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(This prescription is extracted from Volume 10 of the original treatise and attached here.)

Chai Hu (Bupleuri Radix) [4 liang], Gui Zhi (Cinnamomi Ramulus, peeled), Huang Qin (Scutellariae Radix), Ren Shen (Ginseng Radix et Rhizoma) [each 1.5 liang], Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) [1 liang], Ban Xia (Pinelliae Tuber, washed) [2.5 he], Shao Yao (Paeoniae Radix Alba) [1.5 liang], Da Zao (Ziziphi Jujubae Fructus, split) [6 pieces], Sheng Jiang (Zingiberis Rhizoma Recens, sliced) [1.5 liang].

The above nine ingredients. Use seven sheng of water. Decoct to obtain three sheng. Remove the dregs. Take warm.

Hu notes: The above formula is a compound formed by combining the Chai Hu Tang (Bupleurum Decoction) and Gui Zhi Tang (Cinnamon Twig Decoction). It is not called "Gui Zhi Chai Hu Tang" because Chai Hu serves as the sovereign drug. This further indicates that the pathogenic factor in Shaoyang (Lesser Yang) is abundant, while that in Taiyang (Greater Yang) is slight.

In Shanghan (Cold Damage) disease, after five or six days, if sweating has already been applied followed by purgation, and symptoms such as fullness and slight binding in the chest and hypochondrium, difficulty in urination, thirst without vomiting, only sweating on the head, alternating chills and fever, and vexation occur, this indicates the disease has not resolved. Treat with Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction). (This clause also represents a syndrome where Taiyang disease transmits to Shaoyang. After five or six days of Shanghan, sweating was already performed, yet purgation was again used, which cannot be without minor error. Precisely due to the erroneous use of purgation, there is fullness and slight binding in the chest and hypochondrium. "Slight binding" means the pathogen is not severe and has not entered the Fu organs, but resides exactly between the exterior and interior. Difficulty in urination occurs because fluids are depleted after sweating and purging. Since it is fluid depletion rather than retained fluid retention, there is thirst but no vomiting. Only sweating on the head occurs because heat is constrained within the meridians and cannot diffuse outward, thus rising only to the head to cause sweating. Vexation refers to chest vexation. Alternating chills and fever with chest vexation indicate that the Shaoyang pathogen has not resolved. Therefore, Chai Hu Gui Zhi Gan Jiang Tang is given to specifically resolve the pathogen at half-exterior and simultaneously dissipate the binding at half-interior. The above two clauses regarding syndromes and prescriptions are moved from the lower section of the Taiyang chapter and attached here.)

Chai Hu (Bupleuri Radix) [8 liang], Gui Zhi (Cinnamomi Ramulus, peeled) [3 liang], Gan Jiang (Zingiberis Rhizoma) [2 liang], Gua Lou Gen (Trichosanthis Radix) [4 liang], Huang Qin (Scutellariae Radix) [3 liang], Mu Li (Ostreae Concha, roasted) [2 liang], Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) [2 liang].

The above seven ingredients. Use twelve sheng of water. Decoct to obtain six sheng. Remove the dregs. Re-decoct to obtain three sheng. Take one sheng warm. Administer three times daily. After the initial dose, slight vexation may occur; after subsequent doses, sweating will occur and the patient will recover.

Cheng Wuji's commentary cites the *Neijing*: "When heat dominates internally, release it with bitter flavors." The bitter nature of Chai Hu and Huang Qin resolves the pathogen transmitted inward. "Pungent and sweet disperse for Yang"; the pungent and sweet nature of Gui Zhi and Gan Cao disperses the pathogen remaining at the exterior. "Salty softens hardness"; the salty nature of Mu Li eliminates fullness in the chest and hypochondrium. "Pungent moistens"; the pungent nature of Gan Jiang secures sweat caused by Yang deficiency. Fluid insufficiency causes thirst; "Bitter solidifies"; the bitter nature of Gua Lou Gen generates body fluids.

Hu notes: Cheng Wuji's commentary states, "The pungent nature of Gan Jiang secures sweat caused by Yang deficiency." This explanation is highly erroneous. Sweating on the head results from Yang constraint at the exterior, not Yang deficiency above. If it were Yang deficiency, further sweating would be intolerable; how could the post-prescription instructions say "subsequent doses cause sweating"? Moreover, Gan Jiang is pungent and hot; combined with Gui Zhi, it can disperse residual exterior pathogens of Taiyang. To claim it secures sweat, I do not believe it.

Hu notes: The above formula is a modification of Xiao Chai Hu Tang (Minor Bupleurum Decoction). According to the original modification rules: if there is vexation in the chest without vomiting, remove Ban Xia and Ren Shen, add Gua Lou Shi (Trichosanthis Fructus). If thirsty, remove Ban Xia. Currently, there is vexation, thirst, but no vomiting; therefore, Ren Shen and Ban Xia are removed, and Gua Lou Gen is added (4 liang). If there is stiffness and fullness under the ribs, remove Da Zao, add Mu Li. Currently, there is fullness and slight binding in the chest and hypochondrium, which equates to stiffness and fullness; therefore, Da Zao is removed, and Mu Li is added (2 liang). If there is palpitations and difficulty urinating, remove Huang Qin, add Fu Ling (Poria). Currently, there is difficulty urinating, no palpitations, only vexation; this indicates fluid depletion with restlessness and heat, not water accumulation. Therefore, Huang Qin is retained, and Fu Ling is not added. It also states: if coughing occurs, remove Ren Shen, Da Zao, and Sheng Jiang, add Wu Wei Zi (Schisandrae Fructus) and Gan Jiang. Why is Gan Jiang used instead of Sheng Jiang here despite no cough? Gan Jiang is pungent and hot, with two uses: first, to dissipate slight binding in the chest and hypochondrium via its pungency; second, to balance the bitter-cold nature of Huang Qin and Gua Lou Gen with its heat, harmonizing Yin and Yang to cease cold and heat.

After five or six days of Shanghan, if there is vomiting and fever, the Chai Hu syndrome is complete. If other drugs are used for purgation, and the Chai Hu syndrome persists, administer Chai Hu Tang again. Although purgation has been performed, this is not a counter-indication; the patient will inevitably experience trembling and shaking, followed by fever and sweating, leading to resolution. If there is fullness below the heart with hardness and pain, this is Jie Xiong (Chest Binding); treat with Da Xian Xiong Tang (Major Cathartic for the Chest Decoction). If there is fullness without pain, this is Pi (Stagnant Blockage); Chai Hu Tang is not indicated. Instead, Ban Xia Xie Xin Tang (Pinellia Decoction to Drain the Epigastrium) should be used. (This clause involves a Pi-Jie syndrome resulting from erroneous purgation in Shaoyang disease. Cheng Wuji's commentary states: During the fifth or sixth day of Shanghan, when the pathogen is at half-exterior and half-interior, vomiting and fever represent half-exterior and half-interior syndromes, and the Chai Hu syndrome is complete, etc. Regarding resolution through sweating, the annotation is already seen under the appendix examples of Xiao Chai Hu Tang previously. Regarding fullness below the heart, it discusses post-purgation variations to derive treatment methods. However, fullness below the heart must be distinguished by Yin and Yang. If after purgation the pathogen transmits inward and sinks into the chest, Cheng Wuji notes that the chest is the area where Yang Qi receives energy; although the pathogen binds high, hardness and pain necessarily extend downward, constituting Jie Xiong syndrome. Use Da Xian Xiong Tang to purge the binding. If after purgation the pathogen transmits inward and remains below the heart, Cheng Wuji notes that below the heart is the area where Yin Qi receives energy; although blockage is low, Qi rebellion makes it feel high, constituting Pi syndrome. Use Ban Xia Xie Xin Tang to unblock the Pi. Saying "Chai Hu Tang is not suitable for it" means that both Jie Xiong and Pi syndromes arise after the Chai Hu syndrome has ceased, so other formulas like Xian Xiong are appropriate. In my opinion, this clause shows that erroneous purgation in Shaoyang disease can also result in Pi-Jie syndromes. In Volume 5, lower section of Taiyang, it states: Erroneous purgation in Taiyang disease leads to Jie Xiong; erroneous purgation in Taiyin disease leads to Pi. Now, erroneous purgation in Shaoyang disease places the pathogen at half-exterior and half-interior, residing between Yin and Yang, hence also producing Pi-Jie syndromes. The human abdomen is Yin, and the back is Yang. Shaoyang runs along the side of the body, residing between Yin and Yang, constituting half-exterior and half-interior. Furthermore, below the diaphragm is Yin, and above the diaphragm is Yang. Shaoyang resides in the clear pathways and coordinates with the area between the diaphragms, also constituting half-exterior and half-interior. This verifies that in erroneous purgation of Shaoyang disease, the pathogen enters the interior taking advantage of deficiency, distinguishing the origins of Jie Xiong and Pi syndromes. Da Xian Xiong Tang has been seen in Volume 5, lower section of Taiyang.)