一物而毁誉交集者，惟人参为最。好补之家多誉，好攻之家多毁，其誉者复有补阴补阳
之各执，而不知皆非也。徐洄溪、邹润安，则能得是物之性用矣。徐氏云∶人参得天地精英
纯粹之气，补气而无刚燥之病，又能入于阴分。邹氏云∶凡物之阴者，喜高燥而恶卑湿；物
之阳者，恶明爽而喜阴翳。人参不生原隰污下而生山谷，是其体阴；乃偏生于树下而不喜风
日，是为阴中之阳。人身五脏之气，以转输变化为阳，藏而不泄为阴。人参兼变化藏守之用
，且其色黄味甘气凉质润，合乎中土脾脏之德。所由入后天而培先天也。至论病之何以需参
，参之何以愈病，则二家犹未得其当。而陶隐居功同甘草之说为有见矣。盖甘草者，春苗夏
叶秋花冬实，得四气之全。而色黄味甘，迥出他黄与甘之上，故能不偏阳不偏阴，居中宫而
通经脉和众脉，与人参有相似之处。窃谓得此一言，可以测参之全量。虽然，病之非参不治
者，讵能代以甘草。甘草自甘草，人参自人参。欲知人参之真，非取仲圣方融会而详辨之，
庸有冀
少阳为三阳之枢，少阴为三阴之枢。凡言枢者，皆一经中有阴有阳，入则为阴，出则为
阳，犹枢机之转移。少阴水脏而寓君火，固阴阳兼具矣。少阳似有阳无阴，然藏于肝叶，是
一阳初生而尚不离乎阴，故二经相感极易。肝病有热即挟胆火，胆病有寒即挟肝风。肝气之
上逆即胆，胆气之下降即肝。往来寒热虽少阳病，却非全不涉肝，以阳之稚，不能竟远乎阴，
而有出入相争之象也。争则宜解宜和，人知小柴胡汤为少阳和解之剂，不知柴芩专解邪，参
乃所以和之。病兼阴阳，何以解之第有寒药？盖此固少阳势重，退少阳则厥阴自靖，且有人
参调停其间，何患寒热之不止。参为少阳药有凿凿可据者，泻心汤心烦无参，而胁下有水气
则用之。胸痹诸方无参，而胁下逆抢心则用之。即小柴胡汤有加减法，而独于呕于渴于胁下
痞硬不去参，此可知人参为和少阴之专药矣。
少阴之贵于和者，躁是也。烦出于心，躁出于肾，故栀子豉汤、黄连阿胶汤治烦无参。
烦不必兼躁，躁则必兼有烦。烦与躁兼则有阳证有阴证，阳证乃太阳表实、阳明腑实之下侵
及肾，非肾自病，故大青龙汤、大承气汤治烦躁无参。阴证则为肾病上干及心，肾阳几亡，
肾阴岂能独善，故吴茱萸汤、茯苓四逆汤治烦躁有参。又可知人参为和少阴之专药矣。
用参于和，有和其本腑本脏之阴阳者，少阳少阴是也。若干姜黄连黄芩人参汤，则以证
有寒热而和之；木防己汤，则以药兼寒热而和之；桂枝人参汤，所以联表里之不和；生姜泻
心汤，所以联上下之不和；大建中汤，又以椒姜之温燥而化之使和。和之道不一，而不善用
之，
心为牡脏，烦而补之，则烦弥甚。然小柴胡汤烦而兼呕不忌（烦而不呕去半夏人参，谓
烦而呕则不去也。徐氏伤寒类方注误），白虎加人参汤烦而兼渴不忌，以呕渴皆少阳木火为
之，
胸胁满硬呕吐，各有正治之药，用参特以和阴阳耳。然生津止渴，则参有专长，不必定
用于少阳。故津为热劫之阳明证，白虎加人参汤亦用之。土虚而津不生之太阴证，理中丸亦
用之。若渴饮而有水蓄于中，小便不利者，参则不过问也。
止渴有不需参之证，生脉则惟参独擅。盖脉生于营，营属心。心体阴而用阳，惟冲和煦
育之参，能补之。故白虎加人参汤之暑病脉虚（脉不虚者，必有兼证，非正暑病也），四逆
加人参汤之脉微，通脉四逆汤之脉不出，炙甘草汤之脉结代，皆必得有参。参之力，入肾者
轻，入心者重。故足少阴得其和，手少阴得其补，亦可为阴中之阳之一证矣。
参之功在补虚，虽止渴亦补，然止渴与生脉，第证状之显著者耳，参之补岂止是哉。其
色黄，其味甘，其全神自注于脾，而扩之，又能无处不到，故建中汤之名，在饴不在参，以
参之不可以一得名也。今试约举仲圣方之用为补者而言之∶补脾如理中丸、黄连汤（参治腹
中痛），补胃如大半夏汤、甘草泻心汤（许氏内台方有人参），补肺胃如竹叶石膏汤，补肝如
乌梅丸、吴茱萸汤，补心已列如上，他如薯蓣丸，温经汤之补，殆不胜其指数，参之补可不
谓广也乎。心痞最不宜参，然以参佐旋复姜夏，则参可用于散痞矣。腹胀最不宜参，然以参
佐浓朴姜夏，则参可用于除胀矣。参能实表止汗，故有表证者忌之；若汗出后烦渴不解，于
寒剂中用之何妨。参能羁邪留饮，故咳证忌之；若肺虚而津已伤，于散邪蠲饮中用之何妨。
参治往来寒热，似疟皆可用参矣，然外有微热即去参。外台于但寒但热、寒多热少之疟，亦
俱无参，惟疟病发渴者用之。盖补虚则助邪，寒热不均，则不可以遽和，人参止渴，辅芩栝
之不逮也，参惟益阴，故能生津。利不止，虽脉微欲绝亦不加参，以利则阴盛而参复益之也。
然下与吐兼，或吐下之后，其中必虚，津必伤，参又在所必需。盖中土有权，则上下悉受其
范，而不敢违戾也。
徐洄溪以邪正之分合，定人参之去取。邹润安更指小柴胡汤之去参，为邪合之据；桂枝
新加汤之有参，为邪分之据。论似精矣，而实有不然也。身有微热，邪尚在表，若又加以实
表之参，则邪益胶固而不解，故必须去之。新加汤发汗后其表已虚，不虑参之实表，脉沉迟
，尤宜参之生脉，以身疼痛之表邪未尽，故尚需桂枝汤驱邪，惟不能敛外散之气，振内陷之
阳，加芍药则散者敛，加生姜则陷者振，更加以参，则脉不沉不迟表不虚，合内外同归于和
。此二方去参加参之所以然，而徐氏、邹氏未见及此。不知参者，善和阴阳，专用以和正，
不用以驱邪；于驱邪之中而加以参，稍一不当，害即随之。故必得如新加汤，驱邪之他药，
不致以人参堕其功，和正之人参，且能为他药弭其隙，始为真知参而用之无误。况邪正之分
合，当以去某经入某经，及病气之进退衰旺为言，不当以一证一脉，判邪正定分合。伤寒之
邪，不与正俱陷而终驻于表者，未之有也，何邹氏之疏耶。
伤寒温热两证，参之出入，关系极重，仲圣之法亦极严。后人得之则效，失之则不效，
竟有彰彰难掩者，试更详之∶伤寒有表证者，仲圣绝不用参，不特麻黄大小青龙桂枝等汤，
丝毫不犯也，即小柴胡汤，外有微热，亦且去之。黄连汤，有桂枝而并无表证。桂枝人参汤
，有表证而参不以解表。柴胡桂枝汤，表里之邪俱微，故表里兼治，表里兼治，故用参以和
之。此伤寒定法也。温热病，仲圣不备其方，而要旨已昭然若揭。黄芩汤，后世奉为温病之
主方，未尝有参。白虎汤，治阳明热盛，效如桴鼓，亦未尝有参，必自汗而渴且无表证者用
之。此温热定法也。迨自隋唐而降，仲圣法渐置不讲，相传之方，如活人书之人参顺气散、
独活散，未见有宜用参之候。许叔微以白虎汤为治中 而不加参，皆诚有可议。然其他变仲
圣方而不失仲圣法者，不可胜举。如以羌防取伤寒之汗，葱豉取温热之汗，俱不佐参。其佐
参者，五积散邪兼表里，攻其邪复和其正，栝蒌根汤则以渴甚，参苏饮则以脉弱，升麻葛根
汤则以脉弱而渴。至萎蕤饮治风热项强急痛四肢烦热，参似不宜矣；而以葱豉散外，萎蕤清
里，因风热烁津，故加人参以和表里而生津。凡袭用之佳方，未有能出仲圣范围者。至败毒
散，方书有无人参者，其原方本有人参，无表里上下应和之故，而欲扶正以驱邪，过矣。乃
喻西昌以治其时大疫，倍加人参得效，则非法之法，仍以仲圣方为根据。何以言之？盖值饥
馑兵燹之余，正气 败。幸其虚非劳损之虚，又用之于群队表药，补之所以有功。仲圣以白
虎汤治中 ，因虚而加参，正是此意。然伤寒有表证之虚，与温热身热之虚不同，为祸为福
，消息甚微。审辨不易，彼于原方删人参者，其亦有见于此矣。
以上所言人参之治，惟真正大参，试之甚验。若今之党参，有甘无苦，何能与人参比烈
。即别直等参，亦未足言冲和煦育之功。要其为补，皆与人参相近，故防误用之弊，亦当与
人参并视也。
凡是毁誉参半的药物，只有人参最为显著。喜好进补的人多赞誉它，喜好攻邪的人多诋毁它；那些赞誉的人中，又各执“补阴”或“补阳”之说，但这些人都不知道这些观点都是错误的。徐洄溪和邹润安则真正掌握了人参的性味与功用。徐氏说：人参汲取了天地纯粹精微之气，补气而没有刚烈燥热的弊端，又能进入阴分。邹氏说：凡属阴性的事物，喜欢高燥而厌恶卑湿；凡属阳性的事物，厌恶明朗爽洁而喜欢阴暗遮蔽。人参不生长在低洼潮湿的原野，而是生长在山谷之中，这是它的体性属阴；但它偏偏生长在树下而不喜风吹日晒，这是属于“阴中之阳”。人体五脏之气，以转输变化为阳，以藏守而不外泄为阴。人参兼具变化与藏守的作用，而且它的颜色黄、味道甘、气凉、质地滋润，符合中央土脏（脾）的德性。这就是它能进入后天脾胃从而培补先天元气的道理。至于论述为什么疾病需要用人参，以及人参为什么能治愈疾病，这两家还没有找到恰当的解释。而陶隐居认为人参功效类似甘草的说法是有见地的。因为甘草，春生苗、夏长叶、秋开花、冬结实，具备四时的全备之气。而且它色黄味甘，远远超出其他黄色和甘味的药物之上，所以能不偏于阳也不偏于阴，居于中宫（脾胃）而通达经脉、调和诸脉，与人参有相似之处。我私下认为，得到这一句话，就可以推测出人参的全貌了。虽然如此，但对于非用人参不能治疗的疾病，怎么能用甘草来替代呢？甘草就是甘草，人参就是人参。想要了解人参的真谛，必须取张仲景的方剂融会贯通并详细辨析，否则哪里还有希望呢？
少阳是三阳经的枢纽，少阴是三阴经的枢纽。凡是称为“枢”的，都是一经之中既有阴又有阳，入内则为阴，外出则为阳，就像门轴机括的转移一样。少阴是水脏而寓含君火，本来阴阳就都具备了。少阳看似只有阳没有阴，但它藏于肝叶之中，是一阳初生而尚不离乎阴，所以这两经相互感应非常容易。肝病有热就会挟带胆火，胆病有寒就会挟带肝风。肝气上逆就是胆气，胆气下降就是肝气。往来寒热虽然是少阳病的症状，却并非完全不涉及肝脏，因为阳气稚嫩，不能完全远离阴气，而有出入相争的现象。相争就应该宜解宜和，人们只知道小柴胡汤是少阳和解的方剂，却不知道柴胡和黄芩专门用于解除邪气，人参才是用来调和的。疾病兼有阴阳，如何和解？难道只用寒药吗？这固然因为少阳的病势较重，退去少阳之邪则厥阴自然安定，况且有人参调停在其中，还担心寒热不止吗？人参作为少阳药的证据确凿：泻心汤证心中烦闷不用人参，但如果胁下有水气就要用人参；胸痹的各种方剂不用人参，但如果胁下之气逆抢心脏就要用人参；即使是小柴胡汤有加减法，唯独在呕吐、口渴、胁下痞硬的情况下不去掉人参，由此可知人参是和缓少阴的专用药。
少阴之所以贵在“和”，是因为“躁”这个症状。烦出于心，躁出于肾，所以栀子豉汤、黄连阿胶汤治疗烦闷时不用人参。烦不一定兼有躁，但躁一定兼有烦。烦与躁同时出现，则有阳证和阴证之分。阳证乃是太阳表实证、阳明腑实证向下侵及肾脏，并非肾脏自身生病，所以大青龙汤、大承气汤治疗烦躁时不用人参。阴证则是肾病向上干犯心脏，肾阳几乎亡失，肾阴怎么可能独自保全，所以吴茱萸汤、茯苓四逆汤治疗烦躁时用人参。由此又可知人参是和缓少阴的专用药。
使用人参进行“和”法，有调和其本腑本脏阴阳的，如少阳、少阴就是这类。至于干姜黄连黄芩人参汤，是因为证候有寒热而进行调和；木防己汤，是因为药物兼有寒热而进行调和；桂枝人参汤，是用来联络表里不和的；生姜泻心汤，是用来联络上下不和的；大建中汤，又是利用花椒、干姜的温燥性质来化除使之调和。调和的方法不止一种，如果不善于使用，
心为牡脏（阳脏），如果烦闷时反而进补，那么烦闷会更加严重。然而小柴胡汤证见烦闷兼有呕吐时并不禁忌用人参（注：若烦闷而不呕吐则去掉半夏和人参，意思是烦闷且呕吐时就不去掉。徐氏《伤寒类方注》有误），白虎加人参汤证见烦闷兼有口渴时也不禁忌，因为呕吐和口渴都是少阳木火所致，
胸胁满硬、呕吐各有正治的药物，用人参特别只是为了调和阴阳罢了。然而生津止渴，则是人参的专长，不一定非要用于少阳病。所以津液被热邪劫夺的阳明证，白虎加人参汤也使用它。脾气虚弱导致津液不生的太阴证，理中丸也使用它。如果口渴饮水但中有水蓄积，小便不利，那么人参就不管用了。
止渴有不需用人参的情况，而生脉（恢复脉气）则唯独人参擅长。因为脉生于营血，营血归属于心。心的本体属阴而功能属阳，只有冲和煦育的人参，才能补益它。所以白虎加人参汤治疗暑病脉虚（脉不虚者，必有兼夹证，不是真正的暑病），四逆加人参汤治疗脉微，通脉四逆汤治疗脉不出，炙甘草汤治疗脉结代，都必须要有用人参。人参的力量，入肾较轻，入心较重。所以足少阴肾得其调和，手少阴心得其补益，这也算是“阴中之阳”的一个证明了。
人参的功效在于补虚，虽然也能止渴，这也是补的一种表现，然而止渴与生脉，只是症状显著的表现而已，人参的补益作用难道仅仅止于此吗？它的颜色黄，味道甘，精神自然专注于脾，进而推广开来，又能无处不到，所以建中汤的名字，重在饴糖而不在人参，因为人参不能靠单一名称得名。现在试着简要列举张仲景方剂中用人参作为补益的例子：补脾如理中丸、黄连汤（人参治疗腹中痛），补胃如大半夏汤、甘草泻心汤（许氏《内台方》中有人参），补肺胃如竹叶石膏汤，补肝如乌梅丸、吴茱萸汤，补心已列在上面，其他的如薯蓣丸、温经汤的补益作用，简直数不胜数，人参的补益范围难道不广泛吗？心下痞满最不宜用人参，但如果用人参辅助旋覆花、生姜、半夏，那么人参就可以用于消散痞满。腹胀最不宜用人参，但如果用人参辅助厚朴、生姜、半夏，那么人参就可以用于消除胀满。人参能实表止汗，所以有表证者忌用；如果出汗后烦渴不解，在寒凉药剂中使用它有什么妨碍呢？人参能羁留邪气、留住饮邪，所以咳嗽证忌用；如果肺气虚而津液已伤，在疏散邪气、蠲除饮邪的药剂中使用它有什么妨碍呢？人参治疗往来寒热，似疟疾的症状都可以用人参，但是如果体表有轻微发热就去掉人参。《外台秘要》对于只寒不热、或寒多热少的疟疾，也都无人参，只有疟疾发病伴有口渴时才用人参。这是因为补虚会助长邪气，寒热不均，就不能急于调和。人参止渴，是辅助黄芩、瓜蒌根所不及的地方，人参唯有益阴，所以能生津。利下不止，即使脉微欲绝也不加人参，因为利下则阴盛，而人参又会益阴。但是如果下利与呕吐兼见，或者在吐下之后，其中必然虚损，津液必然受伤，人参又在所必需。因为中土有权柄，则上下都受其规范，而不敢违背。
徐洄溪以邪正的分合，来决定人参的去留。邹润安更指出小柴胡汤中去掉人参，是邪气聚合的证据；桂枝新加汤中有人参，是邪气分散的证据。议论似乎很精妙，但实际上并非如此。身体有轻微发热，邪气尚在表，如果再加上实表的人参，那么邪气会更加胶固而不能解散，所以必须去掉。新加汤发汗后表已虚，不必担心人参实表，脉沉迟，尤其适宜用人参来生脉，因为身疼痛表明表邪未尽，所以还需要桂枝汤驱邪，只是桂枝汤不能收敛外散之气，振奋内陷之阳，加入芍药则发散之气得以收敛，加入生姜则内陷之阳得以振奋，再加上人参，则脉不沉不迟、表不虚，使内外同归于调和。这两个方剂中加入或去掉人参的原因，徐氏和邹氏都没有考虑到。不知道人参善于调和阴阳，专门用于调和正气，不用于驱除邪气；在驱除邪气的过程中加入人参，稍一不当，祸害随即而来。所以必须像新加汤那样，驱邪的其他药物不会因用人参而堕废其功效，调和正气的人参还能替其他药物弥合缝隙，这才是真正了解人参并正确使用它。何况邪正的分合，应当以病邪离开某经进入某经，以及病气的进退盛衰来说明，不应当以一个症状、一个脉象，来判断邪正而定分合。伤寒的邪气，不与正气一起陷入而最终停留在表证的，是没有的，邹氏为何如此疏漏呢？
伤寒和温热两种证候，人参的出入使用，关系极其重大，张仲景的法度也非常严格。后人用得对就有效，用得不对就没效，甚至有明显难以掩盖的错误，试再详细说明：伤寒有表证者，张仲景绝对不用人参，不仅麻黄汤、大小青龙汤、桂枝汤等方剂丝毫不涉及，就连小柴胡汤，如果体表有轻微发热，也要去掉人参。黄连汤，虽然有桂枝但并没有表证。桂枝人参汤，虽然有表证但人参不是为了发表。柴胡桂枝汤，表里之邪都很轻微，所以表里兼治，表里兼治，所以用人参来调和它们。这是治疗伤寒的定法。温热病，张仲景没有完备的方剂，但要旨已经昭然若揭。黄芩汤，后世奉为温病的主方，从未见过有人参。白虎汤，治疗阳明热盛，效如桴鼓，也从未见过有人参，必须是自汗、口渴且无表证时才使用。这是治疗温热病的定法。等到隋唐以后，张仲景的法度逐渐被搁置不讲，相传的方剂，如《活人书》中的人参顺气散、独活散，没有见到适宜用人参的证候。许叔微认为白虎汤治疗中暑不加人参，确实值得商议。但是其他变通张仲景方剂而不失张仲景法度的，不可胜数。如用羌活、防风取得伤寒之汗，用葱豉取得温热之汗，都不佐助人参。那些佐助人参的，五积散是因为邪气兼涉表里，攻邪的同时调和正气；栝蒌根汤是因为口渴严重；参苏饮是因为脉弱；升麻葛根汤是因为脉弱且口渴。至于萎蕤饮治疗风热导致的项背强急疼痛、四肢烦热，人参似乎不宜使用；但因为除了葱豉散之外，萎蕤清里，由于风热灼伤津液，所以加人参来调和表里并生津液。凡是沿用的好方子，没有能超出张仲景范围的。至于败毒散，方书中有的没有人参，但其原方本有人参，如果没有表里上下应和的缘故，而想扶正以驱邪，就错了。然而喻西昌用它治疗当时的大瘟疫，倍加人参而得效，这是无法之法，但仍以张仲景方剂为根据。为什么这么说？因为在饥荒兵燹之余，正气败坏。幸好他的虚损不是劳损之虚，又用在众多表药之中，补益所以有功。张仲景在白虎汤治疗中暑时，因为虚损而加人参，正是这个意思。然而伤寒有表证的虚损，与温热身热的虚损不同，是祸是福，消息非常微妙。仔细辨别不容易，那些在原方中删除人参的人，或许也是看到了这一点。
以上所说的人参的治疗应用，只有真正的大人参，试用非常灵验。如果是现在的党参，只有甘味没有苦味，怎么能与人参的猛烈相比。即使是别直参等其他参，也不足以谈论冲和煦育的功效。总之它们作为补益药，都与人参相近，所以防止误用的弊端，也应当与人参一并看待。
Among all substances, only Ginseng Radix et Rhizoma (Renshen) is most subject to both praise and blame. Those fond of tonification often praise it, while those fond of purging often condemn it; among those who praise it, there are further disagreements on whether it tonifies Yin or Yang, yet none of these views are correct. Xu Huixi and Zou Run'an truly grasped the nature and function of this substance. Mr. Xu stated: "Ginseng absorbs the pure and exquisite Qi of Heaven and Earth; it tonifies Qi without causing rigid dryness, and can also enter the Yin aspect." Mr. Zou stated: "All Yin substances prefer high and dry places and dislike low and damp ones; all Yang substances dislike bright and crisp environments and prefer shady and obscured ones. Ginseng does not grow in low, wet marshes but in mountain valleys, indicating its body is Yin; yet it grows under trees and dislikes wind and sunlight, making it 'Yin containing Yang.' In the human body, the Qi of the five Zang organs transforms and circulates as Yang, and stores without leaking as Yin. Ginseng possesses both transformative and storing functions. Moreover, its color is yellow, taste is sweet, nature is cool, and texture is moist, conforming to the virtue of the Central Earth Spleen. This is how it enters the Post-Heaven (Spleen/Stomach) to cultivate the Pre-Heaven (Kidney/Essence)." Regarding why diseases require Ginseng and how it cures them, neither scholar provided a precise explanation. However, Tao Hongjing's statement that Ginseng's efficacy is similar to Licorice Root (Gancao) shows insight. Licorice produces shoots in spring, leaves in summer, flowers in autumn, and fruit in winter, possessing the completeness of the Four Seasons. Its yellow color and sweet taste surpass other yellow and sweet substances, allowing it to be neither biased toward Yang nor Yin, residing in the Central Palace (Middle Jiao), unblocking meridians, and harmonizing various pulses, sharing similarities with Ginseng. I believe that understanding this one point allows one to gauge the full measure of Ginseng. Nevertheless, for diseases that cannot be treated without Ginseng, Licorice cannot replace it. Licorice is Licorice, Ginseng is Ginseng. To know the true nature of Ginseng, one must integrate and carefully distinguish Zhang Zhongjing's formulas; otherwise, hope is slim.
Shaoyang is the pivot of the Three Yang channels, and Shaoyin is the pivot of the Three Yin channels. Anything called a "pivot" implies that within one channel, there is both Yin and Yang: entering makes it Yin, exiting makes it Yang, much like the shifting of a hinge. Shaoyin is a Water organ containing Ministerial Fire, thus inherently possessing both Yin and Yang. Shaoyang seems to have only Yang and no Yin, but it resides within the liver lobes; it is the initial birth of Yang, still inseparable from Yin, so these two channels interact easily. Liver heat carries Gallbladder fire; Gallbladder cold carries Liver wind. Liver Qi ascending becomes Gallbladder Qi; Gallbladder Qi descending becomes Liver Qi. Chills and fever alternating, though symptoms of Shaoyang disease, do not entirely exclude the Liver. Because Yang is tender, it cannot completely distance itself from Yin, resulting in a phenomenon of contention between entry and exit. Contention requires resolution and harmony. People know Xiao Chaihu Tang (Minor Bupleurum Decoction) is a Shaoyang harmonizing formula, but they do not know that Chaihu (Bupleuri Radix) and Huangqin (Scutellariae Radix) specifically resolve pathogenic factors, while Renshen (Ginseng Radix et Rhizoma) is used to harmonize. When a disease involves both Yin and Yang, how is it harmonized? Is it only with cold herbs? This is partly because Shaoyang pathogen is dominant; resolving Shaoyang causes Jueyin to settle naturally. Furthermore, with Renshen mediating between them, why worry about unresolved chills and fevers? There is solid evidence that Renshen is a Shaoyang herb: in Xixin Tang (Three Heart Decoction), if there is heart vexation, Renshen is omitted; but if there is water qi under the hypochondrium, it is included. In formulas for Chest Bi (Chest Impediment), Renshen is usually omitted; but if Qi rebels upward seizing the heart, it is included. Even in Xiao Chaihu Tang, which has modification rules, Renshen is retained when there is vomiting, thirst, or hardness/fullness under the hypochondrium. This shows Renshen is a specialized herb for harmonizing Shaoyin.
The value of Shaoyin lies in "harmony," manifested by restlessness (Zao). Vexation (Fan) originates from the Heart; restlessness originates from the Kidney. Therefore, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) and Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction) treat vexation without Renshen. Vexation need not accompany restlessness, but restlessness always accompanies vexation. When vexation and restlessness coexist, there are Yang and Yin syndromes. Yang syndromes involve Taiyang exterior excess or Yangming interior excess invading the Kidney, not a primary Kidney disease; thus, Da Qinglong Tang (Major Green Dragon Decoction) and Dachengqi Tang (Major Order the Qi Decoction) treat restlessness/vexation without Renshen. Yin syndromes involve Kidney disease affecting the Heart; Kidney Yang is nearly exhausted, so how can Kidney Yin remain intact? Thus, Wuzhuyu Tang (Evodia Decoction) and Fuling Sini Tang (Poria and Replenish the Extremities Decoction) treat restlessness/vexation with Renshen. This again confirms Renshen as a specialized herb for harmonizing Shaoyin.
Using Renshen for "harmonization" includes harmonizing the Yin-Yang of its own Fu and Zang organs, such as Shaoyang and Shaoyin. Ganjiang Huanglian Huangqin Renshen Tang (Ginger, Coptis, Scutellaria, and Ginseng Decoction) harmonizes due to mixed cold-heat symptoms; Mufangji Tang (Stephania and Tripterygium Decoction) harmonizes due to mixed cold-heat ingredients; Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) connects exterior-interior disharmony; Shengjiang Xiexin Tang (Fresh Ginger and Three Heart Decoction) connects upper-lower disharmony; Dajianzhong Tang (Great Construct the Middle Decoction) uses the warm-drying properties of Sichuan Pepper and Ginger to transform into harmony. The ways of harmonizing are diverse. If misused...
The Heart is a Yang (Mu) organ. Tonifying during vexation exacerbates it. However, in Xiao Chaihu Tang, if vexation accompanies vomiting, Renshen is not contraindicated (Note: If vexation occurs without vomiting, Banxia and Renshen are removed; meaning if vomiting accompanies vexation, they are kept. Mr. Xu's annotation in *Shanghan Leifang* is erroneous). In Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction), if vexation accompanies thirst, Renshen is not contraindicated, because vomiting and thirst are caused by Shaoyang Wood-Fire.
For fullness/hardness in the chest and hypochondrium, and vomiting, there are specific treatments; Renshen is used specifically to harmonize Yin and Yang. However, generating fluids and quenching thirst is Renshen's specialty, not limited to Shaoyang. Thus, for Yangming syndrome where fluids are depleted by heat, Baihu Jia Renshen Tang uses it. For Taiyin syndrome where Spleen deficiency fails to generate fluids, Lizhong Wan (Regulate the Middle Pill) uses it. However, if thirst is accompanied by water retention in the middle and difficult urination, Renshen is ineffective.
There are cases of quenching thirst that do not require Renshen, but for generating pulse Qi (Mai), Renshen is uniquely capable. Pulse arises from Ying (Nutritive) Blood, which belongs to the Heart. The Heart's substance is Yin, its function is Yang. Only the mild and nurturing Renshen can tonify it. Thus, in Baihu Jia Renshen Tang for summerheat disease with weak pulse (a non-weak pulse implies concurrent syndromes, not pure summerheat); in Sini Jia Renshen Tang for faint pulse; in Tongmai Sini Tang for absent pulse; and in Zhigancao Tang (Roasted Licorice Decoction) for knotted/intermittent pulse, Renshen is essential. Renshen's influence is lighter in the Kidney and heavier in the Heart. Thus, Foot Shaoyin receives harmony, Hand Shaoyin receives tonification, serving as proof of "Yin containing Yang."
Renshen's merit lies in tonifying deficiency. Although quenching thirst is also a form of tonification, these are merely prominent symptoms; Renshen's tonification extends far beyond this. Its yellow color and sweet taste focus its spirit on the Spleen, expanding to reach everywhere. Hence, Jianzhong Tang (Construct the Middle Decoction) is named after Yi (Maltose), not Renshen, because Renshen cannot be defined by a single name. Briefly listing Zhang Zhongjing's formulas using Renshen for tonification: Tonifying Spleen like Lizhong Wan, Huanglian Tang (Renshen treats abdominal pain); Tonifying Stomach like Banxia Houpo Tang (note: text says Banxia Tang, likely referring to Banxia Houpo or similar context, but text says Banxia Tang) and Ganxiao Xiexin Tang (Xu's Neitai Fang includes Renshen); Tonifying Lung-Stomach like Zhuyeshigao Tang (Leaf, Bamboo Sheath, and Gypsum Decoction); Tonifying Liver like Wumei Wan (Mume Pill) and Wuzhuyu Tang; Tonifying Heart listed above. Others like Shuyu Wan (Dioscorea Pill) and Wenjing Tang (Warm the Meridian Decoction) offer countless examples. Is Renshen's tonification not extensive? Heart Pi (fullness/stuffiness) generally forbids Renshen, but combined with Xuanfu, Jiang, and Xia, Renshen can dissipate Pi. Abdominal distension generally forbids Renshen, but combined with Houpo, Jiang, and Xia, Renshen can remove distension. Renshen consolidates the exterior and stops sweating, so it is contraindicated in exterior syndromes; however, if sweating is followed by unresolved vexation/thirst, using it in cold formulas is acceptable. Renshen can trap pathogens and retain fluid retention, so it is contraindicated in coughs; however, if Lung deficiency exists with damaged fluids, using it in formulas that disperse pathogens and eliminate fluid retention is acceptable. Renshen treats alternating chills/fever resembling malaria; however, if slight exterior heat exists, Renshen is removed. *Waitai Mi Yao* excludes Renshen for pure cold, pure heat, or cold-predominant malaria, using it only when thirst accompanies malaria. This is because tonifying deficiency aids pathogens; if cold/heat are uneven, immediate harmonization is impossible. Renshen quenches thirst, assisting Huangqin and Gualougen where they fall short; Renshen benefits Yin, thus generating fluids. If diarrhea persists, even with a faint pulse nearing extinction, Renshen is not added, because diarrhea indicates Yin excess, and Renshen would further benefit Yin. However, if diarrhea accompanies vomiting, or follows vomiting/diarrhea, the interior is deficient and fluids damaged; Renshen is necessary. If the Middle Earth has authority, the upper and lower follow its norms.
Mr. Xu Huixxi determined the use of Renshen based on the separation/conjunction of Pathogen and Righteous Qi. Mr. Zou Run'an pointed out that removing Renshen from Xiao Chaihu Tang indicates pathogen conjunction; including it in Guizhi Xinjia Tang indicates pathogen separation. The argument seems refined but is actually incorrect. Slight exterior heat means the pathogen is still at the exterior; adding exterior-consolidating Renshen would make the pathogen more stubborn, so it must be removed. Xinjia Tang is used after sweating when the exterior is deficient; there is no fear of Renshen consolidating the exterior. With a deep/slow pulse, Renshen is suitable to generate pulse Qi. Body ache indicates residual exterior pathogen, requiring Guizhi Tang to expel it. Guizhi Tang alone cannot收敛 (gather) dispersed Qi or 振 (rouse) sunken Yang. Adding Shaoyao gathers the dispersed; adding Shengjiang rouses the sunken. Adding Renshen ensures the pulse is not deep/slow and the exterior is not deficient, harmonizing interior and exterior. Mr. Xu and Mr. Zou missed this reasoning. One must understand that Renshen excels at harmonizing Yin-Yang, specifically harmonizing Righteous Qi, not expelling pathogens. Adding Renshen during pathogen expulsion is dangerous if mishandled. Only when other expelling herbs in a formula (like Xinjia Tang) prevent Renshen from hindering efficacy, and Renshen helps other herbs bridge gaps, is it true mastery of Renshen. Furthermore, pathogen/righteous separation should be judged by the movement of pathogen between channels and the rise/fall of disease energy, not by a single symptom or pulse. It is rare for Shanghan pathogen to sink with Righteous Qi and stay at the exterior forever; Mr. Zou's oversight is significant.
In Shanghan and Wenre (Warm Heat) diseases, the use of Renshen is critical, and Zhang Zhongjing's methods are strict. Correct use yields results; incorrect use fails, sometimes obviously. In Shanghan with exterior syndromes, Zhang Zhongjing never uses Renshen. Not only Mahuang Tang, Qinglong Tang, Guizhi Tang avoid it, but even Xiao Chaihu Tang removes it if slight exterior heat exists. Huanglian Tang contains Guizhi but has no exterior syndrome. Guizhi Renshen Tang has an exterior syndrome, but Renshen is not for releasing the exterior. Chaihu Guizhi Tang treats mild exterior-interior pathogens, treating both, hence using Renshen to harmonize. This is the fixed method for Shanghan. For Wenbing (Warm Diseases), Zhang Zhongjing's formulas are incomplete, but principles are clear. Huangqin Tang, revered as the main Wenbing formula, never contains Renshen. Baihu Tang treats Yangming heat excess effectively, also never containing Renshen; it is used only for spontaneous sweating, thirst, and absence of exterior syndrome. This is the fixed method for Wenbing. Since Sui/Tang, Zhang's methods were neglected. Formulas like Ren Shen Shunqi San and Duhuo San in *Huren Shu* show no indication for Renshen. Xu Shumi argued against adding Renshen to Baihu Tang for Zhongshu (Heatstroke), which is debatable. However, many modified formulas retaining Zhang's essence exist. Using Qianghuo/Fangfeng for Shanghan sweat, Congchi for Wenbing sweat, without Renshen. Those with Renshen: Wuji San treats exterior-interior pathogens, attacking pathogen while harmonizing righteousness; Gualou Gen Tang uses Renshen for severe thirst; Renshen Su Yin Tang uses it for weak pulse; Shengma Gengen Tang uses it for weak pulse and thirst. Weiru Yin treats wind-heat with neck stiffness and limb heat; Renshen seems inappropriate, but combined with Congchi dispersing exterior and Weiru clearing interior, since wind-heat scorches fluids, Renshen harmonizes exterior-interior and generates fluids. All good inherited formulas stay within Zhang's scope. Baiku San sometimes lacks Renshen in texts, but the original contained it. Without proper exterior-interior-upper-lower harmonization, attempting to support righteousness to expel pathogen is excessive. However, Yu Xichang used double Renshen for a plague with success. This is "method beyond method," based on Zhang's formulas. Why? After famine and war, Righteous Qi was ruined. Fortunately, the deficiency was not chronic consumption, and it was used with many exterior-releasing herbs, so tonification worked. Zhang Zhongjing adding Renshen to Baihu Tang for deficiency aligns with this. However, deficiency in Shanghan with exterior syndrome differs from deficiency in Wenbing with heat; the difference between disaster and blessing is subtle. Differentiation is difficult. Those who deleted Renshen from original formulas likely saw this.
The above applications apply to genuine large Ginseng, which is very effective. Modern Dangshen (Codonopsis Radix) is sweet without bitterness, lacking Ginseng's potency. Other Ginseng varieties also lack the "mild and nurturing" quality. Generally, they are similar to Ginseng for tonification, so precautions against misuse should apply to them equally.