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The formulas discussed above, such as Gegen Tang (Kudzu Decoction), are all used to treat diseases of the Yangming channel (pathogenic factors in the Yangming meridians). As for diseases of the Yangming fu-organ (pathogenic factors in the Yangming stomach and intestines), a different treatment method should be discussed. The primary formula for its treatment is naturally Baihu Tang (White Tiger Decoction).

Original text from *Shanghan Lun* (Treatise on Cold Pathogenic Diseases): "In cold damage, if the pulse is floating and slippery, this indicates heat at the exterior and cold at the interior; Baihu Tang (White Tiger Decoction) should govern it." (This section is recorded in the Taiyang chapter.)
This pulse condition is both floating and slippery. A slippery pulse indicates that heat has entered the interior. However, since it is slippery combined with floating, it means the heat has not fully entered the interior; half is in the Yangming fu-organ, and half is in the Yangming channel. Being in the channel belongs to the exterior, and being in the fu-organ belongs to the interior; therefore, it is said that there is heat at the exterior and cold at the interior. *Neijing* (Inner Canon) states that febrile diseases all belong to the category of cold damage. It also states that when humans are injured by cold pathogens, they develop febrile diseases. The "cold at the interior" mentioned here likely refers to the fact that the heat pathogen from cold damage has already entered the interior. Chen's interpretation was originally like this, and I also agree with it. As for other commentators who suggest that the characters "cold" and "heat" in these two positions should be swapped, making it "cold at the exterior and heat at the interior," however, since the pulse presents as floating and slippery, the exterior certainly would not present with aversion to cold. Others have suggested that the character "cold" here is a typo for "phlegm," because "phlegm" and "cold" sound similar, and a slippery pulse is also a sign of phlegm. However, in warm diseases, a slippery pulse originally indicates that Yangming heat is solidified, and it sufficiently proves that the patient's qi and blood were originally abundant, making treatment easy to succeed. If one assumes phlegm presence solely based on a slippery pulse, then is Baihu Tang (White Tiger Decoction) a formula for treating phlegm?

Original text from *Shanghan Lun*: "In combined disease of the three yang channels, there is abdominal fullness, heaviness of the body, difficulty in turning over, insensitivity in the mouth, greasy face, delirious speech, and urinary incontinence. If sweating is induced, delirium worsens; if purgation is used, sweat appears only on the forehead, and the hands and feet become cold. If there is spontaneous sweating, Baihu Tang (White Tiger Decoction) should govern it." (This section is recorded in the Yangming chapter.)
The syndrome is a combined disease of the three yang channels, meaning Yangming connects externally with Taiyang and internally with Shaoyang. From this, we know that when the three yang channels converge, Yangming serves as the center. When diseases of the three yang channels converge, the disease of Yangming acts as the core strength. Therefore, the primary governing formula remains Baihu Tang (White Tiger Decoction). This is like a commander attacking an enemy, concentrating all strength to strike the core, causing the rest to collapse spontaneously.

Original text from *Shanghan Lun*: "In cold damage, if the pulse is slippery and there is jue (cold extremities), there is heat at the interior; Baihu Tang (White Tiger Decoction) should govern it." (This section is recorded in the Jueyin chapter.)
A slippery pulse indicates that Yangming heat has transmitted to Jueyin. When the pulse is slippery and accompanied by cold extremities, it is because the Liver governs free flow and drainage. In this syndrome, the heat transmitted from Yangming is constrained within the Liver, causing the Liver to lose its regulatory function and fail to perform free flow and drainage. Thus, the deeper the heat, the deeper the jue (cold extremities). Treating with Baihu Tang (White Tiger Decoction), once the heat dissipates, the jue will naturally resolve.

One might ask: The sequence of transmission in cold damage originally proceeds from Yangming to Shaoyang, and after three transmissions, it reaches Jueyin. Now, saying that Yangming heat transmits to Jueyin seems to contradict the canonical principles. The answer is: Baihu Tang (White Tiger Decoction) is originally the correct medicine for treating Yangming excess heat. If the syndrome is not Yangming excess heat, Zhang Zhongjing would definitely not use Baihu Tang (White Tiger Decoction). This is because the heat of Yangming in the channel did not transmit to the fu-organ (if it entered the fu-organ, it would not transmit elsewhere), but rather transmitted to Shaoyang. From Shaoyang, it underwent zang-fu transmission (such as transmission from Taiyang to Shaoyin, which is zang-fu transmission; the disease governed by Mahuang Fuzi Xixin Tang in the Shaoyin chapter of *Shanghan Lun* is an example). Thus, excess heat from Yangming was transmitted into the Liver. Ultimately, in such syndromes, the guan pulses on both left and right sides must exhibit signs of excess heat. Although this heat from Yangming in the channel entered Jueyin via Shaoyang, there must still be residual heat entering the Yangming fu-organ, causing the fu-organ to accumulate excess heat. Therefore, one can boldly administer Baihu Tang (White Tiger Decoction) without harming the stomach fu-organ.

[Baihu Tang Formula] Zhi Mu (Anemarrhenae Rhizoma) 6 liang, Shigao (Gypsum Fibrosum) 1 jin (crushed), Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang (honey-fried), Jingmi (Oryza Sativa) 6 he.
Take the above four ingredients, add 10 dou of water, boil until the rice is cooked and the decoction is ready, strain, and take 1 sheng warm, three times a day.
In this formula, Shigao (Gypsum Fibrosum) is heavily used as the chief drug, taking advantage of its acrid-cool nature, heavy texture, and light aroma. It not only excels at clearing heat but also effectively expels internal heat through the pores. Zhi Mu (Anemarrhenae Rhizoma) is used for its cool-moistening and yin-nourishing properties; it can assist Shigao (Gypsum Fibrosum) in reducing fever and prevent the consumption of true yin due to prolonged Yangming heat. Gancao (Glycyrrhizae Radix et Rhizoma) is used for its sweet-slowing property, which retains the cooling nature of Shigao (Gypsum Fibrosum) so it does not descend too quickly. Jingmi (Oryza Sativa) is used for its rich juice, which harmonizes the mineral nature of Shigao (Gypsum Fibrosum) to make it compatible with the stomach. With only four ingredients, they cooperate so well to moderate the fierce nature of the prescription, allowing people to use it boldly to save lives in critical moments. It is truly an unparalleled excellent formula. Why do some fear it like a tiger and dare not use it lightly?

Baihu Tang (White Tiger Decoction) appears three times in *Shanghan Lun*. Once in the Taiyang chapter, treating floating and slippery pulses; once in the Yangming chapter, treating spontaneous sweating in combined disease of the three yang channels; and once in the Jueyin chapter, treating slippery pulses with jue. Commentators under the Yangming clause state that if there is no spontaneous sweating, fearing that exterior pathogens might be suppressed and blocked, one dares not rashly use Baihu Tang (White Tiger Decoction). Since this statement emerged, doctors encountering Baihu Tang (White Tiger Decoction) syndromes often refrain from using it if there is no spontaneous sweating, which misleads people significantly. Generally, in cold and warm diseases, the deeper the pathogen penetrates, the more dangerous it becomes. When the pathogen moves from exterior to interior and the Yangming fu-organ gradually becomes solid, urgently administering a large dose of Baihu Tang (White Tiger Decoction) can ensure complete safety. If it should be used but is not, progressing from stomach solidity to intestinal solidity requiring purgation, one can no longer guarantee complete safety. Moreover, the text mentioning "spontaneous sweating" exists only in the Yangming chapter. The Taiyang chapter only mentions floating and slippery pulses, and the Jueyin chapter only mentions slippery pulses with jue; neither mentions spontaneous sweating. Thus, it is known that whenever a slippery pulse is seen, whether floating and slippery or slippery with jue, Baihu Tang (White Tiger Decoction) can be administered. The scriptural meaning is clear. Why do doctors not respect the scriptures and instead adhere to erroneous commentaries?

The diseases governed by Baihu Tang (White Tiger Decoction) are distributed among the Taiyang, Yangming, and Jueyin chapters. Only the Yangming chapter does not specify the pulse condition, which may leave one unsatisfied. However, inferring from the floating and slippery pulse in the Taiyang chapter and the slippery pulse with jue in the Jueyin chapter, the pulse should undoubtedly be洪滑 (hong-hua: surging and slippery), which is the correct pulse for using Baihu Tang (White Tiger Decoction). Therefore, when treating cold damage, if one observes a surging and slippery pulse, knowing that Yangming fu-organ heat is solid, one can boldly administer Baihu Tang (White Tiger Decoction) without error. After taking the medicine, the patient may recover with cool sweating, or even without sweating, the heat may dissipate invisibly. If the pulse is floating and slippery, knowing the disease still involves the exterior, one can add 1 qian of Bohe Ye (Menthae Haplocalycis Folium) or 1 qian each of Lianqiao (Forsythiae Fructus) and Chantui (Cicadae Periostracum) to the formula. After taking it, recovery through sweating occurs shortly. If the pulse is slippery with jue, knowing it is due to stagnation of Jueyin Liver qi, one can use Baimaogen (Imperatae Rhizoma) decoction to decoct the herbs. After taking it, jue resolves shortly, and the disease heals. This is my lifelong experience, so I dare to state it firmly to supplement what ancient books lack.

In recent times, those using Baihu Tang (White Tiger Decoction) often strictly adhere to Wu Juztong's Four Prohibitions. The so-called Four Prohibitions refer to the four conditions listed after Baihu Tang (White Tiger Decoction) in his book *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases) where Baihu Tang (White Tiger Decoction) is contraindicated. However, two of these four conditions clearly contradict the canonical principles. If they are treated as golden rules, this excellent formula for saving crises and rescuing lives would be rendered useless.

Wu Juztong's original text: "Baihu Tang is originally for venting heat out to the exterior. If the pulse is floating, wiry, and thin, it should not be given; if the pulse is deep, it should not be given; if there is no thirst, it should not be given; if there is no sweating, it should not be given. Always keep this in mind to avoid errors."
Analysis: The first two prohibitions originally meant Baihu Tang (White Tiger Decoction) should be banned. Regarding the third point, stating that those without thirst should not receive it: the standard rule for using Baihu Tang (White Tiger Decoction) is to add Renshen (Ginseng Radix) if thirsty; if not thirsty, one takes the original Baihu Tang (White Tiger Decoction) formula without adding ginseng, which is obvious. Wu's assertion that those without thirst should not receive it clearly contradicts the canonical principles. Furthermore, if one follows Wu's words, those who are thirsty could receive Baihu Tang (White Tiger Decoction) without adding ginseng, which again contradicts the canonical principle of "adding ginseng for thirst." Regarding the fourth point, stating that those without sweating should not receive it: Baihu Tang (White Tiger Decoction) appears three times in *Shanghan Lun*. Only the combined disease of the three yang channels in the Yangming chapter presents with sweating. The diseases governed in the Taiyang and Jueyin chapters do not show sweating. Zhang Zhongjing used Baihu Tang (White Tiger Decoction) when sweating was not observed, yet Wu prohibits it when sweating is not observed. Does this not clearly contradict the canonical principles? Moreover, Shigao (Gypsum Fibrosum) originally possesses dispersing properties. For those without sweating, can it not be used to induce sweating? Even according to Wu's own rules, one must have both sweating and thirst to use Baihu Tang (White Tiger Decoction). However, in cases of Yangming excess heat, those with both thirst and sweating account for only one or two out of ten people. Does this not essentially render Baihu Tang (White Tiger Decoction) useless? Wu Juztong was a famous doctor in the late Qing Dynasty, yet he mistakenly set such prohibitions for Baihu Tang (White Tiger Decoction) because he did not understand the nature of Shigao (Gypsum Fibrosum). Later, in his medical cases, he treated an elderly surnamed He who suffered from limb spasms caused by taking hot medicines incorrectly. Each dose contained 8 liang of raw Shigao (Gypsum Fibrosum), taken for nearly fifty days until recovery, totaling over twenty jin of raw Shigao (Gypsum Fibrosum). He also treated a middle-aged surnamed Zhao with retained fluid in the middle jiao causing wheezing. Each dose heavily used raw Shigao (Gypsum Fibrosum); one dose used 6.8 liang, another 12 liang, and another up to 1 jin. He consumed nearly 100 jin of raw Shigao (Gypsum Fibrosum) before recovering. Looking at *Wenbing Tiaobian*, where the dosage of Shigao (Gypsum Fibrosum) in Baihu Tang (White Tiger Decoction) was only 1 liang, decocted into three cups to be taken warm in three doses, the difference is indeed vast. Probably, Wu wrote *Wenbing Tiaobian* first and *Wu's Medical Cases* later. When writing *Wenbing Tiaobian*, he did not understand the nature of Shigao (Gypsum Fibrosum), hence his caution with Baihu Tang (White Tiger Decoction). By the time he wrote *Wu's Medical Cases*, he understood the nature of Shigao (Gypsum Fibrosum), allowing him to boldly use large doses. His knowledge advanced with age, thus remaining a famous doctor.

People value Baihu Tang (White Tiger Decoction) but dare not use it lightly because they do not understand the nature of Shigao (Gypsum Fibrosum). Among ancient books discussing herbs, *Shennong Bencao Jing* (Divine Farmer's Materia Medica) is the foremost, followed by *Mingyi Bielu* (Record of Famous Physicians). *Shennong Bencao Jing* was created by sage gods at the beginning of creation and is indeed the orthodox source for discussing herb properties. *Mingyi Bielu* was compiled by Tao Hongjing during the Five Dynasties period, collecting discussions on herbs by famous physicians from the Han Dynasty to before the Five Dynasties, serving as an appendix to *Shennong Bencao Jing* (Hongjing once copied the former in red ink and the latter in black ink into one book). Now, let us study the texts of *Shennong Bencao Jing* and *Mingyi Bielu* carefully.

*Shennong Bencao Jing* original text on Shigao (Gypsum Fibrosum): "Nature is acrid, slightly cold, non-toxic. It treats wind-stroke with cold and heat, rebellious qi below the heart, frightful panting, dry mouth, scorched tongue, inability to breathe, firm pain in the abdomen, removes evil spirits, treats childbirth issues, and metal wounds."
Analysis: Later materia medica books all regard Shigao (Gypsum Fibrosum) as greatly cold, but *Shennong Bencao Jing* considers it slightly cold, which can be established as a permanent conclusion. Because it is slightly cold, 1 jin is used in Baihu Tang (White Tiger Decoction). In *Wu's Medical Cases*, treating wheezing from phlegm-fluid rising, nearly 100 jin of Shigao (Gypsum Fibrosum) was taken without damaging the spleen and stomach. The text says it treats wind-stroke. Wind-stroke requires dispersing drugs; since Shigao (Gypsum Fibrosum) treats it, its nature is good at dispersing. Its treatment of cold/heat, frightful panting, dry mouth, and scorched tongue needs no explanation. Its ability to treat rebellious qi below the heart and firm abdominal pain may cause doubt, but careful clinical verification reveals facts. I once treated a person suffering from Spring Warmth with solidified Yangming fu-organ heat, experiencing extreme abdominal fullness. I administered 2 liang of raw Shigao (Gypsum Fibrosum) and 5 qian of crushed Zhuru (Bambusae Caulis in Taeniam) decocted. After taking it, he immediately felt a pushing force, and both the fullness and warmth disease healed. I also treated a person with severe swelling and pain in the lower abdomen, unresponsive to multiple treatments. His pulse was deep, surging, and forceful. I administered 3 liang of raw Shigao (Gypsum Fibrosum), 2 qian of Zansanqi (Notoginseng Radix, finely ground and taken with decoction), and 3 qian of Puhuang (Typhae Pollen) decocted. Two doses resulted in complete recovery. This syndrome is what Western medicine calls appendicitis, often viewed as dangerous and difficult to treat. Boldly using large doses of raw Shigao (Gypsum Fibrosum) yields immediate results. Regarding "removing evil spirits," it refers to treating delusions and hallucinations caused by excess heat in cold/warm diseases. Regarding "treating childbirth," the character "ru" (nipple/milk) should be interpreted as "birth" (commentators interpreting it as milk are incorrect). It means that if a woman suffers from excess heat in cold/warm diseases after giving birth, Shigao (Gypsum Fibrosum) can be used. This corresponds to *Jingui Yaolue* stating that for women with deficiency in the breast area causing vexation, confusion, vomiting, and reversal, Anzhong Yiqi (Nourishing the Center and Boosting Qi) is needed, governed by Zhupi Dawan (Bamboo Peel Large Pill), which contains Shigao (Gypsum Fibrosum). Regarding "treating metal wounds," if a person is injured by knives or axes, applying fine powder of raw Shigao (Gypsum Fibrosum) stops bleeding immediately and reduces swelling and pain.

*Mingyi Bielu* original text on Shigao (Gypsum Fibrosum): "Shigao (Gypsum Fibrosum) eliminates seasonal epidemics, headache, body heat, great heat in the three jiao, knotting of qi in the intestines and stomach, releases the muscle layer and induces sweating, stops thirst, irritability and reversal, abdominal distension and sudden qi, sore throat, and can also be used for bathing."
Analysis: "Releasing the muscle layer" means its power reaches the exterior, relaxing the skin and muscles, allowing internal heat to escape through the pores. "Releasing the muscle layer and inducing sweating" means that after releasing the muscle layer, the internal heat transforms into sweat. However, later commentators on Shigao (Gypsum Fibrosum) changed "slightly cold" from *Shennong Bencao Jing* to "greatly cold" and especially disbelieved "releasing the muscle layer and inducing sweating" from *Mingyi Bielu*. For example, modern materia medica works like Zou Run'an's *Benjing Shuzheng* and Zhou Bodu's *Bencao Sibianlu* are renowned, yet they also criticize *Mingyi Bielu*'s claim that Shigao (Gypsum Fibrosum) can release the muscle layer and induce sweating.

I have been active in the medical field for over fifty years and have carefully experienced the usage of Baihu Tang (White Tiger Decoction). If it is Yangming excess heat, half in the channel and half in the fu-organ, or if the heat has entered the fu-organ but still connects to the channel, after taking Baihu Tang (White Tiger Decoction), sweating usually occurs. This is because the coolness of Shigao (Gypsum Fibrosum) combines with Yangming heat to form sweat reaching the exterior. If worried about lack of sweating, adding small amounts of Lianqiao (Forsythiae Fructus) and Chantui (Cicadae Periostracum) as guides causes sweating within moments of ingestion, after which the disease heals, leaving no residual exterior heat. If Yangming heat has completely entered the fu-organ, after taking Baihu Tang (White Tiger Decoction), few sweat, while many do not. Those who sweat resolve heat through sweat; those who do not sweat see heat dissipate internally. Because Shigao (Gypsum Fibrosum) is heavy in texture and light in aroma, its heaviness drives heat downward, and its lightness drives heat upward, keeping the qi transformation of the stomach fu-organ clear and pure, leaving no room for exterior heat to remain.

Shigao's (Gypsum Fibrosum) induction of sweating originally targets sweating from existing excess heat in the body, not new wind-cold pathogens. I once treated a man near thirty who contracted a warmth disease in early spring. A doctor used warm medicines to induce sweating, but sweating worsened the condition. His pulse was surging, slippery, and floating. I administered a large dose of Baihu Tang (White Tiger Decoction) with 1.5 qian each of Lianqiao (Forsythiae Fructus) and Chantui (Cicadae Periostracum). After taking it, he sweated profusely with cool sweat and recovered. However, he had several episodes of diarrhea afterward. Ten days later, he caught another exterior pathogen. His pulse matched the previous one. Because of the previous diarrhea after taking Baihu Tang (White Tiger Decoction), I switched to Tianhuafen (Trichosanthis Radix) and Xuanshen (Scrophulariae Radix) 8 qian each, Bohe Ye (Menthae Haplocalycis Folium) and Gancao (Glycyrrhizae Radix et Rhizoma) 2 qian each, and Lianqiao (Forsythiae Fructus) 3 qian. After taking it, he sweated all over, but the disease did not improve at all, because the sweat produced was hot sweat, not cool sweat. Reluctantly, I returned to the previous formula. To prevent diarrhea, I replaced Jingmi (Oryza Sativa) with 8 qian of Sheng Huai Shanyao (Dioscoreae Hypoglaucae Rhizoma). After taking it, he sweated profusely with cool sweat and recovered. From this case, the miraculous use of Shigao (Gypsum Fibrosum) is truly inconceivable.

Using large doses of Shigao (Gypsum Fibrosum) to induce sweating is not just my personal experiment. A friend in our county, Liu XX, suffered from lung heat and labor-induced asthma, with severe heat. It was mid-summer, and the illness was intense. Having seen me use large doses of raw Shigao (Gypsum Fibrosum) to treat diseases, he used 4 liang of raw Shigao (Gypsum Fibrosum) himself, decocted in a large bowl of water and drank it all at once. He obtained cool sweat all over his body, and his asthma and labor symptoms improved suddenly. A day later, he decocted and drank Shigao (Gypsum Fibrosum) as before, and the illness improved again. Drinking Shigao (Gypsum Fibrosum) decoction every other day always induced sweating, and the illness declined sequentially. After six doses, this chronic disease, difficult to cure with other medicines, was miraculously cured.
Later, Liu XX met me and asked, "How can such a cool medicine like Shigao (Gypsum Fibrosum) induce sweating?" I said, "Shigao (Gypsum Fibrosum) has a nature good at inducing sweating, as explicitly recorded in *Mingyi Bielu*. People with excess heat stored in their zang-fu organs easily sweat after taking it. This syndrome was caused by latent qi transforming into heat, lingering in the lungs for a long time, injuring the lungs. Repeatedly drinking Shigao (Gypsum Fibrosum) decoction drove out this lingering heat, which could not stay and dissipated entirely through sweat."

Using Shigao (Gypsum Fibrosum) to treat lung diseases and labor heat was an experienced method of ancients. Because later generations did not understand the nature of Shigao (Gypsum Fibrosum), they dared not believe ancient formulas even when seeing them, so no one used them later. This formula was recorded in Wang Tao's *Waitai Miyao* (Essential Prescriptions from the Imperial Library). I record it in detail below for medical practitioners to adopt.

*Waitai Miyao* original text: "To treat bone-steaming labor heat and chronic cough, use 1 jin of Shigao (Gypsum Fibrosum) with patterns like needles, 1 liang of Fen Gancao (Powdered Glycyrrhiza), grind finely like flour, mix with water and take three to four times daily. It is said to be non-toxic and highly beneficial, a supreme medicine for nourishing life. Do not ignore its cheapness or suspect its coolness." *Mingyi Bielu* records that the daughter of Yang Shicheng in Luzhou suffered from bone-steaming, internal heat and external cold. Many doctors failed to cure her. The doctor from Chuzhou used this formula, and her body cooled down.
Analysis: The girl surnamed Yang recorded in the book also suffered from latent qi transforming into heat. Diseases of latent qi transforming into heat should originally be treated with Baihu Tang (White Tiger Decoction). If the pulse shows rapidity, Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction) should be used. Doctors did not know this treatment method, hence the prolonged failure to heal. The doctor from Chuzhou treated her with Shigao (Gypsum Fibrosum) and Gancao (Glycyrrhizae Radix et Rhizoma) powder, which is actually a modified universal application of Baihu Tang (White Tiger Decoction). However, there are syndromes that cannot heal unless this modified version is used (must take Shigao powder to heal). This is my clinical experience in treating latent qi transforming into heat. I record a case below to illustrate that using ancient formulas should adapt to the syndrome.

A man near forty years old, originally strong, suddenly felt heat in his heart in late spring. He initially ignored it, but gradually his urination and defecation became obstructed. Multiple doctors and medicines worsened the condition. Abdominal fullness increased, and fever intensified. Urination was possible but dribbling, while defecation had not occurred for over ten days. He also felt heat rushing upward; whatever medicine he swallowed, he vomited immediately. Doctors were helpless. I was invited to examine him. His pulse was wiry, long, and forceful, very solid upon heavy pressure, on both sides. His tongue coating was thick and yellow, with many prickles. I knew it was latent qi transforming into heat. I told the patient, "To cure this disease, a large dose of Baihu Tang (White Tiger Decoction) is indispensable." The patient asked, "Why should I take Baihu Tang (White Tiger Decoction) if I haven't caught an exterior pathogen?" I replied, "This...