治一切血虚，及妇人经病（月经先期为热，后期为寒、为虚、为郁、为痰。朱丹溪曰∶
经水者，阴血也，阴必从阳，故其色红，上应于月，其行有常，故名曰经。为气之配，因气
而行，成块者气之凝，将行而痛者气之滞，行后作痛者，气血俱虚也，色淡亦虚也，错经妄
行者气之乱，紫者气之热，黑则热之甚也，今人见紫黑作痛成块，率指为风冷乘之，而用温
热之剂，祸不旋踵矣。经曰∶亢则害，承乃制，热甚则兼水化，所以热则紫，甚则黑也，若
曰风冷
故知
当归（酒洗） 生地黄（三钱） 芍药（二钱） 芎 （钱半。）凡血证通宜四物汤。
如凉血，
三焦地骨皮，心包络
青皮，脾白芍，胃干
板，血燥加人乳，瘀
炒蒲黄、京墨，久不
加桂附；人肥有痰加
苍术、神曲；瘀滞
此手少阴、足太阴、厥阴药也（心生血，脾统血，肝藏血）。当归辛苦甘温，入心脾生
血，为君；生地甘寒，入心肾滋血，为臣；芍药酸寒，入肝脾敛阴，为佐；芎 辛温，通上
下而行血中之气，为使也（川芎入厥阴心包、肝经，上行头目，下行血海。《玉机微义》曰∶
川芎，血中之气药也，通肝经，性味辛散，能行血滞于气也；地黄血中血药也，通肾经，性
味甘寒，能生真阴之虚也；当归血中主药也，通肝经，性味辛温，分三治，全用活血，各归
其经也；芍药阴分药也，通脾经，性味酸寒，能和血，治血虚腹痛也。此特血病而求血药之
属者也，若气虚血弱，又当从长沙血虚以人参补之，阳旺即能生阴血也。辅佐之属，若桃仁、
红花、苏木、丹皮、血竭者，血滞所宜；蒲黄、阿胶、地榆、百草霜、棕榈灰者，血崩所宜；
苁蓉、锁阳、牛膝、枸杞、龟板、夏枯草、益母草者，血虚所宜；乳香、没药、五灵脂、凌
霄花者，血痛所宜；乳酪血液之物，血燥所宜；姜、桂，血寒所宜；苦参、生地汁，血热所
宜。苟能触类而长，可应无穷之变矣。丹溪治阴虚发热，于血药四物汤亦分阴阳∶血之动者
为阳，芎归主之；血之静者为阴，地芍主之；血之阴不足，虽芎归辛温，亦不用；血之阳不
足，虽姜桂辛热，亦用之；与泻火之法正治从治相同。吴鹤皋曰∶天地之道，阳常有余，阴
常不足，人身亦然。故血者难成而易亏，夫草木无情，安能生血，以地芍能养五脏之阴，芎
归能调营中之气，阴阳调和而血自生耳。若夫失血太多，气息几微之际，慎勿与之，盖四物
阴类，非所以生物者也，当重用参 以固欲绝之气，故曰脱血者先益其气，否则川芎香窜，
反能耗气，气血双亡而死矣。故凡虚损胃虚气弱之人，皆不宜多服。或问四物汤是女门专药，
于内亦有脾胃药乎。一阳子曰∶四物汤隐潜脾胃治法，人昧久矣。脾经少血多气，当归、地
黄生血溉灌脾经；土畏贼邪，木来克土，芍药能泻木补脾；肝欲散，用川芎之辛以散之，非
制木补土脾胃之药乎。或曰∶产后禁用芍药否，曰∶新产血气未平，恐芍药酸收作痛耳。芍
药专治血虚气痛，新产正血气虚痛之时，醇酒微炒，用之何害。又血块凝滞作祸，不可泥于
产后大补气血，放胆下之，用玉烛散无妨，推陈致新，亦是补法，只因产后大补气血一语，
致积血而殒者多矣。附∶子和玉烛散∶归尾 生地 川芎 赤芍 大黄 芒硝 甘草。治经
闭腹痛
本方加黄柏、知母，名知柏四物汤；再加玄参，名滋阴降火汤∶治阴虚有火。知柏四物
，蜜丸，名坎离丸∶治阴虚嗽血（丹溪论劳瘵主乎阴虚，盖自子至以属阳，自午至亥属阴，
阴虚则热，在午后子前；寤属阳，寐属阴，阴虚盗汗，从寐时出；升属阳，降属阴，阴虚则
气降，痰涎上逆，吐出不绝；脉浮属阳，沉属阴，阴虚则浮之洪大，沉之空虚；宜用四物竹
沥，加炒柏、龟板补阴降火之剂。又须远嗜欲，薄滋味，静心调养以助之。《准绳》云∶丹
溪论劳瘵，主乎阴虚，用四物加知柏主之，世医遵用，百无一效，何哉。盖阴虚火必上炎，
芎归辛温，非滋虚降火之药；川芎上窜，非虚炎短乏者所宜；地黄泥膈，非胃弱痰多食少者
所宜；知柏辛苦大寒，虽曰滋阴，其实燥血，虽曰降火，久而增气，反能助火，至其败胃，
所不待言，不若用苡仁、百合、天冬、麦冬、桑皮、地骨、丹皮、酸枣、五味子、枇杷叶之
类，佐以生地汁、藕汁、人乳、童便等。如咳嗽则多用桑皮、枇杷叶，有痰增贝母，有血增
苡仁、百合、阿胶，热甚增地骨，食少增苡仁至七八钱，而麦冬当为之主，以保肺金而滋化
源，无不辄效。又曰∶虚劳之疾，百脉空虚，非粘滞之物填之，不能实也，精血枯涸，非濡
湿之物滋之，不能润也，当用参 、地黄、二冬、枸杞、五味之属，各煎膏，另用青蒿，以
童便熬膏，合前诸汁，并麋角胶、霞天膏化服。大抵苡仁、百合之属治肺虚，参 地黄膏之
属治肾虚，盖心肝属阳，肺肾属阴，故补肺肾即是补阴，非知柏之类也）。本方加黄连、胡
黄连，名二连四物汤（《元戎》∶治虚劳血虚，五心烦热，热入血室，夜分发热血室，冲脉也，
冲为血海，昼静夜热，阳陷阴中，名热入血海）。本方加黄柏、黄芩、甘草，名三黄四物汤∶
治阴虚潮热。本方用生熟（二地，加黄 、丹皮、升麻、柴胡，名三黄补血汤∶治亡血血虚，
六脉俱大，按之空虚二地补血，丹皮凉血，黄 补气，升柴升阳，气旺则能生血，阳生则阴
自长矣）。本方加桃仁、红花、名元戎四物汤∶治脏结便秘，扑损瘀血。本方加羌活、防风
（一用秦艽），名治风六合汤∶治风虚眩运，风秘便难。蜜丸，名补肝丸（肝以散为补也）。
本方加木香、槟榔，名治气六合汤∶治血虚气滞，或血气上冲。本方加羌活、天麻、蜜丸，
名神应养真丹∶治足厥阴经受风寒暑湿，瘫痪不遂；语言謇涩，及血虚香港脚。本方加桃仁、
红花、竹沥、姜汁∶治半身不遂，在左者属瘀血（瘀血不去，则新血不生，故用桃仁、红花
活血去瘀，加竹沥、姜汁者，以痰无分左右也）。本方去白芍，加防风，名防风当归散∶治
发汗过多而成痉证，宜去风养血。本方去地黄，加干姜，名四神汤∶治妇人血虚，心腹 痛
（音鸠、又音绞，急痛也）。本方加阿胶、艾叶、甘草，名胶艾汤∶治冲任虚损，经水淋
沥，及血虚下痢（别见经产门）。本方加艾叶、四制香附（童便、盐水、酒、醋各浸三日），
醋丸，名艾附暧宫丸∶治子宫虚冷。再加阿胶，名妇宝丹∶治虚寒经水不调。本方加丹皮、
地骨∶治妇人骨蒸。本方除芍药、地黄，名芎归汤；为末，名佛手散；又名一奇散，又名君
臣散∶治产后血虚头痛；胎动下血，服此自安；子死腹中，服此即下；催生神效。本方合四
君子，名八珍汤∶治心肺虚损，气血两虚（四君补气，四物补血）。再加黄 、肉桂，名十
全大补汤∶兼助阳固卫（王海藏曰∶桂枝、甘草，小建中也，加黄 即黄 建中也；参术苓
草，四君也；芎归芍地，四物也；以气血俱衰，阴阳并弱，法天地之成数，故曰十全散）。
十全汤去白芍，加山茱、五味、防风、苁蓉，入姜、枣煎，名大补黄 汤（《宝鉴》）∶治气
血两虚，自汗不止（黄 畏防风，合用最能止汗；及阳虚发厥）。四物四君合小柴胡，名三
合散（河间）∶治产后日久虚劳。本方四物各七钱，加防风一两，栀子、黄芩、黄连各三钱，
每服五钱，如脉实，加大黄，名生地黄连汤海藏∶治妇人血风证，去血过多，因而燥涸，循
衣摸床，撮空闭目，扬手掷足，错语失神，脉弦浮而虚（男子去血过多，亦有此证。陶节庵
曰∶大承气汤，气药也，自外而之内者用之；生地黄连汤，血药也，自内而之外者用之；气
血合病，循衣摸床，证同自气之血、血而复之气者，大承气汤下之；自血之气、气而复之血
者，生地黄连汤主之。二者俱不大便，此是承气汤对子，又与三黄石膏汤相表里，是皆三焦
包络虚火之病也，病既危急，只得以此降血中之伏火耳。《纲目》曰∶四物与桂枝、麻黄、
白虎、柴胡、理中、四逆、茱萸、承气、凉膈等，皆可作各
治疗各种血虚证，以及妇女月经病（月经先期多为热证，后期多为寒证、虚证、郁证或痰证。朱丹溪说：经水就是阴血，阴必从属于阳，所以颜色红，上应月亮，运行有规律，所以叫“经”。它是气的配偶，随着气而运行，结成块的是气凝滞，将要来潮时疼痛的是气阻滞，行经后疼痛的是气血俱虚，颜色淡也是虚证，错经妄行是气乱，颜色紫是气热，颜色黑则是热极所致。现在的人见到紫黑作痛成块，一概认为是风冷侵袭，而使用温热药物，灾祸立刻就会到来。《内经》说：亢盛则有害，承制才能平衡，热极则兼有水化之象，所以热甚则色紫，极甚则色黑）。因此知道：当归（酒洗）、生地黄（三钱）、芍药（二钱）、川芎（一钱半）。凡是血证都适宜用四物汤。
如果要凉血，加地骨皮（入三焦）、青皮（入心包络）、白芍（入脾）、干姜（入胃）；血燥加人乳；有瘀血加炒蒲黄、京墨；久病不愈加肉桂、附子；身体肥胖有痰加苍术、神曲；有瘀滞……（原文此处似有缺漏或排版错误，依文意推测为加减法说明）。这是手少阴心经、足太阴脾经、足厥阴肝经的药物（心生血，脾统血，肝藏血）。当归辛苦甘温，入心脾经而生血，作为君药；生地甘寒，入心肾经而滋血，作为臣药；芍药酸寒，入肝脾经而敛阴，作为佐药；川芎辛温，通行上下而行血中之气，作为使药（川芎入厥阴心包、肝经，上行头目，下行血海。《玉机微义》说：川芎是血中的气药，通肝经，性味辛散，能行气滞于血中；地黄是血中的血药，通肾经，性味甘寒，能生真阴之虚；当归是血中的主药，通肝经，性味辛温，分三治，全用活血，各归其经；芍药是阴分药，通脾经，性味酸寒，能和血，治疗血虚腹痛。这仅仅是针对血病而求血药所属的方剂，如果气虚血弱，又应当遵循张仲景（长沙太守）的方法，用人参补益气血，阳气旺盛就能生成阴血。辅助佐使之类的药物，如桃仁、红花、苏木、丹皮、血竭，适宜于血滞；蒲黄、阿胶、地榆、百草霜、棕榈灰，适宜于血崩；苁蓉、锁阳、牛膝、枸杞、龟板、夏枯草、益母草，适宜于血虚；乳香、没药、五灵脂、凌霄花，适宜于血痛；乳酪等血液之物，适宜于血燥；姜、桂，适宜于血寒；苦参、生地汁，适宜于血热。如果能触类旁通，可以应对无穷的变化。
丹溪治疗阴虚发热，在血药四物汤中也区分阴阳：血的动者为阳，由川芎、当归主导；血的静者为阴，由地黄、芍药主导；血之阴不足，虽然川芎、当归辛温，也不用；血之阳不足，虽然姜、桂辛热，也用之；这与泻火法的正治和从治相同。吴鹤皋说：天地的道理，阳常有余，阴常不足，人身也是这样。所以血难成而易亏，草木无情，怎么能生血呢？因为地黄、芍药能养五脏之阴，川芎、当归能调营中之气，阴阳调和而血自然生成。如果失血太多，气息微弱之际，千万不要给服此方，因为四物汤属阴类，不是用来生发阳气的，应当重用参、芪以固护将绝之气，所以说脱血者先益其气，否则川芎香窜，反而耗气，导致气血双亡而死。所以凡是虚损、胃虚气弱的人，都不宜多服。有人问四物汤是妇科专药，里面也有脾胃药吗？一阳子说：四物汤隐含了脾胃治法，人们不明白已经很久了。脾经少血多气，当归、地黄生血灌溉脾经；土怕贼邪，木来克土，芍药能泻木补脾；肝欲散，用川芎之辛以散之，这不是制木补土的脾胃药吗？有人说：产后禁用芍药吗？回答说：新产之后血气未平，恐怕芍药酸收导致疼痛罢了。芍药专门治疗血虚气痛，新产正是血气虚痛的时候，用醇酒微炒，用它有什么害处。又有血块凝滞造成祸患，不可拘泥于产后大补气血，放手攻下，用玉烛散无妨，推陈致新，也是补法，只因为产后大补气血这一句话，导致积血而死亡的很多。附：子和玉烛散：当归尾、生地、川芎、赤芍、大黄、芒硝、甘草。治疗经闭腹痛。
本方加黄柏、知母，名知柏四物汤；再加玄参，名滋阴降火汤：治疗阴虚有火。知柏四物汤，蜜丸，名坎离丸：治疗阴虚咳嗽吐血（丹溪论劳瘵主乎阴虚，盖自子时至午时属阳，自午时至亥时属阴，阴虚则热，在午后子前；醒属阳，睡属阴，阴虚盗汗，从睡时出；升属阳，降属阴，阴虚则气降，痰涎上逆，吐出不绝；脉浮属阳，沉属阴，阴虚则浮之洪大，沉之空虚；宜用四物竹沥，加炒柏、龟板补阴降火之剂。又须远嗜欲，薄滋味，静心调养以助之。《准绳》说：丹溪论劳瘵，主乎阴虚，用四物加知柏主治，世医遵用，百无一效，为什么呢？盖阴虚火必上炎，川芎、当归辛温，不是滋虚降火的药；川芎上窜，不是虚炎短乏者所宜；地黄泥膈，不是胃弱痰多食少者所宜；知柏辛苦大寒，虽说滋阴，其实燥血，虽说降火，久而增气，反能助火，至于败坏胃气，是不言而喻的，不如用薏苡仁、百合、天冬、麦冬、桑皮、地骨、丹皮、酸枣、五味子、枇杷叶之类，佐以生地汁、藕汁、人乳、童便等。如咳嗽则多用桑皮、枇杷叶，有痰增贝母，有血增薏苡仁、百合、阿胶，热甚增地骨，食少增薏苡仁至七八钱，而麦冬当为之主，以保肺金而滋化源，没有不立即见效的。又说：虚劳之疾，百脉空虚，不用粘滞之物填补，不能充实；精血枯涸，不用濡湿之物滋润，不能润泽，应当用人参、黄芪、地黄、二冬、枸杞、五味子之类，各煎膏，另用青蒿，以童便熬膏，合前诸汁，并麋角胶、霞天膏化服。大抵薏苡仁、百合之类治肺虚，人参、黄芪、地黄膏之类治肾虚，盖心肝属阳，肺肾属阴，所以补肺肾即是补阴，不是知柏之类）。
本方加黄连、胡黄连，名二连四物汤（《元戎》：治疗虚劳血虚，五心烦热，热入血室，夜分发热血室，冲脉也，冲为血海，昼静夜热，阳陷阴中，名热入血海）。本方加黄柏、黄芩、甘草，名三黄四物汤：治疗阴虚潮热。本方用生熟地黄（二地），加黄芪、丹皮、升麻、柴胡，名三黄补血汤：治疗亡血血虚，六脉俱大，按之空虚（二地补血，丹皮凉血，黄芪补气，升柴升阳，气旺则能生血，阳生则阴自长矣）。本方加桃仁、红花，名元戎四物汤：治疗脏结便秘，扑损瘀血。本方加羌活、防风（一用秦艽），名治风六合汤：治疗风虚眩晕，风秘便难。蜜丸，名补肝丸（肝以散为补也）。本方加木香、槟榔，名治气六合汤：治疗血虚气滞，或血气上冲。本方加羌活、天麻，蜜丸，名神应养真丹：治疗足厥阴经受风寒暑湿，瘫痪不遂；语言謇涩，及血虚香港脚。本方加桃仁、红花、竹沥、姜汁：治疗半身不遂，在左者属瘀血（瘀血不去，则新血不生，故用桃仁、红花活血去瘀，加竹沥、姜汁者，以痰无分左右也）。本方去白芍，加防风，名防风当归散：治疗发汗过多而成痉证，宜去风养血。本方去地黄，加干姜，名四神汤：治疗妇人血虚，心腹绞痛（音鸠、又音绞，急痛也）。本方加阿胶、艾叶、甘草，名胶艾汤：治疗冲任虚损，经水淋漓，及血虚下痢（别见经产门）。本方加艾叶、四制香附（童便、盐水、酒、醋各浸三日），醋丸，名艾附暖宫丸：治疗子宫虚冷。再加阿胶，名妇宝丹：治疗虚寒经水不调。本方加丹皮、地骨：治疗妇人骨蒸。本方除芍药、地黄，名芎归汤；为末，名佛手散；又名一奇散，又名君臣散：治疗产后血虚头痛；胎动下血，服此自安；子死腹中，服此即下；催生神效。本方合四君子，名八珍汤：治疗心肺虚损，气血两虚（四君补气，四物补血）。再加黄芪、肉桂，名十全大补汤：兼助阳固卫（王海藏说：桂枝、甘草，小建中也，加黄芪即黄芪建中也；参术苓草，四君也；芎归芍地，四物也；以气血俱衰，阴阳并弱，法天地之成数，故曰十全散）。十全汤去白芍，加山茱萸、五味子、防风、苁蓉，入姜、枣煎，名大补黄芪汤（《宝鉴》）：治疗气血两虚，自汗不止（黄芪畏防风，合用最能止汗；及阳虚发厥）。四物四君合小柴胡，名三合散（河间）：治疗产后日久虚劳。本方四物各七钱，加防风一两，栀子、黄芩、黄连各三钱，每服五钱，如脉实，加大黄，名生地黄连汤（海藏）：治疗妇人血风证，去血过多，因而燥涸，循衣摸床，撮空闭目，扬手掷足，错语失神，脉弦浮而虚（男子去血过多，亦有此证。陶节庵说：大承气汤，气药也，自外而之内者用之；生地黄连汤，血药也，自内而之外者用之；气血合病，循衣摸床，证同自气之血、血而复之气者，大承气汤下之；自血之气、气而复之血者，生地黄连汤主之。二者俱不大便，此是承气汤对子，又与三黄石膏汤相表里，是皆三焦包络虚火之病也，病既危急，只得以此降血中之伏火耳。《纲目》说：四物与桂枝、麻黄、白虎、柴胡、理中、四逆、茱萸、承气、凉膈等，皆可作各……（原文未完）
Treats all types of blood deficiency (Xuè Xū, Blood Deficiency) and women's menstrual disorders (Jīng Bìng, Menstrual Diseases). [Note: Early menstruation is due to Heat; late menstruation is due to Cold, Deficiency, Stagnation, or Phlegm. Zhu Danxi said: Menstrual blood is Yin Blood. Yin must follow Yang, hence its red color, corresponding to the moon above, with regular flow, thus named "Jing" (Menses). It is the companion of Qi, moving with Qi. Clots indicate Qi stagnation; pain before flow indicates Qi obstruction; pain after flow indicates both Qi and Blood deficiency; pale color also indicates deficiency. Irregular bleeding indicates Qi chaos; purple color indicates Qi Heat; black color indicates extreme Heat. Nowadays, people seeing purple-black clots with pain generally attribute it to Wind-Cold invasion and use warm-hot formulas, which brings disaster immediately. The Classic says: Excess causes harm, restraint brings balance. Extreme Heat combines with Water transformation, so Heat makes it purple, extreme makes it black.] Therefore, know that: Dang Gui (Radix Angelicae Sinensis, washed with wine), Sheng Di Huang (Rhizoma Rehmanniae Recens, 3 qian), Bai Shao (Radix Paeoniae Alba, 2 qian), Chuan Xiong (Rhizoma Chuanxiong, 1.5 qian). All blood syndromes are suitable for Si Wu Tang (Four Substances Decoction).
If cooling blood is needed, add Gu Pi (Cortex Lycii Radicis, enters San Jiao/Triple Burner); Qing Pi (Pericarpium Citri Reticulatae Viride, enters Xin Bao Luo/Pericardium); Bai Shao (enters Spleen); Gan Jiang (Rhizoma Zingiberis Recens, enters Stomach). For dryness of blood, add Ren Ru (Human Milk). For blood stasis, add Chao Pu Huang (Pollen Typhae, stir-fried) and Jing Mo (Ink Stick). For chronic cases not resolving, add Gui Fu (Cortex Cinnamomi and Radix Aconiti Lateralis Preparata). For obese individuals with phlegm, add Cang Zhu (Rhizoma Atractylodis Lanceae) and Shen Qu (Massa Medicata Fermentata). For blood stasis... [Text implies further modifications]. This formula consists of herbs entering the Hand-Shaoyin Heart Meridian, Foot-Taiyin Spleen Meridian, and Foot-Jueyin Liver Meridian (Heart generates blood, Spleen controls blood, Liver stores blood). Dang Gui is pungent, bitter, sweet, and warm, entering Heart and Spleen to generate blood, serving as the Sovereign (Jun) herb; Sheng Di Huang is sweet and cold, entering Heart and Kidney to nourish blood, serving as the Minister (Chen) herb; Bai Shao is sour and cold, entering Liver and Spleen to astringe Yin, serving as the Assistant (Zuo) herb; Chuan Xiong is pungent and warm, circulating up and down to move Qi within Blood, serving as the Envoy (Shi) herb. (Chuan Xiong enters the Jueyin Pericardium and Liver meridians, ascending to the head and eyes, descending to the Sea of Blood. *Yu Ji Wei Yi* states: Chuan Xiong is the Qi herb within Blood, entering the Liver meridian, with pungent and dispersing nature, capable of moving Qi stagnation in Blood; Di Huang is the Blood herb within Blood, entering the Kidney meridian, with sweet and cold nature, capable of generating true Yin deficiency; Dang Gui is the main herb within Blood, entering the Liver meridian, with pungent and warm nature, dividing into three treatments, fully using blood-activating properties, each returning to its meridian; Bai Shao is a Yin-substance herb, entering the Spleen meridian, with sour and cold nature, capable of harmonizing blood, treating blood-deficiency abdominal pain. These are merely herbs belonging to the blood category for blood diseases. If Qi deficiency and blood weakness exist, one should follow Changsha [Zhang Zhongjing]'s method of supplementing Qi with Ren Shen [Radix Ginseng] when blood is deficient; abundant Yang can generate Yin Blood. Auxiliary herbs include Tao Ren (Semen Persicae), Hong Hua (Flos Carthami Tinctorii), Su Mu (Lignum Sappan), Dan Pi (Cortex Moutan), Xue Jie (Resina Draconis) for blood stasis; Pu Huang, E Jiao (Colla Corii Asini), Di Yu (Radix Sanguisorbae), Bai Cao Shuang (Carbonized Herba Artemisiae Argyi), Zong Lu Hui (Ash of Palm Frond) for metrorrhagia; Cong Rong (Herba Cynomorii), Suo Yang (Herba Cynomorii), Niu Xi (Radix Achyranthis Bidentatae), Gou Qi Zi (Fructus Lycii), Gui Ban (Carapax et Plastrum Testudinis), Xia Ku Cao (Spica Prunellae), Yi Mu Cao (Herba Leonuri) for blood deficiency; Ru Xiang (Resina Olibani), Mo Yao (Resina Myrrhae), Wu Ling Zhi (Faeces Trogopterori), Ling Xiao Hua (Flos Campsis) for blood pain; dairy products for blood dryness; Ginger and Cinnamon for blood cold; Ku Shen (Radix Sophorae Flavescentis) and Sheng Di Huang juice for blood heat. By analogy, one can respond to infinite variations.
Danxi treated Yin-deficiency fever by distinguishing Yin and Yang within the blood herbs of Si Wu Tang: The moving aspect of blood is Yang, governed by Chuan Xiong and Dang Gui; the still aspect is Yin, governed by Di Huang and Bai Shao. If Yin-blood is insufficient, although Chuan Xiong and Dang Gui are pungent-warm, they are not used; if Yang-blood is insufficient, although Ginger and Cinnamon are pungent-hot, they are used. This aligns with the direct and indirect methods of clearing fire. Wu Hegao said: The way of Heaven and Earth is that Yang is often in excess and Yin is often deficient; the human body is the same. Thus, blood is hard to form and easy to lose. Plants have no consciousness, how can they generate blood? Because Di Huang and Bai Shao can nourish the Yin of the five Zang organs, and Chuan Xiong and Dang Gui can regulate the Qi of Ying (Nutrient), harmony of Yin and Yang leads to natural blood generation. If blood loss is excessive and breath is faint, do not administer this, for Si Wu Tang is of the Yin category, not suitable for generating life/Qi. One should heavily use Ren Shen and Huang Qi to consolidate the dying Qi. Hence, it is said that in hemorrhage, first benefit the Qi; otherwise, the aromatic penetration of Chuan Xiong will consume Qi, leading to death from dual exhaustion of Qi and Blood. Therefore, those with deficiency damage, weak stomach, or weak Qi should not take it frequently. Someone asked: Is Si Wu Tang exclusively for gynecology? Does it contain Spleen/Stomach herbs? Yi Yang Zi said: Si Wu Tang implicitly contains Spleen/Stomach treatment methods, long misunderstood by people. The Spleen meridian has little blood and much Qi; Dang Gui and Di Huang generate blood to irrigate the Spleen meridian. Earth fears thief pathogens, Wood overacts on Earth; Bai Shao can drain Wood and tonify Spleen. Liver desires dispersion, using the pungency of Chuan Xiong to disperse it. Is this not a method of restraining Wood and tonifying Earth/Spleen? Some ask: Is Bai Shao contraindicated postpartum? Answer: After new birth, Qi and Blood are unsettled, fearing Bai Shao's astringent nature may cause pain. However, Bai Shao specifically treats Qi-pain from blood deficiency. Postpartum is precisely a time of Qi-Blood deficiency pain. Using it lightly stir-fried with mellow wine, what harm is there? Regarding blood clots causing trouble, do not stick to the idea of massive tonification postpartum. Boldly using purgatives like Yu Zhu San (Jade Candle Powder) is acceptable; eliminating old to generate new is also a tonification method. Many died from retained blood due to the dogma of "massive tonification postpartum." Appendix: Hezi's Yu Zhu San: Dang Gui Wei (Tail of Radix Angelicae Sinensis), Sheng Di Huang, Chuan Xiong, Chi Shao (Radix Paeoniae Rubra), Da Huang (Radix et Rhizoma Rhei), Mang Xiao (Natrii Sulfas), Gan Cao (Radix Glycyrrhizae Uralensis). Treats amenorrhea with abdominal pain.
Adding Huang Bo (Cortex Phellodendri) and Zhi Mu (Rhizoma Anemarrhenae) to this formula creates Zhi Bai Si Wu Tang (Anemarrhena and Phellodendron Four Substances Decoction); adding Xuan Shen (Radix Scrophulariae) creates Zi Yin Jiang Huo Tang (Nourish Yin Descend Fire Decoction): Treats Yin deficiency with fire. Honey-pill form is called Kan Li Wan (Kan-Li Pill): Treats Yin-deficiency coughing blood. (Danxi argued Lao Zhai [Consumption] is primarily Yin deficiency. From Zi to Wu hours belongs to Yang, from Wu to Hai hours belongs to Yin. Yin deficiency causes heat, occurring after noon before midnight. Awakening is Yang, sleeping is Yin. Yin deficiency causes night sweats during sleep. Ascending is Yang, descending is Yin. Yin deficiency causes Qi descent, phlegm-saliva counterflow, continuous spitting. Pulse floating is Yang, sinking is Yin. Yin deficiency makes pulse large and forceful on floating, empty on sinking. Use Si Wu Tang with Zhu Li (Bambusae Succus) plus stir-fried Bai Hu and Gui Ban to nourish Yin and descend fire. Also avoid desires, light diet, calm mind to assist. *Zhun Sheng* says: Danxi's theory on consumption focuses on Yin deficiency, using Si Wu Tang plus Zhi Bai. Physicians followed this with little success. Why? Yin deficiency fire flares upward. Chuan Xiong and Dang Gui are pungent-warm, not suitable for nourishing deficiency and descending fire. Chuan Xiong ascends, unsuitable for deficiency flare-ups with shortness of breath. Di Huang clogs the chest, unsuitable for weak stomach with much phlegm and poor appetite. Zhi Bai are bitter-cold and large-cold. Though said to nourish Yin, they actually dry blood; though said to descend fire, long-term use increases Qi and aids fire, damaging the stomach. Better to use Yi Yi Ren (Semen Coicis), Bai He (Bulbus Lilii), Tian Dong (Radix Asparagi), Mai Dong (Radix Ophiopogonis), Sang Bai Pi (Cortex Mori), Di Gu Pi (Cortex Lycii), Dan Pi, Suan Zao Ren (Semen Ziziphi Spinosae), Wu Wei Zi (Fructus Schisandrae), Pi Pa Ye (Folium Loquae), etc., assisted by Sheng Di Huang juice, Ou Jian (Rhizoma Nelumbinis Juice), Ren Ru, Tong Bian (Infant Urine). For cough, use more Sang Bai Pi and Pi Pa Ye; add Bei Mu (Bulbus Fritillariae Cirrhosae) for phlegm; add Yi Yi Ren, Bai He, E Jiao for blood; add Di Gu Pi for severe heat; add Yi Yi Ren up to 7-8 qian for poor appetite, with Mai Dong as chief to protect Lung Metal and nourish source of transformation, achieving immediate effect. Also: Chronic deficiency diseases involve emptiness of all vessels, requiring sticky substances to fill; dried essence and blood require moistening substances to lubricate. Use Ren Shen, Huang Qi, Di Huang, Er Dong (Tian Dong, Mai Dong), Gou Qi, Wu Wei Zi, decocted into pastes. Separate Qing Hao (Herba Artemisiae Annuae) paste made with infant urine, mix with previous juices, plus Lu Jiao Jiao (Colla Cornus Cervi) and Xia Tian Gao (Paste of Beef/Moose Meat). Generally, Yi Yi Ren and Bai He treat Lung deficiency; Ren Shen, Huang Qi, Di Huang pastes treat Kidney deficiency. Heart and Liver belong to Yang, Lung and Kidney belong to Yin. Thus, tonifying Lung and Kidney is tonifying Yin, not using Zhi Bai type herbs.
Adding Lian Lian (Radix Coptidis) and Hu Lian Lian (Rhizoma Hydrastis) to this formula creates Er Lian Si Wu Tang (Two Coptises Four Substances Decoction) (*Yuan Rong*: Treats chronic deficiency blood deficiency, five-center heat, heat entering Blood Chamber, night fever. Blood Chamber refers to Chong Mai/Thoroughfare Vessel, the Sea of Blood. Quiet by day, hot by night, Yang trapped in Yin, named Heat Entering Blood Sea). Adding Huang Bo, Huang Qin (Radix Scutellariae), Gan Cao creates San Huang Si Wu Tang (Three Yellows Four Substances Decoction): Treats Yin deficiency tidal fever. Using Sheng and Shu Di Huang (Two Dishes), adding Huang Qi (Radix Astragali), Dan Pi, Sheng Ma (Rhizoma Cimicifugae), Chai Hu (Radix Bupleuri) creates San Huang Bu Xue Tang (Three Yellows Tonify Blood Decoction): Treats blood loss and blood deficiency, six pulses large but empty on pressure. (Two Dishes nourish blood, Dan Pi cools blood, Huang Qi tonifies Qi, Sheng/Chai raise Yang. Abundant Qi generates blood; Yang generation leads to Yin growth). Adding Tao Ren, Hong Hua creates Yuan Rong Si Wu Tang (Yuan Rong Four Substances Decoction): Treats organ knotting with constipation, traumatic blood stasis. Adding Qiang Huo (Rhizoma Notopterygii), Fang Feng (Radix Saposhnikoviae) (one uses Qin Jiao [Radix Gentianae Macrophyllae]) creates Zhi Feng Liu He Tang (Wind-Regulating Six-Harmony Decoction): Treats wind-deficiency dizziness, wind-constipation. Honey pills create Bu Gan Wan (Tonify Liver Pill) (Liver benefits from dispersion). Adding Mu Xiang (Radix Aucklandiae), Bing Lang (Areca Seed) creates Zhi Qi Liu He Tang (Qi-Regulating Six-Harmony Decoction): Treats blood deficiency with Qi stagnation, or Qi-Blood rushing upward. Adding Qiang Huo, Tian Ma (Rhizoma Gastrodiae), honey pills create Shen Ying Yang Zhen Dan (Divine Response Nourish True Pill): Treats Foot-Jueyin meridian affected by Wind-Cold-Damp-Heat, paralysis; slurred speech, and blood-deficiency gout. Adding Tao Ren, Hong Hua, Zhu Li, Jiang Zhi (Ginger Juice) treats hemiplegia; left-sided belongs to blood stasis (If stasis is not removed, new blood cannot be generated; thus Tao Ren and Hong Hua activate blood and remove stasis; adding Zhu Li and Jiang Zhi because phlegm knows no left/right distinction). Removing Bai Shao, adding Fang Feng creates Fang Feng Dang Gui San (Saposhnikovia and Angelica Powder): Treats spasms from excessive sweating, suitable for dispelling wind and nourishing blood. Removing Di Huang, adding Gan Jiang creates Si Shen Tang (Four Spirits Decoction): Treats women's blood deficiency with heart/abdominal colic (Jiu/Jiao sound, acute pain). Adding E Jiao, Ai Ye (Folium Artemisiae Argyi), Gan Cao creates Jiao Ai Tang (Donkey-hide Glue and Mugwort Decoction): Treats Chong/Ren vessel deficiency damage, dripping menstruation, and blood-deficiency dysentery (See Obstetrics/Gynecology section). Adding Ai Ye, Si Zhi Xiang Fu (Cyperi Rhizoma processed with infant urine, salt water, wine, vinegar, soaked 3 days each), vinegar pills create Ai Fu Nuan Gong Wan (Mugwort and Cyperi Womb-Warming Pill): Treats uterine deficiency-cold. Adding E Jiao creates Fu Bao Dan (Women's Treasure Pill): Treats deficiency-cold irregular menstruation. Adding Dan Pi, Di Gu Pi treats women's bone-steaming fever. Removing Bai Shao and Di Huang creates Xiong Gui Tang (Chuanxiong and Angelica Decoction); powdered, Fo Shou San (Buddha's Hand Powder); also named Yi Qi San (One Marvel Powder), Jun Chen San (Sovereign-Minister Powder): Treats postpartum blood-deficiency headache; fetal movement with bleeding, taking this ensures safety; dead fetus in womb, taking this expels it; miraculous for labor induction. Combining with Si Jun Zi Tang (Four Gentlemen Decoction) creates Ba Zhen Tang (Eight Treasures Decoction): Treats Heart/Lung deficiency damage, dual Qi-Blood deficiency (Si Jun Zi tonifies Qi, Si Wu nourishes Blood). Adding Huang Qi, Rou Gui (Cortex Cinnamomi) creates Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction): Assists Yang and consolidates Wei (Defensive) Qi. (Wang Haicang said: Gui Zhi and Gan Cao form Xiao Jian Zhong Tang; adding Huang Qi forms Huang Qi Jian Zhong Tang; Ren Shen, Bai Zhu, Fu Ling, Gan Cao form Si Jun Zi Tang; Chuan Xiong, Dang Gui, Bai Shao, Di Huang form Si Wu Tang. Since Qi and Blood are both declining, Yin and Yang both weak, following the completion numbers of Heaven and Earth, it is called Shi Quan San). Shi Quan Tang removing Bai Shao, adding Shan Zhu Yu (Fructus Corni), Wu Wei Zi, Fang Feng, Cong Rong, decocted with Ginger and Jujube, creates Da Bu Huang Qi Tang (*Bao Jian*): Treats dual Qi-Blood deficiency with incessant spontaneous sweating (Huang Qi fears Fang Feng, combined best stops sweat; and Yang deficiency syncope). Si Wu + Si Jun Zi + Xiao Chai Hu Tang creates San He San (Three-Harmony Powder) (He Jian): Treats chronic deficiency consumption postpartum. Si Wu each 7 qian, add Fang Feng 1 liang, Zhi Zi (Fructus Gardeniae), Huang Qin, Huang Lian (Radix Coptidis) each 3 qian, take 5 qian per dose. If pulse is solid, add Da Huang, creates Sheng Di Huang Lian Tang (Rehmannia and Coptis Decoction) (Hai Zang): Treats women's Wind-Blood syndrome, excessive blood loss leading to dryness, grasping at clothes, picking at air, closing eyes, waving hands, throwing feet, confused speech, loss of spirit, pulse string-like, floating, and empty. (Men with excessive blood loss also have this syndrome. Tao Jie'an said: Da Cheng Qi Tang is a Qi herb, used for pathogen moving from exterior to interior; Sheng Di Huang Lian Tang is a Blood herb, used for pathogen moving from interior to exterior. In Qi-Blood combined disease, grasping at clothes, similar to Qi transforming to Blood, Blood transforming back to Qi, Da Cheng Qi Tang purges; from Blood transforming to Qi, Qi transforming back to Blood, Sheng Di Huang Lian Tang governs. Both have constipation; this is the counterpart to Cheng Qi Tang, related to San Huang Shi Gao Tang, all diseases of deficient fire in San Jiao and Pericardium. Since the disease is critical, only this can descend hidden fire in blood. *Ben Cao Gang Mu* says: Si Wu Tang combined with Gui Zhi, Ma Huang, Bai Hu, Chai Hu, Li Zhong, Si Ni, Zhu Yu, Cheng Qi, Liang Ge, etc., can serve as various...)