医学衷中参西录：治阴虚劳热方

治劳瘵羸弱已甚，饮食减少，喘促咳嗽，身热脉虚数者。亦治女子血枯不月。

This formula is used to treat long term exhausting conditions. The patient has reduced appetite, short of breath or asthma, cough. The body feels warm (body temperature may not be high), and the pulse is weak but frequent/fast. It is also used to treat the condition in women, in which the women have menstruation stop due to less blood supply.

生山药（一两）玄参（五钱）于术（三钱）生鸡内金（二钱，捣碎）牛蒡子（三钱，炒，捣）

Shanyao 30 gram, Xuanshen 15 gram, Baizhu 9 gram, Jineijin 6 gram (grind to small pieceses), Niubangzi 9 gram (fried, grind)

热甚者，加生地黄五六钱。脾为后天之本，能资生一身。脾胃健壮，多能消化饮食，则全身自然健壮，何曾见有多饮多食，而病劳瘵者哉？

If the body feels more warm or hot, add herb Shengdi 15 to 18 gram. Spleen is the root and basic foundation for later-life body structure and function. It nourishes the whole body. If the Spleen and the Stomach are strong and work well, and the body can digest the food, the whole body should be strong. When did you see a person who can eat well but suffer severe chronic disease?

《内经》阴阳别论曰：“二阳之病发心脾，有不得隐曲，在女子为不月，其传为风以其先不过阳明，胃腑不能多纳饮食也，而原其饮食减少之故。曰发于心脾，原其发于心脾之故。曰有不得隐曲者何居？盖心为神明之府，有时心有隐曲，思想不得自遂，则心神拂郁，心血亦遂不能濡润脾土，以成过思伤脾之病。

It is said in the chapter about the Yin and the Yang in the book《Nei Jing》: “When the disease starts from the Heart and the Spleen, there would have some hard-to-tell secrets in the heart of the patient. If it happens in woman, the woman would have no period. The disease is passed by Wind. The reason is that the Wind cannot pass through the Yangming stage of previous disease, the Stomach failed to hold and to accept sufficient food, so the appetite is reduced. What means “there is hard-to-tell secrets”? The Heart dominates and is responsible for a clear mind status of the body. If there something that cannot tell out, the mind is not in a relax condition, the emotion is so suppressed and be in a depression condition, so the Heart-Spleen blood cannot nourish the Spleen Soil, so cause such damage to the Spleen.

脾伤不能助胃消食，变化津液，以溉五脏，在男子已隐受其病，而尚无显征；在女子则显然有不月之病。此乃即女以征男也。

When the Spleen fails to help the Stomach to digest the food, to create Jingye from the food, so to nourish all organs with the Jingye, in man, there could have no clear sign in the body; in women, there would be stop of the menstruation.

至于传为风消，传为息贲，无论男女病证至此，人人共见，劳瘵已成，挽回实难，故曰不治。然医者以活人为心，病证之危险，虽至极点，犹当于无可挽回之中，尽心设法以挽回之。

When the condition comes up to the Wind-exhaust condition, or to the Xipen condition, no matter the patient is man or woman, every one knows that the person is already in an exhausted condition. It is called no-cure, since this condition is really hard to cure. However, as a doctor, one should bear the mind to try his best to save the patient. The condition is very severe and in an extreme risk condition, but it is still possible to do something to improve it.

而其挽回之法，仍当遵二阳之病发心脾之旨。戒��者淡泊寡欲，以养其心，而复善于补助其脾胃，使饮食渐渐加多，其身体自渐渐撤消。如此汤用于术以健脾之阳，脾土健壮，自能助胃。山药以滋胃之阴，胃汁充足，自能纳食（胃化食赖有酸汁）。特是脾为统血之脏，《内经》谓“血生脾”，盖谓脾系血液结成，故中多函血。西人亦谓脾中多回血管为血汇萃之所。此证因心思拂郁，心血不能调畅，脾中血管遂多闭塞，或如烂炙，或成丝膜，此脾病之由。而脾与胃相助为理，一气贯通，脏病不能助腑，亦即胃不能纳食之由也。

To improve this condition, we should follow the principle that the two-Yang condition comes from the Heart and the Spleen. The patient should stop to think over the previous missing person or thing, so to nourish his Heart. Then try to support his Spleen-Stomach, to make him able to eat more and digest more, so to make the body stronger day by day. In this formula, the use of herb Baizhu is to nourish the Spleen Yang Qi. When the Spleen is strong, it can naturally help the Stomach in digestion. The herb Shanyao works to nourish the Stomach Yin Qi. When the Stomach Yin is sufficient, it can naturally hold and accept more food for digestion. Especially, the Spleen is responsible to control the blood within the blood vessels. 《Nei Jing》said “Blood develops Spleen”. It means the Spleen consists of Blood, so it contains more Blood in it. Western medicine said that there are many blood vessels in the spleen and the spleen is the place where the blood collects.

This condition is due to the depression or suppression of Heart. The Heart blood is not moving smoothly, so the blood vessels in the Spleen tends to be stagnated, blocked, to form dirty wound, or silk membrane. This is the reason for the disorder in the Spleen. The Spleen and the Stomach help each other. If the Spleen, the Zang organ, is in sick so as not be able to help the Stomach, the Fu organ, e.g. the Stomach would not be able to hole and accept the food for digestion. This is the reason for the Stomach is in sick.

鸡内金为鸡之脾胃，中有瓷、石、铜、铁，皆能消化，其善化有形郁积可知。且其性甚和平，兼有以脾胃补脾胃之妙。故能助健补脾胃之药，特立奇功，迥非他药所能及也。方中以此三味为不可挪移之品。

Jineijin is the spleen and stomach of the chicken. It can digest stone, metal, iron, china, so you see it is good at digest things that have form/shape. Its nature is also mild, having a meaning of using (chicken) Spleen to nourish (human) Spleen. So, it can be used to nourish the Spleen, to work marvelously. This function of the Jineijin cannot be replaced by other herbs, so it cannot be omitted from the herbal formula.

玄参《神农本草经》谓其微寒，善治女子产乳余疾，且其味甘胜于苦，不至寒凉伤脾胃可知，故用之以去上焦之浮热，即以退周身之烧热；且其色黑多液，《神农本草经》又谓能补肾气，故以治劳瘵之阴虚者尤宜也。

Xushen, in the 《Shennun Bencao Jing》, is said to be mild cold in herb nature. It is good at treating woman’s disorder during pregnancy and birth giving. Its taste is more sweet than bitter, so it is not so cold to damage the Spleen-Stomach. It is therefore used to remove the floating Fire in the upper Jiao, e.g. to remove the body hot and fever. It is black in color and rich in juice, so in 《Shennun Bencao Jing》, it is said to be able to nourich the Kidney. It is therefore more suitable in the treatment of exhausting condition with Yin deficiency.

牛蒡子体滑气香，能润肺又能利肺，与山药、玄参并用，大能止嗽定喘，以成安肺之功，故加之以为佐使也。

Herb Niubangzi is smooth and fragrant in smell, can nourish the Lung and promote the function of the Lung. When used together with the Shanyao and Xuanshen, it can stop the cough and solve the short of breath.

地黄生用，其凉血退热之功，诚优于玄参。西人谓其中函铁质，人之血中，又实有铁锈。地黄之善退热者，不但以其能凉血滋阴，实有以铁补铁之妙，使血液充足，而蒸热自退也。又劳瘵之热，大抵因真阴亏损，相火不能潜藏。地黄善引相火下行，安其故宅。《神农本草经》列之上品，洵良药也。

Herb Dihuang, when used as non-cooked, e.g. the original form, can cool the blood and remove body fever. Western people said it contains iron, and in the human blood, there is iron in deed. The herb Dihuang is not only able to cool the blood and remove fever, but also supply more iron to the blood. When the blood is sufficient, the sweating fever would reduce naturally. The fever in the exhausting condition is mostly due to deficiency of the Yin, so the Xiang Fire cannot hide in the Kidney. The Dihuang is good to bring the Xiang Fire down to the Kidney so save there. In the《Shennun Bencao Jing》, it is therefore listed in the super herb group.

然必烧热过甚而始加之者，以此方原以健补脾胃为主，地黄虽系生用，经水火煎熬，其汁浆仍然粘泥，恐于脾胃有不宜也。至热甚者，其脾胃必不思饮食，用地黄退其热，则饮食可进，而转有辅助脾胃生山药，即坊间所鬻之干山药，而未经火炒者也。此方若用炒熟山药，则分毫无效. 于术色黄气香，乃浙江于潜所产之白术也。色黄则属土，气香则醒脾，其健补脾胃之功，迥异于寻常白术。若非于潜产而但观其色黄气香，用之亦有殊效，此以色、味为重，不以地道为重也。

However, the herb Dihuang would be used only if the person is with clear and strong fever. This formula is originally to nourish and support the Spleen-Stomach. Though the Dihuang has been cooked in water to prepare the herbal extinction, the herbal extinction is still stick as sticking mud. There is fear that it is not good for the Spleen-Stomach. When the person has fever, his appetite must be low. The use of the Dihuang can reduce the blood fever, so the appetite can be restored. In this way, it can help the herb Shanyao in the formula. The Shanyao should be original Shanyao without any cook. There is no use to use cooked Shanyao. Baizhu is yellow in color and fragrant in smell. The best Baizhu is the one produced in Yuqian city in Zhejiang province of China. Yellow is associated to the Soil. Fragrant smell can wake up the Spleen. Its Spleen-nourishing function is different from original Baizhu produced in other places of China. If not produced in the Yuqian city, pay attention to its yellow color and fragrant smell, not to the place where it is produced. If yes, use it. Other wise, no healing function.

西人谓：胃之所以能化食者，全赖中有酸汁。腹饥思食时，酸汁自然从胃生出。若忧思过度，或恼怒过度，则酸汁之生必少，或分毫全无，胃中积食，即不能消化。此论与《内经》“二阳之病发心脾”、“过思则伤脾”之旨暗合。

Western medicine states: The stomach can digest food, depending on the acid in it. When the person feels hungry, there would be acid produced in the stomach naturally. If the person in deep missing think, or angry too much, the production of the gastric acid must be less than in normal condition, or even has no gastric acid at all. The food in the stomach, of course, can not be digested. This is in consistence with the saying in the 《Nei Jing》that over-thinking would damage the Spleen.

或问曰：《内经》谓脾主思，西人又谓思想发于脑部，子则谓思发于心者何也？答曰：《内经》所谓脾主思者，非谓脾自能思也。盖脾属土，土主安静，人安静而后能深思，至西人谓思发于脑部，《内经》早寓其理。脉要精微论曰：“头者精明之府。”夫头之中心点在脑，头为精明之府，即脑为精明之府矣。既曰精明，岂有不能思之理，然亦非脑之自能思也。试观古文“思”字作“ ”，囟者脑也，心者心也，是知思也者，原心脑相辅而成，又须助以脾土镇静之力也。

People may ask, 《Nei Jing》said the Spleen is responsible for thinking, the western medicine said it is the brain that is responsible for thinking. How do you said that it is the Heart that is responsible for thinking? My comments are: 《Nei Jing》said that the Spleen is responsible for thinking, not meant that the Spleen itself can think. The Spleen belongs to Soil. Soil is associated with quiet. When the person is in quiet, he can then think things deeply. Though the western medicine said that the brain is responsible for thinking, 《Nei Jing》already implied it. The Maiyao Jingwei Lun in the book said: “the head is the place of clear mind”. The brain is the middle part of the head. If the head is the place of clear mind, it of course means that the brain is the place of clear mind. If it is clear mind, how it cannot think? However, it does not mean that the brain can think things by itself. Let look at the old word of “thinking” in Chinese. The upper part of the old word is “囟”, means the brain. The lower part of the word is “心”, e.g. the heart. Therefore, to think needs the brain and the heart, but also need the Spleen to create quiet and relax condition to allow the brain and heart to have deep think.

或问曰：子解二阳之病发心脾一节，与王氏《内经》之注不同，岂王氏之注解谬欤？答曰：愚实不敢云然。然由拙解以绎经文，自觉经文别有意味，且有实用也。夫二阳之病发心脾，与下三阳为病发寒热，一阳发病、少气、善咳、善泄，句法不同，即讲法可以变通。盖二阳之病发心脾，谓其病自心脾而来也。三阳为病发寒热，是形容三阳之病状也，故将之病“之”字易作“为’字。至一阳发病数句，其句法又与三阳为病句不同，而其理则同也。

People may also ask: your explanation about the “The two-Yang disease starts from the Heart and Spleen” is different from the Dr. Wang. Is that the Dr Wang wrong. My answer: I cannot say so. However, to understand the medical bible, the 《Nei Jing》, in my way, we should feel that the meaning of the sentence is not so simple and it is practically applicable too. The statement “the two-Yang disease starts from the Heart and Spleen”, together with the later “three-Yang disease shows as cold-fever” and “One-Yang disease shows as short of breath, frequent cough, and frequent diarrhea” are different in sentence expression, but the way of the prescription can be harmonized. That “the two-Yang disease starts from the Heart and Spleen”, means the disease is developed from the Heart and the Spleen. That “the three-Yang disease shows the chilly/cold and hot/fever, is to describe the clinic manifestation of the three Yang disease. Similarly, that the one-yang disease, the person has short of breath, frequent cough and frequent diarrhea, is to tell the manifestation too.

或又问：三阳一阳病，皆形容其发病之状，二阳病，独推究其发病之原因者何居？答曰：三阳、一阳，若不先言其病发之状，人即不知何者为三阳、一阳病。至二阳胃腑，原主饮食，人人皆知。至胃腑有病，即不能饮食，此又人人皆知。然其所以不能饮食之故，人多不能知也。故发端不言其病状，而先发明其得病之由来也。

It may also be asked again: the three-Yang and the one-Yang disease both describe the clinic manifestations. Why only the two-Yang disease tells the reason of the disease? The answer is: for the three-Yang and the one-Yang disease, if not mention the clinic manifestations first, the readers would have not been able to know what is the three-Yang disease and the one-Yang disease. For the two-Yang disease, the Stomach, everyone knows it is responsible for digestion. It is also known by everyone that when the Stomach is sick, the person would be hard to eat and to digest. However, most people do not know the reasons for the sick Stomach hard to digest. So, the author do not mention its clinic manifestation, but the reason.

或又问：胃与大肠皆为二阳，经文既浑曰二阳，何以知其所指者专在于胃、答曰：胃为足阳明，大肠为手阳明，人之足经长、手经短，足经原可以统手经，论六经者原当以足经为主。故凡《内经》但曰某经，而不别其为手与足者，皆指足经而言，或言足经而手经亦统其中。若但言手经，则必别之曰手某经矣。经文俱在，可取而细阅也。

One may continue to ask: the Stomach and the Large Intestine both belong to the Yang organ, it is only mentioned roughly the two-Yang, not specifically mention the Stomach, how do you consider it means the Stomach? Answer: the Stomach belongs to the feet Yangming, the Large Intestine belongs to the hand Yangming. In the human, the feet Yangming is longer than the hand Yangming meridian. The feet meridian can represent the hand meridian. When we discuss the six meridian/stage/conditions, it originally means the feet meridian mostly. Therefore, when mentioned in the 《内经》 the meridian, not separate it specifically hand or feet, it always means the feet meridian, or means both the feet and the hand meridians. When it mentions the hand meridian, it only means the hand meridian, not refers to the feet meridian, and it will more specifically mention which hand meridian. The book is there, readers can check to see if it is so.

一九一三年，客居大名。治一室女，劳瘵年余，月信不见，羸弱不起。询方于愚，为拟此汤。连服数剂，饮食增多。身犹发热，加生地黄五钱，五六剂后热退，渐能起床，而腿疼不能行动。又加丹参、当归各三钱，服至十剂腿愈，月信亦见。又言有白带甚剧，向忘言及。遂去丹参加生牡蛎六钱，又将于术加倍，连服十剂带证亦愈。遂将此方邮寄家中，月余门人高如壁来函云：＂邻村赵芝林病痨瘵数年不愈，经医不知多少，服药皆无效．今春骤然咳嗽，喘促异常，饮食减少，脉甚虚数，投以资生汤十剂全愈。”审斯则知此方治劳瘵，无论男女，服之皆有捷效也。

In 1913, I lived in Daming town. There was a girl, who suffered from the exhausting condition for years and had no period. She was so weak to get up. She came to me and I prescribed this formula. After several doses, her diet increased. Her body still felt hot, so herb Shendi 15 gram was added in the formula. After five to six doses, the body hot disappeared. She gradually was able to get up the bed but the leg felt pain and cannot move. Herb Danshen and Danggui, 9 gram each was added in. After ten doses, the leg had no problem any longer and the period appeared. She mentioned that she had heavy discharge, that I forget to ask her before. So, the Danshen was removed, but herb Muli 18 gram was added. The Baizhu in it was doubled. Continuous ten doses made the discharge disappeared. So I send the herb formula to my home. Several months later, my student Dr. Gao Rubi send me a letter, told me that “A patient who lived in the neighbor village suffered from the exhausting condition for several years. He has tried many doctors but all failed. This spring, he suffered sudden cough, short of breath, reduced diet. His pulse is very weak and pulse. I gave him several Zisheng Tang and solved his problem.” So, it is known that this formula not only works for woman but also for man.

女子月信，若日久不见，其血海必有坚结之血。治此等证者，但知用破血通血之药，往往病犹未去，而人已先受其伤。鸡内金性甚和平，而善消有形郁积，服之既久，瘀血之坚结者，自然融化。矧此方与健脾滋阴之药同用，新血活泼滋长，生新自能化瘀也。

If woman’s menstruation has stop for a long time, her blood sea must have hard and clotted blood clot. If use the herbs that break and conduct the blood for the treatment of such condition, it usually causes damage to the body before the healing effect. Jineijin is mild in herbal nature, is good at melting the accumulation/clot/mass in the body. Longer time take of it would naturally make the hard clot disappear. When it is used together with the other herbs that works to nourish the Spleen and the Yin, there would be new blood production. When the new blood produced, the old clot would disappear.

津埠宋氏妇，年将四旬，身体羸弱，前二年即咳嗽吐痰，因不以为事未尝调治。今春证浸加剧，屡次服药无效。诊其脉，左部弦细，右部微弱，数近六至。咳嗽，吐痰白色，气腥臭，喘促自汗，午后发热，夜间尤甚，胸膈满闷，饮食减少，大便秘结，知其已成痨瘵而兼肺病也。从前所服药十余纸，但以止嗽药治其肺病，而不知子虚补母之义，所以无效。为疏方用资生汤加减，生山药八钱，玄参、大生地、净萸肉各六钱，生牡蛎、生杭芍、生赭石各四钱，于术、生鸡内金、甘草各二钱。煎服二剂，汗止喘轻，发热咳嗽稍愈。遂将前方去牡蛎，加蒌仁、地骨皮各三钱，山药改用一两，赭石改用六钱。连服十剂，诸病皆愈，为善后计，用生山药细末八钱煮粥，调白糖服之，早晚各一次。后月余。与介绍人晤面，言此时宋氏妇饮食甚多，身体较前健壮多矣。

Mrs. Song in Tianjin city, about 40 years of old, was weak in whole body condition. Two year ago, she suffered from cough and phlegm. She did not care it at all so did not go to a doctor. This spring, her condition became severe. No any improvement after tried several dose of herbs. Her pulse was: string and thin in the left side, and weak in the right side. It beats six times per breath-circle. She coughed, spit white phlegm, which is with very bad odor. She also had short of breath, self-sweat, fever after noon, which is more at night. She felt fullness in the breast, reduced diet, and constipation. It is so known that she has exhausting condition with lung disease. The tens of herbal formula she taken before were mostly focused on the treatment of the lung, not knowing to supply the Mother (The Spleen) to help the Sun (the Lung), so the healing effect was unsatisfied. For, the Zisheng Tang was used. Shanyao 24 gram, Xuanshen, Shendi, Shanyurou, 18 gram each; Muli, Shaoyao, Daizheshi 12 gram, each; Baizhu, Jineijin, Gancao 6 gram each. Two doses were prepared and given. She felt less sweet and less asthma. Fever and cough were slightly improved. Muli was then removed, but Gualuren 9 gram, Digupi 9 gram were added, Shanyao was changed to 30 gram, Daizheshi was 18 gram. Continued ten doses, whole conditions were improved. To keep the healing effect, she was asked to take Shanyao powder 24 gram to cook soup to drink (with addition of little white sugar), once in the morning and once in the afternoon. Months later, the person who introduced her to me for the treatment told that she had pretty good diet and the whole body was much stronger than before.

又：族嫂年三十五岁，初患风寒咳嗽，因懒于服药，不以为事。后渐至病重，始延医延医。所服之药，皆温散燥烈之品，不知风寒久而化热，故越治越剧，几至不起。后生于腊底回里，族兄邀为诊视。脉象虚而无力，身瘦如柴，咳嗽微喘，饮食减少，大便泄泻，或兼白带，午后身热，颧红，确系痨瘵已成。授以资生汤，加炒薏仁、茯苓片、生龙骨、生牡蛎各三钱，茵陈、炙甘草各钱半。服二剂，身热、颧红皆退，咳嗽泄泻亦见愈。后仍按此方加减，又服六剂，诸病皆痊。嘱其每日用生怀山药细末煮粥，调以白糖服之，以善其后。

Another case: One of my relatives, she was 35 years of old. She cautch Wind-Cold cough, but lazy to take medicine. Later, the problem became severe and she had to a doctor for treatment. The herbs she taken were mostly warm-disperse-drying-strong ones. It is not known that after a long time, the Wind-Cold would change/develop into Fire. So the more treatment as such, the worse the condition, so that she was almost hard to get up. At the end of the year, when I came home, her husband asked me to have a look. Her pulse was weak and Xu, her body was very slim and thin, she had cough with slight short of breath, had poor diet and diarrhea. She had discharge, fever in the afternoon, pink color on cheek. It is therefore known that she had already had exhausting condition now. She was given this Zisheng Tang, with addition of Chao Yiyiren, Fuling, Longgu and Muli 9 gram for each; Yinchen and Zhi Gancao 4.5 gram for each. After two doses, her fever and pink cheek reduced, cough and diarrhea were also near improved. This formula was kept, with little variation, for six doses. All conditions were solved. She was later asked to drink the Shanyao soup everyday, with little bit white sugar added in, for a maintenance.

杨姓女，年十九岁。出嫁二载，月事犹未见，身体羸瘦，饮食减少，干咳无痰，五心烦热，诊其脉细数有力。仿用资生汤方，用生山药一两，于术二钱，牛蒡子三钱，玄参五钱，生地黄四钱，生鸡内金一钱。连服五剂，热退咳减，食欲增加。遂于原方中去生地，倍于术。又服三剂，潮忽至。共服二十剂全愈。

Miss Yang, 19 years of old, got married for two years without menstruation at all. Her body is very thin and slim. She had poor diet and less appetite, dry cough without phlegm, hot feeling on the palms and soles. Her pulse was thin and fast but strong. Mimic the Zisheng Tang, she was given Shanyao 30 gram, Baizhu 6 gram, Niubangzi 9 gram, Xuanshen 15 gram, Shendi 12 gram, Jineijin 3 gram. Continuous five doses helped her have reduced fever and cough but increased appetite. So the Shendi was removed, but the Baizhu was doubled in the formula. With additional three doses, her menstruation came. Totally 20 doses of herbal therapy solved her problem.

族弟妇产后虚羸少食，迁延月余，渐至发灼、自汗、消瘦、乏气、干呕、头晕等证，此方书所谓蓐劳也。经医四人治不效，并添颧红作泻。适生自安东归，为之诊视，六脉虚数。检阅所服之方，有遵《医宗金鉴》三合饮者，有守用养荣汤者，要皆平淡无奇。

One of my relatives. After birth given, she suffered from poor appetite with loss of body weight for several months. She gradually had fever, self-sweat, weight loss, short of breath, dry nausea, and dizziness and so on. This is what told in book as Rulao (straw mat exhausting condition). She had tried four doctors for the treatment but all failed. She had again pink cheek and diarrhea. Just happened that I came back to the town, I had look at her. Her pulse was fast and weak. In review of the herbal formula used before, some were following 《Yizong Jinjian》Sanhe Yin, some were Yangrong Tang. All are ordinary herbal formula.

然病势至此，诚难入手，幸脉虽虚数，未至无神，颧虽红，犹不抟聚（若抟聚则阴阳离矣，不抟聚是其阴阳犹未离），似尚可治。此盖素即阴虚，又经产后亡血，气亦随之，阴不中守，阳不外固，故汗出气乏；其阴阳不相维系，阴愈亏而阳愈浮，故发烧咳嗽头晕；其颧红者，因其部位应肾，肾中真阳上浮，故发现于此，而红且热也；其消瘦作泻者，以二阳不纳，无以充肌肉，更不特肾阴虚，而脾阴胃液均虚，中权失司，下陷不固，所必然者。此是病之原委欤？

However, when the disease developed so far, it is hard to decide the direction of the treatment. The pulse was weak and fast, but not to a condition of poor Spirit yet. The cheek was pink in color, but not to a condition of Zhuanju (Zhuanju condition indicates the separation of the Yin and the Yang). Therefore, it seems that this condition is still possible to improve. The reason for her condition is that, she had original Yin deficiency for a long history. After the birth giving to lose blood, the Qi was lost too. The Yin failed to hold the inside, and the Yang failed to protect the outside of the body, so there were short of breath and self-sweat. Due to the Yin and the Yang not association, the more deficient the Yin, the more floating the Yang, so there were fever, cough and dizziness. The pink cheek is due to the cheek is associated to the Kidney. The True Yang in the Kidney floats up, so showing the pink color in the cheek. It is pink in color and felt hot too. The weight loss and diarrhea were due to the failure of the two Yang to hold the muscle, and to control the movement of the large intestine. More important, the Kidney Yin deficiency, the Spleen Yin would be also deficient. The middle part of the body is in disorder, fails to control the bowel movement, also contribute to the diarrhea. Are these not the reasons for her disease?

再四思维，遂处方，用生怀山药二两，于术三钱，玄参四钱，鸡内金、牛蒡子各二钱（此系资生汤原方稍加重），外加净萸肉、龙骨、牡蛎各五钱，止汗并以止泻。五剂后，汗与泻均止，饮食稍进，惟干咳与发热仅去十之二三。又照原方加粉甘草、天冬、生地等味，连服七剂。再照方减萸肉，加党参二钱，服四剂后，饮食大进，并能起坐矣，惟经尚未行。更按资生汤原方，加当归四钱。服数剂后，又复少有加减，一月经脉亦通。

After think and consider over and over again, she was given the formula: Shanyao 60 gram, Baizhu 9 gram, Xuanshen 12 gram, Jineijin 6 gram, and Niubangzi 6 gram. (This is the original Zisheng Tang but with higher dose), with additional Shanyurou 15 gram, Longgu 15 gram, and Muli 15 gram, to stop the sweat and diarrhea. After five doses, the sweat and diarrhea stop, appetite increased, with the cough and fever reduced 2 or 3 out of level 10. The original formula was kept but added Gancao, Tiandong and Shendi. After seven doses, remove the Shanyurou, added the herb Dangshen 6 gram. After additional four doses, her diet increased dramatically. She could sit up but still no menstruation. Follow the original Zisheng Tang, added Danggui 12 gram. After additional little modification of the ingredients for several doses, the menstruation came after one month too.

治虚劳，脉弦、数、细、微，肌肤甲错，形体羸瘦，饮食不壮筋力，或自汗，或咳逆，或喘促，或寒热不时，或多梦纷纭，精气不固。

This formula is used for the treatment of Xulao (weakness and exhausting condition). The pulse is string, frequent, fast, thin, and weak/mild. The skin is dry and cracked. The body is thin and slim, weight lost. Person can eat but seems the food does not nourish the muscle. The person feels self-sweat, or cough, or asthma, short of breath, or cold/hot shift from time to time, or heavy dreams, and sperm loss at night.

野台参（四钱）生黄（四钱）生山药（四钱）知母（四钱）玄参（四钱）生龙骨（四钱，捣细）生牡蛎（四钱，捣细）丹参（二钱）三棱（钱半）莪术（钱半）

Ingredients: wild Taishen 12 gram, Huangqi 12 gram, Shanyao 16 gram, Zhimu 12 gram, Xuanshen 12 gram, Longgu 12 gram, Muli 12 gram, Danshen 6 gram, Sanleng 4.5 gram, Ezhu 4.5 gram.

气分虚甚者，去三棱、莪术，加生鸡内金三钱；喘者，倍山药，加牛蒡子三钱；汗多者，以白术易黄芪，倍龙骨，牡蛎，加山萸肉，白芍各六钱．若其汗过多，服药仍不止者，可但用龙骨、牡蛎、萸肉各一两煎服，不过两剂其汗即止。汗止后再服原方。若先冷后热而汗出者，其脉或更兼微弱不起，多系胸中大气下陷，细阅拙拟升陷汤后跋语，自知治法。

If the Qi part is too weak, remove the Sanleng and Ezhu, add Jineijin 9 gram; if with asthma, double the Shanyao, add Niubangzi 9 gram; if with heavy sweat, replace the Huangqi with the Baizhu, double the amount of Longgu, Muli, add Shanyurou, Baoshao 18 gram each. If the sweat is still very heavy, use Longgu, Muli and Shanyurou 30 gram each to drink, only two doses would stop the sweat. Resume the original formula after the stop of the sweat. If the person has cold feeling first, then hot and then sweat, or his pulse is weak, it usually indicates the shrink of the the Qi in the chest. Check later chapter for the Qi shrink condition. You would know how to solve it.

仲景治劳瘵，有大黄蟅虫丸，有百劳丸，皆多用破血之药。诚以人身经络，皆有血融贯其间，内通脏腑，外溉周身，血一停滞，气化即不能健运，劳瘵恒因之而成。是故劳瘵者肌肤甲错，血不华色，即日食珍馐服参苓，而分毫不能长肌肉、壮筋力。或转消瘦支离，日甚一日，诚以血瘀经络阻塞其气化也。玉田王清任着《医林改错》一书，立活血逐瘀诸汤，按上中下部位，分消瘀血，统治百病，谓瘀血去而诸病自愈。其立言不无偏处，然其大旨则确有主见，是以用其方者，亦多效验。When Mater Zhang Zhongjing treat the Laoji condition, he used Dahuang Zhechong Wan, or the Bailao Wan. Both contain mostly Blood-breaking herbs. Among body meridians, everywhere has blood circulated within. The blood connects and conducts inside organs and nourishes outside skin. Once the blood stop to circulate, there would be the stop of Qi too. The Laoji condition always comes due to this condition. That’s why the person with the Laoji condition has dry and crack skin, the skin and mucus is not bright. Though he may eat lots of food with great nutrition value, he is still slim and thin, with body weigh loss day after day. This is because the blood blocks the meridian and prevents the Qi movement in the body. Dr. Wang Qingren written book 《Yilin Gaicuo》, set several formula to improve the blood circulation and to remove the block and clotted blood. The formulas are different according to their function on the body upper, middle or lower part. It is claimed to remove the blood clots, so to solve hundred of diseases. His statement is not all correct, but the formulas indeed work.

今愚因治劳瘵，故拟十全育真汤，于补药剂中，加三棱，莪术以通活气血，窃师仲景之大黄虫丸、百劳丸之意也。且仲景于《金匮》列虚劳一门，特以血痹虚劳四字标为提纲。益知虚劳者必血痹，而血痹之甚，又未有不虚劳者。并知治虚劳必先治血痹，治血痹亦即所以治虚劳也。

Now, for the aim to treat the Laoji condition, I set up this Shiquan Yuzhen Tang. To the nourishing herbal formula, I added the Sanleng and Ezhu to break the blood clot, by referring to the Master’s Dahuang Zhezhong Wan and Bailao Wan. The Master, in his book 《Jin Kui》, listed a single chapter discussing the Xuelao (exhausting condition) and he used the Blood Bi and Xulao as its outline of the chapter. From this, it is easy to know that, the person with the Xulao (exhausting condition) must have Blood Bi condition too. If the Blood Bi is severe, the person must also have the Xulao condition. It is furthermore known that to treat the Xulao, the Blood Bi must be treated first. To treat the Blood Bi means to treat the Xulao condition too.

或问：治劳瘵兼用破血之药，诚为确当之论，但破血用三棱、莪术，将毋其力过猛乎？答曰：仲景之大黄虫丸，与百劳丸所用破血之药，若大黄、干漆、水蛭，皆猛于三棱、莪术，而方中不用三棱、莪术者、诚以三棱、莪术《神农本草经》不载。至梁陶弘景着《名医别录》于《神农本草经》外增药品三百六十五味，皆南北朝以前，名医所用之药，亦未载三棱、莪术。是当仲景时犹无三棱、莪术，即有之，亦未经试验可知。而愚于破血药中，独喜用三棱、莪术者，诚以其既善破血，尤善调气。补药剂中以为佐使，将有瘀者瘀可徐消，即无瘀者亦可借其流通之力，以行补药之滞，而补药之力愈大也．况后天资生纳谷为宝。无论何病，凡服药后饮食渐增者易治，饮食渐减者难治。三棱、莪术与参、术、诸药并用，大能开胃进食，又愚所屡试屡效者也。

It may be asked: Would the use of the Sanleng and Ezhu be too strong, though it is right consideration to use the blood-breaking herbs in the treatment of Laoji condition? Answer: In the formula of Master Zhang Zhongjing, such as the Dahuang Zhechong Wan and Baolao Wan, the blood-breaking herbs, such as Dahuang, Ganxi, and Shuizhi, all are much stronger than the Sanleng and Ezhu. The Sanleng and Ezhu were not used in those herbal formulas, for the reason that the Sanleng and Ezhu are not available at that time yet in the book 《Shennun Benzao Jing》. In the Liang dynasty, Dr. Liang Hongjing written the book 《Mingyi Bielu》. He added 365 herbs to the 《Shennun Bencao Jing》. Before the South dynasty and the North Dynasty, the famous doctors did not mention the use of the Sanleng and Ezhu either. So, it is clear that in the time of the Master, there are no herb of Sanleng and Ezhu yet. Even if the two herbs were available, the doctors at that time might not test their herbal property yet. I specifically like to add the Sanleng and Ezhu in the blood-breaking herbs, for the reason that they are good to break the blood clots, but also more good at adjusting the Qi movement too. Add the Sanleng and Eizhu in the nourishing herbs, they work as assistants, to remove blood clots if the person indeed has it in the body; or to solve the stagnation side effect, through their dispersing nature, of the nourishing herbs in person who has no blood clots, so as to make the nourishing herbs work better. No matter what disease, it would be easy to solve, if the person has increased diet after drinking of the herbal tea, and it would be hard to solve, if the person’s diet reduce gradually. The Sanleng and Ezhu are used together with the Shen, Zhu and other herbs, could improve the appetite of patient. This has been well proven again and again in my experience.

或问：劳瘵之证，阴虚发热者居其强半。故钱仲阳之减味地黄丸；张景岳之左归饮，皆为对证良方，以其皆以熟地黄为君，大能滋真阴退虚热也。子方中何以独不用也？

It may asked: In the Laoji condition, most patients showed as Yin deficiency with fever. For this reason, Qian Zhongyang used Jianwei Dihuang Wan; Zhang Jingyue used Zuogui Wan. Both work well. The reason is that both use the Dihuang as the main ingredient, which can nourish the Yin so as to remove the fever. Why you do not use it in your formula?

答曰：若论用熟地，我固过来人也。忆初读方书时，曾阅赵氏《医贯》、《张氏八阵》、《冯氏锦囊》诸书，遂确信其说。

Answer: to talk about the use of Shoudi, I have experience too. At beginning of reading the herb books, I read Dr. Zhao book 《Yi Guang》、《Zhangshi Bazhen》、《Fengshi Jingnang》and I believed it.

临证最喜用熟地，曾以八味地黄丸作汤，加苏子、白芍，治吸不归根之喘逆；

I was good at the use of the herb Shoudi. I had used Bawei Dihuang Wan as a herbal extract, with the addition of Souzi and Baishao, to treat the asthma due to the inhalation failing to reach the deep.

I added Chenpi and Baishao, to treat the cough and heavy phlegm, due to the upper-overwhelming-lower-weak condition.

加苏子、浓朴，治肾不摄气，以致冲气上逆之胀满（时病患服之觉有推荡之力，后制参赭镇气汤治此证更效，

I added herb Souzi and Houpo, to treat the chest fullness condition that is due to Qi upper-floating, which is again due to the Kidney fails to attract the Qi down to the Kidney (Some times, patients may feel a pushing force after drinking of the herbs. Later I set up the Shenzhe ZhenQi Tang, which is more effective).

又尝减茯苓、泽泻三分之二，治女子消渴小便频数（《金匮》谓治男子消渴以治女子亦效，案详玉液汤下），

I tried to remove the Fuling and Zexie to one third, to treat women with thirsty but frequent urine (In the book《Jing Kui》, this formula is used to treat the man with thirsty, here I tried to treat women with thirsty and it works too. See the explanation in detail in the Chapter for Yuye Tang).

又尝去附子，加知母、白芍，治阴虚不能化阳，致小便不利积成水肿；

I tried to remove Fuzi, but add Zhimu and Baishao, to treat the condition, in which the Ying is weak, so not be able to develop/transform into the Yang, causing the harsh in urination and swelling).

I tried to prepare the Liuwei Dihuang Wan as Tang form (the extraction form), with the addition of Chuangqun and Zhimu, to treat the headache that feels as the head to break.

加五味、枸杞、柏子仁，以敛散大之瞳子，且信其煎汁数碗，浩荡饮之之说；

I also added Wuweizi, Goujizi and Boziren, to treat the enlarged pupil. I trusted what it is said to drink several bowl of the herbs, making it work as a water in a big river.

I used Shoudi 120 gram, and Fuling 30 gram, to stop the diarrhea that is so severe as the slippery of the stool out of anus.

I also used Shoudi 120 gram, Baishao 30 gram, to solve the harsh urine due to Yin deficiency.

又尝于一日之中用熟地斤许，治外感大病之后，忽然喘逆，脉散乱欲脱之险证（此证当用后来复汤，彼时其方未拟出，惟知用熟地亦幸成功，是知冯楚瞻谓熟地能大补肾中元气诚有所试也），且不独治内伤也；

I tried to use Shoudi more than 300 grams, to solve the sudden asthma after a severe disease. The pulse is dispersed, and Yin and Yang are to escape (the condition later is solved by the use of Laifu Tang. But at that time when I use the large amount of Shoudi, this formulae has not been set up yet. I only knew that, the Shoudi works by chance, since Mr. Feng Xhuzhang stated that Shoudi can contribute a big supply to the Yuan Qi in the Kidney and I tried).

又尝用熟地、阿胶大滋真阴之类，治温病脉阳浮而阴不应，不能作汗，一日连服二剂，济阴以应其阳，使之自汗（详案在寒解汤下）；

I used the Shoudi and Ajiao to make big supply of True Yin, to treat the condition in which the person have no sweat in a Wen Disease, in which the pulse is floating but the Yin has no response to the sweating therapy. The patient was asked to drink the herbal tea twice a day, to nourish the Yin, so as to help the Yang in the body, to create the sweat (see detail in the Chapter in the Hanjie Tang).

并一切伤寒外感，因下元虚惫而邪深陷者，莫不重用熟地，补其下元，即以托邪外出。

For all Cold-invasion condition, the Xie Qi shrink deeper inside the body, due to the lower part of the body (the Lower Jiao) being weak. In such condition, I always used large amount of Shoudi to supply the lower Jiao, so to push the Xie Qi out of the body.

惟用以治阴虚劳热之证，轻者可效，若脉数至七八至鲜有效者。

Only when I used it in the Yin Deficiency with fever, it worked in mild cases, but not in a condition, in which the pulse is frequent as seven to eight times per breath circle.

彼时犹不知改图，且以为地黄丸，即《金匮》之肾气丸，自古推为良方，此而不效，则他方更无论矣，不知肾气丸原用干地黄，即药坊间之生地也，其桂用桂枝，即《神农本草经》之牡桂也，与今之地黄丸迥不侔矣。

At that time, I do not realize to check or to change the formula. I though that the Dihuang Wan is the same one as introduced in the 《Jing Kui》. This formula has been recommended to be marvelous formula from history. If it does not work, there would have no other choices. I did not realize that the Dihuang used in the 《Jing Kui》is the not cooked Shengdi, not the Shoudi. The herb Gui, should be the Guizhi, e.g. the Mugui in the 《Jing Kui》, not Rougui, so it is completely a different formula as what I used from previous books.

其方《金匮》凡五见，一治“脚气上入少腹不仁”；一治“虚劳腰痛，少腹拘急，小便不利”；一治“短气有微饮，当从小便去之”；一治“男子消渴，小便反多，饮一斗，小便一斗”；一治“妇人转胞，胞系了戾，不得溺”。统观五条，原治少腹膀胱之疾居多，非正治劳瘵之药，况后世之修制，又失其本然乎。

The Shenqi Wan in the book 《Jing Kui》has five major applications: first, it is used for Jiaoqi pushing up, and lower abdomen uneasy feeling; second, for weakness and pain in the lower back, the lower abdomen spasm, harsh in urine; third, for short of breath, the mild Yin condition needs to be removed from urine; fourth, in man with thirsty, the urine however is very much, in which drinking one liter, there would urinate one liter; fifth, in woman with twist of uterus, no way to have urination. Apparently, to have a look at all the five applications, it is originally used mostly for the lower abdomean and urine bladder problems, not for the exhausting condition. The later doctors modified its application, lost its original meaning.

后治一妇人，年近五旬。身热劳嗽，脉数几至八至。先用六味地黄丸加减作汤服不效，继用左归饮加减亦不效。

Later, I had a female patient about fifty years of old. She suffered from fever and exhausting cough. The pulse was up to eight times per breath circle. I had used Liuwei Dihuang Wan, in a form of herbal tea, not as pills, and also used Zuogui Wan. None worked.

愚忽有会悟，改用生黄芪六钱、知母八钱为方，数剂见轻，又加丹参、当归各三钱，连服十剂全愈。以后凡遇阴虚有热之证，其稍有根柢可挽回者，于方中重用黄芪、知母，莫不随手奏效。始知叔和脉法谓数至七八至为不治之脉者，非确论也。

I suddenly realized to change to use the Huangqi 18 gram, Zhimu 24 gram. Afer several doses, the condition was improved. Then I added Danshen and Danggui each for 9 gram. Continued herbs for ten doses, all the condition were solved. So, later, once there are cases with Yin deficiency and fever, and if there is still chance to solve the condition, added in the formula the large amount of herb Huangqi and Zhimu. There has no chases failed since. By this experience, I started to know that, it is not always true that the Mr. Shouhe’s statement that it would be no way to help if the pulse reached up to eight times per breath circle.

盖人禀天地之气以生，人身之气化即天地之气化，天地将雨之时，必阳气温暖上升，而后阴云会合大雨随之。黄芪温升补气，乃将雨时上升之阳气也；知母寒润滋阴，乃将雨时四合之阴云也。二药并用，大具阳升阴应云行雨施之妙。膏泽优渥烦热自退，此不治之治也。

Human being is birth after absorption of the Qi in the heaven and the earth. The Qi development and transformation in the human body and the universe are similar. When the sky is to have rain fall, there must be warm Yang Qi floating up, then the cloud accumulated to cause the rain. The herb Huangqi works to rise the body Qi, similar to the up rising warm Qi on the earth before the rain; the herb Zhimu is cold and wet in herbal nature. It works as the cloud accumulation in the sky before the rain. The combination of the two herbs works as the rising warm Qi and the cloud in the sky before the rain. With the raining, the annoying hot of course will reduce. This is a way of treatment without direct treatment.

况劳瘵者多损肾，黄芪能大补肺气，以益肾水之源，使气旺自能生水，而知母又大能滋肺中津液，俾阴阳不至偏胜，即肺脏调和，而生水之功益普也（黄芪、知母虽可并用以退虚热，然遇阴虚热甚者，又必须加生地黄八钱或至一两，方能服之有效）。

In addition, in a Laoji condition, the person usually has also damage in the Kidney. The herb Huangqi can supply Lung Qi, to supply the upper water source for the Kidney, making the sufficient Qi to nourish the Water. The herb Zhimu can additionally nourish the water part in the Lung, making the Yin and the Yang not over to another extreme, e.g. making the Yin and Ying harmony in the Lung, so as to be able to produce more water in the body. (Huangqi and Zhimu together can remove the Xue Hot/fever. However, in a severe condition, the Shengdi is still needed in the formula to reduce the Xue fever.)

或又问：肾气丸虽非专治虚劳之药，而《金匮》虚劳门，明载其治虚劳腰疼，似虚者皆可服之，子独谓无甚效验，岂古方不可遵欤？

It might be asked: in deed the Shenqi Wan is not specifically used for the treatment of the Xulao condition. However, in the Xulao Chapter of the book《Jing Kui》, it is indicated it can be used for the treatment of Xulao lower back pain. It seems that everyone with the weak condition can use it. How could you say that it does not work. Do you mean that the old formula should not be followed?

答曰：肾气丸若果按古方修制，地黄用干地黄，桂用桂枝，且止为丸剂，而不作汤剂，用之得当，诚有效验。

Answer: If the Shenqi Wan is prepared as it is originally asked, e.g. the herb Dihuang is the Shengdi, the herb Gui is the Guizhi, and they are prepared as pills, not the liquid extraction, and if used in the proper clinic condition, it of course works.

盖生地能逐血痹（《神农本草经》），而熟地无斯效也。桂枝能调营卫，而肉桂无斯效也。血痹逐，则瘀血自消，营卫调，则气血自理。至于山萸肉之酸温，亦能逐痹（《神龙本草经》山茱萸逐寒湿痹）。牡丹皮之辛凉，亦能破血。附子之大辛大温，又能温通血脉，与地黄之寒凉相济，以共成逐血痹之功。是肾气丸为补肾之药，实兼为开瘀血之药，故列于《金匮》虚劳门，而为要方也。

The herb Shengdi can remove and dissolve the Blood Bi condition, but the Shoudi cannot. The Herb Guizhi can adjust and hamony the Ying and Wei, but the Rougui cannot. When the blood Bi condition is dissolved, the stagnated and clotted blood would disappear; the Ying and the Wei Qi are in harmony, the Qi and the Blood work well. For herb Shanyurou, it is sour in herbal nature. It can also dissolve the Blood Bi condition (in the bood （《Shennong Bencao Jing》, Shanzhuyu can dissolve the Cold-Wet Bi）. Herb Mudanpi is cold and spicy in herbal nature. It can also break the blood clot. Herb Fuzi is strong spicy and strong warm. It can warm and conduct the blood vessels. The Fuzi and the Dihuang, one is warm and one is cold. They work together to remove the blood clots. The ShenQi Wan is the Kidney nourishing formula, but also be able to dissolve the blood stagnation and clots. For this reason, it is listed in the book《Jing Kui》Xulao chapter as the most important herbal formula.

其止为丸剂，而不作汤剂者，诚以地黄经水火煎熬，则汁浆稠粘、性近熟地，其逐血痹之力必减，是以《神农本草经》，谓地黄生者尤良也。后贤徐灵胎曾治一人，上盛下虚，胸次痰火壅滞，喘不能卧，将人参切作小块，用清水理痰之药煎汤，送服而愈。后其病复发，病家自用原方，并人参亦煎服，病益甚，灵胎仍教以根据从前，可以悟古人制肾气丸之精义矣。

The reason to make it in pills not in herbal tea form is that the Shendi, after cook in water, becomes sticky and changed its nature similar to the Shoudi. Its ability to melt the blood clots would reduce. This is why in the 《Shennong Bencao Jing》it is said that the non-cooked Shendi is super. Later Dr. Xu Lingtai treated a patient, who has a condition of upper overwhelming but lower weakness. He had accumulated phlegm and Fire in the chest, hard to have breath or lie evenly. The doctor asked to cut herb Renshen into small pieces, cook the Renshen in the pure water and herbs that work to remove phlegm. Drink the herbal tea. The disease is solved. Later, the disease recurred, the family used the same formula and cooked the Renshen together with the other herbs. After drinking, the disease became worse. Doctor Xu asked them prepare the tea as before and the disease was solved again. Here, we can realize the fine meaning of the old Chinese doctors in the herbal preparation.

或又问：肾气丸既按古方修制，可以有效，而《金匮》虚劳门，肾气丸与大黄蟅虫丸之外，又有七方，皆可随证采择，则子之十全育真汤，似亦可以不拟欤？

It may also be asked: The Shenqi Wan, if prepared as originally required from that book, might work. In the chapter for Xulao in the book《Jin Kui》, apart from the Shenqi Wan and Dahuang Zhechong Wang, there are other seven formulas, all of which can be used in clinic. You set up your own formula Shiquan Yuzheng Tang. Could your formula be omitted or not recommended?

答曰：《金匮》虚劳门诸方，虽皆有效，而一方专治虚劳门一证。若拙拟十全育真汤，实兼治虚劳门诸证。如方中用黄芪以补气，而即用人参以培元气之根本。用知母以滋阴，而即用山药、元参以壮真阴之渊源。用三棱、莪术以消瘀血，而即用丹参以化瘀血之渣滓。至龙骨、牡蛎，若取其收涩之性，能助黄芪以固元气；若取其凉润之性，能助知母以滋真阴；若取其开通之性（《神农本草经》龙骨主瘕，后世本草亦谓牡蛎消血），又能助三棱、莪术以消融瘀滞也。至于疗肺虚之咳逆、肾虚之喘促，山药最良。治多梦之纷纭，虚汗之淋漓，龙骨、牡蛎尤胜。此方中意也，以寻常药饵十味，汇集成方，而能补助人身之真阴阳、真气血、真精神，故曰十全育真也。

Answer: though the herbal formulas in the book, all work well, each formula works for a specific disorder/condition. My formula however works for all kinds of the Xulao condition (exhausting condition). For example, the Huangqi in the formula works to supply Qi, Renshen works to enhance the basic foundation of the Yuan Qi. The herb Zhimu works to nourish the Yin, and the Shanyao and Yuanshen to enhance the source of the True Yin. The Sanleng and Ezhu are to melt the stagnated/clotted blood, then the Danshen to remove the residue of the clots. The Longgu and Muli, by their contracting nature, work to help Huangqi to enhance Yuan Qi; by their cold-wet nature, to help Zhimu to nourish the Tru Yin; by their opening nature, to help Sanleng and Ezhu to melt the blood stagnation/clots. (in the book 《Shennong Bencao Jing》, Longgu work to dissolve accumulated mass. Later published herb books also indicate the herb Muli to melt the clotted blood.). To talk about the treatment of asthma and cough due to Lung deficiency, short of breath due to Kidney deficiency, the herb Shanyao is the best choice. To treat multiple dreams and heavy sweat, the Longgu and Muli are the best choice. These are the meaning in the formula to use these herbs. With such ordinary about ten herbs, the formula can nourish the body True Yang, True Yin, True Qi and Blood, True Spirit. So it is called Shiquan Yuzhen Tang. [1]

劳瘵者多兼瘀血，其证原有两种：有因劳瘵而瘀血者，其人或调养失宜，或纵欲过度，气血亏损，流通于周身者必然迟缓，血即因之而瘀，其瘀多在经络；有因瘀血而成劳瘵者，其人或有跌伤碰伤，或力小任重，或素有吐衄证，服药失宜，以致先有瘀血，日久浸成劳瘵，其瘀血多在脏腑。此二者服十全育真汤皆可愈。而瘀血在脏腑者，尤须多用破血之药。又瘀在经络者，亦可用前方资生汤，加当归、丹参。瘀在脏腑之剧者，又宜用拙拟理冲汤，或理冲丸。此数方可参变汇通，随时制宜也。

Laoji condition is usually accompanied with blood stagnation condition. There are two clinic manifestations: first, the blood stagnation is due to the Laoji. The person did not have reasonable/healthy diet habit, or he has too much sex activity, both of which cause the deficiency in the Blood and Qi, making lower the circulation of the blood and Qi in the body. The blood is therefore stagnated. In this case, the stagnation is more in the meridian (skin surface). Second, the blood stagnation causes the Laoji condition. The person may have had physical trauma or damage in the body, or he bear heavy physical labor that is much beyond his physical body, or he has had long term of bleeding from cough, running nose, vomiting or by other ways. Previous treatment did not work, so the condition prolongs to form the Laoji condition. In this case, the blood stagnation is usually in the inside organs. For both conditions, the Shiquan Yuzheng Tang works. However, if the blood stagnation is inside the body, the clot-breaking herbs are needed to add. If the blood stagnation is in the meridian(body surface), Danggui and Danshen can be added in the previous Zisheng Tang for the treatment. If the stagnation is more inside the body, use my formula of Lichong Tang, or Lichong Wan. These formula can be used with little modification to meet the clinic conditions.

世俗医者，遇脉数之证，大抵责之阴虚血涸。不知元气虚极莫支者，其脉可至极数。设有人或力作，或奔驰，至气力不能支持之时，其脉必数。乃以力倦之不能支持，以仿气虚之不能支持，其事不同而其理同也。愚临证细心体验，凡治虚劳之证，固不敢纯用补药，然理气药多于补气药，则脉即加数，补气药多于理气药，则脉即渐缓。是知脉之数与不数，固视乎血分之盈亏，实尤兼视乎气分之强弱。故此十全育真汤中，台参、黄芪各四钱，而三棱、莪术各钱半，补气之药原数倍于理气之药。若遇气分虚甚者，犹必以鸡内金易三棱、莪术也。

Ordinary doctors contribute frequent pulse usually to the Yin Xu and Blood exhaust. They do not know when the Qi is extreme exhausted, there would be also extreme frequent pulse. This is as one works very hard in labor, or one runs, when he has no more energy, his pulse would be frequent. Here we take this physical tiredness to explain the Qi deficiency. The different cases but share the same meaning. During my clinic experience, I dared not to use the nourishing herbs only, when I treat the exhausting condition. If the Qi-adjusting herbs are more than the Qi-nourishing herbs in a formula, the pulse would be frequent. If the Qi-nourishing herbs are more than the Qi-adjusting herbs, the pulse would be not frequent. So it is known that the frequency of the pulse though depends on the amount of the Qi and Blood, also more on the amount of the Qi in the body. For this reason, in the Shiquan Yuzheng Tang, Taishen and Huangqi are both 12 gram, but the Sanleng and Ezhu are only 4.5 gram. The Qi-nourishing herbs are double of the Qi-adjusting herbs. If the Qi is extreme exhausted, the Sanleng and Ezhu must be replaced by herb Jineijing.

药性之补、破、寒、热，虽有一定，亦视乎服药者之资禀为转移。尝权衡黄芪之补力，与三棱、莪术之破力，等分用之原无轩轾。尝用三棱、莪术各三钱，治脏腑间一切瘕积聚，恐其伤气，而以黄芪六钱佐之，服至数十剂，病去而气分不伤，且有愈服而愈觉强壮者。若遇气分甚虚者，才服数剂，即觉气难支持，必须加黄芪，或减三棱、莪术，方可久服。盖虚极之人，补药难为攻，而破药易见过也。若其人气壮而更兼郁者，又必须多用三棱、莪术，或少用黄芪，而后服之不至满闷。又尝权衡黄芪之热力，与知母之寒力，亦无轩轾，等分用之可久服无寒热也（此论汤剂作丸剂则知母寒力胜于黄芪热力）。而素畏热者，服之必至增热，素畏寒者，服之又转增寒，其寒热之力无定，亦犹补破之力无定也。故临证调方者，务须细心斟酌，随时体验，息息与病机相符，而后百用不至一失也。

Though the herbal nature of a herb is fixed, it may change according to the person’s body nature. For example, if we compare the Qi-nourishing nature of the Huangqi with the Qi-breaking nature of the Sanleng and Ezhu, they have no major difference with equal amount for both. If we use 9 gram of Sanleng and 9 gram of Ezhu to solve the mass accumulation condition, for fearing they may damage the body Qi, 18 gram of the Huangqi would be used. Upon the use of tens of doses, the disease would be solved without the damage of the Qi. Someone may feel even stronger with more intake of the herbs. However, if the person is very week in the Qi condition, he may feel very tired and exhausted with the intake of the same herbs. So, more amount of Huangqi has to be involved, or the amount of the Sanleng and Ezhu has to be reduced, for that aim to take it for a long time. When a person is very weak, nourishing herbs are not easy to work, but Qi-breaking herbs are easy to cause damage to the body. If the person is very strong and has Qi stagnation, the herb Sanleng and Ezhu have to be used in large amount, or that of Huangqi has to be reduced, so as to prevent fullness feeling in the chest after the herb intake. Forthermore, if we compare the hot nature of the Huangqi with the cold nature of the Zhimu. They are similar actually. If they are taken in equal amount, there would have no major influence on body cold or hot (if they are used as pills, then the Zhimu is colder than the hot nature of the Huangqi). If the person is easy to feel cold, the two herbs may cause more cold to him. If the one is easy to feel hot, the two herbs may cause more hot to him. Apparently, the cold or hot effect of the herbs are not really fixed, as their nourishing or breaking nature are not fixed. For this reason, doctors must be very careful in herbal prescription. Check the person’s body reaction and adjust the herbs accordingly to prevent any mistake.

弟长男媳，年二十四岁，于本年（丙寅）正月间患寒热往来，自原素畏服药，故隐忍不肯言。至四月初，家人来迓弟，言儿媳病剧。回家视之，虽未卧床不起。而瘦弱实难堪矣。诊其脉，弦而浮数。细询病情，言每逢午后先寒后热，时而微咳无痰，日夜作泻十余次，黎明则头汗出，胸间绵绵作疼，食一下咽即胀满难堪，而诸虚百损之状，显然尽露。筹思良久，为立逍遥散方。服两剂无效。因复至沧取药，适逢张××自津来沧，遂将儿媳之病细述本末。张××曰：“以弟之意，将用何方以治之？”答曰：“余拟将资生汤、十全育真汤二方，汇通用之，可乎？”张××曰：“得之矣。此良方也，服之必效。”弟遂师二方之义，用生怀山药八钱，生白术、净萸肉、生鸡内金、生龙骨、生牡蛎、鲜石斛各三钱，丹参四钱。连服四剂，诸证皆大轻减。又于原方加三棱、莪术（十全育真汤中用此二药者，因虚劳之证多血痹也。）各一钱，粉丹皮、地骨皮各二钱。又连服八剂，诸病悉退，饮食增加，今已完全成功矣。

A lady, 24 years of old, one of my relatives. She suffered from cold-hot shift from January. She usually feared to take medicine, so did not tell her family. Up to the early April, her family member came to me, and said her condition was worse. I followed him home and found that the patient was very slim and thin, though not to a level of hard to get up. Her pulse was floating and frequent. Upon ask, she said every afternoon, she first felt cold, then hot. She had cough from time to time without phlegm. She had diarrhea tens of times every day. In the early morning, she had sweat on the head and felt slight pain on her chest. Even a little eat could cause very much fullness feeling in stomach. All of her conditions show the exhausting and extreme exhausting condition. I have been considered again and again, then prescribed her herbal formula XiaoyaoSan. Two days treatment did not work at all. When I went to Cang county to take herbs, I met Mr．Zhang who came from Tianjing city there. So I told him the patient condition and the history of the treatment. He asked me, what are you going to do for the treatment now? I said, I am going to use the combination of the Zisheng Tang and the Shiquan Yuzheng Tang. Is it ok? He answered: this is good consideration. I would work. So, I followed the meaning of your two formulas, used Shanyao 24 gram; Baizhu, Shanyurou, Jineijin, Longgu, Muli, and Shihu 9 gram each; and Danshen 12 gram. After four days, every condition is much improved. So, herb Sanleng and Ezhu, 3 gram each, were added in the formula (since these two herbs are originally used in the Shiquan Yuzheng Tang, for the reason that the exhausting condition is usually mixed with the blood stagnation condition). In addition, herb Danpi and Digupi, 6 gram each, were added too. After eight days (8 doses intake), the whole condition of the patient was much improved. She had pretty good diet now.

This formula is used to treat exhausting condition with fever, or asthma, or short of breath, or cough, with weak and frequent pulse.

生山药（一两）大生地（五钱）人参（四钱）玄参（四钱）生赭石（四钱，轧细）牛蒡子（三钱，炒，捣）天冬（四钱）甘草（二钱）

Shanyao 30 gram, Shengdi 15 gram, Renshen 12 gram, Xuanshen 12 gram, Daizheshi 12 gram, Niubangzi 9 gram, (fried, grinded), Tianmendong 12 gram, Gancao 6 gram.

劳热之证，大抵责之阴虚。有肺阴虚者，其人因肺中虚热熏蒸，时时痒而作嗽，甚或肺中有所损伤，略一动作，辄发喘促，宜滋补肺阴，兼清火理痰之品，有肾阴虚者，其人因肾虚不能纳气，时时咳逆上气，甚或喘促，宜填补下焦真阴。兼用收降之品。若其脉甚数者，陈修园谓，宜滋养脾阴。盖以脾脉原主和缓，脉数者必是脾阴受伤，宜于滋阴药中，用甘草以引之归脾，更兼用味淡之药，如薏米、石斛之类。特是人身之阴，所盖甚广，凡周身之湿处皆是也。

Lao-re condition (exhausting condition with fever) is mostly contributed to the Yin deficiency. The person has Xu Fire in the lung to steam, so has cough from time to time with itch in throat. In severe case, the lung is severely damaged or deteriorated, very little physical activity may cause heavy cough to cause asthma or short of breath. For the treatment, it is needed to nourish the Lung Yin, together with herbs to remove Fire and to clear the Phlegm. If it is due to the Kidney Yin deficiency, the person cannot inhalated deep, but has rushing-up cough frequently. In severe case, he may have asthma or short of breath. For the treatment, it should be to nourish the True Yin in the lower Jiao, in addition with some contracting-nature herbs. When the pulse is very much frequent, Dr. Xhen Xiuyuan said that the Yin-nourishing therapy should be used. The reason is that the Spleen dominates slow, mild, and soft. Frequent pulse suggests the damage in the Spleen, so herb Gancao should be added in the Yin-nourishing herbs to also nourish the Spleen, with additional use of light-nature herbs, such as Yiyiren or Shihu and so on. The reason is that, the Yin in the body distributes very broad. The Wetness in all of the body belongs to the Yin.

故阴虚之甚者，其周身血脉津液，皆就枯涸。必用汁浆最多之药，滋脏腑之阴，即以溉周身之液，若方中之山药、地黄是也。

Therefore, when the Yin deficiency is severe, the body blood and Jingye would all be dried up. Herbs that contains more juice must and have to be used, to nourish the Yin of the organs, e.g. to irrigate the body liquid. Such herbs are as Shanyao and Shendi in the formula.

然脉之数者，固系阴虚，亦系气分虚弱，有不能支持之象，犹人之任重而体颤也。故用人参以补助气分，与玄参、天冬之凉润者并用，又能补助阴分。且虑其升补之性，与咳嗽上逆者不宜，故又佐以赭石之压力最胜者，可使人参补益之力下行直至涌泉，而上焦之逆气浮火，皆随之顺流而下；更可使下焦真元之气，得人参之峻补而顿旺，自能吸引上焦之逆气浮火下行也。

However, the frequent pulse could be due to the Yin deficiency, but also to Qi deficiency. The body shows evidence of hard to handle the body function, such as the person’s body shacking upon too heavy burden on his body. So, herb Renshen is needed to nourish the Qi. It, when used together with the Xuanshen and Tianmendong, for their cold-wet nature, can also nourish the Yin. For worry that it may not be suitable for person with cough, for its rising-nature, herb Daizheshi was used to suppress the nourishing effect of the Renshen downwards to the Yunquan (acupuncture point on front-middle of the sole). By this way, the rushing-up Fire and Qi can flow down, to nourish the True Yuan Qi in the Lower Jiao, which again can absorb the up-rushing Fire down.

至于牛蒡子与山药并用，最善止嗽，甘草与天冬并用，最善润肺，此又屡试屡效者也。

The use of Niubangzi and the Shanyao together can solve the cough; Gancao and Tianmendong, are good at irrigating the lung. These have been tested and experience in my clinic work again and again.

初制此方时，原无赭石，有丹参三钱，以运化人参之补力。后治一年少妇人，信水数月不行，时作寒热，干嗽连连，且兼喘逆，胸隔满闷，不思饮食，脉数几至七至。治以有丹参原方不效，遂以赭石易丹参，一剂咳与喘皆愈强半，胸次开通，即能饮食，又服数剂脉亦和缓，共服二十剂，诸病皆愈。

In the beginning, the formula did not contain the Daizheshi, but has Danshen 9 gram to transport the nourishing effect from the Renshen. Later in the treatment of a woman, who had no menstruation for several months, had cold/hot shift feeling, frequent dry cough with asthma-like short of breath, fullness feeling in the chest, no appetite, and had pulse several to seven times per breath-circle, the use of the formula containing the Danshen did not work. So later the Danshen was replaced with the Daizheshi. One dose solved the cough and asthma to half level, the fullness in chest was reduced, that appetite was increased. Additional doses made the pulse milder and slower. Totally twenty days of treatments solved all problems.

以后凡治妇女月闭血枯，浸至虚劳，或兼咳嗽满闷者，皆先投以此汤，俾其饮食加多，身体强壮，经水自通。间有瘀血暗阻经道，或显有瘕可据者，继服拙拟理冲汤，或理冲丸以消融之，则妇女无难治之病矣。若其人胸中素觉短气，或大便易滑泻者，又当预防其大气下陷（大气下陷详升陷汤）。用醴泉饮时，宜减赭石、牛蒡子，并一切苏子、蒌仁、紫菀、杏仁，治咳喘套药皆不宜用．

Later, whenever meet a female patients with stop of menstruation and her condition comes to the exhausting condition that is accompanied with cough and fullness in the chest, this formula is used first. When the appetite is improved, the body is stronger, the menstruation is solved. If there is stagnated or clotted blood that blocks the blood conduct in the uterus, or there is evidence for the presence of some mass in the uterus, use my formula of Lichong Tang, or Lichong Wan to melt the mass. By this way, there is no difficult disease in women to treat. If the person feel short of breath in chest, or he is easy to have diarrhea, it should be prevented the Da Qi shrink (see later Chapter). In such case, in the use of the Liquan Yin, the amount of Daizheshi and Niubangzi should be reduced. In addition, the herb Souzi, Gualuren, Ziyuan and Xingren, and all regularly used herbs for cough should not be used.

按：短气与喘原迥异。短气者难于呼气不上达也。喘者难于吸气不下降也。而不善述病情者，往往谓喘为“上不来气”，是以愚生平临证，凡遇自言上不来气者，必细细询问，确知其果系呼气难与吸气难，而后敢为施治也。
Explanation: the short of breath is different from the asthma. Short of breath means the exhalation cannot reach the upper. The asthma means the inhalation cannot reach down to the bottom. For person who is not good at talk or describe his feeling, he may just tell “short of breath”. So, in my clinic, once I meet such person telling “hard to breath”, I would ask him very carefully to verify he has difficulty in inhalation or exhalation before my treatment.

又按：方书名咳喘曰“咳逆”，喘曰“喘逆”，因二证多由逆气上干也。而愚临证实验以来，知因大气下陷而咳喘者，亦复不少。盖肺悬胸中，必赖大气以包举之，而后有所附丽；大气以鼓舞之，而后安然呼吸。大气一陷，则包举之力微，肺即无所附丽，而咳嗽易生。鼓舞之机滞，肺必努力呼吸，而喘促易作。曾治一少年，泄泻半载方愈。后因劳力过度，觉喉中之气不舒，五六呼吸之间，必咳嗽一两声，而其气始舒．且觉四肢无力，饮食懒进．诊其脉微弱异常，知其胸中大气下陷，投以拙拟升陷汤，数剂而愈。
Explanation again: In medical books, the cough-asthma is termed either “rushing-up cough” or “rushing-up asthma”, since the cough and the asthma are usually caused by rushing-up Qi. However, in my experience, in many cases, they can also be caused by the shrink of Big Qi[3] from the chest. The lung is in the chest, around and lifted by the Big Qi; the Big Qi support the lung, which can then be able to work as breath. If the Big Qi shrink down, the force to cover and to support the lung decreased, the lung has not place to attach, so the cough happens. To support the Qi and remove the Qi stagnation, the lung has to work hard, so the asthma happens. I have had a teenage patient. He suffered from long term diarrhea. Later, he felt hard to breath, felt something in the throat, due to a heavy labor work. For every five to six breath, he must have a cough once or twice. By this way, he could feel little better. He also felt tired in the arms and legs, lazy to eat. The pulse felt very weak and mild. It is so known that he has Di Qi shrink condition. He was given my Shengxian Tang, and his problem was solved after only several doses of herbs.

又：曾治一人，年近五旬，素有喘疾。因努力任重，旧证复发。延医服药罔效。后愚诊视其脉，数近六至，而兼有沉濡之象。愚疑其阴虚不能纳气，因其脉兼沉濡，不敢用降气之药。遂用熟地、生山药、枸杞、玄参大滋真阴之药，大剂煎汤，送下人参小块二钱，连服三剂脉即不数，仍然沉濡，喘虽见轻，仍不能愈��

There is another case. A patient of fifty years of old suffered from asthma for long time. Due to heavy labor work, his asthma recurred. He tried several doctors and drunk various herbs but all failed. When I later saw him, his pulse is frequent as to six times per breath-circle. The pulse was also felt kind of deeper and ru[4]. I doubt his condition belongs to Yin deficiency that made him hard to inhale. For the pulse of deeper and ru, I dared not to use QI-shrinking herbs in the formula. So what I use are Shoudi, Shanyao, Goujizi, and Xuanzhen, such Yin-nourishing herbs. After cook, used 6 gram of Renshen with the herbal tea to drink. Continuous intake of three doses did not work. The pulse was still deep and ru. The asthma though was reduced, but not completely disappeared.

因思此证得之努力任重，胸中大气因努力而陷，所以脉现沉濡，且其背恶寒而兼发紧，此亦大气下陷之征也。亦治以升陷汤，方中升麻、柴胡、桔梗皆不敢用，以桂枝尖三钱代之。因其素有不纳气之证，桂枝能升大气，又能纳气归肾也（理详参赭镇气汤下）。又外加滋阴之药，数剂全愈（详案在升陷汤下）。按此二证之病因，与醴泉饮所主之病迥异，而其咳喘则同。必详观升陷汤后跋语，及所载诸案，始明治此二证之理。而附载于此者，恐临证者审证不确，误以醴泉饮治之也。

I then considered his condition was due to hard labor work, that made the Big Qi in the chest shrink, so the pulse is deep and ru. In addition, his back felt chilly and tight, both of which are the evidence for the Big Qi shrink. He was also given the Shengxian Tang. However, the herb Shengma, Chaihu and Jiegen were not used for fear. All the three were replaced with Guizhi Jian. The reaon for such modification is that he had the difficulty in inhalation for a long time. The herb Guizhi can raise the Big Qi, and also bring the Qi back to the Kidney. With addition of other Yin-nourishing herbs, several doses of the formula solved all problems for him. The reason for the diseases in these two cases is different from the main application of the Liquan Yin here, but the cough and the asthma are the same. Readers can check later chapters for the Shengxian Tang, for the explanation and the attached case examples, to understand the principle and meaning here. The two cases are cited here is for the fear that the readers might make mistake in clinic diagnosis and in the use of Liquan Yin.

沈阳娄××，年二十二，虚劳咳嗽，其形羸弱，脉数八至，按之即无。细询之，自言曾眠热炕之上，晨起觉心中发热，从此食后即吐出，夜间咳嗽甚剧，不能安寝。因二十余日寝食俱废，遂觉精神恍惚，不能支持。愚闻之，知脉象虽危，仍系新证，若久病至此，诚难挽回矣。遂投以醴泉饮，为其呕吐，将赭石改用一两（重用赭石之理详参赭镇气汤下），一剂吐即止，可以进食，嗽亦见愈。从前五六日未大便，至此大便亦通下。如此加减服之，三日后脉数亦见愈。然犹六至余，心中犹觉发热，遂将玄参、生地皆改用六钱，又每日于午时，用白蔗糖冲水，送服西药阿斯匹林（药性详参麦汤下）七厘许。数日诸病皆愈，脉亦复常。

Mr. Lu, 22 years of old, lived in Shenyang city. He suffered from exhausting condition with cough. He was very slim and thin. His pulse was frequent as up to eight times per breath-circle. The pulse was hard to feel when press deep. Careful consultation showed that he had slep on hot bed. Next morning, he felt hot in heart. Later he had vomiting after eat, had cough that was worse at night so as not be able to have a sleep. For such condition has last for twenty days, he now felt dizziness and cloudy in mind, hard to support his body. When I saw him, I thought that his condition is newly developed, which is still possible to solve, though the pulse was a sign of a very high emergency condition. If a long term disease develops to such pulse, it would be hard to solve. He was given Liquan Yin. For his having nausea, the amount of Diazheshi was reduced to only 30 gram (the reason to sue large amount of Daizheshi has been listed in later chapter for Shenzhe Zhenqi Tang). One dose made him stop vomit, start to eat, and have reduced cough. The bowel started to move, though previously it needed several days for one bowel movement. Continued this way with little ingredient modification for three days, the pulse became better too, but still six times per breath-circle. So, the Xuanshen and Shengdi both were reduced to only 18 gram. In addition, he was given white sucrose water to drink at noon, to take aspirin some amount. Several days later, all conditions are completely improved, the pulse too.

沈阳苏××，年三十许，劳嗽二年不愈，动则作喘，饮食减少。更医十余人，服药数百剂，分毫无效，羸弱转甚。来院延医。其脉数六至，虽细弱仍有根柢，知其可治。自言上焦恒觉发热，大便三四日一行，时或干燥。遂投以醴泉饮，为其便迟而燥，赭石改用六钱，又加鸡内金二钱（捣细），恐其病久脏腑经络多瘀滞也。数剂后饭量加增，心中仍有热时，大便已不燥，间日一行。遂去赭石二钱，加知母二钱，俾于晚间服汤药后，用白蔗糖水，送服阿斯匹林四分之一瓦，得微汗。后令于日间服之，不使出汗，数日不觉发热，脉亦复常，惟咳嗽未能全愈。又用西药几阿苏六分，薄荷冰四分，和以绿豆粉为丸，梧桐子大，每服三丸，日两次，汤药仍照方服之，五六日后咳嗽亦愈，身体从此康健。

Patient Sou, 30 years of old, lived in Shenyang city too. He had exhausting cough for two years. He would have asthma with little movement or physical work. His diet was also reduced. He had tried about ten doctors, and take herbs for hundreds doses, without any improvement. His body became more slim and thin. When he came to me, I felt his pulse was up to six times per breath-circle. It is thin and weak but still can be felt when press. So I felt his condition is still possible to solve. He said he felt constant hot in his Upper Jiao (the chest), and he had bowel movement once every three or four days, which is sometimes dry and sometimes loss. He was given Liquan Yin to take. For his constipation, the Daizheshi used was 18 gram, and with additional addition of Jineijin 6 gram (grinded), considering that he was sick for a long time, there may have blood stagnation in the meridians and organs. After several days, his appetite was increased and the amount of eating was increased too. Though still felt hot in the chest from time to time, his constipation became once every other day. The Daizheshi was removed, but added Zhimu 6 gram. Again, let him take white sucrose water after drinking of herbal tea in the evening, to help swallow of one quarter tablet of aspirin to create sweat. Later, he was asked to take the aspirin during the day time too, to stop sweat. After several days, he no longer felt hot and the pulse became normal too, though the cough was only partly improved. So, the western medicine Jiasou 6 fen, Bohebing 4 fen, was mixed with green bean powder to prepare the mixture into pills as 1 cm in diameter each. He was asked to take the pills three pills each time, twice a day. During that time, the herbal tea was continued. After five to six days, the cough stop and the body turned to normal.

治劳瘵发热，或喘或嗽，或自汗，或心中怔忡，或因小便不利，致大便滑泻，及一切阴分亏损之症．

This herbal tea is used to treat Laoji fever, with asthma or cough, or self-sweat, or palpitation, or diarrhea due to harsh urine, and all other Yin deficient conditions.

生怀山药（四两，切片）煮汁两大碗，以之当茶，徐徐温饮之。
Shanyao[6] 120 gram (cut into pieces, cook in water to make two big bowl of herbal soup). Drink the herbal soup as drink tea from time to time.

山药之性，能滋阴又能利湿，能滑润又能收涩。是以能补肺补肾兼补脾胃。且其含蛋白质最多，在滋补药中诚为无上之品，特性甚和平，宜多服常服耳。
The Shanyao, in herb nature, can nourish the Yin and remove the Wetness, can create lubrication effect, and contract effect too. It can nourish the Lung, the Kidney and nourish the Spleen or Stomach too. It contains most protein, belong to the most valuable one in the herbal family. Its nature is calm and mild, worth to take for long term.

陈修园谓：山药为寻常服食之物，不能治大病，非也。若果不治大病，何以《金匮》治劳瘵有薯蓣丸。尝治一室女，温病痰喘，投以小青龙加石膏汤，又遵《伤寒论》加减法，去麻黄加杏仁，喘遂定。时已近暮，一夜安稳。至黎明喘大作，脉散乱如水上浮麻，不分至数，此将脱之候也。取药不及，适有生山药两许，急煮汁饮之，喘稍定，脉稍敛，可容取药，方中仍重用山药而愈（详案在仙露汤下）。

Dr. Chen Xiuyuan said: the Shanyao is ordinary food. It cannot treat severe disease. This is not true. If it cannot treat severe disease, how can it be indicated in the herbal formula as Shuyu Wan, in the chapter for Laoji in the book 《Jing Kui》. I have tried to treat a girl. She had Wen Bing[7] asthma with phlegm. I used Xiao Qinglong Tang plus Shigao. I also followed the 《Shanghan Lun》, removed herb Mahuang, but add Xingren. The asthma stoped. It was later evening. The whole night was no problem, but in the morning, her asthma happened again severely. Her pulse was dispersed as massed branches on the water, hard to cout the number. It was a condition of Yin-Yang escaping. There is no time to buy or prepare other herbs at that movement. There was only some Shanyao there available. So, the Shanyao was cooked hurry and given her to drink. Soon her asthma became less and the pulse became calm too. So, there is time to prepare other herbs. The herbal formula used later still contained large amount of Shanyao (see later chapter for Xinlou Tang for detail).

一室女，月信年余未见，已成劳瘵，卧床不起。治以拙拟资生汤，复俾日用生山药四两，煮汁当茶饮之，一月之后，体渐复初，月信亦通。
One case, a girl had no menstruation for several years. She had had the Laoyi condition (exhausting condition) and could not get up the bed. She was given the Zisheng Tang, and was asked to drink the Shanyao soup (Cook Shanyao 60 gram in water. Drink the soup as regular tea). One month later, the health condition was much improved and the menstruation came too.

一妇人，产后十余日，大喘大汗，身热劳嗽。医者用黄芪、熟地、白芍等药，汗出愈多。后愚诊视，脉甚虚弱，数至七至，审证论脉，似在不治。俾其急用生山药六两，煮汁徐徐饮之，饮完添水重煮，一昼夜所饮之水，皆取于山药中。翌日又换山药六两，仍如此煮饮之。三日后诸病皆愈。

A women suffered from severe asthma and heavy sweat, fever and cough, tens days after childbirth. Previous doctor had used Huangqi, Shoudi, Baishao and other herbs. She had more sweat. When I saw her, her pulse was very weak, which was up to seven times per breath-circle. Based on the clinic manifestation and the pulse, it seemed her condition was impossible to improve. I was hurry to give her Shanyao 90 gram, and asked her to drink it as regular tea. On that day, all of the water her body needed came from the Shanyao soup. The next day, the Shanyao soup was repeated again. By this way, after three days, all of the conditions were improved.

一人，年四十余，得温病十余日，外感之火已消十之八九。大便忽然滑下，喘息迫促，且有烦渴之意。其脉甚虚，两尺微按即无。亦急用生山药六两，煎汁两大碗，徐徐温饮下，以之当茶，饮完煎渣再饮，两日共享山药十八两，喘与烦渴皆愈，大便亦不滑泻。

One of my patients was about 40 years of old. He got Wen Bing for more than ten days. Upon he came to me, his condition had been improved about 80%. One day, he suddenly had slipper diarrhea, urgent asthma and short of breath, and had annoying thirst. His pulse was very weak, and the Chi pulse could not be touched upon press deep. He was urgently given the Shanyao soup (90 gram Shanyao), two big bowls and asked to drink it slowly but continuously. After finish the drink, the Shanyao residue was used to cook the tea again. For two days, totally 540 gram of the Shanyao was drunk. His asthma and annoying thirst feeling were improved to disappear and the bowel movement was no longer as slippery.

侄女××，已于归数载，因患瘰证成痨，喘嗽不休，或自汗，或心中怔忡，来函索方。余揣此系阴分亏损已极所致。俾先用一味薯蓣饮，每日用生怀山药四两，煮汁两大碗，当茶频频温饮之。不数剂，喘定汗止，咳嗽亦见轻。继又兼服薯蓣粥，作点心用之，渐渐全愈。
Mu niece had returned home for several years. She suffered from lympha tuberculosis and her condition has developed into the Laoji condition. She had cough with phlegm, or had self-sweat, or had palpitation. A letter send to me asking for herbal formula. I thought that her condition was due to the Yin deficiency. So, I asked her to drink the Shanyao soup, 60 gram per day. After several days, the asthma and the sweat stop, and the cough was improved. Continued use of the Shanyao as rise soup, the overall condition was all improved gradually.

家慈患痰喘咳嗽病，三十年于兹矣。百方不效，且年愈高，病愈进。乃于今春宿病既发，又添发灼、咽干、头汗出、食不下等证。生虽习医，此时惟战兢不敢处方，遂请一宿医诊视，云是痰盛有火，孰知是肺气与脾阴肾阴将虚竭也。与人参清肺汤，加生地、丹皮等味，服二剂，非特未效，遂发灼如火，更添泄泻，有不可终日之势。于是不敢延医，自选用资生汤方，服一剂，亦无显效。转思此时方中于术、牛蒡子、鸡内金等味有未合也。因改用一味薯蓣饮，用生怀山药四两，加玄参三钱。服一剂见效，二剂大见效，三剂即病愈强半矣。后乃改用薯蓣粥，用生怀山药一两为细末，煮作粥，少调以白糖，每日两次当点心服之。又间进开胃之药。旬余而安。

My parent suffered from cough, asthma with phlegm for more than 30 years. She had tried many treatments without any improvement. With the age, the conddition became worse. This spring, her condition recurred, with additional dry throat, sweat on head, and hard to eat. Though I am practicing medicine, I dared not to give prescription at that time. So I asked another doctor to see her. He said it was overwhelming phlegm with Fire, but not know it was due to the Lung Qi and Spleen Qi and Kidney Qi all exhausting. She was given Renshen Qingfei Tang, with addition of Shengdi and Danpi and other herbs in. After two days, the condition became even worse. She felt hair hot as burning and had diarrhea and felt as to die. So I dared not to continue with that doctor and I prescribed by myself the Zisheng Tang. After use of one-day’s amount, there are no clear improvement either. I thought again that the herb Baizhu, Niubangzi, and Jineijin in the formula may not be suitable to the condition, so changed to the only use of Shangyao Yin. My parent was given Shanyao soup 60 gram, Xuanshen 9 gram. Next day, the condition was improved, and two days later, it was much improved. After three days, the condition was much more improved. Later, the Shanyao was cook as regular soup to drink (30 gram) with addition of little white sugar, twice a day. During that time, some herbs for improve appetite were also given. Tens of days later, the condition was completely improved.

治阴分亏损已久，浸至肺虚有痰，咳嗽劳喘，或兼肺有结核者。
This formula is used to solve long term of Yin deficiency. The patient has Lung deficiency with cough, asthma with phlegm, or with lung tuberculosis.

人参（三钱）干麦冬（四钱，带心）生山药（六钱）清半夏（二钱）牛蒡子（三钱，炒，捣）苏子（二钱，炒，捣）生杭芍（三钱）甘草（钱半）
Renshen 9 gram, Maimendong 12 gram (with the inside kernel), Shanyao 18 gram, Banxia 6 gram, Niubangzi 9 gram (fried, grind), Souzi 6 gram (fried, grind), Baishao 9 gram, and Gancao 4.5 gram.

人参为补肺之主药，而有肺热还伤肺之虞，有麦冬以佐之，则转能退热。麦冬为润肺之要品，而有咳嗽忌用之说，有半夏以佐之，则转能止嗽。至于山药，其收涩也能助人参以补气，其粘润也，能助麦冬以滋液。虽多服久服，或有壅滞，而牛蒡子之滑利，实又可以相济。且牛蒡子能降肺气之逆，半夏能降胃气、冲气之逆，苏子与人参同用，又能降逆气之因虚而逆。平其逆气，则喘与嗽不治自愈矣。用白芍者，因肝为肺之对宫，肺金虚损，不能清肃下行以镇肝木，则肝火恒恣横而上逆，故加芍药以敛戢其火。且芍药与甘草同用，甘苦化合味近人参，即功近人参，而又为补肺之品也。
Herb Renshen has capacity to nourish the Lung. In case there is Fire in the lung, it may hurt the lung. So the Maimendong is added to prevent the fire from the Renshen. Maimendong is the herb to wet the lung, so it is said not to use in cough condition. With the use of the Banxia, it turns to stop the cough. Shanyao, for its nature of contracting, it can help the Renshen to nourish the Qi; for its sticky nature, it can help Maimendong to nourish liguid in the body. If take the Shanyao for a long time, it may cause fullness in the stomach, so the use of Niubangzi, for its slippery, can prevent the sticky and fullness side effect from the Shanyao. The Niubangzi per se can depress the up-reversed Lung Qi, and Banxia can surpress the up-reversed Stomach Qi. The use of Souzi and Renshen together can surpress the up-reversed Qi that is due to weakness condition, so the asthma and cough would not happen. The reason to use the Baishao is that the Liver and the Lung is opposide position each other. When the Lung Metal is damaged, it can not move down to surpress the up-moving Liver Wood. The Liver Fire can rush up freely to cause cough too. So the addition of Baishao can attract the Liver Fire. Again, the use of Baishao and Gancao together, the sweet-bitter taste similar to Renshen, and the function is also similar to Renshen, so to be able to nourish the lung.

按：古方多以麦冬治肺虚咳嗽，独徐灵胎谓嗽者断不宜用。盖以其汁浆胶粘太甚，肺中稍有客邪，即可留滞不散，惟济以半夏之辛燥开通，则不惟治嗽甚效，即治喘亦甚效。故仲景治伤寒解后，虚羸少气，气逆欲吐，有竹叶石膏汤，麦冬与半夏同用。治火逆上气，有麦门冬汤，以麦冬为君，亦佐以半夏也。又肺虚劳嗽者，医者多忌用半夏，是未知半夏之性者也。徐灵胎曰：“肺属金喜敛而不喜散。”盖敛则肺叶垂而气顺，散则肺叶张而气逆。半夏之辛，与姜、桂之辛迥别，入喉则闭不能言，涂金疮则血不复出，辛中滞涩，故能疏又能敛也。又辛之敛与酸之敛不同，酸则一主于敛，辛则��中有发散之意，尤与肺投合也。又喻嘉言赞麦门冬汤中用半夏曰：“于大建中气，大生津液药中，增入半夏之辛温一味，以利咽下气，此非半夏之功，实善用半夏之功也。”

Explanation: Old herbal formula in history used herb Maidong in the cough that is due to the Lung deficiency. Only Dr. Xu Lingtai said that it should not be used in the cough condition, because its juice is very sticky. If there is any slight Xie Qi in the lung, it may hold the Xie Qi in the lung causing chronic problem. It can only be used for the cough when used together with Banxia. Banxia is spicy and opening in its herbal nature. It not only works well for cough, but also well for asthma. For this reason, Master Zhang Zhongjing used it in person after a Shanghan disease with weakness, short of breath, Qi up-reverse and willing to nausea. The example formula is the Zhuye Shigao Tang, in which the Maidong and the Banxia are used the same time. Also in the Maimendong Tang, the Mainendong and the Banxia are used together to solve the up-reverse Fire condition. For person with weakness condition and chronic cough, doctors usually dare not to use Banxia, for they do not really understand the nature of the Banxia. Dr. Xu Lingtai said: “The Lung belongs to Metal and it likes contracting but not dispersing”. The reason is that the contracting action makes the Lung leaves falling down, so the air is free to move; and the dispersing action makes the leaves opening so the air is not easy to open, so as to cause the Qi up-reverse. The spicy property of the Banxia is different from that of herb Guizhi and Shenjiang (ginger). When drink, it may cause hard to speak, and when it is smeared on wound, the bleeding can be stop. Its spicy is accompanied with astringent, so it can disperse and also contract. Also, the contracting property from the spicy and from the sour is different too. The sour of a herb focuses on the contracting action; but the spicy of a herb has both contracting and dispersing action. The later property is much similar and matches the function of lung. Mr. Yu Jiayan praised the use of Banxia in the formula Maimendong Tang: “the addition of the spicy-warm Banxia in the formula of Da Jiangzhong Tang or other formula that work to nourish the Yin Ye, can help the swallow of the herbs and clear the throat. It is not the contribution of the Banxia, but the clever use of it by the doctors”.

愚对于此证，悉心研究，知其治法，当细分为数种。肾传肺者，以大滋真阴之药为主，以清肺理痰之药为佐，若拙拟之醴泉饮是也；肺传肾者，以清肺理痰之药为主，以滋补真阴之药为佐，若此参麦汤是也；其因肺肾俱病，而累及脾胃者，宜肺肾双补，而兼顾其脾胃，若拙拟之滋培汤、珠玉二宝粥是也。如此分途施治，斟酌咸宜，而又兼服阿斯匹林，凡其脉之稍有根柢可挽回者，需以时日皆愈也。至于但肺有结核，而未累及他脏者，可于斯编治肺病方中，酌其治法（论肺病治法，实合虚劳肺病详细论之也，凡治虚劳及肺病者皆宜参观）

I have carefully studied this condition and found that the treatment of cough needs to be separated into several aspects. If the cough is due to the Kidney disease that passes into the Lung, the herbal formula use should be mostly to nourish the True Yin, helped by lung-clearing and phlegm-clearing herbs, such as my Liquan Yin; if it is due to the Lung disease, that passes into the Kidney, the herbal formula should focuse to clear the lung and the phlegm, with help of herbs that work to nourish the True Yin. The herbs are as my Shenmai Tang here. In person with the lung and the kidney disease at the same time, and they involve and damage the spleen, the lung and the kidney should be nourished similary, together with some effort on the nourish of the spleen. The herbal formula for this condition is as Zipai Tang, Zhuyu Erbao Tang. Separate by this way, together with the intake of aspirin, the condition should be solved, if the pulse is with root, though it takes some time. If there is tuberculosis only in the lung, not involving other organs, the herbal formula in the later Chapters for the lung disease can be used.

阿斯匹林，其性凉而能散，善退外感之热，初得外感风热，服之出凉汗即愈。兼能退内伤之热，肺结核者，借之以消除其热，诚有奇效。又善治急性关节肿疼，发表痘毒、麻疹及肠胃炎、肋膜炎诸证，西药中之最适用者也。特其发汗之力甚猛。若结晶坚而大者，以治外感，半瓦即可出汗；若当天气寒凉，或近寒带之地，须服至一瓦，或至瓦半。若其略似白粉，微有结晶者，药力薄弱，服至一瓦方能出汗，多可服至瓦半或二瓦。是在临证者，相其药力之优劣，而因时、因地、因人制宜也。至用阿斯匹林治内伤，其分量尤须少用。因内伤发热之人，阴虚阳浮，最易发汗。西人用治肺结核之热，日服三瓦，其在欧洲地寒，且其人自幼多肉食，脏腑营卫壮固，或者犹可，在吾中华则定然不可。是以丁仲祜用阿斯匹林治肺结核，一日三次共服一瓦半，则视西人所用之愚用阿斯匹林治肺结核，视西人所用之数，则减之又减。曾治一少年，染肺结核，咳嗽食少，身体羸弱，半载不愈，求为延医。遂投以理肺清痰、健胃滋阴之药，又于晚间临睡时，用白蔗糖冲水，送服阿斯匹林三分之一瓦。须臾周身即得大汗，过三点钟其汗始止，翌日觉周身酸懒，盖因汗太过也。而咳嗽则较前见轻，食欲亦少振，继服滋补之药数剂，每日只用阿斯匹林六分之一瓦，作一次服下，或出微汗，或不出汗，从此精神渐渐清爽，调治月余而愈。自此以后，用阿斯匹林治肺结核，必先少少试服，初次断不敢稍多也。至西人谓防其出汗，可与止汗之药同服，亦系善法。然仍恐服后止汗之药不效，而阿斯匹林之发汗，仍然甚效也。愚治肺结核证，若一日用至一瓦，或一瓦强，恒作十次，或十余次服下。勿须用止汗之药，亦可不出汗。即有时微见汗，亦系佳兆。凡劳瘵阴虚之证，其脉之急数者，无论肺结核与不结核，于每服滋补剂外，皆宜服阿斯匹林，或半瓦，或至一瓦。恐其出汗多，分几次服下，其初日服之俾微见汗，后日日常服，以或出汗或不出汗为适宜。如此旬日之间，脉之数者可渐和缓。
(This paragran talks about the use of Aspirin in the treatment of cough and lung tuberculosis, so it is not translated. )

治一妇人，年四十三岁，素因家务劳心，又兼伤心，遂患吐血。后吐血虽愈，而喘嗽殊甚，夜不能卧。诸医率用枇杷叶、款冬花、杏仁、紫菀、贝母等药治之。其后右边面颧淡红肿起，嗽喘仍不少愈。后仆为延医，先投以王清任少腹逐瘀汤加苏子沉香二剂，继服书中参麦汤八剂，喘嗽皆愈。
I treated one woman. She was 43 years of old. She had heavy labor work at home, and had kind of stree, so later she got blood vomiting. Later, the blood-vomit is solved, but she has severe asthma and cough, so as hard to have a sleep at night. Previous doctors used herb Bibaye, Kuandonghua, Xingren, Ziyuan, and Baimu for the treatment. Later, she had her cheek on the right side swelling, which was pink in color. The cough and asthma continued without stop. When I saw her, I used the Dr Wang Qingren’s formula of Shaofu Zhuyu Tang plus herb Souzi and Chenxiang. Two days later, she got he Shenmai Tang for the treatment. Eight days later, the cough and asthma was much improved.

又：治一男子，年四十六岁，心中发热作喘，医治三年无效。仆为诊视，先投以书中首方资生汤，遵注加生地黄六钱。一剂见轻，数剂病愈强半。继用参麦汤数剂，病愈十之八九。然病已数年，身体羸弱，非仓猝所能撤消；望先生赐惠，为拟一善后之方，则幸甚矣。

Another case: A man of 46 years of old, had hot in chest and with asthma. He visited various doctors for three years without any improvement. When I saw him, I used Zisheng Tang first, with addition of Shengdi (18 gram). Next day, the condition was improved. Several days later, the condition improved nearly half. Additional use of the same herbal formula, the condition was much more improved. Since the condition has been there for several years, the person is weak and slim. It is not hard to solve the condition in a short time. I wish you can recommend me a formula to solve the remaining cough for him.

治脾肺阴分亏损，饮食懒进，虚热劳嗽，并治一切阴虚之证。

This formula is used to treat Spleen-Lung Yin deficiency. The person has low appetite, and feels hot and cough. It can also be used for other kinds of Yin deficiency.

生山药（二两）生薏米（二两）柿霜饼（八钱）
Shanyao 60 gram, Yiyiren 60 gram, Shishuangbing[9] 24 gram.

上三味，先将山药、薏米捣成粗渣，煮至烂熟，再将柿霜饼切碎，调入融化，随意服之。

Grind the Shanyao and Yiriren into coarse particles, cook in water to well-cooked. Chop the Shishuangbing into small pieces. Add it in the cooked mixture. Eat the mixture from time to time in a casual amount each time.

山药、薏米皆清补脾肺之药。然单用山药，久则失于粘腻；单用薏米，久则失于淡渗，惟等分并用，乃可久服无弊。又用柿霜之凉可润肺、甘能归脾者，以为之佐使。病患服之不但疗病，并可充饥，不但充饥，更可适口。用之对证，病自渐愈，即不对证，亦无他患。柿霜饼，即柿霜熬成者，为柿霜白而净者甚少，故用其熬成饼者。然熬此饼时恒有掺以薄荷水者，其性即不纯良。遇阴虚汗多之证用之即有不宜，若果有白净柿霜尤胜于饼。

Shanyao and Yiyiren, both are to nourish the Spleen and the Lung. However, Shanyao alone may be too sticky; Yiyiren alone may be too less-tasted. The combination of the two material allow a long time intake without original side effect. Shishuangbing, for its cold herbal nature, can nourish the Lung; for its sweet, can nourigh the Spleen. Use it together with the Shanyao and Yiyiren, the formula can not only treat a disease, but also as a diet as regular food. It can not only meet the hungry feeling, but also delicious. If used in a proper case, the disease would of course cure gradually. If it is not match the case, it would not cause other new problems. Sheshuangbing is made from the persimmon. Be careful that the Shishuangbing that is prepared with the involvement of Bohe should not be used, since the Shishuangbing made by this is not suitable in case of Yin deficiency with more sweat.

一少年，因感冒懒于饮食，犹勤稼穑，枵腹力作，遂成劳嗽。过午发热，彻夜咳吐痰涎。医者因其年少，多用滋阴补肾之药，间有少加参、黄芪者。调治两月不效，饮食减少，痰涎转增，渐至不起，脉虚数兼有弦象，知其肺脾皆有伤损也。授以此方，俾一日两次服之，半月全愈.

There has been a boy, who had less appetite due to common cold, but continued his labor work, which eventually made his condition into the exhausting condition. For his young age, doctor used more Yin-nourishing therapy, with little addition of Renshen or Huangqi. Two months of treatment worked nothing. He had reduced appetite, more phlegm, and felt hard to get up too. His pulse was weak and frequent with little string feeling, so it is known that he had Lung-Spleen damage. When I saw him, I asked him to have this herbal soup twice a day. After two weeks, the condition is solved.

或问：脉现弦象，何以即知其脾肺伤损？答曰：脉虽分部位，而其大致实不分部位，今此证左右之脉皆弦，夫弦为肝脉，肝盛必然侮脾，因肝属木脾属土也。且五行之中，惟土可以包括四行，即脾气可以包括四脏。故六部脉中，皆以和缓为贵，以其饶有脾土之气也。今其脉不和缓而弦硬，其脾气受伤，不能包括四脏可知。又肺属金，所以镇肝木者也，故肺金清肃之气下行，肝木必不至恣横，即脉象不至于弦。今其脉既现如此弦象，则肺金受伤，不能镇肝木更可知也。

It may be asked: the pulse is string. How do you know that it indicates the Spleen-Lung damage? Answer: Though the meaning of the pulse depends on its poison on the wrist, but not always so. Now the string pulse can be felt on both side of the hands. String indicates the Liver. Strong Liver suggests that it would hurt the Spleen, since the Liver belongs to the Wood and the Spleen, the Soil. Among the five elements, only the Spleen can hold/endure the other four organs. So, in the six pulses, all pulse should be soft, mild, hominy, or peace, since all of them contain the Spleen nature. Now the pulse is not calm but string and hard, it is therefore known that the Spleen Qi has been damaged, and the Spleen cannot hold/endure the other organs. Again, the Lung belongs to the Metal, which is to compress, or suppress the Liver Wood. So, if the Lung Qi can go down the Liver Qi should not be able to hurry up, so that the pulse should not be as such string feeling. Now the pulse is string, which so suggests that the Lung Qi is weak. It is therefore known that the Lung cannot suppress the Liver Wood.

This formula is used to solve the similar disorders as the Zhuyu Erbao Zhou, especially if there is asthma due to Kidney deficiency.

生山药（一两半）牛蒡子（炒捣,四钱）柿霜饼（冲服,六钱）

Shanyao 45 gram, Niupangzi 12 gram (fried, grind), Shibingbing 18 gram (drink with the Shanyao-Niubangzi herbal soup).

一人，年四十余，素有喘证，薄受外感即发。医者投以小青龙汤，一剂即愈，习以为常。一日喘证复发，连服小青龙汤三剂不愈。其脉五至余，右寸浮大，重按即无。知其从前服小青龙即愈者，因其证原受外感；今服之而不愈者，因此次发喘原无外感也，盖其薄受外感即喘；肺与肾原有伤损，但知治其病标，不知治其病本，则其伤损必益甚，是以此次不受外感亦发喘也。为拟此汤服两剂全愈，又服数剂以善其后。

One case. The person was about 40 years of old, suffered from asthma for a long time. The asthma recurred due to a recent common cold. Doctors gave the person Xiao Qinglong Tang. One dose solved his problem. So later, it became the person’s habit that he would use this formula once he had asthma again. One day, the asthma happened again. This formula was taken for three days without any improvement. The pulse was frequent as up to five times per breath-circle. The right pulse was floating and big but disappeared when pressed hard down. It is known that the herbal tea worked before because the asthma is due to common cold and there was evidence for such out-coming Xie Qi in the body. This time, it did not work since it is not caused due to the out-coming Xie Qi. Little bit out-coming Xie Qi could cause the asthma, suggesting that the Lung and the Kidney are in a weak condition (has been a damaged condition). If the therapy only work for the symptom, but not the basic reason, the damage would be more and more severe. This is why this time the asthma is hard to be improved. The herbal formula here has been used for two day, which solved the asthma. Additional doses have been prescribed for a maintenance.

治肺肾两虚，或咳嗽，或喘逆，或腰膝酸疼，或四肢无力，以治孺子尤佳

This formula is sued for Lung-Kidney deficiency. The patient may have cough, or asthma, or short of breath, or sour or weakness on the lower back or on the knee. It is especially suitable for child.

核桃仁（一斤）柿霜饼（一斤）
Walnut kernel 300 gram, Shishuangbing 300 gram.

先将核桃仁饭甑蒸熟，再与柿霜饼同装入瓷器内蒸之，融化为一，晾冷，随意服凡果核之仁，具补益之性者，皆能补肾。

Steam the walnut kernel to well-cooked. Mixed with the Shishuangbing in the same container and continue to steam again. Cool it down. Eat the mixture casually. Any fruit kernel, if they have property to nourish, they will nourish the Kidney.

核桃乃果核之最大者，其仁既多脂，味更香美，为食中佳品，性善补肾可知。柿霜色白入肺，而甘凉滑润，其甘也能益肺气，其凉也能清肺热，其滑也能利肺痰，其润也能滋肺燥，与核桃同用，肺肾同补，金水相生，虚者必易壮实。且食之又甚适口，饥时可随便服之，故以治小儿尤佳也。
Walnut is the biggest kernel among fruit kernels. It is rich in fat, also delicious. It is good at nourish the Kidney. Shishuangbing is white in color. It goes into the lung after take. It is cold and sweet in herbal nature and has slipper property. For its sweat, it can nourish the lung, for its cold, it can clear the Fire in the lung; for its slippery nature, it can clear the phlegm in the lung; and for its wetness, it na nourish and wet the dried lung. When used with the walnut kernel, the lung and the kidney both would be nourished. With the Metal (lung) and the Water (Kidney) work together, the weak person would be stronger. It can be eat as a food and also a herbal healing stuff, so it is more suit to child.

【附方】俗传治劳嗽方，秋分日取鲜莱菔十余枚去叶，自叶中心穿以鲜槐条，令槐条头透出根外，悬于茂盛树上满百日，至一百零一日取下。用时去槐条，将莱菔切片煮烂，调红沙糖服之，每服一枚，数服即愈。

Another herb formula for the exhausting condition with cough: Laosou Fang.[10] It contains the carrot leaves and brown sugar (the preparation process is omitted – translator)

按：莱菔色白入肺，槐条色黑入肾，如此作用，盖欲导引肺气归肾。其悬于茂盛树上者，因茂树之叶多吐氧气，莱菔借氧气酝酿，其补益之力必增也。悬之必满百日者，欲其饱经霜露，借金水之气，以补金水之脏也。邑中孙姓叟，年近六旬，劳喘，百药不效，后得此方服之而愈．每岁多备此药，以赠劳嗽者．服之愈者甚多．

Explanation: the carrot leave is white in color, so it is associated with the Lung. The Chinese scholar tree brances are black in color, so it is associated with the Kideny. Prepare the formula as above introduced (omitted here), the branch conduct the Lung Qi into the Kidney. …. There is an old man with family name of Sun (about 60 years of old), who suffered from the Laosou condition with much more short of breath. He took hundred of herbal doses without any improvement. Later after he tried this formula, the cough and short of breath disappeared. Later, I prepared this formula every year to donate to people with the Laosou condition. Many get much better with it.

治大病后阴阳不相维系。阳欲上脱，或喘逆，或自汗，或目睛上窜，或心中摇摇如悬旌；阴欲下脱，或失精，或小便不禁，或大便滑泻。一切阴阳两虚，上热下凉之证。

This formula is used for the condition, in which the Yin and Yang are not long associated together. The Yang is to escape from the upper part of the body: the person has either asthma, or sweat, or upper move of pupil in the eyes, or has palpitation with the heart shacking as a flag. The Yin is to escape from the lower part of the body: the person has either leak of sperm liquid, or loss of control of urine and stool. It works for all condition with the Yin-Yang both in deficiency and the upper-hot-lower-cold condition.

大熟地（一两）萸肉（去净核,一两）生山药（六钱）生龙骨（捣细,六钱）生牡蛎（捣细,六钱）茯苓（三钱）生杭芍（三钱）乌附子（一钱）

Shoudi 30 gram, Shanyurou 30 gram, Shanyao 18 gram, Longgu 18 gram, Muli 18 gram, Fuling 9 gram, and Fuzi 3 gram.

或问：既济汤原为救脱之药，方中何以不用人参？答曰：人参之性补而兼升，以治上脱，转有气高不返之虞。喻嘉言《寓意草》中论之甚详。惟与赭石同用，始能纳气归根。而证兼下脱者，赭石又不宜用，为不用赭石，所以不敢用人参。且阳之上脱也，皆因真阴虚损，不能潜藏元阳，阳气始无所系恋而上奔。故方中重用熟地、山药以峻补真阴，俾阴足自能潜阳。而佐以附子之辛热，原与元阳为同气，协同芍药之苦降（《神农本草经》味苦），自能引浮越之元阳下归其宅。更有萸肉、龙骨、牡蛎以收敛之，俾其阴阳固结，不但元阳不复上脱，而真阴亦永不下脱矣。

It may be asked: the Jiji Tang is to used for saving the escaping condition, why not include the herb Renshen in it? Answer: the herbal property of the Renshen is nourishing and raising. If use it in the treatment of escaping condition, it would be worried that it may push the Qi up too much. Dr. Yu Jiayan has explained this in detail in his book. Only when the Renshen is used together with Daizheshi, can the herb bring the Qi down and back to the root (Kidney). If the person has down-escaping condition, it would be worried to use the Daizheshi. Dare not to use the Daizheshi, so not to use the Renshen. Because the Yang escaping condition is due to the deficiency of the True Yin, that fails to attach the Yang back to the Kidney, so that the Yang floats and up-escapes without pulling force from lower part of the body, so in the formula, large amount of Shoudi and Shanyao are used to supply and nourish more True Yin, with the hope that when the Yin is sufficient, the Yang would be attached back to the Kidney. The advantage of the spicy-hot property of the Fuzi is that it is similar to the Yuan Yang. It works with the bitter-falling property of the Baishao to bring the floating Yuan Yang down to the Kidney. The use of the Shanyurou, Longgu and Muli, for their contracting property, can fix and enhance the Yuan Yang and Yuan Yin, so the Yuanyang would not float to escape and the Yuan Yin would not escape downwards either.

一人，年二十余，禀资素羸弱，又耽烟色，于秋初患疟，两旬始愈。一日大便滑泻数次，头面汗出如洗，精神颓愦，昏昏似睡。其脉上盛下虚，两寸摇摇，两尺欲无，数至七至。延医二人皆不疏方。愚后至为拟此汤，一剂而醒，又服两剂遂复初。
A twenty-year-old man was weak in body condition from birth and he was also fall in sex and smoke for many years. He got malaria in early autumn, which was stop after about three weeks. One day, he had slippery diarrhea several times. His face was with heavy sweat as washed, tired in spirit, felt sleepy. His pulse is strong in the upper part but weak in the lower part. The pulse on the Chong position felt as shacking and it was frequent up to seven times per breath-circle. He visited two doctors for the treatment but none gave him prescription. I later gave him this formula. One dose made him awake, additional two doses improved his condition to the early body condition.

友人张××，曾治一少年，素患心疼，发时昼夜号呼。医者屡投以消通之药，致大便滑泻，虚气连连下泄，汗出如洗，目睛上泛，心神惊悸，周身动，须人手按，而心疼如故。延医数人皆不敢疏方。张××投以此汤，将方中萸肉倍作二两，连服两剂，诸病皆愈，心疼竟从此除根。

My friend Mr. Zhang treated a teenage, who suffered from pain in the stomach. He cried day and night when the pain occurred. Previous doctors had used bowel-cleansing therapy, which made him slippery diarrhea, heavy sweat on head, up-moving eyes, palpitation, body shacking (which need other people to press), but the stomach pain remained. He had visited several doctors, none of them dare to treat him. My friend, Mr. Zhang, treated him with this formula, with the Shangyurou doubled in amount. Two days later, every problem disappeared. There was no any stomach pain from then.

或问：此方能治脱证宜矣，而并能治心疼者何也？答曰：凡人身内外有疼处，皆其气血痹而不通。《神农本草经》谓“山茱萸主心下邪气、寒热、温中、逐寒湿痹”，是萸肉不但酸敛，而更善开通可知。李士材治肝虚作疼，萸肉与当归并用。愚治肝虚腿疼，曾重用萸肉随手奏效（详案在曲直汤下）。盖萸肉得木气最浓，酸敛之中大具条畅之性，故善于治脱，尤善于开痹也。大抵其证原属虚痹，气血因虚不能流通而作疼。医者不知，惟事开破，迨开至阴阳将脱，而其疼如故，医者亦束手矣。而投以此汤，惟将萸肉加倍，竟能于救脱之外，更将心疼除根。此非愚制方之妙，实张××之因证施用，而善于加减也。

It might be asked: if this formula can solve the escaping condition, how it can treat the stomach pain? Answer: whenever there is pain in the body, on the surface skin, muscle, tendons, or in the inside organs or tissues, are all due to the block of the the Qi and blood circulation. It is said in the《Shennong Bencao Jing》that, the Shangyurou can treat the Xie Qi under the heart (e.g. the stomach), cold or hot, to warm the middle part of the body, and to expel the Cold-Wet Bi. For this, it is known that, the herb Shangyurou can not only have a property of sour-contracting, but also is good at sour-opening. Dr. Li Shicai used the Shanyurou and the Danggui in the treatment of pain due to Liver weakness. I also solve the leg pain due to the Liver weakness. With the Sanyurou, the pain disappeared very fast (see the Chapter for herb Quzhi Tang). The herb Shanyurou bears most strong Wood nature. Within its sour-contracting property, it also bears opening property, so that it is good in the treatment of the escaping condition, especially in the treatment of Bi syndrome[11]. It is possible that the person had had the Bi syndrome in his stomach before this escaping condition. The Qi and blood cannot flow smoothly due to the weakness condition. Previous doctor did not realize this, so they used mostly the herbs with breaking property, so the condition ended that Yang and Yin are to escape but the pain remained. Doctors had no any more ideas. This Jiji Tang is used with the Shanyurou doubled in amount. It is surprisingly able to solve this Yin-Yang escaping problem and the stomach pain as well. This is not due to the marvelous of my formula, but that Mr. Zhang used this formula in a smart way.

治寒温外感诸证，大病瘥后不能自复，寒热往来，虚汗淋漓；或但热不寒，汗出而热解，须臾又热又汗，目睛上窜，势危欲脱；或喘逆，或怔忡，或气虚不足以息，诸证若见一端，即宜急服。

This formula is used for patient, who had had diseases before and now in a later recovering status, suffered from cold-hot shift, heavy sweat; or only hot without cold, the hot reduced with sweat, but soon the hot comes again; up-moving eyes, the Yin-Yang is to escape; or asthma / short of breath, or palpitation, or short of breath due to Qi deficiency. Once see any one symptom above, this formula should be used as soon as possible.

萸肉（去净核,二两）生龙骨（捣细,一两）生牡蛎（捣细,一两）生杭芍（六钱）野台参（四钱）甘草（二钱,蜜炙）
Shanyurou 60 gram (remove kernel), Longgu 30 gram, Muli 30 gram, Baishao 18 gram, Wild Taishen 12 gram, and Gancao 6 gram (processed with honey).

萸肉救脱之功，较参、术、更胜。盖萸肉之性，不独补肝也，凡人身之阴阳气血将散者，皆能敛之。故救脱之药，当以萸肉为第一。而《神农本草经》载于中品，不与参、术、并列者，窃忆古书竹简韦编，易于错简，此或错简之误欤！
The function of the Escaping-saving function by herb Shanyurou is much stronger than Renshen and Baizhu. Shanyurou not only supply and nourish the Liver, it also contracts the escaping Yin-Yang and Qi-blood. So, the first herb used in the Escape-saving is the Shanyurou. …

凡人元气之脱，皆脱在肝。故人虚极者，其肝风必先动，肝风动，即元气欲脱之兆也。又肝与胆脏腑相根据，胆为少阳，有病主寒热往来；肝为厥阴，虚极亦为寒热往来，为有寒热，故多出汗。萸肉既能敛汗，又善补肝，是以肝虚极而元气将脱者服之最效。愚初试出此药之能力，以为一己之创见，及详观《神农本草经》山茱萸原主寒热，其所主之寒热，即肝经虚极之寒热往来也。特从前涉猎观之，忽不加察，且益叹《神农本草经》之精当，实非后世本草所能及也。又《神农本草经》谓山茱萸能逐寒湿痹，是以本方可用以治心腹疼痛。曲直汤用以治肢体疼痛，以其味酸能敛。补络补管汤，用之以治咳血吐血。再合以此方重用之，最善救脱敛汗。则山茱萸功用之妙，真令人不可思议矣。

When the Yuan Qi is escaping, it escapes from the Liver. That’s why when a person is very weak, his Liver Wind starts to irrigate first, e.g. the moving Liver Wind is the early sign of the Yin-Yang escaping. The Liver and the Gall bladder is the inside-outside relation. The Gall bladder belongs to the Shaoyang meridian/stage/level of the body, and dominate cold and hot shift; the Liver belongs to the Jueyin meridian/stage/level of the body, and dominates the cold-hot shift when it is very weak. For the cold-hot, so there are more sweat. The Shanyurou can restrain the sweat, and is good at nourish the Liver, so works well when the Liver is very weak and when the Yuan Qi is to escape. In the beginning I tried out its such property, I though it is my finding. When I read the book 《Shennong Bencao Jing》about the property of the Shanyurou, it has been indicated there that Shanyurou dominates the treatment of cold-hot shift, which occurs when the Liver is very weak. Only because I did not pay much attention to the detail for the Shanyurou before when I read it, so I did not that before. So, I admired the book very much for its greatness, which can not be overpass by herbal books published in later history. In the book, it said that Shanyurou can also expel (drive away) Cold-Wet Bi Xie. This is the reason that Shanyurou can be used to solve stomach pain. Another herbal formula, the Quzhi Tang, can work for arm and leg pain, for its herbal nature of sour-contracting property. Buluo Buguan Tang can solve cough, bleeding cough or bleeding vomit. If they are combined with this Laifu Tang, the mixture can work to save the Escaping condition with sweat. It is really marvelous the effect of the herb Shanyurou.

一人，年二十余，于孟冬得伤寒证，调治十余日，表里皆解。忽遍身发热，顿饭顷，汗出淋漓，热顿解，须臾又热又汗。若是两昼夜，势近垂危，仓猝迎愚延医。及至，见汗出浑身如洗，目上窜不露黑睛，左脉微细模糊，按之即无，此肝胆虚极，而元气欲脱也，盖肝胆虚者，其病象为寒热往来，此证之忽热忽汗，亦即寒热往来之意。急用净萸肉二两煎服，热与汗均愈其半，遂为拟此方，服两剂而病若失。

One patient was about twenty years of old. He got Cold-invasion disease and got treatment for about ten days. His condition was improved. One day, he felt hot whole of the body, and pretty soon got heavy sweat, then the hot reduced. Soon he felt hot then sweat again. He got such condition for two days, in a very dangerous condition. I was invited urgently to see him. I saw him heave heavy sweat as washed, the eyes moved up without pupils. His left pulse was mild, weak, as smear or cloudy, which disappeared when pressed heavier. This is the condition, in which the Liver-Gall Bladder is very weak, and the Yuan Qi is to escape. When the Liver-Gall Bladder is weak, the clinic manifestation is cold-hot shift syndrome. In the case here, it showed as hot-sweat shift, bearing the similar meaning as the cold-hot shift. He was urgently given Shanyurou 60 gram. The hot and sweat stop to half level. It was followed by this Laifu Tang. After two days, all problems disappeared.

赵叟，年六十三岁，于仲冬得伤寒证，痰喘甚剧。其脉浮而弱，不任循按，问其平素，言有劳病，冬日恒发喘嗽。再三筹思，强治以小青龙汤去麻黄，加杏仁、生石膏，为其脉弱，俾预购补药数种备用。服药后喘稍愈，再诊其脉微弱益甚，遂急用净萸肉一两，生龙骨、生牡蛎各六钱，野台参四钱，生杭芍三钱为方，皆所素购也。煎汤甫成，此时病患呼吸俱微，自觉气息不续，急将药饮下，气息遂能接续。

Mr. Zhao was 63 year of old. He got the Cold-invasion disease during winter, with heavy asthma and more phlegm. His pulse was floating and weak. If press heavily, the pulse disappeared. Upon ask, he said he had chronic cough for many years, and it recurred every winter. I had considered for a long time, then gave him Xiao Qinglong Tang with removal of herb Mahuang, but addition of Shigao. For his weak pulse, I asked him to buy some nourishing herbs in case needed. After intake of the herbal tea, his asthma reduced little bit, but the pulse became much weaker. So It has been urgent to save Shanyurou 30 gram, with Longgu 18 gram, Muli 18 gram, while Taishen 12 gram, Shaoyao 9 gram as a new formula. When the herbal tea was ready, the patient’s breath was very weak, very short of breath. He was asked to drink the tea right away. Then the breath became much better.

李××，年五旬，偶相值，求为诊脉，言前月有病服药已愈，近觉身体清爽，未知脉象何如？诊之，其脉尺部无根，寸部摇摇有将脱之势，因其自谓病愈，若遽悚以危语，彼必不信，姑以脉象平和答之。遂秘谓其侄曰：“令叔之脉甚危险，当服补敛之药，以防元气之暴脱。”其侄向彼述之，果不相信. 后二日，忽遣人迎愚，言其骤然眩晕不起，求为延医。既至，见其周身颤动，头上汗出，言语错乱，自言心怔忡不能支持，其脉上盛下虚之象较前益甚，急投以净萸肉两半，生龙骨、生牡蛎、野台参、生赭石各五钱，一剂即愈。继将萸肉改用一两，加生山药八钱，连服数剂，脉亦复常。按：此方赭石之分量，宜稍重于台参。

Mr. Li was about 50 years of old. One day, we met by chance. He wanted me to have a look at him for his disease. He said that he had had a disease several months ago. After taking herb tea, he has already felt well. He wanted to know how about his pulse. When I felt his pulse, I noticed a no-rooting feeling on his Chi pulse position and a escaping feeling on his Cun position. Because he claimed that he had got recovered from a disease, he would not believe me if I told him his dangerous condition. Therefore I told him that his pulse is in peace and calm, but I told his nephew: “Your uncle’s pulse suggests a very dangerous condition. Contracting and restraining herbs should be taken for prevention of the Yuan Qi escape.” His nephew told his uncle. He did not believe it, as expected. Two days later, he asked someone come to me. The comer said he felt dizziness suddenly and could not get up. When I came to him, seeing his body was shacking, sweat on head, chattering randomly, saying that he felt palpitation very much and he would be able to sustain any more. His pulse was much more strong in the Chun position, but weaker in the Chi position. He was given herb Shanyurou 45 gram, Longgu 15 gram, Muli 15 gram, Wild Taishen 15 gram, Daizheshi 15 gram. One dose solved his condition. Then the Shanyurou was changed to 30 gram, with addition of Shanyao 24 gram. Several doses later, the pulse returned normal. Explanation: in this case, the amount of Daizheshi should be little bit more than the Taisehen.

张港朱××之儿媳，产后角弓反张，汗出如珠，六脉散乱无根，有将脱之象，迎为延医。急用净萸肉二两，俾煎汤服之，一剂即愈。

Mr. Zhu lived in Zhanggang had a daughter-in-law, who suffered from whole body spasm after childbirth. She had heavy sweat, and her pulse was scattering and no root feeling, showing a sing of escaping. I prescribed her Shanyurou 60 gram, cook and drink. One dose treatment solved her condition.

治胸膈满闷，其脉大而弦，按之似有力，非真有力，此脾胃真气外泄，冲脉逆气上干之证，慎勿作实证治之。若用开通之药，凶危立见。服此汤数剂后脉见柔和，即病有转机，多服自愈。
This formula works for a condition with fullness feeling in the chest; the pulse is big and string, which felt as strong, but not. This is the condition in which the Spleen-Stomach True Qi is escaping and the Chong Mai (Chong meridian) Qi rushes up. This condition should not be treated as a Shi condition[12]. If a opening herbal therapy is used, the risk would happen right away. If after several doses of drinking of this herbal tea, the pulse turns peace and calm, it would suggest that the disease is improving. It should be continue more to cure.

野台参（五钱）生赭石（轧细,五钱）生芡实（五钱）生山药（五钱）萸肉（去净核,五钱）清半夏（二钱）茯苓（二钱）

Whild Taishen 15 gram, Daizheshi 15 gram, Qianshi 15 gram, Shanyao 15 gram, Shanyurou 15 gram (remove the kernel), Banxia 6 gram, and Fuling 6 gram.

If the fullness feeling reduced after several drinks, remove Qianshi, but add Baizhu 6 gram.

脉之真有力者，皆有洪滑之象。洪者如波涛叠涌，势作起伏；滑者指下滑润，累累如贯珠。此脉象弦直，既无起伏之势，又无贯珠之形，虽大而有力，实非真有力之象。

If the pulse is really strong with force, it should bear a kind of strong-slippery feeling. Strong means it feels as a big wave moving one after another; slippery means it is smooth and wet, as touching pearl. The pulse for this condition here is string-straight, no waving feeling, no pearl feeling. Though felt big and strong, it is actually not a true strong.

和缓者脾胃之正脉，弦长者肝胆之正脉。然脾胃属土，其脉象原宜包括金、木、水、火诸脏腑，故六部之脉皆有和缓，乃为正象。今其脉弦而有力，乃肝木横恣，侵侮脾土之象，故知其脾胃虚也。
Calm pulse is the normal Spleen-Stomach pulse; String pulse is the normal Liver-Gall Bladder pulse. The Spleen-Stomach belongs to the Soil, which distributes in the Metal, the Wood, the Water and the Fire organs, so normally, the pulse in every position should be in calm feeling. If the Liver pulse is string and strong, it would suggest that the Liver Wood is too strong and it would damage the Spleen Soil. So, it is known that the Spleen-Stomach is weak.

冲脉上隶阳明，故冲气与胃气原相贯通。今因胃气虚而不降，冲气即易于上干。此时脾胃气化不固，既有外越之势，冲气复上干而��挤之，而其势愈外越，故其脉又兼大也。
Chong meridian connects with Yangming meridian. So, the Chong Qi is connected with the Stomach Qi. Now, the Stomach Qi cannot fall down due to its weakness, the Chong Qi would rush up to cause problem. Now, the Spleen-Stomach Qi was escaping, having out-pushing force, with additional Chong Qi rushing up to enhance it, so the pulse is with big feeling.

一媪，年过六旬，胸腹满闷，时觉有气自下上冲，饮食不能下行。其子为书贾，且知医。曾因卖书至愚书校，述其母病证，且言脉象大而弦硬。为拟此汤，服一剂满闷即减，又服数剂全愈。
One old lady, about 60 years of old, felt from time to time, Qi rushing from lower part of the abdomen to the upper body and the eaten food does not move down. His son is a beek-seller and also knows some medicine. He had had come to our school to sell books, so he mentioned to me his mother’s condition. He also mentioned that her pulse was big, string and hard. I asked her to drink this Zhenshe Tang. One dose made her fullness condition reduce, several more doses solved her problem completely.

一人，年近五旬，心中常常满闷，呕吐痰水。时觉有气起自下焦，上冲胃口。其脉弦硬而长，右部尤甚，此冲气上冲，并迫胃气上逆也。问其大便，言甚干燥。遂将方中赭石改作一两，又加知母、生牡蛎各五钱，浓朴、苏子各钱半，连服六剂全愈。
A patient was about 50 years of old. He felt fullness in the chest and stomach, vomiting phlegm and water. From time to time, he felt Gas rush from Lower Jiao of the body (lower abdomen) up to the stomach. His pulse is string, hard and long, especially on the right side. Such Gas rushing-up is not the reverse rushing-up of the Stomach Qi. His bowel movement was said to be very dry. So, the Daizheshi in the formula was changed to 30 gram, also with Zhimu 15 gram, Muli 15 gram, Houpu 4.5 gram, Souzi 4.5 gram. The formula was continued for several days. The whole body condition was completely recovered.

天津王媪，得病月余，困顿已极，求治于弟。诊其脉，六部皆弦硬有力，更粗大异常，询其病，则胸膈满闷，食已即吐，月余以来，未得一饭不吐，且每日大便两三次，所便少许有如鸡矢，自云心中之难受，莫可言喻，不如即早与世长辞，脱此苦恼。细思胸膈满闷，颇似实证者；，然而脉象弦硬粗大，无一点柔和之象，遂忆镇摄汤下注云，治胸膈满闷，其脉大而弦，按之有力，此脾胃真气外泄，冲脉逆气上干之证，慎勿以实证治之云云。即抄镇摄汤原方予之。服一剂，吐即见减，大便次数亦见减，脉遂有柔和之象。四五剂，即诸病全愈。以后遇此等脉象，即按此汤加减治之，无不效如桴鼓。

A old lady, who lived in Tianjin city, got sick for months. She felt very tired ans she came to me for treatment. Her pulse was string, hard, strong, and thick very much. She felt fullness in her chest, vomiting after eat. For several months, there is one meal without vomiting. Her bowel movement was two to three times a day and the stool was very little as chicken stool every time. She claimed very painful in the body, which was very hard to describe, so that she wanted to stop the life without suffering as such any longer. I thought, she felt fullness in the chest, appearing as a Shi Condition, but the pulse was string, had, thick and big, suggesting that it is the escaping of the Stomach Qi, the Chong meridian moved reverse up to cause the nausea. So, I give her he Zhenshe Tang. One dose made her vomit stop, the times of diarrhea reduce and the pulse turned to have a kind of calm feeling. After four to five doses of the formula, the whole conditions were completely solved. Later, whenever found such pulse, I used this formula. The result was excellent.

[1] Shiquan here means all aspect in Chinese. Yu means nourish. Zhen means true.

[2] Yin here means beverage, something to drink, herb extract to drink. Not the Yin in the Yin and Yang concept. This is the typical difficulty in the Chinese-English translation. Many Chinese words share the same Pinyin, which is for help in pronounce, not for spelling of the Chinese character. If we use the Pinyin for the translate, it may have confuse in the expression. If we however use the corresponding English word, it is many times no proper word available. This is the barrier between the languages.

[3] Big Q means big, great, and very important Qi.

[4] It is difficult to explain the ru pulse in English.

[5] Yi here means number one in Chinese; Wei means item; Shuyu means herb Shanyao. So, Yiwei Shuyu Yin means: herbal formula that contains only Shuyu.

[6] Herb Shanyao is also an ordinary Chinese vegetable.

[7] Wen Bing: a group of clinic diseases in Chinese medicine, which are similar to some infectious diseases in western medicine.

[8] Zhou here means soup in Chinese

[9] Shishuangbing: specially prepared persimmon.

[10] Laosou: Lao means exhausting; Sou: means cough, here in Chinese. Fang means formula. So, Laosou Fang means a formula for exhausting condition with cough.

[11] Be Syndrome: clinic conditions that have pain, stiffness, numb, or swelling in the joints or in the muscles. The term arthritis used in the western medicine is only one kind of Bi in the Chinese medicine concept.

[12] Shi condition: a not weak condition. Shi condition is opposite from the weakness condition in Chinese medicine system.