Library

Radix Platycodi (Jiegeng), Rhizoma Anemarrhenae (Beimu) (each 3 fen); Semen Crotonis Tiglii (Badou) (1 qian, stir-fried until black).

For Taiyang disease presenting as Cold-Excess Chest Binding (Han Shi Jie Xiong) without heat signs, this formula is indicated.
This condition may arise when, after the exterior syndrome has resolved and interior heat cleared, excessive consumption of cold foods leads to the binding of cold and excess in the chest. However, it must be a case without heat signs. The bitter nature of Radix Platycodi (Jiegeng) and Rhizoma Anemarrhenae (Beimu) is used to descend Qi; the pungent nature of Semen Crotonis Tiglii (Badou) is used to remove excess. It is also said: if the pathogen is above the diaphragm, vomiting occurs; if below the diaphragm, diarrhea occurs. This illustrates that Radix Platycodi (Jiegeng) and Rhizoma Anemarrhenae (Beimu) act on the upper part, while Semen Crotonis Tiglii (Badou) acts on the lower part. If the purgative effect does not occur after ingestion, drink warm water to promote it; if the effect is too strong, stop it by eating cool congee.

Radix et Rhizoma Rhei (Dahuang) (soaked in wine, 0.5 jin), Semen Lepidii seu Descurainiae (Tinglizi) (stir-fried), Semen Pruni Armeniacae (Xingren) (skin and kernels removed), Natrii Sulfas (Mangxiao) (each 0.5 sheng), Radix Kansui (Gansui) (1 qian), Mel Album (Baimi) (2 he). Process into pills the size of a bullet. Take one pill at a time, administered with honey water decoction. Ingest during the day, expect defecation overnight. If defecation does not occur, administer another dose.

In Taiyang disease, if Chest Binding (Jie Xiong) presents with stiffness of the neck, resembling Soft Spasm (Rou Jing), this formula, by purging, will harmonize the condition.
Chest Binding with neck stiffness refers to chest fullness, hardness, and pain, where the head can extend backward but cannot flex forward. Soft Spasm (Rou Jing) is characterized by sweating and neck stiffness. Although there is sweating here, the neck stiffness is due to fullness and excess in the chest preventing flexion, not due to wind-stroke causing spasm. Hence, it is described as "resembling Soft Spasm." Why use pills instead of decoctions? Decoctions primarily serve to sweep and cleanse. The previous Da Xian Xiong Tang was used because the hardness and pain extended from the epigastrium to the lower abdomen, involving all three Jiaos with excess, thus requiring a decoction for sweeping. Here, only the Upper Jiao is full and excess; using a decoction might damage the Yin of the Middle and Lower Jiaos. Therefore, pills are used to attack the pathogen gently. The bitter-cold nature of Radix et Rhizoma Rhei (Dahuang) and Natrii Sulfas (Mangxiao) clears heat; the bitter-sweet nature of Semen Lepidii seu Descurainiae (Tinglizi) and Semen Pruni Armeniacae (Xingren) drains fullness; Radix Kansui (Gansui) is chosen for its ability to reach the site directly; Mel Album (Baimi) is chosen for its moistening and lubricating properties.

Hirudo (Shuizhi) (30 pieces, stir-fried until brown), Ophryotrocha (Mengchong) (wings and feet removed, stir-fried, 30 pieces), Semen Persicae (Taoren) (30 pieces, skin and kernels removed), Radix et Rhizoma Rhei (Dahuang) (3 liang, washed with wine). Crush and sieve the four herbs, mix uniformly, and combine with refined honey to form pills the size of wutong seeds. Take 5–7 pills per dose, three times daily.

In Taiyang disease, if Chest Binding (Jie Xiong) does not occur, but mania (Fa Kuang) appears, accompanied by hardness and fullness of the lower abdomen, free urination, and a deep, knotted pulse, this indicates that Yang pathogenic factors have followed the meridians into the interior, resulting in blood stasis due to heat binding within. This formula is indicated.
It should have presented as Chest Binding but did not, hence "not Chest Binding"; internal excess of blood-heat causes mania, which is more severe than the delirious state seen in Tao Ren Cheng Qi Tang. Hardness and fullness of the lower abdomen indicate Lower Jiao excess; free urination indicates pathology in the Blood aspect rather than Qi; the pathogen has entered deeply into the interior, hence the deep pulse; accumulation of blood stasis internally results in a knotted pulse. A pulse felt beneath the muscle is called Deep (Chen); a pulse that occasionally pauses is called Knotted (Jie). From the perspective of meridians, it is Taiyang; from the perspective of zang-fu, it is the Bladder. Yang pathogens enter via the meridians and bind in the Bladder, hence termed "following the meridians." Blood-heat in the interior, bound and dry, constitutes blood stasis. The Classics state: Bitter enters the Blood, Saline overcomes Blood. The saline-bitter nature of Hirudo (Shuizhi) and Ophryotrocha (Mengchong) eliminates accumulated blood stasis; Slippery substances facilitate intestinal movement, and Bitter substances purge heat. The bitter-slippery nature of Semen Persicae (Taoren) and Radix et Rhizoma Rhei (Dahuang) facilitates the clearance of heat in the blood.