Library

Shen Shi's formula treats cold damage after six or seven days. Sweating fails to resolve the pathogen. Symptoms include vomiting and rebellious qi, diarrhea, and dysuria (difficult urination). There is fullness and stuffiness in the chest and hypochondrium, slight fever, and vexation. Here is the Huangqin Tang (Scutellaria Decoction).

Huangqin (Scutellariae Radix), Guixin (Cinnamomi Cortex) (each 3 liang), Fuling (Poria), Qianhu (Peucedani Radix) (8 liang), Banxia (Pinelliae Rhizoma) (half sheng, washed).
The above five herbs are sliced. Boil with 12 dou of water until reduced to 6 sheng. Divide into six doses. Take three doses during the day and three at night. Consume ginger porridge between meals. The condition is considered cured when urination becomes smooth.
Hu notes: Regarding the aforementioned indications, "sweating fails to resolve the pathogen, and the pathogen enters the chest and hypochondrium causing fullness" indicates a Shaoyang disease (disease of the Shaoyang channel). The mentions of vomiting and rebellious qi, dysuria, slight fever, and vexation suggest a pattern suitable for modification of Xiaochaihu Tang (Minor Bupleurum Decoction). However, the mention of diarrhea suggests a combined disease of Taiyin and Shaoyang. This formula is named Huangqin Tang, which is significantly different from Zhang Zhongjing's Huangqin Tang. Nevertheless, each has its own brilliance. The use of Huangqin and Qianhu in this formula treats vexation, heat, and fullness in the chest and hypochondrium. The use of Banxia and Fuling stops vomiting and promotes urination. Once urination is smooth, diarrhea will cease naturally. The use of Guixin has two purposes: first, to assist Qianhu in dispersing cold pathogens lingering on the exterior; second, to guide Fuling to unblock damp-water retention in the Bladder. In summary, one should not adhere rigidly to this formula. If there is interior heat and excess Yang, Guixin should be removed. I believe that if vomiting is severe, add Juhong (Citri Reticulatae Pericarpium Rubrum); if fullness is severe, add Zhishi (Aurantii Fructus Immaturus); if vexation is severe, add Gualou Shi (Trichosanthis Fructus); if diarrhea with abdominal pain occurs, add Baishao (Paeoniae Radix Alba). Modifications in clinical practice depend entirely on the practitioner's understanding.

Yao Shi Ji Yan treats cold damage unresolved after seven or eight days. The patient is silent and feels internally vexed and stifled, with dry feces in the abdomen and delirium.

Chaihu (Bupleuri Radix), Banxia (Pinelliae Rhizoma, washed with decoction, each 8 liang), Shengjiang (Zingiberis Rhizoma Recens) (4 liang), Zhimu (Anemarrhenae Rhizoma), Shaoyao (Paeoniae Radix), Dahuang (Rhei Radix et Rhizoma), Weirui (Polygonati Odorati Rhizoma) (each 2 liang), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried).
Another version adds Zhishi (Aurantii Fructus Immaturus) (4 liang) and Huangqin (Scutellariae Radix) (2 liang).
The above ten herbs are sliced and boiled with 1 dou of water until reduced to 3 sheng. Strain the dregs. Take 1 sheng warm, three times daily.
Hu notes: The above formula is essentially Zhang Zhongjing's Dachaihu Tang (Major Bupleurum Decoction), with slight modifications to its preparation. Zhang Zhongjing's original formula contains Dazao (Jujubae Fructus) but lacks Gancao. Essentially, Gancao and Dazao share similar sweet and warm properties. Furthermore, regarding the aforementioned indications, "silent and internally vexed/stifled" corresponds to the "depressed and slightly vexed" described in Zhang Zhongjing's Dachaihu Tang syndrome, with identical meaning. However, "vexation and stifling" here indicates extreme heat, more severe than "slight vexation." Therefore, in Dachaihu Tang, Zhimu and Weirui, with their bitter-cold and sweet-moistening properties, are added to clear and resolve the heat.