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It can guide the Qi of water to ascend, while Talcum (Huashi, 滑石), being heavy and dense in texture, can guide the Qi of fire to descend. When water ascends and fire descends, the principle of Ji Ji (Ji Ji, Hexagram 63: After Completion/Water over Fire) is achieved. Furthermore, Polyporus (Zuling, 猪苓) and Donkey-hide Gelatin (Ejiao, 阿胶), with their black color, communicate with the Kidney, regulating the root of Shaoyin (Shaoyin, Lesser Yin); Poria (Fuling, 茯苓) and Talcum (Huashi, 滑石), with their white color, communicate with the Lung, nourishing the source of Shaoyin; Alisma (Zexie, 泽泻) and Donkey-hide Gelatin (Ejiao, 阿胶), with their salty taste, enter the Kidney first, cultivating the substance of Shaoyin; Polyporus (Zuling, 猪苓), Poria (Fuling, 茯苓), and Talcum (Huashi, 滑shi, 滑石), with their bland taste, promote diuresis in the Bladder, facilitating the function of Shaoyin. These five ingredients all possess sweet and bland properties, obtaining the harmonious Qi of Earth; this represents Earth Qi supporting below the position of Water. All five substances have a moistening and descending nature, serving as agents that nourish Yin and benefit Qi; this represents Yin Essence supporting below the Sovereign Fire. By using these to nourish Yin, promote diuresis, and elevate body fluids, various symptoms will naturally subside.

Sini San (Four Reversal Powder):
Bupleuri Radix (Chaihu, 柴胡), Immature Bitter Orange (Zhishi, 枳实), White Peony Root (Baishao, 芍药), Licorice Root (Gancao, 甘草)

In Shaoyin disease presenting with cold extremities (Jue Ni, 厥逆), diarrhea with a sensation of heaviness in the anus, or accompanied by cough, palpitations, difficult urination, or abdominal pain, this formula is indicated. Shaoyin is the zang organ where Water and Fire coexist. If Water and Fire are disharmonious, Yin and Yang cannot smoothly connect. The limbs are the meeting place of Yin and Yang; thus, cold extremities can be classified into cold syndromes and heat syndromes. When Stomach Yang fails to warm the limbs, it is called Cold Jue (Han Jue, 寒厥); when Yang pathogenic factors internally disturb the Yin aspect, it is called Heat Jue (Re Jue, 热厥). However, since the limbs are not warm, any case of Jue must involve diarrhea. By first examining whether the diarrhea is cold or heat, the nature of the cold extremities becomes clear. Diarrhea with undigested food indicates a cold syndrome, requiring Ginger (Shengjiang, 生姜/干姜) and Aconite (Fuzi, 附子) to strengthen the root of Primordial Yang. Diarrhea with anal heaviness indicates a heat syndrome, hence White Peony Root (Baishao, 芍药) and Immature Bitter Orange (Zhishi, 枳实)—agents with sour and bitter tastes that induce vomiting and purging—are used to clear the heat. Scutellaria (Huangqin, 黄芩) and Coptis (Huanglian, 黄连) are not used because the pathology lies in the Yin aspect, with heat located in the Lower Jiao. Additionally, Bupleuri Radix (Chaihu, 柴胡) with its bitter and neutral nature is used to ascend and disperse, allowing the Minister Fire to spread throughout. Licorice Root (Gancao, 甘草) with its sweet and cool nature is added to alleviate the anal heaviness. Combined as a powder, it disperses excess heat. Taken with rice water, the Middle Qi harmonizes, allowing Yin and Yang in the limbs to reconnect, and the heat in the Three Jiao naturally subsides. From the symptom of diarrhea with anal heaviness, we know that Shaoyin's Yang pathogenic factor is disturbing the Yin; thus, the cold extremities are not due to a cold syndrome. All cases of Jue result from the failure of Shaoyin's pivot mechanism to govern, leading to impaired ascending and descending. Treatment should focus solely on relieving the anal heaviness, without needing to address other symptoms simultaneously. Zhang Zhongjing named this Sini San to distinguish it from Sini Tang (Four Reversal Decoction), given the presence of Jue symptoms. For those with cough, add Schisandra (Wuweizi, 五味子) and Dried Ginger (Ganjiang, 干姜); for palpitations, add Cinnamon Twig (Guizhi, 桂枝); for abdominal pain, add Aconite (Fuzi, 附子); for diarrhea with anal heaviness, add Chinese Leek Bulb (Xiebai, 薤白). These modifications are not suitable for simple diarrhea with anal heaviness. Moreover, why do the dosages vary so significantly—Schisandra, Dried Ginger, and Cinnamon Twig added in small amounts (5 fen), Aconite added as one piece, and Chinese Leek Bulb added in large quantities (3 sheng)? Given that the original powder dosage is only one cun bi (square inch spoonful), it would likely be insufficient for such complex conditions. This clearly indicates later interpolations.

Zhufu Tang (Pig Skin Decoction):
Pig Skin (Zhufu, 猪肤), White Honey (Baimi, 白蜜), Rice Flour (Baifen, 白粉)

Shaoyin disease often involves diarrhea due to deficiency in the Lower Jiao. When Yin is deficient, Yang has no anchor; thus, individuals with Lower Jiao deficiency-cold may paradoxically exhibit Upper Jiao excess-heat. The Shaoyin meridian runs along the throat and flanks the base of the tongue; its branch emerges to connect with the Heart and enters the chest. Whenever Kidney Essence is insufficient and Kidney Fire fails to store, it necessarily travels upward along the meridian to the Yang aspects. Symptoms such as sore throat, chest fullness, and irritability arise because Yin congregates below and Yang congregates above; Heart Fire fails to descend to interact with the Kidney, and Kidney Water fails to ascend to support the Heart, representing the state of Wei Ji (Wei Ji, Hexagram 64: Before Completion/Fire over Water). The pig is an aquatic animal, and its moisture resides in the skin. Using pig skin treats floating fire in the Upper Jiao, combined with the sweetness of white honey and rice flour to drain Heart Fire, moisten the Lungs, and harmonize the Spleen. It nourishes the source of transformation, cultivates the Mother Qi (Kidney nourishing Liver/Lung via Five Elements logic, or generally strengthening the root), promotes water ascent and fire descent, directs upper heat downward, and allows deficient Yang to return to its proper location. Diarrhea stops spontaneously without direct treatment. These three ingredients are foods, not herbs, illustrating that the Dao is found in everyday things.

Gancao Tang (Licorice Decoction):
Licorice Root (Gancao, 甘草)

Jiegeng Tang (Platycodon Decoction):
Licorice Root (Gancao, 甘草), Platycodon Root (Jiegeng, 桔梗)

Banxia Tang (Pinellia Decoction):
Pinellia Rhizome (Banxia, 半夏), Cinnamon Twig (Guizhi, 桂枝), Licorice Root (Gancao, 甘草)

Kuju Tang (Vinegar Decoction):
Pinellia Rhizome (Banxia, 半夏), Egg White (Jizi Bai, 鸡子白), Vinegar (Ku Jiu, 苦酒)

The above four formulas are all designed for Shaoyin sore throat. Since the Shaoyin meridian runs along the throat and flanks the base of the tongue, sore throat occurs. If sore throat arises from other diseases, it need not be treated directly. For example, if the pulse is tight at both Cun and Chi positions, yet sweating occurs accompanied by vomiting and diarrhea, this indicates collapse of Yang (Wang Yang, 亡阳). Only by restoring Yang will vomiting and diarrhea cease, and the sore throat resolve. If diarrhea is accompanied by chest fullness and irritability, this indicates Lower Jiao deficiency and Upper Jiao heat. Ascending Water and descending Fire harmonizes the upper and lower, stopping the pain. If there are no other symptoms and only sore throat exists, it must be differentiated into cold and heat. Appearing within two to three days, it suggests Minister Fire rushing upward; Gancao Tang can be given, using its sweet-cool nature to drain fire and relieve heat. If ineffective, Platycodon Root (Jiegeng, 桔梗) is added to combine with acridity for dispersion, following the principle of "if single prescription fails, use double." These two formulas are mild agents for direct treatment. Since Shaoyin is Yin within Yin, with fine pulses and drowsiness, bitter-cold agents are contraindicated. If Yin syndrome mimics Yang, with aversion to cold and desire to vomit, Gancao and Jiegeng are ineffective. Instead, Pinellia Rhizome (Banxia, 半夏) with its acrid-warm nature disperses rebellious pathogens; Cinnamon Twig (Guizhi, 桂枝) with its sweet-warm nature disperses Yin-cold; Licorice Root (Gancao, 甘草) with its sweet-neutral nature, combined with rice water, forms either a powder or decoction according to the disease's needs. If the throat is injured by pain, forming ulcers and causing loss of voice, it should not be immediately diagnosed as heat. It likely results from vomiting causing throat pain, with phlegm-fluids remaining in the chest. Pinellia Rhizome (Banxia, 半夏) with acrid-warm nature is still used; Vinegar (Ku Jiu, 苦酒) with sour nature astringes ulcers; Egg White (Jizi Bai, 鸡子白) with cooling nature restores voice. The combination reduces Pinellia's harshness, moderates Vinegar's astringency, uses Egg White's moisture to nourish the throat, and prevents phlegm-fluids from obstructing the chest-diaphragm. The preparation method involves placing the egg in a knife ring over fire, boiling only three times before straining. This intent is to slightly expose it to heat without fully extracting Pinellia's flavor. These two formulas are taken by slowly holding and swallowing, representing gentle treatment from the side. The egg resembles the Taiji form, containing both Yin and Yang Qi; the yolk enters the Blood aspect, hence used for irritability and insomnia. This illustrates Zhang Zhongjing's symbolic use of medicinal properties.

The seven formulas for Shaoyin listed above: the first five employ cooling and resolving methods, while the last two employ warming and tonifying methods.