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Houpo (Zizhi Magnoliae Officinalis Cortex), roasted and peeled, ban jin; Shengjiang (Fresh Zingiberis Rhizoma), washed, ban jin; Banxia (Pinelliae Rhizoma), washed, half sheng; Gancao (Glycyrrhizae Radix et Rhizoma), roasted, liang; Renshen (Ginseng Radix et Rhizoma), liang.

The above five herbs are decocted with one dou of water until three sheng remain. The dregs are removed, and the liquid is taken warm, one sheng per dose, three times daily.
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If the pathogen remains unresolved after sweating, accompanied by abdominal fullness and pain, urgent purgation is indicated, and Da Chengqi Tang (Major Order the Qi Decoction) is appropriate. If abdominal fullness persists without reduction, or if any reduction is negligible, purgation should be employed, and Da Chengqi Tang is appropriate.
[Annotation]
This passage elaborates on the previous clause, elucidating their mutual meanings to distinguish different treatments. After sweating, if the exterior syndrome is resolved but abdominal fullness exists without pain, this constitutes "deficient fullness" where the abdomen is sometimes relieved but returns to its previous state. Warmtonifying treatment is indicated, corresponding to the Houpo Shengjiang Banxia Gancao Renshen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction). However, if after sweating the exterior syndrome remains unresolved, accompanied by significant abdominal fullness and severe pain, this constitutes "excess fullness" where the fullness does not diminish or any diminution is insignificant. Purgation is indicated, and Da Chengqi Tang is appropriate. This is because the interior urgency requires attacking the interior first, followed by harmonizing the exterior.
[Collected Annotations]
Yu Chang stated: The phrase "reduction is negligible" vividly describes the state of abdominal fullness. When fullness reaches ten parts, reducing it by one or two parts is insufficient to curb its momentum. This is why, even if external pathogens remain unresolved, purgation is undoubtedly indicated!
Cheng Yingmao stated: If abdominal fullness persists after purgation, a reduction of one or two parts does not count as true relief. Purgation may need to be repeated until the fullness is completely eliminated.
Liu Hongbi stated: There is no method for purgation in Taiyin disease. If referring to the meridians, there is no rationale for purgation in any meridian; if referring to the zang organs, the Spleen specifically has no capacity to withstand purgation. Is Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction with Added Rhubarb) questionable? One must understand that the Spleen and Stomach are exterior-interior partners. If Taiyang disease is mistakenly treated with purgation, the Taiyin is affected. If there happens to be retained food in the Stomach, the Spleen becomes excess due to the Stomach's excess, and pain arises from the Taiyang pathogen. Since there is now great fullness and severe pain, constituting Stomach excess, this formula cannot treat it; thus, Da Chengqi Tang is appropriate.
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In Taiyin disease (Taiyin Disease), if the pulse is floating, sweating may be induced, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate.
[Annotation]
In Taiyin meridian disease, the pulse should be floating and moderate; in Taiyin zang disease, the pulse should be deep and moderate. Now that the pathogen has reached the Taiyin, a floating pulse without moderation indicates that the Taiyang exterior pathogen has not yet fully resolved. Therefore, even if symptoms such as vomiting, diarrhea, anorexia, and intermittent abdominal fullness and pain are present, as long as the pulse is floating rather than deep, Guizhi Tang can be used to induce sweating, resolving the exterior first. Once the exterior is resolved, the interior can then be regulated. From this, we can also infer that in cases described in the Treatise where body pain, abdominal fullness, and diarrhea require urgent rescue of the interior, the pulse must not be floating.
[Collected Annotations]
Wang Kentang stated: In Taiyang disease with a floating pulse and no sweat, Mahuang Tang (Ephedra Decoction) is appropriate. Here, the floating pulse also implies no sweat, but this is omitted because yin syndromes do not typically present with sweat, so it need not be stated. Instead of Mahuang Tang, Guizhi Tang is used. This is because when three yin syndromes involve the exterior, vigorous sweating should be avoided. One must recognize that Guizhi Tang can be used even in the absence of sweat.
Cheng Zhi stated: This discusses the indication for dispersal in Taiyin disease. Taiyin disease refers to conditions with abdominal pain and diarrhea. A Taiyang pulse is floating at all three positions. A floating pulse here indicates the pathogen returning to the exterior, so Guizhi Tang is appropriate for resolution. Mahuang Tang is not used because yin diseases should not undergo vigorous sweating; Guizhi Tang contains the intent of harmonizing the interior.
Cheng Yingmao stated: This is the Taiyang syndrome within Taiyin. Although there is an interior syndrome, treating it from the Taiyang exterior perspective prevents the pathogen from entering the zang organs.
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Originally a Taiyang disease (Taiyang Disease), if the physician mistakenly applied purgation, resulting in abdominal fullness and intermittent pain, it belongs to Taiyin disease and is primarily treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction with Added Peony Root). If there is severe excess pain, Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction with Added Rhubarb) is primarily indicated.
[Annotation]
Originally a Taiyang wind-stroke syndrome, if the physician failed to use Guizhi Tang for sweating and instead used purgation, the pathogen sinks into the interior. With no other symptoms except abdominal fullness and intermittent pain, this belongs to deficient pain in the Taiyin interior. Thus, Guizhi Jia Shaoyao Tang is appropriate to resolve the Taiyang exterior and regulate the Taiyin interior deficiency. If there is severe fullness and excess pain, it belongs to Taiyin heat transformation and Stomach excess pain. Thus, Guizhi Jia Dahuang Tang is appropriate to resolve the Taiyang exterior and attack the Taiyin interior excess.
[Collected Annotations]
Zhao Sizhen stated: There are three types of abdominal fullness in Taiyin disease: pathogens transmitted sequentially through the meridians, cold pathogens directly invading the middle, and pathogens sinking inward after purgation. These must not be confused.
Yu Chang stated: Mistaken purgation in Taiyang disease results in complications above the chest and diaphragm. Here, mistaken purgation leads to abdominal fullness and intermittent pain without chest/diaphragm symptoms, indicating the pathogen has entered the yin position, hence belonging to Taiyin. Using Guizhi Tang to resolve the muscle layer still serves to raise and release the Taiyang pathogen. Doubling Shaoyao (Peony Root) regulates Taiyin qi. Not adding any new herbs to the base formula is truly miraculous! While severe excess and fullness usually warrant urgent purgation, since the yang pathogen has just sunk into Taiyin, harsh purgation is premature. Adding a small amount of Dahuang (Rhubarb) to Guizhi Tang divides the action seven parts exterior and three parts interior to dissipate the pathogen, sharing the same principle as Da Chaihu Tang (Major Bupleurum Decoction).
Cheng Yingmao stated: Mistaken purgation of Taiyang leading to abdominal fullness and intermittent pain reveals Taiyin symptoms. However, the exterior pathogen has sunk and stagnated in the Taiyin; it is not a cold zang disease. Guizhi Tang is still used to raise and release the yang pathogen, but Shaoyao is doubled to harmonize it. If there is severe excess and pain, urgent purgation might seem indicated, but this is yin excess rather than yang excess. Following the Guizhi principle to raise the yang pathogen, Dahuang is added to break up stagnation, allowing both exterior and interior pathogens to have an exit route. The cold departs with the excess, warming naturally without warming agents. Although these two syndromes belong to Taiyin, they actually originate from Taiyang transmission, so the pulse must still be floating, as can be inferred.