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Ephedrae Herba (Mahuang, 麻黄) three liang, remove nodes; Cinnamomi Ramulus (Guizhi, 桂枝) two liang; Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) one liang, honey-fried; Armeniacae Semen Amarum (Xingren, 杏仁) seventy seeds, soaked, peel and remove sharp tips.

Take the above four ingredients, add nine sheng of water. First decoct Ephedrae Herba until the volume decreases by two sheng, skim off the foam on the surface, then add the remaining herbs. Decoct to obtain two and a half sheng of liquid, strain out the dregs, and take eight ge warm. Cover with blankets to induce a slight perspiration resembling moisture; there is no need to drink hot porridge. Other post-medication care should follow the method of Guizhi Tang (Cinnamon Twig Decoction).

When cold pathogen injures Ying (Nutritive Qi), Ying blood suffers disease, resulting in painful joints; this is expected. Why, however, does it present with closed pores, anhidrosis, and wheezing? Since Ying has been injured internally, it is impossible for Wei (Defensive Qi) to remain harmonious externally alone. Therefore, Mahuang Tang (Ephedra Decoction) uses Ephedrae Herba to induce sweating, combined with Cinnamomi Ramulus to harmonize Ying. Armeniacae Semen Amarum is used to dissipate Qi and relieve wheezing; Glycyrrhizae Radix et Rhizoma is used to assist Yang and harmonize Wei. Only when Ying and Wei circulate freely can sweat be produced. According to Li Shizhen, Zhang Zhongjing used Mahuang Tang for cold-induced anhidrosis and Guizhi Tang for sweating. Past renowned physicians have not thoroughly investigated its subtleties. Body fluids transform into sweat; sweat is essentially blood. Within Ying, it is blood; within Wei, it is sweat. When cold injures Ying, Ying blood cannot communicate outwardly with Wei, causing Wei Qi to close and secure, leading to anhidrosis, fever, and increased aversion to cold. When wind injures Wei, Wei Qi cannot protect Ying inwardly, causing Ying Qi to be insecure, leading to sweating, fever, and aversion to wind. Thus, although Mahuang Tang is a heavy sweating formula for Taiyang (Greater Yang) disorders, it is actually a medication to disperse fire stagnation in the Lung channel. Although Guizhi Tang is a light muscle-releasing formula for Taiyang disorders, it is actually a medication to regulate the Spleen and rescue the Lung. Furthermore, Wang Shishan stated that pungent and sweet flavors disperse and belong to Yang. In Zhang Zhongjing’s exterior-releasing formulas, Glycyrrhizae Radix et Rhizoma is always used to retain the pathogenic factor and prevent it from sinking into the Yin levels. If the pathogen has entered the interior, causing abdominal fullness, there would be no reason to reuse Glycyrrhizae Radix et Rhizoma. Observe formulas such as Wuling San (Poria Powder), Dandang Tang (Tigernut Tuber Decoction), Chengqi Tang (Order the Qi Decoction), Daxiehu Tang (Major Bupleurum Decoction), Xiongxian Tang (Chest Trap Decoction), and Shizao Tang (Ten Jujube Decoction); none use Glycyrrhizae Radix et Rhizoma. Only Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) and Taohe Chengqi Tang (Peach Kernel Order the Qi Decoction) use it because they still involve exterior pathogens of the Taiyang portion. It must be known that Glycyrrhizae Radix et Rhizoma in sweating formulas is indispensable. This formula may only be used when both pulse and symptoms are entirely at the exterior level. If the pulse is weak and faint with spontaneous sweating, it must not be used. Nowadays, people rigidly adhere to the idea that any condition within one or two days at the exterior level is suitable for sweating. If the Chi (Cun) position shows a wiry, rapid, deficient, or large pulse, indicating Yin deficiency with excessive fire, sweating will cause hyperactive Yang and heat jue (cold extremities) leading to death. If the Chi position shows a slow and weak pulse with cold feet, indicating Yang deficiency with Yin inclusion, sweating will cause loss of Yang and jue ni (rebellious cold) leading to death. Can one not be cautious?