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To resolve the toxicity of all medicines; also treats tendon hernia (Jin Shen). Tendon hernia refers to pulling pain in the penis, with unbearable swelling and protrusion. This is usually caused by the use of aphrodisiac sorcery. Using this formula also aims at its detoxifying effect.

Gancao (Licorice Root, 2 liang) Heidou (Black Soybean, half sheng)

This belongs to the Foot-Yangming Stomach Meridian. Gancao harmonizes the middle jiao to detoxify, and Heidou dissipates heat to detoxify. (Su Song said: Ancient texts state that soybeans can resolve the toxicity of all medicines; testing confirms this.)

Adding Dahuang (Rhubarb Root and Rhizome) to this formula creates Dahuang Gancao Tang (Rhubarb and Licorice Decoction): treating Xiao Ke (Wasting-Thirst) affecting the Upper, Middle, and Lower Jiao.

The *Neijing* states: All qi stagnation disorders belong to the Lung. It also says: Anger causes qi to rise, joy causes qi to scatter, grief causes qi to consume, fear causes qi to sink, cold causes qi to contract, heat causes qi to leak, shock causes qi to become chaotic, labor causes qi to be depleted, and overthinking causes qi to knot. The nine types of qi changes differ, yet all diseases arise from qi. The body relies on the ascending, descending, exiting, and entering movements of qi. If will/ambition (Zhi) is excessive, it damages the harmonious qi. When healthy, one should nourish, harmonize, and smooth it; when diseased, one must examine which meridian and syndrome are involved, and apply tonification or draining based on cold, heat, deficiency, and excess.

Treating internal injury from mental fatigue: fever, restlessness, headache, aversion to cold, reluctance to speak, aversion to food, pulse floating-large but empty, or panting/thirst, or yang deficiency with spontaneous sweating (add Mahuang Gen (Ephedra Root), Fuxiaomai (Triticum Fruit); Shengma and Chaihu should be stir-fried with honey water to guide Renshen to the exterior, so they cannot be omitted); or qi deficiency failing to control blood; or malaria/dysentery due to spleen deficiency persisting for a long time; all syndromes of sinking clear yang and insufficient middle qi. ("Middle" refers to the Spleen and Stomach. Zang-fu organs and limbs all derive qi from the Spleen and Stomach. Injury from hunger/fullness or labor damages the Spleen and Stomach, leaving the body without qi, leading to illness. Sinking of yang qi allows yin fire to ascend, causing fever and restlessness, which is not excess heat; the head is the meeting point of all yang meridians; if clear yang does not ascend, turbid qi rebels upward, causing headache. The pain comes and goes, unlike external contraction headaches which are continuous; yang deficiency fails to protect the exterior, causing aversion to cold and spontaneous sweating; qi deficiency causes reluctance to speak; spleen deficiency causes aversion to food; spleen/stomach deficiency allows fire to harass the Lung, causing panting; Metal (Lung) suppressed by Fire fails to generate Water (Kidney), causing thirst; spleen deficiency fails to control blood, leading to hematemesis/melena; sinking of clear yang leads to diarrhea/dysentery; qi and blood dual deficiency leads to persistent malaria, called Lao Nue (Chronic Malaria). "Lao" means old/exhaustion. Li Dongyuan's *Differentiation of Internal Injury and External Contraction*: Injury from diet, labor, seven emotions, and six desires is internal injury; injury from wind, cold, summer-heat, and dampness is external contraction. Internal injury fever comes and goes; external contraction fever is severe and continuous. Internal injury aversion to cold resolves with warmth; external contraction aversion to cold persists despite thick clothes and fire. Internal injury aversion to wind fears drafts; external contraction aversion to wind fears any wind. Internal injury headache is intermittent; external contraction headache is continuous until the pathogen enters the interior. Internal injury with dampness may have no thirst, or heart-fire harassing the lung causes dry thirst; external contraction requires 2-3 days for heat to enter the interior before thirst occurs. Internal injury damages qi, causing heavy/weak limbs, fatigue, and desire to sleep; external contraction damages sinews/bones with wind/cold, causing whole-body pain. Internal injury causes shortness of breath; external contraction causes panting with excess qi. Internal injury causes palm heat; external contraction causes back-of-hand heat. Heaven Qi connects to the Lung; the nose is the external opening of the Lung. External contraction cold causes nasal congestion; wind-cold causes runny nose, yet appetite remains, taste is normal, abdomen is peaceful, and excretion is normal. Earth Qi connects to the Spleen; the mouth is the external opening of the Spleen. Internal injury causes reluctance to speak, aversion to food, loss of taste, yellow urine, and constipation or loose stools. Left Renying pulse governs the exterior; in external contraction, Renying is larger than Qikou. Right Qikou pulse governs the interior; in internal injury, Qikou is larger than Renying. Internal injury syndromes are deficiency, suitable for warming, tonifying, and harmonizing; external contraction syndromes are excess, suitable for sweating, vomiting, and purging. Mistaking internal injury for external contraction and using sweating incorrectly severely depletes Yuan Qi, bringing disaster quickly. Thus, Buzhong Yiqi Tang was established to tonify. For combined internal injury and external contraction: if internal injury is heavier, tonification is priority; if external contraction is heavier, dispersing is urgent.

Huangqi (Astragalus Root, honey-fried, 1.5 qian) Renshen (Ginseng Root) Gancao (Licorice Root, fried, 1 qian) Baizhu (Atractylodes Macrocephala Rhizome, soil-fried) Chenpi (Citrus Reticulata Peel, keeping white pith) Danggui (Angelica Sinensis Root, 0.5 qian)

Add Renshen and Wuweizi (Schisandra Berry) for shortness of spirit; remove Renshen for Lung-heat cough; add Gegen (Pueraria Root) for dry throat (Wind-dispelling herbs are mostly drying; Gegen alone stops thirst because it generates clear qi in the Stomach and generates fluids in the Lung). Add Manjingzi (Vernonia Seed) for headache, Chuanxiong (Ligusticum Rhizome) for severe pain, Gaoben (Ligusticum Rhizome) and Xixin (Asarum Root) for brain pain. Add Qianghuo (Notopterygium Rhizome) and Fangfeng (Saposhnikovia Root) for wind-damp binding causing whole-body pain. Add Banxia (Pinellia Tuber) and Shengjiang (Fresh Ginger) for phlegm. Add Qingpi (Citrus Aurantium Green Peel), Kourén (Cardamom Seed), Muxiang (Aucklandia Root), and Yizhiren (Alpinia Oxyphylla Fruit) for stomach-cold and qi stagnation. Add Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), Muxiang, and Sharen (Amomum Fruit) for abdominal distension. Add Shaoyao (Peony Root) and Gancao for abdominal pain. Add Huanglian (Coptis Rhizome) for heat-pain; add Huanglian if eating is possible but epigastric fullness exists. Add Jiegeng (Platycodon Root) for sore throat. Add Rougui (Cinnamon Bark) for cold. Add Cangzhu (Atractylodes Lancea Rhizome) for dampness. Add Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome) for yin-fire. Remove Shengma and Chaihu and add Shudi (Rehmannia Root), Shanzhuyu (Cornus Fruit), and Shanyao (Dioscorea Rhizome) for yin deficiency. Add Jiuhuang Dahuang (Wine-baked Rhubarb) for dry stool. For cough: Spring adds Xuanjinfah (Inula Flower) and Kuandonghua (Fritillaria Thunbergii Bud); Summer adds Maidong (Ophiopogon Tuber) and Wuweizi; Autumn adds Mahuang (Ephedra Herb) and Huangqin (Scutellaria Root); Winter adds Mahuang without removing roots/joints; add Ganjiang (Dried Ginger) in cold weather. Remove Danggui for diarrhea.

This belongs to the Foot-Taiyin Spleen and Foot-Yangming Stomach meridians. The Lung is the root of qi; Huangqi tonifies the Lung and secures the exterior, serving as the Sovereign herb. The Spleen is the root of the Lung (Earth generates Metal; if Spleen/Stomach are deficient, Lung qi fails first). Renshen and Gancao tonify the Spleen, benefit qi, harmonize the middle, and drain fire, serving as Ministers. (Li Dongyuan said: Renshen and Gancao are holy medicines for draining fire. Fatigue causes deficiency-heat; sweet-warm herbs tonify Yuan Qi, resolving deficiency-heat, hence also called "draining".) Baizhu dries dampness and strengthens the Spleen, while harmonizing blood and nourishing yin, serving as Assistants. (Tonifying yang must harmonize yin, otherwise it becomes hyperactive.) Shengma ascends Yangming clear qi (ascending right to restore position); Chaihu (Bupleurum Root) ascends Shaoyang clear qi (rotating left to move upward). As yang ascends, all things are born; as clear qi ascends, yin turbidity descends. Chenpi is added to regulate qi (Chenpi tonifies when used with tonics, drains the Spleen when used alone). Shengjiang is warm; Dazao (Jujube Fruit) is sweet-warm; they harmonize Ying and Wei, open Couli (pores), and produce fluids.

For all deficiencies, first establish the Middle. What is the Middle? The Spleen and Stomach. (Li Dongyuan said: In spleen-stomach deficiency due to diet/labor, Heart-fire becomes hyperactive and attacks the Earth position, then Lung qi is affected. Huangqi is primary, followed by Renshen and Gancao. Spleen-stomach deficiency leads to early Lung qi failure. Huangqi benefits skin/hair and secures Couli to prevent sweating; Renshen treats panting/shortness of breath; fried Gancao uses sweet-warm nature to drain fire and tonify Spleen yuan. Use more for acute pain/severe deficiency with abdominal tightening; reduce for fullness. Baizhu is bitter-sweet-warm, clearing stomach heat and benefiting blood in the waist/navel area. If clear qi sinks below, add Shengma and Chaihu to ascend, guiding the sweet-warm aroma of Renshen/Gancao upward to replenish scattered Stomach qi, solidify the exterior, and relax the Dai Mai. If qi is chaotic in the middle with mixed clear/turbid, use Chenpi (without white pith) to regulate, assisting yang qi ascent to disperse stagnation. Spleen-stomach qi deficiency injured by yin-fire depletes generating qi and Ying blood; lack of blood leaves the Heart un-nourished, causing palpitations/restlessness, named "Ji" (Palpitation). Add sweet-acrid-mild-warm herbs to generate qi. Zhang Zhongjing's method: tonify blood deficiency with Renshen; strong yang generates yin-blood, harmonized with Danggui. Add small amounts of Huangbai to save Kidney water and drain latent yin-fire. If restlessness persists, add Shengdi (Rehmannia Root) to tonify Kidney water; abundant water lowers Heart-fire. Li Shicai said: For deficient patients with colds who cannot tolerate dispersing, this formula can substitute. Li Dongyuan said: Muscle fever is exterior heat. After 1-2 doses, slight sweating occurs naturally due to harmony of yin-yang qi, not forced sweating. *Zhunsheng* states: Four-season colds generally require tonification and dispersing together. Zhu Danxi treated colds mostly with Buzhong Yiqi Tang; qi deficiency uses Sijunzi Tang plus dispersing herbs; blood deficiency uses Siwu Tang plus dispersing herbs. Li Dongyuan treated wind-damp with Buzhong Yiqi Tang plus Qianghuo, Fangfeng, Shengma, Gaoben, Cangzhu. Haizang treated wind-damp: Wuhu Tang for no sweat, Baizhu Tang for sweat. For Gang Jing (Spastic Rigidity), Wuhu Tang plus Qianghuo/Mahuang; for Rou Jing (Flaccid Rigidity), Baizhu Tang plus Fuzi, Baizhu, Guixin. For Zhong Shu (Heat Stroke) with wiry-thin-empty-slow pulse, use Huangqi Tang. These are diseases from hardworking people exposed to pathogens, i.e., colds. *Mingyi Zazhuo* states: Fever has many types with different treatments. Zhang Zhongjing discusses cold/wind as external contraction, requiring release via Ma Huang Tang or Gui Zhi Tang. Cold month onset requires acrid-hot herbs to overcome cold; Spring Warmth requires acrid-cool herbs; Summer Heat requires sweet-bitter-cold agents. Winter Warmth is abnormal weather with leaking yang; avoid hot/warm herbs. Cold Epidemic in warm weather is reversed yin; avoid cold/cool herbs. Warm Epidemic spreading through communities is pestilential qi; treat according to season and luck cycles with acrid-cool/sweet-bitter-cold herbs to clear heat and detoxify. Diet/labor injures Yuan Qi, causing true yang to sink and internal deficiency-heat. Hence Li Dongyuan proposed Buzhong Yiqi theory, using sweet-warm herbs to greatly tonify qi and lift sinking qi (using qi herbs to tonify qi insufficiency). Mental labor/libido injures True Yin; damaged yin-blood leads to excess yang transforming into fire, called Yin Deficiency Fire Hyperactivity Consumption Syndrome. Hence Zhu Danxi proposed "Yang Excess, Yin Insufficiency," using Siwu Tang plus Huangbai/Zhimu to tonify yin and lower fire (using blood herbs to tonify blood insufficiency). Summer Heat Stroke is external but resembles internal injury (Li Dongyuan's Qing Shu Yi Qi). Eating cold foods during summer heat injures the interior; seeking coolness injures the exterior. This is not heat injuring people, but disease caused by heat; treat with acrid-hot exterior-releasing and acrid-warm middle-regulating herbs, similar to cold treatment methods. External vs. Internal, Cold vs. Heat, Qi vs. Blood deficiency are like ice and charcoal. Mistreatment turns mild disease severe and severe disease fatal. *Yi Guan* states: Reading Shanghan books without Dongyuan's books leaves internal injury unclear, killing many; reading Dongyuan without Danxi's books leaves yin deficiency unclear, killing many. Dongyuan's *Piwei Lun* clarifies that fever from hunger/labor is internal injury, resembling colds; strictly forbid sweating/purging. Internal injury is common, external rare; only need warm tonification, no dispersing. If external is common, internal rare, add slight dispersing to warm tonification, focusing on Buzhong Yiqi. If internal injury combines cold, add Mahuang; wind, Gui Zhi; summer-heat, Huanglian; damp, Qianghuo. This is a great benefit, specifically addressing Yang Deficiency Fever. However, 60-70% of Yin Deficiency Fever resembles colds. People see fever and say "cold," demanding dispersing; death follows, and they claim cold methods are exhausted. I have seen Yin Deficiency Fever with high fever/red face/thirst/restlessness cured by a large dose of Liuwei Dihuang Wan. For lower body cold/cold feet with upper body extreme thirst/restlessness or vomiting after drinking, add Rougui and Wuweizi; if severe, add Fuzi served cold. Many lives saved this way.

Removing Danggui and Baizhu, adding Muxiang and Cangzhu creates Tiaozhong Yiqi Tang (Li Dongyuan): Treating Spleen-Stomach disharmony, chest fullness, limb fatigue, poor appetite, shortness of breath, loss of taste (Heart harmony allows tongue to taste); and regurgitation. Adding Shaoyao and Wuweizi also creates Tiaozhong Yiqi Tang (Li Dongyuan): Treating qi deficiency with profuse sweating; other treatments same as above. (Buzhong Yiqi Tang uses purely sweet-warm herbs, following "labor requires warming, damage requires warming"; adding sour Shaoyao/Wuweizi gathers scattered qi, combining releasing and gathering. This is Dongyuan's unique approach to expand the wonder of tonifying the middle.) Adding double Cangzhu, Banxia, and Huangqin (each 3 fen) creates Canzhu Yiwei Tang (Li Dongyuan): Treating internal injury from labor, dry-heat, shortness of breath, thirst, loss of taste, loose yellow stool. Removing Baizhu, adding Cao Kou (Cardamom), Shenqu (Medicated Leaven), Banxia, and Huangbai creates Shengyang Shunqi Tang (Li Dongyuan): Treating injury from diet/labor, fullness, shortness of breath, anorexia, loss of taste, intermittent aversion to cold. (W Hegao said: Shengma/Chaihu acrid-sweet ascend clear qi, making yang qi smooth; Huangbai bitter-cold descends turbid qi, making yin qi smooth; Renshen/Gancao/Danggui tonify deficiency, making upright qi smooth; Banxia/Chenpi benefit the diaphragm, making phlegm-q qi smooth; Cardamom/Shenqu digest food, making grain qi smooth. Dongyuan said: Shengma/Chaihu are thin-flavored and yang-natured, guiding Spleen-Stomach clear qi into the Yang pathway to nourish Spring harmony, and guiding Renshen/Gancao upward to fill Couli and secure exterior defense. Hence tonifying Spleen-Stomach herbs are often named "Ascending Yang and Benefiting Qi." Also: Tonifying with acrid-sweet-warm/herbs of thin flavor (wind herbs) assists Spring-Summer ascending/floating—this is actually "draining." Autumn-Winter descending/storing herbs affect Liver/Heart in the body; acid-bitter-cold/drainage herbs assist Autumn-Winter descending/storing, affecting Lung/Kidneys.) Adding fried Huangqin and Shenqu creates Yiwei Shengyang Tang (Li Dongyuan): Treating irregular menstruation in women; or poor appetite/watery diarrhea after blood loss. (Dongyuan said: Tonifying qi after blood loss is ancient sage method. First tonify Stomach qi to aid generating qi.) Adding Huangbai and Shengdi creates Buzhong Yiqi Jia Huangbai Shengdi Tang: Treating yin-fire harassing yang causing daytime fever exacerbation, spontaneous sweating, shortness of breath, thirst, loss of taste. Adding Shaoyao, Xixin, Chuanxiong, and Manjing creates Shunqi Hezhong Tang (*Ba Jian*): Treating sinking clear yang, headache, aversion to wind, wiry-thin pulse. Adding Qianghuo, Fangfeng, Xixin, and Chuanxiong creates Tiaorong Yangwei Tang (Jie'an): Treating labor-induced cold, body pain, fever, aversion to cold, slight thirst, sweating, body pain, floating-weak pulse.