Wu Ji San

Wu Ji San

From "He Ji Ju Fang"

[Composition] Bai Zhi 100 grams, Chuan Xiong 100 grams, Zhigan Cao 100 grams, Fu Ling 100 grams, Dang Gui 100 grams, Rou Gui 100 grams, Shao Yang 100 grams, Ban Xia 100 grams, Chen Pi 180 grams, Zhi Ke 180 grams, Ma Huang 180 grams, Cang Zhu 720 grams, Gan Jiang 120 grams, Jue Jing 360 grams, Hou Pu 120 grams

[Usage] Except for Rou Gui and Zhi Ke, which are finely ground, the remaining ingredients are coarsely ground, gently roasted over low heat until their color changes, then allowed to cool. Next, add the ground Rou Gui and Zhi Ke and mix thoroughly. Take 9 grams per dose, adding three slices of fresh ginger, brew in water, remove the residue, and take warm.

[Indications] External exposure to wind-cold, internal damage from cold foods.

[Indications] Headache, fever with chills, no sweat, stiffness in the neck and back, abdominal distension and fullness, nausea and vomiting, intestinal rumbling and loose stools, cold pain in the abdomen, menstrual irregularities in women.

[Functions] Resolve exterior and dispel cold, warm the middle burner and eliminate accumulation.

[Formula Explanation] When external wind-cold causes headache, fever, chills, and no sweat, the neck and back become stiff; when internal cold causes abdominal distension and fullness, nausea and vomiting, intestinal rumbling and loose stools, and cold pain in the abdomen, this condition arises from a combination of external cold and internal cold. Individuals who already have internal cold may experience this condition when exposed to external cold. Cold tends to contract and draw things inward; when both external and internal cold are present, it often leads to food stagnation, and may even gradually result in the accumulation of phlegm and dampness, as well as qi stagnation and blood stasis. Therefore, this condition encompasses cold congealing, food stagnation, phlegm accumulation, qi stagnation, and blood stasis—commonly referred to as the Five Accumulations. This formula was designed specifically for the Five Accumulations, hence the name Wu Ji San. Ma Huang and Bai Zhi disperse external cold; Gan Jiang and Rou Gui warm and dispel internal cold, and together they work to eliminate cold and address the root cause of the Five Accumulations, thus serving as the main components. Ping Wei San and Wei Zao Shi to eliminate food stagnation; Er Chen Tang to strengthen the spleen and eliminate phlegm to treat phlegm accumulation; Jue Jing to lift qi and Zhi Ke to descend qi, both acting as qi-lifting agents to relieve qi stagnation; Dang Gui, Bai Shao, and Chuan Xiong nourish blood and activate blood circulation to resolve blood stasis. Together, these herbs treat food, phlegm, qi, and blood accumulation—each serving as a supporting component. Zhigan Cao harmonizes the herbs and acts as a guiding agent.

[Clinical Additions and Subtractions] ① If the exterior is deficient and there is sweat, remove Ma Huang and Cang Zhu; if qi is weak and one feels fatigued, remove Zhi Ke and Chen Pi, and add Ren Shen and Bai Zhu; for severe cold-related abdominal pain, add Wu Zhu Yu and simmered Gan Jiang; for yang deficiency and cold limbs, add Fu Pian; if the exterior cold is severe, use Gui Zhi instead of Gui Zhi.

② This formula is combined with Ren Shen Baidu San, forming the Wu Ji Jiao Jia San (from "Yi Fang Ji Jie"), used to treat heavy body pain due to cold-dampness, as well as soreness in the lower back and legs.

③ When combined with Jing Fang Baidu San, this formula can treat rheumatic arthritis.

④ Remove Ma Huang and Bai Zhi, and add Xiang Fu, Yuan Hu, and other herbs to regulate menstruation and relieve pain, used to treat women with menstrual irregularities and dysmenorrhea.

[Reference Materials] "This formula is commonly used for common colds, gastrointestinal neurosis, and various chronic conditions characterized by poor appetite."

Chapter Five: Clearing Heat and Eliminating Fire

“Heat is the precursor to fire,” and “fire is the extreme of heat”—it is evident that fire and heat share the same nature, differing only in degree. When dealing with heat, we should employ clearing methods; when dealing with fire, we should employ draining methods. Both clearing heat and draining fire are based on the principle of “cooling heat,” and when using formulas that clear heat and drain fire, we often employ cooling and cooling substances. Fire is one of the “Six Evils”; ancient scholars said, “All six qi are transformed from fire,” highlighting the importance of fire and heat in human disease. Fire is divided into “strong fire” and “weak fire”: “strong fire consumes qi,” indicating pathological fire; “weak fire generates qi,” indicating physiological fire. The Lord Fire and the Assistant Fire are usually classified as weak fire; once they become overly abundant, they transition into strong fire. Strong fire can be further divided into two types: false fire and true fire. False fire includes both excess Lord Fire and Assistant Fire, as well as qi-deficiency fever and yin-deficiency fever; true fire can be further categorized into two types: external heat and internal injury heat. External heat refers to all external heat-related illnesses, and these fevers are typically treated according to the patterns of Wei, Qi, Ying, and Blood, with heat present in the Wei, Qi, Ying, and Blood divisions; internal injury heat refers to heat that rises and fire that intensifies due to imbalances in the yin and yang of the organs, known as “organ-fire.” Furthermore, fire can “disperse to become fire,” or “accumulate to become poison”—the term “poison” often refers to modern medical purulent infections, such as boils, abscesses, erysipelas, and septicemia. Based on these concepts of fire and heat, formulas that clear heat and drain fire are generally categorized into the following groups: ① Clearing heat from the Qi division; ② Clearing Ying and Cooling Blood; ③ Clearing Heat and Detoxifying; ④ Clearing Heat from the Organs; ⑤ Clearing False Heat.

I. Clearing Heat from the Qi Division

When heat attacks the body, it first targets the Wei division—the section also known as wind-heat invading the exterior—and the treatment formula belongs to the spicy-cool, exterior-resolving group. When entering the Qi division, we employ the method of clearing heat from the Qi division; this condition is characterized by high fever, thirst, profuse sweating, and a rapid pulse—often referred to as “great heat,” “great thirst,” “profuse sweating,” and “rapid pulse.” Additionally, some cases involve residual heat after a fever, where the body still feels hot and restless.

Bai Hu Tang

From "Shang Han Lun"

[Composition] Shi Gao 30 grams (one jin), Zhi Mu 9 grams (six liang), Zhigan Cao 3 grams (two liang), Jing Mi 15 grams

[Usage] Brewed in water until the rice is cooked, then removed the residue and served warm.

[Indications] Yang Ming Jing syndrome.

[Indications] High fever with thirst, profuse sweating, and a rapid pulse; the tongue is yellow and dry.

[Functions] Clear heat and drain fire, nourish yin and generate fluids.

[Formula Explanation] Yang Ming Jing syndrome involves heat in the Qi division, characterized by four symptoms: high fever, great thirst, profuse sweating, and a rapid pulse. This condition represents internal heat and fire, and the treatment approach focuses on clearing heat and draining fire. The formula uses Shi Gao’s great coldness, which is perfectly suited to clear heat and drain fire as the primary component. Zhi Mu’s bitter coldness both assists Shi Gao in clearing heat and draining fire, while also nourishing yin and generating fluids as a supporting herb. Jing Mi nourishes qi and harmonizes the middle burner as a complementary treatment. Zhigan Cao harmonizes the herbs and acts as a guiding agent.

[Clinical Additions and Subtractions]

① Add Ren Shen, creating Ren Shen Bai Hu Tang (from "Shang Han Lun"), used to treat severe internal heat, where both qi and yin are depleted, and the patient experiences excessive sweating and a rapid pulse.

② Add Gui Zhi, creating Bai Hu Jia Gui Zhi Tang (from "Jin Kui Yao Lü"), used to treat warm malaria, where the patient does not feel cold but experiences heat, joint pain and discomfort, and occasional vomiting.

③ Add Cang Zhu, creating Bai Hu Jia Cang Zhu Tang (from "Huo Ren Shu"), used to treat damp-heat diseases, where heat is abundant but cold is scarce, the body feels heavy and the feet are cold, or in cases of rheumatic arthritis, where joint swelling and pain are observed, headache feels like a wrap, feeling of heat and chest tightness, and thirst but no drinking.

④ Add Ling Yang Jiao and Xi Jiao, creating Ling Yang Jiao Bai Hu Tang (from "Wen Re Jing Wei"), used to treat external heat-related illnesses, where qi and blood are both burned, high fever and thirst, confusion and delirium.

⑤ Add Xuan Shen and Xi Jiao, creating Hua Ban Tang (from "Wen Bing Tiao Bian"), used to treat heat entering the Ying and Blood, delirium, rash, and a tongue that is red and coated with yellow.

[Reference Materials]

① “The pathogenic heat of Yang Ming transforms from heat to fire, so the patient does not feel cold but rather feels heat; heat rises outward, so heat-induced perspiration naturally occurs; heat dries the stomach, so the patient desires to drink water; when heat is abundant and solid, the pulse becomes slippery, yet it still remains within the channels, so it also presents as floating. Yang Ming governs the stomach, and externally it controls the muscles—though there is heat, it has not yet become solid, and it cannot be treated with bitter, cold flavors. Shi Gao’s pungent coldness allows it to resolve heat in the muscles, while its cold nature can overcome stomach fire; its cold nature descends, while its pungency moves outward, both possessing the ability to move both internally and externally, thus serving as the chief herb. Zhi Mu’s bitter moistening properties—bitterness clears fire, moisture nourishes dryness—so it serves as the assistant herb. Using Zhigan Cao and Jing Mi, which harmonize the middle burner, and also allow the earth to absorb heat; as a soil, the cold remedy slows down the cold, while the bitter medicine balances the bitterness, allowing the descending nature to remain in the stomach—both herbs act as supporting agents. … Bai Hu is the golden spirit of the West, and its name is derived from the formula, as autumnal metal is at its peak, and the summer heat naturally subsides.” (Yi Zong Jin Jian)

② Nine cases of large leaf pneumonia were treated, all confirmed by X-ray. The formula used Bai Hu Tang with Huang Qin, Huang Lian, Yin Hua, and Lian Qiao to enhance the effects of clearing heat and detoxifying. For cough and chest pain, add Chuan Bei, Xing Ren, Yu Jin, and Ju Luo; for hemoptysis, add Mao Gen and Zhu Ru; for heartburn and heat, add Shan Zhi and Lu Gen; for a robust physique, add Da Huang; for depletion of fluids, add Xuan Shen, Mai Dong, Tian Hua Fen, and fresh Shihu; for restless sleep at night, add Fu Shen and Yi Yuan San. The average cure time was 16.3 days, and all patients were cured. (Shanghai Journal of Traditional Chinese Medicine, 1957.4)

③ Bai Hu Tang was also frequently used in ophthalmology. It could be applied to cases of eye swelling, conjunctivitis caused by external heat, clouding of the cornea, silver-streaked granules, and wave-like opacity. Case reports include: Wang ××, female, 16 years old, first visited on July 16, 1956. Her left eye was red and swollen, with corneal opacity spreading from bottom to top, directly covering the pupil, causing blurred vision. Her tongue was red and her pulse was rapid, with dry mouth and thirst. The condition was due to heat in the Yang Ming stomach, and the treatment focused on clearing the stomach and draining heat. Prescription: Fresh Rehmannia Root 1 liang, Zhi Mu 3 qian, Raw Shi Gao 1 liang, Rice Seeds 8 qian, Zhigan Cao 1 qian. Second visit: She frequently felt thirsty; upon realizing it was stomach heat, she was given a six-dose regimen of stomach-clearing formulas, and her thirst eased, the redness in her eye also subsided—though she still felt dryness and irritation. This heat had severely damaged her fluids, causing water to fail to reach the body, so she was treated with fluid replenishment, adding Xuan Shen and Mai Dong to the original formula. After six doses, the intraocular inflammation subsided. (Shanghai Journal of Traditional Chinese Medicine, 1964.4)

④ “Raw Shi Gao is as potent as Golden Pill, while calcined Shi Gao is as poisonous as Poisonous Bird… Ancient physicians used Shi Gao for conditions ranging from one to fourteen jin (as seen in ‘Bi Hua Yi Jing’); some used it for dozens of jin (as seen in ‘Wu Jutong’s Medical Cases’); even postpartum women used Shi Gao extensively (as seen in ‘Xu Lingtai’s Medical Cases’), though all of these were raw Shi Gao. Even before the Tang and Song dynasties, people did not use calcined Shi Gao—yet why do modern herbalists claim that Shi Gao, once mentioned in the ‘Benjing,’ now describes it as having a very cold nature, even as a harsh cold, and even more often states that calcination does not harm the stomach? Once this statement was made, it led to widespread errors among the people!” (Medical Zhong Zhong Can Xi Lu)

[Commentary] This formula can be used for various acute and chronic febrile infectious diseases and blood disorders; it can also be used for heatstroke, diabetes, diabetes insipidus; and it can even be used for acute conjunctivitis, eye injuries, and other ophthalmological conditions.