Library

Shengma Gegen Tang (Cinnamon Twig and Pueraria Decoction) treats febrile diseases caused by Cold Damage, plague, and wind-heat, characterized by high fever, headache, and limb pain. It is suitable for use whether the skin eruptions have appeared or not.
Shengma (Rhizoma Cimicifugae), Gan Ge (Radix Puerariae Lobatae, finely chopped), Shaoyao (Radix Paeoniae Rubra or Radix Paeoniae Alba), Gancao (Radix Glycyrrhizae Uralensis, chopped and roasted, equal parts).
Grind the above ingredients into a coarse powder. Take four qian per dose, decoct with one and a half sheng of water until reduced to one sheng. Administer according to age, taking warm at any time.
Zhang Jingyue stated: The syndrome of measles mostly belongs to Fire-Toxin of the Yangming channel. Whenever one wishes to release the exterior and scatter pathogens, this formula is most suitable for cases where the exterior is excess and pathogens are abundant. However, I believe it is even more effective to substitute Chaihu (Radix Bupleuri) for Shengma. For those with slightly deficient Qi and Blood while pathogens remain unresolved, Chaigui Yin (Bupleurium and Angelica Decoction) is the most appropriate.
Wang Shuangchi stated: This is a medicine for the Yangming channel. Since measles originates in the Yangming, this formula is essential. Shengma and Gegen deliver Yang Qi to the exterior, while Shaoyao and Ganhe harmonize the Spleen and Stomach in the middle. Adding Yuanxu (Coriandrum Sativum) and Shengjiang (Rhizoma Zingiberis Recens) induces slight sweating, moistening the primordial organs so that Heat-Toxin does not stagnate.
Ke stated: This is a formula for resolving the exterior and harmonizing the interior in the initial stage of Yangming disease. It can be used to scatter exterior Heat or treat interior deficiency. One formula excels in both aspects. This formula imitates Zhang Zhongjing's Gegen Tang (Kudzu Root Decoction), removing the acrid-warm nature of Jiang (Rhizoma Zingiberis Recens) and Gui (Ramulus Cinnamomi Cassiae) and the cloying sweetness of Dazao (Fructus Jujubae), and substituting Shengma for Mahuang (Herba Ephedrae). Thus, it becomes an exterior-releasing formula for the Yangming channel, not the Taiyang channel. Gegen is sweet and cool, capable of dispersing exterior excess; assisting Shengma in ascending, it directs Clear Yang upward and turbid Yin downward. It can support and disperse the muscular heat inherent to its own channel and lift prolapse associated with concurrent Taiyang disease. Shaoyao astringes Spleen Yin, and Gancao moderates urgency and harmonizes the interior. Using exterior-releasing medicines to treat interior conditions is because the diarrhea is due to exterior excess rather than interior excess. Eruptions originate from the interior and reach the exterior; in the early stage, both interior and exterior are hot, so cooling and dispersing methods are appropriate. If there is no sweat, add Mahuang; if there is sweat, add Guizhi (Ramulus Cinnamomi Cassiae); if thirsty and hot, add Shigao (Gypsum Fibrosum); if sore throat, add Jiegeng (Radix Platycodonis); if headache, combine with Xiong (Radix Ligustici Chuanxiong) and Zhizi (Flos Chrysanthemi Indici); if Shaoyang symptoms exist, add Chaihu and Huangqin (Radix Scutellariae); if Fire is excessive, add Huangqin and Huanglian (Radix Coptidis). For pathogens in the three Yang channels, adjusting this formula yields favorable results.
De noted: Wenren Bohuan said: The Dao has constancy and flexibility; warfare has orthodox and unorthodox tactics; diseases have constant and variable patterns. Constant disease patterns can be predicted, but variable ones cannot. The ancients established Shengma Tang as a fixed rule for treating pediatric smallpox and measles. Is this rigid and inflexible? I have pondered the ancients' intent: Shengma Tang treats the constant pattern of eruptions, not the variable one. What is the constant pattern? Fever before spots appear is constant; residual heat and stagnation with uncooled skin after crusting is also constant. Hence, Shengma Tang states it treats eruptions before appearance and after appearance. "Before appearance" means before spots are seen; "after appearance" means after crusting. This is why Shengma Tang is for the constant pattern of eruptions. When spots have appeared or crusts have not yet formed, symptoms vary infinitely, and treatment must be adjusted according to the syndrome, not bound by fixed rules. Just as Cold Damage varies, how can one stick to a single medicine to address infinite variations? Moreover, the herbs in Shengma Tang merely cool the muscles and release the exterior. Before spots appear and after crusting, cooling and releasing are appropriate. Did the ancients intend to use it when eruptions are actively erupting? Ignorant people today fail to investigate this; seeing spots, they still administer it to children, causing cold muscles, weak exterior, sinking pathogens, and danger. Alas, reading ancient texts without exploring their subtleties disqualifies one from practicing medicine.

Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Seed, Licorice, and Gypsum Decoction) treats internal onset of Warmth, simultaneous exterior and interior Heat, headache, body pain, aversion to cold absent but aversion to heat present, absence of sweat with wheezing, severe restlessness and thirst, and floating pulse on both Cun and Chi positions. Use this to induce sweating and clear Fire. Contraindicated if the pulse is floating and weak, deep and tight, deep and fine, accompanied by aversion to cold, spontaneous sweating, and absence of thirst.
Mahuang (Four liang), Xingren (Fifty seeds, processed to remove double kernels, skin, and tips), Gancao (Two liang, roasted), Shigao (Eight liang, crushed and wrapped in silk).
Take the four ingredients, decoct in seven sheng of water. First boil Mahuang to reduce by one sheng, skim off the foam, then add other herbs. Boil to obtain two sheng, strain, and take one sheng warm. Originally called Huang'er Bei.
Wang stated: For asthmatics, Guizhi Tang plus Houpo (Cortex Magnolia Officinalis) and Xingren treats cold asthma. Now, Mahuang and Shigao plus Xingren treat hot asthma. Mahuang opens hair follicles, Xingren descends interior Qi, and Gancao carries the acrid-cool nature of Shigao to vent from the Lung, allowing Yang Qi to ascend and descend appropriately, dispersing separately. Although sweating is contraindicated for asthma, this formula focuses on urgently clearing Lung Heat to preserve Yin. Once Heat clears and wheezing stops, sweating ceases naturally, and Yang is preserved. Comparing these two asthmas—one cold, one hot—the treatments reflect the separation of Ying and Wei pathways.
Ke stated: This is the main formula for inducing sweating and expelling pathogens in Warm Diseases. Shigao is a heavy agent for clearing Fire; both Qinglong Tang (Blue Dragon Decoction) and Baihu Tang (White Tiger Decoction) rely on it for success. However, improper use invites disaster. Qinglong Tang uses Jiang and Gui to unblock Exterior Yang for cases with no sweat and irritability; Baihu Tang uses Jingmi (Semen Oryzae Sativum) to preserve Stomach fluids for cases with sweat, irritability, and thirst. This formula has only Heat, no Cold, so Jiang and Gui are omitted. Wheezing is in the Lung, not the Stomach, so Jingmi is unnecessary. The focus is preserving Yin, not worrying about loss of Yang. Thus, using Mahuang Tang minus Guizhi (to remove restraint), utilizing Mahuang's specific opening, Xingren's descending, Gancao's harmonizing, and doubling Shigao's great coldness clears interior and exterior excess Heat. Profuse sweating ensues, eliminating interior/exterior restlessness, heat, wheezing, and thirst.
Cheng Fusheng stated: This treats cold penetrating deeply into the Lung causing wheezing and heat. Sweat has occurred, but wheezing persists due to incomplete expulsion of cold pathogens. If there is no significant heat, it indicates Heat congestion in the Lung. Thus, Mahuang scatters pathogens, Shigao removes heat, and Xingren benefits the Lung. Reducing Mahuang and removing Jiang/Gui from Qinglong Tang makes it a stable formula for dispersing, removing heat, and clearing the Lung. Shigao clears Lung Heat, so it is usable for Lung Heat.
De noted: Cheng Xuanxuan said: I treat acute, dangerous syndromes of measles obscured by wind, resulting in lung closure, wheezing, and irritability, often using this formula with success. Measles originating from Lung closure leads to internal attack of Fire-Toxin, often causing wheezing and danger. This formula: Mahuang releases Lung pathogens, Xingren descends Lung Qi, Gancao moderates Lung urgency, Shigao clears Lung Heat. Simple herbs with focused efficacy yield rapid results. Xuanxuan authored *Yi Shu* (Medical Compendium), now published.

Baihu Tang (White Tiger Decoction)
Treats Yangming syndrome with spontaneous sweating, thirst desire for drinking water, surging-large-floating-slippery pulse, no aversion to cold but aversion to heat.
Shigao (One jin, crushed and wrapped in silk), Zhimu (Radix Anemarrhenae Asphodeloides, Six liang), Gancao (Two liang, roasted), Jingmi (Six he).
Take the four ingredients, decoct in ten sheng of water until rice is cooked and soup is ready. Strain, take one sheng warm, three times daily.
Wang stated: Baihu Tang treats simultaneous exterior-interior Heat of the Yangming channel. Unlike Tiaowei Chengqi Tang which guides Heat from the Yangming Fu organ, Baihu Tang drains Heat from the Yangming Jing channel. Shigao drains Yang, Zhimu nourishes Yin, Jingmi moderates Yangming Yang, and Gancao moderates Yangming Yin. Since Shigao is heavy and Zhimu slippery, fearing they rush downward, a special decoction method ensures that when rice is cooked, the acrid-cool-heavy-slippery properties are carried upward by Jingmi and Gancao, lingering in Yangming to achieve clearing and transforming effects. Named "White Tiger," the tiger represents the acrid-cool nature of Shigao and Zhimu, rectifying Metal (Lung) so Yangming Heat resolves naturally, following the principle of draining the child.
Ke stated: Yangming pathogens transform via Heat, hence no aversion to cold but aversion to heat. Heat steaming outward causes spontaneous sweating. Heat consuming Stomach fluids causes thirst. Pathogen abundance and excess cause surging pulse. Half remaining in the channel causes floating and slippery qualities. Yangming belongs to the Stomach and governs muscles externally. Despite high heat, it has not formed solid excess. However, Fire blazing and Earth drying cannot be treated solely with bitter-cold substances. The Classics state: Sweet enters the Spleen first; also: Use sweet to drain. Thus, sweet-cold substances are superior for draining Stomach Fire and generating fluids. Shigao is acrid-cool; acrid resolves muscles, cold overcomes heat. Sweet enters Spleen, substance is firm and descending, embodying Earth generating Metal. White color connects to Lung, soft texture contains fat resembling Metal, enabling Water generation. It serves as the Sovereign herb. Zhimu is cold and descending; bitter drains Lung Fire, acrid moistens Kidney dryness, serving as Minister. Gancao is the vessel of the Central Palace, draining Fire in Earth. With cold herbs, it moderates their coldness, keeping sinking properties lingering in the Stomach. Jingmi is mild and warm, possessing balanced virtue, sweet and agricultural, providing post-heaven life sustenance. These two serve as Assistant herbs, preventing injury to Stomach and Spleen by yin-cold substances. Soup entering the Stomach transports to Spleen and Lung, distributing fluid essence, eliminating severe restlessness and thirst. "White Tiger" refers to the Western Metal Spirit; naming the formula thus implies that when Autumn Metal commands, summer heat resolves. Adding Renshen (Radix Ginseng) supplements and controls the cold of Shigao and Zhimu, draining Fire without injuring Earth, ensuring absolute safety.
De noted: Baihu Tang originally aims to radiate Heat to the exterior. It is contraindicated if the pulse is floating, string-tight, and fine, or deep, fine, and faint. Even with high fever, if there is no restlessness/thirst or sweating, the pathology is not in Yangming. Do not mistakenly prescribe Baihu Tang. Students must be cautious and not reckless.

Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction)
Shigao (One jin, crushed and wrapped in silk), Zhimu (Six liang), Gancao (Two liang, roasted), Jingmi (Six he), Renshen (Three liang).
Take the five ingredients, decoct in ten sheng of water until rice is cooked and soup is ready. Strain, take one sheng warm, three times daily.
Wang stated: Why use Baihu Tang plus Renshen for Yangming Heat disease transforming into dryness? Shigao's acrid-cool only disperses exterior Heat; Zhimu's sweet-bitter only descends interior Heat; Gancao and Jingmi only carry drugs to linger in the Middle Jiao. If long-standing Heat injures Qi in the Stomach channel, and Qi deficiency fails to generate fluids, Renshen is required to nourish Righteousness and restore fluids before Baihu Tang can clear and transform dryness.
Ke stated: Adding Renshen is because Qi is the mother of Water; where pathogens gather, Qi is necessarily deficient. Yin deficiency leads to Qi deficiency. In this great cold formula, Renshen's power is needed to greatly tonify True Yin. Once Yin Qi recovers, fluids generate spontaneously. For those with high fever but undamaged Yuan Qi and unexhausted fluids, without severe thirst, merely nourishing Yin to suppress Yang suffices; adding Renshen for Qi tonification is unnecessary. If Yuan Qi is already depleted, using purely Yin-cold formulas removes Fire but leaves no source for Qi generation. Only adding Renshen drains Fire without injuring Earth and allows Metal to receive Qi, achieving perfect legislative design. This formula focuses on restlessness and thirst, indicating Heat has entered the interior. If there is no sweat, restlessness, thirst, and unresolved exterior, it is Mahuang Xingren Gancao Shigao Tang syndrome.

Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction)
Zhuye (Leaf of Bambusa Textilis, three handfuls), Shigao (One jin, crushed and wrapped in silk), Maimendong (Radix Ophiopogonis Japonici, one sheng), Renshen (Three liang), Banxia (Rhizoma Pinelliae Ternatae, half sheng, washed), Gancao (Two liang, roasted), Jingmi (Half sheng).
Take the six ingredients, decoct in ten sheng of water to obtain six sheng. Strain, add Jingmi, cook until rice is done and soup is ready. Remove rice, take one sheng warm, three times daily.
Wang stated: This soup travels through both Hand and Foot channels without violating principles because the Stomach resides in the Middle Jiao, distributing fluids to various organs. Tonifying Stomach and draining Lung follows the meaning of tonifying the Mother and draining the Child. Zhuye, Shigao, and Maimendong drain Lung Heat; Renshen, Banxia, and roasted Gancao calm Stomach rebellion; Jingmi moderates in the middle, allowing all herbs to achieve clearing and transforming effects. It is a variation of Baihu Tang, Yuebi Tang (Ma Huang, Shi Gao, Sheng Jiang, Da Zao, Gan Cao, Xing Ren), and Maimendong Tang.
Qian Tianlai stated: Zhuye is cold and stops restlessness/heat; Shigao enters Yangming and clears Stomach Heat; Banxia eliminates phlegm-fluids and stops vomiting; Renshen tonifies post-illness deficiency; together with Maimendong, it greatly adds fluids to the Stomach. Fearing cold damages the Stomach, Gancao harmonizes, and Jingmi assists Stomach Qi.
Zhou Yuzai stated: Shigao is coldest; combined with Zhuye to clear Heat, pathogens in Stomach and Small Intestine are removed. Banxia resolves phlegm to stop vomiting; Maimendong clears Lung to remove restlessness, lowering pathogens in Upper and Middle Jiao. Only Gancao generates flesh, and Jingmi benefits Stomach Qi, suitable for emaciation and shortness of breath. Cold Damage is a Heat disease. Even after resolution, internal Heat may not be fully cleared. Thus, sweet-cold substances clear Heat and tonify deficiency, designed for syndromes where Heat pathogens are not fully retreated. Using this for emaciation is inappropriate.
De noted: Xu Huixi annotated: This is Mr. Zhang Zhongjing's formula for convalescence after Cold Damage recovery. Its method specifically nourishes Lung and Stomach Yin Qi to restore fluids. Although Cold Damage traverses all six channels, sweating, vomiting, and purgation all affect Lung and Stomach. The *Neijing* states: Injury by Cold results in Heat disease. Thus, nourishing Lung and Stomach is an unchanging method from Qibo/Huangdi to Zhang Zhongjing. Later mediocre doctors use warm-hot medicines to aggressively tonify Spleen and Kidney, causing the refined essence passed down through thousands of sages to vanish completely.