天师曰∶气治者，气实气虚而不可不平之也，气实者，非气实，乃正气虚而邪气实也。若作正气之
实，而用消气之药，使正气益虚而邪气益实，害且不可救药。方用补正之药，而佐以祛邪之品，则正气自
旺，邪气日消矣。方用人参一钱，白术一钱，甘草一钱，柴胡三钱，白芍三钱，麻黄一钱，半夏一钱，水
煎服。此方之妙，亦是用散药于补正之中，使正气旺于邪气，自然两相击斗，邪可逃亡，否则适所取败。
此气病宜知气治耳。
张公曰∶气治法甚多，天师止言一条，似乎未备，余更广之。气陷，补中益气汤可用；气衰，六君
子汤可采∶气寒，人参白术附子汤可施；气虚，则用四君子；气郁，则用归脾汤；气热，则用生脉散∶气
喘，则用独参汤；气动，则用二陈汤加人参；气壅滞，则用射干汤∶气逆，则用逍遥散。余广至此，气治
之法，庶几全乎，人可因症而施治也。
华君曰∶同。予更有论。气虚、气实，原有分别。气虚则羸弱而难施，气实则壮盛而易察。虚者用天
师之方，实者另有一方。枳壳五分，白术一钱，陈皮五分，茯苓三钱，甘草一钱，山楂十粒，柴胡一钱，白
芍三钱，炒栀子一钱，水煎服。（〔批〕消实汤。）亦可佐天师之未逮。
雷公曰∶华君补得妙。
论治血宜顺性
天师曰∶血治者，乃血病不肯归经，或上或下，或四肢皮毛，合处出血者是也。血循经络，外
行于皮毛，中行于脏腑，内行于筋骨，上行于头目两手，下行于二便两足一脐。是周身无非血路，一不归
经，自然各处妄行，有孔则钻，有洞则泄，甚则吐呕，标出于毛孔，流出于齿缝，渗出于腹脐而不止大小便之
出也。然则血宜顺其性而不宜拂。方用当归三钱，白芍三钱，熟地五钱，川芎一钱，荆芥末一钱，生地五钱，
麦冬三钱，茜草根一钱，甘草一钱，水煎服。此方即四物汤加减，妙在用茜草根、荆芥，引血归经，不拂乱
其性，则血自归经，各不相犯矣。倘用止血之剂，未尝无效。然而如石压草，一时虽止，而性思冲突，必得
空隙，仍飞越沸腾，
何如此方顺其性而引之，譬如与强横之人同行，少拂其意，便怀愠怒，愠怒未已，必致斗殴，皮碎血流
是其常也。若赞扬称颂，顺其性而与之饮食，则同群相得，转得其气力，以助我匮乏。同舟无敌国之形，
一室无操戈之事，久且为我绸缪，彻我桑土，不特血不妄行，亦将润筋生色，永断覆辙之患，又何必绝之
太甚，以自取争斗哉，此血治之法，尤当留意。
张公曰∶讲得近理近情。治血以四物汤为主，加荆芥、茜草更妙，顺其性而引其归经也。然而用六味
丸汤治血症亦妙。盖血病最忌寒凉之品，寒则凝滞不行，难以归经。六味丸汤，妙在不寒不热，补肾水以
滋肝木。肝木得养，则血有可藏之经，自然不致外泄，何至上吐。方用熟地五钱，山茱萸三钱，山药二钱，
丹皮二钱，泽泻二钱，茯苓二钱。此六味地黄汤方也。又加麦冬三钱，北五味一钱，得此二味，又去清
补肺金，使皮毛有养，毛孔坚固，则血难外越。肺金不干，下且足以克肝，而肝木畏金之克，又何至上犯于
肺耶。故血症最宜用此方。久服三年不吐，始庆重生，否则，尚在生死之间也。
华君曰∶同。而余又另有方，用生地一两，荆芥一钱，麦冬三钱，元参三钱，水煎服。（〔批〕止
血归经方。）一剂止血，后用六味汤全愈。
雷公曰∶血症，余亦有奇方。用生地一两，三七根末三钱，荆芥末一钱，人参三钱，水煎，调末服。
一剂即止血。
后亦须用六味汤调理。
天师说：治疗气病的原则，在于调理气的实证和虚证，使其恢复平衡。所谓气实，并非正气充实，而是正气虚弱而邪气亢盛。如果误认为是正气的实证，而使用消导气机的药物，会使正气更加虚弱，邪气更加亢盛，其危害将不可挽救。正确的方剂应使用补益正气的药物，并辅以祛除邪气的药材，这样正气自然旺盛，邪气日渐消退。方用人参一钱，白术一钱，甘草一钱，柴胡三钱，白芍三钱，麻黄一钱，半夏一钱，加水煎服。此方的妙处，在于在补益正气之中配合发散邪气的药物，使正气强于邪气，正气与邪气自然相互搏击，邪气便会逃散；否则就会招致失败。这就是治疗气病应当知晓的气治法。
张公说：气治法有很多，天师只讲述了一条，似乎不够完备，我在此基础上进一步扩充。气陷（中气下陷），可以使用补中益气汤；气衰（元气不足），可以采用六君子汤；气寒（阳气不足），可以施用人参白术附子汤；气虚，则使用四君子汤；气郁（气机郁滞），则使用归脾汤；气热，则使用生脉散；气喘，则使用独参汤；气动（气机紊乱），则使用二陈汤加人参；气壅滞（气机阻塞不通），则使用射干汤；气逆（气机上逆），则使用逍遥散。我扩充至此，气治的方法，差不多就齐全了，人们可以根据症状来实施治疗。
华君说：同意。我还有进一步的论述。气虚和气实，原本是有区别的。气虚表现为身体瘦弱难以施治，气实则表现为体质壮盛容易察觉。虚证使用天师的方子，实证则有另外一方。枳壳五分，白术一钱，陈皮五分，茯苓三钱，甘草一钱，山楂十粒，柴胡一钱，白芍三钱，炒栀子一钱，加水煎服。（批注：消实汤。）这也可以弥补天师方子的不足之处。
论治疗血病应当顺应其本性
天师说：治疗血病，是指血液病变不能回归经脉，或者向上、向下出血，或者在四肢皮毛等部位出血。血液循行于经络，外行于皮毛，中行于脏腑，内行于筋骨，上行于头目和双手，下行于大小便和双足及脐部。全身无非是血路，一旦不回归经脉，自然会到处妄行，有孔洞就钻入，有缝隙就渗出，严重时出现呕吐，血液从毛孔流出，从齿缝渗出，从腹部脐部渗漏不止，甚至导致大小便出血不止。既然这样，血液宜顺应其本性而不宜违背。方用当归三钱，白芍三钱，熟地黄五钱，川芎一钱，荆芥末一钱，生地黄五钱，麦冬三钱，茜草根一钱，甘草一钱，加水煎服。此方即四物汤加减而成，妙在用茜草根、荆芥，引导血液回归经脉，不扰乱其本性，那么血液自然回归经脉，各不相犯。如果使用止血药剂，未尝没有效果。然而这如同石头压草，虽然暂时止住，但血液的本性想要冲撞突破，必定寻找空隙，仍然会飞越沸腾。何如这个方子顺应其本性而引导它，譬如与强横的人同行，稍微违背他的心意，他就会怀恨发怒，愤怒不已，必然导致斗殴，皮破血流是常有的事。如果赞扬称颂，顺应其本性并供给饮食，就能与其和睦相处，反而得到他的力气，来助我的匮乏。就像同舟共济没有敌国的形状，同一间屋中没有持戈相向的事情，久而久之他会为我修缮房屋，不仅血液不再妄行，还会滋润筋骨、润泽面色，永远断绝翻车的祸患，又何必过于绝情以自取争斗呢？这就是治疗血病的方法，尤其应当留意。
张公说：讲得合乎情理。治疗血病以四物汤为主，加上荆芥、茜草更妙，这是顺应其本性而引导其回归经脉。然而使用六味丸汤治疗血症也很奇妙。因为血病最忌讳寒凉的药物，寒则凝滞不行，难以回归经脉。六味丸汤的妙处在于不寒不热，补肾水以滋养肝木。肝木得到滋养，那么血液就有可藏纳的经脉，自然不至于外泄，怎么会向上吐血呢？方用熟地黄五钱，山茱萸三钱，山药二钱，牡丹皮二钱，泽泻二钱，茯苓二钱。这就是六味地黄汤的方子。又加入麦冬三钱，北五味子一钱，有了这两味药，又能清补肺金，使皮毛得到滋养，毛孔坚固，那么血液就难以外越。肺金不受干扰，向下足以克制肝木，而肝木畏惧金的克制，又怎么会向上侵犯肺脏呢？所以血症最适合使用此方。久服三年不吐血，才值得庆贺重生，否则，还在生死之间徘徊。
华君说：同意。而我又有另外的方子，用生地黄一两，荆芥一钱，麦冬三钱，玄参三钱，加水煎服。（批注：止血归经方。）一剂即可止血，之后用六味汤完全治愈。
雷公说：对于血症，我也有奇方。用生地黄一两，三七根末三钱，荆芥末一钱，人参三钱，加水煎煮，调服粉末。一剂即可止血。
之后也必须用六味汤进行调理。
Tian Shi (Heavenly Master) said: The treatment of Qi disorders aims to balance excess and deficiency of Qi. What is termed "Qi excess" is not an abundance of healthy Qi, but rather a state where healthy Qi is deficient while pathogenic Qi is excessive. If one mistakenly treats it as an excess of healthy Qi and uses drugs that dissipate Qi, healthy Qi will become further depleted and pathogenic Qi more entrenched, leading to incurable harm. The correct prescription should employ herbs that tonify healthy Qi, assisted by agents that dispel pathogens. In this way, healthy Qi will naturally flourish, and pathogenic Qi will gradually diminish. The formula consists of Ren Shen (Ginseng Radix) 1 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1 qian, Gan Cao (Licorice Root) 1 qian, Chai Hu (Bupleuri Radix) 3 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Ma Huang (Ephedrae Herba) 1 qian, and Ban Xia (Pinelliae Rhizoma) 1 qian, decocted in water and taken orally. The brilliance of this formula lies in combining dispersing agents within the framework of tonifying healthy Qi, ensuring that healthy Qi surpasses pathogenic Qi. Consequently, the two will contend, and the pathogen will flee; otherwise, defeat is inevitable. This illustrates the principle of treating Qi disorders.
Zhang Gong stated: There are many methods for treating Qi disorders. Tian Shi mentioned only one, which seems incomplete. I shall expand upon it. For Qi sinking (prolapse due to Qi deficiency), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) can be used; for Qi decline (deficiency of primal Qi), Liu Jun Zi Tang (Six Gentlemen Decoction) may be adopted; for Cold Qi (Yang deficiency), Ren Shen Bai Zhu Fu Zi Tang (Ginseng, Atractylodes, and Aconite Decoction) can be applied; for Qi deficiency, Si Jun Zi Tang (Four Gentlemen Decoction) is used; for Qi stagnation (stagnation of Qi mechanism), Gui Pi Tang (Restore the Spleen Decoction) is indicated; for Heat Qi, Sheng Mai San (Generate the Pulse Powder) is employed; for wheezing, Du Shen Tang (Single Ginseng Decoction) is used; for agitated Qi (disordered Qi movement), Er Chen Tang (Two Aged Ingredients Decoction) with added Ren Shen is prescribed; for Qi obstruction (blockage of Qi flow), She Ye Tang (Belamcanda Decoction) is utilized; for rebellious Qi (ascending Qi), Xiao Yao San (Free and Easy Wanderer Powder) is applied. With these additions, the methods for treating Qi disorders are nearly complete, allowing practitioners to treat based on symptoms.
Hua Jun agreed and added: There is indeed a distinction between Qi deficiency and Qi excess. Qi deficiency manifests as emaciation and weakness, making treatment difficult; Qi excess presents as robustness and strength, making it easier to identify. For deficiency, Tian Shi’s formula is used; for excess, there is another formula. It consists of Zhi Ke (Immature Bitter Orange) 5 fen, Bai Zhu 1 qian, Chen Pi (Citrus Reticulatae Pericarpium) 5 fen, Fu Ling (Poria) 3 qian, Gan Cao 1 qian, Shan Zha (Crataegi Fructus) 10 seeds, Chai Hu 1 qian, Bai Shao 3 qian, and Chao Zhi Zi (Fried Gardenia Fruit) 1 qian, decocted in water and taken orally. (Annotation: Xiao Shi Tang (Eliminate Excess Decoction).) This also supplements the limitations of Tian Shi’s approach.
Lei Gong remarked: Hua Jun’s supplementation is excellent.
On Treating Blood Disorders by Following Their Nature
Tian Shi said: Treating blood disorders refers to conditions where blood fails to return to its vessels, bleeding either upwards or downwards, or from the limbs, skin, and hair follicles. Blood circulates through the meridians, moving externally through the skin and hair, centrally through the zang-fu organs, internally through the sinews and bones, upwards to the head, eyes, and hands, and downwards to the urination/defecation orifices, feet, and umbilicus. The entire body is traversed by blood pathways. Once blood fails to remain within its vessels, it wanders recklessly, penetrating any opening and leaking through any gap. Severe cases involve vomiting, bleeding from pores, oozing from the gums, persistent leakage from the abdomen and umbilicus, and even continuous bleeding from stool or urine. Therefore, blood should be guided according to its nature rather than opposed. The formula uses Dang Gui (Angelica Sinensis Radix) 3 qian, Bai Shao 3 qian, Shu Di Huang (Rehmanniae Radix Preparata) 5 qian, Chuan Xiong (Ligusticum Chuanxiong Rhizoma) 1 qian, Jing Jie Mo (Schizonepetae Spica Powder) 1 qian, Sheng Di Huang (Rehmanniae Radix) 5 qian, Mai Dong (Ophiopogonis Radix) 3 qian, Qian Cao Gen (Rubiae Cordifoliae Radix et Rhizoma) 1 qian, and Gan Cao 1 qian, decocted in water. This formula is a modification of Si Wu Tang (Four Substances Decoction). Its brilliance lies in using Qian Cao Gen and Jing Jie to guide blood back into the vessels without disrupting its nature, allowing blood to return naturally without conflict. While hemostatic agents may temporarily stop bleeding, they act like pressing grass with a stone: although effective initially, the nature of the blood seeks to break free and will eventually surge violently when given space. In contrast, this formula guides the blood by following its nature. It is akin to traveling with a domineering person; slight opposition provokes anger and potentially violent conflict. However, if one praises and accommodates them, providing sustenance, harmony is achieved, and their strength aids one’s own deficiencies. Like sharing a boat without enemies, or coexisting peacefully in one room, over time, the blood becomes cooperative, nourishing the sinews and complexion, permanently preventing recurrence. Why oppose it so severely as to invite conflict? Thus, the method of treating blood requires careful attention.
Zhang Gong commented: This reasoning is sound and humane. Treating blood disorders primarily with Si Wu Tang, supplemented by Jing Jie and Qian Cao, effectively follows the nature of blood to guide it back to the vessels. However, using Liu Wei Wan Tang (Six-Ingredient Pill Decoction) for blood disorders is also ingenious. Blood disorders most strictly contraindicate cold and cooling substances, as cold causes stagnation and impedes the return of blood to the vessels. Liu Wei Wan Tang is brilliant because it is neither cold nor hot; it tonifies Kidney Water to nourish Liver Wood. When Liver Wood is nourished, blood has a vessel in which to reside and naturally does not leak outward, let alone vomit upwards. The formula contains Shu Di Huang 5 qian, Shan Zhu Yu (Corni Fructus) 3 qian, Shan Yao (Dioscoreae Rhizoma) 2 qian, Dan Pi (Moutan Cortex) 2 qian, Ze Xie (Alismatis Rhizoma) 2 qian, and Fu Ling 2 qian. This is the formula for Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction). Adding Mai Dong 3 qian and Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 1 qian allows for clearing and tonifying Lung Metal, nourishing the skin and hair, and strengthening the pores, thereby preventing blood from escaping outward. With Lung Metal undisturbed, it can adequately control Liver Wood. Since Liver Wood fears Metal’s control, it will not attack the Lungs upward. Therefore, this formula is highly suitable for blood disorders. Long-term use for three years without hematemesis signifies rebirth; otherwise, the patient remains on the brink of life and death.
Hua Jun agreed and added: I have another formula: Sheng Di Huang 1 liang, Jing Jie 1 qian, Mai Dong 3 qian, and Yuan Shen (Scrophulariae Radix) 3 qian, decocted in water. (Annotation: Zhi Xue Gui Jing Fang (Stop Bleeding and Return Blood to Vessels Formula).) One dose stops the bleeding, followed by Liu Wei Tang for complete recovery.
Lei Gong stated: I also have a unique formula for blood disorders. Use Sheng Di Huang 1 liang, San Qi Gen Mo (Notoginseng Root Powder) 3 qian, Jing Jie Mo 1 qian, and Ren Shen 3 qian. Decoct in water and take with the powder. One dose stops the bleeding.
Subsequently, Liu Wei Tang must be used for regulation.