治老弱诸沉寒痼冷，小便滑数，大便时泄，腰腿脐腹疼痛困倦，瘦虚食减。
附子（炮，去皮脐） 白术 山药 肉豆蔻 赤石脂 干姜（各一两） 肉桂（半两）
上为细末，面糊为丸，如梧桐子大，每服一二十丸，空心用温酒送下。
治下元虚寒，腰腹冷痛，崩漏带下，一切冷病。
椒目 川乌 细辛 干姜 官桂（各等分）
上为粗末，水煮澡洗下部，为妙。
治阳虚阴盛，手足厥冷，暴吐大下，脉细羸瘦，伤寒阴证，并皆治之。
川乌（炮，去皮，四两） 天雄（炮，去皮，三两） 附子（炮，去皮脐） 钟乳粉（各
二两） 阳起石（火 ） 朱砂（另研，各一两）
上为细末，酒煮神曲糊丸，如梧桐子大，每服五十丸，空心用温酒或盐汤送下。
治阴病手足厥冷，脐腹疼痛，真气不足，衰惫欲绝。
沉香 丁香（各二钱） 麝香（一钱） 附子（炮，去皮脐，四钱）
上锉碎，用水二盅，生姜七片，枣二枚，去核，煎至七分，去滓，空心温服。
《内经》曰∶诸血者皆属于心。又云∶肝藏血。夫血错经妄行者，岂无因而致哉？又曰
∶阳明厥逆，喘咳身热，善惊衄吐血，淫淫汗出鼽衄，脾移热于肝，则为惊衄。阳气者，大
怒则形气绝，而血菀于上，使人薄厥。怒则气逆，甚则呕血。肺咳之状，咳而喘息，有音，
甚则唾血，暴痹内逆，肝肺相搏，血溢鼻口，可于手太阴经内求穴以泻之。足少阴肾之脉，
从肾贯肝入肺中，循咽喉，其病则饥不欲食，面黑，咳唾则有血。《金匮要略》曰∶夫酒客
咳者，必至吐血，此因极饮过度所致也。《原病式》曰∶衄者阳热怫郁，干于足阳明而上热
，则血妄行鼻衄也。又云∶血溢者，上出也，血有余而妄行也。《局方发挥》论口鼻出血，
皆系阴虚阳盛，有升无降，血随气上窍，法当补阴益阳，气降则血归经。东垣云∶杂病见血
者，多责其热也。夫血者阴也，气者阳也。气主煦之，血主濡之。今血妄行，上出于口鼻者
，皆气逆也，分之则各有所属，治之则各有所主。如衄血出于肺，呕吐血出于胃，其经有虚
实之分，当以脉理究治。唾血出于肾，血证上行，或衄或吐，或呕哕唾者，皆逆也。若血下
行者为顺。《内经》又云∶荣者，水谷之精气也。和调于五脏，酒陈于六腑，乃能入于脉也
。心主之，肝藏之，脾裹之，肺营之，肾泄之。生化于脾，总总于心，藏诸于肝，宣布于
肺，随气营运，灌溉一身。夫人目得之而能视，耳得之而能听 ，手得之而能摄，掌得之而
能握，足得之而能步，脏得之而能液，腑得之而能气。是以出入升降，濡润宣通者，由此使
然也。寒则凝结，暑则气流泽，热则生通，为脉涩则血少，充则血实。血虚常以饮食滋胃，
乃中焦受气取汁，变化而赤为血也。故经云水入于经，其血乃成。又曰∶血者神气也，持之
则存，失之则亡。且人身皆藉气血所养，可不谨哉？诸经有云∶阳道实，阴道虚，阳易亢，
阴易乏，阳道常饶，阴道常乏，阳常有余，阴常不足。可见人之生也，故气常有余，血常不
足。年至四十，阴气自半，起居衰矣。男子十六岁而精通，至六十四岁而精绝；女子十四岁
而经行，至四十九岁而经断。而阴血之难成易亏也如此。阴气一伤，最难调治，以其阳虚阴
亏，妄行于上则吐衄，衰涸于中则虚劳，妄返于下则便红，移热于膀胱则癃溺，血渗透肠间
则为肠风，阴虚阳搏则为崩中，湿蒸热瘀则为滞下，热极腐化则为脓血热极色紫黑者，热胜
于阴，发于疮疡，湿滞于血则为脾痛瘾疹，蓄之在上则人喜妄，蓄之在下则人喜狂。前证诸
论至详，其脉沉细者顺，洪大弦数者逆。治法病在何经何病，随经而治之。对证之方，条具
于后。且如长沙公言∶少阴病但厥无汗，而强发之，必动其血，或从口鼻耳目中出，是名下
厥上竭，为难治。又不可不知也。
治疗年老体弱者的各种深重寒邪与久治不愈的冷病，表现为小便频数滑利，大便时常泄泻，腰腿、肚脐及腹部疼痛且伴有困倦乏力，身体消瘦虚弱、食欲减退。
附子（炮制，去皮和脐） 白术 山药 肉豆蔻 赤石脂 干姜（各一两） 肉桂（半两）
以上药物研成细末，用面糊制作成丸药，大小如梧桐子，每次服用一二十丸，空腹时用温酒送服。
治疗下焦元阳虚寒，腰部和小腹冷痛，妇女崩漏（非经期大量出血或淋漓不断）及带下病，以及一切寒性疾病。
椒目 川乌 细辛 干姜 官桂（各等分）
以上药物研成粗末，用水煮后清洗下部（外洗），效果更佳。
治疗阳气虚弱、阴寒内盛，导致手足冰冷，突然剧烈呕吐和大泻，脉象细微、身体羸瘦，以及伤寒阴证，均予以治疗。
川乌（炮制，去皮，四两） 天雄（炮制，去皮，三两） 附子（炮制，去皮和脐） 钟乳粉（各二两） 阳起石（火煅） 朱砂（单独研磨，各一两）
以上药物研成细末，用酒煮神曲糊制作成丸药，大小如梧桐子，每次服用五十丸，空腹时用温酒或盐汤送服。
治疗阴寒病症导致的手足冰冷，肚脐和腹部疼痛，真气不足，极度衰弱几乎断绝。
沉香 丁香（各二钱） 麝香（一钱） 附子（炮制，去皮和脐，四钱）
以上药物切碎，用水两盅，生姜七片，大枣二枚（去核），煎煮至剩余七分药液，滤去药渣，空腹温服。
《黄帝内经》说：所有的血液都归属于心。又说：肝贮藏血液。血液运行失常、妄行溢出，难道没有原因吗？又说：阳明经气逆乱，出现气喘咳嗽、身体发热、容易惊恐、鼻出血或吐血，汗出淋漓、鼻塞流涕或鼻出血，脾脏将热邪转移给肝脏，就会导致惊恐和鼻出血。人体的阳气，在大怒时会导致形体和气机隔绝，血液郁积于上部，使人发生薄厥（因大怒而致的昏厥）。发怒会导致气机上逆，严重时会导致呕血。肺咳嗽的症状是，咳嗽并伴有喘息声，声音响亮，严重时唾中带血，突然发生的痹症且气机内逆，肝肺之气相互搏结，血液从鼻口溢出，可以在手太阴肺经中寻找穴位进行泻法治疗。足少阴肾经，从肾脏贯穿肝脏进入肺部，沿着咽喉，其病变表现为饥饿但不想进食，面色发黑，咳嗽吐痰时带有血液。《金匮要略》说：经常饮酒的人咳嗽，必然会导致吐血，这是因为过度饮酒所致。《原病式》说：鼻衄（鼻出血）是由于阳热郁结，侵犯足阳明胃经并导致上焦热盛，从而使血液妄行从鼻而出。又说：血溢是指血液从上窍流出，是血有余而妄行的表现。《局方发挥》论述口鼻出血，都认为是阴虚阳盛，只有上升没有下降，血液随着气机上逆至清窍，治疗方法应当补阴益阳，气降则血液回归经脉。李东垣说：杂病中出现出血症状的，多归责于热邪。血属于阴，气属于阳。气主要起到温煦作用，血主要起到濡润作用。现在血液妄行，从上窍（口鼻）流出，都是气逆造成的，分析起来各有归属，治疗时各有主治方向。例如鼻衄血出于肺，呕吐血出于胃，其经络有虚实之分，应当通过脉理来探究和治疗。唾血出于肾，血证向上逆行，无论是鼻衄还是吐血，或是呕吐、呃逆、唾血，都属于气逆。如果血液向下排出则为顺证。《黄帝内经》又说：营气，是水谷的精微精气。它与五脏调和，输布到六腑，然后才能进入脉管。由心主宰，肝贮藏，脾包裹，肺营运，肾排泄。它由脾生化，由心统摄，由肝贮藏，由肺宣布，随着气的运行而营运，灌溉全身。人眼得到它就能视物，耳朵得到它就能听声，手得到它就能抓取，手掌得到它就能握持，脚得到它就能行走，脏腑得到它就能产生津液，腑得到它就能产生气机。因此，出入升降、濡润宣通的功能，都是由它促成的。寒冷时血液凝结，暑热时气血流动润泽，热盛时则生通畅，脉道涩滞则血少，充盈则血实。血虚通常通过饮食滋养胃气，这是中焦接受水谷之气，提取汁液，变化而成红色的血液。所以经文说水进入经脉，血液才能形成。又说：血就是神气，保持住它就存在，失去了它就消亡。况且人体都依赖气血的滋养，能不谨慎吗？各经书中说：阳道实，阴道虚，阳容易亢盛，阴容易匮乏，阳道常充足，阴道常匮乏，阳常有余，阴常不足。可见人的生长过程中，气常有余，血常不足。人到四十岁，阴气减半，起居能力衰退了。男子十六岁精通（具备生殖能力），到六十四岁精绝；女子十四岁月经来潮，到四十九岁月经断绝。阴血的难成易亏就是这样。阴气一旦受损，最难调治，因为阳虚阴亏，妄行于上则导致吐血鼻衄，衰涸于中则导致虚劳，妄返于下则导致便血，移热于膀胱则导致小便不通，血液渗透肠间则成为肠风，阴虚阳搏则导致崩中，湿蒸热瘀则成为痢疾，热极腐化则成为脓血。热极色紫黑的，是热胜于阴，发于疮疡；湿滞于血则成为脾痛的瘾疹；蓄积在上部则让人喜欢胡言乱语，蓄积在下部则让人喜欢发狂。前文所述的诸种理论非常详尽，脉象沉细的为顺证，洪大弦数的为逆证。治疗方法需根据疾病所在的经络和病症，随经进行治疗。对症的方剂，详细列在后面。就像长沙公（张仲景）所说：少阴病只见四肢厥冷而无汗，如果强行发汗，必定扰动血液，血液可能从口、鼻、耳、目中流出，这叫做下厥上竭，属于难治之症。这也是不可不知道的。
Treats various deep-seated cold pathogens and chronic cold conditions in the elderly and weak, manifesting as frequent and slippery urination, occasional diarrhea, pain and fatigue in the waist, legs, umbilicus, and abdomen, emaciation, weakness, and reduced appetite.
Prepared Fuzi (Aconiti Lateralis Radix Praeparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Shanyao (Dioscoreae Rhizoma), Roudoukou (Myristicae Semen), Chishizhi (Halloysit Rubrum), Prepared Ganjiang (Zingiberis Rhizoma) (each 1 liang), Rougui (Cinnamomi Cortex) (0.5 liang).
Grind the above into a fine powder, make pills with wheat paste, size of *Cocculus trilobus* seeds. Take 10–20 pills per dose, swallowed with warm wine on an empty stomach.
Treats deficiency-cold of the Lower Yuan (Lower Burner/Original Qi), cold pain in the waist and abdomen, metrorrhagia and leukorrhea, and all types of cold diseases.
Jiaomu (Semen Capsici), Chuanwu (Aconiti Radix), Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Guangui (Cinnamomi Ramulus) (equal parts).
Grind the above into a coarse powder, boil in water, and wash the lower part externally for best results.
Treats Yang deficiency with Yin excess, causing cold limbs, sudden severe vomiting and purging, thready pulse, emaciation, and Yin syndromes of Cold Damage (Shanghan). All are treated by this formula.
Chuanwu (Aconiti Radix, prepared, peeled, 4 liang), Tianxiong (Aconiti Radix Preparata, prepared, peeled, 3 liang), Prepared Fuzi (Aconiti Lateralis Radix Praeparata, prepared, peeled), Zhongru Fen (Gypsum Fibrosum Pulvis) (each 2 liang), Yangqishi (Leucogynum Oreites), Zhusha (Cinnabaris, separately ground) (each 1 liang).
Grind the above into a fine powder, make pills with fermented glutinous rice dough boiled in wine, size of *Cocculus trilobus* seeds. Take 50 pills per dose, swallowed with warm wine or salted water on an empty stomach.
Treats Yin-cold syndromes causing cold limbs, umbilical and abdominal pain, insufficiency of True Qi, extreme exhaustion nearing collapse.
Chenxiang (Aquilariae Lignum Resinatum), Dingxiang (Syzygii Flos) (each 2 qian), Shexiang (Moschus) (1 qian), Prepared Fuzi (Aconiti Lateralis Radix Praeparata, prepared, peeled, 4 qian).
Cut into pieces, add 2 bowls of water, 7 slices of fresh ginger, and 2 jujubes (pitted). Decoct until 0.7 bowl remains, strain, and take warm on an empty stomach.
The *Neijing* (Yellow Emperor's Inner Canon) states: "All blood belongs to the Heart." It also says: "The Liver stores blood." If blood flows irregularly and acts recklessly, is there no cause? It further states: "When the Yangming channel reverses, there is wheezing, coughing, body heat, frightfulness, epistaxis, and hematemesis; profuse sweating, nasal congestion, and epistaxis occur; if Spleen heat transfers to the Liver, it causes fright and epistaxis." When human Yang Qi is subjected to great anger, form and Qi become severed, and blood stagnates in the upper part, causing Bo Jue (syncope due to rage). Anger causes Qi to reverse; severely, it leads to vomiting blood. The symptoms of Lung cough include coughing with wheezing and audible sounds; severely, it leads to spitting blood. Sudden Bi syndrome with internal Qi reversal, where Liver and Lung Qi clash, causes blood to overflow from the nose and mouth; one should seek acupoints on the Hand Taiyin Lung Channel to drain it. The Foot Shaoyin Kidney Channel originates from the Kidney, passes through the Liver, enters the Lung, follows the throat; its disease manifests as hunger without desire to eat, dark complexion, and blood in sputum. The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: "Those who drink alcohol and cough will inevitably vomit blood; this is caused by excessive drinking." The *Yuanbing Shi* (Treatise on Original Causes of Disease) states: "Epistaxis is due to Yang heat being constrained, affecting the Foot Yangming channel and causing upper heat, leading to reckless blood flow from the nose." It also says: "Blood overflowing refers to bleeding from the upper orifices, caused by blood excess and reckless flow." The *Jufang Fahui* discusses oral and nasal bleeding, attributing them to Yin deficiency and Yang excess, with rising but no descending, causing blood to follow Qi up to the clear orifices; the treatment method should be to tonify Yin and benefit Yang, so that when Qi descends, blood returns to the vessels. Li Dongyuan said: "In miscellaneous diseases, bleeding is mostly attributed to Heat." Blood is Yin, Qi is Yang. Qi primarily warms, Blood primarily moistens. Now, when blood flows recklessly and exits from the upper orifices (mouth/nose), it is all due to Qi reversal; analyzed separately, each has its affiliation; treated separately, each has its main focus. For example, epistaxis comes from the Lung, hematemesis from the Stomach; their channels have deficiency and excess distinctions, which should be investigated and treated via pulse diagnosis. Spitting blood comes from the Kidney. Blood syndromes moving upward, whether epistaxis, hematemesis, vomiting, hiccups, or spitting blood, are all reversals. If blood moves downward, it is considered smooth/compliant. The *Neijing* also states: "Ying Qi (Nutritive Qi) is the essence of food and drink. It harmonizes with the Five Zang organs, is elaborated in the Six Fu organs, and then enters the vessels. It is governed by the Heart, stored by the Liver, enveloped by the Spleen, managed by the Lung, and excreted by the Kidney. It is generated by the Spleen, controlled by the Heart, stored in the Liver, distributed by the Lung, circulating with Qi to irrigate the whole body." Eyes see because of it, ears hear because of it, hands grasp because of it, palms hold because of it, feet walk because of it, Zang organs produce fluids because of it, Fu organs generate Qi because of it. Thus, the functions of entering/exiting, ascending/descending, moistening, and unblocking are caused by this. Cold causes coagulation, summer heat causes fluid flow and lubrication, extreme heat causes obstruction, sluggish pulses indicate blood deficiency, fullness indicates blood excess. Blood deficiency is often nourished by diet to strengthen the Stomach; this is the Middle Jiao receiving Qi, extracting juices, transforming them into red blood. Hence, the classics say: "Water enters the vessels, and blood is formed." It also says: "Blood is Shen Qi (Spiritual Qi); holding it preserves life, losing it leads to death." Moreover, the entire body relies on Qi and Blood for nourishment; can one not be cautious? Various classics state: "The Yang path is solid, the Yin path is deficient; Yang easily becomes hyperactive, Yin easily becomes depleted; the Yang path is usually abundant, the Yin path is usually deficient; Yang is often in excess, Yin is often insufficient." This shows that in human life, Qi is often in excess, while Blood is often insufficient. At age forty, Yin Qi halves, and daily activities decline. Males reach seminal emission at sixteen and seminal depletion at sixty-four; females begin menstruation at fourteen and cease at forty-nine. Thus, the difficulty in forming and ease of depleting Yin Blood is evident. Once Yin Qi is injured, it is hardest to regulate, because Yang deficiency and Yin depletion cause reckless flow upward leading to hematemesis and epistaxis, depletion inward leading to deficiency consumptive disease, reckless return downward leading to bloody stool, transfer of heat to the Bladder leading to strangury, blood permeating the intestines leading to Chang Feng (intestinal wind), Yin deficiency with Yang pounding leading to Beng Zhong (metrorrhagia), damp-heat stasis leading to dysentery, extreme heat rotting leading to pus and blood. Extreme heat with purple-black color indicates heat overcoming Yin, manifesting as sores and ulcers; dampness stagnating in blood leads to Pi Tong (spleen pain) and urticaria; accumulation in the upper part causes delirious speech, accumulation in the lower part causes mania. The aforementioned theories are very detailed. A thready and fine pulse is favorable; a surging, large, wiry, and rapid pulse is unfavorable. Treatment methods depend on the affected channel and disease, treating according to the channel. Symptomatic formulas are listed below. As Changsha Gong (Zhang Zhongjing) stated: "Shaoyin disease with only cold limbs and no sweat, if forced sweating is applied, it will surely disturb the blood, causing it to exit from the mouth, nose, ears, or eyes; this is called Lower Jue and Upper Exhaustion, a difficult-to-treat condition." This must also be known.