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[Guizhi Shao Yao Zhi Gan Tang (Cinnamon Twig, Peony, and Licorice Decoction)]
(Zhang Zhongjing)
Treats Jueyin Cold Damage (Cold damage affecting the Jueyin channel), characterized by coldness of the hands and feet, and a fine pulse that is nearly imperceptible.
[Cheng Wuji's commentary: The coldness of the hands and feet is due to deficiency of Yang Qi on the exterior, failing to warm the four extremities; the fine pulse nearly vanishing is due to blood deficiency failing to fill the vessels.]

Composition: Danggui Radix Angelicae Sinensis (3 liang), Guizhi Ramulus Cinnamomi (3 liang), Shaoyao Radix Paeoniae Alba (3 liang), Xixin Herba Asari (3 liang), Zhigancao Radix Glycyrrhizae Preparata (2 liang), Tongcao Medulla Tetrapanacis (i.e., Mutong Caulis Akebiae, 2 liang), Dazao Fructus Jujubae (25 pieces).

This is a formula for the Foot-Jueyin Liver Channel. Cheng Wuji stated: The pulse is the residence of Blood. All Blood belongs to the Heart. To unblock the pulses, one must first tonify the Heart and nourish the Blood. [Formula logic:] Bitter flavors enter the Heart first to relieve tension; Dazao, Zhigancao, and Tongcao are used to moderate the stagnation of Yin Blood. ("Sini" or "Four Reversals" has many causes, some due to Cold, some due to Heat. This case is due to Wind-Cold invading the blood vessels causing reversal of Qi, so Danggui and Xixin, which are Qi-moving herbs within the Blood category, are used as the Sovereign herb; to scatter the reversal in the pulses, one must first remove pathogens from the Blood, so Guizhi is used to disperse Wind in the Taiyang Blood level, and Xixin to disperse Cold in the Shaoyin Blood level, serving as Ministers; without harmonying Ying and Wei, the pulse cannot be unblocked, so Shaoyao, Zhigancao, and Dazao are used to harmonize Ying and Wei; Tongcao benefits the nine orifices, unblocks the blood vessels and joints, and all other drugs rely on it to break stagnation, thus the coldness of the extremities dissipates.) Zhou Yangjun said: Sini Tang is entirely aimed at restoring Yang; Sini San is entirely aimed at harmonizing the exterior and interior; Guizhi Shao Yao Zhi Gan Tang is entirely aimed at nourishing Blood and unblocking the pulses. It avoids acrid-hot substances to prevent damaging Yin fluids. [The original text here appears incomplete or corrupted, ending with "Ji yu wai zu", omitted for translation.]

[Sini San (Four Reversals Powder)]
(Zhang Zhongjing. This is a harmonizing cold-natured formula, named Sini, attached here.)
Treats Shaoyin syndrome of Cold Damage, where Yang pathogenic factors have entered the interior, causing four reversals (cold extremities) that do not warm, or cough, or palpitations, or difficulty in urination, or abdominal pain, or diarrhea with a sensation of heaviness/tenesmus at the anus.
[Mechanism analysis:] Therefore urination... [Text missing] Four limbs... [Text missing]

Composition: Chaihu Radix Bupleuri, Shaoyao Radix Paeoniae Alba (stir-fried), Zhishi Fructus Aurantii Immaturus (bran-fried), Zhigancao Radix Glycyrrhizae Preparata (equal parts, ground into powder). Take with water.
If coughing, add Wuweizi Fructus Schisandrae and Ganjiang Rhizoma Zingiberis Recens; these also treat diarrhea (Wuweizi averts rebellious Qi, Ganjiang disperses Lung Cold. The Lung and Large Intestine are exterior-interior pairs; upper cough and lower diarrhea share similar treatment principles); if palpitations, add Guizhi Ramulus Cinnamomi to guide Yang Qi; if difficulty in urination, add Fuling Poria (sweet and bland to leach out dampness); if abdominal pain, add Fuzi Radix Aconiti Lateralis Preparata (to tonify deficiency and dispel Cold); if diarrhea with tenesmus, add Xieium Bulbus Allii Macrostemonis (to unblock the Large Intestine and drain Qi stagnation).

This is a medicine for the Foot-Shaoyin Kidney Channel. In Cold Damage, Yang is primary. If Yang pathogens transmit to the interior forming Sini syndrome, there is an image of Yin advancing, yet one dares not use bitter-cold purgatives, fearing damage to... [Text missing] Yuan Yin (Primal Yin)... [Text missing].
Treatment depends on the specific modifications. (Tao Jian'an said: When disease is in one channel, there are cases using both hot and cold medicines. For example, in Shaoyin syndrome, cold medicines like Baihu Tang and Sini San are used, while hot medicines like Zhenwu Tang and Sini Tang are also used. Unskilled doctors hesitate and do not know how to proceed. They do not understand that treating Shaoyin with cold medicines addresses heat syndromes transmitted via channels; treating Shaoyin with hot medicines addresses cold syndromes directly attacking the body. Wang Ang's note: In Zhang Zhongjing's *Shanghan Lun*, only one formula using hot medicines exists for Yangming syndrome (Zhuyu Tang); Shaoyang formulas focus on harmonization, sometimes adding Ganjiang; the other four channels frequently use Jiang, Fu, Yu, Gui, countless in number. Must they all be direct attacks? Yangming and Shaoyang channels have no hot formulas; would direct attacks spare these two channels? Moreover, Zhang Zhongjing mentions transmitted diseases but never uses the term "direct attack." On what basis is this distinction made? Thus, Cheng Jiaoqian's theory of direct-attack cold vs. transmitted heat, though traditionally passed down, may not be...) [Text cuts off]