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(Zhang Zhongjing)
Treats Shanghan (Cold Damage) with fever, where sweating does not resolve the condition. Yang pathogenic factors enter the interior, and heat binds in the interior (Here, "interior" does not refer to the interior of the Three Yin meridians, but rather the Stomach Fu-organ; this belongs to Shaoyang-Yangming combined disease. The Three Yin meridians can also transform into Yangming, such as Taiyin using Guizhi Jiada Huang Tang [Cinnamon Twig plus Rhubarb Decoction], Shaoyin having three Chengqi formulas, and Jueyin having one Xiaochengqi Tang [Minor Order the Qi Decoction]; all these involve Yangming syndrome characteristics). There is epigastric fullness and stuffiness (Xinxia Pi), vomiting accompanied by diarrhea; or there is alternating chills and fever, irritability, thirst, delirium, abdominal fullness, constipation. The exterior syndrome has not been resolved, while the interior syndrome is urgent. The pulse may be flooding (Hong) or deep, solid, wiry, and rapid (Chen Shi Xian Shu). ("Exterior syndrome not resolved" means fever, headache, hypochondriac pain, and chills/fever persist; "Interior syndrome urgent" means epigastric hardness, dry thirst, delirium/manic behavior, and constipation. A deep-solid pulse indicates pathogen in the interior; wiry-rapid indicates pathogen in Shaoyang; flooding indicates pathogen in Yangming. Regarding cases with vomiting and diarrhea, why is this formula used? Zhang Jianshan said: For those with interior deficiency, even if stool is difficult, do not attack with purgatives; for those with interior excess, even with vomiting and diarrhea, purgation is permissible. Irritability and frequent vomiting indicate severe interior heat binding in the stomach...)

Chaihu (Bupleuri Radix) (8 liang), Banxia (Pinelliae Tuber) (0.5 sheng), Huangqin (Scutellariae Radix), Shaoyao (Paeoniae Radix Alba) (3 liang), Shengjiang (Zingiberis Rhizoma Recens) (5 liang), Dazao (Jujubae Fructus) (12 pieces, split), Zhishi (Aurantii Fructus Immaturus).
This is a modification of Chaihu Tang (Bupleurum Decoction). Cui Shi considered:
This formula acts on the Foot-Shaoyang Gallbladder meridian and Foot-Yangming Stomach meridian. Since the exterior syndrome remains, Chaihu is used to release the exterior; since the interior syndrome involves dryness and excess, Dahuang (Rhei Radix et Rhizoma) and Zhishi are used to purge the interior; Shaoyao soothes the Spleen and astringes Yin (it can drain Liver fire, preventing Wood from overacting on Earth); Huangqin clears heat and relieves thirst; Banxia harmonizes the Stomach and stops vomiting; Shengjiang is pungent and dispersing, while Dazao is sweet and moderating, together they regulate Ying and Wei (Nutritive and Defensive levels) and promote fluid circulation. This treats both exterior and interior simultaneously; it is a mild form of purgative formula (Zhou Yangjun said: For Taiyang pathogen entering the Bladder Fu-organ, Zhang Zhongjing used Wuling San (Five-Ling Powder); for Shaoyang combined with Yangming Fu-organ syndrome, he used Dahuang Tang (Major Bile-Purging Decoction); both are methods of resolving exterior and interior simultaneously. Wang Ang's note: This is Shaoyang-Yangming combined disease, thus formed by modifying Xiao Chaihu Tang (Minor Bupleurum Decoction) and Xiaochengqi Tang. Shaoyang disease should generally not be purged, but if combined with Yangming Fu-organ syndrome, purgation is indicated. Mild cases use Xiaochengqi Tang, severe cases use Dahuang Tang. Question: Dahuang Tang is purgative, while Guizhi Renshen Tang (Cinnamon Twig and Ginseng Decoction) is tonifying; why do both treat diarrhea and epigastric fullness/hardness? Zhang Jianshan said: Fullness caused by premature purgation results from interior deficiency with協热 (collateral heat) diarrhea; because exterior and interior are unresolved, Guizhi Renshen Tang is used to release exterior and harmonize interior. If Shanghan fever persists after sweating, with epigastric fullness/hardness, vomiting, and diarrhea, this is excess, so Dahuang Tang should be used to purge. Tao Jian'an said: When Shanghan pathogenic heat transmits to the interior, medication must depend on the depth of heat: If all three Jiaozao (San Jiao) are injured, presenting fullness, distension, dryness, excess, and hardness, Da Chengqi Tang (Major Order the Qi Decoction) is suitable; if pathogen is in the Middle Jiao, presenting dryness, excess, and hardness, Tiaowei Chengqi Tang (Regulate the Stomach Order the Qi Decoction) is suitable, adding Gancao (Glycyrrhizae Radix et Rhizoma) to harmonize the middle, removing Zhishi and Houpo (Magnoliae Officinalis Cortex) to avoid damaging the misty Qi of the Upper Jiao; if pathogen is in the Upper Jiao, presenting fullness and excess, Xiao Chengqi Tang is suitable, removing Mangxiao (Natrii Sulfas) to avoid damaging the True Yin of the Lower Jiao. If exterior syndrome is unresolved and interior syndrome is urgent, requiring purgation, Dahuang Tang is used to unblock exterior and interior and treat gently. Da Chengqi Tang is the most intense, Xiao Chengqi Tang is next, Tiaowei Chengqi Tang is next, and Dahuang Tang is milder still, largely due to concern that Mangxiao's nature is restless and urgent, so it is not used lightly...)