上中二焦之阳气虚微。不能冲和化导。故致急迫之痛也。梦失精者。详九条注。以上四句。凡五症。就阳分气
分之标。着劳字一边而言。四肢 疼者。阴气暴虚。阳失所辅而不能独行。停阻于四肢骨节之缝。故生虚热
而疼也。手足烦热。亦指手足心而言。以劳宫、涌泉。为手足少阴之应。虚阴不足济膏火之自焚耳。咽干口
燥者。真阴大亏。脾肺无游溢之化也。以上三症。就阴分血分之本。着虚字一边而言。小建中汤义。虽见伤寒
门桂枝汤。及本汤下。但其方意微妙。后人不得整片神理。徒将逐味药性。刻舟求剑。致使寿世金丹。活人甘
露。如同泥沙袜线。毫无粘连控制。因令弃而不用。良可悲悼。故不避饶舌。重复剖之。所祈同志仁人。细认虚
劳一症。初则起于阴虚而阳馁。继则成于上空而下脱。再将此方原属填上气以控下阴。蒸阳精以滋阴液
之意。大声疾呼。俾千万人知而用之。得天下后世之病此而鲜夭折者。是仆之所深愿也。夫人身宗气。比之
碧落真阳。其盛满流行之用。所以中主寰区。包裹宇宙。提挚地轴。镇静妖氛者也。此气稍被虚劫。先则水土
下脱。大地深陷。而不可数计。后则妖水突泛。载土上浮。地阖天位。则气迫而散矣。故宗气于人。为有生之大
宝。空虚则为善饥。为心跳。及动摇。为忙乱无奈者。皆所谓悸也。上空而下气乘之。轻则为晕眩。为胃脘膨闷。
为两胁 胀。为二便不干而难。不癃而短。为耳聋目赤而齿痛损落。重则为善惊。为上气喘促。为吐衄亡血。
凡此、皆不足以御下之候也。其或为气利。为泄泻而完谷不化。为便血尿血。为失精。妇人为崩淋带漏。为小
月。此又不能以气上提之变也。仲景穷理格物。深知木中之桂。辛甘而温。得天地东方生气之正。而其嫩枝
尤具尖颖锐发之势。而为少火生气。温暖轻灵之妙药也。取以填补胸中之阳。允为至品。但以辛甘而温。其
性飘忽。走不而守。故倍加酸敛而内行下走之芍药。监而制之。使不得任性发越。而留之在中矣。然芍药之
力。既藉之以内行。又恐乘之而下走。则失胸中阳位之部。故佐甘草之甘以守中者。犹为未足。复重加胶饴
之甜。托住其下走。则确在中焦以上。而无可挪动矣。然后佐以辛温而通神明之生姜者。所以扩充桂枝之
量。而使匀满心肺之夹空也。佐以甘温而多津液之大枣者。所以补救桂枝之偏。而使滋润胸中之阳液也。
夫气充则能送形质之便溺于下行。尤能提神气之精汁而下固。津生。则能游溢其精气而上作甘泉。尤能
远被其恩膏而外通手足。六味药中。彼此串插。如鱼鳞之相错。如云锦之互旋。岂逐味散解者所能尽其奥
耶。本方之建中气。犹为易见。以所用多阳药故也。至其并主四肢 疼。手足烦热。咽干口燥三症。皆系阴
虚之候。夫以阳药而治阴虚。大是奇创。不知大枣甘粘难燥。胶饴为米麦之真液。得姜桂辛温之性。以呵嘘
蒸发之。则其阴津以阳液之化导。而流行鼓动矣。
十五条 虚劳。里急。诸不足。黄 建中汤主之。
黄 建中汤方 桂枝（三两去皮） 芍药（六两） 甘草（三两炙） 大枣（十二枚） 生姜（三两）
胶饴（一升） 黄 （一两半）
上七味。以水七升。先煮六味。取三升。去滓。内胶饴。更上微火消解。温服一升。日三服。气短胸满者。加生
姜。腹满者。去枣。加茯苓一两半。及疗肺虚损不足。补气。加半夏三两。
里急有三候。皆阳气亏空之故。一则宗气上虚而下阴乘之。以致吸气不能深入。而喘急也。一则腹中为阴
位。不得阳气以温和化导之。而殊觉弦急也。一则上气不能传送。因而大便不畅。尝若有坠急之象也。诸不
足者。俱就阳气而言。盖指胃分之悍气。胸分之宗气。及表分之卫气。诸样不足之谓。主本汤者。建中之义已
见。加黄 者。以黄 之走气分。其功用有三。住气一也。提气二也。固气三也。以建中之全力。得黄 为主。而
温胃蒸胸以及走表而固密之。不特本条里急等之三症。并诸气虚馁者。俱可愈于温和匀满之治。且前条
所云马刀侠瘿及盗汗者。亦可化导而提摄之矣。仲景以末后一方。总补诸条之有脉症而无方治者。其变
幻之文例每如此。气短胸满者。胸中之气虚。而下气冲之。故胸满。胸满故吸气艰于下引而短也。生姜能填
宗气而安下逆。故加之。枣性浮腻。而实中气。故腹满者去之。然腹满者多系脾湿。故加渗湿之茯苓也。疗肺
虚损不足。用此汤以补气者。加半夏。非以半夏功能补气之谓也。盖肺虚不足。下气必乘虚而上逆。不加降
逆之半夏。则药气与所冲之客气。互争胸分。而 胀喘促之候见矣。
十六条 虚劳。腰痛。少腹拘急。小便不利者。八味肾气丸主之。
肾气丸方
熟地黄（八两） 山茱萸（四两） 桂枝（一两） 附子（一两炮） 薯蓣（四两） 白茯苓（三两）
泽泻（三两） 丹皮（三两）
上八味。末之。炼蜜和丸如梧桐子大。酒下十五丸。加至二十五丸。日再服。
腰为肾之府。肾精竭而肾气虚。不能自强。故痛也。少腹拘急。小便不利。俱有二义。盖少腹为阴位。肾气虚而
无阳和以化被之。则阴气凝切而拘急。膀胱为肾之府。肾气虚。而主令传化之机自滞。故不利也。又胸中宗
气。其先天受之于肾。其后天养之于胃。肾精短而气自馁。既不能授气于胸。胃无命门之底火。而其腐熟水
谷之化。又不能生悍气以上供之。则胸中之阳光衰薄。不能温照九地。故少腹拘急。不能分布黄泉。故小便
不利也。细按方意。始知其名虽肾气。实所以补气源而上引之。以填心肺之夹空者也。仲景之意。盖谓诸气
之虚。由于命门之火衰薄。而命门之虚。又因精血枯竭之所致。故用熟地黄为君以补肾精。山茱萸为佐以
补肝血。缩用炮附桂枝于精血药内者。先则取其从阴而下行。终则资其蒸水以化气也。佐薯蓣者。尤有妙
义。盖峻补下焦之精血。而并益其气。苟不培中焦之土以镇之。则肝肾之贼阴冲起。而喘咳等候必见。譬诸
天地。上气下水。其间惟大地为之中隔。故癸水安于黄泉之下。而癸中之壬。方能化气以与太虚之清阳。氤
氲充塞之理也。至于茯苓、泽泻。又所以佐薯蓣之功。而渗泄癸水之渣质耳。牡丹、花当谷雨。故名谷雨花。得
从厥阴而透达少阳之正性。其皮更为行津走气之路。用以为使。是欲其领桂附之阳神阳液。而上嘘心肺
之空也。丸则取其下行。酒服欲其升发。与建中汤为一上一下。一男一女。一标一本。相济相成之妙方也。
十七条 虚劳。诸不足。风气百疾。薯蓣丸主之。
薯蓣丸方
薯蓣（三十分） 人参（十分） 茯苓（五分） 白术（六分） 甘草（二十八分） 干地黄 当归（各十八分）
芎（六分） 芍药（六分） 阿胶（七分） 麦冬（六分） 杏仁（六分） 桔梗（五分） 柴胡（五分） 桂枝
（十八分） 防风（六分） 干姜（三分） 白蔹（二分） 豆黄卷 神曲（各十八分） 大枣（百枚为膏）
上二十一味。末之。炼蜜和丸如弹子大。空腹酒服一丸。一百丸为剂。
诸不足、与上文不同。上文就三焦及经络之阳气而言。此则兼上中二焦之阴津阳气而两言之也。细按方
意自见。风气有二因。脾胃之精悍中虚。则胸中之阳气上馁。而在表之卫气。亦因之而外虚矣。故外风容易
袭入者一也。脾胃之土衰。不能生肺金清肃之气。则肝木横肆。而内生虚风者二也。风气百疾。凡眩冒、麻木、
疼痛、皆是。主本方者。又与上条肾气丸相为体用者也。盖胸中之气。其先天受于下焦之肝肾。其后天养于
中焦之脾胃。先天之气下削。而不能上蒸者。既立肾气一丸。以资其化源。后天之气中虚。而不能上育者。故
又立薯蓣一丸。以大其培养耳。夫阳生于阴。气藏于血。脾胃之阳气。所以中虚者。以脾胃之阴精。先经枯竭
也。故用甘温之薯蓣为君。甘浮之甘草为臣者。所以定脾胃之大车巨舰也。以培土之白术。投其所喜。以渗
湿之茯苓。去其所恶以为佐。则又大车之骡马。巨舰之绳缆也。然后先装地黄当归阿胶以为主。芎 芍药
麦冬以为佐。则其所以补阴补血者。确在脾胃中之阴血可必矣。次装生气之豆黄卷。行气之曲以为主。提
气之人参。温气之干姜以为佐。则其所以补阳补气者。又确在脾胃中之阳气可必矣。于是以甘浮之大枣
上托之。利气之杏仁疏导之。开提之桔梗上透之。辛散之白蔹外引之。则其所补之阴阳。从中焦而氤氲蒸
被。贮之胸中。而充行经络矣。此治诸不足之精意也。至其以辛温而散邪之桂枝为主。芬芳而清膈之柴胡
为佐。又殿之以密表之防风者。所以祛内外之风气百疾。而尤防其复袭也。肾气以小丸吞服。欲其难化而
下至于肾。本方以大丸嚼服。欲其易发而中尽于胃也。空腹。则胃有余力而易化。酒服。则药有助气而速行
也。此于金匮中。除鳖甲煎丸外。为第二大方。计药二十一味。用意凡十一层。真旋转造化之奇制也。豆黄
卷、大豆色黄象中土。浸令 生。干而卷之。则其芽性具锐发生气之势。与赤小豆卷异用而同义。曲即酒曲。
其性温暖。具沤发之用。不特取其行药。且使腐化谷食以生精悍也。白蔹辛甘而生蔓。辛甘走气。蔓则经络
之象。是行气于经络之品也。余药别见。方论中详略不同者此也。
十八条 虚劳。虚烦不得眠。酸枣仁汤主之。
酸枣仁汤方 酸枣仁（二升） 茯苓 知母 芎 （各二两） 甘草（一两）
上五味。以水八升。煮酸枣仁得六升。内诸药。煮取三升。分温三服。
人之所以得眠者。以阳伏于阴。气藏于血。而得覆庇之妙也。阴血虚于里于下。则阳气艰于伏藏。而浮扬于
上。且上焦之津液又虚。不足胜阳气非时之扰。故烦而不得眠也。是其治例。不外乎润而降之之理矣。但润
药皆阴。降药趋下。苟非抬高下引。则失神气浮扬之位而无益也。夫枣性最高。为胸分之药。酸能敛气归根。
仁能伏神守宅。故重用而先煮之以为主。然后以川芎滋心血。以知母润肺气。以甘草浮缓之。而使徐徐下
行。且以解虚烦之躁急也。以茯苓降渗之。而使少少下引。正以领枣仁之敛伏也。譬之亢旱之天。大地干燥。
太阳既没。红尘高扬。黄埃飞布。太虚役役。不得瞑合。若非露下天清。乌能夜凉气润而静伏乎。此仲景之方
药。与造化相为始终也。
十九条 五劳。虚极。羸瘦。腹满。不能饮食。食伤。忧伤。饮伤。房室伤。饥伤。劳伤。经络营卫气伤。内
有干血。肌肤甲错。两目黯黑。缓中补虚。大黄 虫丸主之。
大黄 虫丸方
大黄（十分蒸） 黄芩（二两） 桃仁 杏仁（各一升） 干地黄（十两） 芍药（四两）
甘草（三两） 干漆（一两） 虻虫（一升） 水蛭（百枚） 蛴螬（一升） 虫（半升）
上十二味。末之。炼蜜和丸小豆大。酒饮服五丸。日三服。
此条为虚劳之变症。与上文诸条之候不同。上文诸症。大概精血虚于下。则神气馁于上。而成虚劳者。此则
阴虚而阳火独长。阳 残阴。因而血干于内者。五劳。注见首卷。虚极。当指阴血枯竭而言。非兼气言也。阴血
枯竭。故属阴之分肉。损削而羸瘦。且方中纯用血药。而不略带气药者可证也。又阴血枯竭。则肠胃干涩而
多结滞。故腹满。宿垢占据手足阳明之腑。故不能饮食也。伤于食。则气滞。伤于忧。则气结。伤于饮。则气浮。伤
于房室。则气孤。伤于饥。则气焰。伤于劳。则气张。伤于经络营卫。则气阻。俱能生烦热。而为膏火自煎之候。夫
气以火动而见有余。血以气热而受炮炙。则内有烙干之血。各因所伤而凝于其部矣。人身惟气调血畅。则
气血融和。浑成无迹。今其肌肤中之可共见者。隐隐如鳞甲之相错。此非里有干血。而败气外呈之一证乎。
又气畅血调。则水火交光。精明有神。今其两目中之所自见者。蒙蒙如黯黑之旋转。此非下有干血。而神境
上悬之一证乎。夫阴阳之道。相宜于配偶。而相残于偏弊者也。阳长阴短。则阳气常弓弯于外。而阴气常弦
急于中矣。攻其干血而补其新血。是续阴以缓阳。故曰缓中补虚。主本汤者。诸症由于血虚。补血固为要着。
然干血不去。则生气尝以恶鬼而消阻。是逐淤更于补血为先着矣。故以性喜吸血之虻虫、水蛭为主者。取
其直入血分也。漆为木液。其象犹血。干则具干血之状。以之为使。又令其引入干血之所也。然后以行淤之
桃仁。破而动之。以利气之杏仁。疏而泄之。总交于缓攻慢取之熟大黄。徐徐击散。而收平贼之功矣。地黄色
黑而滋肝肾。蛴螬浆多而补津液。 虫活血而续损伤。以养肝之芍药。养脾之甘草为之使。盖又以肝脾二
脏。操藏血行血之大权故也。但血之所以内干者。原因阳火独长之所致。苟非带用凉血之品。诚恐干血既
去。而新血不虞其复干乎。故又于诸血药中。加黄芩一味。则攻击者为救燹之兵。而润泽者为清和之露矣。
上焦和中焦的阳气虚弱微小，不能冲和化导，因此导致急迫的疼痛。梦遗失精的症状，详见第九条注释。以上四句话，总共涉及五种症状，是从阳分气分的标症角度，着重于“劳”字这一方面而言的。四肢疼痛，是因为阴气突然虚弱，阳气失去辅助而不能独自运行，停滞阻塞在四肢骨节的缝隙中，所以产生虚热而疼痛。手足烦热，也是指手心脚心发热，因为劳宫穴、涌泉穴分别是手少阴心经和足少阴肾经的应验之处，这是阴虚不足，无法济助膏火，导致自我焚烧的缘故。咽喉干燥、口舌干燥，是真阴严重亏损，脾肺没有游溢转化的功能所致。以上三种症状，是从阴分血分的本症角度，着重于“虚”字这一方面而言的。小建中汤的含义，虽然在《伤寒论》桂枝汤条文中有所体现，以及在本方条文下也有提及，但其方义微妙，后人未能完全领会其神理，只是逐味分析药性，刻舟求剑，致使这救世的金丹、活人的甘露，如同泥沙袜线一样，毫无粘连控制力，因而被抛弃不用，实在令人悲悼。所以我不避啰嗦，重新剖析它。希望志同道合的仁人君子，仔细认识虚劳这一病症，起初是由于阴虚而阳气衰竭，随后发展成上面空虚而下面脱陷。再将此方原本属于填补上部之气以控制下部之阴，蒸腾阳精以滋润阴液的意思大声疾呼，使千万人知晓并应用它，让天下后世患此病的人很少夭折，这是我深深的愿望啊。人体的宗气，好比碧落中的真阳，它盛满流行的作用，所以中间主宰寰区，包裹宇宙，提挚地轴，镇静妖氛。这气稍微被虚弱劫夺，先则水土向下脱陷，大地深陷，不可胜数；后则妖水突然泛滥，载土上浮，地阖天位，那么气就会逼迫而散失。所以宗气对于人，是有生以来的大宝，空虚则表现为容易饥饿、心跳、动摇，以及忙乱无奈，都称为悸。上面空虚而下面的气乘虚而入，轻则表现为晕眩、胃脘部胀闷、两胁胀痛、大小便不干结但排出困难、不癃闭但尿量少、耳聋目赤且牙齿疼痛脱落；重则表现为容易受惊、上气喘促、吐血衄血亡血。凡这些，都是不足以抵御下部邪气的征候。或者表现为气利、泄泻完谷不化、便血尿血、失精，妇女表现为崩漏带下、小产，这些又不能通过提升气机来改变的变证。张仲景穷究物理，深知木中之桂枝，辛甘而温，得天地东方生气之正，而其嫩枝尤其具有尖颖锐发之势，是少火生气、温暖轻灵的妙药。取用它来填补胸中的阳气，确为至品。但因为辛甘而温，性质飘忽，走而不守，所以加倍加入酸敛而内行下走的芍药，来监制它，使其不得任性发越，而留存在中部。然而芍药的力量，既然借助它向内运行，又恐怕它顺势向下走，从而失去胸中阳位的部位，所以佐以甘草的甘味来守中，还觉得不够，再加重胶饴的甜味，托住其向下走的趋势，那么就确实固定在中焦以上，而无可挪动了。然后佐以辛温而通神明生姜，用来扩充桂枝的量，而使心肺之间的空隙充满。佐以甘温而多津液的大枣，用来补救桂枝的偏颇，而使胸中的阳液得到滋润。气充盛则能送形质的便溺下行，尤能提神气的精汁而下固；津液生成，则能游溢精气而上作甘泉，尤能远被恩膏而外通手足。六味药中，彼此穿插，如鱼鳞相错，如云锦互旋，岂是逐味散解者所能穷尽其奥妙呢？本方建立中气，还为易见，因为所用多为阳药。至于它同时主治四肢疼痛、手足烦热、咽干口燥这三种症状，都是阴虚的征候。用阳药来治阴虚，真是奇创。不知道大枣甘粘难燥，胶饴是米麦的真液，得姜桂辛温的性质，以呵嘘蒸发之，那么其阴津就以阳液的化导，而流行鼓动了。
第十五条 虚劳，里急，诸不足，黄芪建中汤主之。
黄芪建中汤方：桂枝（三两去皮）、芍药（六两）、甘草（三两炙）、大枣（十二枚）、生姜（三两）、胶饴（一升）、黄芪（一两半）。
以上七味药，用水七升，先煮前六味，取三升，去渣，加入胶饴，再上火微火消解。温服一升，每日三次。气短胸满者，加生姜；腹满者，去大枣，加茯苓一两半。兼治肺虚损不足，补气，加半夏三两。
里急有三种表现，都是阳气亏空的缘故。一种是宗气上部虚弱而下面阴气乘之，导致吸气不能深入而喘急；一种是腹部为阴位，得不到阳气以温和化导，所以特别觉得弦急；一种是上部之气不能传送，因而大便不畅，常常有坠急的现象。诸不足，都是就阳气而言，大概是指胃分之悍气、胸分之宗气及表分之卫气等各种不足的称谓。主用本汤，建立中气的意义已经显现。加入黄芪，是因为黄芪走气分，其功用有三：驻气一，提气二，固气三。以建立中气的全力，得黄芪为主，而温胃蒸胸以及走表而固密，不仅本条里急等三种症状，连同各种气虚馁者，都可以痊愈于温和匀满的治疗中，而且前条所说的马刀侠瘿及盗汗者，也可以化导而提摄了。张仲景以最后一个方子，总补各条中有脉症而无方治的情况，其变幻的文例往往如此。气短胸满，是胸中之气虚，而下气冲之，所以胸满；胸满故吸气艰于下引而短。生姜能填宗气而安下逆，所以加它。枣性浮腻而实中气，所以腹满者去掉它。然而腹满者多系脾湿，所以加渗湿的茯苓。疗肺虚损不足，用此汤补气，加半夏，并非说半夏功能补气。盖肺虚不足，下气必乘虚而上逆，不加降逆的半夏，则药气与所冲的客气，互争胸分，而胀喘促的征候就出现了。
第十六条 虚劳，腰痛，少腹拘急，小便不利者，八味肾气丸主之。
肾气丸方：熟地黄（八两）、山茱萸（四两）、桂枝（一两）、附子（一两炮）、薯蓣（四两）、白茯苓（三两）、泽泻（三两）、丹皮（三两）。
以上八味药，研末，炼蜜和丸如梧桐子大。酒送服十五丸，加至二十五丸，每日两次。
腰为肾之府，肾精竭而肾气虚，不能自强，所以痛。少腹拘急、小便不利，都有两层含义。盖少腹为阴位，肾气虚而无阳和以化被之，则阴气凝切而拘急；膀胱为肾之府，肾气虚，而主令传化之机自滞，所以不利。另外，胸中宗气，其先天受之于肾，其后天养之于胃，肾精短而气自馁，既不能授气于胸，胃无命门之底火，而其腐熟水谷之化，又不能生悍气以上供之，则胸中之阳光衰薄，不能温照九地，所以少腹拘急；不能分布黄泉，所以小便不利。细按方意，始知其名虽叫肾气，实则所以补气源而上引之，以填心肺之夹空。张仲景的意思，大概是说诸气之虚，由于命门之火衰薄，而命门之虚，又因精血枯竭之所致。所以用熟地黄为君以补肾精，山茱萸为佐以补肝血。缩用炮附子和桂枝于精血药内，先则取其从阴而下行，终则资其蒸水以化气。佐以薯蓣，更有妙义。盖峻补下焦之精血，而并益其气，苟不培中焦之土以镇之，则肝肾之贼阴冲起，而喘咳等候必见。譬诸天地，上气下水，其间惟大地为之中隔，故癸水安于黄泉之下，而癸中之壬，方能化气以与太虚之清阳，氤氲充塞之理也。至于茯苓、泽泻，又是用来佐薯蓣之功，而渗泄癸水之渣质。牡丹花当谷雨，故名谷雨花，得从厥阴而透达少阳之正性，其皮更为行津走气之路，用以为使，是想让它带领桂附的阳神阳液，而上嘘心肺的空处。丸剂取其下行，酒服欲其升发，与建中汤为一上一下、一男一女、一标一本、相济相成的妙方。
第十七条 虚劳，诸不足，风气百疾，薯蓣丸主之。
薯蓣丸方：薯蓣（三十分）、人参（十分）、茯苓（五分）、白术（六分）、甘草（二十八分）、干地黄、当归（各十八分）、川芎（六分）、芍药（六分）、阿胶（七分）、麦冬（六分）、杏仁（六分）、桔梗（五分）、柴胡（五分）、桂枝（十八分）、防风（六分）、干姜（三分）、白蔹（二分）、豆黄卷、神曲（各十八分）、大枣（百枚为膏）。
以上二十一味药，研末，炼蜜和丸如弹子大。空腹酒服一丸，一百丸为剂。
诸不足，与上文不同。上文就三焦及经络之阳气而言，此则兼上中二焦之阴津阳气而两言之。细按方意自见。风气有二因：脾胃之精悍中虚，则胸中之阳气上馁，而在表之卫气，亦因之而外虚矣，故外风容易袭入者一也；脾胃之土衰，不能生肺金清肃之气，则肝木横肆，而内生虚风者二也。风气百疾，凡眩冒、麻木、疼痛，皆是。主用本方，又与上条肾气丸相为体用。盖胸中之气，其先天受于下焦之肝肾，其后天养于中焦之脾胃。先天之气下削，而不能上蒸者，既立肾气一丸，以资其化源；后天之气中虚，而不能上育者，故又立薯蓣一丸，以大其培养耳。夫阳生于阴，气藏于血，脾胃之阳气，所以中虚者，以脾胃之阴精，先经枯竭也。故用甘温之薯蓣为君，甘浮之甘草为臣，所以定脾胃之大车巨舰。以培土之白术，投其所喜；以渗湿之茯苓，去其所恶，以为佐，则又大车之骡马，巨舰之绳缆。然后先装地黄、当归、阿胶以为主，川芎、芍药、麦冬以为佐，则其所以补阴补血者，确在脾胃中之阴血可必矣。次装生气之豆黄卷，行气之神曲以为主，提气之人参，温气之干姜以为佐，则其所以补阳补气者，又确在脾胃中之阳气可必矣。于是以甘浮之大枣上托之，利气之杏仁疏导之，开提之桔梗上透之，辛散之白蔹外引之，则其所补之阴阳，从中焦而氤氲蒸被，贮之胸中，而充行经络矣。此治诸不足之精意也。至其以辛温而散邪之桂枝为主，芬芳而清膈之柴胡为佐，又殿之以密表之防风，所以祛内外之风气百疾，而尤防其复袭。肾气丸以小丸吞服，欲其难化而下至于肾；本方以大丸嚼服，欲其易发而中尽于胃。空腹，则胃有余力而易化；酒服，则药有助气而速行。此于金匮中，除鳖甲煎丸外，为第二大方，计药二十一味，用意凡十一层，真旋转造化之奇制。豆黄卷，大豆色黄象中土，浸令芽生，干而卷之，则其芽性具锐发生气之势，与赤小豆卷异用而同义。曲即酒曲，其性温暖，具沤发之用，不特取其行药，且使腐化谷食以生精悍。白蔹辛甘而生蔓，辛甘走气，蔓则经络之象，是行气于经络之品。余药别见，方论中详略不同者此也。
第十八条 虚劳，虚烦不得眠，酸枣仁汤主之。
酸枣仁汤方：酸枣仁（二升）、茯苓、知母、川芎（各二两）、甘草（一两）。
以上五味药，用水八升，煮酸枣仁得六升，内诸药，煮取三升，分温三服。
人之所以得眠，是以阳伏于阴，气藏于血，而得覆庇之妙。阴血虚于里于下，则阳气艰于伏藏，而浮扬于上，且上焦之津液又虚，不足胜阳气非时之扰，故烦而不得眠。是其治例，不外乎润而降之理。但润药皆阴，降药趋下，苟非抬高下引，则失神气浮扬之位而无益。夫枣性最高，为胸分之药，酸能敛气归根，仁能伏神守宅，故重用而先煮之以为主。然后以川芎滋心血，以知母润肺气，以甘草浮缓之，而使徐徐下行，且以解虚烦之躁急。以茯苓降渗之，而使少少下引，正以领枣仁之敛伏。譬之亢旱之天，大地干燥，太阳既没，红尘高扬，黄埃飞布，太虚役役，不得瞑合，若非露下天清，乌能夜凉气润而静伏？此仲景之方药，与造化相为始终。
第十九条 五劳，虚极，羸瘦，腹满，不能饮食，食伤，忧伤，饮伤，房室伤，饥伤，劳伤，经络营卫气伤，内有干血，肌肤甲错，两目黯黑，缓中补虚，大黄䗪虫丸主之。
大黄䗪虫丸方：大黄（十分蒸）、黄芩（二两）、桃仁、杏仁（各一升）、干地黄（十两）、芍药（四两）、甘草（三两）、干漆（一两）、虻虫（一升）、水蛭（百枚）、蛴螬（一升）、䗪虫（半升）。
以上十二味药，研末，炼蜜和丸小豆大。酒饮服五丸，每日三次。
此条为虚劳之变症，与上文诸条之候不同。上文诸症，大概精血虚于下，则神气馁于上，而成虚劳者；此则阴虚而阳火独长，阳燔残阴，因而血干于内。五劳，注见首卷。虚极，当指阴血枯竭而言，非兼气言。阴血枯竭，故属阴之分肉，损削而羸瘦，且方中纯用血药，而不略带气药者可证。又阴血枯竭，则肠胃干涩而多结滞，故腹满；宿垢占据手足阳明之腑，故不能饮食。伤于食，则气滞；伤于忧，则气结；伤于饮，则气浮；伤于房室，则气孤；伤于饥，则气焰；伤于劳，则气张；伤于经络营卫，则气阻。俱能生烦热，而为膏火自煎之候。夫气以火动而见有余，血以气热而受炮炙，则内有烙干之血，各因所伤而凝于其部。人身惟气调血畅，则气血融和，浑成无迹。今其肌肤中之可共见者，隐隐如鳞甲之相错，此非里有干血，而败气外呈之一证乎？又气畅血调，则水火交光，精明有神。今其两目中之所自见者，蒙蒙如黯黑之旋转，此非下有干血，而神境上悬之一证乎？夫阴阳之道，相宜于配偶，而相残于偏弊。阳长阴短，则阳气常弓弯于外，而阴气常弦急于中。攻其干血而补其新血，是续阴以缓阳，故曰缓中补虚。主用本汤，诸症由于血虚，补血固为要着，然干血不去，则生气尝以恶鬼而消阻，是逐瘀更于补血为先着。故以性喜吸血之虻虫、水蛭为主，取其直入血分。漆为木液，其象犹血，干则具干血之状，以之为使，又令其引入干血之所。然后以行瘀之桃仁，破而动之；以利气之杏仁，疏而泄之；总交于缓攻慢取之熟大黄，徐徐击散，而收平贼之功。地黄色黑而滋肝肾，蛴螬浆多而补津液，䗪虫活血而续损伤，以养肝之芍药，养脾之甘草为之使，盖又以肝脾二脏，操藏血行血之大权。但血之所以内干，原因阳火独长之所致，苟非带用凉血之品，诚恐干血既去，而新血不虞其复干。故又于诸血药中，加黄芩一味，则攻击者为救燹之兵，而润泽者为清和之露。
The Yang Qi of the Upper and Middle Jiao is deficient and weak, failing to harmonize and guide transformation, thus leading to urgent pain. Nocturnal emission with loss of essence is detailed in the commentary on Article 9. The above four sentences cover five symptoms in total; they discuss from the perspective of the branch aspects of Yang and Qi, focusing on the aspect of "consumption" (Lao). Pain in the four limbs occurs because Yin Qi suddenly becomes deficient, causing Yang Qi to lose its support and unable to move independently, stagnating and blocking the gaps between the bones and joints of the limbs, thereby generating deficiency heat and pain. Heat and vexation in the hands and feet also refer to the palms and soles; since Laogong (PC8) and Yongquan (KI1) correspond to the Hand-Shaoyin Heart Meridian and Foot-Shaoyin Kidney Meridian respectively, this indicates that insufficient Yin cannot nourish the "fat fire," leading to self-burning. Dryness of the throat and mouth results from a severe deficit of True Yin, where the Spleen and Lung lack the function of free overflow and transformation. These three symptoms are discussed from the perspective of the root aspects of Yin and Blood, focusing on the aspect of "deficiency" (Xu). The meaning of Xiao Jian Zhong Tang (Minor Construct the Middle Decoction), although seen in the Guizhi Tang section of the *Shanghan Lun* and under this formula's own article, has subtle implications. Later generations failed to grasp its spiritual logic entirely, merely analyzing each herb's properties individually like carving a mark on a moving boat, rendering this golden pill for saving lives and sweet dew for reviving people as useless as mud or sand, leading to its abandonment, which is truly lamentable. Therefore, I do not shy away from verbosity and re-analyze it. I hope like-minded benevolent scholars carefully recognize the syndrome of consumption: initially arising from Yin deficiency and Yang exhaustion, subsequently developing into upper emptiness and lower collapse. By loudly proclaiming that this formula originally belongs to filling the Qi above to control the Yin below, and steaming Yang essence to nourish Yin fluids, may thousands know and use it, so that those suffering from this disease in the world and future generations rarely die young; this is my deep wish. The Zong Qi (Pectoral Qi) of the human body is comparable to the True Yang of the Blue Sky; its abundant and circulating function governs the central region, envelops the universe, lifts the earth's axis, and calms demonic disturbances. If this Qi is slightly depleted by deficiency, first the water and earth collapse downward, the earth sinks deeply beyond count; later, demonic waters surge upward, carrying earth up, closing the heaven and earth positions, causing the Qi to be forced and scattered. Thus, Zong Qi is the great treasure of life; when empty, it manifests as easy hunger, palpitations, trembling, and restless anxiety, all referred to as "palpitations" (Ji). When the upper part is empty and lower Qi takes advantage, mild cases manifest as dizziness, epigastric distension and fullness, bilateral hypochondriac distension, difficulty in urination and defecation without retention, tinnitus, red eyes, and toothache/loss; severe cases manifest as fright, shortness of breath and panting, hematemesis, epistaxis, and blood loss. All these are signs insufficient to resist lower pathogenic factors. Alternatively, it may manifest as Qi diarrhea, loose stools with undigested food, hematochezia, hematuria, seminal emission, or in women, metrorrhagia, leukorrhea, and miscarriage; these are variations that cannot be corrected by lifting Qi. Zhang Zhongjing thoroughly investigated principles and things, deeply knowing that Cinnamon Twig (Guizhi) within Wood is pungent, sweet, and warm, obtaining the correct vital energy of the East from Heaven and Earth, and its tender branches especially possess a sharp, penetrating momentum, making it a miraculous medicine for generating Qi through mild fire and providing warmth and lightness. Using it to fill the Yang in the chest is indeed supreme. However, due to its pungent, sweet, and warm nature being volatile and moving without staying, we double the amount of Sour and Astringent Shaoyao (White Peony Root) that moves inward and downward to monitor and restrain it, preventing it from acting recklessly and allowing it to remain in the middle. Yet, relying on Shaoyao's power to move inward, we fear it might顺势 go downward, losing the position of Yang in the chest; therefore, we assist with Gancao (Licorice Root)'s sweetness to guard the center, but still feel it insufficient, adding heavy amounts of Yi Tang (Maltose) to hold back its downward movement, firmly fixing it above the Middle Jiao. Then, assisting with Xinwen (Pungent-Warm) Shengjiang (Fresh Ginger) that communicates with spirit expands the quantity of Guizhi, filling the spaces between the Heart and Lungs. Assisting with Ganwen (Sweet-Warm) Dazao (Jujube) rich in fluids remedies Guizhi's bias, moistening the Yang fluids in the chest. When Qi is充盈, it can send waste downwards and secure the essence of Spirit-Qi downwards; when fluids generate, they overflow Qi-Essence upwards as sweet springs and extend grace externally to the limbs. Among the six herbs, they interlock like fish scales or cloud brocade; how could those dissecting herbs individually exhaust their profundity? Establishing Middle Qi in this formula is easily seen because it uses mostly Yang herbs. That it simultaneously treats limb pain, hand-foot heat, and dry throat/mouth—all signs of Yin deficiency—using Yang herbs to treat Yin deficiency is a radical innovation. One must realize that Dazao is sweet, sticky, and hard to dry; Yi Tang is the true fluid of rice and wheat; aided by the pungent-warm nature of Jiang and Gui to evaporate and stimulate, its Yin fluids transform via Yang guidance and circulate dynamically.
Article 15: Consumption, interior tension, various deficiencies, Huangqi Jianzhong Tang (Astragalus Minor Construct the Middle Decoction) governs.
Huangqi Jianzhong Tang Formula: Guizhi (3 liang, bark removed), Shaoyao (6 liang), Gancao (3 liang, honey-fried), Dazao (12 pieces), Shengjiang (3 liang), Yi Tang (1 sheng), Huangqi (1.5 liang).
These seven ingredients: Use 7 sheng of water, first decoct the first six ingredients to obtain 3 sheng, remove dregs, add Yi Tang, heat gently over low fire to dissolve. Take 1 sheng warm, three times daily. For shortness of breath and chest fullness, add Shengjiang. For abdominal fullness, remove Dazao, add Fuling (Poria) 1.5 liang. It also treats lung deficiency damage and insufficiency, tonifying Qi, add Banxia (Pinellia) 3 liang.
Interior tension has three manifestations, all due to Yang Qi deficiency. First, Zong Qi is deficient above while Yin Qi invades below, causing inhalation to fail to penetrate deeply, resulting in panting. Second, the abdomen is a Yin location; lacking Yang Qi for warmth and transformation, it feels distinctly tense. Third, Qi above cannot transmit, causing difficult defecation, often feeling like a dragging urgency. "Various deficiencies" refers generally to Qi, specifically mentioning the Han Qi of the Stomach, Zong Qi of the Chest, and Wei Qi of the Exterior. Using this formula establishes the meaning of constructing the Middle. Adding Huangqi works because Huangqi enters the Qi level, having three functions: stabilizing Qi, lifting Qi, and consolidating Qi. With the full power of constructing the Middle, led by Huangqi, warming the stomach and chest, and securing the exterior, not only the three symptoms of interior tension mentioned here, but all Qi deficiencies can be cured by gentle, even, and full treatment. Moreover, the conditions mentioned in the previous article, such as scrofula and night sweats, can also be transformed and lifted. Zhang Zhongjing used this final formula to collectively treat conditions in previous articles that had pulse/symptoms but no formulas; his literary style often varies thus. Shortness of breath and chest fullness occur because Chest Qi is deficient and Lower Qi rushes up, causing fullness; fullness makes deep inhalation difficult, causing shortness of breath. Shengjiang fills Zong Qi and calms rebellious Lower Qi, hence added. Dazao is floating and greasy, solidifying Middle Qi, so it is removed for abdominal fullness. Abdominal fullness is often due to Spleen dampness, so Fuling to leach dampness is added. To treat lung deficiency using this formula to tonify Qi, Banxia is added not because Banxia tonifies Qi, but because Lung deficiency allows Lower Qi to rebel upwards vacuously; without Banxia to direct rebellion downwards, the medicinal Qi and invading pathogenic Qi compete in the chest, causing distension and panting.
Article 16: Consumption, lower back pain, hypogastric tension, and dysuria are governed by Ba Wei Shen Qi Wan (Eight-Ingredient Kidney Qi Pill).
Shen Qi Wan Formula: Shu Dihuang (Rehmanniae Radix Praeparata, 8 liang), Shanzhuyu (Corni Fructus, 4 liang), Guizhi (Cinnamomi Ramulus, 1 liang), Fuzi (Aconiti Lateralis Radix Praeparata, 1 liang, processed), Shanyao (Dioscoreae Rhizoma, 4 liang), Fuling (Poria, 3 liang), Zexie (Alismatis Rhizoma, 3 liang), Mudanpi (Moutan Cortex, 3 liang).
These eight ingredients: Powder them, mix with refined honey to form pills the size of sophora seeds. Take 15 pills with wine, increasing to 25 pills, twice daily.
The waist is the mansion of the Kidney; when Kidney Essence is exhausted and Kidney Qi is deficient, it cannot strengthen itself, causing pain. Hypogastric tension and dysuria have two meanings. The hypogastrium is a Yin location; with deficient Kidney Qi lacking Yang harmony, Yin Qi condenses tightly causing tension. The Bladder is the mansion of the Kidney; with deficient Kidney Qi, the mechanism of command and transformation stagnates, causing dysuria. Furthermore, Zong Qi in the chest receives its pre-heaven source from the Kidney and post-heaven nourishment from the Stomach. Short Kidney Essence leads to deficient Qi; it cannot transmit Qi to the chest, and the Stomach lacks the bottom fire of the Gate of Life to transform food into Han Qi to supply upwards. Thus, the sunlight in the chest is thin, unable to warm the nine regions, causing hypogastric tension; unable to distribute to the yellow springs, causing dysuria. Carefully analyzing the formula reveals that although named Kidney Qi, it actually supplements the source of Qi and draws it upward to fill the voids between the Heart and Lungs. Zhang Zhongjing's intent was likely that Qi deficiency stems from the decline of the Fire of the Gate of Life, which in turn is caused by the exhaustion of Essence and Blood. Thus, Shu Dihuang is used as the Sovereign to tonify Kidney Essence, Shanzhuyu as Minister to tonify Liver Blood. Including Pao Fuzi and Guizhi among Essence-Blood tonics first utilizes their descent from Yin, ultimately utilizing them to steam Water to transform Qi. Assisting with Shanyao has profound meaning: severely tonifying Lower Jiao Essence and Blood while benefiting Qi; if the Middle Jiao Earth is not cultivated to stabilize them, the treacherous Yin of Liver and Kidney will surge, causing panting and cough. Like Heaven and Earth, with Upper Qi and Lower Water, only the Great Earth acts as an intermediate barrier, allowing Gui Water to rest in the yellow springs, and the Ren within Gui to transform Qi to fill the Great Void with Yin-Yang interaction. Fuling and Zexie assist Shanyao to leach the dregs of Gui Water. Mudanpi (Peony Bark), blooming at Grain Rain, obtains the correct nature of penetrating from Jueyin to Shaoyang; its bark is a pathway for fluids and Qi, used as Envoy to lead the Yang Spirit and Fluids of Gui and Fu upward to ventilate the emptiness of the Heart and Lungs. Pills descend; wine promotes ascent. This contrasts with Jianzhong Tang as one ascending/one descending, one male/one female, one branch/root, a miraculous formula of mutual assistance and completion.
Article 17: Consumption, various deficiencies, wind pathogens causing myriad diseases, Shenyao Wan (Dioscorea Pill) governs.
Shenyao Wan Formula: Shenyao (30 parts), Renshen (10 parts), Fuling (5 parts), Baizhu (6 parts), Gancao (28 parts), Dihuang (18 parts), Danggui (18 parts), Chuanxiong (6 parts), Shaoyao (6 parts), Ejiao (7 parts), Maidong (6 parts), Xingren (6 parts), Jiegeng (5 parts), Chaihu (5 parts), Guizhi (18 parts), Fangfeng (6 parts), Ganjiang (3 parts), Bailian (2 parts), Douhuangjuan (18 parts), Shenqu (18 parts), Dazao (100 pieces made into paste).
These twenty-one ingredients: Powder them, mix with refined honey to form pills the size of a bullet. Take one pill with wine on an empty stomach; 100 pills constitute a dose.
"Various deficiencies" differs from the text above. The above discussed Yang Qi of the Three Jiao and meridians; this discusses both Yin fluids and Yang Qi of the Upper and Middle Jiao. Wind pathogens have two causes: First, deficiency of Jing-Han in the Spleen/Stomach leads to deficient Yang Qi in the chest and deficient Wei Qi on the exterior, allowing external wind to invade easily. Second, weakness of Spleen Earth fails to generate Lung Metal's clear descending Qi, causing Liver Wood to act wildly and generate internal deficiency wind. Myriad diseases caused by wind include dizziness, numbness, and pain. Using this formula complements the previous Shen Qi Wan as substance and function. Chest Qi receives pre-heaven source from Lower Jiao Liver/Kidney and post-heaven nourishment from Middle Jiao Spleen/Stomach. Since pre-heaven Qi descends and cannot steam upward, Shen Qi Wan was established to aid its source. Since post-heaven Qi is deficient in the middle and cannot nourish upward, Shenyao Wan was established to greatly cultivate it. Yang is born from Yin; Qi hides in Blood. The reason Middle Jiao Yang Qi is deficient is that Middle Jiao Yin Essence was previously exhausted. Thus, sweet-warm Shenyao is Sovereign, sweet-floating Gancao is Minister, to stabilize the great chariot and ship of the Spleen/Stomach. Baizhu cultivates Earth, pleasing it; Fuling leaches dampness, removing what it dislikes, serving as assistants like mules for the chariot or ropes for the ship. Then, Dihuang, Danggui, and Ejiao are loaded as main tonics, Chuanxiong, Shaoyao, and Maidong as assistants, ensuring Yin and Blood tonification definitely resides in Middle Jiao Yin-Blood. Next, Douhuangjuan generating Qi and Shenqu moving Qi are loaded as mains, Renshen lifting Qi and Ganjiang warming Qi as assistants, ensuring Yang and Qi tonification definitely resides in Middle Jiao Yang-Qi. Then, Dazao lifts upwards, Xingren guides Qi downwards, Jiegeng opens and penetrates upwards, Bailian disperses and guides outwards. The supplemented Yin and Yang steam from the Middle Jiao, store in the chest, and circulate through the meridians. This is the refined intent for treating various deficiencies. Guizhi pungent-warm disperses evil as sovereign, Chaihu fragrant clears diaphragm as minister, Fangfeng secures exterior as rear guard, to dispel internal/external wind pathogens and prevent recurrence. Shen Qi Wan is taken as small pills swallowed, desiring slow digestion reaching the Kidney; this formula is taken as large pills chewed, desiring rapid release finishing in the Stomach. Empty stomach allows easier digestion; wine aids Qi and speeds action. Excluding Biejia Jian Wan, this is the second largest formula in *Jingui Yaolue*, with 21 herbs and 11 layers of intent, a miraculous creation rotating creation. Douhuangjuan (soybean sprouts) resembles Middle Earth; soaking until sprouting and drying retains the sharp vital-generating momentum of the sprout, differing in use but same in principle from Red Bean Sprouts. Shenqu (yeast) is warm and fermenting, not only aiding drug movement but rotting grain to generate Jing-Han. Bailian is pungent-sweet and vining; vining represents meridians, making it a Qi-moving product for meridians. Other herbs are seen elsewhere; differences in detail in formula commentaries are due to this.
Article 18: Consumption, deficiency vexation and inability to sleep, Suanzaoren Tang (Sour Jujube Seed Decoction) governs.
Suanzaoren Tang Formula: Suanzaoren (2 sheng), Fuling, Zhimu, Chuanxiong (each 2 liang), Gancao (1 liang).
These five ingredients: Use 8 sheng of water, decoct Suanzaoren to obtain 6 sheng, add other herbs, decoct to obtain 3 sheng. Divide into three warm doses.
Sleep is achieved because Yang rests in Yin, Qi hides in Blood, receiving protection. When Yin-Blood is deficient internally and inferiorly, Yang finds it difficult to rest and floats upward. Additionally, Upper Jiao fluids are deficient, unable to withstand untimely disturbance by Yang, causing vexation and insomnia. Treatment follows moistening and descending. But moistening herbs are Yin, descending herbs tend downward; unless lifted high and guided down, the position of floating Spirit-Qi is lost, yielding no benefit. Jujube seed (Suanzaoren) is highest in nature, belonging to the Chest division; sour gathers Qi returning to the root, kernel subdues Spirit guarding the house. Hence, heavily used and decocted first as sovereign. Then Chuanxiong nourishes Heart Blood, Zhimu moistens Lung Qi, Gancao floats and relaxes to slowly descend and relieve deficiency vexation agitation. Fuling descends and leaches to guide slightly downward, leading the gathering/subduing of Suanzaoren. Like a sky in drought, earth dry, sun set, red dust rising, yellow haze flying, the Great Void restless, unable to close; unless dew falls and sky clears, how can night cool, air moist, and quiet resting occur? This formula of Zhang Zhongjing corresponds with Creation from beginning to end.
Article 19: Five Labors, extreme deficiency, emaciation, abdominal fullness, inability to eat, injuries from food, worry, drink, sexual activity, hunger, labor, injury to meridians Ying/Wei Qi, internal dry blood, skin resembling scales, dark eyes, soothe middle and tonify deficiency, Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) governs.
Dahuang Zhechong Wan Formula: Dahuang (10 parts, steamed), Huangqin (2 liang), Taoren, Xingren (each 1 sheng), Dihuang (10 liang), Shaoyao (4 liang), Gancao (3 liang), Ganqi (1 liang), Mengchong (1 sheng), Shuizhi (100 pieces), Qicao (1 sheng), Zhechong (0.5 sheng).
These twelve ingredients: Powder them, mix with refined honey to form pills the size of soybeans. Take 5 pills with wine, three times daily.
This article describes a variation of consumption, different from previous syndromes. Previous syndromes generally involved Essence/Blood deficiency below leading to Spirit/Qi exhaustion above; this involves Yin deficiency with sole excess of Yang Fire, burning and damaging Yin, causing blood to dry internally. "Five Labors" is noted in Volume 1. "Extreme deficiency" refers to exhaustion of Yin-Blood, not including Qi. Exhaustion of Yin-Blood causes flesh belonging to Yin to diminish and emaciate, proven by the formula using only Blood herbs without Qi herbs. Exhaustion of Yin-Blood causes dry intestines/stomach with stagnation, leading to abdominal fullness; old feces occupying Hand/Foot Yangming Fu organs cause inability to eat. Injury from food causes Qi stagnation; injury from worry causes Qi knotting; injury from drink causes Qi floating; injury from sex causes Qi isolation; injury from hunger causes Qi flare-up; injury from labor causes Qi expansion; injury from meridians/Ying-Wei causes Qi blockage. All generate vexation/heat, resembling fat-fire self-burning. Qi moves by Fire appearing excessive; Blood is roasted by Hot Qi, creating internally baked dry blood, coagulating in respective areas due to injury. Only when Qi is regulated and Blood flows smoothly do they merge seamlessly. Now, skin shows hidden patterns like overlapping scales, indicating internal dry blood and presenting敗 Qi externally. When Qi flows and Blood regulates, Water/Fire interact, eyes are bright. Now, eyes show murky rotation like darkness, indicating internal dry blood suspending Spirit internally. Yin/Yang suit pairing but harm imbalance. Yang excess/Yin deficiency means Yang bows outward while Yin tightens inward. Attacking dry blood and tonifying new blood extends Yin to soften Yang, hence "soothe middle and tonify deficiency." Treating these symptoms due to Blood deficiency, tonifying Blood is key; however, if dry blood remains, Vital Qi is obstructed like by evil ghosts, so removing stasis is prior to tonifying Blood. Mengchong and Shuizhi, loving blood, are sovereign to enter Blood level directly. Ganqi (Dry Lacquer) is tree fluid, resembling blood, dried resembling dry blood, used as Envoy to guide into dry blood locations. Taoren moves stasis to break and move; Xingren benefits Qi to drain and vent; combined with slow-acting cooked Dahuang to gradually scatter and pacify rebels. Dihuang is black/nourishing to Liver/Kidney; Qicao is juicy/nourishing to fluids; Zhechong activates blood/healing; Shaoyao nourishes Liver, Gancao nourishes Spleen, used as Envoys, leveraging Liver/Spleen control over storing/moving blood. Since internal dryness is caused by sole Yang Fire excess, cooling Blood herbs are needed; otherwise, after dry blood removal, new blood might dry again. Adding Huangqin among Blood herbs makes attackers soldiers rescuing from fire, and moisturizers dew clearing and harmonizing.