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Rhubarb (2 liang) Coptis Rhizome (1 liang)

The above two ingredients. Soak them in boiling water (Ma Fei Tang). After a short while, strain off the dregs. Divide into two doses and take warm.

If the pulse is floating and tight, and purgation is mistakenly applied, the tight pulse enters the interior instead, resulting in Pi syndrome (a sensation of fullness and obstruction in the epigastrium). Palpation reveals softness; this is merely Qi stagnation forming a Pi. When there is epigastric fullness, palpation feels soft, and the pulse at the Guan position is floating, Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Heart-Draining Decoction) is indicated. Ke Yunbo commented on this passage, suggesting that "palpation feels soft" should be read as "palpation feels hard," implying there must be symptoms requiring urgent purgation, thus justifying a more峻猛 (harsh) purgative formula. He suspected this was due to bamboo slip dislocation. This argument forces the text to fit preconceived notions, thereby burying the profound and ingenious methods of the Sages. I argue that the text states the tight pulse enters the interior; interior pathogens cannot be expelled through the exterior and must be resolved from within. However, if palpation is not soft, it indicates the presence of fluid retention in the middle jiao; if palpation is soft, it indicates no fluid retention, hence it is called merely Qi Pi. If the exterior pathogen has not resolved, the pulse should be floating at both the Cun and Chi positions. Now, only the Guan position is floating, indicating middle jiao Pi formation with an upward reversal of Qi. Since it is termed Qi Pi, one should facilitate the smooth flow of Qi. The dosages of Rhubarb and Coptis in this formula are light; soaking them in boiling water and taking the strained liquid warm extracts their Qi rather than their heavy flavors, allowing Qi to flow smoothly and resolving the Pi naturally. Moreover, the classic explicitly states that when the exterior is unresolved, one should not attack the Pi. Here, the exterior has resolved, and the pathogen has entered the interior, making this method appropriate for attacking the Pi. The ancients' prescription is subtle in using herbs without being limited by them. Observing the administration method, this is not an urgent purgative. Compared to Da Xian Xiong Tang (Major Chest-Stagnating Decoction) using Rhubarb and Xiao Xian Xiong Tang (Minor Chest-Stagnating Decoction) using Coptis, although the herbs are the same, the preparation differs.

Rhubarb (2 liang) Coptis Rhizome (1 liang) Scutellaria Root (1 liang) Aconite Root (one piece, processed, skin removed, broken apart, decocted separately to extract juice)

The above four ingredients. Chop the first three ingredients. Soak them in two sheng of boiling water. Strain off the dregs. Mix in the Aconite juice. Divide into two doses and take warm. When there is epigastric fullness accompanied by aversion to cold and sweating, Fu Zi Xie Xin Tang (Aconite Heart-Draining Decoction) is indicated. In this passage, Ke added the eight characters "hard stool, vexation, and inability to sleep" after "epigastric fullness." He argued that aversion to cold indicates unresolved exterior, so Rhubarb should not be used; sweating indicates stomach excess, so Aconite should not be used; sweating indicates collapse of Yang, so Scutellaria and Coptis should not be used. Only with "hard stool, vexation, and inability to sleep" would this formula be applicable. I consider this view particularly absurd. Generally, aversion to cold without sweating belongs to Exterior Excess; aversion to cold with spontaneous sweating belongs to Exterior Deficiency. If there is merely sweating and aversion to cold, Zhongjing already provided the Shaoyao Gancao Fuzi Tang (Peony and Licorice Aconite Decoction). Now, with epigastric fullness accompanied by aversion to cold and sweating, it represents Exterior Deficiency and Interior Excess. If one only secures the exterior, the interior pathogens will become more congested; if one only clears the interior, the exterior Yang will perish. Therefore, combining the Three Yellows (Rhubarb, Coptis, Scutellaria) with Aconite allows Aconite to secure the exterior and the Three Yellows to clear the interior. Furthermore, the Three Yellows combined with Aconite prevent their bitter-cold nature from retaining Yin pathogens; Aconite combined with the Three Yellows prevents its acrid-hot nature from damaging body fluids. This is a skillful application of counteracting methods (Fan Zuo), enabling the formula to restore Yang and expel pathogens effectively. If one insists on adding "hard stool, vexation, and inability to sleep" to align with the Three Yellows, then does the use of Rhubarb in the classics apply only to stomach excess? There are cases of diarrhea where Rhubarb is paradoxically used. Regarding vexation and inability to sleep, how do we know it is not caused by stomach deficiency and rebellious hostile Qi? One cannot simply treat it with bitter-cold downward-draining methods. Moreover, given the potent and fierce nature of Aconite, how can it be suitable for conditions with hard stool, vexation, and insomnia? Ke adhered rigidly to his own views and arbitrarily altered the classic text. Regardless of how erroneous his statements are, even if his insights were accurate, one should preserve doubts. His biased view, clinging to herbs to seek formulas, turns the Sages' extremely flexible and divine living methods into rigid rules, which is highly aberrant. I have reviewed medical records of past experts, finding numerous cures using Fu Zi Xie Xin Tang. I have also personally tested it. Thus, I dare to directly refute Ke's errors.