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Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix Alba), and Gancao (Glycyrrhizae Radix et Rhizoma) constitute the Mahuang Guizhi Ban Tang (Half-Mahuang Half-Guizhi Decoction). Cangzhu (Atractylodis Rhizoma), Gancao, Chenpi (Citri Reticulatae Pericarpium), and Houpo (Magnoliae Officinalis Cortex) constitute the Pingwei San (Pingwei Powder). Zhike (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Chenpi, Fuling (Poria), and Banxia (Pinelliae Rhizoma) constitute the Zhigeng Banxia Deng Tang (Zhigeng-Banxia and Other Herbs Decoction). Additionally, Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix) are used to regulate blood; adding Ganjiang (Zingiberis Rhizoma) forms the Houpou San (Houpou Powder). The combination of these aforementioned herbs constitutes a formula for releasing the exterior, warming the middle, and draining heat (the term "draining heat" is erroneous here), as well as a prescription for resolving phlegm, dissipating痞 (fullness), and regulating menstruation. Although it is formulated for conditions involving internal cold and external contraction with simultaneous involvement of the interior and exterior, it is essentially not the precise formula of Zhang Zhongjing utilizing Mahuang, Guizhi, Jiang (Ginger), and Fu Zi (Aconite) for treating interior-exterior syndromes. Regarding vomiting due to cold accumulation, dysentery, abdominal masses (Jia), epidemic diseases, stiffness and tension in the neck and back, add Congbai (Allii Fistulosi Bulbus) and Douchi (Sojae Semen Praeparatum); for cold limbs (Jue Ni), add Wuzhuyu (Evodiae Fructus); for alternating chills and fever with cough and counterflow qi, add Zao (Jujubae Fructus); for difficult labor in women, add Vinegar. Only then can one understand that its application is not limited to a single method. Only those who know how to apply flexible methods will select its use.

Hu notes: Wang Yijian's Shengliao Wuji San (Raw Material Wuji Powder) also treats gynecological disorders such as irregular menstruation, postpartum induction of labor, complications from cold-heat and lochia retention, as well as Pi (accumulations), Jia (masses), podagra, sores, and scabies. Therefore, Haizang stated, "Only then can one understand that its application is not limited to a single method." However, since only those who know how to apply flexible methods will select it, this implies that the formula should not be used lightly nor indiscriminately.

Cangzhu (peeled), Chenpi (deprived of white pith, each 3 liang), Guan Gui (Cinnamomi Cortex), Chuanxiong (each 1 liang), Houpo, Banxia (each processed with ginger juice, 1.5 liang), Fuling (peeled), Ganjiang (each 1 liang), Zhike (bran-fried, 2 liang), Baizhi (Angelicae Dahuricae Radix), Gancao, Jiegeng (each 1 liang).

Additional modifications: For Taiyin channel cold invasion presenting with yellowish clean complexion, deep, slow, and delayed pulse, abdominal pain, cold limbs, vomiting, and diarrhea, add Tu Chao Baizhu (earth-fried Atractylodis Macrocephalae Rhizoma, 1.5 liang), and double the amount of Ganjiang in this formula. For deficiency cases, use Ren Shen (Ginseng Radix et Rhizoma, 2 liang) from the original formula.

For abdominal pain, ancient formulas use Shaoyao regardless of cold or heat. I believe this is not suitable for cold invasion. If pain is severe, double the amount of Guan Gui in this formula. For persistent vomiting, add Dingxiang (Caryophylli Flos, 7 grains) to decoct together. If vomiting occurs, remove Baizhu and add Shengjiang (Zingiberis Rhizoma Recens, 3 slices), totaling 6 slices for decoction. For frequent diarrhea with paradoxical thirst, re-add Baizhu. For palpitations, double the amount of Fuling in this formula.

For Shaoyin channel cold invasion presenting with red face (indicating floating deficient yang, water extreme resembling fire), cold body, deep, fine, weak pulse nearly disappearing, add Pao Fuzi (Prepared Aconiti Lateralis Radix, 1 piece). For deficiency cases, use Ren Shen (2 liang) from the original formula. If the pulse is imperceptible, increase Ren Shen to 3 liang. If the face is red, add 3 stalks of Lianxu Congbai (scallion bulb with roots) to decoct together. For incessant cold sweating, remove Cangzhu from this formula and substitute Guan Gui with Guizhi. For paradoxical fever, use Mahuang (1 liang) from the original formula and add Xixin (Asari Radix et Rhizoma, 1 liang). For sore throat, double the amount of Jiegeng in this formula.

For Jueyin channel cold invasion presenting with blue-black complexion, deep, wiry, and weak pulse, headache, cold limbs, and retraction of the testicles into the abdomen, add Wuzhuyu (soaked in salt water, 1.5 liang) and Danggui (1.5 liang) from the original formula. For muscle cramps, add Mugua (Chaenomelis Fructus, 1 liang). For ascariasis colic, remove Gancao from this formula and add Wumei (Mume Fructus, 3 pieces) to decoct together. For wind invasion causing dizziness and numbness, add Fangfeng (Saposhnikoviae Radix, 1 liang). For damp invasion causing swelling, fullness, and soreness, increase Cangzhu by half, totaling 4.5 liang. For qi stagnation causing stabbing pain, add Muxiang (Aucklandiae Radix, 0.5 fen), ground in water, and mix into the prepared decoction. For coagulation and stasis of blood vessels, double the amount of Danggui in the original formula, totaling 3 liang. For pain in limbs and joints, double Gui (Cinnamon), totaling 3 liang.

Grind the above herbs into powder. Take 4 qian per dose, decoct with 1.5 cups of water and 3 slices of Shengjiang until reduced to 0.7 cup. Strain and take warm.

Hu further notes: The original Wuji San contains sixteen ingredients, while the above formula retains twelve after reduction. Generally, it contains more stomach-warming herbs because internal injury from raw/cold food and external contraction of cold pathogens damage stomach qi. Thus, Baizhi, a Yangming channel herb, is retained. However, Baishao (Paeoniae Radix Alba) is sour and cold, likely unsuitable for cold invasion, so it is uniquely removed. Others like Mahuang, Danggui, and Ren Shen are used according to the patient's deficiency/excess, whether affecting qi or blood, and whether requiring exterior-releasing or tonifying methods, ensuring no errors.

Pang Anshi said: The Classic states, "Yang deficiency leads to external cold, Yin deficiency leads to internal heat, Yang excess leads to external heat, Yin excess leads to internal cold." Using this distinction: if Yin alone is excessive and Yang suddenly perishes, there must be cold limbs, beating pain in the umbilical/abdominal region, body pain as if beaten, blue face, vomiting or diarrhea, and a fine pulse near disappearance. This is called Yin Du (Yin Toxin). One must urgently moxa below the navel and administer acrid-hot medicines to restore Yang. Resolution occurs through sweating.

Qianjin Yin Du Gancao Tang Formula: Treats Shanghan (Cold Damage) where, within one or two days of onset, Yin Du forms, or after six to seven days of medication up to ten days, transforming into Yin Du. Symptoms include heavy body, stiff back, colicky abdominal pain, throat obstruction, toxic vapors attacking the heart, hardness below the heart, shortness of breath, vomiting, blue lips and black face, and cold limbs. The pulse is deep, fine, tight, and rapid. Zhang Zhongjing stated this is a Yin Du syndrome. If treated within five to six days, it is curable; by the seventh day, it is incurable.

Gancao, Shengma (Bupleuri Radix, each 0.5 liang), Danggui, Shujiao (Zanthoxyli Pericarpium, each 6 zhu), Biejia (Trionycis Carapax, 1 liang).

Chop the above five herbs. Decoct in five sheng of water to obtain two and a half sheng. Divide into three doses. After the time it takes a person to walk five li, administer another dose. Cover warmly to induce sweating; the toxin should exit via sweat for recovery. If no sweat occurs, the disease remains; repeat preparation and administration. (Pang's formula includes Guizhi and Xionghuang [Realgar]; I suggest adding Rougui (Cinnamomi Cortex) 0.5 liang to the above formula and omitting Xionghuang.)

Hu notes: The above formula actually originates from Zhang Zhongjing's Jingui Yaolue. Jingui states: Yang Du presents with red face, mottled rash like brocade, sore throat, and expectoration of pus and blood; curable within five days, incurable by the seventh. Shengma Biejia Tang is indicated. Yin Du presents with blue-green face, body pain as if beaten, and sore throat; curable within five days, incurable by the seventh. Shengma Biejia Tang without Xionghuang and Shujiao is indicated. Sun Simiao's Qianjin Fang divided this into two decoctions: for Yang Du, named Shengma Tang (based on Jingui formula but removing Biejia and adding Guixin/Cinnamon Heart); for Yin Du, removing only Xionghuang, named Gancao Tang (the formula above). I argue that Yin Du involves sudden Yang perishing; without acrid-hot agents, how can Yang be restored? Thus, Shengma Tang should omit Shujiao, and Gancao Tang should add Rougui. Pang Anshi of Qishui used all three (Shujiao, Rougui, Xionghuang) in both formulas, which is inexplicable.

Hu further notes: Yin Du is a toxin of extreme Yin cold penetrating the Three Yin channels. The meridians of the Three Yin traverse the abdomen. Taiyin connects to the throat and tongue base; Shaoyin follows the throat and tongue base; Jueyin follows behind the throat entering the nasopharynx. Taiyin branches ascend through the diaphragm to the heart; Shaoyin emerges to connect with the heart and enters the chest; Jueyin pierces the diaphragm and ascends to the lung. Cold pathogen invading the Three Yin channels causes colicky abdominal pain, throat obstruction, and toxic vapors attacking the heart. Extreme Yin cold merging with Jueyin (the end of Yin) causes vomiting, blue lips, black face, and cold limbs. Heavy body indicates Yin governs stillness. Stiff back is not a Taiyang disease but results from heart/abdominal pain and hardness, preventing Qi flow, causing back discomfort. The formula is named Gancao Tang to signify acrid-sweet dispersing action. Shujiao and Gancao are acrid-sweet. Shujiao unblocks the Triple Burner, warms Spleen/Stomach, reaches Mingmen, and enters the Qi aspect of Taiyin and Shaoyin. Gancao moderates its acrid intensity, embodying dispersal with tonification. Danggui enters the Blood aspect of Jueyin and is also acrid-sweet. These three, guided by Biejia, penetrate the deepest Yin levels to extract Yin toxins internally. Without Shengma's acrid-sweet-bitter nature, the pathogen cannot be lifted to the muscle layer and dispersed via Yang-induced sweat.

Question: Yin syndromes generally do not produce sweat; why does the above formula induce sweat via warming covers? Answer: In Yin syndromes, cold pathogen enters the Zang organs. Since Zang Yang is already weak, inducing sweat might cause the faint Yang to escape with the sweat; hence, sweating is prohibited. However, in Yin Du before the fifth day, the pathogen is in the channels, and True Yang is not yet severely depleted. The pulse is deep, fine, stagnant, tight, and rapid, allowing for sweating. Furthermore, Zhongjing's method uses Mahuang Fuzi Xixin Tang for Shaoyin disease with paradoxical fever, and Mahuang Fuzi Gancao Tang for Shaoyin disease in 2-3 days without interior signs. Both are mild diaphoretic formulas. Generally, prohibiting sweat in Yin syndromes is the norm; inducing sweat is the variation. Understanding both norm and variation allows one to speak of medicine.