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Decoction of Ma Huang (Ephedrae Herba) with Gu Zhi (Cinnamomi Ramulus) and Shi Gao (Gypsum Fibrosum), known as Da Qing Long Tang: Ma Huang (Ephedrae Herba) six liang, Gu Zhi (Cinnamomi Ramulus) two liang, Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle) two liang, Xing Ren (Armeniacae Semen Amarum) forty kernels, Sheng Jiang (Zingiberis Rhizoma Recens) three liang, Da Zao (Jujubae Fructus) twelve pieces, Shi Gao (Gypsum Fibrosum) the size of a chicken egg. The above seven ingredients are decocted in nine sheng of water. First, boil Ma Huang until the volume reduces by two sheng, skim off the foam on the surface, then add the remaining herbs. Continue boiling to obtain three sheng of liquid, strain out the dregs, and take one sheng warm. Aim for a slight sweating; if sweating is excessive, apply warm powder to the body to stop it.

Decoction of Ma Huang (Ephedrae Herba) with Wu Wei Zi (Schisandrae Chinensis Fructus), known as Xiao Qing Long Tang: Ma Huang (Ephedrae Herba) three liang, Bai Shao (Paeoniae Radix Alba) three liang, Wu Wei Zi (Schisandrae Chinensis Fructus) half sheng, Gan Jiang (Zingiberis Rhizoma) three liang, Gan Cao (Glycyrrhizae Radix et Rhizoma Praeparatum cum Melle) three liang, Xi Xin (Asari Radix et Rhizoma) three liang, Gui Zhi (Cinnamomi Ramulus) three liang, Ban Xia (Pinelliae Tuber Praeparatum cum Alumine et Zingibere) half sheng. The above eight ingredients are decocted in ten sheng of water. First, boil Ma Huang until the volume reduces by two sheng, skim off the foam on the surface, then add the remaining herbs. Continue boiling to obtain three sheng of liquid, strain out the dregs, and take one sheng warm.

[Collected Explanations]
You Yi stated: Da Qing Long Tang is derived from combining Gui Zhi Tang (Cinnamon Twig Decoction) and Ma Huang Tang (Ephedra Decoction), removing Bai Shao (Paeoniae Radix Alba) and adding Shi Gao (Gypsum Fibrosum). It is suitable for conditions where fluid retention is not severe but accompanied by heat. If there is excessive fluid intake and latent cold, Xiao Qing Long Tang (Minor Blue Dragon Decoction) should be used.

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When fluid retention is in the Lung, the pulse is not wiry; the patient suffers mainly from asthma and shortness of breath.
[Annotation]
The wiry pulse is indicative of various types of fluid retention, but it primarily relates to the Liver. When water resides in the Liver region, it causes Xuan Yin (Hanging Fluid Retention), resulting in a deep and wiry pulse. When water resides in the Lung region, it causes Zhi Yin (Branching Fluid Retention), so the pulse is not wiry. Asthma, coughing, and shortness of breath are symptoms of fluid retention in the Lung; pain radiating from the hypochondrium is a symptom of fluid retention in the Liver. Since there is no pain radiating from the hypochondrium characteristic of the Liver, but only suffering from asthma and shortness of breath characteristic of the Lung, it is said that fluid retention in the Lung does not present with a wiry pulse.
[Collected Notes]
Li [Name] stated: The wiry pulse is associated with the Liver, hence fluid retention in the Lung does not show a wiry pulse. Suffering from asthma and shortness of breath is due to pathogenic factors obstructing the Lung. As mentioned previously, "coughing, reverse qi, leaning to breathe, and shortness of breath" constitute Zhi Yin (Branching Fluid Retention).

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Zhi Yin (Branching Fluid Retention) also causes asthma preventing lying down, accompanied by shortness of breath, while the pulse appears normal.
[Annotation]
Zhi Yin (Branching Fluid Retention) is a disease of water in the Lung, thus causing asthma that prevents lying down and shortness of breath. A "normal" pulse here refers to the typical Lung pulses, which may be floating, choppy, or short. This elaborates on the meaning of "pulse not wiry" mentioned in the previous clause.

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When Zhi Yin (Branching Fluid Retention) causes difficulty breathing, Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction) is indicated.
[Annotation]
This follows the previous clause to explain the treatment. Asthma, coughing, inability to lie down, shortness of breath, and inability to breathe smoothly are all acute syndromes of water in the Lung. Therefore, Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction) is used to directly drain the water from the Lung.
[Collected Notes]
Shen Mingzong stated: This is Zhi Yin (Branching Fluid Retention) overflowing into the Lung. Zhi Yin (Branching Fluid Retention) stores in the chest and diaphragm, interfering upward with the Lung. Qi rebellion makes breathing difficult and unsmooth, causing difficulty breathing. In emergencies, treat the branch first. Thus, the sweetness of Da Zao (Jujubae Fructus) protects the Spleen, while the bitterness of Ting Li Zi (Descurainiae Semen) drains the Lung. This allows Lung Qi to flow freely and the Spleen to transport effectively. It is a harsh formula for attacking Zhi Yin (Branching Fluid Retention) in the Lung.
You Yi stated: Difficulty breathing indicates Lung fullness and Qi closure. Ting Li Zi (Descurainiae Semen) enters the Lung to open closures and drain fullness. Da Zao (Jujubae Fructus) is used to prevent damage to healthy Qi.
Ting Li Da Zao Tang (Descurainia Seed and Jujube Decoction) formula (see in the section on Lung Abscess).

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When there is Zhi Yin (Branching Fluid Retention) between the diaphragm, the patient experiences asthma and chest fullness, epigastric hardness and distension, dark facial complexion, and a deep, tight pulse. Having suffered for dozens of days, if treatments with emetics or purgatives failed to cure, Mu Fang Ji Tang (Stephania Tetrandra Decoction) is indicated. If the condition is deficient, recovery occurs immediately. If it is excess, relapse occurs after three days. If repeated administration of the same formula fails, Mu Fang Ji Tang (Stephania Tetrandra Decoction) modified by removing Shi Gao (Gypsum Fibrosum) and adding Fu Ling (Poria) and Mang Xiao (Natrii Sulfas) is indicated.
[Annotation]
Zhi Yin (Branching Fluid Retention) causes asthma, chest fullness, and difficulty breathing due to water in the chest and Lung. Combined with epigastric hardness and distension, it indicates water accumulation connecting to the diaphragm, hence called "Zhi Yin (Branching Fluid Retention) between the diaphragm." A dark facial complexion is the sign of deeply accumulated water pathogens. A deep and tight pulse is also the sign of deeply accumulated water pathogens. Due to deep accumulation, symptoms such as asthma, chest fullness, and epigastric hardness occur. After dozens of days, if emetic treatment failed, it means the water pathogen is not solely accumulated in the Upper Jiao, so dispersing methods are ineffective. If purgative treatment failed, it means the water pathogen is not solely accumulated in the Lower Jiao, so draining methods are ineffective. Epigastric hardness and distension indicate fluid accumulation in the Middle Jiao. Therefore, Mu Fang Ji Tang (Stephania Tetrandra Decoction) is used to open the water accumulation in the Three Jiao and regulate Qi in the Upper, Middle, and Lower Jiao. Ginseng is included because healthy Qi was damaged by emesis and purgation. Thus, if the water accumulation is deficient, recovery occurs upon ingestion. If the water accumulation is excess, even if temporarily cured, it will relapse. Re-administering the original formula will not work. One should modify the original formula by removing the cold nature of Shi Gao (Gypsum Fibrosum), adding Mang Xiao (Natrii Sulfas) to aggressively break hard accumulations, and adding Fu Ling (Poria) to directly channel water pathways. There will be no failure to cure.
[Collected Notes]
Li [Name] stated: Asthma, chest fullness, and epigastric hardness/distension result from the upward reversal of Zhi Yin (Branching Fluid Retention) between the diaphragm. A black face indicates that fluid retention corresponds to the Water element of the North. A deep pulse indicates fluid retention, and a tight pulse indicates cold; both are Yin pulses, as fluid retention inherits Yin-cold qi. Since neither emesis nor purgation worked, both Yin and Yang Qi are deficient. Mu Fang Ji Tang (Stephania Tetrandra Decoction) tonifies deficiency and dissipates fluid retention; deficient patients recover upon receiving tonification. In excess cases, the fluid pathogen is firmly accumulated and unresolved, leading to relapse and non-recovery. This is because cold qi has condensed and remains unresolved. Therefore, Shi Gao (Gypsum Fibrosum) is removed to avoid damaging Stomach Qi. Fu Ling (Poria) is added for its bland property to leach out fluid retention, and Mang Xiao (Natrii Sulfas) is added for its salty property to soften hard accumulations.