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(Zhang Zhongjing) Treats Yangming syndrome of Cold Damage (Shanghan), characterized by aversion to cold being absent, but aversion to heat present, thirst, constipation, delirium, and abdominal fullness. It also treats dryness-excess in the Middle Jiao, and abdominal fullness following vomiting in Cold Damage. (When pathogenic factors are at the Exterior, there is fever, sweating, and aversion to cold; when pathogenic factors have entered the Interior, the Exterior syndrome resolves, hence no aversion to cold, but fever with sweating and an actual aversion to heat. Excessive sweating depletes Body Fluids, and Heat enters the Interior, causing thirst and constipation. Without Water to control Fire, and with dry feces inside, delirious speech occurs. If symptoms persist after vomiting with abdominal fullness, it indicates Heat entering the Stomach; however, since there is fullness without pain, urgent purgation is not suitable. A small amount of Tiaowei Chengqi Tang should be given to harmonize it. In Yangming disease, if irritability occurs without prior emesis or purgation, irritability after emesis is considered internal irritability, irritability after purgation is deficiency irritability, and irritability without emesis or purgation indicates stagnant Heat in the Stomach.) It also treats Zhongxiao (Middle Xiao/Intermediate Diabetes) in Xiao Ke (Wasting-Thirst Syndrome), characterized by excessive hunger with frequent urination.

Dahuang (Rhubarb Root and Rhizome, soaked in wine) 1 liang, Mangxiao (Mirabilite) 1 liang, Gancao (Licorice Root, honey-fried) 5 qian. Take warm, in small amounts frequently.

This acts on the Foot-Taiyang and Foot-Yangming meridians. (Li Dongyuan stated: This is a medicine for Zhengyang Yangming). Dahuang is bitter and cold, clearing Heat and sweeping away excess; Mangxiao is salty and cold, moistening dryness and softening hardness; these two substances descend rapidly, so sweet and neutral Gancao is used to moderate their action, preventing damage to the Stomach Qi, thus named "Tiaowei Chengqi" (Regulate the Stomach and Inherit the Qi). Zhi Shi (Immature Bitter Orange) and Houpo (Magnolia Bark) are omitted to avoid offending the Qi aspect of the Upper Jiao. (Zhuansheng states: The Yangming syndrome is divided into three grades: Taiyang, Zhengyang, and Shaoyang. According to Materia Medica, Dahuang soaked in wine enters the Taiyang meridian, while Dahuang washed in wine enters the Yangming meridian. Soaking takes longer than washing, thus guiding the drug to the highest parts. Zhang Zhongjing included Tiaowei Chengqi Tang in the Taiyang chapter, noting Dahuang was soaked in wine, and instructed to take it warm in small amounts to harmonize Stomach Qi. Furthermore, this formula treats irritability without emesis/purgation, persistent steaming fever after sweating, and abdominal fullness after vomiting. These cases indicate that the Taiyang Exterior has not completely resolved, the pathology is upper, and aggressive purgation is inappropriate; thus, a mild formula for harmonization is suitable. Regarding Zhengyang Yangming, urgent purgation is indicated, and in Da Chengqi Tang, Dahuang is noted as washed in wine. Washing is lighter than soaking, slightly enhancing its descending nature to treat the Middle Jiao; regarding Shaoyang Yangming, it moves away from Zhengyang towards Taiyin, with pathology lower down, so in Xiao Chengqi Tang, Dahuang is not wine-processed, as Shaoyang is unsuitable for purgation, hence [Zhi Shi and Houpo are removed]...)

Adding Danggui (Angelica Sinensis Root) and decocting with Shengjiang (Fresh Ginger) and Dazao (Jujube Fruit) creates Danggui Chengqi Tang (Liu Wansu): Treats interior Heat and Fire stagnation, dry and rough skin, dry throat and nose, constipation of stool and urine, or mania due to Blood stasis. (Adding Danggui enters the Blood aspect to moisten dryness and regulate Ying, consistent with the intent of Tao Ren Chengqi Tang. Adding Jiang and Zao guides the formula to the Stomach.) Removing Mangxiao from this formula creates Dahuang Gancao Tang: Used in Jin Gui Yao Lue to treat vomiting immediately after eating; used in Waitai Miyao to treat vomiting clear water. (Zhuansheng notes: Zhang Zhongjing said those wanting to vomit should not be purged, yet why use Dahuang and Gancao to treat vomiting immediately after eating? The answer is: For those wanting to vomit, the pathology is upper, and inducing upward expulsion is appropriate. Opposing this by forcing downward movement would cause obstruction and confusion, worsening the condition. However, if vomiting persists uncontrollably, with only ascending and no descending, one must counteract this trend and guide it downward. Nothing acts faster than Dahuang for this purpose, hence it is not prohibited. Zhu Danxi rigidly adhered to the view that vomiting must never be treated with purgatives, which is indeed correct in many contexts.) Using 2.5 liang of Dahuang, 2 liang of Mangxiao, and 2 liang of Gancao, this variant is also known as Po Guan Dan: Treats profuse sweating and extreme thirst, constipation with delirium, Yang-Jie syndrome, and various sores and swellings with Heat.