Author: Michael

ST36 and LR 3 足三里-太冲 by Wang Leting 王乐亭

ST36 and LR 3 足三里-太冲  by  Wang Leting 王乐亭 (1895 to 1984)

ST-36 is able to supplement blood, invigorate blood, cool blood and clear blood, and LR-3 is able to drain the liver and gallbladder, descend counterflow qi, regulate, free the menses, move qi, stop pain and also cool and invigorate the blood. When the two are paired together, they can calm the liver and descend counterflow, move blood and free the menses, cool and invigorate blood, course and free the qi mechanism of the liver and stomach, clear and regulate brewing heat of hte liver, stomach and gallbladder, it governs the treatment of painful menstruation, qi counterflow of the liver and gallbladder, dizziness and headache, vexation and tendency to anger, vomiting and retching, stomach pain, patterns that below to qi counterflow or stagnation or brewing heat, also patterns of rib-side pain, zang-zao (visceral vexation), mania and withdrawal, disharmony between the gallbladder and stomach, and oppression within the stomach.

 

Dà Cháihú Tāng 大柴胡湯 (Part 1)

From the Yīfāng Jíjiě 《医方集解》 1689 CE by Wang Ang 王昂.

 

少陽陽明解表攻裏，仲景
It is for shàoyáng and yángmíng resolving the exterior and attacking the interior, by Zhòngjǐng

治傷寒發熱，汗出不解，陽邪入裏，熱結在裏（1）。心下痞鞕，嘔而下利，或往來寒熱，煩渴譫語，腹滿便秘，表證未除，裏證又急，脈洪或沉實弦數者（2）。
It treats cold damage with heat effusion, unresolved after sweating, yáng evil entering the interior, and heat binding internally (1). Hard glomus below the heart, retching and diarrhoea, or possibly alternating chills and fever/heat, vexation and thirst with delirious speech, abdominal fullness and constipation, and exterior pattern that is has not yet resolved, and an interior pattern with urgency, the pulse is surging or possibly deep, replete, wiry, and rapid (2).

  1. 裏非三陰之裏，乃胃腑也。此為少陽陽明，三陰亦有轉入陽明者，如太陰有桂枝加大黃湯，少陰有三大承氣，厥陰一小承氣，皆兼陽明證也。
    The interior is not the interior of the three yīn, it is the stomach fǔ-bowel. This is shàoyáng and yángmíng [disease], the three yīn can also transfer to enter the yángmíng, for example in tàiyīn there is Guìzhī Jiā Dàhuáng Tāng [pattern], and shàoyīn has three Dà Chéng Qì [patterns], and juéyīn also has Xiǎo Chéng Qì [pattern], these are all concurrent yángmíng patterns.
  2. 表證未除者，發熱，頭痛，脅痛，寒熱仍在也。裏證又急者，痞鞕，燥渴，譫狂，便秘也。脈沉實為在裏，弦數者邪在少陽也。洪者邪在陽明也。其嘔而下利者，何亦用之，張兼善曰：裏虛者便雖難而勿攻，裏實者雖吐利而可下，心煩喜嘔，裏熱已甚，結於胃中，故下之則愈。
    For an exterior pattern that has not yet resolved, there is heat effusion, headache, rib-side pain, and chills and fevers; these are still present. For an interior pattern with urgency, there is hard glomus, dryness and thirst, delirious mania, and constipation. When the pulse is deep and replete, it indicates the interior; when the pulse is wiry and rapid, the evil is located in shàoyáng; when it is surging, the evil is located in yángmíng.

For those with retching and diarrhoea, why can [this formula] also be utilised?

Zhāng Jiānshàn[1] said, “When the interior is deficient, although the stool may be difficult [to pass], [one] should not attack. When the interior is excess although there is retching and diarrhoea, [one] can precipitate. With heart vexation and frequent retching, the interior heat has already become severe and become bound in the stomach; therefore, precipitate it and there will be recovery.”

柴胡 八兩  半夏 半升  黃芩、芍藥 三兩  生薑 五兩  大棗 十二枚擘  枳實 四枚  大黃 二兩酒浸

Cháihú 8 liǎng , Bànxià ½ shēng, Huángqín and Sháoyào 3 liǎng each,  Shēngjiāng 5 liǎng, Dàzǎo 12 pieces (split) Zhǐshí 4 pieces, Dàhuáng 2 liǎng (alcohol steeped/soaked)

一方無大黃，下註云：若不加大黃，恐不為大柴胡湯也。崔氏去柴胡加前胡，名大前胡湯，胡洽云：亦出仲景方，治同。

One instance of this formula does not have dàhuáng. An annotation below it says: “if dàhuáng is not added, then I fear it cannot be Dà Cháihú Tāng. Master Cuī removed cháihú and added qiánhú, and names it Dà Qiánhú Tāng. Hú Qià says that this was also a Zhòng Jǐng formula, and treated identical [patterns].”

 

[1] Unfortunately, I am unable to locate who this person is.

 

Next week will include further commentary on this formula.

 

With special thanks to Allen Tsaur for editing.

Dǎohuàn Sàn (Rearrangement Powder) 倒換散

Dǎohuàn Sàn (Rearrangement Powder) 倒換散

From the section on Urinary Stoppage in the Yī Fāng Kǎo (Analysing Medical Formulas) by Wu Kun, 1584 CE. 《醫方考·小便不通門第三十八》

大黃（一兩） 荊芥（二兩）
dà huáng (1 liǎng) Jīngjiè (2 liǎng)

每服末二錢。
Every dose take 2 qián [of the powder].

 

內熱小便不通者，此方主之。
For those with internal heat and urinary stoppage,[1] this formula governs it.

內熱而小便不通者，鬱其少火，而氣不化也。 《內經》曰∶膀胱者，州都之官，津液藏焉，氣化則能出矣。然化氣之道，莫妙於升降。天地以升而降化萬物，奈何而昧於人乎？
For those with internal heat that leads to urinary stoppage, this is depression of the lesser fire, and then qì cannot transform. The Nèijīng says the bladder, it is the official of provinces and cities, the jīnyè-fluids are stored within it;  with qì transformation, it (jinyè-fluids) can emanate. And for the dào (principle/natural law) of this qì transformation, there is nothing more marvelous than the [movements] of ascending and descending. Heavens and earth, by ascending and descending, are able to transform the ten-thousand things. How can people be ignorant of this?

 

故用荊芥之輕清者以升其陽。用大黃之重濁者以降其陰。清陽既出上竅，則濁陰自歸下竅，而小便隨泄矣。方名倒換者，小便不通，倍用荊芥。大便不通，倍用大黃。顛倒而用，故曰倒換。
Thus, by utilising the light and clear [nature] of jīngjiè, it can raise the yáng. By utilising the heavy and turbid [nature] of dàhuáng, it can descend the yīn. Once the yáng exits via the upper orifices, the turbid yīn will naturally return to the lower orifices, and then urination will be discharged subsequently.

For the name of the formula name, Dǎohuàn (Rearranging), when urination is stopped, double the dosage of jīngjiè; when there is constipation, double the dosage of the dàhuáng; [the dosage] can be reverted in use,, therefore it is called Rearrangement [Powder].

Thanks to Allen Tsaur and Will Ceurvels for their help, and Mark Gearing for picking up an error in the dosages.

[1] According to the Practical Dictionary “this is either dribbling urination or complete blockage in severe cases.”

[2] From Suwen Chapter 5.

The Fourth Point of the Heart Channel – Líng Dào – Spirit Pathway (HE-4)

The Fourth Point of the Heart Channel
Líng Dào – Spirit Pathway (HE-4)
心經第四靈道

[This is from the upcoming translation of Explanations of Channels and Points, translated by Michael Brown and edited by Allen Tsaur, published by Purple Cloud Press. This work may not reflect the final edition. This blog will be updated approximately every 10 days.]

穴在掌後一寸五分，手少陰心脈所行爲經金。《銅人》：鍼三分，灸三壯。

This point is located 1 cùn and 5 fēn behind palm. The hand shàoyīn heart vessel flows here, as the river and metal [point]. The Tóngrén states “needle 3 fēn, moxa 3 cones”.

注：心主神靈，此穴爲心經所行，故曰靈道，走而不守也。

Explanation: the heart governs the spirits[1], this point is where the heart channel travels, therefore it is called Líng Dào (Spirit Pathway), as it moves and does not guard[2].

心之心病：心痛乾嘔，悲恐，相引瘈瘲，肘攣，暴瘖不能言。

Heart diseases of the heart: heart pain with dry retching, sorrow and fear, alternating tugging and slackening[3], hypertonicity of the elbow, sudden loss of voice with inability to speak.

注：心痛而乾嘔，乃心氣之逆也，悲恐乃心氣之虛也，相引瘈瘲，心爲一身神明之主，而邪乘之，故有是症，

Explanation: heart pain leading to dry retching is a result of the counterflow of heart qì. Sorrow and fear are due to the deficiency of heart qì. For alternating tugging and slackening, the heart governs the bright spirit of the entire body, when an evil overwhelms it, then there are these signs.

肘攣乃本經所行之部分也，暴瘖不能言，乃心氣不至於舌也。以上症皆心經所行部分，責之以通其滯。

For hypertonicity of the elbow, this is the area where this channel travels. Sudden loss of voice with inability to speak is a result of the heart qì not arriving at the tongue. The above signs are all areas where the heart the channel travels, seek this [point] in order to free the stagnation.

[1] This is the two terms神 Shén and靈 Líng together. For the distinction between the two types of spirit, please refer to the explanation in HE-2.

[2] This is a common phrase in herbal treatment. The Practical Dictionary notes that this phrase describes the mobile nature of the medicinals, that tend to cause movement.

[3] Alternating tugging and slackening 相引瘈瘲 may be similar to the condition of clonic convulsions.

Lung Shu (BL-13) – Part 2

[This is from the upcoming translation of Explanations of Channels and Points, translated by Michael Brown and edited by Allen Tsaur, published by Purple Cloud Press. This work may not reflect the final edition. Another point will come out next Wednesday.]

肺腧之本病：肺痿咳嗽，肉痛皮癢，嘔吐支滿，不嗜食，腰脊强痛，背僂，肺中風偃卧，胸滿短氣，瞀滿汗出，百毒病，食後吐水，勞瘵，口舌乾，勞熱上氣，寒熱，喘滿虚煩，傳屍骨蒸，癭氣，小兒龜背◦

Principal diseases of Fèi Shù: lung wilting with cough, flesh pain with itchy skin, vomiting with propping fullness, no desire to eat, stiffness and pain of the lumbar spine, a hump on the back[1], wind strike of the lung [and can only] lie in supine position, fullness of the chest with shortness of breath, visual distortion with fullness and sweating, disease of the hundred toxins, vomiting of fluids after eating, consumption [disease], dry mouth and tongue, taxation heat with qì ascent, chills and fever, panting and fullness with vacuity vexation, corpse transmission with steaming bone, goitre, child with a tortoise back[2].

注：喘嗽二症，所得之始雖不同，而成病傷肺者，故宜責此穴，以散肺之火與風。嘔吐支滿，氣全上逆也，取此穴以散上逆之氣。

Explanation: the two signs of panting and cough, even though they have different origins, however, they both eventually become diseases that damage the lung; therefore it is appropriate to seek this point in order to dissipate the fire and wind in the lung. Vomiting and propping fullness, this is entirely due to counterflow ascent of qì, choose this point in order to dissipate the counterflow ascent of qì.

腰脊强痛，氣逆作下也，肺統一身之氣，取腧穴以散下逆之氣。背者，肺之室也，先氣鬱在内，而後背爲之僂，故先泄此穴，以散其中鬱之氣。

Stiffness and pain of the lumbar spine, this is descending qì counterflow, as the lung controls the qì of the entire body, choose the back transport point in order to dissipate the descending qì counterflow. The upper back is the chamber of the lung, initially when there is qì depression in the interior, then subsequently the upper back will become stooped; thus initially drain this point in order to dissipate the depression of qì in the interior.

肺中風於内，而氣滯偃卧，則肺葉閉塞而氣不通，遂胸滿氣短矣，故取此穴以散其中鬱之風。肺傷風則汗出瞀而且悶，皆風氣爲之，宜泄此穴。

When the lung is struck by wind in the interior[3], then qì becomes stagnant and then one can only lie supine. This is due to the lobes of the lung being blocked, which obstructs the flow of qì, resulting in fullness of the chest and shortness of breath; therefore, choose this point in order to dissipate the internal depression of wind. When the lung is damaged by wind that causes sweating with visual distortion and oppression, in all cases it is the effect of wind qì, it is appropriate to drain this point.

食後吐水，氣逆載水上也，泄此穴以散上逆之氣。勞瘵口乾並上氣，熱上蒸而氣逆極矣，泄此穴以散肺中之火與氣。

Vomiting of fluids after eating is counterflow qì with simultaneous ascending of water, drain this point in order to dissipate the counterflow ascent of qì. Consumption pdisease], dry mouth, and qì ascent, these are due to ascending and steaming of heat leading to extreme counterflow of qì, drain this point in order to dissipate the fire and qì within the lung.

倏寒倏熱，此肺受邪也，而又喘滿虚煩，則肺中之邪甚，審其虚實而補泄之。傳屍而至骨蒸，此病極矣，先泄此穴，後更别治。

Sudden chills and sudden fevers, this is due to the lung contracting evil. When it is further combined with panting, fullness and vacuity vexation, this is a severe evil within the lungs. Examine whether it is deficiency or excess and then [appropriately] tonify or drain it. Corpse transmission leading to steaming bone, the disease has become critical, initially drain this point, and then subsequently proceed with other treatments.

癭氣者，肺氣之鬱也，泄此穴以散肺氣。小兒龜背，乃肺氣之弱也，宜補此穴以生其肺氣。

Goitre qì is depression of lung qì, drain this point in order to dissipate lung qì. For a child with a tortoise back, this is a result of weak lung qì, it is appropriate to tonify this point in order to generate the lung qì.

肺腧之胃病：黄疸。

Stomach disease of Fèi Shù: juandice.

注：胃有濕熱，蒸爲黄疸，泄此穴以散胃之熱，更宜解胃之濕熱。

Explanation: when the stomach has damp heat, [the damp heat] will steam to become jaundice, drain this point in order to dissipate the heat of the stomach, it is even more appropriate to resolve the damp heat of the stomach.

肺腧之心病：狂走欲自殺。

Heart disease of Fèi Shù: manic walking with desire to kill oneself.

注：此火迷心而逆上之病也，泄此穴以散逆上之火。

Explanation: this is fire confounding the heart leading to the disease of counterflow ascent, drain this point in order to dissipate counterflow ascent of fire.

[1] Like a a hunchback.

[2] Also like a hunchback. The Practical Dictionary states this is “a deformity in infants which the spine curves outward giving the back the appearance of a tortoise’s shell”.

[3] i.e. internal wind.

Lung Shu (BL-13) – Part 1

[This is from the upcoming translation of Explanations of Channels and Points, translated by Michael Brown and edited by Allen Tsaur, published by Purple Cloud Press. This work may not reflect the final edition. Part 2 next will include the diseases that BL-13 treats]

BL-13 Fèi Shù – Lung Shu
膀胱經第十三穴肺腧

穴在第三椎下兩旁，相去脊一寸五分。《千金》云：對乳引繩度之。甄權云：以搭手，左取右，右取左，當中指末是穴，正坐取之。

This point is located beside and below the third vetebra, 1 cùn 5 fēn from the spine, on each side. The Qiānjīn states [it is] opposite the breast, draw a string to locate it. The Zhēnquán states put the hand over the shoulder, for left [point] use right [hand], for right [point] use left [hand], spot under the tip of the middle finger is the point, sit upright to locate it.

《甲乙》：鍼三分，留七呼，得氣即泄。甄搏：灸百壯。《明下》：灸三壯。《素》戒云：刺中肺，三日死，其動爲咳。

The Jiǎyǐ states needle 3 fēn, retain for 7 respirations, obtain qì then promptly drain. Zhēn bó states moxa 100 zhuàng. The Míngxià states moxa 3 cones. The Sùwèn warns piercing into the lung, in three days there will be death, and manifest as coughing.[1]

注：五臟六腑皆系於背，乃系於背之挾脊脂絡中，其腧穴，按臟腑之高下而定焉，實臓腑至要之處，爲臓腑之本也。太陽一經，歷主其穴，所謂巨陽者，蓋一身之臓腑無所不統也。

Explanation: the five zàng-viscera and six fǔ-bowels all have connectors on the back, that connect to the fatty network on the back that clasps the spine. As for the [back] transport points, [their locations] are determined by the relative height of the zàng-viscera and fǔ-bowels. They are truly the most crucial places and foundations of the zàng-viscera and fǔ-bowels. The channel of the tàiyáng passes through and governs these points. This is the reason it is called the great yáng, as all the zàng-viscera and fǔ-bowels of the body are governed by it, without exception.

各腧即統其原於挾脊之兩旁，而各腧臟腑之餘，本經背一行之支别者，又再分按其部而主之，故臓腑外受之邪，無不取於本經在背之穴也。

Each back transport [point] precisely controls its origin on the [lateral] side of the paravertebrals, and transports the surplus of its respective zàng-viscera and fǔ-bowels. For the diverging branch of first line of this channel on the back, it also governs based on its location. Thus, when the zàng-viscera and fǔ-bowels externally contract an evil, without exception always select a point of this channel that is on the back.

肺處五臓最高之所，故肺腧首取之，乃系肺之原本處也。仲景曰傷寒太陽與少陽並病，頭項强痛或眩冒，時如结胸，心下痞者，當刺足太陽肺腧、肝腧。

The lung is situated in the highest place of the five zàng-viscera, therefore Fèi Shù (BL-13) is the first to adopt [this category], it also connects place that is the origin and foundation of the lung. Zhòngjǐng says “When there is cold damage of the tàiyáng together with the shǎoyáng, this is dragover disease. There is headache and stiff painful nape, or possibly veiling dizziness, periodically feeling as if there is chest bind, glomus below the heart, one should peirce the foot tàiyáng Fèi Shù (BL-13) and Gān Shù (BL-18)”.[2]

又諸腧穴，皆爲臟腑至要之所，鍼之深斷不可過三分，故古人著戒有中肺、中心、中膈之戒，非真中肺、中心也，謂中其系肺、系心之本也。

For all the back transport points, they are the most crucial places for all the zàng-viscera and fǔ-bowels, thus the depth of needling should certainly not exceed 3 fēn; therefore, the ancients composed warnings against [piercing] into lung, heart, and diaphragm; however, this is not truly [piercing] the lung and the heart, but the foundation of the connector to the lung, and of the connector to the heart.

所謂前邊深似井，言在腹諸穴也，後邊薄似餅，言在背諸穴也，可不慎哉。

It is said that the front [of the body] is deep like a well, that is regarding all the points on the abdomen. The back of the body is thin like a round flat cake. Regarding all the points on the back, [one] cannot carelessly [pierce] them!

[1] From Sùwèn Chapter 52.

[2] This is slightly modified quote from Line 171 of the Shānghán Lùn.

Zhīmǔ from Běncǎo Jīngjiě

Zhīmǔ from Běncǎo Jīngjiě 《本草經解》 (c. 1724 CE), attributed to Yè Tānshì 葉天士

氣寒，味苦，無毒。主消渴熱中，除邪氣，肢體浮腫，下水，補不足，益氣。

Its qì is cold, flavour is bitter, not poisonous. It governs dispersion-thirst with heat in the interior, eliminates evil qì, puffy swelling of the body and limbs, watery diarrhoea, tonifies insufficiency, increases qì.

知母氣寒，稟天冬寒之水氣，入足少陰腎經；味苦無毒，得地南方之火味，入手少陰心經。氣味俱降，陰也。

Zhīmǔ’s qì is cold, it is endowed with water qì of heavenly winter-cold, it enters the foot shàoyīn kidney channel. Its flavour is bitter and is not poisonous, it is virtued with the fire flavour of the southern direction, it enters the shàoyīn heart channel. The qì and flavour both descends, it is yīn.

腎屬水，心屬火，水不制火，火爍津液，則病消渴；火熏五內，則病熱中。其苦之者，苦清心火，寒滋腎水也。

The kidneys belong to water, the heart belongs to fire, when water cannot restrain fire, if fire scorches the jīn-fluids and yè-humours, then the disease of dispersion-thirst occur; if fire fumes the five internal [zàng-viscera], then the disease of heat in the interior will occur. [Because] it is bitter [flavour], and bitter clears heart fire, and cold enriches the kidney-water.

除邪氣者，苦寒之味，能除燥火之邪氣也。

Regarding eliminating evil qì, its flavour is bitter-cold, so it is able to eliminate the dry and fire evil qì.

熱勝則浮，火勝則腫；苦能清火，寒能退熱，故主肢體浮腫也。腎者水藏，其性惡燥，燥則開合不利，而水反蓄矣；知母寒滑，滑利關門而水自下也。補不足者，苦寒補寒水之不足也。益氣者，苦寒益五臟之陰氣也。

When heat is prevalent there will be floating, when fire is prevalent there will be swelling; bitter [flavour] is able to clear fire, cold [qì] is able to abate heat, therefore it governs puffy swelling in the limbs and body. The kidneys are the water zàng-viscus, their nature is to be averse to dryness. When there is dryness then opening and closing [of the bowels] is inhibited, and water will on the contrary accumulate; Zhīmǔ is cold and lubricating, it can lubricate and disinhibit the opening and closing [of the bowels] and then the water will naturally descend. Regarding tonifying insufficiency, the bitter-cold tonifies the insufficiency of cold-water. Regarding increasing qì, the bitter-cold increase the yīn qì of the five zàng-viscera.

Zhīmǔ 知母 (Běncǎo Bèiyào 本草備要)

Zhīmǔ 知母

From the Běncǎo Bèiyào 本草備要 (1694).

 

瀉火補水，潤燥滑腸

Drains fire, tonifies water, moistens dryness and lubricates the intestines.

辛苦寒滑。

Pungent and bitter, cold and lubricating.

上清肺金而瀉火（瀉胃熱、膀胱邪熱、腎命相火），下潤腎燥而滋陰，入二經氣分（黃柏入二經血分，故二藥必相須而行）。消痰定嗽，止渴安胎（莫非清火之用）。

Ascends and clears lung-metal and drains heat (drains stomach fire, bladder evil-fire, [in addition] to kidney, mingmen and ministerial-fire). Descends to moisten kidney dryness and enriches yīn, enters the qì aspect of these two channels (huángbǎi enters the blood aspect of these two channels, therefore these two herbs are mutually reliant on each other [when used together]). Disperses phlegm and stabilises cough, allays thirst and quietens the foetus (invariably [all its] functions are clearing fire).

治傷寒煩熱，蓐勞（產勞）骨蒸（退有汗之骨蒸），燥渴虛煩，久瘧下痢（治嗽者，清肺火也，治渴者，清胃熱也。退骨蒸者，瀉腎火也），利二便，消浮腫（小便利則腫消。東垣曰：熱在上焦氣分，結秘而渴，乃肺中伏熱，不能生水，膀胱絕其化源。

[Zhīmǔ] treats cold damage (shānghán) heart vexation, childbirth taxation (taxation during delivery) steaming bone (abates the sweating of steaming bone), Dry [mouth] and thirst with vacuity vexation, enduring malaria and dysentery (Ceases cough by clearing lung fire. Ceases thirst by clearing stomach heat. Abates steaming bone by draining kidney fire). Disinhibits urination and defecation, disperses puffy swelling ([once] the urine is disinhibited then the swelling will dissipate. Dōngyuán states heat that is located in the upper jiāo qì aspect, [it will] knot and obstruct and cause thirst, this is latent heat within the lung, [the lung] cannot generate water, the bladder is severed from its source of transformation.

宜用滲濕之藥，瀉火清金，滋水之化源。熱在下焦血分，便閉而不渴，乃真水不足，膀胱乾涸，無陰則陽無以化。宜用黃柏、知母大苦寒之藥，滋腎與膀胱之陰。而陽自化，小便自通。丹溪曰：小便不通，有熱有濕，有氣結於下，宜清、宜燥、宜升。

It is appropriate to use herbs that percolate dampness, drain fire and clear metal, and enrich water at the source of transformation. Heat located in the lower jiāo blood aspect, there will be constipation and absence of thirst, this is due to insufficiency of true water (i.e. the kidneys) and dryness and desiccation of the bladder, when there is absence of yīn then yáng is unable to perform transformation. It is appropriate to use huángbǎi and zhīmǔ; herbs that are strongly bitter and cold [in order to] enrich the yīn of kidney and bladder. And then yáng will naturally transform, and urination will spontaneously flow. Dānxī states for urinary stoppage, [there are patterns] of heat, dampness, and qì knotting in the lower, [in these cases] it is appropriate to clear, dry and ascend.

又有隔二隔三之治。如肺不燥，但膀胱熱，宜瀉膀胱，此正治；如因肺熱不能生水，則清肺，此隔二之治；如因脾濕不運而精不上升，故肺不能生水，則燥胃健脾，此隔三之治。瀉膀胱，黃柏、知母之類；清肺，車前、茯苓之類；燥脾，二術之類。昂按：凡病皆有隔二隔三之治，不獨便閉也）。

Also there are treatments of two sections and three sections]. If the lung is not dry, but the bladder is hot, it is appropriate to drain the bladder, this is straight treatment. If there is lung heat and it cannot engender water, then clear the lung, these two sections [require] treatment.

If there is spleen damp and it cannot transport and then the essence does not ascend, then [also] the lung cannot engender water, then dry the stomach and fortify the spleen, these three sections [require] treatment. Drain the bladder heat with [herbs] like huángbǎi and zhīmǔ; clear the lung with [hebs] like chēqián and fúlíng; dry the spleen with [herbs] like the two types of shù (báizhú and cāngzhú). Wāng Áng states: all diseases that require treatment of two or three sections, not only constipation).

然苦寒傷胃而滑腸，多服令人瀉（李士材曰：苦寒肅殺，非長養萬物者也。世以其滋陰，施之虛損之人，則如水益深矣，特表出以為戒）。

Yet the bitter-cold [nature] damages the stomach and lubricates the intestines, it is often taken to drain (or cause diarrhoea) (Lǐ Shìcái states: bitter-cold herbs are harsh, [they] stop the ten thousand things from growing and nourishing. Later generations use it to enrich yīn, give to people with vacuity detriment, but if water is too greatly increased, tè biǎo chū yǐwéi jiè)

Yù Píng Fēng Sàn

Commentary from the Yīfāng jíjiě 《医方集解》 1689 CE

【Indications – 主治】

治自汗不止，氣虛表弱，易感風寒(1)。

1. 陽也者，衛外而為固也。陽虛不能衛外，故津液不固而易泄，且畏風也。此與傷風自汗不同，彼責之邪實，此責之表虛，故補散各異。

It treats incessant spontaneous sweating, qì deficiency with weakness of the exterior, easily susceptible to wind-cold [strike](1).

1. Regarding yáng, it defends the exterior and moreover it secures [the exterior]. If there is yáng deficiency then it is unable to defend the exterior, thus the jīnyè-fluids are not secured and easily leak, and in addition to fear of wind. This [pattern] and spontaneous sweating by wind damage at not identical, the latter is blamed on an excess evil, this is blamed on an exterior deficiency, that is difference between tonification and dissipation.

【Composition – 組成】

黃耆 炙  防風 一兩  白朮 炒二兩

為末，每服三錢。

Huáng qí (roasted), fángfēng each 1 liǎng

Báizhú (blast flied) 2 liǎng

【Formula Explanation – 方義】

此足太陽手足太陰藥也。黃耆補氣，專固肌表，故以為君，白朮益脾，脾主肌肉，故以為臣，防風去風，為風藥卒徒，而黃耆畏之，故以為使，以其益衛固表，故曰玉屏風。

These are foot tàiyáng, hand and foot tàiyīn herbs. Huángqí tonifies qì, specialises in securing the fleshy exterior, therefore it is the monarch herb. Báizhú governs boosting the spleen, the spleen governs the flesh, therefore it is the minister herb. Fángfēng eliminates wind, using a wind medicinal then [the wind] will suddenly leave, more over huángqí wèi zhī, therefore it is the courier herb. Because it supplements the wèi-defensive and secures the exterior, thus it is called Yù Píng Fēng (Jade Screen [Protecting from] Wind).

【Discussion of the formula – 方論】

李東垣曰：黃耆得防風而功益大，取其相畏而相使也。

Lǐ Dōngyuán said “Huángqí together with fángfēng increases the function greatly, this is the point of [using the herbal relationships of] fear and empowering.

《証治準繩》曰：卒中偏枯之證，未有不因真氣不週而病者，故黃耆為必用之君藥，防風為必用之臣藥，黃耆助真氣者也。防風載黃耆助真氣以周于身者也。亦有治風之功焉，許胤宗治王太后中風口噤，煎二藥薰之而愈，況服之乎？

The Criterion for Patterns and Treatments states: the pattern stroke and hemiplegia, has never been not caused by zhēn-true qì circulating which leads to this disease. Therefore huángqí must be the monarch herb, and fángfēng must be the minister herb, because huángqí assists the zhēn-true qì. Fángfēng enables huángqí to assist the zhēn-true qì around the whole body. It also has the treats wind with excellence, Xǔ Yìnzōng (of the Tang Dynasty) treated the Emperor’s mother for wind-strike with clenched jaw, [after] cooking the two herbs and then she]recovered. What could be comparable to taking this formula?

【Additional Formulas – 附方】

前藥等分煎，名黃耆湯，潔古用代桂枝湯，治春夏發熱有汗，脈微弱，惡風寒者，惡風甚，加桂枝。

Using the three herbs in equal parts and fried, this is named Huángqí Tāng, Jiégǔ uses it as a substitute for Guìzhī Tāng. It treats spring-summer fevers with sweating, faint and weak pulse, aversion to wind and cold, if the aversion to wind is severe then add guìzhī.

又用川芎、蒼朮、羌活、等分，名川芎湯，以代麻黃湯，治秋冬發熱無汗惡風寒者，惡寒甚加麻黃。

Another use chuānxiōng, cāngzhú, and qiānghuó, in equal parts, and this formula is named Chuānxiōng Tāng, it can be substituted for Máhuáng Tāngit. It treats autumn and winter fevers, absence of sweating and aversion to wind-cold, if the aversion to wind is severe add máhuáng.