医理真传3: 阴虚症门问答

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医理真传

Yi Li Zhen Chuan

原著       ·  郑钦安

Author; Zhen Qin-An (Qing dynasty, China)

 

医理真传卷三

Volume 3

阴虚症门问答

Questions and answers for Yin deficiency

问曰:头脑独发热,心烦热,小便短赤,咽干者,何故?

Q: A person feels hot inside the head, feels annoying hot in the chest, has short and red urine, and feels dry throat. What is this condition?

答曰:此心热移于小肠,小肠热移于肾也。夫肾上通于脑,脑热由肾热也。肾为水脏,统摄前后二阴,前阴即小肠膀胱,后阴即阳明大肠。肺与大肠为表里,心与小肠为表里。今因心热移于小肠,小肠受热,故便短;小肠血液为热所灼,势必乞救于肾水,热及于肾。肾水为邪火所扰,不能启真水上腾,故咽干;真水不能上交于巅,故脑热。法宜养阴、清热、降火为主,方用导赤散。

A: This is a condition, in which the heart Fire moves into small intestine, and the the intestine Fire moves to the Kidney. The kidney conducts the brain. The Brain hot is due to the kidney hot. The kidny is Water ortgan. It governs the front urine and the rear anus. The front urine belongs to the Taiyang small intestine and urine bladder; the rear anus belongs to the Yangming large intestine. The Lund and the large intesteine are couple; the Heart and the small intestine are couple. Now, due to the hot moved from the heart to the small intestine, the small intestine bears the hot, so the urine becomes shot. The blood in the small intestine was burned, so it tends to ask for help from the kidney for water, so the hot transfers into the kidney. The Kidney water is burned by the Xie Fire, fails to steam up to wet the throat, to the throat feels dry. The True Fire fails to conduct to the top of the head, so the brain feels hot. The principle for the treatment should be to nourich the Yin, clear the Fire and surpress the Fire. The herb formula is Daochi San.

导赤散

Daochi San

生地一两     木通五钱    甘草三钱   淡竹叶二钱

Shendi 30 gram, Mutong 15 gram, Gancao 9 gram, and Danzhuye 6 gram.

用药意解

The meaning fo the herb formula:

按导赤散一方,乃养阴、清热、降火和平之方也。夫生地黄甘寒入肾,凉血而清热,肾热清而脑热自解。木通甘淡,能降心火下行,导热从小便而出,故曰导赤。竹叶甘寒,寒能胜热。甘草味甘,最能缓正,亦能清热。此方行气不伤气,凉血不伤血,中和之剂,服之无伤,功亦最宏,苟能活法圆通,发无不中也。

The formula Daochi San works to nourich the Yin, clear the Hot and to depress the Fire. The herb Shendi is sweet the cold in herbal nature. It affiliates to the Kidney, to cool the Fire and clear the Fire. When the kidney hot is cleared, the brain hot is reduced too. The herb Mutong is weet and platen in herbal nature. It can conduct the heart Fire down, clear the Hot out of the body through the urine. For this reason, the herb formula is called Daochi San. The word “Dao” in Chinese and here means conducting. The word “Chi” means hot. “San” means herbal powder.

问曰:两上眼皮红肿痛甚,下眼皮如常,渐渐烦渴,饮冷者,何故?

Q: The two upper eyelids are swelling, pain and red in clor. The lower one are normal. The patient gradually feels annoying thirsty, willing to drink cold water. What ‘s this condition?

答曰:此元阴不足于胃之上络,胃中之火,遂发于上而津液伤也。

A: This is a condition, in which the Yuan Yin is insufficient in the Stomach meridian. The stomach Fire flaots up and dries the Yin liquid.

夫上眼皮属阳明胃,下眼皮属太阴脾。今病在胃而不在脾,故上肿而下不肿,胃火太盛,渐伤津液,故口渴饮冷。然未至饮冷,阴血尚未大伤;若已至饮冷,阳明之腑症悉具。苟谓风、寒之时气所作,必有风、寒之实据可验。此则无故而发,现于阳明地界,故知其元阴不足于胃之上络,胃中之火,得以袭之也。法宜灭火救阴为主,方用人参白虎汤。

The upper eyelid belongs to Yangming Stomach and the lower lid belongs to the Taiyin Spleen. Now the disease is in the Stomach, not in the Spleen, so it is swelling in the upper but not in the lower lids. The Stomach Fire is overwhelming, so to burn the Yin liguid, so the patient feels thirsty and willing to drink cold water. Since it has not come to the condition, in which the patient wishes to drink lots of ice water, it suggests that the Yin blood has not been damaged yet. Otherwise, willing to drink ice cold water would suggests the damage to the Yangming stage. If such condition is due to the invation of the Wind or Cold, there would have the evidence for the common cold. Now, there is no any strong evidence suggesting the invasion of the Wind and/or Cold Xie Qi. The diseased location is on the Yangming meridian, so consider it is due to the insufficient Yuan Yin in the Stomach meridian, which again cause the invasion of Stomach Fire. For the treatment, use herbs to clear the Fire, save the Yin liquid. The herb formula is Renshen Baihu Tang.

人参白虎汤

Baihu jia Renshen Tang

如无人参,即以洋参、沙参代之。

If there is no herb Renshen (the ginsheng), use Xiyangshen or Shashen.

人参五钱    石膏八钱    知母六钱    甘草二钱    粳米一撮

Renshen 15 gram, Shaogao 24 gram, Zhimu 18 gram, Gancao 6 gram, Genmi 15 gram.

古方分两,石膏用至一斤,知母六两,人参三两,甘草二两,米六合。因阳明胃火燎原,盘踞中宫,周身精血,顷刻有灼尽之势,非杯水可救,故施猛剂,取其速灭也。若此病虽属胃火,不得照此例以施之,故改用分两,不失经旨,可也。

In the original old herb formula, the Shigao needed is 150 gram; Zhimu, 90 gram, Renshen, 45 gram, Gancao 30 gram and Genmi, 124 gram. It is used for the condition, in which Yangming Stomach Fire is very strong. The Fire sticks in the middle of the body, burning the Jingxue of the body. It may pretty soon burn down the Yin liquid of the body. Small cup of water does not work to solve the condition, so it is needed to use urgent and strong therapy to kill the Fire as soon as possible. Here, though the disease belongs to the Stomach Fire too, it should not follow the same dose. So the herbal doses are modified. Of course it still follows the principle of the original formula. It should be allowed.

用药意解

The meaning of the Baihu plus Renshen Tang:

按人参白虎汤一方,乃灭火救阴之神剂也。夫病人所现病形,未见阳明之实据,不得妄施;若已现阳明之实据,即当急投。今病人上眼皮红肿痛甚,又见口渴饮冷,明明胃火已盛,津液已伤,此际若不急用人参以扶元阴,石膏以清胃热,知母以滋化源,甘草、粳米以培中气,势必灼尽津液,为害匪轻。此等目疾,不得不用此方。若视此方专为伤寒之阳明症立法,则为固执不通。不知仲景立法,方方皆是活法,凡属阳明之燥热为病者,皆可服也。妙处即在分两轻重上颠倒。今人过畏石膏不用,往往误事,实由斯道之不明,六经之不讲也。

The herb Baihu plus Renshen Tang is the marvelous formula for killing the Fire and saving the Yin liquid in the body. The patient’s condition introduced here did not show any concrete evidence for a Yangming fullness condition, so it should be produent to use the herbs. If there are strong evidences indicating the Yangming true Fire, this formula shuld be used as soon as possible. Now, the patient has only the swelling, pain, and red color in the upper eyelids, also has thirsty and willing to drink cold, indicating the Stomach Fire is strong and the Yin liquid has been hurted. At this movement, if we do not use the formula to solve the Fire, the Yin liquid would die. Therefore, for such eye problem, this formula must be used urgently. If we regard this formula as only for the Yangming stage of the Shanghan disease, it means we are too sturben. It should know that, every formula of the Master Zhang can be used actively and in a flexible manner. This formula should be used for any condition that belongs to Yangming. The only thing needs to pay attention is to vary the dose according to various clinic conditins. In this formula, the herb Shigao is to clear stomach Fire; Zhumu to nourish the source of water; the Gancao and Genmi to nourish the middle Stomach Qi. Nowadays, doctor fears the herb Shigao so hesitate to use it. It cause delay for the treatment, due to the unclear for the Master’s idea.

问曰:两耳前后红肿痛甚,口苦者,何故?

Q: The patient has swelling and red skin color in front and in the rear of the two ears, with bitter taste in mouth. What is this condition?

答曰:此元阴不足于少阳之经,少阳经之阳气旺而为病也。夫两耳前后,俱属少阳地界,今红、肿、痛甚,少阳之火旺可知。如系风、寒阻滞所作,必现头痛、身痛、寒热往来之候;内有抑郁所作,必有忧思不解之情;审察内外无据,则元阴之不足无疑。元阴之不足,亦有由生。有因脾胃久伤,而生化太微;有因房劳过度,元阳不足,而转运力微,阴血渐虚,即不能滋荣于木,木燥而木病丛生,此红、肿、疼、痛、耳聋、口苦、胁痛、筋挛诸症作矣。兹揭出于两耳前后,不言胁痛、筋挛,举一隅也。

A: This is a condition, in which the Yin Qi is insufficient in the Shaoyang meridian. So the Shaoyang Yang Qi is overwhelming to cause the disease. The front and the rear part of the ear belong to the Shaoyang meridian. It is now swelling, pain and red in color, indicating the Fire overwhelming in the Shaoyang meridian. If it is due to the invation of Wind or Cold, the person should also has headache, body pain, hot-cold shif feeling. If it is due to the inside damage, such as Qi stagnation, the person should have evidience of emotional disorders, such as depression. If there are no such evidences, this condition should be considered be the Shaoyang Yin deficiency. The reasons for the Shaoyang Yin deficiency can be variable. If the person has a long history of stomach system damage/disorder, there would have no enough nutrition to supply the Yin Qi. If the person has too much sex activity, the Yuan Yang has been exhuasted too much; the transport function for nutrition is reduced; the Yin blood is therefore insufficient; there would have no enough blood and nutrition to nourish the Wood; when the Wood is dry, there would have lots of disorders in the Wood system, so the person may feel pain, have swelling, red color in skin, deafness, bitter taste in mouth, pain on side of abdomen, spasm of tendons, etc. Here we mention only the sysmptoms on the ear, not the pain on the side of abdomen, for simply give you an example.  

其中更有至要者,人身上下四旁,全凭元阴、元阳二气充塞,元阴不足,无论在于何部,元阳之气即旺于元阴不足之部而成病。元阳不足,亦无论在于何部,元阴之气即旺于元阳不足之部而成病。然二气寓于凡精凡气之中,凡精气盛,元阴元阳自盛,凡精气衰,元阴元阳自衰,此二气盈虚消息机关,发病主脑。论二气,论部位,六经自在其中;验外感,察内伤,戕伐之机关自定。

知得此理,仲景之心法可通,明澈无疵,调和水火之方有据。此病可与小柴胡汤倍人参、黄芩。

The most important concept is: The whole of the body, the upper and the lower, the left and the right side, all depend on the Yuan Yin and the Yuan Yang to fill. If the Yuan Yin is insiffucient in any part of the body, the Yuan Yang would be relatvely overwhelming there to cause a disease. For the same reason, if the Yuan Yang is insufficient in any port of the body, the Yuan Yin would be relatively overwhelming there to cause a disease. The Yin Qi and the Yang Qi however are melted in the ordinary Jing Qi. If the Jing Qi is sufficient, the Yuan Yin and the Yuan Yang is certainly sufficient. If it is insufficient, the two Qi would be insufficient too. This is the mechanism, by which the Yuan Yin and the Yuan Yang increase or decrease. When we discuss the two Qi, the location of the disease, we also imply the six stage/meridian/layer of the body. By evaluating the reasons for the disease, due to the invading Xie Qi, or due to the inside damage/exhaust, the treatment principle is easy to set up.

Upon understand this, it would be easy to understand the secret of Master Zhang and to set up a treatment principle for a disease. For the condition introduced here, use Xiaochaihu Tang but double the herb Renshen and Huangqin.

小柴胡汤

Xiaochaihu Tang

人参八钱    柴胡六钱    黄芩七钱    半夏四钱   甘草三钱   大枣四枚   生姜三钱

Renshen 24 gram, Chaihu 18 gram, Huangqin 21 gram, Banxia 12 gram, Gancao 9 gram, Chinse date 10 gram, Fresh ginger 9 gram.

古方柴胡用至半斤,黄芩三两,人参三两,甘草二两,生姜三两,半夏半升,大枣十二枚,是因寒伤太阳之气,不能从胸出入,逆于胸胁之间,留于少阳地界,少阳居半表半里之间,从表则热,从里则寒,故少阳主寒热往来。今为太阳未解之邪所侵,中枢不运,仲景立小柴胡一法,实以伸少阳之木气,木气伸,而太阳未解之邪,亦可由中枢之转运而外出矣。

In the original herb formula in the <<Shanghan Lun>>, the Chaihu used is 90 gram, Huangqin 45 gram, Renshen 45 gram, Gancao 30 gram, Shenjiang 45 gram, Banxia 124 gram, and Chinese date 62 gram. It is used for the invasion of the Cold Xie Qi in the Taiyang stage. The Xie Qi stagnates in the Shaoyang stage/layer… Now, in this condition, it is used for the Xie Qi in the Taiyang stage. The Xie Qi causes the stop of the hub function of the middle part of the body. The Master Zhang’s Xiao Chaihu Tang is actually to stretch the Shaoyang Wood Qi. When the Shaoyang Wood Qi is moving freely, the Xie Qi that stagnated in the Taiyang would be depleted out of the body.

用药意解

The meaning of the herb formula:

按小柴胡汤一方,乃表里两解之方,亦转枢调和之方也。夫此方本为少阳之经气不舒立法,实为太阳之气逆胸胁立法。仲景以治太阳,实以之治少阳,治少阳即以治太阳也,人多不识。余谓凡属少阳经病,皆可服此方,不必定要寒伤太阳之气逆于胸胁,不能外出者可服。

The herb formula Xiao Chaihu Tang is a formula to solve the disease which locates between the outside layer and the inside layer of the body. It is a formula to adjust and smooth the hub of the Qi movement in the body. Originally, it is to harmany the Qi in the Shaoyang stage, but actually for the Taiyang Qi stagnating in the chest and the side of the abdomen. The Master Zhang, when he treats the Taiyang disease, he actually treats the Shaoyang, and when he treats the diseases in the Shaoyang, he actually also means to treat the Taiyang. Many people do not know this. I mean that it can be used in any disease in the Shaoyang stage, not need to wait until the Taiyang Qi reverse up in the chest and in the side of the abdomen.

若此病红肿,确实已在少阳,无外感,无抑郁,非元阴之不足而何。将古方改用分两,以人参之甘寒为君,扶元阴之不足,柴胡苦平为臣,舒肝木之滞机,佐黄芩之苦以泻少阳之里热,佐半夏、生姜之辛散,以宣其胁聚之痰水,枣、甘为使,以培中气。然枣、甘之甘,合苦寒之品,可化周身之阴,合辛散之品,可调周身之阳,化阳足以配阴,化阴足以配阳,阴阳合配,邪自无容,故能两解也。然古方重柴胡,功在转其枢,此方倍参、芩,功在养阴以清其热。变化在人,方原无定。总在活活泼泼天机,阴阳轻重处颠倒,不越本经界限,可也。

In this condition, the diseased part is red in color and swelling. It is in the Shaoyang stage. The patient has no evidence for common cold, no depression either. If it is not the Yuan Yin insuffiency, what else it would be? Here we change the herbal dose. The herb Renshen is used as the king, to supply more Yin to the body; Chaihu as minister, to smooth the Liver Wood stagnated Qi; the Huangqin, which is bitter in herbal nature, to deplete the Shaoyang inside Hot; the Banxan and Shenjiang, whichare spicy and dispersing in herbal nature, to clear the phlegm water that accumulated in the chest; the Chinese date and herb Gancao, to nourish the middle Spleen Qi. In addition, the sweet from the Chinese date and the Gancao, when coupled with bitter herbs, can develop Yin Qi to the body. When coupled with spicy and dispersing herbs, they can devleop and adjust the Yang Qi in the body. They can transform the Yang into the Yin ansd transform the Yin into the Yang in the body. When the Yin and the Yang is suffient and transform each other, the Xie Qi would be able to stay in the body. However, in the old formula, the herb Chaihu is the king herb, to harmony the hub function of the body Qi movement. Here we increase the dose of the herb Renshen and Huangqin, for the aim to nourish the Yin so to clear the Fire. The herb dose can be varied according to the clinic condition. It does not mean that the ingredient and the dose should not be changed at all.

问曰:鼻尖红肿,上牙龈肿痛,大便不利,烦躁谵语,口渴饮冷者,何故?

Q: The patient has swelling and red color in the nose; has welling and pain in the upper gum; has constipation, annoyed and irritable, and delirious speech; and has thirsty and drink cold water. What is this condition?

答曰:此元阴不足于胃,胃火旺盛,阴血又反伤也。夫元阴之气,若无一脏不足,必无红肿火症之虞,人只知为风邪、火邪所作,而不知元阴之早亏于内也。阴虚则火旺,故火症丛生。今病人所现症形,已具阳明之里症,此刻胃火旺极,阴血衰甚也。须知凡血之内寓元阴,凡气之内寓元阳,病人元阴先不足而火生,火生太烈,更足以伤其凡血。故曰:"壮火食气",食气者,食尽元阴之气也。世医以桂、附为壮火,不知桂、附补元阳之衰,阳虚人之要药,非阳旺阴虚之所宜也。

A: This is a condition, in which the Yuan Yin is insufficient in the Stomach. The Stomach Fire is overwhelming, that again hurts and damages the Yin blood. For the Yuan Yin Qi, if it is not insufficient in any part of the body, there would have no swelling and red color there. People know that such condition can be caused by Wind or Fire invasion, but not know that the Yin Qi is already not enough in the body long time ago. When the Yin is insufficient, the Yang would be relatively more, e.g. the Fire is overwhelming. The patient’s condition now shows the evidence for a Yangming inside disease. At this movement, the Stomach Fire is very much, the Yin Blood would be depeled soon. It should be known that, the every kind of blood holds the Yuan Yin in it, and the every kind of Qi holds Yuan Yang in it. For the patient, his Yuan Yin is insufficient first, so the Fire burns. When the Fire is overwhelming, it hurts and burns off the ordinary blood. So it is said: “the overwhelming Fire eats up the Qi”. It is the Yin Qi that is to be eaten up. Ordinary doctors believe that the herb Guizhi, Rougui, and Fuzi is strong Fire, but they do not know that they can supply the insufficient Yuan Yang and are the key herbs for people with Yang deficiency, not for the people with Yin deficiency and Yang overwhelming.

此病法宜泻火救阴为主,方用大承气汤主之。

For this condition, the treatment principle should be to clear the Fire and save the Yin. Use Da Chenqi Tang.

大承气汤

Da Chenqi Tang

芒硝六钱   大黄五钱   枳实三钱   厚朴八钱  

Mangxiao 18 gram, Dahuang 15 gram, Zhishi 9 gram, and Houpo 24 gram.

古方厚朴用至半斤,大黄四两,枳实五枚,芒硝五合,是因太阳之邪流入燥地,已经化为热邪,大实、大满、大聚、大便不通,狂叫、腹痛,脉沉、实。阳明至此,非清凉、升散可解,惟有下夺一法。仲景故立此方,以为阳明之将坏立法。然未至里实之盛者,亦可改分两以施之,不失本经里症宗旨,可也。

In original herb formula, the herb Houpo used is 90 gram, Dahuang 60 gram, Zhishi 72 gram and Mangxiao 100 gram. The reason is that, the Taiyang Xie Qi has moved into the Yangming Dryness place, and has transformed into the Hot Xie Qi. The body is very fullness in abdomen, has no bowel movement. The person is mad to cry, has pain in abdomen. His pulse is deep and full feeling. When a disease develops to this stage, it cannot be solved with the use of ordinary cold or floating herbs. The only choice is the use of bowel clearning therapy. Master Zhang sets up this formula, for the urgent and dangerous Yangming condition. However, if the clinic condition has not developed into the big fullness in the abdomen, the condition can be treated with modification of the herb dose, without loss of its origial meaning.

用药意解

The meaning of the Da Chenqi Tang:

按大承气汤一方,乃起死回生之方,亦泻火救阴之方也。夫病人胃已经实,元阴将亡,已在瞬息之间,苟不急用大黄、芒硝苦寒之品,以泻其亢盛之热,枳实、厚朴苦温之味,以破其积滞之邪,顷刻元阴灼尽,而命即不生。

The Da Chenqi Tang is one of the most important formula to save life. It is also a formula to clear Fire and to save the Yin Qi. For the patient, his abdomen has become big and heavy fullness, and his Yin Qi is to die, so the life is to loss soon. If the bitter and cold herbs, such as the Dahuang and Mangxiao, are not used urgently to clear and to deplete the overwhelming Fire; not use the bitter and warm herbs, such as the Zhishi and Houpo, to break its accumulated and the stagnated mass, the Yuan Yin will die very soon to risk life.

仲景立法,就在这元阴、元阳上探盛衰,阳盛极者阴必亡,存阴不可不急,故药之分两,不得不重。阴盛极者阳必亡,回阳不可不急,故四逆汤之分两,亦不得不重。二方皆有起死回生之功,仲景一生学问,阴阳攸分,即在二方见之也。他如一切方法,皆从六气变化而出,六经主气为本,各有提纲界限;六气为客,各有节令不同,不得混视。至于此病,虽具阳明里症,尚未大实之甚,而即以此方改分两治之,不失本经里症治法,分两虽殊,时势亦异,学者苟能细心体会,变化自有定据也。

Master Zhang alsway focuses on the Yuan Yin and the Yuan Yang. When the Yuan Yang is overwhelming, the Yuan Yin will die, so it is urgent to save the Yin, so the amount of the herbs in the formula of the Da Chenqi Tang has to be heavy. When the Yin is overwhelming, the Yuan Yang would die. It should not be delayed to save the Yang Qi. So the Herb Sini Tang has to use heavy dose. Both formulas can work to save life. The medical experience of Master Zhang falls on the Yin and Yang, which reflects on the use of these two formulas. Other formulas are developed according to the six Qi. The main Qi in each of the six Qi stages are the background. Each has clear parameter for a diagnosis. There are six outside Qi, which is called guest Qi when they invade into the body to cause a disease. Each quest Qi has its own season distribution. They should not be missed up. The condition introduced here, though belongs to the Yangming stage, the level is not so heavy yet, so the herb formula can be vaired to match the clinic severity. If the readers can study the variation carefully, they should learn the priciple in confidence.

问曰:两目两眥,赤脉缕缕,痛甚,舌肿厚,小便不利者,何故?

Q: The patient has his two eye corners red in color and multiple blood vessiles, which feels pain too. His tongue is swelling and thick. His urine is not smooth. What is this condition?

答曰:此元阴不足,而少阴火沸也。夫大小眼角属心与小肠,二经之元阴不足,元阳之气便盛而为病,即为客邪,不必定要风寒闭塞而作,才为客气。知得此理,便得二气盈虚消息主客之道。况目窠乃五脏精华所聚之地,原著不得一毫客气,著一毫客气,则目病丛生。

A: This is a condition, in which the Yuan Yin is insufficient, so the Shaoyin Fire is floating. The eye corners belong to the Heart and Small intestine. When the Yuan Yin in the two meridians are not sufficient, the Yuan Yang there would be overwhelming to cause a disease. In this case, the overwhelming Yang Qi can be regarded as a guest Xie Qi too. It does not mean that only the invading Wind or Cold Xie Qi can be regarded as Xie Qi. Understand this, it would be easy to understand the cause and the result of the Yin Qi and Yang Qi in the course of a disease. In addition, the eyes are the place, where all organ Jing Qi accumulate. It cannot bear even a slight guest Qi. A slight amount of Xie Qi can cause various diseases in the eyes.

客气二字,外指风、寒、暑、湿、燥、火时气,内指元阴、元阳偏盛所现,与风、寒、暑、湿、燥、火时气不同。从外感来者,必有发热、头痛、清涕、畏寒等情;从内二气发者,必无外形可征。元阴不足为病者,火必旺,即为实邪,多红、肿、痛甚;元阳不足为病者,阴必盛,即为虚邪,多不肿痛。即有肿痛甚者,乃元阳外脱之候,必现阴象以为据。若无阴象可验,便是实火,此认症之要也。

The word “guest Qi”, means the invading Wind, Cold, Hot, Wetness, Dryness and Fire, such natural Qi. It can also refer to the overwhelming Yang Qi due to difficiency in the Yin Qi, or the overwhelming Yin Qi due to difficiency in the body Yang Qi. The clini manifestations due to the overwhelming Yang Qi or the overwhelming Yin Qi are different from these outsife quest Qi.If the disease is caused by the invading Xie Qi, there would be fever, headache, running nose, chilly, etc. If it is due to an inside quest Qi, there would have no such symptoms. If it is due to the insufficient Yin Qi, the Fire would be overwhelming. The overwhelming Yang Qi will be a Shi Xie. It means that the diseased location feels welling, very pain with red color on the skin. If the disease is caused due to an insufficiency of Yang Qi, the Yin Qi would be overwhelming. The overwhelming Yin Xie is a Xu Xie, so the diseased location usually has no swelling or pain. If there indeed has pain and swelling, it usually would be the evidence for a Yuan Yang to escape. In this condition, there should be evidence for a Yin overwhelming. If there is no evidence for Yin overwhelming, it must be a Shi Fire. This is the trick for a diagnosis.

目科虽云七十二种,总不出阴、阳、虚、实四字,目科以五脏所属,名为五轮。风轮主肝,黑珠也;血轮主心,两眦也;气轮主肺,白睛也;水轮主肾,瞳子也;肉轮主脾,上下皮也。又分八廓,八廓即乾、坎、艮、震、巽、离、坤、兑是也,其要原不在此,学者务要在二气偏盛上求之,六气上求之,可也。

Though in Chinese medicine, there are 72 kinds of diseases in the eye, all can summarized as the Yin, the Yang, the Xu and the Shi conditions. The eye is allocated into five organs, called five circles. The middle brown part belongs to the Wind, the Liver. The corner of the eye belongs to the Blood, the Heart. The broad white part of the eye belongs to the Qi, the Lung. The middle black hole belongs to the Water, the Kidnedy. The eye lids belong to the Soil, the Spleen. It can also be separated into 8 parts. …..These are not our focus to discuss here. The beginners must pay much attention to the Yin Qi and the Yang Qi, the six stages of the disease. That’s all enough.  

此病两眦与舌肿,小便不利者,心与小肠皆热也。 法宜养阴清热为主,方用大剂导赤散,加洋参、黄连主之,解见上。

For the condition here, the patient has swelling in the corner of the eyes and the swelling in the tongue; has harsh urine, indicating Hot in both the Heart and the Small intestine. The principle for the treatment should be to clear the Hot. The herb formula is large dose of Doshi San, plus Xiyangshen and Huanglian. See the explanation above.

问曰:咽喉痛,干咳无痰,五心烦热,欲饮冷者,何故?

Q: Patient has sour throat, dry cough without phelem; feels annoying hot in the palm and sole; has willingness to drink cold water. What is this condition?

答曰:此元阴不足,而少阴火旺逼肺也。夫少阴之脉挟咽喉,喉之痛由于火旺,肺之咳由于火逼,无痰者,火盛而津枯,五心烦热者,元阴虚而为邪火灼,欲饮冷者,阴欲阴以救也。法宜清热润燥救阴为主。方用黄连阿胶汤主之。

A: This is the condition, in which the Yuan Yin is insufficient, so Shaoyin Fire is overwhelming, that attacks the Lung. The Shaoyin meridian goes up aroud the throat. The pain in the throat is due to the burning of Fire. The cough is caused by the Fire attack. No plegm is due to the Fire overwhelming and body liquid is less. Annoying hot feeling in the palms, the soles, and in the chest is due to the burning of the Fire. Willing to drink cold water suggests the body wants to save the Yin with Yin. The principle in the treatment should be to clear the Fire, wet the Dryness, and save the Yin. The herb formula Huanglina Ajiao Tang should be used mostly.

黄连阿胶汤

Huanglian Ajiao Tang

黄连四钱     黄芩四钱     芍药二钱     阿胶二钱     鸡子黄二枚

Huanglian 12 gram, Huangqin 12 gram, Shaoyao 6 gram, Ajiao 6 gram, Jizihuang 30 gram.

用药意解

The meaning of the herb formula:

按黄连阿胶汤一方,乃交阴阳之方,实养阴、清热之方也。夫此方本为少阴热化症而为心烦不得卧者立法。盖心烦者,坎中之精不能上交于心;不得卧者,离中之阴不能下降于肾。方中芩、连、芍药之苦,直清其热,又得鸡子黄以补离中之气,阿胶以补坎中之精,坎、离得补,阴、阳之气自调,升、降不乖,而水、火互为其根矣。今病人所现症形,全系元阴亏损,元阳变为客邪所作,故取苦寒柔润之品,以滋其枯涸之区,俾火熄而阴可立复,病可立瘳也。古方分两,立意不同,故所用甚重,今病势稍异,故改用之。

The Huanglian Ajiao Tang is the formula that works to conduct the Yin and Yang. It is acully the formula to nourish the Yin and to clear the Hot. Originally, this formula is designed for Shaoyin Hot-transformation condition, and is used for patient who feels annoyed anad hard to fall into sleep. The symptom of annoying is due to the Jing in the Kan fails to conduct the upper Heart. Failure to fall into sleep is due to the Yin in the Li (Heart) can not go down to the kidney. The herb Huangqin, Huanglian and Shaoyao are bitter in herb nature, work to clear the Hot. They are accompanied by the Jizihuang to supply the Qi in the Li (Heart). Ajiao can supply the Jing in the Kan (Kidney). The Kan and the Li are supplied, so the Yin and the Yang can adjust by themselves. The rising and the falling function are restored. The Water and the Fire are the root each other again. Now the conditions of the patient all suggest the Yuan Yin insufficiency, so the Yuan Yang becomes a quest Xie Qi to cause the disease. So, take the bitter and cold herbs to nourish the withered part of the body. When the Fire is died, the Yin will be restored soon and the disease can be recovered soon. The doses for the herbs in the original formula are heavy than used here, scine the original formula is used in different conditions.

问曰:产妇二三日,偶有小疾,服行瘀破滞之药不效,延至月馀,酿成周身肿胀,又服消胀之药,更加乳肿不食,肛门逼胀,痛欲死者,何故?

Q: A woman had birth delivery two days ago. She felt not good somehow. She was given medicine to dissolve stagnated blood without any effect. This condition has been lasted for more than one month and has developed into swelling all over the body. After taking herbs to solve the swelling, she got more swelling in the breasts and lost appetite, felt pushing feeling in the anus, which is pain to die. What is this condition? 

答曰:此服药不当,酿成血脱之候也。夫产后之人,血暴下注,每多血虚,即有瘀滞、腹痛、乳肿、血晕之症,只宜温中、活血、行气之品,不可大施破血、破滞之味,昧者专以破瘀滞为主,不知气得温而瘀滞自行,血得活而瘀滞自散。此病因误服消导,酿成坏症,独不思产妇血既大虚,全赖扶阳气以生之,今不扶其阳而更耗其阳,阳气既耗,阴血何由得生?瘀滞何由得行?今成血脱,而元气无依,周身散漫,故肿胀丛生。此刻只宜收纳元阳,犹虑不及,尚服见肿消肿之药,更加乳肿,肛门逼胀欲死,其下脱之机已经暴露。法宜峻补其血,血得补而气有所依,气有依而肿胀自然不作。方用当归补血汤,加鹿茸、黑姜、麦芽、甘草、葱酒。

A: This is due to improper intake of medicine that caused blood depletion. Women after baby delivery usually have heavy loss of blood, so the blood is insufficient. Even if she has blood stagnation, stomach pain, breast swelling, and dizziness, she should be given herbs that work to warm middle part of the body, to promote the blood circulation and to promote the Qi movement. It if forbideen to use herbs to break the blood. Stupid doctor only know to break the blood stagnation, not know that the stagnated blood will disappear by itself when the Qi is warmed. This condition is due to mistreatment with herbs that work to break the stagnated blood. People do not think that, after delivery, women have insufficient blood. New blood depends on the Yang Qi to born. If we do not support the Yang Qi but destroy the Yang Qi, how the Yin blood would be produced? How the stagnated blood can be dissolved? Now, the blood is not enough, the Yuan Qi has nowhere to attach, so it floats in all over the body to cause swelling. At this movement, it might not be enough to only contract the Yuan Yang. If we use reducing-swelling herbs upon see a swelling, the swellming would be more, the anus feels push and bloating to die. The evidence for a Yang Qi escaping from the lower part of the body has already shown clearly. The principile for the treatment should be to supply more blood. When the blood is enough, the Qi can attach on it, so the there is no swelling. The formula would be Danggui Buxue Tang, plus Lourong, Black ginger, Mai Ya, Gancao, Chinese green onion and wine.

当归补血汤

Danggui Buxue Tang

当归四钱   黄芪一两   鹿茸三钱   麦芽五钱   黑姜四钱   炙草二钱   甜酒半杯   葱头子四个

Danggui 12 gram, Huangqi 30 gram, Lurong 9 gram, Maiya 15 gram, Black ginger 12 gram, Zhi Gancao 6 gram, sweet wine 250 ml, Chinse green onion stem 4.

用药意解

The meaning of the formula:

按补血汤一方,乃活血、行气之方,实补气、补血之方也。夫当归味苦入心能补心,心者生血之源也;黄芪甘温补肺,肺者正气之宗也。当归得黄芪而血有所附,黄芪得当归而气有所依,即名补血汤亦可,即名补气汤亦可。古人称为补血汤者,取阳生阴长之义。余谓气血双补,欲补气者,当倍当归而轻黄芪,从阴以引阳法也;欲补血者,当倍黄芪而轻当归,从阳以引阴法也。此方倍黄芪,故名补血汤。

The formula Buxue Tang is a formula that works to activate blood circulation and to promote Qi movement in the body. It is a formula to supply blood and Qi. The herb Danggui is bitter and it can go to the heart to supply the heart. The heart is the source of the blood production. The herbs Huangqi is sweet and warm in herbal nature. It can supply the lung. The lung is the master of the Qi movement in the body. When the Danggui is coupled with the Huangqi, the blood has something (the Qi) to attach. When the Huangqi is accompanied with the Danggui, the Qi has somewhere (the blood) to stay. Therefore it can be called as a blood-spplying formula, or a Qi-supplying formula. Either way is correct. The old Chinese call it the blood-suppllying formula, means to supply the Yang Qi for the aim to product more blood. I said it supply both the blood and the Qi, since by varying the herb dose, it can supply either more blood or more Qi. If the aim is to produce more Qi, double the amount of herb Danggui, but less Huangqi. This is a way of producing more Yang but by supplying more Yin first. On the other hands, if we wish to produce more blood, we can double the amount of Huangqi but reduce the amount of Ganggui. This is a way of producing more Yin by supplying more Yang first. Here, the formula has more Huangqi, so it is called Buxue Tang. In Chinse, here the “xue’ means blood.

今产妇病四十馀日,既酿成血虚欲脱而未脱之际,忽得补血之品,而血虚可复,又得补气之物,而血有统制。血既有统,而欲下者不下,则肛门逼胀之症可除。加鹿茸者,取纯阳之质,以助真阳之气;佐姜、草者,有温中之功,又有化阴之意;用葱头以降离阴而下交;用甜酒以鼓坎阳而上行,使麦芽从中以消散其壅滞之气血,不寒不燥,故治此病易也。况当归重用,有活血之能,黄芪重用,有行气之妙。前贤往往用于血虚发热之症颇效。余谓血虚气虚,皆可,不必固执。

In this case, the woman is more than 40 days after delivery. She is in a condition, in which the blood is insufficient and is to deplete but not yet. At that movement, if she got blood supply, the blood insuficience cany be corrected. If she got Qi supplication therapy, the blood can also be under government. When the blood is under the control and governing, the Yang that is to escape cannot escape, so the anus bloating feeling can be solved. The Lurong in the fomula is pure Yang herb, which supply the True Yang Qi. The Ginger and the Gancao work to warm the middle part of the body, can alos supply more Yin. The Chinese green onion can conduct the Li Yin (the Heart Yin) down with the Kidney; the sweet wine helps the Kan Yang (the True Yang in the Kidney) moves up to meet the Heart. The Maiya works to disperse the stagnaged Qi and blood. So the disease can be solved. In the formula, when the Danggui is more in dose, it can activate the blood circulation; when the Huangqi is more in dose, it can stimulate the Qi movement. Previous smart doctors usually used it for a blood deficiency condition with hot feeling. I believe that this herbal formula can be used to suplly either the blood or the Qi. We don’t need to be stubborn.

问曰:病人口臭、色黄,饮冷,呃逆不休,水泻不止,步履如常者,何故?

Q: The patient has strong and bad odor from mouth; his tongue covering is yellow in color; has willing to drink cold water, has contineous hiccup; has water-diarrhea, but the walk is normal. What is this condition?

答曰:此元阴不足,而胃火旺甚也。夫口臭有二,有先天精气发泄者,口虽极臭,而舌滑润微黄,人无神而阴象全现,决不饮冷。胃火旺者,口臭,舌必干黄,口渴饮冷。呃逆者,火之上冲,泻不止者,火之下降,步履如常者,火之助也。法宜下夺为主,方用大承气汤主之,解见上。此条上、中、下三部俱备,学者不必定要全见,而始用此方,活法圆通,人贵于知机耳。

A: This is a condition, in which the Yuan Yin is insufficient so the Stomach Fire is relavely overwhelming. Theoretically, there are two kinds of clinic conditions contributed to the bad odor from mouth. If the bad odor in mouth is due to the escape and depletion of innate Jing Qi (the True Yang, or the True Fire), the mouth odor is very strong, the tongue is slippery and slight yellow in color. The person has very low desire in life and has lots of evidience for a Yin overwhelming. He must not have willing to drink cold water. If the condition is due to Stomach Fire, the person has strong mouch odor; his tongue is dry and yellow in color; feels thristy and willing to drink cold water. His hiccup is due to the pushing up of the Fire. His water diarrhea is due to the falling down of the Fire. His walk is normal, since the walk is help by the Fire. In such condition, the principle in the treatment is to deplete the Fire through bowel movement, using herb formula of Da Chenqi Tang. In this condition, patient has the symptoms in the upper, the middle and the lower part of the body. The learners do not need to wait for all the condition show up so to start the treatment. The medicine should be performed in a flexible manner. The most important thing is to understand the meaning and the mechanism.

问曰:平人干咳无痰者,何故?

Q: A person has dry cough, no phelgm, without any other health problem. What is this condition?

答曰:此元阴不足,而肺燥也。夫肺为金,生水之源也。元阴不足,由于肺燥不能生水,肺燥实由于元阴不足而邪火生,火旺克金,故肺燥。肺气燥,斯干咳作矣。法宜苦甘化阴养血为主,方用甘草干姜汤,合当归补血汤,加五味子治之。

A: This is a condition, in which the Yuan Yin is insufficient, so the Lung is in a dryness condition. The Lung belongs to Metal, which is the source of Water in the body. When the Yuan Yin is insuficient, the Lung is dry so as not be able to product Water, so that a Xie Fire is born. The Xie Fire combats against and depresses the Metal, to the Lung is dry. When the Lung is dry, the dry cough occurs. The principle in the treatment is to use bitter and sweet herbs to develop Yin and nourish the blodo. The herbal formula is the Gancao Ganjiang Tang, plus Danggui Buxue Tang, and plus Wuweizi.  

甘草干姜汤

Gancao Ganjiang Tang

炙甘草二两   干姜五钱炮

Zhi Gancao 60 gram, Paojiang 15 gram.

用药意解

The meaning of the herbs:

按甘草干姜汤一方,乃辛甘化阳之方,亦苦甘化阴之方也。夫干姜辛温,辛与甘合则从阳化,干姜炮黑,其味即苦,苦与甘合则从阴化。仲景以此方治误吐逆烦躁而厥者,取大甘以化热、守中而复阳也。

The herb Gancao Ganjiang Tang is a formulat that is spicy and sweet in herbal nature, so to develop Yang Qi in the body. It is also a bitter and sweet in herbal nature, so to develop Yin in the body. Ganjiang is spicy and warm; the spicy and the sweet works together to develop the Yang. When the Ganjiang is processed into Paojiang, the Paojiang is black in color and the taste becomes bitter. The bitter works with the sweet to develop theYin. Master Zhang uses it to solve reversing annoyed and irritable and reverse cold in hands and feet, due to a mist-treatment by using vomiting therapy. The meaning is that, it is strong sweet so to develop Hot; it is so protect the middle of the body and restore Yang.

又治吐血,治中寒,取辛甘以化阳。阳气也,气能统血,阳能胜寒,阳能温中也。又用以治拘急,治筋挛,治肺痿,治肠燥,取苦甘以化阴。阴血也,血能胜热,血能润燥,血能养筋也。今病人既现干咳无痰,肺气之燥明矣。即以化阴之法,合当归补血汤,加五味子治之,俾燥热解而肺气清,肃令行而干咳自不作矣。

This formula is also used to solve blood vomiting and middle Cold condition, for its spicy and sweet that is able to develop Yang Qi. Yang means Qi. The Qi can govern the blood. Yang can suppress the Cold. Yang can warm the middle. It is also used for the treatment of muscle spasm, tendon spasm, lung shrinken, intestine dryness, for its bitter and sweet in herb nature, which enables it to develop Yin. Yin means the blood. The blood can solve the Hot. The blood can wet the dryness. The blood can nourish the tendon. Now the patient has dry cough, suggesting the Yangming dryness of the Lung. The Gancao Ganjiang Tang should be used together with Danggui Buxue Tang and Wuweizi, to clear dryness and hot, so as to clear the lung, and to restore the function of the lung in clearing the pathway for the Qi movement. When the pathway for the Qi movement is clear, of course there would have no cough.

【阐释】笔者对治多种肺、胃虚寒病症,常用甘草干姜汤加味而获效。对治血症,无论其为血热妄行,或阴虚火动,或阳不统血,皆先选用甘草干姜汤加血馀炭,以止其血,然后才对症下药,屡屡获效。

Future explanation by the editor: the editor has used this formula for various disease in the lung, and the cold-weakness of Stomach. For disorders in the blood, no matter it is Hot Blood, Yin deficiency-Fire floating, or Yang deficiency-bleeding, all chooce the Gancao Ganjiang Tang plus Xueyutan to stop the blood first. Then use other herbs for additional symptomatic treatment.

问曰:妇女病,忽喜忽笑,言语异常,似颠非颠,似狂非狂者,何故?

Q: A woman has a disorder. She laughes sometimes, and feels happy sometimes. Her talk hears strange. She looks as mad, but also as not mad. What is this condition?

答曰:此真水不能上交于心,心热生而神无主也。夫人一身,全赖水、火两字,水、火相依而行,彼此互为其根,火下降则肾脏温,水上升则心脏凉,此阴、阳颠倒之妙也。今病人所现症形,明系真阴不足,不能上交于心,则心热生。心者,神之主也,热甚则神昏,故喜笑言语异常,而人若颠也。诸书称为热入血室,尚未窥透此理,不知心者,生血之源也,血室者,冲脉之所居也。冲为血海,即有热入,未必即若颠狂也,当以热甚神昏为确。法宜养阴清热,交济阴、阳为主,方用栀豉汤主之。

A: This is a condition, in which the True Water fails to conduct up to the Heart. The Heart produces Hot, so the spirit has no boss/supervisor/manager to control it. For the whole human body, it can be said that it depends on mostly the Water and the Fire. The Water and the Fire moves parallel in the body and they are the root to each other. When the Fire moves down, the Kidney will be warmed up. When the Water moves up to the Heart, the Heart will be cooled down. This is the interesting for the transfer and transformation between the Yin and the Yang. The conditions for the patient clearly indicate an insufficiency in the True Yin, which cannot conduct up to the Heart, so the Heart Hot occurs. The Heart is the manager of the spirit. Hot makes the consciousness loss, so the patient shows invarious happy and laugh and talk. In various books, such condition is talked to be due to Hot moves into the Blood space (uterus). They actually did not find the real reason. They do not know that, the Heart is the source of the blood. Blood space is there the Chong Mai meridian locates. Chong Mai is the blood sea. Even if there is Hot invasion, it is not necessary to have a madness. For the condition here, the principle in the treatment should be to nourish the Yin, clear the Hot, to conduc the Yin and Yang. The formula is Zhizichi Tang.

栀豉汤

Zhizichi Tang

栀子一两   豆豉二两

Zhizi 30 gram, Daochi 60 gram.

用药意解

The meaning of the herbal formula:

按栀豉汤一方,乃坎、离交济之方,非涌吐之方也。夫栀子色赤、味苦、性寒,能泻心中邪热,又能导火热之气下交于肾,而肾脏温。

The Zhizichi Tang is a formula to conduct the Kan and the Li. It is not a formula to stimulate vomiting. The herb Zhizi is red in color, bitter in taste, cold in herbal nature. It is able to deplete Xie Fire in the Heart and conduct the Heart Fire down to the Kidny to warm the Kidney.

豆形象肾,制造为豉轻浮,能引水液之气上交于心,而心脏凉。一升一降,往来不乖,则心、肾交而此症可立瘳矣。仲景以此方治汗、吐、下后虚烦不得眠,心中懊憹者,是取其有既济之功。前贤以此方列于涌吐条,未免不当。独不思仲景既列于汗、吐、下后虚烦之症,犹有复吐之理哉。

The shape of the bean looks similar to the kidney. It is processed into the chi. The Chi is light in weight and floating. It can bring the Water Qi up to the Heart to cool down the Heart. Therefore, one herb works to bring up and another works to bring down. The Qi moves in the body so gos and comes. The Heart and the Kidney are so conducted and harmanized each other. Master Zhang used this formula to solve the annoying emotion, that causes poor sleep, which is again due to the mis-use of the sweat therapy, vomiting therapy or bowel-cleasing therapy. He used this formula for the formula has condution function. That he listed this formula into the Vomiting volume of the book seems not proper. But why we do not think that, if it is used for annoying emotion after sweat, vomiting and diarrhea, how can we use it form vomiting again.

问曰:每日早饭后即咳吐黄痰数口,五心潮热,心烦、口渴,大热饮冷,六脉细、数者,何故?

Q: After every breakfast, the patient coughs several mouths of yellow phlegm. He feels hot in the palm, sole and chest; feels annoyed, thirsty, and very hot; has willing to drink cold water. His pulse is thin and frequent. What’s this condition?

答曰:此元阴虚极,火旺而津液欲竭也。夫大热、口渴、饮冷,心烦、咳吐黄痰,症象白虎之形,然六脉细、数,细为血虚,数为血热,明明血虚生内热,则又非白虎之的症也。医于此际,不可猛浪,务要审确。余细推究病情,伤寒阳明症之烦躁、口渴、饮冷、发热,是从外感得来,脉必长大,定有头疼、身痛、恶寒等情。血虚之大渴、饮冷、烦躁、发热,从内伤得来,或吐血,或久咳,或产后血暴虚,或抑郁损伤心脾,脉必细微,甚则细、数,定少头疼、身痛、恶寒等情,切切不可轻用白虎。误用白虎,为害匪轻。法宜峻补真阴为主,方用独参汤,或当归补血汤亦可,解见上。

A: This is a condition, in which the Yuan Yin is very insuficient; the Fire is overwhelming and the Jing Ye (body liquid part) is to depleted off. The symptoms as fever, thirsty, like to drink cold, annoyed, cough with yellow phlegm, all look as Baihu Tang condition. However, the pulse is thin and fast. The thin indicates blood deficiency, and the frequent pulse indicates blood hot. Clearly, it is that the Blood deficiencey develops inside Hot. It is not a Baihu Tang condition. Whenever doctor meets such condition, you should not be careless. I studied such condition again. If in Shanghan Yangming condition, The annoyed, thirsty, drinking cold water and fever, all come from Xie Qi invasion out of the body. The pulse should be long and big. The person must has headache, pain in the body, and chilly, etc. The thirsty, drink cold water, annoyed, fever, if they are due to blood deficiency, are caused by inside damage. The reason can be vomiting blood, or long time cough, or heavy bleeding during baby delivery, or long time depression that damages the Heart and Spleen. In such condition, the pulse must be thin and weak. In severe case, the pulse can be thin and frequent. The persone should have no clear headache, body pain, or chilly. In the later case, herb formula Baihu Tang should not be used. Otherwise there might be big mistake. The principle in the treatment should be to supply more True Yin, by using Dushen Tang, or use Danggui Buxue Tang. See the explanation above.

独参汤

Dushen Tang

人参即以洋参代之洋参二两

Renshen 60 gram.  The Renshen can be replaced by Xiyangshen.

用药意解

The meaning of the herb formula:

按独参汤一方,乃补阴之第一方也。今人用为补阳、回阳,大悖经旨,由其不知水、火立极之妙,药性功用之专。余为活人计,不得不直切言之。

The Dushen Tang is the number one formula to supply the Yin. Nowadays, doctors used it to supply the Yang, to restore the Yang. It is a very big mistake, since they do not really understand the meaning of the Fire and the Water and the focus of the herb. To save life, I have to argue with these ordinary doctors again.

夫人身所恃以立命者,惟此水、火而已,水、火即气、血,即阴、阳,然阳之根在乎坎,天一生水,一点元阳含于二阴之中是也;阴之根在乎离,地二生火,一点元阴藏于二阳之内是也。水、火互为其根,乾、坤颠倒,各有妙用。故经云:"善补阳者,于阴中求阳;善补阴者,于阳中求阴。"今人罕明此理,一见阳虚症,用药即着重心,而不知着重肾;一见阴虚症,用药即着重肾,而不知着重心。究其所用药品,阳虚重在人参,阴虚重在熟地。查熟地甘寒补阴,尚不为错,而人参甘寒,近来所出洋参味苦,苦寒之品,皆补阴之品,非补阳之品。故仲景不用参于回阳,而用参于大热亡阴之症以存阴,如人参白虎汤、小柴胡汤之类是也。

Human life depends on just such Water and the Fire. The Water and the Fire are the Qi and the Blood, respectively. They are the Yin and the Yang, respctively. The root of the Yang is in the Kan (the Kidney). The Yuan Yang is located in the two water in the kidney. The root of the Yin is in the Li (the heart). The Yuan Yin is hiden in the two Yang in the heart. The Water and the Fire are roots each other. That the Qian and the Kun reverse, bears big meaning. So the medical bible (the book <<Nai Jing>>) said: “The best way to supply the Yang is to supply the Yang in the Yin. The best way to supply the Yin is to supply the Yin the the Yang.” Nowadays, there are very little people understand this. They use the herbs to focus on the heart, do not know to focus on the kidney, the movement they see a Yang deficiency. They use herb on the kidney, not know on the heart, the movement they see a Yin deficiency. Upon check the herbs they used, they used Renshen for Yang deficiency, and herb Shoudi for Yin deficiency. The herb Shoudi is sweet and cold in herbal nature. It is not wrong to use it to supply the Yin. The herb Renshen however is sweet and cold and the recently imported North America Renshen is bitter in nature. The herbs with the bitter and cold in herbal nature are all to supply the Yin, not to supply theYang. This is why the Master Zhang do not use it to restore the Yang, but use it in a condition, in which the Hot and Fire depletes the Yin, to save the Yin. The herb formula he used are as Baihu jia Renshen Tang, Xiao Chaihu Tang, etc.

大凡药品,性具苦、寒、酸、濇、咸味者,功专在阴;具甘、温、辛、淡、辣味者,功专在阳。今人着重在后天坎、离之阴、阳,而不知着重坎、离中立极之阴阳,故用药多错误也。

Generally speaking, the herbs with the bitter, cold, sour, salty taste, function to nourish the Yin. The herbs with the sweet, warm, spicy, mild or flatten, hot taste, function mostly to nourish the Yang. Nowadays, doctors focus more on the Yin and Yang of the aquired Kan (Kidney) and the Li (the Heart), do not know to focus on the basic Yin and the basic Yang in the Kan and the Li. So, when they use the herbs, they comit lots of mistakes.

仲景一生学问,即在这先天立极之元阴、元阳上探求盈虚消长,揭六经之提纲,判阴阳之界限,三阳本乾元一气所分,三阴本坤元一气所化,五脏六腑,皆是虚位,二气流行,方是真机,阴阳盈缩,审于何部,何气所干,何邪所犯,外感由三阳而入内,六客须知,内伤由三阴而发外,七情贵识,用药各用实据,如六经主方是也。然补坎阳之药,以附子为主;补离阴之药,以人参为先,调和上下,权司中土,用药又以甘草为归。此皆立极药品,奈人之不察何!

The great contribution of the Master Zhang in whole of his life is the focus on the basic Yuan Yin and the basic Yuan Yang. Based on this finding, he proposed the six Jing principles for the diagnosis and treatment; for separating the Yin condition and the Yang condition. The three Yang is actually developed from the one Qi of the Qian Yuan, and the three Yin is developed from the one Qi of the Kun Yuan. The five concrete organs and the six hollow organs, all are therefore simply a concept. The movement of the two Qi in the body is the key function of the life. Pay attention to the increase and the decrease of the Yin Qi and the Yang Qi. Where are they sufficient and insufficient? Which Qi attacks this location? Which Xie Qi attacks this location? The out-coming diseases come into the body through the three Yang stages/meridians. The six Xie Qi should be verified. The inside-developed diseases develop from the inside of the body and develop outwards. The seven emotional factors must be known clearly. The herbs used must matach the clinic evidences. The example is the main formula for each stages/meridians. Among the formula, the herb Fuzi is the major ingredient in the formula to supply the Kan Yang. The herb Renshen is the major ingredient to supply the Li Yin. The herb Gancao works to adjust, to harmony the upper and the lower part of the body. It works on the middle part of the body. These herbs are the leader herbs in each extreme condition.

余细推世之用人参以补心,即为补阳也,不知心虽属阳,外阳而内阴,功用在阴,周身阴血俱从火化得来,故色赤。经云:"心生血"。又曰:"火味苦。"以苦补心,即是补离中之阴也,而非补真阳也。千古以来,用参机关,惟仲景一人知之,而时珍本草云:"能回元气于无何有之乡"。推斯意也,以为水火互为其根。经云:"阳欲脱者,补阴以留之",独参汤是也。"阴欲脱者,补阳以挽之",回阳饮是也。至于阴盛逼阳于外者,用参实以速其阳亡也。阳盛灼阴将尽者,回阳实以速其阴亡也。凡用参以冀回阳,总非至当不易之理,学者宜知。若此症所现,乃阳旺阴虚之甚,正当用参以扶立极之元阴,元阴盛而周身之阴血自盛,血盛而虚者不虚,病者不病矣。

I deduce that, current ordinary doctors use the Renshen to supply the Heart, for the reason that they believe the Renshen suppies the Yang. They do not know that, though the Heart belongs to the Yang, it is Yang in its outside and Yin in its inside (Two Yang and one Yin for the Heart). Its basic nature is Yin and its function is Yang. The Yin blood of the whole body is produced from the Heart Fire. This is the reason that the color of the blood is red. Medical bible said: “It is the heart that produces blood”. It also said: “The Fire tastes bitter”. To use bitter herbs to supply the Heart, is to supply the Yin in the Li (Heart). It is not really to supply the True Yang. For the thousands of years, it is only the Master Zhang, who recognized this truth. Doctor Li Shizheng said in his book <<Ben Cao Gang Mu>>: “the Rensen can supply the Yuan Qi from nowhere”. I quest his meaning is that the Water is the source of the Fire, and the Fire is also the source of the Water. Medical bible said: “When the Yang is to escape, supply more Yin to keep it”. The formula is the Dushen Tang. “When the Yin is to escape, supply more Yang to keep it”. The herb formula should be the Huiyangyin Tang. If the Yin is overwhelming that presses the Yang to deplete, the use of the Renshen is actually to speed up the death. If the Yang is overwhelming that burns the Yin to die, the use of Huiyangyin is to speed up the death of the Yin. In any case, to use the Renshen to restore the Yang is anyway not all a correct way. The beginners must know this. If the condition shows Yang overwhelming but Yin deficiency, the Renshen should be used to supply the most important Yuan Yin. When the Yuan Yin is sufficient, the Yin blood is sufficient. When the blood is sufficient, the weakness is not longer weak. The disease should be solved.

问曰:酒客病,身大热而喘,口渴饮冷,无头疼、身痛、畏寒者,何故?

Q: A liqor drinker feels hot and fever and asthma. He feels thirsty and drinks cold water. But he has no headache, no pain in the body, and no chilly. What’s this condition?

答曰:此积湿生热,热盛而伤血也。夫嗜酒之人,易生湿热症,因酒性刚烈发散,入腹顷刻,酒气便窜于周身皮肤,烈性一过,湿气便留中脘。中土旺者,湿气易去;中气弱者,湿气难消,久久中气更虚,湿气因而成疾,湿气流注四肢,便成痰火手脚。医生一见痰火手足,便照痰火治之,鲜有愈者。以余主治,法宜温中除湿,辛甘化阳之品。若此症由湿聚日久,因而生热,热气逼肺,则喘症生,热伤津液,则口渴作。法宜清热、燥湿、升解为主,方用葛根黄连黄芩汤。

A: This is a condition, in which the accumulated Wetness develops Hot. The overwhelming Hot damages/burns the blood. Person who drinks lots of liqor is easy to have Wet and Hot condition. This is because the liquor in strong and disperse in nature. Once comes into the stomach, the liquor Qi moves and penetrates to the skin of the whole body. After the alcohol effect, the wetness remains in the body. If the person is strong in the middle Stomach-Spleen system, the wetness can be removed off (metabolized) easily. If the stomach system is weak or poor, the wetness will remain. After a long time, the middle Qi is more weak and the wetness so causes disease. The wetness Qi flows to the arms and legs, causing the Phlegm-Fire in the hands and feet. Ordinary doctors treat this condition as the Phlegm-Fire, the movement they see such Phlegm-Fire. The success rate is very rare. If I meet such condition, I would warm the middle to remove the wet, using sweet and spicy herbs. If this condition lasts longe time, the wet will develop Hot. The hot floats up to press the lung, so it causes cough and asthma. The Hot burns the body liquid, so the person feels thirsty. The principle in the treatment is to clear Hot, dry the wetness, and rising and dispersing the Xie Qi. The herbal formula should be Gegen Huanglian Huangqin Tang.

葛根黄连黄芩汤

Gegen Huanglian Huangqiin Tang.

葛根一两   黄连五钱   黄芩五钱   甘草五钱

Gegen 30 gram, Huanglian 15 gram, Huangin 15 gram, Gancao 15 gram.

古方葛根用至半斤,芩、连、草各二两,因太阳桂枝症误下,邪陷于中土,下利不止,脉促喘汗者,内陷之邪,尚欲从肌腠而外出不能出,涌于脉道,则脉促,涌于华盖,则气喘。仲景故用葛根以升腾胃气,鼓邪仍从外出,佐以芩、连之苦,苦以坚之,坚毛窍以止汗,坚肠胃以止泻,又以甘草调中,邪去而正立复,病自不难解矣。今改用分两,借以治酒客之积湿生热,大热而喘者,亦更妙也。

In the original formula in old book, the Gegen was used as 90 gram, the Huanglian, Huanqin and Gancao are all 30 gram. It is used for the diarrhea, asthma, heavy sweat, all due to misuse of bowel-cleansing therapy in Taiyang Guizhi condition, which makes the Xie Qi cannot be expelled out of the body but wave to the blood vesicle to cause frequent pulse, and to the chest to cause asthma. The Master used the herb Gegen to activate Stomach Qi up, push the Xie Qi leaving the body. Helped by the herb Huanglian and Huangqin, for their bitter that can function to stregthen the skin sweat holes so to stop the sweat; strengthen the intestine to stop diarrhea. With the herb Gancao to harmany the middle part of the body, the Xie Qi will be depleted and the defense Qi will be restored and the disease disappears. Now, the doses of the ingredients are modified to solve the accumulated Wetness and Hot due to alcohol with fever and asthma. It is more wonderful.

用药意解

The meaning of the herb formula:

按葛根黄连黄芩汤一方,乃表里两解之方,亦宣通经络、燥湿、清热之方也。夫葛根气味甘辛,禀秋金之气,乃阳明胃经主药也。阳明主燥,肌肉属阳明胃,胃热甚故肌肉亦热,胃络上通心肺,热气上涌于肺故喘,热伤脾中阴血故渴。今得葛根之升腾,宣通经络之邪热,热因湿积者,热去而湿亦去矣。况得芩、连之苦,苦以清热,苦能燥湿,复得甘草和中以培正气,内外两解,湿热自化为乌有矣。此方功用尚多,学者不可执一。

The herb formula Gegen Huanglian Huangqin Tang is the formula that works to solve Xie Qi in both the outside and inside of the body. It works to open the meridian, dry the wetnewss, and clear the hot. The herb Gegen is sweet and spicy, bears the autumn Qi, and is the main herbs for the Yangming Stomach meridian. Yangming dominates Dryness. The muscle belongs to Yangming Stomach. If the stomach is hot, the muscle is hot too. The Stomach meridian conducts up with the Lung and Heart, so the Hot can rise up to the Lung to cause asthma. The Hot damages the Spleen Yin blood to cause thirsty. Now, through the floating property, the Gegen disperses the Xie Qi in the meridian. If the Hot is caused by the Wetness, the depletion of the Hot will promote the depletion of the Wetness. In addition with the bitter of the Huanglian and Huangqin, the bitter herbs can clear the Fire and to dry the Wetness. Again with the Gancao to nourish the middle part of the body to develop the Zhen Qi (the defense Qi), the Xie Qi is so solved from both the inside and the outside. The Wetness should be depleted off. This formula has a lot of function. Beginners should not misunderstand its only function here.  

问曰:老人大便艰涩不出者,何故?

Q: Old person has hard constipation. Why?

答曰:此血虚甚而不能分润沟渠也。夫年老之人,每多气、血两虚,气旺则血自旺,气衰则血自衰。然年老之人,禀赋原有厚薄,不得概谓气血两虚。亦有素禀阳旺者,精神不衰,出言声厉,饮食不减,此等多由火旺阴亏。亦有禀赋太薄,饮食不健,素多疾病,乃生机不旺,运化太微,阴血渐衰,不能泽润肠胃,肠胃枯槁,此真血虚之侯。

A: This is a condition, in which the blood is deficiency and fails to moisture the colon. Old person is usually short of the blood and the Qi. If the Qi is sufficient, the blood is sufficient too. If the Qi is insufficient, the blood is insufficient too. However, every person is different for his innate body nature, stronger or weaker. It should not say that every old person will have insufficient Qi and blood when he becomes old. Some persons are originally with very strong Yang in the body. They are with higher mode and active action, high voice in talk, very good appetite. Such conditions are usually due to overwhelming Yang that causes insuficient Yin. Some other persons are weak from innate. They have lower appetite, and are easy to get diseases. This is because the Qi movement and the metabolism in the body are low. The supply of the Yin blood is not sufficient, that cannot nourish and wet the stomach and intestine, so the stomach and intestine is withered. This is a true blood deficient condition.  

二条乃言老人之禀赋。亦有因外邪入阳经,变为热邪,伏于肠胃而闭结者。亦有阴盛阳微,下焦无阳,不能化阴而闭结者,亦有肺内伏热而闭结者,认症总宜清耳。若老人大便艰涩,无外症者,即是血枯居多,法宜苦甘化阴为主,方用当归补血汤加蜂蜜,或甘草干姜汤,解见上。或麻仁丸。

These two conditions talk about the body conditions of old person. In clinic, there is also a condition, in which the out-coming Xie Qi invades into the Yang meridians, which turns into hot Xie Qi, and hides in the stomach-intestine to block the bowel movement. In some other conditions, it is Yin overwhelming and Yang deficiency, the Yang Qi in the lower Jiao cavity, which fails to melt the Yin so to cause the block of the bowel movement. In addition, in other condition, if there is hidden Hot in the lung, the hidden Hot can also cause block of bowel movement. All conditions should be identified clearly. For old person, if there is no evidence for a out-invading disease, their constipation is usually due to the blood withered. The principle in the treatment should be to use the bitter and sweet herbs to develop Yin. The herb formula is the Danggui Buxue Tang plus honey, or the Gancao Ganjiang Tang. See the explanations above. Or use the Maren Wan.

麻仁丸

Maren Wan

麻仁二两    芍药八钱    枳实八钱    大黄一两六钱    厚朴二钱    杏仁一两    白蜜一两

Maren 60 gram, Shaoyao 24 gram, Zhishi 24 gram, Dahuang 45 gram, Houpo 6 gram, Xinren 30 gram, Honey 30 gram.

用药意解

The meaning of the herb formula:

按麻仁丸一方,乃润燥行滞之方,实苦甘化阴之方也。夫人身精血,俱从后天脾胃化生,脾与胃为表里,胃主生化,脾主转输,上下分布,脉络沟渠,咸赖滋焉。今胃为伏热所扰,生化之机不畅,伏热日炽,胃土干燥,渐渐伤及脾阴,脾阴虚甚,津液不行于大肠,肠、胃火旺,积粪不行,故生穷约。穷约者,血枯而无润泽,积粪转若羊矢也。故仲景立润肠一法,使沟渠得润,穷约者,自不约也。药用麻仁、杏仁,取多脂之物,以柔润之,取大黄、芍药之苦,以下降之,取厚朴、枳实之苦温,以推荡之,使以白蜜之甘润,与苦合而化阴。

The herb formula Maren Wan, is a formula to wet the dryness and to clear the block. It is actually a bitter-sweet formula to develop the Yin. The body Jing and blood are both developed from acquired Spleen-Stomach system. The Spleen and the Stomach are the brother and sister systems. The Stomach works to digest the food, and the Spleen works to transport the nutration. Now, the Stomach is disturbed by the hidden hot, the digestion function is blocked or prevented. When the hidden Hot is more and more along the days, the Stomach Soil is dried. Gradually, the dryness affects and involves the Spleen to damage the Spleen Yin. When the Spleen Yin is insuficient, the Ying liquid cannot flow down to the large intestine. The Fire in the intesteine and the stomach is overwhelming, the hosting stool cannot move, to cause Qunyue. Qunyue means the blood is withered, the stool looks as sheep stool. The Master Zhang Zhongjing sets up this principle of intestine wetness, to wet the intestine, the block is so solved. In the formula, the ingredients include the Maren and Xinren. They both are rich in fat, which has soft-wetting herb property. The herb Dahuang and Shaoyao are bitter, able to push down the Qi movement. The herb Houpo and Zhishi is bitter and warm, to push the stool to move in the intestine. The honey is sweet and sleek in herbal nature. Together with the bitter herbs, the honey can develop the Yin.

阴得化而阳生,血得润而枯荣,肠胃水足,流通自如,推荡并行,其功迅速。此方宜用为丸,缓缓柔润,以治年老血枯,实为至当之法。今改用分两为汤,取其功之速,亦经权之道也。

When the Yin is nourished and supplied, the blood becomes sleek, the stomach-intestine is rich in water, the stool movement is smooth in the intestine, the constipation is so possible to solve. This formula should be used as pill to function slowly for lubrication. For elderly patients with constipation, this is very suitable solution. The herb dose has been varified from the original formula and the pill form has been changed into the herb tea for fast effect.

问曰:男子阳物挺而不收者,何故?

Q: A man has his penis erected for long time and hard to make it down. What is this condition?

答曰:此元阴将绝,阳孤无匹也。夫阳物之举,乃阳旺也。阳旺极宜生阴,阴生阳自痿,乃阴阳循环不易之理。今出乎至理之外,挺而不收,明明有阳无阴象也。此际法宜救阴,大补先天元阴为主,方用独参汤主之,解见上。或六味地黄汤亦可。

A: This is a condition, in which the Yuan Yin is to be depleted off, and the single Yang has no accompany. The erection of the penis suggests the overwhelming of the Yang. When the Yang is at overwhelming, it will develop or give birth to the Yin. When the Yin is born, the Yang will be withered naturally. This is the no-variation law for the Yin and the Yang transformation. Now, the thing happens beyond the common law, showing erection without changing to soft. It clearly indicates the Yang without Yin. The principile in the treatment should be to save the Yin, to supply the innate Yuan Yin. The herbal formula is the Dushen Tang. See the explanation above. Or, the herbal formula of Liuwei Dihuang Wang can be used.

六味地黄汤

Liuwei Dihuang Tang

熟地一两   枣皮八钱    淮药五钱    茯苓五钱    丹皮六钱    泽泻三钱

Shoudi 30 gram, Chinse date peel 24 gram, Hui Shanyao 15 gram, Fuling 15 gram, Danpi 18 gram, Zexie 9 gram.

用药意解

The meaning of the formula:

按地黄汤一方,乃利水育阴之方也。夫地黄甘寒,滋肾水之不足;二皮酸寒,敛木火之焰光;山药、茯苓,健脾化气行水,泽泻甘寒,补养五脏,又能消湿。此病由水虚而火旺,又加木火助之,故不收。

The herb formula Liuwei Dihuang Tang is a formula to produce Water and to nourish the Yin. The herb Dihuang is sweet and cold in herb nature. It is to supply more kidney Water. The Date peel and the Danpi are sour and cold in herbal nature. They work to contract the flame of the Wood. Shanyao and Fuling work to help the Spleen in evaporating the Water and to promote the Water metabolism. The Zexie is sweet and cold in herbal nature. It works to nourish all the organs in the body and to solve the Wetness. This disease is due to the Fire overwhelming that is again due to the insufficient Water. Additionally it is also due to the Wood Fire burning. So the penis cannot become soft.

今得地黄补水,又能滋肝,肝主宗筋,乃阳物之根也。宗筋得润,而阳物立痿,佐二皮一敛一泻,火光即灭。又得山、苓、泽泻,健脾化气以行津液,庶几此病易瘳。古人云:"补阳以配阴",乃为阳痿不举(柱)〔注〕脚,为一切阳虚(柱)〔注〕脚。"补阴足以配阳",乃为阳挺不收(柱)〔注〕脚,为一切阴虚(柱)〔注〕脚。此条应专以滋阴为是。不应利水,利之似反伤阴,不知用利药于地黄之内,正取其利,以行其润之之力也。学者不可执一,分两与古方不同,改用也。

The herb Dihuang works to supply more Water and to nourish the Liver. The Liver dominates the function of penis. When the penis is nourished, the penis can erect and turn soft as will. Together with the herb date peel and the Danpi, one of which is to contract and another is to deplete. They work to make the Fire down. In addition with the use of the Shanyao, Fuling and Zexie, to promote the function of the Spleen in guide the Qi movement and the Water metabolism, so the problem is easy to solve. Old Chinese said: “Supply the Yang to matach the Yin”. This is the principle for the treatment of impotence. It is also the principle for the treatment of all Yang insufficiency. That “Supply the Yin to match the Yang” is the principle for the treatment of the continuous erected penis. It is also the principle for the treatment of all Yin deficiency.

The clinic condition listed here should be solved by nourishing more Yin. The urine therapy should not be used. Otherwise, it would damage the Yin. However, we use the urine-promoting herbs in this formula for the presence of the herb Dihuang. The urine-promoting herb would help the Dihuang to lubricate the body function. Beginners should not be too stubborn. The herb dose has been modified to match the clinic condition. This should be allowed.

问曰:病人每日半夜候,两足大热如火至膝,心烦,至午即愈者,何故?

Q: Every middle night, the patient feels very hot as fire burning from the feet to the knees. He also felt annoyed but this feeling stop upon noon. What is this condition?

答曰:此血虚阳旺也。夫人身以阴、阳两字为主,阳生于子至已时,属三阳用事,正阳长阴消之时,阴虚不能配阳,阳旺故发热。至午即愈,乃阴长阳消,阳不胜阴,故热退。世人以为午后发热为阴虚,是未识阴、阳消长之道也。余治一易姓妇,每日午初,即面赤发热,口渴喜热汤,至半夜即愈,诸医概以补阴不效,余以白通汤,一服而愈。此病法宜补阴以配阳为主,方用补血汤,或地黄汤,解见上。

A: This is a condition, in which the blood is insufficient and the Yang is overwhelming. Our body is dominated by the Yin and the Yang. The Yang is born at the Zi shi (1 am) util the Ji shi (1 pm). This is the time period in which the Yang Qi dominates in the body (and in the nature). This is the time period in which the Yang is growing and the Yin subsiding. Since the Yin is insufficient. It cannot match (to balance, or to harmony) the Yang Qi in the body. The Yang Qi is overwhelming, so body feels hot. Upon the noon, the Yin starts to grow, the Yang starts to subside, so the Yang is not longer over the Yin, so the Hot stop. Ordinary people think that fever in the afternoon belongs to the Yin deficiency. They did not recognize the truth of the Yin and the Yang. I have a patient. Her family name is Yi. She had fever little before noon. Her face was red in color. She felt thirsty and wished to drink hot water. Such conditions disappeared upon middle night. Various doctors had tried the Yin-supplying therapy without any success. I used Baitong Tang. One drink solved all problems. For the conditions listed here, the principle in the treatment should be to supply more Yin so as to match the Yang. Use Buxue Tang, or the Liuwei Dihuang Tang. See the explanations above.

问曰:秋月人忽然腹痛水泻,日数十次,完谷不化,精神不倦者,何故?

Q: In autumn, the person suddenly has stomach pain and diarrhea. He has diarrhea tens times a day, with un-digested food in the stool. However he is still active in motion and in physical action. What is this condition?

答曰:此肺中之元阴不足,肺气燥甚也。夫大便水泻至完谷不化,谁不以为脾胃之败也。不知肺气燥极,亦有此症。肺与大肠为表里,大肠主传送,饮食入胃,不待消化,随燥热之气下降,而直趋大肠,故日泻数十次,腹痛饮冷不倦。若果脾败完谷不化,精神之倦极可知,决然病久非暴也。至于水泻一症,有泻出色黄极者,胃火旺也。泻出色白者,下元无火也。泻出色青者,厥阴之寒化也。泻出色如酱汁者,太阴之湿化也。泻出如溏鹜者,脏有寒也。亦有泻出色白如涎者,肺有热也。有泻出淡赤色者,阳不统阴也。以上数症,临症时再察虚、实、新、久,脉息有神、无神,用药自有据也。此症法宜清燥为主,方用甘桔汤,加二冬、地骨、桑皮、黄芩、杏仁、白蜜治之。

A: This is a condition, in which the Yuan Yin is insuficient in the lung. So the Lung Qi is too dry. Generally speaking, the water-like diarrhea with un-digested food in the stool is believed to be the death of the digestive system. People do not know that it can also happen when the Lung Qi is too dry. The Lung and the Large intestine is the brother and sister relationship. The Lund dominates the inside and the Large intestine dominates the outside. The Large intesteine dominates the transport of digested food. Now, the food comes into the stomach and passes soon down to the large intesteine along with the Dry-Hot Qi, so to cause diarrhea tens times a day, abdomen pain, and willing to drink cold water without fatique. If this condition was really due to the death of the digestive system, the patient should be very tired. The patient must have had such dirrhea for a long time. For water-diarrhea, if the stool looks very much yellow in color, it suggests the Fire in stomach; if it is white color, it is due to no-Fire in the lower Jiao of the body; if it is blue in color, it is the Cold-transformation of the Jueyin stage; if the stool is as brown as source, it is the Wet-transformation of the Taiyin stage/meridian; if the stool is loss as duck stool, it suggests the Cold in the organs. If the stool is white as phlegm, it indicates the Hot in the lung. If the stool is slight red in color, it suggests that the Yang fails to control the Yin. Rememb these conditions, then in clinic, combined with the patient’s condition, as the Xue, the Shi, the acute disease, or the long term disease, as well as the pulse is with the spirit, or no spirit, it would be easy to decide the treatment principle. For the condition indicated here, the principle should be to clear the Dryness. The herb formula is the Ganjie Tang plus two Dong, Digupi, Sanbpi, Huangqin, Xingren and white honey.

甘桔汤

Ganjie Tang

甘草一两     桔梗八钱     天冬四钱     麦冬四钱     地骨三钱     桑皮三钱     黄芩二钱     杏仁二十粒     白蜜五钱

Gancao 30 gram, Jiegen 24 gram, Tiandong 12 gram, Maidong 12 gram, Digupi 9 gram, Sangpi 9 gram, Huangqin 6 gram, Xingren 8 gram, white honey 15 gram.

用药意解

The meaning of the herbal formula:

按甘桔汤一方,乃苦甘化阴之方也。此方仲景用以治少阴之咽痛症,因少阴之火上浮于咽,少阴之络挟咽故也。得甘桔之合化,而少阴得养,故愈。今用以治太阴,取桔梗之苦以开提肺气,而伏热立消,取甘草之甘,大甘足以化热,苦与甘合,又能化阴,化阴足以润肺,又加以二冬、二皮、黄芩、杏仁、白蜜,一派甘寒、苦降之品以助之,而肺燥立止,水泻自不作矣。

The Ganjie Tang is bitter-sweet herb formula, so it is to develop the Yin. It is used by the Master Zhang Zhongjing to solve the sour throat in the Shaoyin Stage, since the Shaoyin Fire floats up to the throat, and the Shaoyin meridian distributes around the throat. With the Ganjie, the Shaoyin meridian is nourished, so the sour throat is solved. Now, it is used to solve the problem in the Taiyin meridian/stage. The Jiegen is bitter, able to rise the Lung Qi and so as to clear the hidden Fire. The Gancao is sweet. It’s strong sweet enables the produce warm. The combination of the bitter with the sweet can develop the Yin, and the Yin is able to wet the Lung. Plus the two Dong, tow pi, the Huangqin, the Xingren, and the white honey, all are sweet and cold and bitter so as to promote the Qi to fall down. All work together to clear the Dryness in the Lung and the water-diarrhea stops.

问曰:病人干咳,周身皮肤痒者,何故?

Q: Patient has dry cough and itch whole the body. What is the condition?

答曰:此元阴虚不能润肺,肺燥而不能行津液于皮肤也。夫病人干咳,乃血虚肺燥之验。肺主皮毛,肺气清,则节令行而不乖,脏腑咸赖;肺气燥,则节令失,而津液不行,百病丛生。津液不行于内,则肺痿、脏结、肠燥、痿躄、筋挛、骨蒸等症即起;津液不行于外,则皮毛、肌肤、爪甲、枯搞、燥痒之症立作。此条言血虚肺燥,有如是等症,法宜清燥、养营为主,方用补血汤,合甘草干姜汤,加五味、白蜜治之,解见上。

A: This is due to the Yuan Yin is insufficient, so that it fails to nourish the Lung. The Lung is in dryness condition, so fails to govern the liquid to the skin. The dry cough is the sign of the blood deficiency with lung dryness. The Lung dominates the skin and hair. If the Lung Qi is clear, the movement of the Qi in the body is smoothly and the organs are in reasonable condition. If it is in dryness condition, the jump of the Qi in each body joint is hard, so the liquid fails to distribute in the whole body and various disease happen. If the liquid fails to distribute in the inside of the body, there will be the paralysis of the lung, congestion of the organs, dry intestine, paralysis, tendon spasm, hot bone, etc. If the liquid fails to distribute to the surface of the body, the skin, muscle, nails, all would be withered, dry and itch. The condition listed here indicates the blood deficiency and Lung dryness. The principle in the treatment should be to clear the dryness and nourish the Yinqi in the body. Use Buxue Tang, plus Gancao Ganjiang Tang, plus Wuweizi, white honey. See explanations above.

业斯道者,须知人身气血运用机关,气血之根皆在下,培养在中,发用在上。根即此也,培养即此也,发用即此也。肺主气,即发用之外圈,心主血,即发用之内圈。外圈本乾体所化,内圈本坤体所生,天包乎地,地成乎天,混然一物。地气上腾,指坎中一阳,由下而中而上,一呼即起;天气下降,指离中真阴,由上而中而下,一吸即入。故曰呼、吸者,阴、阳之橐籥也。呼则气行而血随,吸则血行而气附。呼吸虽判乎阴阳,其实升则二气同升,降则二气同降,升降循环不已,故即上、下以判阴、阳也。先圣恐人不明,故画卦以明阴、阳,乾坤则称为先天,六子乃为后天,今人专在后天论阴阳生克固是,而不在先天论阴阳盛衰,是知其末,而未知其本也。苟有知得阴阳升降之道者,庶可与共学适道矣。

For person practices the medicine should understand the Yin and the Yang, the Qi and the blood. The root for the Qi and the blood is in the lower part. They are nourished in the middle part, and functions in the upper part of the body. … The Lung dominates the Qi. It functions in the outside. The Heart dominates the blood. It functions inside. The outside is developed from the Qin body, and the inside is developed by the Kun body. The Sky covers the Land. The Land makes the Sky as a Sky. They are mixed as one thing actually. The Land Qi rises, meaning that one Yang in the Kan rises, from the lower, through the middle, reaching the upper, and it rises upon exhalation. The Sky Qi falls, meaning that True Yin in the Li, from the upper, through the middle, reaching the lower part of the body, and it falls upon inhalation. Therefore, when mention the exhalation and the inhalation, they refer to the Yin and Yang. In exhalation, the Qi moves and the blood follows. In inhalation, the blood moves and the Qi follows. Though the exhalation and the inhalation are allocated into the Yin and the Yang, they rise and fall the same time. The rising and the falling are in a no-end running circle. So, use the upper and the lower to tell the Yin and the Yang. The previous Masters feared that the ordinary people cannot understand, so they draw the Gua to show the Yin and the Yang. The Qian and the Kun are termed as innate; the six sons are termed the acquired. Nowadays, people are talking and pay attention to the acquired Yin and the acquired Yang, for their transform and exchange, but not on the innate Yin and innate Yang. It is as they only know the end branches but not the beginning root. Only the few people who know the innate Yin and innate Yang and their importance can be met to discuss the medicine.   

问曰:筋缩不伸者,何故?

Q: The tendons are shrinken, but not strech. What is this condition?

答曰:此血虚不能养筋,筋燥故也。夫筋之燥也有由生,虽云水能生木,其实水、火之功用在心、肺,肺主气,心主血,肺气行于五脏,血亦行于五脏,肺气行于六腑,血亦行于六腑。肺气燥极,则运用衰,津液不润于筋,则筋燥作。筋燥甚,故缩而不伸也。法宜清燥养血为主,方用芍药甘草汤主之,或加二冬、白蜜亦可。

A: This is because the blood is insufficient so as not be able to nourish the tendon, the tendons are in dryness condition. There is also reason for the dryness of the tendons. Though it is said that, the Water can develop and give birth to the Wood, it actually functions, together with the Fire, on the Lung and the Heart. The Lung dominates the Qi. The Heart dominates the blood. The Lung Qi travels in all the organs, so does the blood. The Lung Qi goes to all the hollow organs, so does the blood. When the Lung Qi is too dry, its function is damaged too. The liquid cannot nourish the tendons, so the tendons becomes dryness too, which again causes the tendon shrinken but not stretch. The principle in the treatment should be to clear the dryness and nourish the blood.

芍药甘草汤

Shaoyao Gancao Tang

芍药二两    甘草二两炙

Shaoyao 30 gram, Zhi Gancao 30 gram.

用药意解

The meaning of the herbal formula:

按芍药甘草汤一方,乃苦甘化阴之方也。夫芍药苦平入肝,肝者阴也。甘草味甘入脾,脾者土也。苦与甘合,足以调周身之血,周身之血既调,则周身之筋骨得养,筋得血养而燥气平,燥气平则筋舒而自伸矣。然亦不必拘定此方,凡属苦甘、酸甘之品,皆可以化阴。活法圆通之妙,即在此处也,学者须知。

The Shaoyao Gancao Tang is a bitter-sweet herb formula to develop the Yin. The Shaoyai is bitter in herbal nature. It focuses on the Liver. The Liver is the Yin organ. The Gancao is sweet. It focuses on the Spleen. The Spleen is the Soil. The combination of the bitter and the sweet activates the whole body blood circulation, which again nourish the tendons in the body. When the tendons are nourished by the blood, the dryness Qi disappears. When the Dryness Qi subsides, the tendons become stretched. However, it is not necessary to stick to only this formula. Any formula with bitter-sweet, or sour-sweet, can develop the Yin. The smart of the herbs are here. He beginners should know this.

问曰:年老之人多健忘,言语重复者,何故?

Q: Old people tend to forget things, and repeat talking. Why?

答曰:此元阴虚极,而神无主也。夫心生血,神藏于血之中,神者火也、气也,即坎中一阳,而寓于血之中,气与血相依,故别其名曰心藏神,即此可知鬼神之用也。书曰:"鬼神者,二气之良能也。"良能二字,即真阴、真阳之本性也,神禀阳之灵,天体也,位尊,故曰神;鬼禀阴之灵,地体也,位卑,故曰鬼。人之为善,则性从阳,光明气象;人之为恶,则性从阴,黑暗气象。人死而为神,为鬼,即在平日修持上判也。将死之际,善气重者,元神从天门而出,定为神道;恶气重者,元神从地户而入,定为鬼道。若老人气血已衰,精神自然不足,不足故神昏也。然又非热甚神昏之谓也,法宜养血为主,气、血双补亦可。方用补血汤、独参汤,或参枣汤亦可,补血、独参二汤,解见上。

A: This is because the Yuan Yin is too weak. The spirit has no “boss” to control it. The Heart develops the blood. The spirit is hidden and hosted in the blood. The spirit is the Fire, the Qi, and the one Yang in the Kan (Kidney). It hosts in the blood. The Qi and the blood go together, so it is said that the Heart hosts the spirit. So it is known that the spirit is the function aspect of the consciousness. It is said in book: “The consciousness is the functioning of the two Qi”. “Functioning” means the function of the True Yin and the True Yang. The consciousness bears the spirit of the Yang. It is the Sky. It is honest. So it is said the “Shen”, the angle, the superbeing. Ghost bears the spirit of the Yin. It is the Land (the earth). Its position is lower, so it is called the ghost. If a person is kind in nature, his/her behavior bears the Yang, bright; if he is not kind, his nature bears the Yin, so black. That a person would turn to an angle, or a ghost, depends on his behavior in the life. Close to the death, if the person bears more kind Qi, the Yuan Shen moves from the sky door of the person, becomes the superbeing; if he bears more unkind Qi, his Yuan Shen would move out of the body through the lower door, and becomes the ghost. If a old person is weak in his Qi and blood, his spirit of course is not strong, so his conscious is as cloud. But such cloud consciousness is unlike that during a strong fever (coma). The principle in the treatment is to nourish the blood, or nourish both the Qi and the blood. The herbal formula are Buxue Tang, Dushen Tang, or Shenzao Tang.  

参枣汤

Shenzao Tang

洋参一两    枣仁一两    甘草五钱    猪心一个

America Gingshen 30 gram, Chinese date kernal 15 gram, Gancao 15 gram, Pig heart one.

以上三味为细末,同猪心炖服,或同猪心捣为丸俱可。

Grind the herbs into powder. Cook with the pig heart to eat. Or prepare mud with the pig heart and make it into pills.

用药意解

The meaning of the herbal formula:

按参枣汤一方,乃苦甘化阴,酸甘敛阴之方也。因元阴虚极,不能养神,神无所主,故时明时昧,犹若残灯将灭,而火光不明,苟能更添其膏,火光自然复明也。今以洋参之甘苦,枣仁之酸敛,以扶其元阴。元阴敛而真气即敛,故曰藏神。又得猪心同气相求,庶几心神明而不昧。复取甘草从中合化,而真血有源源不竭之妙也。此方不独治老年健忘,凡属思虑损伤阴血者,皆可服也。

The Shenzao Tang is a bitter-sweet herb formula, so as to develop the Yin. Is is also a sour-sweet formula, so as to contract the Yin. Since very weak, the Yin fails to nourish the spirit (consciousness). The spirit has no boss to control it, so it is clear in mind sometime, but it is as cloud other times. It is as a lamp to die. If the fire light is dark, and if more oil is added, the fire can be bright again. Again with the America gingshen, its bitter and sweet nature, as well as the Date hernal, for its sour-contracting nature, both can nourish the Yun Yin. The contract/restore of the Yuan Yin means that of the True Qi, so it is called to host the spirit. In addition with the pig heart, it is said the same to nourish the same, as in Chinese medicine, the pig heart to nourish the human heart, so as to clear the mind/consciousness. With the use of the Gancao, the True blood has continuous supply. This formula not only works for the treatment of the dementia of the old people, but also those who has poor memery and sleep due to too much worry that damaged the Yin blood.    

问曰:大肠脱出数寸,肛门如火,气粗而喘,欲饮冷者,何故?

Q: The large intestine protrodes several inches. The anus feels burning as by a fire. The person feels heavy breath and asthma, has willing to drink cold. What is this condition?

答曰:此元阴不足于肺,肺火旺而大肠之火亦旺也。夫脱肛一症,原有阳虚阴虚之别。阳虚之脱肛者,由元气衰极,不能约束也。其人必困倦无神,渴必饮热,阴象全见,法宜温中。阴虚之脱肛者,由于下焦火旺,逼出也。其人精神不衰,渴喜饮冷,热象全见。然此二症,多起大泻大痢之后,治者务要认定阴、阳实据,自然获效。此症即阴虚火旺也,火上逼肺,故喘,火下逼肠,故肛出。法宜滋阴泻火,方用大黄黄连泻心汤,或葛根黄连黄芩汤亦可,解见上。

A: This is a condition, in which the Yuan Yin is not sufficient in the lung. The lung Fire is overwhelming and the large intestine Fire is also overwhelming. Theoretically, there are different reasons for the protrotion of anus. It can be due to a Yang deficiency or a Yin deficiency too. If it is due to the Yang deficiency, the Yuan Qi is too weak to control the anus. The person must be tired, no ambitious, feels thirsty and willing to drink warm water. All conditions show as Yin condition. The principle for the treatment is to warm the middle part of the body. If it is due the Yin deficiency, the lower part is rich in the Fire. The Fire pushes the anus out. The person has no weak spirit, feels thirsty but willing to drink cold. All other conditions show as a Hot condition. However, such two conditions are usually after a sever diarrhea. The healer must recognize and pay attention to the evidence for the Yin and the Yang conditions. The condition listed here belongs to the Yin deficiency-Fire overwhelming. The Fire pushes up to press the lung, so asthma. It pushes down to press the large intestine/colon, so the anus protrotion. The treatment principle should be to nourish the Yin and clear the Fire. The formula used is the Dahuang Huanglian Xiexin Tang, or Gegen Huanglian Huangqin Tang. See the explanation above.

大黄黄连泻心汤

Dahuang Huanglian Huangqin Tang

大黄一两      黄连五钱

Dahuang 30 gram, Huanglian 15 gram.

用药意解

The meaning of the formula:

按大黄黄连泻心汤一方,乃泻火之方也。仲景以此方治心下痞满,按之濡者。是因无形之热邪,伏于心下,而以此方泻之也。今借以治此症,似亦未切,不知大黄、黄连苦寒,能泻三焦邪热,此病既因热上攻肺,而喘症生,热下攻肠,而脱肛作,得大黄、黄连之苦寒泻火。火邪一去,上下自安,亦握要之法也。

The Dahuang Huanglian Xiexin Tang is a formula to clear the Fire. Master Zhang Zhongjing used it to treat the fullness in the upper abdoman, in which condition the upper abdomen is soft when pressed. It is a condition, in which the no-form hot Xie Qi is hidden in the stomach area. So this formula is used to clear such hidden/hosting Fire. Now it is used to sole the conditions listed here. On surface it seems not a suitable clinic condition. But people do not know that, the Dahuang and Huanglian is bitter-cold in herbal nature, able to clear the Fire in all three Jiao cavity. The condition here is due to the Fire attacks the lung and the large intestine. The Dahuang and Huanglian should be able to clear this Fire too. After subside of the Fire, the upper and the lower part of the body sourly are calm too. This is the way to maste the key.

问曰:小便便时痛甚,口渴饮冷,其淋症乎?非淋症乎?

Q: The person feels very pain in urination, thirsty and willing to drink cold. Is this condition a Ling condition or not?

答曰:此膀胱之元阴不足,为邪火所灼,乃太阳腑症之甚者也。

A: This is a condition, in which the Yuyin is insuficient in the urine bladder. The urine bladder is burned by the Xie Fire. It is a very severe conditon of the Taiyang Fu condition.

因邪犯太阳,从太阳之标阳而化为热邪,伏于膀胱,故口渴、饮冷而便痛,法宜化气行水,方用五苓散主之。其实近似淋症,淋症亦皆膀胱之症也。前贤有血淋、气淋、沙淋、石淋、劳淋五淋之别,总而言之,不出阴、阳两字。有阳衰不能化停滞之精而作者,十有七八。推其源,多起于梦中遗精,忽觉而提其气以留之,不能复位,发泄不畅,当心气下降而便溺,败精欲出而不能出,故小便痛甚,此受病之根也。

The Xie Qi attacks the Taiyang stage. It follows the Taiyang surface layer to transform it self into a Fire Xie Qi and hosts in the urine bladder. The person so feels thirsty and has willing to drink cold and feels pain in urination. For the treatment, it is needed to supply more Qi so as to conduct the Water movement. The formula should be the Wuling San. This condition is similar to a Ling condition. The Ling conditions all are the urine bladder problems too. Previous medical experts separated the Ling conditions as the blood Ling, Qi Ling, sand Ling, stone Ling, and exhausting Ling. However, they all can be separated into the Yin and the Yang condition. In seven or eight out of ten cases, the condition is due to the Yang deficiency, which fails to warm and to promote the flowing of the Jing. The reason for such condition is usually due to leakage of the Jing in the dream. The person suddenly feels it and lifts the Jing Qi to hold it, but fails to restore the Jing Qi back. The Jing Qi is therefore not expeled smoothly. When the Heart Qi falls, it follows to fall out of the body. The old Jing cannot leave the body so the pain is very severe. This is the reason for this condition listed here.  

此病法宜大助元阳,鼓之化之,俾气化行而精气畅。世人一见便痛为火,不敢轻投桂、附,是未识透此中消息也。亦有精停日久,阻滞气机,郁而为热,灼尽膀耽阴血,败精为邪火所熬,故有砂、石之名,总缘火由精停起见。阳虚之人,得此者多,方宜白通汤、三才、潜阳诸方。阴虚之人,火旺太甚,宜滋肾丸、六味丸、五苓散之类,解见上。或附子泻心汤亦可。

For the treatment, it should be to help the Yuan Yang to activate the Jing Qi movement. Ordinary doctors dared not to use the herbs, such as the Guizhi or Fuzi, since they did not understand the real reason for this condition. They believe that this condition is a Fire condition, the movement they see the pain in the urination. In ather cases, the Jing is stored in the lower part of the body for a long time, blocking the Qi movement, stagnated to cause a Fire, the Fire burns the bladder Yin blood, and the Fire also burns the Jing into sand or stone, so that it is called the sand Ling, or a stone Ling condition. Its reason so is due to the stop of the Jing. People with a Yang dificiency condition have more chance to have such condition. The herbs should be the Baitong Tang, Sancai Tang, or Qian Yang Dan. If the condition is due to the Yin deficiency, the Fire is overwhelming, the herb Zishen Wan, Liuwei Wan, Wuling San should be used. See the explanation above. In the Yin deficiency, the herb Fuzi Xiexin Tang can also be used.  

五苓散

Wuling San

白术一两    茯苓八钱    猪苓五钱    泽泻五钱    桂枝六钱

Baizhu 30 gram, Fuling 24 gram, Zhuling 15 gram, Zexie 15 gram, Guizhi 18 gram.

附子泻心汤

Fuzi Xiexin Tang

附子一枚     黄芩五钱     黄连五钱     大黄一两

Fuzi 15 gram, Huangqin 15 gram, Huanglian 15 gram, Dahuang 30 gram.

用药意解

The meaning of the formula.

按五苓散一方,乃化气行水之方也。因寒伤太阳之腑,气化不宣,水道不利而生邪热。热伤津液,不能上升,故渴;气化不行,尿欲出而不即出,故痛。今得二苓、术、泽,专行其水以培中,最妙在桂枝一味,化膀胱气机,气机化行,自然郁热解而寒邪亦解。此方重在化气,不重在去热一面,可知气化行,即是去热也,世多不识。

The formula Wuling San is to activate the Qi and Water movement in the body. The Cold Xie Qi attacks the Taiyang layer, the Qi distribution in the body is disturbed, so the Water flow and distribution are affected, so as to cause Xie Hot. The Hot burns the liquid part of the body. The liquid cannot evaporate, so to cause thirsty; the Qi is stagnated, so the urination becomes slow and difficult, and pain. With the herb Fuling, Zhuling, Baizhu, Zexie, all work to remove the water, so to support the middle of the body (Spleen). The smart thing is the use of the herb Guizhi. It works to activate the Qi function in the urine bladder. When the Qi moves smoothly in the bladder, the Hot of course dissolves and the Cold subsides. This formula focuses on the activation of the Qi movement, not on the removal of the Hot. It is so known that, the movement of the Qi helps to remove the Hot/Fire. Ordinary doctors usually do not know this concept.

按附子泻心汤一方,乃寒、热并用之方也。仲景以此方治心下痞,而复恶寒、汗出者,是少阴无形之热,伏于心下而作痞,复见太阳之寒,又见汗出,有亡阳之虑,故用芩、连、大黄以泻少阴无形之伏热,又用附子以固根蒂而追元阳,寒热互用,真立方之妙也。今借以治停精而生热为淋者,用附子以鼓先天之阳,佐芩、连、大黄以泻伏热,是不固之固,不利之利也。方书多用利水清热之品,是治热结一法,而遗化精一法。余意方中再加安桂二、三钱,以助附子之力,而又能化气,气化精通,热解邪出,何病淋之患哉?如三才封髓丹加安桂,滋肾丸倍安桂,皆可酌用,切勿专以分利为主也。

The herbal formula Fuzi Xiexin Tang, is a formual exersizing both Hot and Cold funtions in the body. The Master Zhang Zhongjing used it for the treatment of the clinic condition, in which patient feels bloating in the stomach area, chilly, and sweat. In this condition, Shaoyin no-flame Hot hides in the stomach area to cause the bloating feeling, then the body is also attacked by Taiyang Cold and has sweat. For fear of the Yang depletion, it is used the herb Huangqin and Huanglian to clear the Shaoyin Fire, and used the Fuzi to stregthen the root of the Yuan Yang, and to contract back the escaping Yuan Yang back. This is smart in this formula that it uses both Hot herbs and Cold herbs together. Now, it is used to solve the Ling condition, which is caused by accumulation of the Hot in the lower part of the body, which again due to the stop of the Jing liquid first. The herb Fuzi in the formula is to promote the innate Yuan Yang. The herb Huangqin, Huanglina, and Dahuang, is to clear the hidden Fire. It works to enhance though not directly to enhance, and to deplete though not directly to deplete. For such condition, medical books usually suggested to use the water-clearing and hot-depletion therapy. It is the therapy for the Hot-knob condition of course. But they omitted the Jing-melting here. In my opinion, it is better to add herb Rougui 6 to 9 gram, to help the Fuzi, to disperse the Qi. When the Qi movement is smooth, the Ying liquid movement is smooth too and then the Hot is released through the Jing liquid. How would the Ling condition be worried more? Other herbal formula, such as Sancai Fengshui Dan plus Rougui, or Zishen Wan but double the Rougui, all can be used. Not only focus on the urination therapy.  

问曰:五更后常梦遗精,或一月三、五次,甚则七、八次者,何故?

Q:  A patient usually has dream and leakage of Jing liquid. It can be three to five times a month, even seven to eight times a month. What is this condition?

答曰:此元阳虚而神不为主也。夫遗精一症,与遗尿有些微之别。

A: This is due to the Yang insuficiency that Shen is not longer controling the expel of the Jing liquid. There is some difference between the urine leak and the Jing leak.

尿窍易开,精窍不易启。然二窍之开阖,总属心气下降,轻重、浅深不同耳。然而梦遗之症,诸书所论纷纷,未有实据,以余细揆其理,人身以神为主,神居二气之中,昼则寄于心,夜则寄于肾。

The swith for urine is easy to open and close. The swith for the Jing liquid is not so easy. However, both swithes are controled by the falling of the Heart Qi, though the falling is slight or strong, shollow or deeper. Various books talk about the Jing leakage during dream, but they have no concrete reasons or evidences. I believe, the body function is controled by the Shen. The Shen locates in the Yin Qi and the Yang Qi. It hosts in the Heart during the day time and in the Kidney at night.

遗精之症,戌亥以前者,病在于肾,子时以后者,病在于心,此人神从阴、从阳之道也。人身上下关窍,总在一神字统之。

For the Jing leakage, if it happens before the 1 am of the day, the reason contributes to the Kidney. If it happens after 1 am, it is due to the Heart. This is because the Shen follows the Yin and the Yang circle in the body. Every swithes in the body are controled by the Shen. 

神即火也,气也,坎中之真阳也。真阳配真阴,神始有主;真阴配真阳,神始有依。梦遗之病,务审究在上半夜,或下半夜,以定神之所在。病于上半夜者,主阴盛阳衰,阳虚不能统摄精窍,而又兼邪念之心火动之,故作,法宜扶阳为主,如潜阳丹、白通汤、桂枝龙骨牡蛎汤之类是也。病在下半夜者,主阳盛阴衰,阴虚不能配阳,阳气既旺,而又有邪念之心火助之,神昏无主,而不能镇静,故作,法宜扶阴以抑阳,如封髓丹倍黄柏、参枣汤加黄连,补血汤、将军蛋、洋参蛋之类是也。

The Shen is the Fire, the Qi and the True Yang in the Kan. When the True Yang is coupled with the True Yin, the Shen has something to control. When the True Yin is along with the True Yang, the Shen has somewhere to stay. For the Jing leakage, it is needed to verify if it happens before or after the middle night, to tell where the Shen is. If the disease happens before the middle night, it tells a condition, in which the Yin is overwhelming but the Yang is weak. The insufficient Yang fails to control the switch for the Jing liquid, together with the Heart Fire disturbing (sex dream, for example), the Jing liquid leaks. For therapy, it should be to help the Yang, using formula, such as the Qian Yang Dan, Baitong Tang, Guizhi Longgu Muli Tang, etc. If the leakage happens after the middle night, it suggests the Yang overwhelming but the Yin is weak. The insufficient Yin cannot match the Yang, the Yang Qi is so relatively overwhelming. Together with the disturbing Heart Fire (during dream), the Shen has nothing to control it, so as not be calm and cause the Jing liquid leak. For the treatment, it should be to nourish the Yin so as to supress the Yang. Use herb formula as Fengsui Dan but double the Huangbo, or Shenzao Tang plus Huanglian, or Buxue Tang, Jiangjun Dan, America Gingshen, etc.

其中受病之根,由于素多淫念,或目之所见而心思,耳之所闻而慕切,念头辗转不断,一片淫情,不觉已固结于神之中也。一经熟睡,元神游于梦幻之乡,或有见,或有闻,或有交,邪念一动,心火下流,兼以相火助之,直冲精窍,窍开而精自泄也。此病而云血虚神无主者,是遗泄在五更后,正阳长阴消之时,故知其血虚也,法宜补阴以配阳,方用参枣汤,解见上。

The reason for the disease is due to the person has frequent sex mind/image, or the sex information, by seeing or by hearing, results in his long time imaging. The imagination continues and sticks into the subconsciousness. Once falling into deep sleep, the Yuan Shen floats and travels in the dream, showing sex picture, hearing sex sounds, having sex activity. The evil mind trigues the Heart Fire flows down, together with the help of the Minister Fire, to push the switch of the Jing liquid. The swith is open and the Jing liquid is leak. In the condition listed here is said to be due to blood insuficiency so that the Shen has nothing to control, for the reason that the Jing leak happens after the middle night, which is the time when the Yang normally is growing and the Yin is subsiding. This allows the consideration that the blood is insufficient. The treatment principle should be to nourish the Yin so to matach the Yang. The herbal formula should be the Shenzao Tang. See the explanation above.

问曰:平人精神不衰,饮食健旺,常口渴而欲饮冷,小便亦常觉不快,夜夜遗尿者,何故?

Q: An apparent normal peron has reasonable activity, normal appetite and digestion, but often feels thirsty and has willing to drink cold, feels harsh in the urination and urine leakage during night. What is the condition?

答曰:此元阴不足,而下焦有伏热也。世多以遗尿属下元无火,其实不尽然。有真下元无火者,乃阳虚不能统束关窍,其人必精神困倦,饮食减少,有阳虚之实据可凭,法宜收纳元阳,补火为要。此则精神不衰,饮食如常,定是膀胱素有伏热,亦有心移热于小肠,肝移热于脬而遗者,是热动于中,关门不禁也。即在心、肝两部脉息上求之便了。若果心移热而作者,导赤散可用;肝移热于脬而作者,小柴胡倍黄芩亦可医。再审其上半夜与下半夜,以探阴阳消长机关,而按法治之,必不失也。此症直决为膀胱伏热,是因其人精神饮食有余,渴常饮冷,便常不快,是以知之也。法宜滋肾、泻火为主,方用六味地黄汤,加知、柏,解见上。

A: This is a condition, in which the Yuan Yin is insufficient and there is hidden Fire in the lower part of the body. Most people believe that, the urine leakage is due to the no-Fire in the lower part of the body. It is in fact not true. If the condition is due to the no-Fire in the lower part of the body, the person must feel very tired, low energy in the body, reduced appetite, and more other evidences suggesting the Yang deficiency. In such Yang deficiency condition, the principle of the treatment should be to contract back the Yuan Yang and to supply more Fire. In the condition listed here, the person has higher activity, not tired, normal appetite, so it must have hidden Fire in his urine bladder. It can also be due to the Fire comes from the Heart to the Small intesteine, or from the Liver to the urine bladder. In both cases, the Fire disturbs the function of the switch for the urine. It would be known by the pulses for the Heart or the Liver. For the Fire moved from the Heart, use herb Daochi San. For that from the Liver, use formula of Xiao Chaihu Tang but double the Huangqin. Again, check if the leak happens before or after the middle night, to decide the status of the Yin and the Yang, so give the herbs accordingly. It should work. The condition listed here is diagnosed as the hidden Hot in the urine bladder, since the person is active in his spirit and diet, feels thirsty and willing to drink cold water, and has harch urination. It is needed to nourish the Kidney and to deplete the Fire. The herbal formula should be the Liuwei Dihuang Wan, plus Zhimu, and Huangbo. See the explanations above.

问曰:两足冷如冰,不能步履,服桂、附、除湿药不效,而更甚者,何故?

Q: The patient feel ice-cold in the feet, feels hard to walk. The use of Guizhi, Fuzi and other herbs to deplete the Wetness, do not work, but makes the conditon worse. What is the is condition?

答曰:此非阳衰湿侵于下,实血虚肺燥,不能行津液于至下也。

A: This is not because the Yang deficiency that causes the Wetness remains in the leg. It is actually due to the blood insuficiency and the Lung Dryness. It cannot guide the Jing liquid down to the legs.

夫人身上下,全赖二气布护,真阳不足,亦有冷者,服桂、附以助之即愈。脾虚不能转运水湿而作者,服健脾除湿药必效。此则不然,知非阳虚湿盛,乃由血虚肺燥也。肺乃百脉之宗,出治节者也。肺气行,则津液流通贯注,百脉增荣;肺气燥,则津液不行,百脉失养。今两足冷如冰,乃水衰火极之象,人身水居其一,火居其二,火甚则津枯而骨髓失养,其实由肺之燥而津液不充,津液不充,邪火立起。火未甚时,犹觉内热;火既极时,却又作冷。古人云:"阳极生阴,阴极生阳。"病机之颠倒如是,浅见者何能一一周知。此病法宜苦甘化阴润燥为主,方用芍药甘草汤,或六味地黄汤,加二冬、白蜜,或黄连阿胶汤俱可,解见上。

The whole body, upper and lower part, all depend on the protection and nourish of the two Qi. If the True Yang is insuficient, the person could feel cold. The condition can be solved by taking herbs containing the Guizhi, Rougui or Fuzi. If it is due to the Spleen deficiency that fails to make the circulation of water in the leg, the use of herbs that nourish the Sleen would also work. This does not apply to the patient here. It is therefore known that it is not due to the Yang deficiency or Wetness overwhelming, but blood deficiency and Lung Dryness. The Lung is the origin of the meridian and blood vessels. It also works to make sure the Qi movement smoothly over each joint. When the Lung Qi works properly, the Jing liquid flows smoothly in whole body; if it is in a dryness condition, the Jing liquid in the body moves in the body in a harsh manner and blood vessels has stagnations. Now, in this condition, the feet are very cold as an ice, suggesting a Water deficiency and Fire overwhelming condition. In the body function, the Water takes one part and the Fire takes two parts. If the Fire is overwhelming, the liquid is withered and the bone marrow has poor nutrition. The reason is the Lung Dryness, which causes the Jing liquid is poorly distributed, which again results in the Fire overwhelming. When the Fire is overwhelming, the one feels hot inside of the body. When the Fire reaches the extreme, the body feels cold. The old people said: “When the Yang reaches the extreme, it turns into or develops or transforms into the Yin. In the same way, when the Yin reaches the extreme, it transforms into its opposite side: the Yang”. The machanism for a normal and a diseases condition is as such. How a shallow-knowledged person understands? For the condition listed here, it is best to use bitter-sweet herbs to develop the Yin to wet the Dryness. Use herbal formala as Shaoyao Gancao Tang, or Liuwei Dihuang Tang, plus the two Dong, and white honey. See the explanations above.

问曰:四肢肌肉皮肤干粗瘦削,奄奄欲绝,常思冷饮,人俱以为疳病也,不知是否?

Q: The muscles in the arms and legs are very slim and dry. The person feels as to die, has willing to drink cold water. Most people believe that he has a Gan disease. Are they right?

答曰:此胃有伏热,而食尽脾阴之血液也。夫周身肌肉,统于脾胃,脾气充则肉盈,脾阴足则肉活,周身肌肉红活充盈,乃后天健旺之征。脾与胃为表里,彼此皆不可偏,偏则病作。今病人四肢干枯饮冷,干枯乃火之象,亦不足之象,饮冷是病之情,亦阴枯乞救之情,以此推求,知其胃有伏热未解,食尽脾阴所致。此等病症,小儿居多,由饮食损伤脾胃,久久元气日落,或食生冷鲜物,停滞于内,邪热丛生,服药未当,渐渐而成者,十居其八。妇女忧郁,损伤肝脾,渐渐而成者亦多。世医一见枯槁,便以疳症目之,而立五疳之名,总非至当。此症法宜甘润养阴为主,方用甘草黑姜汤,加五味,解见上。如因内有积热者,审轻重治之。

A: This is a condition, in which there is hidden Hot in the Stomach that eats up the Spleen blood. The muscles in the whole body are governed by the Spleen-Stomach. If the Spleen Qi is sufficient, the muscle will be strong. If the Spleen Yin is sufficient, the movement and activity of the muscles would be flexible. The powerful muscle is the sign of health of the acquired metabolic system. The Spleen and the Stomach are the brother and sister relationship, or a surface-inside relationship. None of them could be insufficient. Otherwise there will be diseases. Now, the patient has dry and withered phenomenon and likes to drink cold water. The Dryness and withered are the sign of a Fire, and/or that of a insufficiency. Willing to drink cold is the sign of the disease level, also a sign of Yin withered so as to ask for a save. Deduced from this, it is known that there is Fire in the Stomach that eats up the Spleen Yin. Such condition is more in the children. The reason is the damage from a diet. After a long time, the Yuan Qi is withered. It can also be due to eating cold, not-cooked food. Such food stagnated in the stomach, created Hot-Fire. It has not been solved by taking medicine, so as to cause the continuous depletion of the Spleen blood. More than 80% of the cases belong to this reason. For women with depression, the depression damages the Liver-Spleen, which can also cause this condition. Ordinary doctors diagnose this condition as the Gan condition, the movement they see the withered muscles. They also classify the Gan condition into five subgroups. It is not a proper way. The condition here should be treated by using sweet herbs to nourish the Yin. The formula is the Gancao Paojiang Tang, plus Wuweizi. See the explanations above. If the condition is caused due to the accumulated Fire, use herbs accordingly.

问曰:病赤白痢日数十次,腹痛拘急者,何故?

Q: The patient has diarrhea tens of times a day with white and red color in the stool. He also has pain in the abdomen. What is this condition?

答曰:此元阴不足以致肺燥,复感客燥而移燥于大肠也。诸书俱称赤白为湿热病,以白属湿,以赤属热,照方施治,应效者少。余细维此理,人身以坎、离立极,运用机关全在心、肺,心属火,化血而居肺下;肺属金,化气而居心上。肺位最尊,气机运转,外充皮肤肌肉,内充筋骨脏腑,有天包乎地之义。肺气一行,心血随之,下而复上,上而复下,循环不已,二气调和,百节无伤;肺气、血气偶乖,诸症蜂起,岂独痢疾为然。

A: This is a condition, in which the Yuan is insufficient in the Lung, so as to cause Lung Dryness. With additional invasion of out-coming Dryness Xie, the combined Dryness Xie attacks the large intestine. It is said that the red-white diarrhea is due to the Wet-Hot attack to the large intestine, since red color belongs to the Hot, and white color belongs to the Wetness. However, the successful rate is low when applying the recommended herbal therapy. I have been thinking the reason for this clinic phenomenon for a while. I believe, the function of the body depends on the two poles, the Kan and the Li. The functional organs are the heart and the lung. The heart belongs to the Fire. It develops blood and resides under the lung. The lung belongs to the Metal. It works to develop the Qi and resides over the heart. The lung is very honorable. It works to handle the Qi movement in the body. The Qi distributes in the outside to the skin and muscle and inside, in the organs, bones and tendons. Its function bears the meaning to cover both the sky and the earth. When the Lung Qi moves, the Heart blood follows. It moves down then up, up then down as no-end circle. If the Qi and the blood are in a harmony status, every step for the body is normal. If they are abnormal, various diseases can occur. The diarrhea is not a exception at all.

查痢疾多生于秋,乃燥金主气之时,复感外来之燥邪,客于肺金,闭塞清道,转输失职,津液不行于大肠,大肠亦生燥热,故曰肺移燥于大肠也。肺气壅则大肠之气壅,而血亦与之俱壅,故痢症作。白者重在气之滞,赤者重在血之涩,赤、白相兼,心、肺俱受燥也。治痢者当在心、肺二处求之,切勿惑于夏伤于暑,秋必成痢。推是说也,以为夏日炎天,暑湿大行,交秋之际,暑湿未尽,胶固大肠,欲出不出而成痢。余谓人之肠胃糟粕,有一、二日换一次者,有三、五日换一次者,岂尽湿热之胶固大肠耶?以白为湿,湿甚宜泻;以赤为热,热甚宜闭。今则不泻不闭,而欲出不出,其为肺气之滞,心血之涩也明甚,何得即以湿、热蕴酿加之?此说亦近理,但湿、热合病亦多,何不成痢?独于秋月乃痢,明明燥邪客于肺。

The fact is that dysentery happens usually in the autumn. The autumn is the time period in which the Dryness Metal dominates. During this period, if the body is attacked by out-coming Dryness Xie Qi, which hosts in the Lung Metal, blocks the tunnels for Qi transportation and movement, which again reduce the Jing liquid distribution to the large intestine, so there is Dryness Hot developing in the large intestine too. If the Lung Qi is stagnated, the Large intestine Qi is stagnated too. Then, the blood stagnation follows, so the dysentery. The white color in the stool suggests the Qi stagnation, and the red color suggests the blood stagnation. The co-exist of the red and white color in the stool suggests the Dryness attack on both the Lung and the Heart. Therefore, to treat the dysentery, the attention should be paid on both the Heart and the Lung. Do not stick to the saying that if the person is damaged in the summer by the Hot, he will have dysentery in the autumn. Such concept is induced by the consumption that, in summer the person is exposed in the heavy Hot and Wetness. In the autumn, the Hot-Wetness remains somehow not subside completely but stick in the large intestine to cause the dysentery. However, I believe that ordinary person can have bowel movement once every two or three days, or once every three to five days. How can we regard it as the stick of Hot-Wetness in the large intestine? If the white color is regarded as the Wetness, the extensive Wetness should be continuous diarrhea. If the red color is due to the Hot, extensive Hot should show as stop of the bowel movement. Now, it is not diarrhea, neither stop of the bowel movement. It should be the clear evidence for Lung Qi stagnation and blood stick. How can we contribute it only to the Hot-Wetness? This theory seems reasonable, but there are many clinic conditions caused by the Hot-Wetness. Why in such cases there is no dysentery? The person is normal in any time of the year, but only dysentery in the autumn. It clearly indicates the invasion of the Dryness Xie Qi in the Lung system.

要知白者,气也、火也,亦大肠之精也;赤者,血也、水也,亦大肠之液也。赤色虽似火象,其实周身血液,俱从火化得来,故曰血为阴,又曰血虽阴类,运从阳,指肺气行而血随之也。余谓治痢当着重肺燥为主,虽赤、白有浅深之分,其源总归于燥之一字,但治其燥,则二脏之气即舒,不治痢而痢自止,不治赤白而赤白自消,握要之法也。

It should know that the white is the Qi and the Qi is the Fire, as well as the Jing of the Large intestine, and that the red is the Blood, the Blood is the Water, as well as the Liquid of the Large intestine. Though the red color is the sign of a Fire, the whole body blood is developed from the Fire. Therefore the blood belongs to the Yin. It is also said that the blood though belongs to the Yin, but works as a Yang. This means the Lung Qi moves and the blood follows. I recommend that, it should be focused on the Lung Dryness to treat dysentery. Though there is the degree deference for the red or the white dysentery, their source is the Dryness. When treat the Dryness, the Lung Qi and the heart Qi is smooth. The dysentery subside without directly treat the dysentery. The red and the white stool stop without directly treat the red and the white. This is way to master the key.  

舒驰远以痢为四纲,其说亦可从,但未将受病根处明明指出,概谓白属湿成,赤属血因,纷纷聚讼,愈出愈奇,总非确论,惟有调气、行血一语,略可遵从。法宜清燥、救肺为主,方用杏、冬二皮白蜜甘桔汤主之。

Dr. Shu Chiyuan introduced the four outlines for the diagnosis and treatment of dysentery. His comments can be referred. However, he failed to clearly point out the real root for the dysentery. He summarized that the white belongs to the phlegm, red to the blood. He collected the augments together, and made the analysis for the problem even more complex. Only his statement for the Qi and the blood can be adapted somehow. For this condition, it should be to clear the Dryness and to save the Lung. Herbal formula should be the Xindong Erpi Ganjie Baimi Tang

至于似痢非痢,亦不可不辨。痢之为病,腹痛拘急,逼胀异常,欲出不出,出亦无多,日数十次。似痢非痢者,腹虽痛而不甚,便虽逼胀而所出尚多,日三、五次,甚七、八次,一痛即泻,四时皆有,多得于大病久病之后。乃由中气大衰,大肠失职,肠、胃稍有存积,气虚不能载之,故似痢而实非痢也。法宜大健中土,中土气足,自能载之,而不失节也。方用附子理中汤,加吴茱萸、安桂最妙。治痢诸书,皆云调气、行血,余亦立一方,亦可酌用,名大黄木香汤。

In clinic, there are some other conditions that are similar to the dysentery. For the dysentery, the patient feels pain in the abdomen, feels pushing feeling inside the anus, and feels that the stool is to be out, but cannot come out. If there is stool out, the amount is little. It can be tens of times a day. For the dysentery-similar condition, the patient has also pain in the abdomen, but not severe. There is also pushing feeling inside the anus, but the amount of the stool is more. The bowel movement can be three to five times a day, or even seven to eight times a day. The patient has the bowel movement the movement he feels the pain in the abdomen. Such condition can happen in all of the seasons and more often happen after a heavy disease. This condition is due to the exhausting of middle Qi in the body. The function of the large intestine is in disorder, so that the weakened Qi in the middle part of the body cannot hold even little storing stool in the intestine. It appears as the dysentery but actually not. For the treatment, use herbs to re-build the middle Qi. When the middle Soil is strong, it can certainly hold the content in the intestine. The herbal formula should be the Fuzi Lizhong Tang plus Wuzhuyu and Rougui. For the treatment of dysentery, various book talk about the use of medicine to adjust the Qi and promote the movement of the blood. Here I recommend another formula: Dahuang Muxiang Tang.

杏冬二皮甘桔白蜜汤

Xindong Erpi Ganjie Baimi Tang

杏仁五钱     天冬四钱     麦冬四钱     地骨皮三钱     桑皮五钱     桔梗四钱     甘草三钱     白蜂蜜半杯

Xinren 15 gram, Tiandong 12 gram, Maidong 12 gram, Digupi 9 gram, Sangbaipi 15 gram, Jiegen 12 gram, Gancao 9 gram and honey 125 ml.

大黄木香汤

Dahuang Muxiang Tang.

大黄六钱    木香六钱     当归五钱     苏叶三钱     甘草三钱     白蜜半杯

Dahuang 18 gram, Muxiang 18 gram, Danggui 15 gram, Souye 9 gram, Gancao 9 gram, honey 125 gram.

用药意解

按杏冬二皮汤一方,乃清燥、润肺之方也。因燥邪客肺,肺气壅塞,津液不行于大肠,以致气机滞涩,故取杏仁之苦以降之利之,又佐二冬、二皮、甘、桔、白蜜以开之、润之,俾燥邪去而肺气清,肃令行而气机畅,何痢之有哉?

The herbal formula of Xindong Erpi Tang is the one to clear the Dryness and nourish the Lung. Dryness Xie Qi in the lung can block the lung Qi. The Jingye cannot distribute to the large intestine, so the Qiji is stagnated. In the formula, the Xinren is bitter, works to promote the fall of the Qi. The Maimendong and Tianmendong, Sangbaipi and Digupi, Jiegen and honey work to open and to nourish the lung. The Dryness Xie Qi is removed, the lung Qi is cleared. The direction of the lung works, the Qiji is therefore in normal order. How would be any more dysentery?

按大黄木香汤一方,乃调气、行血之方也。大黄同当归、甘草,能泻血分之燥热而化阴,木香、苏叶、白蜜,能调气分之滞而化阳,气、血两化,阴、阳不偏,自然痢疾不作矣。

The Dahuang Muxiang Tang is to adjust the Qi and to promote the blood circle. With the Danggui and Gancao, the Dahuang can deplete the Dryness-Hot in the blood, so to develop the Yin. The herb Muxiang, Souye and honey work to clear the Qi stagnation, so to develop the Yang. With the Qi and the blood both development, the Yin and the Yang none is extreme, certainly there would have no dysentery anymore.

问曰:病人每日早饭后心烦,两手、足心痛痒异常,至午初即愈者,何故?

Q: Patient feels annoyed after breakfast every day, feels very pain and itch in the palm and soles, which stop upon the early noon. What is this condition?

答曰:此元阴不足,心阳气有余也。夫人身上下四旁,莫非二气充塞,二气皆不可偏,偏于阳则阴虚,偏于阴则阳弱。今病人两手心痒,两足心痒,阴虚、阳虚皆有此候,不得概谓血虚。此病而断为阴虚者,见其病之在上半日也。

A: This is due to the Yuan Yin insufficiency, so the Heart Yang Qi is overwhelming. The Yin Qi and the Yang Qi in the body, none can be too extreme. If the Yang is extreme, the Yin would be insufficient. If the Yin is too much, the Yang would be in deficient. Now the patient feels itch in the palms and soles. Either Yin deficiency or Yang deficiency can be the reason. It should not be overstated to be a Yin deficient condition. The reason to tell the condition listed here to be a Yin deficiency, is that it happens in the morning every day.  

人身就是这一团真气,出阴入阳,出阳入阴,一日之内,上半日属三阳,阳有馀,阴即不足,故易曰:"君子道长,小人道消";下半日属三阴,阴有余,阳即不足,故易曰:"小人道长,君子道消"。君子、小人,即阴、阳之谓也。其实推其至极,还是这一团真气,由盛而衰,由衰而盛也,故圣人云:"老子其犹龙乎!"反之吾身,不亦有犹龙之老子乎!此病法宜补阴以配阳,方用黄连鸡子阿胶汤,或补血汤,解见上。

The human body is such mass of True Qi. It comes out of the Yin and comes in the Yang. It comes out of the Yang, then in the Yin. Within a day, the morning belongs to the three Yang. The Yang is relatively more in the morning, so the Yin is relatively less. The afternoon belongs to the three Yin. The Yin is relatively more, so the Yang is relatively less in the afternoon. If we furthermore summarize, it is actually the Qi that is moving in the body during the day. It becomes strong then weak, and weak then strong again. For the condition listed here, the treatment should focuses on supplying more Yin so as to match the Yang. Use formula Huanglian Jizi Ajiao Tang, or use Buxue Tang. See the explanations above.

查阴虚发痒,外形手、足心肉必干枯,起粗白皮。阳虚发痒者,手、足心肉柔润不枯,无白皮干粗色,但痒极而欲重按重压,以此定之,再参看各部气色(更)〔便〕了。阳虚宜收纳回阳为主,方用潜阳丹、四逆汤、封髓丹之类,解见阳虚门。

If the itch is due to a Yin deficiency, the shape of the hands and feet must be as withered. There are thick and white skin pieces. If it is due to Yang deficiency, the palms and the soles are soft and not withered. The skin has no thick and dried skin piece. But, the itch might be very heavy and the person wants to press the skin heavily. Refer to the Qi and tint of the other parts of the body to make a final diagnosis. For Yang deficiency, it should be to contract back the Yang, use the Qian Yang Dan, Sini San, or Fengshui Dan. See the explanations above.

问曰:吐血后,头眩晕不止者,何故?

Q: After vomiting blood, the person feels continuous dizziness. Why?

答曰:此血虚而不能荣于上也。夫头晕一症,有上实下虚者,有上虚下实者,有清阳不升者,有浊阴上干者,有挟虚风者,有挟虚火者,有脏腑偏盛而致者,种种不一,括其旨归,总不出阴、阳两字。

A: This is a condition, in which the blood is insufficient, so as not be able to nourish the head. There are various reasons for the dizziness. It can be due to a upper-Shi but lower-Xu condition, or a upper-Xu and lower-Shi condition. It can also be due to the light Yang Qi does not float up to the head, or due to the attack of the heavy Yin to the head. During the same time, there reasons might be mixed with Xu Wind, or Xu Fire. Furthermore, it can be caused by the overwhelming or weakness of some organs in the body. All in all, the reasons can be summarized into the Yin and the Yang.  

凡治此病,察其人面白无神,饮食减少,二便自利,困倦欲卧,喜热畏冷,或气短而心悸不宁,或饱闷而腹痛泄泻,或遗尿不禁而自汗频添,脉浮无力而空,诸如此类,都属阳虚,清气不充所作,法宜辛甘扶阳之品,按定上、中、下病情消息以斟酌之便了。察其人精神不衰,舌黄、喜冷,饮食易消,二便短少,或心烦热而咳吐黄痰,或饱食而即刻昏晕,或晕数刻而依旧如常,脉实有力而长,诸如此类,都属阴虚火旺,上干所作,法宜苦甘化阴之品,按定上、中、下病情消息以酌量之便了。此病既由吐血而后眩晕,明明阴血暴虚,不能上荣于巅,血虚亦能风生,故作眩,法宜养血为主。方用补血汤主之,加味随机而施。如外感六淫之气,只作痛不作眩,学者须知。

For such a condition listed here, it is needed to see if the person has face pale and has lower ambition, lower appetite, easy and frequent urination and bowel movement (diarrhea), tired to have a sleep, likes hot but hates cold, has short of breath or palpitation, has fullness in the stomach after eating, or has pain in the abdomen with diarrhea, or has urine leak and frequent self sweat. All of such conditions suggest the Yang deficiency. For the treatment, it should be to use spicy-sweet herbs. Modify the herbal formula according to the location of the Yang deficiency: in the upper, the middle or the lower part of the body. If the person has high ambition, yellow tongue covering, likes to drink cold water, has good appetite, has short urine or stool, or feel annoyed hot and cough and spilt yellow phlegm, or has dizziness or cloudy mind after a heavy eat, or after dizzy for a while then everything is as usual, and has stronger pulse. All of these suggest Yin deficiency and Fire overwhelming. For the treatment, use bitter-sweet herbs to develop the Yin. Modify the formula according to the location of the Yin deficiency.

The condition listed here occurs after a vomiting of blood. It clearly indicates a heavy and sudden loss of the Yin blood. The blood is not enough to circle up to the head. Blood deficiency can create Wind. Wind can cause the dizziness. For the treatment, use herbs to nourish the blood. The formula is Buxue Tang. By the way, if the condition is due to the invasion of out-coming Xie qi, the head feels only pain but no dizziness. The beginners should know this difference.

问曰:女病血崩后,忽顶巅痛甚者,何故?

Q: After a heavy bleeding, the woman suddenly feels very pain on the top of the head. Why?

答曰:此血虚甚而阳无所附,暴浮于上也。夫气、血两字,彼此互为其根,不可稍有缺陷,阳气暴虚,阴血即无所主,阴血暴虚,阳气即无所托。今病人血骤下奔,海底枯涸,龙无水养,飞腾于上,故顶巅痛甚。此际若不细察受病之因,而见痛治痛,则既竭于上之阳,倾刻即灭也。法宜峻补其水,海中有水,龙即能返于渊,此真阴、真阳互根之妙用也。方用补血汤主之,解见上。或补水汤可。

A: This is due to the blood deficiency, so that the Yang has nowhere to attach in the body, so it floats up to the head. The Qi and the blood are the root each other. None can be depleted for a while. If the Yang Qi is depleted very much and suddenly, the Yin blood would have no governor to control it. If the Yin blood is suddenly lost very much, the Yang Qi would have nowhere to stay. Now the blood is depleted heavily from lower part of the body, the bottom of the sea is depleted, the Dragon has no water to nourish it, so it fly up to cause the headache. At this movement, if we do not carefully check the reason for the headache, and start to treat headache the movement we see the headache, the Yang Qi that floating at the top of the head would be die. For the treatment, we should supply more Water. When there is enough Water in the sea, the Dragon would turn back. This is the trick for the True Yin and True Yang in the body. The herbal formula should be the Buxue Tang, or the Bushui Tang.

补水汤

Bushui Tang. “Bu” here means the supply in Chinese. “shui” means water.

贫者以沙参易洋参    洋参二两   黄柏一两   白蜜一两

America Reshen 60 gram, Huangbo 15 gram, honey 15 gram.

If the patient is poor, the America Renshen can be replaced with Shashen.

用药意解

The meaning of the herbs:

按补水汤一方,乃苦甘化阴之方也。夫洋参色白味苦,苦能补心,心者、生血之源也;黄柏味苦,苦能坚肾,肾者,注水之区也;又得白蜜之甘,能润肺而生金,金者、水之母也。况苦与甘合,足以化阴,阴得化生,而源不竭,龙虽属阳而性喜水,既有其水,则龙潜于渊,太空廓朗,而上、下咸安矣,何顶痛之有哉?

The formula Bushui Tang is a bitter-sweet herb formula to develop the Yin. The America Renshen is white and bitter in herbal nature. Bitter can nourish the heart. Heart is the source of blood. Herb Huangbo is bitter too. Bitter can strength the Kidney. Kidney is the container of the Water. The honey is sweet. Sweet can nourish the lung to develop Metal. Metal is the mother of the Water. The combination of the bitter and the sweet can develop the Yin. The Yin is developed, and its source is not depleted. The Dragon belongs to the Yang. It likes the Water. With water, it hides in the pool, so the sky is clear. When the upper and the lower part of the body is in calm, how could headache happen?

以上数十条,专论阴虚,指出元阴不足一句,反复推明。要知元阴即血也、水也,真火寓于其中,则为太极,则为气、血相依,又为水、火互根,又为心藏神。凡血虚之症,所现纯是一派枯槁、憔悴、燥熯,干粗之火形,何也?血中寓火,火旺自然阴亏,阴虚自然火旺,以此推求,便得阴虚之主脑也。三阴与三阳,病形各殊,三阳不足之症,所现纯是阴色,为其阳不足,而阴有余也;三阴不足之症,所现全是阳色,为其阴不足,而阳有余也,此辨认阴虚、阳虚之切法也。

The tens of paragraphs above focus on the discussion on the Yin deficiency. It pointed out the Yuan Yin deficiency and explained repeatedly. It should know that, the Yuan Yin is the blood and the Water. The True Yang hosts inside to form the Taiyi, meaning the Qi and the blood help, work, cooperate together, meaning the Water and the Fire are the root each other, and meaning that the Shen residues in the Heart. For blood deficiency, the person show withered, dryness, thick, e.g. such Fire picture. Why? This is because there is Fire in the blood. If the Fire is overwhelming, the Yin must be in deficiency. If the Yin is insufficient, the Yang must be overwhelming too. Deduced by this, it would be known the real reason for the Yin deficiency. For the three Yin and the three Yang, the clinic manifestations are different. If the three Yang are insufficient, the person shows all the Yin conditions, since the Yang is insufficient so as the Yin is relatively overwhelming. If the three Yin are insufficient, the person shows overall Yang pictures, since the Yin is insufficient, the Yang is overwhelming. This is the key to identify the Yin deficiency and the Yang deficiency.

历代以来,著作者数十余家,皆含糊不清,并未将阴、阳底蕴明明指出,一味在后天五行生克上论,铺张满纸,究竟人身立极,一元妙义,二气消长机关,全未说透,宗旨不明,源头不澈,故知斯道之精者寡矣。可惜仲景一生心法,无一人道破,定六经之旨归,罕能了了。甚至有著瘟疫,著痢症,自诩专家,欲与仲景并驾,不知立法之祖,定六经早已判乾坤之界限,明六气业已括万病之攸归。

From the history, there are tens of authors published their books. None of them explained the Yin and the Yang clearly but focused on the acquired Five-element supplying-blocking relationships. They consumed lots of papers for writing, but did not explain clearly the way the Yin-Yang transformation, or the one-unit concept of the Yin and the Yang. The basic meaning of the Yin and the Yang was not clear, so there is only a little people really understand the medicine. It is very pitty that the Master Zhang Zhongjing’s whole life contribution in the medicine was not explained out by any person. Very rarely one can point out the nature of the six meridians/stages. There are even some people who wrote about the epidemic diseases and the dysentery, with aim to mark themselves the same level as Master Zhang Zhongjing. They do not know, that the key principle of the medicine has been marked out by the six Jing/stage theory of the Master, and that the six Qi theory has included all the diseases, e.g. it is applicable for all diseases.  

六气即是六经之体,外感六气,便是六经之客。三百九十七法,法法神奇;一百一十三方,方方绝妙。全是活活泼泼天机,绝无一毫碍法。知其妙者,以四逆汤、白通汤、理中、建中诸方,治一切阳虚症候,决不有差;以黄连鸡子阿胶、导赤散、补血、独参诸方,治一切阴虚症候,定不能误。

It should know, that the six Qi is the functional target of the six Jing/meridian/stage. The out-coming six Qi is the guesting/invading Xie Qi. The 397 herbal therapies, all are marvelous. The 113 formula, all are smart. All are clear and flexible principle without any hidding or unclear meaning. The doctor who understand its marvelous can use Sini Tang, Baitong Tang, Lizhong Tang and Jiangzhong Tang, etc. to solve various Yang deficient conditions. No mistakes. Or they could use Huanglian Jizi Ajiao Tang, Daochi San, Buxue Tang and Dushen Tang, to sovle various Yin deficient conditions.  

虽然阴虚所备诸方,尤贵圆通,有当柔润以扶阴者,独参、黄连、当归补血之类是也;有当清凉以扶阴者,导赤、人参白虎之类是也;有当苦寒以扶阴者,大、小承气、三黄石膏之类是也。此皆救阴、补阴之要诀也。

Though there are various formulas ready for the Yin deficient conditions, their use needs to be verified in detail. There are some conditions that need the soft lubricating therapy, using Renshen, Huanglian, Dangui Buxue and so on. There are conditions that need light cooling therapy, using Daochi San, Renshen Baihu Tang. There are conditions that need bitter-cold therapy, using Da Chenqi Tang, Xiao Chenqi Tang, Sanhuang Shigao Tang, and so on. All are the key herbal formula to save the Yin, and to supply the Yin.

补阳亦然,有当轻清以扶阳者,大、小建中之类是也;有当温养以扶阳者,甘草干姜汤、理中汤之类是也;有当辛温、辛热以扶阳者,四逆、白通之类是也。此皆治阳虚之要诀也。

Similarly, among the Yang supplying therapy, some conditons need light and mild Yang supplying therapy, using Da Jianzhong Tang, Xiao Jianzhong Tang. There are some conditions that need warm-nourishing therapy, using Gancao Ganjiang Tang, Lizhong Tang. In some conditions, it is needed to use spicy warm therapy, using Sini Tang, Baitong Tang. These are all the keys in the treatment of the Yang deficiency.

他如外感六气,按节令,掣提纲,随邪变化,细详六经贯解。须知仲景伤寒之六经,并非专为伤寒说法,而六步之法已经说明。即以太阴一经而论,太阴主湿而恶湿,主湿是本经之气,恶湿即外之客气,湿土旺于长夏,故六月末土旺而湿令大行,人之本气弱者,感外来之湿邪,每多腹痛、吐、泻。仲景故立理中汤一法,后贤改用香砂、四君、六君,以调脾土一切诸症,皆是套理中汤一方出来也,又何常不可用哉?千百年来,名贤迭出,立方亦多,而仲景之法,遂晦而不明,不得不宣扬 "":原书为""之也。

For the disease that is caused by the invading six Qi, their treatments depend on the seasons, the stage/meridians the Xie Qi invaded and located. See the explanation in detail in the previous chapter for the six Jing. It should know that, the Master Zhang Zhongjing’s six Jing is not only discussed for the Shanghan disease. It has been suggested in the separation of the six stage of a disease. Let’s take the Taiyin meridian/stage as an example. Taiyin dominates Wetness but also hates Wetness. Wetness is the major Qi in the Taiyin meridian/stage. It hates and would be damaged by the out-coming Wetness Qi. The Wetness Soil is strong in the peak time of the summer. So, at the end of June, the Soil is strong and the Wetness functions a lot. If a person is originally weak, then attacked by the Wetness Xie Qi, he would have pain in stomach, vomiting and diarrhea. For the treatment of this disorder, Master Zhang Zhongjing used the Lizhong Tang. Later famous doctor used Xiangsha, Sijunzi Tang, or Liujunzi Tang, to harmony the Spleen Soil function. All are deduced from the Lizhong Tang. No reason we refuse to use them. For the hundreds and thousands of years, there are lots of famous doctors who developed various formula. The formula of the Master however became as unclear as a cloud. Here we have to re-introduce and re-explain it.