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Treats combined diseases of the three Yang meridians, characterized by headache, fever, mental restlessness and insomnia, dry throat, deafness, aversion to cold, absence of sweating, where symptoms of all three Yang meridians appear simultaneously.

Shi Gao (Gypsum Fibrosum), Chai Hu (Bupleuri Radix), Qiang Huo (Notopterygii Rhizoma et Radix), Bai Zhi (Angelicae Dahuricae Radix), Huang Qin (Scutellariae Radix), Shao Yao (Paeoniae Radix), Jie Geng (Platycodonis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ge Gen (Puerariae Lobatae Radix). Add Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus). Decoct in water and take orally.

[Annotation] Tao Hua formulated this prescription to replace Ge Gen Tang (Cinnamon Twig and Kudzu Root Decoction). However, he did not realize that Ge Gen Tang acts only on the Taiyang (Greater Yang) and Yangming (Yang Brightness) meridians, whereas this prescription uses Chai Hu as the sovereign drug, thereby also treating Shaoyang (Lesser Yang); thus, it is not suitable for combined diseases of Taiyang and Yangming. If used for combined diseases of the three Yang meridians where pathogenic factors in both exterior and interior are mild, it will invariably be effective. Zhang Zhongjing treats combined diseases of the three Yang meridians with Bai Hu Tang (White Tiger Decoction) because the heat is severe. He stated: "Sweating induces delirium and urinary incontinence; purging causes sweating on the forehead and cold extremities." This serves as a warning that only harmonizing methods should be employed, and one should not lightly resort to sweating or purging techniques. This prescription benefits from Ge Gen and Bai Zhi to resolve pathogens of the primary disease of the Yangming meridian. Qiang Huo resolves residual pathogens of the Taiyang meridian. Chai Hu resolves newly entered pathogens of the Shaoyang meridian. Assisted by Shi Gao and Huang Qin to treat heat in various meridians, with a specific focus on clearing Yangming heat. Shao Yao assists in astringing the dispersing properties of other herbs to prevent excessive sweating. Jie Geng guides the herbs upward to the three Yang meridians. Gan Cao harmonizes the various herbs and regulates the exterior and interior. When applied to diseases involving the three Yang meridians, adjusting the ingredients according to clinical judgment ensures recovery. For cases with thirst and desire to drink, double the dosage of Shi Gao and add Gua Lou Gen (Trichosanthis Radix) to clear heat and generate fluids. For severe aversion to cold and absence of sweating, reduce the dosages of Shi Gao and Huang Qin, add Ma Huang (Ephedrae Herba), and increase the dosage during spring and summer to disperse Taiyang cold. For cases with sweating, add Gui Zhi (Cinnamomi Ramulus) to dispel Taiyang wind; there is no situation where this would not work.

Sheng Ma (Cimicifugae Rhizoma), Ge Gen, Shao Yao, Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma). The above four ingredients, decoct in water and take orally.

[Collected Annotations] Ke Qin said: This is a formula for early-stage Yangming disease, serving to release the exterior and harmonize the interior. It can be used to dissipate exterior heat or treat interior deficiency, excelling in both aspects. Fever with spontaneous sweating, aversion neither to cold nor preference for heat, constitutes the fundamental syndrome of the Yangming meridian. Zhang Zhongjing did not establish a specific formula for releasing the exterior; when observing early Yangming onset with profuse sweating and aversion to cold, he used Gui Zhi Tang (Cinnamon Twig Decoction); when there was no sweating and aversion to cold, he used Ge Gen Tang. Although the symptoms resembled those of Taiyang, they were termed Yangming because the exterior disease of Yangming originated from Taiyang, hence the treatment remained similar to that of Taiyang. This prescription treats spontaneous Yangming disease without using Ma Huang or Gui Zhi, fearing that excessive sweating would damage body fluids and lead to stomach dryness. Sheng Ma and Ge Gen are used to diffuse the yang qi of the stomach region to dissipate exterior heat at the muscle level; Shao Yao and Gan Cao purge fire from the Spleen meridian to resolve interior heat in the Stomach fu-organ. It stops sweating if present and induces sweating if absent, functioning similarly to Gui Zhi Tang but avoiding the acrid-warm nature of Sheng Jiang and Gui Zhi, and without the need for warm gruel to assist yang. Excess in the Stomach is an interior syndrome of Yangming; Zhang Zhongjing used the three Cheng Qi Tang formulas. However, in early Yangming disease, heat often shifts to the Spleen causing diarrhea. As stated in the *Nei Jing* (Inner Canon): "Sudden violent diarrhea and tenesmus belong to heat." Diarrhea is indeed a sign of stomach heat. Therefore, in combined diseases of Taiyang and Yangming, spontaneous diarrhea occurs; Zhang Zhongjing used Ge Gen Tang to release the exterior heat of both Yang meridians, which simultaneously treats the interior heat. This prescription imitates this principle, removing the acrid-warm Sheng Jiang and Gui Zhi, replacing Ma Huang with Sheng Ma, making it an exterior-releasing formula for Yangming rather than Taiyang. Ge Gen has a sweet-cool nature, capable of resolving exterior excess; cooperating with Sheng Ma to ascend, it allows clear yang to reach the upper part while turbid yin descends. Thus, Shao Yao astringes Spleen yin, and Gan Cao moderates urgency and harmonizes the interior, stopping diarrhea naturally. The reason interior treatments still use exterior-releasing herbs is that this diarrhea results from exterior excess, not interior excess. Erythema and measles emerge from the interior to the exterior, originating from Shaoyin and manifesting in Taiyang; in the initial stage, both interior and exterior are hot, so cooling and dispersing methods are appropriate. If there is no sweating, add Ma Huang; if sweating, add Gui Zhi; if thirsty and hot, add Shi Gao; if sore throat, add Jie Geng; if headache, combine with Xiong Zhi San (Ligusticum and Angelica Powder); if swelling of head and face, combine with Xiao Du Yin (Detoxification Decoction); if Shaoyang symptoms exist, add Chai Hu and Huang Qin; if fire is excessive, add Huang Qin and Huang Lian (Scrophulariae Radix). For pathogens in the three Yang meridians, modifying this formula accordingly yields favorable results.