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Due to deficiency of healthy Qi, cold pathogenic factors take the opportunity to invade. Cold pathogenic factors, taking advantage of the body's Qi deficiency, suppress and hide the Yang Qi, preventing it from being disseminated and emitted, thereby forming Jue syndrome (cold extremities). Yu Mao (depression and dizziness) refers to mental confusion and loss of consciousness; Bu Ren (numbness) refers to limb stiffness and lack of sensation, which is called Shi Jue (corpse-like fainting). This is because the stomach lacks grain Qi, causing the Spleen's transport to become sluggish, blocking the flow of Qi between the upper and lower parts, thus resulting in tightness of the mouth and inability to speak. The term "Zhan" (shivering) indicates that cold is in the Exterior; the term "Li" (trembling) indicates that cold is in the Interior.

Question: Why does the Ru pulse (soft pulse) correspond to the "eleven heads"?
Answer: Because the Five Zang and Six Fu organs influence each other through multiplication and subjugation, it is called "eleven formations."
Note: The Ru-Ruo pulse reflects the state of Qi and Blood. The variations involve "eleven heads," where "head" refers to the eleven locations comprising the Five Zang and Six Fu organs.

Question: How do we know if pathogenic factors have invaded the Fu organs? How do we know if they have invaded the Zang organs?
Answer: Whenever Yang pulses (Floating and Rapid) appear, it indicates invasion of the Fu organs; whenever Yin pulses (Slow and Choppy) appear, it indicates invasion of the Zang organs.
Note: Fu organs belong to Yang; seeing Yang pulses indicates invasion of the Fu organs. Zang organs belong to Yin; seeing Yin pulses indicates invasion of the Zang organs. If the pulse is Ru-Ruo, it indicates invasion of the Fu organs; if the pulse is Ru-Ruo, it indicates invasion of the Zang organs.

(Although Cheng Wuji's commentary on Shanghan formulas is quite clear, it fails to exhaustively explain the profound principles of herb properties. Therefore, I specifically select ninety herbs used in Zhang Zhongjing's 113 formulas from *Shanghan Lun*, gathering theories from various schools to elucidate them. If students can study these carefully and investigate in detail, the lost intentions of Zhang Zhongjing (the Changsha太守) in prescribing and formulating will likely not be obscured, allowing one to extend this knowledge and apply it by analogy.)

(Herbs with thin flavors belong to Yang within Yin. Thin flavors promote unblocking; Sour, Bitter, Salty, and Neutral herbs fall into this category.)

**Ephedrae Herba (Mahuang, 麻黄)**: Temperature is Warm; Flavor is Bitter and Acrid. Both Qi and flavor are light/thin, belonging to Yang, governing ascending movement. Non-toxic. It is a formula for the Hand Taiyang channel, enters the Foot Taiyang Bladder channel, travels to the Hand Shaoyin Heart channel and Yangming channels. It induces sweating from the Taiyang and Shaoyin channels.
[Li Gao] Light and dispersing herbs can remove excess solidities, such as Mahuang and Gegen. When excessive pathogens from the six climatic factors lodge in the Yang aspect between the skin and hair, closing the Cou Li (pores) and obstructing the circulation of Ying and Wei Qi and Blood, this is called "Excess." These two herbs have light and clear natures, so they can remove this excess. Mahuang is slightly bitter; its hollow structure represents Yang within Yin. It enters the Foot Taiyang Water channel. This channel runs down the back; originally a Cold Water channel, it is further affected by external cold, making sweating appropriate to expel cold pathogens from the skin and Qi level, relieving exterior excess. However, excessive sweating leads to loss of Yang through sweat; or if used in cases of spontaneous sweating due to dietary/labor fatigue or miscellaneous diseases with deficient exterior, it will deplete the person's Yuan Qi, so caution is essential.
[Zhang Yuansu] Mahuang treats Wei Excess; Guizhi Tang (Cinnamon Twig Decoction) treats Wei Deficiency. Although both are used for Taiyang syndromes, they actually regulate Ying and Wei. The Heart governs Ying (Blood); the Lung governs Wei (Qi). Thus, Mahuang is a Hand Taiyin Lung herb, and Guizhi is a Hand Shaoyin Heart herb. For coughs caused by Shanghan (Cold Damage) or Shangfeng (Wind Strike), using Mahuang and Guizhi constitutes the source of decoctions.
[Li Shizhen] Zhang Zhongjing used Mahuang for anhidrosis (no sweat) in Shanghan, and Guizhi for hyperhidrosis (sweating).历代名医 (Famous doctors through history) explained this merely by following the text without investigating the subtleties. I often ponder and seem to have gained insight differing from previous explanations. Body fluids transform into sweat; sweat is blood. In Ying it is blood; in Wei it is sweat. Cold damages Ying; Ying blood becomes stagnant internally, unable to communicate externally with Wei. Wei Qi closes and secures, body fluids do not flow, resulting in no sweat, fever, and aversion to cold. Wind damages Wei; Wei Qi leaks externally, unable to protect Ying internally. Ying Qi becomes weak, body fluids are not secured, resulting in sweat, fever, and aversion to wind. However, Wind and Cold pathogens enter via the skin and hair, which are the exterior correspondence of the Lung. The Lung governs Wei Qi and encompasses the whole body like Heaven. Although this syndrome belongs to Taiyang, the Lung actually receives the pathogen. Symptoms often include red face, oppression, cough with phlegm, wheezing, and chest fullness—is this not a Lung disease? Generally, when the exterior is closed, pathogenic heat attacks internally, causing stagnation of Lung Qi. Therefore, Mahuang and Gancao (Licorice Root) combined with Guizhi draw out Ying-level pathogens to the muscle surface; Xingren (Apricot Seed) is added to drain Lung and benefit Qi. After sweating, if there is no high fever but wheezing persists, Shigao (Gypsum) is added. Zhu Gong's *Huoren Shu* states adding Shigao and Zhimu after the Summer Solstice are all drugs to drain Lung fire. Thus, although Mahuang Tang is a heavy sweating agent for Taiyang, it is essentially a drug to disperse Fire Stagnation in the Lung channel. If Cou Li are not dense, body fluids leak externally, and Lung Qi becomes deficient. Deficiency requires tonifying the mother (Earth generates Metal), so Guizhi combined with Gancao disperses wind externally to save the exterior and controls Liver Wood internally to prevent attacking the Spleen; Shaoyao (Peony Root) is added to drain Wood and secure the Spleen, draining East (Liver) to supplement West (Lung). Ginger and Jujube are used to move Spleen fluids and harmonize Ying and Wei. After purgation, if slight wheezing occurs, Houpo (Magnolia Bark) and Xingren are added to benefit Lung Qi; if the pulse is deep and slow after sweating, Renshen (Ginseng) is added to benefit Lung Qi. Zhu Gong added Huangqin (Scutellaria Root) to create Yangdan Tang to drain Lung heat. All these act on the Spleen and Lung. Thus, although Guizhi Tang is a light muscle-releasing agent for Taiyang, it is essentially a drug to regulate the Spleen and rescue the Lung.
[Processing] Remove the rhizome and root joints, chop finely, boil in running water for two or three boils, skim off the foam on top, otherwise it causes heart vexation. If sweating continues excessively after taking Mahuang, soak the hair in cold water, or decoct the root joints to stop sweating. When taking Mahuang, avoid wind, otherwise the illness will recur.

**Asari Radix et Rhizoma (Xixin, 细辛)**: Temperature is Warm; Flavor is Very Pungent. Qi is denser than flavor, belonging to Yang. Non-toxic. It is a Shaoyin channel herb and a guiding herb for the Hand Shaoyin channel.
[Li Gao] Treats Shaoyin headache effectively; should be used in small doses, with Du Huo (Angelica Pubescens Root) as the assistant herb, to warm the Yin channels, scatter cold-dampness, and remove internal cold. It treats pathogenic factors in the interior's exterior, hence Zhang Zhongjing uses Mahuang Fuzi Xixin Tang (Ephedra, Aconite, and Asari Decoction) for Shaoyin syndromes.
[Yi Lao] For Shaoyin headache, use Qianghuo (Notopterygium Root) for Taiyang, Xixin for Shaoyin, Baizhi (Angelica Dahurica Root) for Yangming, Chuanxiong (Sichuan Lovage Rhizome) and Wuzhuyu (Evodia Fruit) for Jueyin, and Chaihu (Bupleurum Root) for Shaoyang. Users should follow the channel and not err. Xixin has subtle fragrance and flavor, acting slowly, entering the Shaoyin channel, similar to Du Huo.
[Processing] Select those without double leaves, soak in melon water overnight, dry, chop finely, and use.

**Bupleuri Radix (Chaihu, 柴胡)**: Temperature is Neutral; Flavor is Slightly Bitter. Both Qi and flavor are light/thin, belonging to Yang, governing ascending movement. Non-toxic. It is a guiding herb for the Shaoyang and Jueyin channels. It removes deficiency-heat and vexation, releases muscle heat, eliminates alternating chills and fever, morning tidal fever, and is a must-use herb for women before and after childbirth. It excels at relieving headaches of its own channel, which other herbs cannot stop. It treats epigastric stuffiness and chest/diaphragm pain.
[Zhang Yuansu] In the channels, it governs Qi; in the Zang, it governs Blood. Moving forward implies aversion to heat; retreating implies aversion to cold. Only herbs with slightly cold Qi and thin flavors can travel through channels and remove pathogens inside and outside the Zang-Fu. It guides clear Qi upward to follow the Yang pathway, likely because Shaoyang Qi emerges from the earth like tender young Yang, hence associated with Shaoyang.
[Processing] Remove the rhizome, chop finely, sieve evenly with a bamboo sieve, and use.

**Puerariae Lobatae Radix (Gegen, 葛根)**: Temperature is Neutral; Flavor is Sweet. Non-toxic. It is a guiding herb for the Yangming channel and a traveling herb for the Foot Yangming channel. It treats thirst due to Spleen-Stomach deficiency, clears Stomach heat, and resolves alcohol toxicity.
[Tao Hongjing] Fresh Gegen crushed and juiced and drunk resolves fever from Warm Diseases.
[Su Song] Zhang Zhongjing used Gegen Tang (Kudzu Decoction) for Shanghan because it primarily treats high fever, releases the muscle layer, and opens the Cou Li.
[Li Gao] Raises Yang and generates fluids. For thirst due to Spleen deficiency, nothing else removes it except this. Do not use excessively, lest it damage Stomach Qi. Zhang Zhongjing treated Taiyang-Yangming combined disease by adding Mahuang and Gegen to Guizhi Tang; he also used Gegen Huangqin Huanglian Tang (Kudzu, Scutellaria, and Coptis Decoction) to block the path of Taiyang entering Yangming; it is not purely a Taiyang herb. Severe headache like breaking is Yangming Wind Strike, treatable with Gegen Congbai Tang (Kudzu and Scallion Decoction), a celestial herb for Yangming. If Taiyang disease has just begun and has not entered Yangming, but presents with headache, do not immediately use Shengma (Cimicifuga Rhizome) and Gegen to induce sweating, as this reversely draws pathogens into Yangming, like inviting thieves to destroy the home.
[Li Shizhen] *Bencao Ten Formulas* states light herbs remove excess, such as Mahuang and Gegen. Mahuang is a Taiyang herb, additionally entering the Lung channel (which governs skin/hair); Gegen is a Yangming herb, additionally entering the Spleen channel (which governs muscles). Thus, both are light and dispersing, yet their entry points differ significantly.
[Processing] Chop finely, sieve evenly with a bamboo sieve, and use.

**Cimicifugae Rhizoma (Shengma, 升麻)**: Temperature is Neutral; Flavor is Bitter and Sweet. Flavor is thin, Qi is dense, belonging to Yin within Yang. Non-toxic. It is a primary herb for the Yangming channel.
[Li Gao] It can resolve heat in the muscle layer; it is the specific herb for Wind Strike in the Hand and Foot Yangming channels. To tonify the Spleen and Stomach, it must be used as a guiding herb to achieve tonification. With Congbai (Scallion White) or Baizhi, it can also travel through Hand/Foot Yangming and Taiyin channels to disperse Wind pathogens of its own channel. For those with insufficient Yuan Qi, this herb raises Yang Qi upward from within Yin. Shengma enters the Foot Yangming channel. If Taiyang syndrome at onset is treated with Shengma and Gegen to induce Yangming sweating, or if treatment is delayed leading to Yangming dryness where Taiyang cannot be resolved, transmission to Yangming is inevitable. Incorrect prescription is not only useless but harmful. Zhu氏 says if blood stasis enters the interior, causing nosebleed or hematemesis, Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is the sage medicine for Yangming. If Xijiao is unavailable, Shengma can substitute. Shengma and Xijiao have vastly different properties; why substitute? Merely because Shengma guides Dihuang and other herbs into the Yangming channel. Zhang Zhongjing said if Taiyang disease is treated with sweating or diuresis, severely depleting body fluids, causing dry Stomach and transformation to Yangming, the harm is immeasurable. He also said Taiyang disease with no sweat uses Gegen Tang; if spontaneous sweating occurs, it is exterior deficiency, and this should not be used. Zhu氏 used Shengma because of exterior excess with no sweat.
[Processing] Scrape off black skin, remove rotten parts; the white interior is best. Chop finely, sieve evenly with a bamboo sieve, and use.

**Allii Fistulosi Bulbus (Congbai, 葱白)**: Temperature is Neutral; Flavor is Pungent. Non-toxic. Qi is dense, flavor is thin, governing ascending movement, belonging to Yang. Enters Hand Taiyin and Foot Yangming channels. Primarily governs dispersion to unblock Yang Qi between upper and lower. Hence, *Huoren Shu* treats severe headache from Shanghan with Lianxu Congbai Tang (Scallion White Decoction with Roots). Zhang Zhongjing treated Shaoyin disease with diarrhea of undigested food, interior cold with exterior heat, cold extremities, and faint pulse using Bitong Tang (White Connecting Decoction), internally using Congbai. If face is red, Si Ni Tang (Frigid Extremities Decoction) plus Congbai. If abdominal pain, remove Congbai. Cheng Wuji explained: Kidney dislikes dryness; urgently eat pungent to moisten. Congbai is pungent and warm, unblocking Yang Qi.
[Li Shizhen] Cong is one of the five strong-smelling vegetables in Buddhism. Raw it is pungent and dispersing; cooked it is sweet and warm. Solid outside, hollow inside; it is a vegetable for the Lung. Lung diseases benefit from eating it. Lung governs Qi, corresponds externally to skin/hair, and combines with Yangming. Thus, treated syndromes mostly belong to Taiyin and Yangming, utilizing its function of unblocking Qi and dispersing. Unblocking Qi detoxifies and regulates Blood disorders. Qi is the commander of Blood; when Qi moves, Blood moves. Thus, it has special effects in treating traumatic injuries, etc.

**Melonis Fructus (Gua Di, 瓜蒂)**: Temperature is Cold; Flavor is Bitter. Toxic. Syndromes resembling Guizhi Tang pattern but without headache or neck stiffness, with superficial Floating pulse at Cun position, epigastric hardness, Qi rushing up to throat causing breathing difficulty, indicates Cold in the Chest; vomiting is indicated. Summerheat stroke with body heat, heaviness, pain, and weak pulse indicates Cold Water injury in summer, water moving in skin; vomiting is indicated. Shaoyang disease with headache, chills/fever, tight/small pulse indicates Phlegm above the diaphragm; vomiting is indicated. Various excesses in the chest causing depression/pain, inability to eat, desire for pressure but producing turbid saliva, diarrhea >10 times/day, with slightly wiry pulse at Cun position; vomiting is indicated. Vexation, irritability, insomnia without prior sweating/purging is called Excess Vexation; vomiting is indicated. Food retention in the Upper Jiao; vomiting is indicated. All are suitable for treatment with Gua Di San (Melon Seed Powder). Only patients with blood loss or deficiency constitutions should not receive Gua Di San.
[Cheng Wuji] High things are vented; things above are vomited. Hence, the bitterness of Gua Di and Xiang Chi (Fermented Soybean) induces vomiting; the sourness of Chixiaodou (Red Bean) aids sour-bitter vomiting and drainage, which is Yin.
[Li Gao] *Nan Jing* states: Pulse present above, absent below; the patient should vomit. If they do not vomit, death ensues. This is due to dietary injury filling the chest, damaging the generating Qi of Wood in Taiyin, which lies hidden below. Gua Di San is suitable to vomit it. *Su Wen* says "When Wood is stagnant, it must be reached." Vomiting away tangible matter from the Upper Jiao allows Wood to flourish, Heaven and Earth interact, and all things flow. If Chi pulse is absent, do not use this, lest it damage True Yuan and restore Stomach Qi.
[Li Shizhen] Gua Di is a Yangming channel herb for removing Damp-Heat, thus it guides out Phlegm-Saliva from chest/epigastrium, dampness from head/eyes, water-Qi from skin, and jaundice/Damp-Heat. Good Melon Seeds are round and short. Long ones like bottle gourds are named Vegetable Gourds and should not be used. Harvest when fully mature, naturally falling onto the vine. Tie in a windy place facing East and dry.

**Platycodonis Radix (Jie Geng, 桔梗)**: Temperature is Slightly Warm; Flavor is Bitter, Pungent, Sweet. Slightly toxic. Flavor is dense, Qi is light, belonging to Yin within Yang, governing ascending movement. Enters Hand Taiyin Lung channel Qi level and Foot Shaoyin channel. Treats sore throat, benefits Lung Qi.
[Li Gao] Jie Geng clears Lung Qi and benefits the throat. Its white color makes it a guiding herb for the Lung. Combined with Gancao, it acts as a boat/oar agent. Like Dahuang (Rhubarb Root), a harsh bitter-draining downward herb, if one wishes to guide it to the highest part of the chest, success requires pungent-sweet agents to raise it. Like iron/stone entering a river, without boats/oars it cannot float. Thus, with this herb, other medicines cannot sink.
[Li Shizhen] Zhu Gong's *Huoren Shu* treats chest stuffiness without pain using Jie Geng and Zhike (Aurantii Fructus), taking advantage of unblocking Lung and benefiting diaphragm/downward-moving Qi. Zhang Zhongjing's *Shanghan Lun* treats Cold-Excess Knotting Chest using Jie Geng, Beimu (Fritillaria Bulb), and Badou (Croton Seed), taking advantage of warming middle, digesting grain, and breaking accumulation. It also treats Lung Abscess with pus expectoration using Jie Geng and Gancao, taking advantage of bitter-pungent clearing Lung, sweet-warm draining fire, and expelling pus/blood/nourishing internal leakage. For Shaoyin syndrome with sore throat after 2-3 days, Jie Geng and Gancao are used, taking advantage of bitter-pungent scattering cold and sweet-neutral clearing heat. Combined, they regulate cold and heat. Later generations renamed this Gan Jie Tang (Licorice and Platycodon Decoction) to treat all throat/mouth/tongue diseases. Emperor Renzong of Song added Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), and Lianqiao (Forsythia Fruit), naming it Rusheng Tang (Like Sage Decoction). Remove rhizome, soak in rice wash overnight, bake dry, slice, sieve evenly with bamboo sieve, and use.