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Zhi Shi (Immature Bitter Orange, Fructus Aurantii Immaturus) [2 pieces] Zhi Zi (Gardenia Fruit, Fructus Gardeniae) [14 pieces] Chi Xiao Dou (Fermented Soybean, Semen Sojae Preparatum) [1 sheng]

The above three ingredients. Boil in seven sheng of Qing Jiang Shui (clear sour rice water) alone until reduced to four sheng. Add Zhi Shi and Zhi Zi, boil until two sheng remains. Then add Chi Xiao Dou, boil for five or six more boils. Strain the dregs. Take warm, divided into two doses. Cover with blankets to induce a slight sweat.

Zhi Chi Tang (Gardenia and Fermented Soybean Decoction) disperses constrained heat in the Upper Jiao (Upper Burner). It serves as a mild emetic. Here, Qing Jiang Shui is boiled alone first to reduce by three sheng, making the water property mature and heavy/sinking. This aids the descending force of Zhi Shi, guiding Zhi Chi downwards. It clears the upper and drains the lower, thereby unblocking the San Jiao (Triple Burner). When Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) harmonize, the disease heals spontaneously. If there is retained food (Su Shi), add Da Huang (Rhubarb Root, Radix et Rhizoma Rhei) in pieces the size of chess stones, about five or six pieces. This is the treatment method for recurrence due to diet, which does not go beyond this principle. Because recurrence is caused by food, removing the food causes the pathogen to transform naturally. From this, one can realize that treating diseases should always focus on addressing the pathogen.

Zhi Zi (Gardenia Fruit, Fructus Gardeniae) [15 pieces] Gan Cao (Licorice Root, Radix Glycyrrhizae Preparata) [1 liang, honey-fried] Huang Bo (Phellodendron Bark, Cortex Phellodendri Chinensis) [1 liang]

The above three ingredients. Boil in four sheng of water until one and a half sheng remains. Strain the dregs. Take warm, divided into two doses.

For Tai Yang Disease (Exogenous Cold Damage) presenting with jaundice and fever, Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Decoction) is the primary formula. Note: Jaundice with fever indicates that the heat has a tendency to vent outward. Since the pathology moves from interior to exterior, treat the interior. Therefore, use Zhi Zi and Huang Bo to directly clear the heat; once the heat is cleared, the jaundice will resolve. Gan Cao is used to guide the medicinal properties to linger in the Middle Jiao (Middle Burner), clearing heat and directing dampness.

Note: Zhi Chi Tang is a mild emetic. In this formula, Zhi Zi is used with the sweet and moderating nature of Honey-fried Gan Cao, and the bitter and descending nature of Huang Bo. Zhi Zi also resolves damp-heat from the Middle Jiao. Truly, this demonstrates the subtlety of prescription formulation, achieving the effect of using medicine without being limited by the conventional efficacy of the herbs.

Gua Di (Melon Seed, Semen Cucumis Melonis) [Stir-fried until yellow] Chi Xiao Dou (Red Adzuki Bean, Semen Phaseoli Angularis) [Each 1 fen]

The above two ingredients. Grind and sieve each separately into powder, then mix them together. Take one Qian Bi (a measure equivalent to a coin scoop) of the powder. Use Xiang Chi Dou (Fragrant Fermented Soybean, Semen Sojae Preparatum) one he, and hot water seven he. Boil into a thin porridge. Strain the dregs. Mix with the powder and take in one dose. If vomiting does not occur, gradually increase the dose slightly until vigorous vomiting occurs. Do not administer to patients who have lost blood or are constitutionally deficient.

Whenever pathogens are located in the chest, emesis is appropriate. This is what is meant by "Those in the upper region should be evacuated upwards." All three ingredients are emetic agents. They must be boiled into a thin porridge so that they linger in the Middle Jiao, thereby guiding the pathogen to surge upward and be expelled. Zhi Chi Tang expels empty/deficiency pathogens, while this formula expels solid/excess pathogens. Although both are emetic methods, their indications differ.