuffiness and rebellions due to chest Yang deficiency are detailed earlier. Heart feels supported because True Qi permeates it. Upper True Qi deficiency leaves Heart unsupported, feeling suspended—hence "hanging heart." Chest is Yang position; Yin pathogen lodging makes Yin-Yin incompatible, causing Yin infiltration pain—hence "hanging heart pain." Use acrid-warm Guizhi/Shengjiang to fill True Qi treating heart suspension; use bitter-warm Zhishi to open stuffiness breaking stagnant Qi treating pain. Generally, this modifies the intent of Article 5's Zhishi Xiebai Tang. This and next two articles expand on Chest Bi symptoms. While Chest Bi warrants this formula, do not rigidly stick to Chest Bi; any case of upper deficiency with lower Qi rebelling and lingering warrants it. Hence, no "Chest Bi" prefix, just "various rebellions."
Article 9 Heart pain radiating to back, back pain radiating to heart, treat with Wutou Chishizhi Wan.
Formula: Wutou (one fen, processed), Chishizhi (one liang), Fuzi (half liang, processed), Ganjiang (one liang), Shujiao (one liang).
Powder the five ingredients, honey-pill like wu zi size. Take one pill before meals. If no effect after three doses, slightly increase dosage. (One pill may be error).
Carefully analyzing symptoms/treatment, pulse should be Yang Micro Yin Wiry. Micro is in Cunkou; Wiry should be in Chi below Guan. True Yang in chest-heart is root of exterior Wei Qi and master of Middle/Lower Jiao. Upper True Yang deficiency allows Stomach/Spleen pathogens to invade nearby, causing Articles 4-7 symptoms. Kidney is Yang-Zang; Liver is under Extreme Yin. Their deficiency-cold is like barbarians from Wu-Chu invading declining Zhou royal house. However, Liver-Kidney Yin pathogen encroachment is worse than Central Plains rebellion. Thus, heart pain radiating to back matches Article 4, but with internal chest Yang deficit, thin Wei Qi, cold entering from back, and Lower Yin rebellion penetrating Bi, similar types resonate, causing back pain radiating inward to heart. San Jiao transformation generates Yang from bottom via Mingmen heat steaming grain/water into fierce Qi, misting up to store as Chest Yang. Since this syndrome belongs to Lower Jiao cold rebellion, warming Lower to warm Upper is essential. Use Wutou's old-Yang to strengthen Pre-heaven Yuan Qi; Fuzi's born-Yang to emit Post-heaven transformation Qi; Shujiao's acrid-astringent to supplement and seal Yang; Ganjiang's acrid-dispersive to plant root and lift. Combine with heavy-aroma red-colored Chishizhi marrow as messenger. Heavy-aroma descends easily; red favors Yin-Zang. Marrow enters essence-blood to warm origin of creation. Pills differ from decoctions/powders limited to Upper/Middle Jiao...