Library

[Formula of Fuzi Decoction]
Fuzi (Aconiti Lateralis Radix Praeparata, peeled, raw, broken into eight pieces) 2 units; Fuling (Poria), 3 liang; Renshen (Ginseng Radix et Rhizoma), 2 liang; Baizhu (Atractylodis Macrocephalae Rhizoma), 4 liang; Shaoyao (Paeoniae Radix Alba), 3 liang.
The above five herbs are boiled in 8 sheng of water to obtain 3 sheng of decoction. The dregs are removed, and 1 sheng is taken warm, three times a day.

[Explanation of the Formula]
Shaoyin (Lesser Yin) is the zang-organ associated with cold water. Therefore, severe cases of cold pathogen invasion often enter the Shaoyin channel. Consequently, the Shaoyin channel sees the most fatal syndromes. In this formula, Fuzi (Aconiti Lateralis Radix Praeparata) serves as the sovereign drug (Jun Yao). Two units are used for their sharp potency and heavy responsibility. Used raw, it first strengthens the ministerial fire (Xiang Huo) yang of Shaoyin, and secondly disperses cold inside and outside the body. Thus, body pain stops naturally, aversion to cold is eliminated, and the hands and feet become warm. Renshen (Ginseng Radix et Rhizoma) serves as the minister drug (Chen Yao) to consolidate the root of vital qi, ensuring that the five zang organs and six fu organs have a foundation, and the twelve meridians have roots. The pulse will naturally not be deep, and the bone joints will harmonize. Furthermore, Baizhu (Atractylodis Macrocephalae Rhizoma) assists in cultivating earth (Spleen), Shaoyao (Paeoniae Radix Alba) pacifies wood (Liver), and Fuling (Poria) drains water. When water is drained, fire becomes prosperous; when fire is prosperous, yin shadows dissipate. When wood is pacified, earth is stabilized; when earth is stable, water is controlled. When controlled, transformation and generation proceed smoothly. This is indeed a perfect therapeutic strategy. It is truly regrettable if one dares not use it due to fear, leading to delay and error!

@@@
In Shaoyin disease, if the pulse is deep, urgent warming is required; Sini Tang (Four Reversals Decoction) is indicated.

[Annotation]
In Shaoyin disease, characterized by an inclination to sleep and a deep pulse, if there are no signs of fever or dry mouth, the cold pathogen has entered the zang organs. One should not hesitate but urgently warm with Sini Tang (Four Reversals Decoction) to eliminate yin and assist yang.

[Collected Annotations]
Wu Renju stated: A deep pulse must be differentiated as deficiency or excess, considering the duration of the illness. If the condition has persisted for many days and the deep pulse is forceful, it requires discussion from another perspective.

Zhi Gancao (Prepared Licorice Root), 2 liang; Ganjiang (Dried Ginger), 1.5 liang; Fuzi (Aconiti Lateralis Radix Praeparata, raw, peeled, broken into eight pieces), 1 unit.
The above three herbs are boiled in 3 sheng of water to obtain 1.2 sheng of decoction. The dregs are removed, and the decoction is divided into two warm doses. For robust individuals, a large Fuzi (Aconiti Lateralis Radix Praeparata) of 1 unit and Ganjiang (Dried Ginger) of 3 liang may be used.

[Explanation of the Formula]
The name "Sini" (Four Reversals) indicates its treatment of Shaoyin disease where cold pervades both interior and exterior, resulting in cold extremities (Jue Ni). Gancao (Licorice Root) with its sweet and warm nature warms and nourishes yang as the sovereign drug. Ganjiang (Dried Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata) with their acrid and warm nature assist yang to overcome cold as minister drugs. Gancao combined with Jiang and Fu drives kidney yang and warms the middle jiao to dispel cold, possessing the function of warming earth within water. Jiang and Fu combined with Gancao penetrate joints and travel to the four limbs, possessing the power to drive out yin and restore yang. As kidney yang is driven, cold yin dissipates, yang reaches the exterior, the pulse rises, and the hands and feet become warm.

[Collected Exegesis]
Wang Hu stated: Shaoyin disease originally presents with a faint and thin pulse and an inclination to sleep. Now, upon light palpation, the faint pulse is absent; upon heavy palpation, the thin pulse nearly vanishes, becoming hidden and sinking. This indicates the cold pathogen has deeply penetrated the interior, likely entering the zang organs. Warming cannot be delayed. If slightly delayed, symptoms such as aversion to cold, curled-up posture, vomiting, diarrhea, irritability, inability to lie down or sleep, cold extremities, and absence of pulse will arise, leading immediately to various fatal syndromes. Can the use of Sini Tang (Four Reversals Decoction) be delayed?

@@@
In Shaoyin disease, if diarrhea occurs, Baitong Tang (White Penetration Decoction) is the primary treatment.

[Annotation]
Shaoyin disease, characterized by an inclination to sleep and a faint-thin pulse, already indicates yang being constrained by yin. The addition of diarrhea suggests that yin descent has reached its extreme, and yang is about to collapse downward. Therefore, Congbai (Allii Tuberosi Bulbus) is used as the sovereign drug to thoroughly unblock yang and promote its ascent. Ganjiang (Dried Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata) are used as assistant drugs to urgently overcome yin and slow its descent, thereby restoring the yang that has not yet collapsed.

[Collected Annotations]
Fang Youzhi stated: Shaoyin disease accompanied by diarrhea indicates not only involvement of the channels but also severe cold in the zang organs and extreme abundance of yin. The use of Ganjiang (Dried Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata) aims to overcome yin, so cold dissipates naturally. The use of Congbai (Allii Tuberosi Bulbus), named "Baitong," aims to unblock yang, so yin dissipates naturally when yang is unblocked.

Cheng Zhi stated: This passage discusses that diarrhea should be treated by unblocking yang. Shaoyin disease refers to the syndrome of faint-thin pulse and inclination to sleep. Shaoyin diarrhea represents extreme yin abundance, fearing the occurrence of Ge Yang (deflection of yang). Thus, Jiang and Fu are used to dissipate yin, and Congbai (Allii Tuberosi Bulbus) to raise yang. "Tong" (unblock) implies two functions: one to warm and allow yang to enter; the other to disperse and allow yin to scatter easily.

Wang Hu stated: Kidney deficiency without fire fails to govern water, causing diarrhea. Baitong Tang (White Penetration Decoction) is used to warm the interior and dispel cold.