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When pathogenic Yang-heat enters the interior in Taiyang cold damage, causing severe heat in the Sanjiao (Triple Burner), accompanied by the four cardinal symptoms of Pi (epigastric fullness/stuffiness), Man (abdominal distension), Zao (intestinal dryness), and Shi (fu-organ excess/accumulation), along with fever, delirium, and a deep, forceful pulse.

Zhi Shi (Immature Bitter Orange, 5 pieces) Hou Po (Magnolia Bark, half jin) Mang Xiao (Mirabilite, three he) Da Huang (Rhubarb Root and Rhizome, four liang, washed with wine). Wang Haicang stated: "When pathogenic factors reside in high positions, only wine can guide the medicinal efficacy there; if raw Da Huang is used, it will fail to clear the heat from the upper regions, potentially leading to sequelae such as red eyes, throat obstruction, head swelling, and heat diseases above the diaphragm after recovery." Use one dou of water, first decoct Zhi Shi and Hou Po until five sheng remain, discard the dregs, add Da Huang, decoct until two sheng remain, discard the dregs, then add Mang Xiao, simmer over low heat for one or two boils, take warm orally, and stop once bowel movement occurs.

"Cheng" means to follow or smooth out. When pathogens enter the stomach, they stagnate fecal matter, causing constipation, blockage, and excess, preventing the Qi mechanism from descending smoothly. Unblocking removes stagnation, purging resolves closure, allowing Qi to flow freely; hence it is named "Cheng Qi". It should only be administered when there is significant fullness and excess with dry stool. If these conditions are not met, it may induce cold syndromes belonging to Jie Xiong (Chest Binding) or Pi Qi (Pi Syndrome). Zhang Zhongjing said: "To use Da Cheng Qi Tang, first administer Xiao Cheng Qi Tang. If flatus follows, dry stool is present, and Da Cheng Qi Tang can be used to purge; if no flatus occurs, do not purge!"

Treat Yangming syndrome in cold damage characterized by delirium, hard stools, tidal fever, and wheezing, as well as miscellaneous diseases involving upper Jiao obstruction with stuffiness and fullness.

Da Huang (Rhubarb Root and Rhizome, four liang) Hou Po (Magnolia Bark, two liang, stir-fried with ginger) Zhi Shi (Immature Bitter Orange, three pieces, bran-fried). Cut into sizes similar to hemp seeds, divide into two doses. Use one zhan of water and three slices of ginger, decoct until half a zhan remains, strain and drink. If unrelieved, administer again.

Treat cold damage presenting with abdominal fullness, dry retching, irritability, thirst, delirium, hardness and pain upon pressing the epigastrium, constipation of both urine and stool, Yangming stomach heat, skin eruptions, and a deep pulse indicating suitability for purgation.

Da Huang (Jin Wen variety preferred) Mang Xiao (Mirabilite) Hou Po (Magnolia Bark) Zhi Shi (Immature Bitter Orange) (each five qian) Gan Cao (Licorice Root, half liang). For each dose using one liang of herbs, decoct with ginger-water until one zhong remains, add Mang Xiao, boil for one round, and take orally in one go.

Treat various febrile conditions where harmonizing methods have failed, presenting with aversion to cold absent but persistent steaming fever, epigastric fullness/hardness or pain, irritability, thirst, dry throat, slippery-rapid-forceful pulse, general abdominal fullness/excess/pain, irritability, thirst, delirium, red urine, hard stools, and slippery-excessive-tight pulse.

Da Huang (Rhubarb Root and Rhizome, soaked in wine) Mang Xiao (Mirabilite, one liang) Gan Cao (Licorice Root, honey-fried, five qian). Adjust dosage according to condition. First decoct the former two ingredients, remove dregs when cooked, add Mang Xiao, boil for two or three rounds, take all at once. Stop when bowel movement occurs; if unrelieved, administer again.