DONGUIBOGAM; Internal Bodily Elements-Qi 氣 기 (4)

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Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)

16 Middle Qi 中氣중기

① Formulas for Universal Relief (本事) says, “When one is suddenly delighted, yang is damaged, and when one suddenly gets angry, yin is damaged. When one’s mind is saddened with anxiety, qi is usually reversed, creating rattling noise caused by phlegm, and he or she becomes unconscious and clenches the teeth. If one mistakes it for wind stroke and uses medicine, it can kill the person. When these symptoms occur, melt and feed a Liquid Styrax Pill (蘇合香元) to the patient urgently, and cure according to the symptoms after the patient wakes up.”

② Effective Formulas Handed Down for Generations (得效) says, “In the case of wind stroke, the pulse is floating, the body is warm, and lots of phlegm and drool come out from the mouth. In the case of middle qi, the pulse is sunken, the body is cold, and there is no phlegm and drool in the mouth. Treating wind stroke with middle qi medicine does not hurt the patient, but curing middle qi with the wind stroke medicine immediately damages the person. In this case, use a Liquid Styrax Pill first
and put Acori Gramineri Rhizoma (菖蒲) in a Seven Emotions Decoction before use.”

③ Mr. Fang said, “Wind stroke cannot be cured a lot of the time, but people get recovered from middle qi soon. What is the reason? Wind stroke and middle qi are both caused by rage. Among the five minds, anger is the most extreme. This is because disease comes all of a sudden. Because qi and blood of the young are not yet deficient and body fluid not yet dried, Fire is afraid of Water and hence cannot go up. Thus, the body is cold and there will not be phlegm or drool, and so the person will wake up soon. Because qi and blood of the old are deficient and body fluid dried, Fire is not afraid to move upward. Thus, the body gets warm and phlegm and drool will form, making it hard to treat most of the time.”

④ Introduction to Medicine (入門) says, “When struck with middle qi, use Eight Substances Smooth Qi Powder if the body is deficient and a Four Ingredients for Seven Emotions Decoction when the body is excessive.”

⑤ Recovery from the Myriad Diseases (回春) says, “Middle qi is when a person collapses during a quarrel because he or she has suddenly burst with anger and caused qi to flow upward, resulting in dizziness and fainting. First feed the person with water decocted with Zingiberis Rhizoma Crudus (生薑) in order to wake the person up, and then use Aucklandia Smooth Qi Powder.”

⑥ The Medical Mirror of Past and Present (醫鑑) says that the “Inner Classic (內經) says ‘When one’s voice does not come out and his or her pulse does not beat without any reason, it can be recovered automatically with no treatment.’ This refers to a sudden reflux of qi. Because it can be cured when qi returns, there is no need for medicine.”

  • Eight Substances Smooth Qi Powder 八味順氣散 팔미순기산
    It is the best for treating middle qi. Chop the following and decoct: Ginseng Radix (人參), Atractylodis Rhizoma Alba (白朮), Poria Sclerotium (白茯苓), Citri Unshius Pericarpium Immaturus (靑皮), Angelicae Dahuricae Radix (白芷), Citrus Unshius Pericarpium (陳皮), Linderae Radix (烏藥) (7 pun each), and Glycyrrhizae Radix (甘草) (3 pun).[B090]
  • Aucklandia Smooth Qi Powder 木香順氣散 목향순기산
    It treats middle qi. Chop the following herbs, add 3 pieces of Zingiberis Rhizoma Crudus (生薑) and decoct: Linderae Radix (烏藥), Citri Unshius Pericarpium Immaturus (靑皮), Cyperi Rhizoma (香附子), Citrus Unshius Pericarpium (陳皮), Pinelliae Tube Preparata (半夏製), Magnoliae Cortex (厚朴), Aruantii Fructus Immaturus (枳殼) (1 don each), Aucklandiae Radix (木香), Amomi Fructus (砂仁) (5 pun each), Cinnamomi Cortex (桂皮), Zingiberis Rhizoma (乾薑), and Glycyrrhizae Radix Praeparata (灸甘草) (3 each).

17 Qi Reflux 上氣상기

① Divine Pivot (靈樞) says, “If pathogenic qi is in the lungs, there is cold and heat as well as qi reflux.

② The Inner Classic (內經) says, “The lungs stores qi. If qi is excessive, one is out of breath and coughs, and there is qi reflux.” ③ The qi reflux is when there is more exhalation than inhalation in breathing. One should use a Perilla Seed Direct Qi Downwards Decoction, Secret Direct Qi Downwards Decoction, Greatest Sage Recovery Elixir [The prescription is shown later], Direct Qi Downwards Aquilaria Decoction, or Speed up Qi Decoction (快氣湯).

  • Perilla Seed Direct Qi Downwards Decoction 蘇子降氣湯 소자강기탕
    It treats shortness of breath caused by qi reflux. Chop the following herbs, put in 3 pieces of Zingiberis Rhizoma Crudus (生薑), 3 Zizyphi Fructus (大棗), and 5 leaves of Perillae Folium (紫蘇葉) and decoct: Pinelliae Tube Fermentata (半夏麴), parched and ground Perillae Semen (蘇子) (1 don each), Cinnamomi Cortex Spissus (肉桂), Citrus Unshius Pericarpium (陳皮) with its inner white layer peeled (7.5 pun each), Angelica Gigantis Radix (當歸), Angelicae Decursivae Radix (前胡), Magnoliae Cortex (厚朴), and Glycyrrhizae Radix Praeparata (灸甘草) (5 pun each).
  • Secret Direct Qi Downwards Decoction 秘傳降氣湯 비전강기탕
    It cures dizziness blurred vision, and weakness in the lumbar region and legs caused by qi reflux or disorders in the upward-downward movement of qi. Chop the following herbs, put in 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 3 leaves of Perillae Folium (紫蘇葉) and decoct: Mori Cortex (桑白皮) (1don), Citrus Unshius Pericarpium (陳皮), Aruantii Fructus Immaturus (枳殼), Bupleuri Radix (柴胡), Glycyrrhizae Radix Praeparata (灸甘草) (5 pun each), Lycii Radicis Cortex (地骨皮), Acanthopanacis Cortex (五加皮), Drynariae Rhizoma (骨碎補), Terminaliae Cortex (訶子皮), Amomi Tsao-ko Fructus (草果), Platycodonis Radix (桔梗), and Pinelliae Tube Fermentata (半夏麴) (3 pun each).
  • Direct Qi Downwards Aquilaria Decoction 沈香降氣湯 침향강기탕
    It cures disorder in the upward-downward movement of qi and dyspnea caused by qi reflux. Grind the following finely and put the powder in water decocted by adding Perillae Folium (紫蘇葉) and salt by 2 don: Cyperi Rhizoma (香附子) (便香附子) (4 nyang), Glycyrrhizae Radix Praeparata (灸甘草) (1.2 nyang), Amomi Fructus (砂仁) (5 don), and Aquillariae Lignum (沈香) (4 don).
  • Speed up Qi Decoction 快氣湯 쾌기탕
    It cures the same symptoms as above. Grind the following finely and put the powder in salty water by 1 don each time. Cyperi Rhizoma (香附子) (3.5 nyang), Amomi Fructus (砂仁) (8 don), and Glycyrrhizae Radix Praeparata (灸甘草) (4 don).
  • A Prescription 一方
    It cures when one is suffering from dyspnea, noisy breathing, and being out of breath from sudden qi reflux. Grind Ginseng Radix (人參) finely and put the powder in warm water by 1 don each time, and drink 5~6 times a day.It is also good to decoct thickly.
    Another Prescription 又方
    It cures qi reflux. Pound and crush 1 doe of Brassicae Junceae Folium (白芥子). Put it in a sack and soak it in 2 doe of wine for 7 days. Warm it up 2 times a day and eat 3 hops each time.

18 Downward Qi 下氣하기

① The Compendium of Medicine (綱目) says, “Downward qi belongs to the heart. The Classic (經) says, ‘Summer pulse is the pulse of the heart. If the heart pulse is not prosperous, qi goes down and thus one breaks wind.'”

② It also says, “If a person with epilepsy or phthisis passes gas continuously, he or she is certain to die. Because his or her genuine qi has been used up and the intestines, stomach, and skin have been clogged, food qi cannot be spread outwardly, and thus it goes into the intestines and stomach.”

③ Liu Hejian said, “Because the intestines and stomach bind together, causing food qi to stagnate inside, one belches, or breaks wind a lot.”

④ Zhongjing said, “In the case of a yang brightness disease of Cold Damage, when there is dry feces in the stomach, one is certain to break wind. It can be cured by purgation.” Breaking of wind means qi moving downward. More details appear in the chapter Cold.

19 Shortness of Breath 短氣 단기

① The Doctrine on Illuminating the Principles of Cold Damage (明理) says, “Shortness of breath refers to one’s inability to continue breathing from qi shortness. It feels as if qi is dashing upward, but it is not so. Although one breathes frequently, the breaths are not connected. Eventhough it looks like dyspnea, one’s shoulders do not move up and down. Also, one looks like as
if moaning, but the person is not in pain. Thus, this pattern is very hard to differentiate. Its real symptom is rapid and short breath.”

② Zhongjing said, “Among common people, when one has cold and heat, and when he or she cannot breathe well because the breath is short, it is the excess pattern.” He also said, “When one’s breath is short and has a little bit of phlegm, it should be drawn out by urination. A Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction is mainly used, and a Kidney Qi Pill [The
prescription is shown in the chaper Deficiency Vexation] is also mainly used.”

③ Introduction to Medicine (入門) says, “Shortness of breath is when breaths are not connected with one another. There are four kinds to shortness of breath: one with chest bind, one in which water qi causes throbbing, one in which a wind pathogen and dampness pathogen collide with each other, and one in which the body and qi are weak by birth. Mostly, when distention and fullness can be felt in the epigastric region, it means it is an excess pattern and that pathogenic qi is inside. When the epigastric region is full but smooth, it means it is a deficiency pattern and that pathogenic qi is in the exterior.”

④ Dongyuan said, “When one has a short breath and urinates well, a Four Gentlemen Decoction with the removal of Poria Sclerotium (茯苓) and addition of Astragali Radix (黃芪) can be prescribed for tonification.”

⑤ Introduction to Medicine (入門) says, “When one’s qi has been dissipated, causing internal deficiency, tiredness, weakness, and shortness of breath, use a Regulate the Center and Augment the qi Decoction [Prescription appears in the chapter Internal Damage] or Ginseng Nurture Nutrient Decoction [Prescription appears in the chapter Deficiency Vexation].”

⑥ Classic of the Pulse says, “If the wrist pulse is sunken, it means that breathing in the chest is short.”

  • Poria, Cinnamon Twig, Atractylodes, and Licorice Decoction 苓桂朮甘湯 영계출감탕
    It cures shortness of breath caused by phlegm in the chest. Chop the
    following herbs and decoct in water: Poria Sclerotium Rubra (赤茯苓) (2 don),
    Cinnamomi Ramulus (桂枝), Atractylodis Rhizoma Alba (白朮) (1.5 don each), and
    Glycyrrhizae Radix (甘草) (5 pun).

20 Shortage of Qi 少氣 소기

① The Compendium of Medicine (綱目) says, “Shortage of qi is when one is weak and cannot speak well.”

② Divine Pivot (靈樞) says, “The lungs store qi. When qi is insufficient, one’s breathing becomes weak, and it results in a shortage of qi. It also says, “If the lungs are deficient, one cannot continue breathing because of a shortage of qi. ” It also says, “The kidneys create qi. If the kidneys are deficient, one becomes weak and cannot continue talking, experiences dull pain in the bones, and cannot move the body because it feels languid.” It also says, “CV17 is the sea of qi. When qi is insufficient, one becomes weak and cannot speak well.”

③ The Inner Classic (內經) says, “If one is weak as if frightened, it is because his or her form and qi have dissipated because the flow of the waterways has been incapacitated. Repeating the same words over and over again for a whole day with a weak voice is caused by exhausted qi. One should use Generate Pulse Powder [Prescription appears in the chapter Summer-heat.], Ginseng Paste, Unaccompanied Ginseng Decoction, or Astragalus Decoction.

④ Zhang Yilao (易老) says, “When one’s genuine qi is deficient with a weak pulse, and an aversion to talking, one should use a Four Gentlemen Decoction, Ginseng and Astragalus Decoction, or Augment Qi Pill .”

⑤ Dongyuan said, “When one’s middle qi has become deficient because his or her spleen and stomach have been damaged internally, one should use a Tonify the Center to Augment the qi Decoction, or Augment Stomach and Raise Yang Decoction [Prescriptions all appear in the chapter on Internal Damage].”

  • Ginseng Paste 人參膏 인삼고
    ① It cures the deficiency of source qi which results in deficient essence and spirit and not being able to speak continuously. It is the best way to recover source qi. Chop and put 1 geun [1geun (斤) 600g] of Ginseng Radix (人參) in a porcelain bowl. Pour water until the height becomes about the length of a finger, and boil it over a medium fire until the water becomes half the original volume. Pour it into another bowl. Decoct the residue 3 times with the same method. Stop decocting when no taste of the Ginseng Radix (人參) can be felt when chewed. Then, put the remaining juice in a
    pot, boil it down until it becomes plaster, and take it 5~6 spoons a day. Used with Asparagi Tuber (天門冬) when there is lung Fire, mysterious effects can be experienced.  ② Ginseng Radix (人參) cures deficiencies of yang in the spleen and lungs. It tonifies rapid, short breathing, and a deficiency of qi. However, if not led by Cimicifugae Rhizoma (升麻), it cannot tonify ascending qi. It is good to use 1 pun of Cimicifugae Rhizoma (升麻) and 3 pun of Ginseng Radix (人參) together. If one wishes to tonify the source qi of the lower energizer and to purgate the Fire pathogen in the kidneys, Poria Sclerotium (茯苓) should be used as the courier medicine. ③ Ginseng Paste or an Unaccompanied Ginseng Decoction is highly effective only when it is decocted with running water from a distant place (長流水).
    Unaccompanied Ginseng Decoction 獨參湯 독삼탕
    Decoct only Ginseng Radix (人參).
    Astragalus Decoction 黃芪湯 황기탕
    It cures fever caused by a qi deficiency, an insect-crawling sensation caused by shaking of all vessels, and tightness and palpitations in the chest, and heaviness and stuffiness in the head caused by the rising of ministerial Fire
    from the feet. It refreshes and harmonizes qi, in turn pacifying it. Chop the following herbs and decoct: Astragali Radix (黃芪) (2 don), Ginseng Radix (人參), Glycyrrhizae Radix (甘草) (1 don each), Angelica Gigantis Radix (當歸) (5 pun), and 9 berries of Schisandrae Fructus (五味子).
    Four Gentlemen Decoction 四君子湯 사군자탕
    ① It tonifies the deficiency of genuine qi, and it also cures shortness of breath and a shortage of qi. Chop the following herbs and decoct in water: Ginseng Radix (人參) (stem scars removed), Poria Sclerotium (白茯苓), Atractylodis Rhizoma Alba (白朮), and Glycyrrhizae Radix Praeparata (灸甘草) (1.25 don each).
    ② Mr. Fang said, “Ginseng Radix (人參) tonifies the lungs and helps the spleen. Atractylodis Rhizoma Alba (白朮) fortifies the spleen and dries dampness. Poria Sclerotium (茯苓) lowers qi and exudes dampness. Glycyrrhizae Radix (甘草) tonifies the stomach and harmonizes the middle. It is like the placid gentleman, who does not behave cunningly or urgently.”      ③ The Medical Mirror of Past and Present (醫鑑) says, “Ginseng Radix (人參) tonifies source qi. Atractylodis Rhizoma Alba (白朮) strengthens the spleen and stomach. Poria Sclerotium (茯苓) draws out dampness and pulls Ginseng Radix (人參) down, tonifying the source qi of the lower energizer.”
  • Ginseng and Astragalus Decoction 人參黃芪湯 인삼황기탕
    It cures the deficiency and shortage of qi. Ginseng Radix (人參), 2 don. Astragali Radix (黃芪), Atractylodis Rhizoma Alba (白朮), Citrus Unshius Pericarpium (橘皮) (1 don each). Angelica Gigantis Radix (當歸), Poria Sclerotium (白茯苓), Glycyrrhizae Radix Praeparata (灸甘草) (5 pun each). Chop the forementioned herbs and decoct in water with 3 pieces of Zingiberis Rhizoma Crudus (生薑) and 2 Zizyphi Fructus (大棗), and drink on an empty stomach.
    • Augment Qi Pill 益氣丸 익기환
    It cures damage of qi caused by talking too much, or avoidance of talking from a shortage of qi. It tonifies the upper energizer, adding qi to it. Grind the following herbs finely, knead with pan-fried rice cake soaked in water, and make it into pills the size of Euryales Semen (芡實): Ginseng Radix (人參), Liriopis Tuber (麥門冬) (7 don each), Citrus Unshius Pericarpium (橘皮), Platycodonis Radix (桔梗), Glycyrrhizae Radix Praeparata (灸甘草) (5don each), and 21 berries of Schisandrae Fructus (五味子). Chew 1 pill at a time and swallow with saliva. Pan-fried rice cake is a flour pancake fried in oil.