Library

Shegan Mahuang Decoction (Blackberry Lily and Ephedra Decoction): Shegan (Belamcandae Rhizoma) 3 liang, Mahuang (Ephedrae Herba) 4 liang, Shengjiang (Zingiberis Rhizoma Recens) 4 liang, Xixin (Asari Radix et Rhizoma), Ziwan (Asternis Radix), Kua Donghua (Toddliae Flos) each 3 liang, Wuweizi (Schisandrae Fructus) half sheng, Dazao (Jujubae Fructus) 7 pieces, Banxia (Pinelliae Rhizoma) half sheng.

The above nine ingredients are decocted with one dou two sheng of water. First, boil Mahuang for two boiling cycles, remove the foam on the surface, then add the remaining herbs. Decoct until three sheng of liquid remains. Divide into three doses and take warm.

[Collected Annotations]
Cheng Lin stated: Cough accompanied by rebellious Qi rising, with a continuous sound in the throat resembling that of a water chicken (frog), is the indication for this decoction. The *Neijing* states: "The Lung dislikes rebellious Qi." One should urgently consume bitter substances to drain it. The bitterness of Shegan and Ziwan serves to drain rebellious Qi. Using pungent substances to drain it, the pungency of Mahuang, Shengjiang, Xixin, Banxia, and Kua Donghua serves to drain wind pathogens. Using sour substances to astringe, and using sour substances to tonify, the sourness of Wuweizi serves to tonify deficiency. According to the principle of "tonifying the mother in cases of deficiency," the sweetness of Dazao serves to tonify the mother (Spleen Earth, which is the mother of Lung Metal).

@@@

Severe rebellious Qi rising, with an unsmooth sensation in the throat, requiring the cessation of rebellion and descent of Qi, is treated with Maidong Tang (Ophiopogon Decoction).

[Commentary]
The character "Da" (Great) in "Da Ni Shang Qi" (Great Rebellious Qi Rising) should likely be "Huo" (Fire). Only then do the textual meaning, pathology, and medication align; this is certainly a transcription error.

[Annotation]

Cough with rebellious Qi rising and a continuous sound in the throat resembling a water chicken indicates cold-fluid retention rebelling upward. Currently, cough with rebellious Qi rising, without the water chicken sound but with an unsmooth sensation in the throat, indicates Fire Qi rebelling upward. "Unsmooth" refers to a sensation in the throat as if obstructed by something, lacking smoothness. Maidong Tang is used as the primary treatment to stop the rebellious Fire Qi and descend its upward movement.

Maidong (Ophiopogonis Radix) 7 sheng, Banxia (Pinelliae Rhizoma) 1 sheng, Renshen (Ginseng Radix) 3 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang, Jingmi (Oryza Sativa) 3 he, Dazao (Jujubae Fructus) 12 pieces.

The above six ingredients are decocted with one dou two sheng of water until six sheng of liquid remains. Take one sheng warm per dose, three times during the day and once at night.

[Collected Annotations]
Zhou Yangjun stated: Yu Chang said: This is a syndrome of dryness and lack of fluids in the Stomach, with deficient Fire flaming upward. Maidong Tang is an excellent method for treating the root cause. If drugs that lower Fire cause Fire to rise further, and cooling drugs cause Heat to intensify, not only is there no benefit, but harm ensues. Any disease can survive if there is Stomach Qi, and will die if there is none. Stomach Qi is the mother Qi of the Lung. In materia medica, the herb Zhi Mu (Anemarrhenae Rhizoma) implies that the Lung relies on its cooling nature, knowing that cooling is the mother of the Lung. Bei Mu (Fritillariae Bulbus) implies that the Lung relies on its ability to resolve phlegm and solidify the Lung, knowing that resolving phlegm is the mother of the Lung. However, when repeatedly applied to syndromes of rebellious Fire Qi and unsmooth throat, they often fail, making their names misleading. Who would have known that Zhang Zhongjing possessed such a brilliant method? By adding one portion of pungent-warm Banxia to the large group of Maidong, Renshen, Gancao, and Jingmi—which greatly tonify Middle Qi and generate fluids—its ability to soothe the throat and descend Qi is not merely due to the efficacy of Banxia itself, but rather the skillful application of Banxia, a marvel unprecedented in ancient and modern times.

@@@

Cough with rebellious Qi rising, frequent expectoration of turbid saliva, and inability to lie down (only able to sit), is treated with Zao Jiao Wan (Soap Fruit Pill).

[Annotation]

Cough with rebellious Qi rising and a water-chicken-like sound in the throat indicates Cold-Fluid rushing to the Lung, which is the indication for Shegan Mahuang Tang. Cough with rebellious Qi rising and an unsmooth throat indicates Fire Qi rushing to the Lung, which is the indication for Maidong Tang. Currently, cough with rebellious Qi rising, characterized only by frequent expectoration of turbid saliva and abundant phlegm-saliva, along with an inability to lie down (only able to sit), indicates severe Qi rebellion. This is a disease caused by Phlegm-Qi, neither Cold-Fluid nor Fire Qi. Zao Jiao Wan is used to guide and disperse the Phlegm and unblock the Qi. It is assisted by the sweetness of Jujube Paste to moderate the fierce nature of the drug.

[Collected Annotations]
Cheng Lin stated: Turbid saliva obstructing the Lung prevents lying down, hence the frequent expectoration of turbid matter. Zao Jiao (Gleditsiae Sinensis Fructus) tastes pungent and salty; pungency disperses, and salinity softens. Nothing surpasses it in unblocking congestion, guiding stagnation, benefiting orifices, and eliminating wind. Therefore, it is suitable for cough with rebellious Qi rising, frequent expectoration of turbid saliva, and inability to lie down. However, since the drug's nature is fierce, it is assisted by the sweetness of Jujube Paste to moderate its action.

Wei Litong stated: Cough with rebellious Qi rising, frequent expectoration of turbid saliva, and inability to lie down (only able to sit) is more severe than having a water-chicken sound in the throat. A滞 (stagnant) sound involves external contraction, while expectorating turbid saliva indicates internal injury. Inability to lie down suggests that Lung Abscess (Fei Yong) is about to form. This is Heat in the Upper Jiao, where Phlegm and Blood wrap around and accumulate into a lesion. It is imperative to promptly unblock this accumulation so that body fluids may slowly regenerate and dryness may be moistened. Zao Jiao Wan is indicated. Zao Jiao dispels wind and resolves bi-syndrome precisely because it has the ability to remove stasis and cleanse filth. When rebellious Qi rises and turbid saliva is frequently expectorated, and foul-smelling phlegm-blood has accumulated in the chest and diaphragm, must we not urgently cleanse and wash it away completely? It is like using Zao Jiao for bathing to remove grease and dirt. Formulating it as a pill allows for slow melting and action from top to bottom, clearing the upper part. If a decoction were used to purge everything directly, it could not treat the sticky coagulation in the upper part. The legislative wisdom of the ancients is truly excellent. This is the primary treatment for preventing the formation of Lung Abscess.