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The syndrome of jaundice (yellowing of the skin, sclera, and urine) mostly arises from damp-heat. All formulas for treating jaundice are formulas for treating damp-heat.
However, there are cases where a patient originally suffers from Yangming disease, harbors damp-heat internally but does not develop jaundice; in such instances, a different treatment approach is naturally required. The Yangming chapter of *Shanghan Lun* indeed records a formula for this condition.
Original text from *Shanghan Lun*: "If the pulse is floating, accompanied by fever, thirst with desire to drink water, and difficult urination, Zhu Ling Tang should be administered."
The "floating pulse" mentioned in this section refers to the pathogen having entered the Yangming stage but still involving the Bladder Fu organ (Bladder). Generally, Taiyang disease presents with a floating pulse whether it affects the meridians or the Fu organs. This occurs because the Bladder Fu contains excess heat, leading to difficult urination. The heat that has entered the Yangming stage cannot be dispersed and eliminated downward through the Bladder Fu; instead, it rebels upward and affects the Lung, resulting in thirst and desire to drink water. Treating with Zhu Ling Tang aims to disperse and eliminate the heat through the Bladder Fu.
[Zhu Ling Tang Formula] Polyporus (with skin removed), Poria, Donkey-hide Gelatin, Talcum, Alisma rhizome, each 1 liang.
Take the above five herbs. Add four sheng of water. First decoct the first four herbs until two sheng remains. Remove the dregs. Add the Donkey-hide Gelatin and melt it. Take seven he of the warm decoction per dose, three times daily.
Polyporus and Poria are both diuretic and leaching agents. However, Polyporus grows under maple trees, absorbing the yin and soft qi of maple roots. Its nature is good at resolving yang obstruction, making it particularly suitable for treating difficult urination caused by heat; thus, it is used as the principal herb. Alisma rhizome is used because it can guide fluid qi upward to relieve thirst, and subsequently descend to promote urination. Talcum is used because its nature can substitute for Gypsum to clear excess heat in the Yangming stage, and it can also guide heat out through urination. Donkey-hide Gelatin is used because the Bladder Fu is originally connected to the Shaoyin Kidney. Fearing that various diuretic herbs might damage the Shaoyin, Donkey-hide Gelatin, a substance that greatly nourishes true yin, is added to assist the Qi transformation of the Shaoyin.

In summary, the syndromes in the Yangming chapter are generally dry and hot. Cases that are not dry but turn damp represent a variant syndrome of Yangming. This has been elucidated in the formulas for treating jaundice. Furthermore, cases that are not hot but become cold are also variant syndromes of Yangming. Since the disease is now cold, it must be treated with hot-natured medicines to be symptomatic; therefore, warm and hot agents require further study.
Original text from *Shanghan Lun*: "If the pulse is floating and slow, with exterior heat and interior cold, and diarrhea with undigested food, Si Ni Tang should be administered."
Exogenous pathogens affecting humans often transform according to the individual's constitution, similar to the spread of seasonal epidemics. Individuals exposed to the same pathogen in the same room or time may present with conditions that are distinctly cool or hot. Generally, if a person's zang-fu organs harbor accumulated heat, external pathogens will exacerbate the heat; if they harbor accumulated cold, external pathogens will exacerbate the cold. Understanding this allows for a discussion on Si Ni Tang.
[Si Ni Tang Formula] Licorice root (roasted) 2 liang, Dried ginger 1.5 liang, Aconite root (raw, skin removed, broken into eight pieces) one piece.
Take the above three herbs. Add three sheng of water. Decoct until one sheng and two he remain. Remove the dregs. Divide into two warm doses. For robust individuals, use one large Aconite root and 3 liang of Dried ginger.
Dried ginger is the principal herb for warming the Spleen and Stomach. Combined with Licorice root, it moderates its fierce nature to make it mild, and preserves its warming power for longevity. However, the warmth of the Spleen and Stomach relies heavily on the vigor of Mingmen Fire (Ministerial Fire). Aconite root, being black and entering the Kidney, possesses extraordinary heat that effectively supplements the Ministerial Fire in the Kidney, thereby consolidating the root source of Spleen and Stomach warmth. The formula is named "Si Ni" (Four Rebellions/Cold Extremities) because the Spleen governs the four limbs; those with Spleen-Stomach deficiency-cold often feel cold extremities. After taking this medicine, the coldness of the limbs can reverse.
The note "raw" for Aconite root in the formula does not mean using it immediately after excavation. Because Aconite root is highly toxic, growers soak the excavated root in salt water, and pharmacies undergo multiple processing steps before it is usable. Thus, "raw" in the formula specifically means unroasted/uncooked by fire.