凡心脾阳气不足，五脏气血并伤，自汗恶寒，身热腰背疼痛，感冒时气，似虐非
虐，劳伤发热，并用此方，名为十全补正汤。是方五脏均伤，气血并补，倘有外邪乘
虚而袭者，正气得此补助之功，自能互相法逐，而邪无可容之地矣。书曰∶补正而邪自
除也。故名之。
人参（一钱五分） 炙黄 （二钱） 枣仁（二钱，炒研） 当归（一钱二分，酒炒）
白术（炒黄，二钱） 白芍药（一钱二分，酒炒） 白茯苓（一钱二分） 生杜仲（二钱）
川续断（一钱五分） 牛膝（二钱） 甜薄桂（八分） 加大枣二枚，水煎服。
如心有浮热，再加灯心；如阴虚甚者，加熟地；如有外感去人参，加柴胡、生姜；
如气滞加木香少许；如咳嗽，去参 加炒麦冬；如右尺有力去薄桂；如肺脉洪大去黄
。
都门张姓母患痿症，数载不能起床，祷于关圣得直遇清江贵公子一签，傍人以予浙
江人为告，延视之，气血俱虚，乃付以前方不及十剂，步履如常，可见药缘之凑合，而
关夫子之附应也。
旨哉！立斋先生所云，气血虚而变现诸症，难以病名也。友人张子芳，年将六旬，
身无发热头疼等候，但饮食日少，大便甚细而难，小便甚赤而涩。凡间三日，则夜必气
逆上壅欲死，通宵不寐，精神渐疲，形容枯槁，六脉洪数，惟右关尺则少缓无力。余
曰∶此阴道亏极，孤阳无根据，但三日而一甚，此兼脾主信而为病也。凡症之难名者，
悉由本气为病，但从根本治之，根本一得，纵有外邪，无可藏匿，而自外现矣。乃以熟
地一两六钱、炒麦冬三钱、炒白术六钱、牛膝三钱、五味子附子各一钱，参汤冲服，数
剂之后，每至及期乃发寒热。如三虐状。余曰∶今邪外达矣。照方再服，邪既由此而
出，更可由此而散矣。十余剂后，至期睡卧俱安，三虐全已，大便粗大而阳，小便淡白
而长，饮食渐加，精神渐复。
凡察病虽有望、闻、问、切四法，然究竟必以凭脉为主，盖脉现脏腑之真情，病多
疑似之假象。友人张氏，曾患杨梅恶疮，清凉解毒方愈，未几而复头颅面颊鼻柱牙床，
疼痛不堪，饮食俱难延纳，益信余毒为害，复用清凉解毒之方，渐至饮食俱废，坐卧不
能，精神疲困，乃延余视，按其脉六脉微弱。余曰∶果属阳毒，脉宜洪大矣。况头为
清阳之会，脑为精髓之海，面属阳明多血多气，牙属少阴诸骨之余，今真阴真阳已为寒
凉久困，故阴阳失职而为病，岂可入井而再下石乎？即恶疮之初发，亦由自己精血元阳
亏损，而阴寒凝泣之气得以乘之。若概以清凉为事，则益增其害，独不思《经》曰∶气
血不和，留结为痈。凡生于肌肉者，气血之病也。成于筋骨者，精髓之病也。人身气血
精髓之外，有何毒瓦斯，可并行于经络者乎！
天之风寒暑湿燥热火六气之外，有何毒瓦斯介于其间乎？如冬寒冻疮，夏暑热疖有何毒
乎？若能以调和气血为标，填补真阴真阳为本，则茉卫周行。如水流不污矣。乃以煎方
同八味丸并服，不及半月，诸痛并瘳，而饮食精神俱旺矣。
《经》曰∶邪之所凑，其正必虚。又曰∶不治其虚，安问其余？又曰∶治病必求其
本，诚万世医旨之格言也。假如停滞发热，脸红烦燥，似有余也。然究其本也，乃脾胃
正虚，不能传化，则虚乃其本也。理宜推扬谷气，助脾消化，设徒从标攻克，则内阳之
患，接踵而至，更如伤风感冒，壮热头疼，虽似有余，然即《经》所谓∶邪气盛则实，
实因胃气不固所召也。若纯用猛剂发散，则表气愈虚，外邪之乘，何时而已？更如咳嗽
喘促，烦燥不安，肺气热盛有余，然究其源，非水虚不能制火，即火虚虚阳上浮，设
从标理肺为事，虽暂愈而发愈甚，故凡外凑有余之病，即本经正气不足之时。若不从源
调治，正当不足，而更不足之，虚者日虚，危亡继其后矣。贵乎顾本求源，杜微防渐，
则病根永绝，正气发生，不惟去病，更可长年矣。
或曰∶子之治病则甚效，而用药则甚常，大抵所用，不越八珍十全、归脾养荣、
独参、生脉、六味、八味、参、 、木、附理中数汤居多，岂百病治法相同乎？余曰∶
《经》云∶知其要者一言而终，昔岐黄神圣，不过昭明阴阳盛衰，邪正虚实，胜负生克，
此外无别论也。盖天地造化虽奇，而其阴阳则一，不外五行生克之用，其为真阴真阳之
主者，日月是也。人身大小强弱虽殊，而其安危修短，不外五脏盛衰之变，以气血为
用，而水火为根也。若将舍此而嗜奇，是欲达天地阴阳于五行之外，而谓生人另有脏腑
气血水火之用耶。夫天人一体，造化不能奇而外乎阴阳，人生不能奇而殊其脏腑，司命
者岂可越脏腑气血水火之外，嗜奇为事乎！况邪之所毒，其正必虚，病至于危。元神已
惫。一胜一负，理之所常，治病者顾本攻邪，补偏救弊，尚虞不及，敢为嗜异，南辕
北辙，有济于世耶，故先贤仲景制八味以补命门，是重先天之阳也。仲景减桂附而用六
味，以治小儿，是重先天之阴也。养葵守六味八味而互用，是先天阴阳并重也。东垣重
脾胃而立补中益气，是培后天化生之源也。丹溪补气血而以四君四物为主，是助后天之
用也。水斋以归脾养荣八味为主，是先天后天通例也。先贤博及群书，不敢沽高仗异
者。亦限乎天人一理之常经耳。设天地阴阳之理，另行一途，人身脏腑之间，尚有异
用，岂数千载名贤叠出，何难创其说而重后世哉！
古人凡用热药，多令冷冻饮料，恐有假阳在上，一遇热药，必拒格而不得入，故使冷
服，则冷遇冷相须而入，自不吐出，下嗌之后，冷性既除，热性始发，假阳自平，诚为
良法。倘症纯系虚寒，而无假阳之候者，只须温进，不必冷服。盖纯虚纯寒之症。若如
冷冻饮料，益促亡阳，变生泄泻呃逆诸候，及至热性发时，功不掩过，已无及矣。故凡遇极
虚极寒危症，而欲挽回垂绝者，药中不可少兼阴分之味，服药不可少存寒阴之性，盖症
至假阳亦无，焉能任此假冷，腹中全无阳和之气，不能少任阴分之药耳。
夫桂附二味，古哲不甚常用，而所用亦甚少，其效颇速，今人常用而且重，其效甚
缓者何也？盖因天地气化转薄，人与草木，均禀天气以有生，况草木更假地味以成形，
气化薄而所禀亦薄矣。人之先天之气，即元阳之气也。元阳之气既薄，焉得不假桂附之
力乎，所以今人常用宜也。奈桂附亦禀天地之气而力薄矣。所以虽重用而奏功甚缓也。
况百病之生，莫不由火离其位也。而治之欲愈其病者，可不令火藏其源乎。
古人相传之谚语，其义甚深，后人可罔顾名而详审之，譬如言人之死而曰∶完了，
寓意最确，盖人之生，由于精气神之三实，精者阴血化生之华也。神者元气凝聚之真
也。阴血不足，则不能化生其精华，元气不充，则不凝聚其真神，然神以精为根据附，精
倚神而光明，故《经》所谓∶精则养神也。凡精神合德为用，则长有天命，何病之有？
虽有强邪，亦能任之。如精神失守而不彰，则天命匪长，百病踵起，即遇微邪，便足为
害，诚由精神完了，而力不能任之，况有形之疾病无期，而无形之元气易绝，凡吐血吐
痰痨怯将危之际，由于阴精先完者，必形容虽枯槁，神气却清爽。然精华既竭，神无根据
附，倏忽气绝而逝。凡中风中寒暴死之症，由于元阳真气先完，故形容虽肥壮，而神思
却糊涂，盖真神既缺，虽阴精未竭，犹水失阳和，便成坚冰而不活，故每多人事不省而
毙，观此则完之一字，珍生君子及司命者，可不进思乎！《经》曰∶不治其虚，安问其
余，正虑精神先完于疾病未愈之前也。
古人用药。凡治大病，必用大力，君主之药数味，则功专不泛，可以立挽沉 。如
治小病则用小力，佐使之药，皆可成功奏绩，何劳刚烈猛剂，反致大动伤生。至于汤
丸膏散，各有所宜，其治五脏及经络之病者，必用大剂作汤，以荡涤之。欲走阳分，
宜热服，欲走阴分，宜温服，欲达经络之表，宜酒煎，治心肺之病者必浓煎小剂，食
远徐徐缓咽以阴之，盖其位在上而近，不厌频而少也。治肾病者所居最下，补阳之药，
有伤心肺，补阴之药，不利脾胃。贵乎作丸吞服，以直达下焦而始化，所谓偷关过之法
也。若急症须投煎剂，必食前多服顿服，始能达及下焦，治脾胃者惟宜散矣。盖诸物运
化，皆仗脾胃。若二经一病，运化便难，丸则不能施展见功，煎则疾趋下走，散则惟凭
渣滓，直入胃家，不行经络，且不劳胃化，中宫便见其长，脾困一醒，自能营运药力，
而其功愈见矣。治五脏枯槁之病者，必仗膏滋，方能粘润填补，丸则太缓，煎则太速，
散则质薄，均难见效也。且有久服补养气血之药，而气血似乎日衰，再服疏利之剂而气
血似乎顿长者，此非补养之误也。盖补养日久，生气既多，泄气反重，且粘滞太过，血
则壅而不行，气则伏而不用，所以疏利一投，而气血宣行，前功顿见也。有久服温补
元阳之药，而元阳似乎日困，后服清凉之剂，而元阳似乎顿壮者，此非温补之误也。
盖如春夏发生长养，则气血流溢无拘，所以人多困倦。若非秋冬敛肃闭藏之气，何能为
成实坚固之用耶？更凡一经或虚或病，而用药或治或补，专在一经为事者，其功虽捷，
可暂而不可久，久而胜负相生，反增偏害之势。若隔一隔二为治者，其效虽缓，其力甚
长，盖如源深则流远，根深则蒂固，况脏得生气，自相长养，便无偏胜之害矣。此
（张）之管见，并及以补所遗。
一少年劳心，色欲过度，乃患小便淋漓，甚胀而疼，且二便牵痛其肝，两寸沉
微，左关甚弱，右关数滑而尺弦涩，乃知心肺之气不足，而下陷于肾肝，肝肾之气又不
足，所以一则不能疏泄，一则不能闭藏，中气既虚，则清阳不能上升，而中宫郁滞，蒸
为湿热，渗入膀胱，因乃似淋非淋，二便牵痛。如大瘕泄也。余令早晨服八味合二妙，
作汤，使寒热互为向导，去其湿热以澄其源，日中食速，用补中益气汤，但心气已
虚，焉敢更泻其气，乃去陈皮，肝气已弱，焉敢再疏其肝，乃去柴胡，其渣临晚煎服探
吐，浊气下壅，必得淡渗，乃加茯苓，但恐去柴胡而升麻独提无力，乃加酒炒嫩防风以
助之，防风酒炒者，去其辛散之性，益其升腾之力也。渣服探吐者，盖湿与郁与热，得
一升发而自散，况上窍通而下窍自利也。果服之甚效，其方于后，以广识见。
凡是心脾阳气不足，五脏气血同时受损，出现自汗、怕冷、身体发热、腰背疼痛，或是感染时行疫病，症状像疟疾又不完全是疟疾，以及因劳累导致的发热，都使用这个方子，名叫十全补正汤。此方针对五脏均受损伤的情况，气血双补。如果有外邪趁虚侵袭，正气得到补助后，自然能协同驱除邪气，使邪气无处容身。医书说：“扶助正气，邪气自然消除。”因此得名。
人参（一钱五分） 炙黄芪（二钱） 酸枣仁（二钱，炒后研碎） 当归（一钱二分，酒炒）
白术（炒至微黄，二钱） 白芍药（一钱二分，酒炒） 白茯苓（一钱二分） 生杜仲（二钱）
川续断（一钱五分） 牛膝（二钱） 甜薄桂（八分） 加大枣两枚，水煎服。
如果心中浮热，再加灯心草；如果阴虚严重，加熟地黄；如果有外感，去掉人参，加柴胡、生姜；如果气滞，加少许木香；如果咳嗽，去人参加炒麦冬；如果右尺脉有力，去掉薄桂；如果肺脉洪大，去掉黄芪。
京城有一位姓张的人的母亲患痿症，多年不能起床，向关圣帝君祈祷，求得一支签文，旁边人告知我是浙江人，于是请我去诊治。发现其气血俱虚，便给予上述方剂，不到十剂药，就能正常行走，可见药物机缘的巧合，以及关夫子（关羽）的灵验。
说得真好！立斋先生所说，气血虚弱而变现出各种症状，很难用具体的病名来概括。我的朋友张子芳，年近六十，身体没有发热头疼等症状，只是饮食日渐减少，大便非常细且难解，小便非常红且涩痛。每隔三天，夜里必定气逆上冲，感觉快要死去，整夜无法入睡，精神逐渐疲惫，形体枯槁，六脉洪数，只有右关、右尺脉稍缓无力。我说：“这是阴气亏损到了极点，孤阳没有依附，每三天加重一次，这是因为兼有脾主信（规律性）而为病。凡是大难命名的病症，都是由本气生病引起的，只要从根本治疗，根本稳固了，即使有外邪，也无处藏匿，自然会显露出来。”于是用熟地黄一两六钱、炒麦冬三钱、炒白术六钱、牛膝三钱、五味子和附子各一钱，用人参汤冲服。几剂之后，每到那个时间点就发作寒热，像三次疟疾的症状。我说：“现在邪气已经外达了。”照原方再服，邪气既然由此而出，更可以由此而散。十余剂后，到时间睡觉安稳，所谓的“三虐”完全好了，大便变粗变大且通畅，小便淡白而长，饮食逐渐增加，精神逐渐恢复。
凡是诊察疾病虽然有望、闻、问、切四种方法，但终究必须以脉诊为主，因为脉象显现脏腑的真实情况，而病症多呈现疑似的假象。我的朋友张某，曾患杨梅疮（梅毒），服用清凉解毒方后痊愈，不久又复发，导致头颅、面颊、鼻梁、牙床疼痛不堪，饮食难以吞咽，更加确信是余毒为害，再次服用清凉解毒之方，渐渐导致饮食废绝，坐卧不能，精神疲困，于是请我去诊治。按脉发现六脉微弱。我说：“如果确实是阳毒，脉象应该洪大。况且头为清阳汇聚之处，脑为精髓之海，面部属阳明经多血多气，牙齿属少阴经骨骼之余。现在真阴真阳已被寒凉药物久困，所以阴阳失职而致病，怎么能像落井还要再扔石头呢？即使是恶疮初发，也是由于自身精血元阳亏损，阴寒凝滞之气得以乘虚而入。如果一概以清凉解毒为事，只会增加危害，难道没想过《内经》说：‘气血不和，留结为痈’。凡是生于肌肉的，是气血的病；成于筋骨的，是精髓的病。人身除了气血精髓之外，还有什么毒瓦斯可以在经络中并行呢？在天地风寒暑湿燥火六气之外，还有什么毒瓦斯夹杂其中呢？比如冬天的冻疮，夏天的暑疖，有什么毒呢？如果能以调和气血为标，填补真阴真阳为本，那么营卫周流运行，就像流水不腐一样。”于是用煎剂同八味丸一起服用，不到半个月，各种疼痛都痊愈，饮食和精神都旺盛了。
《内经》说：“邪气聚集的地方，正气必然虚弱。”又说：“不治疗其虚损，还问其余什么呢？”又说：“治病必求其本”，这确实是万世医学宗旨的格言。假如停滞发热，脸红烦躁，似乎有余证。但究其根本，是脾胃正气虚弱，不能传化，所以虚才是根本。理应推扬谷气，帮助脾胃消化，如果只从表面攻伐，那么内阳的祸患将接踵而至。又如伤风感冒，高热头疼，虽然看似有余，但这正是《内经》所说的“邪气盛则实”，实是因为胃气不固所招致的。如果纯用猛剂发散，表气会更虚，外邪侵袭，何时才能停止？又如咳嗽喘促，烦躁不安，肺气热盛似乎有余，但究其源头，不是水虚不能制火，就是火虚导致虚阳上浮。如果从表面调理肺部，虽然暂时痊愈但发作更甚。所以凡是外部凑集表现为有余的病，其实是本经正气不足的时候。如果不从源头调治，正当不足之时反而更使其不足，虚者日虚，危亡紧随其后。关键在于顾护根本、探求源头，防微杜渐，这样病根永绝，正气发生，不仅能去除疾病，还可以延年益寿。
有人问：“您治病很有效，但用药很平常，大致所用，离不开八珍汤、十全补正汤、归脾汤、养荣汤、独参汤、生脉散、六味地黄丸、八味地黄丸、参附理中汤等为数居多，难道百病的治法都相同吗？”我说：“《内经》云：‘知其要者，一言而终。’昔日岐伯、黄帝这些神圣之人，不过是阐明阴阳盛衰、邪正虚实、胜负生克罢了，此外没有别的论述。天地造化虽然奇妙，但其阴阳原理是一致的，不外乎五行生克的作用，主宰真阴真阳的是日月。人身大小强弱虽然不同，但其安危长短，不外乎五脏盛衰的变化，以气血为作用，以水火为根本。如果舍弃这些而追求奇特，是想达到天地阴阳在五行之外的境界，并认为人生另有脏腑气血水火的作用吗？天人一体，造化不能奇于阴阳之外，人生不能奇于脏腑之外，掌生死命运的人，岂可越出脏腑气血水火之外，追求奇特为事呢？何况邪气之所以有毒，是因为正气必然虚弱，病至于危险阶段，元神已疲惫。一胜一负，是常理。治病者顾护根本、攻逐邪气，补救偏颇，还担心不够，怎敢追求特异，南辕北辙，对世间有益处呢？所以先贤张仲景制作八味丸以补命门，是重视先天的阳；张仲景减去桂附而用六味丸，用于治疗小儿，是重视先天的阴。赵献可（号守葵）六味八味互用，是先天阴阳并重；李东垣重视脾胃而立补中益气汤，是培补后天化生的源头；朱丹溪补气血而以四君子汤、四物汤为主，是助益后天的作用；赵献可（水斋）以归脾、养荣、八味为主，是先天后天通例。先贤博览群书，不敢沽名钓誉、仗恃奇异，也是受限于天人一理的常经。假如天地阴阳的道理另行一条途径，人身脏腑之间还有异用，那岂止数千载名贤叠出，何难创立学说以重后世呢！”
古人凡是使用热药，多令冷冻饮料（冷服），恐怕有假阳在上，一遇到热药，必然拒格而不能进入，所以让冷服，则冷遇冷相互吸引而进入，自然不会吐出，咽下之后，冷性既除，热性始发，假阳自平，这确实是良法。如果病症纯粹是虚寒，而没有假阳的征候，只需温服，不必冷服。因为纯虚纯寒的病症，如果像冷冻饮料那样冷服，会加速亡阳，变生泄泻、呃逆诸候，等到热性发作时，功效掩盖不了过错，已经来不及了。所以凡是遇到极虚极寒的危重症，想要挽回垂绝的生命，药中不可少兼阴分之味，服药不可少存寒阴之性，因为症至假阳也没有了，怎么能承受这种假冷的药性？腹中全无阳和之气，不能稍微承受阴分的药物。
桂枝、附子这两味药，古代哲人不太常用，而且用量很少，效果颇快；今人常用而且重用，效果却很慢，为什么呢？大概因为天地气化转薄，人与草木，都禀受天气以生存，何况草木更借助地味以成形，气化薄而所禀受的气也薄了。人的先天之气，就是元阳之气。元阳之气既然薄弱，怎能不假借桂附之力呢？所以现在人常用是适宜的。无奈桂附也禀受天地之气而力薄了。所以虽然重用而奏效很慢。况且百病的产生，没有不由火偏离其位引起的。而想要治愈疾病，可不令火藏其源吗？
古人相传的谚语，含义很深，后人不可不顾名义而详细审察它。譬如说人死曰“完了”，寓意最确切。盖人的生存，由于精气神的三实。精者是阴血化生的精华。神者是元气凝聚的真体。阴血不足，就不能化生其精华；元气不充，就不能凝聚其真神。然而神以精为根据依附，精倚靠神而光明，所以《内经》所谓：“精则养神”。凡是精神合德为用，就能长寿，有什么病呢？虽有强邪，也能抵御。如果精神失守而不彰显，寿命就不长，百病随之而起，即使遇到微邪，也足以为害，诚然是精神“完了”，而力量不能抵御。何况有形的疾病无期，而无形的元气易绝。凡吐血、吐痰、劳怯将危之际，是由于阴精先“完”者，必然形体虽枯槁，神气却清爽。然而精华既竭，神无根据依附，忽然气绝而逝。凡中风、中寒暴死的病症，是由于元阳真气先“完”，故形体虽肥壮，而神思却糊涂。盖真神既缺，虽然阴精未竭，犹如水失去阳和之气，便成坚冰而不活，所以多人事不省而毙。观此，“完”之一字，珍爱生命者及掌生死命运的人，能不深思吗！《内经》说：“不治其虚，安问其余”，正是忧虑精神先“完”于疾病未愈之前。
古人用药，凡是治大病，必用大力，君主之药数味，则功效专一不泛，可以立即挽回沉疴。如治小病则用小力，佐使之药，皆可成功奏绩，何必用刚烈猛剂，反致大动伤生。至于汤、丸、膏、散，各有适宜之处。其治五脏及经络之病者，必用大剂作汤，以荡涤之。欲走阳分，宜热服；欲走阴分，宜温服；欲达经络之表，宜酒煎。治心肺之病者必浓煎小剂，食远徐徐缓咽以引之，盖其位在上而近，不厌频而少也。治肾病者所居最下，补阳之药，有伤心肺；补阴之药，不利脾胃。贵在作丸吞服，以直达下焦而始化，所谓“偷关过”的方法。若急症须投煎剂，必食前多服顿服，始能达及下焦。治脾胃者惟宜散矣。盖诸物运化，皆仗脾胃。若二经一病，运化便难，丸则不能施展见功，煎则疾趋下走，散则惟凭渣滓，直入胃家，不行经络，且不劳胃化，中宫便见其长，脾困一醒，自能营运药力，而其功愈见矣。治五脏枯槁之病者，必仗膏滋，方能粘润填补，丸则太缓，煎则太速，散则质薄，均难见效也。且有久服补养气血之药，而气血似乎日衰，再服疏利之剂而气血似乎顿长者，此非补养之误也。盖补养日久，生气既多，泄气反重，且粘滞太过，血则壅而不行，气则伏而不用，所以疏利一投，而气血宣行，前功顿见也。有久服温补元阳之药，而元阳似乎日困，后服清凉之剂，而元阳似乎顿壮者，此非温补之误也。盖如春夏发生长养，则气血流溢无拘，所以人多困倦。若非秋冬敛肃闭藏之气，何能为成实坚固之用耶？更凡一经或虚或病，而用药或治或补，专在一经为事者，其功虽捷，可暂而不可久，久而胜负相生，反增偏害之势。若隔一隔二为治者，其效虽缓，其力甚长，盖如源深则流远，根深则蒂固，况脏得生气，自相长养，便无偏胜之害矣。此（张）之管见，并及以补所遗。
一个少年劳心过度，色欲过度，于是患小便淋漓，非常胀且疼，且二便牵痛其肝，两寸脉沉微，左关脉甚弱，右关脉数滑而尺脉弦涩，于是知道心肺之气不足，而下陷于肾肝，肝肾之气也不足，所以一则不能疏泄，一则不能闭藏，中气既虚，则清阳不能上升，而中宫郁滞，蒸为湿热，渗入膀胱，因而似淋非淋，二便牵痛，如大瘕泄。我令早晨服八味丸合二妙散，作汤剂，使寒热互为向导，去其湿热以澄其源；日中进食时，用补中益气汤，但心气已虚，焉敢更泻其气，乃去陈皮；肝气已弱，焉敢再疏其肝，乃去柴胡；其药渣临晚煎服探吐，浊气下壅，必得淡渗，乃加茯苓；但恐去柴胡而升麻独提无力，乃加酒炒嫩防风以助之。防风酒炒者，去其辛散之性，益其升腾之力也。渣服探吐者，盖湿与郁与热，得一升发而自散，况上窍通而下窍自利也。果服之甚效，其方于后，以广识见。
Whenever the Yang Qi of the Heart and Spleen is insufficient, and the Qi and Blood of the Five Zang Organs are simultaneously injured, presenting with spontaneous sweating, aversion to cold, body heat, pain in the waist and back, contraction of seasonal epidemic pathogens, symptoms resembling malaria but not quite, fever due to overexertion, this formula should be used, named Shiquan Buzheng Tang (Ten Complete Decoction for Supplementing Righteousness). This formula addresses the injury of all five Zang organs, supplementing both Qi and Blood. If external pathogens take advantage of the deficiency to invade, the righteous Qi, aided by this supplementation, can naturally cooperate to expel the pathogens, leaving no place for them to reside. The medical texts state: "Supplement the righteousness, and the pathogens will eliminate themselves." Hence the name.
Ren Shen (Ginseng Radix) [1 qian 5 fen], Zhi Huang Qi (Honey-fried Astragali Radix) [2 qian], Zao Ren (Ziziphi Spinosae Semen, stir-fried and crushed) [2 qian], Dang Gui (Angelicae Sinensis Radix, wine-fried) [1 qian 2 fen], Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried until slightly yellow) [2 qian], Bai Shao Yao (Paeoniae Radix Alba, wine-fried) [1 qian 2 fen], Bai Fu Ling (Poria [with Pine Wood]) [1 qian 2 fen], Sheng Du Zhong (Eucommiae Cortex, raw) [2 qian], Chuan Xu Duan (Dipsaci Radix) [1 qian 5 fen], Niu Xi (Achyranthis Bidentatae Radix) [2 qian], Tian Bo Gui (Cinnamomi Ramulus, thin bark) [8 fen]. Add two Da Zao (Jujubae Fructus), decoct in water and take orally.
If there is floating heat in the heart, add Deng Xin Cao (Junci Medullia); if Yin deficiency is severe, add Shu Di Huang (Rehmanniae Radix Preparata); if there is an external contraction, remove Ren Shen, add Chai Hu (Bupleuri Radix) and Sheng Jiang (Zingiberis Rhizoma Recens); if there is Qi stagnation, add a small amount of Mu Xiang (Aucklandiae Radix); if there is cough, remove Ren Shen and add Chao Mai Dong (Ophiopogonis Radix, stir-fried); if the right Chi pulse is forceful, remove Bo Gui; if the Lung pulse is surging and large, remove Huang Qi.
The mother of a Mr. Zhang in the capital suffered from Wei Syndrome (flaccidity syndrome), unable to get out of bed for several years. She prayed to Guan Sheng Di Jun (Lord Guan), obtaining a lot that indicated she would meet a noble young man from Qingjiang. Someone informed me that I was from Zhejiang, so he invited me to examine her. I found her Qi and Blood were both deficient, so I prescribed the aforementioned formula. In less than ten doses, she could walk normally. This shows the coincidence of medicinal affinity and the efficacy of Lord Guan.
Well said! As Mr. Lizhai stated, when Qi and Blood are deficient and manifest various symptoms, it is difficult to name the disease specifically. My friend, Mr. Zhang Zifang, nearly sixty years old, had no fever or headache, but his diet decreased daily, his stool was very thin and difficult to pass, and his urine was very red and painful/obstructed. Every three days, at night, his Qi would reverse and rush upward, feeling as if he were dying, unable to sleep all night. His spirit gradually became fatigued, his appearance withered, and his six pulses were surging and rapid, except for the right Guan and Chi positions which were slightly slow and weak. I said: "This is extreme depletion of Yin, with solitary Yang having no foundation. The worsening every three days indicates involvement of the Spleen's governing rhythm. For diseases difficult to name, they all stem from disorders of the fundamental Qi. Treat the root, and once the root is secured, even if external pathogens exist, they will have nowhere to hide and will manifest externally." Thus, I used Shu Di Huang [1 liang 6 qian], Chao Mai Dong [3 qian], Chao Bai Zhu [6 qian], Niu Xi [3 qian], Wu Wei Zi (Schisandrae Chinensis Fructus) and Fu Zi (Aconiti Lateralis Radix Preparata) [each 1 qian], taken with Ren Shen Tang (Ginseng Decoction). After a few doses, at each interval, he developed alternating chills and fever, resembling malaria. I said: "Now the pathogen has reached the exterior." Continue taking the same prescription. Since the pathogen exits through here, it can also dissipate through here. After more than ten doses, he slept peacefully at the appointed times, the "three-malaria" symptoms completely resolved, his stool became thick and large and smooth, urine pale white and long, diet gradually increased, and spirit recovered.
Although diagnosing diseases involves inspection, listening/smelling, inquiry, and palpation, ultimately, pulse diagnosis must be primary, as the pulse reveals the true condition of the Zang organs, while symptoms often present deceptive appearances. My friend Mr. Zhang once suffered from Yangmei Chuang (chancre/syphilis). After healing with a cooling and detoxifying formula, it relapsed, causing unbearable pain in the head, cheeks, nasal bridge, and gums, making eating difficult. Believing it was residual toxin, he again used cooling and detoxifying formulas, leading to loss of appetite, inability to sit or lie down, and mental fatigue. I examined him and found his six pulses were faint. I said: "If it were truly Yang toxin, the pulse should be surging and large. Moreover, the head is the meeting point of clear Yang, the brain is the sea of essence, the face belongs to the Yangming channel (abundant in blood and Qi), and teeth are the remnants of the Shaoyin bones. Now, True Yin and True Yang have been trapped by cold-cooling medicines for a long time, causing Yin and Yang to lose their functions. How can one throw stones into a well that is already sinking? Even the initial onset of the chancre was due to the loss of essence, blood, and Yuan Yang, allowing Yin-cold stagnant Qi to invade. If one generally uses cooling methods, it only increases harm. Have you not considered the Classic saying: 'When Qi and Blood are disharmonious, accumulation forms abscesses.' Diseases arising in muscles are disorders of Qi and Blood; those forming in sinews and bones are disorders of essence and marrow. Outside of Qi, Blood, and Essence/Marrow in the human body, what toxins can run parallel in the meridians? Outside the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) of Heaven and Earth, what toxins are interspersed? For example, frostbite in winter or heat boils in summer—where is the toxin? If one takes harmonizing Qi and Blood as the branch treatment, and replenishing True Yin and True Yang as the root treatment, then Ying and Wei will circulate freely, like flowing water that does not become turbid." I prescribed the decoction together with Ba Wei Wan (Eight-Ingredient Pill) to be taken concurrently. In less than half a month, all pains healed, and diet and spirit became robust.
The Classic says: "Where pathogens gather, righteousness must be deficient." It also says: "If you do not treat the deficiency, how can you ask about the rest?" And: "Treating disease must seek its root." These are indeed eternal maxims of medical wisdom. Suppose there is stagnation fever, red face, and irritability, appearing as excess. However, investigating the root, it is Spleen-Stomach righteous Qi deficiency failing to transport and transform; thus, deficiency is the root. One should promote grain Qi and assist Spleen digestion. If one merely attacks from the branch, internal Yang disasters will follow. Similarly, in wind-cold common cold with high fever and headache, although it seems like excess, it is what the Classic calls "Pathogenic Qi flourishing leads to excess," caused by failure of Stomach Qi to consolidate. If one purely uses strong dispersing agents, exterior Qi becomes more deficient, and external pathogens will invade endlessly. Again, in cough and wheezing with irritability, Lung Qi heat appears excessive, but the source is either Water deficiency failing to control Fire, or Fire deficiency causing floating empty Yang. If one treats the Lung from the branch, it may temporarily heal but recur worse. Therefore, any disease presenting as external excess is actually a time of deficiency in the relevant channel's righteous Qi. If one does not treat from the source, further depleting what is already deficient, the deficient will become increasingly deficient, followed by danger and death. It is crucial to protect the root, seek the source, prevent subtle changes, so that disease roots are permanently eliminated, righteous Qi arises, not only curing the disease but also prolonging life.
Someone asked: "Your treatments are effective, but your prescriptions are ordinary, mostly using Ba Zhen Tang, Shiquan Buzheng Tang, Gui Pi Tang, Yang Rong Tang, Du Shen Tang, Sheng Mai San, Liu Wei Wan, Ba Wei Wan, Can Fu Li Zhong Tang, etc. Are the treatments for all hundred diseases the same?" I said: "The Classic states: 'He who knows the essentials needs but one word to finish.' The ancient sages Qibo and Huangdi merely clarified the flourishing and decline of Yin and Yang, the emptiness and fullness of pathogenic and righteous Qi, victory and defeat, generation and restriction. There is no other theory outside this. Although Heaven and Earth's creation is wondrous, its Yin and Yang principle is one, not exceeding the application of Five Elements generation and restriction. Those governing True Yin and True Yang are the Sun and Moon. Although humans vary in size and strength, their safety and longevity depend on the changes in the flourishing and decline of the Five Zang, utilizing Qi and Blood, with Water and Fire as roots. If one abandons these for the bizarre, one seeks Yin and Yang beyond the Five Elements, claiming humans have different Zang, Qi, Blood, Water, and Fire functions. Heaven and Man are one body; creation cannot be wondrous outside Yin and Yang, nor can human life differ in Zang organs. How can physicians seeking life and death go beyond Zang, Qi, Blood, Water, and Fire to pursue the bizarre? Moreover, where pathogens are toxic, righteousness must be deficient. When disease reaches crisis, Yuan Shen is exhausted. Victory and defeat are normal. Treating disease requires protecting the root and attacking pathogens, correcting bias and saving defects; we still fear insufficiency, how dare we pursue the exotic? Going south by driving the chariot north, how can it benefit the world? Thus, the ancient sage Zhang Zhongjing created Ba Wei Wan to tonify Ming Men (Gate of Life), emphasizing pre-heaven Yang; Zhang Zhongjing reduced Gui and Fu to use Liu Wei Wan for children, emphasizing pre-heaven Yin. Zhao Xianke (pseudonym Shoukui) used Liu Wei and Ba Wei interchangeably, emphasizing both pre-heaven Yin and Yang. Li Dongyuan emphasized Spleen and Stomach, establishing Bu Zhong Yi Qi Tang, cultivating the post-heaven source of transformation. Zhu Danxi supplemented Qi and Blood primarily with Si Jun Zi Tang and Si Wu Tang, assisting post-heaven function. Zhao Xianke (Shuizhai) used Gui Pi, Yang Rong, and Ba Wei as mainstays, a general rule for pre- and post-heaven. Ancient sages studied extensively, daring not to seek fame or rely on oddities, limited by the constant principle of Heaven and Man being one. If the principles of Heaven and Earth's Yin and Yang took another path, and human Zang organs had different functions, why would thousands of years of famous sages emerge without creating new theories to emphasize later generations!"
Ancients, when using hot medicines, often instructed patients to drink them cold, fearing that false Yang above would reject the hot medicine upon entry. Thus, cold administration allows cold to meet cold, facilitating entry without vomiting. After swallowing, the cold nature dissipates, and the hot nature activates, calming false Yang. This is indeed a good method. If the syndrome is purely deficiency-cold without false Yang signs, simply take it warm; no need for cold administration. Because in pure deficiency-cold syndromes, cold administration accelerates Yang collapse, causing diarrhea, hiccups, etc. By the time the hot nature acts, the merit cannot cover the fault, and it is too late. Therefore, in extremely deficient and cold critical cases, aiming to restore near-death conditions, the medicine must include Yin-natured ingredients, and the patient should retain some cold/nature during ingestion. When false Yang is absent, how can the body tolerate such falsely cold properties? With no Yang-warming Qi in the abdomen, it cannot bear Yin-natured medicines.
Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) were not frequently used by ancient philosophers, and when used, in small amounts, yet effects were fast. Moderns use them frequently and heavily, yet effects are slow. Why? Because the Qi of Heaven and Earth has thinned. Humans and plants derive life from Heaven's Qi; plants additionally rely on Earth's flavor to form shape. Thinner Qi results in thinner endowment. Human pre-heaven Qi is Yuan Yang Qi. Since Yuan Yang Qi is thin, how can it not borrow the power of Gui and Fu? Thus, modern frequent use is appropriate. Alas, Gui and Fu also inherit Heaven and Earth's Qi, so their power is thin. Hence, heavy use yields slow results. Moreover, the origin of all diseases lies in Fire departing from its position. To cure disease, one must not let Fire hide its source.
Ancient proverbs have deep meanings; later generations should not ignore the name but examine it carefully. For instance, saying a person died means "finished/wan le," which is most accurate. Human life depends on the solidity of Jing (Essence), Qi, and Shen (Spirit). Jing is the flower of Yin-Blood transformation. Shen is the truth of Yuan Qi condensation. Insufficient Yin-Blood cannot generate its essence; un-filled Yuan Qi cannot condense its true Shen. Shen relies on Jing for support; Jing shines relying on Shen. Thus, the Classic says: "Jing nourishes Shen." When Spirit and Jing function in harmony, one enjoys natural lifespan; what disease could there be? Even strong pathogens can be resisted. If Spirit and Jing lose their hold and fail to manifest, lifespan is short, and hundred diseases arise. Even slight pathogens cause harm. Truly, when Spirit and Jing are "finished," strength cannot resist. How much more so for有形 (form-based) diseases with no limit, while无形 (formless) Yuan Qi easily perishes. At the verge of death from hematemesis, spitting phlegm, or consumption, due to prior exhaustion of Yin-Jing, although the form is withered, the Shen-Qi remains clear. Yet, since essence and flower are exhausted, Shen has no foundation, and suddenly Qi cuts off and passes. In sudden death from stroke or cold invasion, due to prior exhaustion of Yuan Yang and True Qi, although the form is robust, the Shen-thought is confused. Since true Shen is lacking, even if Yin-Jing is not depleted, it is like water losing Yang-warmth, becoming solid ice and lifeless. Thus, many die unconscious. Observing this, the character "Wan" (Finished) should make those who cherish life and physicians reflect deeply! The Classic says: "Do not treat the deficiency, how can you ask about the rest?" This precisely worries about Spirit and Jing finishing before the disease heals.
In ancient times, when treating major diseases, great force was used. A few sovereign herbs ensured focused efficacy, capable of immediately reversing critical conditions. For minor diseases, small force was used; assistant and envoy herbs sufficed. Why use harsh, fierce agents that disturb and injure life? Regarding decoctions, pills, pastes, and powders, each has its suitability. For diseases of the Five Zang and meridians, large-dose decoctions are used to purge. To target Yang divisions, take hot; to target Yin divisions, take warm; to reach the exterior of meridians, decoct with wine. For Heart and Lung diseases, decoct strongly in small quantities, swallow slowly far from meals to guide it down, as their location is upper and near, tolerating frequent small doses. For Kidney diseases, located lowest, Yang-tonifying drugs may hurt Heart/Lung; Yin-nourishing drugs may hinder Spleen/Stomach. Pills swallowed whole are best to reach lower Jiao directly for transformation, a method called "stealing past the pass." For acute cases requiring decoctions, take large doses immediately before meals to reach lower Jiao. For Spleen/Stomach diseases, powders are suitable. All transformations rely on Spleen/Stomach. If two channels are diseased, transformation is difficult; pills cannot exert effect, decoctions rush downward, powders rely on dregs entering stomach directly without traversing meridians, sparing stomach transformation. Middle Jiao benefits, Spleen trouble wakes, naturally transporting medicinal power, enhancing efficacy. For withered diseases of Five Zang, pastes are needed for sticky, moist filling; pills are too slow, decoctions too fast, powders too thin, all hard to see effect. Also, long-term use of Qi/Blood tonics may seem to decrease Qi/Blood, while subsequent use of draining/promoting agents seems to instantly increase them. This is not error in tonification. Long-term tonification generates much Sheng Qi (generating Qi), but Xie Qi (draining Qi) becomes heavier, and stickiness is excessive. Blood stagnates and does not move; Qi hides and does not function. Thus, one dose of draining/promoting causes Qi and Blood to circulate, revealing previous merits. Long-term use of warming/tonifying Yuan Yang may seem to trap Yuan Yang daily, while subsequent cooling agents seem to instantly strengthen Yuan Yang. This is not error in warming/tonifying. Like spring/summer growth, Qi and Blood flow freely without restraint, causing fatigue. Without autumn/winter gathering and storing Qi, how can one achieve solidification? Furthermore, treating one channel exclusively for deficiency or disease, using specific agents, achieves quick results but cannot last long. Long-term use leads to mutual generation of victory/defeat, increasing bias and harm. Treating with intervals (skipping one or two channels) is slower but lasts longer, like deep sources flowing far, deep roots holding firm. Moreover, Zang organs receiving generating Qi nurture each other, avoiding bias harm. These are my humble views, added to supplement omissions.
A youth overworked mentally and excessively indulged in sexual desire, suffering from dribbling urination, severe distension and pain, with pain radiating to the liver from both bowels. Cun pulses were deep and faint, Left Guan very weak, Right Guan rapid and slippery, Chi string-like and choppy. I knew Heart/Lung Qi was insufficient, sinking into Kidney/Liver. Kidney/Liver Qi was also insufficient, thus failing to disperse and failing to store. Middle Qi was deficient, so Clear Yang could not rise, causing Middle Jiao stagnation, steaming into damp-heat, seeping into Bladder. Thus, it resembled strangury but wasn't, with pain in both bowels, like Da Xia Xie (major abdominal mass diarrhea). I ordered morning intake of Ba Wei Wan combined with Er Miao San, made into decoction, using cold and heat as guides to remove damp-heat and clarify the source. At noon, before food, use Bu Zhong Yi Qi Tang. But Heart Qi is already deficient, how dare I drain Qi further? Remove Chen Pi (Citri Reticulatae Pericarpium). Liver Qi is already weak, how dare I soothe Liver further? Remove Chai Hu. Take the dregs in evening, decoct and induce vomiting. Turbid Qi sinking obstructs, necessitating light diuresis, so add Fu Ling. Fearing that removing Chai Hu leaves Sheng Ma (Cimicifugae Rhizoma) alone lifting weakly, add Jiu Chao Nen Fang Feng (Saposhnikoviae Radix, wine-fried tender) to assist. Wine-frying Fang Feng removes its pungent-dispersing nature, enhancing its ascending power. Taking dregs to induce vomiting: Dampness, stagnation, and heat, upon receiving ascending release, dissipate naturally. Moreover, if upper orifices open, lower orifices benefit. Indeed, it was very effective. The formula follows, to broaden knowledge.