13) Needles

Injectable solutions, also a new formulation developed in recent years. These are sterile solutions made from herbs through extraction, purification, and formulation processes, ready for subcutaneous, intramuscular, or intravenous injections. They offer advantages such as rapid onset of action and minimal interference from digestive processes, making them ideal for emergency treatment or for patients who cannot take oral medications. Examples include Angelica Injection, Earthworm Injection, and Andrographis Injection.

In addition to the above formulations, there are also lubricating agents and moxibustion agents. Lubricating agents are inserted into the anus to automatically dissolve after entering the anal canal, providing lubrication; moxibustion agents are made by twisting mugwort into various shapes for moxibustion treatments.

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Chapter Five: Decoction Preparation Methods and Changes in Dosage

I. Decoction Preparation Methods

Different types of herbs require different decoction methods. Herbs that induce sweating should not be decocted for too long; herbs with rich, nourishing flavors should be decocted over low heat for a longer time; minerals and rocks should be decocted first and for a prolonged period; fragrant herbs that are sensitive to heat should be added last. Gelatinous herbs like Ejiao, Lu Jiao, and Gui Ban Jiao should be added to the decoction while it is still warm, allowing them to melt. Precious, small herbs like Pearl and Niuhuang should be ground into powder and taken as a decoction; precious, hard-to-grind herbs like Rhinoceros Horn and Antelope Horn can be ground using mills or pestles to make them easier to consume. Fresh, juicy herbs like Rehmannia Root and Sugarcane can be pressed to extract their juices for drinking. Herbs with impurities like Vulture's Liver or Iron Oxide can be decocted first to obtain the upper clear liquid, then used to decoct the herbs. Some herbs should be soaked in water before decoction, or boiled with alcohol, to help extract their active ingredients more easily. Throughout history, medical practitioners have debated the best water for decoction, with some advocating for running water or pure water; others favored freshly drawn water or groundwater; some preferred boiling water or water from the yin-yang cycle, while others even chose rainwater or snowmelt—each having its own reasons. Today, tap water, well water, and spring water are commonly used, with clean, hygienic water being preferred. Decoction utensils can be made of sand pots, which are inexpensive and do not undergo chemical changes. As for how to take the medicine, a typical regimen involves two decoctions and two doses; in cases of severe illness, a single dose can be taken at once. Decoctions are usually taken warm—though if the patient feels excessively irritable due to heat or if the condition is characterized by excessive yang energy and deficient yin, they can be taken cold; if the patient experiences severe vomiting, they can also be taken cold, with frequent small intakes. The timing of medication should be flexible based on the condition: for mild illnesses, one dose per day or two doses every other day; for severe illnesses, two doses per day is also acceptable. If the condition is located in the upper burner, aiming to keep the medicine in the upper burner, it can be taken after meals; if the condition is located in the lower burner, aiming to deliver the medicine directly to the lower burner, it can be taken before meals.

II. Dosage Conversion

Due to frequent changes in measurement systems throughout history, the dosages and names of herbs in ancient prescriptions varied. Modern scholars have conducted extensive research, yet the results remain inconsistent. Generally speaking, the three jin of the Han and Jin dynasties roughly correspond to one jin today; one liang is approximately equivalent to three qian today; one chi is about six inches and nine tenths of a foot today; one dou is roughly two liters; one liter of water is roughly two he (200 milliliters); one qian of powdered medicine is roughly three fen; and one chicken egg-sized pill is roughly three qian.

In 1978, various regions across China adopted a public system for prescribing drug dosages, with conversion standards as follows: one jin equals 500 grams, one liang equals 30 grams, and one qian equals 3 grams.

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Detailed Discussion

Defining the Nature of the Formula

Chapter One: Exterior-Releasing Formulas

“Table” refers to exterior syndrome; the clinical manifestations of exterior syndrome include: <u>headache</u>, fever with chills, body aches with a floating pulse; if there is sweat and a slow pulse, it is considered exterior deficiency (stroke); if there is no sweat and a tight pulse, it is considered exterior excess (cold); if there is thirst, sore throat, excessive heat, and a rapid pulse, it is considered exterior heat (warm disease). Together, these three conditions are collectively referred to as exterior syndrome; the first two are combined as wind-cold exterior syndrome, while the latter is known as wind-heat exterior syndrome. The Su Wen states: “Let it rise when it is light, and let it spread when it is heavy.” It also says: “For those affecting the skin, let them sweat and release.” Based on this perspective, later generations developed two main therapeutic approaches for exterior syndrome: dispersing cold and releasing wind-heat. Any formula that employs these approaches is called an exterior-releasing formula. The Su Wen also states: “Cold should be treated with warmth, and heat should be treated with coolness.” Therefore, when treating wind-cold, warm herbs should be used; when treating wind-heat, cool herbs should be employed. Both wind-cold and wind-heat arise from exposure to wind; therefore, to treat wind-cold, one should use pungent herbs to disperse the cold; to treat wind-heat, one should use cooling herbs. Both wind-cold and wind-heat are caused by wind evil ascending; thus, to treat wind-cold, one should use pungent, warm herbs to disperse the cold; to treat wind-heat, one should use pungent, cool herbs.

I. Pungent, Warm Formulas for Dispersing Cold

This formula is designed for wind-cold exterior syndrome. Wind-cold exterior syndrome is a collective term for the colds and strokes described in the Shang Han Lun, with clinical manifestations including headache, body aches, fever with chills, and a floating pulse.

This condition can be further distinguished into two types—whether there is sweat or not, and whether the pulse is slow or tight—as previously mentioned.

20·

Any formula capable of treating exterior syndrome is called an exterior-releasing formula—for fever, chills, and colds. There are also distinctions between the two cases, such as a slow pulse and a tight pulse, which indicate exterior deficiency versus exterior excess.

20·

When there is a lack of sweat and a tight pulse, it is considered exterior deficiency (wind-cold exterior syndrome), and when there is a rapid pulse and a feeling of cold, it is considered exterior excess (cold).

[Composition] Ma Huang 9 grams (three layers), Gui Zhi 6 grams (two layers), Apricot Kernel 9 grams (seventy pieces), Roasted Licorice, Adjusting the Lung

Cough

[Usage] Decocted in water and taken warm to induce sweating. It is advisable to apply the remedy all over the body.

<u>[Indications]</u> Wind-cold exterior excess

Ma Huang Tang treats wind-cold exterior excess.

<u>[Indications]</u> Headache, body aches, fever with chills, no sweat, cough and wheezing, a floating, tight pulse.

[Functions] <u>Disperses cold and induces sweating</u>, <u>Opens the lungs and relieves wheezing</u>.

④ [Formula Explanation] When wind-cold exterior excess occurs, there is headache, body aches, fever with chills, no sweat, and a floating, tight pulse; when lung qi is not opened, there is cough and wheezing. Wind-cold exterior excess is the root cause, while lung qi not being opened is the manifestation. Ma Huang is pungent and warm, possessing the functions of dispersing cold, releasing cold, and inducing sweating to treat the root cause; it also has the function of opening the lungs and relieving wheezing to treat the manifestation. Gui Zhi promotes yang and opens the muscles, assisting Ma Huang in inducing sweating and driving wind evil outward—this serves as a supporting role. Apricot Kernel opens the lungs and, when paired with Ma Huang, enhances the power of opening the lungs and relieving wheezing, making it a complementary treatment. Licorice harmonizes all the herbs as an intermediary.

[Clinical Additions and Subtractions]

① Remove Gui Zhi and replace it with San Niao Tang (from the He Ji Ju Fang), which focuses solely on opening the lungs and relieving cough.

② Add Zhi Shi to Ma Huang Jia Zhi Tang (from the Jin Kui Yao Lü), which specializes in dispelling wind and removing dampness, treating joint pain.

[References] According to pharmacological research, Ma Huang contains not only ephedrine, which can relieve bronchial smooth muscle spasms, but also ephedra oil, which promotes sweat gland secretion, and pseudoephedrine, which has a significant diuretic effect. Additionally, the volatile oils in Ma Huang exhibit remarkable inhibitory effects against influenza viruses.

[Commentary] This formula is often used for upper respiratory infections, influenza, and acute tracheitis.

. Deep… number, slippery, like a bubble… 21·

Rong Ru - Yellow Qi Management, Wei

Ying moves within the vessels, Wei moves outside the vessels, dissolving cold and dispersing.

Gui Zhi Tang regulates the Wei aspect of the body.

The essence of the path is to open the pathways and disperse cold.

Gui Zhi Tang regulates the Wei aspect of the body.

[Composition] Gui Zhi 9 grams (three layers), White Peony 9 grams (three layers), Licorice 6 grams (two layers), Soaking in Water

Decocted and taken warm in three doses, with a warm porridge recommended afterward to aid the medicinal effects.

[Indications] Wind-cold exterior deficiency (Wei and Ying are out of balance).

[Indications] Headache, body aches, fever with chills, with sweat, a floating, slow pulse.

4)[Functions] Opens the exterior and releases the muscles, harmonizing Wei and Ying. It is the source of sweat.

[Formula Explanation] Ying is the material basis for sweat, while Wei represents the body’s defensive functions. When wind evil attacks the exterior, Wei weakens while Ying strengthens, leading to sweat—this is what is commonly referred to as Wei and Ying being out of balance. In this formula, Gui Zhi is pungent and warm, opening the muscles and promoting yang while regulating Wei—this is the primary focus. White Peony helps to calm Yin and harmonize Ying, while Gui Zhi’s pungent warmth disperses cold without harming Yin, making it a supporting component. With the two herbs working together, they address both the exterior and the interior, jointly achieving the functions of opening the exterior, releasing the muscles, and harmonizing Wei and Ying. Ginger regulates Wei to assist Gui Zhi, while large dates help to harmonize Ying with White Peony—both herbs strengthen Gui Zhi and White Peony’s ability to harmonize Wei and Ying as complementary treatments. Licorice harmonizes all the herbs as an intermediary. It also helps to regulate the flow of Qi and Blood.

[Clinical Additions and Subtractions]

① Add Hou Po and Apricot Kernel to Gui Zhi Jia Hou Po Xing Zi Tang (from the Shang Han Lun), treating exterior cold with wheezing.

② Add Ge Gen to Gui Zhi Jia Ge Gen Tang (from the Shang Han Lun), treating exterior deficiency with neck and back stiffness.

③ Remove White Peony and replace it with Gui Zhi Jia Bai Shao Tang (from the Shang Han Lun), treating exterior deficiency with chest fullness; if there is slight chills, add Aconite to this formula, named Gui Zhi Jia Bai Shao Jia Aconite Tang (from the Shang Han Lun).

④ Add Aconite to Gui Zhi Jia Aconite Tang (from the Shang Han Lun), treating slight stiffness in the limbs,

Wind-cold exterior excess: Wei is not balanced,

Difficult to bend or stretch.

[References]

① According to modern experimental research, the volatile oils in Gui Zhi can stimulate sweat glands and dilate skin blood vessels, thus inducing sweating; they can also stimulate gastrointestinal motility and increase the secretion of digestive fluids, making them beneficial for stomach health and aiding digestion. Gui Zhi also exhibits certain inhibitory effects against influenza viruses.

② “This formula is the pinnacle of Zhong Jing’s group of formulas—it is the first formula for nourishing Yin and Yang, opening the muscles and inducing sweating, and harmonizing Wei and Ying. For those with stroke, colds, or other conditions where the pulse is floating and weak, and where sweat emerges but the exterior remains unrelieved, this formula is effective; for others, if only one or two symptoms appear, it is not necessary to have all of them.” (From the Ming Yi Fang Lun)

③ Patient Li, male, 48 years old, began experiencing symptoms yesterday: chills and fever, headache, slight sweating, chest discomfort, nausea, thin white tongue coating, a slightly rapid but weak pulse, and a heavy pressure point. Prescription: Gui Zhi 3 grams, White Peony 3 grams, Ginger 2 grams, Roasted Licorice 2 grams, Large Dates 4 pieces, Pinellia 3 grams. After one consultation, the fever subsided, and the patient felt dizziness but had no appetite. Prescription: Reduce Pinellia and add Malt 3 grams; after one dose, the patient recovered completely (Guangdong Medical Journal, May 21, 1964).

[Commentary] Besides treating colds and flu, this formula can also be used in conjunction with other conditions such as heart disease, nephritis, neurasthenia, and rheumatic arthritis.

Xiao Qing Long Tang

Shang Han Lun

[Composition] Ma Huang 9 grams (three layers), Peony 9 grams (three layers), Gui Zhi 9 grams (three layers), Roasted Licorice 9 grams (three layers), Dried Ginger 9 grams (three layers), Five-flavor Berry 9 grams (half a liter)

Asarum 3 grams (three layers), Half

[Usage] Decocted in water and taken.

Summer’s journey begins, ginger’s spicy flavor half accompanies the breath.

[Indications] Wind-cold exterior excess with phlegm and fluid. [Indications] Headache, fever with chills, no sweating, wheezing and coughing due to qi reversal, thin and clear phlegm and sputum, a swollen tongue with white greasy coating, and a floating tight pulse.

[Functions] Releases the exterior and dispels cold, warms the lungs and transforms dampness.

[Formula Explanation] In cases of exterior cold with solid symptoms such as headache, fever, chills, no sweating, and a floating tight pulse; when accompanied by phlegm and dampness, symptoms include coughing, wheezing, and thin, clear phlegm, along with a swollen tongue and white greasy coating. This condition often arises in individuals who have previously accumulated phlegm and dampness; once they are exposed to wind-cold, the exterior and interior become interconnected, leading to the formation of phlegm and dampness. The primary cause of this condition is wind-cold triggering phlegm and dampness, so wind-cold serves as the root cause while phlegm and dampness act as secondary manifestations. <u>Ma Huang and Gui</u> branches release the exterior and disperse pathogenic factors to treat the root cause, which is considered beneficial for life. <u>Jiang, Xiexin, Wuwei Zi, and Banxia</u>, on the other hand, warm and transform phlegm and dampness to address the secondary manifestation—these herbs are typically characterized by their warm, yang‑boosting properties, but they can also lead to yin deficiency and fluid depletion. Therefore, using only Shaoyao to gather yin and transform fluids helps prevent yin loss, thus serving as a complementary treatment. Licorice replenishes qi and harmonizes the middle burner, while also balancing all the herbs, acting as a guiding agent to facilitate harmony.

[Clinical Additions and Subtractions]

① Add gypsum, forming the Xiao Qinglong with Gypsum Decoction (from Jin Kui Yao Lü), used to treat exterior cold with internal dampness combined with internal heat.

② If lung cold leads to severe dampness, reduce the amount of Wu Wei Zi compared to Jiang, Xiexin; if there is also lung qi deficiency, increase the dosage of Wu Wei Zi accordingly.

[Reference Materials]

① According to Jin Kui Yao Lü, this formula was used to treat excessive phlegm and coughing that caused difficulty breathing and inability to lie down comfortably—this formula focuses primarily on treating cold phlegm and coughing, regardless of whether the exterior symptoms are present or not, and can be used appropriately in various cases.

② “This formula, like Wu Ling, is used to treat exterior cold without proper resolution, where water accumulates in the lower abdomen. While Wu Ling treats water retention without proper flow, it promotes diuresis while gently inducing sweating, thereby addressing the stagnation of water; this formula addresses the movement of water without it being properly contained, so it employs both pungent, warming herbs to disperse water and sour-bitter herbs to calm the lungs and nourish their source of transformation.” (Ming Yi Fang Lun)

③ Jiang ××, male, 64 years old, cadre. First visit on December 26th. He had suffered from cough and asthma for over ten years, with increased breathlessness during physical labor. Now he experiences shortness of breath and coughing, feels cold and has a fever, with thin phlegm and sputum, a gurgling sound in his throat, palpitations like springtime, and chest discomfort. The cold air triggered latent dampness, causing water to accumulate in the heart. Treatment should focus on releasing the exterior and promoting diuresis. Prescription: 1 qian of Ma Huang, 2 qian of Gui Zhi, 4 fen of Bei Xiexin, 1 qian of Jiang, 3 qian of Banxia, 1 qian of Dan Fu Pi, 3 qian of Sheng Bai Zhu, 3 qian of Lingshi, 4 qian of Fu Ling, 1 qian of Ju Hong, 1 qian of Su Zi, and 7 fen of Wu Wei Zi. On December 29th, upon follow-up, the cough had subsided, the fever and chills were gone, though he still experienced breathlessness during exertion. His palpitations and low back pain remained, and the dampness and external cold had been resolved. However, his kidney qi was weak and unable to adequately retain and regulate, so the plan was to strengthen kidney qi to address the root cause. Prescription: 1 qian of Dan Fu Pi, 3 qian of Huai Shan Yao, 3 qian of Shan Yu Rou, 4 qian of Lu Shi, 7 fen of Wu Wei Zi, 4 qian of Hu Tao Rou, and 1 qian of Shen Xiang. Note: A chest X-ray and Western medical diagnosis indicated emphysema. After seven doses of medication, all symptoms had improved. (Jiangsu Traditional Chinese Medicine, 1965.10:22)

[Commentary] This formula can be used for bronchial asthma, asthmatic bronchitis, chronic bronchitis, and emphysema.

Specializing in Qi and moving the head, the large leafy head.

Da Qinglong Decoction

From Shang Han Lun

[Composition] Ma Huang 10g (6 liang), Gui Zhi 6g (2 liang)

Yellow decoction with raw gypsum, fresh jujubes

Xingren 6g (40 seeds), roasted licorice 6g (2 liang), raw gypsum 30g (a chicken egg-sized portion), fresh ginger 6g (3 liang), 4 jujubes (12 pieces)

[Indications] Headache, body aches, fever with chills, no sweating, <u>thirst</u>, irritability, and a floating, tight, or rapid pulse.

[Functions] Release the exterior and dispel cold, clear heat and relieve irritability.

[Formula Explanation] In cases of exterior cold with solid symptoms such as headache, body aches, fever with chills, no sweating, and a floating tight pulse; when accompanied by internal heat, thirst and irritability appear. The condition involves exterior cold entering the interior and transforming into heat; when treating exterior cold, the primary remedy should be <u>Ma Huang</u> and <u>Gui Zhi</u>, which are used to promote sweating and release the exterior as the main therapeutic approach. Gypsum clears internal heat and also relieves irritability as a supporting measure. The lungs are connected to the skin and hair; when wind-cold attacks the exterior, the lung qi fails to circulate, leading to wheezing and coughing. Xingren opens the lungs and stops coughing as a complementary treatment; when wind-cold attacks the exterior, the vital energy and defensive qi become unbalanced, so ginger and jujubes harmonize the vital energy and defensive qi, also serving as complementary treatments. Licorice balances all the herbs and acts as a guiding agent to facilitate harmony.

[Clinical Additions and Subtractions] ① Remove Gui Zhi, ginger, and jujubes, and form the Ma Xing Gan Shi Decoction (from Shang Han Lun), a specialized formula for treating wind-heat accumulation in the lungs. ② Adding Carthamus Seed can treat acute conjunctivitis or other external eye inflammations. ③ Removing Xingren and Gui Zhi, and forming the <u>Yue Bi Tang</u> (from Jin Kui Yao Lü), used to treat <u>water retention</u> and <u>swelling throughout the body</u>.

[Reference Materials] ① “When the Sun Tai is affected by wind-cold, with a floating, tight pulse, fever, chills, body aches, and no sweating but irritability, the Da Qinglong Decoction is the primary choice. However, if the pulse is weak and the patient sweats easily while feeling cold, it should not be taken—taking it could lead to cold shock, muscle twitching, and even more serious complications. This is considered an adverse reaction.” (Shang Han Lun) ② “The name ‘Da Qinglong’ comes from the image of a dragon rising up to bring rain and clouds; when treating wind, one uses Gui Zhi, and when treating cold, one uses Ma Huang. By combining Gui Zhi and Ma Huang into a single formula, it becomes a key remedy for both wind and cold. Since the patient has no sweating, the dosage of Shaoyao is reduced to avoid its drying effect; since the patient is irritable, gypsum is added to resolve the heat.” (Yi Zong Jin Jian) ③ Shi ××, male, 36 years old. First visit on November 3, 1965, lasting three days. He had a fever of 39.5°C, no sweating, irritability, and pain all over his head and body. His pulse was floating and rapid, with a thin, white coating on his tongue. Prescription: 1.5 qian of Ma Huang and Gui Zhi, 3 qian of Xingren, 1 liang of raw gypsum, 1 qian of raw licorice, 1.5 qian of Zhu Ru, 30 slices of Bamboo Leaf, 1 foot of fresh Reed Root—taken in a decoction. After one dose, his fever and chills subsided, but his cough worsened. The original formula was adjusted by removing Ma Huang and Gui Zhi, adding 1.5 qian each of Ji Geng and Sang Ye. Another dose was taken, and the patient fully recovered. (Chinese Medicine Magazine, 1966.3)

[Commentary] This formula is used for severe colds, acute bronchitis, bronchopneumonia, lobar pneumonia, and respiratory infections complicated by infection.

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Ren Shen Baidu San (Baidu San)

[Composition] ① Qiang <u>Live, Duhuo</u> ② Chai Hu, Qian Hu ③ <u>Zhi Ke, Jie Geng</u> ④ Chuan Xiong ⑤ Fu Ling ⑥ Dang Shen, each 30g, with Licorice 15g

[Dosage Method] Grind the herbs into powder, take 6g per dose, 2–3 times daily, and take warm after brewing with <u>ginger and mint</u>. Modern practice often uses this formula as a decoction, reducing the herbal quantity by a factor of 10 and adding a small amount of mint and ginger.

[Indications] Exterior cold with dampness.

[Indications] Headache, body aches, fever with chills, no sweating, fullness and discomfort in the chest and diaphragm, joint pain, nasal congestion with heavy mucus, frequent coughing with thick phlegm, a white greasy coating on the tongue, and a floating or <u>slippery</u> pulse.

[Functions] Disperses wind-cold and eliminates dampness.

[Formula Explanation] In cases of exterior cold with solid symptoms such as headache, body aches, fever with chills, no sweating, and a floating tight pulse; when accompanied by dampness, symptoms include nasal congestion, heavy mucus in the chest and diaphragm, joint pain, frequent coughing with thick phlegm, and a slippery pulse. This condition arises when wind-cold combines with dampness, and both evils together are the primary causes of illness. Qiang Hu and Duhuo both disperse wind-cold and eliminate dampness; these two herbs work together to treat the underlying conditions, making them the primary remedies. Dampness tends to linger and obstruct the flow of qi; fullness in the chest and diaphragm, joint pain, and nasal congestion are all clinical signs of dampness obstructing qi. Using <u>Qian Hu to descend qi and Jie Geng to lift qi</u>, <u>Chai Hu to disperse qi</u>, and <u>Zhi Ke to disperse qi</u>, we gather the strengths of these herbs, allowing the two herbs to focus particularly on dispersing wind-cold and eliminating dampness—thus earning the title of “complementary treatment.” When evil forces gather, qi naturally becomes deficient; the reason wind-cold combined with dampness attacks the body is due to qi deficiency, so Dang Shen is used to replenish qi, embodying the principle of strengthening the body to dispel evil. This can be considered a <u>complementary treatment</u>; Chuan Xiong activates blood circulation and dispels wind, while Fu Ling strengthens the spleen and drains dampness—all serve as complementary treatments. Ginger and mint help balance cold and heat, also acting as complementary treatments. Licorice balances all the herbs and acts as a guiding agent to facilitate harmony.

[Clinical Additions and Subtractions] ① Remove Dang Shen and add Yin Hua and Lian Qiao, forming the <u>Inhui Baidu San</u> (from Yifang Ji Jie), used to treat early-stage boils and abscesses with redness, swelling, and pain, where the exterior symptoms are present. ② Remove Dang Shen and add Jing Jie and Fang Feng, forming the <u>Jing Fang Baidu San</u> (from Medical Zheng Zhuan), a common formula for treating colds caused by wind-cold.

[Reference Materials] ① “When encountering seasonal pathogens, experiencing chills and high fever, as well as colds, fevers, dampness, epidemics, malaria, and early-stage dysentery—when the exterior is not yet resolved—this formula can be used for all conditions. All seasonal pathogens and epidemics are influenced by the abnormal energies of heaven and earth, and they always target those who are already weakened. Therefore, the formula first uses Ren Shen to replenish righteous qi and dispel evil, then Qiang Hu moves to the exterior to disperse wandering evil, Duhuo moves inward to clear hidden evil, Chai Hu and Jie Geng dissipate heat and elevate qi, Zhi Ke and Qian Hu eliminate phlegm and descend qi, Chuan Xiong is aromatic and helps move qi within the blood, Fu Ling drains dampness with a mild nature to benefit qi, and Licorice harmonizes all the herbs, preventing competition between them. Ginger dispels harmful substances and removes evil, ensuring no stagnation occurs—each herb contributes its own strength to achieve complete efficacy. It is precisely Ren Shen’s powerful ability to guide the process that makes this formula effective. As for treating dysentery, this formula exemplifies the method of Yu Shi, turning the current flow around to draw the evil out from within the body.” (Cheng Bian Fang Du) ② Ren Shen Baidu San was used to treat two cases of dysentery, with symptoms including chills and high fever, no sweating, headache, abdominal pain with diarrhea, mixed red and white stools, urgency and heaviness in the lower abdomen, varying from 20 to 30 bowel movements per day, a white, slippery coating on the tongue, and a floating, tight pulse—all of which were symptoms of summer dampness, wind-cold, and miscellaneous colds affecting the exterior, while food and cold things were consumed internally, leading to stagnation and accumulation. After taking just one dose of this formula, the patient began to sweat profusely, the external symptoms disappeared completely, the number of bowel movements decreased, and after two additional doses, the patient fully recovered. (Jiangsu Traditional Chinese Medicine, 1962.8)

[Commentary] ① This formula shows remarkable efficacy in treating early-stage dysentery with external symptoms; Yu Jia Yan referred to this formula as a “dysentery treatment that turns the current flow around.” ② The formula’s properties lean toward pungent, warm, and dry herbs, making it suitable for cases of external cold combined with dampness. If the dampness is accompanied by heat, however, this formula is not ideal. ③ This formula can be used for colds and flu, and can also be adapted for surgical infections and dysentery.

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Jiu Wei Qiang Huang Tang (Qiang Huo Fang Feng Tang, Da Qiang Huang Tang) From Cishi Nan Zhi

[Composition] Qiang Huo 10g, Fang Feng 10g, Xiexin 3g, Cang Zhu 6g, Bai Zhi 3g, Chuan Xiong 3g, Huang Qin 6g, Sheng Di 10g, Liang Cao 3g

[Dosage Method] Add two slices of fresh ginger and three inches of green onion to the decoction, then take warm after boiling with water.

[Indications] Exterior cold with dampness combined with internal heat.

[Indications] Headache, body aches, fever with chills, no sweating, joint pain, thirst with slight irritability, a thin, white, but slightly greasy coating on the tongue, a floating, tight, or slippery pulse.

[Functions] <em>Release the exterior and dispel cold</em>, <em>eliminate dampness and clear heat</em>.

[Formula Explanation] When wind-cold attacks the exterior, the patient experiences headache, body aches, fever with chills, and a floating, tight pulse; when dampness is present, joint pain appears, the tongue is white and greasy, and the pulse is slippery; when internal heat is also present, thirst and slight irritability arise. These symptoms result from wind-cold combined with dampness attacking the exterior, leading to heat inside the body. In the formula, <em>Qiang Huo and Fang Feng</em> primarily dispel cold and release the exterior. <em>Bai Zhi</em> eliminates dampness from the Yangming meridian, <em>Cang Zhu</em> eliminates dampness from the Taiyin meridian, and Xiexin eliminates dampness from the Shaoyin meridian as a supporting remedy; <em>Huang Qin</em> specifically clears internal heat as a supporting remedy. “When treating wind, first activate blood circulation; when blood is active, wind will naturally subside,” <em>Sheng Di and Chuan Xiong nourish blood and activate blood circulation as complementary treatments</em>; Licorice replenishes qi and supports the body, embodying the principle of strengthening the body to dispel evil—also serving as a complementary treatment. Ginger and green onion use their pungent properties to disperse and guide all the herbs to the exterior, thus facilitating harmony.

[Clinical Additions and Subtractions] ① If dampness is light, remove Cang Zhu; if the headache is not severe, remove Xiexin; if there is no internal heat, remove Sheng Di and Huang Qin. ② Remove <em>Bai Zhi</em> and add Chuan Xiong, Duhuo, Fang Gen, Huang Lian, and Bai Zhu, forming the Da Qiang Huang Tang, which still treats the <em>Jiu Wei Qiang Huang Tang</em> syndrome—but with even greater efficacy.

[Reference Materials] Jiu Wei Qiang Huang Tang was used to treat 120 cases of colds caused by wind-cold, with 112 cases showing effectiveness. This formula was applied mainly for patients with symptoms such as chills and fever, excess cold with little heat, headache, and sore limbs. If the patient also experienced nausea, vomiting, stomach discomfort, or a thick, white coating on the tongue due to dampness, then Sheng Di and Huang Qin were removed; if the cough produced thick phlegm, Xingren and Qian Hu were added; if the throat was dry or painful, Bo Yu Zi and Mint were used; if there was a history of wind-heat disease, and the current symptoms included sore limbs, then Silver Flower Vine was added. Based on clinical experience, this formula proved effective for cases of wind-cold invading the exterior, with heavy cold and little heat, and no sweating. (Fujian Traditional Chinese Medicine, 1964.5)

[Commentary] This formula is effective for treating colds and flu accompanied by fever, and can also be used to treat rheumatic joint pain.

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Xiang Su San From He Ji Ju Fang

[Composition] Xiang Fu 60g, Zi Su 60g, Chen Pi 30g, Liang Cao 15g, Liang Cao 15g, Chuan Xiong 30g, Huang Qin 6g, Sheng Di 10g, Liang Cao 3g

[Dosage Method] Grind all ingredients into coarse powder, take 9g per dose, brew with water, remove the residue, and take warm; modern practice often uses this formula as a decoction, reducing the dosage proportionally.

[Indications] Exterior cold with qi stagnation.

[Indications] Headache, fever with chills, no sweating, fullness and discomfort in the chest and diaphragm, loss of appetite, a thin, white coating on the tongue, and a floating, tight pulse.

[Functions] <em>Release the exterior and dispel cold, move qi and resolve stagnation</em>.

[Formula Explanation] This formula is designed for cases of exterior cold with qi stagnation; in cases of exterior cold, the patient experiences headache, fever with chills, no sweating, a thin white coating on the tongue, and a floating tight pulse; in cases of qi stagnation, the patient experiences fullness and discomfort in the chest and diaphragm, and loss of appetite. When the exterior is cold, the cold invades the body, causing qi to stagnate due to its cold, constricting and drawing energy inward. In the formula, Su Ye is pungent and warm, its warmth dispels cold and its fragrance moves qi to resolve stagnation—making it the primary remedy. Bai Zhi enhances the yang of the Yangming meridian, Cang Zhu enhances the yang of the Taiyin meridian, and Xiexin enhances the yang of the Shaoyin meridian as a supporting remedy; Huang Qin specifically clears internal heat as a supporting remedy. “When treating wind, first activate blood circulation; when blood is active, wind will naturally subside,” <em>Sheng Di and Chuan Xiong nourish blood and activate blood circulation as complementary treatments</em>; Licorice replenishes qi and supports the body, embodying the principle of strengthening the body to dispel evil—also serving as a complementary treatment. Ginger and green onion use their pungent properties to disperse and guide all the herbs to the exterior, thus facilitating harmony.

[Clinical Additions and Subtractions] ① Add Xingren and Sang Pi if the cough is severe; add Banxia if there is phlegm; add Chuan Xiong and Bai Zhi if the headache is severe; add Gui Zhi and Fang Feng if the patient has spontaneous sweating due to cold; add Ma Huang and Jiang when the patient has no sweating due to cold; add Qiang Huo and Fang Feng if the patient has nasal congestion and dizziness; add Yuan Huo if there is pain under the heart. ② Add Green Onion and Dou Chi, forming the Xiang Su Cong Chi Tang (from Popular Treatise on Cold and Heat), whose diuretic and exterior-dispersing effects are stronger than this formula.

[Reference Materials] “Zi Su disperses the qi of the exterior and releases external cold, Xiang Fu moves the defensive qi of the interior and resolves internal stagnation, Orange Red can move both the exterior and interior to assist, and Licorice harmonizes the middle burner—and also facilitates exterior dispersion.” (Yifang Ji Jie)

[Commentary]

① This formula is often used for gastrointestinal colds; if there is fullness in the stomach, add Hou Po and Zhi Ke to open the qi, relieve bloating, and eliminate fullness; if digestion is poor, add Ji Nei Jin and Roasted Liu Qu to aid digestion and eliminate stagnation.

② In recent years, this formula has been used successfully to treat neurasthenia, hysteria, and urticaria.

Ma Huang Fuzi Xiexin Tang From Shang Han Lun

[Composition] Ma Huang 6g (2 liang), Fuzi 6g (1 piece), Xiexin 3g (2 liang)

[Dosage Method] Boil Ma Huang with water first, remove the foam, add all the herbs, remove the residue, and take warm.

[Indications] Yang deficiency combined with exterior cold. Exterior cold with solid symptoms.

[Indications] Headache, fever with chills, no sweating,

[Functions] Help yang and release the exterior.

[Formula Explanation] For those with yang deficiency and exterior cold, when suddenly exposed to wind-cold, although they may exhibit exterior symptoms, their pulse is not floating but rather deep and slow. This condition involves both yang deficiency and exterior cold; the Classic of Difficulties states, “When evil forces gather, qi naturally becomes deficient,” indicating that exterior cold is the primary symptom, while yang deficiency is the underlying condition. The primary remedy focuses on resolving the exterior cold, while the secondary remedy focuses on strengthening yang. Ma Huang moves to the exterior, dissolving cold and dispersing the exterior—its role is to resolve the exterior cold. Fuzi enters the interior, warming the meridians and assisting yang—its role is to support the primary remedy. Xiexin both assists Ma Huang in resolving the exterior and helps Fuzi strengthen yang, making it a complementary treatment.

[Clinical Additions and Subtractions]

① Remove Xiexin and add roasted licorice, forming the Ma Huang Fuzi Liang Cao Tang (from Shang Han Lun), which has similar effects to this formula, but its ability to resolve exterior cold is somewhat weaker.

② Add Fang Feng and Chuan Xiong to treat headaches and fear of cold that occur regularly.

[Reference Materials]

① Yu Jia Yan said, “A deep, slow pulse indicates internal symptoms; in Shaoyin, there should not be external heat. If there is fever, it signifies external cold from the Sun Tai—this is precisely the time to use methods that disperse the exterior. However, the methods for treating the exterior in the Three Yin differ greatly from those for the Three Yang; the Three Yin must use warming herbs to treat the exterior, and Shaoyin is especially crucial. Thus, Ma Huang and Fuzi are combined to allow the external cold to leave the Sun Tai, while Shaoyin’s true yang does not escape.” (Shang Lun)

② Used in a case of voice loss: a 38-year-old woman with a history of pulmonary tuberculosis. She initially had a cold but did not receive treatment. Suddenly, her fever and chills subsided, her voice became hoarse, her pronunciation was unclear, and she had throat pain and coughing with phlegm—she feared that her old illness might be triggered. She visited the clinic on April 25, 1974. Her tongue was pale with little coating, her pulse was deep, slow, and weak—this was due to untreated cold, with cold invading Shaoyin. The prescription was Ma Huang Fuzi Xiexin Tang combined with Er Chen Wan with modifications. Prescription: Ma Huang 3qian, Fuzi 3qian, Xiexin 5fen, Shi Chang Pu 1/2qian, Fa Ban Xia 3qian—two doses, taken in a decoction. Two days later, the patient came to report that after taking two doses, her voice had cleared and her pain had stopped. She continued to seek treatment for tuberculosis and was advised to take formulas that tonify the lungs and benefit the stomach. (New Chinese Medicine, 1975.3:25)

[Commentary] This formula is often used for chronic bronchitis and edema in chronic nephritis.

II. Pungent and Cool Formulas for Resolving Exterior Cold

These formulas are designed for cases of wind-heat presenting as exterior cold. The Classic of Difficulties says, “Pungent and sweet flavors disperse yang,” indicating that formulas for dispersing wind should primarily use pungent herbs; it also says, “Heat is cooled by cold,” suggesting that when treating wind-heat, one should not only use pungent herbs but also incorporate cooling properties. Therefore, formulas used to treat wind-heat in the exterior are called pungent and cool formulas for resolving exterior cold. The clinical manifestations of wind-heat in the exterior include headache, fever with chills (with more heat than cold), thirst, dry throat, a floating, rapid pulse—as mentioned earlier.

Sang Ju Yin From Wen Bing Tiao Bian

[Composition] Sang Ye 9g, Ju Hua 9g, Xing Ren 9g, Lian Qiao 9g, Bo He 3g, Jie Geng 9g, Lu Gen 12g, Liang Cao 3g

[Dosage Method] Take in a decoction.

[Indications] Wind-heat in the exterior combined with cough.

[Indications] Headache, fever with chills (with more heat than cold), thirst, dry throat, cough, a floating, rapid pulse.

[Functions] Disperse wind-heat and open the lungs to stop cough.

[Formula Explanation] When wind-heat attacks the exterior, it is easy for cough to accompany it; Ye Tian Shi said, “When wind-evil enters, it first attacks the lungs.” When lung qi is not flowing, cough occurs. In the formula, Sang Ye and Ju Hua disperse wind-heat to treat the root cause—this is the primary remedy. Xing Ren opens the lungs to stop cough as a complementary treatment. The lungs belong to Metal, which is most easily overcome by Fire; especially when wind-heat attacks the lungs, clearing lung fire is a pressing need. Therefore, using Lian Qiao and Bo He to clear heat and detoxify is a complementary treatment. Fire easily damages yin and depletes fluids; Lu Gen nourishes yin and generates fluids; the lungs are the reservoir for phlegm, and when lung qi is not flowing, phlegm increases—Jie Geng’s function of clearing phlegm and stopping cough is also a complementary treatment. Licorice balances all the herbs and acts as a guiding agent to facilitate harmony.

[Clinical Additions and Subtractions]

① Add gypsum and Zhimu if the heat is severe; if the tongue is red and the patient is restless, with severe night-time fever, add Xuan Shen, Xi Jiao, Sheng Di, and Dan Pi; if lung heat is severe, add Huang Qin; if thirst is severe, add Tian Hua Fen.

② Add Ma Xing Gan Shi Tang to treat childhood pneumonia.

③ Add White Zizania, Cassia Seed, and Summer Grass to treat epidemic conjunctivitis.

[Reference Materials]

① “This formula is pungent and sweet, dispersing wind while being slightly bitter. The lungs are the clean, empty organs; a slight bitterness lowers, while pungency and coolness balance—this is why this formula avoids pungent warmth.” (Wen Bing Tiao Bian)

② This formula was used to treat 50 cases of influenza, all of whom had fever with chills, headache, nasal congestion with runny nose, cough, and poor appetite—with an efficacy rate of 86.5%. After two days of taking the medicine, the fever completely subsided, but symptoms like nasal congestion and cough took longer to disappear. (Guangdong Traditional Chinese Medicine, 1959.2)

[Commentary] This formula is often used for influenza, acute pharyngitis, acute bronchitis, and bronchopneumonia.

Yin Qiao San From Wen Bing Tiao Bian

[Composition] Jing Jie Sui 12g, Jie Geng 18g, Jin Yin Hua 30g, Lian Qiao 30g, Bo He 18g, Zhu Ye 12g, Dan Dou Chi 15g, Niu Bang Zi 18g, Liang Cao 15g

[Dosage Method] Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Shangyan is dispersing; take 18 grams each time, decocted in fresh reed root soup, with a strong aroma that emerges—then take it immediately, avoiding excessive boiling. “The upper burner is like feather, not lifted unless light,” if this formula is boiled too long, its flavor becomes heavy and it enters the middle burner. For severe cases, take three times a day, one time at night; for mild cases, take two times a day, one time at night. Modern usage: prepare as a decoction, decocted in water and taken orally, reducing the dosage according to the original formula.

[Main Indications] Wind-heat exterior syndrome combined with throat swelling and pain.

[Indications] Headache, fever with chills (more heat than cold), thirst, dry throat, throat swelling and pain, floating and rapid pulse.

[Functions] Disperse wind-heat, clear heat and detoxify.

[Formula Explanation] For wind-heat exterior syndrome, characterized by headache, fever with chills (more heat than cold), dry throat, thirst, and a floating, rapid pulse; when wind-heat intensifies and accumulates into toxins, throat swelling and pain occur. In this formula, two flowers and Forsythia are used both to disperse wind-heat and clear heat and detoxify, treating both the surface and the interior, thus serving as the primary components. Douchei and Mint assist Yin and Forsythia in dispersing wind-heat and clearing heat and detoxifying, acting as auxiliary herbs. When heat and toxins accumulate in the throat, it is necessary to clear the throat; Burdock Seed and Platycodon Root clear and benefit the throat, providing complementary treatment. Heat easily damages Yin and depletes body fluids; Reeds and Bamboo Leaves clear heat and generate fluids, also serving as complementary treatments. Jingjie dispels wind and clears cold, working together to regulate Yin within Yang, again serving as complementary treatment. Licorice harmonizes all the herbs and acts as an intermediary to guide them.

[Clinical Additions and Subtractions]

① If there is no sweat with headache and obvious chills, increase the amount of Jingjie and add White Tussah, Vincetorum Rhizome.

② If there is high fever with profuse sweating and thirst, use more Yin Hua and Forsythia while reducing Jingjie, or add Raw Gypsum and Paeoniae Radix. ③ If there is chest tightness and vomiting, along with thick, greasy tongue coating, add Ho Xiang and Peilan. ④ If coughing produces thick phlegm, add Apricot Kernel and Fritillaria; for severe throat swelling and pain, consider adding Borneol, Xuan Shen, Ban Lan Gen, Dandelion, Large Green Leaf, or Dianthus, as appropriate.

[Reference Materials]

① “This formula strictly follows the principle in ‘Nei Jing’: ‘When wind invades internally, treat with pungent coolness, assisted by bitter and sweet flavors; when heat invades internally, treat with salty cold, assisted by sweet and bitter flavors.’” (‘Wen Bing Tiao Bian’)

② “This formula is a medicinal formula from Wu’s ‘Wen Bing Tiao Bian’. The warm diseases treated by this formula differ from those caused by warm epidemics, yet they are distinct from the warm diseases caused by latent pathogenic factors. This formula focuses solely on warm pathogenic factors in the four seasons that invade the surface and affect the lungs; therefore, it uses pungent and cool agents to gently resolve the upper burner… Wu specifically opened up a new perspective on the treatment of warm diseases caused by external factors, which was something previously unexplored by predecessors.” (‘Cheng Bian Fang Du’)

③ In a study of 1,150 cases of wind-heat colds treated with Yin Qiao San, using the formula in coarse powder form, 18 grams per dose, the fever generally decreased after one dose; mild cases recovered quickly, while those with severe fever took longer to reduce their fever, though other symptoms were also rapidly alleviated—typically recovering within 2–4 days, with an average recovery time of 2.7 days. (‘Guangdong Traditional Chinese Medicine’, 1962.5)

Ma Huang Xing Ren Gan Cao Shi Tang ‘Shang Han Lun’

[Composition] Ma Huang 9 grams (4 liang) Xing Ren 9 grams (50 pieces) Zhì Gan Cao 6 grams (2 liang) Sheng Shi 25 grams (half jin)

[Usage] Boil Ma Huang in water, remove the foam, add all the herbs, filter out the residue, and take while warm.

[Indications] Wind-heat invading the lungs, causing lung qi to fail to disperse.

[Indications] Headache, fever, thirst, cough with wheezing, and a floating, rapid pulse.

[Functions] Disperse wind and clear the lungs, stop cough and relieve wheezing.

[Formula Explanation] When wind-heat invades the lungs, lung qi fails to disperse; when wind-heat is present, you’ll find headache, fever, thirst, and a floating, rapid pulse; when lung qi fails to disperse, cough and wheezing occur. Although Ma Huang is pungent and warm, when paired with the cold, pungent and cool Sheng Shi, it reverses the pungent warmth and becomes a heavy, pungent and cool formula. These two herbs work in harmony between the exterior and the interior, fulfilling the major role of dispersing wind and clearing the lungs as the primary ingredients. Xing Ren stops cough and relieves wheezing, aiding lung qi to open and disperse, serving as an auxiliary. Gan Cao harmonizes the middle burner and replenishes qi, embodying the principle of supporting righteous qi—this can be considered a complementary treatment; it also helps to harmonize all the herbs as an intermediary to guide them.

[Clinical Additions and Subtractions]

① Add Mulberry Bark, Cortex Phellodendri, Lysimachia, and Jujube to treat childhood pneumonia.

② Remove Sheng Shi and add Coix Seed, forming the Ma Huang Xing Ren Yi Qi Gan Cao Tang (from ‘Jin Kui Yao Lü’), used to treat rheumatic pain throughout the body, fever, and worsening symptoms in the late afternoon.

③ Remove Sheng Shi and form the San Niao Tang (from ‘He Ji Ju Fang’), used to treat colds caused by wind, nasal congestion, heaviness of the body, inability to speak clearly, or colds affecting the head and eyes, accompanied by stiffness in the limbs, and frequent coughing with thick phlegm.

[Reference Materials]

① “After sweating, do not administer Gui Zhi Tang again; if the patient sweats but still has shortness of breath and no high fever, then Ma Huang Xing Ren Gan Cao Shi Tang may be used.” (‘Shang Han Lun’)

② Preliminary report on the use of Jia Wei Ma Xing Shi Gan Tang to treat children’s coughs and wheezing: Among the selected cases, infants, young children, and children—regardless of the duration of the illness—were primarily characterized by cough accompanied by wheezing, with a history of recurrent episodes. During attacks, either fever or no fever might occur, with coughing occurring in bursts, wheezing and gasping, noisy wheezing, lighter during the day and heavier at night, red tip of the tongue, thin white coating, and a cloudy, greasy coating in the middle or base of the tongue, a tense, fine, and rapid pulse. All patients had undergone chest X-rays to rule out substantive lung lesions; after taking this formula, all patients stopped other medications and continued outpatient treatment as scheduled. Typically, after three doses, symptoms eased, and after six doses, symptoms disappeared. The maximum number of doses was 23, while the minimum was 2. Prescription: Ma Huang 1 qian, Sheng Shi 5 qian (first decocted), Xing Ren 3 qian, Gan Cao 1 qian, Sweet Lysimachia 1.5 qian, Jujube 3 qian, Chai Xia 2 qian, decocted twice in water and divided into four doses daily. Additionally, Shan Ci Gu 1 qian, ground into powder, divided into three doses and swallowed three times a day. (‘Jiangsu Traditional Chinese Medicine’, 1965.11:15)

[Commentary] This formula is often used for acute tracheitis, large leaf pneumonia, and childhood bronchopneumonia; it can also be used for scarlet fever, urticaria, acute conjunctivitis, chronic bronchitis, bronchial asthma, sinusitis, and other conditions.

Additions and Subtractions: Wei Rui Tang ‘Tong Shi Shang Han Lun’

[Composition] Wei Rui 9 grams, Bai Wei 3 grams, Scallions 3 stalks, Dou Che 10 grams, Platycodon Root 4 grams, Jujube 2 pieces, Zhì Gan Cao 2 grams, Mint 4 grams

[Usage] Decocted in water and taken orally.

[Indications] Lung and kidney yin deficiency combined with exterior heat.

[Indications] Five heart palpitations and heat, cough with phlegm, sticky phlegm that is difficult to expel; headache, fever with chills, thirst and dry throat, floating and rapid pulse.

[Functions] Nourish yin and release exterior heat.

[Formula Explanation] When yin deficiency exists and wind-heat is encountered, this condition arises. Lung and kidney yin deficiency leads to five heart palpitations and heat, cough with phlegm, sticky phlegm that is difficult to expel; when wind-heat invades externally, you’ll find headache, fever with chills, thirst and dry throat, and a floating, rapid pulse. When lung and kidney yin deficiency occurs, sweat sources become depleted; without sufficient sweat, exterior heat cannot dissipate. Therefore, nourishing yin should be prioritized in this condition. In the formula, Wei Rui nourishes the yin of the lungs and kidneys, opening the source of sweat as the primary component. Dou Che and Mint disperse wind-heat, serving as auxiliary herbs. Wind-heat resides in the exterior; when lung qi fails to disperse, Platycodon Root opens the lungs and stops cough; heat easily damages yin, so Bai Wei clears heat and nourishes yin; Scallions open yang qi, ensuring that the yin-nourishing herbs do not retain harmful pathogens; Jujube strengthens the spleen and supports righteous qi—these are all complementary treatments. Licorice harmonizes all the herbs as an intermediary to guide them.

[Clinical Additions and Subtractions]

① For more severe exterior symptoms, add Fang Feng and Ge Gen; for sticky phlegm in cough, add Burdock Seed and Gou Teng; for heart palpitations and thirst, add Bamboo Leaves and Paeoniae Radix.

② Remove Scallions, Dou Che, Mint, Platycodon Root, and Jujube from this formula, adding Ma Huang, Du Huo, Xing Ren, Chuan Xiong, Qing Mu Xiang, and Gypsum, forming the Qian Jin Wei Rui Tang (from ‘Qian Jin Fang’), used to treat wind-heat invading the lungs combined with yin deficiency (wind-heat).

[Reference Materials] “The formula takes raw Jade Bamboo to nourish yin and moisten dryness as its principal ingredient. The secondary ingredients include Scallions, Dou Che, Mint, Platycodon Root, and herbs that disperse wind and cool heat. Bai Wei’s bitter and salty properties help to descend and drain excess heat. Licorice and Jujube provide sweet and moistening effects, helping to enhance the yin-nourishing and moistening properties of Jade Bamboo. This formula is an excellent choice for colds with wind-heat and winter-heat-induced coughs, dry throat, and phlegm buildup.” (‘Tong Shi Shang Han Lun’)

[Commentary] This formula can be used for pulmonary tuberculosis combined with upper respiratory tract infections; it can also be used for early-stage external infections, especially when yin deficiency is present. If yin deficiency is absent, this formula should not be used.

Sheng Ma Ge Gen Tang ‘Xiao Er Yao Zheng Quan’

[Composition] Sheng Ma, Ge Gen, Shaoyao, Zhì Gan Cao each in equal parts

[Usage] Grind the herbs into a coarse powder, take 12 grams per dose, and decoct in water. Modern usage involves preparing as a decoction, adjusting the proportions according to the original formula, and taking it in water after decoction.

[Indications] Wind-heat causing rash.

·38·

[Indications] Headache, fever with chills (more heat than cold), thirst, dry throat, initial rash, floating and rapid pulse.

[Functions] Disperse wind-heat and detoxify to promote rash eruption.

[Formula Explanation] When wind-heat invades the exterior, you’ll find headache, fever with chills, thirst, dry throat, and a floating, rapid pulse; when the rash first appears, it indicates that heat and toxins have entered the Yangming meridian, directly impacting the blood and marrow. In this formula, Sheng Ma and Ge Gen are both pungent and sweet, slightly cold in nature—they both disperse wind-heat in the exterior while detoxifying and promoting rash eruption in the interior, making them the primary ingredients. When treating wind, focus on the blood; when blood flows, wind naturally subsides. Shaoyao nourishes and activates blood circulation to facilitate wind dispersion; it also promotes rash eruption (activating blood and promoting rash) as an auxiliary. Gan Cao benefits qi and harmonizes the middle burner, serving as a complementary treatment; it also harmonizes all the herbs as an intermediary to guide them.

[Clinical Additions and Subtractions]

① Add Mint, Jingjie, Chuanxu, Burdock Seed, and Yin Hua for early measles; remove Shaoyao, and add Red Shaoyao, Xuan Shen, Danpi, Zicao, and Large Green Leaf for measles that has not yet erupted.

② If there is throat pain, add Platycodon Root, Xuan Shen, and Borneol.

[Reference Materials]

① “When Yangming suffers from cold and wind, with headache, body aches, fever with chills, no sweat, thirst, eye pain, dry nose, inability to sleep, and when Yangming develops rashes that want to erupt but don’t, with alternating chills and fever, and frequent outbreaks of disease.” (‘Cheng Fang Qie Yong’)

② “Once measles has developed red spots, do not take this formula. Yangming is the exterior, while Sheng Ma is the primary medicine for Yangming; when rashes are about to erupt but haven’t fully appeared, it is advisable to take this formula to promote toxin elimination, but avoid overusing cold remedies to attack heat, nor should you induce sweating to clear the exterior—doing so would weaken the qi of both the exterior and the interior.” (‘Yi Fang Ji Jie’)

[Commentary]

① This formula is most commonly used for early measles, capable of promoting outward excretion and lifting the qi; however, if measles has already fully erupted, use with caution.

② It can also be used in combination with other formulas to treat acute pharyngitis, acute bacterial dysentery, and other conditions.

·39·

Cangrizi San ‘San Yin Fang’

[Composition] Cangrizi 60 grams, Mint 15 grams, Xinyi 15 grams, Bai Zhi 30 grams

[Usage] Grind all ingredients into a powder, take 6 grams per dose, mixed with scallion or tea decoction. Recently, it is often prepared as a decoction, decocted in water according to the original dosage, adjusted based on individual needs.

[Indications] Wind-heat combined with dampness.

[Indications] Headache, fever with chills, dry mouth, nasal congestion with thick mucus, slow progression of the disease, floating and rapid pulse combined with slippery pulse.

[Functions] Disperse wind-heat and treat dampness to clear the nose.

[Formula Explanation] When wind-heat is present, you’ll find headache, fever with chills, dry mouth, and a floating, rapid pulse; when wind-heat is combined with dampness, you’ll find nasal congestion with thick mucus, slow progression of the disease (dampness tends to linger and is not easily eliminated). Although Cangrizi is pungent and warm, when paired with the cool and pungent Mint, they work together to disperse wind-heat and treat dampness in the nose as the primary components. Because dampness is heavy and tends to obstruct qi, Xinyi’s aromatic properties are used to open the nasal passages as an auxiliary. When qi is blocked, headaches are particularly severe—since wind can reach only the top of the head, the wind-based Bai Zhi is used to reach the upper layers and relieve pain, which can be considered a complementary treatment. Scallions and tea open yang qi and clear the upper layers, guiding the herbs upward as an intermediary to guide them.

[Clinical Additions and Subtractions] If headache is severe, add Chuan Xiong and Fang Feng; if yellow mucus appears, add Two Flowers, Forsythia, and Scutellaria; for ear deafness and tinnitus, add Ge Gen and Vincetorum Rhizome.

[Reference Materials]

① ‘Cheng Bian Fang Du’ states that Bai Zhi is the primary ingredient, saying: “Although the disease originates from heat, the clear substances transform into turbid ones; since the disease is located in the upper burner, we must use pungent and ascending herbs to dissolve it. If we merely use bitter and cold herbs to clear and descend, not only will the turbidity not be dissolved, but the heat in the upper burner will also remain uneliminated. Thus, Bai Zhi, with its pungent warmth and dryness, enters Yangming to disperse evil and overcome dampness as the main ingredient.”

② Experiments on Cangrizi showed that it inhibited Staphylococcus aureus. A yellowish-white crystalline substance with glycoside-like properties was isolated from the fruit of Cangrizi; it was temporarily named AA₂, possibly being the main toxic component of Cangrizi. Animal experiments indicated that its primary effect was to cause a sharp drop in blood sugar, leading to convulsions and death. (Shanghai College of Traditional Chinese Medicine: ‘Clinical Handbook of Chinese Herbs’)

[Commentary] This formula can be used for various types of chronic rhinitis and sinusitis; modifications of this formula can also treat rheumatic arthritis, bacterial dysentery, acute and chronic intestinal inflammation, epilepsy, and leprosy.

·40·

Chapter Two: Diuretics

According to ‘Su Wen – Three Sections and Nine Horizons’, “When reality is present, treat with diuresis.” For internal real conditions, the method of diuresis should be employed. Any formula with diuretic effects is called a diuretic; these formulas typically function to promote bowel movements, eliminate excess heat, and expel water and dampness—these functions collectively fall under the category of diuretic therapy. Clinically, internal real conditions can be categorized into four types: ① Internal heat accumulation, whose treatment should involve cold diuresis; ② Cold accumulation and stagnation, whose treatment should involve warm diuresis; ③ Dryness of fluids leading to constipation, whose treatment should involve moistening diuresis; ④ Deficiency of righteous qi leading to solidification, whose treatment should involve tonifying diuresis. Based on this understanding, diuretics are divided into four categories: cold diuresis, warm diuresis, moistening diuresis, and tonifying diuresis.

When using diuretics, pay attention to the following points: 1. If exterior symptoms have not yet been resolved and internal reality is not abundant, first resolve the exterior symptoms; once the exterior symptoms are relieved, then proceed with diuresis. 2. If exterior symptoms have not yet been resolved but internal reality is already abundant, employ a dual approach to resolve both the exterior and interior. 3. When internal reality is already abundant and righteous qi is deficient, employ a method that combines both attacking and nourishing. 4. Diuretics can easily deplete stomach qi; once the effect is seen, stop treatment—do not overprescribe.

I. Cold Diuresis

Cold diuretics have the effect of draining heat and eliminating excess, suitable for conditions involving internal heat accumulation. These conditions are characterized by constipation, abdominal fullness and pain, even with fever and delirium, a yellowish-brown tongue coating, and a slippery, firm pulse. This formula can also be used for intestinal carbuncles caused by damp-heat accumulation and stagnation of qi.

·42·

Da Cheng Qi Tang ‘Shang Han Lun’

[Composition] Dahuang 9 grams (4 liang) Houpo 6 grams (8 liang, peeled and roasted) Zhishi 9 grams (5 pieces, roasted) Mingshao 15 grams (3 he)

[Usage] First boil Zhishi and Houpo in water, remove the residue, add Dahuang, then continue boiling to remove the residue, add Mingshao, and simmer over low heat for one or two boils, then divide and take warm.

[Indications] Yangming腑 Real (Internal Heat Accumulation)

[Indications] Abdominal fullness and discomfort, abdominal distension, constipation, abdominal pain that resists pressure, even with high fever and delirium, a thick, dry yellow tongue coating, and a洪大, powerful pulse.

[Functions] Drain heat and eliminate excess.

[Formula Explanation] Abdominal fullness and discomfort indicate a feeling of fullness; abdominal distension means the abdomen is swollen; constipation means the bowels are dry; abdominal pain that resists pressure indicates solidification. Among these four symptoms, solidification is the core issue. This condition is due to heat accumulation rather than cold stagnation; therefore, the bitter and cold Dahuang is used to drain heat and eliminate excess as the primary ingredient—after all, abdominal pain is common in such cases. As ‘Shang Han Lun’ says, “When the abdomen feels extremely full and painful, add Dahuang,” which aligns perfectly with this principle. Heat easily damages fluids; when fluids are depleted, the bowels become dry, so Mingshao is used to soften and strengthen the bowels and promote bowel movements as an auxiliary. If solidification is not removed, qi stagnates; when qi stagnates, fullness and discomfort arise, so Zhishi and Houpo are used to eliminate fullness and discomfort, as well as to move qi and guide stagnation as complementary treatments.

[Clinical Additions and Subtractions]

① Remove Mingshao and call the formula Xiao Cheng Qi Tang (from ‘Shang Han Lun’), used to treat Yangming腑 conditions, with chest and abdominal fullness, a thick, old yellow tongue coating, and a slippery, rapid pulse.

② Remove Zhishi and Houpo, and add Licorice to form the Tiao Wei Cheng Qi Tang (from ‘Shang Han Lun’), used to treat Yangming腑 conditions, with thirst and constipation, abdominal pain that resists pressure, a thick, old yellow tongue coating, and a slippery, rapid pulse.

③ Remove Mingshao and add Qianghuo to form the San Hua Tang (from ‘Huo Fa Ji Yao’), used to treat stroke and urinary obstruction.

[Reference Materials]

① “This is a true Yangming remedy. When heat invades internally, treat with salty cold; for those with hardened qi, use salty softness; when heat is intense, use cold to dissipate it. Thus, the salty cold of Mingshao is used to moisten dryness and soften hardness, while the bitter cold of Dahuang is used to drain heat and stasis, to relieve dryness and solidification, to strengthen the stomach, and the bitter and descending qualities of Zhishi and Houpo are used to eliminate fullness and discomfort, as the saying goes, ‘when earth is congested, it must be released.’ However, do not prescribe lightly if the condition is not truly severe—there is a risk of cold causing chest tightness and abdominal fullness.” (‘Yi Fang Ji Jie’)

② Experimental research suggests that Da Cheng Qi Tang not only increases gastrointestinal motility and expands gastrointestinal capacity, but also improves blood circulation and reduces capillary permeability; the mechanism behind this formula’s treatment of intestinal obstruction and intestinal inflammation may be related to these effects. This provides a theoretical basis for some of the traditional Chinese medicine principles such as ‘the six organs should be used through smooth flow,’ ‘when things are blocked, pain arises,’ and ‘pain decreases as bowel movements improve.’ (Gansu Provincial Committee for Health: ‘Selected Materials from the National Conference on Integrated Chinese and Western Medicine’, April 1971)

③ In a clinical trial of 90 cases of acute intestinal obstruction, the formula was Da Cheng Qi Tang with radish seeds added. Among the 90 cases, 76 were due to adhesive intestinal obstruction, while the remainder were caused by other factors. Of the patients who sought medical attention, 57 had been hospitalized for more than 24 hours. The majority of their clinical symptoms included abdominal pain, vomiting, abdominal distension, and cessation of bowel movements. Among them, 23 cases were able to resolve the obstruction with a single dose of the formula, with a maximum of 6 doses, averaging 2 doses. In 24 cases, the obstruction became strangulated, or clinical symptoms did not improve after 48 hours of observation, necessitating surgery. (Materials from Hubei College of Traditional Chinese Medicine)

[Commentary]

① This formula can also treat heat accumulating elsewhere; although the patient experiences watery, foul-smelling diarrhea, but the fullness and pain do not subside, the treatment should follow the principle of “open the way and let the path go freely,” using “opening the path and facilitating the flow.”

② This formula is often used for acute intestinal obstruction, acute cholecystitis, acute appendicitis, and can also be used for acute bacterial dysentery or toxic dysentery, as well as schizophrenia.

③ The brewing method for this formula recommends adding Dahuang and Mingshao later, as prolonged boiling of these two herbs can diminish their diuretic effect. According to ‘Ancient and Modern Famous Physicians’ it says, “Raw materials have sharp energy and act first; cooked materials have dull energy and act gently.” Modern experimental research shows that prolonged boiling of Dahuang breaks down anthraquinone compounds, weakening its diuretic effect.

Liang Ge San ‘He Ji Ju Fang’

[Composition] Chuan Dahuang 600 grams, Pu Xiao 600 grams, Gan Cao 600 grams, Lian Qiao 1000 grams, Shan Zhi Ren 300 grams, Bo He Ye 300 grams, Huang Qin 300 grams

[Usage] Grind the herbs into a coarse powder, add 7 bamboo leaves and a small amount of honey to each 6 grams, decoct in water, remove the residue, and take after meals; adjust the dosage for children accordingly. Modern usage: decoct 10–20 grams at a time. Alternatively, you can prepare one-fiftieth of the above formula as a decoction.

[Indications] Real heat in the lungs and stomach.

[Indications] Heat in the chest and diaphragm, coughing up blood-streaked phlegm, flushed face and parched lips, fever with sweating, irritability and thirst, constipation and red urine, sores on the tongue and mouth, yellow tongue coating and a rapid pulse.

[Functions] Cool the diaphragm and promote bowel movements.

[Formula Explanation] When heat in the lungs and stomach is intense, fire rises to the chest and diaphragm; the treatment should focus on draining heat and cooling the diaphragm, hence the name Liang Ge San. When lung fire is intense, you’ll find heat in the chest and diaphragm, coughing up blood-streaked phlegm, flushed face and parched lips; when stomach fire is intense, you’ll find fever with sweating, irritability and thirst, constipation and red urine, sores on the tongue and mouth. The formula’s name Liang Ge reflects the primary role of clearing the lungs; Lian Qiao, Huang Qin, Zhi Ren, and Bo He are used to clear the heat in the lungs as the primary components. Dahuang and Mingshao are used to drain the solidified heat in the stomach as an auxiliary. Bamboo leaves relieve irritation, and honey adds moisture—both serve as complementary treatments. Gan Cao harmonizes all the herbs as an intermediary to guide them.

[Clinical Additions and Subtractions] This formula can be used to treat acute gallbladder disorders; if jaundice is present, add Yin Chen and Guang Yu Jin; for chest and flank pain, add Chai Hu, Chuan Lian Zi, and Yuan Hu; for combined stones, add Qian Jin Cao, Hu Zhang, and Zhi Shi. In addition, adding Large Green Leaf, Ban Lan Gen, and Dandelion can treat meningitis and Japanese encephalitis.

[Reference Materials] “‘Su Wen – The Ultimate True Principles’ states: ‘When heat invades internally, treat with salty cold, assisted by sweet and bitter flavors.’ This formula takes the salty cold of nitrate and sulfur to drain heat in the center; the bitter and cold properties of Lian Qiao, Bamboo, Zhi Ren, and Qin help to drain heat in the upper layers, while the sweet and bitter qualities of grass and honey soothe the urgency—when all these elements are combined, the salty cold, bitter, and sweet flavors deeply align with the therapeutic principles of ‘Nei Jing,’ allowing the heat in the upper and middle burner to be cleared and drained downward, thereby cleansing the chest and diaphragm and relieving all symptoms.” (Editor-in-chief of Jiangsu New Medical College: ‘Chinese Herbal Formulas’)

[Commentary] Based on the dominant idea that the lungs and large intestine are in a complementary relationship, this formula employs diuretic methods to treat the lungs (a method of “taking the root to pull the branch”), which is one of the essence of traditional Chinese medicine. For cases such as lung abscesses, pulmonary tuberculosis with hemoptysis, pneumonia, chronic bronchitis, mediastinal tumors, and others, if yellow tongue coating and constipation are present, this formula can be used with modifications.

Da Xian Xiong Tang

‘Shang Han Lun’

[Composition] Dahuang 9 grams (2 liang) Mingshao 15 grams (1 sheng) Gan Sui 1 gram (1 qian bo)

[Usage] First boil Dahuang in water, remove the residue, add Mingshao, boil for one or two boils, then add Gan Sui powder, and take warm—stop when bowel movements become regular.

[Indications] Large chest and lower abdominal fullness and pain that makes it difficult to approach, constipation, dry mouth, and occasional fever.

[Functions] Drain heat and eliminate water. [Fangjie] The Sun is the water of the Bladder; in cases of Shanghan, it is the water of Heaven and Earth. When the Sun’s disease is improperly treated with diuretics, the cold water evil enters the chest and flanks. Where there is stagnation and accumulation, there must be latent yang; when the heat of latent yang combines with the cold water that has entered internally, it becomes lodged in the chest, which is known as “Jie Xiong.” In this formula, rhubarb clears excess heat, while amur bark expels water and dampness. These two herbs clear heat and eliminate water to treat the root cause and serve as the primary treatments. When water and heat combine and become lodged in the chest, mirabilite’s salty nature softens the hard tissue, while its bitter taste disperses the obstruction, allowing the obstruction to dissolve, the qi to flow freely, and the pain to subside—this can serve as an auxiliary treatment.

[Clinical Additions and Subtractions] Add platycodon root and apricot kernels; make pills with honey, known as Da Lie Xin Wan (from “Shang Han Lun”), which shares similar therapeutic effects.

[Reference Materials]

① “When a patient with Sun disease suffers from excessive sweating followed by subsequent diarrhea, and the patient experiences constipation for five or six days, with dryness on the tongue and thirst, a slight tidal fever in the late afternoon, and abdominal distension and pain below the heart that makes it difficult to touch—Da Lie Xin Tang is indicated for such cases.” (from “Shang Han Lun”)

② “When water accumulates internally, heat cannot disperse; when heat accumulates internally, water cannot flow. Therefore, amur bark is used to directly attack the water, while mirabilite and yellow mustard are employed to strongly eliminate the heat.” (from “Shang Han Lai Su Ji”)

③ Wen ××, female, 52 years old, member of Tongshan Commune. The patient usually enjoyed drinking cold water and often experienced soreness and stiffness in her limbs and joints. She first visited the clinic on October 26, 1973. She presented with fullness and distension in the lower abdomen up to the heart, with no tenderness upon palpation, a feeling of discomfort in the heart, restlessness when lying down or sitting, constipation, thirst, dry tongue with yellow coating, and a pulse that was floating at the thumb and deep at the wrist. Her constitution was characterized by excess moisture and phlegm, and she had been drinking cold beverages for many years—her condition was due to fluid retention in the diaphragm. Water and heat were combined in the heart, and the treatment should focus on using Da Lie Xin Tang to clear heat and eliminate water. Prescription: 1.5 qian of amur bark, 4 qian of rhubarb, 3 qian of mirabilite; decocted in water, strained to remove residue, then divided into two doses and taken warm. On October 30, she returned for a follow-up visit, reporting that after taking the medicine, she felt frequent bowel movements, the fullness and pain in her chest and abdomen had subsided, and all symptoms had lessened. She continued to take half the original dose, adding 1.5 qian of coptis and continuing the treatment for three more doses. Her condition improved. After stopping the medication for a few days, her symptoms reappeared. This process repeated twice, indicating that the root cause of chronic fluid retention was still present, and the medicinal power was insufficient. She was prescribed another dose of the original formula. The next day, she learned that her heart felt even more uncomfortable than before, causing her to feel restless while sitting or standing. Thirty minutes after eating, she suddenly vomited several bowls of clear water; thereafter, all her symptoms had resolved. A follow-up visit half a month later showed that the fullness had subsided and bowel movements were regular, and she had recovered to normal health. (New Chinese Medicine, 1974.5:31)

[Commentary] This formula, with additions and subtractions, can treat exudative pleurisy, intestinal obstruction, and peritonitis.

Shi Zao Tang

From “Shang Han Lun”

[Composition] Equal parts of large spurge, daphne, and amur bark; ten jujubes

[Administration] Grind all three herbs into powder. First, boil the jujubes in water, strain out the residue, then add the powdered herbs. Adults take 3 grams, children take 1.5 grams, and take the medicine warm at dawn. If symptoms do not improve after a short time, take another dose the next day, increasing the dosage by 0.5 grams. Once rapid bowel movements occur, gradually transition to a light porridge diet. Modern usage: Each time, mix 1–2 grams of herbal powder with jujube soup and take once daily on an empty stomach in the morning.

[Indications] Fluid retention.

[Suitable Symptoms] Coughing with expectoration, chest, back, and flank pain, fullness and distension in the heart, nausea and shortness of breath, headache and dizziness, and a deep, tense pulse.

[Functions] Expel water and dampness.

[Formula Explanation] According to “Jin Gui Yao Lü,” “After drinking, if water flows beneath the ribs, causing coughing and expectoration, this is called ‘Xuan Yin.’” It is evident that the formation of Xuan Yin results from water accumulating beneath the ribs. When water accumulates, it causes coughing and expectoration, chest and back pain, and fullness and distension in the heart; when water rises upward, it leads to nausea and shortness of breath, headache and dizziness. In this formula, amur bark is effective at moving water and dampness through the channels; large spurge helps to eliminate water and dampness from the internal organs; and daphne is good at clearing phlegm and water from the chest. All three herbs are potent agents for eliminating water and dampness; when combined, they can help eliminate stubborn phlegm and water, even when they are deeply rooted. However, these herbs are strong and contain some toxicity, which may easily damage the body’s vital energy. Therefore, jujubes strengthen the spleen and support the body’s righteous qi, allowing the spleen to function vigorously and effectively eliminate water and dampness; when the body’s righteous qi is sufficient, the powerful herbs are harmless. The formula is named Shi Zao, emphasizing the importance of supporting the body’s righteous qi—Shi Zao serves as an auxiliary remedy, with large spurge, amur bark, and daphne all acting as the main ingredients.

[Clinical Additions and Subtractions]

① Remove daphne and add white mustard seeds, creating “Kong Xian Dan” (from “San Yin Fang”), which treats phlegm and water that have accumulated in the heart and diaphragm, causing sudden chest and back pain, and unbearable pain in the hands, feet, neck, and waist.

② Remove large spurge and add green peel, aged peel, wood fragrance, areca nut, black tamarind, rhubarb, and light powder, creating “Zhou Che Wan” (Liu He Jian), which treats edema and water retention, where both form and qi are abundant, constipation occurs, and the pulse is deep and forceful.

[Reference Materials]

① Li Shizhen said, “In the treatment of Shang Han’s Sun syndrome, when the exterior is not yet resolved, there is water in the heart and lower abdomen, accompanied by coughing, nausea, fever, or wheezing, or diarrhea—Xiao Qing Long Tang is indicated for such cases; when the exterior is resolved, but there is occasional headache and chills, water accumulates in the heart, with nausea, pain radiating to both sides, or wheezing, or coughing—Da Lie Xin Tang is indicated for such cases.” (from “Cheng Fang Qie Yong”)

② Da Lie Xin Tang achieved satisfactory results in treating 51 cases of exudative pleurisy. All 51 cases were confirmed by X-ray to have pleural effusion; the Da Lie Xin Tang was prepared by grinding large spurge, daphne, and amur bark into powder (powder is preferred) for oral administration, and 10–15 jujubes were broken and their juice extracted, totaling 300 milliliters. The administration method was to drink half of the jujube juice on an empty stomach at 10 a.m., then take the herbal powder (about 3 parts of each herb are suitable) with the jujube juice 5 minutes later. Repeat the treatment every other day, generally administering 4–6 doses. Treatment outcomes showed that 96% of patients experienced improvement in pleural effusion within eight days, 88.2% saw complete resolution within 20 days, and the average time to resolve the fluid was 16.2 days. In a few cases, after the fluid had been absorbed, lingering chest pain remained. (Fujian Traditional Chinese Medicine, 1965.6:43)

For those who drink excessively, add pollen and dendrobium; for those with dry mouth and lips, add saishen and yuzhu.

[Reference Materials] Wu Jutong said, “In cases of Yangming wind-heat, if the downward movement is not smooth… when fluids are insufficient and water stagnates, supplement with fluids; if further action is needed, increase the fluid intake—then use Zeng Ye Tang to promote fluid circulation.” (from “Wen Bing Tiao Bian”)

[Commentary] This formula is primarily used for constipation caused by heat accumulating in the liquid phase; if the condition is more characterized by dryness in the liquid phase with little heat accumulation, and the abdomen does not experience significant discomfort, or if constipation is due to yin deficiency, then Zeng Ye Tang should be used—this is the so-called “protect the deficient, preserve the fluids” approach. However, if heat accumulation is predominant while fluids are still abundant, then Di Wei Cheng Qi Tang should be used—this is the “remove heat while preserving fluids” approach.

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Chapter Three: Harmonizing Agents

For conditions affecting the exterior, use methods to induce sweating; for conditions affecting the interior, use methods to induce defecation; for conditions that exist in both the exterior and interior, use methods to harmonize. This method is commonly referred to as “healing methods,” and it is one of the Eight Methods. Any formula that promotes harmony is called a “harmonizing agent.” The primary indications for harmonizing agents are Shaoyang syndromes (both exterior and interior), because formulas that harmonize Shaoyang typically also have the effect of regulating the liver and spleen, as well as balancing the gastrointestinal tract. Therefore, in addition to Shaoyang harmonizing formulas, harmonizing agents also include formulas that regulate the liver and spleen, and formulas that balance the gastrointestinal tract.

I. Harmonizing Shaoyang

Shaoyang syndromes are both exterior and interior syndromes, and the principle of treatment is to harmonize them. Common symptoms include: bitter taste in the mouth, dry throat, dizziness, alternating chills and fever, chest and flank discomfort, chest and flank fullness, irritability and nausea, a feeling of wanting to eat but unable to, a tense pulse, and a thin white tongue coating.