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Treatment for Liver Injury Due to Depression and Anger, with Deficiency of Liver Blood. (Manifestations include emotional depression with irritability, hyperactive Liver Fire, and blood deficiency.) Alternating chills and fever resembling malaria. (There must be initial mild aversion to cold; this is due to Yang Qi sinking into the interior, making this syndrome prone to misdiagnosis.) Five-center heat (heat sensation in the palms, soles, and chest), dry nose, and dry throat. (Blood deficiency generates internal heat.) Dizziness, blurred vision, and dry eyes. (These are the fundamental manifestations of Liver injury and blood deficiency.) Pain in the hypochondrium and ribs. (The Liver meridian traverses the hypochondrium and ribs.) Generalized body pain. (Blood fails to nourish the sinews.) Lethargy and poor appetite. (Disease affecting the mother organ leads to lethargy; Liver Wood overacting on Stomach Earth leads to reduced intake.) Irregular menstruation. (Due to the struggle between blood heat.) Or a heavy bearing sensation in the lower abdomen, painful and difficult urination, or swelling, pain, and pus discharge. (Vaginal itching may also occur; all are caused by Liver Fire, as the Liver meridian encircles the genitalia and reaches the lower abdomen.) Or generalized pruritus, red and white wandering wind (a dermatological condition characterized by migrating erythema), or scrofula and lymphatic nodules. (Liver injury with hyperactive fire causes blood dryness generating wind, leading to skin itching, oozing pus, varying colors from red to white, and unpredictable migration. Scrofula appears as beads strung together, mostly occurring between the anterior/posterior chest and ribs; lymphatic nodules resemble hazelnuts or beans, sometimes strung like beads, occurring anywhere on the head, neck, or limbs. These all belong to Liver Fire and blood dryness causing sinew contraction.)

Chai Hu (Bupleuri Radix) (Able to disperse blood stasis and qi stagnation in various meridians). Bo He (Menthae Haplocalycis Herba) (If Wood Qi is depressed, Xin [acrid] flavors of Chai Hu and Bo He are used to disperse it; each 5 qian. This addition was made by Zhao Xianke. If the acrid-warm nature is disliked, use sparingly, or substitute with cooling-blood and yin-nourishing herbs such as Sheng Di Huang [Rehmanniae Radix], or alternatives like Dan Shen [Salviae Miltiorrhizae Radix]). Ru Zhi Bai Zhu (Milky-processed Atractylodis Macrocephalae Rhizoma) (When Wood is excessive, Earth becomes deficient; Bai Zhu supports Earth. If the aromatic-dry nature is disliked, substitute with Shi Hu [Dendrobii Caulis], Yi Yi Ren [Coicis Semen], or Shan Yao [Dioscoreae Rhizoma]). Fu Ling (Poria) (When Wood is withered, it burns easily; Wood and Fire communicate, disturbing the Heart; Fu Ling calms the Spirit. I often combine it with Mai Dong [Ophiopogonis Tuber] to clear Heart heat and descend fire). Gan Cao (Glycyrrhizae Radix et Rhizoma) (The Liver is the General; when Fire moves, it is fierce. Zhu Danxi stated: When Fire is extreme, sudden use of cold-cooling herbs is contraindicated, lest suppression cause rebound flare-up. Raw Gan Cao clears heat while moderating intensity, calming the rampant Fire. Each 1 qian). Add Dan Pi (Moutan Cortex) (Cool blood and invigorate blood), Hei Shan Zhi (Gardeniae Fructus, charred) (Drain fire, each 0.5 fen). Named Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). Zhao Xianke believed Shan Zhi descends water via its curved structure, suggesting substitution with Wu Zhu Yu (Evodiae Fructus) and Huang Lian (Coptidis Rhizoma) stir-fried with ginger juice. Lü Wancun stated: Shan Zhi does not only treat water retention, but Huang Lian is more versatile, reaching the depression of the Heart and Stomach in the upper jiao! I assert that for acid regurgitation, it works miraculously.

This formula combines acrid dispersing, sour astringing, and sweet-slowing blood-nourishing properties, along with calming the Heart and supporting the Spleen. It is a key herb for the Liver channel and a miraculous agent in gynecology. Cang Gong (Chunyu Yi) passed it down to Chu... Alternating chills and fever resembling malaria, which over time develops into consumptive disease (Lao). I believe women are generally prone to depression; anger and depression injure the Liver, causing qi knotting and blood coagulation, leading to hyperactive fire and blood deficiency, resulting in Lao. Thus, the previous discussion states: virgins who do not laugh often, as well as widows, nuns, and monks, are susceptible to this syndrome. Li Jiezi's *Gynecological Medical Cases* frequently uses this formula with repeated success. It further states: For cases where depression and anger injure the Liver causing chills and fever, accompanied by palpitations, insomnia, and poor appetite, combine with Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). Li Shizhen stated: Kou Zongshi claimed there is not a single word in the Materia Medica about Chai Hu treating Lao, excluding it regardless of whether organs have heat or not, which is not a comprehensive view. Li Dongyuan stated that Chai Hu should be added for conditions with heat and removed for those without. I argue that Lao involves five types of exhaustion and diseases affect five zang organs. Chai Hu is a guiding herb for the Liver, Gallbladder, Pericardium, and Triple Burner. Therefore, if Lao is in the Liver with malaria-like chills and fever, it is appropriate to use; however, if Lao is in the Lung or Kidney, it should not be used. Shen Shi stated: If the disease originates in the Liver, presenting first with hypochondriac pain followed by cough, this is Wood carrying Pericardium Ministerial Fire to punish Metal. Treat the root first by adding herbs that clear the Lung, while addressing the branch, adhering to the principle of soothing the Liver when depression is severe. Zhang Jingyue (Jiayan) stated that for Lao with aversion to cold and fever, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is contraindicated. He also stated that for bone-steaming fever, where heat is deep within, all light and ascending agents are contraindicated, as they may draw heat outward, increasing its intensity and burning up fluids and muscles. This aligns with the statement above that Chai Hu is not used for Lao in the Lung and Kidney. Zhao Xianke highly praised the wide application and miraculous efficacy of this formula. For all symptoms including alternating chills and fever like malaria, vomiting and acid regurgitation, epigastric discomfort, chest and hypochondriac pain, lower abdominal distension, dizziness, night sweats, jaundice, wind-warmth, hernia, and undigested food diarrhea, as well as all depression syndromes, this is a symptomatic formula; with modifications, it achieves efficacy. I analyze: For nuns and widows, once desire arises, the Ministerial Fire in the Kidney inevitably moves; prolonged movement depletes Kidney Water. Depression and anger injure the Liver, causing hyperactive fire and blood deficiency, leaving Liver Wood withering. Without Kidney Water irrigation, it is like dry wood fueling a raging fire, uncontrollable. Although using this formula, one must primarily strengthen Water (nourish Yin).