Library

When pathogenic factors of cold damage are in the exterior, the body must be soaked to induce sweating. When pathogenic factors are in the interior, the bowels must be purged to promote defecation. If the pathogen is neither in the exterior nor in the interior, but in the half-exterior half-interior stage, it is not suitable for diaphoresis, nor for emesis or purgation; at this time, harmonization is appropriate. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is a formula for harmonizing the exterior and interior.

Chai Hu (Bupleuri Radix) has a bitter, neutral, and slightly cold taste. The *Nei Jing* (Classic of Internal Medicine) states: "For excessive heat within, use bitter substances to disperse." When pathogens are in the half-exterior half-interior, they have nearly matured into heat. As heat transmits inward, direct attack is contraindicated; instead, one should intercept and weaken the pathogen by first dissipating heat. Therefore, bitter-cold herbs are used as the main component. Thus, Chai Hu (Bupleuri Radix) is used as the Sovereign herb, and Huang Qin (Scutellariae Radix) as the Minister herb, to form a formula that thoroughly disperses heat from the exterior.

Ren Shen (Ginseng Radix et Rhizoma) has a sweet and warm taste; Gan Cao (Glycyrrhizae Radix et Rhizoma) has a sweet and neutral taste. When pathogens transmit to the interior, the interior Qi becomes dysfunctional. Sweet substances are used to moderate this dysfunction. Therefore, sweet herbs serve as assistants. Thus, Ren Shen (Ginseng Radix et Rhizoma) and Gan Cao (Glycyrrhizae Radix et Rhizoma) are used as Assistant herbs to support healthy Qi and restore its function.

Ban Xia (Pinelliae Rhizoma) has a pungent and slightly warm taste. When pathogens initially enter the interior, interior Qi rebels upward. Pungent substances are used to scatter this rebellion. Therefore, pungent herbs serve as assistants. Thus, Ban Xia (Pinelliae Rhizoma) is used as an Assistant herb to smooth rebellious Qi and scatter pathogens.

When interior Qi is peaceful and upright, pathogens cannot penetrate deeply. These three Assistant herbs work with Chai Hu (Bupleuri Radix) to harmonize the interior. Sheng Jiang (Zingiberis Rhizoma Recens) has a pungent and warm taste; Da Zao (Jujubae Fructus) has a sweet and warm taste. The *Nei Jing* states: "Pungent and sweet combinations disperse Yang." Since exterior pathogens remain unresolved and gradually transmit inward without yet forming excess, both exterior and interior should be addressed simultaneously. Pathogens in the exterior must be dispersed using pungent and sweet substances. Thus, Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) are used as Envoy herbs to assist Chai Hu (Bupleuri Radix) in harmonizing the exterior.

The combination of these seven ingredients forms an appropriate formula for simultaneous resolution of exterior and interior conditions. Pathogens coming from the exterior have not yet consolidated into excess; invading due to deficiency, their transmission varies. Therefore, modifications are made to address them.

If there is irritability in the chest without vomiting, remove Ban Xia (Pinelliae Rhizoma) and Ren Shen (Ginseng Radix et Rhizoma), and add Gua Lou Shi (Trichosanthis Fructus). Irritability indicates heat; vomiting indicates rebellious Qi. Chest irritability without vomiting means heat is concentrated but Qi is not rebelling, suggesting pathogens are gradually becoming excess. Ren Shen (Ginseng Radix et Rhizoma) is sweet and tonifying; removing it prevents aiding heat. Ban Xia (Pinelliae Rhizoma) is pungent and dispersing; removing it is appropriate because there is no Qi rebellion. Gua Lou Shi (Trichosanthis Fructus) is bitter and cold; clearing heat requires cold nature, and draining heat requires bitter flavor. Adding Gua Lou Shi (Trichosanthis Fructus) unblocks stagnant heat in the chest.

If thirst occurs, remove Ban Xia (Pinelliae Rhizoma), and add Ren Shen (Ginseng Radix et Rhizoma) and Gua Lou Gen (Trichosanthis Radix). Insufficiency of body fluids causes thirst. Ban Xia (Pinelliae Rhizoma) is pungent and drying, depleting fluids; removing it allows fluids to recover easily. Ren Shen (Ginseng Radix et Rhizoma) is sweet and moistening; Gua Lou Gen (Trichosanthis Radix) is bitter and firm/astringent. The combination of bitter-firmness and sweet-moisture generates fluids, resolving thirst.

If abdominal pain occurs, remove Huang Qin (Scutellariae Radix) and add Bai Shao (Paeoniae Radix Alba). Pain results from obstruction where flow is required. Pathogens entering the interior cause insufficiency of interior Qi; cold qi stagnation leads to abdominal pain. Huang Qin (Scutellariae Radix) is bitter and cold; bitterness is drying and cold damages the middle. Removing it helps harmonize middle Qi. Bai Shao (Paeoniae Radix Alba) is sour, bitter, and slightly cold; sourness drains and benefits the middle. Adding it promotes circulation of interior Qi, relieving pain.

If fullness and hardness occur under the ribs, remove Da Zao (Jujubae Fructus) and add Mu Li (Ostreae Concha). The *Nei Jing* states: "Sweet substances cause fullness in the center." Da Zao (Jujubae Fructus) is sweet and warm; removing it allows hardness to gradually dissipate. Salty substances soften hardness. Mu Li (Ostreae Concha) is sour, salty, and cold; adding it resolves fullness and softens hardness.

If palpitations below the heart and difficult urination occur, this indicates water retention without movement. Remove Huang Qin (Scutellariae Radix) and add Fu Ling (Poria). The *Nei Jing* states: "The Kidney desires firmness; urgently consume bitter substances to firm it." Firming the Kidney makes water more secure. Huang Qin (Scutellariae Radix) is bitter and cold; removing it allows retained water to flow. The *Nei Jing* states: "Bland substances have permeating and draining actions, belonging to Yang." Fu Ling (Poria) is sweet and bland; adding it promotes the flow of fluids.

If there is no thirst but slight external heat, remove Ren Shen (Ginseng Radix et Rhizoma) and add Gui Zhi (Cinnamomi Ramulus). No thirst indicates sufficient fluids; removing Ren Shen (Ginseng Radix et Rhizoma) is appropriate as it primarily acts internally. Slight external heat indicates predominant exterior symptoms; adding Gui Zhi (Cinnamomi Ramulus) induces sweating to disperse exterior pathogens.

If coughing occurs, remove Ren Shen (Ginseng Radix et Rhizoma), Da Zao (Jujubae Fructus), and Sheng Jiang (Zingiberis Rhizoma Recens), and add Wu Wei Zi (Schisandrae Fructus) and Gan Jiang (Zingiberis Rhizoma). Rebellious Lung Qi causes coughing. Sweet substances tonify the middle, causing further Lung Qi rebellion; thus, the sweetness of Ren Shen (Ginseng Radix et Rhizoma) and Da Zao (Jujubae Fructus) is removed. Wu Wei Zi (Schisandrae Fructus) is sour and warm. The Lung desires consolidation; urgently consume sour substances to consolidate it. Since Qi rebels and does not consolidate, add the sourness of Wu Wei Zi (Schisandrae Fructus). Sheng Jiang (Zingiberis Rhizoma Recens) and Gan Jiang (Zingiberis Rhizoma) come from the same plant; fresh ginger is warm, dried ginger is hot. For internal invasion of cold qi, pungent-hot substances are used to disperse. Generally, all coughs originate from cold. Thus, Sheng Jiang (Zingiberis Rhizoma Recens) is removed and Gan Jiang (Zingiberis Rhizoma) is added to utilize the proper warming and heating effects.

Those who understand these principles can make minor adjustments, applying logic by analogy.

Chai Hu (Sovereign, half sheng) Huang Qin (Minister, 3 liang) Ren Shen (Assistant, 1 liang) Gan Cao (Assistant, 3 liang, honey-fried)
Ban Xia (Assistant, half sheng, washed) Sheng Jiang (Envoy, 3 liang, sliced) Da Zao (Envoy, 12 pieces, split)

Take the above seven ingredients, add 12 dou of water, boil to obtain 6 sheng, remove dregs, and decoct again to obtain 3 sheng. Take 1 sheng warm, three times daily.