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。
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）
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？《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。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。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。而其挽回之法
，仍当遵二阳之病发心脾之旨。戒病者淡泊寡欲，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。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。
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。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。
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。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。
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。
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。
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。
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。
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。
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
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。
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。
附录∶
直隶青县张××来函∶
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。
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。
四川泾南周××来函∶
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。
奉天法库县万××来函∶
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。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？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。
治疗虚劳消瘦极度严重，饮食减少，气喘急促咳嗽，身体发热且脉象虚数的病证。也治疗女子血枯经闭不行的病症。
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，捣碎）
若热势严重的，加生地黄五六钱。脾脏是后天之本，能够资生滋养全身。脾胃功能健壮，大多能消化饮食，那么全身自然就会健壮，何曾见过多吃多喝却患虚劳病的呢？《黄帝内经·阴阳别论》说：“二阳之病发心脾，有不得隐曲，在女子为不月，其传为风消，其传为息贲，此四者，得之外内，皆在女子上。”这里先追溯阳明胃腑不能多纳饮食的原因，进而探究饮食减少的缘故；说是发于心脾，是追溯发病于心脾的原因；说“有不得隐曲”，是什么意思呢？盖因心是神明之府，有时心中有所隐曲，思想不能如意遂愿，则心神拂郁不畅，心血也就不能濡润脾土，从而形成过思伤脾的病证。脾受伤后不能帮助胃消化食物、变化津液以灌溉五脏，在男子身上已经暗中受病，但还没有明显征象；在女子身上则显然出现月经不来的病证。这是通过女子的病症来推知男子的病情。至于传变为风消（形容消瘦如被风吹去），传变为息贲（形容喘息气逆），无论男女病证发展到这一步，人人共见，虚劳已成，挽回确实困难，所以说是不治之症。然而医者以救活人为宗旨，病证虽然危险到了极点，仍应当在无可挽回之中，尽心设法去挽回它。而挽回的方法，仍然应当遵循“二阳之病发心脾”的宗旨。告诫病人淡泊寡欲，以养护心神，同时善于补助脾胃，使饮食渐渐增多，身体自然渐渐消退病邪。这个方子中用白术来健脾阳，脾土健壮，自然能帮助胃；用山药来滋胃阴，胃汁充足，自然能纳食（胃消化食物依赖有酸汁）。只是脾是统血的脏器，《黄帝内经》说“血生于脾”，大概是指脾系血液凝结之处，所以中间多含有血。西方人也认为脾中有许多回血管，是血液汇聚的地方。这个病证因为心思拂郁，心血不能调畅，脾中的血管遂多闭塞，或者像烂肉烤肉一样，或者形成丝膜，这就是脾病的原因。而脾与胃相助为理，一气贯通，脏病不能帮助腑，也就是胃不能纳食的原因。鸡内金是鸡的脾胃，里面有瓷、石、铜、铁等坚硬之物都能消化，可知它善于化解有形的郁积。而且它的性质非常平和，兼有以脾胃补脾胃的妙处。所以它能辅助健补脾胃的药物，立下奇功，绝非其他药物所能比及。方中以这三味药为不可挪移的关键药物。
玄参：《神农本草经》说它微寒，善于治疗女子产后余疾，而且它的味甘胜于苦，不至于寒凉损伤脾胃，可知用它来去除上焦的浮热，进而退去全身的烧热；而且它色黑多液，《神农本草经》又说能补肾气，所以用来治疗虚劳阴虚的患者尤其适宜。牛蒡子质地滑利气味芳香，能润肺又能利肺，与山药、玄参并用，大能止咳定喘，完成安肺的功效，所以把它作为佐使药加入。
地黄生用，其凉血退热的功效，确实优于玄参。西方人认为其中含有铁质，人的血液中，也确实有铁锈。地黄善于退热，不仅因为它能凉血滋阴，实在有以铁补铁的妙处，使血液充足，而蒸热自然消退。另外，虚劳的热，大抵是因为真阴亏损，相火不能潜藏。地黄善于引导相火下行，安守其故宅。《神农本草经》将其列为上品，确实是良药。但是必须等到烧热过分严重时才加入它，因为这个方子原本以健补脾胃为主，地黄虽然是生用，经过水火煎熬，其汁浆仍然粘腻，恐怕对脾胃不宜。至于热势严重的，脾胃必定不想饮食，用地黄退其热，则饮食可以进食，反而有助于脾胃。
生山药，就是市面上出售的干山药，而没有经过火炒的。这个方子如果用炒熟的山药，则分毫无效。
于术色黄气香，是浙江于潜所产的白术。色黄则属土，气香则醒脾，它健补脾胃的功效，迥异于寻常的白术。如果不是于潜出产，但只要观察其色黄气香，使用也有特殊疗效，这是以颜色、味道为重，不以产地地道为重。
西方人说：胃之所以能消化食物，全赖其中有酸汁。肚子饥饿想吃饭时，酸汁自然从胃中生出来。如果忧思过度，或恼怒过度，则酸汁的产生必然很少，或者分毫全无，胃中积存的食物，就不能消化。这种理论与《黄帝内经》“二阳之病发心脾”、“过思则伤脾”的宗旨暗合。
有人问：《黄帝内经》说脾主思，西方人又说思想发于脑部，您却说思发于心，为什么呢？回答：《黄帝内经》所谓脾主思，不是说脾自己能思考。大概脾属土，土主安静，人安静后才能深思。至于西方人说思发于脑部，《黄帝内经》早蕴含其理。《脉要精微论》说：“头者精明之府。”头的中心点在脑，头是精明之府，即脑是精明之府了。既然叫精明，岂有不思考的道理，然而也不是脑自己就能思考。试看古文中“思”字写作“囟下心”，囟指脑，心指心，由此可知思考，原是心脑相辅相成而成，又须借助脾土的镇静之力。
有人问：您对“二阳之病发心脾”这一节的解释，与王氏《内经》的注解不同，难道王氏的注解有误吗？回答：我实在不敢这么说。然而由我的拙解来演绎经文，自觉经文别有意味，且有实用价值。夫“二阳之病发心脾”，与下文“三阳为病发寒热”、“一阳发病、少气、善咳、善泄”，句法不同，讲解方法也可以变通。大概“二阳之病发心脾”，是说病自心脾而来。“三阳为病发寒热”，是形容三阳病的症状，所以将“之病”的“之”字易作“为”字。至于“一阳发病”几句，其句法又与“三阳为病”句不同，而其道理则是相同的。
又有人问：三阳、一阳的病，都是形容其发病的状态，唯独二阳的病，推究其发病的原因，这是什么原因呢？回答：三阳、一阳，如果不先说其发病的状态，人们就不知道什么是三阳、一阳病。至于二阳胃腑，原本主管饮食，人人皆知。至于胃腑有病，就不能饮食，这又是人人皆知。然而其所以不能饮食的原因，很多人不能知道。所以开头不说病状，而先阐明得病的由来。
又有人问：胃与大肠皆为二阳，经文既笼统地说二阳，怎么知道其所指的专在于胃？回答：胃为足阳明，大肠为手阳明，人的足经长、手经短，足经原本可以统摄手经，论述六经的人原本应当以足经为主。所以凡是《黄帝内经》只说某经，而不分别其为手与足的，都指足经而言，或者说足经而手经也包含在其中。如果只说手经，则一定特别称为手某经。经文俱在，可以取来仔细阅读。
一九一三年，客居大名。治疗一位室女，患虚劳一年多，月经不来，消瘦虚弱起不了床。询问药方给我，我为她拟定此汤。连续服用几剂，饮食增多。身体仍然发热，加生地黄五钱，五六剂后热退，渐渐能起床，但腿疼不能行动。又加丹参、当归各三钱，服用至十剂腿好，月经也来了。又说有白带很严重，先前忘记提及。于是去掉丹参加生牡蛎六钱，又将白术加倍，连续服用十剂带下证也好了。于是将此方邮寄回家，月余后门人高某促迫异常，饮食减少，脉象甚虚数，投以此资生汤十剂全愈。审视这些情况，就知道此方治疗虚劳，无论男女，服用都有捷效。
女子月经，如果日久不见，其血海必有坚结之瘀血。治疗这类病证的人，只知道用破血通血的药物，往往病还未去，而人已经先受其伤。鸡内金性质非常平和，而善于消除有形的郁积，服用既久，瘀血的坚结者，自然融化。况且此方与健脾滋阴的药物同用，新血活泼滋长，生新自能化瘀。
附录：
直隶青县张××来函：
津埠宋氏妇，年龄将近四十岁，身体虚弱，前两年就开始咳嗽吐痰，因为不以为事未曾调治。今年春天病情逐渐加剧，屡次服药无效。诊其脉，左部弦细，右部微弱，数近六至。咳嗽，吐白色痰，气腥臭，气喘自汗，午后发热，夜间尤其严重，胸膈满闷，饮食减少，大便秘结，知道其已成痨瘵兼肺病。从前所服药物十余纸，仅以止嗽药治疗其肺病，而不知“子虚补母”的道理，所以无效。为她开方用资生汤加减，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。煎服两剂，汗止喘轻，发热咳嗽稍愈。于是将前方去掉牡蛎，加瓜蒌仁、地骨皮各三钱，山药改用一两，赭石改用六钱。连续服用十剂，诸病皆愈，为了善后调理，用生山药细末八钱煮粥，调白糖服用，早晚各一次。后来一个多月，与介绍人见面，说此时宋氏妇饮食很多，身体较前健壮多了。
又：族嫂年三十五岁，初患风寒咳嗽，因为懒于服药，不以为事。后来逐渐病重，才开始延医诊治。所服用的药物，都是温散燥烈的品种，不知道风寒久了会化热，所以越治越厉害，几乎致死。后来我在腊月底回乡，族兄邀请为我诊视。脉象虚而无力，身体瘦如柴，咳嗽微喘，饮食减少，大便泄泻，有时兼白带，午后身热，颧红，确系痨瘵已成。授予资生汤，加炒薏仁、茯苓片、生龙骨、生牡蛎各三钱，茵陈、炙甘草各钱半。服用两剂，身热、颧红皆退，咳嗽泄泻也见好转。后来仍按此方加减，又服用六剂，诸病皆痊愈。嘱咐其每日用生怀山药细末煮粥，调以白糖服用，以善其后。
四川泾南周××来函：
杨姓女，年十九岁。出嫁二年，月经还未来潮，身体消瘦，饮食减少，干咳无痰，五心烦热，诊其脉细数有力。仿照使用资生汤方，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。连续服用五剂，热退咳减，食欲增加。于是在原方中去掉生地，倍用于术。又服用三剂，月经忽然到来。共服用二十剂全愈。
奉天法库县万××来函：
族弟妇产后虚羸少食，拖延月余，逐渐出现发灼、自汗、消瘦、乏气、干呕、头晕等症状，这是方书所说的蓐劳。经过四位医生治疗无效，并添上颧红作泻。恰逢我从安东回来，为之诊视，六脉虚数。检阅所服的方子，有遵照《医宗金鉴》三合饮的，有坚守用养荣汤的，都要么平淡无奇。然而病势到了这一步，确实难以下手，幸好脉虽虚数，未至无神，颧虽红，犹不抟聚（如果抟聚则阴阳离决了，不抟聚是其阴阳尚未离决），似乎还可以治疗。这大概是素来即阴虚，又经过产后亡血，气也随之耗散，阴不能内守，阳不能外固，所以汗出气乏；其阴阳不相维系，阴愈亏而阳愈浮，所以发烧咳嗽头晕；其颧红的，因为其部位对应肾，肾中真阳上浮，所以发现于此，而且红且热；其消瘦作泻的，因为二阳不纳，无以充肌肉，更不必说肾阴虚，而脾阴胃液均虚，中权失司，下陷不固，是必然的。这是病的原委吗？再四思维，于是处方，用生怀山药二两，于术三钱，玄参四钱，鸡内金、牛蒡子各二钱（这是资生汤原方稍加重），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，连续服用七剂。再照方减去萸肉，加党参二钱，服用四剂后，饮食大进，并能起坐矣，惟月经尚未行。更按资生汤原方，加当归四钱。服用数剂后，又复少有加减，一月后经脉亦通。
Treatment for consumptive disease (Laozai) with extreme emaciation, reduced appetite, panting and cough, body heat, and a deficient and rapid pulse. It is also used for amenorrhea due to blood exhaustion in women.
Raw Dioscoreae Rhizoma (Shanyao) (30g), Scrophulariae Radix (Xuanshen) (15g), Atractylodis Macrocephalae Rhizoma (Baizhu/Yushu) (9g), Raw Gavis Gallae Endothelium Corneum (Jineijin) (6g, crushed), Arctii Fructus (Niubangzi) (9g, stir-fried, crushed).
If the heat is severe, add Raw Rehmanniae Radix (Shengdihuang) 15-24g. The Spleen is the foundation of post-heaven acquisition and can nourish the whole body. If the Spleen and Stomach are robust, they can generally digest food and drink; thus, the whole body naturally becomes healthy. Have you ever seen someone who eats and drinks excessively yet suffers from consumptive disease? The *Neijing* (Huangdi Neijing), Chapter "Yin Yang Bie Lun" states: "Diseases of the Two Yangs originate from the Heart and Spleen... In women, this manifests as amenorrhea... it transmits to become wind-consumption (Fengxiao)... it transmits to become breath-gathering (Xiben)... These four conditions arise from internal and external factors..." Here, we first trace the reason why the Yangming Stomach cannot accept much food, thereby exploring the cause of reduced intake. Saying it originates from the Heart and Spleen traces the root cause to these organs. What does "having unspoken difficulties" (Bu de yinqu) mean? The Heart is the mansion of the Spirit (Shen). When there are hidden concerns or desires that cannot be fulfilled, the Heart Spirit becomes depressed, and Heart Blood fails to moisten the Spleen Earth, leading to illness caused by excessive thinking damaging the Spleen. Once damaged, the Spleen cannot assist the Stomach in digesting food and transforming fluids to irrigate the Five Zang organs. In men, this illness is secretly incurred without obvious signs; in women, it clearly manifests as amenorrhea. This uses female pathology to infer male pathology. As for transmission to wind-consumption (emaciation) or breath-gathering (panting/asthma), regardless of gender, when the condition reaches this stage, consumptive disease is established, and recovery is truly difficult; hence, it is said to be untreatable. However, physicians aim to save lives. Even if the danger is extreme, one must strive to recover the patient from the irrecoverable. The method of recovery should still follow the principle of "Two Yang diseases originating from Heart and Spleen." Advise the patient to live simply and reduce desires to nourish the Heart, while skillfully tonifying the Spleen and Stomach so that food intake gradually increases, and the body naturally recovers. In this formula, Baizhu strengthens Spleen Yang; robust Spleen Earth assists the Stomach. Shanyao nourishes Stomach Yin; sufficient Stomach juices allow for food acceptance (Stomach digestion relies on acidic juices). The Spleen is the organ that controls blood. The *Neijing* says "Blood is generated by the Spleen," implying the Spleen is where blood coagulates and contains much blood. Western medicine also considers the spleen rich in venous vessels, a gathering place for blood. In this condition, mental depression causes Heart Blood to flow poorly, leading to blockage in splenic vessels, resembling rotting meat or forming membranes; this is the origin of splenic disease. The Spleen and Stomach assist each other, connected by one Qi. If the Zang cannot assist the Fu, the Stomach cannot accept food. Jineijin is the gizzard lining of the chicken, which contains hard substances like porcelain, stone, copper, and iron that it can digest, showing its ability to resolve有形 (tangible) accumulations. Its nature is very mild, possessing the wonder of using the Stomach to tonify the Stomach. Thus, it aids herbs that strengthen and tonify the Spleen and Stomach, achieving remarkable results unmatched by other drugs. These three ingredients are indispensable in the formula.
Xuanshen: The *Shennong Bencao Jing* states it is slightly cold and treats residual diseases after childbirth in women. Its sweet taste outweighs its bitter taste, indicating it will not damage the Spleen and Stomach with coldness. Thus, it is used to clear floating heat from the Upper Jiao and retreat systemic fever. Being dark-colored and fluid-rich, and according to the *Shennong Bencao Jing* being able to tonify Kidney Qi, it is especially suitable for treating Yin deficiency in consumptive disease. Niubangzi is smooth and fragrant, moistening and benefiting the Lungs. Combined with Shanyao and Xuanshen, it greatly stops cough and calms panting, achieving the effect of calming the Lungs, hence added as an assistant and guide drug.
Raw Dihuangs: When used raw, its efficacy in cooling blood and retreating heat indeed surpasses Xuanshen. Westerners say it contains iron, and human blood actually contains rust. Dihuangs' ability to retreat heat lies not only in cooling blood and nourishing Yin but also in the subtlety of "tonifying iron with iron," making blood sufficient so that steaming heat naturally retreats. Furthermore, heat in consumptive disease largely stems from True Yin deficiency, allowing Ministerial Fire (Xianghuo) to fail to hide. Dihuangs guides Ministerial Fire downward to rest in its original home. Listed as a top-grade herb in the *Shennong Bencao Jing*, it is truly a good medicine. However, it is added only when heat is excessive because this formula primarily focuses on strengthening the Spleen and Stomach. Although used raw, after decoction, its juice remains sticky and muddy, which may be unsuitable for the Spleen and Stomach. When heat is severe, the Spleen and Stomach lose appetite; using Dihuangs to retreat heat allows food intake to resume, thereby assisting the Spleen and Stomach.
Raw Shanyao refers to dried Chinese yam sold in markets that has not been stir-fried. If stir-fried Shanyao is used in this formula, it will be ineffective.
Yushu (Atractylodes from Yuqian): Yellow in color and fragrant in odor, produced in Yuqian, Zhejiang. Yellow corresponds to Earth; fragrance awakens the Spleen. Its power to strengthen and tonify the Spleen and Stomach differs significantly from ordinary Baizhu. Even if not from Yuqian, as long as it is yellow and fragrant, it yields special effects. This emphasizes color and taste over geographical origin.
Western medicine states: The Stomach digests food relying entirely on acidic juices. When hungry, acidic juices naturally secrete from the Stomach. Excessive worry or anger reduces or eliminates acid secretion, causing undigested food accumulation. This aligns with the *Neijing* principles of "Two Yang diseases originating from Heart and Spleen" and "Excessive thinking damages the Spleen."
Q: The *Neijing* says the Spleen governs thought, while Westerners say thought originates in the brain. Why do you say thought originates in the Heart?
A: When the *Neijing* says the Spleen governs thought, it does not mean the Spleen thinks itself. The Spleen belongs to Earth, and Earth is quiet; only in quietness can one think deeply. Regarding Western views on the brain, the *Neijing* implies this too. The *Mai Yao Jing Wei Lun* states: "The head is the mansion of clarity and spirit." The center of the head is the brain; thus, the brain is the mansion of clarity. Since it is "clear and spiritual," how could it lack the ability to think? Yet, the brain does not think alone. Observe the ancient character for "thought" (思), composed of "cranium" (囟, meaning brain) above and "heart" (心) below. This shows that thinking requires the cooperation of Heart and Brain, aided by the stabilizing force of Spleen Earth.
Q: Your interpretation of "Two Yang diseases originating from Heart and Spleen" differs from Wang Bing's commentary. Is his annotation wrong?
A: I dare not claim so. However, interpreting the text through my explanation reveals deeper meaning and practical utility. The syntax of "Two Yang diseases originate from Heart and Spleen" differs from "Three Yang diseases manifest as chills and fever" and "One Yang disease onset...". Thus, the explanation can vary. "Two Yang diseases originate from Heart and Spleen" means the disease arises from the Heart and Spleen. "Three Yang diseases manifest as chills and fever" describes the symptoms of Three Yang diseases, hence changing "of" (Zhi) to "becomes" (Wei). The syntax of "One Yang disease" differs from "Three Yang," though the principle is similar.
Q: Why do Three Yang and One Yang describe symptoms, while Two Yang investigates the cause?
A: For Three Yang and One Yang, describing symptoms first helps identify them. For Two Yang (Stomach), everyone knows it governs diet. Everyone knows stomach illness prevents eating. But few know *why* eating is prevented. Hence, the text starts with the cause rather than symptoms.
Q: Both Stomach and Large Intestine are Two Yang. How do we know it refers specifically to the Stomach?
A: Stomach is Foot-Yangming; Large Intestine is Hand-Yangming. Foot meridians are longer and can encompass Hand meridians. Discussions on Six Meridians prioritize Foot meridians. Therefore, when the *Neijing* mentions a meridian without specifying Hand or Foot, it refers to the Foot meridian. If only Hand is mentioned, it specifies "Hand [Meridian Name]." The text supports this.
In 1913, residing in Daming, I treated a maiden with consumptive disease for over a year, amenorrhea, and extreme weakness. She consulted me, and I prescribed this decoction. After several doses, appetite increased. Body heat persisted, so I added 15g of Raw Dihuangs. After five to six doses, heat subsided, and she could get up, though leg pain prevented walking. I added Danshen and Danggui, each 9g. After ten doses, legs healed, and menstruation returned. She then mentioned severe leukorrhea, previously omitted. I removed Danshen, added Raw Oyster Shell (Muli) 18g, and doubled Yushu. After ten doses, leukorrhea cured. I mailed this formula home. A month later, my student Gao suffered from extreme fatigue, reduced appetite, and a deficient-rapid pulse. I administered Ten Doses of Zisheng Tang, resulting in full recovery. This proves Zisheng Tang is effective for consumptive disease in both men and women.
If menstruation is absent for a long time, firm blood stasis exists in the Sea of Blood. Treatments often use blood-breaking herbs, harming the patient before curing the disease. Jineijin is mild yet resolves tangible accumulations. Long-term use naturally dissolves firm stasis. Moreover, combined with Spleen-tonifying and Yin-nourishing herbs, new blood grows actively, generating new tissue that naturally transforms stasis.
Appendix:
Letter from Zhang XX, Qing County, Hebei:
Mrs. Song, nearly 40, weak. Coughed and expectorated sputum for two years, untreated. Condition worsened this spring; previous medicines failed. Pulse: Left wiry-thin, Right weak, rapid (~6 beats/cun). Cough, white foul-smelling sputum, panting, spontaneous sweating, afternoon fever (worse at night), chest oppression, reduced appetite, constipation. Diagnosis: Consumptive disease complicated by Lung pathology. Previous treatments only stopped cough, ignoring "tonifying the mother when the daughter is deficient" (Kidney-Lung relationship). Prescribed Modified Zisheng Tang: Raw Shanyao 24g, Xuanshen, Raw Dihuang, Cornus 18g each, Raw Muli, Raw Shaoyao, Raw Hematite 12g each, Yushu, Raw Jineijin, Licorice 6g each. Two doses: Sweat stopped, panting eased, fever/cough improved. Removed Muli, added Trichosanthis Semen 9g, Cortex Lycii Radicis 9g, increased Shanyao to 30g, Hematite to 18g. Ten doses: All symptoms resolved. Maintenance: Raw Shanyao powder 24g porridge with sugar, twice daily. One month later: Mrs. Song ate well and was stronger.
Another case: My clan sister, 35, initially had wind-cold cough, ignored treatment. Condition worsened; previous doctors used warm/drying dispersants, worsening heat. I diagnosed her late winter. Pulse: Deficient/weak. Emaciated, slight panting, reduced appetite, diarrhea, occasional leukorrhea, afternoon fever, malar flush. Diagnosis: Established consumptive disease. Prescribed Zisheng Tang + Stir-fried Coix Seed, Poria, Raw Dragon Bone, Raw Oyster Shell 9g each, Artemisiae Scopariae Herba, Roasted Licorice 4.5g each. Two doses: Fever/flush subsided, cough/diarrhea improved. Continued modifications for six doses: Full recovery. Maintenance: Raw Shanyao porridge with sugar.
Letter from Zhou XX, Jingnan, Sichuan:
Ms. Yang, 19, married two years, no menstruation, emaciated, reduced appetite, dry cough, five-palm heat, fine-rapid-strong pulse. Used Zisheng Tang: Raw Shanyao 30g, Yushu 6g, Niubangzi 9g, Xuanshen 15g, Raw Dihuang 12g, Raw Jineijin 3g. Five doses: Heat retreated, cough reduced, appetite increased. Removed Dihuang, doubled Yushu. Three more doses: Menstruation arrived. Total 20 doses: Cured.
Letter from Wan XX, Fakuxian, Fengtian:
Clan brother's wife, postpartum weakness, poor appetite, delayed one month. Symptoms: burning sensation, sweating, emaciation, fatigue, dry retching, dizziness. Diagnosis: Postpartum consumption (Rulao). Four doctors failed; added malar flush and diarrhea. Pulse: Six positions deficient-rapid. Previous formulas were bland. Condition critical but treatable (pulse has spirit, flush not clustered). Pathogenesis: Pre-existing Yin deficiency + postpartum blood loss -> Qi loss -> Yin fails to hold, Yang fails to secure -> sweat/fatigue. Yin/Yang disconnect -> Yin def leads to Yang float -> fever/cough/dizziness. Malar flush: Kidney area, true Yang floating upward. Emaciation/diarrhea: Two Yang (Stomach/Large Intestine) fail to nourish muscles; Spleen/Stomach Yin/Juices deficient; central pivot fails, sinking/unsecured. Prescription: Raw Huai Shanyao 60g, Yushu 9g, Xuanshen 12g, Jineijin, Niubangzi 6g each (Modified Zisheng Tang base), plus Cornus, Dragon Bone, Oyster Shell 15g each (to stop sweat/diarrhea). Five doses: Sweat/diarrhea stopped, appetite improved, cough/heat reduced slightly. Added Licorice, Asparagus Root, Raw Dihuang. Seven doses. Reduced Cornus, added Codonopsis 6g. Four doses: Appetite great, sat up. Menstruation not yet started. Returned to Zisheng Tang base + Danggui 12g. Few adjustments over several doses. One month later: Menstruation flowed.