蔻（八钱） 桔梗（一两） 藿香（一两） 川黄连（四钱）
砂仁（两半） 白扁豆（两半） 山楂（两半）
上十八味，为细末，炼蜜丸，弹子大，每服二丸，米饮下。
【集注】罗谦甫曰∶此方始于缪仲醇，以治妊娠脾虚及胎滑。盖胎资始于足少阴，资
生于足阳明。故阳明为胎生之本，一有不足，则元气不足以养胎，又不足以自养，故当三
月正阳明养胎之候，而见呕逆。又其甚者，或三月、或五月而堕，此皆阳明气虚不能固耳。
古方安胎，类用芎、归，不知此正不免于滑。是方以参、术、茯、草、莲、芡、山药、扁
豆、薏苡之甘平，以补脾元；陈皮、曲、柏、砂、藿、桔之香辛，以调胃气，其有湿热，以
黄连清之、燥之。既无参苓白术散之补滞，又无香砂枳术丸之燥消，能补能运，臻于至和。
于以固胎，永无滑堕。丈夫服之，调中养胃。名之资生，信不虚矣。
六味地黄丸 治肾精不足，虚火炎上，腰膝痿软，骨热酸痛，足跟痛，小便淋秘或不
禁，遗精梦泄，水泛为痰，自汗、盗汗，亡血消渴，头目眩运，耳聋齿摇，尺脉虚大者。
熟地黄（八两） 山茱萸（四两） 白茯苓（三两）
干山药（四两） 牡丹皮（三两） 泽泻（三两）
上为末，炼蜜丸，如桐子大，空心淡盐汤下。
【集注】柯琴曰∶肾虚不能藏精，坎宫之火无所附而妄行，下无以奉肝木升生之令，上
绝其肺金生化之源。地黄禀甘寒之性，制熟则味浓，是精不足者补之以味也，用以大滋
肾阴，填精补髓，壮水之主。以泽泻为使，世或恶其泻肾而去之，不知一阴一阳者，天地
之道；一开一阖者，动静之机。精者属癸，阴水也，静而不走，为肾之体；尿者属壬，阳
水也，动而不居，为肾之用。是以肾主五液，若阴水不守，则真水不足，阳水不流，则邪
水泛行。故君地黄以密封蛰之本，即佐泽泻以疏水道之滞也。然肾虚不补其母，不导其
上源，亦无以固封蛰之用。山药凉补，以培癸水之上源，茯苓淡渗，以导壬水之上源。加
以茱萸之酸温，借以收少阳之火，以滋厥阴之液。丹皮辛寒，以清少阴之火，还以奉少
阳之气也，滋化源，奉生气，天癸居其所矣。壮水制火，特其一端耳。
【按】五行皆一，惟火有二，君火、相火也。君火为心经之火，君主一身之火也。相
火为肾中之火，宣布一身之火也。使君火无相火，则不能宣布诸火，以奉生身之本，相
火无君火，则不能君主诸火，以制其妄行之灾，故李杲立“内伤劳倦，火乘土位”之论，
以心火有余，用升阳气、泻阴火朱砂安神等药，而未及心火之不足者，以前人已有归脾、
养心等方也。震亨立阳常有余，阴常不足之论，以肾火有余，用补阴、补天等药，而未
及肾火之不足者，以前人己有肾气、桂附地黄汤丸也，根据本方加附子、肉桂，名桂附地
黄丸，治两尺脉弱，相火不足，虚羸少气，王冰所谓“益火之原，以消阴翳”者是也。加
黄柏、知母，名知柏地黄丸，治两尺脉旺，阴虚火动，午热骨痿，王冰所谓“壮水之主，以
制阳光”者是也。经云∶阴平阳秘，精神乃治。若阴阳偏胜，则疾病丛生。夫肾取象乎
坎，阳藏于阴之藏也。不独阴盛阳衰，阳畏其阴而不敢附，即阴衰阳盛，阴难藏阳亦无
可根据，虽同为火不归原，而其为病则异也。故于肾药中加桂、附，壮阳胜阴，使阳无所畏，
而自归原矣。加知柏补阴秘阳，使阳有所贮，而自归藏矣。世人但知以桂、附引火归原，不
知以知、柏平阴秘阳，举世皆蒙其误，故震汉特立补阴之论，以辟以火济火之非。而未
达其旨者，从而诽之，良可叹也。
八味地黄丸 治命门火衰，不能生土，以致脾胃虚寒，饮食少思，大便不实，或下元
衰惫，脐腹疼痛，夜多漩尿等证。
熟地黄（九蒸为度，捣膏，八两） 干山药（四两）
山萸肉（四两） 白茯苓 丹皮 泽泻（各三两） 肉桂 附子（各一两）
上八味为末，炼蜜丸如桐子大，酒下十五丸，日再服。
【集注】赵献可曰∶君子观象于坎，而知肾中具水火之用。今人入房而阳易举者，阴
虚火动也；阳事先痿者，命门火衰也。真水竭则隆冬不寒，真火熄则盛夏不热。是方也，
熟地、山药、泽泻、丹皮、茯苓、山萸皆濡润之品，所以能壮水之主；肉桂、附子辛润
之物，能于水中补火，所以能益火之原。水火得其养，则肾气复矣。
喻昌曰∶《金匮》用八味丸，治香港脚上入少腹不仁者。香港脚即阴气，少腹不仁即攻心
之渐，故用之以驱逐阴邪也。其虚劳腰痛，少腹拘急，小便不利，则因过劳其肾，阴气逆
于少腹，阻遏膀胱之气化，小便不能通利，故用之温养下焦，以收肾气也。其短气有微饮
者，饮，亦阴类，阴其胸中之阳，自致短气，故用之引饮下出，以安胸中也。消渴病，饮
水一斗，小便亦一斗，此肾气不能摄水，小便恣出，源泉有立竭之势，故急用以逆折其
水也。夫肾水下趋之消证，肾气不上升之渴证，非用是以蛰护封藏，蒸动水气，舍此曷
从治哉！后人谓八味丸为治消渴之圣药，得其旨矣。
柯琴曰∶命门之火，乃水中之阳。夫水体本静，而川流不息者，气之动、火之用也，
非指有形者言也，然火少则生气，火壮则食气，故火不可亢，亦不可衰。所云火生土者，
即肾家之少火游行其问，以息相吹耳。若命门火衰，少火几于熄矣。欲暖脾胃之阳，必
先温命门之火，此肾气丸纳桂、附于滋阴剂中十倍之一，意不在补火，而在微微生火，即
生肾气也。故不曰温肾，而名肾气，斯知肾以气为主，肾得气而土自生也。且形不足者，
温之以气，则脾胃因虚寒而致病者固痊，即虚火不归其原者，亦纳之而归封蛰之本矣。崔
氏加减八味丸，以五味之酸收，易附子之辛热，肾虚而不寒者宜之也。《千金方》于八味
外，更加元参之咸寒，以助熟地而滋肾；加芍药之酸寒，助丹皮以滋肝。总之为桂附加
锁钥耳。以之壮水则有余，以之益火恐不足也。《济生方》加牛膝、车前以治水肿，倍茯
苓以辅地黄、山药、茱萸，与泽、丹、车、牛等列，随证加减，允为得法。益阴肾气丸于
六味外加当归、五味、柴胡，以治目暗不见，化裁愈妙矣。
资生肾气丸 治肾虚脾弱，腰重脚肿，小便不利，腹胀喘急。痰盛，已成鼓证，其效如神。
熟地黄（四两） 白茯苓（三两） 牡丹皮（一两）
泽泻（一两） 干山药（一两） 车前子（一两） 山茱萸（一两） 牛膝（一两） 肉桂
（一两） 附子（五钱）
上十味，蜜和丸，每服八十九，空心米饮下。
【集注】李中梓曰∶经云∶诸湿肿满，皆属于脾。又云∶其本在肾，其末在肺，皆聚
水也。又曰∶肾者主水，胃之关也，关门不利，故聚水而从其类也。肿胀之病，诸经虽
有，无不由于脾、肺、肾者，盖脾主营运，肺主气化，肾主五液。凡五气所化之液，悉属
于肾；五液所行之气，悉属于肺；转输二脏，以制水生金者，悉属于脾。故肿胀不外此三
经也。然其治法，有内、外、上、下、虚、实，不可不辨也。在外则肿，越婢汤、小青龙汤
证也。在内则胀，十枣丸、神 丸证也。在上则喘，葶苈大枣汤、防己椒目葶苈大黄丸
证也。在下则小便闭，沉香琥珀丸、疏凿饮子证也。此皆治实之法，若夫虚者，实脾饮此方证也。
张介宾曰∶地黄、山药、丹皮，以养阴中之真水。山萸、桂、附，以化阴中之真气。
茯苓、泽泻、车前、牛膝，以利阴中之滞。能使气化于精，即所以治肺也；补火生土，即
所以治脾也；壮水利窍，即所以治肾也。补而不滞，利而不伐，治虚水方，更无有出其
右者。然当因此扩充，随证加减。若其人因大病之后，脾气大虚而病水胀者，服此虽无
所碍，终不见效，每熟计之，脾气大伤，诚非肾药之所能治。专用理中汤一两，加茯苓
一两。命火衰者，加附子；两足冷者，加肉桂；腹胀甚者，加浓朴。三大剂而足胫渐消，
十余剂而腹胀退。凡治中年之后脾肾虚寒者，悉用此法。盖气虚者，不可复行气，肾虚者，
不可专利水。温补即所以化气，塞因塞用之妙，顾在用之者何如耳。古法治肿，不用补
剂，而用去水等药，微则分利，甚则推逐。如五苓散、五淋散、五皮散、导水茯苓汤之类，
皆所以利水也，如舟车神 丸、浚川散、禹攻散、十枣汤之类，皆所以逐水也。但察其
果系实邪，则此等治法，仍不可废也。
大补阴丸治阴亏火旺，肺痿咳血，骨蒸盗汗，虚劳之证。
黄柏（盐酒炒） 知母（盐水炒，各四两） 熟地（酒蒸） 败龟版（酥炙，各六两）
猪脊髓和炼蜜为小丸，日干。每服三钱，淡盐汤下。
【注】朱震亨云∶阴常不足，阳常有余，宜常养其阴，阴与阳齐，则水能制火，斯无
病矣。今时之人，过欲者多，精血既亏，相火必旺，真阴愈竭，孤阳妄行，而劳瘵、潮
热、盗汗、骨蒸、咳嗽、咯血、吐血等证悉作。所以世人火旺致此病者，十居八九，火
衰成此疾者，百无二三。震亨发明先圣千载未发之旨，其功伟哉！是方能骤补真阴，承
制相火，较之六味功效尤捷。盖因此时以六味补水，水不能遽生；以生脉保金，金不免
犹燥，惟急以黄柏之苦以坚肾，则能制龙家之火；继以知母之清以凉肺，则能全破伤之
金。若罔顾其本，即使病去犹恐复来，故又以熟地、龟版大补其阴，是谓培其本、清其
源矣。虽有是证，若食少便清，则为胃虚，不可轻用。
封髓丹 治梦遗、失精及与鬼交。
黄柏 砂仁 甘草
上蜜为丸，每服三钱。
【集注】赵羽皇曰∶经云∶肾者主水，受五脏六腑之精而藏之。又曰∶肾者，主蛰，封
藏之本，精之处也。盖肾为坚脏，多虚少实，因肝木为子，偏喜疏泄母气，厥阴之火一动，
精即随之外溢。况肝又藏魂，神魂不摄，宜其夜卧鬼交精泄之证作矣。封髓丹为固精之
要药，方用黄柏为君，以其味性苦寒，又能坚肾。肾职得坚，则阴水不虞其泛溢；寒能
清肃，则龙火不至于奋扬。水火交摄，精有不安其位者乎？佐以甘草，以甘能缓急，泻
诸火与肝火之内扰，且能使水土合为一家，以妙封藏之固。若缩砂者，以其味辛性温，善
能入肾，肾之所恶在燥，而润之者惟辛，缩砂通三焦达津液，能内五脏六腑之精而归于
肾，肾家之气内，肾中之髓自藏矣。此有取于封髓之意也。
汪昂曰∶此方加天冬、地黄、人参，名三才封髓丹。用天冬补肺以生水，地黄补肾
以益精，用人参补脾，从饮食中化生水精也。以药有天、地、人之名，而补亦在上、下、中
之分，使天地位育参赞居中，故曰三才也。喻昌曰∶加黄柏以入肾滋阴，砂仁以入脾行滞，
甘草以少变天冬、黄柏之苦，俾合人参创建中气，以伸参两之权，殊非好为增益成方之比也。
虎潜丸 治肾阴不足，筋骨痿软，不能步履。
龟版 黄柏（各四两） 知母 熟地（各二两）
牛膝（三两五钱） 芍药（一两五钱） 锁阳（一两） 虎骨（一两） 当归（一两） 陈皮（七钱五分）
上为末，煮羯羊肉，捣为丸，桐子大，淡盐汤下。
【集注】王又原曰∶肾为作强之官，有精血以为之强也。若肾虚精枯，而血必随之，精
血交败，湿热风毒遂乘而袭焉。此不能步履、腰酸筋缩之证作矣。且肾兼水火，火胜烁阴，
湿热相搏，筋骨不用宜也。方用黄柏清阴中之火，燥骨间之湿，且苦能坚肾，为治痿要
药，故以为君。虎骨去风毒。健筋骨为臣。因高源之水不下，母虚而子亦虚，肝藏之血不
归，子病而母愈病，故用知母清肺原，归芍养肝血，使归于肾。龟禀天地之阴独浓，茹
而不吐，使之坐镇北方。更以熟地、牛膝、锁阳、羊肉群队补水之品，使精血交补。若陈
皮者，疏血行气。兹又有气化血行之妙，其为筋骨壮盛，有力如虎也必矣。《道经》云∶
虎向水中生，以斯为潜之义焉夫！是以名之曰∶虎潜丸
叶仲坚曰∶痿原虽分五脏，然其本在肾，其标在肺。《内经》云∶五脏因肺热叶焦，发
为痿 。又曰∶阳气内伐，水不胜火，则骨痿髓虚，故足不任身。骨痿者生于大热也，若
视为虚寒而投以桂、附，多致不救。是方以虎名者，虎于兽中禀金气之至刚，风生一啸，
特为肺金取象焉。其潜之云者，金从水养，母隐子胎，故生金者必丽水，意在纳气归肾也。
龟应北方之象，禀阴最浓，首常向腹，善通任脉，能大补真阴，深得夫潜之意者。黄柏
味浓，为阴中之阴，专补肾膀之阴不足，能
使足膝中气力涌出，故痿家必用二者为君，一以固本，一以治标，恐奇之不去，则偶之也。
熟地填少阴之精，用以佐龟版、知母清太阴之气；用以佐黄柏、牛膝入肝舒筋。归、芍
佐之，肝血有归；陈皮疏之，气血以流，骨正筋柔矣。又虑热则生风，逗留关节，用虎
【方剂组成】白豆蔻（八钱） 桔梗（一两） 藿香（一两） 川黄连（四钱）
砂仁（一两半） 白扁豆（一两半） 山楂（一两半）
以上十八味药材，研成细末，用炼蜜制成丸药，大小如弹子，每次服用两丸，用米汤送服。
【集注】罗谦甫说：此方始于缪仲醇，用于治疗妊娠期间脾虚及胎动不安（滑胎）。大概胎儿的孕育起始于足少阴肾经，生长依赖于足阳明胃经。因此，阳明胃经是胎儿生长的根本，一旦不足，则元气不足以滋养胎儿，也不足以自养身体，所以在怀孕三个月正当阳明经养胎的时候，会出现呕吐逆气。更严重的，或在三个月、或五个月时发生流产，这都是因为阳明气虚不能固摄所致。古方安胎，大多使用川芎、当归，不知道这正不免于导致滑胎。此方用人参、白术、茯苓、甘草、莲子、芡实、山药、扁豆、薏苡仁的甘平之性，来补益脾元；陈皮、神曲、黄柏、砂仁、藿香、桔梗的香辛之性，来调理胃气，如果有湿热，用黄连来清除它、燥湿它。既没有参苓白术散的补益而致滞涩，又没有香砂枳术丸的燥烈消导，能够补益又能运化，达到至为和谐的状态。以此来固护胎儿，永远不会有滑胎堕胎之患。男子服用，能调和中焦、养胃气。命名为“资生”，确实名不虚传。
六味地黄丸 治疗肾精不足，虚火上炎，腰膝痿软无力，骨骼发热酸痛，足跟痛，小便淋沥涩痛或闭塞不通或失禁，遗精梦泄，水液泛滥形成痰饮，自汗、盗汗，失血、消渴，头晕目眩，耳聋牙齿松动，尺脉虚大者。
熟地黄（八两） 山茱萸（四两） 白茯苓（三两）
干山药（四两） 牡丹皮（三两） 泽泻（三两）
以上研成细末，用炼蜜制成丸药，如梧桐子大小，空腹时用淡盐汤送服。
【集注】柯琴说：肾虚不能藏精，肾中（坎宫）之火无所依附而妄行，向下无法奉助肝木升发之令，向上断绝了肺金生化之源。地黄禀受甘寒的性质，制成熟地后味道浓厚，这是“精不足者，补之以味”的道理，用来大滋肾阴，填精补髓，壮大水之主源。以泽泻为使药，世人或许厌恶其泻肾而将其去掉，却不知道一阴一阳是天地的规律；一开一阖是动静的枢机。精属于癸，是阴水，静止而不流动，是肾的本体；尿属于壬，是阳水，流动而不居留，是肾的功能。因此肾主管五液，如果阴水不守，则真水不足，阳水不流，则邪水泛滥流行。所以君药用地黄来密封蛰藏的根本，同时佐使泽泻来疏通水道的滞塞。然而肾虚如果不补其母（肺），不引导其上源（脾），也没有办法巩固封蛰的作用。山药凉补，以培补癸水（肾水）的上源，茯苓淡渗，以引导壬水（膀胱水）的上源。加上山茱萸的酸温，借以收敛少阳之火，以滋助厥阴之液。牡丹皮辛寒，以清少阴之火，返还以奉助少阳之气，滋生化源，奉助生气，天癸就能安居其位了。壮水制火，只是其中一方面罢了。
【按语】五行都只有一个，只有火有两个，即君火和相火。君火是心经之火，君主一身之火。相火是肾中之火，宣布一身之火。如果君火没有相火，就不能宣布诸火，以奉养生命之本；相火没有君火，就不能君主诸火，以制止其妄行的灾害，所以李杲立“内伤劳倦，火乘土位”的理论，针对心火有余，用升阳气、泻阴火的朱砂安神等药，而没有涉及心火不足的，因为前人已有归脾、养心等方剂了。朱震亨立“阳常有余，阴常不足”的理论，针对肾火有余，用补阴、补天等药，而没有涉及肾火不足的，因为前人已有肾气、桂附地黄汤丸了，根据本方加附子、肉桂，名为桂附地黄丸，治疗两尺脉弱，相火不足，身体虚弱瘦弱、气短，王冰所说的“益火之原，以消阴翳”就是这种情况。加黄柏、知母，名为知柏地黄丸，治疗两尺脉旺，阴虚火动，午后发热、骨痿，王冰所说的“壮水之主，以制阳光”就是这种情况。经文说：阴平阳秘，精神乃治。如果阴阳偏胜，则疾病丛生。肾取象于坎卦，阳藏在阴之中。不仅阴盛阳衰，阳畏惧阴而不敢依附，即使阴衰阳盛，阴难以藏阳也无所依据，虽然同为火不归原，但其所导致的病症却不同。所以在补肾药中加入桂、附，壮阳胜阴，使阳无所畏惧，而自然回归本源。加入知母、黄柏补阴秘阳，使阳有所贮藏，而自然回归潜藏。世人只知道用桂、附引火归原，不知道用知母、黄柏平阴秘阳，举世都蒙受其误，所以朱震亨特别立补阴的理论，以驳斥以火济火的错误。而未通达其旨意的人，从而诽谤他，实在令人叹息。
八味地黄丸 治疗命门火衰，不能生土，以致脾胃虚寒，饮食减少思虑，大便不成形，或者下元衰惫，脐腹疼痛，夜间多尿等症状。
熟地黄（九蒸为度，捣成膏，八两） 干山药（四两）
山萸肉（四两） 白茯苓 丹皮 泽泻（各三两） 肉桂 附子（各一两）
以上八味研成细末，用炼蜜制成丸药如梧桐子大小，酒送服十五丸，每日两次服用。
【集注】赵献可说：君子观察坎卦，就知道肾中具有水火的作用。现在人房事过度而阳气容易举起的，是阴虚火动；阳气事先痿软的，是命门火衰。真水枯竭则隆冬不寒冷，真火熄灭则盛夏不炎热。此方中，熟地、山药、泽泻、丹皮、茯苓、山萸都是濡润的物品，所以能壮大水之主源；肉桂、附子是辛润之物，能于水中补火，所以能益火之原。水火得到养护，则肾气恢复了。
喻昌说：《金匮要略》用八味丸，治疗脚气上冲入少腹感觉麻木不仁者。脚气即是阴气，少腹不仁即是攻心的开始，所以用它来驱逐阴邪。如果是虚劳腰痛，少腹拘急，小便不利，则是由于过度劳累肾脏，阴气逆于少腹，阻遏膀胱的气化功能，小便不能通利，所以用它来温养下焦，以收纳肾气。如果是短气有微饮者，饮，也是阴类，阴邪占据胸中之阳，自然导致短气，所以用它来引导饮邪下行排出，以安宁胸中。消渴病，饮水一斗，小便也一斗，这是肾气不能摄水，小便恣意流出，源泉有立即枯竭的趋势，所以急忙用它来逆流遏制其水势。肾水下趋导致的消证，肾气不上升导致的渴证，不用此方以蛰护封藏，蒸动水气，除此之外还有什么方法可以治疗呢！后人称八味丸为治疗消渴的圣药，得其旨意了。
柯琴说：命门之火，是水中之阳。水的本体本是静止的，而川流不息，是气的运动、火的作用，不是指有形的东西而言，然而火少则生气，火壮则食气，所以火不可亢盛，也不可衰弱。所谓火生土，就是肾家的少火游行其间，以气息相吹耳。如果命门火衰，少火几乎熄灭了。想要暖脾胃之阳，必须先温命门之火，此肾气丸将桂、附纳入滋阴剂中十分之一，意图不在补火，而在微微生火，即产生肾气。所以不叫温肾，而名肾气，由此可知肾以气为主，肾得到气而土自然生长。而且形体不足的，用气来温养，那么脾胃因虚寒而导致的病症固然痊愈，即使是虚火不归其原的，也纳入而归复封蛰的根本了。崔氏加减八味丸，用五味子的酸收，替代附子的辛热，适合肾虚而不寒者。《千金方》在八味之外，更加玄参的咸寒，以助熟地而滋肾；加芍药的酸寒，助丹皮以滋肝。总之是为了给桂附加锁钥。用来壮水则有余，用来益火恐怕不足。《济生方》加牛膝、车前来治疗水肿，倍用茯苓以辅佐地黄、山药、山茱萸，与泽泻、丹皮、车前子、牛膝等同列，随证加减，颇为得法。益阴肾气丸在六味之外加当归、五味子、柴胡，来治疗目暗不见，化裁更加巧妙了。
资生肾气丸 治疗肾虚脾弱，腰部沉重脚部肿胀，小便不利，腹胀喘急。痰多，已成鼓胀证，效果如神。
熟地黄（四两） 白茯苓（三两） 牡丹皮（一两）
泽泻（一两） 干山药（一两） 车前子（一两） 山茱萸（一两） 牛膝（一两） 肉桂
（一两） 附子（五钱）
以上十味，用蜂蜜调和制成丸药，每次服用八十九丸，空腹用米汤送服。
【集注】李中梓说：经文说：诸湿肿满，皆属于脾。又说：其本在肾，其末在肺，都是聚水而成。又说：肾者主水，是胃的关口，关门不利，所以聚水而从其同类。肿胀的病，各经虽然有，无不由于脾、肺、肾三脏，大概脾主营运，肺主气化，肾主五液。凡是五气所化的液，都属于肾；五液所行之气，都属于肺；转输二脏，以制水生金的，都属于脾。所以肿胀不外乎这三经。然而其治疗方法，有内、外、上、下、虚、实，不可不辨别。在外则肿，是越婢汤、小青龙汤的证候。在内则胀，是十枣丸、神祐丸的证候。在上则喘，是葶苈大枣汤、防己椒目葶苈大黄丸的证候。在下则小便闭，是沉香琥珀丸、疏凿饮子的证候。这些都是治疗实证的方法，至于虚证，是实脾饮、此方（资生肾气丸）的证候。
张介宾说：地黄、山药、丹皮，用来养阴中之真水。山萸、桂、附，用来化阴中之真气。茯苓、泽泻、车前、牛膝，用来利阴中之滞。能使气化于精，就是所以治肺；补火生土，就是所以治脾；壮水利窍，就是所以治肾。补而不滞，利而不伐，治疗虚水之方，没有能超过它的。然而应当因此扩充，随证加减。如果其人因病后，脾气大虚而病水胀者，服用此方虽然无碍，终究不见效，仔细考虑，脾气大伤，确实不是肾药所能治疗的。专用理中汤一两，加茯苓一两。命火衰者，加附子；两足冷者，加肉桂；腹胀甚者，加厚朴。三大剂而足胫渐消，十余剂而腹胀退。凡治疗中年之后脾肾虚寒者，都用此法。大概气虚者，不可再行气，肾虚者，不可专利水。温补就是所以化气，塞因塞用的妙处，在于使用者如何运用罢了。古法治肿，不用补剂，而用去水等药，轻微则分利，严重则推逐。如五苓散、五淋散、五皮散、导水茯苓汤之类，都是所以利水，如舟车神祐丸、浚川散、禹功散、十枣汤之类，都是所以逐水。只要察看确实系实邪，则这些治法，仍不可废除。
大补阴丸 治疗阴亏火旺，肺痿咳血，骨蒸盗汗，虚劳之证。
黄柏（盐酒炒） 知母（盐水炒，各四两） 熟地（酒蒸） 败龟版（酥炙，各六两）
猪脊髓和炼蜜为小丸，晒干。每次服用三钱，淡盐汤送服。
【注】朱震亨说：阴常不足，阳常有余，宜常养其阴，阴与阳齐，则水能制火，斯无病矣。现今之人，纵欲者多，精血既亏，相火必旺，真阴愈竭，孤阳妄行，而劳瘵、潮热、盗汗、骨蒸、咳嗽、咯血、吐血等证悉作。所以世人火旺导致此病的，十居八九，火衰成此疾的，百无二三。朱震亨发明先圣千载未发之旨，其功德伟大啊！此方能骤补真阴，承制相火，较之六味地黄丸功效尤其快捷。盖因此时以六味补水，水不能遽生；以生脉保金，金不免犹燥，惟急以黄柏之苦以坚肾，则能制龙雷之火；继以知母之清以凉肺，则能全破伤之金。若不顾及其根本，即使病去犹恐复发，所以又以熟地、龟版大补其阴，这是谓培其本、清其源了。虽然有这些证候，如果食少便溏，则为胃虚，不可轻用。
封髓丹 治疗梦遗、失精及与鬼交。
黄柏 砂仁 甘草
以上用蜜制成丸药，每次服用三钱。
【集注】赵羽皇说：经文说：肾者主水，受五脏六腑之精而藏之。又说：肾者，主蛰，封藏之本，精之处也。大概肾为坚脏，多虚少实，因为肝木为子，偏喜疏泄母气，厥阴之火一动，精即随之向外溢出。况且肝又藏魂，神魂不摄，适宜其夜卧鬼交精泄之证发作。封髓丹为固精的要药，方用黄柏为君药，因为其味性苦寒，又能坚肾。肾职得到坚固，则阴水不担心其泛溢；寒能清肃，则龙火不至于奋扬。水火交摄，精有不安心其位的吗？佐以甘草，以甘能缓急，泻诸火与肝火之内扰，且能使水土合为一家，以奇妙地巩固封藏。如果缩砂仁，因为其味辛性温，善于入肾，肾所恶在燥，而润之者唯有辛，缩砂仁通三焦达津液，能将内五脏六腑之精归于肾，肾家之气在内，肾中之髓自然收藏了。此有取于封髓之意。
汪昂说：此方加天冬、地黄、人参，名为三才封髓丹。用天冬补肺以生水，地黄补肾以益精，用人参补脾，从饮食中化生水精。因为药物有天、地、人之名，而补亦在上、下、中之分，使天地位育参赞居中，故曰三才。喻昌说：加黄柏以入肾滋阴，砂仁以入脾行滞，甘草以少许改变天冬、黄柏之苦，使得合人参创建中气，以伸参两之权，绝非好为增益成方之比。
虎潜丸 治疗肾阴不足，筋骨痿软，不能步履。
龟版 黄柏（各四两） 知母 熟地（各二两）
牛膝（三两五钱） 芍药（一两五钱） 锁阳（一两） 虎骨（一两） 当归（一两） 陈皮（七钱五分）
以上研成细末，煮羯羊肉，捣为丸，如梧桐子大小，淡盐汤送服。
【集注】王又原说：肾为作强之官，有精血以为之强。如果肾虚精枯，而血必随之，精血交败，湿热风毒遂乘而袭焉。此不能步履、腰酸筋缩之证发作。且肾兼水火，火胜烁阴，湿热相搏，筋骨不用宜也。方用黄柏清阴中之火，燥骨间之湿，且苦能坚肾，为治痿要药，故以为君。虎骨去风毒。健筋骨为臣。因高源之水不下，母虚而子亦虚，肝藏之血不归，子病而母愈病，故用知母清肺原，归芍养肝血，使归于肾。龟禀天地之阴独浓，茹而不吐，使之坐镇北方。更以熟地、牛膝、锁阳、羊肉群队补水之品，使精血交补。若陈皮者，疏血行气。兹又有气化血行之妙，其为筋骨壮盛，有力如虎也必矣。《道经》云：虎向水中生，以此作为潜之义焉夫！是以名之曰：虎潜丸
叶仲坚说：痿原虽分五脏，然其本在肾，其标在肺。《内经》云：五脏因肺热叶焦，发为痿躄。又说：阳气内伐，水不胜火，则骨痿髓虚，故足不任身。骨痿者生于大热也，若视为虚寒而投以桂、附，多致不救。是方以虎名者，虎于兽中禀金气之至刚，风生一啸，特为肺金取象焉。其潜之云者，金从水养，母隐子胎，故生金者必丽水，意在纳气归肾也。龟应北方之象，禀阴最浓，首常向腹，善通任脉，能大补真阴，深得夫潜之意者。黄柏味浓，为阴中之阴，专补肾膀之阴不足，能使足膝中气力涌出，故痿家必用二者为君，一以固本，一以治标，恐奇之不去，则偶之也。熟地填少阴之精，用以佐龟版、知母清太阴之气；用以佐黄柏、牛膝入肝舒筋。归、芍佐之，肝血有归；陈皮疏之，气血以流，骨正筋柔矣。又虑热则生风，逗留关节，用虎
[Formula Composition] Kou (Bai Dou Kou, Amomi Fructus) (8 qian), Jiegeng (Platycodonis Radix, Jie Geng) (1 liang), Huoxiang (Agastaches Herba, Huo Xiang) (1 liang), Chuan Huanglian (Coptidis Rhizoma, Huang Lian) (4 qian).
Sharen (Amomi Fructus, Sha Ren) (1.5 liang), Baibian Dou (Dolichoris Semen, Bai Bian Dou) (1.5 liang), Shanzha (Crataegi Fructus, Shan Zha) (1.5 liang).
The above eighteen ingredients are ground into a fine powder, mixed with refined honey to form pills the size of a bullet. Take two pills per dose, swallowed with rice water.
[Annotations] Luo Qianfu said: This formula originated from Miao Zhongchun and is used to treat spleen deficiency and fetal restlessness (Hua Tai) during pregnancy. Generally, the conception of the fetus begins in the Foot-Shaoyin Kidney Meridian, and its growth relies on the Foot-Yangming Stomach Meridian. Therefore, the Yangming Stomach Meridian is the root of fetal growth. If it is deficient, Yuan Qi (Original Qi) is insufficient to nourish the fetus and also insufficient for self-nourishment. Thus, during the third month when the Yangming meridian nourishes the fetus, symptoms such as vomiting and regurgitation appear. In more severe cases, miscarriage may occur at three or five months. These are all due to Qi deficiency in the Yangming meridian failing to secure the fetus. Ancient formulas for calming the fetus mostly use Chuanxiong (Ligustici Chuanxiong Rhizoma, Chuan Xiong) and Danggui (Angelicae Sinensis Radix, Dang Gui), not realizing that this may inadvertently lead to slipping (miscarriage). This formula uses the sweet and neutral properties of Renshen (Ginseng Radix et Rhizoma, Ren Shen), Baizhu (Atractylodis Macrocephalae Rhizoma, Bai Zhu), Fuling (Poria, Fu Ling), Gancao (Glycyrrhizae Radix et Rhizoma, Gan Cao), Lianzi (Nelumbinis Semen, Lian Zi), Qianshi (Euryales Semen, Qian Shi), Shanyao (Dioscoreae Rhizoma, Shan Yao), Bian Dou (Dolichoris Semen, Bai Bian Dou), and Yiyiren (Coicis Semen, Yi Yi Ren) to tonify the Spleen Yuan. It uses the aromatic and pungent properties of Chenpi (Citri Reticulatae Pericarpium, Chen Pi), Qu (Medicated Leaven, Shen Qu), Baibo (Phellodendri Cortex, Huang Bo - *Note: Text says Bai Bo but context implies Huang Bo/Huang Lian for heat, likely typo for Huang Bo or referring to Phellodendron*, Ba Bo), Sharen (Amomi Fructus, Sha Ren), Huoxiang (Agastaches Herba, Huo Xiang), and Jiegeng (Platycodonis Radix, Jie Geng) to regulate Stomach Qi. For damp-heat, Huanglian (Coptidis Rhizoma, Huang Lian) is used to clear and dry it. It lacks the cloying nature of Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) and the drying/clearing nature of Xiangsha Zhizhu Wan (Amomum and Atractylodes Formula Pill). It can tonify and transport, achieving perfect harmony. By doing so, it secures the fetus, preventing miscarriage forever. When taken by men, it harmonizes the Middle Jiao and nourishes the Stomach. Named "Zisheng" (Nourishing Life), the name is indeed well-deserved.
Liuyi Dihuang Wan (Six-Ingredient Rehmannia Pill) Treats Kidney Essence deficiency, deflection of Deficient Fire upward, weakness and soreness of the waist and knees, bone heat and pain, heel pain, stranguria or retention or incontinence of urine, nocturnal emission, spontaneous sweating, night sweats, blood loss, Xiao Ke (Wasting-Thirst), dizziness and vertigo, deafness, loose teeth, and a large and empty Chi pulse (Radial pulse at the deep level).
Shudihuang (Prepared Rehmanniae Radix, Shu Di Huang) (8 liang), Shanzhuyu (Corni Fructus, Shan Zhu Yu) (4 liang), Baifuling (White Poria, Bai Fu Ling) (3 liang).
Ganshanyao (Dried Dioscoreae Rhizoma, Gan Shan Yao) (4 liang), Mudanpi (Moutan Cortex, Mu Dan Pi) (3 liang), Zexie (Alismatis Rhizoma, Ze Xie) (3 liang).
Grind the above into powder, mix with refined honey to form pills the size of paulownia seeds. Take on an empty stomach with light salt water.
[Annotations] Ke Qin said: Kidney deficiency fails to store Essence, causing the Fire of the Kan Palace (Kidney) to have no attachment and wander recklessly. Downward, it cannot support the Liver Wood's ascending function; upward, it cuts off the source of Lung Metal's generation and transformation. Rehmannia possesses a sweet and cold nature. When prepared, its flavor becomes rich. This follows the principle "for deficiency of Essence, tonify with flavor." It is used to greatly nourish Kidney Yin, fill Essence and marrow, and strengthen the Master of Water. Using Zexie (Alismatis Rhizoma, Ze Xie) as an envoy, some people dislike its draining effect on the Kidney and remove it, not knowing that Yin and Yang are the Way of Heaven and Earth; opening and closing are the mechanism of motion and stillness. Essence belongs to Gui (Yin Water), which is static and does not flow, constituting the Substance of the Kidney. Urine belongs to Ren (Yang Water), which is dynamic and does not stay, constituting the Function of the Kidney. Therefore, the Kidney governs the Five Fluids. If Yin Water is not retained, True Water is insufficient; if Yang Water does not flow, Evil Water floods. Thus, the Sovereign herb Rehmannia seals the root of storage, while assisting Zexie to unblock the stagnation of the water passages. However, if Kidney deficiency is not treated by tonifying its Mother (Lung) and guiding its Upper Source (Spleen), there is no way to consolidate the function of storage. Shanyao (Dioscoreae Rhizoma, Shan Yao) is cool and tonifying, cultivating the upper source of Gui Water (Kidney Water). Fuling (Poria, Fu Ling) is bland and permeating, guiding the upper source of Ren Water (Bladder Water). Adding Shanzhuyu (Corni Fructus, Shan Zhu Yu)'s sour and warm nature helps to gather Shaoyang Fire and nourish Jueyin fluid. Mudanpi (Moutan Cortex, Mu Dan Pi) is pungent and cold, clearing Shaoyin Fire and returning to support Shaoyang Qi, nourishing the source of transformation, supporting Sheng Qi (Vital Qi), allowing Tian Gui (Menstrual Fluid/Essence) to reside in its place. Strengthening Water to control Fire is merely one aspect.
[Commentary] The Five Elements each have one, but Fire has two: Jun Fire (Monarch Fire) and Xiang Fire (Minister Fire). Jun Fire is the Fire of the Heart Meridian, governing the Fire of the body. Xiang Fire is the Fire within the Kidney, disseminating the Fire of the body. If Jun Fire lacks Xiang Fire, it cannot disseminate the various Fires to support the root of life; if Xiang Fire lacks Jun Fire, it cannot govern the various Fires to prevent disasters of reckless movement. Therefore, Li Guo established the theory of "Internal Injury from Overwork, Fire invading the Earth Position," addressing excess Heart Fire with herbs like Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill) to raise Yang Qi and drain Yin Fire, but did not address Heart Fire deficiency because predecessors already had Guipi Tang (Restore the Spleen Decoction) and Yangxin Tang (Nourish the Heart Decoction). Zhu Zhenheng established the theory "Yang is often in excess, Yin is often deficient," addressing excess Kidney Fire with Bu Yin Wan (Tonify Yin Pill) and Butian Wan (Tonify Heaven Pill), but did not address Kidney Fire deficiency because predecessors already had Shenqi Wan (Kidney Qi Pill) and Guifu Dihuang Wan (Cinnamon Twig and Dogwood Pill). Based on this formula, adding Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi) and Rougui (Cinnamomi Cortex, Rou Gui) creates Guifu Dihuang Wan, treating weak Chi pulses (both sides), insufficient Xiang Fire, emaciation and shortness of breath, which corresponds to Wang Bing's saying "Benefit the origin of Fire to dissipate Yin shadows." Adding Huangbai (Phellodendri Cortex, Huang Bo) and Zhimu (Anemarrhenae Rhizoma, Zhi Mu) creates Zhibai Dihuang Wan, treating vigorous Chi pulses, Yin deficiency with Fire moving, afternoon tidal fever, and bone wasting, corresponding to Wang Bing's saying "Strengthen the Master of Water to control the Sunlight." The Classic states: "When Yin is balanced and Yang is firm, Spirit is regulated." If Yin and Yang are biased towards excess, diseases arise. The Kidney takes the image of Kan (Water trigram), where Yang is hidden within Yin. Not only when Yin is excess and Yang is deficient does Yang fear Yin and dare not attach, but even when Yin is deficient and Yang is excess, Yin has no basis to hide Yang. Although both are Fire not returning to its origin, the resulting diseases differ. Therefore, adding Gui (Cinnamomi Cortex, Rou Gui) and Fu (Aconiti Lateralis Radix Praeparata, Fu Zi) to Kidney herbs strengthens Yang to overcome Yin, making Yang fearless and naturally returning to its origin. Adding Zhimu (Anemarrhenae Rhizoma, Zhi Mu) and Huangbai (Phellodendri Cortex, Huang Bo) tonifies Yin to secure Yang, giving Yang a place to store and naturally returning to concealment. People only know to use Gui and Fu to guide Fire back to its origin, not knowing to use Zhimu and Huangbai to balance Yin and secure Yang. The world is misled by this. Therefore, Zhu Zhenheng specifically established the theory of Tonifying Yin to refute the error of using Fire to aid Fire. Those who do not understand its purport criticize him, which is truly lamentable.
Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) Treats Mingmen (Gate of Life) Fire decline, failing to generate Earth, leading to Spleen-Stomach deficiency-cold, lack of appetite, loose stools, or decline of the Lower Origin, umbilical and abdominal pain, frequent urination at night, etc.
Shudihuang (Prepared Rehmanniae Radix, Shu Di Huang) (Steamed nine times, mashed into paste, 8 liang), Ganshanyao (Dried Dioscoreae Rhizoma, Gan Shan Yao) (4 liang).
Shanyurou (Corni Fructus, Shan Zhu Yu) (4 liang), Baifuling (White Poria, Bai Fu Ling), Mudanpi (Moutan Cortex, Mu Dan Pi), Zexie (Alismatis Rhizoma, Ze Xie) (3 liang each), Rougui (Cinnamomi Cortex, Rou Gui), Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi) (1 liang each).
Grind the above eight ingredients into powder, mix with refined honey to form pills the size of paulownia seeds. Take fifteen pills with wine, twice a day.
[Annotations] Zhao Xianke said: Observing the Kan trigram, a gentleman knows that the Kidney contains the functions of Water and Fire. Nowadays, those whose Yang rises easily after intercourse suffer from Yin deficiency with Fire movement; those whose Yang flaccidifies beforehand suffer from Mingmen Fire decline. If True Water is exhausted, winter does not feel cold; if True Fire is extinguished, summer does not feel hot. In this formula, Shudi (Prepared Rehmanniae Radix, Shu Di Huang), Shanyao (Dioscoreae Rhizoma, Shan Yao), Zexie (Alismatis Rhizoma, Ze Xie), Mudanpi (Moutan Cortex, Mu Dan Pi), Fuling (Poria, Fu Ling), and Shanyurou (Corni Fructus, Shan Zhu Yu) are moistening substances, thus able to strengthen the Master of Water. Rougui (Cinnamomi Cortex, Rou Gui) and Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi) are pungent and moistening substances, able to tonify Fire within Water, thus able to benefit the Origin of Fire. When Water and Fire are nourished, Kidney Qi recovers.
Yu Chang said: In *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), Bawei Wan is used to treat Hongjiao (Gout/Feet Disease) entering the lower abdomen with numbness. Hongjiao is Yin Qi; numbness in the lower abdomen is the beginning of attacking the Heart, so it is used to expel Yin pathogens. For deficiency labor with lumbar pain, hypogastric tension, and dysuria, it is due to overworking the Kidney, causing Yin Qi to rebel in the lower abdomen, obstructing Bladder Qi transformation, preventing smooth urination. Thus, it is used to warm and nourish the Lower Jiao to collect Kidney Qi. For shortness of breath with slight fluid retention, fluid is also a Yin category. Yin occupying Yang in the Chest causes shortness of breath, so it is used to guide fluid downward to calm the Chest. For Xiao Ke (Wasting-Thirst), drinking one dou of urine results in one dou of urination. This is Kidney Qi failing to control water, with urine flowing freely, threatening the source with imminent exhaustion. Thus, it is urgently used to reverse and restrain the water. For Xiao syndrome caused by Kidney Water sinking, and Ke syndrome caused by Kidney Qi failing to rise, without using this to protect storage and vaporize Water Qi, what other treatment could be used? Later generations called Bawei Wan the holy medicine for treating Xiao Ke, understanding its purport.
Ke Qin said: Mingmen Fire is Yang within Water. The nature of Water is originally still, but flowing endlessly is the movement of Qi and the function of Fire, not referring to有形 (material form). However, little Fire generates Qi, strong Fire consumes Qi. Therefore, Fire must not be hyperactive nor deficient. What is meant by "Fire generates Earth" is the Shaohuo (Lesser Fire) of the Kidney roaming within, breathing together. If Mingmen Fire declines, Shaohuo is nearly extinguished. To warm the Yang of the Spleen and Stomach, one must first warm Mingmen Fire. This Shenqi Pill places Gui (Cinnamomi Cortex, Rou Gui) and Fu (Aconiti Lateralis Radix Praeparata, Fu Zi) in a Yin-tonifying agent at one-tenth the dosage. The intent is not to tonify Fire, but to slightly generate Fire, i.e., generate Kidney Qi. Hence, it is not called Warming Kidney, but named Kidney Qi, showing that the Kidney is governed by Qi. When the Kidney has Qi, Earth naturally grows. Moreover, for deficiency of form, warming with Qi cures diseases caused by Spleen-Stomach deficiency-cold. Even for Deficient Fire not returning to its origin, it returns to the root of storage. Cui Shi's Modified Eight-Ingredient Pill replaces the pungent-hot Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi) with the astringent Wuweizi (Schisandrae Fructus, Wu Wei Zi), suitable for Kidney deficiency without cold. *Qianjin Fang* adds Xuan Shen (Scrophulariae Radix, Xuan Shen) salty-cold to assist Shudi (Prepared Rehmanniae Radix, Shu Di Huang) in nourishing the Kidney, and Shaoyao (Paeoniae Radix, Bai Shao) sour-cold to assist Mudanpi (Moutan Cortex, Mu Dan Pi) in nourishing the Liver. Overall, it acts as a lock and key for Gui (Cinnamomi Cortex, Rou Gui) and Fu (Aconiti Lateralis Radix Praeparata, Fu Zi). It is sufficient for strengthening Water but perhaps insufficient for benefiting Fire. *Jisheng Fang* adds Niuxi (Achyranthis Bidentatae Radix, Niu Xi) and Cheqianzi (Plantaginis Semen, Che Qian Zi) to treat edema, doubling Fuling (Poria, Fu Ling) to assist Dihuang (Rehmanniae Radix, Di Huang), Shanyao (Dioscoreae Rhizoma, Shan Yao), and Zhuyu (Corni Fructus, Shan Zhu Yu), listed with Zexie (Alismatis Rhizoma, Ze Xie), Danpi (Moutan Cortex, Mu Dan Pi), Cheqianzi (Plantaginis Semen, Che Qian Zi), and Niuxi (Achyranthis Bidentatae Radix, Niu Xi), adjusting according to symptoms, which is appropriate. Yiyin Shenqi Pill adds Danggui (Angelicae Sinensis Radix, Dang Gui), Wuweizi (Schisandrae Fructus, Wu Wei Zi), and Chaihu (Bupleuri Radix, Chai Hu) to the Six Ingredients to treat dim vision, with clever modifications.
Zisheng Shenqi Wan (Nourishing Kidney Qi Pill) Treats Kidney deficiency and Spleen weakness, heavy waist and swollen feet, dysuria, abdominal distension and rapid breathing. Excessive phlegm, progressing to Guzhang (Drum Distension/Bloating), with miraculous efficacy.
Shudihuang (Prepared Rehmanniae Radix, Shu Di Huang) (4 liang), Baifuling (White Poria, Bai Fu Ling) (3 liang), Mudanpi (Moutan Cortex, Mu Dan Pi) (1 liang).
Zexie (Alismatis Rhizoma, Ze Xie) (1 liang), Ganshanyao (Dried Dioscoreae Rhizoma, Gan Shan Yao) (1 liang), Cheqianzi (Plantaginis Semen, Che Qian Zi) (1 liang), Shanzhuyu (Corni Fructus, Shan Zhu Yu) (1 liang), Niuxi (Achyranthis Bidentatae Radix, Niu Xi) (1 liang), Rougui (Cinnamomi Cortex, Rou Gui) (1 liang), Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi) (5 qian).
The above ten ingredients are mixed with honey to form pills. Take eighty-nine pills per dose on an empty stomach with rice water.
[Annotations] Li Zhongzi said: The Classic states: "All dampness, swelling, and fullness belong to the Spleen." It also states: "Its root is in the Kidney, its branch is in the Lung; all are accumulated water." It further says: "The Kidney governs Water and is the gate of the Stomach. If the gate is not functional, water accumulates following its kind." Swelling diseases exist in all meridians but none do not originate from the Spleen, Lung, and Kidney. The Spleen governs transportation and transformation; the Lung governs Qi transformation; the Kidney governs the Five Fluids. All fluids transformed by the Five Qi belong to the Kidney; all Qi transported by the Five Fluids belongs to the Lung; transporting between these two organs to control Water generating Metal belongs to the Spleen. Thus, swelling involves only these three meridians. However, treatment methods vary by interior/exterior, upper/lower, deficiency/excess, and must be distinguished. Exterior swelling is treated with Yebipai Tang (Ma Huang Decoction) and Xiao Qinglong Tang (Minor Blue Dragon Decoction). Interior distension is treated with Shizao Wan (Ten Jujube Pill) and Shenyao Wan (Divine Elixir Pill). Upper asthma is treated with Tingli Dazao Tang (Descurainia Seed and Jujube Decoction) and Fangji Jiumu Tingli Dahuang Wan (Stephania, Plantago, Descurainia, and Rheum Pill). Lower urinary retention is treated with Chenxiang Hupo Wan (Aquilaria and Amber Pill) and Shuqiang Yinzi (Dispersing Irrigation Decoction). These are all treatments for excess syndromes. For deficiency, it is Shipai Yin (Solidify Spleen Decoction) and this formula (Zisheng Shenqi Wan).
Zhang Jiebin said: Dihuang (Rehmanniae Radix, Di Huang), Shanyao (Dioscoreae Rhizoma, Shan Yao), and Danpi (Moutan Cortex, Mu Dan Pi) nourish True Water within Yin. Zhuyu (Corni Fructus, Shan Zhu Yu), Gui (Cinnamomi Cortex, Rou Gui), and Fu (Aconiti Lateralis Radix Praeparata, Fu Zi) transform True Qi within Yin. Fuling (Poria, Fu Ling), Zexie (Alismatis Rhizoma, Ze Xie), Cheqianzi (Plantaginis Semen, Che Qian Zi), and Niuxi (Achyranthis Bidentatae Radix, Niu Xi) promote stagnation within Yin. Enabling Qi transformation from Essence treats the Lung; tonifying Fire to generate Earth treats the Spleen; strengthening Water and unblocking orifices treats the Kidney. Tonifying without stagnation, draining without damaging, this is the best formula for treating deficiency-water. However, it should be expanded and adjusted according to symptoms. If a patient suffers from water swelling due to severe Spleen Qi deficiency after a major illness, taking this formula will cause no harm but will ultimately be ineffective. Carefully consider: severe Spleen injury cannot be treated by Kidney herbs alone. Use Lizhong Tang (Regulate the Middle Decoction) 1 liang plus Fuling (Poria, Fu Ling) 1 liang. For declining Mingfire, add Fuzi (Aconiti Lateralis Radix Praeparata, Fu Zi); for cold feet, add Rougui (Cinnamomi Cortex, Rou Gui); for severe abdominal distension, add Houpo (Magnoliae Officinalis Cortex, Hou Po). After three doses, leg swelling gradually subsides; after ten-plus doses, abdominal distension recedes. For middle-aged patients with Spleen-Kidney deficiency-cold, this method is always used. Generally, for Qi deficiency, one should not further move Qi; for Kidney deficiency, one should not solely promote diuresis. Warming and tonifying is how to transform Qi. The subtlety of "treating blockage with blockage" depends on the practitioner. Ancient treatments for swelling did not use tonics but drugs to remove water. Mild cases use separation and promotion; severe cases use pushing and purging. Such as Wuling San (Five-Ingredient Powder), Wulin San (Five-Dysuria Powder), Wupi San (Five-Rind Powder), Daoshui Fuling Tang (Guiding Water Poria Decoction) are for promoting water. Such as Zhouche Shenyao Wan (Chariot Divine Elixir Pill), Junchuan San, Yugong San, Shizao Tang (Ten Jujube Decoction) are for purging water. As long as it is confirmed as an Excess pathogen, these methods should not be abandoned.
Dabu Yin Wan (Great Tonification of Yin Pill) Treats Yin deficiency with Fire hyperactivity, Fei Wei (Limb Withering/Cough with Blood), bone-steaming night sweats, and Xu Lao (Deficiency Consumption) syndromes.
Huangbai (Phellodendri Cortex, Huang Bo) (Salt-wine fried), Zhimu (Anemarrhenae Rhizoma, Zhi Mu) (Salt-water fried, 4 liang each), Shudi (Prepared Rehmanniae Radix, Shu Di Huang) (Wine-steamed), Baiguiban (Testudinis Carapax et Plastrum, Gui Ban) (Fried with butter, 6 liang each).
Mix with pig spinal cord and refined honey to form small pills. Dry them daily. Take 3 qian per dose with light salt water.
[Note] Zhu Zhenheng said: "Yin is often deficient, Yang is often in excess." One should constantly nourish Yin. When Yin and Yang are equal, Water controls Fire, and there is no disease. Nowadays, many indulge in desires. Once Jing and Blood are depleted, Xiang Fire (Minister Fire) becomes vigorous, True Yin exhausts further, Lone Yang moves recklessly, and syndromes such as Lao Zhai (Consumption), tidal fever, night sweats, bone steaming, cough, hemoptysis, and hematemesis all arise. Therefore, nine out of ten cases of this disease in the world are caused by Fire hyperactivity, while less than two out of a hundred are caused by Fire decline. Zhu Zhenheng revealed the unfathomable purport of the Sages for a thousand years; his merit is great! This formula can suddenly tonify True Yin and control Xiang Fire, with effects even faster than Liuyi Wan (Six-Ingredient Pill). At this time, using Liuyi to tonify Water, Water cannot be generated quickly; using Shengmai to protect Metal, Metal remains dry. Only by urgently using the bitter taste of Huangbai (Phellodendri Cortex, Huang Bo) to firm the Kidney can Longlei Fire (Dragon Thunder Fire) be controlled; subsequently, using the cooling property of Zhimu (Anemarrhenae Rhizoma, Zhi Mu) to cool the Lung can preserve damaged Metal. If the root is ignored, even if the disease leaves, recurrence is feared. Therefore, Shudi (Prepared Rehmanniae Radix, Shu Di Huang) and Guiban (Testudinis Carapax et Plastrum, Gui Ban) are used to greatly tonify Yin. This is called cultivating the root and clearing the source. Although these syndromes exist, if appetite is poor and stool is loose, it indicates Stomach deficiency, and this should not be used lightly.
Fengsui Dan (Seal Marrow Pill) Treats nocturnal emission, spermatorrhea, and sexual intercourse with ghosts.
Huangbai (Phellodendri Cortex, Huang Bo), Sharen (Amomi Fructus, Sha Ren), Gancao (Glycyrrhizae Radix et Rhizoma, Gan Cao).
Form pills with honey. Take 3 qian per dose.
[Annotations] Zhao Yuhuang said: The Classic states: "The Kidney governs Water and receives the Essence of the Five Zang and Six Fu organs to store it." It also states: "The Kidney governs hibernation, is the root of sealing and storing, and is the residence of Essence." The Kidney is a solid organ, mostly deficient and rarely excess. Because Liver Wood is the child, it prefers to disperse the Mother's Qi. When Jueyin Fire moves, Essence flows out with it. Moreover, the Liver stores Hun (Ethereal Soul). If Hun and Shen (Spirit) are not controlled, syndromes of nocturnal ghost intercourse and essence leakage naturally arise. Fengsui Dan is an important herb for securing Essence. The formula uses Huangbai (Phellodendri Cortex, Huang Bo) as the Sovereign herb because its bitter-cold nature firms the Kidney. When Kidney function is firm, Yin Water need not fear flooding; Cold clears and肃ifies, preventing Long Fire (Dragon Fire) from rising. Water and Fire interact, ensuring Essence remains in its place. Assisted by Gancao (Glycyrrhizae Radix et Rhizoma, Gan Cao), sweetness relieves urgency, drains internal disturbance of various Fires and Liver Fire, and combines Earth and Water into one family to wonderfully secure storage. As for Suanshashen (Amomi Fructus, Sha Ren), its pungent-warm nature enters the Kidney well. The Kidney dislikes dryness, and pungency moistens. Suanshashen opens the Triple Burner and reaches fluids, returning Essence of the Five Zang and Six Fu to the Kidney. With Kidney Qi inside, Kidney Marrow is naturally stored. This takes the meaning of "Sealing Marrow."
Wang Ang said: Adding Tiantong (Asparagi Radix, Tian Dong), Dihuang (Rehmanniae Radix, Di Huang), and Renshen (Ginseng Radix et Rhizoma, Ren Shen) to this formula creates Santai Fengsui Dan (Three Capabilities Seal Marrow Pill). Tiantong (Asparagi Radix, Tian Dong) tonifies Lung to generate Water; Dihuang (Rehmanniae Radix, Di Huang) tonifies Kidney to benefit Essence; Renshen (Ginseng Radix et Rhizoma, Ren Shen) tonifies Spleen to transform Water and Essence from diet. Because the herbs bear the names of Heaven, Earth, and Man, and tonification is divided among Upper, Lower, and Middle, enabling Heaven and Earth to nurture and Man to mediate, it is called Santai (Three Capabilities). Yu Chang said: Adding Huangbai (Phellodendri Cortex, Huang Bo) enters the Kidney to nourish Yin; Sharen (Amomi Fructus, Sha Ren) enters the Spleen to move stagnation; Gancao (Glycyrrhizae Radix et Rhizoma, Gan Cao) slightly modifies the bitterness of Tiantong (Asparagi Radix, Tian Dong) and Huangbai (Phellodendri Cortex, Huang Bo), allowing it to combine with Renshen (Ginseng Radix et Rhizoma, Ren Shen) to create Middle Qi, extending the authority of the Two Shen (Renshen and Fushen/Gancao). This is far from merely adding to existing formulas.
Hujian Wan (Tiger Hiding Pill) Treats Kidney Yin deficiency, flaccidity and weakness of sinews and bones, inability to walk.
Guiban (Testudinis Carapax et Plastrum, Gui Ban), Huangbai (Phellodendri Cortex, Huang Bo) (4 liang each), Zhimu (Anemarrhenae Rhizoma, Zhi Mu), Shudi (Prepared Rehmanniae Radix, Shu Di Huang) (2 liang each).
Niuxi (Achyranthis Bidentatae Radix, Niu Xi) (3.5 liang), Shaoyao (Paeoniae Radix, Bai Shao) (1.5 liang), Suoyang (Cynomorii Herba, Suo Yang) (1 liang), Hugugu (Pantheris Os, Hu Gu) (1 liang), Danggui (Angelicae Sinensis Radix, Dang Gui) (1 liang), Chenpi (Citri Reticulatae Pericarpium, Chen Pi) (0.75 liang).
Grind into powder, boil male sheep meat, mash into pills the size of paulownia seeds. Take with light salt water.
[Annotations] Wang Youyuan said: The Kidney is the official of strength, relying on Jing and Blood for strength. If Kidney deficiency leads to Jing depletion, Blood follows. Jing and Blood mutually defeat, allowing Damp-Heat, Wind, and Toxicity to attack. Thus, syndromes of inability to walk, sore waist, and contracted sinews arise. The Kidney encompasses Water and Fire. If Fire wins and scorches Yin, and Damp-Heat combines, sinew and bone dysfunction is expected. The formula uses Huangbai (Phellodendri Cortex, Huang Bo) to clear Fire within Yin and dry Dampness between bones. Its bitterness firms the Kidney, making it an essential herb for treating Wei Syndrome (Flaccidity). Thus, it is the Sovereign. Hugugu (Pantheris Os, Hu Gu) removes Wind Toxicity and strengthens sinews and bones, serving as Minister. Because high-source Water does not descend, Mother deficiency leads to Son deficiency; Liver-stored Blood does not return, Son disease worsens Mother disease. Thus, Zhimu (Anemarrhenae Rhizoma, Zhi Mu) clears Lung origin, and Danggui (Angelicae Sinensis Radix, Dang Gui) and Shaoyao (Paeoniae Radix, Bai Shao) nourish Liver Blood, guiding it to the Kidney. Guiban (Testudinis Carapax et Plastrum, Gui Ban) inherits dense Yin from Heaven and Earth, swallowing without spitting, sitting in the North. Combined with Shudi (Prepared Rehmanniae Radix, Shu Di Huang), Niuxi (Achyranthis Bidentatae Radix, Niu Xi), Suoyang (Cynomorii Herba, Suo Yang), and Lamb Meat, all water-tonifying substances, Jing and Blood are mutually supplemented. Chenpi (Citri Reticulatae Pericarpium, Chen Pi) moves Blood and Qi. There is the subtlety of Qi transforming Blood and Blood moving Qi. Thus, sinews and bones become strong and powerful like a tiger. The Daoist Classic says: "The Tiger is born from Water." This is the meaning of "Hiding." Hence, it is named Hujian Wan (Tiger Hiding Pill).
Ye Zhongjian said: Although Wei Syndrome (Flaccidity) originates from the Five Zang, its root is in the Kidney, and its branch is in the Lung. The *Neijing* states: "When the Five Zang are affected by Lung Heat with withered leaves, Wei Syndrome arises." It also states: "When Yang Qi invades internally, Water cannot overcome Fire, leading to Bone Wei and Marrow Deficiency, hence the feet cannot support the body." Bone Wei arises from Great Heat. If viewed as Deficiency-Cold and treated with Gui (Cinnamomi Cortex, Rou Gui) and Fu (Aconiti Lateralis Radix Praeparata, Fu Zi), it often leads to death. This formula is named after the Tiger because the Tiger, among beasts, embodies the most rigid Metal Qi. Its roar generates wind, symbolizing Lung Metal. "Hiding" means Metal is nurtured by Water; Mother hides in Son's womb. Therefore, generating Metal requires Water, intending to guide Qi back to the Kidney. Guiban (Testudinis Carapax et Plastrum, Gui Ban) corresponds to the North image, inheriting the densest Yin. Its head often faces the abdomen, connecting the Ren Mai (Conception Vessel), greatly tonifying True Yin, deeply understanding the meaning of "Hiding." Huangbai (Phellodendri Cortex, Huang Bo) has a rich flavor, being Yin within Yin, specifically tonifying insufficiency of Yin in the Kidney and Bladder, causing strength to surge in the feet and knees. Therefore, practitioners of Wei Syndrome must use these two as Sovereigns: one to secure the root, one to treat the branch. Fearful that single herbs fail, they use paired herbs. Shudi (Prepared Rehmanniae Radix, Shu Di Huang) fills Shaoyin Essence, assisting Guiban (Testudinis Carapax et Plastrum, Gui Ban) and Zhimu (Anemarrhenae Rhizoma, Zhi Mu) to clear Taiyin Qi; assisting Huangbai (Phellodendri Cortex, Huang Bo) and Niuxi (Achyranthis Bidentatae Radix, Niu Xi) to enter the Liver and relax sinews. Danggui (Angelicae Sinensis Radix, Dang Gui) and Shaoyao (Paeoniae Radix, Bai Shao) assist, giving Liver Blood a home; Chenpi (Citri Reticulatae Pericarpium, Chen Pi) moves, allowing Qi and Blood to flow, straightening bones and softening sinews. Furthermore, fearing Heat generates Wind lingering in joints, Tiger...