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Shaoyin disease, characterized by body pain, coldness in the hands and feet, bone and joint pain, and a deep pulse (Chen Mai), is primarily treated with Fuzi Tang (Aconite Decoction).

In Shaoyin disease, if after one or two days of onset, the mouth feels neutral (not bitter or dry) and there is aversion to cold specifically in the back, moxibustion should be applied, and Fuzi Tang (Aconite Decoction) should be administered.

The Shaoyin meridian governs water and corresponds to the Kan trigram (☵) in imagery. With one Yang line residing within, it often presents with heat syndromes. This represents fire within water, and Yang within Yin. However, this specific case involves pure Yin without Yang, where severe Yin-cold penetrates the skin, causing body pain. The four limbs fail to receive the warming influence of Yang Qi, resulting in cold hands and feet. When Cold pathogenic factors enter the Zang organs from the meridians, but the organ Qi is sufficient to prevent deep invasion, the pathogens may infiltrate inward from the Yin level into the bones, causing bone and joint pain. Although this body and bone pain resembles that seen in Mahuang Tang (Ephedra Decoction) syndrome, the nature of Yin/Yang and Cold/Heat are distinctly different. A deep pulse indicates that Shaoyin fails to store, and Kidney Qi sinks independently. The term "mouth" here encompasses both the throat and tongue, as the Shaoyin meridian runs along the throat and surrounds the root of the tongue; thus, Shaoyin diseases often present with dry mouth, dry tongue, or sore throat. Here, "neutral" means no dryness or thirst, indicating that the Fire transformation function is nearly extinguished. Human life carries Yin and embraces Yang; therefore, the Back-Shu points of the five Zang organs are connected to the back. Aversion to cold in the back occurs because the Qi transformation at the Shu points is weak, allowing Yin-cold to take advantage of this deficiency. Since Yang Qi has condensed into Yin-cold, moxibustion on the Back-Shu points is necessary to promote the flow of Yin Qi, transforming it into Yang. Urgent warming with Fuzi Tang (Aconite Decoction) strengthens the Mingmen Fire and Yuan Yang, thereby harmonizing the Yin.

Fuzi Tang (Aconite Decoction):
Fuzi (Prepared Aconiti Lateralis Radix, 2 pieces, processed) Baizhu (Atractylodis Macrocephalae Rhizoma, 4 liang) Renshen (Ginseng Radix et Rhizoma, 2 liang) Shaoyao (Paeoniae Radix) Fuling (Poria, each 3 liang)
Boil in 8 sheng of water until reduced to 3 sheng, remove the dregs, and take 1 sheng warm, three times daily.

This is the premier formula for warming and tonifying in Shanghan Lun (Treatise on Cold Damage). It appears similar to Zhenwu Tang (True Warrior Decoction) but is fundamentally different. By doubling the dosage of Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuzi (Prepared Aconiti Lateralis Radix), removing Shengjiang (Zingiberis Rhizoma Recens), and adding Renshen (Ginseng Radix et Rhizoma), the purpose is to warm and tonify to strengthen Yuan Yang. In contrast, Zhenwu Tang (True Warrior Decoction) focuses on warming and dispersing to promote diuresis of Kidney water.

If Shaoyin disease persists for two to three days and progresses to four or five days, presenting with abdominal pain, difficult urination, heavy and painful limbs, and spontaneous diarrhea, this indicates the presence of Water Qi (fluid retention). Patients may also experience cough, clear urination, diarrhea, or vomiting. In such cases, Zhenwu Tang (True Warrior Decoction) is indicated.

The primary intention of establishing Zhenwu Tang (True Warrior Decoction) is to address Water Qi. Difficult urination is the root of the pathology. Abdominal pain, diarrhea, and heavy/painful limbs are all manifestations of Water Qi pathology caused by difficult urination. However, difficult urination is actually due to the lack of Yang within the Kan trigram. When the Fire function within Kan cannot circulate freely, the Kidney's water metabolism fails, resulting in lower Jiao deficiency-cold and an inability to control water. The treatment principle is to strengthen Yuan Yang to dispel Yin shadows and purge stagnation to clarify the water source, hence this formula was created. The final sentences of the text directly point to the presence of Water Qi. The subsequent symptoms (cough, clear urination, diarrhea, vomiting) represent modifications of Zhenwu Tang (True Warrior Decoction) rather than the main syndrome. If Water Qi exists but does not belong to the Shaoyin category, Zhenwu Tang (True Warrior Decoction) should not be used.

Zhenwu Tang (True Warrior Decoction):
Fuling (Poria) Shaoyao (Paeoniae Radix) Shengjiang (Zingiberis Rhizoma Recens, each 3 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang) Fuzi (Prepared Aconiti Lateralis Radix, 1 piece, processed)
Boil in 8 sheng of water until reduced to 3 sheng, take 7 ge warm, three times daily. If coughing, add Wuweizi (Schisandrae Fructus, half sheng) and Xixin (Asari Radix et Rhizoma, 1 liang). If urination is clear accompanied by diarrhea, remove Shaoyao (Paeoniae Radix) and Fuling (Poria), and add Ganjiang (Zingiberis Rhizoma, 1 liang). If vomiting, remove Fuzi (Prepared Aconiti Lateralis Radix) and increase Shengjiang (Zingiberis Rhizoma Recens) so that the total amount reaches half jin.

Zhenwu (True Warrior) governs the Water of the North. Kan represents water, with one Yang line inside, symbolizing the剛 (firmness) within the 柔 (yielding); hence the name Zhenwu. This embodies the meaning that Yang is rooted in Yin, and stillness is the basis of movement. The nature of water is originally still; what moves it incessantly is the function of Fire. If Fire loses its proper position, water flows backward. The sovereign herb Fuzi (Prepared Aconiti Lateralis Radix) is acrid and warm, stabilizing Yang within Yin. The assistant herb Shaoyao (Paeoniae Radix) is sour and cold, restraining the flaming upward tendency. Fuling (Poria) is sweet and bland, promoting leaching to correct the downward moistening nature. Baizhu (Atractylodis Macrocephalae Rhizoma) is sweet and bitter, controlling the overflow of water pathogens. When Yin and Yang are balanced and secure, the pivot mechanism of Shaoyin has a master, opening and closing functions are appropriate, urination becomes smooth, and abdominal pain and diarrhea cease. Shengjiang (Zingiberis Rhizoma Recens) is used to disperse Water Qi in the four limbs and floating heat in the skin.

Cough is caused by Water Qi invading the Lung. Adding Wuweizi (Schisandrae Fructus) with its sour-warm property assists Shaoyao (Paeoniae Radix) to consolidate Kidney Water Qi; assisting Xixin (Asari Radix et Rhizoma) with its acrid-warm property helps Shengjiang (Zingiberis Rhizoma Recens) disperse Lung Water Qi. If urination is clear with diarrhea, it indicates a lack of Yang in the Stomach. Thus, abdominal pain is not related to Ministerial Fire, and limb heaviness is due to Spleen dampness. Therefore, remove the sour-cold Shaoyao (Paeoniae Radix) and add the acrid-hot Ganjiang (Zingiberis Rhizoma), even removing the sweet-neutral Fuling (Poria). This transforms the formula into a Middle-Jiao warming agent rather than a diuretic. Vomiting indicates Water Qi stagnating in the Middle Jiao, leading to Middle Jiao dysfunction. Limb stiffness does not involve Shaoyin but results from Taiyin dampness failing to circulate. This differs from Water Qi invading the Lung; treatment does not require Fuzi (Prepared Aconiti Lateralis Radix) to warm the Kidney, but rather doubles Shengjiang (Zingiberis Rhizoma Recens) to disperse pathogens. This becomes a Middle-Jiao harmonizing agent, not a Lower Jiao remedy.

Fuzi (Prepared Aconiti Lateralis Radix), Shaoyao (Paeoniae Radix), Fuling (Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma) are crucial to Zhenwu Tang (True Warrior Decoction). Removing any one of them renders it no longer Zhenwu Tang (True Warrior Decoction).

In Taiyang disease, after sweating therapy, if the condition remains unresolved, the patient still has fever, palpitations in the epigastrium, dizziness, and tremulous body movements with a desire to fall to the ground, Zhenwu Tang (True Warrior Decoction) is indicated.

Kidney fluids entering the Heart transform into sweat. If sweating does not cover the whole body, the disease is not resolved. This is because Taiyang Yang is weak, failing to defend the exterior and maintain solidity, while Shaoyin Yin essence is deficient, unable to store essence and respond urgently to external pathogens. Persistent fever and epigastric palpitations indicate the loss of Kan Yang to the exterior and Kidney Water overwhelming the Heart. Dizziness and body tremors result from epigastric palpitations. "Tremulous desire to fall" describes the state of body shaking. Generally, when Water follows Fire, rising Kidney Fire allows Water pathogens to invade upwards. If Kidney Fire returns to its origin, Water Qi naturally descends, and exterior heat resolves accordingly. The use of Zhenwu Tang (True Warrior Decoction) in this clause lies entirely in descending Fire and promoting diuresis, focusing on fever and palpitations, not on dizziness or tremors. In cases of Cold Damage with厥逆 (cold extremities) and palpitations, treating Water Qi first is appropriate, again focusing on palpitations rather than cold extremities. However, that scenario stems from Taiyang Cold-Water invading internally, thus using Guizhi (Cinnamomi Ramulus). This scenario involves Shaoyin pathological Water overflowing, thus using Fuzi (Prepared Aconiti Lateralis Radix). Zhang Zhongjing's formula is designed for treating Water in Shaoyin disease. Those who force-fit the Three Guidelines theory argue it was set for errors from taking Da Qinglong Tang (Major Blue Dragon Decoction). They do not realize that after taking Da Qinglong Tang (Major Blue Dragon Decoction), if 厥逆 (cold extremities) and muscle twitching occur, it is due to Stomach Yang escaping outward. Mild cases use Gancao Ganjiang Tang (Licorice and Ginger Decoction), severe cases use Jianzhong Tang (Establish the Middle Decoction) or Lizhong Tang (Regulate the Middle Decoction), leaving no time to treat the Kidney. Even if one wishes to treat the Kidney, there is Fuzi Tang (Aconite Decoction) for major warming and tonification; why use Zhenwu Tang (True Warrior Decoction)? One must understand that if urination is clear and there are no palpitations, it is not a Zhenwu Tang (True Warrior Decoction) syndrome.