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Taiyin disease is primarily treated with Lizhong Wan, and Jueyin disease is primarily treated with Wu Mei Wan. Pills act to slow down. The "slowing" in Taiyin is used to harmonize the Qi of the Spleen and Stomach; the "slowing" in Jueyin is used to restrain the rebellion of Ministerial Fire (physiological fire residing in the Liver and Gallbladder). Observing the main formulas listed in this section: when treating cold hands and feet with a faint pulse almost imperceptible, Ginger Rhizome (Shengjiang) and Aconite Root (Fuzi) are not used; when treating diarrhea with a deep and knotted pulse, Phellodendron Bark (Huangbai) is used; when treating palpitations with a intermittent pulse (Dai pulse), Rehmannia Root (Shengdihuang) and Ophiopogon Tuber (Maidong) are used. This is all because the Liver possesses Ministerial Fire, which should be purged rather than tonified, unlike the deficiency Yang floating from the Kidney, which requires warming and tonification. All three Yin meridians have heat syndromes specific to their own channels: The heat in Taiyin is excess heat in the Spleen moving the Yang of the Stomach cavity; the heat in Shaoyin is Kidney Yin deficiency causing Yuan Yang to scatter; the heat in Jueyin is excessive heat in the Liver and Gallbladder with stifled fire generating internal heat. The world is misled by the theory of pathogenic heat transmitted through the meridians. When encountering heat syndromes of the three Yin meridians, they often lack direction. Seeing fever with a deep pulse, they diagnose it as a Yang syndrome; seeing a Yin pulse, they dare not treat it; encountering wind-stroke with diarrhea, they recklessly call it "Lou Di Shang Han" (leaky bottom cold damage). Not understanding Zhang Zhongjing's theories, and therefore daring not to use his formulas, is this not ignorance?

Wu Mei Wan:
Dark Plum (Wumei), Dried Ginger (Ganjiang), Cinnamon Twig (Guizhi), Prepared Aconite Child Lateral Root (Fuzi), Sichuan Pepper (Shuchuanjiao), Coptis Rhizome (Huanglian), Phellodendron Bark (Huangbai), Ginseng Root (Renshen), Angelica Sinensis Root (Danggui), Asarum Root (Xixin).

Among the Six Meridians, Jueyin disease is the most difficult to treat. Its root is Yin, its branch is Heat; its substance is Wind-Wood, its function is Ministerial Fire, embodying the principle of the waxing and waning moon. When Yin is about to exhaust, Yang begins to emerge. Thus, one Yang is recorded, and one Yin stands alone. Therefore, the fever in Jueyin disease is caused by the Ministerial Fire of Shaoyang. When Fire is excessive, Water is deficient, leading to Xiao Ke (wasting-thirst/polydipsia); when Qi is excessive, it becomes Fire, leading to a sensation of Qi rushing up to strike the Heart; pain and heat in the heart region occur because Wood overacts on Earth, leading to hunger without desire to eat, which is the manifestation of Wind. When hungry, the Stomach is empty, and roundworms smell food odor and emerge, leading to vomiting of worms. This is a Fire syndrome of Jueyin, not a Cold Damage syndrome of Jueyin. The *Neijing* states: "You must subdue what dominates the disease, and first address its cause. Use astringency or dispersion, counteraction or compliance, acting according to what is beneficial, regulate the Middle Qi, and bring it to peace." This is the treatment method for Jueyin. Zhang Zhongjing's formulas mostly use Pungent-Sweet or Sweet-Cool herbs as Sovereign drugs. Only this formula uses Sour-astringent herbs because Jueyin governs the Liver and belongs to Wood. The *Hongfan* says: "Wood is crooked and straight; crookedness and straightness produce Sour." The *Neijing* says: "Wood generates Sour; Sour enters the Liver; use Sour to purge the Liver, use Sour to astringe the Liver." Using the great Sourness of Dark Plum as the Sovereign drug is to subdue what dominates the disease. Assisting with Coptis Rhizome to purge Heart Fire and remove stuffiness, and Phellodendron Bark to nourish Kidney Yin and remove thirst addresses the cause first. The Kidney is the Mother of the Liver; using Sichuan Pepper and Prepared Aconite Child Lateral Root to warm the Kidney gives Fire a home, allowing the Liver to be nourished, thus securing the root. The Liver desires dispersion; Asarum Root and Dried Ginger disperse it; the Liver stores Blood; Cinnamon Twig and Angelica Sinensis Root guide blood back to the vessels. Cold and Hot herbs are used together, and Five Flavors are collected. Because the flavors do not harmonize, Ginseng Root is added to regulate Middle Qi. Soaking Dark Plum in vinegar seeks similar energies; steaming under rice utilizes grain Qi. Adding honey to make pills, taking small amounts and gradually increasing the dose, treats the root with slowness. Zhang Zhongjing's formula was originally the method for treating various Jueyin syndromes. Wang Shuhe placed it under the clause for vomiting worms, making people unaware that it is the master formula for Jueyin. Looking at its ingredients, they match various symptoms; does it only target vomiting worms? Roundworms are creatures of cold and rawness, formed with damp-heat, so Cold and Hot herbs are used mutually to treat them. Moreover, chest irritability with vomiting worms indicates Huanglian and Huangbai are used as "cold for hot" treatment. Worms become quiet with Sour, dormant with Pungent, and descend with Bitter. No vermifuge formula surpasses this. Chronic diarrhea leads to deficiency; regulating Cold and Heat, supporting healthy Qi, and using Sour to astringe will stop the diarrhea. My commentary: For various syndromes of Jue cold and fever where no formula is given in other clauses, one should know the treatment method lies within this formula.

Danggui Sini Tang:
Cinnamon Twig (Guizhi), White Peony Root (Shaoyao), Angelica Sinensis Root (Danggui), Asarum Root (Xixin), Thoroughwort Herb (Tongcao), Licorice Root (Gancao), Jujube Fruit (Dazao).

Danggui Sini Tang plus Evodia Fruit and Fresh Ginger Decoction:
The above formula plus Evodia Fruit (Wuzhuyu), Fresh Ginger (Shengjiang), and Wine.

This is a formula for dispersing exterior pathogens in Jueyin Cold Damage. Jueyin resides at the convergence and end of two Yins, named "Yin's Extinct Yang." Exterior invasion by Cold causes Yin and Yang Qi to fail to connect smoothly, resulting in cold hands and feet and a faint pulse almost imperceptible. However, Ministerial Fire resides in the Jueyin Zang organ. If the Zang Qi is solid and hot, Cold pathogens cannot invade. If only the meridians are injured externally and the Zang organs internally, then those who first experience Jue will later experience fever. In early stages of Cold Damage, if there is no interior Cold syndrome but extreme exterior Cold, one should only warm and disperse the exterior, not hastily tonify. This formula uses Guizhi Tang to resolve the exterior, with Danggui as the Sovereign drug because Jueyin governs the Liver, which is the Blood Chamber. The Liver suffers from tension; Sweet flavor relieves it, hence doubling the amount of Jujube Fruit, similar to the method of adding Maltose in Xiaojianzhong Tang. The Liver desires dispersion; it should be dispersed with Pungent flavor. Asarum Root's Pungency can unblock Qi and Blood of the three Yin meridians, reaching the hair follicles externally, more potent than Ephedra Herb, capable of dispersing severe Cold in the exterior. Fresh Ginger is not used to avoid horizontal dispersion. Thoroughwort Herb (i.e., Akebia Stem) opens the nine orifices and joints, opening the closure of Jueyin and moving Qi in the Liver. Despite such severe Yin Cold, Shaoyao is still used to prevent harm from Ministerial Fire. In this formula, Guizhi combined with Danggui and Shaoyao generates Blood in the Ying level; Xixin combined with Tongcao moves Qi in the Wei level; Gancao combined with Dazao harmonizes Qi and Blood. By relaxing the Middle to regulate the Liver, Ying Qi reaches the Hand-Taiyin Lung meridian, and the pulse naturally continues; warming the exterior to expel pathogens allows Wei Qi to circulate to the four extremities, and hands and feet naturally warm. There is no need for tonification by Codonopsis Root or Atractylodes Macrocephala Rhizome, nor drying effects of Dried Ginger and Cinnamon Twig. This Jueyin Ni (reversal cold) is treated differently from Taiyin and Shaoyin, yet still adheres to the principle that Pungent-Sweet dispersion is Yang. If the person has chronic interior Cold, their Ministerial Fire is also insufficient. Adding the Pungent-Hot Evodia Fruit reaches the Jueyin Zang directly; the Pungent dispersion of Fresh Ginger floods the sinews; clear wine warms the collaterals, preventing sinew flaccidity. Thus, Qi and Blood remain normal, limbs warm, and pulse returns. This is another formula for Jueyin suffering from both interior and exterior Cold, suitable for cold accumulation in the Bladder causing lower abdominal fullness and pain with cold limbs.

Xiaojianzhong Tang:
Cinnamon Twig (Guizhi), White Peony Root (Shaoyao), Licorice Root (Gancao), Fresh Ginger (Shengjiang), Jujube Fruit (Dazao), Maltose (Yitang).

Jueyin governs closure. Exterior invasion by Cold causes Liver Qi to stagnate, Heat to suppress below, damaging Middle Qi. Hence this formula is created. For unresolved exterior conditions in all six meridians, Guizhi Tang is used to resolve the exterior. For example, if Taiyin is affected by downward陷陷 of Yang pathogens due to mistaken purgation in Taiyang, Guizhi Tang with doubled Shaoyao is used to purge Wood pathogen attacking Spleen. Here, Liver Fire presses upon Heart and Spleen. In Guizhi Jia Shaoyao Tang, Maltose is added to take Sour-Bitter to calm Liver Fire, Pungent-Sweet to relieve Spleen urgency, and supplement Grain Qi to harmonize the Middle. This formula secures the interior and repels the exterior, purging while tonifying, hence named "Jian" (Establish). Since exterior symptoms remain, Ginger and Cinnamon are still used to disperse the exterior, not solely focusing on the interior, hence called "Xiao" (Small). "Middle" refers to two places: the Heart center and the Abdominal center. For instance, in Cold Damage after two or three days, palpitations and irritability in the Heart indicate Jueyin Qi rebelling upward to the Heart. This is slightly milder than pain and heat in the heart region, distinguishing between deficiency and excess. Pain with heat is Excess, requiring Bitter-Cold to purge Heart Fire; palpitations with irritability are Deficiency, requiring Sweet-Warm to protect Heart Qi. This establishes the palace city of the abdomen. In Cold Damage, if Yang pulse is choppy and Yin pulse is wiry, with acute abdominal pain, it indicates Jueyin rebellious Qi invading Spleen and Stomach. This is heavier than hunger without desire to eat or vomiting worms upon eating, distinguishing between substantial and insubstantial forms. Vomiting worms upon eating is substantial, requiring Sour-Bitter to calm worms; acute abdominal pain is insubstantial, requiring Pungent-Cold to stop pain. This establishes the metropolis of the abdomen. Those who do not understand Jueyin diseases do not understand Zhang Zhongjing's rationale for Jianzhong Tang; not knowing the Gallbladder resides within the Liver means not understanding the method of treating interior before exterior. Although Cold comes from outside, Heat originates from within. One must first open Jueyin's closure to turn Shaoyin's pivot; first calm the wiry Yin pulse of Jueyin to unblock the choppy Yang pulse of Shaoyang. This is why for abdominal pain, Xiaojianzhong Tang is given first, and if ineffective, Xiaochaihu Tang follows. Whenever Shaoyao is used for abdominal pain, it is due to Ministerial Fire pathology. If caused by deficiency-Cold, it is highly inappropriate, hence the distinction between Jianzhong Tang and Lizhong Tang. Question: If abdominal pain is warmed with Xiaojianzhong Tang and then cooled with Xiaochaihu Tang, is it first Heat then Cold? Is Zhang Zhongjing just testing? Answer: "Ineffective" means not yet cured, not worsened. First using Jianzhong Tang resolves muscle layer and releases exterior, stopping pain via Shaoyao; subsequently using Chaihu tonifies middle and expels pathogens, stopping pain via Renshen. According to Chaihu modification rules, for abdominal pain, Huangqin is removed and Shaoyao added, doubling the efficacy of Jianzhong Tang. Knowing Yang pulse remains choppy, Renshen aids Guizhi; Yin pulse remains wiry, Chaihu aids Shaoyao. If cured after one dose of Jianzhong Tang, neither Renshen's tonification nor Chaihu's dispersion is needed.

Fuling Gancao Tang:
Cinnamon Twig (Guizhi), Fresh Ginger (Shengjiang), Poria (Fuling), Licorice Root (Gancao).

This is a sweating agent for dispersing interior pathogens in Jueyin Cold Damage. Whenever Cold Damage presents with Jue and palpitations below the heart, water should be treated first, then Jue; otherwise, water will infiltrate the Stomach and cause diarrhea. This formula intends to promote urination but uses exterior-releasing herbs for interior syndromes, hence named with an interior herb despite heavy use of Ginger and Cinnamon. In Jueyin Cold Damage, those who first have fever will later have Jue, and during fever, they will have Xiao Ke. Now presenting with Jue and palpitations below the heart indicates the source of diarrhea; at this time, there is no heat or thirst. Because excessive drinking during Xiao Ke phase led to water Qi below the heart failing to transform into sweat, accumulating and not dissipating, causing cold limbs and palpitations. The Lung is the mother of Water; if Lung Qi fails to transform, Water Qi does not move. Poria transforms Qi, clearing the source of water. Combined with Polyporus and Alisma Rhizome, it executes Western descending command,输输 to Bladder as urine. Cinnamon Twig and Fresh Ginger enter Lung via Pungent flavor, allowing Water Qi to communicate with Lung, moving Ying-Wei and Yin-Yang, exiting to muscle surface as sweat. Assisted by Gancao to moderate, whole-body sweating stops Jue, water essence distributes, and palpitations settle. Treating water is treating Jue. Jueyin thirst occurs before sweating; Taiyang thirst occurs after sweating. For Cold Damage with palpitations, sweating, and thirst, water Qi does not move and fluids are deficient; mild sweating disperses water Qi, hence Wuling San. For Cold Damage with palpitations, no sweating, and no thirst, fluids are intact; strong sweating is possible, hence this formula. Wuling San uses mild sweating, so little Guizhi is added, and Baizhu replaces Shengjiang to fear water infiltrating Spleen. This formula uses equal parts Ginger, Cinnamon, and Fuling, without Shaoyao and Dazao, for strong sweating. Gancao assists Pungent sweating and fears water infiltrating Stomach. Jueyin Jue without diarrhea, or Jue followed by diarrhea, occurs because weak Heat cannot transform water, water infiltrates Stomach. Zhang Zhongjing mentions symptoms but not treatment. Sweating with this formula stops diarrhea, following the principle of "lifting those that sink." This formula is a harsh sweating agent, differing from Mahuang Tang in intent but similar in rapid effect. Because water Qi is below the heart, not in skin/hair, Mahuang is not used; palpitation without panting, Xingren is not used; exterior not hot, interior not thirsty, Xiao Qinglong Tang is not used. Zhang Zhongjing's water-transforming sweating agents are not like this.

Commentary: Cold Damage with sweating and thirst is the divergence point between Shanghan and Wenbing, deserving attention. Know that non-chills but aversion to heat is Wenbing; having water Qi and palpitations below heart is still Shanghan. Without water Qi, Wuling San becomes drying-hot, a fire-stoking medicine for Wenbing.

Zhigancao Tang:
Roasted Licorice Root (Zhigancao), Ginseng Root (Renshen), Donkey-hide Gelatin (Ejiao), Hemp Seed (Haren), Cinnamon Twig (Guizhi), Ophiopogon Tuber (Maidong), Fresh Ginger (Shengjiang), Jujube Fruit (Dazao), Clear Wine, Rehmannia Root (Shengdihuang).

In Jueyin Cold Damage, Ministerial Fire is suppressed internally, Liver Qi stagnates, Blood Chamber dries up, causing Ying Qi imbalance and choppy pulse with Dai/Jie characteristics. As Cheng Jiaoqian said: "This is knotting unable to advance, replaced by beating, not Yin excess." In Jueyin disease, Qi rushes to Heart, causing palpitations. This palpitation stems from Dai/Jie pulse, without cold limbs, not caused by water Qi. Without Sweet-Cold abundant fluids to nourish Yin and harmonize Yang, Liver Fire persists, Heart Blood fails to generate. Heart unsettled, palpitations continue; pulse abnormal, how to regulate Dai/Jie? Thus, Shengdihuang is Sovereign, Maidong is Minister, Zhigancao is Assistant, heavily tonifying True Yin, opening the path for Yin-nourishing schools. Named after Gancao to carry drugs to Heart, tonifying Empty Li to calm Shenming. However, large Cold agents cannot support sprouting and flourishing mechanisms. Renshen and Guizhi assist Maidong to unblock pulse; Ginger and Dazao assist Gancao to harmonize Ying; Ejiao and Haren assist Dihuang to tonify Blood; Gancao prevents rapid descent; Clear Wine guides upward. Shengdihuang and Maidong benefit from Wine power.

Shao Kun San:

Transmission via sexual intercourse is a rare disease. The transmitter initially had Cold Damage but planted Desire Fire; the receiver had Desire Fire but manifested as Yin deficiency. This is the origin of Yin-Yang Yi disease. No exterior chills/fever, no interior excess/diarrhea. Caused by interaction of essences, manifesting immediately, different from winter failing to store Essence leading to spring Warmth disease. Where pathogens gather, Qi is deficient. Yin deficiency attracts Yang, causing shortness of breath and heat rushing to chest; Qi insufficient to move, head heavy and body heavy; Pathogen strikes Yin, genital cramping; Chong-Ren meridians injured, lower abdominal urgency; Spirit scattered, visual spots; Sinews/bones shaken, knee/shin cramping; Disease from Kidney, toxin invades water pathways, difficulty urinating. Minerals likely cannot cure; must rely on Yin-Yang resonance. Underwear guards male/female Yin-Yang. Guarding outside clears inside. Formless pathogens treated with form. Taking hidden underwear, burning and ingesting, form-Qi resonates, urination resumes. Glans slight swelling, turbid Yin exits lower orifice, clear Yang exits upper orifice, desire fire calms, symptoms cease. Male takes female's, female takes male's. Better treated with Liuwei Dihuang Wan combined with Shengmai San.