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Mu Fang Ji (Stephaniae Tetrandrae Radix) 3 liang, Shi Gao (Gypsum Fibrosum) the size of an egg 12 pieces, Gui Zhi (Cinnamomi Ramulus) 2 liang, Ren Shen (Ginseng Radix et Rhizoma) 4 liang.
The above four herbs are decocted with 6 sheng of water until 2 sheng remain. Divide into two doses and take warm.

Mu Fang Ji (Stephaniae Tetrandrae Radix) and Gui Zhi (Cinnamomi Ramulus) each 2 liang, Ren Shen (Ginseng Radix et Rhizoma) and Fu Ling (Poria) each 4 liang, Mang Xiao (Natrii Sulfas) 3 he.
The above four herbs are decocted with 6 sheng of water until 2 sheng remain. Strain, add Mang Xiao (Natrii Sulfas), and simmer slightly. Divide into two doses and take warm. Mild loose stools indicate cure.
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When there is Zhi Yin (fluid retention in the diaphragm region) under the heart, the patient suffers from severe dizziness and vertigo. Ze Xie Tang (Alisma Decoction) is indicated.
[Annotation]
"Under the heart" refers to the area below the diaphragm. Fluid retention above the diaphragm causes panting and fullness; fluid retention between the diaphragm causes palpitations and stuffiness; fluid retention below the diaphragm causes primarily dizziness and vertigo. Ze Xie Tang (Alisma Decoction), a mild and small formula, is used to treat mild cases of Zhi Yin (fluid retention in the diaphragm region). If Yang deficiency leads to abundant water, Ling Gui Zhu Gan Tang (Poria, Cinnamon Twig, Atractylodes Macrocephala and Licorice Decoction) or Wu Ling San (Five-Ingredient Powder with Poria) should be employed.
[Collection of Annotations]
You Yi stated: When pathogenic water-fluids ascend to the position of clear Yang, they cause dizziness and vertigo. "Mao" refers to mental confusion and lack of clarity, as if obscured by something; "Xuan" refers to visual spinning and sudden darkness. Ze Xie (Alismatis Rhizoma) drains water-Qi, while Bai Zhu (Atractylodis Macrocephalae Rhizoma) tonifies Earth-Qi to overcome water.

Ze Xie (Alismatis Rhizoma) 5 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 2 liang.
The above two herbs are decocted with 2 sheng of water until 1 sheng remains. Divide into two doses and take warm.
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Patients suffering from Tan Yin (phlegm-fluids) should be treated with warm herbs to harmonize.
[Annotation]
Thick and turbid substances constitute Tan (Phlegm), indicating excess Yang; thin and clear substances constitute Yin (Fluids), indicating excess Yin. If there is only Tan (Phlegm) without Yin (Fluids), cool herbs should be used; if there is only Yin (Fluids) without Tan (Phlegm), hot herbs should be used to warm. If both Tan (Phlegm) and Yin (Fluids) are present, neither pure cooling nor pure heating is appropriate; therefore, warm herbs should be used to harmonize.
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In patients with chronic Zhi Yin (fluid retention in the diaphragm region) who experience cough, irritability, and chest pain, if they do not die suddenly but survive for one hundred days or a year, Shi Zao Tang (Ten Jujube Decoction) is appropriate.
[Annotation]
Zhi Yin (fluid retention in the diaphragm region) refers to water-fluids retained above and below the diaphragm. Water invading the Lung causes cough; water invading the Heart causes irritability; water knotting in the Chest causes pain. If the patient's constitution and Qi are substantial, Shi Zao Tang (Ten Jujube Decoction) can be used to purge. However, the reason such patients do not die immediately, or survive for one hundred days or even a year, is that water-fluids are Yin pathogens, and Yin nature is slow, so sudden death does not occur.
Shi Zao Tang (Ten Jujube Decoction) formula (see above).
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For patients with chronic cough, a Xian pulse (wiry pulse) indicates the presence of water-fluids. Shi Zao Tang (Ten Jujube Decoction) is indicated.
[Annotation]
This follows the previous clause to explain the pulse. "Chronic cougher" refers to long-term cough patients; attacking/purging is generally not suitable for them initially. However, if the pulse is Xian (wiry), the cough is caused by water-fluids. Since water-fluids are present, purging is applicable, hence Shi Zao Tang (Ten Jujube Decoction) is used.
[Collection of Annotations]
Wei Litong stated: Cough may result from drinking cold liquids or external contraction of Wind-Cold, described as "cold form and cold drinks injure the Lung," which is external Wind-Cold cough. It may also result from overexertion, where Yin deficiency generates internal heat that scorches Lung Metal, constituting internal injury consumptive cough. These are unrelated here. Zhang Zhongjing terms this "cougher," specifically referring to cough due to phlegm-fluids inside with rebellious Qi rushing upward. Thus, the pulse must be Xian (wiry), lacking the floating pulse of external contraction or the rapid pulse of internal deficiency. Seeing only a Xian (wiry) pulse indicates water-fluids causing pathology in the middle. Treating with Shi Zao Tang (Ten Jujube Decoction) controls the water pathogen, allowing it to drain downward and preventing upward rebellion.
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A Shuang Xian pulse (bilateral wiry pulse) indicates Cold, often occurring after severe purgation leading to interior deficiency. A Pian Xian pulse (unilateral wiry pulse) indicates Fluid retention.
[Commentary]
This clause originally followed the first clause regarding "mild shortness of breath" but is placed here separately.
[Annotation]
Shuang Xian (bilateral wiry) means both left and right pulses are wiry; Pian Xian (unilateral wiry) means either the left or right pulse alone is wiry. Pian Xian (unilateral wiry) indicates Fluid retention, so purging is indicated; Shuang Xian (bilateral wiry) indicates Cold, so purging is not indicated. Even if Pian Xian (unilateral wiry) requires purging, severe purgation should be avoided. Severe purgation would further weaken the interior, transforming a single wiry pulse into a bilateral wiry pulse. The wiry pulse belongs to Yin; double Yin generates Cold, hence "Shuang Xian (bilateral wiry) indicates Cold." This reminds practitioners not to assume the wiry pulse exclusively indicates Fluid retention.
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A Xian Shuo pulse (wiry and rapid) with Cold Fluids is difficult to treat in winter and summer.
[Commentary]
The character "Shuo" (rapid) in "Xian Shuo" should likely be "Chi" (slow) to align with the pathology of Cold Fluids; this is a transcription error.
[Annotation]
Single Xian (wiry) indicates Fluid retention, which normally warrants purging. However, if single Xian (wiry) is accompanied by Chi (slow) and Cold Fluids, purging is contraindicated. Cough due to Cold Fluids is difficult to treat in winter and summer because extreme Yin resides internally in summer and externally in winter. This elaborates on the previous two clauses regarding when Xian (wiry) pulse-related fluid diseases can or cannot be purged.
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In chronic cough lasting years, a Ruo pulse (weak pulse) indicates treatability; a Shi Da Shuo pulse (full, large, and rapid pulse) indicates death. A Xu pulse (deficient pulse) implies suffering from dizziness, due to pre-existing Zhi Yin (fluid retention in the diaphragm region) in the chest. Treatment should focus on the Fluid disease category.
[Annotation]
Chronic cough for years corresponds to annually recurring conditions like phlegm-fluid cough and water-wheezing today. A Ruo (weak) pulse indicates the pathogen is not advancing, suggesting treatability. A Shi Da Shuo (full, large, rapid) pulse indicates daily pathogen advancement, implying a fatal prognosis. A Xu (deficient) pulse indicates righteous Qi deficiency, inevitably causing dizziness. Carefully examining that the patient has pre-existing Zhi Yin (fluid retention in the diaphragm region), treatment should not focus solely on cough but seek methods within the context of Fluid disease management.
[Collection of Annotations]
You Yi stated: Chronic cough persisting for years is caused by Zhi Yin (fluid retention in the diaphragm region) soaking the Lung; persistent fluids lead to persistent cough. Long-term cough depletes Qi; if the pulse is instead full, large, and rapid, the pathogen remains strong. Facing depleted Qi with strong pathogen cannot last long, hence death. If the pulse is deficient, both righteous Qi and pathogenic fluid Qi are weak, making it treatable. However, although fluid Qi is weak, righteous Qi cannot resist it, still obscuring Clear Yang Qi, causing dizziness. Since this disease is caused by Zhi Yin (fluid retention in the diaphragm region), removing the fluids cures the disease, hence "treatment belongs to the Fluid disease category."
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Cough with rebellious Qi, leaning to breathe, unable to lie flat, is treated with Xiao Qing Long Tang (Minor Blue Dragon Decoction). After Xiao Qing Long Tang (Minor Blue Dragon Decoction) induces sweating, if excessive salivation, dry mouth, Cun pulse (inch position) deep, Chi pulse (cubit position) faint, cold limbs, Qi rushing from the lower abdomen to the chest and throat, numbness in limbs, facial flushing resembling drunkenness, followed by downward flow to the inner thighs, difficult urination, and intermittent dizziness occur, administer Fu Ling Gui Zhi Wu Wei Gan Cao Tang (Poria, Cinnamon Twig, Schisandra and Licorice Decoction) to treat the Qi rush. Once the Qi rush subsides but cough and chest fullness recur, use Fu Ling Gui Zhi Wu Wei Gan Cao Tang (Poria, Cinnamon Twig, Schisandra and Licorice Decoction) minus Gui Zhi (Cinnamomi Ramulus), adding Gan Jiang (Zingiberis Rhizoma) and Xi Xin (Asari Radix et Rhizoma) to treat cough and fullness. Once cough and fullness cease but thirst recurs and Qi rush reappears, this is due to Xi Xin (Asari Radix et Rhizoma) and Gan Jiang (Zingiberis Rhizoma) being hot herbs; taking them should cause immediate thirst. If thirst stops instead, it indicates Zhi Yin (fluid retention in the diaphragm region); Zhi Yin (fluid retention in the diaphragm region) typically causes dizziness, and dizzy patients often vomit. For vomiting, add Ban Xia (Pinelliae Rhizoma) to remove water. Use Fu Ling Gui Zhi Wu Wei Gan Cao Tang (Poria, Cinnamon Twig, Schisandra and Licorice Decoction) minus Gan Cao (Glycyrrhizae Radix et Rhizoma) and Gui Zhi (Cinnamomi Ramulus), adding Xi Xin (Asari Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Ban Xia (Pinelliae Rhizoma). If water is removed, vomiting stops, but edema appears, add Xing Ren (Armeniacae Semen Amarum). Although Ma Huang (Ephedrae Herba) should be added for edema, it is omitted because the patient already has numbness; forcing its use would cause Jue (cold reversal). This is because the patient has Blood deficiency, and Ma Huang (Ephedrae Herba) disperses Yang. If facial flushing resembles drunkenness, this is Stomach Heat rushing upward steaming the face; add Da Huang (Rhei Radix et Rhizoma) to drain it.
[Commentary]
The character "Xia" (downward/purge) in "after Xiao Qing Long Tang (Minor Blue Dragon Decoction) xia" should be "Han" (sweat); both Xiao and Da Qing Long Tang (Major Blue Dragon Decoction) are sweating formulas, so this is a transcription error.
[Annotation]
Ke Ni (rebellious cough) is an ancient term for cough; Yi Xi (leaning to breathe) refers to current shortness of breath. Cough with shortness of breath inability to lie down is often Phlegm-Fluids in chronic cases, or combined with exterior Cold in acute cases. Thus, Xiao Qing Long Tang (Minor Blue Dragon Decoction) is used to induce sweating, dispersing interior fluids and exterior Cold. Xiao Qing Long Tang (Minor Blue Dragon Decoction) is strongly acrid and warm, suitable only for those with excess. Misusing it in deficiency damages Yin with acrid-heat (causing salivation/dry mouth) and damages Yang with heavy sweating (causing cold limbs). Facial flushing indicates Yang floating outward; difficult urination and Qi rushing indicate Yin depletion inward; deep/faint pulses indicate weak interior Qi; limb numbness indicates weak exterior Qi; intermittent dizziness indicates severe deficiency. Although Yin-Yang and Interior-Exterior are all deficient, this is a complicated disease resulting from erroneous sweating, mixing Cold and Heat. Therefore, Fu Ling Gui Zhi Wu Wei Gan Cao Tang (Poria, Cinnamon Twig, Schisandra and Licorice Decoction) is given to first unblock Yang and harmonize Yin. Wait for the rushing Qi to calm before discussing other methods. Now, although the Qi rush has subsided, cough and chest fullness recur, indicating Cold Fluids stored in the chest. Gui Zhi (Cinnamomi Ramulus) is disliked for moving outward, so Gan Jiang (Zingiberis Rhizoma) and Xi Xin (Asari Radix et Rhizoma) are added to conquer interior Cold Fluids. After taking this, cough/fullness stop, but thirst and Qi rush recur, indicating Min Fire rebelling upward, stirred by the hot herbs Gan Jiang (Zingiberis Rhizoma) and Xi Xin (Asari Radix et Rhizoma). If thirst occurs immediately upon taking but stops later, it indicates pre-existing Zhi Yin (fluid retention in the diaphragm region). Zhi Yin (fluid retention in the diaphragm region) causes dizziness; this dizziness is due to fluids rebelling in the chest causing vomiting, not Yang deficiency blocking ascent. Hence, Ban Xia (Pinelliae Rhizoma) is added to remove water, and Gan Cao (Glycyrrhizae Radix et Rhizoma) is removed to avoid sweet flavor aiding vomiting. After water removal and vomiting cessation, if facial edema appears, add Xing Ren (Armeniacae Semen Amarum) to descend rebellious Qi and stop cough/vomiting. If edema is not due to cough/vomiting but Wind invasion, Ma Huang (Ephedrae Herba) should be added. Here, Blood deficiency causes numbness, Yang deficiency causes cold limbs, and swelling follows cough/vomiting, so Ma Huang (Ephedrae Herba) is omitted. If accompanied by facial flushing like drunkenness, this is Stomach Heat rushing upward; add Da Huang (Rhei Radix et Rhizoma) to drain Stomach Heat.