西洋参∶味甘微苦，性凉。能补助气分，兼能补益血分，为其性凉而补，凡欲用人参而不受人参之温补者，
皆可以此代之。惟白虎加人参汤中之人参，仍宜用党参而不可代以西洋参，以其不若党参具有升发之力，能助
石膏逐邪外出也。且《神农本草经》谓人参味甘，未尝言苦，适与党参之味相符，是以古之人参，即今之党参，
若西洋参与高丽参，其味皆甘而兼苦，故用于古方不宜也。西洋参产于法兰西国，外带粗皮则色黄，去粗皮则
色白，无论或黄或白，以多有横纹者为真。愚用此参，皆用黄皮多横纹
者，因伪造者能造白皮西洋参，不能造黄皮西洋参也。
黄 ∶性温，味微甘。能补气，兼能升气，善治胸中大气（即宗气，为肺叶 辟之原动力）下陷。《神农
本草经》谓主大风者，以其与发表药同用，能祛外风，与养阴清热药同用，更能熄内风也。谓主痈疽、久败疮
者，以其补益之力能生肌肉，其溃脓自排出也。表虚自汗者，可用之以固外表气虚。小便不利而肿胀者，可用
之以利小便。妇女气虚下陷而崩带者，可用之以固崩带。为其补气之功最优，故推为补药之长，而名之曰 也。
【附案】沧州董氏女，年二十余。胸胁满闷，心中怔忡，动则自汗，其脉沉迟微弱，右部尤甚，为其脉迟，
疑是心肺阳虚，询之不觉寒凉，知其为胸中大气下陷也。其家适有预购黄 一包，俾用一两煎汤服之。其族兄
××在座，其人颇知医学，疑药不对证。愚曰∶“勿多疑，倘有差错，余职其咎。”服后，果诸病皆愈。其族兄
疑而问曰∶“《神农本草经》黄 原主大风，有透表之力，生用则透表之力益大，与自汗证不宜，其性升而能
补，有膨胀之力，与满闷证不宜，今单用生黄 两许，而两证皆愈，并心中怔忡亦愈，其义何居？”答曰∶
“黄 诚有透表之力，气虚不能逐邪外出者，用于发表药中，即能得汗，若其阳强阴虚者，误用之则大汗如雨
不可遏抑。惟胸中大气下陷，致外卫之气无所统摄而自汗者，投以黄 则其效如神。至于证兼满闷而亦用之者，
确知其为大气下陷，呼吸不利而作闷，非气郁而作闷也。至于心与肺同悬胸中，皆大气之所包举，大气升则心
有所根据，故怔忡自止也。”继加桔梗二钱，知母三钱，又服两剂以善其后。
一妇人产后四五日，大汗淋漓，数日不止，情势危急，气息奄奄，其脉微弱欲无，问其短气乎？心中怔忡
且发热乎？病患不
能言而颔之。知其大气下陷，不能吸摄卫气，而产后阴分暴虚，又不能维系阳分，故其汗若斯之脱出也。遂用
生黄 六钱，玄参一两，净萸肉、生杭芍各五钱，桔梗二钱，一剂汗减，至三剂诸病皆愈。从前五六日未大便，
至此大便亦通下。
邑王氏女，年二十余，心中寒凉，饮食减少，延医服药，年余无效，且益羸瘦。后愚诊视，其左脉微弱不
起，断为肝虚证。其父知医，疑而问曰∶“向延医延医，皆言脾胃虚弱，相火衰损，故所用之方皆健脾养胃，
补助相火，曾未有言及肝虚者，先生独言肝虚，但因左脉之微弱乎？抑别有所见而云然乎？”答曰∶“肝脏之
位置虽居于右，而其气化实先行于左，试问病患，其左半身必觉有不及右半身处，是其明征也。”询之，果觉
坐时左半身下坠，卧时不敢向左侧，其父方信愚言，求为疏方。遂用生黄 八钱，柴胡、川芎各一钱，干姜三
钱，煎汤饮下，须臾左侧即可安卧，又服数剂，诸病皆愈。惟素有带证尚未除，又于原方加牡蛎数钱，服数剂
带证亦愈。其父复疑而问曰∶“黄 为补肺脾之药，今先生用以补肝，竟能随手奏效，其义何居？”答曰∶
“肝属木而应春令，其气温而性喜条达，黄 之性温而上升，以之补肝原有同气相求之妙用。愚自临证以来，
凡遇肝气虚弱不能条达，用一切补肝之药皆不效，重用黄 为主，而少佐以理气之品，服之复杯即见效验，彼
谓肝虚无补法者，原非见道之言也。”
《神农本草经》谓黄 主大风者，诚有其效（参阅“论肢体痿废之原因及治法”中傅××妻治案）。
《神农本草经》谓黄 主久败疮，亦有奇效。奉天张××，年三十余。因受时气之毒，医者不善为之清解，
转引毒下行，自脐下皆肿，继又溃烂，睾丸露出，少腹出孔五处，小便时五孔皆出尿。为疏方∶生黄 、花粉
各一两，乳香、没药、银花、甘草各
三钱，煎汤连服二十余剂。溃烂之处，皆生肌排脓出外，结疤而愈，始终亦未用外敷生肌之药。
黄 之性，又善利小便。（参阅曲直汤下王姓治案）
黄 不但能补气，用之得当，又能滋阴。本村张媪年近五旬，身热劳嗽，脉数至八至，先用六味地黄丸
加减煎汤服不效，继用左归饮加减亦不效。踌躇再四忽有会悟，改用生黄 六钱，知母八钱，煎汤服数剂，见
轻，又加丹参、当归各三钱，连服十剂全愈。盖虚劳者多损肾，黄 能大补肺气以益肾水之上源，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，而生水之功益普也。至数剂后，又加丹参、当归者，因血
痹虚劳，《金匮》合为一门，治虚劳者当防其血有痹而不行之处，故加丹参、当归以流行之也。
黄 之性，又善治肢体痿废，然须细审其脉之强弱，其脉之甚弱而痿废者，西人所谓脑贫血证也。盖人之
肢体运动虽脑髓神经司之，而其所以能司肢体运动者，实赖上注之血以涵养之。其脉弱者，胸中大气虚损，不
能助血上升以养其脑髓神经，遂致脑髓神经失其所司，《内经》所谓“上气不足，脑为之不满”也。拙拟有加
味补血汤、干颓汤，方中皆重用黄 。凡脉弱无力而痿废者，多服皆能奏效。若其脉强有力而痿废者，西人所
谓脑充血证，又因上升之血过多，排挤其脑髓神经，俾失所司，《内经》所谓“血菀（同郁）于上，为薄厥”
也。如此等证，初起最忌黄 ，误用之即凶危立见。迨至用镇坠收敛之品，若拙拟之镇肝熄风汤、建瓴汤治之。
其脉柔和而其痿废仍不愈者，亦可少用黄 助活血之品以通经络，若服药后，其脉又见有力，又必须仍辅以镇
坠之品，若拙拟之起痿汤，黄 与赭石、 虫诸药并用也。
黄 升补之力，尤善治流产、崩带。西傅家庄王××妻，初次受妊，五月，滑下二次，受妊至六七月时，
觉下坠见血。求为治
疗，急投以生黄 、生地黄各二两，白术、净萸肉、 龙骨、 牡蛎各一两，煎汤一大碗顿服之，胎气遂安，
又将药减半，再服一剂以善其后。至期举一男，强壮无恙。
沈阳朱××，黎明时来院扣门，言其妻因行经下血不止，精神昏愦，气息若无。急往诊视，六脉不全仿佛微
动，急用生黄 、野台参、净萸肉各一两， 龙骨、 牡蛎各八钱，煎汤灌下，血止强半，精神见复，过数点
钟将药剂减半，又加生怀山药一两，煎服全愈。
邑刘氏妇，年二十余，身体羸弱，心中常觉寒凉，下白带甚剧，屡治不效，脉甚细弱，左部尤甚。投以生
黄、生牡蛎各八钱，干姜、白术、当归各四钱，甘草二钱，数剂全愈。盖此证因肝气太虚，肝中所寄之相火
亦虚，因而气化下陷，湿寒下注而为白带。故重用黄 以补肝气，干姜以助相火，白术扶土以胜湿，牡蛎收涩
以固下，更加以当归之温滑，与黄 并用，则气血双补，且不至有收涩太过之弊（在下者因而竭之），甘草之
甘缓，与干姜并用，则热力绵长，又不至有过热僭上之患，所以服之有捷效也。
按∶炉心有氢气，人腹中亦有氢气，黄者能引氢气上达于肺，与吸入之氧气相合而化水，又能鼓胃中津
液上行，又能统摄下焦气化，不使小便频数，故能治消渴。玉液汤、滋 饮，皆治消渴之方，原皆重用黄 。
黄 入汤剂，生用即是熟用，不必先以蜜炙。若丸散剂中宜熟用者，蜜炙可也。若用治疮疡，虽作丸散，
亦不宜炙用。王洪绪《外科证治全生集》曾详言之。至于生用发汗、熟用止汗之说，尤为荒唐。盖因气分虚陷
而出汗者，服之即可止汗，因阳强阴虚而出汗者，服之转大汗汪洋。若气虚不能逐邪外出者，与发表药同服，
亦能出汗。是知其止汗与发汗不在生、熟，亦视用之者何如耳。
附录∶
柳河仲××来函∶
庚午季秋，偶觉心中发凉，服热药数剂无效。迁延旬日，陡觉凉气上冲脑际，顿失知觉，移时始苏。日三
四发。屡次延医延医不愈。乃病不犯时，心犹清白，遂细阅《衷中参西录》，忽见夫子治坐则左边下坠，睡时不
敢向左侧之医案，断为肝虚。且谓黄 与肝木有同气相求之妙用，遂重用生黄 治愈。乃恍悟吾睡时亦不能左
侧，知病源实为肝虚，其若斯之凉者，肝中所寄之相火衰也。爰用生箭 二两，广条桂五钱，因小便稍有不利，
又加椒目五钱。煎服一剂，病大见愈。遂即原方连服数剂，全愈。
西洋参：味甘，微苦，性凉。能够补助气分，兼能补益血分，因为它的性质是凉而具有补益作用，凡是想要用人参但患者不能承受人参温补性质的，都可以用西洋参来替代。只有在白虎加人参汤中的人参，仍然适宜使用党参，而不应用西洋参替代，因为党参不像西洋参那样缺乏升发之力，党参能帮助石膏将病邪驱逐出体外。而且《神农本草经》记载人参味甘，未曾提到味苦，这恰好与党参的味道相符，所以古代所说的人参，就是现在的党参；至于西洋参和高丽参，它们的味道都是甘而兼苦，因此用于古方是不适宜的。西洋产自法兰西国，外表带有粗皮时颜色发黄，去掉粗皮后颜色变白，无论黄色还是白色，以横纹多者为真品。我使用这种人参，都选用黄皮且横纹多的，因为伪造者能制造白皮的西洋参，却无法制造黄皮的西洋参。
黄芪：性温，味微甘。能够补气，兼能升提气机，善于治疗胸中大气（即宗气，是推动肺叶开合的原动力）下陷。《神农本草经》说它主治大风（外感风邪重症），是因为它与发表药同用时，能祛除外风；与养阴清热药同用时，更能平息内风。说它主治痈疽、久败疮（长期不愈的溃疡），是因为它的补益力量能促进肌肉生长，使溃烂处的脓液自然排出。对于表虚自汗的患者，可以用它来固护体表之气虚。对于小便不利并伴有肿胀的患者，可以用它来通利小便。妇女因气虚下陷导致的崩漏（非经期大量出血）和带下病，可以用它来固摄止崩止带。因为它补气功效最优，所以被推崇为补药之首，并命名为“黄芪”（意为黄耆，耆即长也，言其功长）。
【附案】沧州董姓女子，二十多岁。胸胁满闷，心中悸动不安（怔忡），活动后自汗，脉象沉迟微弱，右部尤为明显。因其脉迟，起初怀疑是心肺阳虚，询问后发觉患者并不觉得寒冷，从而知道这是胸中大气下陷所致。家中恰好有预先购买的黄芪一包，便让她用一两煎汤服用。她的族兄在场，此人颇懂医学，怀疑药不对症。我说：“不要多疑，如果有差错，我承担后果。”服药后，果然所有病症都痊愈了。族兄疑惑地问：“《神农本草经》记载黄芪原主治大风，具有透表发散之力，生用则透表之力更大，这与自汗证不宜；黄芪性升且能补，有膨胀之力，这与满闷证不宜。现在单用生黄芪约两许，却使两种病症都痊愈，连心中的怔忡也好了，其中的道理何在？”我回答说：“黄芪确实有透表之力，如果是气虚不能驱邪外出，配合发表药使用，就能出汗；但如果患者阳气强盛阴虚，误用黄芪会导致大汗淋漓如雨，无法遏制。只有当胸中大气下陷，导致卫外之气无所统摄而自汗时，投用黄芪则效果如神。至于证候兼有满闷也使用黄芪的情况，是因为确切知道这是大气下陷，呼吸不畅导致的闷，而非气机郁滞导致的闷。心和肺同悬于胸中，都被大气所包举，大气上升则心有所依托，所以怔忡自然停止。”随后加入桔梗二钱，知母三钱，又服两剂以巩固疗效。
一位妇人产后四五日，大汗淋漓，数日不止，情势危急，气息微弱，脉象微弱似无。问她是否短气？心中是否怔忡且发热？病患不能说话但点头示意。判断其为大气下陷，不能吸摄卫气，加之产后阴分突然虚弱，又不能维系阳分，所以汗出如此严重脱失。于是用生黄芪六钱，玄参一两，山茱萸肉五钱，生白芍五钱，桔梗二钱，一剂后汗减，至三剂时诸病皆愈。从前五六天未大便，至此大便也通畅排下。
县里王氏女子，二十多岁，心中感觉寒冷，饮食减少，请医生服药，一年多无效，反而更加消瘦。后来我诊视，发现她左脉微弱不起，断定为肝虚证。其父懂医，疑惑地问：“之前请医生诊治，都说脾胃虚弱，相火衰损，所以用的方子都是健脾养胃，补助相火，从未有人提及肝虚。先生唯独说是肝虚，仅仅是因为左脉微弱吗？还是有其他观察依据？”我回答说：“肝脏的位置虽然在右侧，但其气化功能实际上先行于左侧。试问患者，她的左半身一定觉得不如右半身有力，这是明显的征象。”询问后，果觉坐时左半身下坠，卧时不敢向左侧睡，其父才相信我的话，请求开方。于是用生黄芪八钱，柴胡一钱，川芎一钱，干姜三钱，煎汤饮下，片刻后左侧即可安卧，又服数剂，诸病皆愈。只是素有带下病尚未去除，又在原方中加入牡蛎数钱，服数剂后带下病也痊愈了。其父又疑惑地问：“黄芪是补肺脾的药，现在先生用来补肝，竟然随手奏效，其中的道理何在？”我回答说：“肝属木而应春令，其气温和且性情喜条达舒畅，黄芪性温而上升，用它补肝原本就有同气相求的妙用。我自临证以来，凡遇到肝气虚弱不能条达，用一切补肝的药都不见效，重用黄芪为主药，稍加理气之品，服药后很快见效。那些说肝虚无补法的人，原本就不是见识大道之言。”
《神农本草经》说黄芪主治大风，确实有效（参阅“论肢体痿废之原因及治法”中傅某妻治案）。《神农本草经》说黄芪主治久败疮，也有奇效。奉天张某某，三十多岁。因感受时气毒邪，医生不善清解，反而引毒下行，从脐下全部肿胀，继而又溃烂，睾丸露出，小腹出现五个孔洞，小便时五个孔都流出尿液。为他开方：生黄芪一两，天花粉一两，乳香三钱，没药三钱，金银花三钱，甘草三钱，煎汤连续服用二十余剂。溃烂之处，都长出肌肉排出脓液，结疤而愈，始终也未用外敷生肌的药物。
黄芪不但能补气，用得恰当，又能滋阴。本村张老太，年近五十，身热劳嗽，脉数达到八至（每息八至），先用六味地黄丸加减煎汤服用无效，继用左归饮加减也无效。犹豫再三忽然领悟，改用生黄芪六钱，知母八钱，煎汤服数剂，病情减轻，又加丹参三钱，当归三钱，连服十剂全愈。大概虚劳病患者多损伤肾，黄芪能大补肺气以益肾水之上源，使气旺自然能生水，而知母又大能滋肺中津液，使阴阳不至偏胜，而生水之功更加普遍。至于数剂后又加丹参、当归的原因，是因为血痹虚劳，《金匮要略》将其合为一门，治疗虚劳者应当防止血液痹阻不行，所以加丹参、当归以流通血脉。
黄芪的性质，又善于治疗肢体痿废，但必须仔细审察脉象的强弱。脉象极弱而痿废的，是西医所说的脑贫血证。大概人的肢体运动虽由脑髓神经主管，但其之所以能主管肢体运动，实在依赖上注的血来涵养它。脉弱者，胸中大气虚损，不能助血上升以滋养脑髓神经，遂致脑髓神经失去其主管功能，《内经》所谓“上气不足，脑为之不满”。我拟定的加味补血汤、干颓汤，方中都重用黄芪。凡是脉弱无力而痿废的，多服都能奏效。如果脉强有力而痿废的，是西医所谓的脑充血证，又因上升之血过多，排挤脑髓神经，使其失去主管功能，《内经》所谓“血郁于上，为薄厥”。像这样的证候，初起最忌用黄芪，误用则凶险立刻显现。等到使用镇坠收敛的药物，如我拟定的镇肝熄风汤、建瓴汤来治疗。如果脉柔和而痿废仍不愈的，也可以少用黄芪辅助活血药物以通经络，如果服药后，脉象又见有力，又必须仍辅以镇坠之品，如我拟定的起痿汤，黄芪与赭石、土鳖虫等药并用。
黄芪升补之力，尤其善于治疗流产、崩漏带下。西傅家庄王某某妻，初次怀孕，五月时滑胎两次，怀孕至六七个月时，感觉下坠见血。求我治疗，急投生黄芪二两，生地黄二两，白术一两，山茱萸肉一两，龙骨一两，牡蛎一两，煎汤一大碗顿服，胎气遂安，又将药量减半，再服一剂以善后。到期生下一男婴，强壮无恙。
沈阳朱某某，黎明时来院敲门，说他妻子因行经下血不止，精神昏愦，气息若无。急忙前往诊视，六脉不全仿佛微动，急用生黄芪一两，野台参一两，山茱萸肉一两，龙骨八钱，牡蛎八钱，煎汤灌下，血止大半，精神恢复，过几个钟头将药剂减半，又加生怀山药一两，煎服全愈。
县里刘氏妇，二十多岁，身体羸弱，心中常觉寒冷，下白带甚剧，屡治不效，脉甚细弱，左部尤为明显。投以生黄芪八钱，生牡蛎八钱，干姜四钱，白术四钱，当归四钱，甘草二钱，数剂全愈。大概此证因肝气太虚，肝中所寄的相火亦虚，因而气化下陷，湿寒下注而为白带。故重用黄芪以补肝气，干姜以助相火，白术扶土以胜湿，牡蛎收涩以固下，再加当归之温滑，与黄芪并用，则气血双补，且不至有收涩太过之弊（在下者因而竭之），甘草之甘缓，与干姜并用，则热力绵长，又不至有过热僭上之患，所以服之有捷效。
按：炉心有氢气，人腹中也有氢气，黄芪能引氢气上达于肺，与吸入的氧气相合而化水，又能鼓动胃中津液上行，又能统摄下焦气化，不使小便频数，所以能治消渴。玉液汤、滋肭饮，都是治疗消渴的方子，原本都重用黄芪。
黄芪入汤剂，生用即是熟用，不必先用蜜炙。若丸散剂中宜熟用的，可以蜜炙。若用于治疗疮疡，即使作丸散，也不宜炙用。王洪绪《外科证治全生集》曾详细说明。至于生用发汗、熟用止汗的说法，尤为荒唐。大概因气分虚陷而出汗的，服用即可止汗；因阳强阴虚而出汗的，服用则转为大汗汪洋。若气虚不能驱邪外出，与发表药同服，也能出汗。可知其止汗与发汗不在于生、熟，也视使用者如何运用罢了。
附录：
柳河仲某某来函：
庚午年秋季，偶然觉得心中发凉，服热药数剂无效。拖延十天，突然觉得凉气上冲脑际，顿时失去知觉，过了一会儿才苏醒。每天发作三四次。屡次请医生诊治不愈。于是病不发作时，心神尚清醒，便仔细阅读《衷中参西录》，忽然看见先生治疗坐时左边下坠，睡觉时不敢向左侧睡的医案，断定为肝虚。并且说黄芪与肝木有同气相求的妙用，于是重用生黄芪治愈。这才恍悟我睡觉时也不能左侧，知道病源实为肝虚，那种凉的感觉，是肝中所寄的相火衰弱的缘故。于是用生箭芪二两，广条桂五钱，因为小便稍有不利，又加椒目五钱。煎服一剂，病大见好转。随即原方连服数剂，全愈。
Western Ginseng (Xi Yang Shen): Sweet in taste, slightly bitter, cool in nature. It can tonify the Qi aspect and simultaneously nourish the Blood aspect. Due to its cool yet tonifying nature, whenever Ren Shen (Ginseng Root) is indicated but the patient cannot tolerate its warming tonification, Western Ginseng can be used as a substitute. However, in Bai Hu Jia Ren Shen Tang (White Tiger Decoction Plus Ginseng), Ren Shen should still be replaced by Dang Shen (Codonopsis Root) rather than Western Ginseng, because Dang Shen possesses ascending and dispersing power that helps Shi Gao (Gypsum Fibrosum) expel pathogens outward. Moreover, *Shen Nong Ben Cao Jing* (Divine Farmer's Materia Medica) states that Ren Shen tastes sweet and does not mention bitterness, which coincides with the taste of Dang Shen. Therefore, the "Ren Shen" of ancient times refers to what is now called Dang Shen. In contrast, both Western Ginseng and Korean Ginseng (Gao Li Shen) taste sweet and bitter; thus, they are unsuitable for use in ancient formulas. Western Ginseng originates from France. When covered with rough bark, it appears yellow; after removing the bark, it turns white. Regardless of color, those with numerous transverse rings are authentic. I exclusively use Western Ginseng with yellow skin and many transverse rings, as counterfeiters can produce white-skinned Western Ginseng but cannot replicate the yellow-skinned variety.
Astragalus (Huang Qi): Warm in nature, slightly sweet in taste. It tonifies Qi and has an ascending effect, making it particularly effective for treating the sinking of the Great Qi in the chest (i.e., Zong Qi / Pectoral Qi, the primary driving force for lung expansion). *Shen Nong Ben Cao Jing* states it treats severe wind disorders ("Da Feng"), because when combined with exterior-releasing herbs, it dispels external wind; when combined with Yin-nourishing and heat-clearing herbs, it extinguishes internal wind. It is said to treat carbuncles and chronic ulcers because its tonifying power promotes flesh regeneration and facilitates the natural discharge of pus. For patients with spontaneous sweating due to exterior deficiency, it can be used to secure the exterior Qi. For edema accompanied by difficult urination, it promotes diuresis. For women suffering from metrorrhagia and leukorrhea due to Qi deficiency and sinking, it secures against leakage. Because its Qi-tonifying efficacy is superior, it is regarded as the chief among tonics, hence named "Huang Qi" (Yellow Elder/Chief).
[Attached Case 1] A woman from the Dong family in Cangzhou, over twenty years old, presented with fullness and oppression in the chest and hypochondrium, palpitations (Zheng Tong), and spontaneous sweating upon exertion. Her pulse was deep, slow, and weak, especially on the right side. Initially suspecting Heart and Lung Yang deficiency due to the slow pulse, inquiry revealed no sensation of cold, leading to the diagnosis of sinking Great Qi in the chest. The family had purchased a packet of Huang Qi, so she was instructed to take one liang decocted in water. Her cousin, who understood medicine, doubted the prescription. I stated, "Do not doubt excessively; if there is an error, I will bear responsibility." After ingestion, all symptoms resolved. The cousin asked skeptically, "*Shen Nong Ben Cao Jing* states Huang Qi treats severe wind and has exterior-dispersing properties; raw usage enhances this dispersing power, which seems contraindicated for spontaneous sweating. Its ascending and tonifying nature causes distension, seemingly contraindicated for fullness. How did single-dose raw Huang Qi cure both conditions and the palpitations?" I replied, "Huang Qi indeed has dispersing power. If Qi deficiency prevents pathogen expulsion, combining it with exterior-releasing herbs induces sweating. However, in cases of strong Yang and deficient Yin, misuse causes uncontrollable profuse sweating. Only when Great Qi sinks, causing Wei Qi to lose control and resulting in spontaneous sweating, does Huang Qi prove miraculous. Regarding fullness: if caused by respiratory difficulty due to sinking Great Qi rather than Qi stagnation, Huang Qi is appropriate. Since Heart and Lung hang in the chest and are enveloped by Great Qi, when Great Qi rises, the Heart finds support, and palpitations cease." Subsequently, Jie Geng (Platycodon Root) and Zhi Mu (Anemarrhena Rhizome) were added, and two more doses were taken to consolidate recovery.
A woman, four or five days postpartum, suffered from profuse sweating lasting several days, presenting with critical condition, faint breath, and a pulse so weak it seemed absent. She nodded affirmatively to questions about shortness of breath, palpitations, and fever. This indicated sinking Great Qi failing to secure Wei Qi, compounded by sudden postpartum Yin deficiency failing to anchor Yang, causing such severe sweat loss. Treatment involved Sheng Huang Qi (Raw Astragalus) 6 qian, Xuan Shen (Scrophularia Root) 1 liang, Jing Yu Rou (Prepared Cornus Fruit) 5 qian, Sheng Bai Shao (Raw White Peony Root) 5 qian, and Jie Geng 2 qian. Sweating decreased after one dose, and all symptoms resolved after three doses. Bowel movements, absent for five to six days, also resumed.
A young woman from the Wang family in the county, over twenty, complained of coldness in the heart region and reduced appetite. Medical treatment for over a year failed, and she became increasingly emaciated. My examination revealed a weak, unrising left pulse, leading to a diagnosis of Liver deficiency. Her father, knowledgeable in medicine, questioned why only Liver deficiency was diagnosed based on the weak left pulse, given previous diagnoses of Spleen/Stomach weakness and diminished Ministerial Fire. I explained, "Although anatomically located on the right, Liver Qi function manifests primarily on the left. Does the patient feel her left side is weaker than the right?" Inquiry confirmed she felt a downward dragging sensation in her left side while sitting and dared not lie on her left side. Her father accepted the diagnosis. Prescription: Sheng Huang Qi 8 qian, Chai Hu (Bupleurum Root) 1 qian, Chuan Xiong (Ligusticum Rhizome) 1 qian, Gan Jiang (Dried Ginger) 3 qian. Within moments, she could lie comfortably on her left side. After several doses, all symptoms resolved except for persistent leukorrhea. Several qian of Mu Li (Oyster Shell) were added to the original formula, curing the leukorrhea after a few doses. Her father asked why Huang Qi, a Lung/Spleen tonic, cured Liver deficiency. I answered, "The Liver corresponds to Wood and Spring, favoring warmth and free flow. Huang Qi is warm and ascending, matching the Liver's nature (same energy seeks similar energy). In my clinical experience, when Liver Qi fails to flow freely and other Liver tonics fail, heavy use of Huang Qi with minor Qi-regulating herbs yields rapid results. Those claiming 'Liver deficiency has no tonification method' lack profound understanding."
*Shen Nong Ben Cao Jing*'s claim that Huang Qi treats severe wind is valid (see Fu's wife case under "Causes and Treatments of Limb Paralysis"). Its efficacy for chronic ulcers is also remarkable. Patient Zhang from Fengtian, over thirty, contracted seasonal toxic pathogens. Poor medical management directed the toxin downward, causing swelling below the navel, followed by ulceration, exposed testicles, and five holes in the lower abdomen discharging urine. Prescription: Sheng Huang Qi 1 liang, Hua Fen (Tian Hua Fen/Trichosanthes Root) 1 liang, Ru Xiang (Frankincense) 3 qian, Mo Yao (Myrrh) 3 qian, Yin Hua (Honeysuckle Flower) 3 qian, Gan Cao (Licorice Root) 3 qian. Taken continuously for over twenty doses, the ulcers regenerated flesh, discharged pus, formed scars, and healed without topical applications.
Huang Qi also promotes diuresis (see Wang case under Qu Zhi Tang).
Beyond tonifying Qi, proper use of Huang Qi can also nourish Yin. An elderly woman, Zhang, nearly fifty, suffered from fever and chronic cough with a rapid pulse (eight beats per respiration). Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) and Zuo Gui Yin (Left Restoring Decoction) failed. Realizing the need for a different approach, I prescribed Sheng Huang Qi 6 qian and Zhi Mu 8 qian. Symptoms improved after several doses. Dan Shen (Salvia Root) and Dang Gui (Angelica Sinensis) 3 qian each were added, and ten doses resulted in full recovery. Consumptive diseases often damage the Kidney; Huang Qi tonifies Lung Qi to benefit the source of Kidney Water. As Qi flourishes, Water generates. Zhi Mu nourishes Lung fluids, balancing Yin and Yang. Dan Shen and Dang Gui were added later because Blood Bi and consumptive disease are linked in *Jin Gui Yao Lue*; preventing blood stasis is crucial in treating consumption.
Huang Qi effectively treats limb paralysis, provided the pulse is assessed carefully. Weak pulse with paralysis indicates cerebral anemia (Western term). Limb movement is controlled by brain marrow nerves, which rely on ascending blood for nourishment. Weak pulse signifies deficient Great Qi in the chest, unable to assist blood ascent to nourish the brain, leading to nerve dysfunction (*Nei Jing*: "Insufficiency of Upper Qi leads to incomplete filling of the Brain"). My formulas, Jia Wei Bu Xue Tang (Modified Blood-Tonifying Decoction) and Gan Tui Tang (Dry Atrophy Decoction), heavily feature Huang Qi and are effective for weak-pulse paralysis. Conversely, strong pulse with paralysis indicates cerebral congestion (Western term), where excessive ascending blood compresses brain nerves (*Nei Jing*: "Blood stagnates above, causing abrupt collapse"). Huang Qi is strictly contraindicated initially; misuse brings immediate danger. Such cases require sedative and astringent herbs like Zhen Gan Xi Feng Tang (Settle Liver and Extinguish Wind Decoction) or Jian Ling Tang (Build High Terrace Decoction). If the pulse becomes soft but paralysis persists, small amounts of Huang Qi can aid blood-invigorating herbs to unblock collaterals. If the pulse strengthens again, sedatives must be reintroduced, as in Qi Wei Tang (Raise Atrophy Decoction), combining Huang Qi with Zhe Shi (Magnetite) and E Chong (Ground Beetle).
Huang Qi's ascending and tonifying power is particularly effective for miscarriage, metrorrhagia, and leukorrhea. Wife of Wang from Xifu Village, pregnant for the first time, experienced two miscarriages at five months and threatened abortion with bleeding at six to seven months. Emergency treatment: Sheng Huang Qi 2 liang, Sheng Di Huang (Rehmannia Root) 2 liang, Bai Zhu (Atractylodes Rhizome) 1 liang, Jing Yu Rou 1 liang, Long Gu (Fossilized Bone) 1 liang, Mu Li 1 liang. Decocted in a large bowl and taken at once, fetal stability was restored. The dose was halved for one more dose. She delivered a healthy boy.
Zhu from Shenyang arrived at dawn reporting his wife's continuous menstrual bleeding, confusion, and near-absent breath. Pulse was faint and irregular. Emergency prescription: Sheng Huang Qi 1 liang, Ye Tai Shen (Wild Codonopsis) 1 liang, Jing Yu Rou 1 liang, Long Gu 8 qian, Mu Li 8 qian. Decocted and administered, bleeding stopped significantly, and consciousness returned. Hours later, the dose was halved, plus Sheng Huai Shan Yao (Chinese Yam) 1 liang, resulting in full recovery.
Wife of Liu in the county, over twenty, was emaciated, felt cold in the heart, and suffered severe leukorrhea resistant to prior treatments. Pulse was very fine and weak, especially on the left. Prescription: Sheng Huang Qi 8 qian, Sheng Mu Li 8 qian, Gan Jiang 4 qian, Bai Zhu 4 qian, Dang Gui 4 qian, Gan Cao 2 qian. Full recovery after several doses. This condition stemmed from severe Liver Qi deficiency and deficient Ministerial Fire, causing Qi sinking and cold-dampness descending. Heavy Huang Qi tonified Liver Qi; Gan Jiang assisted Ministerial Fire; Bai Zhu strengthened Earth to overcome dampness; Mu Li astringed to secure the lower jiao; Dang Gui warmed and moistened, combining with Huang Qi to tonify Qi and Blood without excessive astringency. Gan Cao moderated Gan Jiang's heat, preventing upward flare-up, ensuring rapid efficacy.
Note: Furnaces contain hydrogen; humans have hydrogen in the abdomen. Huang Qi guides hydrogen up to the lungs to combine with inhaled oxygen, forming water. It also stimulates stomach fluids upward and regulates Lower Jiao Qi, preventing frequent urination, thus treating Xiao Ke (Wasting-Thirst). Yu Ye Tang (Jade Fluid Decoction) and Zi Na Yin (Nourish Adrenal Decoction) both heavily feature Huang Qi for this purpose.
In decoctions, raw Huang Qi acts as cooked Huang Qi; honey-frying is unnecessary. For pills/powders requiring cooked properties, honey-frying is acceptable. For sores/ulcers, even in pills/powders, frying is inappropriate (as detailed in Wang Hongxu's *Waike Zhengzhi Quansheng Ji*). Claims that raw Huang Qi induces sweating and cooked stops it are absurd. It stops sweating in Qi-sinking cases but causes profuse sweating in Yang-excess/Yin-deficiency cases. Combined with exterior-releasing herbs for Qi-deficient pathogen retention, it induces sweating. Thus, sweating effects depend on clinical application, not raw/cooked status.
Appendix:
Letter from Zhong of Liuhe:
In late autumn of the Gengwu year, I felt coldness in the heart. Hot herbs failed. Ten days later, cold qi rushed to the brain, causing unconsciousness, recurring 3-4 times daily. Doctors failed. During remission, I read *Zhong Zhong Can Xi Lu*, specifically the case of left-side dragging and inability to sleep on the left, diagnosed as Liver deficiency. Noting Huang Qi's affinity with Liver Wood, I used heavy raw Huang Qi and recovered. I realized my own inability to sleep on the left confirmed Liver deficiency as the root cause, with coldness due to deficient Ministerial Fire. Prescription: Sheng Jian Huang Qi 2 liang, Guang Tiao Gui (Cinnamon Twig) 5 qian. Due to slight urinary difficulty, Jiao Mu (Zanthoxylum Seed) 5 qian was added. One dose brought significant improvement. Continued dosage led to full recovery.