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Treats patients with deficiency and weakness accompanied by excessive phlegm-fluids obstructing the chest.
Ren Shen Lu (Ginseng Stalk), ground into powder, taken orally mixed with water, one or two qian. Alternatively, mix with Zhu Li (Bamboo Sap) for administration (Zhu Li lubricates and resolves phlegm).
This formula acts on the Hand-Taiyin Lung Meridian and Foot-Taiyin Bladder Meridian. The Classic states: "For pathogenic factors located superiorly, employ the method of vomiting." When phlegm-fluids are obstructed superiorly, the appropriate treatment is to induce vomiting. Since the patient is weak and emaciated, Ren Shen Lu is used instead of Li Lu (Veratrum Rhizome) or Gua Di (Melon Peduncle); its dispersing action contains a tonifying quality, preventing damage to Yuan Qi (Original Qi). (Zhu Danxi stated: Ren Shen tonifies Yin within Yang, whereas Ren Shen Lu rather drains the Taiyin.)

(Zhang Zhongjing)
Treats post-typhoid conditions following emesis or purgation, characterized by empty vexation, insomnia, severe cases involving restlessness and turning over, and a sensation of stifling discomfort in the epigastrium; as well as after severe purgation where body heat persists, accompanied by binding pain in the epigastrium, or phlegm lodged in the diaphragm region (After sweating, vomiting, or purging, Zheng Qi (Upright Qi) is deficient, allowing Xie Qi (Pathogenic Factors) to invade and bind in the chest due to deficiency, causing febrile vexation. Febrile vexation refers to heat combined with agitation; 'Ao Nao' refers to a feeling of remorseful stifling and oppression. Daytime activity corresponds to Yang, nighttime rest to Yin; since Yang heat has not dissipated and Yin Qi has not recovered, sleep is impossible. If body heat subsides but epigastric binding pain remains...)
Zhi Zi (Gardenia Fruit, 14 pods) Dan Chi (Light Fermented Soybean, 4 he). Administer to induce mild vomiting (Zhang Zhongjing stated: Do not administer if the patient's stool is slightly loose).
This formula acts on the Foot-Taiyin Bladder Meridian and Foot-Yangming Stomach Meridian. Vexation arises from excess heat. Zhi Zi is bitter and cold, red in color entering the Heart, thus serving as the Jun (Emperor) herb. Dan Chi is bitter and can disperse heat; its fermented nature counters scorched dryness (Kidney Qi becomes hot under heat influence, Heart Qi becomes scorched; Dou Chi is steamed and fermented, hence termed 'fermented'). It assists Zhi Zi in vomiting out empty vexation, thus serving as the Chen (Minister) herb. Sour and bitter flavors have the effect of涌泄 (vomiting and draining) and belong to Yin. This formula vomits out formless empty vexation; if there is substantial pathogen in the diaphragm, Gua Di San (Melon Peduncle Powder) should be used. (Wang Haicang stated: Vexation relates to Qi disorders, restlessness to Blood disorders; vexation originates from the Lung, restlessness from the Kidney. Hence, Zhi Zi treats Lung vexation, and Xiang Chi treats Kidney restlessness. It is also used as an emetic because pathogens are in the Upper Jiao; vomiting disperses the pathogen, as the Classic says, "For superior locations, use the method of rising/vomiting." One might ask: Since both vexation and restlessness stem from the Heart, why say vexation comes from the Lung and restlessness from the Kidney? The answer is: Heat causes vexation, extreme heat causes restlessness. Vexation is Yang, restlessness is Yin. Generally, these are diseases of Heart Fire. When Fire is exuberant, Metal becomes dry and Water becomes deficient, leaving Fire alone. Thus, Lung and Kidney combine to produce vexation and restlessness. Note: Loose stools indicate an indication for vomiting; constipation indicates an indication for purging. If stools are slightly loose, do not administer, as there is interior deficiency-cold below; although there is vexation, it is not accumulated heat. If vexation and restlessness are caused by retained food, Zhi Zi Da Huang Tang (Gardenia and Rhubarb Decoction) is indicated.)
Adding Gan Cao (Licorice Root) to this formula creates Zhi Zi Gan Cao Chi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) (Zhang Zhongjing): Treats the aforementioned symptoms accompanied by shortness of breath (Sweet flavor tonifies Qi). Adding Sheng Jiang (Fresh Ginger) creates Zhi Zi Sheng Jiang Chi Tang (Gardenia, Fresh Ginger, and Fermented Soybean Decoction) (Zhang Zhongjing): Treats the aforementioned symptoms accompanied by vomiting (Pungent flavor disperses). Removing Dan Chi and adding Gan Jiang (Dried Ginger) creates Zhi Zi Gan Jiang Tang (Gardenia and Dried Ginger Decoction) (Zhang Zhongjing): Treats typhoid mistakenly treated with purgation, resulting in persistent body heat and slight vexation (Zhi Zi clears heat and relieves vexation; Gan Jiang warms the interior damaged by erroneous purgation). Removing Dan Chi and adding Hou Po (Magnolia Bark) and Zhi Shi (Immature Bitter Orange) creates Zhi Zi Hou Po Tang (Gardenia, Magnolia Bark, and Immature Bitter Orange Decoction) (Zhang Zhongjing): Treats typhoid after purgation, presenting with vexation and abdominal fullness (Zhi Zi vomits empty vexation; Zhi Shi and Hou Po drain abdominal fullness; this is also a method of resolving both exterior and interior simultaneously). Adding Da Huang (Rhubarb Root) and Zhi Shi creates Zhi Zi Da Huang Tang (Gardenia and Rhubarb Decoction) (Zhang Zhongjing): Treats wine jaundice with yellowing, stifling discomfort in the heart, or painful heat; also treats typhoid recurrence due to dietary indiscretion (Mild cases use digestion-promoting methods, severe cases use vomiting and purging). Adding Zhi Shi creates Zhi Shi Zhi Zi Chi Tang (Immature Bitter Orange, Gardenia, and Fermented Soybean Decoction) (Zhang Zhongjing): Treats typhoid recurrence due to exertion (After typhoid recovery, when Qi and Blood are not yet balanced and residual heat remains, illness induced by labor is called Lao Fu (Exertion Recurrence); illness induced by diet is called Shi Fu (Dietary Recurrence)). Adding Xie Bai (Macrostemon Bulb) creates Chi Xie Tang (Fermented Soybean and Macrostemon Decoction) (Zhang Wenzhong): Treats typhoid diarrhea resembling rotten meat juice, bloody dysentery, latent qi abdominal pain, and various heat syndromes (Zhi Xia refers to dysentery. Zhi Zi and Dan Chi are bitter and cold, capable of ascending and dispersing; Xie Bai is pungent and warm, capable of opening chest bi and relieving Large Intestine Qi stagnation). Adding Xi Jiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*) and Da Qing (Isatis Leaf) creates Xi Jiao Da Qing Tang (Rhinoceros Horn and Isatis Decoction): Treats toxic macules with intense heat and headache.