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In general, if a patient's body is light and they can turn and change position by themselves, the disease is easy to treat. If the body feels heavy and they cannot turn or change position, it is difficult to treat. This is because in Yin syndromes (syndromes characterized by deficiency of Yang and excess of Yin), heaviness of the body is invariably accompanied by cold feet, curling up while lying down, aversion to cold, a preference for lying with the face towards the wall, keeping eyes closed and avoiding light, and reluctance to see people. Additionally, in Yin toxicity syndromes, the body pain feels as if beaten by a club, and the body is as heavy as a mountain, unable to turn. Furthermore, dampness obstruction and wind-damp bi syndromes also primarily manifest as heaviness and pain in the body, making turning difficult; these must be differentiated. Generally, in Yang syndromes (syndromes characterized by excess of Yang and heat), the body is light, hands and feet are warm, eyes are open, and there is a desire to see people; such cases are treatable. However, if there is a sensation of the head being heavy and vision blurring, this indicates the collapse of the Tianzhu bone (the cervical vertebrae supporting the head and neck) and the failure of Yuan Qi (Original Qi). In the progression of Shanghan (Cold Damage) transmission, symptoms such as picking at clothes and touching the bed, or grasping at empty air with both hands, indicate that the Shen (Spirit) has departed and the Hun (Ethereal Soul) is chaotic. In summary, patients with moist and lustrous skin will survive, while those with dry and rough skin will die. The *Neijing* states: "If the pulse is floating and surging, sweat oozes like oil, panting does not cease, the body is insensible, and consciousness alternates between calmness and confusion, this is a sign of impending death."

(Febrile sensation, Aversion to Cold, Aversion to Wind, Headache, Stiffness and Pain in the Neck and Occiput, Body Pain)
The *Neijing* states: "The manifestation of Taiyang disease (Disease of the Bladder/Large Intestine Channel) includes stiffness and pain in the neck and occiput, along with aversion to wind and cold." Cases that do not transmit to other channels certainly exist, but transmission occurs frequently. As stated in the classics: On the first day of Shanghan, when the Taiyang channel is affected, if the pulse remains quiet, it indicates no transmission; however, if the patient has a strong urge to vomit and the pulse is rapid and urgent, it indicates transmission. It is also stated that if, on the second or third day of Shanghan, symptoms of Yangming disease (Disease of the Stomach/Large Intestine Channel) or Shaoyang disease (Disease of the Gallbladder/San Jiao Channel) do not appear, it indicates no transmission. The treatment methods for the Taiyang channel include sweating (Diaphoresis), vomiting (Emesis), purging (Purgation), warming (Warming and Tonifying), harmonizing (Harmonizing), and acupuncture. This is because the pathogenic factors affecting the Taiyang channel are diverse, leading to various modes of transmission. Although releasing the muscle layer through sweating is one method, syndromes vary in severity and pulses in depth and superficiality; medication must be prescribed according to the pulse and syndrome to truly understand Zhang Zhongjing's profound intent. For example: for febrile sensation, aversion to cold, and a floating-tight pulse, use Mahuang Tang (Ephedra Decoction); for spontaneous sweating, aversion to wind, and a floating-slow pulse, use Guizhi Tang (Cinnamon Twig Decoction). These are fixed methods corresponding to pulse and syndrome. Again: for stiffness in the neck and back with spontaneous sweating and aversion to wind, use Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Pueraria Decoction); for a faint pulse with aversion to cold, use Guizhi Mahuang Ban Tang (Half Cinnamon Twig and Ephedra Decoction); for febrile sensation, aversion to cold, more heat than cold, and a weak pulse, use Guizhi Er Yuebi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction); for a floating-tight pulse, spontaneous sweating, frequent urination, irritability, slight aversion to cold, and cramping in the legs, use Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Decoction). Furthermore: after sweating, if further sweating is indicated but excessive sweating leads to continuous leakage of sweat, aversion to wind, difficulty in urination, mild stiffness in the four limbs, and difficulty in flexion and extension, use Guizhi Jia Fuzi Tang. After taking Guizhi Tang, if massive sweating occurs and the pulse becomes surging, administer Guizhi Tang again using the previous method. If symptoms resemble malaria and occur twice a day, use Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction). Zhang Zhongjing's twenty-seven sweating formulas treat fifty-nine syndromes with great precision. How should Qinglong Tang (Blue Dragon Decoction) be used? How should Wuling San (Five-Ling Powder) be used? How should Fuling Gancao Jiang Tang (Poria, Licorice, and Ginger Decoction) be used? This is due to the variations in disease severity and the urgency of treatment. Mr. Qingbi Du stated: "Yang-heat syndromes in Shanghan and transmitted pathogens undergo varied transformations. If not distinguished precisely, errors in sweating, vomiting, or purging methods can lead to life or death instantly. This differs from Yin-cold pathogens confined to one channel without further transmission, which are easier to treat by simply applying warming herbs according to the severity of the cold. Modern mediocre physicians often favor hot-natured drugs and ignore the subtleties and difficulties of cooling drugs."

[Sweating Method]
Guizhi Tang (Cinnamon Twig Decoction), Guizhi Jia Gegen Tang (Cinnamon Twig Decoction plus Pueraria Decoction), Guizhi Jia Nongpo Xingzi Tang (Cinnamon Twig Decoction plus Pinellia, Magnolia Bark, and Apricot Kernel Decoction), Guizhi Jia Fuzi Tang (Cinnamon Twig Decoction plus Aconite Decoction), Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction minus Peony Decoction), Guizhi Qu Shaoyao Jia Fuzi Tang (Cinnamon Twig Decoction minus Peony plus Aconite Decoction), Guizhi Mahuang Ban Tang (Half Cinnamon Twig and Ephedra Decoction), Guizhi Er Yuebi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction), Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction), Guizhi Qu Gui Jia Fuling Baizhu Tang (Cinnamon Twig Decoction minus Cinnamon plus Poria and Atractylodes Macrocephala Decoction), Gegen Tang (Pueraria Decoction), Gegen Jia Banxia Tang (Pueraria Decoction plus Pinellia Decoction), Gegen Huanglian Huangqin Tang (Pueraria, Coptis, and Scutellaria Decoction), Mahuang Tang (Ephedra Decoction), Da Qinglong Tang (Major Blue Dragon Decoction), Xiao Qinglong Tang (Minor Blue Dragon Decoction), Guizhi Jia Shaoyao Renshen Xinjia Tang (Cinnamon Twig Decoction plus Peony and Ginseng New Formula), Mahuang Xingren Gancao Shigao Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction), Wuling San (Five-Ling Powder), Guizhi Qu Shaoyao Jia Shuqi Longgu Muli Jiuni Tang (Cinnamon Twig Decoction minus Peony plus Coelia, Dragon Bone, and Oyster Shell Rescue Decoction), Guizhi Jia Gui Tang (Cinnamon Twig Decoction plus More Cinnamon Twig), Guizhi Gancao Longgu Muli Tang (Cinnamon Twig, Licorice, Dragon Bone, and Oyster Shell Decoction), Guizhi Fuzi Tang (Cinnamon Twig and Aconite Decoction), Fuling Gancao Jiang Tang (Poria, Licorice, and Ginger Decoction), Wenli San (Clam Shell Powder), Qu Gui Jia Baizhu Tang (Remove Cinnamon Add Atractylodes Macrocephala Decoction), Gancao Fuzi Tang (Licorice and Aconite Decoction).

[Vomiting Method]
Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), Zhizi Gancao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction), Zhizi Shengjiang Chi Tang (Gardenia, Ginger, and Fermented Soybean Decoction), Zhizi Nongpo Tang (Gardenia and Magnolia Bark Decoction), Zhizi Ganjiang Tang (Gardenia and Dried Ginger Decoction), Gouti San (Melon Seed Powder).

[Purging Method]
Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction), Da Chaihu Tang (Major Bupleurum Decoction), Chengqi Tang (Directing Downward Decoction), Chaihu Jia Mangxiao Tang (Bupleurum plus Mirabilite Decoction), Tao Ren Chengqi Tang (Apricot Kernel Directing Downward Decoction), Didang Wan (Reach the Ground Pill), Da Jianxiong Tang (Major Chest-Piercing Decoction), Didang Tang (Reach the Ground Decoction), Da Jianxiong Wan (Major Chest-Piercing Pill), Baisan (White Powder), Shizao Tang (Ten Dates Decoction), Dahuang Huanglian Xiexin Tang (Rhubarb, Coptis, and Heart-Draining Decoction), Fuzi Xiexin Tang (Aconite Heart-Draining Decoction).

[Warming Method]
Gancao Ganjiang Tang (Licorice and Dried Ginger Decoction), Shaoyao Gancao Tang (Peony and Licorice Decoction), Sini Tang (Reverse-Recovery Decoction), Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction), Fuling Guizhi Gancao Dazao Tang (Poria, Cinnamon Twig, Licorice, and Jujube Decoction), Nongpo Shengjiang Gancao Banxia Renshen Tang (Magnolia Bark, Ginger, Licorice, Pinellia, and Ginseng Decoction), Fuling Guizhi Baizhu Gancao Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala, and Licorice Decoction), Shaoyao Gancao Fuzi Tang (Peony, Licorice, and Aconite Decoction), Fuling Sini Tang (Poria Reverse-Recovery Decoction), Guizhi Gancao Tang (Cinnamon Twig and Licorice Decoction), Zhenwu Tang (True Warrior Decoction), Xiao Jianzhong Tang (Minor Constructing the Middle Decoction), Zhigancao Tang (Roasted Licorice Decoction).

[Harmonizing Method]
Xiao Chaihu Tang (Minor Bupleurum Decoction), Chaihu Jia Longgu Muli Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction), Xiao Xiantong Tang (Minor Chest-Penetrating Decoction), Chaihu Guizhi Ganjiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction), Banxia Xiexin Tang (Pinellia Heart-Draining Decoction), Shengjiang Xiexin Tang (Ginger Heart-Draining Decoction), Gancao Xiexin Tang (Licorice Heart-Draining Decoction), Chaihu Guizhi Tang (Bupleurum and Cinnamon Twig Decoction), Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction), Baihu Tang (White Tiger Decoction), Baihu Jia Renshen Tang (White Tiger plus Ginseng Decoction), Huangqin Tang (Scutellaria Decoction), Huangqin Jia Banxia Shengjiang Tang (Scutellaria plus Pinellia and Ginger Decoction).

[Regulating Method]
Chishizhi Yuyuliang Tang (Red Halloysite and Yuliang Stone Decoction), Xuanshu Daihzeshi Tang (Inula, Hematite, and Gastrodia Decoction), Huanglian Tang (Coptis Decoction).

[Acupuncture Method]
Longitudinal and transverse needling of Qimen (LR14); administering Guizhi Tang combined with needling Fengchi (GB20) and Fengfu (GV16); needling Qimen (LR14) for concurrent Taiyang and Shaoyang diseases; needling Qimen (LR14) for heat entering the Blood Chamber; needling Dazhui (GV14) and Feishu (BL13) for concurrent Taiyang and Shaoyang diseases.

The pulse of Taiyang disease is floating, with symptoms of stiffness and pain in the neck and occiput, and aversion to cold. (Cheng Wuji notes: The *Neijing* states that when both Cun and Chi pulses are floating, the Taiyang channel is diseased. Taiyang governs the exterior and is the master of all Yang qi. Floating pulse, stiffness/pain in neck/occiput, and aversion to cold indicate a Taiyang exterior syndrome. Any headache indicates the pathogen is in the exterior.) When Taiyang disease presents with febrile sensation, spontaneous sweating, aversion to wind, and a slow pulse, it is named Wind Strike (Zhongfeng). (The content described in the previous Taiyang line applies here; subsequent lines follow this pattern. Cheng Wuji notes: Wind is Yang, Cold is Yin. Wind injures Wei (Defensive) qi, causing febrile sensation, sweating, and aversion to wind. Ying (Nutritive) pathology causes febrile sensation, no sweating, aversion to wind but not cold. Wei pathology causes febrile sensation, sweating, aversion to cold but not wind. Since Wei is Yang and protects the exterior, when diseased, it fails to secure the exterior, leading to loose pores, sweating, and aversion to wind. Shanghan presents with a tight pulse, while Wind Strike presents with a slow pulse, because Cold is rigid and urgent, while Wind is loose and slow.) For Taiyang disease with headache, febrile sensation, sweating, and aversion to wind, Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. For Taiyang disease with febrile sensation and sweating, this is due to Weak Ying and Strong Wei, causing sweating. To rescue from this Wind pathogen, Guizhi Tang (Cinnamon Twig Decoction) is appropriate. (Cheng Wuji notes: In Taiyang Wind Strike, Wind merges into Wei, making Wei Excess and Ying Deficient. Ying is Yin, Wei is Yang. Febrile sensation and sweating indicate Yin weakness and Yang excess. The *Neijing* states that when Yin is deficient, Yang invades, causing shortness of breath, intermittent fever, and sweating. Administer Guizhi Tang (Cinnamon Twig Decoction) to dissipate the Wind pathogen and harmonize Ying and Wei.) In Taiyang Wind Strike, the pulse is floating on the Yang position and weak on the Yin position. Floating Yang indicates spontaneous heat generation; weak Yin indicates spontaneous sweating. The patient shivers with aversion to cold, chills with aversion to wind, has a mild fever, nasal congestion, and dry retching. Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Cheng Wuji notes: Yang pulse monitors Wei, Yin pulse monitors Ying. A floating Yang pulse indicates Wei affected by Wind; a weak Yin pulse indicates weak Ying qi. Wind merging into Wei makes Wei Excess and Ying Deficient, causing spontaneous fever and sweating. The classic states 'Taiyang disease with fever and sweating is due to Weak Ying and Strong Wei.' 'Sese' describes the feeling of inadequacy and aversion to cold; 'Xixi' describes the chilling sensation of aversion to wind. Wei deficiency causes aversion to wind; Ying deficiency causes aversion to cold. With Weak Ying and Strong Wei, both aversions occur because spontaneous sweating relaxes the skin and loosens pores, contributing to aversion to wind. 'Xixi' describes a mild heat, like feathers covering the body, indicating heat in the exterior. Nasal congestion and dry retching result from Wind obstructing and reversing Qi. Guizhi Tang (Cinnamon Twig Decoction) harmonizes Ying and Wei and disperses the Wind pathogen.) When a patient has no internal organ pathology but experiences intermittent fever and spontaneous sweating that does not resolve, this is Disharmony of Wei Qi. Sweating before the onset of symptoms will cure the condition; Guizhi Tang (Cinnamon Twig Decoction) is the primary treatment. (Intermittent fever and sweating refer to episodes of fever and sweating that stop intermittently, causing the disease to linger. Medication should not be given during the episode but before it starts, waiting for cessation to administer, hence 'prior to its time.' The *Suwen* states: 'When it is full, it must break; when it declines, matters prosper.' This refers to this principle.)

Guizhi Tang (Cinnamon Twig Decoction) Formula:
Guizhi (Cinnamomi Ramulus, 3 liang, bark removed), Shaoyao (Paeoniae Radix Alba, 3 liang), Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Shengjiang (Zingiberis Rhizoma Recens, 3 liang, sliced), Dazao (Jujubae Fructus, 12 pieces, split). The above five ingredients are crushed, boiled in 7 sheng of water with gentle heat until 3 sheng remain, strained, and taken warm. Drink 1 sheng. Shortly after ingestion, drink a bowl of hot thin porridge to assist the medicinal power. Cover warmly for about an hour until a slight perspiration is achieved throughout the body. This is ideal; do not allow profuse sweating like pouring water, or the disease will not be resolved. If sweating occurs after one dose and the illness resolves, stop remaining doses; do not finish the decoction. If no sweating occurs, administer another dose following the same method. If still no sweating, shorten the interval, allowing three doses to be consumed within half a day. For severe cases, administer over 24 hours, observing the patient. If symptoms persist after one dose, prepare another. If no sweating occurs, continue to two or three doses. Avoid cold, raw, sticky, slippery, meat, wheat products, five pungent spices, dairy, and foul-smelling foods. ("Shao cu" in Song edition means "slowly and calmly".)
Cheng Wuji notes: The *Neijing* says Guizhi Tang is primarily for releasing the muscle layer. If the pulse is floating-tight, with fever but no sweating, it must not be given. Remember this always to avoid error. Guizhi Tang (Cinnamon Twig Decoction) specifically treats Taiyang Wind Strike, requiring loose pores and spontaneous sweating where Wind disturbs Wei Qi. Zhang Zhongjing considers releasing the muscle layer lighter than inducing sweating. Therefore, after sweating, vomiting, or purging, if body pain persists due to internal consumption of Jin Ye (Body Fluids), even if an exterior pathogen exists, only releasing the muscle layer is needed, so a small amount of Guizhi Tang (Cinnamon Twig Decoction) is used to harmonize. Guizhi is acrid and hot, used as the Sovereign herb. 'Gui' resembles 'Gui' (jade tablet), guiding other herbs, embodying the principle that Acrid and Sweet disperse Yang. Dispersing Wind requires Acrid as the main component. The *Neijing* states: "For Wind excess, soothe with Acrid, assist with Bitter,缓和 with Sweet, and astringe with Sour." Thus, Shaoyao is the Minister, and Gancao is the Assistant. The *Neijing* says: "For internal Wind,缓和 with Sweet, disperse with Acrid." Shengjiang is Acrid-Warm, Dazao is Sweet-Warm, used as the Envoy. Moreover, this formula is not solely for dispersing; since the Spleen transports fluids for the Stomach, Ginger and Jujube specifically move Spleen fluids to harmonize Ying and Wei. Mahuang Tang (Ephedra Decoction) omits Ginger and Jujube because it focuses purely on inducing sweating, where fluid circulation is not the primary mechanism for achieving permeability.

Pang Anshi notes: For Guizhi Tang (Cinnamon Twig Decoction) syndromes, there is typically spontaneous sweating, normal urination frequency, warm hands and feet (or slightly cool fingertips when exposed, warming when covered), mild whole-body heat, slight irritability, and aversion to cold. It may be used under these conditions. If the patient has no sweating, frequent urination, inverted cold limbs, body coldness, aversion to heat instead of cold, or has recently drunk alcohol, Guizhi Tang (Cinnamon Twig Decoction) must absolutely not be used. A tight pulse definitely indicates no sweating; even if sweating is present, it must not be mistaken for a Guizhi Tang (Cinnamon Twig Decoction) syndrome.

Xu Shimicro notes: A patient with febrile sensation, aversion to cold, spontaneous sweating, and a weak-floating pulse was cured after three doses. This formula ranks first among Zhang Zhongjing's 113 formulas, yet modern practitioners rarely use it. Why? Zhang Zhongjing stated for Taiyang Wind Strike: "Yang floating and Yin weak... mild fever... suitable for Guizhi Tang (Cinnamon Twig Decoction)." The pulse and syndrome are clearly described by Zhang Zhongjing, but later generations failed to understand deeply, fearing its use. If the Cun pulse is weak, it is called Yang insufficiency; Yin Qi enters Yang, causing chills. If the Chi pulse is weak, it is called Yin insufficiency; Yang Qi sinks into Yin, causing sweating. This is due to Yuan Qi (Original Qi) pathology. Yang weakness causes aversion to cold; Yin weakness causes fever. Physicians using sweating deplete Yang, and purging depletes Yin. Generally, when Yin is insufficient, Yang follows inward, causing fever; when Yang is insufficient, Yin invades Yang, causing aversion to cold. These two examples are clear and simple; why hesitate to use Guizhi Tang (Cinnamon Twig Decoction)?

Li Dongyuan notes: Zhang Zhongjing created this formula for Exterior Deficiency. Guizhi is Acrid-Hot, dispersing and assisting Yang, light in nature, rising upwards, thus serving as the Sovereign. Shaoyao and Gancao act as Assistants. If the Yang pulse is choppy and the Yin pulse is string-like, indicating abdominal cramping pain, Xiao Jianzhong Tang (Minor Constructing the Middle Decoction) is formulated with Shaoyao as Sovereign and Guizhi/Gancao as Assistants. One treats Exterior Deficiency, the other Interior Deficiency, each with specific indications. Students should extend this logic. Replacing Guizhi with Rougui (Cortex Cinnamomi) treats cold-induced abdominal pain effectively. In summer heat-induced abdominal pain, adding Huangqin and removing Guizhi stops pain immediately. Guizhi is contraindicated in Spring and Summer.

Tao Hua notes: Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) were designed for contemporary Shanghan, not for later Warm-Heat diseases. Using them to treat Spring Warmth or Summer Heat would be a grave error.

In Taiyang disease, whether fever has appeared or not, there is invariably aversion to cold, body pain, vomiting/reversal of Qi, and a tight pulse at both positions, named Shanghan. (Cheng Wuji notes: The *Neijing* states that injury by Cold results in heat disease because Cold Qi lodges in the channels, causing Yang Qi stagnation and heat formation. Wind Strike causes immediate fever because Wind is Yang. Shanghan mentions 'fever or no fever' because Cold is Yin and does not immediately cause heat; heat forms only after stagnation. Wind injures Wei, Cold injures Ying. Wei deficiency causes aversion to wind; Ying deficiency causes aversion to cold. Ying injured by Cold causes aversion to cold. Qi pathology causes numbness; Blood pathology causes pain. Wind relaxes Qi, Cold reverses Qi. Body pain and vomiting indicate Cold in Ying. The *Neijing* states: 'Full pulse with body cold indicates Cold injury.' A tight pulse at both positions confirms Shanghan. Seeing aversion to cold alone indicates the pathogen is in the exterior; this is a key principle.) For Taiyang disease with headache, fever, body pain, lower back pain, joint pain, aversion to wind, no sweating, and wheezing, Mahuang Tang (Ephedra Decoction) is the primary treatment. (Cheng Wuji notes: Cold injures Ying. Headache, body pain, lower back pain, and joint pain indicate impaired Ying blood in the Taiyang channel. The *Neijing* states: "Wind and Cold invading humans cause hair to stand erect, skin pores to close, and heat to arise," indicating Cold in the exterior. Wind merging into Wei causes sweating and aversion to wind/cold due to Wei Excess and Ying Deficiency. Cold merging into Ying causes no sweating and aversion to wind due to Ying Excess and Wei Deficiency. Because Ying is strong and Wei is weak, Qi rebels causing wheezing. Mahuang Tang (Ephedra Decoction) induces sweating to resolve this.)

Mahuang Tang (Ephedra Decoction) Formula:
Mahuang (Ephedrae Herba, 3 liang, nodes removed), Guizhi (Cinnamomi Ramulus, 2 liang, bark removed), Gancao (Glycyrrhizae Radix et Rhizoma, 1 liang, honey-fried), Xingren (Armeniacae Semen Amarum, 70 seeds, soaked, skin and tips removed). The above four ingredients are boiled in 9 sheng of water. First boil Mahuang, reduce by 2 sheng, remove foam, add other herbs, boil until 2.5 sheng remain, strain, and take 8 ge warm. Cover to induce slight sweating. No porridge is needed. Remainder follows Guizhi Tang (Cinnamon Twig Decoction) method. (When using Mahuang, remove nodes, soak briefly in vinegar-water to prevent excessive sweating. In deep winter with dense pores, use raw Mahuang.) If sweating continues excessively after Mahuang administration, place the patient's hair in a basin of water (keeping feet out), and sprinkle a powder made of roasted glutinous rice (1 sheng), Longgu (Fossilia Ossis Mastodi), Muli (Concha Ostreae), and Fangfeng (Saposhnikoviae Radix, 1 liang each) ground fine over the body. Subsequently use secret formulas to prevent Yang collapse and death; this is an excellent method.

Wu Qian notes: Some say sweating requires Mahuang, but there are contraindications. Why? When Shanghan occurs in cold weather, with Cold pathogen in the exterior closing pores, causing body pain, stiffness, aversion to cold, and no sweating, Mahuang's Acrid-Bitter properties are necessary to open pores, expel Cold, and resolve via sweating. However, in midsummer heat, Mahuang is strictly contraindicated; Acrid-Cool agents like Gegen (Puerariae Radix), Congbai (Allii Fistulosi Bulbus), and Douchi (Sojae Semen Preparatum) should be used instead. Mahuang can be combined with cooling agents, as in Tongjie San (Unblocking Release Powder).

Cheng Wuji notes: Materia Medica states "Light agents can remove excess," referring to Mahuang and Gegen treating Excess patterns where Cold is in the exterior, pores are closed, and the exterior is solid. Light agents lift the pathogen. Mahuang is Acrid-Sweet-Bitter, used as Sovereign because it is a light agent specializing in dispersion. For Wind in the exterior with loose pores, Guizhi releases the muscle layer. For Cold in the channel with solid exterior and closed pores, Guizhi alone cannot disperse; Mahuang must induce sweating, with Guizhi as Minister. The *Neijing* states: "For internal Cold, treat with Acrid-Hot, assist with Acrid-Bitter." Also, "The Liver dislikes tension; eat Sweet to缓和." The Liver masters Ying. In Shanghan, Ying exceeds Wei, blocking blood flow; Sweet herbs缓和 this. Thus, Gancao (Sweet-Flat) and Xingren (Bitter-Warm) are Assistants/Envoys. Guizhi Tang (Cinnamon Twig Decoction) treats Wind Strike; Wind injures Wei, making Wei Excess and Ying Deficient. Zhang Zhongjing states "sweating and aversion to wind is Weak Ying/Strong Wei," so Shaoyao harmonizes Ying. Mahuang Tang (Ephedra Decoction) treats Shanghan; Cold injures Ying, making Ying Excess and Wei Deficient. The *Neijing* states "Qi accumulation causes Blood deficiency, Blood accumulation causes Qi deficiency." Thus, Xingren facilitates Qi movement.

For Taiyang Wind Strike with floating-tight pulse, fever, aversion to cold, body pain, no sweating, and irritability, Da Qinglong Tang (Major Blue Dragon Decoction) is the primary treatment. If the pulse is weak, with sweating and aversion to wind, it must not be administered. Doing so causes cold extremities, twitching muscles, and palpitations, which is adverse. (Cheng Wuji notes: This is Wind Strike presenting with Cold pulse. Floating indicates Wind injuring Wei; Tight indicates Cold injuring Ying. Both Ying and Wei are diseased, causing fever, aversion to cold, and body pain. Wind merging into Wei causes Weak Ying/Strong Wei; Cold merging into Ying causes Strong Ying/Weak Wei. Now Wind and Cold both injure, making Ying and Wei Excess, hence no sweating and irritability. Da Qinglong Tang (Major Blue Dragon Decoction) induces sweating to remove Wind-Cold from Ying and Wei. If pulse is weak, with sweating and aversion to wind, Ying and Wei are Deficient. Taking Qinglong Tang would cause Yang collapse, leading to cold extremities and twitching, which is an adverse reaction.) For Shanghan with floating-slow pulse, body pain absent but heaviness present, fluctuating in intensity, and no Shaoyin syndrome, Da Qinglong Tang (Major Blue Dragon Decoction) induces sweating. (Cheng Wuji notes: This is Shanghan presenting with Wind pulse. Shanghan usually causes body pain; here Wind dominates, so no pain. Wind Strike causes heaviness; here Wind is combined, so heaviness fluctuates. Without cold extremities, vomiting, diarrhea, or Shaoyin interior signs, the exterior Wind-Cold is severe. Da Qinglong Tang (Major Blue Dragon Decoction) disperses exterior Wind-Cold.)

Da Qinglong Tang (Major Blue Dragon Decoction) Formula:
Mahuang (Ephedrae Herba, 6 liang, nodes removed), Guizhi (Cinnamomi Ramulus, 2 liang, bark removed), Gancao (Glycyrrhizae Radix et Rhizoma, 2 liang, honey-fried), Xingren (Armeniacae Semen Amarum, 40 seeds, skin and tips removed), Shengjiang (Zingiberis Rhizoma Recens, 3 liang, sliced), Dazao (Jujubae Fructus, 12 pieces, split), Shigao (Gypsum Fibrosum, size of a chicken egg, crushed). The above seven ingredients are boiled in 9 sheng of water. First boil Mahuang, reduce by 1 sheng, remove foam, add other herbs, boil until 3 sheng remain, strain, and take 1 sheng warm. Aim for slight sweating. If sweating is excessive, dust with warm powder. If sweating occurs after one dose, stop remaining doses. If re-administered, excessive sweating causes Yang collapse, resulting in deficiency, aversion to wind, irritability, and insomnia.

Cheng Wuji notes: Qinglong represents the East, Wood spirit, corresponding to Spring and governing the Liver, promoting growth and nourishing Ying. All things sprout with two divisions; the Liver has two lobes, corresponding to this, hence named Qinglong (Blue Dragon) to disperse Wind-Cold injuring both Ying and Wei, aligning with Liver Wood nature. Guizhi Tang (Cinnamon Twig Decoction) treats Wind Strike; Mahuang Tang (Ephedra Decoction) treats Shanghan. Wind Strike with floating-tight pulse shows Cold features in Wind Strike; Shanghan with floating-slow pulse shows Wind features in Shanghan. This is dual Wind-Cold injury. Wind combined with Cold, or Cold with Wind, cannot be fully resolved by Guizhi Tang (Cinnamon Twig Decoction) alone (dispersing Wind but not Cold) nor Mahuang Tang (Ephedra Decoction) alone (dispersing Cold but not Wind). Hence Zhang Zhongjing specially formulated Qinglong Tang (Major Blue Dragon Decoction) to resolve both. Mahuang is Sweet-Warm, Guizhi is Acrid-Hot. Cold injures Ying, requiring Sweet to缓和; Wind injures Wei, requiring Acrid to disperse. With dual injury, Acrid-Sweet combination disperses. For exterior deficiency with loose pores, Guizhi dominates; for exterior solidity with closed pores, Mahuang dominates. Thus, Mahuang is Sovereign, Guizhi is Minister. Gancao is Sweet-Flat, Xingren is Sweet-Bitter. Bitter-Sweet assists Mahuang in releasing the exterior. Dazao is Sweet-Warm, Shengjiang is Acrid-Warm. Acrid-Sweet combination assists Guizhi in releasing the muscle layer. Wind is Yang pathogen, Cold is Yin pathogen. Wind injures Yang, Cold injures Yin. Dual injury of Ying/Wei/Yin/Yang requires heavy and light agents together to harmonize Yin/Yang and Ying/Wei. Shigao is Bitter-Acid-Mild-Cool, heavy, reaching the muscle layer, acting as Envoy. Da Qinglong Tang (Major Blue Dragon Decoction) is a heavy sweating agent; overuse causes Yang collapse. The *Neijing* warns: "If pulse is weak, with sweating and aversion to wind, do not administer. Doing so causes cold extremities and twitching, which is adverse." Also: "Stop after one dose if sweating occurs. Re-administration causes Yang collapse, aversion to wind, irritability, and insomnia." Use with caution.

Wu Qian notes: Zhang Zhongjing uses Da Qinglong Tang (Major Blue Dragon Decoction) for Shanghan with fever, aversion to cold, and irritability. When exterior pathogen prevents sweating, causing severe irritability, if the pulse is floating-tight or floating-rapid, urgently use this decoction to induce sweating and cure. This is Zhang Zhongjing's brilliant method. Like extreme heat relieved by rain, the principle is clear. Ignoring this and using cooling herbs for irritability causes harm. If the pulse is not floating-tight, but rapid, without aversion to wind/cold or body pain, it must not be used. Misuse causes significant harm. Hence, practitioners unclear on pulse/syndrome often dare not use it.

Xu Shimicro notes: Zhang Zhongjing's Shanghan treatments prioritize: first Guizhi, second Mahuang, third Qinglong. Guizhi treats Wind Strike, Mahuang treats Shanghan, Qinglong treats Wind Strike with Cold pulse or Shanghan with Wind pulse. The three stand firm like a tripod, everyone knows...