(景岳) 此益火之剂也。凡命门之阳衰阴胜者,宜此方加减主之。如治阴盛格阳,真
寒假热等证,宜加泽泻二钱煎成,用凉水浸冷服之,尤妙。
熟地(三四钱或加至一二两) 山药(炒) 杜仲(姜制) 枸杞(二钱炙) 甘草(一二
钱) 肉桂(一二钱) 制附子(一二三钱) 萸肉(一钱) 水二盏,煎七分,食远服。
如气虚血脱,或厥或昏,或汗或晕,或虚狂,或短气者,必大加人参白术,随宜用之。如小
腹多痛,加吴茱萸六七分。如火衰不能生土,为呕哕吞酸者,加炮姜二三钱。如阳衰中寒,
泄泻腹痛,加人参肉豆蔻,随宜用之。如淋带不止,加破故纸一钱。如血少血滞,腰膝软痛
者,加当归二三钱。
(仲阳) 治肝肾不足,真阴亏损,精血枯竭,憔悴羸弱,腰痛足酸,自汗盗汗,水泛
为痰,(丹溪曰∶久病阴火上升,津液生痰不生血,宜补血以制相火,其痰自除。)发热咳嗽,
(肾虚则移热于肺而咳嗽,按之至骨,其热烙手,骨困不任为肾热。)头晕目眩,(直指方云∶
淫欲过度,肾气不能归元,此气虚头晕也。吐衄崩漏,肝不摄血,致血妄行,此血虚头晕也。)
耳鸣耳聋,遗精便血,消渴淋沥,失血失音,舌燥喉痛,虚火牙痛,足跟作痛,下部疮疡等
证。(诸证皆由肾水不足,虚火上炎所致。)
熟地(八两) 山茱肉(酒润) 山药(四两) 茯苓(乳拌) 丹皮 泽泻(三两) 上
丸法如前,
肾中水虚不能制火者,此方主之。今人足心热,阴股热,腰脊痛,率是此证,乃咳血之
渐也。熟地滋阴补肾,生血生精,山萸温肝逐风,涩精秘气;牡丹泻君相之伏火,凉血退蒸。
(时珍曰∶伏火,即阴火也。阴火,即相火也。世人专以黄柏治相火,不知丹皮之功更胜,
丹皮能入肾泻阴火,退无汗之骨蒸。)山药清虚热于肺脾,补脾固肾。(能涩精。)茯苓渗脾
中湿热,而通肾交心。泽泻泻膀胱水邪,而聪耳明目。壮水之主,以制阳光,即此方也。
加黄柏知母各二两,名知柏八味丸。治阴虚火动,骨痿髓枯,(因下焦湿火,)尺脉旺者
宜之。加桂一两,名七味地黄丸。引无根之火,降而归元。治肝经气虚,筋无所养,变为寒
证,以致筋骨疼痛,脚软懒行。及伤寒服凉药过多,木中无火,手足牵引。肝经血虚,以致
火燥筋挛,变为结核瘰 等证。经曰∶辛以润之,此方是也。加五味,名都气丸,治劳嗽。
(益肺之源。以生肾水也。)加肉桂一两,五味二两。名加减八味丸。治肾水不足,虚火上
炎,发热作渴,口舌生疮,或牙龈溃烂,咽喉作痛,或形体憔悴,寝汗发热,五脏齐损。加
五味二两,麦冬三两,名八仙长寿丸,治虚损劳热。加杜仲炒(姜牛)膝(洗酒)各二两,
治肾虚腰膝酸痛。去泽泻,加益智仁三两,(盐酒炒)治小便频数。(益智辛热,涩精固气。)
用熟地二两。山药山萸丹皮归尾五味柴胡各五钱,茯神泽泻各二钱半,蜜丸,朱砂为衣,名
益阴肾气丸,(即明目地黄丸。东垣。)治肾虚目昏。(加柴胡者。所以升阳于上也。)加柴胡
五味白术当归甘草,名滋肾生肝饮,治血虚气滞。或肩背绊痛,或胃脘当心而痛,或肝火郁
与胃中,以致倦怠嗜卧,饮食不思,口渴咽燥,及妇人小便自遗,频数无度。凡伤寒后,热
已退而见口渴者用之。薛氏用治妇女郁怒伤肝脾,以致小便淋沥不利,月经不调,两肋胀闷,
小腹作痛,寒热往来,胸乳作痛,左关弦洪,右关弦数。此郁怒伤肝脾,血虚气滞为患。(高
鼓峰曰∶六味丸,薛氏一变而为滋肾生肝饮,用六味减半分两。而加柴胡五味白术当归甘草,
合
生金以制木也。以制为生,天地自然之序也。)去山萸,而加柴胡归尾生地五味,辰砂为衣
,名滋阴肾气丸。治目神水宽大渐散,或如雾露中行,渐观空中有黑花,视物二体,久则光
不收,及内障。神水淡白色。(高鼓峰曰∶又一变而为滋阴肾气丸,独去山茱萸,而加柴胡
归尾生地五味,仍合逍遥都气,肾肝同治。用归尾生地者,行瘀滞也,柴胡疏木气也,去芍
药,恐妨于行之疏之也。名滋阴者,厥阴也。皆用五味者,虽合都气,然实防木之反克,泻
丁之义也。去山茱萸,不欲强木也。)去泽泻,而用参 归术陈皮甘草五味麦冬,名人参补
气汤。治肾水不足,虚火上炎,咳嗽脓血,发热作渴,小便不调等证。(高鼓峰曰∶又一变
而为人参补气汤,其义愈变化无穷,真有游龙戏海之妙。夫白术之与六味,其功相反,焉得
合之。曰∶从合生脉来,则有自然相通之义。借茯苓以合五味异功之妙,用归 以合养血之
奇,其不用泽泻者,盖为发热作渴,小便不调,则无再竭之理。理无再竭,盒饭急生,生脉
之所由来,既当生脉,异功之可以转入也。且水生高原,气化能出,肺气将败,故作渴不调。
此所以急去泽泻,而生金滋水。复崇土以生金,其苦心可不知哉。)加生地柴胡五味,复等
其分,名加味地黄丸,又名抑阴地黄丸。治肝肾阴虚,耳内痒痛出水,或眼昏痰喘,或热渴
便涩等证。(高鼓峰曰∶又一变而为加味地黄丸,真愈出而愈奇矣。柴胡从逍遥来,生地从
固本来,五味仍合都气。其曰耳内痒痛出水,或眼昏痰喘,或热渴便涩,而总为肝肾阴虚,
则知阴虚半由火郁而致也,故用柴胡以疏之。郁火非生地不能凉,故用生地。用五味,仍泻
丁以补金,补金以生水也。曰抑阴,为郁火太盛,非疏之不可,疏之所以抑之。生地凉血,
便有泻义,泻之所以抑之也。)加五味生地当归,名抑阴肾气丸。治诸脏亏损,胸膈痞闷,
发热,潮热,晡热,或寒热往来,五心烦热。或口干作渴,月经不调,或筋骨酸倦,饮食少
思。或头目不清,痰气上壅,咳嗽晡甚。或小便赤数,两足热痛,或腰膝痿软,肢体作痛等
证。去泽泻,加川楝子当归使君子川芎,以赤茯苓换白茯苓,名九味地黄丸,治肾疳。加柴
胡芍药,名疏肝益肾汤。治胃脘痛而大便燥结者,此肝血虚也,逍遥散所不俞者,此方妙。
加当归芍药柴胡枣仁山栀,名滋水清肝饮。治胃脘燥痛,气逆左肋上,呕吐酸水,忽热忽止
等证。
(张景岳)这是补益命门真火的方剂。凡是命门阳气衰弱、阴寒偏盛的病症,适宜用此方加减治疗。例如治疗阴寒内盛格拒阳气、真寒假热等证候,宜在煎成后加入泽泻二钱,用凉水浸冷后服用,效果尤为奇妙。
熟地黄(三四钱,或加至一二两) 山药(炒制) 杜仲(姜汁制) 枸杞子(二钱,炙) 甘草(一二钱) 肉桂(一二钱) 制附子(一二三钱) 山茱萸(一钱) 水两盏,煎至七分,饭后服用。
如果是气虚血脱,或者出现四肢厥冷、昏迷、出汗、眩晕、虚性狂躁、短气等症状的,必须大量加入人参、白术,根据具体情况使用。如果小腹部多痛,加入吴茱萸六七分。如果火衰不能温煦脾土,导致呕吐、呃逆、吞酸的,加入炮姜二三钱。如果阳衰中寒,出现泄泻腹痛的,加入人参、肉豆蔻,根据情况使用。如果淋浊带下不止,加入破故纸(补骨脂)一钱。如果血少血滞,腰膝酸软疼痛的,加入当归二三钱。
(钱乙/薛己引)治疗肝肾不足,真阴亏损,精血枯竭,形体憔悴瘦弱,腰痛脚酸,自汗盗汗,水液泛滥化为痰饮,(朱丹溪说:久病阴火上升,津液生痰而不生血,应当补血以制约相火,痰自然消除。)发热咳嗽,(肾虚则移热于肺而咳嗽,按之至骨,热度烫手,骨骼困倦不堪忍受,这是肾热。)头晕目眩,(《直指方》说:淫欲过度,肾气不能归元,这是气虚导致的头晕。吐衄崩漏,肝不摄血,导致血液妄行,这是血虚导致的头晕。)耳鸣耳聋,遗精便血,消渴淋沥,失血失音,舌燥喉痛,虚火牙痛,足跟作痛,下部疮疡等证候。(这些证候都是由肾水不足,虚火上炎所致。)
熟地黄(八两) 山茱萸(酒润) 山药(四两) 茯苓(乳汁拌) 牡丹皮 泽泻(三两) 以上药物制成丸药的方法如前所述。
肾中水虚不能制约火的,以此方主治。现在人足心热,大腿内侧热,腰脊痛,大都是这个证候,这是咳血的先兆。熟地黄滋阴补肾,生血生精;山茱萸温肝祛风,固涩精气;牡丹皮清泻君火和相火的伏火,凉血退蒸。(李时珍说:伏火,就是阴火。阴火,就是相火。世人专门用黄柏治疗相火,不知道牡丹皮的功效更胜一筹,牡丹皮能入肾清泻阴火,退除无汗的骨蒸。)山药清肺脾的虚热,补脾固肾。(能固涩精气。)茯苓渗利脾中的湿热,并通肾交心。泽泻泻膀胱的水邪,并使耳聪目明。“壮水之主,以制阳光”,说的就是这个方剂。
加入黄柏、知母各二两,名为知柏八味丸。治疗阴虚火动,骨痿髓枯,(因下焦湿火引起),尺脉旺盛者适宜使用。加入肉桂一两,名为七味地黄丸。引导无根之火下降回归本源。治疗肝经气虚,筋脉无所滋养,变为寒证,导致筋骨疼痛,脚软懒行。以及伤寒服用凉药过多,木中无火,手足牵引抽搐。肝经血虚,导致火燥筋挛,变为结核瘰疬等证候。《内经》说:辛以润之,这个方剂就是体现这一原理的。加入五味子,名为都气丸,治疗劳嗽。(补益肺之源,以滋生肾水。)加入肉桂一两,五味子二两,名为加减八味丸。治疗肾水不足,虚火上炎,发热口渴,口舌生疮,或牙龈溃烂,咽喉疼痛,或形体憔悴,夜间出汗发热,五脏俱损。加入五味子二两,麦冬三两,名为八仙长寿丸,治疗虚损劳热。加入炒杜仲(姜牛膝)、洗酒浸牛膝各二两,治疗肾虚腰膝酸痛。去掉泽泻,加入益智仁三两(盐酒炒),治疗小便频数。(益智仁辛热,能固涩精气。)用熟地黄二两,山药、山茱萸、牡丹皮、当归尾、五味子各五钱,茯神、泽泻各二钱半,蜜丸,朱砂为衣,名为益阴肾气丸,(即明目地黄丸,出自李东垣)。治疗肾虚目昏。(加入柴胡的原因,是为了升发阳气于上。)加入柴胡、五味子、白术、当归、甘草,名为滋肾生肝饮,治疗血虚气滞。或者肩背牵绊疼痛,或者胃脘当心而痛,或者肝火郁结与胃中,导致倦怠嗜卧,饮食不思,口渴咽燥,以及妇人小便自遗,频数无度。凡伤寒后,热已退而见口渴的用此方。薛己用它治疗妇女郁怒伤及肝脾,导致小便淋沥不利,月经不调,两肋胀闷,小腹作痛,寒热往来,胸乳作痛,左关脉弦洪,右关脉弦数。这是郁怒伤肝脾,血虚气滞为患。(高鼓峰说:六味丸,薛氏一变而为滋肾生肝饮,用六味地黄丸减半分量,而加入柴胡、五味子、白术、当归、甘草,合用意在“生金以制木”。以制为生,是天地自然的秩序。)去掉山茱萸,加入柴胡、当归尾、生地、五味子,辰砂为衣,名为滋阴肾气丸。治疗目神水宽大渐散,或像雾露中行,渐渐看空中有黑花,视物重影,久了则光不收拢,以及内障。神水淡白色。(高鼓峰说:又一变而为滋阴肾气丸,唯独去掉山茱萸,加入柴胡、当归尾、生地、五味子,仍然合用逍遥散和都气丸之意,肝肾同治。用当归尾、生地的原因,是行瘀滞;柴胡疏理肝木之气;去掉芍药,是恐怕妨碍行的疏泄作用。名为滋阴,是因为涉及厥阴。都用五味子的原因,虽然合用都气丸,但实际上是防止木反克土,有泻丁(心火)之义。去掉山茱萸,是不想强助肝木。)去掉泽泻,用人参、当归、白术、陈皮、甘草、五味子、麦冬,名为人参补气汤。治疗肾水不足,虚火上炎,咳嗽脓血,发热口渴,小便不调等证候。(高鼓峰说:又一变为人参补气汤,其义变化无穷,真有游龙戏海之妙。白术与六味地黄丸的功效相反,怎么能合用呢?回答说:从合生脉散而来,则有自然相通的意义。借茯苓来合异功散的妙处,用当归来合养血的神奇之处,它不用泽泻的原因,是因为发热口渴、小便不调,就没有再竭肾水的道理。理无再竭,盒饭急生(此处原文可能有误,应为“必当急生”),这就是生脉散由来所在。既然应当生脉,异功散就可以转入其中了。况且水生高原,气化能出,肺气将败,所以作渴不调。这就是为什么急去泽泻,而生金滋水。又崇土以生金,其中的苦心怎能不知道呢?)加入生地、柴胡、五味子,分量相等,名为加味地黄丸,又名抑阴地黄丸。治疗肝肾阴虚,耳内痒痛出水,或眼昏痰喘,或热渴便涩等证候。(高鼓峰说:又一变而为加味地黄丸,真是愈出愈奇。柴胡从逍遥散来,生地固本来,五味子仍合都气丸。所说的耳内痒痛出水,或眼昏痰喘,或热渴便涩,总归为肝肾阴虚,则知阴虚多半由火郁所致,所以用柴胡以疏解它。郁火非生地不能凉,所以用生地。用五味子,仍是泻丁补金,补金生水。称为抑阴,是因为郁火太盛,非疏解不可,疏解就是为了抑制它。生地凉血,便有泻的含义,泻就是为了抑制它。)加入五味子、生地、当归,名为抑阴肾气丸。治疗诸脏亏损,胸膈痞闷,发热,潮热,晡热,或寒热往来,五心烦热。或口干作渴,月经不调,或筋骨酸倦,饮食少思。或头目不清,痰气上壅,咳嗽傍晚加重。或小便赤数,两足热痛,或腰膝痿软,肢体作痛等证候。去掉泽泻,加入川楝子、当归、使君子、川芎,以赤茯苓换白茯苓,名为九味地黄丸,治疗肾疳。加入柴胡、芍药,名为疏肝益肾汤。治疗胃脘痛而大便燥结的,这是肝血虚,逍遥散所不及的,此方甚妙。加入当归、芍药、柴胡、枣仁、山栀,名为滋水清肝饮。治疗胃脘燥痛,气逆向左肋上,呕吐酸水,忽热忽止等证候。
(Zhang Jingyue) This is a formula for tonifying the fire of the Mingmen (Gate of Life). For conditions where the Yang Qi of the Mingmen is deficient and Yin Cold prevails, this formula should be used with modifications. For example, in treating conditions such as Yin excess repelling Yang, or true cold with false heat, it is advisable to add Ze Xie (Alisma Rhizoma) two qian after decoction, soak it in cold water until cool, and then take it; the effect is particularly excellent.
Shu Di Huang (Rehmanniae Radix Praeparata) (3-4 qian, or increased to 1-2 liang), Shan Yao (Dioscoreae Rhizoma, stir-fried), Du Zhong (Eucommiae Cortex, processed with ginger juice), Gou Qi Zi (Lycii Fructus, roasted) (2 qian), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1-2 qian), Rou Gui (Cinnamomi Cortex) (1-2 qian), Zhi Fu Zi (Aconiti Lateralis Radix Praeparata) (1-3 qian), Yu Rou (Corni Fructus) (1 qian). Add two zhan of water, decoct to obtain 0.7 zhan, take after meals.
In cases of Qi deficiency and blood collapse, or when there are symptoms such as cold extremities, coma, sweating, dizziness, manic delirium due to deficiency, or shortness of breath, Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) must be added in large amounts according to the specific situation. If there is frequent pain in the lower abdomen, add Wu Zhu Yu (Evodiae Fructus) 6-7 fen. If Fire deficiency fails to warm the Spleen Earth, leading to vomiting, hiccups, or acid regurgitation, add Pao Jiang (Zingiberis Rhizoma Praeparatum) 2-3 qian. If Yang deficiency causes middle Jiao cold, resulting in diarrhea and abdominal pain, add Ren Shen and Rou Dou Kou (Myristicae Semen) according to the situation. If there is continuous stranguria and leukorrhea, add Po Gu Zhi (Psoraleae Fructus) 1 qian. If there is blood deficiency and blood stasis causing soreness and pain in the waist and knees, add Dang Gui (Angelicae Sinensis Radix) 2-3 qian.
(Qian Yi / Xue Ji citing) Treats insufficiency of the Liver and Kidney, depletion of True Yin, exhaustion of Essence and Blood, emaciation and weakness, low back pain and sore feet, spontaneous sweating and night sweats, water overflowing to transform into phlegm, (Zhu Danxi said: In chronic illness, Yin Fire rises, fluids transform into phlegm rather than generating blood; one should nourish blood to control Minister Fire, and the phlegm will clear itself.) fever and cough, (Kidney deficiency transfers heat to the Lung causing cough; pressing to the bone reveals heat that burns the hand, and skeletal fatigue indicates Kidney heat.) dizziness and vertigo, (*Zhizhi Fang* states: Excessive sexual indulgence prevents Kidney Qi from returning to its root, causing Qi-deficiency dizziness. Hematemesis, epistaxis, metrorrhagia, where the Liver fails to contain blood, causing reckless blood movement, results in blood-deficiency dizziness.) tinnitus and deafness, spermatorrhea and hematochezia, Xiao Ke (wasting-thirst) and stranguria, loss of voice due to bleeding, dry tongue and sore throat, toothache due to deficient fire, heel pain, sores and ulcers in the lower body, and other syndromes. (All these syndromes are caused by insufficient Kidney Water and rising deficient fire.)
Shu Di Huang (8 liang), Shan Zhu Yu (Corni Fructus, moistened with wine), Shan Yao (4 liang), Fu Ling (Poria, mixed with milk), Mu Dan Pi (Moutan Cortex), Ze Xie (Alismatis Rhizoma) (3 liang). Prepare pills as described previously.
When Kidney Water is deficient and cannot control Fire, this formula is indicated. Nowadays, people often experience heat in the soles of the feet, heat in the medial thigh, and pain in the lumbar spine; these are mostly this syndrome, which is a precursor to hemoptysis. Shu Di Huang nourishes Yin and tonifies the Kidney, generates blood and essence; Shan Zhu Yu warms the Liver and expels wind, secures essence and consolidates Qi; Mu Dan Pi clears latent fire of the Sovereign and Minister, cools blood and reduces steaming bone sensation. (Li Shizhen said: Latent fire is Yin Fire. Yin Fire is Minister Fire. People usually use Huang Bo (Phellodendri Cortex) to treat Minister Fire, not knowing that Mu Dan Pi is more effective; Mu Dan Pi enters the Kidney to drain Yin Fire and reduce wuxiang (bone-steaming without sweat).) Shan Yao clears deficient heat in the Lung and Spleen, tonifies the Spleen and consolidates the Kidney. (It can secure essence.) Fu Ling leaches damp-heat from the Spleen and connects the Kidney with the Heart. Ze Xie drains water pathogens from the Bladder and improves hearing and vision. "Strengthen the master of Water to control the sunlight" refers to this formula.
Add Huang Bo (Phellodendri Cortex) and Zhi Mu (Anemarrhenae Rhizoma) each 2 liang, named Zhi Bai Ba Wei Wan. It treats Yin deficiency with hyperactive fire, bone atrophy and marrow exhaustion (due to damp-heat in the Lower Jiao), suitable for those with a vigorous Chi pulse. Add Rou Gui 1 liang, named Qi Wei Di Huang Wan. It guides rootless fire down to return to its origin. It treats Liver channel Qi deficiency where sinews lack nourishment, transforming into cold syndromes causing joint and bone pain, weak legs and reluctance to walk. It also treats cases where excessive use of cooling medicines in Shang Han (Cold Damage) depletes Fire in Wood, causing twitching of hands and feet. Or Liver blood deficiency causing fire-dryness and sinew contraction, transforming into tubercles and scrofula. The *Classic* says: "Acrid flavors moisten"; this formula embodies this principle. Add Wu Wei Zi (Schisandrae Fructus), named Du Qi Wan, treating laborious cough. (Tonifies the source of the Lung to generate Kidney Water.) Add Rou Gui 1 liang and Wu Wei Zi 2 liang, named Jia Jian Ba Wei Wan. It treats insufficient Kidney Water with rising deficient fire, fever and thirst, sores on the mouth and tongue, or ulcerated gums, sore throat, emaciation, night sweats with fever, and damage to all five Zang organs. Add Wu Wei Zi 2 liang and Mai Dong (Ophiopogonis Radix) 3 liang, named Ba Xian Chang Shou Wan, treating consumptive febrile disease. Add Chao Du Zhong (processed Eucommiae Cortex) and Niu Xi (Achyranthis Bidentatae Radix, washed and soaked in wine) each 2 liang, treating Kidney deficiency with soreness and pain in the waist and knees. Remove Ze Xie, add Yi Zhi Ren (Alpiniae Oxyphyllae Fructus) 3 liang (stir-fried with salted wine), treating frequent urination. (Yi Zhi Ren is acrid and hot, securing essence and consolidating Qi.) Use Shu Di Huang 2 liang, Shan Yao, Shan Zhu Yu, Mu Dan Pi, Dang Gui Wei (tail of Angelicae Sinensis Radix), Wu Wei Zi each 5 qian, Fu Shen (Poria with Hostwood) and Ze Xie each 2.5 qian, honey-pilled, coated with Cinnabar, named Yi Yin Shen Qi Wan (also known as Ming Mu Di Huang Wan, from Li Dongyuan). It treats Kidney deficiency causing blurred vision. (Chai Hu is added to raise Yang Qi upward.) Add Chai Hu (Bupleuri Radix), Wu Wei Zi, Bai Zhu, Dang Gui, and Gan Cao, named Zi Shen Sheng Gan Yin, treating blood deficiency and Qi stagnation. It treats shoulder and back stiffness and pain, epigastric pain below the heart, or Liver fire constrained within the Stomach causing lethargy, preference for lying down, poor appetite, dry mouth and throat, and women's urinary incontinence with frequent, uncontrolled urination. It is used when thirst appears after the fever has subsided following Shang Han. Xue Ji used it to treat women whose Liver and Spleen were injured by depression and anger, causing difficult and scanty urination, irregular menstruation, distension and fullness in the hypochondrium, lower abdominal pain, alternating chills and fever, chest and breast pain, a wiry and surging Left Guan pulse, and a wiry and rapid Right Guan pulse. This is pathology due to depression and anger injuring the Liver and Spleen, resulting in blood deficiency and Qi stagnation. (Gao Gugeng said: Liu Wei Di Huang Wan, transformed by Xue Ji into Zi Shen Sheng Gan Yin, uses half the dosage of Liu Wei Di Huang Wan plus Chai Hu, Wu Wei Zi, Bai Zhu, Dang Gui, and Gan Cao, combining to "generate Metal to control Wood." Controlling is generating, the natural order of Heaven and Earth.) Remove Shan Zhu Yu, add Chai Hu, Dang Gui Wei, Sheng Di Huang (Rehmanniae Radix), and Wu Wei Zi, coated with Chen Sha (Cinnabar), named Zi Yin Shen Qi Wan. It treats widening and scattering of the Shen Shui (spiritual water of the eye), visual disturbances like walking in fog, seeing black spots in the air, diplopia, eventual failure of light convergence, and internal cataracts. The Shen Shui is pale white. (Gao Gugeng said: Another transformation is Zi Yin Shen Qi Wan, uniquely removing Shan Zhu Yu and adding Chai Hu, Dang Gui Wei, Sheng Di Huang, and Wu Wei Zi, still combining principles of Xiao Yao San and Du Qi Wan, treating Liver and Kidney together. Dang Gui Wei and Sheng Di Huang are used to move stasis; Chai Hu soothes Liver Qi; Shao Yao is removed to avoid hindering the dispersing action. Named Zi Yin because it involves Jue Yin. All use Wu Wei Zi to prevent Wood from counter-attacking Earth, having the meaning of draining Ding (Heart Fire). Removing Shan Zhu Yu avoids strengthening Wood excessively.) Remove Ze Xie, use Ren Shen, Dang Gui, Bai Zhu, Chen Pi (Citri Reticulatae Pericarpium), Gan Cao, Wu Wei Zi, and Mai Dong, named Ren Shen Bu Qi Tang. It treats insufficient Kidney Water with rising deficient fire, cough with purulent blood, fever and thirst, and abnormal urination. (Gao Gugeng said: Another transformation into Ren Shen Bu Qi Tang shows infinite variation, truly like a swimming dragon playing in the sea. Bai Zhu and Liu Wei Di Huang Wan have contrary effects, how can they be combined? The answer is: Derived from He Sheng Mai San, there is a natural connection. Using Fu Ling combines the wonder of Yi Gong San; using Dang Gui combines the miracle of nourishing blood. It does not use Ze Xie because fever, thirst, and abnormal urination imply no reason to further exhaust the Kidneys. Since there is no reason to exhaust, one must urgently generate; this is the origin of Sheng Mai San. Since Sheng Mai is needed, Yi Gong San can be incorporated. Moreover, Water generates the High Source (Lung), Qi transformation emerges; if Lung Qi is failing, thirst and abnormal urination occur. Thus, Ze Xie is urgently removed to generate Metal and nourish Water. Then Earth is fortified to generate Metal; how could one not know this painstaking effort?) Add Sheng Di Huang, Chai Hu, and Wu Wei Zi in equal parts, named Jia Wei Di Huang Wan, also known as Yi Yin Di Huang Wan. It treats Liver-Kidney Yin deficiency with itchy and painful ears discharging fluid, blurry vision with phlegm and panting, or fever with thirst and difficult urination. (Gao Gugeng said: Another transformation into Jia Wei Di Huang Wan is truly increasingly miraculous. Chai Hu comes from Xiao Yao San, Sheng Di Huang solidifies the root, Wu Wei Zi still combines with Du Qi Wan. The symptoms of ear itch/pain/discharge, blurry vision/phlegm-panting, or fever/thirst/difficult urination all point to Liver-Kidney Yin deficiency, indicating that Yin deficiency is partly caused by Fire constraint. Thus, Chai Hu is used to disperse it. Constrained Fire cannot be cooled without Sheng Di Huang, hence its use. Wu Wei Zi is used to drain Ding and tonify Metal, tonifying Metal to generate Water. Called Yi Yin because constrained Fire is too strong and must be dispersed; dispersion is the method of inhibition. Sheng Di Huang cools blood, having a draining meaning, and draining is the method of inhibition.) Add Wu Wei Zi, Sheng Di Huang, and Dang Gui, named Yi Yin Shen Qi Wan. It treats deficiency of all Zang organs, chest and diaphragm stuffiness, fever, tidal fever, afternoon fever, or alternating chills and fever, five-palm heat. Or dry mouth with thirst, irregular menstruation, soreness and fatigue of bones and sinews, poor appetite. Or unclear head and eyes, phlegm-Qi obstructing upwards, cough worse in the evening. Or red and frequent urination, hot and painful feet, weak and soft waist and knees, body pain, and other syndromes. Remove Ze Xie, add Chuan Lian Zi (Toosendan Fructus), Dang Gui, Shi Jun Zi (Quisqualis Fructus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), replacing Bai Fu Ling with Chi Fu Ling (Poria with Red Sandalwood), named Jiu Wei Di Huang Wan, treating Kidney Gan (pediatric malnutrition due to parasitic infection). Add Chai Hu and Shao Yao, named Shu Gan Yi Shen Tang. It treats epigastric pain with dry stool constipation, which is Liver blood deficiency; this formula is superior to Xiao Yao San for such cases. Add Dang Gui, Shao Yao, Chai Hu, Suan Zao Ren (Ziziphi Spinosae Semen), and Zhi Zi (Gardeniae Fructus), named Zi Shui Qing Gan Yin. It treats dry epigastric pain, Qi rebelling upward to the left hypochondrium, vomiting sour fluid, intermittent fever, and other syndromes.