Library

(Paragraph 113 ○ The principles of various prescriptions have already been clarified in the notes of this clause, so no further repetition is made here.)

Guizhi (Cinnamon Twig) (3 liang), Shaoyao (Peony Root) (3 liang, washed with wine), Gancao (Licorice Root) (2 liang, honey-fried), Shengjiang (Fresh Ginger) (3 liang, sliced), Dazao (Jujube Fruit) (12 pieces, split open).
The above five herbs are coarsely crushed. Boil with 7 sheng of water over a gentle fire until 3 sheng remain. Strain the dregs. Take 1 sheng when the temperature is suitable. Shortly after taking the medicine, drink more than 1 sheng of thin rice porridge to assist the medicinal power. Cover with warm clothing for about one hour. It is best if there is a slight perspiration all over the body; do not let the sweat flow profusely, otherwise the disease will certainly not be eliminated. If sweating occurs after the first dose and the illness improves, stop subsequent doses; it is not necessary to finish the entire decoction. If there is no sweating, take another dose according to the previous method. If still no sweating, shorten the interval between doses slightly, allowing three doses to be taken within half a day. For severe cases, administer medicine continuously day and night, observing for one zhou period (two hours). If symptoms persist after finishing one ji (dose/decoction), prepare and take another. If there is still no sweating, continue up to two or three ji. Avoid cold, raw, sticky, slippery foods, meat, wheat products, the "five pungent spices," alcohol, dairy products, and foul-smelling foods.

This prescription specifically treats syndromes where the Wei Qi (Defensive Qi) is affected by Wind pathogen. Because the Wei Qi is injured and cannot secure the exterior, spontaneous sweating occurs. Therefore, the acrid nature of Guizhi (Cinnamon Twig) is used to disperse the pathogen, while the sour nature of Shaoyao (Peony Root) assists the Yin. However, since one disperses and one astringes, Gancao (Licorice Root) is needed to harmonize the Stomach. Moreover, inducing sweating requires acrid and sweet substances to promote Yang Qi; thus, Shengjiang (Fresh Ginger) assists Guizhi (Cinnamon Twig), and Dazao (Jujube Fruit) assists Gancao (Licorice Root). However, the prescription does not specify whether to use Chi Shaoyao (Red Peony Root) or Bai Shaoyao (White Peony Root). *Shenghui Fang* and Jie'an both use Chi Shaoyao (Red Peony Root), while Sun Shang and Shuwei both use Bai Shaoyao (White Peony Root). Yet, their tonifying and purging effects differ. Zhang Zhongjing stated: "When a patient has fever and sweating, this indicates Ying deficiency and Wei excess. Although Ying is not directly invaded by pathogens, it is not in a balanced state." Thus, Wei excess leads to Ying deficiency, indicating that Bai Shaoyao (White Peony Root) must be used. Since Ying is weak and unable to secure itself, how can Chi Shaoyao (Red Peony Root), which purges, be used? Nevertheless, one cannot apply a uniform rule. For example, if Taiyang syndrome is incorrectly treated with purgatives and transmits to Taiyin, resulting in abdominal fullness and occasional pain, Bai Shaoyao (White Peony Root) should be doubled to tonify Ying blood deficiency. In cases of severe excess, Dahuang (Rhubarb Root) must be added, and Chi Shaoyao (Red Peony Root) is appropriate to purge excess. For individuals with inherent damp-heat abundance or habitual drinkers, when initially contracting cold with symptoms of chills and aversion to heat, using Guizhi Tang (Cinnamon Twig Decoction) requires adding Huangqin (Scutellaria Root) to overcome heat, rather than using Bai Shaoyao (White Peony Root) to aid Yin. Flexibility in clinical practice is key. ○ Note: Guizhi (Cinnamon Twig) enters the Heart and is a Blood-invigorating herb, yet Zhang Zhongjing uses it to treat Wind affecting Wei Qi; Mahuang (Ephedra Herb) moves Lung Qi and is a Qi-moving herb, yet Zhang Zhongjing uses it to treat Cold affecting Ying Blood. These are examples of using Blood herbs for Qi diseases and Qi herbs for Blood diseases. Therefore, Xu Xueshi's assertion that "pulse floating and slow indicates Wind affecting Ying; pulse floating, tight, and choppy indicates Cold affecting Wei" is erroneous. One fails to realize that Wind affects Wei, causing Wei Qi to be invaded; when Wei Qi is invaded, it cannot internally protect Ying, leading to insecure Ying Qi and spontaneous sweating. Guizhi (Cinnamon Twig), a Blood herb, must penetrate and reach Ying and Wei, while Shaoyao (Peony Root) protects Ying and secures the exterior. When Ying and Wei harmonize, spontaneous sweating resolves. Cold affects Ying, causing Ying Qi to be invaded; when Ying Qi is invaded, it cannot externally communicate with Wei, leading to Qi stagnation and absence of sweating. Mahuang (Ephedra Herb), a Qi herb, must open the interstices (Couli), while Guizhi (Cinnamon Twig) strengthens Ying and disperses pathogens. Profuse sweating releases the stagnation and dissipates latent heat.