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[Liangge San (Cooling the Diaphragm Powder)] Treats hyperactivity of Heart Fire in the upper jiao, and dryness-excess syndrome in the middle jiao. Symptoms include irritability, thirst, red eyes, dizziness, oral ulcers, cracked lips, hematemesis (vomiting blood), epistaxis (nosebleed), constipation of both stool and urine, various wind syndromes causing clonic spasms (Chi Zong, 瘛疭), skin macules or mania caused by Stomach Heat, as well as infantile convulsive emergencies and black depression of smallpox lesions.
Lianqiao (Forsythiae Fructus) 4 liang, Dahuang (Rhei Radix et Rhizoma) soaked in wine, Huangqin (Scutellariae Radix) stir-fried with wine, Bohe (Menthae Haplocalycis Herba) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang, Zhizi (Gardeniae Fructus) stir-fried, Mangxiao (Natrii Sulfas). Grind all ingredients into fine powder. Take 3 qian per dose, decoct with Zhuye (Bambusae Folium) and raw honey.

[Collected Annotations] Wang Ang stated: This is a formula for purging excess fire from the upper and middle jiao. When heat invades internally, it is treated with salty-cold substances, assisted by bitter-sweet substances. Therefore, Lianqiao, Huangqin, Zhuye, and Bohe are used to dissipate fire upwards, while the potent properties of Dahuang and Mangxiao purge heat downwards in the middle, allowing qi to ascend and descend, thereby clearing the diaphragm naturally. Gancao and raw honey are used because the pathology is located at the diaphragm; sweet flavors soothe and relieve urgency. In ancient prescriptions, Liangge San was frequently used. Adding Shichangpu (Acori Tatarinowii Rhizoma) and Yuanzhi (Polygalae Radix) to this base formula creates Zhuan She Gao (Tongue-Turning Paste), which treats latent heat in the Heart meridian. Adding Qingdai (Indigo Naturalis) and Lan Gen (Isatidis Radix) creates Huo Ming Jin Dan (Life-Saving Golden Pill), which treats Wind-Heat in the Liver meridian. Zhang Jiegu removed Mangxiao and Dahuang, adding Jiegeng (Platycodonis Radix) as a carrier to float the medicinal action upward, treating various heats in the upper jiao; it is suitable for those with loose stools. One should not disparage this formula due to its strong purgative nature.

[Zhu Ye Huang Qi Tang (Bamboo Leaf and Astragalus Decoction)] Treats Xiao Ke (Wasting and Thirsting Syndrome), deficiency of Qi and Blood, and thirst caused by hyperactive Stomach Fire.
Dan Zhu Ye (Lophatheri Herba) and Sheng Di Huang (Rehmanniae Radix Recens) each 2 qian; Huang Qi (Astragali Radix), Mai Dong (Ophiopogonis Radix), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Huang Qin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix), Banxia (Pinelliae Rhizoma), Shigao (Gypsum Fibrosum) each 1 qian. Decoct these ingredients in water and take orally.

[Collected Annotations] Ke Qin stated: When both Qi and Blood are deficient but Stomach Fire is exclusively hyperactive, skilled practitioners employ simultaneous tonification and purgation. Using cold herbs does not damage Yang Qi, and using warm herbs does not aid Fire; thus, Righteous Qi is supported while Pathogenic factors recede. Si Jun Zi Tang (Four Gentlemen Decoction) consists of Qi-tonifying herbs. Adding Huang Qi while removing Bai Zhu and Huang Qin prevents Fire from adhering to dryness. Si Wu Tang (Four Substances Decoction) consists of Blood-tonifying herbs. Doubling the dosage of Sheng Di Huang and using it fresh takes advantage of its cold nature. Renshen, Huang Qi, and Gancao are supreme remedies for treating irritability and heat; this represents purgation within tonification. Furthermore, the sweet-cold nature of Di Huang purges Fire from the Heart and Kidney; Zhu Ye assists Shaoyao in clearing Fire from the Liver and Gallbladder; Shigao assists Shaoyao in clearing Fire from the Spleen and Stomach; Mai Dong combined with Huang Qin clears Fire from the Lungs and Intestines. Thus, Stomach Fire cannot remain exclusively hyperactive, and the benefit to Qi and Blood becomes evident. Only Banxia possesses warm, middle-jiao harmonizing, and acrid-dispersing properties. Its use in a strongly cold formula aims to unblock the pathways of Yin and Yang. Qibo treated insomnia due to Yin deficiency by prescribing Banxia Tang; sleep was achieved after one cup. Modern practitioners forbid its use in cases of dryness and thirst, demonstrating a lack of understanding of Yin-Yang principles.

[Commentary] This formula is essentially Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) supplemented with Sheng Di Huang, Dang Gui, Bai Shao, Chuan Xiong, Huang Qi, and Huang Qin. The original formula treats irritability, thirst, shortness of breath, and nausea following the resolution of Shang Han (Cold Damage). This formula treats Xiao Ke (Wasting and Thirsting Syndrome) characterized by Qi and Blood deficiency and hyperactive Stomach Fire. Due to Qi deficiency, Huang Qi is added to assist Renshen and Gancao in tonifying Qi; due to Blood deficiency, Dang Gui, Chuan Xiong, Shao Yao, and Di Huang are added to tonify Blood; due to hyperactive Stomach Fire, Huang Qin is added to assist Shigao in clearing Stomach Fire. Since the symptom of irritability and thirst is common to both, the remaining herbs are identical. By comparing these two formulas, the rationale for using Banxia becomes clear. The Spleen transports fluids for the Stomach. When Spleen dampness and Stomach dryness impede fluid circulation, heat transforms fluids into Phlegm, while cold transforms them into Fluid Retention (Yin). Once Stomach Fire is cleared and Spleen dampness dried, Phlegm and Fluid Retention are naturally eliminated. Banxia resolves Phlegm and breaks up Fluid Retention, clarifying fluids that have not yet transformed into Phlegm and resolving existing turbid fluids; no other herb can compare. Therefore, both formulas utilize Banxia in cases of hyperactive Stomach Fire and dryness-thirst.