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Rhizoma Rhei Preparata (Dahuang) 2 liang, Rhizoma Coptidis (Huanglian) 1 liang.
The above two herbs are soaked in 2 sheng of boiling water (Mafei Tang). After a short while, the liquid is squeezed out and the dregs discarded. The decoction is divided into two doses and taken warm.

[Fangjie - Analysis of the Formula]
Pi syndrome (epigastric fullness and obstruction) is caused by deficient pathogenic factors, yet Dahuang and Huanglian are used. Would this not arouse suspicion among later practitioners? However, Zhang Zhongjing's points of potential confusion are precisely where understanding lies.
This is likely because later generations failed to study carefully and did not grasp the method, actually decocting and administering the herbs, which completely contradicts the original intent. Observe that he uses boiling water like hemp seeds to soak Dahuang and Huanglian, squeezing out the liquid after a brief moment and discarding the dregs. This extracts only the formless Qi (light and clear energetic properties) of the herbs, not their substantial flavor (heavy and thick taste), thereby utilizing their light aroma and flavor to avoid severe purgation. Although it is said to attack Pi, the subtlety of this attacking method is inconceivable.

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If the pulse is floating and tight, and a purgative method is mistakenly applied, the tightness moves inward, resulting in Pi syndrome. Palpation reveals softness without hardness; this is merely Qi Pi (Qi-type stagnation).

[Annotation]
In Taiyang disease, if the pulse is floating and tight, sweating should be induced. If purgatives are mistakenly used, the floating-tight pulse transforms into a sinking-tight pulse. This indicates cold pathogenic factors sinking inward to form Pi, which is the diagnostic sign. "Soft upon palpation" means there is no hardness or pain, only a sensation of Qi stagnation and discomfort. This is the indication for Gancao Xiexin Tang.

[Jizhu - Collected Annotations]
Cheng Yingmao stated: Mistaken purgation leading to Pi involves errors in both syndrome differentiation and pulse diagnosis. Therefore, the rescue method must still be determined by combining pulse and syndrome analysis. When the tightness moves inward, the floating-tight pulse becomes sinking-tight. The exterior pathogen sinks inward and fails to disperse, lodging in the epigastrium and causing Pi.

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When there is epigastric fullness and obstruction, palpation reveals no hardness, and the Guan position pulse is floating, Dahuang Huanglian Xiexin Tang is the primary treatment.

[Commentary]
There should be a "not" character before "soft". If palpation reveals softness, it is a deficient Pi syndrome. In such cases, tonification is insufficiently addressed, let alone using Dahuang for purgation.

[Annotation]
This clarifies the previous clause. "Soft upon palpation" refers merely to Qi Pi. However, if there is epigastric Pi and palpation reveals it is NOT soft (indicating resistance or hardness), this is a Heat Pi suitable for attack. Yet, since the Guan pulse is floating rather than sinking-tight, the accumulated heat is shallow, and harsh purgation is not appropriate. Thus, Dahuang Huanglian Xiexin Tang is used.

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When there is epigastric fullness and obstruction, accompanied by aversion to cold and sweating, Fuzi Xiexin Tang is the primary treatment.

[Annotation]
Epigastric pain indicates Jie Xiong (chest binding). Absence of pain indicates Xin Xia Pi (epigastric Pi). Epigastric Pi accompanied by aversion to cold and sweating is not due to unresolved exterior syndrome, but rather deficiency of Exterior Yang. Therefore, Dahuang, Huanglian, and Huangqin are used to clear the heat of Pi, while Fuzi warms the Exterior Yang. This treats both external cold and internal heat simultaneously. The brilliance lies in soaking the three yellows (Sanhuang) in boiling water, squeezing out the liquid quickly, and separately decocting Fuzi. The principle emphasizes light clearing of Pi heat and heavy support of Yang.

[Jizhu - Collected Annotations]
Fang Youzhi stated: Pi originates from Yin pathogens lurking internally with deficient heat congealing upward. Aversion to cold and sweating indicate exterior deficiency and Yang failing to protect the surface. Xiexin Tang clears heat and dissipates Pi; adding Fuzi consolidates Yang and stops sweating. With Huangqin and Fuzi combined, the dual resolution of interior and exterior is fully manifested.
Li Zhongzi stated: The bitter-cold nature of the three yellows clears the middle and nourishes Yin; the acrid-hot nature of Fuzi warms the meridians and consolidates Yang. The mutual use of cold and hot, and simultaneous application of attack and tonification without contradiction, demonstrates Zhang Zhongjing's divine mastery.
Cheng Yingmao stated: This clause should be read alongside: "After severe purgation in Taiyang disease, followed by repeated sweating, if there is epigastric Pi and aversion to cold, the exterior is unresolved. Do not attack Pi; first resolve the exterior. Once the exterior is resolved, then attack Pi. Resolve the exterior with Guizhi Tang; attack Pi with Dahuang Huanglian Xiexin Tang." In that case, Guizhi Tang is used because sweating was incomplete and initial aversion to cold persisted, indicating unharmonized exterior. Here, Fuzi is added because sweating has occurred, initial aversion to cold ceased, but aversion to cold and sweating have returned, indicating deficiency of Exterior Yang. Careful comparison of similarities and differences is required.