Library

Decoction of Ramulus Cinnamomi (Guizhi Tang) consists of Ramulus Cinnamomi (Guizhi) three liang (with the bark removed).
Note: The original text of the Decoction of Ramulus Cinnamomi includes the phrase "with the bark removed." The aroma and flavor of Ramulus Cinnamomi are entirely contained in the bark; if the bark is removed, only dead wood remains, how can it exert the effect of resolving the muscle layer and inducing sweating? These two characters should be deleted. Subsequent cases follow this example. (*Zongjin Yijian*)

In Taiyang disease (disease of the Taiyang channel), after purgation, if there is an upward rush of Qi, the Decoction of Ramulus Cinnamomi may be administered, using the method described previously. If there is no upward rush of Qi, it should not be given.
"Using the previous method" refers to the method of drinking hot thin porridge, which is consistent with the later mention of "following the previous method." To interpret it as adding purgative herbs to the decoction is a major error! (Ke Yunbo)

After taking the Decoction of Ramulus Cinnamomi, or after purgation, if there is still stiffness and pain in the head and neck, slight fever (Xi Xi Fa Re), absence of sweat, fullness and slight pain in the epigastrium, and difficulty in urination, the Decoction of Ramulus Cinnamomi minus Ramulus Cinnamomi plus Rhizoma Alismatis (Ze Xie) and Atractylodis Macrocephalae Rhizoma (Bai Zhu) is the primary treatment.
Note: "Minus Ramulus Cinnamomi" should likely be "minus Radix Paeoniae Alba (Baishao)." If Ramulus Cinnamomi is removed from this formula, what would treat the persistent headache, fever, and absence of sweat characteristic of the exterior syndrome? Careful study reveals that the text states to prepare and take this decoction "according to the method of the Decoction of Ramulus Cinnamomi," which clarifies the meaning. The correct method for taking the Decoction of Ramulus Cinnamomi involves covering the patient with blankets for about the time it takes to cook a meal, resulting in a slight, generalized sweat. If Ramulus Cinnamomi is removed, the remaining herbs—Radix Paeoniae Alba, Radix Glycyrrhizae, Rhizoma Alismatis, and Atractylodis Macrocephalae Rhizoma—lack the acrid-sweet herbs that navigate Ying and Wei. Claiming to follow the "method of the Decoction of Ramulus Cinnamomi" becomes meaningless. Furthermore, in the discussion regarding pulse compression, chest fullness, sweating, and aversion to cold, the Decoction of Ramulus Cinnamomi minus Radix Paeoniae Alba plus Radix Aconiti Lateralis Preparata (Fuzi) is used, where Radix Paeoniae Alba is removed due to chest fullness. Although the current presentation differs slightly, the presence of "fullness" indicates that Radix Paeoniae Alba should be removed. This should be corrected. (*Zongjin Yijian*)

Whenever a formula contains instructions for additions and subtractions, these adjustments apply to assistant and courier herbs. If the sovereign herb is removed, a new formula name should be established. It is inexplicable why this formula retains the name of the Decoction of Ramulus Cinnamomi despite the removal of Ramulus Cinnamomi. Perhaps the intent remains closely related to Ramulus Cinnamomi even after its removal. (*Shanghan Leifang*)

In Taiyang disease, presenting with fever and aversion to cold, where heat predominates over cold, and the pulse is faint and weak, this indicates a lack of Yang (fluid deficiency). Re-inducing sweating is contraindicated; instead, the Two-Parts Decoction of Ramulus Cinnamomi and One-Part Yuebi Decoction (Guizhi Er Yuebi Yi Tang) is appropriate.
"Lack of Yang" is a general term for fluid deficiency, as fluids belong to Yang and blood belongs to Yin. Lack of Yang implies spleen-stomach weakness, thus precluding further sweating; however, without sweating, wind-cold cannot be resolved. Taking two parts of Ramulus Cinnamomi treats the wind pathogen, while one part of Yuebi treats the stagnant heat. "Yuebi" refers to the acrid-cool nature of Gypsum Fibrosum (Shigao), which transforms stomach stagnation heat, thereby generating fluids and allowing the Spleen Qi to ascend and transport stomach fluids. The common version reads "Yuebi" (Little Maid), implying the Spleen is like a young maid; if so, the character "Yue" loses its meaning, making the term incoherent. Now, following the *Waitai Miyao*, the correct term is restored. (Zhang Luyu)

Note: The main text does not describe a Yuebi syndrome or formula; later authors supplemented it from the *Jingui Yaolue*. I believe that since Zhongjing stated sweating is contraindicated, Ephedrae Herba (Mahuang) would certainly not be used. Stating "lack of Yang" refers to a lack of Stomach Yang, so Gypsum Fibrosum would also not be used. Ancient formulas often share names but differ in ingredients; one must examine the reality, not just the name. Such pulse and symptom presentations are common, and Bupleuri Radix (Chaihu) combined with Ramulus Cinnamomi is more appropriate. ○ Note: Yu Jiayan stated: "Yuebi" refers to the acrid-cool nature of Gypsum Fibrosum. Using it to simultaneously resolve cold, its soft and slow nature surpasses that of a female maid. However, are acrid-cool herbs agents for treating cold? Can heavy mineral substances be as soft and slow as a maid? ○ Note: The *Waitai Miyao* suggests changing "Pi" (Spleen) to "Bi" (Maid), aligning with the *Neijing* principle that "when Spleen Qi is not moistened, it cannot transport fluids for the Stomach." This raises Taiyin fluids to nourish Yangming fluids and induce sweating, similar to Cheng Wuji's concept of "ascending Spleen Qi." However, it is suitable only when accompanied by irritability and thirst, and when the pulse is not faint and weak. (Ke Yunbo)

The 113 formulas of Zhang Zhongjing were named according to their indicated treatments in the *Lun*. However, many errors, alterations, and changes were made by Wang Shuhe, such as the Two-Parts Decoction of Ramulus Cinnamomi and One-Part Yuebi Decoction, and the Half-Half Decoction of Ramulus Cinnamomi and Ephedrae Herba (Guizhi Mahuang Ge Ban Tang), among others. These are recorded here specifically for examination. (Cheng Jiaoqian)

Note: Regarding the Half-Half Decoction of Ramulus Cinnamomi and Ephedrae Herba, the Two-Parts Decoction of Ramulus Cinnamomi and One-Part Ephedrae Herba, and the Two-Parts Decoction of Ramulus Cinnamomi and One-Part Yuebi Decoction, the so-called "one-two half-half" theory does not match the calculated dosages in the formulas. The reason is unknown. Some claim that the original formulas are decocted separately, and one part or two parts are mixed for administration. But why are specific weights noted for each herb in the formula? This remains for further study. (Xu Lingtai)

Decoction of Ramulus Cinnamomi minus Radix Paeoniae Alba plus Rhizoma Trichosanthis (Shuqi), Longgu, and Molluscum Concha (Muli) for Saving from Deviation (Jiuni Tang).
Rhizoma Trichosanthis (Shuqi) is unclear; claiming it is the sprout of Dichroa Febrifuga Radix (Changshan) is erroneous! (Ke Yunbo)

In Taiyang disease, presenting with stiffness and tension in the nape and back (Jin Jin), sweating, and aversion to wind, the Decoction of Ramulus Cinnamomi plus Rhizoma Puerariae (Gegen) is the primary treatment.
Old versions of the formula containing Ephedrae Herba (Mahuang) are incorrect. (Ke Yunbo)
This decoction in Cheng Wuji's version contains Ephedrae Herba, which is wrong; if it contained Ephedrae Herba, it would be the Decoction of Rhizoma Puerariae (Gegen Tang). (*Shanghan Leifang*)

Ten-Jujube Decoction (Shizao Tang) consists of Radix Daphnes (Yuanhua), Radix Kansui (Gansui), and Radix Euphorbiae (Daji) in equal parts, and ten large jujubes (Dazao).
Note: The *Shennong Bencao Jing* states: Radix Daphnes (Raohua) has a bitter and cold taste, treating shānghán and warm malaria, draining water from the twelve channels, breaking accumulations and masses, cleansing retained food and pathogens in the intestines, and promoting urination. Zhang Zhongjing’s original formula utilizes this property. Why did later authors change it to Radix Daphnes (Yuanhua)? Even if it is Radix Daphnes, the *Bielu* states it eliminates phlegm-fluid in the chest; however, the *Bencao Jing* states Radix Daphnes (Yuanhua) is acrid and warm, completely different from Raohua. Treating them as interchangeable deviates from Zhang Zhongjing’s original intent. (Yu Jiayan)

In shānghán or wind-stroke, if the physician erroneously uses purgation, the patient suffers diarrhea dozens of times daily with undigested food. There is borborygmus in the abdomen, hardness and fullness in the epigastrium, dry retching, irritability, and inability to find peace. Seeing epigastric fullness, the physician assumes the pathogen remains and purges again, worsening the fullness. This is not heat binding, but rather deficiency in the Stomach with rebellious Qi ascending, causing hardness. The Licorice Decoction for Resolving Epigastric Fullness (Ganxie Xixin Tang) is the primary treatment.
It is passed down that Yi Yin’s decoctions originally included the Licorice Decoction for Resolving Epigastric Fullness. This formula has seven ingredients, but the official edition lacks Codonopsis Radix (Renshen), indicating an omission. (Yu Jiayan)

In shānghán, with a knotted and intermittent pulse (Jiedai Mai) and palpitations (Xindong Ji), the Roasted Licorice Decoction (Zhigancao Tang) is the primary treatment.
None of the 113 formulas use Rehmanniae Radix (Dihuang) or Ophiopogonis Radix (Ma Dong), likely added by Wang Shuhe. However, these two are recorded in the *Shennong Bencao Jing* as premier yin-nourishing herbs, perhaps omitted from the *Shanghan Lun* due to context. This might address hyperactive Yang and exhausted Yin, opening a path for subsequent generations to use yin-nourishing methods. ○ Old versions of the formula use Semen Persicae (Maren), which is incorrect. Semen Ziziphi Spinosae (Suanzaoren) should be used to calm the spirit; this can harmonize the knotted pulse and stop palpitations. (Ke Yunbo)

In shānghán, if the physician uses pill-based strong purgatives, and fever persists with slight irritability, the Gardenia and Ginger Decoction (Zhizi Ganjiang Tang) is the primary treatment. ○ In shānghán, after five or six days, following strong purgation, if fever persists and there is painful knotting in the heart region, the condition is unresolved; the Gardenia and Fermented Soybean Decoction (Zhichi Chi Tang) is the primary treatment.
Note: The Gardenia and Ginger Decoction should be the Gardenia and Fermented Soybean Decoction; the Gardenia and Fermented Soybean Decoction should be the Gardenia and Ginger Decoction. It is illogical to use dried ginger for irritability-heat or fermented soybeans for painful knotting. They should be swapped. (*Zongjin Yijian*)

In shānghán, presenting with fever and jaundice, the Gardenia, Phellodendri Cortex (Huangbai), and Licorice Decoction (Zhizi Bopi Tang) is the primary treatment.
Note: The Licorice (Gancao) in this formula should be Coicis Semen (Yiyiren) or Artemisiae Scopariae Herba (Yinchen Hao); this is likely a transcription error. (*Zongjin Yijian*)

In the modification instructions for the Minor Green Dragon Decoction (Xiao Qinglong Tang), if there is slight diarrhea, remove Ephedrae Herba (Mahuang) and add Radix Daphnes (Raohua) the size of a chicken egg, roasted until red.
Note: Adding Radix Daphnes (Raohua) the size of a chicken egg is certainly a transcription error. According to materia medica, Raohua aggressively drains water and is very potent; a dose of five fen can cause dozens of bowel movements. How could one use a chicken-egg-sized dose of Raohua for mild diarrhea caused by retained fluid? It should be changed to adding four liang of Poria (Fuling). (*Zongjin Yijian*)

For Cold-Excess Chest Binding (Han Shi Jie Xiong) without heat signs, administer the Three-White Minor Intra-Chest Binding Decoction (San Bai Xiao Jianxiong Tang); it can also be taken as a powder.
If Taiyang exterior heat is not resolved and purgation is used, heat pathogens bind with cold water, forming Heat-Excess Chest Binding. If Taiyin abdominal fullness and pain occur and purgation is used, cold pathogens bind with cold medicines, forming Cold-Excess Chest Binding. "Without heat signs" means absence of limb restlessness. Named "Three White" because all three ingredients are white, distinguishing it from the Minor Intra-Chest Binding Decoction. Old versions mistakenly wrote "Three Items"; administering Coptidis Rhizoma (Huanglian) and Trichosanthis Fructus (Gualou) would lead to death from excess Yin. Another mistake writes "White Powder," creating two different formulas. Huanglian and Arecae Semen Preparatum (Badou) are as different as heaven and earth in temperature; saying "can also be taken" misleads people! (Ke Yunbo)

For Cold-Excess Chest Binding without heat signs, administer the Three-Items Minor Intra-Chest Binding Decoction; the White Powder may also be taken.
Note: "Administer the Three-Items Minor Intra-Chest Binding Decoction" should be "Three-Item White Powder." The characters "Minor Intra-Chest Binding Decoction" are likely misplaced text. Scutellariae Radix (Huangqin), Trichosanthis Fructus (Gualou), and Coptidis Rhizoma (Huanglian) are the components of the Minor Intra-Chest Binding Decoction, all cold-natured, unsuitable for Cold-Excess Chest Binding. The "Three-Item White Powder" consists of Platycodonis Radix (Jiegeng), Fritillariae Bulbus (Beimu), and Arecae Semen Preparatum (Badou), all white, warming and attacking, matching the cold-excess pathology. The phrase "may also be taken" is superfluous and should be deleted. (*Zongjin Yijian*)

In Yangming disease, with spontaneous sweating, if sweating is induced and urination is free, this indicates internal exhaustion of body fluids. Although the stool is hard, purgation is contraindicated; one must wait for the patient's urge to defecate and use honey suppositories (Mi Jian Dao) to facilitate passage. Radix Trichosanthis (Tugua Gen) and Porcine Bile (Zhudanshi) can also be used as suppositories.
Formula for Radix Trichosanthis (missing)
Note: Tugua is commonly known as Chibao. The *Zhouhou Fang* treats constipation by crushing the root, extracting juice, and blowing it into the anus via a tube, which shares the same principle as the Porcine Bile formula. The *Waitai* formula suggests carving the root into a suppository shape and inserting it, which is incorrect. Honey suppositories melt and lubricate the stool internally; Radix Trichosanthis does not melt. Carving it into a suppository likely deviates from Zhang Zhongjing’s original intent. (*Zongjin Yijian*)

For deficient patients requiring purgation but unable to tolerate it, suppository methods are appropriate. Differentiate accordingly: for fluid exhaustion, use honey suppositories; for excess heat pathogens, use bile suppositories; for solidified damp-heat, phlegm-fluid, use radish seed oil-soaked Trichosanthis Radix (Gualou Gen) suppositories. For Yin-binding constipation, add ginger juice and powdered Raw Aconite (Sheng Fuzi) to honey suppositories, or use sauce-ginger suppositories. This effectively supplements Zhang Zhongjing’s omissions. (*Shanghan Zuankan*)

At the foot pulse (Zuyang Mai), floating and choppy: floating indicates strong Stomach Qi, choppy indicates frequent urination. The interaction of floating and choppy pulses leads to difficult defecation; this is Spleen Constraint (Pi Yue), treated with the Hemp Seed Pill (Maren Wan).
Cheng Wuji said: "Yue" means constrained. Strong Stomach and weak Spleen constrain fluids, preventing distribution, directing them only to the Bladder, hence frequent urination and hard stool, called Spleen Constraint. This pill resolves Spleen dryness, moistens the intestines, allows fluids to enter the Stomach, restores normal bowel movements, reduces urination, and cures the condition. I have doubts: If it is "constrained," the Spleen is weak and cannot transform; Spleen weakness implies Earth deficiency, involving dispersion of Spleen Qi and consumption of Spleen Blood. The origin is likely prolonged illness, excessive sweating, or severe purgation, leading to枯竭 Yin-blood, blazing internal fire, damaging Yuan Qi and the Spleen. Damaging Yuan Qi affects Lung Metal, losing Qi control; damaging the Spleen, since Lung is the child of Spleen, Lung consumption depletes fluids, stealing mother Qi for self-rescue. Metal depletion leaves Wood unchecked, making Earth injury inevitable. Spleen loses transport, Lung loses transmission, leading to constipation and frequent urination without storage. Ideally, nourish Yin-blood to curb Yang fire, clear Metal, restrain Wood, strengthen Earth, allow fluids to enter the Stomach, moisten intestines, and restore flow. Using Cortex Magnoliae Officinalis (Zhi) and Pericarpium Citri Reticulatae (Ke) as ministers, with Radix Paeoniae Alba for blood, and Hemp Seed (Huoren) and Apricot Kernel (Xingren) as assistants, works for excess heat and Qi. But for excess heat with deficient Qi, although temporary relief occurs, will it not weaken the Spleen further and dry the intestines? Users of this formula must avoid rigid application. (Yu Jiayan)

In Taiyang disease, after passing the stage for over ten days, if purgation was wrongly applied two or three times, and after four or five days, Shaoyang symptoms persist, first administer the Minor Bupleurum Decoction (Xiao Chaihu Tang). If vomiting continues, epigastric urgency arises, and there is slight depression and irritability, the condition is unresolved; administer the Major Bupleurum Decoction (Da Chaihu Tang) to purge, and it will heal.
Note: Major Bupleurum Decoction is a purgative for the half-exterior/half-interior Qi level, not specifically for the bowels. Epigastric urgency and hardness are disorders of the stomach gate, not the Stomach organ itself. Heat binding in the interior is not solid accumulation in the Stomach. Moreover, if diarrhea occurs, the intestinal pathway is open; Zhongjing’s reason for omitting Radix Rhei Preparata (Dahuang) is clear. If "purge" implies adding Dahuang, what flavor would be added to the Ten-Jujube Decoction’s "purge"? (Ke Yunbo)

Note: Xu Shuwu stated: Major Bupleurum Decoction exists in versions with and without Radix Rhei Preparata (Dahuang). Dahuang clears accumulated heat, a crucial herb in shānghán. Wang Shuhe said: Without Dahuang, it cannot be called Major Bupleurum Decoction. Also, Zhongjing said "purge to heal"; without Dahuang, how would epigastric urgency be resolved? Following Wang Shuhe is correct. It should be supplemented. (*Zongjin Yijian*)

In Shaoyin disease, with diarrhea, sore throat, chest fullness, and irritability, the Pig Skin Decoction (Zhufu Tang) is the primary treatment.
"Fu" refers to the black skin scraped off a pig. The *Li Yun Shu* states: "Ge" is the thick inner hide; "Fu" is the thin outer skin. The idiom "superficial" derives from this meaning. (Yu Jiayan)

Pig skin moistens Shaoyin dryness, similar to the intent of using Black Donkey-hide Gelatin (Ejiao). Interpreting it as the thin skin at the hair roots makes it inferior and ineffective, contradicting the instruction to roast until fragrant. Using only the outer skin, removing the inner fatty white layer, is correct. (*Shanglun Pian*)

Four-Reversal Powder (Sini San): Radix Glycyrrhizae (Gancao), Radix Paeoniae Alba (Shaoyao), Aurantii Fructus Immaturus (Zhishi), and Bupleuri Radix (Chaihu), four ingredients, each ten parts, pounded and sifted, taken with rice water as a square-inch spoonful, three times daily. ○ For cough, add Schisandrae Fructus (Wuweizi) and Rhizoma Zingiberis Recens (Ganjiang), five parts each. ○ For palpitations, add Ramulus Cinnamomi (Guizhi), five parts. ○ For difficulty in urination, add Poria (Fuling), five parts. ○ For abdominal pain, add one Radix Aconiti Lateralis Preparata (Fuzi), roasted until cracked. ○ For heaviness in defecation, first decoct three sheng of Allii Macrostemonis Bulbus (Xiebai) in five sheng of water to obtain three sheng, strain, then add three square-inch spoonfuls of the powder to the decoction, boil to obtain one and a half sheng, divide into two warm doses.
This imitates the purging method of Major Bupleurum Decoction. Since Shaoyin is the Yin pivot, removing the great cold of Scutellariae Radix (Huangqin) and the acrid-dispersing properties of Rhizoma Zingiberis Recens (Sheng Jiang) and Rhizoma Pinelliae (Banxia), and replacing Jujubae Fructus (Dazao) with Radix Glycyrrhizae (Gancao) has deep significance. However, a square-inch spoonful may be insufficient. For Shaoyang palpitations, Poria is added; here, Ramulus Cinnamomi is added. For Shaoyang abdominal pain, Radix Paeoniae Alba is added; here, Radix Aconiti Lateralis Preparata is added. Although the methods differ in Yin-Yang, they may not suit heaviness in defecation. Allii Macrostemonis Bulbus is slippery, clearing lower Jiao Qi stagnation, but is too acrid-warm and pungent. Using three sheng at once with three spoonfuls of powder results in tasting only the bulb, not the medicine. Also, additions use five parts, while Fuzi uses one piece and Xiebai uses three sheng. Why such disparity? One cannot help suspecting editorial errors by Wang Shuhe! (Ke Yunbo)

Floating and slow pulse, exterior heat and interior cold, diarrhea with undigested food: Four-Reversal Decoction (Sini Tang) is the primary treatment.
When treating deficiency, Zhongjing prioritizes the interior. For shānghán with diarrhea and faint pulse, he uses Codonopsis Radix (Renshen); for body ache after sweating with a deep-slow pulse, he adds Renshen. Here, with a slow pulse, diarrhea of undigested food, no irritability or cough, Middle Qi is greatly deficient, and Yuan Qi is escaping. Warming without tonifying cannot save deviation. Observing that in Poria and Four-Reversal Decoction for irritability, Renshen is used, how much more so in Pulse-Rescuing Four-Reversal Decoction? This must be an omission in the original formula. (Ke Yunbo)

Diarrhea with undigested food, interior cold and exterior heat, sweating and cold extremities: Pulse-Rescuing Four-Reversal Decoction (Tongmai Sini Tang) is the primary treatment.
Note: This formula is designed for Yin conditions resembling Yang. The difference from Four-Reversal Decoction is the absence of aversion to cold and presence of flushed face. The difference in the formula, if lacking Renshen, would be identical to Ramulus Cinnamomi Decoction plus extra Ramulus Cinnamomi or Radix Paeoniae Alba. Why the name "Pulse-Rescuing"? Renshen promotes blood vessels; why omit it when the pulse is near extinction? Old editions state at the end: "For flushed face, add Scallion White (Congbai); for stopped diarrhea and absent pulse, add Renshen." Is this not a scribe’s negligence, adding supplementary instructions to the main formula? And "subtract" instructions refer to removing existing ingredients, whereas removing Congbai, Shaoyao, and Jiegeng implies later modifications. (Ke Yunbo)

Cold extremities, fine pulse nearly imperceptible: Return-to-Extremities Decoction with Angelica (Danggui Sini Tang) is the primary treatment.
This syndrome is interior; it should be Four-Reversal Base Formula plus Angelicae Sinensis Radix (Danggui), similar to Poria and Four-Reversal Decoction. Using Ramulus Cinnamomi Decoction to attack the exterior is an error. Named Four-Reversal Decoction, how can it lack Renshen and Fuzi? (Ke Yunbo)

Shānghán for six or seven days, after strong purgation, if the Cun pulse is deep and slow, extremities are cold, lower pulses are absent, throat is obstructed, spitting of pus and blood occurs, and diarrhea is unceasing, it is difficult to treat. Ephedrae Herba and Asari Rhizome et Radix (Mahuang Shengma Tang) is the primary treatment.
Shānghán for six or seven days, after strong purgation, Cun pulse is deep and slow. Cun is Yang, governing the Upper Jiao; deep and slow indicates lack of Yang. Deep indicates interior, so sweating is inappropriate; slow indicates Cold in the Zang organs, so clearing fire is inappropriate. Absent lower pulses, cold extremities, and unceasing diarrhea indicate exhaustion of Lower Jiao Yuan Yang. Obstructed throat and spitting of pus/blood indicate Upper Jiao deficient Yang has no root and is perishing, causing chaos. Using Renshen and Fuzi to restore Yang fails, hence "difficult to treat." Thus, Zhongjing provides no formula, clearly! Using Ephedrae Herba, Asari Rhizome et Radix, and Ramulus Cinnamomi to disperse, combined with Anemarrhenae Rhizoma (Zhimu), Asparagi Radix (Tian Dong), Scutellariae Radix (Huangqin), Radix Paeoniae Alba, and Gypsum Fibrosum to clear, applies a method for Yang-excess to a Yang-perishing condition, hastening death. How can sweating and healing be expected? Using only Zingiberis Rhizoma (Ganjiang) for warmth, and Poria, Atractylodis Macrocephalae Rhizoma, Radix Glycyrrhizae, and Angelicae Sinensis Radix for tonification, substituting Polygonati Rhizoma (Yuzhu) for Renshen, is like attacking a fortified city with a weak army. Using fourteen herbs is like casting a wide net hoping to catch one rabbit, regardless of pulse-disease correspondence. This is likely reckless talk! (Ke Yunbo)

Yang-Toxin disease: red face with mottled patterns like brocade, sore throat, spitting pus and blood. Treatable within five days, untreatable after seven. Corydalis and Turtle Shell Decoction (Shengma Biejia Tang) is the primary treatment. ○ Yin-Toxin disease: blue-green face and body, body pain as if beaten, sore throat. Treatable within five days, untreatable after seven. Corydalis and Turtle Shell Decoction minus Realgar (Xionghuang) and Sichuan Pepper (Shuzao) is the primary treatment.
Note: Yang-Toxin is primarily treated with Corydalis and Turtle Shell Decoction. Corydalis Radix (Shengma) lifts and penetrates toxic pathogens; Testudinis Carapax et Plastrum (Biejia) clears heat and anchors Spirit; Angelicae Sinensis Radix harmonizes blood and regulates Ying; Radix Glycyrrhizae clears fire and detoxifies. This aligns with the *Neijing* principle: "When heat floods the interior, treat with salty-cold, assist with acrid-sweet." The inclusion of Sichuan Pepper and Realgar seems intended for the Yin-Toxin formula, possibly due to transcription error. A slight shift makes the meaning for Yang-Toxin more precise, reducing user hesitation. (*Wu Yi Huijiang*)

After recovery from serious illness, relapse due to overexertion: Aurantii Fructus Immaturus, Gardeniae Fructus, and Fermented Soybean Decoction (Zhishi Zhichi Tang) is the primary treatment. If there is retained food, add Radix Rhei Preparata (Dahuang) the size of five or six chess pieces. ○ After recovery from serious illness, with fluid retention below the waist: Oyster Shell and Smilacis Glabrae Rhizoma (Muli Ze Xie) Powder is the primary treatment. ○ After resolution of shānghán, with emaciation, shortness of breath, and rebellious Qi causing nausea: Bamboo Leaf and Gypsum Decoction (Zhuye Shigao Tang) is the primary treatment.
Wang Shuhe focused solely on shānghán, calling it "serious illness." Since it is serious illness, post-recovery treatment should involve regulation and tonification. Relapse due to overexertion implies recurrence from labor; tonification is required...