1. Huang Long Tang from "Six Books of Shang Han"

1. Huang Long Tang from "Six Books of Shang Han"

[Composition] Rheum palmatum 9 grams, Glauber's salt 12 grams, Citrus aurantium 6 grams, Magnolia officinalis 3 grams, Licorice 3 grams, Dang Gui 9 grams, Ginseng 6 grams.

[Administration] Add three slices of ginger and two jujubes, then add a pinch of Platycodon grandiflorus, boiling until hot.

[Indications] Internal accumulation of real heat and dual deficiency of qi and blood.

[Symptoms] Epigastric fullness and distension, fever and abdominal pain, severe constipation, shortness of breath, fatigue, thick yellow tongue coating, and a deep, thin pulse.

[Functions] Clear heat and promote bowel movements, tonify qi and nourish blood.

[Explanation] The syndrome of internal accumulation of real heat manifests as epigastric fullness and distension, fever and abdominal pain, and severe constipation; the syndrome of dual deficiency of qi and blood manifests as shortness of breath, fatigue, and a deep, thin pulse. The former is the root cause, while the latter is the symptom. Rheum palmatum and Glauber's salt clear fire and promote bowel movements, addressing the root cause as the primary function. Dang Gui tonifies blood, and Ginseng tonifies qi, serving as supplementary functions to address the symptoms. Platycodon grandiflorus elevates yang to prevent blood from descending; Citrus aurantium and Magnolia officinalis widen the intestines to facilitate the passage of heat and stasis; ginger and jujubes harmonize ying and wei, serving as additional measures. Licorice harmonizes the herbs as a facilitating agent.

[Reference Materials] ① When there is epigastric pain, pure diarrhea, delirium, thirst, fever, etc., it is due to heat evil spreading inward, resulting in hardened stool in the stomach. This type of diarrhea is not caused by cold, but rather by daily consumption of herbal decoctions, so urgent purging is required, termed "heat-related diarrhea syndrome." Those with heat should use this soup. ("Six Books of Shang Han") ② If the syndrome should be purged but treatment is delayed or medication is taken slowly, heat evil will accumulate, consuming qi and blood, leaving the spirit exhausted, with heat evil remaining alone, leading to behaviors such as touching beds, picking at empty threads, trembling muscles and bones, and blurred vision—all due to the failure to purge in time. Even if the heat evil is not completely eliminated, the original spirit will be lost; if tonified, the pathogenic toxin will worsen, and if purged, the little qi remaining will be unable to withstand the attack. Neither purging nor tonifying works, leaving neither physiological nor psychological benefits, forcing the use of Tao's Huang Long Tang. (Wu You Ke)

[Commentary] This formula was originally designed to treat heat-related complications, specifically to preserve yin during urgent purging. Later, physicians began using it to treat epidemic diseases where purging was delayed and the syndrome was one of deficiency of vital energy and excess of pathogenic factors, thus expanding its clinical applications.

2. Zeng Ye Cheng Qi Tang from "Wen Bing Tiao Bian"

[Composition] Rehmannia glutinosa 24 grams, Scrophularia ningpoensis 30 grams, Ophiopogon japonicus 24 grams, Rheum palmatum 9 grams, Glauber's salt 4.5 grams.

[Administration] Use eight cups of water, boil down to three cups, take one cup first, then another later.

[Indications] Severe heat, damage to yin, and constipation.

[Symptoms] Hot flashes and thirst, dry and hard stools, dark red tongue coating with little moss, and a thin, rapid pulse.

[Functions] Clear heat, nourish yin, and promote bowel movements.

[Explanation] When heat evil damages yin, it leads to hot flashes and thirst, dark red tongue coating with little moss, and a thin, rapid pulse, resulting in yin deficiency and constipation. If only purging is done, yin will be further damaged and stools will become even drier; if only nourishing is done, heat evil will not be eliminated, and constipation will be difficult to resolve. Only by simultaneously nourishing yin and purging can both root cause and symptoms be addressed, achieving remarkable results. Those with yin deficiency suffer from heat evil, so Rheum palmatum clears heat and purges fire as the primary function; Rehmannia glutinosa, Scrophularia ningpoensis, and Ophiopogon japonicus nourish yin and reduce fire as supplementary functions; Glauber's salt softens hard stools and clears toxins, while Scrophularia ningpoensis softens hard stools and detoxifies—both serve as additional measures.

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【Clinical Modifications】For constipation without obvious bowel obstruction, omit mirabilis; for yellow and greasy tongue coating, omit rehmannia; for excessive thirst and drinking, add pollen and dendrobium; for dry mouth and chapped lips, add adenophora and polygonatum.

【Reference Material】Wu Jutong said: "In Yangming warm diseases, if purgation fails to clear the bowels... due to insufficient body fluids and stagnation of water, intermittently administer Zengye Decoction. If still no effect, use Zengye Chengqi Decoction for purgation." (From "Warm Disease Differentiation")

【Commentary】This formula is mainly used for constipation caused by heat accumulation and fluid deficiency. If the condition leans more toward fluid deficiency with less heat accumulation, and there is no abdominal discomfort, indicating yin deficiency-related constipation, Zengye Decoction should be used—this is the principle of "protecting the deficiency and preserving body fluids." However, if there is more heat accumulation and sufficient body fluids, Tiaowei Chengqi Decoction is more appropriate—this is the principle of "rapidly eliminating excess while preserving body fluids."

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Chapter 3: Harmonizing Formulas

When pathogenic factors reside in the exterior, sweating is employed; when they are in the interior, purgation is used; and when they are in the semi-exterior, semi-interior, harmonization is applied. This method is collectively known as the "harmonizing method" and is one of the Eight Methods. Any formula that has a harmonizing effect is called a harmonizing formula. The primary indication for harmonizing formulas is Shaoyang syndrome (semi-exterior, semi-interior). This is because harmonizing formulas for Shaoyang typically have the effects of balancing the liver and spleen as well as regulating the stomach and intestines. Therefore, in addition to Shaoyang-harmonizing formulas, there are also formulas that balance the liver and spleen and those that regulate the stomach and intestines.

I. Harmonizing Shaoyang

Shaoyang syndrome refers to the semi-exterior, semi-interior condition, which is treated with harmonization. Symptoms include: bitter taste in the mouth, dry throat, dizziness, alternating chills and fever, fullness and distension in the chest and hypochondria, irritability and tendency to vomit, reluctance to eat, a wiry pulse, and a thin white tongue coating.

1. Xiao Chaihu Tang from "Shanghan Lun"

【Composition】Chaihu 12 grams (half a jin), Huangqin 9 grams (three liang), Renshen 9 grams (three liang), Banxia 9 grams (half a sheng), Zhigancao 6 grams (three liang), Shengjiang 9 grams (three liang), Dazao 12 pieces

【Administration】Decocted in water and taken orally.

【Indications】Shaoyang syndrome (semi-exterior, semi-interior).

【Symptoms】Bitter taste in the mouth, dry throat, dizziness, alternating chills and fever, fullness and distension in the chest and hypochondria, irritability and tendency to vomit, reluctance to eat, a wiry pulse, and a thin white tongue coating.

【Functions】Harmonizes Shaoyang.

【Formula Analysis】The Shaoyang meridian runs through the hypochondria and lies between the Taiyang and Yangming meridians—that is, in the so-called semi-exterior, semi-interior region. When pathogenic factors and vital energy clash, chills and fever alternate; when pathogenic factors reside in the hypochondria, there is fullness and distension in the chest and hypochondria; when qi is stagnant in the chest, there is irritability; when the liver wood overcomes the earth, there is a tendency to vomit and a lack of appetite; bitter taste in the mouth, dry throat, and dizziness are all manifestations of pathogenic factors invading Shaoyang. In this formula, Chaihu dispels pathogenic factors from Shaoyang, while Huangqin clears heat from Shaoyang; together, these two herbs take on the major task of harmonizing Shaoyang and serve as the main components. When pathogenic factors invade Shaoyang, the qi must be weak, so Renshen and Dazao are used to tonify qi and replenish deficiency as auxiliary ingredients. Since Shaoyang corresponds to the liver and gallbladder, and the liver wood overcomes the earth, leading to upward rebellion of stomach qi and subsequent vomiting, Banxia and Shengjiang are added to descend rebellious qi and stop vomiting as complementary treatments. Zhigancao harmonizes all the herbs and serves as a guiding agent.

【Clinical Modifications】① "If there is chest irritation but no vomiting, omit Banxia and Renshen, and add one piece of Gualou Shi; if there is thirst, omit Banxia and add Renshen to make a total of four and a half liang, along with four liang of Gualou Gen; if there is abdominal pain, omit Huangqin and add three liang of Shaoyao; if there is a feeling of fullness under the ribs, omit Dazao and add four liang of Muli; if there is palpitations in the heart and difficulty urinating, omit Huangqin and add four liang of Fuling; if there is no thirst but mild fever, omit Renshen and add three liang of Guizhi to induce mild sweating and improve symptoms; if there is cough, omit Renshen, Dazao, and Shengjiang, and add half a sheng of Wuweizi and two liang of Ganjiang." ("Shanghan Lun") ② Adding Guizhi Tang to the above formula creates Chaihu Guizhi Tang ("Shanghan Lun"), which treats combined Shaoyang and Taiyang syndromes. ③ Adding wine-fried Changshan and Caoguo can be used to interrupt malaria.

【Reference Materials】① After five or six days of cold injury, if there is wind invasion, alternating chills and fever, fullness and distension in the chest and hypochondria, reluctance to eat, irritability and tendency to vomit, or if there is chest irritation without vomiting, or thirst, or abdominal pain, or fullness under the ribs, or palpitations in the heart and difficulty urinating, or no thirst but slight fever, or cough, then Xiao Chaihu Tang is the main treatment. ("Shanghan Lun") ② For cold injuries with wind invasion, if any one symptom appears, it does not necessarily mean all symptoms are present. ("Shanghan Lun") ③ The name "Xiao Chaihu" is chosen because it corresponds to Shaoyang, but the essence of the formula and its modifications are fully explained by the principle of "allowing the upper burner to function smoothly, enabling body fluids to descend, and harmonizing stomach qi." Why? Because the Shaoyang meridian runs through the hypochondria, situated between the yang side of the abdomen and the yin side of the back. Pathogenic factors from the exterior, wanting to enter the interior, are blocked by the internal qi, resulting in alternating chills and fever; the conflict between exterior and interior causes stagnation at the boundary, leading to fullness and distension in the chest and hypochondria; the mind becomes confused and sluggish due to resistance, hence the reluctance to speak; when the liver is invaded, it affects the earth, causing a lack of appetite; when gallbladder fire is trapped and cannot be released, there is irritability; when heart qi is stagnant and becomes turbid, phlegm accumulates, leading to a tendency to vomit. Vomiting, however, allows both liver and gallbladder fire to be released, thus creating a sense of relief. These are all typical manifestations of Shaoyang syndrome. (Cheng Jiaoqian) ④ This formula was used to treat eight cases of postpartum fever, all with temperatures above 38°C. Before using this formula, five cases had been treated with antibiotics without effect, and three had shown only slight improvement. After taking this formula for 2–5 doses (average of 3 doses), all cases recovered. Case Liu, female, 28 years old, delivered her first baby at term via vaginal delivery, with pre-delivery blood pressure of 150/100 mmHg. She once experienced convulsions, and on the seventh day after delivery, her temperature suddenly rose to 39.6°C, with lochia that had no foul odor. White blood cell count was 13,400, with 85% neutrophils. Antibiotics were administered for three days without effect. Symptoms included scanty but incomplete lochia, no abdominal distension or pain, alternating chills and fever, persistent fever for several days, facial and head swelling, bitter taste and nausea, chest tightness, frequent sighs, pale red tongue, thin greasy tongue coating, and a wiry, rapid pulse. Her liver yang was strong, but postpartum blood stasis created an opening for pathogenic factors to invade, affecting the liver-gallbladder meridian and disrupting Shaoyang qi, leading to disharmony between defensive and nutritive qi. The proposed formula was: vinegar-fried Chaihu eight fen, half a qian of Banxia, one and a half qian of fried Huangqin, four slices of Renshen, three qian of whole Danggui, one and a half qian of fried Shaoyao, three qian of purple Danshen, five fen of powdered Zhigancao, three qian of Yimu Cao, eight fen of fried black Jingjie, and one slice of Shengjiang. After taking one dose, she began to sweat and her fever subsided. After two doses, the fever dropped to 37.4°C, and after three doses, the fever completely disappeared. Finally, she was given a nourishing formula to consolidate the results, and after eight doses, she fully recovered. ("Shanghai Journal of Traditional Chinese Medicine," October 1965, p. 14)

【Commentary】① This formula can also treat women who develop a cold and fever during menstruation, which is essentially a case of pathogenic factors entering the blood chamber. ② Xiao Chaihu syndrome largely corresponds to what modern medicine calls acute and chronic inflammatory response syndromes. Any chronic or subacute inflammatory disease, such as chronic cholecystitis, chronic hepatitis, chronic pelvic inflammatory disease, exudative pleurisy, etc., can be treated with this formula and its modifications.

2. Haoqin Qingdan Tang from "Revised Popular Shanghan Lun"

【Composition】Qinghao 6 grams, Danzhuru 9 grams, Zhifanxia 4.5 grams, Chifuling 9 grams, Huangqin 6 grams, Zhike 4.5 grams, Chenpi 4.5 grams, Biyusan (i.e., talc, licorice, indigo) 9 grams

【Administration】Decocted in water and taken orally.

【Indications】Gallbladder fire combined with dampness, with stomach qi reversing and phlegm accumulating.

【Symptoms】Alternating chills and fever, chest and hypochondrial distension and pain, bitter taste in the mouth and oppression in the chest, dry heaving and hiccups, fullness and distension in the epigastrium, acid regurgitation and belching, yellow and greasy tongue coating, and a slippery, rapid pulse.

【Functions】Clears gallbladder fire and eliminates dampness, harmonizes stomach qi and transforms phlegm.

【Formula Analysis】When gallbladder fire combines with dampness, there are alternating chills and fever, chest and hypochondrial distension and pain, and bitter taste in the mouth and oppression in the chest; when stomach qi reverses and phlegm accumulates, there is dry heaving and hiccups, fullness and distension in the epigastrium, and acid regurgitation and belching. Gallbladder fire originates from liver qi stagnation, and when liver wood overcomes the earth, stomach qi reverses and phlegm accumulates. In this formula, Qinghao is bitter, cold, and aromatic, clearing heat from the liver and gallbladder while also having the effect of aromatically transforming dampness, serving as the main component. Huangqin is bitter, cold, and enters the gallbladder, clearing heat and drying dampness as a supplementary ingredient. Wentai Tang harmonizes stomach qi, descends rebellious qi, and transforms dampness to eliminate phlegm as complementary treatments. Biyusan clears heat and promotes diuresis, allowing damp-heat to be expelled through urine, serving as a guiding agent.

【Clinical Modifications】When used in combination with Zuojin Wan, the efficacy is even greater; adding Caoguo and Caokou strengthens the effect of harmonizing stomach qi and eliminating fullness; adding Sangzhi, Yiyiren, and Siguoluo can unblock meridians and relieve pain; omitting Chenpi and Banxia and adding Yinchen can treat jaundice caused by damp-heat.

【Reference Materials】① Qinghao has a refreshing and penetrating aroma, drawing pathogenic factors out from the Shaoyang gallbladder meridian. Although its effect on opening up the skin and pores is milder than Chaihu's, its ability to dispel evil and promote circulation is superior to Chaihu's, which is why people nowadays prefer Qinghao and are wary of Chaihu. ("Revised Popular Shanghan Lun") ② The "fire" in the gallbladder is intense, so Qinghao, Huangqin, and Zhifanxia are used as the main components to clear gallbladder fire. When gallbladder fire is intense, it inevitably affects the stomach, causing qi to stagnate and form phlegm, so Zhike, Erchen, and other herbs are added to harmonize stomach qi and transform phlegm. However, the qi in the lower burner must flow smoothly for the gallbladder fire to be cleared and harmonized, and Biyusan is added to guide the fire downward. By adding Chifuling, damp-heat is allowed to be expelled through the bladder, thus achieving harmony in the gallbladder meridian. Anyone experiencing chest tightness and vomiting, or chills and fever like malaria, will find this formula effective. ("Revised Popular Shanghan Lun") ③ Haoqin Qingdan Tang has the functions of clearing heat, promoting bile secretion, and transforming turbid qi, and is mainly used for semi-exterior, semi-interior conditions. It takes the Three Burners as the central hub: if the middle burner is affected, it impacts the lung defenses above and the urinary system below, and extends into the internal organs and external muscles. If the stomach and intestines are out of balance, the liver and gallbladder are overheated, or damp-heat is congested, this formula can be considered. However, when damp-heat is intertwined, it tends to turn into fire, so treatment should carefully assess whether dampness or heat predominates and adjust accordingly. ("Zhejiang Journal of Traditional Chinese Medicine," July 1980)

【Commentary】This formula can be modified and used for acute and chronic cholecystitis, as well as acute and chronic hepatitis.

II. Harmonizing Liver and Spleen

"When liver disease occurs, we know it will spread to the spleen." Liver disease spreading to the spleen means that liver wood overcomes the earth, which is also called liver-spleen disharmony. To treat this condition, the method of harmonizing liver and spleen should be used. Common symptoms include bitter taste in the mouth, dry throat, fullness and distension in the chest and hypochondria, abdominal bloating and pain, and loss of appetite.

1. Si Nisi Tang from "Shanghan Lun"

【Composition】Chaihu, Zhishi, Baishao, and Zhigancao each in equal parts

【Administration】All ingredients are ground into powder, sieved, and mixed with warm water before consumption, 10 grams per dose. In modern times, it is often prepared as a decoction, boiled in water and taken orally.

【Indications】Liver-spleen disharmony and severe limb cold due to excess heat.

【Symptoms】Bitter taste in the mouth, dry throat, fullness and distension in the chest and hypochondria, abdominal bloating and pain, and loss of appetite; also treats cases of internal qi stagnation or severe dysentery with cold extremities.

【Functions】Harmonizes liver and spleen, and resolves both internal and external issues.

【Formula Analysis】This formula can treat both liver-spleen disharmony and severe limb cold, making it one of the representative formulas for treating different diseases with the same therapeutic approach in traditional Chinese medicine. Severe limb cold is a clinical manifestation of internal heat being blocked by external yin, also known as the "excess yang blocking yin" syndrome, characterized by cold extremities. Therefore, this formula can treat such conditions, hence the name "Si Nisi Tang." In this formula, Chaihu opens up the channels between the exterior and interior, facilitating the release of internal heat to the exterior, serving as the main component. Zhishi disperses qi and breaks up blockages, assisting Chaihu in opening up the channels between the exterior and interior. Baishao softens the liver and nourishes yin, both replenishing the yin fluids that are about to be depleted and treating the liver's tendency to become overly active and cause cold extremities, serving as a complementary treatment. Zhigancao harmonizes all the herbs and serves as a guiding agent. The focus here is on restoring yang qi to alleviate cold extremities, fully embodying the principle of treating the symptoms first. Liver-spleen disharmony is a condition where liver wood overcomes the earth; only when liver qi is stagnant can it rebel against the stomach, leading to liver-spleen disharmony. Signs of liver qi stagnation include: bitter taste in the mouth, dry throat, fullness and distension in the chest and hypochondria; when liver qi invades the stomach, there is abdominal bloating and pain, and loss of appetite. In this formula, Chaihu primarily soothes the liver. Zhishi helps Chaihu soothe the liver as a supplementary component. Baishao softens the liver and nourishes yin, because when liver qi is stagnant, it easily turns into fire, and fire consumes yin, so softening the liver and nourishing yin is a complementary treatment. Zhigancao harmonizes all the herbs and serves as a guiding agent. The emphasis here is on soothing the liver; when liver qi is relieved, it can no longer invade the stomach, fully reflecting the principle of addressing the root cause gradually.

【Clinical Modifications】 ① Omit Zhishi and add Chuanxiong, Xiangfu, and Zhike to create Chaihu Shugan San ("Jingyue Quanshu"), which treats liver qi stagnation. ② For patients with food stagnation, add Maiya and Jineijin; for those with blood stasis, add Danshen and Shixiao San; for those with jaundice, add Yinchen and Yujin; for those with acid regurgitation, add Zuojin Wan; for those with severe diarrhea, add Xiebai.

【Reference Materials】 ① "For Shaoyin disease, with four extreme symptoms—cough, palpitations, difficulty urinating, abdominal pain, or severe diarrhea—Si Nisi Tang is the main treatment." ("Shanghan Lun") ② "Si Nisi Tang is a formula that treats both the exterior and interior. When heat accumulates internally, yang qi cannot reach the exterior, resulting in internal heat and external cold. At the same time, it is not advisable to use purgatives that might hinder the cold extremities, so only Zhishi is used to disperse the accumulated heat, while Chaihu is still used to allow yang qi to escape, so that the limbs naturally warm up." ("Famous Doctors' Formula Commentary") ③ An example of Si Nisi Tang treating nervous abdominal distension. Ms. Yang, 42 years old. In the morning, her chest and abdomen felt normal, but in the afternoon, she suddenly experienced abdominal distension, with her belly swelling like a drum, producing sounds when tapped, making her restless and in great pain. She was usually irritable and easily angered, had difficulty with bowel movements, her urination was sometimes frequent and sometimes infrequent, she had poor appetite, eating only three liang a day, and couldn't sleep at night. Western medical diagnosis: gastric neurosis, despite multiple treatments with both Chinese and Western medicines, no effect. Traditional Chinese medicine consultation: the patient appeared apathetic, her face was dull and lacked luster, she was slightly overweight, spoke little, had a deep, wiry pulse, and showed strong signs of stagnation. Based on the analysis of these symptoms, it was determined that she suffered from liver qi stagnation, spleen function impairment, and blockage of the central mechanism, leading to abnormal ascension and descent. The treatment should focus on relieving liver qi stagnation, regulating qi flow, improving the central mechanism, and adjusting the ascension and descent. Given the long duration of the illness, it was decided to treat both the interior and exterior, using Si Nisi Tang combined with Simo Yinzi for internal administration (Chaihu three qian, Baishao four qian, Zhike four qian, Zhigancao two qian, Muxiang three qian, Wuyao three qian, Binglang three qian, Tongcaogen six qian, Jixueteng one liang, all decocted in water). In addition, radish seeds half a jin, scallions (including roots) one jin, orange leaves half a jin, and ginger two liang were chopped, mashed, and heated (with a little liquor added), then wrapped in cloth (divided into two packages, rotated) and applied externally to the chest and abdomen. After using this method, she frequently passed gas, her chest and abdomen became comfortable, her bowel movements improved, and her abdominal distension greatly decreased. Later, she continued to use the formula to further relieve liver qi stagnation and regulate qi flow, adding water-draining herbs: Chaihu three qian, Baishao four qian, Zhike four qian, Fuling pi eight qian, Dafu pi four qian, winter melon peel one liang, Chenpi three qian, Sangpi three qian, fish eel one liang, and Tonghua gen six qian, all decocted in water and taken in two doses. After taking several doses of this formula, all symptoms disappeared. Later, she used the Xiangsha Liujunzi Tang to further adjust the formula and strengthen the regulation of the spleen and stomach, achieving good results. ("New Medical Journal," July 1975, p. 43)

[Commentary] This formula can be used for gastric and duodenal ulcers, acute and chronic hepatitis, intercostal neuralgia, and acute and chronic cholecystitis, with appropriate modifications.

2. Xiaoyao San from "Heji Ju Fang"

[Composition] Danggui 35 grams, Baishao 35 grams, Baizhu 35 grams, Fuling 35 grams, Zhigancao 15 grams, Chaihu 35 grams

[Administration] All ingredients are coarsely ground, 6 grams per dose, with 9 grams of roasted ginger and a small amount of peppermint added during decoction. In modern times, it can also be prepared as a decoction, boiled in water, with dosage reduced to one-third of the original amount.

[Indications] Liver qi stagnation and spleen deficiency.

[Symptoms] Bitter taste in the mouth, dry throat, dizziness, irritability and anger, fullness and distension in the chest and hypochondria, abdominal bloating, poor appetite, and fatigue.

[Functions] Soothes the liver and strengthens the spleen.

[Formula Analysis] When liver qi is stagnant, it rebels against the stomach; prolonged rebellion leads to spleen weakness. Stagnation of liver qi causes bitter taste in the mouth, dry throat, irritability and anger, fullness and distension in the chest and hypochondria, and dizziness; spleen weakness leads to abdominal bloating, poor appetite, and fatigue. The former causes the latter, so liver qi stagnation is the root cause, while spleen deficiency is the result. In this formula, Chaihu takes on the major responsibility of soothing the liver as the main component. Baizhu and Fuling strengthen the spleen and tonify qi as supplementary components. The liver stores blood, and when it is stagnant, blood volume decreases (blood deficiency); Danggui and Baishao nourish the liver's blood, serving as complementary treatments. Peppermint clears heat on the surface, while ginger disperses cold on the surface, both working to open up the skin and pores, facilitating qi flow, serving as complementary treatments. Zhigancao harmonizes all the herbs and serves as a guiding agent.

[Clinical Modifications] ① Add Danpi and Shan Zhi to create Danzhi Xiaoyao San ("Internal Medicine Abstract"), which treats cases of excessive liver fire. ② Add Shengdi or Shudi to increase the effect of nourishing yin and replenishing blood, creating Hei Xiaoyao San ("Medical Brief Six Books · Women's Health Guidelines").

[Reference Materials] ① "Xiaoyao": According to "Shuowen Jiezi," "xiaoyao" is synonymous with "xiaoyao," and Zhuangzi's "Xiaoyao You" explains: "Just as ice melts when exposed to sunlight, though it may deplete, its essence remains unchanged; just as a boat floats on water, though it moves, its core remains intact. In medicine, dispersing qi stagnation and shaking blood stagnation do not harm the fundamental nature of the body." ("Jiangxueyuan Ancient Formula Selection Commentary") ② This formula, with added ingredients, was used to treat 253 cases of non-jaundiced hepatitis, with symptoms including: fullness and distension in the hypochondria, enlarged liver, weakness and limpness in the limbs, poor appetite, irregular bowel movements, shortness of breath, insomnia and frequent dreams, lower back and shoulder pain, and recurrent chills and fever. As a result, 36 cases achieved complete recovery of liver function, 139 cases showed improvement, for a total effectiveness rate of 68.8%. ("Guangdong Traditional Chinese Medicine," August 1960) ③ Veteran traditional Chinese medicine practitioner Yue Meizhong used this formula, adding chrysanthemum, summer-withered grass, mistletoe, danpi, shanzhi, and nüzhenzi, to cure a patient with hypertensive encephalopathy. ("Yue Meizhong Medical Case Collection")

[Commentary] This formula has a wide range of applications, suitable for liver diseases and stomach ailments; it can also be used for menstrual irregularities in women and various pregnancy-related conditions; moreover, it can be applied to ophthalmological diseases.

3. Danggui Shaoyao San from "Jinkui Yaolue"

[Composition] Danggui 9 grams (three liang), Baishao 50 grams (one jin), Chuanxiong 9 grams (three liang), Fuling 12 grams (four liang), Zexie 25 grams (half a jin), Baizhu 12 grams (four liang)

[Administration] All ingredients are ground into powder, 6 grams per dose, with a small amount of alcohol added, and consumed with boiling water. In modern times, it is often prepared as a decoction, with dosage adjusted proportionally.

[Indications] Liver meridian stasis and spleen dysfunction.

[Symptoms] Pregnant women experiencing persistent abdominal pain and mild edema in the whole body and lower limbs.

[Functions] Activates the liver and softens the liver, strengthens the spleen and eliminates dampness.

[Formula Analysis] The liver governs the Chong and Ren meridians, which in turn govern pregnancy. When the liver meridian is stagnant, there is persistent abdominal pain during pregnancy; when liver wood overcomes the earth, there is edema in the lower limbs. The former is the cause, the latter is the effect. In this formula, Danggui, Baishao, and Chuanxiong primarily soften the liver, while Fuling, Baizhu, and Zexie strengthen the spleen and eliminate dampness as supplementary components. A small amount of alcohol adds warmth and disperses, facilitating the smooth flow of liver qi and helping to dissipate dampness, serving as a guiding agent.

[Clinical Modifications] ① Remove Zexie and Fuling from this formula and add Huangqin, creating Danggui San ("Jinkui Yaolue"), which is commonly taken by pregnant women to ensure a safe pregnancy. ② Add Sandren, Du Zhong, Chuan Xuduan, Jisheng, Ajiao, Ai Ye, and Huangqin to this formula, which can treat threatened miscarriage.

[Reference Materials] ① For pregnant women experiencing abdominal pain, Danggui Shaoyao San is the main treatment. ("Jinkui Yaolue") ② Practitioner Yue Meizhong used this formula to treat two cases of lower abdominal pain in women. In one case, the pain was accompanied by dizziness and leukorrhea, diagnosed as chronic pelvic inflammatory disease. After taking several doses of Danggui Shaoyao Tang, the abdominal pain and dizziness basically disappeared, and the leukorrhea decreased significantly. In another case, the woman had long-term lower abdominal pain, a heavy feeling in the lower abdomen, abundant leukorrhea, and dizziness. After taking several doses of Danggui Shaoyao Tang, both the abdominal pain and leukorrhea decreased, and she switched to using Shaofu Zhuyu Tang to treat her specific symptoms. ("Yue Meizhong Medical Case Collection")

[Commentary] This formula can be used for habitual miscarriage, threatened miscarriage, dysmenorrhea, chronic nephritis, beriberi, and other conditions.

III. Harmonizing Stomach and Intestines

The method of harmonizing stomach and intestines is used to treat conditions where pathogenic factors reside in the stomach and intestines, with alternating cold and heat, manifesting as epigastric fullness and distension, nausea and vomiting, intestinal rumbling and diarrhea. This condition often arises from improper purgation in cases of Taiyang disease, where cold pathogens penetrate inward and combine with the latent yang qi in the stomach and intestines, forming a state of alternating cold and heat. The saying "where there is fullness and distension, there must be latent yang qi" underscores the importance of latent yang qi in the formation of this condition. The stomach belongs to the Yangming meridian, while the small intestine is closely related to the heart, both serving as theoretical bases for the existence of latent yang qi.