黄 ，味甘，气微温，气薄而味浓，可升可降，阳中之阳也，无毒。专补气。入手太阴、
足
太阴、手少阴之经。其功用甚多，而其独效者，尤在补血。夫黄 乃补气之圣药，如何补血
独效。盖气无形，血则有形。有形不能速生，必得无形之气以生之。黄 用之于当归之中，
自能助之以生血也。夫当归原能生血，何藉黄 ，不知血药生血其功缓，气药生血其功速，
况气分血分之药，合而相同，则血得气而速生，又何疑哉。或疑血得气而生，少用黄 足矣
，即不少用，与当归平用亦得，何故补血汤中反少用当归而倍用黄 ？不知补血之汤，名虽
补血，其实单补气也。失血之后，血已倾盆而出，即用补血之药，所生之血不过些微，安能
遍养五脏六腑，是血失而气亦欲失也。在血不能速生，而将绝未绝之气，若不急为救援，一
旦解散，顷刻亡矣。故补血必先补气也。但恐补气则阳偏旺而阴偏衰，所以又益之当归以生
血，使气生十之七而血生十之三，则阴阳有制，反得大益。生气而又生血，两无他害也。至
于
补中益气汤之用黄 ，又佐人参以成功者也。人参得黄 ，兼能补营卫而固腠理，健脾胃而
消痰食，助升麻、柴胡，以提气于至阴之中，故益气汤中无人参，则升提乏力，多加黄 、
白术，始能升举。倘用人参、白术而减去黄 ，断不能
升气于至阴也。故气虚之人，毋论各病，俱当兼用黄 ，而血虚之人尤宜多用。惟骨蒸痨热
与中满之人忌用，然亦当临症审量。（〔批〕无黄 不能提气于至阴，创论亦是确论。）
或问黄 性畏防风，而古人云黄 得防风，其功愈大，谓是相畏而相使也，其说然乎？
此说
亦可信不可信之辞也。黄 无毒，何畏防风，无畏而言畏者，以黄 性补而防风性散也，合
而用之，则补者不至大补，而散者不至大散，故功用反大耳。（〔批〕黄 欲防风者，以防
风
能通达上下周身之气，得黄 而生，黄 达表，防风御风，外来之风得黄 而拒绝也。）
或问黄 补气，反增胀满，似乎黄 不可补气也，岂有药以解其胀，抑可不用黄 耶？
夫黄
乃补气药，气虚不用黄 ，又用何药。然服之而增胀满者，非黄 之助气，乃黄 之不助
气也。阴阳有根，而后气血可补。阴阳之根将绝。服补药而反不受补。药见病不能受，亦不
去补病矣。此黄 补气而反增胀满，乃不生气之故。然亦因其不可生而不生也，又岂有别药
以解其胀哉。
或问黄 气分之药，吾子以为补血之品，是凡有血虚之症，俱宜用黄 矣，何以古人用
补血
之药多，用四物汤、佛手散，绝不见用黄 之补血者，岂古人非欤？古人未尝非也，第以血
症不同，有顺有逆。顺则宜用血药以补血，逆则宜用气药以补血也。盖血症之逆者，非血逆
而气逆也，气逆而后血逆耳。血逆而仍用血分之药，则气不顺而血愈逆矣，故必须补气以
安血
也。气逆则血逆，气安则血安，此不易之理也。凡血不宜上行，呕咯吐衄之血，皆逆也。血
犹洪水，水逆则泛滥于天下，血逆则腾沸于上焦，徒治其血，又何易奏平成哉。故必用补气
之药
于补血之中，虽气生夫血，亦气行夫血也。此黄 补血汤所以独胜于千古也。（〔批〕补血
分气逆气顺，确有见解。）
或问黄 以治气逆之血，发明独绝，然而亦有用四物汤、佛手散以止血而效者，又是何
故？
洵乎吾子之善问也。夫血逆亦有不同，有大逆，有小逆。大逆者，必须补气以止血；小逆者
，亦可调血以归经。用四物汤、佛手散治血而血止者，血得补而归经也。盖血最难归经，何
以四物、佛手偏能取效，正因其血逆之轻耳。逆轻者，气逆之小也；逆重者，气逆之大也。
以四物汤、佛手散治血而血安，虽亦取效，终必得效之迟，不若补血汤治气而血止得效之捷
也。
或问黄 补气，初作胀满，而少顷安然者，何也？此气虚见补，反作不受也。黄 补气
之虚
，而胃中之望补，更甚于别脏腑。黄 一入胃中，惟恐有夺其补者，乃闭关而不肯吐，此胀
满所由生也。治之法，用黄 不可单用，增入归、芎、麦冬三味，使之分散于上下之间，
自
无胀满之忧矣。故服黄 胀满有二症，一不能受而一过于受也。过于受者，服下胀而少顷宽
；不能受者，初胀轻而久反重。以此辨之最易别耳。
或问黄 补气之圣药，宜乎凡气虚者，俱可补之矣，何喘满之病反不用者？恐其助满而
增胀
也。先生既明阴阳之道，深知虚实之宜，必有以教我也。曰∶黄 补气而不可治胀满者，非
黄之故，不善用黄 之故也。夫人喘大满，乃肾气欲绝，奔腾而上升，似乎气之有余，实
是气之不足。古人用人参大剂治之者，以人参不能助胀而善能定喘耳，用之实宜。然天下贫
人多而富人少，安得多备人参救急哉。古人所以用黄 代之，而喘满增剧，遂不敢复用，且
志之书曰∶喘满者不可用黄 ，因自误而不敢误人也。谁知黄 善用之以治喘满实神。铎受
异人传，不敢隐也。黄 用防风之汁炒而用之，再不增胀增满，但制之实有法。防风用少，
则力薄不能制黄 ，用多则味浓，又嫌过制黄 ，不惟不能补气，反有散气之忧。大约黄
用一斤，用防风一两。先将防风用水十碗煎数沸，漉去防风之渣，泡黄 二刻，湿透，以火
炒之干。再泡透，又炒干，以汁干为度。再用北五味三钱，煎汤一大碗，又泡半干半湿，复
炒之，火焙干，得地气，然后用之。凡人参该用一两者，黄 亦用一两。定喘如神，而又不
增添胀满，至妙之法，亦至便之法也。凡用黄 ，俱宜如此制之。虽古人用黄 加入防风，
治病亦能得效，然其性尚未制伏，终有跳梁之虞，不若先制之为宜，彼此畏忌而成功更神，
又何喘病之不可治哉。（〔批〕用制黄 以治喘者，救贫寒之人也。若富贵膏梁之子，毕竟
宜用人参。）
或疑黄 得防风其功更大，用黄 加入防风足矣，而必先制而后用，毋乃太好奇乎？不
知用
黄而加防风，则防风之性与黄 尚有彼此之分，不若先制之，调和其性情，制伏其手足，
使之两相亲而两相合，绝不知有同异之分。如异姓之兄弟胜于同胞，相顾而收其全功也。
或疑黄 补气之虚，止可补初起之虚，而不可补久病之虚，予问其故。曰∶初虚之病，用
黄易受；久虚之病，用黄 难受也。嗟乎。虚病用补，宜新久之皆可受，其不可受者，非
气之虚，乃气之逆也。气逆之虚，必用人参，而不可用黄 。在初虚气逆之时，即忌黄 矣
，何待久病而后不可用哉。若气虽虚而无逆，则久病正宜黄 ，未有不服之而安然者也。谁
谓黄 之难受乎。（〔批〕黄 不能补气逆之虚，妙论。）
或疑黄 补气，何以必助之当归以补血，岂气非血不生耶？不知气能生血，而血不能生
气，
不能生气，而补气必补血者，非取其助气也。盖气虚之人，未有不血亦随之而俱耗者也。我
大用黄 以生气，则气旺而血衰，血不能配气之有余，气必至生血之不足，反不得气之益，
而转得气之害矣。故补气必须补血之兼施也。但因气虚以补气，而复补其血，则血旺而气仍
衰，奈何。不知血旺则气不去生
血，故补血而气自旺，不必忧有偏胜之虞。然多补其气而少补其血，则又调剂之甚宜也。
或问黄 何故必须蜜炙，岂生用非耶？然疮疡之门，偏用生黄 ，亦有说乎？曰∶黄 原不
必
蜜炙也，世人谓黄 炙则补而生则泻，其实生用未尝不补也。
黄芪，味甘，气微温，气味轻薄而味道浓厚，既能上升又能下降，属于阳中的阳，无毒。专门补益元气。归入手太阴肺经、足太阴脾经、手少阴心经。它的功效很多，但特别显著的功效，尤其在于补血。黄芪本是补气的神药，为何在补血方面独显奇效？这是因为气是无形的，血则是有形的。有形的物质不能迅速生成，必须依赖无形的气来化生它。黄芪配合当归使用，自然能帮助当归生成血液。当归原本就能生血，为何还需要借助黄芪呢？不知道单纯用血药生血，其功效缓慢；用气药生血，其功效迅速。况且气分药和血分药合用且性质协调，那么血得到气的推动就能迅速生成，这又有什么可怀疑的呢？有人质疑：血得气而生，少量使用黄芪就足够了，即使不减少用量，与当归等量使用也可以，为什么在补血汤中反而减少当归的用量，加倍使用黄芪？不知道所谓的补血汤，名字虽然叫补血，其实主要是补气。失血之后，血液已经大量流失，此时即使用补血药，所生成的血液也不过是微量，怎么能够遍养五脏六腑呢？因此，血丢失时，气也随之想要脱失。既然血不能迅速生成，而对于将绝未绝之气，如果不紧急救援，一旦解散，顷刻间就会消亡。所以，补血必须先补气。但又担心单纯补气会导致阳气偏旺而阴液偏衰，所以又加入当归以生血，使得气生成十分之七，血生成十分之三，这样阴阳就有制约，反而获得大的益处。既生气又生血，两者都没有其他害处。至于补中益气汤中使用黄芪，又是佐助人参来共同完成治疗效果的。人参得到黄芪的配合，兼能补益营卫、固护腠理，健运脾胃、消除痰食，辅助升麻、柴胡，从至阴之中提升清气，所以在益气汤中如果没有人参，升提的力量就不足；如果多加黄芪、白术，才能起到升举的作用。倘若用人参、白术而减去黄芪，绝对不能将气从至阴中提升上来。所以气虚的人，不论患什么病，都应当兼用黄芪，而血虚的人尤其应该多用。只有骨蒸痨热（阴虚发热）和中满（胸腹胀满）的人忌用黄芪，但也应当根据具体病情审慎衡量。（〔批注〕没有黄芪就不能将气提升至至阴，这一创见也是确切的理论。）
有人问：黄芪的药性畏惧防风，但古人说黄芪得到防风的帮助，功效更大，说是相畏而相使的关系，这种说法对吗？这种说法是可以相信也可以不相信的话。黄芪无毒，怎么会畏惧防风？所谓“畏”，是因为黄芪的性质是补益，而防风的性质是发散。两者合用，则补益不会过于峻猛，发散也不会过于猛烈，所以功效反而更大。（〔批注〕黄芪需要防风，是因为防风能通达上下周身的气机，得到黄芪的资助后，黄芪达于体表，防风抵御风邪，外来的风邪被黄芪拒绝。）
有人问：黄芪补气，反而增加胀满，似乎黄芪不可用于补气，难道有药物能解除这种胀满，还是说可以不用黄芪呢？黄芪是补气药，气虚如果不使用黄芪，还能用什么药？然而服用后增加胀满的，不是黄芪助长了气，而是黄芪没能真正助长气。阴阳有根基，然后气血才可以补益。如果阴阳的根基将绝，服用补药反而不能受纳。药物看到病症无法受纳，也就不再去补益病症了。这就是黄芪补气反而增加胀满的原因，是因为它不能生气。这也是因为身体无法接受补益而不产生补益效果，难道还有别的药物能解除这种胀满吗？
有人问：黄芪是气分之药，我认为它是补血的佳品，那么凡是血虚的症状，都应该使用黄芪了，为什么古人使用补血药较多，使用四物汤、佛手散，却很少见到用黄芪来补血的案例，难道是古人错了吗？古人并没有错，只是血证的情况不同，有顺证和逆证之分。顺证适宜用血药来补血，逆证适宜用气药来补血。大概血证的逆证，不是血逆而是气逆，气逆导致血逆。血逆仍然使用血分药，则气不顺而血更加逆乱，所以必须补气来安血。气逆则血逆，气安则血安，这是不变的真理。凡是不宜上行的血，如呕吐、咯血、吐血、衄血的血，都属于逆证。血就像洪水，水逆流则泛滥天下，血逆流则沸腾于上焦，仅仅治疗血，又怎么能容易奏效平定呢？所以必须在补血之中使用补气药，虽然是气生血，也是气行血。这就是黄芪补血汤之所以独胜千古的原因。（〔批注〕区分补血时分气逆气顺，确有见解。）
有人问：黄芪治疗气逆导致的出血，发明独特绝妙，然而也有使用四物汤、佛手散止血而有效的情况，这是什么原因？确实是你善于提问啊。血逆也有不同，有大逆和小逆。大逆，必须补气来止血；小逆，也可以调血使其归经。使用四物汤、佛手散治血而血止住的，是因为血得到补益而归经。血最难归经，为什么四物汤、佛手散偏偏能取效？正因为它们的血逆较轻罢了。逆轻，就是气逆轻微；逆重，就是气逆严重。用四物汤、佛手散治血而血安，虽然也能取效，终究见效慢，不如补血汤治气而血止见效快。
有人问：黄芪补气，起初感到胀满，过了一会儿就安然无恙，为什么呢？这是气虚之人见到补药，反而表现为不受纳。黄芪补的是气的虚弱，而胃中对补益的渴望，比其他脏腑更甚。黄芪一进入胃中，唯恐有东西抢夺它的补益作用，于是关闭门户不肯吐出，这就是胀满产生的原因。治疗方法是，使用黄芪不可单用，应加入当归、川芎、麦冬三味药，使药力分散于上下之间，自然就没有胀满的担忧了。所以服用黄芪出现胀满有两种症状：一种是不能受纳，一种是过度受纳。过度受纳者，服下后胀满，过一会儿就宽松；不能受纳者，起初胀满轻，久了反而重。以此辨别最容易区分。
有人问：黄芪是补气的神药，按理说凡是气虚的人都可补益，为什么喘满的病反而不使用呢？是担心它助长胀满而增加胀感吧。先生既然通晓阴阳之道，深知虚实适宜之处，一定有教导我的方法。回答说：黄芪补气但不能治疗胀满，这不是黄芪的过错，而是不善用黄芪的缘故。人出现气喘胸满，是肾气将绝，奔腾而上冲，看起来像是气有余，实际上是气不足。古人使用大剂量人参治疗，是因为人参不能助长胀满而善于定喘，使用它确实适宜。然而天下穷人多数而富人少数，哪里能多备人参来救急呢？古人所以用黄芪代替，但喘满加重，于是就不敢再用，并且记载在书中说：喘满者不可用黄芪，因为自己误用而不敢再误导他人。谁知道善于运用黄芪来治疗喘满其实很神奇。我陈士铎接受异人的传授，不敢隐瞒。黄芪用防风的汁液炒制后使用，就不再增加胀满，但炮制确实有法度。防风用得少，则力量薄弱不能制约黄芪；用得多，则味道浓烈，又嫌过度制约黄芪，不但不能补气，反而有散气的忧虑。大约黄芪用一斤，用防风一两。先将防风用水十碗煎煮几沸，滤去防风的渣滓，浸泡黄芪两刻钟，湿透，用火炒干。再浸泡透，又炒干，以汁液干为限度。再用北五味子三钱，煎汤一大碗，又浸泡到半干半湿，再炒，火焙干，吸收地气，然后使用。凡是人参该用一两的，黄芪也用一两。定喘如神，而且不增添胀满，是极妙的法子，也是极方便的法子。凡是使用黄芪，都应当如此炮制。虽然古人使用黄芪加入防风，治病也能取效，但其药性尚未完全制约，终有跳梁（药效失控）的忧虑，不如先炮制为宜，彼此相互制约而成功更神奇，还有什么喘病不可治的呢？（〔批注〕用炮制的黄芪来治疗喘证，是为了救济贫寒之人。若是富贵膏粱之子，毕竟适宜用人参。）
有人怀疑：黄芪得到防风功效更大，用黄芪加入防风就够了，却一定要先炮制而后使用，未免太好奇了吧？不知道用黄芪加防风，则防风的药性与黄芪尚有彼此之分，不如先炮制，调和它们的性情，制约它们的手脚，使它们两相亲近而两相融合，完全不知道有同异之分。如同异姓兄弟胜过同胞兄弟，互相照应而收全功。
有人怀疑：黄芪补气虚，只可补初起的虚损，而不可补久病的虚损，我问其原因。回答说：初起虚的病，使用黄芪容易受纳；久虚的病，使用黄芪难以受纳。唉！虚病用补，无论是新病还是久病都应该能受纳，那些不能受纳的，不是气的虚损，而是气的逆乱。气逆的虚损，必须用人参，而不可用黄芪。在初起气逆之时，就忌讳使用黄芪了，何待久病之后才不可用呢？如果气虽虚而无逆乱，则久病正适宜用黄芪，没有不服用而安然无恙的。谁说黄芪难以受纳呢？（〔批注〕黄芪不能补气逆之虚，这是精妙的论述。）
有人怀疑：黄芪补气，为什么必须辅助当归来补血，难道气不是由血生的吗？不知道气能生血，而血不能生气。不能生气，而补气必兼补血，并非为了取助于气。大概气虚的人，没有不伴随血也一起耗损的。我大量使用黄芪以生气，则气旺而血衰，血不能配益气之有余，气必然导致生血之不足，反而得不到气的益处，转而得到气的害处了。所以补气必须兼施补血。但因为气虚而补气，又补其血，则血旺而气仍衰，怎么办呢？不知道血旺则气不去生血，所以补血而气自然旺盛，不必担忧有偏胜的忧虑。然而多补其气而少补其血，则是调剂得非常适宜的。
有人问：黄芪为什么必须蜜炙，难道生用不好吗？然而在疮疡科门，偏用生黄芪，也有说法吗？回答说：黄芪原本不一定非要蜜炙，世人认为黄芪炙则补而生则泻，其实生用也未尝不补。
Astragali Radix (Huangqi), sweet in taste, slightly warm in nature, with a light aroma and strong flavor, capable of ascending and descending, belongs to the Yang within Yang, non-toxic. It specifically tonifies Qi. It enters the Hand Taiyin Lung Meridian, Foot Taiyin Spleen Meridian, and Hand Shaoyin Heart Meridian. Its functions are numerous, but its most remarkable efficacy lies particularly in nourishing Blood. Astragalus is indeed a divine medicine for tonifying Qi; how can it be uniquely effective in nourishing Blood? This is because Qi is formless, whereas Blood has form. Formed substances cannot be generated rapidly; they must rely on formless Qi to generate them. When Astragalus is used together with Angelicae Sinensis Radix (Danggui), it naturally assists in generating Blood. Angelicae Sinensis Radix itself can generate Blood; why does it need to rely on Astragalus? One should know that using Blood-nourishing medicines alone to generate Blood is slow, while using Qi-tonifying medicines to generate Blood is fast. Moreover, when Qi-regulating medicines and Blood-nourishing medicines are combined harmoniously, Blood receives the impetus from Qi and generates rapidly. What could there be to doubt? Some may question: Since Blood is generated by Qi, a small dose of Astragalus should suffice. Even if not reduced, using equal amounts with Angelicae Sinensis Radix would work. Why does the Bu Xue Tang (Blood-Nourishing Decoction) use less Angelicae Sinensis Radix and double the dose of Astragalus? The reason is unknown. Although named "Blood-Nourishing," this decoction essentially focuses on tonifying Qi. After hemorrhage, blood has been lost profusely. Even if Blood-nourishing medicines are administered, the amount of new Blood generated will be minimal. How can such a small amount nourish the Five Zang and Six Fu organs? Thus, when Blood is lost, Qi also tends to escape. Since Blood cannot be regenerated quickly, the Qi that is on the verge of collapse but not yet gone must be rescued urgently. If not saved immediately, once dispersed, it will vanish in an instant. Therefore, to nourish Blood, one must first tonify Qi. However, there is a fear that tonifying Qi alone might cause Yang to become excessive and Yin deficient. Hence, Angelicae Sinensis Radix is added to generate Blood, ensuring that seven-tenths of the effect comes from Qi generation and three-tenths from Blood generation. This balances Yin and Yang, resulting in great benefit. Generating both Qi and Blood causes no harm. In the case of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Astragalus is used in conjunction with Ginseng Radix et Rhizoma (Renshen) to achieve success. With the assistance of Astragalus, Ginseng Radix et Rhizoma can simultaneously tonify Ying and Wei (Defensive and Nutritive Qi), consolidate the Couli (pores/skin texture), strengthen the Spleen and Stomach, and resolve phlegm and food stagnation. It aids Shengma Rhizoma (Cimicifugae Rhizoma) and Chaihu Radix (Bupleuri Radix) to lift Qi from the deepest Yin levels. Without Ginseng Radix et Rhizoma in the Qi-augmenting decoction, the lifting force is weak. Adding more Astragalus and Atractylodis Macrocephalae Rhizoma (Baizhu) enables proper elevation. If Ginseng Radix et Rhizoma and Atractylodis Macrocephalae Rhizoma are used without Astragalus, it is impossible to lift Qi from the profound Yin. Therefore, individuals with Qi deficiency should generally use Astragalus regardless of their specific disease, and those with Blood deficiency especially should use it frequently. However, it is contraindicated for those with bone-steaming tubercular fever (Gu Zheng Lao Re - Yin-deficiency heat) and abdominal fullness (Zhong Man). Nevertheless, clinical judgment is required. [Commentary: Without Astragalus, Qi cannot be lifted to the profound Yin; this innovative theory is indeed accurate.]
Someone asks: Astragalus is said to be inhibited by Saposhnikoviae Radix (Fangfeng), yet ancients stated that Astragalus becomes more effective with Fangfeng, describing a relationship of mutual inhibition and mutual enhancement. Is this true? This statement is credible yet questionable. Astragalus is non-toxic; why would it fear Fangfeng? The term "fear" implies that Astragalus has a tonifying nature, while Fangfeng has a dispersing nature. When combined, the tonification is not overly aggressive, and the dispersion is not too intense, thus enhancing overall efficacy. [Commentary: Astragalus needs Fangfeng because Fangfeng can unblock Qi throughout the body. Assisted by Astragalus, Astragalus reaches the exterior, Fangfeng defends against wind, and external wind pathogens are repelled by Astragalus.]
Someone asks: Astragalus tonifies Qi but sometimes increases distension, suggesting it might not be suitable for tonifying Qi. Is there a medicine to relieve this distension, or should Astragalus simply be avoided? Astragalus is a Qi-tonifying herb. If Qi deficiency exists and Astragalus is not used, what else can be used? However, if distension increases after ingestion, it is not because Astragalus promotes Qi excessively, but because it fails to properly assist Qi. Only when Yin and Yang have a root can Qi and Blood be tonified. If the root of Yin and Yang is perishing, the body cannot accept tonics. When a medicine finds that the condition cannot tolerate tonification, it ceases to tonify. This explains why Astragalus, intended to tonify Qi, causes increased distension—it fails to generate Qi. It is due to the body's inability to accept tonification that no benefit arises. Are there other medicines to relieve such distension?
Someone asks: Astragalus acts on the Qi level, yet you consider it a Blood-nourishing agent. Shouldn't all cases of Blood deficiency use Astragalus? Why do ancient texts show frequent use of Blood-nourishing formulas like Siwu Tang (Four Substances Decoction) and Foshou San (Buddha's Hand Powder), rarely mentioning Astragalus for Blood nourishment? Were the ancients wrong? The ancients were not wrong; rather, Blood disorders differ, having favorable (Shun) and unfavorable (Ni) patterns. Favorable patterns suit Blood-nourishing medicines; unfavorable patterns suit Qi-tonifying medicines. In unfavorable Blood disorders, it is not Blood that rebels, but Qi that rebels, leading to rebellious Blood. If rebellious Blood is treated with Blood-level medicines, Qi remains unsmooth, and Blood becomes more rebellious. Thus, one must tonify Qi to calm Blood. When Qi rebels, Blood rebels; when Qi calms, Blood calms. This is an immutable principle. Blood that should not ascend, such as in vomiting, hemoptysis, epistaxis, constitutes rebellion. Blood is like floodwater; if water flows backward, it floods the world; if Blood rebels, it boils in the Upper Jiao. Treating only Blood makes it difficult to achieve peace. Therefore, Qi-tonifying medicines must be included in Blood-nourishing prescriptions. Although Qi generates Blood, Qi also moves Blood. This is why Huangqi Bu Xue Tang (Astragalus Blood-Nourishing Decoction) excels through the ages. [Commentary: Distinguishing between Qi rebellion and smoothness in Blood nourishment shows profound insight.]
Someone asks: Astragalus uniquely treats Blood disorders caused by Qi rebellion, yet Siwu Tang and Foshou San also stop bleeding effectively. Why? Indeed, you ask well. Blood rebellion varies into major and minor forms. Major rebellion requires Qi tonification to stop bleeding; minor rebellion can be managed by regulating Blood to return it to its vessels. Using Siwu Tang or Foshou San stops bleeding because the Blood is replenished and returns to its channels. Blood is hardest to return to its channels; why do these formulas succeed? Because the Blood rebellion is mild. Mild rebellion indicates slight Qi rebellion; severe rebellion indicates significant Qi rebellion. While Siwu Tang and Foshou San can stabilize Blood, their effect is slower compared to the rapid cessation of bleeding achieved by Bu Xue Tang treating Qi.
Someone asks: Astragalus tonifies Qi, causing initial distension that resolves shortly after. Why? This occurs because Qi deficiency patients initially reject tonics. Astragalus tonifies Qi deficiency, and the Stomach craves tonification more than other organs. Upon entering the Stomach, fearing competition for tonification, the Stomach closes up and refuses to release, causing distension. The treatment is to never use Astragalus alone; add Danggui, Chuanxiong Rhizoma (Chuanxiong), and Ophiopogonis Radix (Maidong) to disperse the action throughout the upper and lower body, eliminating distension concerns. There are two types of distension from Astragalus: intolerance and over-reaction. Over-reaction presents as initial distension that relaxes soon after; intolerance presents as mild initial distension that worsens over time. These are easily distinguished.
Someone asks: As a divine Qi tonic, shouldn't all Qi deficiencies use it? Why is it avoided in cases of panting and fullness? Perhaps due to fears of exacerbating fullness. Having mastered Yin-Yang and Deficiency-Excess principles, I seek your guidance. Answer: Astragalus tonifies Qi but cannot treat fullness; this is not Astragalus's fault, but improper usage. Panting and chest fullness indicate Kidney Qi nearing exhaustion, surging upward. It appears as Qi excess but is actually Qi deficiency. Ancients used large doses of Ginseng Radix et Rhizoma because it does not aggravate fullness and effectively calms panting. However, Ginseng is expensive and scarce for the poor. Ancients substituted Astragalus, but when panting worsened, they stopped using it and recorded that "Astragalus is contraindicated in panting/fullness," avoiding further error. Who knew that skilled use of Astragalus could miraculously treat panting/fullness? I received transmission from an unusual master and dare not hide it. Process Astragalus with Saposhnikoviae Radix juice: fry until dry. Too little Fangfeng fails to control Astragalus; too much overwhelms it, risking Qi dispersion. Generally, use 1 jin of Astragalus with 1 liang of Fangfeng. Boil Fangfeng in 10 bowls of water briefly, remove dregs, soak Astragalus for 30 minutes until wet, then stir-fry dry. Repeat soaking and frying until juice is absorbed. Then decoct 3 qian of Schisandrae Fructus (Wuweizi) in 1 bowl of water, soak Astragalus until half-wet/half-dry, stir-fry, and bake dry to absorb Earth Qi. Use 1 liang of Astragalus where 1 liang of Ginseng is indicated. This calms panting miraculously without increasing fullness. All Astragalus should be processed this way. Although ancients used raw Astragalus with Fangfeng successfully, the properties were not fully controlled, risking erratic effects. Pre-processing is better, ensuring mutual restraint and greater efficacy. [Commentary: Using processed Astragalus for panting saves the poor. For the wealthy, Ginseng is preferable.]
Some suspect that adding Fangfeng to Astragalus is sufficient and pre-processing is unnecessarily curious. Not knowing that combining raw Astragalus and Fangfeng leaves their natures distinct. Pre-processing harmonizes their characters, subdues their actions, making them intimately united without distinction, like sworn brothers surpassing biological ones, achieving complete efficacy.
Some suspect Astragalus only treats acute Qi deficiency, not chronic. Reason given: Acute deficiency accepts Astragalus easily; chronic deficiency rejects it. Alas! Tonification for deficiency should be accepted by both new and old conditions. Those who reject it suffer from Qi rebellion, not simple deficiency. Qi rebellion requires Ginseng Radix et Rhizoma, not Astragalus. Even in early stages of Qi rebellion, Astragalus is contraindicated. If Qi is deficient but not rebellious, even chronic deficiency suits Astragalus, with no adverse reactions. Who says Astragalus is hard to tolerate? [Commentary: Astragalus cannot tonify Qi deficiency accompanied by rebellion; a brilliant argument.]
Some suspect: Astragalus tonifies Qi, why must it be assisted by Danggui to nourish Blood? Isn't Blood the source of Qi? Know that Qi generates Blood, but Blood does not generate Qi. Tonifying Qi requires accompanying Blood nourishment not to aid Qi directly, but because Qi deficiency invariably involves concurrent Blood depletion. Using large doses of Astragalus to generate Qi makes Qi vigorous but Blood weak. Blood cannot match the excess of Qi, leading to insufficient Blood generation, losing Qi's benefits and suffering its harms. Thus, tonifying Qi must include Blood nourishment. But if Qi deficiency is treated by tonifying Qi and then separately tonifying Blood, Blood becomes vigorous while Qi remains weak. How to resolve this? Knowing that when Blood is vigorous, Qi does not need to generate more Blood, so tonifying Blood naturally strengthens Qi, avoiding imbalance. However, tonifying Qi more heavily than Blood is the ideal balance.
Someone asks: Why must Astragalus be honey-fried? Is raw use inferior? Yet in Sores and Ulcers, raw Astragalus is preferred. Explanation: Astragalus need not necessarily be honey-fried. People believe fried Astragalus tonifies and raw Astragalus drains, but raw use also tonifies.