脉微。取效甚速。一也。如王孟英治痰喘汗多。气逆脘疼。不食碍眠。肢冷便溏。面红汗冷。脉弦软无神。苔
白不渴。乃寒痰上实。肾阳下虚也。以此汤加干姜、五味、人参、杏仁、川朴等品。一剂知。二剂已。二也。
而善用此方者。首推叶天士先生。如治脾阳伤极。由误攻寒痞。变成单腹胀。以此方加川朴。又治食伤脾阳。
腹胀足肿。以此方去芍、姜。加草果仁、浓朴、广皮。又治浊阴窃据脾肾。跗肿腹满。以此方去芍、姜。加川
朴、草蔻、泽泻。又治肿胀由足入腹。食谷不能运。脉细软。以此方去芍。加浓朴、荜茇。又治脾肾虚寒。泻
多腹满。小便不利。以此方去芍、姜。加人参、益智仁、菟丝子。其他加减颇多。不能尽述。
通脉四逆汤 回阳通脉法 俞氏经验方 载仲景《伤寒论》
川附子（五钱炮去皮脐） 川姜（四钱） 清炙草（二钱） 鲜葱白（五枚杵汁分冲）
【秀按】阳气即生气也。阴霾即死气也。是以阳被阴逼。不走即飞。但其间有结有散。结则尚可破散其阴以
通阳。散则宜随阳之所在而返回。故脉沉或伏者仅阴之结。但用四逆汤。脉微欲绝而面赤者。乃阴盛格阳也。
故于四逆汤加葱白。由是推之。葱白之为用大矣。考葱之为物。寸根着土。即便森然。以其得生阳之气盛。故
于死阴中得一线生阳。即可培植而生发。葱白形虽中空。具从阴达阳之性。而内含稠涎。外包紧束。能使阳仍
不离于阴。所以病至下利清谷。里寒外热。手足厥逆。脉微欲绝。身反不恶寒。面赤色。一派阴霾用事。只有
外热面赤。身不恶寒数症。可以知阳未尽灭。然阴盛于内。格阳于外。已经昭着。故必重用附姜。尤赖得生阳
气盛之葱白。培种微阳。庶几春回黍谷矣。此为回复残阳。急通脉道之主方。咽痛者。加桔梗一钱。宣肺气以
止痛。呕者。加生姜汁一小匙冲。宣逆气以和胃。呃逆者。加公丁香九支。柿蒂三十个。降气逆以止呃。大腹
痛者。加紫瑶桂五分。生白芍三钱。温通脾络以止痛。小腹绞痛者。加盐水炒吴茱萸五分。小茴香四分。温运
肝气以止疼。痛甚者。加蜜炙延胡钱半。明乳香六分。活血通络以止痛。利虽止而脉微不出者。加吉林大参钱
半。提神益气以生脉。
回阳急救汤 回阳生脉法 俞氏经验方 载陶节庵《伤寒六书》
黑附块（三钱） 紫瑶桂（五分） 别直参（二钱） 原麦冬（三钱辰砂染） 川姜（二钱） 姜半夏（一钱）
湖广术（钱半） 北五味（三分） 炒广皮（八分） 清炙草（八分） 真麝香（三厘冲）
【秀按】少阴病下利脉微。甚则利不止。肢厥无脉。干呕心烦者。经方用白通加猪胆汁汤主之。然不及此方
面面顾到。故俞氏每用之以奏功。揣其方义。虽仍以四逆汤加桂温补回阳为君。而以《千金》生脉散为臣者。以参
能益气生脉。麦冬能续胃络脉绝。五味子能引阳归根也。佐以白术、二陈、健脾和胃。上止干呕。下止泻利。
妙在使以些许麝香。斩关直入。助参、附、姜、桂、以速奏殊功。浅学人每畏其散气而不敢用。岂知麝香同冰
片及诸香药用。固属散气。同参、术、附、桂、麦、味等温补收敛药用。但显其助气之功。而无散气之弊矣。
此为回阳固脱。益气生脉之第一良方。
【廉勘】此节庵老名医得心应手之方。凡治少阴中寒。及夹阴伤寒。阳气津液并亏。暨温热病凉泻太过。克
伐元阳。而阳虚神散者多效。妙在参、术、附、桂、与麝香同用。世俗皆知麝香为散气通窍之药。而不知麝食
各种香药。含英咀华。蕴酿香精而藏于丹田之间。故西医药物学中。推为壮脑补神之要药。阅过香港曹锡畴麝
香辨者。皆深悉之。惜吾国医界尚多茫茫耳。陶俞二家。于西医学未曾进行之前。能深信麝香功用。配合于温
补回阳之中。殊有卓识。吴鞠通辄诋其谬。亦未免所见不广。信口雌黄者矣。以余所验。服此方后。脉渐渐缓
出者生。不出者死。暴出者亦死。手足不温者亦死。若舌卷囊缩。额汗如珠不流。两目直视者速死。
附姜白通汤 回阳通格法 俞氏经验方 载喻嘉言《医门法律》
川附子（五钱炮去皮脐） 干姜（四钱） 葱白（五茎取汁冲） 猪胆（半枚取汁冲）
【秀按】猝中阴寒。厥逆呕吐。下利色青气冷。肌肤凛栗无汗。脉微欲绝。甚则十指脶纹绉瘪。俗名瘪脶痧
证。实则为盛阴没阳之候。故以大剂附姜回阳为君。臣以葱汁。得生阳之气独盛。以辛通脉道。反佐以一味胆
汁者。恐阳药一饮即吐。格拒而不得入也。此为温热回阳。苦辛通格之良方。然必内外兼治。庶几能奏捷效。
故嘉言外治两法。（1）用葱一大握。以带轻束。切去两头。留白二寸许。以一面熨热。安脐上。用熨斗盛炭
火。熨葱白上面。取其热气从脐入腹。甚者连熨二三饼。（2）用艾灸关元气海。各二三十壮。内外协攻。务在
一时之内。令得阴散阳回。身温不冷。脉渐出者。次服附姜归桂汤。以驱营分之寒。若病患畏胆汁太苦者。代
以莹白童便亦可。
附姜归桂汤 回阳温营法 俞氏经验方 载喻氏《医门法律》
川附子（二钱炮） 川姜（一钱炮） 紫瑶桂（八分） 当归（二钱） 净白蜜（两匙冲）
【秀按】中寒暴病。用附姜回阳后。继用此方者。因附姜专主回阳。而其所中之阴寒。必先伤营。故加归桂
驱营分之寒。庶几药病相当。冲以白蜜者。柔和阳药之刚烈也。此为回阳暖血。温和营分之良方。
附姜归桂参甘汤 回阳兼补血气法 俞氏经验方 载喻氏医门法律
淡附片（一钱） 白归身（钱半） 老东参（一钱） 嫩闽姜（六分） 川姜（八分炮） 官桂（六分）
清炙草（八分） 大红枣（两枚）
【秀按】阴寒渐衰。阳气将回。病势已有转机。故君以附、姜、轻剂。温和阳气。即臣以归、桂、暖血。
参、草、益气。佐以闽姜。使以大枣。调和营卫也。此为轻剂回阳。双补血气之良方。若阳已回。身温色活。
手足不冷。吐利渐除者。本方附、姜、官桂。可减其半。加蜜炙绵 一钱。土炒于术一钱。酒炒白芍钱半。五
味子十二粒。温和平补。俾不致有药偏之害。
正阳四逆汤 回阳攻毒法 俞氏经验方 载陶氏《伤寒全生集》
生附子（三钱炮去皮脐） 清炙草（一钱） 真麝香（五厘冲） 川姜（三钱炮不可焦） 皂荚
炭（八分） 生姜汁（两匙冲）
【秀按】猝中阴毒。吐利腹疼。身如被杖。四肢厥逆。冷过肘膝。昏沉不省。心下硬满。面唇手指皆有黑
色。舌卷囊缩。烦躁冷汗自出。或时呻吟。六脉或沉伏。或沉微欲绝。汤药每多不受。此皆阴寒毒瓦斯入深。乃
最危最急之证。较中寒证尤笃。故用生附子以毒攻毒为君。臣以干姜回阳。皂荚麝香速通经隧。佐以炙草和
药。使以姜汁和胃。且姜汁炙草二味。更有和解附毒之功。调剂合法。此为回阳急救。直攻阴毒之良方。然必
内外兼治。庶可十救一二。外治法。先以通关散。（生半夏一钱、细辛五分、川芎五分、青藜芦五分、麝香五
厘。）搐鼻取嚏。以通清窍。次用麝香三厘。皂荚末三分。肉桂末二分。硫黄二分。共研细末。以葱汁调粘。
填入脐中。再以生姜薄片贴于脐上。放大艾火于姜片上。蒸二七壮。炙关元气海二七壮。必将阴退阳复。手足
温暖即止。知人事者生。昏沉不省。过一周时必死。或仍用喻西昌熨脐法。亦能通阳气而利小便。
新加八味地黄汤 补阳镇冲法 俞氏经验方
浓附块（钱半） 大熟地（六钱炒松） 山萸肉（八分） 紫石英（四钱杵） 紫瑶桂（五分） 淮
山药（三钱杵） 浙茯苓（四钱） 泽泻（钱半）
先用铁落五钱。镇元黑锡丹三钱。用水六碗。煎成四碗。取清汤代水煎药。
【秀按】肾气虚喘。动则喘甚。腰痛足冷。小便不利。肾水上泛为痰。嗽出如沫而味咸。故以八味地黄温补
肾气为君。去丹皮者。恐其辛散肺气也。臣以紫石英温纳冲气。妙在佐以铁落合黑锡丹。重镇冲逆。以纳气定
喘。用之得当。奏效如神。此为温补肾阳。镇纳虚喘之良方。气虚自汗者。加蜜炙绵 皮三钱。五味子三分。
小便利者。去苓泽。防其损津液也。
【廉勘】以上六经正治六法。统计一百零一方；方方有法，法法不同，真可调门门透澈，息息通灵者矣。先
祖谓伤寒专科，必先通杂证，而后能善治感证；今观俞氏方法，益信而有征。但必列一百一方者，推其意，大
抵仿陶氏肘后百一方例耳。
【荣斋按】程钟龄说∶“补者，补其虚也。《经》曰‘不能治其虚，安问其余？’又曰∶‘邪之所凑其气必虚。’
又曰∶‘精气夺则虚。’又曰∶‘虚者补之。’补之为义大矣哉！然有当补不补误人者，有不当补而补误人
者，亦有当补而不分气血，不辨寒热，不识开阖，不知缓急，不分五脏，不深求调摄之方以误人者；是不可不
讲也。何谓当补不补？夫虚者损之渐，损者虚之积也，初时不觉，久则病成；假如阳虚不补，则气日消，阴虚
不补，则血日耗，消且耗焉，则天真荣卫之气渐绝，而亏损成矣！虽欲补之将何及矣。又有大虚之症，内实不
足，外似有余，脉浮大而涩，面赤火炎，身浮头眩，烦躁不宁，此为出汗晕脱之机；更有精神浮散，彻夜不寐
者，其祸尤速。法当养荣归脾辈，加敛药以收摄元神，俾浮散之气，退藏于密，庶几可救。复有阴虚火亢，气
逆上冲，不得眠者；法当滋水以制之，切忌苦寒泻火之药，反伤真气，若误清之，去生远矣！古人有言∶‘至
虚有盛候，反泻衔冤’者，此也。此当补不补之误也。然亦有不当补而补者何也？病有脉实症实，不能任补
者，固无论矣！即其人本体素虚，而客邪初至，病势方张，若骤补之，未免闭门留寇。更有大实之症，积热
在中，脉反细涩，神昏体倦，甚至憎寒振栗，欲着覆衣，酷肖虚寒之象；而其人必有唇焦口燥，便闭溺赤诸
症，与真虚者相隔天渊，倘不明辨精切，误投补剂，陋矣！古人有言∶‘大实有羸状，误补益疾’者此也。此
不当补而补之之误也。然亦有当补而补之不分气血，不辨寒热者何也？《经》曰∶‘气主煦之，血主濡之。’气用
四君子汤，凡一切补气药，皆从此出也；血用四物汤，凡一切补血药，皆从此出也。又如血热之症，宜补血行
血以清之，血寒之症，宜温经养血以和之。立斋治法，血热而吐者调之阳乘阴，热迫血而妄行也，治用四生
丸，六味汤。血寒而吐者，谓之阴乘阳，如天寒地冻，水凝成冰也，治用理中汤加当归；医家常须识此，勿令
误也。更有去血过多，成升斗者，无分寒热，皆当补益；所谓血脱者益其气，乃阳生阴长之至理。盖有形之
血，不能速生，无形之气，所当急固，此气血寒热之分也。然又有补之而不识开阖、不知缓急者，何也？天地
之理，有阖必有开，用药之机，有补必有泻；如补中汤加参 ，必用陈皮以开之，六味汤用熟地，即用泽泻以
导之。古人用药，补正必兼泻邪，邪去则补自得力；是以古方中，有补散并行者，参苏饮益气汤是也；有消补
并行者，枳术丸理中丸是也；有攻补并行者，泻心汤硝石丸是也；有温补并行者，治中汤参附汤是也；有清补
并行者，参连饮人参白虎汤是也。更有当峻补者，有当缓补者，有当平补者；如极虚之人，垂危之病，非大剂
汤液不能挽回，予常用参附煎膏日服数两，而救阳微将脱之症；又尝用参麦煎膏，服至数两，而救津液将枯之
症。亦有无力服参，而以 、术代之者。随时处治，往往有功。至于病邪未尽，元气虽虚，不任重补，则从容
和缓以补之；相其机宜，循序渐进，脉症相安，渐为减药，谷肉果菜食养尽之，以底于平康。其有体质素虚，
别无大寒大热之症，欲服丸散以保真元者；则用平和之药，调理气血，不敢妄使偏僻之方，久而争胜，反有伤
也，此开阖缓急之意也。然又有补之而不分五脏者何也？夫五脏有正补之法，有相生而补之之法。《难经》曰∶
‘损其肺者益其气，损其心者和其荣卫，损其脾者调其饮食，适其寒温，损其肝者缓其中，损其肾者益其精。
’此正补也。又如肺虚者补脾，土生金也；脾虚者补命门，火生土也；心虚者补肝，木生火也；肝虚者补肾，
水生木也；肾虚者补肺，金生水也；此相生而补之也。药既补矣，更加摄养有方，斯为善道。谚有之曰∶
‘药补不如食补。’我则曰∶食补不如精补，精补不如神补；节饮食，惜精神，用药得宜，病有不痊焉者寡矣。”
脉象微弱。取效非常迅速。这是第一种情况。比如王孟英治疗痰喘、汗多、气逆、胃脘疼痛、食欲不振、睡眠受阻、四肢冰冷、大便稀溏、面色发红但冷汗淋漓、脉象弦软无神、舌苔白且不口渴的症状，这是寒痰上盛、肾阳下虚的证候。用此汤加入干姜、五味子、人参、杏仁、厚朴等药物。服用一剂后症状减轻，两剂后痊愈。这是第二种情况。
而善于运用此方的人，首推叶天士先生。例如治疗脾阳损伤至极，因误用攻下法导致寒邪痞结，演变成单腹胀满，用此方加入厚朴；又治疗饮食损伤脾阳，导致腹胀足肿，用此方去掉芍药、生姜，加入草果仁、厚朴、陈皮；又治疗浊阴占据脾肾，导致足背浮肿、腹部胀满，用此方去掉芍药、生姜，加入厚朴、草豆蔻、泽泻；又治疗肿胀从足部蔓延至腹部，进食后食物无法运化，脉象细软，用此方去掉芍药，加入厚朴、荜茇；又治疗脾肾虚寒，腹泻严重且腹部胀满，小便不利，用此方去掉芍药、生姜，加入人参、益智仁、菟丝子。其他的加减变化很多，无法一一叙述。
通脉四逆汤 回阳通脉法 俞氏经验方 记载于张仲景《伤寒论》
川附子（五钱，炮制，去皮脐） 川干姜（四钱） 清炙甘草（二钱） 鲜葱白（五枚，捣汁分次冲服）
【秀按】阳气就是生气，阴霾就是死气。因此当阳气被阴寒逼迫时，如果不走散就会飞越。但其中有的凝结，有的散失。凝结则还可以破除散开阴寒以通达阳气；散失则应当顺着阳气所在之处使其返回。所以脉象沉或伏的，仅仅是阴寒的凝结，只用四逆汤即可；脉微欲绝且面赤的，乃是阴盛格阳（阴寒极盛，逼迫阳气浮越于外）。所以在四逆汤中加入葱白。由此推断，葱白的功效真是巨大啊。考察葱这种植物，寸根着地，便能茂盛生长，因为它得生阳之气旺盛，所以在死阴之中能得到一线生阳之气，就可以培植并生发。葱白形状虽然中空，具有从阴达阳的性质，而内部含有稠密的津液，外部包裹紧密束缚，能使阳气仍然不离开阴液。所以病情发展到下利清谷（拉出未消化的食物）、里寒外热、手足厥冷、脉微欲绝、身体反而不恶寒、面色发红，一派阴霾主事，只有外热面赤、身不恶寒这几症，可以知道阳气尚未完全灭尽。然而阴寒盛于内，格拒阳气于外，已经非常明显。所以必须重用附子、干姜，尤其依赖生阳之气旺盛的葱白，来培植微弱的阳气，或许就能像春回黍谷一样恢复生机。这是回复残存阳气、急通脉道的主方。咽喉痛的，加桔梗一钱，宣通肺气以止痛；呕吐的，加生姜汁一小匙冲服，宣降逆气以和胃；呃逆的，加公丁香九支、柿蒂三十个，降气逆以止呃；大腹痛的，加紫瑶桂五分、生白芍三钱，温通脾络以止痛；小腹绞痛的，加盐水炒吴茱萸五分、小茴香四分，温运肝气以止痛；痛剧烈的，加蜜炙延胡索半钱、明乳香六分，活血通络以止痛；腹泻虽止但脉微不出者，加吉林大参半钱，提神益气以生脉。
回阳急救汤 回阳生脉法 俞氏经验方 记载于陶节庵《伤寒六书》
黑附块（三钱） 紫瑶桂（五分） 别直参（二钱） 原麦冬（三钱，辰砂染） 川干姜（二钱） 姜半夏（一钱） 湖广术（钱半） 北五味子（三分） 炒广皮（八分） 清炙甘草（八分） 真麝香（三厘，冲服）
【秀按】少阴病下利脉微，甚至下利不止，四肢厥冷无脉，干呕心烦的，经方用白通加猪胆汁汤主治。然而不如此方面面俱到。所以俞氏每每使用它来取得疗效。推测其方义，虽然仍以四逆汤加肉桂温补回阳为君药，而以《千金方》中的生脉散为臣药，是因为人参能益气生脉，麦冬能续接胃络之脉绝，五味子能引阳气归根。佐以白术、二陈汤（半夏、陈皮等），健脾和胃，上止干呕，下止泻利。妙在使药中使用少许麝香，斩关直入，辅助人参、附子、干姜、肉桂，以迅速奏效。浅学之人往往畏惧其散气而不敢使用，哪里知道麝香同冰片及诸香药一起用时，确实属于散气；同人参、白术、附子、肉桂、麦冬、五味子等温补收敛药一起用时，只显现其助气的功效，而没有散气的弊病。这是回阳固脱、益气生脉的第一良方。
【廉勘】这是陶节庵老名医得心应手的方子。凡是治疗少阴中寒，以及夹阴伤寒，阳气津液并亏，以及温热病凉泻太过，克伐元阳，而阳虚神散的病症，大多有效。妙在人参、白术、附子、肉桂与麝香同用。世俗都知道麝香是散气通窍的药，却不知道麝鹿食用各种香药，含英咀华，酝酿香精而藏于丹田之间。所以西医药物学中，推崇其为壮脑补神的要药。阅读过香港曹锡畴《麝香辨》的人，都深知这一点。可惜我国医界尚多茫然无知。陶、俞二家，在西医学尚未传入之前，能深信麝香的功用，配合于温补回阳之中，确有卓识。吴鞠通却诋毁其谬误，也未免所见不广，信口雌黄了。以我的验证，服用此方后，脉象渐渐缓和出现的可生，不出的死，突然暴出的也死。手足不温的也死。如果舌卷囊缩，额头出汗如珠且不流动，两眼直视的速死。
附姜白通汤 回阳通格法 俞氏经验方 记载于喻嘉言《医门法律》
川附子（五钱，炮制，去皮脐） 干姜（四钱） 葱白（五茎，取汁冲服） 猪胆（半枚，取汁冲服）
【秀按】猝然中阴寒，四肢厥逆呕吐，下利色青气冷，肌肤凛栗无汗，脉微欲绝，甚至十指指甲纹路皱瘪，俗名瘪脶痧证，实则是盛阴没阳的证候。所以以大剂量附子、干姜回阳为君药，臣以葱汁，得生阳之气独盛，以辛味通达脉道，反佐一味胆汁，是恐怕阳药一喝就吐，产生格拒而不能进入体内。这是温热回阳、苦辛通格的良方。然而必须内外兼治，才能奏捷效。所以喻嘉言的外治两法：（1）用一大把葱，用带子轻轻束住，切去两头，留白约二寸，将一面熨热，放在肚脐上，用熨斗盛炭火，熨葱白上面，取其热气从脐入腹，严重的连续熨二三饼。（2）用艾灸关元、气海穴，各灸二三十壮。内外协同攻击，务必在一时之内，令阴散阳回，身体温暖不冷，脉象渐渐出现。随后服用附姜归桂汤，以驱除营分之寒。如果病人畏惧胆汁太苦，可以用莹白童便代替。
附姜归桂汤 回阳温营法 俞氏经验方 记载于喻氏《医门法律》
川附子（二钱，炮制） 川干姜（一钱，炮制） 紫瑶桂（八分） 当归（二钱） 净白蜜（两匙，冲服）
【秀按】中寒暴病，用附子、干姜回阳后，继用此方，是因为附子、干姜专主回阳，而所中之阴寒，必先伤及营血。所以加入当归、肉桂驱除营分之寒，才使得药病相当。冲入白蜜，是为了柔和阳药的刚烈性质。这是回阳暖血、温和营分的良方。
附姜归桂参甘汤 回阳兼补血气法 俞氏经验方 记载于喻氏《医门法律》
淡附片（一钱） 白归身（钱半） 老东参（一钱） 嫩闽姜（六分） 川干姜（八分，炮制） 官桂（六分） 清炙甘草（八分） 大红枣（两枚）
【秀按】阴寒逐渐衰退，阳气即将回复，病势已有转机。所以君药用附子、干姜轻剂，温和阳气；即臣药用当归、肉桂暖血；人参、甘草益气；佐以闽姜，使以大枣，调和营卫。这是轻剂回阳、双补血气的良方。如果阳气已回，身体温暖面色红润，手足不冷，吐利逐渐消除，本方中的附子、干姜、官桂可减少一半，加入蜜炙绵黄芪一钱、土炒于术一钱、酒炒白芍钱半、五味子十二粒，温和平补，以免有药偏的危害。
正阳四逆汤 回阳攻毒法 俞氏经验方 记载于陶氏《伤寒全生集》
生附子（三钱，炮制，去皮脐） 清炙甘草（一钱） 真麝香（五厘，冲服） 川干姜（三钱，炮制不可焦） 皂荚炭（八分） 生姜汁（两匙，冲服）
【秀按】猝然中阴毒，吐利腹痛，身体像被杖打一样，四肢厥逆，冷过肘膝，昏沉不省人事，心下硬满，面唇手指都有黑色，舌卷囊缩，烦躁冷汗自出，或不时呻吟，六脉或沉伏，或沉微欲绝，汤药往往多不受纳。这都是阴寒毒瓦斯深入，是最危最急的证候，比中寒证更为严重。所以用生附子以毒攻毒为君药，臣以干姜回阳，皂荚、麝香迅速通达经络，佐以炙甘草调和药性，使以姜汁和胃。而且姜汁、炙甘草两味，更有和解附子毒性的功效。调剂合法，这是回阳急救、直攻阴毒的良方。然而必须内外兼治，才可以十救一二。外治法：先用通关散（生半夏一钱、细辛五分、川芎五分、青藜芦五分、麝香五厘），搐鼻取嚏，以通清窍。次用麝香三厘、皂荚末三分、肉桂末二分、硫黄二分，共研细末，用葱汁调粘，填入脐中，再以生姜薄片贴于脐上，放大艾火于姜片上，蒸十四壮，灸关元、气海十四壮。必将阴退阳复，手足温暖即止。知人事者可生，昏沉不省，过一周必死。或者仍用喻昌（字西昌）熨脐法，也能通阳气而利小便。
新加八味地黄汤 补阳镇冲法 俞氏经验方
浓附块（钱半） 大熟地（六钱，炒松） 山萸肉（八分） 紫石英（四钱，杵碎） 紫瑶桂（五分） 淮山药（三钱，杵碎） 浙茯苓（四钱） 泽泻（钱半）
先用铁落五钱、镇元黑锡丹三钱，用水六碗，煎成四碗，取清汤代水煎药。
【秀按】肾气虚喘，动则喘甚，腰痛足冷，小便不利，肾水上泛为痰，咳出如沫而味咸。所以以八味地黄丸温补肾气为君药。去掉牡丹皮，是恐怕其辛散肺气。臣以紫石英温纳冲气。妙在佐以铁落合黑锡丹，重镇冲逆，以纳气定喘。用得恰当，奏效如神。这是温补肾阳、镇纳虚喘的良方。气虚自汗的，加蜜炙绵黄芪皮三钱、五味子三分。小便利的，去掉茯苓、泽泻，防止其损耗津液。
【廉勘】以上六经正治六法，统计一百零一方；方方有法，法法不同，真是可调门门透彻，息息通灵的了。先祖说伤寒专科，必须先通晓杂证，然后才能善于治疗感证；现在看俞氏的方法，更加相信且有证据。但必定列出这一百零一方，推测其用意，大抵是仿照陶氏《肘后百一方》的体例罢了。
【荣斋按】程钟龄说：“补，是补其虚。《内经》说‘不能治其虚，安问其余？’又说‘邪之所凑，其气必虚。’又说‘精气夺则虚。’又说‘虚者补之。’补的意义太大了！然而有当补不补误人的，有不当补而补误人的，也有当补而不分气血，不辨寒热，不识开阖，不知缓急，不分五脏，不深求调摄之方以误人的；这些是不可不讲清楚的。什么叫当补不补？虚是损的渐进，损是虚的积累，起初不觉察，久了则病成；假如阳虚不补，则气日消，阴虚不补，则血日耗，消且耗焉，则天真荣卫之气渐绝，而亏损形成了！虽然想补，又将来得及吗？又有大虚之症，内实不足，外似有余，脉浮大而涩，面赤火炎，身浮头眩，烦躁不宁，此为出汗晕脱之机；更有精神浮散，彻夜不寐的，其祸尤速。法当用养荣归脾辈，加敛药以收摄元神，使浮散之气，退藏于密，或许可以挽救。再有阴虚火亢，气逆上冲，不得眠的；法当滋水以制之，切忌苦寒泻火之药，反伤真气，若误清之，离生路就远了！古人有言：‘至虚有盛候，反泻衔冤’者，就是这个道理。这是当补不补的误人。然而也有不当补而补的为什么呢？病有脉实症实，不能任补的，固且不论；即使其人本体素虚，而客邪初至，病势方张，若骤补之，未免闭门留寇。更有大实之症，积热在中，脉反细涩，神昏体倦，甚至憎寒振栗，欲着覆衣，酷肖虚寒之象；而其人必有唇焦口燥，便闭溺赤诸症，与真虚者相隔天渊，倘不明辨精切，误投补剂，陋矣！古人有言：‘大实有羸状，误补益疾’者此也。这是不当补而补的误人。然而也有当补而补之不分气血，不辨寒热的什么呢？《内经》说：‘气主煦之，血主濡之。’气用四君子汤，凡一切补气药，皆从此出也；血用四物汤，凡一切补血药，皆从此出也。又如血热之症，宜补血行血以清之，血寒之症，宜温经养血以和之。立斋治法，血热而吐者调之阳乘阴，热迫血而妄行也，治用四生丸，六味汤。血寒而吐者，谓之阴乘阳，如天寒地冻，水凝成冰也，治用理中汤加当归；医家常须识此，勿令误也。更有去血过多，成升斗者，无分寒热，皆当补益；所谓血脱者益其气，乃阳生阴长之至理。盖有形之血，不能速生，无形之气，所当急固，此气血寒热之分也。然又有补之而不识开阖、不知缓急的什么呢？天地之理，有阖必有开，用药之机，有补必有泻；如补中汤加参，必用陈皮以开之，六味汤用熟地，即用泽泻以导之。古人用药，补正必兼泻邪，邪去则补自得力；是以古方中，有补散并行的，参苏饮益气汤是也；有消补并行的，枳术丸理中丸是也；有攻补并行的，泻心汤硝石丸是也；有温补并行的，治中汤参附汤是也；有清补并行的，参连饮人参白虎汤是也。更有当峻补的，有当缓补的，有当平补的；如极虚之人，垂危之病，非大剂汤液不能挽回，予常用参附煎膏日服数两，而救阳微将脱之症；又尝用参麦煎膏，服至数两，而救津液将枯之症。亦有无力服参，而以芪、术代之者。随时处治，往往有功。至于病邪未尽，元气虽虚，不任重补，则从容和缓以补之；相其机宜，循序渐进，脉症相安，渐为减药，谷肉果菜食养尽之，以底于平康。其有体质素虚，别无大寒大热之症，欲服丸散以保真元者；则用平和之药，调理气血，不敢妄使偏僻之方，久而争胜，反有伤也，此开阖缓急之意也。然又有补之而不分五脏的什么呢？夫五脏有正补之法，有相生而补之之法。《难经》说：‘损其肺者益其气，损其心者和其荣卫，损其脾者调其饮食，适其寒温，损其肝者缓其中，损其肾者益其精。’此正补也。又如肺虚者补脾，土生金也；脾虚者补命门，火生土也；心虚者补肝，木生火也；肝虚者补肾，水生木也；肾虚者补肺，金生水也；此相生而补之也。药既补矣，更加摄养有方，斯为善道。谚有之曰：‘药补不如食补。’我则曰：食补不如精补，精补不如神补；节饮食，惜精神，用药得宜，病有不痊焉者寡矣。”
Pulse is faint. Efficacy is obtained very rapidly. This is the first case. For example, Wang Mengying treated phlegm-panting, excessive sweating, rebellious Qi causing epigastric pain, anorexia, sleep disturbance, cold limbs, loose stools, red face with cold sweat, wiry and soft pulse without spirit, white tongue coating without thirst. This is a syndrome of excess cold-phlegm above and deficiency of Kidney-Yang below. Using this decoction added with Ganjiang (Dried Ginger), Wuweizi (Schisandra Berry), Renshen (Ginseng), Xingren (Apricot Seed), Houpo (Magnolia Bark) and other herbs. Symptoms improved after one dose, resolved after two doses. This is the second case.
Those who skillfully use this formula are primarily Mr. Ye Tianshi. For instance, treating extreme injury to Spleen-Yang caused by mistaken purgation leading to cold stagnation, evolving into abdominal distension (Dan Zhang Fu), using this formula added with Houpo (Magnolia Bark). Also treating food injury to Spleen-Yang causing abdominal distension and foot edema, using this formula removing Shaoyao (Peony Root) and Shengjiang (Fresh Ginger), adding Caoguo Ren (Tsaoko Cardamom Seed), Houpo (Magnolia Bark), Guangpi (Tangerine Peel). Also treating turbid Yin occupying Spleen and Kidney causing ankle edema and abdominal fullness, using this formula removing Shaoyao (Peony Root) and Shengjiang (Fresh Ginger), adding Houpo (Magnolia Bark), Cao Kou (Cardamom), Zexie (Alisma). Also treating swelling spreading from feet to abdomen, inability to transport food, fine and soft pulse, using this formula removing Shaoyao (Peony Root), adding Houpo (Magnolia Bark), Bibo (Long Pepper Fruit). Also treating Spleen-Kidney deficiency-cold with severe diarrhea, abdominal fullness, and difficult urination, using this formula removing Shaoyao (Peony Root) and Shengjiang (Fresh Ginger), adding Renshen (Ginseng), Yizhiren (Bitter Apricot Seed - *Note: Context implies益智仁 Yi Zhi Ren*), Tusizi (Dodder Seed). There are many other modifications that cannot be fully described.
Tongmai Sini Tang (Cinnamon Twig and Aconite Decoction for Unblocking Pulse) Method: Restore Yang and Unblock Pulse. Yu's Empirical Formula. Recorded in Zhang Zhongjing's "Shanghan Lun" (Treatise on Cold Damage).
Chuan Fuzi (Aconiti Lateralis Radix Praeparata, 5 qian, processed, skin and umbilicus removed) Chuan Jiang (Zingiberis Rhizoma, 4 qian) Qing Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, 2 qian) Xian Congbai (Allii Fistulosi Bulbus, fresh, 5 stalks, crushed juice taken separately)
[Commentary by Xiu]: Yang Qi is the vital Qi; Yin-Mao (dark mist) is the dead Qi. Therefore, when Yang is oppressed by Yin, if it does not flee, it will fly away. However, there is condensation and dispersion among them. Condensation can still be broken to disperse Yin and unblock Yang; dispersion requires following the location of Yang to return it. Thus, a deep or hidden pulse indicates only Yin condensation, treated solely with Sini Tang. A pulse faint as if ceasing with red face indicates Yin excess repelling Yang outward. Therefore, Congbai (Scallion White) is added to Sini Tang. From this, we deduce that the utility of Congbai is immense. Examining Cong (Scallion), its short root touches the earth and grows lush because it possesses abundant Sheng Yang (Vital Yang) Qi. Thus, within dead Yin, obtaining a thread of Vital Yang allows cultivation and growth. Although Congbai is hollow inside, possessing the nature of reaching Yang from Yin, it contains dense fluids internally and is tightly bound externally, ensuring Yang remains close to Yin. So when illness progresses to diarrhea with undigested food, interior cold with exterior heat, cold extremities, pulse faint as if ceasing, body actually not aversion to cold, and red face—a scene dominated by Yin-Mao—only the symptoms of exterior heat, red face, and no aversion to cold indicate that Yang has not completely extinguished. However, Yin excess inside repelling Yang outside is already evident. Therefore, heavy doses of Fuzi (Prepared Aconite Root) and Jiang (Ginger) are necessary, relying especially on the Vital Yang-rich Congbai to cultivate weak Yang, so that spring may return like grain in millet fields. This is the main formula for restoring residual Yang and urgently unblocking the pulse. For sore throat, add Jiegeng (Platycodon Root) 1 qian to diffuse Lung Qi and relieve pain. For vomiting, add Shengjiangzhi (Fresh Ginger Juice) 1 small spoon taken separately to diffuse rebellious Qi and harmonize Stomach. For hiccups, add Gong Dingxiang (Caryophylli Flos) 9 pieces and Shidi (Kaki Calyx) 30 pieces to descend rebellious Qi and stop hiccups. For severe abdominal pain, add Ziyaogui (Cinnamomi Cortex) 5 fen and Sheng Baishao (White Peony Root) 3 qian to warm and unblock Spleen collaterals to relieve pain. For cramping lower abdominal pain, add Yan Shui Chao Wuzhuyu (Evodiae Fructus stir-fried with salt water) 5 fen and Xiaohuixiang (Foeniculi Fructus) 4 fen to warm and move Liver Qi to relieve pain. For severe pain, add Mi Zhi Yanhusuo (Corydalis Rhizoma honey-fried) half qian and Ming Rushanxiong (Boswelliae Resina) 6 fen to invigorate blood and unblock collaterals to relieve pain. If diarrhea stops but pulse faint and absent, add Jilin Dashen (Ginseng Radix) half qian to revive spirit and boost Qi to generate pulse.
Huiyang Jijiu Tang (Decoction for Restoring Yang and Emergency Rescue) Method: Restore Yang and Generate Pulse. Yu's Empirical Formula. Recorded in Tao Jian'an's "Shanghan Liushu" (Six Books on Cold Damage).
Hei Fu Kuai (Aconiti Lateralis Radix Praeparata, black variety, 3 qian) Ziyaogui (Cinnamomi Cortex, 5 fen) Biezhi Shen (Panacis Ginseng Radix, selected) 2 qian Yuan Maidong (Ophiopogonis Radix, stained with Cinnabar, 3 qian) Chuan Jiang (Zingiberis Rhizoma, 2 qian) Jiang Banxia (Pinelliae Rhizoma Preparata, 1 qian) Huguang Zhu (Atractylodis Macrocephalae Rhizoma, 1.5 qian) Bei Wuwei (Schisandrae Chinensis Fructus, 3 fen) Chao Guangpi (Citri Reticulatae Pericarpium stir-fried, 8 fen) Qing Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, 8 fen) Zhen Shexiang (Moschus, real, 3 li, taken separately)
[Commentary by Xiu]: In Shaoyin disease with diarrhea and faint pulse, even progressing to uncontrollable diarrhea, cold extremities, absent pulse, dry retching, and irritability, the classic formula uses Bitong Jia Zhudanji Tang (Bitong Decoction plus Pig Bile). However, it does not cover all aspects as well as this formula. Therefore, Yu frequently uses it to achieve success. Speculating on its rationale, although it still uses Sini Tang added with Gui (Cinnamon) to warm, tonify, and restore Yang as the sovereign herb, it uses Shengmai San (Generate Pulse Powder) from "Qianjin Fang" as the minister herb. This is because Renshen (Ginseng) can boost Qi and generate pulse, Maidong (Ophiopogon) can continue the絕 (cut off) pulse of the Stomach collaterals, and Wuweizi (Schisandra) can guide Yang back to its root. The assistant herbs include Baizhu (Atractylodes) and Erchen Tang (Two-Cured Decoction) to strengthen Spleen and harmonize Stomach, stopping dry retching above and diarrhea below. The brilliance lies in the envoy herb using a small amount of Shexiang (Musk), breaking through barriers directly, assisting Renshen, Fuzi, Jiang, and Gui to quickly achieve remarkable results. Novices often fear its dispersing effect on Qi and dare not use it. How could they know that when Shexiang is used with Bingpian (Borneol) and other aromatic drugs, it indeed disperses Qi; but when used with Renshen, Baizhu, Fuzi, Gui, Maidong, and Wuweizi (warming, tonifying, and astringent drugs), it only displays its Qi-boosting function without the drawback of dispersing Qi. This is the premier excellent formula for restoring Yang, securing collapse, boosting Qi, and generating pulse.
[Commentary by Lian]: This is a formula mastered by the old famous doctor Tao Jian'an. It is effective for treating Shaoyin cold invasion, cold damage with yin involvement, simultaneous deficiency of Yang Qi and Body Fluids, and excessive cooling/purging in warm diseases damaging Yuan Yang, leading to Yang deficiency and scattered spirit. The brilliance lies in using Renshen, Baizhu, Fuzi, and Gui together with Shexiang. The secular world knows Shexiang as a drug for dispersing Qi and opening orifices, but does not know that musk deer eat various aromatic plants, refining their essence and storing aromatic ingredients in the Dantian. Therefore, Western pharmacology promotes it as a key drug for strengthening the brain and nourishing the spirit. Those who have read Cao Xichou's "Shexiang Bian" (Discrimination of Musk) in Hong Kong know this well. Unfortunately, much of the Chinese medical community remains ignorant. Tao and Yu, before the introduction of Western medicine, had the insight to trust the efficacy of Musk and combine it with warming and tonifying formulas to restore Yang, showing outstanding vision. Wu Jutong criticized it as erroneous, which was narrow-minded and baseless. Based on my experience, after taking this formula, if the pulse gradually appears slowly, life is saved; if it does not appear, death ensues; if it appears suddenly/violently, death also ensues. If hands and feet remain cold, death ensues. If the tongue curls, scrotum retracts, forehead sweats like beads that do not flow, and eyes stare straight ahead, death is rapid.
Fujiang Bitong Tang (Aconite and Ginger Bitong Decoction) Method: Restore Yang and Unblock Repulsion. Yu's Empirical Formula. Recorded in Yu Jiayan's "Yimen Falv" (Legal Principles of Medicine).
Chuan Fuzi (Aconiti Lateralis Radix Praeparata, 5 qian, processed, skin and umbilicus removed) Ganjiang (Zingiberis Rhizoma, 4 qian) Congbai (Allii Fistulosi Bulbus, 5 stalks, juice taken separately) Zhu Dan (Suis Fel, half piece, juice taken separately)
[Commentary by Xiu]: Sudden invasion of Yin-cold causes cold extremities, vomiting, diarrhea with green color and cold odor, shivering skin without sweat, and pulse faint as if ceasing, even to the point of wrinkled nails (Suoming Bi La Sha Syndrome). This is actually a state of overwhelming Yin submerging Yang. Therefore, a large dose of Fuzi and Jiang to restore Yang is the sovereign herb. Congzhi (Scallion Juice) is the minister herb, possessing abundant Vital Yang Qi, using pungency to unblock the pulse. One drop of Danshi (Bile Juice) is used as a counter-agent to prevent the Yang-warming drugs from being vomited immediately due to repulsion. This is an excellent formula for warming, restoring Yang, and using bitter-pungent methods to unblock repulsion. However, internal and external treatments must be combined to achieve quick results. Therefore, Jiayan's two external treatment methods: (1) Use a large handful of Cong (Scallion), bind lightly with a strip, cut off both ends, leave about 2 cun of white part, heat one side, place on the navel, use a heating iron with charcoal fire to heat the top of the scallion white, taking advantage of the heat entering the abdomen from the navel. Severe cases use 2-3 cakes continuously. (2) Moxibustion at Guanyuan and Qihai acupoints, 20-30 moxa cones each. Internal and external attacks cooperate, aiming to disperse Yin and restore Yang within an hour, making the body warm, pulse gradually appearing. Then take Fujiang Guigui Tang to dispel cold in the Ying (Nutritive) level. If the patient fears the bitterness of bile, Yingbai Tongbian (Clear Child Urine) can be substituted.
Fujiang Guigui Tang (Aconite, Ginger, Angelica, and Cinnamon Decoction) Method: Restore Yang and Warm Ying. Yu's Empirical Formula. Recorded in Yu Shi's "Yimen Falv".
Chuan Fuzi (Aconiti Lateralis Radix Praeparata, 2 qian, processed) Chuan Jiang (Zingiberis Rhizoma, 1 qian, processed) Ziyaogui (Cinnamomi Cortex, 8 fen) Danggui (Angelicae Sinensis Radix, 2 qian) Jing Bai Mi (White Honey, 2 spoons, taken separately)
[Commentary by Xiu]: After sudden cold attack, using Fuzi and Jiang to restore Yang, continuing with this formula is because Fuzi and Jiang specialize in restoring Yang, but the invaded Yin-cold first injures the Ying (Nutritive) level. Therefore, adding Danggui (Angelica) and Guigui (Cinnamon) dispels cold in the Ying level, ensuring the medicine matches the disease. Adding Bai Mi (White Honey) softens the harshness of the Yang-warming drugs. This is an excellent formula for restoring Yang, warming blood, and gently warming the Ying level.
Fujiang Guigui Shengan Tang (Aconite, Ginger, Angelica, Cinnamon, Ginseng, and Licorice Decoction) Method: Restore Yang while Tonifying Blood and Qi. Yu's Empirical Formula. Recorded in Yu Shi's "Yimen Falv".
Dan Fupian (Aconiti Lateralis Radix Praeparata, 1 qian) Bai Guishen (Angelicae Sinensis Radix, flesh part, 1.5 qian) Lao Dongshen (Panacis Ginseng Radix, aged, 1 qian) Nen Minjiang (Zingiberis Rhizoma, tender, Fujian origin, 6 fen) Chuan Jiang (Zingiberis Rhizoma, 8 fen, processed) Guanzi Gui (Cinnamomi Cortex, official grade, 6 fen) Qing Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, 8 fen) Da Hongzao (Jujubae Fructus, 2 pieces)
[Commentary by Xiu]: As Yin-cold gradually declines and Yang is about to return, the disease condition shows signs of turning. Therefore, the sovereign herbs are light doses of Fuzi and Jiang to gently warm Yang. The minister herbs are Danggui and Guigui to warm blood. Renshen and Cao (Licorice) boost Qi. Minjiang (Ginger) assists, and Hongzao (Jujube) acts as the envoy to harmonize Ying and Wei. This is an excellent formula for light-dose restoration of Yang and dual tonification of blood and Qi. If Yang has returned, body is warm, complexion is lively, hands and feet are not cold, and vomiting/diarrhea are gradually eliminated, reduce the dosage of Fuzi, Jiang, and Guigui in this formula by half. Add Mi Zhi Mian Huangqi (Astragali Radix honey-fried) 1 qian, Tu Chao Yuzhu (Atractylodis Macrocephalae Rhizoma soil-fried) 1 qian, Jiu Chao Baishao (White Peony Root wine-fried) 1.5 qian, and Wuweizi (Schisandra) 12 grains. This provides gentle and balanced tonification to avoid harm from medication bias.
Zhengyang Sini Tang (True Yang Sini Decoction) Method: Restore Yang and Attack Toxin. Yu's Empirical Formula. Recorded in Tao Shi's "Shanghan Quansheng Ji".
Sheng Fuzi (Aconiti Lateralis Radix, raw, 3 qian, processed, skin and umbilicus removed) Qing Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, 1 qian) Zhen Shexiang (Moschus, real, 5 li, taken separately) Chuan Jiang (Zingiberis Rhizoma, 3 qian, processed, not burnt) Zaojia Tan (Gleditsiae Sinensis Spina Preparata, charred, 8 fen) Shengjiangzhi (Fresh Ginger Juice, 2 spoons, taken separately)
[Commentary by Xiu]: Sudden invasion of Yin-toxin causes vomiting, diarrhea, abdominal pain, body feeling like being beaten, cold extremities extending past elbows and knees, lethargy and unconsciousness, hardness/fullness in the epigastrium, black color on face, lips, and fingers, curled tongue, retracted scrotum, irritability, spontaneous cold sweat, occasional groaning. Six pulses may be deep-hidden or faint as if ceasing. Decoctions are often rejected. These are all signs of Yin-cold toxin penetrating deeply, representing the most critical and urgent syndrome, more severe than simple cold invasion. Therefore, Sheng Fuzi (Raw Aconite) is used as the sovereign herb to attack toxin with toxin. Ganjiang (Dried Ginger) is the minister herb to restore Yang. Zaojia (Gleditsia) and Shexiang (Musk) rapidly unblock meridians. Zhi Cao (Honey-fried Licorice) assists in harmonizing the drugs. Shengjiangzhi (Fresh Ginger Juice) acts as the envoy to harmonize the Stomach. Moreover, Ginger Juice and Licorice have the function of resolving Fuzi toxicity. Properly compounded, this is an excellent formula for emergency restoration of Yang and direct attack on Yin-toxin. However, internal and external treatments must be combined to save 1 or 2 out of 10. External treatment: First use Tongguan San (Opening Pass Powder: Sheng Banxia 1 qian, Xixin 5 fen, Chuanxiong 5 fen, Qing Licilu 5 fen, Shexiang 5 li). Snuff into nose to induce sneezing to clear orifices. Next, mix Shexiang 3 li, Zaojia powder 3 fen, Rougui powder 2 fen, Liuhuang 2 fen, grind finely, mix with Congzhi (Scallion juice) to form paste, fill into the navel. Place thin slices of fresh ginger on the navel, place large moxa cone on the ginger slice, steam for 14 moxa cones (two sevens). Moxa Guanyuan and Qihai for 14 cones. This will surely cause Yin retreat and Yang recovery. Stop when hands and feet become warm. Regaining consciousness means survival; lethargy and unconsciousness lasting over a week leads to death. Alternatively, use Yu Xichang's Navel Heating Method, which can also unblock Yang Qi and promote urination.
Xinjia Bawei Dihuang Tang (Newly Added Eight-Ingredient Rehmannia Decoction) Method: Tonify Yang and Suppress Chong Vessel Rebellion. Yu's Empirical Formula.
Nong Fu Kuai (Aconiti Lateralis Radix Praeparata, concentrated, 1.5 qian) Da Shudi (Rehmanniae Radix Preparata, large, 6 qian, fried until loose) Shanyurou (Corni Fructus, 8 fen) Zi Shiyin (Quartz, purple, 4 qian, crushed) Ziyaogui (Cinnamomi Cortex, 5 fen) Huai Shanyao (Dioscoreae Rhizoma, 3 qian, crushed) Zhe Fuling (Poria, 4 qian) Zexie (Alismatis Rhizoma, 1.5 qian)
First, boil Tieluo (Iron Filings) 5 qian and Zhenyuan Hexi Dan (Black Tin Pill) 3 qian in 6 bowls of water, boil down to 4 bowls. Take the clear liquid to decoct the herbs.
[Commentary by Xiu]: Kidney Qi deficiency panting, worsening with movement, lower back pain, cold feet, difficult urination, Kidney water rising to form phlegm, coughing up frothy sputum with salty taste. Therefore, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is used as the sovereign herb to warmly tonify Kidney Qi. Mudanpi (Moutan Bark) is removed to avoid its pungent dispersing effect on Lung Qi. Zi Shiyin (Purple Quartz) is the minister herb to warmly grasp Chong Qi. The brilliance lies in assisting with Tieluo (Iron Filings) and Hexi Dan (Black Tin Pill) to heavily suppress Chong rebellion, grasping Qi and stabilizing panting. Used appropriately, it works miraculously. This is an excellent formula for warming Kidney Yang and suppressing false panting. For Qi deficiency with spontaneous sweating, add Mi Zhi Mian Huangqipi (Astragali Cortex honey-fried) 3 qian and Wuweizi (Schisandra) 3 fen. For free urination, remove Fuling (Poria) and Zexie (Alisma) to prevent fluid loss.
[Commentary by Lian]: The above six correct treatment methods for the Six Meridians total 101 formulas. Each formula has its method, and each method differs. Truly, every door is thoroughly understood, and every breath connects spiritually. My ancestor said that specializing in Shanghan (Cold Damage) requires first mastering miscellaneous diseases before effectively treating infectious conditions. Observing Yu's methods confirms this. The reason for listing 101 formulas is likely modeled after Tao's "Zhouhou Baiyi Fang" (Hundred-One Formulas from the Elbow Reserve).
[Commentary by Rongzhai]: Cheng Zhongling said: "Tonification means tonifying deficiency. The Classic says, 'If you cannot treat deficiency, how can you ask about the rest?' It also says, 'Where evil gathers, Qi must be deficient.' And, 'Loss of Essence and Qi constitutes deficiency.' And, 'Deficiency is treated by tonification.' The meaning of tonification is profound! However, there are errors of failing to tonify when needed, tonifying when unnecessary, tonifying without distinguishing Qi and Blood, Cold and Heat, Opening and Closing, Urgency and Slowness, Five Zang organs, and lacking proper regulation methods. These must be discussed. What is failing to tonify when needed? Deficiency is the gradual result of damage; damage is the accumulation of deficiency. Initially unnoticed, it becomes illness over time. If Yang deficiency is not tonified, Qi diminishes daily; if Yin deficiency is not tonified, Blood depletes daily. Diminished and depleted, the innate Ying and Wei Qi gradually cease, and deficiency forms! Even if one wishes to tonify, it may be too late. There are also severe deficiency syndromes where internal reality is insufficient but externally appears excess: floating, large, and choppy pulse, red face, fiery sensation, floating body, dizziness, irritability. This is the mechanism of syncope from sweating. More severely, scattered spirit and insomnia all night occur, with faster disaster. The method should use Yangrong Guipi category herbs, adding astringents to gather the scattered Yuan Shen (Original Spirit), so that scattered Qi retreats and hides secretly, perhaps saving the patient. Again, Yin deficiency with hyperactive Fire, rebellious Qi rushing upward, insomnia: the method should nourish Water to control it. Avoid bitter-cold purging drugs that damage True Qi. Mistaken clearing moves far from life. The ancients said, 'Extreme deficiency presents with excess symptoms; mistakenly purging brings injustice.' This is the error of failing to tonify when needed. But what about tonifying when unnecessary? Diseases with excess pulse and excess symptoms cannot tolerate tonification, obviously. Even if the person is constitutionally deficient, if pathogenic factors just arrived and the disease force is strong, sudden tonification is like locking the door and leaving the thief inside. There are also severe excess syndromes with accumulated heat in the center, but pulse is fine and choppy, confusion, fatigue, aversion to cold with shivering, desire to cover with blankets, mimicking deficiency-cold. Yet the person has dry lips/mouth, constipation, dark urine, vastly different from true deficiency. If not carefully distinguished, mistakenly giving tonics is foolish. The ancients said, 'Severe excess presents with emaciated symptoms; mistakenly tonifying worsens the disease.' This is the error of tonifying when unnecessary. But what about tonifying without distinguishing Qi and Blood, Cold and Heat? The Classic says, 'Qi warms, Blood moistens.' For Qi, use Sijunzi Tang (Four Gentlemen Decoction); all Qi-tonifying drugs derive from this. For Blood, use Siwu Tang (Four Substance Decoction); all Blood-tonifying drugs derive from this. For Blood-heat syndromes, tonify and move Blood to clear heat. For Blood-cold syndromes, warm meridians and nourish Blood to harmonize. Lizhai's treatment: Hematemesis due to Blood-heat is Yang invading Yin, heat forcing Blood to run wild; treat with Sisheng Wan (Four Generations Pill) and Liuwei Tang (Six-Ingredient Decoction). Hematemesis due to Blood-cold is Yin invading Yang, like water freezing in winter cold; treat with Lizhong Tang (Regulate Middle Decoction) added with Danggui. Doctors must recognize this to avoid errors. For massive blood loss (measured in liters/sheng), regardless of cold or heat, tonification is required. 'Blood loss requires boosting Qi,' which is the ultimate principle of Yang generating Yin. Formidable Blood cannot be generated quickly; Intangible Qi must be urgently secured. This distinguishes Qi/Blood and Cold/Heat. But what about tonifying without understanding Opening/Closing and Urgency/Slowness? Heaven and Earth have closing and opening; medication has tonifying and purging. For example, Buzhong Yiqi Tang added with Renshen must use Chenpi (Tangerine Peel) to open it; Liuwei Dihuang Wan using Shudi (Prepared Rehmannia) must use Zexie (Alisma) to guide it. Ancients used drugs to tonify righteousness while simultaneously purging evil; once evil is gone, tonification gains strength. Thus, ancient formulas include those combining tonifying and dispersing (Renshen Su Yin, Yiqi Tang), combining dissolving and tonifying (Zhiju Wan, Lizhong Wan), combining attacking and tonifying (Xiexin Tang, Xiaoshi Wan), combining warming and tonifying (Zhizhong Tang, Shenfu Tang), combining clearing and tonifying (Shenlian Yin, Renshen Baitu Tang). There are urgent tonifications, slow tonifications, and mild tonifications. For extremely deficient persons in critical illness, large-decoction liquids are needed to reverse the condition. I often use Shenfu Jian Gao (Ginseng-Aconite Paste) taken several taels daily to rescue Yang micro-collapse. I have also used Shenmai Jian Gao (Ginseng-Ophiopogon Paste) taken several taels to rescue drying Body Fluids. For those unable to afford Renshen, Huangqi (Astragalus) and Baizhu (Atractylodes) substitute. Treating according to circumstances often yields merit. When pathogenic factors are not fully cleared and Yuan Qi is deficient, tolerating heavy tonification is impossible; then tonify gently and slowly. Observe opportunities, proceed step by step. When pulse and symptoms stabilize, gradually reduce dosage. Complete nourishment with grains, meats, fruits, and vegetables to reach health. For those constitutionally deficient without major cold/heat symptoms, wanting to preserve True Yuan with pills/powders: use mild drugs to regulate Qi and Blood, daring not to use eccentric formulas that compete over time and cause harm. This is the meaning of Opening/Closing and Urgency/Slowness. But what about tonifying without distinguishing Five Zang organs? The Five Zang have direct tonification methods and mutually-generating tonification methods. The Nanjing says: 'Damage Lung, benefit Qi; damage Heart, harmonize Ying and Wei; damage Spleen, regulate diet and temperature; damage Liver, soothe middle; damage Kidney, benefit Essence.' This is direct tonification. For example, tonify Spleen for Lung deficiency (Earth generates Metal); tonify Mingmen for Spleen deficiency (Fire generates Earth); tonify Liver for Heart deficiency (Wood generates Fire); tonify Kidney for Liver deficiency (Water generates Wood); tonify Lung for Kidney deficiency (Metal generates Water). This is mutually-generating tonification. After medicating, add proper preservation, and this is the good way. Proverb says, 'Medicine tonification is inferior to Food tonification.' I say, 'Food tonification is inferior to Essence tonification, Essence tonification is inferior to Spirit tonification.' Regulate diet, cherish spirit, use drugs appropriately, and few illnesses will not heal."