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[Formula of Xiao Qing Long Tang]
Mahuang (Ephedrae Herba, removed nodes) 3 liang, Shaoyao (Paeoniae Radix Alba) 3 liang, Wuweizi (Schisandrae Fructus) half sheng, Ganjiang (Zingiberis Rhizoma) 2 liang, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 3 liang, Banxia (Pinelliae Tuber, washed) half sheng, Guizhi (Cinnamomi Ramulus) 3 liang, Xixin (Asari Radix et Rhizoma) 3 liang.
The above eight herbs are boiled in ten dou of water. First, boil Mahuang until the volume decreases by two dou, skim off the foam on the surface, then add the remaining herbs. Boil until three sheng remains, strain the dregs, and take one sheng warm each time.
Modifications: If there is thirst, remove Banxia and add Gualougen (Trichosanthis Radix) 3 liang. If there is a sensation of choking, remove Mahuang and add one Pao Fuzi (Aconiti Lateralis Radix Praeparata). If there is difficulty in urination and fullness in the lower abdomen, remove Mahuang and add Fuling (Poria) 4 liang. If there is wheezing, remove Mahuang and add Xingren (Armeniacae Semen Amarum, skin and tips removed) half sheng. If there is mild diarrhea, remove Mahuang and add Raohua (Daphnes Genkwa Flower) the size of a chicken egg, stir-fried until red.

[Commentary]
"Add Raohua the size of a chicken egg, stir-fried until red" must be a transcription error. According to Bencao (Materia Medica), Raohua belongs to the same category as Yuanhua (Daphnes Genkwa Flos). Used to attack fluid retention, its potency is very fierce. A dose of five fen can cause dozens of bowel movements. How could one use a chicken-egg-sized dose of Raohua to treat mild diarrhea caused by retained fluid? It seems appropriate to change it to adding Fuling 4 liang.

[Analysis of the Formula]
There are two types of Taiyang disease with retained fluid: one is Wind-stroke with sweating, representing Exterior Deficiency syndrome, corresponding to the Wuling San (Five-Ling Powder) syndrome; the other is Cold Damage without sweating, representing Exterior Excess syndrome, corresponding to the Xiao Qing Long Tang (Minor Blue Dragon Decoction) syndrome. Since the Exterior Excess presents with no sweating, it combines the formulas of Mahuang Tang and Guizhi Tang to release the exterior. Dazao (Jujubae Fructus) is removed because its nature is cloying; Xingren is removed because there is no wheezing, but if wheezing occurs, it is added back; Shengjiang (Zingiberis Rhizoma Recens) is removed because Ganjiang is already present, but if vomiting occurs, Shengjiang is used again. Ganjiang and Xixin are used as assistants, extremely warming and dispersing, allowing cold and fluid to be resolved through sweating. Banxia is used to expel phlegm-fluid and clear residual fluid; Wuweizi is used to astringe Lung Qi and conserve depleted Qi. If there is thirst, Banxia is removed and Huafen (Trichosanthis Radix) is added to avoid dryness and generate fluids. For mild diarrhea, choking sensation, difficulty in urination, and lower abdominal fullness, Mahuang is removed to shift focus from the exterior to the interior. Adding Fuzi disperses cold, stopping the choking; adding Fuling promotes diuresis, stopping mild diarrhea and relieving lower abdominal fullness. This formula, along with Yebiao Tang (Yuebi Decoction), treats fluid overflowing into the exterior causing abdominal distension and edema, suitable for resolution via sweating. Both work effortlessly. Yebiao Tang treats cases with heat, using Shigao (Gypsum Fibrosum) as the sovereign herb to disperse Yang-water; Xiao Qing Long Tang treats cases with cold, using Ganjiang and Guizhi as assistant herbs to disperse Yin-water.

[Collected Interpretations]
Ke Qin said: Both Da Qing Long Tang and Xiao Qing Long Tang treat diseases with both exterior and interior syndromes, employing a method of simultaneous release of both. Da Qing Long Tang involves interior heat, while Xiao Qing Long Tang involves interior cold. Thus, the herbs for releasing the exterior are the same, but those treating the interior differ. This formula, like Wuling San, treats unresolved exterior syndrome with water qi (fluid accumulation) under the heart. However, Wuling San treats stagnant and immobile water, focusing on渗泻 (percolation and purgation) to promote urination and slightly induce sweating to eliminate water from below. This formula treats moving and unsettled water, utilizing acrid-warm herbs to disperse water and vigorously inducing sweating to eliminate water from the outside. Zhongjing's methods for releasing the exterior and promoting diuresis are profound and divine.

Zhao Liang said: Regarding Yi Yin (Overflowing Fluid) syndrome, "Jinkui Yaolue" states: "It should be treated by inducing sweating," using Xiao Qing Long Tang. Generally, when fluid overflows to the exterior, Ying and Wei (Nutritive and Defensive Qi) are all obstructed. One must imitate the method for Cold Damage injuring both Ying and Wei, inducing sweating to dissipate the fluid. Only then will Ying and Wei circulate, meridians unblock, and fluid throughout the body dissipate. Therefore, Xiao Qing Long Tang is the primary choice, and this principle can be extrapolated.

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In Cold Damage, if there is water qi in the heart region, causing cough with slight wheezing, fever, but no thirst: After taking the decoction, if the patient becomes thirsty, this indicates that the cold has departed and the disease is about to resolve. [Note: The phrase "Xiao Qing Long Tang Zhu Zhi" belongs before "fever but no thirst".]

[Commentary]
The six characters "Xiao Qing Long Tang Zhu Zhi" (Xiao Qing Long Tang governs it) should be placed after "fever but no thirst" to align with the meaning of "becoming thirsty after taking the medicine." How could one administer Xiao Qing Long Tang after the cold has departed and the disease is resolving?

[Annotation]
In Cold Damage, if there is water qi under the heart, causing cough with slight wheezing, fever, but no thirst, this is external cold pathogen combined with internal retention of cold fluid. It is appropriate to use Xiao Qing Long Tang for simultaneous exterior and interior resolution. Thirst appearing after sweating resolves the condition indicates dryness inside due to resolved cold, not thirst from stagnant fluid failing to transform. Hence it says: "Cold has departed, disease is about to resolve." One should give small amounts of water frequently to moisten dryness; once Stomach Qi harmonizes, recovery will occur naturally.

[Collected Annotations]
Cheng Wuji said: Cough with slight wheezing is due to cold water attacking the Lung. Fever without thirst indicates the exterior syndrome has not yet ceased. Administering Xiao Qing Long Tang releases the exterior and disperses water. Thirst after taking the medicine indicates interior warmth and dispersion of water qi, signifying impending resolution.

Fang Youzhi said: Fever without thirst indicates dominance of cold. Thus, becoming thirsty after taking medicine signifies cold departing and impending resolution. The general idea resembles the previous clause, so the treatment is the same.

Cheng Zhi said: This clarifies that when cold-fluid is unresolved, Xiao Qing Long Tang is indicated. Water qi under the heart implies cold in the diaphragm area. Hence wheezing, cough, fever, and no thirst. Thirst after taking medicine indicates resolution of cold-fluid. This is the method to resolve water qi using Xiao Qing Long Tang; it does not mean continuing to use Xiao Qing Long Tang after resolution.

Zhang Lu said: When wind-cold carries fluid retention with pathology at the exterior, there is no thirst. Thirst after taking medicine signals cold departure, fluid injury, and impending resolution. Although thirsty, medication is unnecessary; wait quietly for fluid return. Cough with slight wheezing indicates counterflow of fluid retention. Now that fluid is gone and thirst exists, it differs from thirst caused by fluid counterflow. In modern editions, placing "Xiao Qing Long Tang Zhu Zhi" after "cold departed, disease resolving" is a textual error (cuojian).

Wang Hu said: The previous clause mentions thirst before taking medicine, caused by stagnant fluid failing to transform fluids. This clause mentions thirst after taking medicine, caused by fluid loss after sweating. Since the causes of thirst differ, how can Xiao Qing Long Tang still be used? It should be placed before "after taking medicine," which is evident.

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After erroneous purgation followed by repeated sweating, chills and tremors occur, with a faint and fine pulse. This is because both interior and exterior are deficient.

[Annotation]
Sweating should precede purgation. Purging first, then sweating, leads to chills and tremors with a faint, fine pulse, indicating deficiency of both exterior and interior. This occurs because improper purgation damages the interior-guarding Yang, resulting in a faint pulse; improper sweating damages the exterior-guarding Yang, resulting in chills and tremors.

[Collected Annotations]
Zheng Zhongguang said: Treating Cold Damage requires sweating first, then purging. If pathogens remain after purging and sweating is不得已 (unavoidably) repeated, although pathogens leave, both interior and exterior become deficient. Thus, fine pulse and chills indicate greater damage.

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After erroneous purgation followed by repeated sweating, restlessness during the day preventing sleep, but quietness at night, no vomiting, no thirst, no exterior syndrome, deep and faint pulse, and no significant body heat: Gan Jiang Fu Zi Tang (Dry Ginger and Aconite Decoction) governs it.

[Annotation]
This elaborates on the pulse and symptoms from the previous clause to propose treatment. Purging empties the interior; sweating empties the exterior. Yin and Yang are both deficient, with Yang having no anchor. Quietness at night, no vomiting or thirst, indicates no Yang syndrome internally. No exterior syndrome, no significant heat, and deep/faint pulse indicate no Yang syndrome externally. With no Yang in interior/exterior and pure Yin, daytime restlessness is a false Yang syndrome. This represents solitary Yin governing itself in the Yin aspect and lone Yang disturbing itself in the Yang aspect, indicating separation rather than conflict. Therefore, Gan Jiang Fu Zi Tang is used to assist Yang to harmonize with Yin. Although Yin is abundant, it does not repel Yang; Yang is weak and fails to attach.

[Collected Annotations]
Yu Chang said: The previous clause only mentioned chills and faint/fine pulse, not specifying the disease, as deficiency syndromes vary. However, chills and faint/fine pulse reveal Yang deficiency. If daytime restlessness occurs, it indicates disturbance by deficient Yang. Nighttime quietness, no vomiting/thirst, shows deficient Yang disturbance without external pathogens. Deep/faint pulse and no significant heat confirm restlessness as a sign of Yang collapse, making Gan Jiang Fu Zi Tang essential. By inference, daytime quietness and nighttime restlessness indicate Yin disease without Yang involvement.

Cheng Yingmao said: After purging and sweating, daytime restlessness is false heat from disturbed deficient Yang. Nighttime quietness, no vomiting/thirst, no exterior syndrome, deep/faint pulse, and no significant heat indicate true cold from dominant Yin. Gan Jiang Fu Zi Tang is appropriate to retrieve Yang from Yin. One should not hesitate due to the false heat of daytime restlessness.