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The source of cough caused by *Zhiyin* (fluid retention in the chest) in the chest can be addressed without hastily seeking miraculous formulas outside standard texts (those who have thoroughly studied *Jingui Yaolue* will naturally understand this). There is also the method of modifying *Xiaochaihu Tang* (Minor Bupleurum Decoction) to freely regulate body fluids and treat symptoms of depression or melancholy.

In *Shanghan* (Cold Damage) disease involving the Yangming channel, presenting with great thirst and high fever, the indicated treatment is *Baihu Tang* (White Tiger Decoction), which addresses a "li" (interior) syndrome within the "biao" (exterior) stage. When the pathogen transmits further into the interior, presenting with delirium, fullness in the chest and abdomen, and constipation, this constitutes an "interior-of-interior" syndrome. In such cases, one of the three *Chengqi Tang* (Descending to Restore Harmony Decoctions) should be selected according to the specific presentation. Details are provided in the *Shanghan* section and will not be repeated here. Liu Hejian used *Sanyi Chengqi Tang* (Three-One Descending to Restore Harmony Decoction) to replace the aforementioned three formulas.

The "interior-of-exterior" refers to Yangming syndrome: heat, thirst, and profuse sweating are treated with *Baihu Tang*. Stomach excess, afternoon tidal fever, abdominal distension like a drum, and delirium indicate the "interior-of-interior"; these are pacified using *Zhishi Dahuang Tang* (Rhubarb and Immature Bitter Orange Decoction, referring generally to the *Chengqi* family; specifically, the other two *Chengqi* formulas are used based on symptoms).

Heart pain (the Heart is the sovereign organ; if it suffers from pathogenic invasion causing pain, accompanied by cold limbs extending to the joints, it is called *Zhenxintong* (True Heart Pain), which is incurable. The heart pain mentioned here actually refers to pain of the Pericardium). Chest and precordial pain (caused by disordered Lung Qi). Epigastric pain (caused by disordered Stomach Qi). Bilateral hypochondriac pain (indicative of Liver and Gallbladder disorders). Greater abdominal pain (associated with the Spleen). Lesser abdominal pain (associated with the Liver and Kidneys). Ancients often categorized heart/abdominal pain into nine types: Yin (fluid), Shi (food), Re (heat), Leng (cold), Feng (wind), Chong (parasites), Ji (palpitation), Zhu (transmission), and Qulai (intermittent). *Ji* pain arises from Heart deficiency and internal movement. *Zhu* pain results from pathogenic adherence. *Qulai* pain is irregular in onset and cessation, also due to pathogenic factors. The distinction between *Zhu* (Yin) and *Qulai* (Yang) is minor and need not be rigidly adhered to. Instead, differentiate by upper, middle, lower, and lateral regions. From the heart/chest to the epigastrium is the upper region; Yang Qi should be diffused. If Yang Qi is deficient, use Huangqi (Astragali Radix); if Qi is excess, use Zhishi (Immature Bitter Orange); if Qi is knotted, use Beimu (Fritillariae Bulbus) and Gualoupi (Trichosanthis Pericarpium); if Qi rebels, use Banxia (Pinelliae Rhizoma) and Xiebai (Allii Macrostemonis Bulbus); if Qi is stagnant, use Tanxiang (Santalum Album Lignum) and Sharen (Amomi Fructus). From the epigastrium to the Spleen is the middle region; Yin and Yang should be harmonized. Zhang Zhongjing's *Lizhong Wan* (Regulate the Middle Pill) uses Renshen (Ginseng Radix et Rhizoma) and Gancao (Glycyrrhizae Radix et Rhizoma)—both sweet, cold, and fluid-rich, belonging to the Yin category—to tonify Yin. It uses Baizhu (Atractylodis Macrocephalae Rhizoma) and Ganjiang (Zingiberis Rhizoma) to tonify Yang. This serves as an eternal standard. For instance, *Tongmai Sini Tang* (Pulse-Returning Decoction) urgently restores Yang; if there is abdominal distress, bitter-cold Shaoyao (Paeoniae Radix Alba) is added to nourish Yin. *Huanglian Tang* (Coptis Decoction) focuses on clearing fire; because abdominal pain is present, pungent-warming Jiang (Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) are indispensable to open Yang. This principle is subtle; only those well-versed in the *Neijing* can discuss it. From the umbilicus to the genitalia is the lower region; Yin Cold should be broken. *Jingui Yaolue* calls this *Hanhan* (Cold Hernia) [Note: Jin dynasty physicians defined hernia as testicular swelling, whereas *Jingui* defines it as severe abdominal pain]. The primary herbs are Fuzi (Aconiti Lateralis Radix Praeparata), Wutou (Aconiti Radix), and Shujiao (Zanthoxyli Pericarpium), utilizing their intense heat to support Yang and break Yin. If anterior pain penetrates posteriorly and posterior pain penetrates anteriorly, indicating indistinct boundaries between Yin and Yang, add Chishizhi (Halloysit Rubrum) 1–2 liang to block the pathogen. Additionally, *Shengjiang Danggui Yangrou Tang* (Fresh Ginger, Angelica, and Mutton Decoction) uses the turbid essence of mutton to guide action into the Yin level to break Yin, which is particularly miraculous. The hypochondriac region is the lateral side; the pivot mechanism should be facilitated. Liver and Gallbladder Qi moves laterally. *Xiaochaihu Tang* (Minor Bupleurum Decoction) is the principal formula for Shaoyang, and *Danggui Sini Tang* (Angelica Sinensis Decoction for Frigid Extremities) is the principal formula for Jueyin. Adding 49 fresh Juye (Citri Reticulatae Pericarpium Viride/Fresh Tangerine Peel) leaves may be beneficial.

For the above syndromes: A fine and slow pulse indicates Cold; treat primarily with Jiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), and Wuzhuyu (Evodiae Fructus). A large and rapid pulse indicates Heat; treat primarily with Jinlingzi (Meliosmae Fructus), Huanglian (Coptidis Rhizoma), Shashen (Glehniae Radix), and Shaoyao (Paeoniae Radix Alba). Pain with diarrhea indicates Deficiency; treat primarily with *Fuzi Lizhong Tang* (Aconite Regulate the Middle Decoction). Pain with constipation indicates Excess; treat primarily with *Xiao Chengqi Tang* (Minor Descending to Restore Harmony Decoction). There are also cases of Cold-Excess pain, treated with *Dahuang Fuzi Tang* (Rhubarb and Aconite Decoction) to warm and unblock. If vomiting worms occurs, use *Fuzi Lizhong Tang*, remove Gancao, and add Danggui (Angelicae Sinensis Radix), Chuanjiao (Zanthoxyli Pericarpium), Huanglian (Coptidis Rhizoma), and Wumei (Mume Fructus). If food stagnation is present, first use *Pingwei San* (Powder to Level the Stomach) with Maiya (Hordei Fructus Germinatus) and Shanzha (Crataegi Fructus) to digest and guide out; otherwise, purge with *Chengqi Tang*. If pain is caused by anger, use *Qi Qi Tang* (Seven Qi Decoction) with Beimu (Fritillariae Bulbus), Fuxiong (Ligustici Chuanxiong Rhizoma), and Xiangfu (Cyperi Rhizoma) to resolve stagnation; this is common knowledge and needs no elaboration. Furthermore, *Ren Zhi Zhi Zhi Fang* treats stabbing Spleen pain refractory to all medicines using *Heji Choudao San* (Harmonizing Extractor Knife Powder) with miraculous effect. This formula was kept secret by physicians until the 18th year of the Jiaqing reign, when Xu Bingnan of Changzhou included it in his publication of You Shi's *Jingui Yi*. The Heart and Abdomen belong to Yin, hence they are listed under Interior Syndromes.

(Classical Text Basis) *Suwen: Ju Tong Lun* states: "Meridian Qi flows continuously, circling without end. When Cold Qi enters the meridians, its flow becomes sluggish and stagnant. If it resides outside the vessels, Blood becomes deficient; if it resides inside the vessels, Qi becomes obstructed, resulting in sudden pain." *Suwen: Jue Bing Pian* states: "True Heart Pain presents with cyanosis of hands and feet up to the joints, severe heart pain. Onset in the morning leads to death in the evening; onset in the evening leads to death in the morning." Note: The classical texts are extensive; this excerpt captures only the essential points.