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Radix Puerariae (Ge Gen) 8 liang, Radix Scutellariae (Huang Qin) 3 liang, Rhizoma Coptidis (Huang Lian) 3 liang, Radix Glycyrrhizae (Gan Cao), prepared (Zhi) 2 liang.
The above four ingredients are decocted with eight sheng of water. First, boil the Radix Puerariae until the volume decreases by two sheng. Then add the remaining herbs, and continue boiling until two sheng of liquid remains. Strain out the dregs, and divide into two doses to be taken warm.

[Collected Explanations]
Ke Qin stated: The persistence of external heat indicates that the exterior syndrome is not resolved; the continuous diarrhea indicates that the interior qi is not harmonized. Although the etiology of diarrhea caused by erroneous purgation is the same, there are distinctions. In one case, the pulse is faint and weak, and there is epigastric fullness and obstruction (Pi Zhang); this indicates that the pulse reflects deficiency of righteous qi while the symptoms reflect excess of pathogenic factors. In another case, the pulse is rapid and intermittent (Cu Mai), accompanied by wheezing and spontaneous sweating; this indicates that the pulse reflects excess of pathogenic factors while the symptoms reflect deficiency of righteous qi. Exterior vs. Interior, and Deficiency vs. Excess should be differentiated based on the pulse. Moreover, since a weak pulse appears after multiple erroneous purgations, it can be further deduced that the epigastric fullness and obstruction is due to deficiency. Therefore, the acrid-sweet-warm tonifying method of Lizhong Tang is used to stop diarrhea and resolve epigastric fullness and obstruction, and Guizhi Tang (Cinnamon Twig Decoction) is added to release the exterior. By decocting the first four ingredients first and adding Guizhi later, the power to harmonize the middle jiao is profound, while the energy to relieve the muscle layer is sharp. This embodies a flexible approach within simultaneous resolution of both exterior and interior. The Guizhi pattern originally presents with a slow pulse; after erroneous purgation, the pulse becomes rapid and intermittent, indicating internal abundance of yang qi and pathogenic steaming outward, causing sweating. Heat raging internally causes fire to rebel and rush upward, resulting in wheezing; sudden urgent diarrhea results in purging. Therefore, Ge Gen, which is clear, light, ascending, and stimulating, is used as the sovereign herb to relieve the muscle layer and stop diarrhea; Huang Qin and Huang Lian, which are bitter and cold, clearing and肃 (descending), are used as assistant herbs to stop sweating and calm wheezing; Gan Cao is added to harmonize the middle. By decocting Ge Gen first and adding other herbs later, the power to relieve the muscle layer is pure, and the qi to clear the interior is sharp, which is distinct from methods that tonify the middle and expel pathogens.
In Taiyang disease, if after purgation the pulse is rapid and intermittent (Cu Mai) and there is chest fullness, Guizhi Qu Shaoyao Tang (Cinnamon Twig Decoction without Paeonia) is the primary formula. If there is slight aversion to cold, Fuzi Tang (Aconite Decoction) added to the Guizhi Qu Shaoyao Tang formula is the primary treatment.

[Commentary]
If there is slight aversion to cold, it should correspond to the pattern of "sweating with slight aversion to cold." Without the phrase "sweating," it indicates the exterior is not yet resolved, and there is no need to use the formula with added Fuzi.

[Annotation]
In Taiyang disease, if the exterior is not resolved and purgation is erroneously applied, real pathogenic factors sinking into the chest cause chest fullness, with qi rushing up to the throat causing dyspnea; this is the indication for Goudi San (Melon Seed Powder). If deficient pathogenic factors sink into the chest, it causes qi rushing upward, which is the indication for Guizhi Tang. Now, after purgation, pathogenic factors sink into the chest, causing chest fullness and a rapid and intermittent pulse. It seems like a chest excess pattern but lacks the symptom of qi rushing to the throat causing dyspnea; it seems like a chest deficiency pattern but presents with chest fullness. Therefore, Goudi San is not used to treat excess, nor is Guizhi Tang used to treat deficiency. Instead, the sweet and acrid nature of Guizhi is used to harmonize the Taiyang exterior, and the sour-astringent nature of Shaoyao is removed to avoid aggravating the chest fullness. If there is sweating and slight aversion to cold, adding Fuzi to the Guizhi Qu Shaoyao Tang formula is used to prevent the complication of Yang collapse.

[Commentary]
The previous clause described a rapid and intermittent pulse, wheezing, sweating, aversion to cold absent, and continuous diarrhea, classified as an Excess-Heat syndrome. This clause describes a rapid and intermittent pulse, chest fullness, sweating, slight aversion to cold, no wheezing, and no diarrhea, classified as a Deficiency-Cold syndrome. Why? The sweating in the previous clause was caused by internal heat steaming outward, hence sweating without aversion to cold, representing Yang Excess; wheezing and diarrhea were both Heat syndromes. The sweating in this clause was caused by failure of Exterior Yang to secure, hence sweating with slight aversion to cold, representing Yang Deficiency; even without wheezing or diarrhea, it is a Cold syndrome. One must understand that Zhang Zhongjing established his principles by distinguishing at extremely subtle points, fearing that people might overlook these subtleties. Here, he uses "slight aversion to cold" to elucidate the meaning. The differentiation of Cold vs. Heat is not based on "sweating," but on "sweating with aversion to cold" versus "sweating without aversion to cold"; it is not based on "rapid and intermittent pulse," but on whether the pulse is "forceful" or "weak." From this, we can also know that differentiation of Deficiency vs. Excess is not only based on chest fullness, but also on whether the fullness is intermittent or constant and unrelenting.

[Collected Notes]
Yu Chang said: Observing the "slight aversion to cold" in this clause together with the previous one reveals that within the rapid and intermittent pulse, chest fullness, wheezing, and sweating, there was originally a latent mechanism of collapsing deficient Yang. Thus, Zhang Zhongjing specifically used the three characters "slight aversion to cold" to elucidate the principle, showing that Yang deficiency leads to aversion to cold. It also shows that aversion to cold without sweating is not due to Yang deficiency.
Cheng Yingmao said: There are cases where Yang excess presents with a rapid and intermittent pulse, and cases where Yang deficiency presents with such a pulse. One must differentiate based on forcefulness or weakness, and still rely on external symptoms for differentiation.
Shen Mingzong said: Erroneous purgation disturbs the qi of Yin and Yang, leading to a rapid and intermittent pulse. Pathogens enter the chest and diaphragm, nearly forming Jie Xiong (Chest Binding), but there is only fullness and obstruction without pain. Therefore, Guizhi Tang is used to lift the pathogen from the chest and diaphragm so it may be resolved from the exterior. Shaoyao is removed because its sour-astringent nature is disliked, as it would draw pathogens inward. If the pulse is rapid and intermittent, there is chest fullness, and slight aversion to cold, this indicates deficiency and constriction, with Yang Qi about to collapse, which is not comparable to Yang Excess. Therefore, Fuzi is added to protect the True Yang. However, aversion to cold after purgation for wind injury is completely different from aversion to cold before purgation. Similarly, aversion to cold after sweating is different from aversion to cold before sweating.