Library

After erroneous purgation followed by erroneous sweating, if the patient experiences restlessness during the day preventing sleep, yet remains quiet at night, with no vomiting, no thirst, no exterior syndrome, a deep and faint pulse, and no significant body heat, Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) should be administered.
Ganjiang (Rhizoma Zingiberis Preparatum), 1 liang; Fuzi (Radix Aconiti Lateralis Preparata, peeled, used raw, broken into eight pieces), 1 piece. These two ingredients are boiled in 3 sheng of water to obtain 1 sheng of decoction. The dregs are removed, and the decoction is taken all at once.

In Shaoyin disease presenting with cold extremities and palpitations in the epigastrium, if sweating or purgation fails to resolve the condition and restlessness ensues, Fuling Sini Tang (Poria and Sini Decoction) should be administered.
Fuling (Poria), 6 liang; Renshen (Radix Ginseng), 1 liang; Gancao (Radix Glycyrrhizae Preparata, honey-fried), 1 liang; Ganjiang (Rhizoma Zingiberis Preparatum), 1 liang; Fuzi (Radix Aconiti Lateralis Preparata, used raw, broken into eight pieces), 1 piece. These five ingredients are boiled in 5 sheng of water to obtain 3 sheng of decoction. The dregs are removed, and 7 ge of the warm decoction is taken three times daily.

[Annotation] Whenever Taiyang disease is treated improperly, such as purging after sweating or sweating after purging, leading to compounded errors and resulting in a "disaster disease" (Huai Bing). If the patient's Yang qi is abundant and transforms into heat, the condition shifts to the Three Yang meridians; if Yang qi is deficient and transforms into cold, it belongs to the Three Yin meridians. The restlessness treated by these two formulas both belong to disaster diseases. Although restlessness can occur in all six meridians, it is more common in Taiyang and Shaoyin, because Taiyang is the superficial aspect of True Yin (Shaoyin), and Shaoyin is the root of True Yang (Taiyang). Restlessness occurring without prior sweating or purgation usually indicates a Yang pattern, characterized by a solid and large pulse, thirst, and fever; here, "fan" (mental agitation) is due to Yang excess, and "zao" (physical restlessness) is due to Yin deficiency. Restlessness occurring after sweating and purgation usually indicates a Yin pattern, characterized by a deep and faint pulse, sweating, and cold extremities; here, "fan" is due to Yang deficiency, and "zao" is due to extreme Yin cold. Purging before sweating is therapeutically adverse. With no significant external heat and no internal thirst or vomiting, it may seem that Yin and Yang are harmonizing themselves, but in reality, reckless sweating has caused Yang collapse. Thus, deficient Yang disturbs the Yang aspect, causing daytime restlessness and insomnia; excessive Yin resides peacefully in the Yin aspect, causing nighttime quietness. A deep and faint pulse indicates impending collapse of True Yang accompanied by restlessness. Ganjiang and Fuzi are used to strengthen Yang to coordinate with Yin. Ginger and Aconite are "Yang within Yang"; used raw, their power is sharper; without Gancao, their momentum is fiercer. This formula is more potent than Sini Tang, aiming to rescue separated Yang, hence it must be used urgently. Sweating before purging is therapeutically orderly, but if the disease persists with lingering cold extremities and palpitations, and sudden昼夜 (day and night) restlessness increases, it may seem like Yin excess repelling Yang, but actually, Kidney Water is overacting on the Heart. This is because Water Qi does not reside in its proper position, carrying Yin pathogenic factors upward. This is restlessness due to Yang deficiency with Water Qi retention. Fuling is used as the sovereign herb with Sini Tang to suppress Yin and eliminate Water Qi. Renshen assists Sini Tang to generate Qi and benefit Yang. Ginseng and Poria act like noble ministers, harmonized with Gancao, making this formula milder than Sini Tang. Since Yin and Yang are not urgent, it should be used slowly. Removing Gancao and adding Renshen and Fuling naturally distinguishes between slow and urgent approaches. Such is the subtlety of Zhang Zhongjing’s prescription usage.