医学衷中参西录:治癃闭方

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第二十一章.治癃闭方

Chapter 21. herbs for urine block

 

1.宣阳汤

1. Xuanyang Tang (Xuan here means to disperse, to distribute; Yang is the Yang Qi)

治阳分虚损,气弱不能宣通,致小便不利。
This formula is used for difficulty in urination, due to Yang Qi deficiency, in which the Qi is not enough to conduct the urine.

野台参(四钱) 威灵仙(钱半) 麦冬(六钱,带心) 地肤子(一钱)

Wild Taishen 12 gram, Weilingxian 4.5 gram, Maidong 18 gram (with the kernel), Difuzi 3 gram.

 

2.济阴汤

2. Jiyin Tang (Ji means to nourish, to supply, and to support; Yin means the Yin in the Yin-Yang concept).

治阴分虚损,血亏不能濡润,致小便不利。
This formula is used to solve the difficult in urine, due to Yin deficiency, so that the blood is not sufficient to wet or humidify (the urine conduct).

怀熟地(一两) 生龟板(五钱,捣碎) 生杭芍(五钱) 地肤子(一钱)
Huai Shoudi 30 gram, Guiban 15 gram (grind), Baishao 15 gram, and Difuzi 3 gram.

阴分阳分俱虚者,二方并用,轮流换服,如下案所载服法。小便自利。
If the Yin and the Yang both are in deficiency, use the two formula in turn, as showed in the following case. The urine would be smooth to go.

一媪,年六十余,得水肿证,延医治不效。时有专以治水肿名者,其方秘而不传。服其药自大便泻水数桶,一身肿尽消,言忌咸百日,可保永愈。数日又见肿,旋复如故。服其药三次皆然,而病患益衰惫矣。盖未服其药时,即艰于小便,既服药后,小便滴沥全无,所以旋消而旋肿也。再延他医,皆言服此药,愈后复发者,断乎不能调治。后愚诊视,其脉数而无力。愚曰:脉数者阴分虚也,无力者阳分虚也。膀胱之腑,有下口无上口,水饮必随气血流行,而后能达于膀胱,出为小便。《内经》所谓州都之官,津液藏焉,气化则能出者是也。
A lady, 60 years of old, got the swelling (edema) condition. Doctors were unable to help her. There was a doctor who was good at to solve the swelling condition, but the formula was his secret to show. The lady drank his formula tea and had water-diarrhea several big basins, with the swelling disappeared completely. She was told to inhibit the salt intake for hundred days. If so, it is ensured she would never have the swelling again. Several days later, the swelling came back again as before. She tried that herbal formula three times and every time it happened the same way. She was much more weak in body condition. Before she took the herbs, her problem is the difficulty in the urination. After take of the herbs, her urine was completely stopped, so that swelling goes and comes very soon. When she changed to other doctor, the doctor said, if the condition recurred after that herbal formula, it would be no way to treat again. Later, when I saw the lady, her pulse was frequent and weak. I said: the frequent pulse indicates the weakness in the Yin portion of the body, and the weak pulse indicates the Yang deficiency. The urine bladder has lower opening, but no upper opening. The water must follow the Qi and blood to circle and to transport to the bladder and comes out as urine. …

此脉阴阳俱虚,致气化伤损,不能运化水饮以达膀胱,此小便所以滴沥全无也。一方,以人参为君,辅以麦冬以济参之热,灵仙以行参之滞,少加地肤子为向导药,名之曰宣阳汤。一方以熟地为君,辅以龟板以助熟地之润,芍药以行熟地之滞(芍药善利小便,故能行熟地之泥),亦少加地肤子为向导药,名之曰济阴汤。二方轮流服之,先服济阴汤,取其贞下起元也。服至三剂,小便稍利。再服宣阳汤,亦三剂小便大利。又再服济阴汤,小便直如泉涌,肿遂尽消。

Her pulse indicated the Yin and the Yang both in deficient condition, unable to transport the water to the bladder, so that there is no water out as urine. The formula I prescribed to her used herb Renshen as the main ingredient (the king herb), with help from Maidong to promote the Hot from the Renshen; from the Weilingxian to prevent the stickness of the Rensheng; and from the Difuzi as guider. The formula was named Xuan Yang Tang. Another herbal formula used Shoudi as the main ingredient (the king herb), with the help from Guiban to promote the wetness from Shoudi; from Shaoyao to prevent the stickness of Shoudi (the Shaoyao can improve urine, so to prevent the side effect of Shoudi as stick); and from Difuzi as herbal guider. It is named Ji Yin Tang. The two formulas were taken in turn. The Ji Yin Tang was drunk first for three days, taking its meaning to start from lower Yuan; then changed to the Xuan Yang Tang for another three days. The urine came out very smoothly. When take the Ji Yin Tang again, the urine came out as spring, and the swelling disappeared completely.

一妇人,年三十许,因阴虚小便不利,积成水肿甚剧,大便亦旬日不通,一老医投以八正散不效。友人高××为出方,用生白芍六两,煎汁两大碗,再用阿胶二两,熔化其中,俾病患尽量饮之。老医甚为骇疑,高××力主服之。尽剂而二便皆通,肿亦顿消。后老医与愚觌面,为述其事,且问此等药何以能治此病?答曰:此必阴虚不能化阳,以致二便闭塞。白芍善利小便,阿胶能滑大便,二药并用,又大能滋补真阴,使阴分充足,以化其下焦偏胜之阳,则二便自能通利也。
A lady, 30 years of old, had difficulty in urine due to Yin deficiency. The condition developed into severe swelling, so that the bowel movement became constipated too. A old doctor gave her Bazhen San, but is did not work. My friend Gao prescribed her: Baishao 180 gram, cooked for two big bowls. Use herb Ajiao 60 gram to dissolve in it to drink. The old doctor surprised very much but Mr. Gao insisted her to drink. After two doses, the urine and the stool both came out, and the swelling disappeared too. Later, the old doctor met me and told me this story, and asked why such herbs can treat this disease. I told him, this case must be Yin deficiency and hard to develop the Yang, so that the urine and the stool could not come out. The herb Baishao is good to smooth the urine; and the Ajiao can smooth the stool. The combination of the two herbs could nourish the True Yin. When the Yin is sufficient, it can develop the Yang in the Lower Jiao, so to smooth the urine and the stool.   

××治一水肿证。其人年六旬,二便皆不通利,心中满闷,时或烦躁。知其阴虚积有内热,又兼气分不舒也,投以生白芍三两,橘红、柴胡各三钱,一剂二便皆通。继服滋阴理气、少加利小便之药而愈。
Mr. Zi treated one swelling case. The person was 60 years of old. His urine and stool both stopped to come out. He felt annoying and fullness in the heart. It was considered to be the Yin deficiency with inside accumulated Hot, and with the stagnation of the Qi in the chest. He was given Baishao 90 gram, Juhong 9 gram, Chaihu 9 gram. After one dose of drinking, the urine and stool came out easily. Later, he drunk the Yin-nourishing, Qi-promoting, and little urine-smoothing herbs and got a final cure.

一妇人,年四十许,得水肿证,百药不效。偶食绿豆稀饭,觉腹中松畅,遂连服数次,小便大利而愈。
A lady, 40 years of old, got swelling condition. Occasionally, when she ate green bean soup, she felt loss of abdomen, so she repeated several times of the green bean soup. The urine became smooth and the condition was cured.

有人向愚述其事,且问所以能愈之故。答曰:绿豆与赤小豆同类,故能行水利小便,且其性又微凉,大能滋阴退热。凡阴虚有热,致小便不利者,服之皆有效也。

Someone told me this story and asked why the green bean worked. I said: the green bean and the red bean (Chi Xiao Dou) are the same group, so it can smooth the urine. In addition, it is mild cold in herbal nature, could nourish the Yin and clear the Hot. If the condition is Yin deficiency with Hot and with difficult in the urine, it works.

 

3.白茅根汤

3. Baimaogen Tang (Baimaogen: name of a herb).

治阳虚不能化阳,小便不利,或有湿热壅滞,以致小便不利,积成水肿。
This formula is used to treat the difficulty in urine, which is due to Yang Deficiency, so that it cannot develop Yang; or due to Wet-Hot accumulation, which blocks the urine tract and causes swelling.

白茅根(一斤,掘取鲜者去净皮与节间小根细切)
Baimaogen 250 gram (use fresh one, peel the skin the the knob in between the stem).

将茅根用水四大碗煮一沸,移其锅置炉旁,候十数分钟,视其茅根若不沉水底,再煮一沸,移其锅置炉旁,须臾视其根皆沉水底,其汤即成。去渣温服多半杯,日服五六次,夜服两三次,使药力相继,周十二时,小便自利。
Cook the Baimaogen in water 1250 ml for one boiling. Move it away from the oven and wait for ten minutes to see if there is precipitation of the herbs in the bottom. If not, continue to cook and check and make sure all the herbs down in the bottom. Drink the supernatants about 100  to 125 ml, five to six times during the day, and two to three times at night, to make the herbal healing power continued. For about 12 hours, the urine would be smooth.

茅根鲜者煮稠汁饮之,则其性微凉,其味甘而且淡。为其凉也,故能去实火。为其甘也,故能清虚热。为其淡也,故能利小便。又能宣通脏腑,畅达经络,兼治外感之热,而利周身之水也。然必须如此煮法,服之方效。若久煎,其清凉之性及其宣通之力皆减,服之即无效矣。所煮之汤,历一昼夜即变绿色,若无发酵之味,仍然可用。

The fresh Baomaogen, when cooked into thick soup to drink, is mild cooling in herbal nature, and sweet and pale in taste. For its cooling nature, it can clear the sthenic Fire. For its sweet, it can clear the asthenic Fire. For its pale, it can smooth the urine. It can also open the organs, smooth the meridians, and treat both the out-invading Hot, and clear the whole body extra water. However, it must be cook as introduced here to work. If cooked for a long time, its cooling nature, and dispersing nature would reduce, so no healing effect. The herbal tea from the Baimaogen would turn to green overnight. If there is no fermenting odor, it can still be drunk.  

一妇人,年四十余,得水肿证。其翁固诸生,而精于医者,自治不效,延他医延医亦不效。偶与愚遇,问有何奇方,可救此危证。因细问病情,知系阴虚有热,小便不利。遂俾用鲜茅根煎浓汁,饮旬日全愈。
A lady, 40 years of old, got swelling condition. Her husband knew medicine. He treated her, but no effect. She was sent to other doctors, but no improvement either. He met me by chance and asked if there was any special formula to use for her. After asking her condition in detail, I thought that she had Yin deficiency with Hot, so that the urine is not smooth. I asked her to use the fresh Maogeng to cook thick soup to drink. After several days, the condition was solved.

一媪,年六十余,得水肿证。医者用药,治愈三次皆反复,再服前药不效。其子商于梓匠,欲买棺木,梓匠固其亲属,转为求治于愚。因思此证反复数次,后服药不效者,必是病久阴虚生热,致小便不利。细问病情,果觉肌肤发热,心内作渴,小便甚少。俾单用鲜白茅根煎汤,频频饮之,五日而愈。
A old lady, 60 years of old, had swelling condition. Doctors used herbs, but her condition goes and come back again for three times. Then it did not work at all when drink the previous herbal tea again. Her son discussed with a carpenter and was to buy coffin for her. The carpenter was his relative, and turned to me for help. I thought that, her condition had been recurred several times and later the herbal tea failed to work again, indicating a condition of long term disease, in which Yin was deficient with Hot developed, so as to block the urine. When I asked in detail, in deed she felt hot in the muscle and thirsty in heart with little bit urine. I asked her to drink this fresh Baimaogen herbal tea. After five days, the condition was solved.

一妇人,年四十许,得水肿证。其脉象大致平和,而微有滑数之象。俾浓煎鲜茅根汤饮之,数日病愈强半。其子来送信,愚因嘱之曰:有要紧一言,前竟忘却。患此证者,终身须忌食牛肉。病愈数十年,食之可以复发。孰意其子未返,已食牛肉。且自觉病愈,出坐庭中,又兼受风。其证陡然反复,一身尽肿,两目因肿甚不能开视。愚用越婢汤发之,以滑石石膏(用越婢汤原方,常有不汗者,若以滑石石膏则易得汗),一剂汗出,小便顿利,肿亦见消。再饮白茅根汤,数日病遂全愈。
A lady, 40 years of old, got swelling condition. Her pulse was roughly mild, with slight slippery and frequent feeling. I asked her to drink the fresh Baimaogen herbal tea. After several days, the condition was improved half more. Her son came to me, I told him: a very important thing that I forget to tell you before. Person with such condition should not eat any beef for whole life. Even if the disease is cured for tens of years, beef eating could cause recur. However, before her son came home, she had had already eaten beef. She felt her condition is ok, so sat in the yard, and attacked by the Wind. Her condition became worse very soon with swelling in whole body. The swelling was so severe that her eyes could not open at all. I used Yubi Tang to disperse the Xie Qi, using Huashi to replace the Shigao (with the original Yuebi Tang, someone would not have sweat. If use Huashi in stead of the Shigao in it, it is easy to create sweat). After one dose, she got sweat and the urine came out, and the swelling reduced. Then she drank the Baimaogen Tnag again, her condition was solved after several days.

白茅根,拙拟二鲜饮与三鲜饮,用以治吐衄。此方又用以治水肿,而其功效又不止此也。愚治伤寒温病,于大便通后,阳明之盛热已消,恒俾浓煮鲜茅根汤,渴则饮之,其人病愈必速,且愈后即能饮食,更无反复之患。盖寒温愈后,其人不能饮食与屡次复病者,大抵因余热未尽,与胃中津液未复也。白茅根甘凉之性,既能清外感余热,又能滋胃中津液。至内有郁热,外转觉凉者,其性又善宣通郁热使达于外也。
The herb Baimaogen has been used in my Erxian Yin and Sanxian Yin to treat vomit blood. Here, I use it for swelling. Its function is not limited to these yet. When I treat Shanghan disease or Wen disease, after the bowel movement comes normal and the Yngming extreme Hot has been cleared, I commonly let the patient to drink the fresh Baogen soup whenever he/she feels thirsty, the disease would be solved much faster and after cure, he/she could eat food soon, and even more important, the disease has no chance to recur. Commonly, if the disease is cured, but if the person could not eat or drink, or the disease recurs again, the common reason is the remaining of Hot in the body and the liquid (Jinye) in the stomach has not come out yet. The cooling nature of the Baimaogen can clear out-invading Fire, and also supply liquid to the Stomach. If the person feels accumulated Hot inside but feels cold on the body surface, its dispersing nature could make the accumulated inside Fire out of the body.  

按:凡膨胀,无论或气、或血、或水肿。治愈后,皆终身忌食牛肉。盖牛肉属土,食之能壅滞气血,且其彭亨之形,有似腹胀,故忌之也。医者治此等证,宜切嘱病家,慎勿误食。

Comments: For bloating condition, no matter if it is due to Qi, Blood, or water swelling, after cure, the person should avoid eating beef. The reason is: the beef belongs to soil. It could cause stagnation of the Qi and blood. Its expanding looking is similar to the bloating, so it should be avoided. When a doctor treats such condition, remember to tell the patient for prevention as such. 

 

4.温通汤

4. Wen Tong Tang (Wen here means to warm up in Chinese;  Tong means to open, and to conduct, or to distribute).

治下焦受寒,小便不通。
This formula is used for difficulty in urine, due to Cold attack to the Lower Jiao of the body.

椒目(八钱,炒捣) 小茴香(二钱,炒捣) 威灵仙(三钱)
Jiaomu (piperales) 24 gram (fry and grind), Xiao Huixian (cumin) 6 gram (fry and grind), Weilingxian 9 gram.

人之水饮,由三焦而达膀胱。三焦者,身内脂膜也。曾即物类验之,其脂膜上皆有微丝血管,状若红绒毛,即行水之处。此管热则膨涨,凉则凝滞,皆能闭塞水道。若便浊兼受凉者,更凝结稠粘杜塞溺管,滴沥不通。故以椒目之滑而温、茴香之香而热者,散其凝寒,即以通其窍络。更佐以灵仙温窜之力,化三焦之凝滞,以达膀胱,即化膀胱之凝滞,以达溺管也。凉甚者,肉桂附子干姜皆可酌加。气分虚者,更宜加人参助气分以行药力。

The water-humidity of body goes into the urine bladder through the three Jiao of the body. The three Jiao is the fat membrane of the body. I checked it with similar animals. There are micro-blood vesicles on its membrane, looks as red fluff, which is the channel for water movement. This channel would open more when it is warmed and it would block and become narrow when it is cold, so to block the water channels. If the urine is cloudy and murky, then with attack by Cold Xie Qi, the Cold would cause more stick to block the urine tract, so cause difficulty in urine. The Jaomu (piperales0 in the formula is warm and slippery, and the Huixiang is fragrant and warm. Both can dissolve the Cold, so to open the tract. Together with the herb Weilingxian, for its warm and fast moving property, can dissolve the stagnation in the three Jiao, to make the water easier to reach the urine bladder, e.g. to dissolve the bladder stagnation. If the Cold is very severe, the herb Rougui, Fuzi or Ganjiang, all can be used. If the Qi is deficient very much, add herb Renshen to help the Qi, so to improve the function of the herbs.

 

5.加味苓桂术甘汤

5. Jiawei Lingguizhugan Tang (Jiawei means to add; Ling means herb Fuling; Gui means herb Guizhi; Zhu means herb Baizhu, and Gan means herb Gancao).

治水肿小便不利,其脉沉迟无力,自觉寒凉者。
This formula is used for swelling and difficulty in urination.  The pulse is deep, late and weak. The person feels cold.

于术(三钱) 桂枝尖(二钱) 茯苓片(二钱) 甘草(一钱) 干姜(三钱) 人参(三钱) 附子(二钱)威灵仙(一钱五分)
Baizhu 9 gram, Guizhi tip 6 gram, Fuling 6 gram, Gancao 3 gram, Ganjiang 9 gram, Renshen 9 gram, Fuzi 6 gram, and Weilingxian 4.5 gram.

肿满之证,忌用甘草,以其性近壅滞也。惟与茯苓同用,转能泻湿满,故方中未将甘草减去。若肿胀甚剧,恐其壅滞者,去之亦可。
For swelling condition, the herb Gancao is forbidden to use, since its nature is stagnation. Only used together with herb Fuling, the Gancao can then work to clear the Wetness and bloating. For this reason, the Gancao was not depleted from the formula. If the swelling is very severe, and if it is feared its stagnation and fullness nature, it can be removed.

服药数剂后,小便微利;其脉沉迟如故者,用此汤送服生硫黄末四五厘。若不觉温暖,体验渐渐加多,以服后移时觉微温为度。
After several doses of drinks, the urine is slightly smooth; if the pulse is still deep, late as before, drink Liuhuang (brimstone powder) several gram. If there is no warm feeling, increase the amount of the Liuhuang powder until feel mild warm.

人之水饮,非阳气不能宣通。上焦阳虚者,水饮停于膈上。中焦阳虚者,水饮停于脾胃。下焦阳虚者,水饮停于膀胱。水饮停蓄既久,遂渐渍于周身,而头面肢体皆肿,甚或腹如抱瓮,而膨胀成矣。此方用苓桂术甘汤,以助上焦之阳。即用甘草协同人参干姜,以助中焦之阳。又人参附子,名参附汤(能固下焦元阳将脱).协同桂枝,更能助下焦之阳(桂枝上达胸膈,下通膀胱故肾气丸用桂枝不用肉桂)。三焦阳气宣通,水饮亦随之宣通,而不复停滞为患矣。至灵仙与人参并用,治气虚小便不利甚效(此由实验而知,故前所载宣阳汤并用之)。而其通利之性,又能运化术、草之补力,俾胀满者服之,毫无滞碍,故加之以为佐使也。若药服数剂后,脉仍如故,病虽见愈,实无大效,此真火衰微太甚,恐非草木之品所能成功。故又用生硫黄少许,以补助相火。诸家本草谓其能使大便润,小便长,补火之中大有行水之力,故用之因凉成水肿者尤良也。服生硫黄法,其中有治水肿之验案宜参观。
The Water-fluid in the body must depend on the Yang Qi to move. If the Yang Qi is weak in the Upper Jiao, the Water-fluid would accumulate above the diagram. If it is weak in the Middle Jiao, it would stay in the Spleen-Stomach; if it is weak in the Lower Jiao, the Water-fluid would accumulate in the urine bladder. If the water-fluid accumulates for a long time, and spills all over the body, the head, arm, leg, and whole body would be swelling. In severe case, the abdomen looks as hold al big basin, e.g. a bloating condition. The Lingguizhugan Tang works to support the Yang Qi in the Upper Jiao, e.g. the Gancao helps the Renshen and Ganjiang to help the Yang Qi in the Middle Jiao. Again, the Renshen and the Fuzi together is the formula of Shenfu Tang (able to fix and enhance the Yuan Yang in the Lower Jiao, which is to escape). The Gancao helps the Guizhi to help the Yang Qi in the Lower Jiao (the herb Guizhi goes up to the chest and goes down to open the urine bladder, so that the Guizhi, but not the Rougui, is used). When the Yang Qi in the three Jiao is opened, the distribution of Water-Humidity in the whole body is also functioning well, so as not to cause disorder due to accumulation or retention. The use of herb Weilingxian and the Renshen works well to promote the urine in Qi deficiency (It is known from clinic test, so they are used together in previous Xuan Yang Tang). Its opening and dispersing property is good to transport the nourishing function of the Gancao and Renshen, so that the two herbs can still be used in person with bloating and swelling. If, after drink of the herbal tea several doses, the pulse is the same, the disease is only improved to some lever, it is due to too weak of the True Fire in the Lower Jiao. The use of the plant herbs might not work properly, so, the Liuhuang (brimstone powder) is used to help the Xiang Fire. The medical books said that the Liuhuang could wet the stool, and promote the urination. It helps to promote urine at the same time to nourish the Fire. So, it is the best choice in a swelling due to Cold. In the chapter for the way to drink the Liuhuang, there are cases for its use in the treatment of swelling as reference.

 

脉沉水肿,与脉浮水肿迥异。脉浮者,多系风水,腠理闭塞,小便不利。当以《金匮》越婢汤发之,通身得汗,小便自利。若浮而兼数者,当是阴虚火动,宜兼用凉润滋阴之药。脉沉水肿,亦未可遽以凉断。若沉而按之有力者,系下焦蕴热未化,仍当用凉润之药,滋阴以化其阳,小便自利。惟其脉沉而且迟,微弱欲无,询之更自觉寒凉者,方可放胆用此汤无碍。或但服生硫黄,试验渐渐加多,亦可奏效。特是肿之剧者,脉之部位皆肿,似难辨其沉浮与有力无力,必重按移时,使按处成凹,始能细细辨认。
The swelling with deep pulse is different from the swelling with floating pulse. Swelling with floating pulse is most commonly due to Wind-Water condition, which blocks the skin layer so the urine is difficult. The herbal formula of Yubi Tang in the book
Jin Kuishould be used to disperse the Wind by creating sweat, so the urine is released. If the pulse is floating and frequent, it could be due to flurry of Yin Deficiency. The herbal formula should contain some cooling-wetting herbs to nourish the Yin. Swelling with deep pulse should not be diagnosed as the Cold condition without care. If the pulse is deep but strong, it is due to accumulated and folded Fire in the Lower Jiao. Cooling-wetting herbs should be used. To nourish the Yin is so to develop more Yang, so the urine is smooth again. If the pulse is deep and weak, and it almost hardly feels when press harder, and if the person feels cold, than use this Jiawei Lingguizhugan Tang. In another way, the person can only be given the Liuhuang powder (brimstone) to take. The amount of it is increased gradually until he feels warm. It could also work. It should be pointed out that, in severe case with heavy swelling, the position to feel the pulse is also swelling, so that it is very hard to feel the pulse for its floating or deep, strong or weak. The finger must press hard and move, to press a hollow on the skin, then feel the pulse carefully.

 

苓桂术甘汤,为治上焦停饮之神方。《金匮》曰:短气有微饮,当从小便去之,苓桂术甘汤主之,肾气丸亦主之。喻嘉言注云:呼气短,宜用苓桂术甘汤,以化太阳(膈上)之气;吸气短,宜用肾气丸,以纳少阴(肾经)之气。推喻氏之意,以为呼气短,则上焦阳虚,吸气短,则下焦阴虚,故二方分途施治。然以之为学人说法,以自明其别有会心则可;以之释《金匮》,谓其文中之意本如是则不可。愚临证体验多年,见有膈上气旺而膺胸开朗者,必能运化水饮,下达膀胱,此用苓桂术甘汤治饮之理也。见有肾气旺,而膀胱流通者,又必能吸引水饮,下归膀胱,此用肾气丸治饮之理也。故仲景于上焦有微饮而短气者,并出两方,任人取用其一,皆能立建功效。况桂枝为宣通水饮之妙药,茯苓为淡渗水饮之要品,又为二方之所同乎。且《金匮》之所谓短气,乃呼气短,非吸气短也。何以言之,吸气短者,吸不归根即吐出,《神农本草经》所谓吐吸,即喘之替言也。《金匮》之文,有单言喘者,又有短气与喘并举者。若谓短气有微饮句,当兼呼气短与吸气短而言,而喘与短气并举者,又当作何解耶(惟论溢饮变其文曰气短似言吸气短)?

The Lingguizhugan Tang is the fantastic formula to treat the Water-accumulation in the Upper Jiao. In the book Jin Kui, it said: “For the short of breath, if it is due to mild water-accumulation, the water should be solved by promoting urine. The herbal formula of Lingguizhugan Tang, or Shenqi Wan both can be used.” Dr. Yu Jiayan explained: “if the exhalation is short/difficult, use Lingguizhugan Tang to develop Yang Qi in the Taiyang zoon of the body (over the diagram). If the inhalation is difficult, use Shenqi Wan to contract the Shaoyin Qi. According to him, the difficulty of exhalation suggests the Yang deficiency in the Upper Jiao. The difficulty of inhalation suggests the Yin deficiency in the Lower Jiao. So they need different herbal formula. This is a scholar explanation. To explain the Jin Kuias such is not a proper way. In my so many year clinic experience, I noticed that, if the person is rich in the Qi in the chest, the Qi must be able to transport water to the bladder. This is the mechanism by which the Lingguizhugan Tang could work for swelling treatment. If the Qi is rich in the Kidney, the urine is smooth, the Kidney Qi could contract the Water into the urine bladder. This is the mechanism, by which the Shenqi Wan works. For this reason, the Master Zhang Zhongjing showed the two formulas at the same time, allow us to choose either one for treatment. Especially, the herb Guizhi is best to disperse the Water in the Upper Jiao, and the Fuling is best to distribute water in the body. They are shared in the two formulas. Again, the short of breath indicated in this book means short of exhalation, not inhalation. …

用越婢汤治风水,愚曾经验,遇药病相投,功效甚捷。其方《金匮》以治风水恶风,一身悉肿,脉浮不渴,续自汗出,无大热者。而愚临证体验以来,即非续自汗出者,用之亦可,若一剂而汗不出者,可将石膏易作滑石(分量须加重)。

To use Yubi Tang for the Wind-Water condition, I have tried. If the herbal formula matches the disease, it works very fast. In the book Jin Kui, it treats the Wind-Water condition, in which the person hates exposure to the wind, has swelling all over the body; the pulse is floating; he has no thirsty; has sweat but no big hot. From my experience, even if the person has no sweat, the formula also works. If the first doses does not create sweat, change the herb Shigao into Huashi (with higher amount).

 

6.寒通汤

6. Hantong Tang

治下焦蕴蓄实热,膀胱肿胀,溺管闭塞,小便滴沥不通。
This formula is used to solve difficulty in urine, e.g. urine retention, due to accumulation of sthenic Fire in the Lower Jiao, that blocks the urine tract and cause bloating in the bladder.

滑石(一两) 生杭芍(一两) 知母(八钱) 黄柏(八钱)
Huashi 30 gram, Bishao 30 gram, Zhimu 24 gram, Huangbo 24 gram.

一人,年六十余,溺血数日,小便忽然不通,两日之间滴沥全无。病患不能支持,自以手揉挤,流出血水少许,稍较轻松。揉挤数次,疼痛不堪揉挤。 徨无措,求为延医。其脉沉而有力,时当仲夏,身复浓被,犹觉寒凉。知其实热郁于下焦,溺管因热而肿胀不通也。为拟此汤,一剂稍通,又加木通海金沙各二钱,服两剂全愈。

A man, 60 years of old, suffered from urine bleeding for several days. One day, the urine could not come out at all. It lasted for two days. The person could no hold at all, so press the bladder with his hands. There was some blood-water out and he felt slight release. After pressed several times, he felt very much pain and hard to endure the press any longer. For no way to help, he turned to me for help. His pulse was deep and strong. It was summer time but he felt cold even he was covered heavy covering. It was considered to be due to a sthenic Fire in the Lower Jiao. The urine tract was swelling due to the Fire. He was given this formula. After one dose, the urine opened little bit. After addition of herb Mutong and Haijinsha 6 gram for each into the formula, the condition was solved after two doses. 

 

7.升麻黄

7. Shenma Huangqi Tang (Shenma is the name of a herb; Huangqi is also the name of a herb)

治小便滴沥不通。偶因呕吐咳逆,或侧卧欠伸,可通少许,此转胞也。用升提药,提其胞而转正之,胞系不了戾,小便自利。
This formula is used for difficulty in urination. The urine may come out little bit after nausea, or cough; or after lying down on side with body stretching some. This condition is due to Zhuanbao (turning of uterus). Use Qi-raising herbs to lift the uterus and change it to normal position, so the urine can come out naturally. 

生黄芪(五钱) 当归(四钱) 升麻(二钱) 柴胡(二钱)
Huangqi 15 gram, Danggui 12 gram, Shenma 6 gram, Chaihu 6 gram.

一妇人,产后小便不利,遣人询方。俾用生化汤加白芍,治之不效,复来询方。言有时恶心呕吐,小便可通少许。愚恍悟曰,此必因产时努力太过,或撑挤太甚,以致胞系了戾,是以小便不通。恶心呕吐,则气机上逆,胞系有提转之势,故小便可以稍通也。遂为拟此汤,一剂而愈。
A lady had hard urine after childbirth. She asked someone come for herbal formula. I used Shenhua Tang plus herb Baishao. It did not work, so she asked the formula again. She had nausea and vomit sometimes, at which time, the urine could come little. I suddenly realized it is the Zhuanbao condition, due to hard press during the childbirth, or to expanding too much to the uterus. During nausea and vomit, the Qi lifts up, so raises the uterus and so the urine could come out little bit. She was given this formula. One dose solved her problem.

三焦之气化不升则不降。小便不利者,往往因气化下陷,郁于下焦,滞其升降流行之机也。故用一切利小便之药不效,而投以升提之药恒多奇效。是以拙拟此汤,不但能治转胞,并能治小便癃闭也。
For the Qi in the three Jiao, if there is no rising, there would be no falling. The difficult in urine is usually due to the sink of Qi in the Lower Jiao, blocking the circle of its raising-falling. So, if the urine-promoting herbs do not work, the raising herbs work. For this reason, the herbal formula here can not only be able to lift the uterus but also to solve the urine retention.

古方有但重用黄芪,治小便不利,积成水肿者(参阅陆定圃《冷庐医话》)。
In ancient time, there is formula to use large amount of herb Huangqi to solve swelling due to difficulty in urination (refer to the book
Len Lu Yi Huaby Mr. Lu Dingpu).

水肿之证,有虚有实,实者似不宜用黄芪 。然其证实者甚少,而虚者居多。至其证属虚矣,又当详辨其为阴虚阳虚,或阴阳俱虚。阳虚者气分亏损,可单用、重用黄芪 。阴虚者其血分枯耗,宜重用滋阴之药,兼取阳生阴长之义,而以黄 辅之。至阴阳俱虚者,黄芪与滋阴之药,可参半用之。医者不究病因,痛诋为不可用,固属卤莽,至其连用除湿猛剂,其卤莽尤甚。盖病至积成水肿,即病因实者,其气血至此,亦有亏损。猛悍药,或一再用犹可。若不得已而用至数次,亦宜以补气血之药辅之。况其证原属重用黄芪治愈之虚证乎。至今之医者,对于此证,纵不用除湿猛剂,亦恒多用利水之品。不知阴虚者,多用利水之药则伤阴;阳虚者,多用利水之药亦伤阳。夫利水之药,非不可用,然贵深究其病因,而为根本之调治,利水之药,不过用作向导而已。
For the swelling condition, there is asthenic and sthenic condition. In the sthenic swelling, it seems not good to use herb Huangqi. However, in clinic, there are more asthenic swelling cases than the sthenic swelling. For the asthenic swelling, it is still needed to identify if it is due to Yin deficiency or Yang deficiency. In the Yang deficiency, the Huangqi can be used alone, or in large amount. In the Yin deficiency, the blood is not sufficient, Yin-nourishing herbs should be used mostly. The use of Huangqi is only a supplementary to it to develop the Yin by nourishing the sufficient Yang (rich Yang would transform into the Yin). If the Yin and the Yang both are deficient, use both Huanqi and the Yin-nourishing herbs together, half and half. Doctors do not check and identify the reasons for the swelling, so simply refuse the use of Huangqi. It is too reckless. When they use strong and sharp Wet-depleting herbs, they are much more reckless. When a disease develops into the swelling stage, even if it belongs to a sthenic swelling, the Qi and blood is also with some weakness. The sharp and strong herbs can be used in a short time. If they are used again and again, the Qi and the blood should be supplied to some level, not to speak of the original condition that needs the large amount of Huangqi. The current doctors, even if they do not use strong and sharp Wet-depleting herb, use large amount of urine-promoting herbs. They do not know that, more urine-promoting herbs may damage the Yin. For Yang deficiency, more use of the urine-promoting herbs will also damage the Yang. It does not mean not to use the urine-promoting herbs, but the swelling should be treated according to its source. The urine-promoting herbs, e.g. the water-depleting herbs, should be used only as a guider.

 

【附方】葛稚川《肘后方》治小便不通,用大蝼蛄二枚,取下体,以水一升渍饮,须臾即通。
Appendix formula: In the book
Zhou Hou Fangby Dr. Ge Zhichuan, there is a formula for the treatment of difficult urine: big Lougu (Mole cricket) two. Use its later half body part. Rinse it into 1000 ml water to drink. The urine comes out very soon.

又《寿域方》用土狗后半,焙研调服半钱,小便即通,生研亦可。
In the book
Shou Yu Fang, it is introduced to use later half body part of Lougu. Bake it and grind into powder to drink 1.5 gram. The urine will start right away. The Lougu can also be drink without bake.

又《唐氏经验方》用土狗后截和麝香捣,纳脐中缚定,即通。

The book Tangshi Jinyan Fangintroduced to use the later half part of Lougu and Shexiang (musk). Grind them into powder. Apply the mixture into the naval and fold it. The urine would come out.


按:土狗即蝼蛄,《日华诸家本草》谓其治水肿,头面肿。李时珍谓其通大小便,治石淋,诚为利小便要药。凡小便不通者,无论凉热虚实,皆可加于药中以为向导。即单服之,亦甚有效验。然观古方,皆用其后半截。盖其前半,开破之力多,后半利水力多。若治二便皆不通者,当全用之。
Reference: The Tugou means the Lougu (Mole cricket). In the book
Ri Hua Zhujia Bencao, it is said Lougu treats swelling and eodema in head and face. Dr. Li Shizhen said it can promote the urine and stool movement, to treat stone ling condition. It is really valuable hernb to smooth urine. For difficulty in urine, no matter it is due to Cold or Hot, to asthenic or sthenic condition, it can be added into the herbal formula as guider. Even drink it alone can work. However, when look at the ancient books, it is usually used its later half part of the body, since the front part of its body is with strong opening property and the later part of the body has more function to smooth the urine. In the treatment of difficulty in both urine and stool, its whole body should be used.

俗传:治小便不通闻药方。用明雄黄一钱,蟾酥五分(焙发),麝香六厘,共研细,鼻闻之,小便即通。

In folk description, there is a formula for smell to solve difficulty in urine. It asked to use Xionghuang (realgar) 3 gram, Chantu (toad cake) 1.5 gram (bake), Shexiang (musk) 0.18 gram. Grind all into powder, smell it. The urine will come out.

 

8.鸡胵汤

8. Jizhi Tang (Jizhi means the inside membrane of the chicken stomach).

治气郁成臌胀,兼治脾胃虚而且郁,饮食不能运化。
This formula is used to treat the bloating condition, due to Qi stagnation. It is also used to treat bloating feeling due to weakness of the Spleen and Stomach, the food cannot be digested.

鸡内金(四钱,去净瓦石糟粕捣碎) 于术(三钱) 生杭芍(四钱) 柴胡(二钱) 广陈皮(二钱) 生姜(三钱)
Jineijin (inside membrane of chicken stomach) 12 gram (remove stone residue, and grind), Baizhu 9 gram, Baishao 12 gram, Chaihu 6 gram, Chenpi 6 gram, and fresh ginger 9 gram.

《内经》谓:诸湿肿满,皆属于脾。诚以脾也者,与胃相连以膜,能代胃行其津液。且地居中焦(为中焦油膜所包),更能为四旁宣其气化。脾若失其所司,则津液气化凝滞,肿满即随之矣。是臌胀者,当以理脾胃为主也。西人谓脾体中虚,内多回血管。若其回血管之血,因脾病不能流通,瘀而成丝成块,原非草木之根 所能消化。鸡内金为鸡之脾胃,中有瓦石铜铁皆能消化,其善化有形瘀积可知。故能直入脾中,以消回血管之瘀滞。而又以白术之健补脾胃者以驾驭之,则消化之力愈大。柴胡,《神农本草经》谓主肠胃中饮食积聚,能推陈致新,其能佐鸡内金消瘀可知。且与陈皮并用,一升一降,而气自流通也。用芍药者,因其病虽系气臌,亦必挟有水气,芍药善利小便,即善行水,且与生姜同用,又能调和营卫,使周身之气化流通也。夫气臌本为难治之证,从拟此方之后,连治数证皆效。
It is said in the book
Nei Jin: “all wetness, swelling and bloating condition is related to Spleen.” The spleen is connected with the stomach with its inside membrane. It can replace stomach to transport water (Jinye). It is located in the middle part of the body (it is folded by middle oily membrane). It can disperse its Qi to the whole body. If the function of the Spleen is in disorder, the distribution of the body Jinye (liquid) is in disorder, the swelling and bloating will happen. For this reason, to treat the bloating condition, the spleen should be worked on. … Jineinin is the inside membrane of the chicken stomach. It can digest whatever iron, stone in the stomach, so it is good to digest the mass with form, and so it can go into the Spleen, to dissolve the block in the blood vessels. Helped by Baizhu to nourish the Spleen-Stomach, its bloat-disolving property is stronger. In the bookShennong Bencao Jin, it is said that herb Chaihu can dissolve water-yin accumulation in the stomach and intestine, and can develop new one and deplete and remove old one. It is therefore known that it can help Jineijin to digest the stagnation. When the Chaihu is used together with Chenpi, one is to raise and another is to cause falling. The raising and falling property enable the Qi move up and down. The reason for the use of Shaoyao is that, it is good at promoting water metabolism and promoting urine, though the condition here belongs to the Qi bloating (air bloating), it must be accompanied with Water-humidity in the body. The Shaoyao can remove the accumulated Water-humidity. When the Shaoyao and the fresh ginger are used together, they can harmony the Yin and Wei portion of the body, to promote the Qi metabolism in the whole body. Originally, the Qi bloating condition is a hard disorder to treat. After use of this formula, several cases were cured.

治一叟年六旬,腹胀甚剧。治以此汤数剂,其效不速。用黑丑一钱炒研细,煎此汤送下,两剂大见功效。又去黑丑,再服数剂全愈。
A old man, 60 years of old, suffered from severe abdomen bloating. He was given this formula several doses, the improvement was not so fast. Then he was asked to drink herb Heichou 3 gram in powder, with the help of this formula, two doses solved his problem. After removal of the Heichou, the formula was asked to drink for additional several doses, the condition was cured.

若小便时觉热,且色黄赤者,宜酌加滑石数钱。鸡内金虽饶有消化之力,而诸家本草,实有能缩小便之说,恐于证之挟有水气者不宜。方中用白芍以利小便,所以济鸡内金之短也。
If feels hot in urine, and the urine color is yellow, add Huashi several grams. Jineijin has digest function, but various medical books said it can reduce the urine, so that it is feared not suit in case there is water-humidity in the body. The use of Baishao can promote the urine, so to prevent the side effect of the Jineijin in possible causing water retention.

《内经》谓:按之 而不起者,风水也。愚临证体验以来,知凡系水臌,按之皆不能即起。气臌则按之举手即起。或疑若水积腹中,不行于四肢,如方书所谓单腹胀者,似难辨其为气为水。不知果为水证,重按移时,举手则有微痕,而气证则无也。且气臌证,小便自若,水臌证,多小便不利,此又其明征也。

It is said in the bookNei Jinthat, “it would belong to Wind-Water condition, if press the finger on the swelling/bloating spot for a while, then leave it, and the spot does not return to original height after leave of the finger”. From my experience in clinic, I found that, if it is Water-bloating, the spot will not go up to return. If it is due to Qi-bloating (air bloating), the spot will come up to original level soon after leave of the finger. If doubt if it is due to the Water accumulation in the abdomen, not distribute to the arms and legs, as said in the medical books, the abdomen bloating alone, it is hard to make a diagnosis. If it is an accumulation of water, there would have a finger print on the skin after removal of the finger. If it is due to air accumulation, there would have no such finger print. In addition, in the air-accumulation, the urine is normal, while in water-accumulation, the person usually has difficult urine.

 

9.鸡胵茅根汤

9. Jizhi Maogen Tang (Jizhi means the Jineijin, the inside membrance of chicken stomach; Maogen means herb Baimaogen)

治水臌气臌并病,兼治单腹胀,及单水臌胀,单气臌胀。
This formula is used for water-bloating and air-bloating condition; or for abdomen bloating alone, or for water-bloating alone, or air-bloating (the Qi-bloating alone).

鸡内金(五钱,去净瓦石糟粕轧细) 生于术(分量用时斟酌) 鲜茅根(二两,锉细)
Jineijin 15 gram (remove stone and other debris, grind), Baizhu (the amount needed depends on clinic condition), fresh Baimaogen 60 gram (grind).

先将茅根煎汤数茶盅(不可过煎,一两沸后慢火温至茅根沉水底汤即成)。先用一盅半,加生姜五片,煎鸡内金末,至半盅时,再添茅根汤一盅,七八沸后,澄取清汤(不拘一盅或一盅多)服之。所余之渣,仍用茅根汤煎服。日进一剂,早晚各服药一次。初服小便即多,数日后大便亦多。若至日下两三次,宜减鸡内金一钱,加生于术一钱。又数日,胀见消,大便仍勤,可减鸡内金一钱,加于术一钱。又数日,胀消强半,大便仍勤,可再减鸡内金一钱,加于术一钱。如此精心随病机加减,俾其补破之力,适与病体相宜,自能全愈。若无鲜茅根,可用药局中干茅根一两代之。无鲜茅根即可不用生姜。所煎茅根汤,宜当日用尽,煎药后若有余剩,可当茶温饮之。
Cook the Baimaogen first to collect several cups. Do not cook over. After one to two boiling, wait until the the herbs precipitates down the bottom, the herbal tea is ready. Use about 200 ml of the Baomaogen tea, add fresh ginger five pieces, and the Jineijin powder in to cook until the total volume is about 100 ml, add another 100 ml Baomaogen and continue the cook. After seven to eight boiling, collect the supernatants to drink (no matter how much volume it is). Cook the reside again with the Baimaogen soup. Drink it twice a day. One dose is for one day. From the beginning, the urine will be more. After several days, the stool will be more too. If the bowel movement is more than 3 times a day, reduce the amount to Jineijin 3 gram and add Baizhu 3 gram. After another several days, the bloating is reduced more and the bowel movement is still frequent, reduce Jineijin 3 gram again, and add Baizhu 3 gram too. After another several days, the bloating reduced furthermore and the bowel movement is still frequent, reduce Jineijin 3 gram again and add Baizhu 3 gram more. By such modification carefully, to make the breaking and supplying function of the herbs matches the person’s body condition, the disorder should be cured. If there is no fresh Baimaogen, the dry Baimaogen 30 gram can be used. If no fresh Baimaogen, the fresh ginger can be omitted from the formula too. The Baomaogen herbal tea should be used up on the same day. If there is some herbal tea left, drink it the same day as ordinary tea.  

鸡内金之功效,前方下已详论之矣。至于茅根最能利水,人所共知。而用于此方,不但取其利水也,茅根春日发生最早,是禀一阳初生之气,而上升者也。故凡气之郁而不畅者,茅根皆能畅达之。善利水又善理气,故能佐鸡内金,以奏殊功也。加生姜者,恐鲜茅根之性微寒也。且其味辛能理气,其皮又善利水也。继加于术,减鸡内金者,因胀已见消,即当扶正以胜邪,不敢纯用开破之品,致伤其正气也。或疑此方,初次即宜少加于术者。而愚曾经试验,早加于术,固不若晚加之有效也。
The function of the Jineijin is to be discussed bellow. For the function of Baimaogen in water-depletion, it is well known. The reason to use it in the formula here, is not only due to its water-depletion function, but also to its raising function, since its root grows the most early in the spring, so it bears the most early Yang Qi. Whenever the Qi is stagnated, the herb Baimaogen can disperse it. For its water-depletion and Qi-promoting function, it can so help Jineinin to solve the bloating. The addition of fresh ginger is to prevent the side effect from Baimaogen, for its mild cold nature. The fresh ginger is spicy, so it can adjust and to promote the Qi movement. Its peel can improve water distribution and metabolism. For reducing Jineijin and adding Baizhu, the reason is that the bloating is reduced and the body defense system should be supplied. It is dared not to only use the Qi-breaking herbs, for it would damage the Zhen Qi (body defense Qi). I have also tested that, addition of the herb Baizhu in later stage works better than addition of it in early stage of the treatment.

或问:茅根能清热利小便,人所共知。至谓兼理气分之郁,诸家本草皆未言及,子亦曾单用之,而有确实之征验乎?答曰:此等实验,已不胜记。曾治一室女,心中常觉发热,屡次服药无效。后愚为诊视,六脉皆沉细,诊脉之际,闻其太息数次,知其气分不舒也。问其心中胁下,恒隐隐作疼。遂俾剖取鲜茅根,锉细半斤,煎数沸当茶饮之。两日后,复诊其脉,已还浮分,重诊有力,不复闻其太息。问其胁下,已不觉疼,惟心中仍觉发热耳。再饮数日,其心中发热亦愈。
It might be asked: it is well known that the herb Baimaogen can clear the fire and to promote urine, but it was never mentioned in medical books that the herb can promote the Qi distribution and movement. You have used it alone. Do you really have experience that it works? Answer: I have tested this for many cases, countless cases. I treated a young girl. She felt hot in heart. She drank herbal tea many times without any improvement. Later when I saw her, her pulse was deep and thin on both sides. I notices her had ling sign several times when I felt her pulse, so I knew that she had Qi stagnation. Upon asking, she answered that she felt mild ache in the heart and on the side of the abdomen. I asked to prepare fresh Baomaogen herbal tea for her to drink. After two days, her pulse was returned to floating position and felt strong when press hard, and no longer heard her ling sign. She had neither pain, only hot in the heart. The herbal tea was asked to drink for several more days, which solved her hot feeling in the heart too.

又尝治少年,得肺鼠疫病。其咽喉唇舌,异常干燥。精神昏昏似睡。周身肌肤不热。脉象沉微。问其心中,时常烦闷。此鼠疫之邪,闭塞其少阴,致肾气不能上达也。问其大便,四日未行。遂投以大剂白虎加人参汤,先用茅根数两煎汤,以之代水煎药,取汁三盅,分三次饮下。其脉顿起,变作洪滑之象。精神已复,周身皆热,诸病亦皆见愈。俾仍按原方将药煎出,每饮一次,调入生鸡子黄一枚,其病遂全愈。

A boy got respiratory plague (Black death). He felt dry in mouth and throat very much. He was sleepy and the body was not hot and the pulse was deep and weak. When asked, he told he felt annoying in the heart. This is due to the plaque Xie Qi, that blocked the Shaoyin, prevented the Kidney Qi from going up. He did not have bowel movement for four days. He was given large amount of Baihu jia Renshen Tang. The Baimaogen tens of grams were cooked first. The Baimaogen tea was used to cook other herbs. The final tea was drunk in three separate times. His pulse turned up in floating level and became waving and slippery feeling. His mode had turned normal, the body became warm. Everything appeared better. The herbs were cook as the original required. Each time when drink the tea, added on egg yolk in it. The disease was cured completely.

盖茅根生于水边,原兼禀寒水之气。且其出地之时,作尖锐之锥形,故能直入少阴,助肾气上达,与心相济,则心即跳动有力,是以其脉,遂洪滑外现也。再加生鸡子黄,以滋少阴之液,俾其随气上升,以解上焦之因燥生热,因热生烦,是以诸病皆愈也。此二案皆足征茅根理气之效也。

The Baimaogen grows beside water. It originally bears the Cold-Water nature. When it grows above the soil, its tip appears as cone shape, so it can penetrates into the Shaoyin right away to help the Kidney Qi to go up to the heart. The Heart will beat stronger. This is the reason that his pulse became waving-slippery. In addition due to the use of egg yolk to nourish the Shaoyin liquid part, to make it raised with the up going Kidney Qi, to solve the Hot (the Hot is due to Dryness, the Hot again causes annoyed) in the Upper Jiao. This is the reason that the whole condition is solved. These two cases are enough to prove that the Baimaogen root can adjust and promote the Qi movement.