沙篆曰。经云。诸痛皆因于气。百病皆生于气。子和曰。天地之气。常则安。变则动。人并
天地之气。五运佚侵于外。七情交战于中。是以圣人啬气如持至宝。庸人役物而反伤太和。此轩
岐所谓诸痛皆因于气。百病皆生于气。遂有九气
不同之说。气本一也。因所触而为九。怒喜悲恐寒热惊思劳也。盖怒则气上。怒则气逆。甚则呕
血及餐泄。故气上矣。喜则气缓。喜则气和志达。营卫通利。故气缓矣。悲则气消。悲则心系急。
肺布叶举。而上焦不通。营卫不散。热气在中。故气消矣。恐则气下。恐则精却。却则上焦闭。
闭则气还。还则下焦胀。故气不行矣。寒则气收。寒则腠理闭。气不行。故气收矣。炅则气泄。
炅则腠理开。营卫通。汗大泄。故气泄矣。惊则气乱。惊则心无所根据。神无所归。虑无所定。故
气乱矣。劳则气耗。劳则喘息汗出。外内皆越。故气耗矣。思则气结。思则心有所存。神有所归。
正气留而不行。故气结矣。尝考其为病之详。变化多端。如怒气所至为呕血。为餐泄。为煎厥。
为薄厥。为阳厥。为胸满胁痛。怒则气逆而不下。为喘渴烦心。为消瘅。为肥气。为目暴盲。耳
暴闭。筋缓。发于外为痈疽。喜气所至。为笑不休。为毛革焦。为内病。为阳气不收。甚则为狂。
悲气所至。为阴缩。气并于肺而肝木受邪。金太过则肺亦自病。恐伤肾。肾属水。恐则气并于肾
而心火受邪。水太过则肾亦自病。思伤脾。脾属土。思则气并于脾而肾水受邪。土太过则脾亦自
病。寒伤形。形属阴。寒胜热则阳受病。寒太过则阴亦自病。热伤气。气属阳。热胜寒则阴受病。
热太过则阳亦自病。凡此数者。更相为治。故悲可以治怒。以怆恻苦楚之言感之。喜可以治悲。
以谑浪亵狎之言娱之。恐可以治喜。以迫遽死亡之言怖之。怒可以治思。以污辱欺罔之言触之。
思可以治恐。以虑彼志此之言夺之。凡此五者。必诡诈谲怪。然后可以动人耳目。易人视听。若
胸中无才识之人。亦不能用此法耳。
丹溪云。冷气滞气逆气。皆是肺受火邪。气得炎上之化。有升无降。熏蒸清道。甚则转成剧
病。局方类用辛香燥热之剂以火济火。咎将谁执。气无补法。世俗之言也。以其为病。痞满闷塞。
似难于补。不思正气虚者不能营运。邪滞着而
不出。所以为病。经云。壮者气行则已。怯者则着而成病。苟或气怯。不用补法。气何由行。气
属阳。无寒之理。上升之气。觉恶寒者。亢则害。承乃制也。气有余。便是火。自觉冷气从下而
上者。非真冷也。盖上升之气。自肝而出。中挟相火。自下而上。肾热为甚。火极似水。阳亢阴微也。
喻嘉言曰。人之体中肌肉丰盛。乃血之荣旺。极为美事。但血旺易致气衰。久而弥觉其偏也。
夫气与血。两相维附。何以偏旺耶。盖气为主则血流。血为主则气反不流。非真气之衰也。气不
流有似乎衰耳。所以一切补气之药。皆不可用。而耗气之药反有可施。缘气得补而愈锢。不若耗
之以助其流动之势。久之血仍归其统握之中耳。
七气所致。三因方论最详。喜怒忧思悲恐惊。谓之七气所伤。有少痰在咽喉间。如绵絮相似。
咯不出。咽不下。并宜四七汤为末。炼蜜和姜汁为丸噙化。及局方乌沉汤、诸七气汤。分虚实选
用。盛怒成疾。面色青黄。或两胁胀满。沉香降气散、木香调气散。或四七汤加枳壳、木香。虚
加人参、石菖蒲。肥人气滞。必有痰。以二陈、苍术、香附。燥以开之。瘦人气滞。必有火且燥。
宜苏子、山栀、当归、芍药、丹皮。降以润之。老人胸膈气滞。痞满不舒。或作痛。或不能食。
脉虽数实滑大。当作虚治。慎不可用耗气药。宜理中丸。或六君子加香、砂之类。气不归源。补
骨脂为主。白术、沉香佐之。一切冷气。及妇人血气攻击。心腹撮痛。局方乌沉汤最捷。妇女性
执多偏属阴。气易于动。如痞闷胀痛。上凑心胸。或攻筑胁肋。腹中结块。月水不调。或眩晕呕
吐。往来寒热。一切气候。先用加味逍遥散。或苏子降气、沉香降气、四磨、六磨选用。气从左
边起者。肝火也。气刺痛。皆属火。当降火药中加枳壳。气郁不舒而痛者。木香调气散。忧而痰
郁。导痰汤加香附、乌药。因死血而痛者。桃仁、红花、归头。食积寒痰流入胁下背膂刺痛。诸
药不效者。神保丸。久患气结。诸
药不开者。先服沉香化气丸三五服以开其结。后用六君子送降气散调之。暴怒气厥。不省人事者。
苏合香丸灌之。诸气为患。须分暴病久病。暴怒伤阴。阳气独亢。气厥不省者。可用辛香破气以
通阴闭。若久抱抑郁。气不宣通。营卫不和者。又当辛温散结以调营卫。始为合宜也。
枳壳利肺气。多服损胸中至高之气。青皮泻肝气。多服能损真气。木香调诸经气兼泻肺。能
使上焦之气下达。阴火上冲禁用。砂仁醒脾气而能上升。然后滞气得以下通。白豆蔻能温肺气而
使下行。然后阳气得以上达。香附快滞气。陈皮泄逆气。乌药、紫苏、川芎俱能散气。使浊气从
汗散也。浓朴泻胃气。前胡下气推陈。槟榔泻至高之气能使浊气下坠。后重有积者宜之。藿香之
馨香。上行胃气。沉香升降诸气。脑麝散真气。苏子、杏仁下气润燥。气滞有火者宜之。豆蔻、丁
沉、檀、麝俱辛热。能散郁气。暴郁者宜用。稍久成火者忌之。禀壮气实。气不顺而刺痛。当用
枳壳、乌药。不已。加木香。若肥人气刺痛。用二陈加浓朴、枳壳。气虚脉微弱者。即当用异功
加枳壳、木香。
石顽曰。举世皆言气无补法。局方三因七气、四磨、六磨等方。其中俱用人参。能无助气为
患乎。古人立方用参。非尽为补而设也。如局方七气。原以肉桂、半夏为主。而借人参引入气分
以散气。岂用补之谓耶。其三因七气。纯是辛散。即用一味人参。但可随诸药建行气之功。不致
伤气足矣。何暇逞其补性乎。至于四磨、六磨。不过赖以资应敌之需。尚恐不及。安能望其补益哉。
〔诊〕下手脉沉。便知是气。其或沉滑。气兼痰饮。沉极则伏。涩弱难治。皆由大气郁滞不舒。
以故脉显沉伏。大都沉实有力。则宜辛散。沉弱少力。则宜温养。气主煦之。总不离乎辛温散结也。
汪石山治一孀妇。年四十余。患走气遍身疼痛。或背胀痛。或胁插痛。或一月二三发。发则
呕尽所食方快。饮食不进。久伏床枕。或用流气饮、二陈汤。益甚。汪诊之。脉皆细微而数。右
脉尤弱。曰。此忧思伤脾而气郁也。当补脾散郁。以人参三钱。黄 二钱。归身一钱半。川芎八
分。香附、黄连、甘草、干姜、砂仁各五分。数剂稍缓。再以参、 、川芎、香附、山栀、甘草、
神曲糊丸服而愈。
飞畴治一妇。平昔虚火易于上升。因有怒气不得越。致中满食减。作酸嗳气。头面手足。时
冷时热。少腹不时酸痛。经不行者半载余。其脉模糊。快而无力。服诸破气降气行血药不效。不
知此蕴怒伤肝。肝火乘虚而克脾土。脾受克则胸中之大气不布。随肝火散漫肢体。当知气从湿腾。
湿由火燥。惟太阳当空。则阴霾之气自散。真火令行。则郁蒸之气自伏。又釜底得火则能腐熟水
谷。水谷运则脾胃有权。大气得归而诸证可愈矣。因用生料八味倍桂、附。十日而头面手足之冷
热除。间用异功而中宽食进。如是出入调理。两月经行而愈。
沙元台说：医经记载，各种疼痛都因气机失调引起，百种疾病都源于气的变化。张子和说：天地的正常运行之气，常态下使人安宁，异常变动则引发扰动。人顺应天地之气，若五运六气在体外侵袭，七情在体内交争冲突，因此圣人像珍视至宝一样爱惜元气，而庸人却役使外物反而损伤了体内的太和之气。这正是黄帝、岐伯所说的“诸痛皆因于气，百病皆生于气”，从而有了九种不同气机变化的说法。气本质上是统一的，因为接触的不同刺激而分为九种，即怒、喜、悲、恐、寒、热、惊、思、劳。
大概愤怒会使气机上逆，大怒则气机逆乱，严重时会导致呕血或完谷不化的泄泻，这就是气上逆的表现。喜悦能使气机舒缓，喜悦则气和顺、意志通达，营卫之气通畅流利，所以气机舒缓。悲哀会使气机消损，悲哀则心脉拘急，肺叶扩张举升，导致上焦不通畅，营卫之气不能布散，热气郁结在中焦，所以气机消损。恐惧会使气机下沉，恐惧则精气退缩，精气退缩则上焦闭塞，闭塞则气机返还，返还则下焦胀满，所以气机下行不畅。寒冷会使气机收敛，寒冷则腠理闭塞，气机运行受阻，所以气机收敛。炎热会使气机外泄，炎热则腠理开泄，营卫通畅，大汗淋漓，所以气机外泄。惊恐会使气机紊乱，惊恐则心神无主，神志无所归依，思虑无法安定，所以气机紊乱。劳累会使气机耗散，劳累则喘息出汗，内外之气皆越出耗散，所以气机耗散。思虑会使气机郁结，思虑则心神专注于某处，正气停留而不行，所以气机郁结。
我曾经考察这些气机失调致病的具体情况，变化多端。例如由怒气引起的，有呕血、完谷不化的泄泻、煎厥、薄厥、阳厥、胸胁胀满疼痛等。因为气逆而不能下行，会出现气喘、口渴、心烦，甚至发展为消瘅（类似糖尿病）、肥气（腹中积块）、突然失明、突然耳聋、筋脉弛缓；发于体表则为痈疽疮疡。由喜气引起的，有笑不止、毛发枯焦、内脏病变、阳气不收摄，严重时甚至会发狂。由悲气引起的，有阴器收缩，气并聚于肺导致肝木受邪，金气太过则肺也自病。恐惧伤肾，肾属水，恐惧使气并聚于肾导致心火受邪，水气太过则肾也自病。思虑伤脾，脾属土，思虑使气并聚于脾导致肾水受邪，土气太过则脾也自病。寒邪伤形体，形体属阴，寒胜热则阳受病，寒邪太盛则阴也自病。热邪伤气，气属阳，热胜寒则阴受病，热邪太盛则阳也自病。以上几种情况，可以互相治疗，所以可以用悲伤来治疗怒气，用凄惨苦楚的话语去感动他；可以用喜悦来治疗悲伤，用戏谑轻浮的话语去娱乐他；可以用恐惧来治疗喜悦，用紧迫死亡的话语去恐吓他；可以用愤怒来治疗思虑，用污辱欺骗的话语去触动他；可以用思虑来治疗恐惧，用谋划此事彼事的话语去转移他的注意力。这五种方法，必须使用诡诈奇特的手段，才能打动人的耳目，改变人的视听。如果胸中没有才识的人，也不能运用这种方法。
朱丹溪说：冷气、滞气、逆气，都是肺受到火邪的影响，气具有炎上的特性，只有上升没有下降，熏蒸清道，严重时转为重病。《局方》类方剂多用辛香燥热的药物以火助火，这罪责归于谁呢？说气病不能用补法，这是世俗的说法。因为气病表现为痞满闷塞，似乎难以进补。但不想正气虚弱者不能营运，邪气滞留而出不去，所以才生病。医经说：“壮年人气行则病愈，体弱者气滞着而成病。”如果气怯弱，不用补法，气怎么能运行呢？气属于阳，没有寒冷的道理。上升的气，感觉恶寒的，是亢盛为害，需要制约它。气有余，就是火。自觉冷气从下而上，并非真正的冷。因为上升的气，发自肝脏，中间夹带相火，自下而上，肾热尤为严重，火极似水，这是阳亢阴微的表现。
喻嘉言说：人体肌肉丰盛，是血液荣旺的表现，是非常好的事情。但血旺容易导致气衰，时间久了更加觉得偏颇。气和血，相互维系依附，为什么会有偏旺的情况呢？大概气为主则血流顺畅，血为主则气反而不流动，这并不是真气的衰弱，而是气不流动看起来像衰弱罢了。所以一切补气药都不宜使用，而耗气药反而可以使用。因为气得到补益会更加固滞，不如耗散它以助其流动之势，久而久之血液仍会回归统摄之中。
七气所致疾病，《三因方》论述最详细。喜、怒、忧、思、悲、恐、惊，称为七气所伤。症状如有少量痰在咽喉间，像棉絮一样，咳不出，咽不下，都适宜用四七汤研末，炼蜜和姜汁做成丸药含化。以及《局方》乌沉汤、各种七气汤，根据虚实选用。盛怒成疾，面色青黄，或两胁胀满，可用沉香降气散、木香调气散，或四七汤加枳壳、木香，虚证加人参、石菖蒲。肥胖人气滞，必有痰，用二陈汤、苍术、香附，燥湿以开通之。瘦人气滞，必有火且燥，宜用苏子、山栀、当归、芍药、丹皮，降火以润之。老人胸膈气滞，痞满不适，或作痛，或不能进食，脉虽数实滑大，当作虚证治疗，千万不可用耗气药，宜用理中丸，或六君子汤加木香、砂仁之类。气不归源，以补骨脂为主药，白术、沉香辅助。一切冷气，及妇人血气攻冲，心腹撮痛，用《局方》乌沉汤最快捷。妇人性情执拗多偏属阴，气易于动，如痞闷胀痛，上凑心胸，或攻筑胁肋，腹中结块，月经不调，或眩晕呕吐，往来寒热，一切气病，先用加味逍遥散，或苏子降气、沉香降气、四磨、六磨汤选用。气从左边起的，是肝火。气刺痛，都属火，应在降火药中加枳壳。气郁不舒而痛的，用木香调气散。忧而痰郁，用导痰汤加香附、乌药。因死血而痛的，用桃仁、红花、归头。食积寒痰流入胁下背膂刺痛，诸药无效的，用神保丸。久患气结，诸药不开的，先服沉香化气丸三五服以开其结，后用六君子汤送服降气散调理。暴怒气厥，不省人事的，用苏合香丸灌服。诸气为患，须分暴病久病。暴怒伤阴，阳气独亢，气厥不省的，可用辛香破气以通阴闭。若久抱抑郁，气不宣通，营卫不和的，又当辛温散结以调营卫，这才合适。
枳壳利肺气，多服损伤胸中至高之气。青皮泻肝气，多服能损真气。木香调诸经气兼泻肺，能使上焦之气下达，阴火上冲禁用。砂仁醒脾气而能上升，然后滞气得以下通。白豆蔻能温肺气而使下行，然后阳气得以上达。香附快滞气，陈皮泄逆气。乌药、紫苏、川芎俱能散气，使浊气从汗散出。浓朴泻胃气，前胡下气推陈，槟榔泻至高之气能使浊气下坠，后重有积者适宜。藿香的馨香，上行胃气。沉香升降诸气。脑麝散真气。苏子、杏仁下气润燥，气滞有火者适宜。豆蔻、丁香、沉香、檀香、麝香俱辛热，能散郁气，暴郁者适宜，稍久成火者忌用。禀赋强壮气实，气不顺而刺痛，当用枳壳、乌药，无效加木香。若肥人气刺痛，用二陈汤加浓朴、枳壳。气虚脉微弱者，即当用异功散加枳壳、木香。
石顽说：世人都说气无补法，《局方》三因七气、四磨、六磨等方，其中都用人参，难道没有助气为患吗？古人立方用参，并不全是为了补益而设。如《局方》七气汤，原以肉桂、半夏为主，而借人参引入气分以散气，哪里是用补的意思呢？至于三因七气汤，纯是辛散，即使只用一味人参，也只是随诸药建行气之功，不致伤气足矣，哪有空闲逞其补性呢？至于四磨、六磨汤，不过是赖以资应敌之需，尚恐不及，怎能指望其补益呢？
【诊法】下手切脉，脉沉便知是气病。或者脉沉滑，是气兼痰饮。脉沉极则伏，涩弱难治，都是由大气郁滞不舒，所以脉显沉伏。大都脉沉实有力，则宜辛散；脉沉弱少力，则宜温养。气主煦之，总不离乎辛温散结。
汪石山治疗一位寡妇，四十多岁，患走气遍身疼痛，有时背部胀痛，有时胁肋插痛，有时一月发作两三次，发作时吐尽所吃食物才舒服，饮食不进，长期卧床。曾用流气饮、二陈汤，病情加重。汪石山诊察，脉皆细微而数，右脉尤其弱，说：这是忧思伤脾而气郁。应当补脾散郁，用人参三钱，黄芪二钱，当归身一钱半，川芎八分，香附、黄连、甘草、干姜、砂仁各五分。服用数剂后稍缓，再用参、芪、川芎、香附、山栀、甘草、神曲糊丸服用而痊愈。
飞畴治疗一位妇女，平素虚火易于上升，因为有怒气不得发泄，导致中满食减，作酸嗳气，头面手足时冷时热，少腹不时酸痛，月经半年多不来。其脉模糊，快而无力，服用各种破气降气行血药无效。不知这是蕴怒伤肝，肝火乘虚而克脾土，脾受克则胸中之大气不布，随肝火散漫肢体。应当知道气从湿腾，湿由火燥，惟太阳当空，则阴霾之气自散，真火令行，则郁蒸之气自伏。又如同釜底得火则能腐熟水谷，水谷运则脾胃有权，大气得归而诸证可愈。因此用生料八味丸倍加桂枝、附子，十日而头面手足之冷热除，间用异功散而中宽食进。如此出入调理，两个月经行而痊愈。
Sha Yuantai said: The medical classics state that all pain is caused by Qi (vital energy) dysfunction, and a hundred diseases arise from Qi. Zhang Hezi said: The normal Qi of heaven and earth brings peace in its constant state, but disturbance arises when it changes. Humans align with the Qi of heaven and earth; if the Five Movements and Six Qi invade from outside, and the Seven Emotions clash within, then sages cherish Qi as if it were a supreme treasure, while ordinary people exploit external things and thereby damage the internal Taihe (Great Harmony) Qi. This is what Xuanyuan (Yellow Emperor) and Qibo referred to when they said, "All pain is due to Qi, and all diseases arise from Qi," leading to the theory of nine different types of Qi movements. Qi is fundamentally one, but becomes nine due to different stimuli: anger, joy, sorrow, fear, cold, heat, fright, thought, and fatigue.
Generally, anger causes Qi to ascend; severe anger leads to rebellious Qi, which may result in hematemesis or undigested food diarrhea, representing Qi ascending. Joy causes Qi to relax; joy brings harmony to Qi and the mind, allowing Ying (nutritive) and Wei (defensive) Qi to flow freely, thus relaxing Qi. Sorrow causes Qi to dissipate; sorrow tightens the Heart vessels and expands the lungs, blocking the Upper Jiao (Upper Burner), preventing Ying and Wei Qi from dispersing, causing heat to stagnate in the middle, thus dissipating Qi. Fear causes Qi to sink; fear causes Essence to retreat, closing the Upper Jiao, causing Qi to return and distend the Lower Jiao, thus impeding Qi descent. Cold causes Qi to contract; cold closes the interstices (pores), obstructing Qi movement, thus contracting Qi. Heat causes Qi to leak; heat opens the interstices, allowing Ying and Wei Qi to flow freely with profuse sweating, thus leaking Qi. Fright causes Qi to become chaotic; fright leaves the Heart without support, the Spirit without refuge, and thoughts without focus, thus chaotic Qi. Fatigue causes Qi to consume; fatigue leads to panting and sweating, with internal and external Qi escaping, thus consuming Qi. Thought causes Qi to knot; thought fixes the mind on one object, causing Zheng Qi (Upright Qi) to remain stagnant, thus knotting Qi.
I have examined the details of diseases caused by these Qi disturbances, which are diverse. For instance, anger can cause hematemesis, undigested food diarrhea, Jian Jue (Frying Syncope), Bo Jue (Thinning Syncope), Yang Jue (Yang Syncope), chest fullness, and hypochondriac pain. Because Qi rebels and cannot descend, it causes wheezing, thirst, and vexation, potentially developing into Xiao Dan (wasting-thirst), Fei Qi (abdominal mass), sudden blindness, sudden deafness, flaccid tendons, or carbuncles and sores on the exterior. Joy can cause incessant laughter, dry and brittle hair, internal disease, failure of Yang Qi to secure, and even mania in severe cases. Sorrow can cause retraction of the genitals; Qi gathers in the Lung, damaging Liver Wood; excessive Metal damages the Lung itself. Fear damages the Kidney (Water); Qi gathers in the Kidney, damaging Heart Fire; excessive Water damages the Kidney itself. Thought damages the Spleen (Earth); Qi gathers in the Spleen, damaging Kidney Water; excessive Earth damages the Spleen itself. Cold damages the Form (Yin); if Cold overcomes Heat, Yang is diseased, and excessive Cold damages Yin. Heat damages Qi (Yang); if Heat overcomes Cold, Yin is diseased, and excessive Heat damages Yang. These factors can treat each other; thus, sorrow can treat anger by evoking pity; joy can treat sorrow by entertaining with playful words; fear can treat joy by frightening with talk of death; anger can treat thought by provoking with insults; thought can treat fear by distracting with planning. These five methods require cunning and unusual tactics to move the senses. Only those with talent and insight can use them.
Zhu Danxi said: Cold Qi, stagnant Qi, and rebellious Qi are all caused by the Lung suffering from Fire pathogenic factors. Qi has the nature of flaming upward, rising without descending, steaming the clear passages, and potentially becoming severe illness. The *Ju Fang* (Standard Prescriptions) often uses acrid, aromatic, drying, and hot herbs to add fire to fire; who bears the blame? Saying Qi disorders cannot be treated with tonification is a secular view. Although Qi disorders present with fullness and blockage, seemingly difficult to tonify, one must consider that deficiency of Zheng Qi prevents circulation, allowing pathogenic stagnation to persist. The classics say: "In the strong, Qi moves and the disease resolves; in the weak, Qi stagnates and disease forms." If Qi is weak, without tonification, how can it move? Qi belongs to Yang and does not inherently involve cold. The sensation of cold accompanying ascending Qi is due to hyperactivity causing harm, requiring control. Excess Qi becomes Fire. The sensation of cold rising from below is not true cold but rather Qi originating from the Liver, carrying Ministerial Fire, with severe Kidney heat; extreme Fire resembles Water, indicating Hyperactive Yang and Deficient Yin.
Yu Jiayan said: Abundant muscle indicates flourishing Blood, which is excellent. However, flourishing Blood can lead to Qi decline over time, creating imbalance. Qi and Blood sustain each other; why the imbalance? When Qi dominates, Blood flows; when Blood dominates, Qi fails to flow. This is not true Qi deficiency but apparent deficiency due to stagnation. Therefore, Qi-tonifying herbs should be avoided, while Qi-consuming herbs may be used. Tonifying Qi makes it more stagnant; consuming Qi aids its flow, eventually restoring Blood's regulation.
The *San Yin Fang* discusses diseases caused by the Seven Qi most extensively. Joy, anger, worry, thought, sorrow, fear, and fright are the Seven Qi injuries. Symptoms include phlegm stuck in the throat like cotton, impossible to cough up or swallow. Siqi Tang (Four Qi Decoction) powder mixed with honey and ginger juice for lozenges is suitable, along with Wuchen Tang (Black Sink Decoction) and various Seven Qi Decoctions from *Ju Fang*, selected based on excess or deficiency. Severe anger causing disease presents with blue-yellow complexion or hypochondriac distension; Chenxiang Jiangqi San (Aucklandia Descending Qi Powder), Muxiang Tiaoqi San (Costus Regulating Qi Powder), or Siqi Tang plus Zhike (Bitter Orange) and Muxiang are used, adding Renshen (Ginseng) and Shichangpu (Acorus) for deficiency. Phlegm-stagnation in obese individuals requires Erchen Tang (Two-Cured Decoction), Cangzhu (Atractylodes), and Xiangfu (Cyperus) to dry and open. Stagnation-fire-dryness in thin individuals requires Su Zi (Perilla Seed), Shanzhi (Gardenia), Danggui (Angelica), Shaoyao (Peony), and Danpi (Moutan) to descend and moisten. Elderly chest-diaphragm Qi stagnation with fullness, pain, or anorexia, even with rapid/slippery/large pulses, should be treated as deficiency; avoid Qi-consuming herbs. Lizhong Wan (Regulate the Middle Pill) or Liujunzi Tang (Six Gentlemen Decoction) plus Muxiang and Sharen is appropriate. For Qi failing to return to its source, Buguzhi (Psoralea) is primary, assisted by Baizhu (Atractylodes) and Chenxiang (Agarwood). For all cold Qi and women's Blood-Qi attacking heart/abdomen pain, Wuchen Tang is fastest. Women, being Yin-predominant and emotionally volatile, may experience chest oppression, flank pain, abdominal masses, irregular menstruation, dizziness, vomiting, or alternating chills/fever. Use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Su Zi Jiangqi, Chenxiang Jiangqi, Simo, or Limo Decoctions. Qi rising from the left indicates Liver Fire; stabbing pain indicates Fire, requiring Zhike in fire-descending formulas. Qi depression pain uses Muxiang Tiaoqi San. Worry-phlegm stagnation uses Daotan Tang (Phlegm-Expelling Decoction) plus Xiangfu and Wuyao. Blood stasis pain uses Taoren (Peach Kernel), Honghua (Safflower), and Guitou (Angelica Head). Food accumulation/cold-phlegm stabbing in flanks/back resistant to treatment uses Shenbao Wan. Chronic Qi knots unresponsive to herbs first take Chenxiang Huaqi Wan to open, followed by Liujunzi Tang delivering Jiangqi San. Sudden anger syncope with unconsciousness requires Suhexiang Wan (Styrax Pill). Acute vs. chronic Qi disorders differ: acute anger injuring Yin with hyperactive Yang syncope needs acrid-aromatic Qi-breaking herbs to open Yin closure. Chronic depression with non-circulating Qi and disharmonious Ying/Wei needs acrid-warm knot-resolving herbs to harmonize Ying/Wei.
Zhike benefits Lung Qi but damages high Chest Qi if overdosed. Qingpi clears Liver Qi but damages True Qi if overdosed. Muxiang regulates meridians and clears Lung, directing Upper Jiao Qi downward; contraindicated for Minsterial Fire rushing up. Sharen awakens Spleen Qi and ascends, allowing stagnant Qi to descend. Baidoukouwarms Lung Qi and descends, allowing Yang Qi to ascend. Xiangfu relieves stagnant Qi; Chenpi drains rebellious Qi. Wuyao, Zisu, and Chuanxiong scatter Qi, releasing turbidity via sweat. Houpo drains Stomach Qi; Qianhu pushes down old Qi; Binglang drains high Qi and drops turbidity, suitable for tenesmus with accumulation. Huoxiang's fragrance ascends Stomach Qi. Chenxiang regulates ascending/descending Qi. Nao She (Camphor/Musk) scatters True Qi. Su Zi and Xingren descend Qi and moisten dryness, suitable for stagnation-fire. Doukou, Dingchen, Tan, and She are acrid-hot, scattering depression-qi, suitable for acute depression but contraindicated for prolonged heat. Strong constitution with Qi stagnation/stabbing pain uses Zhike and Wuyao, adding Muxiang if ineffective. Obese Qi-stabbing uses Erchen Tang plus Houpo and Zhike. Qi-deficiency with weak pulse uses Yigong San plus Zhike and Muxiang.
Shiwan said: The world claims Qi disorders cannot be tonified, yet *Ju Fang* prescriptions like San Yin Seven Qi, Simo, and Limo contain Renshen. Does this not aid Qi pathology? Ancients used Ginseng not solely for tonification. In Ju Fang Seven Qi, Gui (Cinnamon) and Banxia (Pinellia) are primary; Ginseng guides Qi to disperse stagnation, not for tonification. In San Yin Seven Qi, purely acrid-dispersing, one dose of Ginseng merely assists Qi-moving herbs without harming Qi. Simo/Limo rely on Ginseng for endurance, not tonification.
[Diagnosis] A deep pulse indicates Qi disorder. Deep-slippery indicates Qi with Phlegm-Fluid. Extreme deep implies hidden pulse; choppy/weak is hard to treat, caused by Great Qi stagnation. Generally, deep-solid-strong pulses suit acrid-dispersion; deep-weak pulses suit warming-nourishment. Qi warms; treatment always involves acrid-warm knot-resolving.
Wang Shishan treated a widow, 40+, with wandering Qi body pain, back/hypochondriac distension/pain, recurring monthly, relieved by vomiting food, anorexia, bedridden. Liuiqi Yin and Erchen Tang worsened it. Pulse was fine, rapid, weak right side. Diagnosis: Worry/thought damaged Spleen, Qi depressed. Treatment: Tonify Spleen, scatter depression. Renshen 3 qian, Huangqi 2 qian, Danggui 1.5 qian, Chuanxiong 0.8 qian, Xiangfu, Huanglian, Gancao, Ganjiang, Sharen 0.5 qian each. After relief, pills of Renshen, Huangqi, Chuanxiong, Xiangfu, Shanzhi, Gancao, Shenqu cured her.
Feichou treated a woman with rising deficient fire, suppressed anger causing epigastric fullness, reduced appetite, acid belching, alternating cold/heat in head/extremities, lower abdominal pain, amenorrhea >6 months. Pulse vague, rapid, weak. Qi-breaking/blood-moving herbs failed. Diagnosis: Suppressed anger injured Liver; Liver Fire attacked Spleen Earth; Central Qi failed to distribute, dispersing with Liver Fire. Qi rises from dampness; dampness dries from fire. Sun dispels yin-mists; True Fire settles steaming. Pot on fire cooks food; digestion empowers Spleen/Stomach; Central Qi returns, symptoms resolve. Treatment: Shengliao Bawei Wan doubled with Guizhi and Fuzi. Cold/heat resolved in 10 days. Intermittent Yigong San improved appetite. Regulation led to menstruation and cure.