营气始手太阴而出于中焦，卫气始足太阳而出于下焦。营奉胃中水谷之精气以行于经隧
，卫举胃中水谷之悍气以行于肌表。黄 中央黄，次层白，外皮褐，北产体虚松而有孔，味
甘微温，叶则状似羊齿，明系由胃达肺，向外而不中守。有外皮以格之，却又不泄出。独茎
直上，根长二三尺，故能由极下以至极上。凡其所历皆营卫与足太阳手太阴经行之境，论其
致用，则未易一二明也。
刘潜江疏黄 ，以治阳不足而阴亦不利之病，不治阳有余而阴不足之病，与阳不得正其
治于上，阴即不能顺其化于下四语，最为扼要。其解内经阳者卫外而为固，阴者藏精而起亟
，虽稍落宽廓而理固如是。乃邹氏以阳不胜阴，则五脏气争，九窍不通，与卫外起亟，强为
牵合。不知卫生总微论，以黄 一味治小便不利，乃提阳于上而阴自利于下也。即经所谓起
亟，刘氏所谓顺其化于下也。五脏气争之九窍不通，则是阴之争而非阴之不利，与此盖毫厘
之差耳。
黄 与牛膝，皆根长二三尺，别录皆言利阴气。惟牛膝一茎直下而味苦酸平，黄 一茎
直上而味甘微温。故牛膝利阴气，是下利其阴气。黄 利阴气，是从阴中曳阳而上而阴以利
。牛膝有降无升，黄 有升无降，皆屡验不爽。刘氏谓黄 先自下而上，又自上而下。邹氏
谓黄 能升而降，能降而升。此盖黄 疏营卫之后，营卫则然，黄 无此狡狯也。
凡药之用宏而不专主于一者，辨之不精，即致贻误。如黄 补表而不实表，不实表故不
能止汗。如人参之属，疏表而不解表，不解表故不能发汗。如麻黄之属，其亦能止汗、发汗
者，则借黄 疏通营卫、调和阴阳之力也。金匮方黄 无不生用，后世多以蜜炙。然遇中虚
之证
缪仲醇谓黄 功能实表，有表邪者勿用。岂知黄 惟不实表，故表邪亦有用之者。如本
经之排脓止痛，金匮之治风湿、风水、黄汗，皆堪为不实表之据。若伤寒之邪，宜从表泄，
黄虽不实表，而亦无解表之长，且有补虚羁邪之患，断非所宜也。
足太阳脉上额交巅，黄 入太阳经，故能上至于头。膀胱与肾为表里，故亦能益肾气以
化阴而上升。凡方书治尿血等证皆是。汪 庵云∶阴虚者宜少用，恐升气于表而里愈虚。斯
言得之矣。
试以金匮用黄 诸方言之∶小建中汤尤在泾诠解之精，实胜诸家。惟黄 建中汤加黄
两半，第视为充虚塞空，则失之泛矣。诸不足三字所该者广。营卫二气，岂能升降无愆。芍
药用至六两，意在敛里破脾结。加黄 则为疏营卫之气，俾胃中津液，得输于营卫而无阻。
核之黄 桂枝五物汤，黄 与生姜俱较此加倍，且减芍药去甘草，显为宣通血痹而然。岂建
中加黄 ，是徒取补塞乎。桂枝加黄 汤之黄 ，则尤非徒补之谓矣。黄汗与中风汗自出之
汗，同为邪汗，同宜化邪汗为正汗，桂枝汤正的对之方。然黄汗由于阳虚，与桂枝证之但须
泄邪者，瘥有不同，故减少桂芍而加疏表补虚之黄 ，以泄邪而化气。至腰 痛，身重，小
便不利，则由阳不下通，尤非黄 不能下疏其卫。黄瘅脉浮亦用之者，正以黄 为太阳药也
。然则 芍桂酒汤，何为抑之以苦酒哉。盖黄汗同而身肿不同，渴亦不同。肿则阳微表虚，
不任汗解，渴则水气郁于三焦，肾阴不得上朝，自当以通阳化气泻水为亟。 芍桂枝取以通
阳而化气。苦酒则泄热泻水而下达，三物得之，由三焦一气直下也。去生姜者，不使横扩也
。去甘枣者，恐其中停也。用黄 特多，则因其虚。以补剂驱邪，故须六七日乃解，无速效
也。防己黄 汤治汗出恶风，而不以桂枝汤加减者，以彼无湿此有湿也。风水亦用此方，以
与风湿无异也。风湿例用麻桂，而此不用者，盖彼为身痛，此则身重，身痛者风盛而喜动，
身重者湿盛而喜静。脉浮则邪仍在表，表可不解乎，然汗已出而虚虚可虑。湿可不驱乎，然
湿即去而风必愈淫。惟防己解肌表之风湿，直泄而不横泄。黄 宣营卫之壅蔽，疏表而亦补
表。脾土强则能胜湿，故佐以术甘。姜枣多则妨身重，故减其分数。又以后坐被上，被绕腰
下，助下焦温化之气，而邪得以微汗而解。视夫徒知发汗利水补虚，而不能与病机相赴者，
真有霄壤之别。
皮下例宜发汗，而防己茯苓汤，虽水气在皮肤中而脉不言浮，四肢则聂聂动而肿。经云
∶肉蠕动名曰微风。是水浸其脾，脾阳不能达于四肢，而又为微风所搏，故动而肿。动而不
痛，脉不浮，则发汗非宜。防己为风水要药，偶以茯苓，使直泄于小便。病在皮肤，非黄
不能
汗出表虚而宜止汗之证，而四逆加人参与茯苓四逆诸汤，仲圣用人参不用黄 ，以参能
实表， 不实表也。感伤风寒而宜发汗之证，如桂枝与麻黄诸汤，仲圣绝不加 ，以表有邪
，非表之虚也。表有邪而挟虚者，则参不宜而 为宜。然 能直疏不能横解，且性味甘温，
驱邪岂其所胜。故风湿、风水、黄汗等证，仲圣用黄 ，亦只为防己茯苓之辅而已。惟补虚
通痹，则 之专司。故黄 建中汤、黄 桂枝五物汤，皆以黄 统率全方。仲圣之辨药，可
谓精矣。后世用黄 为表剂而至当者，无如唐书许允宗之治柳太后病风，以黄 防风煮数十
斛，于床下蒸之，药入腠理，一周而瘥。此必尚有外证可凭，故开手即以解散风邪为治。经
云∶邪之所凑，其气必虚。又云∶大气一转，邪风乃散。夫补虚散邪，法亦多端，而黄 防
风收效若是之捷者，何也？病者脉沉口噤，自属经络机窍为风邪所中，阳虚而阴壅，大可想
见。黄 非风药，而补阳利阴，通其气道，厥有专长。防风得之，乃克由阳明达表，大驱其
风。此其得诀，在认定脉沉可任黄 ，否则遇中风脉浮汗出而用之，不愈助其虐乎。宋人许
叔微医学至深，而其用黄 ，则似不如允宗之当。本事方载邱生病伤寒尺脉迟弱，叔微谓未
可发汗，而以黄 建中加当归，先调其营血，极为有见。然尺弱宜兼益肾阴，而用由太阳上
升之黄
陆定圃冷庐医话，载许辛木部曹谓其嫂吴氏，患子死腹中，浑身肿胀，气喘身直。其兄
珊林观察，检名人医案得一方，以黄 四两，糯米一酒钟，水煎与服。即便通肿消，已烂之
胎，成十数块逐渐而下，一无苦楚。又山阴王某患肿胀，自顶至踵皆遍，气喘声嘶，大小便
不通，许亦告以前方，煎一大碗，服尽而喘平，小便大通，肿亦随消。继加祛湿平胃之品，
至两月后，独脚面有钱大一块不消。更医痛诋前方，迭进驱湿猛剂，竟至危殆。仍以前方挽
回，用黄 至数斤，脚肿全消而愈。黄 治肿胀有此大效，得不诧为异事。然此亦仲圣早有
以示人者，金匮凡水湿之证，身重身肿，皆不禁用黄 ，皆使水湿下行。许氏所治亦是水肿
。内经三焦为水道，膀胱为水腑，黄 从三焦直升至肺，鼓其阳气，疏其壅滞。肺得以通调
水道，阴气大利，此实黄 之长技。其脚面之不易消，与用 至数斤，盖由仅仗此一味，而
制方之
营气起始于手太阴肺经，产生于中焦；卫气起始于足太阳膀胱经，产生于下焦。营气奉承胃中水谷的精微之气，运行于经脉隧道之中；卫气举起胃中水谷的剽悍之气，运行于肌表之间。黄芪色黄居中央，内层白，外皮褐，北方出产的质地虚松且有孔隙，味道甘甜、性微温，叶片形状像羊齿，明显是由胃达肺，向外发散而不居中守固。因为有外皮包裹阻隔它，所以又不致泄出。唯独茎干直上生长，根长二三尺，所以能从极下到达极上。凡它所经过的地方，都是营卫与足太阳、手太阴经运行的区域，论述它的实际运用，就不容易一二说清楚了。
刘潜江疏解黄芪，用于治疗阳气不足而阴气也不通畅的病证，不治疗阳气有余而阴气不足的病证，这与“阳不能在上方得到正确的治理，阴就不能在下方顺利化生”这四句话，最为扼要。他解释《内经》中“阳者卫外而为固，阴者藏精而起亟”，虽然稍微宽泛廓大，但道理确实如此。然而邹氏将“阳不胜阴，则五脏气争，九窍不通”与“卫外起亟”强行牵合在一起。不知道《卫生总微论》，用黄芪一味药治疗小便不利，这是提举阳气于上，而阴气自然通利于下。也就是经文所说的“起亟”，刘氏所说的“顺其化于下”。至于五脏气争导致的九窍不通，那是阴气的争斗而不是阴气的阻滞不利，与此（黄芪治小便不利）相差毫厘。
黄芪与牛膝，都是根长二三尺，《别录》都说能利阴气。只是牛膝一茎直下，味道苦酸平，黄芪一茎直上，味道甘微温。所以牛膝利阴气，是向下利导阴气；黄芪利阴气，是从阴中牵引阳气而上行，从而阴气得以通利。牛膝只有降没有升，黄芪只有升没有降，这都是多次验证无误的。刘氏说黄芪先自下而上，又自上而下。邹氏说黄芪能升而降，能降而升。这大概是黄芪疏通营卫之后，营卫的状态如此，黄芪并没有这种狡诈变化。
凡是药物的作用宏大而不专门主治某一方面的，辨析如果不精确，就会导致贻误。比如黄芪补表但不实表，因为不实表所以不能止汗。像人参这类药，疏表但不解表，因为不解表所以不能发汗。像麻黄这类药，它能止汗、发汗，则是借助黄芪疏通营卫、调和阴阳的力量。《金匮要略》方剂中的黄芪无不生用，后世多用蜜炙。然而遇到中气虚弱的证候……
缪仲醇说黄芪的功能是实表，有表邪的人不要用。哪里知道黄芪正因为不实表，所以表邪也有使用它的。如《本经》说的排脓止痛，《金匮》治风湿、风水、黄汗，都可以作为不实表的依据。如果是伤寒之邪，应该从表发泄，黄芪虽然不实表，但也无解表的长处，而且有补虚羁留邪气的祸患，绝对不是适宜的。
足太阳脉上行至额部交于巅顶，黄芪入太阳经，所以能上至于头。膀胱与肾互为表里，所以也能益肾气以化阴而上升。凡是方书治疗尿血等证候都是这个原理。汪昂说：阴虚的人宜少用，恐怕升气于表而里更虚。这话是对的。
试着以《金匮要略》使用黄芪的各首方剂来说明：小建中汤尤在泾的诠解非常精辟，实在胜过各家。只是黄芪建中汤加黄芪二两半，如果只视为充虚塞空，那就失之宽泛了。“诸不足”三字所涵盖的范围很广。营卫二气，怎么能升降没有差错呢？芍药用至六两，意在收敛里气、破除脾结。加入黄芪就是疏通营卫之气，使胃中的津液，能输送到营卫而没有阻碍。对照黄芪桂枝五物汤，黄芪与生姜都比此方加倍，且减去芍药去掉甘草，显然是为了宣通血痹而设的。难道建中加黄芪，是仅仅取用补塞吗？桂枝加黄芪汤中的黄芪，就更不是仅仅取用补益的意思了。黄汗与中风汗自出的汗，同为邪汗，同样适宜将邪汗化为正汗，桂枝汤正是对症的方子。然而黄汗由于阳虚，与桂枝证只需泄邪不同，疗效也有差异，所以减少桂枝芍药而加入疏表补虚的黄芪，以泄邪而化气。至于腰痛、身重、小便不利，是由于阳气不能下达，尤其非黄芪不能向下疏导卫气。黄瘅脉浮也使用它，正是因为黄芪是太阳经的药。那么芪芍桂酒汤，为什么要用苦酒来抑制它呢？大概黄汗相同而身体浮肿不同，口渴也不同。浮肿则是阳气微弱表虚，不耐受汗解；口渴则是水气郁结于三焦，肾阴不能上朝，自然应当以通阳化气泻水为急务。芪芍桂枝取用以通阳而化气。苦酒则泄热泻水而下达，三味药配合，由三焦一气直下。去掉生姜，是不让它横向扩散。去掉甘枣，是担心其中停聚。使用黄芪特别多，是因为患者体虚。以补剂驱邪，所以需要六七天才能解除，没有速效。防己黄芪汤治疗汗出恶风，而不以桂枝汤加减，是因为彼方无湿此方有湿。风水也用此方，因为它与风湿无异。风湿例用麻黄桂枝，而此方不用，大概彼方是身痛，此方则是身重，身痛者是风盛而喜欢动，身重者是湿盛而喜欢静。脉浮则邪气仍在表，表可不解吗？然而汗已出而虚虚（使虚者更虚）值得忧虑。湿可不驱吗？然而湿即去而风必更加淫溢。只有防己能解肌表之风湿，直接泄出而不横向泄散。黄芪宣通营卫的壅蔽，疏表同时也补表。脾土强盛则能胜湿，所以佐以术、甘。姜枣多则妨碍身重，所以减少其分量。又让病人后坐于被上，被子绕腰下，助下焦温化之气，而邪气得以微汗而解。比起那些只知道发汗利水补虚，而不能与病机相契合的医生，真有天壤之别。
皮下病变例宜发汗，而防己茯苓汤，虽然水气在皮肤中而脉象不言浮，四肢则微微颤动而肿。经文说：肉蠕动名叫微风。这是水浸渍其脾，脾阳不能达于四肢，而又被微风所搏，所以动而肿。动而不痛，脉不浮，则发汗不适宜。防己是治疗风水的要药，偶尔配伍茯苓，使水气直接从尿液排泄。病在皮肤，非黄芪不能……
出汗表虚而适宜止汗的证候，而四逆加人参及茯苓四逆诸汤，张仲景用人参不用黄芪，因为人参能实表，黄芪不实表。感伤风寒而适宜发汗的证候，如桂枝与麻黄诸汤，张仲景绝不加黄芪，因为表有邪气，不是表虚。表有邪气而挟带虚损的，则人参不宜而黄芪适宜。然而黄芪能直接疏导不能横向解散，且性味甘温，驱邪难道是它的擅长吗？所以风湿、风水、黄汗等证候，张仲景使用黄芪，也只是作为防己茯苓汤的辅助而已。只有补虚通痹，才是黄芪的专职。所以黄芪建中汤、黄芪桂枝五物汤，都以黄芪统率全方。张仲景辨别药物，可以说是精密了。后世使用黄芪作为表剂而至当的，没有超过唐书许允宗治疗柳太后病风的，用黄芪防风煮数十斛，在床下蒸熏，药气进入腠理，一周就痊愈了。这必定还有外证可以凭借，所以开手就以解散风邪为治。经文说：邪之所凑，其气必虚。又说：大气一转，邪风乃散。补虚散邪的方法也很多端，而黄芪防风收效如此快捷，为什么呢？病人脉沉口噤，自然属于经络机窍被风邪所中，阳虚而阴壅，大概可以想象。黄芪不是风药，而补阳利阴，通其气道，确有专长。防风得到它，才能由阳明达表，大驱其风。这其中的诀窍，在于认定脉沉可以使用黄芪，否则遇到中风脉浮汗出而使用它，不是更加助长它的肆虐吗？宋人许叔微医学造诣极深，而他使用黄芪，则似乎不如许允宗得当。《本事方》记载邱生病伤寒尺脉迟弱，许叔微说不可发汗，而以黄芪建中加当归，先调其营血，非常有见地。然而尺弱宜兼益肾阴，而使用由太阳上升的黄芪……
陆定圃《冷庐医话》记载许辛木部曹说他嫂子吴氏，患子死腹中，浑身肿胀，气喘身直。她的哥哥珊林观察，检查名人医案得到一个方子，用黄芪四两，糯米一酒钟，水煎给服。立刻通肿消，已烂的胎，成十数块逐渐而下，毫无痛苦。又山阴王某患肿胀，自顶至踵皆遍，气喘声嘶，大小便不通，许也告诉他前方，煎一大碗，服尽而喘平，小便大通，肿亦随消。继加祛湿平胃之品，至两月后，独脚面有钱大一块不消。换医生痛斥前方，迭进驱湿猛剂，竟至危殆。仍以前方挽回，用黄芪至数斤，脚肿全消而愈。黄芪治肿胀有此大效，不得不诧异为异事。然而这也是张仲圣早有以示人的，《金匮》凡水湿之证，身重身肿，都不禁用黄芪，都使水湿下行。许氏所治也是水肿。《内经》说三焦为水道，膀胱为水腑，黄芪从三焦直升至肺，鼓动其阳气，疏其壅滞。肺得以通调水道，阴气大利，这实在是黄芪的长技。其脚面之不易消，与用黄芪至数斤，大概由仅仗此一味，而制方之……
Ying Qi (Nutritive Qi) originates in the Hand Taiyin Lung Meridian and is generated in the Middle Jiao; Wei Qi (Defensive Qi) originates in the Foot Taiyang Bladder Meridian and is generated in the Lower Jiao. Ying Qi receives the essence of water and grain from the Stomach to circulate within the meridians, while Wei Qi lifts the fierce qi of water and grain from the Stomach to circulate on the muscle surface. Huangqi (Astragalus Root) is yellow in the center, white in the inner layer, and brown on the outer skin. The variety produced in the North is loose with pores, tastes sweet, and is slightly warm. Its leaves resemble fern fronds, clearly indicating a pathway from the Stomach to the Lungs, moving outward rather than staying central and guarding. Because it has an outer skin to block it, it does not leak out easily. Only its stem grows straight upward, and its root is two or three chi long, enabling it to reach from the extreme lower to the extreme upper. All areas it traverses are the domains where Ying Wei and the Foot Taiyang and Hand Taiyin meridians travel. Discussing its practical application is not easy to explain simply.
Liu Qianjiang analyzed Huangqi as treating diseases where Yang deficiency leads to Yin obstruction, but not treating diseases where Yang excess leads to Yin deficiency. This aligns most succinctly with the statement: "If Yang cannot govern properly above, Yin cannot transform smoothly below." His interpretation of the *Neijing* saying, "Yang guards the exterior and solidifies, Yin stores essence and rises urgently," although somewhat broad, holds true reasoning. However, Zou forcibly conflated "When Yang cannot overcome Yin, the Qi of the Five Viscera contends, and the nine orifices become blocked" with "Guarding the exterior and rising urgently." He failed to realize that the *Weisheng Zongwei Lun* uses Huangqi alone to treat difficult urination, which is lifting Yang to the upper part so that Yin naturally benefits below. This corresponds to the scripture's mention of "rising urgently" and Liu's concept of "smooth transformation below." The nine-orifice blockage caused by the contention of Visceral Qi is due to Yin contention, not Yin obstruction, differing by a hair's breadth from this case.
Both Huangqi and Niuxi (Achyranthes Root) have roots two or three chi long, and the *Bielu* states both benefit Yin Qi. However, Niuxy has a single stem growing downward, with a bitter, sour, and neutral taste; Huangqi has a single stem growing upward, with a sweet and slightly warm taste. Thus, Niuxi benefits Yin Qi by directing it downward, whereas Huangqi benefits Yin Qi by pulling Yang up from within Yin, thereby facilitating the flow of Yin. Niuxi descends without ascending, while Huangqi ascends without descending; both principles have been verified repeatedly without error. Liu stated that Huangqi first moves up from below and then down from above. Zou claimed Huangqi can ascend and descend, and descend and ascend. This likely refers to the state of Ying and Wei after Huangqi has unblocked them; Huangqi itself possesses no such cunning variability.
For any herb whose action is broad but not specifically targeted, imprecise differentiation leads to errors. For instance, Huangqi tonifies the exterior but does not consolidate it; because it does not consolidate, it cannot stop sweating. Herbs like Renshen (Ginseng Root) disperse the exterior but do not resolve the exterior pathogen; because they do not resolve the pathogen, they cannot induce sweating. Herbs like Mahuang (Ephedra Herb) can both stop and induce sweating, relying on Huangqi's power to unblock Ying and Wei and harmonize Yin and Yang. In the *Jin Gui Yao Lue*, Huangqi is always used raw, whereas later generations often use honey-fried versions. However, in cases of Middle Jiao deficiency...
Miao Zhongchun stated that Huangqi consolidates the exterior and should not be used when exterior pathogens exist. How could he know that precisely because Huangqi does not consolidate the exterior, it is useful for exterior pathogens? Examples include the *Shennong Bencao Jing*'s description of expelling pus and relieving pain, and the *Jin Gui*'s treatment of Wind-Dampness, Water Swelling, and Yellow Sweat, all serving as evidence that it does not consolidate the exterior. If the pathogen is Cold Damage, it should be vented from the exterior. Although Huangqi does not consolidate the exterior, it lacks the strength to resolve the exterior and carries the risk of tonifying deficiency and trapping the pathogen, making it unsuitable.
The Foot Taiyang meridian travels up to the forehead and intersects at the vertex. Since Huangqi enters the Taiyang meridian, it can reach the head. The Bladder and Kidney are interior-exterior pairs, so Huangqi can also tonify Kidney Qi to transform Yin and ascend. This principle applies to formulas in various texts treating hematuria etc. Wang Ang said: "Those with Yin deficiency should use it sparingly, fearing that raising Qi to the exterior will further deplete the interior." This statement is correct.
Let us analyze the formulas using Huangqi in the *Jin Gui*: You Zaijing's commentary on Xiao Jianzhong Tang is particularly exquisite, surpassing other schools. However, regarding Huangqi Jianzhong Tang adding two taels and half of Huangqi, viewing it merely as filling voids and blocking emptiness is too superficial. The phrase "various deficiencies" covers a wide range. Can Ying and Wei Qi rise and fall without error? Using six taels of Shaoyao (Peony Root) aims to gather the interior and break Spleen stagnation. Adding Huangqi unblocks Ying and Wei Qi, allowing stomach fluids to transport to Ying and Wei without obstruction. Comparing this to Huangqi Guizhi Wuwu Tang, where Huangqi and Shengjiang (Fresh Ginger Rhizome) are doubled compared to this formula, and Shaoyao is reduced and Gancao (Licorice Root) removed, it is clearly designed to promote blood circulation and dispel Bi syndrome. Is adding Huangqi to Jianzhong Tang merely for tonification and filling? In Guizhi Jia Huangqi Tang, the role of Huangqi is certainly not just simple tonification. The sweat from Huanghan (Yellow Sweat) and the spontaneous sweating from Wind Strike are both pathological sweats, both requiring the transformation of pathological sweat into normal sweat. Guizhi Tang is the precise formula for this. However, Huanghan stems from Yang deficiency, differing from the Guizhi pattern which only requires venting pathogens, leading to different therapeutic effects. Therefore, Guizhi and Shaoyao are reduced, and Huangqi, which disperses the exterior and tonifies deficiency, is added to vent pathogens and transform Qi. Regarding lower back pain, heaviness, and difficult urination, these result from Yang failing to descend; only Huangqi can downwardly disperse Wei Qi. It is also used for Huangdan (Yellow Jaundice) with a floating pulse because Huangqi is a Taiyang herb. Then why is Kujie (Vinegar) used to suppress the Qishao Guijiu Tang? Generally, Huanghan presents similarly, but edema differs. Edema indicates weak Yang and deficient exterior, intolerant to sweating. Thirst indicates water-Qi stagnating in the Three Jiao, preventing Kidney Yin from ascending; thus, promoting Yang, transforming Qi, and draining water is urgent. Qishao and Guizhi promote Yang and transform Qi. Kujie drains heat and water downward. These three ingredients work together to move directly downward through the Three Jiao. Removing Shengjiang prevents lateral expansion. Removing Gancao and Dazao (Jujube Fruit) prevents middle-jiao retention. Using large amounts of Huangqi addresses the deficiency. Using a tonifying formula to drive out pathogens takes six to seven days to resolve, lacking rapid effect. Fangji Huangqi Tang treats sweating and aversion to wind; it does not modify Guizhi Tang because the latter lacks Dampness, whereas this formula addresses Dampness. Fengshui (Wind Water) also uses this formula as it is similar to Wind-Dampness. Wind-Dampness typically uses Mahuang and Guizhi, but this formula does not, because the former involves body pain (wind predominance, desire to move), while this involves body heaviness (dampness predominance, desire for stillness). A floating pulse indicates the pathogen remains in the exterior; must the exterior not be resolved? However, sweating has already occurred, raising concerns about further depletion. Must Dampness not be expelled? Yet if Dampness is removed, Wind may become excessive. Only Fangji resolves exterior Wind-Dampness by direct drainage without lateral dispersion. Huangqi promotes Ying and Wei circulation, resolving exterior congestion while also tonifying the exterior. Strengthening Spleen Earth overcomes Dampness, hence assisting with Baizhu (Atractylodes Macrocephala Rhizome) and Gancao. Too much Ginger and Jujube hinders relief of heaviness, so their dosages are reduced. Having the patient sit on a quilt wrapped around the waist aids Lower Jiao warming transformation, allowing pathogens to resolve via slight sweating. Compared to those who only know sweating, diuresis, and tonification without matching the disease mechanism, there is indeed a world of difference.
Subcutaneous conditions usually require sweating. However, in Fangji Fuling Tang, although water-Qi is in the skin and the pulse is not described as floating, the limbs tremble and swell. The scripture says: "Muscle twitching is called Mild Wind." This is water soaking the Spleen, Spleen Yang unable to reach the limbs, combined with assault by Mild Wind, causing movement and swelling. Movement without pain and a non-floating pulse indicate sweating is inappropriate. Fangji is a key herb for Fengshui; occasionally paired with Fuling (Poria), it allows direct drainage via urination. For diseases in the skin, only Huangqi can...
In cases of sweating with exterior deficiency requiring sweating cessation, Zhang Zhongjing uses Renshen but not Huangqi in Sini Jia Renshen Tang and Fuling Sini Tang, because Renshen consolidates the exterior, whereas Huangqi does not. In cases of Wind-Cold invasion requiring sweating induction, such as Guizhi and Mahuang tangs, Zhang Zhongjing absolutely does not add Huangqi, because the exterior has pathogens, not exterior deficiency. When the exterior has pathogens accompanied by deficiency, Renshen is unsuitable, and Huangqi is suitable. However, Huangqi can directly disperse but not laterally resolve, and its sweet-warm nature makes driving out pathogens not its specialty. Therefore, in Wind-Dampness, Fengshui, and Huanghan patterns, Zhang Zhongjing uses Huangqi only as an assistant to Fangji Fuling Tang. Only for tonifying deficiency and unblocking Bi is Huangqi the primary agent. Thus, Huangqi Jianzhong Tang and Huangqi Guizhi Wuwu Tang are led by Huangqi. Zhang Zhongjing's differentiation of herbs was truly precise. Among later generations using Huangqi as an exterior-resolving agent, none were more appropriate than Xu Yongzong in the Tang History treating Empress Dowager Liu's wind illness. He boiled dozens of hu of Huangqi and Fangfeng (Saposhnikovia Root) and steamed the patient in the vapor below the bed. The medicine entered the couli (pores), and she recovered in one week. This must have relied on external symptoms, initiating treatment with dispersing Wind pathogens immediately. The scripture says: "Wherever pathogens gather, Qi must be deficient." And again: "When the Great Qi rotates, Wind pathogens scatter." There are many methods for tonifying deficiency and scattering pathogens, yet why did Huangqi and Fangfeng achieve such rapid results here? The patient had a deep pulse and locked jaw, indicating meridians and orifices were struck by Wind pathogens, with Yang deficiency and Yin stagnation, which can be imagined. Huangqi is not a Wind herb, but its ability to tonify Yang, benefit Yin, and unblock Qi pathways is its specialty. With Fangfeng, it can reach the exterior via the Yangming channel, greatly driving out Wind. The key lies in recognizing that a deep pulse permits the use of Huangqi; otherwise, using it for Wind Stroke with a floating pulse and sweating would only exacerbate the condition. Song dynasty physician Xu Shuwu had profound medical knowledge, yet his use of Huangqi seemed less appropriate than Xu Yongzong's. *Ben Shi Fang* records Qiu Bing suffering from Cold Damage with a slow and weak Chi pulse. Xu Shuwu said sweating was inadvisable and instead used Huangqi Jianzhong Tang plus Danggui (Angelica Sinensis Root) to first regulate Ying and Blood, showing great insight. However, a weak Chi pulse should also tonify Kidney Yin, yet using Huangqi which ascends from Taiyang...
Lu Dingpu's *Leng Lu Yi Hua* records Minister Xu Xinmu stating his sister-in-law Wu suffered from fetal death retained in the uterus, whole-body swelling, asthma, and rigid body. Her brother, Inspector Shanlin, found a prescription from famous medical cases: four liang of Huangqi and one wine cup of Nuomi (Glutinous Rice), decocted in water and administered. Immediately, swelling subsided, and the decomposed fetus broke into ten-plus pieces and passed gradually without pain. Another case from Shanyin, Mr. Wang, suffered from swelling from head to toe, asthma, hoarseness, and urinary/fecal retention. Xu advised the same formula; after drinking a large bowl, breathing calmed, urination flowed freely, and swelling subsided. Subsequently, dampness-dispelling and Stomach-calming herbs were added. Two months later, only a coin-sized area on the sole remained swollen. Other physicians criticized the previous formula, administering strong dampness-draining agents, leading to critical danger. The original formula was used again to rescue him, using several jin of Huangqi, completely eliminating foot swelling and curing the disease. Such great efficacy of Huangqi in treating swelling is astonishing. However, Zhang Zhongjing had already shown this. In the *Jin Gui*, for all Water-Dampness conditions with heaviness and swelling, Huangqi is permitted to direct water-dampness downward. Xu's cases were also edema. The *Neijing* states the Three Jiao is the water pathway and the Bladder is the water organ. Huangqi ascends directly from the Three Jiao to the Lungs, stirring Yang Qi and resolving stagnation. The Lungs can then regulate water passages, greatly benefiting Yin. This is truly Huangqi's specialty. The difficulty in resolving the sole swelling and the need for several jin of Huangqi likely stem from relying solely on this single herb and the formulation...