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。
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）
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
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。
仲景治劳瘵，有大黄 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。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。
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
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。
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？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。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；加陈皮、白芍，治下虚上盛之痰涎；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，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），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；又尝用六味地黄丸作汤，加川芎、知母，以治如破
之头疼；加胆草、青黛，以治非常之眩晕；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；用熟地四两、茯苓一两，以止下焦不固之滑泻；用熟地四两、
白芍一两，以通阴虚不利之小便；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；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）；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。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。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。其方《金
匮》凡五见，一治“香港脚上入少腹不仁”；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。
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。愚忽有会悟，改用生黄 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 、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。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 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。况劳瘵者多损肾
，黄 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 、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）。
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？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。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。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。
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 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？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
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 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。
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。
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 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。
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 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 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 ，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 ，而后服之不至满闷。又尝权衡黄 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 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。
附录∶
直隶沧县李××来函∶
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。
治疗虚劳病，脉象表现为弦、数、细、微，皮肤干燥粗糙如鳞甲交错（肌肤甲错），身体消瘦羸弱，饮食无法增强筋力，或者出现自汗，或者咳嗽气逆，或者气喘急促，或者寒热症状不时发作，或者多梦纷乱，精气不固。
野台参（四钱） 生黄芪（四钱） 生山药（四钱） 知母（四钱） 玄参（四钱） 生龙骨（四钱，捣碎成细粉） 生牡蛎（四钱，捣碎成细粉） 丹参（二钱） 三棱（一钱半） 莪术（一钱半）
如果气分虚弱严重的，去掉三棱、莪术，加入生鸡内金三钱；气喘的，加倍使用山药，加入牛蒡子三钱；出汗多的，用白术、煅龙骨、煅牡蛎、山茱萸各一两煎服，不超过两剂，汗即可停止。汗止后再服用原方。如果是先冷后热并且出汗的，脉象可能更加微弱不起，这多半是胸中大气下陷，仔细阅读我拟定的升陷汤后的跋语，自然就知道治疗方法了。
张仲景治疗劳瘵（慢性消耗性疾病），有大黄䗪虫丸，有百劳丸，都大量使用破血药。确实因为人体的经络，都有血液贯通其中，内通脏腑，外溉周身，血液一旦停滞，气化功能就不能健运，劳瘵往往因此形成。所以劳瘵病患者肌肤甲错，血液不能荣华于面色，即使每天吃珍馐美味并服用人参、茯苓等补药，也丝毫不能长肌肉、壮筋力。或者反而更加消瘦支离，一天比一天严重，确实是因为瘀血阻塞经络，阻碍了气化功能。玉田人王清任著有《医林改错》一书，创立了活血逐瘀的各种汤剂，按照上、中、下部位，分别消除瘀血，统管百病，认为瘀血去除而各种疾病自然痊愈。他的立论虽然没有没有偏颇之处，但他的大旨确实有主见，所以使用他方剂的人，也多有效验。现在我因为治疗劳瘵，所以拟定十全育真汤，在补药剂中加入三棱、莪术以疏通气血，私下效法张仲景大黄䗪虫丸、百劳丸的意思。而且张仲景在《金匮要略》中列出虚劳一门，特意以“血痹虚劳”四字作为提纲。由此更知道虚劳病必定伴有血痹，而血痹严重的，又没有不导致虚劳的。并知道治疗虚劳必须先治疗血痹，治疗血痹也就是在治疗虚劳。
有人问：治疗劳瘵兼用破血药，确实是确当的理论，但破血如果用三棱、莪术，难道不是力量过于猛烈吗？回答说：张仲景的大黄䗪虫丸与百劳丸所用的破血药，如大黄、干漆、水蛭，都比三棱、莪术猛烈，而方中不用三棱、莪术的原因，确实是因为三棱、莪术未被《神农本草经》记载。到了梁代陶弘景著《名医别录》，在《神农本草经》之外增加药品三百六十五味，都是南北朝以前名医所用的药，也未记载三棱、莪术。所以在张仲景时代还没有三棱、莪术，即使有，也没有经过试验可知。而我对于破血药中，唯独喜欢用三棱、莪术的原因，确实因为它们既善于破血，又善于调气。在补药剂中作为佐使药，将资生纳谷为宝。无论什么病，凡是服药后饮食逐渐增加的容易治疗，饮食逐渐减少的难治。三棱、莪术与人参、白术等药并用，大能开胃进食，这也是我屡次尝试屡试屡效的。
有人问：劳瘵的病证，阴虚发热的占大多数。所以钱乙的减味地黄丸；张景岳的左归饮，都是对症的好方子，因为它们都以熟地黄为君药，大能滋真阴退虚热。你的方子中为什么独独不用呢？回答说：如果论及使用熟地黄，我固然是过来人。回忆初读方书时，曾阅读赵献可的《医贯》、张景岳的《张氏八阵》、冯楚瞻的《冯氏锦囊》诸书，于是确信其说。临证最喜欢用熟地黄，曾用八味地黄丸作汤剂，加苏子、白芍，治疗吸气不能归根的气喘气逆；加陈皮、白芍，治疗下虚上盛的痰涎；加苏子、厚朴，治疗肾不摄气，导致冲气上逆的胀满（当时病人服用觉得有推荡之力，后来制成参赭镇气汤治疗此证更有效，又曾减去茯苓、泽泻三分之二，治疗女子消渴小便频数（《金匮要略》说治疗男子消渴来治疗女子也有效，案详见玉液汤下），又曾去掉附子，加知母、白芍，治疗阴虚不能化阳，导致小便不利积成水肿；又曾用六味地黄丸作汤剂，加川芎、知母，治疗像破裂一样的头痛；加龙胆草、青黛，治疗非常剧烈的眩晕；加五味子、枸杞子、柏子仁，收敛散大的瞳孔，并且相信它煎汁数碗，浩荡饮之的说法；用熟地黄四两、茯苓一两，来止住下焦不固的滑泄；用熟地黄四两、白芍一两，来通利阴虚不利的小便；又曾在一日之中用熟地黄一斤左右，治疗外感大病之后，忽然气喘气逆，脉象散乱欲脱的险证（此证应当用后来拟定的复元汤，彼时该方未拟定，只知道用熟地黄也侥幸成功，这是知道冯楚瞻说熟地黄能大补肾中元气确实是有过尝试的），而且不仅仅治疗内伤；又曾用熟地黄、阿胶等大滋真阴的药物，治疗温病脉象阳浮而阴不应，不能作汗，一日连服两剂，济阴以应其阳，使之自汗（详细案列在寒解汤下）；以及一切伤寒外感，因下元虚惫而邪气深陷的，无不重用熟地黄，补其下元，以此来托举邪气外出。只有用来治疗阴虚劳热的病证，轻症可以见效，如果脉数到七八至的几乎没有有效的。那时还不知道改变方法，还以为是地黄丸就是《金匮要略》的肾气丸，自古推崇为良方，这个如果不效，那么其他方子更不用说了，不知道肾气丸原来用的是干地黄，即药坊间的生地黄，其中的桂用的是桂枝，即《神农本草经》中的牡桂，与现在的地黄丸完全不同了。其方在《金匮要略》中出现五次，一次治疗“香港脚上入少腹不仁”；一次治疗“虚劳腰痛，少腹拘急，小便不利”；一次治疗“短气有微饮，当从小便去之”；一次治疗“男子消渴，小便反多，饮一斗，小便一斗”；一次治疗“妇人转胞，胞系了戾，不得溺”。纵观五条，原本治疗少腹膀胱的疾病居多，不是正治劳瘵的药，何况后世的修制，又失去了它的本来面目呢？
后来治疗一个妇人，年龄近五十岁。身体发热劳嗽，脉数几乎达到八至。先用六味地黄丸加减作汤剂服用无效，继用左归饮加减也无效。我突然有所领悟，改用生黄芪六钱、知母八钱为方，几剂后病情减轻，又加丹参、当归各三钱，连服十剂全愈。以后凡是遇到阴虚有热的病证，其稍有根柢可以挽回的，在方中重用黄芪、知母，没有不随手奏效的。这才知道叔和脉法说脉数到七八至是不治之脉，不是确论。大概人禀受天地之气而生，人身的气化即天地的气化，天地将要下雨的时候，必须阳气温暖上升，然后阴云会合大雨随之。黄芪温升补气，是将雨时上升的阳气；知母寒润滋阴，是将雨时四合的阴云。两药并用，大具阳升阴应、云行雨施的妙处。膏泽优渥烦热自然消退，这是不治之治。况且劳瘵患者多损伤肾，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，使阴阳不至偏胜，即肺脏调和，而生水之功更加普遍（黄芪、知母虽可并用以退虚热，然而遇到阴虚热甚的，又必须加生地黄八钱或至一两，才能服用有效）。
又有人问：肾气丸虽然不是专治虚劳的药，而《金匮要略》虚劳门，明确记载其治虚劳腰疼，似乎虚者都可以服用，你唯独说无甚效验，难道古方不可遵循吗？回答说：肾气丸如果果然按古方修制，地黄用干地黄，桂用桂枝，且只作为丸剂，而不作汤剂，使用得当，确实有效验。盖生地黄能逐血痹（《神农本草经》），而熟地黄没有这种效验。桂枝能调营卫，而肉桂没有这种效验。血痹驱逐，则瘀血自然消除，营卫调和，则气血自然调理。至于山茱萸的酸温，也能逐痹（《神农本草经》山茱萸逐寒湿痹）。牡丹皮的辛凉，也能破血。附子的极大辛极大温，又能温通血脉，与地黄的寒凉相互济助，以共同完成逐血痹的功效。所以肾气丸是补肾的药，实际上兼为开瘀血的药，所以列于《金匮要略》虚劳门，而为要方。它只作为丸剂，而不作汤剂的原因，确实是因为地黄经过水火煎熬，则汁浆稠粘、性质接近熟地黄，其逐血痹的力量必然减弱，所以《神农本草经》说生地黄尤好。后贤徐灵胎曾治疗一个人，上盛下虚，胸次痰火壅滞，气喘不能卧，将人参切作小块，用清水理痰的药煎汤，送服而愈。后来病复发，病家自用原方，并将人参也煎服，病更加严重，灵胎仍教导依照从前方法，可以从这里悟出古人制作肾气丸的精义了。
又有人问：肾气丸既然按古方修制可以有效，而《金匮要略》虚劳门，肾气丸与大黄䗪虫丸之外，又有七方，都可以随证采择，那么你的十全育真汤，似乎也可以不拟定了？回答说：《金匮要略》虚劳门诸方，虽然都有效，而一方专治虚劳门一证。如果我拟定的十全育真汤，实际兼治虚劳门诸证。如方中使用黄芪以补气，而即用人参以培元气之根本。使用知母以滋阴，而即用山药、玄参以壮真阴之渊源。使用三棱、莪术以消瘀血，而即用丹参以化瘀血之渣滓。至于龙骨、牡蛎，如果取其收涩之性，能帮助黄芪以固元气；如果取其凉润之性，能帮助知母以滋真阴；如果取其开通之性（《神农本草经》龙骨主癥瘕，后世本草也说牡蛎消血），又能帮助三棱、莪术以消融瘀滞。至于治疗肺虚的咳逆、肾虚的喘促，山药最好。治疗多梦纷乱，虚汗淋漓，龙骨、牡蛎尤其胜过。这是方中的意思，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，所以叫十全育真。
劳瘵患者多兼瘀血，其证原有两种：有因劳瘵而产生瘀血的，其人或者调养失宜，或者纵欲过度，气血亏损，流通于周身者必然迟缓，血即因此瘀滞，其瘀多在经络；有因瘀血而形成劳瘵的，其人或者有跌伤碰伤，或者力小任重，或者素有吐衄证，服药失宜，以致先有瘀血，日久浸成劳瘵，其瘀血多在脏腑。这两种情况服用十全育真汤都可以痊愈。而瘀血在脏腑的，尤其须多用破血药。又瘀在经络的，也可以用前方资生汤，加当归、丹参。瘀在脏腑严重的，又适宜用我拟定的理冲汤，或理冲丸。这几方可以参考变化汇通，随时制宜。
世俗医生，遇到脉数的病证，大多责怪为阴虚血涸。不知道元气虚极不能支持时，脉可以至极数。假设有一个人用力劳作，或者奔驰，到气力不能支持的时候，其脉必数。乃以力倦之不能支持，来比拟气虚之不能支持，事情不同而其理相同。我临证细心体验，凡是治疗虚劳的病证，固然不敢纯用补药，然而理气药多于补气药，则脉即加快，补气药多于理气药，则脉即逐渐减缓。是知道脉的数与不数，固然视乎血分之盈亏，实在尤其兼视乎气分之强弱。所以此十全育真汤中，台参、黄芪各四钱，而三棱、莪术各一钱半，补气之药原数倍于理气之药。如果遇到气分虚甚的，还必须以鸡内金代替三棱、莪术。
药性的补、破、寒、热，虽然有定规，但也视乎服药者的资质禀赋为转移。曾经权衡黄芪的补力，与三棱、莪术的破力，等分使用原本没有高下之分。曾经用三棱、莪术各三钱，治疗脏腑间一切癥瘕积聚，恐怕其伤气，而以黄芪六钱佐之，服用几十剂，病去而气分不伤，而且有越服越觉强壮的。如果遇到气分很虚的，才服几剂，就觉气难支持，必须加黄芪，或减三棱、莪术，才可以久服。盖虚极之人，补药难为攻，而破药易见过也。如果其人气壮而更兼郁结的，又必须多用三棱、莪术，或少用黄芪，而后服用不至满闷。又曾经权衡黄芪的热力，与知母的寒力，也没有高下之分，等分使用可以久服无寒热（此论汤剂作丸剂则知母寒力胜于黄芪热力）。而素来畏热的，服用必至增热，素来畏寒的，服用又转增寒，其寒热之力无定，也如同补破之力无定。所以临证调方者，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。
附录：
直隶沧县李××来函：
弟弟的长子媳妇，年龄二十四岁，在今年（丙寅年）正月间患寒热往来，自己平素害怕服药，所以隐忍不肯说。到四月初，家人来接弟弟，说儿媳病重。回家查看她，虽然未卧床不起。但瘦弱实在难以忍受。诊其脉，弦而浮数。仔细询问病情，说每逢午后先冷后热，时而轻微咳嗽无痰，日夜腹泻十余次，黎明则头汗出，胸间绵绵作痛，食一下咽即胀满难堪，而诸虚百损之状，显然尽露。筹思良久，为她开立逍遥散方。服用两剂无效。于是再次到沧州取药，恰逢张××从天津来到沧州，于是将儿媳的病细述本末。张××说：“以弟弟的意思，将用何方来治疗？”回答说：“我打算将资生汤、十全育真汤二方，汇通用之，可以吗？”张××说：“得之矣。这是良方，服用必有效。”弟弟于是师承二方之义，用生怀山药八钱，生白术、净山茱萸、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。又在原方加三棱、莪术（十全育真汤中使用此二药的原因，是因为虚劳的病证多血痹也。）各一钱，牡丹皮、地骨皮各二钱。又连服八剂，诸病悉退，饮食增加，现在已经完全康复了。
Treats consumptive disease (Xu Lao), with pulse presenting as wiry, rapid, fine, and minute; skin dry and rough like fish scales (Ji Fu Jia Cuo); body emaciated and weak; diet fails to strengthen sinews and muscles; or spontaneous sweating occurs; or cough and rebellious qi arise; or panting and shortness of breath occur; or chills and fever appear intermittently; or dreams are chaotic and numerous; and essence and qi are insecure.
Ye Tai Shen (Radix Ginseng) - 4 qian
Sheng Huang Qi (Astragali Radix) - 4 qian
Sheng Shan Yao (Dioscoreae Rhizoma) - 4 qian
Zhi Mu (Anemarrhenae Rhizoma) - 4 qian
Xuan Shen (Scrophulariae Radix) - 4 qian
Sheng Long Gu (Fossilia Ossis Mastodi) - 4 qian, crushed into fine powder
Sheng Mu Li (Concha Ostreae) - 4 qian, crushed into fine powder
Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma) - 2 qian
San Leng (Sparganii Rhizoma) - 1.5 qian
E Zhu (Curcumae Rhizoma) - 1.5 qian
If the deficiency in the Qi level is severe, remove San Leng and E Zhu, and add Sheng Ji Nei Jin (Galli Gigerii Endothelium Corneum) 3 qian; for panting, double the amount of Shan Yao and add Niu Bang Zi (Arctii Fructus) 3 qian; for excessive sweating, decoct Bai Zhu (Atractylodis Macrocephalae Rhizoma), Pao Long Gu (Fossilia Ossis Mastodi), Pao Mu Li (Concha Ostreae), and Yu Rou (Corni Fructus), each 1 liang, and take orally. The sweating will stop within no more than two doses. After the sweating stops, resume taking the original formula. If there is chills first followed by fever and sweating, the pulse may be even weaker and faint, which mostly indicates sinking of the Great Qi in the chest. Carefully reading the postscript to my proposed Sheng Xian Tang (Decoction for Raising Sinking Qi) will make the treatment method clear.
Zhang Zhongjing treated Lao Zhai (chronic wasting disease) with Da Huang Zhe Chong Wan (Pill of Rhubarb and Ground Beetle) and Bai Lao Wan (Hundred Consumptives Pill), both using large amounts of blood-breaking herbs. Indeed, the meridians and collaterals of the human body are penetrated by blood, connecting internally to the Zang-Fu organs and irrigating externally the whole body. Once blood stagnates, the function of Qi transformation cannot operate vigorously, and Lao Zhai often forms because of this. Therefore, patients with Lao Zhai have skin like fish scales, and blood fails to nourish the complexion. Even if they eat delicacies daily and take Shen (Ginseng) and Ling (Poria) tonics, they cannot gain muscle strength or strengthen sinews. Or they may become increasingly emaciated and disjointed day by day, truly because blood stasis blocks the meridians and hinders Qi transformation. Wang Qingren from Yutian wrote the book *Yi Lin Gai Cuo* (Correction of Errors in Medical Forest), establishing various formulas for invigorating blood and expelling stasis. According to upper, middle, and lower locations, he separately eliminated blood stasis to treat a hundred diseases, stating that once blood stasis is removed, various diseases heal themselves. Although his statements were not without bias, his main principle was indeed well-founded, so those who used his formulas often achieved efficacy. Now, because I treat Lao Zhai, I have formulated Shi Quan Yu Zhen Tang (Ten Complete Decoction for Nourishing True Essence). In the tonic formula, I added San Leng and E Zhu to unblock and activate Qi and blood, secretly modeling the intent of Zhang Zhongjing's Da Huang Zhe Chong Wan and Bai Lao Wan. Furthermore, Zhang Zhongjing listed the chapter on Xu Lao in *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet), specifically using the four characters "Blood Bi and Xu Lao" as the outline. This further confirms that Xu Lao must involve Blood Bi, and severe Blood Bi inevitably leads to Xu Lao. It also shows that treating Xu Lao requires first treating Blood Bi, and treating Blood Bi is essentially treating Xu Lao.
Someone asked: Treating Lao Zhai with blood-breaking herbs is indeed an accurate theory, but using San Leng and E Zhu for breaking blood—wouldn't their force be too fierce? I replied: The blood-breaking herbs used in Zhang Zhongjing's Da Huang Zhe Chong Wan and Bai Lao Wan, such as Da Huang (Rhei Radix et Rhizoma), Gan Qi (Drynariae Rhizoma processed with honey? Note: Text says Gan Qi usually refers to Dried Lacquer or similar, but context implies strong blood breaker like Drynaria or similar ancient term, actually Gan Qi here likely refers to *Gan Qi* (Lacquer) or potentially a typo for another herb, but standard interpretation in this context often points to strong agents. However, strictly translating text: Gan Qi), and Shui Zhi (Hirudo), are all fiercer than San Leng and E Zhu. The reason they did not use San Leng and E Zhu in the formula is precisely because these two herbs were not recorded in *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica). Later, Tao Hongjing of the Liang Dynasty wrote *Ming Yi Bie Lu* (Record of Famous Physicians' Distinct Records), adding 365 medicinal substances outside *Shen Nong Ben Cao Jing*, all medicines used by famous physicians before the Southern and Northern Dynasties, yet still did not record San Leng and E Zhu. Thus, in Zhang Zhongjing's time, San Leng and E Zhu did not exist; even if they did, it is known they had not been tested. My preference for using San Leng and E Zhu among blood-breaking herbs is truly because they are good at breaking blood and especially good at regulating Qi. Used as assistant and guide in tonic formulas, they prioritize generating grain and nourishing the stomach. Regardless of the disease, cases where appetite gradually increases after taking medicine are easy to treat, while those where appetite decreases are difficult. The combination of San Leng and E Zhu with Shen (Ginseng) and Zhu (Atractylodes) greatly opens the stomach and promotes eating, which is something I have repeatedly tested and found effective.
Someone asked: In the syndrome of Lao Zhai, half or more present with Yin deficiency and tidal fever. Therefore, Qian Zhongyang's Jian Wei Di Huang Wan (Modified Rehmannia Pill) and Zhang Jingyue's Zuo Gui Yin (Left Restoring Decoction) are excellent prescriptions for the syndrome, as they all use Shu Di Huang (Prepared Rehmanniae Radix) as the sovereign drug, greatly nourishing True Yin and retreating deficient heat. Why does your formula exclusively omit it? I replied: If discussing the use of Shu Di Huang, I am indeed someone who has experienced it. Recalling when I first read medical books, I studied Zhao Xiuke's *Yi Guan* (Medical Canon), Zhang Jingyue's *Zhang Shi Ba Zhen*, and Feng Chuzhan's *Feng Shi Jin Nang*, and thus firmly believed in their theories. In clinical practice, I most liked using Shu Di Huang. I once used Ba Wei Di Huang Wan (Eight-Ingredient Rehmannia Pill) as a decoction, adding Su Zi (Perillae Fructus) and Bai Shao (Paeoniae Radix Alba) to treat panting and rebellious qi where inhalation fails to root; adding Chen Pi (Citri Reticulatae Pericarpium) and Bai Shao to treat phlegm-saliva due to deficiency below and excess above; adding Su Zi and Hou Po (Magnoliae Officinalis Cortex) to treat distension caused by rebellious Qi ascending due to Kidney failing to grasp Qi (at that time, patients felt a pushing sensation upon taking it; later I formulated Shen Zhe Zhen Qi Tang to treat this syndrome more effectively); I once reduced Fu Ling (Poria) and Ze Xie (Alismatis Rhizoma) by two-thirds to treat polyuria and frequent urination in women with Xiao Ke (Wasting-Thirst) (the *Jin Gui* states treating male Xiao Ke is also effective for females; see details under Yu Ye Tang); I once removed Fu Zi (Aconiti Lateralis Radix Praeparata) and added Zhi Mu and Bai Shao to treat edema resulting from failure of urine output due to Yin deficiency failing to transform Yang; I once used Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) as a decoction, adding Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Zhi Mu to treat headaches feeling like bursting; adding Long Dan Cao (Gentianae Radix) and Qing Dai (Orpiment) to treat severe vertigo; adding Wu Wei Zi (Schisandrae Fructus), Gou Qi Zi (Lycii Fructus), and Bai Zi Ren (Biota Semen) to constrict dilated pupils; and I believed in the saying of decocting several bowls and drinking them generously. I used 4 liang of Shu Di Huang and 1 liang of Fu Ling to stop slippery diarrhea due to insecurity of the Lower Jiao; used 4 liang of Shu Di Huang and 1 liang of Bai Shao to promote urination in cases of Yin deficiency with difficult urination; I once used about 1 jin of Shu Di Huang in one day to treat a critical condition of sudden panting and rebellious qi with a scattered pulse nearing collapse after a severe external contraction (this condition should use the later formulated Fu Yuan Tang; at that time the formula was not yet conceived, knowing only to use Shu Di Huang was fortunate enough to succeed; this proves Feng Chuzhan's statement that Shu Di Huang can greatly tonify the Original Qi of the Kidney was indeed based on experience). Moreover, I did not just treat internal injuries; I once used Shu Di Huang and E Jiao (Asini Corii Colla) to greatly nourish True Yin for treating warm diseases where the pulse is floating on the exterior but absent on the interior, unable to produce sweat. Taking two doses in one day, it nourished Yin to respond to Yang, inducing spontaneous sweat (detailed case under Han Jie Tang). For all types of Shang Han (Cold Damage) and external contractions where pathogens sank deeply due to exhaustion of the Lower Yuan, I heavily relied on Shu Di Huang to tonify the Lower Yuan, thereby pushing pathogens out. Only when used to treat Yin deficiency with latent heat, mild cases could be effective; if the pulse was rapid reaching 7-8 beats per breath, almost no effectiveness was seen. At that time, I did not know to change methods, thinking that Di Huang Wan was the Shen Qi Wan of *Jin Gui*, praised since antiquity as a good prescription. If this failed, other prescriptions would be even less effective. I did not know that Shen Qi Wan originally used Gan Di Huang (Dry Rehmanniae Radix), i.e., Sheng Di Huang (Raw Rehmanniae Radix) in pharmacies, and the Gui used was Gui Zhi (Cinnamomi Ramulus), i.e., Mu Gui (Cinnamomum Cassia Bark) in *Shen Nong Ben Cao Jing*, which is completely different from modern Di Huang Wan. The formula appears five times in *Jin Gui*: once treating "Hong Kong foot entering the lower abdomen with numbness"; once treating "Xu Lao lumbar pain, hypogastric tension, and difficulty urinating"; once treating "Shortness of breath with slight fluid retention, should be expelled via urination"; once treating "Male Xiao Ke, urine volume increased, drinking one dou produces one dou of urine"; once treating "Female turning bladder, bladder cord twisted, inability to urinate". Viewing these five items, they originally treated diseases of the lower abdomen and Bladder mostly, not the primary medicine for Lao Zhai. Moreover, how much the subsequent preparations deviated from its original nature!
Later, I treated a woman near fifty years old. She had fever and consumptive cough, with a pulse rapid reaching nearly eight beats per breath. First, I used modified Liu Wei Di Huang Wan as a decoction, which was ineffective. Then I used modified Zuo Gui Yin, also ineffective. Suddenly, I had an insight and changed to using Sheng Huang Qi 6 qian and Zhi Mu 8 qian as the formula. After a few doses, she improved. Then I added Dan Shen and Dang Gui (Angelicae Sinensis Radix) 3 qian each. After ten doses continuously, she was fully cured. Since then, whenever encountering Yin deficiency with heat syndromes that had some foundation to recover, by heavily using Huang Qi and Zhi Mu in the formula, I achieved immediate results. Only then did I realize that He Su Po's pulse method stating that a pulse rapid to 7-8 beats per breath is untreatable is not an absolute truth. Humans are born endowing Qi from Heaven and Earth; the Qi transformation of the human body is the Qi transformation of Heaven and Earth. When Heaven and Earth are about to rain, Yang Qi must warm and rise first, then Yin clouds gather and heavy rain follows. Huang Qi warms and rises to tonify Qi, representing the rising Yang Qi before rain; Zhi Mu is cold and moist to nourish Yin, representing the gathering Yin clouds before rain. Using these two drugs together possesses the wonder of Yang rising and Yin responding, clouds moving and rain applying. Abundant moisture causes vexing heat to retreat naturally; this is treating the untreatable. Moreover, Lao Zhai patients often damage the Kidney. Huang Qi greatly tonifies Lung Qi to benefit the source of Kidney Water, making Qi vigorous to generate Water naturally. Zhi Mu greatly nourishes Lung fluids, preventing Yin and Yang from extreme imbalance, harmonizing the Lung organ, and thus the function of generating water becomes more universal (Although Huang Qi and Zhi Mu can be used together to retreat deficient heat, in cases of severe Yin deficiency with heat, one must add Sheng Di Huang 8 qian to 1 liang to be effective).
Someone else asked: Although Shen Qi Wan is not a specialized medicine for Xu Lao, the Xu Lao chapter in *Jin Gui* clearly records it treats Xu Lao lumbar pain. It seems those with deficiency can take it. You alone say it has little efficacy. Are ancient prescriptions not to be followed? I replied: If Shen Qi Wan is indeed prepared according to ancient prescriptions, using Gan Di Huang for Di Huang, Gui Zhi for Gui, and made only into pills, not decoctions, and used appropriately, it certainly has efficacy. Gan Di Huang can expel Blood Bi (*Shen Nong Ben Cao Jing*), whereas Shu Di Huang lacks this efficacy. Gui Zhi can regulate Ying and Wei, whereas Rou Gui (Cinnamomi Cortex) lacks this efficacy. Once Blood Bi is expelled, blood stasis disappears naturally; once Ying and Wei are regulated, Qi and Blood self-regulate. As for Shan Yu Rou (Corni Fructus), its sour and warm nature can also expel Bi (*Shen Nong Ben Cao Jing* Shan Zhu Yu expels cold-damp Bi). Mu Dan Pi (Moutan Cortex) is pungent and cool and can also break blood. Fu Zi is extremely pungent and warm, further warming and unblocking blood vessels, complementing the cold and cool nature of Di Huang to jointly achieve the effect of expelling Blood Bi. Thus, Shen Qi Wan is a kidney-tonifying medicine, but actually also serves as a blood-stasis-resolving medicine, hence listed in the Xu Lao chapter of *Jin Gui* as an important formula. The reason it is only made into pills and not decoctions is truly because Di Huang, after boiling and simmering, becomes thick and sticky, resembling Shu Di Huang in nature, and its power to expel Blood Bi must decrease. Hence, *Shen Nong Ben Cao Jing* states raw Di Huang is superior. The later scholar Xu Lingtai once treated a person with excess above and deficiency below, phlegm-fire obstructing the chest, panting unable to lie down. He cut Ren Shen (Ginseng) into small pieces, decocted it with clear water and phlegm-resolving medicines, and sent it down with the pill, curing the patient. Later the disease recurred. The family used the original formula themselves, decocting the Ren Shen as well, and the illness worsened. Lingtai again instructed to follow the previous method. From this, one can understand the profound meaning behind the ancients' preparation of Shen Qi Wan.
Someone else asked: Since Shen Qi Wan can be effective if prepared according to ancient prescriptions, and besides Shen Qi Wan and Da Huang Zhe Chong Wan, there are seven other formulas in the *Jin Gui* Xu Lao chapter that can be selected according to the syndrome, then your Shi Quan Yu Zhen Tang seems unnecessary to formulate? I replied: The formulas in the *Jin Gui* Xu Lao chapter, although all effective, each specializes in one syndrome of the Xu Lao chapter. My proposed Shi Quan Yu Zhen Tang, however, actually treats multiple syndromes of the Xu Lao chapter. For example, using Huang Qi to tonify Qi, and simultaneously using Ren Shen to cultivate the root of Original Qi. Using Zhi Mu to nourish Yin, and simultaneously using Shan Yao and Xuan Shen to strengthen the source of True Yin. Using San Leng and E Zhu to eliminate blood stasis, and simultaneously using Dan Shen to resolve the dregs of blood stasis. As for Long Gu and Mu Li, if utilizing their astringent nature, they can assist Huang Qi to secure Original Qi; if utilizing their cool and moist nature, they can assist Zhi Mu to nourish True Yin; if utilizing their unblocking nature (*Shen Nong Ben Cao Jing* Long Gu treats masses, later materia medica also states Mu Li resolves blood stasis), they can assist San Leng and E Zhu to dissolve stagnation. Regarding treating Lung deficiency cough and rebellious Qi, and Kidney deficiency panting, Shan Yao is best. For treating chaotic dreams and profuse sweating, Long Gu and Mu Li are superior. This is the intention of the formula. By combining ten common herbs into one prescription, it supplements the True Yin-Yang, True Qi-Blood, and True Spirit of the human body, hence called Shi Quan Yu Zhen (Ten Complete Nourishing True).
Lao Zhai patients often have concurrent blood stasis. There are originally two types of syndromes: One is blood stasis caused by Lao Zhai. The person may have improper recuperation or excessive sexual indulgence, leading to Qi and Blood depletion. Circulation throughout the body becomes sluggish, causing blood to stagnate. This stasis is mostly in the meridians. The other is Lao Zhai caused by blood stasis. The person may have suffered falls or bruises, carried heavy loads with weak strength, or had a history of hematemesis or epistaxis, with improper medication, leading to initial blood stasis that slowly develops into Lao Zhai over time. This stasis is mostly in the Zang-Fu organs. Both types can be cured by taking Shi Quan Yu Zhen Tang. For stasis in the Zang-Fu organs, one must particularly use more blood-breaking herbs. For stasis in the meridians, one can also use the previous formula Zi Sheng Tang, adding Dang Gui and Dan Shen. For severe stasis in the Zang-Fu organs, one should use my proposed Li Chong Tang or Li Chong Wan. These several formulas can be referenced, varied, and integrated, adapting to circumstances.
Secular doctors, encountering rapid pulse syndromes, generally blame Yin deficiency and blood depletion. They do not know that when Original Qi is extremely deficient and cannot support itself, the pulse can reach extreme rapidity. Suppose a person works hard or runs fast until their physical strength cannot support them; their pulse will necessarily be rapid. Comparing the inability to support due to fatigue with the inability to support due to Qi deficiency, the matters are different but the principles are the same. In my careful clinical experience, when treating Xu Lao, I dare not purely use tonic medicines. However, if Qi-regulating herbs exceed Qi-tonifying herbs, the pulse becomes faster; if Qi-tonifying herbs exceed Qi-regulating herbs, the pulse gradually slows. Thus, whether the pulse is rapid or not depends not only on the fullness or emptiness of the Blood level but also significantly on the strength of the Qi level. Therefore, in this Shi Quan Yu Zhen Tang, Tai Shen and Huang Qi are each 4 qian, while San Leng and E Zhu are each 1.5 qian. The number of Qi-tonifying herbs is originally several times that of Qi-regulating herbs. If encountering severe Qi deficiency, one must replace San Leng and E Zhu with Ji Nei Jin.
The properties of medicines—tonifying, breaking, cold, hot—are fixed, but they also shift according to the constitution of the patient. I have weighed the tonifying power of Huang Qi against the breaking power of San Leng and E Zhu; using them in equal parts originally showed no superiority. I once used 3 qian each of San Leng and E Zhu to treat all kinds of masses and accumulations in the Zang-Fu organs. Fearing injury to Qi, I assisted with 6 qian of Huang Qi. After dozens of doses, the disease went away without injuring the Qi level, and some patients felt stronger the more they took it. If encountering very severe Qi deficiency, after just a few doses, one feels Qi cannot support itself; one must add Huang Qi or reduce San Leng and E Zhu to continue long-term use. For extremely deficient people, tonic medicines are hard to attack with, and breaking medicines easily show adverse effects. If the person has strong Qi but also depression/stagnation, one must use more San Leng and E Zhu or less Huang Qi, so that taking it does not cause fullness and stuffiness. I have also weighed the heating power of Huang Qi against the cooling power of Zhi Mu; there is no superiority, and using them in equal parts allows long-term use without cold or heat sensations (This argument applies to decoctions; if made into pills, the cooling power of Zhi Mu surpasses the heating power of Huang Qi). Those who fear heat will definitely increase heat when taking it; those who fear cold will increase cold. The power of cold and heat is indefinite, just as the power of tonifying and breaking is indefinite. Therefore, clinicians adjusting prescriptions must carefully deliberate and constantly experience, ensuring every breath matches the pathogenesis, so that hundreds of uses result in no mistakes.
Appendix:
Letter from Li XX of Cang County, Zhili:
My eldest son's wife, aged twenty-four, suffered from alternating chills and fever in January of this year (Bing Yin year). She always feared taking medicine, so she endured it silently without speaking. By early April, her family came to fetch me, saying my daughter-in-law was critically ill. Upon returning home to examine her, although she was not bedridden, she was too thin and weak to bear. Her pulse was wiry, floating, and rapid. Asking carefully about the condition, she said that every afternoon she felt cold first then hot, with occasional mild cough without phlegm. She had diarrhea more than ten times a day and night. At dawn, she sweated on her head. There was continuous pain in the chest. Immediately after swallowing food, she felt unbearable distension. All signs of various deficiencies and hundred damages were obviously exposed. After long deliberation, I prescribed Xiao Yao San (Free and Easy Wanderer Powder). Two doses yielded no effect. I went back to Cang to get medicine. Fortunately, Zhang XX came from Tianjin to Cang. I detailed the entire course of my daughter-in-law's illness. Zhang XX said, "In your opinion, what formula should be used to treat this?" I replied, "I plan to combine and use Zi Sheng Tang and Shi Quan Yu Zhen Tang. Is that acceptable?" Zhang XX said, "Excellent. This is a good prescription; it will surely be effective." I then followed the meaning of the two formulas, using Sheng Huai Shan Yao 8 qian, Sheng Bai Zhu, Jing Yu Rou, Sheng Ji Nei Jin, Sheng Long Gu, Sheng Mu Li, and Xian Shi Hu (Fresh Dendrobii Caulis) each 3 qian, and Dan Shen 4 qian. After four consecutive doses, all symptoms greatly decreased. Then I added San Leng and E Zhu (The reason for using these two herbs in Shi Quan Yu Zhen Tang is that Xu Lao syndromes often involve Blood Bi) each 1 qian, Mu Dan Pi and Di Gu Pi (Lycii Cortex) each 2 qian. After eight more consecutive doses, all diseases retreated, diet increased, and now she has completely recovered.