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The original formula of Chaihu Tang (Bupleurum Decoction), with the addition of Mangxiao (Mirabilite), has different dosages for each herb.
Chaihu (2 liang 16 zhu) Huangqin (Scutellaria Root) Gancao (Licorice Root, honey-fried) Renshen (Ginseng Root) Shengjiang (Fresh Ginger Slice, cut, each 1 liang) Banxia (Pinellia Tuber, 20 zhu) Dazao (Jujube Fruit, 4 pieces, torn open) Mangxiao (Mirabilite, 2 liang). The above eight herbs are boiled in 4 sheng of water until reduced to 2 sheng. Strain the dregs, add Mangxiao, and boil slightly until bubbling. Divide into two warm doses. If the condition is not resolved, prepare another dose. "Not resolved" refers to constipation.
This prescription is the lightest in dosage. Calculated by modern weights, it is approximately 2 liang. Divided into two doses, one dose amounts to only 1 liang.
Note: Da Chaihu Tang (Major Bupleurum Decoction) adds Dahuang (Rhubarb Root) and Zhishi (Immature Bitter Orange), effectively combining the effects of Xiao Chengqi Tang (Minor Order the Qi Decoction); this formula adds Mangxiao, effectively combining the effects of Tiaowei Chengqi Tang (Regulate the Stomach and Order the Qi Decoction). Both are formulas treating Shaoyang Yangming combined syndromes.
After thirteen days of Taiyang cold damage without resolution, there is fullness and distension in the chest and hypochondrium with vomiting, tidal fever occurring in the late afternoon, followed by slight diarrhea. This originally belongs to a Chaihu syndrome. After improper purgation, diarrhea did not occur; now, conversely, diarrhea has occurred. It is known that the physician used pill-based purgatives, which was not the correct treatment. Tidal fever indicates excess pathogenic factors. First, administer Xiao Chaihu Tang (Minor Bupleurum Decoction) to resolve the exterior, then treat primarily with Chaihu Jia Mangxiao Tang (Bupleurum Decoction plus Mirabilite). *Bencao* states: Mangxiao treats accumulations in the six fu organs. Since diarrhea has already occurred, using purgation again exemplifies the method of "treating obstruction with unblocking agents" (Tong Yin Tong Yong). With tidal fever and diarrhea, the pathogen does not stagnate and knot, so the medication is slightly milder compared to Da Chaihu Tang syndrome.

Zhizi (14 Gardenia Fruits, torn open) Xiangchi (4 he Fermented Soybeans, wrapped in silk). The above two herbs are boiled in 4 sheng of water. First boil Zhizi until 2.5 sheng remains, then add Xiangchi, and boil until 0.5 sheng remains. Strain the dregs and divide into two doses. Take one dose warm. If vomiting occurs, stop taking the subsequent dose. This prescription has the smallest dosage; this is typical for all medicines treating the Upper Jiao.
After sweating, vomiting, and purging methods have all been employed, they may not all have been errors, but the Righteous Qi (Zheng Qi) has already been damaged. Deficiency vexation and insomnia occur. "Deficiency" refers to the deficiency of Righteous Qi; "vexation" refers to disturbance by pathogenic factors. Although excess pathogens are removed after sweating, vomiting, and purging, residual pathogens remain in the Upper Jiao due to insufficient Righteous Qi, causing agitation of Yang Qi and resulting in inability to sleep. In severe cases, there must be tossing and turning with inner restlessness ("Ao Nao"). "Tossing and turning" means the body cannot find peace; "inner restlessness" means the heart/mind cannot find tranquility. Apply Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) to induce vomiting. This cannot be eliminated by sweating or purging; inducing vomiting will expel phlegm-fluids and stagnant Qi.
Note: After sweating, vomiting, and purging, if pathogens are not fully cleared, the disease is no longer in the meridians but between the Lung and Stomach, forming tangible pathological products. Therefore, it must be expelled via vomiting. The description of "tossing and turning and inner restlessness" is extremely detailed and precise. Physicians must empathize with patients as if experiencing the symptoms themselves to ensure accurate medication.
After sweating or purging, if vexation-heat and chest oppression occur, the vexation-heat and oppression are slightly more substantial than previous deficiency vexation symptoms. Treat primarily with Zhizi Chi Tang.
During Taiyang cold damage, five or six days later, after violent purging (mis-treatment), body heat persists, and there is knotted pain in the heart/chest area, indicating the disease has not resolved. Both external and internal pathogens remain unresolved; the knotted pain is more severe than simple oppression. Treat primarily with Zhizi Chi Tang. Note: Why not use Xiao Xianxiong Tang (Minor Chest-Harmonizing Decoction) for chest oppression and knotted pain? Because Xiao Xianxiong Tang syndrome involves pain in the Xin Xia (epigastrium/substernal region). The chest is above the heart, so Xianxiong Tang should not be used. Why not use various Xiexin Tang (Drain the Epigastrium Decoctions)? Because Xiexin Tang syndrome involves epigastric fullness-stuffiness (Pi), which is formless Qi stagnation, whereas pain is a tangible sign, so Xiexin Tang should not be used. Ancient physicians treated diseases with precision, ensuring no deviation internally or externally, nor exceeding boundaries vertically.
Yangming disease presents with floating and tight pulse, dry throat and bitter taste, chest fullness and wheezing, fever and sweating, aversion to cold absent but aversion to heat and heavy body present. These are all primary Yangming symptoms, not acquired through mis-treatment. If sweating is induced, irritability, mental confusion, and delirium may occur, indicating Yang deficiency due to excessive sweating. If burning needles are added, fearfulness, palpitations, irritability, and insomnia will definitely occur, reflecting the previous concept of Yang collapse and mania caused by fire-induced sweating. If purging is applied, the Stomach becomes empty, rebellious Qi agitates the Diaphragm, causing inner restlessness. This is because the previous three therapies were likely inappropriate, leading to unresolved disease and these specific manifestations. "Coating on the tongue" is a key diagnostic clue. A white coating on the tongue indicates material accumulation in the chest, allowing for emetic therapy. Otherwise, if pathogens have not yet knotted, there may be nothing to vomit. Treat primarily with Zhizi Chi Tang.
In Yangming disease, after purging, if heat remains on the exterior, it indicates incomplete resolution of exterior pathogens. Hands and feet are warm, ruling out Jie Xiong (Chest Binding). There is no excess pathogen. Inner restlessness, hunger but inability to eat, indicate retention and knotting of phlegm-fluids. Only head sweating occurs because Yang pathogens are above, attempting to vent but failing. Treat primarily with Zhizi Chi Tang.
After diarrhea, if vexation increases, and pressing the epigastrium reveals softness/fluidity (Ru), where "softness" indicates damp stagnation rather than oppression or pain, it constitutes deficiency vexation. Zhizi Chi Tang is appropriate.