亦多见老年妇女，心营、肺卫俱虚，皮肤发痒，但无疹块，遇风更甚。舌润无苔，。脉多沉弱。用桂枝汤，杭芍改赤芍，并加重赤芍剂量，再加葛根、防风，均能取得疗效。皮肤发痒，临床有虚实之别。虚证多见老年妇女，其中有津枯血燥与营卫俱虚之不同，如属津枯血燥发痒，必见舌红质干，脉多弦细而数，此方叉非所宜。
足阳明胃为多气多血之海，胃肠病证直接与气血失调有关，此证之治疗应将调和营卫与调和气血结合起来。如病在胃，出现寒热、呕吐、恶心、舌腻、脉紧者，用藿香桂枝汤，解表和中，理气燥湿降胃(方见医案部分)；如病在肠，出现寒热、腹痛、泄泻，脉紧或浮紧，用桂枝汤加葛根、防风，如出现里急腹痛泻痢，用桂枝汤加葛根、香附、黄连、木香、焦楂。每年夏秋季节，胃肠型感冒，多以此二方施治，能收退热、止呕、止泻、止痢之效。
妊娠初期，营卫不和，畏寒，疲乏、食少、呕吐，本《金匮》用桂枝汤为妊娠第一方之旨，重用生姜，确能缓解妊娠反应，增进食欲，止呕吐，除畏寒。此方仅用于营卫不和，胃气虚弱者，如兼有肝胃郁热，或胆气上逆者，属小柴胡汤适应证，本方又非所宜。
此类痹证是病邪伤及营卫，“营虚不仁”，“卫虚不用”。“营虚不仁”是病邪伤及营分，血中营气不足，因而肢体感觉麻痹，临床治疗中，宜以桂枝汤倍芍药为第一步，进而用新加汤为第二步，新加汤再加当归为第三步。“卫虚不用”是病邪伤及卫分则局部的真气去，而邪气独留。真气去则功能消失，因而肢体运动受限，临床治疗，以黄芪桂枝五物汤为第一步，进而用桂枝汤加附片为第二步，或再加黄芪为第三步。若营卫两虚，常以新加汤加重附片剂量而取效。
(八)营卫不调之失眠 《灵枢·营卫生会篇》“营卫各行二十五度，分为昼夜……夜半而大会，万民皆卧，命曰合阴……”，说明营卫与人体的寤寐关系极为密切。如老年之人，或病后营气虚衰，营卫失常，卫气内伐，经常出现难于入眠，或多梦易醒。甩桂技汤倍芍药加山萸肉、果杞、桔络可取宁心安眠之效。
清代王清任的补阳还五汤，将补气药与活血化瘀药结合起来，用治半身不遂，口眼歪斜等中风后遗症有一定疗效。但因缺乏脉象，以方测证，脉象必属虚象，如属实象，即弦滑数之类脉象，此方不可误投，否则，不但无效，还可导致变证。既然营卫与气血相关，则气虚所致之半身不遂直接涉及营血与卫气，只有营卫健运，才能促进气血生成。只有营卫健运，补阳还五汤才能发挥补气和活血化瘀的作用。因此，余常将此方与调和营卫的桂枝汤结合起来运用。实践证明，较单用补阳还五汤原方疗效明显提高。然而，半身不遂一证，病理较为复杂，有虚实之分，有阴阳之别，虚实之中，又有虚实相兼等情况，临床必须仔细体审病情，方随证变，才可取效。
(十)治胸、腹、背、腰及上下肢疼痛
膀胱与肾相表里，其经脉互相联络。足太阳膀胱经脓起于目内眦，上头顶，下项，行于背、腰部，后分二行，至下肢外侧后面，到达足小趾的至阴穴与足少阴肾经相通，过足底涌泉穴绕内踝穴，沿下肢内侧后面上行，入少腹，挟脐旁上行腹部和胸部，至锁骨下的俞府穴而止。由于外邪或里寒之气导致营卫失调，经气阻滞，出现胸、腹、背、腰及上下肢疼痛，用本方加防风、香附、麦芽，在增强营卫功能盼基础上兼以理气祛寒行滞。若上肢痛，上方加桑枝以通络；下肢痛加淮牛膝，活血通经并补肝肾。
(十一)用于体弱，病后或产后营卫失调
此类患者常感时而微寒，时而微热，自汗，疲乏，脉缓，可用桂枝汤加党参，或用桂枝汤与生脉散合用。
患儿发热不高，气血较弱，痘疹隐约不现，古有“疹出于肺，痘出于胃”之说。审无唇红舌赤等热象者，可用桂枝汤加川芎、葛根，增强营卫，鼓舞肺胃之阳，促痘疹外现。如兼寒邪外束，亦可加麻绒少许，使之宣发外透。
结语
本文从营卫的生成、分布与生理功能、营卫与脏腑的关系、营卫的病理表现等方面，论述了营卫在人体的重要意义，以及因营卫失调和营卫不足所产生的一些疾病。这些病证，在营卫理论的学术思想指导下，通过长期临床实践，以桂枝汤为基础，灵活加减，取得了良好的疗效，从而说明了桂枝汤加减可广泛用于内、妇、儿、外各科由于营卫不足和失调所致的不少疾病。
姜桂苓半汤的组成原理及临床运用
本方取材于清朝郑钦安姜桂汤和局方二陈汤。前者见于《医理真传》鼻流清涕不止条，原治上焦阳虚而致鼻流清涕不止；后者乃一切痰饮为患之总方。方中夏、苓二味，功能燥湿健脾，化痰止呕，中医有“痰生百病，湿生灾”之语。取二方之长融为一方，用治心阳不足或心肺阳虚所致诸证，以及升降失调、上下不通等，或因心肺阳虚导致中焦寒湿、肝胃虚寒等，皆可运用。经临床四十余年之实践证明，功效卓著。
心肺同居胸中，“胸为清阳之腑”，受不得任何寒浊之气，脏虽属阴，其用在阳。“心者血，肺者气”，气血的运行，全靠心肺阳气的推动，寒则凝，温则通。故寒邪上逆，气血阻滞，则心肺之阳被遏，以至出现上焦虚寒之症，如胸痛、咳逆短气、畏寒肢冷、面唇青紫等。心肺阳虚，包括心肺气虚，但有时以心阳虚明显，有时以心肺阳虚并见。心肺阳虚可由本身病变引起，亦可由其他脏腑病变导致。心主一身之血，肺主一身之气，人身百病千端，无不关乎气血。明乎此，通过调理心肺阳气，温通气血，则可治疗多种疾病。
按照上述理论，本方以生姜、桂枝为君药。生姜性温，黄坤载谓“入肺胃而驱浊，走肝脾而行滞，荡胸中之瘀满，排胃里之壅遏，善通鼻塞，最止腹痛，调和脏腑，宣达荣卫，行经之要品，发表之良药”。又谓：“生姜疏利通达，下行肺胃而降浊阴，善止呕哕而扫瘀腐，清官除道穴力最为迅捷。”
桂枝辛甘而温，《本经》称其“治上气咳逆”，张锡纯渭：“通阳化气，力善宣通，能升大气(即胸中之气)．降逆气(如冲气，肝气之类)，散邪气(如风寒之类)……诸家本草，鲜有言其能降逆气者，是用桂枝而弃其所长也。……乃医者皆知麻黄泻肺定喘，而鲜知桂枝降气定喘，是不读《本经》之过也。”又谓：“为其味甘，故又善和脾胃，能使脾气之陷者上升，胃气之逆者下降，脾胃调和则留饮自除，积食自化。其宣通之力，又能导引三焦下通膀胱以利小便”。生姜与桂枝相伍，则辛温助阳，相须为用，同气相求，相辅相成。故二者相伍，既温扶心阳，又宣通肺气，使周身阳气通调，气血流畅。郑钦安谓：“心者，气之帅也。心阳得补，而肺气更旺”。“要知补心阳即是补真火(肾阳)也。……此方(姜桂汤)功用似专在上，其实亦在下也。学者不可视为寻常，实有至理存焉”。在此方基础上，佐以半夏和茯苓，健脾燥湿，温化痰饮之功益胜。且茯苓甘淡，宁心安神，甘则能补脾阴，脾阴既旺则生啼金，淡则能渗利水化饮。黄坤载谓：“泄水燥土，冲和淡荡，百病皆宜，至为良药”，“人之中气，左右回旋，脾主升清，胃主降浊，在下之气，不可一刻而不升，在上之气，不可一刻而不降；一刻不升则清气下陷，一刻不降则浊气上逆。浊气上逆则呕哕，痰饮皆作，一切惊悸、眩晕、吐衄、嗽喘、心痞、胁胀、膈噎、反胃种种诸病，于是生焉。而总由于中气之湿寒。……凡此诸症，悉宜温中燥土之药，加半夏以降之。”
以上分析，可知本方用药四味，平平无奇，但其理甚深。组合之后，既能扶阳强心温肺，又能宣通表里，交通上下。中医治病，全在掌握气化升降原理。本方之效能，在于使上中下及人体内外得以一致，符合机体的统一性。兹结合临床实践阐述如下：
(一)各种心脏病，当出现心阳不足时(包括心气不足)，症见心悸、气短、自汗、劳累则加剧，面皓神疲，目瞑喜卧，畏寒肢冷，舌淡而胖，苔薄白或白滑，脉浮大或濡缓、或沉细而结代。可用本方加枣仁、元肉、砂仁，温阳益气，养心安神。若气虚明显者，加苏条参或太子参，或加口芪、党参；兼胸痛、胸闷或胸痛彻背者，加香附、麦芽。若心肾阳衰，症见面浮肢肿，手足厥冷，面色灰暗，口唇发青，原方生姜易干姜，重用茯苓，再加附片、上肉桂，强心温肾，化气行水。
(二)心肺阳虚，久咳不止，咯痰清稀，气短乏力者，用本方加苏子、陈皮、炙远志、温肺强心，降逆止咳。
(三)心肺阳虚，又兼气阴不足，症见气短乏力，动即作喘，自汗、心烦、潮热，舌淡红，脉虚大或虚数。用本方合生脉散加山萸肉、桔络、乌梅，温阳益气，养阴生津。
(四)心肾阳虚，神不内守，心阳外越，出现惊悸多梦，夜眠不宁者，本方加炙远志，石菖蒲、山萸肉、果杞、元肉、秫米之类，交通心肾，宁心安神；甚者加龙骨、牡蛎、砂仁、炙甘草，潜镇浮阳，收纳心气。
(五)心肺阳虚，兼肺气郁滞、咳嗽喘息者，本方重用生姜30克，加桑白皮、苏子、白蜜，温肺散郁，降逆止喘。若心肾阳虚明显者，原方加附片，砂仁、五味子，生姜易干姜，温肾强心，化痰平喘。
(六)高血压出现心肾阳虚症状者，用本方加杜仲、天麻、钩藤、砂仁、荷顶，温通心肾，平肝熄风。
(七)小儿百日咳后期，肺阴肺阳俱虚，阳不化阴，余咳不止，面浮色青，舌淡，脉沉细，本方生姜易炮姜，加炙甘草、五味子、白蜜，扶阳益阴，降气止咳。
(八)脾胃虚寒，寒气上逆，胸闷恶心，脘腹胀满，本方加砂仁、麦芽，温中散寒，降逆止呕。
(九)肝寒气郁，胆气上逆，寒气滞于肝胆经脉，出现两腮硬结日久不散，皮色如常，或发青者，用本方加柴胡、香附、麦芽，温肝舒郁，行气散结。
(十)脾胃寒湿，兼肝气郁滞，出现肝区疼痛或见痞块者，本方加乳香、没药、丹皮、郁金、佛手、紫丹参，以温肝达木，活血祛瘀，理气止痛。
总之，本方主治之症甚多，治愈病例不少。
三豆汤及其加减方的临床运用 《本草纲目))记载：扁鹊三豆饮由绿豆、赤小豆、黑豆、甘草节组成，治疮毒初起，又治“天行痘疹，预服此饮，疏解热毒，纵出亦少”。故历代医家多将此方用治痘疹、疮毒之症。
根据多年实践验证，本方药性平和，味甘而淡，不伤胃气，而有清热解毒，活血祛风，养肝润肺，滋燥生津诸作用。具有滋养之功，但滋而无滞，虽清热解毒，但清而不伐。全方清中寓补，补中寓清。若能灵活加减，除疮毒、痘疹之外，还可用于因风、热、燥、火等阳邪为患，导致伤津耗液之燥热等证；更适用于脏腑机能失调如内脏津亏，或脏腑燥热伤阴之证，如肺肾阴虚，肝肾阴虚，肺虚燥热，肺胃郁热，肝虚不眠等方面。经多年广泛运用于临床，灵活加减，疗效颇佳。
一、基础方及各豆功能
(一)基础方及加减药味基础方：黑豆，绿豆，红饭豆。替换用药方：淡豆豉，扁豆。
加减法：疏风解表加：桑叶、薄荷；清热解毒加：银花、连翘；泻火解毒加：黄芩、栀子、生石膏；破滞去瘀加：枳实、焦楂；清咽利膈加：牛蒡子、桔梗；宣肺止咳加：杏仁、贝母、枳壳；宣透痘疹加；虫蜕、芫荽、香菌脚；祛风止痒加：僵蚕、蝉蜕、刺吉力；清热消肿加：元参、夏枯草；清心除烦加：竹茹、灯心、栀子；养阴润燥加：麦冬、沙参、果杞、五味子；养肝润燥加：乌梅、冰糖；补益脾肺加：山药、莲子、苡仁；补脾养阴加：太子参、乌梅、山药。
上列各组药物，视病情需要可选择一、二组加入。
(二)各豆的功能
黑豆：性味甘平，入肝、肾二经。功能活血，利水，祛风，解毒。本品尚有润肾燥而止盗汗，补肾虚而止遗尿。
绿豆：性味甘平，入心、胃二经。功能清热解毒，消暑，利水。《药性三字经》谓本品“通行十二经”，“解一切药草。牛、马、金石诸毒。”
红饭豆：又名赤豆，本品性味甘酸平，入心、小肠二经。功能利水除湿，止痒，和血排脓，消肿解毒。古人有“久食瘦人”之说。
淡豆豉：由黑豆经加工发酵而成，性味辛而微苦，入肺、胃二经，有解毒除烦之功，但因炮制方法不同而性味各异。用青蒿、桑叶同制者，则药性偏寒，用麻黄、苏叶等同制者，则药性偏温。
扁豆：性味甘，微温。入肺、脾二经，健脾养胃，消暑除湿，补脾而不滋腻，化湿而不燥烈，为缓和滋养之品。二、临床应用
(一)用于麻疹
1．麻疹初期，证偏阳热者，用淡豆豉、黑豆、绿豆，加桑叶、薄荷、虫蜕、香菌脚。若服后疹出顺畅，发热渐退，改用红饭豆、黑豆、绿豆加乌梅、冰糖，养肝润燥生滓，以资调整。
亦多见于老年妇女，心营与肺卫均虚弱，皮肤发痒，但没有疹块，遇风后症状加重。舌面湿润无苔，脉象多沉弱。使用桂枝汤（Cinnamon Twig Decoction），将白芍改为赤芍，并增加赤芍的剂量，再加葛根和防风，均能取得疗效。皮肤发痒在临床上分为虚证和实证两种情况。虚证多见于老年妇女，其中有津液枯竭血液燥热与营卫俱虚的不同。如果属于津枯血燥引起的发痒，必然见到舌质红而干燥，脉象多弦细而数，此方就不适宜了。
足阳明胃经是多气多血的经脉，胃肠病证直接与气血失调有关，治疗此证应将调和营卫与调和气血结合起来。如病位在胃，出现寒热往来、呕吐、恶心、舌苔腻、脉紧等症状，使用藿香桂枝汤，以解表和中，理气燥湿降胃（方剂见医案部分）；如病位在肠，出现寒热、腹痛、泄泻，脉紧或浮紧，使用桂枝汤加葛根、防风；如出现里急后重、腹痛泻痢，使用桂枝汤加葛根、香附、黄连、木香、焦山楂。每年夏秋季节，胃肠型感冒，多以此二方施治，能收退热、止呕、止泻、止痢之效。
妊娠初期，营卫不和，畏寒，疲乏、食少、呕吐，本《金匮》用桂枝汤为妊娠第一方之旨，重用生姜，确能缓解妊娠反应，增进食欲，止呕吐，除畏寒。此方仅用于营卫不和，胃气虚弱者，如兼有肝胃郁热，或胆气上逆者，属小柴胡汤适应证，本方又非所宜。
此类痹证是病邪伤及营卫，“营虚不仁”，“卫虚不用”。“营虚不仁”是病邪伤及营分，血中营气不足，因而肢体感觉麻痹，临床治疗中，宜以桂枝汤倍芍药为第一步，进而用新加汤为第二步，新加汤再加当归为第三步。“卫虚不用”是病邪伤及卫分则局部的真气去，而邪气独留。真气去则功能消失，因而肢体运动受限，临床治疗，以黄芪桂枝五物汤为第一步，进而用桂枝汤加附片为第二步，或再加黄芪为第三步。若营卫两虚，常以新加汤加重附片剂量而取效。
(八)营卫不调之失眠 《灵枢·营卫生会篇》“营卫各行二十五度，分为昼夜……夜半而大会，万民皆卧，命曰合阴……”，说明营卫与人体的寤寐关系极为密切。如老年之人，或病后营气虚衰，营卫失常，卫气内伐，经常出现难于入眠，或多梦易醒。甩桂技汤倍芍药加山萸肉、果杞、桔络可取宁心安眠之效。
清代王清任的补阳还五汤，将补气药与活血化瘀药结合起来，用治半身不遂，口眼歪斜等中风后遗症有一定疗效。但因缺乏脉象，以方测证，脉象必属虚象，如属实象，即弦滑数之类脉象，此方不可误投，否则，不但无效，还可导致变证。既然营卫与气血相关，则气虚所致之半身不遂直接涉及营血与卫气，只有营卫健运，才能促进气血生成。只有营卫健运，补阳还五汤才能发挥补气和活血化瘀的作用。因此，余常将此方与调和营卫的桂枝汤结合起来运用。实践证明，较单用补阳还五汤原方疗效明显提高。然而，半身不遂一证，病理较为复杂，有虚实之分，有阴阳之别，虚实之中，又有虚实相兼等情况，临床必须仔细体审病情，方随证变，才可取效。
(十)治胸、腹、背、腰及上下肢疼痛
膀胱与肾相表里，其经脉互相联络。足太阳膀胱经脓起于目内眦，上头顶，下项，行于背、腰部，后分二行，至下肢外侧后面，到达足小趾的至阴穴与足少阴肾经相通，过足底涌泉穴绕内踝穴，沿下肢内侧后面上行，入少腹，挟脐旁上行腹部和胸部，至锁骨下的俞府穴而止。由于外邪或里寒之气导致营卫失调，经气阻滞，出现胸、腹、背、腰及上下肢疼痛，用本方加防风、香附、麦芽，在增强营卫功能盼基础上兼以理气祛寒行滞。若上肢痛，上方加桑枝以通络；下肢痛加淮牛膝，活血通经并补肝肾。
(十一)用于体弱，病后或产后营卫失调
此类患者常感时而微寒，时而微热，自汗，疲乏，脉缓，可用桂枝汤加党参，或用桂枝汤与生脉散合用。
患儿发热不高，气血较弱，痘疹隐约不现，古有“疹出于肺，痘出于胃”之说。审无唇红舌赤等热象者，可用桂枝汤加川芎、葛根，增强营卫，鼓舞肺胃之阳，促痘疹外现。如兼寒邪外束，亦可加麻绒少许，使之宣发外透。
结语
本文从营卫的生成、分布与生理功能、营卫与脏腑的关系、营卫的病理表现等方面，论述了营卫在人体的重要意义，以及因营卫失调和营卫不足所产生的一些疾病。这些病证，在营卫理论的学术思想指导下，通过长期临床实践，以桂枝汤为基础，灵活加减，取得了良好的疗效，从而说明了桂枝汤加减可广泛用于内、妇、儿、外各科由于营卫不足和失调所致的不少疾病。
姜桂苓半汤的组成原理及临床运用
本方取材于清朝郑钦安姜桂汤和局方二陈汤。前者见于《医理真传》鼻流清涕不止条，原治上焦阳虚而致鼻流清涕不止；后者乃一切痰饮为患之总方。方中夏、苓二味，功能燥湿健脾，化痰止呕，中医有“痰生百病，湿生灾”之语。取二方之长融为一方，用治心阳不足或心肺阳虚所致诸证，以及升降失调、上下不通等，或因心肺阳虚导致中焦寒湿、肝胃虚寒等，皆可运用。经临床四十余年之实践证明，功效卓著。
心肺同居胸中，“胸为清阳之腑”，受不得任何寒浊之气，脏虽属阴，其用在阳。“心者血，肺者气”，气血的运行，全靠心肺阳气的推动，寒则凝，温则通。故寒邪上逆，气血阻滞，则心肺之阳被遏，以至出现上焦虚寒之症，如胸痛、咳逆短气、畏寒肢冷、面唇青紫等。心肺阳虚，包括心肺气虚，但有时以心阳虚明显，有时以心肺阳虚并见。心肺阳虚可由本身病变引起，亦可由其他脏腑病变导致。心主一身之血，肺主一身之气，人身百病千端，无不关乎气血。明乎此，通过调理心肺阳气，温通气血，则可治疗多种疾病。
按照上述理论，本方以生姜、桂枝为君药。生姜性温，黄坤载谓“入肺胃而驱浊，走肝脾而行滞，荡胸中之瘀满，排胃里之壅遏，善通鼻塞，最止腹痛，调和脏腑，宣达荣卫，行经之要品，发表之良药”。又谓：“生姜疏利通达，下行肺胃而降浊阴，善止呕哕而扫瘀腐，清官除道穴力最为迅捷。”
桂枝辛甘而温，《本经》称其“治上气咳逆”，张锡纯渭：“通阳化气，力善宣通，能升大气(即胸中之气)．降逆气(如冲气，肝气之类)，散邪气(如风寒之类)……诸家本草，鲜有言其能降逆气者，是用桂枝而弃其所长也。……乃医者皆知麻黄泻肺定喘，而鲜知桂枝降气定喘，是不读《本经》之过也。”又谓：“为其味甘，故又善和脾胃，能使脾气之陷者上升，胃气之逆者下降，脾胃调和则留饮自除，积食自化。其宣通之力，又能导引三焦下通膀胱以利小便”。生姜与桂枝相伍，则辛温助阳，相须为用，同气相求，相辅相成。故二者相伍，既温扶心阳，又宣通肺气，使周身阳气通调，气血流畅。郑钦安谓：“心者，气之帅也。心阳得补，而肺气更旺”。“要知补心阳即是补真火(肾阳)也。……此方(姜桂汤)功用似专在上，其实亦在下也。学者不可视为寻常，实有至理存焉”。在此方基础上，佐以半夏和茯苓，健脾燥湿，温化痰饮之功益胜。且茯苓甘淡，宁心安神，甘则能补脾阴，脾阴既旺则生啼金，淡则能渗利水化饮。黄坤载谓：“泄水燥土，冲和淡荡，百病皆宜，至为良药”，“人之中气，左右回旋，脾主升清，胃主降浊，在下之气，不可一刻而不升，在上之气，不可一刻而不降；一刻不升则清气下陷，一刻不降则浊气上逆。浊气上逆则呕哕，痰饮皆作，一切惊悸、眩晕、吐衄、嗽喘、心痞、胁胀、膈噎、反胃种种诸病，于是生焉。而总由于中气之湿寒。……凡此诸症，悉宜温中燥土之药，加半夏以降之。”
以上分析，可知本方用药四味，平平无奇，但其理甚深。组合之后，既能扶阳强心温肺，又能宣通表里，交通上下。中医治病，全在掌握气化升降原理。本方之效能，在于使上中下及人体内外得以一致，符合机体的统一性。兹结合临床实践阐述如下：
(一)各种心脏病，当出现心阳不足时(包括心气不足)，症见心悸、气短、自汗、劳累则加剧，面皓神疲，目瞑喜卧，畏寒肢冷，舌淡而胖，苔薄白或白滑，脉浮大或濡缓、或沉细而结代。可用本方加枣仁、元肉、砂仁，温阳益气，养心安神。若气虚明显者，加苏条参或太子参，或加口芪、党参；兼胸痛、胸闷或胸痛彻背者，加香附、麦芽。若心肾阳衰，症见面浮肢肿，手足厥冷，面色灰暗，口唇发青，原方生姜易干姜，重用茯苓，再加附片、上肉桂，强心温肾，化气行水。
(二)心肺阳虚，久咳不止，咯痰清稀，气短乏力者，用本方加苏子、陈皮、炙远志、温肺强心，降逆止咳。
(三)心肺阳虚，又兼气阴不足，症见气短乏力，动即作喘，自汗、心烦、潮热，舌淡红，脉虚大或虚数。用本方合生脉散加山萸肉、桔络、乌梅，温阳益气，养阴生津。
(四)心肾阳虚，神不内守，心阳外越，出现惊悸多梦，夜眠不宁者，本方加炙远志，石菖蒲、山萸肉、果杞、元肉、秫米之类，交通心肾，宁心安神；甚者加龙骨、牡蛎、砂仁、炙甘草，潜镇浮阳，收纳心气。
(五)心肺阳虚，兼肺气郁滞、咳嗽喘息者，本方重用生姜30克，加桑白皮、苏子、白蜜，温肺散郁，降逆止喘。若心肾阳虚明显者，原方加附片，砂仁、五味子，生姜易干姜，温肾强心，化痰平喘。
(六)高血压出现心肾阳虚症状者，用本方加杜仲、天麻、钩藤、砂仁、荷顶，温通心肾，平肝熄风。
(七)小儿百日咳后期，肺阴肺阳俱虚，阳不化阴，余咳不止，面浮色青，舌淡，脉沉细，本方生姜易炮姜，加炙甘草、五味子、白蜜，扶阳益阴，降气止咳。
(八)脾胃虚寒，寒气上逆，胸闷恶心，脘腹胀满，本方加砂仁、麦芽，温中散寒，降逆止呕。
(九)肝寒气郁，胆气上逆，寒气滞于肝胆经脉，出现两腮硬结日久不散，皮色如常，或发青者，用本方加柴胡、香附、麦芽，温肝舒郁，行气散结。
(十)脾胃寒湿，兼肝气郁滞，出现肝区疼痛或见痞块者，本方加乳香、没药、丹皮、郁金、佛手、紫丹参，以温肝达木，活血祛瘀，理气止痛。
总之，本方主治之症甚多，治愈病例不少。
三豆汤及其加减方的临床运用 《本草纲目))记载：扁鹊三豆饮由绿豆、赤小豆、黑豆、甘草节组成，治疮毒初起，又治“天行痘疹，预服此饮，疏解热毒，纵出亦少”。故历代医家多将此方用治痘疹、疮毒之症。
根据多年实践验证，本方药性平和，味甘而淡，不伤胃气，而有清热解毒，活血祛风，养肝润肺，滋燥生津诸作用。具有滋养之功，但滋而无滞，虽清热解毒，但清而不伐。全方清中寓补，补中寓清。若能灵活加减，除疮毒、痘疹之外，还可用于因风、热、燥、火等阳邪为患，导致伤津耗液之燥热等证；更适用于脏腑机能失调如内脏津亏，或脏腑燥热伤阴之证，如肺肾阴虚，肝肾阴虚，肺虚燥热，肺胃郁热，肝虚不眠等方面。经多年广泛运用于临床，灵活加减，疗效颇佳。
一、基础方及各豆功能
(一)基础方及加减药味基础方：黑豆，绿豆，红饭豆。替换用药方：淡豆豉，扁豆。
加减法：疏风解表加：桑叶、薄荷；清热解毒加：银花、连翘；泻火解毒加：黄芩、栀子、生石膏；破滞去瘀加：枳实、焦楂；清咽利膈加：牛蒡子、桔梗；宣肺止咳加：杏仁、贝母、枳壳；宣透痘疹加；虫蜕、芫荽、香菌脚；祛风止痒加：僵蚕、蝉蜕、刺吉力；清热消肿加：元参、夏枯草；清心除烦加：竹茹、灯心、栀子；养阴润燥加：麦冬、沙参、果杞、五味子；养肝润燥加：乌梅、冰糖；补益脾肺加：山药、莲子、苡仁；补脾养阴加：太子参、乌梅、山药。
上列各组药物，视病情需要可选择一、二组加入。
(二)各豆的功能
黑豆：性味甘平，入肝、肾二经。功能活血，利水，祛风，解毒。本品尚有润肾燥而止盗汗，补肾虚而止遗尿。
绿豆：性味甘平，入心、胃二经。功能清热解毒，消暑，利水。《药性三字经》谓本品“通行十二经”，“解一切药草。牛、马、金石诸毒。”
红饭豆：又名赤豆，本品性味甘酸平，入心、小肠二经。功能利水除湿，止痒，和血排脓，消肿解毒。古人有“久食瘦人”之说。
淡豆豉：由黑豆经加工发酵而成，性味辛而微苦，入肺、胃二经，有解毒除烦之功，但因炮制方法不同而性味各异。用青蒿、桑叶同制者，则药性偏寒，用麻黄、苏叶等同制者，则药性偏温。
扁豆：性味甘，微温。入肺、脾二经，健脾养胃，消暑除湿，补脾而不滋腻，化湿而不燥烈，为缓和滋养之品。二、临床应用
(一)用于麻疹
1．麻疹初期，证偏阳热者，用淡豆豉、黑豆、绿豆，加桑叶、薄荷、虫蜕、香菌脚。若服后疹出顺畅，发热渐退，改用红饭豆、黑豆、绿豆加乌梅、冰糖，养肝润燥生滓，以资调整。
Also frequently seen in elderly women, with both Heart Ying (Nutritive Qi) and Lung Wei (Defensive Qi) deficiency. The skin itches, but there are no rashes or wheals; symptoms worsen upon exposure to wind. The tongue is moist without coating, and the pulse is often deep and weak. Using Guizhi Tang (Cinnamon Twig Decoction), replacing Bai Shao (White Peony Root) with Chi Shao (Red Peony Root), increasing the dosage of Chi Shao, and adding Ge Gen (Kudzu Root) and Fang Feng (Saposhnikovia Root), can all achieve therapeutic effects. Skin itching in clinical practice is distinguished into deficiency and excess patterns. Deficiency patterns are common in elderly women, further differentiated into dryness due to fluid depletion and blood dryness versus simultaneous deficiency of Ying and Wei. If the itching is due to fluid depletion and blood dryness, one must observe a red tongue body with a dry texture and a wiry, thin, and rapid pulse; in such cases, this formula is not suitable.
(Five) Gastrointestinal Type Cold and Diarrhea/Dysentery
The Foot-Yangming Stomach Meridian is the sea of abundant Qi and Blood. Gastrointestinal disorders are directly related to Qi and Blood imbalance. Treatment for these conditions should combine harmonizing Ying and Wei with regulating Qi and Blood. If the pathology is in the Stomach, presenting with alternating chills and fever, vomiting, nausea, greasy tongue coating, and tight pulse, Huoxiang Guizhi Tang (Patchouli and Cinnamon Twig Decoction) is used to release the exterior and harmonize the middle, regulate Qi, dry dampness, and direct Stomach Qi downward (formula details see Medical Cases section). If the pathology is in the Intestines, presenting with chills and fever, abdominal pain, diarrhea, and a tight or floating-tight pulse, Guizhi Tang is modified with Ge Gen (Kudzu Root) and Fang Feng (Saposhnikovia Root). If tenesmus, abdominal pain, and dysentery occur, Guizhi Tang is modified with Ge Gen (Kudzu Root), Xiang Fu (Cyperus Rhizome), Huang Lian (Coptis Rhizome), Mu Xiang (Aucklandia Root), and Jiao Zha (Charred Hawthorn Fruit). During summer and autumn seasons, gastrointestinal type colds are often treated with these two formulas, effectively reducing fever, stopping vomiting, diarrhea, and dysentery.
(Six) Ying-Wei Disharmony and Weak Stomach Qi during Pregnancy
In early pregnancy, Ying and Wei are disharmonious, manifesting as aversion to cold, fatigue, poor appetite, and vomiting. Following the principle from *Jin Gui Yao Lue* that Guizhi Tang (Cinnamon Twig Decoction) is the first formula for pregnancy, using a heavy dose of Sheng Jiang (Fresh Ginger) can indeed alleviate pregnancy reactions, improve appetite, stop vomiting, and remove aversion to cold. This formula is only suitable for cases of Ying-Wei disharmony and weak Stomach Qi. If accompanied by Liver-Stomach stagnant heat or rebellious Gallbladder Qi, it falls under the indications for Xiaochaihu Tang (Minor Bupleurum Decoction), and this formula is not appropriate.
(Seven) Bi Syndrome Caused by Damage to Ying and Wei
This type of Bi Syndrome (Obstruction Syndrome) involves pathogens damaging Ying and Wei: "Ying deficiency leads to insensitivity," and "Wei deficiency leads to immobility." "Ying deficiency leading to insensitivity" means pathogens have damaged the Ying level, resulting in insufficient Ying Qi in the blood, causing numbness and loss of sensation in the limbs. In clinical treatment, the first step is Guizhi Tang (Cinnamon Twig Decoction) with doubled Shao Yao (Peony Root), followed by Xinjia Tang (Modified New Additions Decoction) as the second step, and adding Dang Gui (Angelica Sinensis) to Xinjia Tang as the third step. "Wei deficiency leading to immobility" means pathogens have damaged the Wei level, causing local True Qi to depart while pathogens remain alone. When True Qi departs, function is lost, leading to restricted limb movement. Clinically, the first step is Huangqi Guizhi Wuwu Tang (Astragalus and Cinnamon Twig Five-Substance Decoction), followed by Guizhi Tang (Cinnamon Twig Decoction) with Fupian (Prepared Aconite Child Root) as the second step, or adding Huangqi (Astragalus Root) as the third step. If both Ying and Wei are deficient, Xinjia Tang (Modified New Additions Decoction) with an increased dose of Fupian (Prepared Aconite Child Root) is often effective.
(Eight) Insomnia Due to Ying-Wei Disharmony
The *Ling Shu: Ying Wei Hui Hui Chapter* states: "Ying and Wei each circulate twenty-five cycles, dividing day and night... They meet at midnight, when all people sleep, called 'He Yin' (Harmonizing Yin)..." This illustrates the close relationship between Ying-Wei and human wakefulness/sleep. For example, in the elderly or those recovering from illness, if Ying Qi is depleted and Ying-Wei regulation is abnormal, with Wei Qi invading inward, frequent difficulty falling asleep or vivid dreaming with easy awakening occurs. Using Guizhi Tang (Cinnamon Twig Decoction) with doubled Shao Yao (Peony Root), plus Shan Yu Rou (Cornus Fruit), Gou Qi Zi (Goji Berry), and Ju Luo (Tangerine Pith) can achieve the effect of calming the Heart and promoting sleep.
(Nine) Combining Buyang Huanwu Tang to Treat Sequelae of Stroke Due to Qi Deficiency, Blood Stasis, and Ying-Wei Insufficiency
Wang Qingren's Buyang Huanwu Tang (Tonify Yang to Restore Five Tenths Decoction) from the Qing Dynasty combines Qi-tonifying herbs with blood-invigorating and stasis-resolving herbs. It has certain efficacy in treating sequelae of stroke such as hemiplegia and facial deviation. However, lacking pulse diagnosis, inferring the syndrome from the formula suggests the pulse must be deficient. If the pulse is excess-type, such as wiry, slippery, or rapid, this formula must not be mistakenly administered; otherwise, it will not only be ineffective but may also cause adverse changes. Since Ying-Wei is related to Qi and Blood, hemiplegia caused by Qi deficiency directly involves Ying Blood and Wei Qi. Only when Ying and Wei move vigorously can they promote the generation of Qi and Blood. Only when Ying and Wei move vigorously can Buyang Huanwu Tang exert its effects of tonifying Qi and invigorating blood/resolving stasis. Therefore, I often combine this formula with Guizhi Tang (Cinnamon Twig Decoction) to harmonize Ying and Wei. Clinical practice proves that the efficacy is significantly higher than using the original Buyang Huanwu Tang alone. However, the pathology of hemiplegia is complex, involving deficiency and excess, Yin and Yang distinctions, and combinations thereof. Careful assessment of the condition is required in clinical practice, and the formula must change according to the syndrome to be effective.
(Ten) Treating Pain in Chest, Abdomen, Back, Waist, and Upper/Lower Limbs
The Bladder and Kidney are interior-exteriorly related, and their meridians interconnect. The Foot-Taiyang Bladder Meridian originates at the inner canthus of the eye, goes up to the vertex, down the nape, runs along the back and waist, then splits into two branches, reaching the posterior-lateral aspect of the lower limbs, arriving at the Zhiyin (BL67) acupoint on the little toe, connecting with the Foot-Shaoyin Kidney Meridian. It passes through the Yongquan (KI1) acupoint on the sole, circles the medial malleolus, ascends along the posterior-medial aspect of the lower limb, enters the lower abdomen, runs alongside the umbilicus up the abdomen and chest, ending at the Shufu (LU11) acupoint below the clavicle. Due to external pathogens or internal cold Qi causing Ying-Wei disharmony and meridian Qi stagnation, pain in the chest, abdomen, back, waist, and upper/lower limbs may occur. Using this formula with Fang Feng (Saposhnikovia Root), Xiang Fu (Cyperus Rhizome), and Mai Ya (Barley Sprout) enhances Ying-Wei function while regulating Qi, dispelling cold, and moving stagnation. For upper limb pain, add Sang Zhi (Mulberry Twig) to unblock collaterals; for lower limb pain, add Huai Niu Xi (Achyranthes Root) to invigorate blood, unblock meridians, and tonify Liver and Kidney.
(Eleven) Used for Body Weakness, Post-Illness, or Postpartum Ying-Wei Disharmony
Such patients often feel slight chills or slight fever intermittently, spontaneous sweating, fatigue, and a moderate pulse. Guizhi Tang (Cinnamon Twig Decoction) can be combined with Dang Shen (Codonopsis Root), or Guizhi Tang (Cinnamon Twig Decoction) can be combined with Shengmai San (Generate the Pulse Powder).
(Twelve) Used for Early Stage of Infantile Measles and Chickenpox
Patients have low-grade fever and weak Qi and Blood, with measles/rash appearing faintly. Ancient texts state, "Measles originate from the Lung, chickenpox from the Stomach." If there are no signs of heat such as red lips and tongue, Guizhi Tang (Cinnamon Twig Decoction) can be combined with Chuan Xiong (Ligusticum Rhizome) and Ge Gen (Kudzu Root) to strengthen Ying-Wei, stimulate Lung and Stomach Yang, and promote the eruption of rash. If accompanied by external cold constraint, a small amount of Ma Rong (Ephedra Husk) can be added to facilitate diffusion and outward expression.
Conclusion
This article discusses the important significance of Ying and Wei in the human body, and some diseases caused by Ying-Wei disharmony and insufficiency, from aspects such as the generation, distribution, and physiological functions of Ying-Wei, their relationship with Zang-Fu organs, and their pathological manifestations. Guided by the academic thought of Ying-Wei theory, through long-term clinical practice, using Guizhi Tang (Cinnamon Twig Decoction) as a base with flexible modifications, good therapeutic effects have been achieved. This demonstrates that modified Guizhi Tang (Cinnamon Twig Decoction) can be widely used for many diseases in Internal Medicine, Gynecology, Pediatrics, and Surgery caused by Ying-Wei insufficiency and disharmony.
Composition Principle and Clinical Application of Jianggui Lingban Tang
Jianggui Lingban Tang (Ginger, Cinnamon Twig, Pinellia, and Poria Decoction) is composed of four herbs: Sheng Jiang (Fresh Ginger), Gui Zhi (Cinnamon Twig), Fa Ban Xia (Processed Pinellia Tuber), and Fu Ling (Poria).
This formula is derived from Zheng Qin'an's Jianggui Tang (Ginger and Cinnamon Twig Decoction) from the Qing Dynasty and the Bureau Formula Erchen Tang (Two-Aged Decoction). The former appears in *Yi Li Zhen Zhuan* under the entry for persistent runny nose, originally treating persistent runny nose due to Upper Jiao Yang deficiency; the latter is the general formula for all phlegm-fluid retention disorders. Ban Xia (Pinellia Tuber) and Fu Ling (Poria) in the formula function to dry dampness, strengthen the Spleen, resolve phlegm, and stop vomiting. There is a saying in Traditional Chinese Medicine: "Phlegm generates hundreds of diseases, dampness generates disasters." Combining the strengths of these two formulas into one, it can be used to treat various syndromes caused by Heart Yang insufficiency or Heart-Lung Yang deficiency, as well as disorders of ascending/descending mechanisms and blockage between upper and lower parts, or Middle Jiao cold-dampness and Liver-Stomach deficiency-cold caused by Heart-Lung Yang deficiency. Clinical practice over forty years has proven its remarkable efficacy.
Heart and Lung reside together in the chest. "The chest is the mansion of Clear Yang," intolerant of any cold turbid Qi. Although the Zang organs belong to Yin, their function belongs to Yang. "The Heart governs Blood, the Lung governs Qi." The circulation of Qi and Blood relies entirely on the propulsion of Heart and Lung Yang Qi. Cold causes stagnation, warmth promotes flow. Thus, when cold pathogens rebel upward and Qi/Blood stagnate, Heart and Lung Yang Qi are suppressed, leading to Upper Jiao deficiency-cold symptoms such as chest pain, cough with shortness of breath, aversion to cold and cold limbs, and cyanosis of the face and lips. Heart-Lung Yang deficiency includes Heart-Lung Qi deficiency, but sometimes Heart Yang deficiency is prominent, and sometimes Heart-Lung Yang deficiency appears together. Heart-Lung Yang deficiency can be caused by lesions of the organs themselves or by lesions of other Zang-Fu organs. The Heart governs the Blood of the whole body, and the Lung governs the Qi of the whole body. All diseases of the human body concern Qi and Blood. Understanding this, by regulating Heart and Lung Yang Qi and warming/unblocking Qi and Blood, various diseases can be treated.
According to the above theory, this formula uses Sheng Jiang (Fresh Ginger) and Gui Zhi (Cinnamon Twig) as Sovereign herbs. Sheng Jiang (Fresh Ginger) is warm. Huang Kunzai stated: "It enters the Lung and Stomach to drive out turbidity, moves through the Liver and Spleen to move stagnation, clears stasis-fullness in the chest, removes obstruction in the Stomach, is excellent for relieving nasal congestion, best for stopping abdominal pain, harmonizes Zang-Fu organs, disseminates Ying and Wei, is a key herb for moving meridians, and a fine medicine for releasing the exterior." He also said: "Sheng Jiang (Fresh Ginger) is smooth, beneficial, penetrating, descends to the Lung and Stomach to descend turbid Yin, is excellent for stopping vomiting and sweeping away stasis/rot, and its power to clear official pathways and remove obstructions is most swift."
Gui Zhi (Cinnamon Twig) is pungent, sweet, and warm. *Ben Jing* states it treats "rebellious Qi and cough." Zhang Xichun said: "It unblocks Yang and transforms Qi, excels in dissemination and flow, can raise Great Qi (Qi in the chest), descend rebellious Qi (such as Chong Qi, Liver Qi), and scatter pathogenic Qi (such as Wind-Cold)... Among various materia medica, few mention its ability to descend rebellious Qi; thus, using Gui Zhi (Cinnamon Twig) while abandoning its strength is a mistake... Physicians know Mahuang (Ephedra Herb) drains the Lung and calms wheezing, but few know Gui Zhi (Cinnamon Twig) descends Qi and calms wheezing; this is the fault of not reading *Ben Jing*." He also said: "Because its taste is sweet, it also harmonizes the Spleen and Stomach, enabling sinking Spleen Qi to rise and rebellious Stomach Qi to descend. When Spleen and Stomach are harmonized, retained fluids are eliminated and accumulated food is transformed. Its disseminating power can also guide the Triple Burner to connect with the Bladder to promote urination." When Sheng Jiang (Fresh Ginger) and Gui Zhi (Cinnamon Twig) are combined, their pungent-warm nature assists Yang, acting synergistically, seeking same Qi, complementing each other. Thus, combined, they warm/support Heart Yang and disseminate Lung Qi, making the Yang Qi of the whole body smooth and Qi/Blood flow freely. Zheng Qin'an stated: "The Heart is the commander of Qi. When Heart Yang is supplemented, Lung Qi becomes even more vigorous." "Know that tonifying Heart Yang is equivalent to tonifying True Fire (Kidney Yang)... This formula (Jianggui Tang) seems to focus only on the upper, but actually affects the lower. Scholars must not view it as ordinary; there is profound truth within." On the basis of this formula, adding Ban Xia (Pinellia Tuber) and Fu Ling (Poria) strengthens the function of strengthening the Spleen, drying dampness, and warming/phlegm-fluid transformation. Furthermore, Fu Ling (Poria) is sweet and bland, calming the Heart and Spirit. Sweet tonifies Spleen Yin; when Spleen Yin is robust, Metal is generated. Bland promotes leaching water and transforming fluids. Huang Kunzai stated: "Leaching water and drying earth, mild and pure, suitable for all diseases, truly a fine medicine," "The Middle Qi of humans rotates left and right. The Spleen governs ascending Clear Qi, the Stomach governs descending Turbid Qi. Qi below cannot fail to ascend for a moment; Qi above cannot fail to descend for a moment. Failure to ascend leads to sinking of Clear Qi; failure to descend leads to rebellion of Turbid Qi. Rebellion of Turbid Qi causes vomiting, phlegm-fluid retention arises, and all kinds of palpitations, dizziness, hematemesis/hemoptysis, cough/wheezing, Heart oppression, hypochondriac distension, diaphragmatic dysphagia, regurgitation, and various other diseases arise. All ultimately stem from damp-cold of the Middle Qi... All these symptoms are suitable for warming the Middle and drying Earth herbs, adding Ban Xia (Pinellia Tuber) to descend them."
From the above analysis, it is known that the four herbs in this formula are ordinary, but the principle is profound. After combination, it can support Yang, strengthen the Heart, warm the Lung, unblock interior/exterior, and communicate upper/lower. Treating disease in TCM lies entirely in mastering the principles of Qi transformation, ascending, and descending. The efficacy of this formula lies in unifying the upper, middle, lower, and inside/outside of the body, conforming to the unity of the organism. Elaborated below combining clinical practice:
(One) Various Heart Diseases: When Heart Yang insufficiency (including Heart Qi insufficiency) appears, with symptoms of palpitations, shortness of breath, spontaneous sweating, worsening with exertion, pale face with mental fatigue, preference for closing eyes and lying down, aversion to cold and cold limbs, pale and swollen tongue, thin white or white-slippery coating, and floating-large, soft-moderate, or deep-thin and knotted-intermittent pulse. This formula can be combined with Suan Zao Ren (Ziziphus Seed), Yuan Rou (Longan Aril), and Sha Ren (Amomum Fruit) to warm Yang, tonify Qi, nourish the Heart, and calm the Spirit. If Qi deficiency is obvious, add Su Tiao Shen (Codonopsis) or Tai Zi Shen (Pseudostellaria Root), or add Huang Qi (Astragalus Root) and Dang Shen (Codonopsis Root); if accompanied by chest pain, chest tightness, or radiating chest pain, add Xiang Fu (Cyperus Rhizome) and Mai Ya (Barley Sprout). If Heart-Kidney Yang collapse appears, with facial edema, limb swelling, cold hands and feet, dull complexion, and cyanotic lips, replace Sheng Jiang (Fresh Ginger) with Gan Jiang (Dried Ginger) in the original formula, use a heavy dose of Fu Ling (Poria), and add Fupian (Prepared Aconite Child Root) and Shang Rou Gui (Cinnamon Bark) to strengthen the Heart, warm the Kidney, transform Qi, and move water.
(Two) Heart-Lung Yang Deficiency: Persistent cough, expectoration of clear thin sputum, shortness of breath, and fatigue. Use this formula combined with Su Zi (Perilla Fruit), Chen Pi (Tangerine Peel), and Zhi Yuan Zhi (Polygala Root) to warm the Lung, strengthen the Heart, descend rebellious Qi, and stop cough.
(Three) Heart-Lung Yang Deficiency with Qi and Yin Insufficiency: Symptoms include shortness of breath, fatigue, panting upon exertion, spontaneous sweating, irritability, tidal fever, pale-red tongue, and large-deficient or rapid-deficient pulse. Combine this formula with Shengmai San (Generate the Pulse Powder), adding Shan Yu Rou (Cornus Fruit), Ju Luo (Tangerine Pith), and Wu Mei (Mume Fruit) to warm Yang, tonify Qi, nourish Yin, and generate fluids.
(Four) Heart-Kidney Yang Deficiency: Spirit fails to reside internally, Heart Yang rebels outward, presenting with palpitations, vivid dreams, and restless sleep. Add Zhi Yuan Zhi (Polygala Root), Shi Chang Pu (Acorus Rhizome), Shan Yu Rou (Cornus Fruit), Gou Qi Zi (Goji Berry), Yuan Rou (Longan Aril), and Shu Mi (Glutinous Rice) to this formula to communicate Heart and Kidney, calm the Heart, and soothe the Spirit. In severe cases, add Long Gu (Fossil Bone), Mu Li (Oyster Shell), Sha Ren (Amomum Fruit), and Zhi Gan Cao (Honey-fried Licorice Root) to submerge and settle floating Yang, and gather Heart Qi.
(Five) Heart-Lung Yang Deficiency with Lung Qi Stagnation, Cough, and Wheezing: Use 30 grams of Sheng Jiang (Fresh Ginger) in this formula, adding Sang Bai Pi (Mulberry Root Bark), Su Zi (Perilla Fruit), and White Honey to warm the Lung, dissipate stagnation, descend rebellious Qi, and stop wheezing. If Heart-Kidney Yang deficiency is obvious, add Fupian (Prepared Aconite Child Root), Sha Ren (Amomum Fruit), and Wu Mei (Mume Fruit) to the original formula, replace Sheng Jiang (Fresh Ginger) with Gan Jiang (Dried Ginger) to warm the Kidney, strengthen the Heart, resolve phlegm, and calm wheezing.
(Six) Hypertension with Heart-Kidney Yang Deficiency Symptoms: Use this formula combined with Du Zhong (Eucommia Bark), Tian Ma (Gastrodia Rhizome), Gou Teng (Uncaria Vine), Sha Ren (Amomum Fruit), and He Ding (Lotus Calyx) to unblock Heart and Kidney, calm Liver, and extinguish Wind.
(Seven) Late Stage of Infantile Pertussis: Both Lung Yin and Lung Yang are deficient, Yang fails to transform Yin, residual cough persists, facial edema with bluish color, pale tongue, deep-thin pulse. Replace Sheng Jiang (Fresh Ginger) with Pao Jiang (Roasted Ginger) in this formula, add Zhi Gan Cao (Honey-fried Licorice Root), Wu Mei (Mume Fruit), and White Honey to support Yang, benefit Yin, descend Qi, and stop cough.
(Eight) Spleen-Stomach Deficiency-Cold with Rebellious Cold Qi: Chest tightness, nausea, epigastric and abdominal fullness. Add Sha Ren (Amomum Fruit) and Mai Ya (Barley Sprout) to this formula to warm the Middle, dispel cold, descend rebellious Qi, and stop vomiting.
(Nine) Liver Cold with Qi Stagnation, Rebellious Gallbladder Qi, Cold Pathogens Stagnating in Liver-Gallbladder Meridians: Hard nodules on both cheeks persisting for a long time, normal skin color or bluish. Use this formula combined with Chai Hu (Bupleurum Root), Xiang Fu (Cyperus Rhizome), and Mai Ya (Barley Sprout) to warm the Liver, soothe stagnation, move Qi, and dissipate nodules.
(Ten) Spleen-Stomach Cold-Dampness with Liver Qi Stagnation: Liver area pain or visible masses. Add Ru Xiang (Frankincense), Mo Yao (Myrrh), Dan Pi (Moutan Cortex), Yu Jin (Curcuma Rhizome), Fo Shou (Finger Citron), and Zi Dan Shen (Salvia Miltiorrhiza Root) to this formula to warm the Liver, invigorate Wood, invigorate blood, resolve stasis, regulate Qi, and stop pain.
In summary, this formula treats many symptoms and has cured numerous cases.
Clinical Application of Sandou Tang and Its Modified Formulas
*Ben Cao Gang Mu* records: Bianque Sandou Yin (Three Bean Drink) is composed of Lu Dou (Mung Bean), Chi Xiao Dou (Adzuki Bean), Hei Dou (Black Soybean), and Gan Cao Jie (Licorice Knot). It treats initial stage of sores/toxins and "epidemic measles/chickenpox; taking this drink beforehand disperses and resolves heat-toxin, and even if erupted, the severity is reduced." Therefore, physicians of past dynasties often used this formula for measles, chickenpox, and sore/toxin conditions.
Based on years of practical verification, this formula has mild properties, sweet and bland taste, does not damage Stomach Qi, and has functions of clearing heat and resolving toxicity, invigorating blood and dispelling wind, nourishing the Liver and moistening the Lung, and hydrating dryness and generating fluids. It has nourishing power but is non-stagnating; although it clears heat and resolves toxicity, it is non-destructive. The entire formula contains tonification within clearing, and clearing within tonification. With flexible modifications, besides sores/toxins and measles/chickenpox, it can also be used for dry-heat syndromes caused by Yang pathogens such as Wind, Heat, Dryness, and Fire damaging fluids and consuming essence; it is more suitable for organ dysfunction syndromes such as visceral fluid deficiency or organ dry-heat injuring Yin, such as Lung-Kidney Yin deficiency, Liver-Kidney Yin deficiency, Lung deficiency with dry-heat, Lung-Stomach stagnant heat, and Liver deficiency insomnia. Extensively applied clinically for many years with flexible modifications, the efficacy is quite good.
I. Basic Formula and Functions of Each Bean
(One) Basic Formula and Modified Herbs
Basic Formula: Hei Dou (Black Soybean), Lu Dou (Mung Bean), Hong Fan Dou (Red Rice Bean).
Alternative Formula: Dan Dou Chi (Fermented Soybean), Bian Dou (Lablab Bean).
Modification Methods:
For dispersing Wind and releasing Exterior: add Sang Ye (Mulberry Leaf), Bo He (Mint).
For clearing Heat and resolving Toxicity: add Yin Hua (Honeysuckle Flower), Lian Qiao (Forsythia Fruit).
For purging Fire and resolving Toxicity: add Huang Qin (Scutellaria Root), Zhi Zi (Gardenia Fruit), Sheng Shi Gao (Raw Gypsum).
For breaking stagnation and removing stasis: add Zhi Shi (Immature Bitter Orange), Jiao Zha (Charred Hawthorn Fruit).
For clearing throat and benefiting diaphragm: add Niu Bang Zi (Arctium Seed), Jie Geng (Platycodon Root).
For diffusing Lung and stopping cough: add Xing Ren (Apricot Seed), Bei Mu (Fritillaria Bulb), Zhi Ke (Aurantium Fruit).
For diffusing and expressing measles/rash: add Chan Tui (Cicada Slough), Yuan Xu (Coriander), Xiang Jun Jiao (Cedar Leaf Tip - *Note: likely a specific regional term*).
For dispelling Wind and stopping itch: add Jiang Can (Silkworm), Chan Tui (Cicada Slough), Ci Ji Li (Tribulus Fruit).
For clearing Heat and reducing swelling: add Yuan Shen (Scrophularia Root), Xia Ku Cao (Prunella Spike).
For clearing Heart and removing irritability: add Zhu Ru (Bamboo Shavings), Deng Xin Cao (Juncus Effusus), Zhi Zi (Gardenia Fruit).
For nourishing Yin and moistening dryness: add Mai Dong (Ophiopogon Tuber), Sha Shen (Glehnia Root), Gou Qi Zi (Goji Berry), Wu Mei (Mume Fruit).
For nourishing Liver and moistening dryness: add Wu Mei (Mume Fruit), Bing Tang (Rock Sugar).
For tonifying Spleen and Lung: add Shan Yao (Dioscorea Rhizome), Lian Zi (Lotus Seed), Yi Yi Ren (Coix Seed).
For tonifying Spleen and nourishing Yin: add Tai Zi Shen (Pseudostellaria Root), Wu Mei (Mume Fruit), Shan Yao (Dioscorea Rhizome).
Select one or two groups of the above drugs based on clinical needs.
(Two) Functions of Each Bean
Hei Dou (Black Soybean): Nature is sweet and neutral, enters Liver and Kidney meridians. Functions: invigorates blood, promotes urination, dispels wind, resolves toxicity. It also moistens Kidney dryness to stop night sweats, tonifies Kidney deficiency to stop enuresis.
Lu Dou (Mung Bean): Nature is sweet and neutral, enters Heart and Stomach meridians. Functions: clears heat and resolves toxicity, relieves summerheat, promotes urination. *Yao Xing San Zi Jing* states it "travels through the twelve meridians" and "resolves all herbal medicines and poisons of cattle, horses, metals, and stones."
Hong Fan Dou (Red Rice Bean): Also known as Chi Dou (Adzuki Bean). Nature is sweet, sour, and neutral, enters Heart and Small Intestine meridians. Functions: promotes urination and eliminates dampness, stops itching, harmonizes blood and expels pus, reduces swelling and resolves toxicity. Ancients said "long-term consumption makes one thin."
Dan Dou Chi (Fermented Soybean): Made from fermented Black Soybeans. Nature is pungent and slightly bitter, enters Lung and Stomach meridians. Has functions of resolving toxicity and removing irritability, but nature varies with processing methods. Processed with Qing Hao (Artemisia Annua) and Sang Ye (Mulberry Leaf) yields a cold nature; processed with Ma Huang (Ephedra Herb) and Su Ye (Perilla Leaf) yields a warm nature.
Bian Dou (Lablab Bean): Nature is sweet, slightly warm. Enters Lung and Spleen meridians. Strengthens Spleen and nourishes Stomach, relieves summerheat and eliminates dampness. Tonifies Spleen without being cloying, transforms dampness without being drying. It is a mild nourishing product.
II. Clinical Applications
(One) Used for Measles
1. Early stage of measles, syndrome leaning towards Yang-Heat: Use Dan Dou Chi (Fermented Soybean), Hei Dou (Black Soybean), Lu Dou (Mung Bean), adding Sang Ye (Mulberry Leaf), Bo He (Mint), Chan Tui (Cicada Slough), and Xiang Jun Jiao (Cedar Leaf Tip). If after administration the rash erupts smoothly and fever gradually subsides, switch to Hong Fan Dou (Red Rice Bean), Hei Dou (Black Soybean), Lu Dou (Mung Bean) adding Wu Mei (Mume Fruit) and Bing Tang (Rock Sugar) to nourish the Liver, moisten dryness, and generate fluids, to aid adjustment.