2. Fangfeng Tongsheng San from "Xuanming Lun"

2. Fangfeng Tongsheng San from "Xuanming Lun"

[Composition] Schizonepeta 15 grams, fangfeng 15 grams, talc 90 grams, ephedra 15 grams, atractylodes 15 grams, platycodon 30 grams, angelica 15 grams, ligusticum 15 grams, white peony 15 grams, gypsum 30 grams, rhubarb 15 grams, mirabilite 15 grams, forsythia 15 grams, scutellaria 30 grams, peppermint 15 grams, gardenia 15 grams, licorice 60 grams.

[Administration] Grind into powder, take 6 grams each time, add three slices of fresh ginger, and decoct in warm water. In modern times, it is also made into a decoction or water pills taken with boiling water.

[Indications] Exterior symptoms combined with interior excess.

[Symptoms] Headache, fever and chills, red eyes and sore throat, thirst and sore throat, chest and diaphragm fullness, coughing up phlegm, hard stools, yellow and greasy tongue coating, and a robust, rapid pulse.

[Functions] Harmonize the exterior and purge the interior.

[Formula Analysis] This formula is used for external wind-pathogen invasion combined with internal excess heat. Headache and fever with chills are signs of wind-cold invading the exterior; thirst, sore throat, and red eyes are signs of wind-heat attacking the exterior. This formula embodies both wind-cold and wind-heat. Chest and diaphragm fullness, coughing up phlegm, hard stools, yellow and greasy tongue coating, and a robust, rapid pulse all indicate internal excess heat. Ephedra resolves wind-cold on the exterior, while forsythia disperses wind-heat on the exterior; together, these two herbs accomplish the task of resolving exterior pathogenic qi. Internal excess heat and exterior pathogenic qi coexist, and only bitter, cold herbs can truly address the root cause. Mirabilite and scutellaria purge the excess heat inside, working in tandem with ephedra and forsythia—one attacking the exterior, the other the interior—to jointly fulfill the mission of harmonizing the exterior and purging the interior, serving as the primary agents. Schizonepeta and fangfeng assist ephedra in resolving wind-cold on the exterior; peppermint and platycodon help forsythia disperse wind-heat, while gypsum, scutellaria, and gardenia aid mirabilite and scutellaria in eliminating the excess heat inside. All these herbs work together to support the primary agents, serving as complementary agents. "Wherever pathogenic qi gathers, the qi must be deficient," so angelica, ligusticum, and white peony nourish and activate blood; atractylodes and licorice strengthen the spleen and replenish qi, collectively supporting the main agents and serving as complementary agents. Talc clears urine, allowing heat to escape from the bottom up, serving as a guiding agent; fresh ginger disperses qi, helping all the herbs reach the entire body, also serving as a guiding agent.

[Clinical Modifications]

① If there is excessive sweating, omit ephedra; if the heat is mild, omit gypsum; if the stools are very dry,

add mirabilite; if wind-heat is severe, add mulberry leaves and burdock seeds; if the condition is urgent, consider omitting angelica and atractylodes, which support the main agents.

② If this formula omits rhubarb and mirabilite, it becomes a "double-decoction" (from "Yifang Jijie"), a general-purpose formula for harmonizing the exterior and interior.

[References]

① This is a formula that treats the exterior, qi, and three jiaos simultaneously... Sweating does not harm the exterior, purging does not harm the interior, hence the name "Tongsheng," emphasizing its remarkable efficacy. (From "Six Medical Books by Wang Xugao")

② This formula can treat obesity by promoting the elimination of metabolic waste and fat. (From "Japanese Kampo Medicine," October 1972)

③ A 50-year-old woman suffering from chronic headaches, particularly on the right side of her head and the left cheek, with high blood pressure, was treated about a month ago. She also experienced mild left facial nerve paralysis and mild speech impairment, with bowel movements only once a week, a strong, taut pulse, no tongue coating, slight abdominal bloating, some resistance in the epigastric region, and blood pressure of 170/90. After taking this formula along with dried orange peel and processed pinellia for three doses, not only were her headaches cured, but her speech impairment also nearly recovered. (From "Foreign Medicine," September 1973)

[Commentary] This formula can treat various conditions, such as neuralgia, psoriasis, hypertension, sequelae of epidemic meningitis, habitual colds, and obesity.

2. Exterior-Harmonizing, Interior-Purging

This method is suitable for cases where exterior symptoms are present alongside interior heat. Compared with interior heat, exterior symptoms are secondary, while interior heat is primary. If exterior symptoms are dominant and interior heat is secondary, then it falls under the category of exterior-harmonizing formulas.