Liu Yi San

Liu Yi San

(Shanghan Biao Ben)

[Composition] Huashi 180 grams, Gan Cao 30 grams

[Usage] Grind into powder, take 9 grams each time, mix with a small amount of honey, dissolve in warm water, and take three times a day. In modern times, it is prepared as a decoction.

[Indications] Summer with dampness.

[Indications] Body heat, irritability, thirst, difficulty urinating, urinary retention with pain, or vomiting and diarrhea, or red and white diarrhea.

[Functions] Clear heat and drain dampness.

[Formula Explanation] Summer conditions manifest as body heat, irritability, and thirst; dampness manifests as difficulty urinating, urinary retention with pain, or vomiting and diarrhea, or red and white diarrhea. In the formula, Huashi is mildly cold, and its cold nature clears heat and dispels summer heat; its light quality helps to drain water and eliminate dampness—only this single herb can clear heat and drain dampness to treat summer conditions with dampness. With Gan Cao as an auxiliary, it harmonizes the qi within and can also moderate the excessive coldness of Huashi. The two herbs are formulated in a ratio of six to one, hence the name Liu Yi San.

[Clinical Additions and Subtractions]

This formula is also known as Tian Shui San, and when combined with辰砂, it becomes Yi Yuan San (He Jian Liu Shu), with the effects of clearing heat and draining dampness, calming the heart and soothing the spirit; when combined with peppermint, it becomes Ji Su San (He Jian Liu Shu), with the effects of clearing heat and draining dampness, dispersing wind and heat; when combined with indigo, it becomes Bi Yu San (He Jian Liu Shu), which can also clear liver fire. For sand stones, add Ha Jin Sha and Qian Jin Cao; for blood stones, add raw cypress leaves, raw plantain, and raw lotus roots, forming San Sheng Yi Yuan San. Add red yeast to form Qing Liu Wan, used to treat red diarrhea; add ginger to form Wen Liu Wan, used to treat white diarrhea.

[Reference Materials]

“Treatment for summer colds, where both exterior and interior are hot, with irritability and thirst, difficulty urinating, diarrhea and fever, cholera with vomiting and diarrhea, miscarriage due to alcohol poisoning, and even stone stones—all are remarkably effective.”

When there is difficulty urinating, all types of diarrhea, dysuria, and other conditions related to heat are treated with this formula, which acts by dispersing the exterior and draining water to dispel summer heat. Huashi has a light quality that can disperse the exterior, a heavy quality that can clear and descend, coldness that can overcome heat, and smoothness that can open the channels; its light quality helps to drain water. When combined with Gan Cao, it harmonizes the qi within, mitigating the excessive coldness of Huashi. By using a ratio of six to one, this formula is called Liu Yi San.

“With this formula, we treat summer colds, where both exterior and interior are hot, with irritability and thirst, difficulty urinating, diarrhea and fever, cholera and malaria, and even toxic substances in milk—these conditions are all remarkably effective.” (Cheng Fang Jian Du) [Notes and Additional Information]
This formula is commonly used to treat various urinary tract disorders, such as infections, stones, and tuberculosis; it is also frequently employed for oral diseases and gastrointestinal issues common in summer.

---

Qing Shu Yi Qi Tang

From "Wen Re Jing Wei"

[Ingredients]

• 30 grams of watermelon rind (Xigua Cui Yi)

• 6 grams of light bamboo leaves (Dan Zhu Ye)

• 15 grams of lotus stem (He Geng)

• 9 grams of ophiopogon (Mai Dong)

• 3 grams of coptis (Huang Lian)

• 6 grams of licorice (Gan Cao)

• 4.5 grams of American ginseng (Xiang Yang Shen)

• 9 grams of dendrobium (Shi Hu)

• 6 grams of rehmannia (Zhi Mu)

• 15 grams of glutinous rice (Jing Mi)

[Preparation Method]
Take the herbs and decoct them in water.

[Indications]
Cooling the body and replenishing qi during summer heat.

[Indications for Use]
Excessive sweating with thirst, a pulse that is large but weak.

[Functions]
Clearing summer heat and replenishing qi.

[Formula Explanation]
Zhang Jiegu once said: “The lung governs qi; when summer heat intensifies and fire burns through metal, the lung becomes damaged and qi weakens.” It is clear that summer heat most easily harms qi. When real heat accumulates in the qi portion, one experiences the symptoms of Baihu Tang; when summer heat damages qi, one feels excessive sweating, thirst, and a large, weak pulse. This condition is similar to the Baihu syndrome, but the difference lies in that the Baihu syndrome involves pathogenic heat accumulating in the qi portion, while this syndrome involves heat accumulating in the qi portion. Since summer heat affects the heart, coptis is used to clear heat from the heart meridian, acting as the primary treatment. Watermelon rind and lotus stem help clear heat and dispel summer heat as auxiliary ingredients. Summer heat often depletes qi and harms yin; therefore, American ginseng, glutinous rice, and licorice nourish qi, while ophiopogon, dendrobium, and rehmannia nourish yin, providing a complementary treatment. Bamboo leaves clear heat and promote urination, helping to eliminate summer heat through urine, serving as an auxiliary agent.

[Clinical Additions and Subtractions]
① Remove coptis and rehmannia, adding white peony and cicada slough to treat summer heat in children.
② If there is excessive sweating, add floating wheat; if fatigue is severe, add Sheng Mai San; if thirst persists, add gypsum.

[Reference Materials]
① “Baihu Jia Ren Shen Tang and Wang’s Qing Shu Yi Qi Tang are both formulas for clearing summer heat and replenishing qi, both treating deficiency of both qi and fluids. However, their underlying mechanisms differ. If summer heat resides in the Yangming stomach meridian, where pathogenic heat moves outward, presenting with high fever, excessive sweating, thirst, and a pulse that is洪 and weak, then Baihu Jia Ren Shen Tang is used. Conversely, if summer heat stagnates internally, causing body heat, restlessness, yellow urine, dry mouth and thirst, then Wang’s Qing Shu Yi Qi Tang is employed. The former contains gypsum to release heat from the surface, while the latter contains coptis to clear heat and relieve restlessness. Although both formulas aim to clear summer heat and replenish qi, they differ in that the former primarily focuses on releasing heat from the surface, while the latter primarily focuses on clearing heat from the interior.” (Jiangsu New Medical College: “Interpretation of Warm Disease Studies”)

② Additionally, Li Dongyuan’s “Qing Shu Yi Qi Tang” is another formula, composed of astragalus, chaozhu, shengma, ginseng, baizhu, chenpi, liuqu, zexie, mai dong, danggui, zhigancao, huangbai, ge gen, qing pi, wu wei zi. It treats individuals with qi deficiency who experience summer dampness, where spleen dampness fails to transform, leading to body heat, headache, thirst, self-sweating, sluggish limbs, loss of appetite, chest fullness and heavy body, loose stools, short, red urine, and a greasy tongue with a weak pulse. Both formulas are called Qing Shu Yi Qi Tang, but Li Dongyuan’s Qing Shu Yi Qi Tang is used for those whose original qi is deficient yet have been harmed by summer dampness; Wang Mengying’s Qing Shu Yi Qi Tang (this formula) is used for those whose summer heat has depleted qi and yin, without accompanying dampness.

[Notes and Comments]
This formula is suitable for pre-summer heat symptoms and mild summer heat cases. For severe summer heat accompanied by shock, coma, or heat cramps, this formula is not recommended.

---

Chapter 7: Agents for Opening the Orifices and Clearing the Channels

Opening the orifices is a method for treating delirium. When a patient loses consciousness and does not recognize their surroundings, it indicates that pathogenic factors have entered the heart’s pericardium, blocking the heart’s orifices. In such cases, only by opening the orifices can delirium be treated. However, there are two types of delirium: 1) Delirium accompanied by clenched teeth and stiff neck, which is known as “closed delirium.” 2) Delirium accompanied by open mouth and closed eyes, along with involuntary urination, which is known as “open delirium.” This group of formulas is only effective for closed delirium and not for open delirium. The orifices refer to the jaw, and patients with closed delirium exhibit two main symptoms: delirium and clenched teeth. Therefore, while opening the orifices, using agents to clear the channels complements each other perfectly. Closed delirium can be divided into two types: cold and heat. The formulas for opening the orifices and clearing the channels differ between cooling and warming approaches.