Library

Chai Hu (Radix Bupleuri, half jin) Huang Qin (Radix Scutellariae, half jin, washed) Ban Xia (Rhizoma Pinelliae, half jin, washed) Ren Shen (Radix Ginseng, three liang) Gan Cao (Radix Glycyrrhizae, three liang) Sheng Jiang (Rhizoma Zingiberis Recens, three liang) Da Zao (Fructus Jujubae, twelve pieces)
Take the above seven ingredients, boil with one dou and two sheng of water, reduce to six sheng, remove the dregs, and decoct again to obtain three sheng. Take one sheng warm each time, three times a day.
If there is irritability in the chest without vomiting, remove Ban Xia and add one fruit of Gua Lou Shi (Trichosanthis Fructus, which clears turbidity and relieves irritability).
If there is thirst, remove Ban Xia, increase the dosage of Ren Shen to four liang and half, and add Gua Lou Gen (Radix Trichosanthis, four liang; Ren Shen and Gua Lou Gen benefit qi, generate fluids, clear the Metal element, and stop thirst).
If there is abdominal pain, remove Huang Qin and add Shao Yao (Radix Paeoniae Alba, three liang; Shao Yao drains the Wood of Jia, clears ministerial fire, extinguishes wind-dryness, and stops abdominal pain).
If there is fullness and hardness under the hypochondrium, remove Da Zao and add Mu Li (Concha Ostreae, four liang; Mu Li softens hardness and dissipates fullness).
If there is palpitation of the heart and difficulty in urination, remove Huang Qin and add Fu Ling (Poria, four liang; Fu Ling drains water and removes dampness; once dampness is removed, Wood Qi flows freely, wind is extinguished, and palpitations settle naturally).
If there is no thirst but a slight fever on the exterior, remove Ren Shen and add Gui Zhi (Ramulus Cinnamomi, three liang); cover with blankets to induce a slight sweat for recovery (Gui Zhi releases exterior pathogens of the Tai Yang channel).
If there is cough, remove Ren Shen, Da Zao, and Sheng Jiang, and add Wu Wei Zi (Fructus Schisandrae, half jin) and Gan Jiang (Rhizoma Zingiberis Secatus, two liang; Wu Wei Zi and Gan Jiang descend rebellious Qi and stop cough).

When blood is weak and qi is exhausted, the couli (pores and skin texture) open, allowing pathogenic factors to enter. They contend with healthy qi and knot at the hypochondrium. The struggle between healthy qi and pathogenic factors results in alternating chills and fever occurring intermittently, silence, and lack of desire to eat. Since the zang and fu organs are connected, pain must shift downward. Because the pathogen is high and the pain is low, vomiting occurs. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment.
Shaoyang disease arises because external contraction of wind-cold by the Taiyang and Yangming channels causes their qi to become stagnant and oppressive, invading the Shaoyang. Due to this invasion from the two yang channels, blood becomes weak and qi exhausted, causing the couli to open. The pathogens from the Taiyang and Yangming channels then enter internally, contending with the healthy qi of the Shaoyang channel itself. This stagnation and obstruction of channel qi knots at the hypochondrium. The Shaoyang channel runs from head to foot along the hypochondrium; when diseased, its qi fails to descend and blocks horizontally at the hypochondrium, causing bitter fullness in the chest and hypochondrium and hardness under the hypochondrium. When healthy qi is compromised, yang is constrained by pathogenic yin, manifesting as cold (yin pathogen); yang is constrained and manifests as heat (yang pathogen). The intermittent struggle between these forces causes alternating chills and fever. Prolonged struggle exhausts healthy qi, leading to mental fatigue, silence, and anorexia. The spleen and stomach are connected by membranes; invaded by wood-pathogens (liver/gallbladder), stomach qi rebels upward while spleen qi sinks. Sinking spleen qi suppresses liver qi, which attacks spleen earth, causing pain in the lower abdomen. Rebellious stomach qi fills the upper epigastrium, preventing descending junfire and causing turbid qi to surge, resulting in irritability and vomiting. Stomach rebellion places the pathogen high; spleen sinking places pain low; thus irritability and vomiting occur. These are indications of Xiao Chai Hu syndrome, treated primarily with Xiao Chai Hu Tang. Internal transmission of pathogens signifies that healthy qi has become pathological; this is internal transmission, not necessarily direct interior contraction of wind-cold.