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[Da Yi Han Wan] (Great Cold-Dispelling Pill) treats deficiency-cold of the Zang-Fu organs. Heart and abdominal pain, diarrhea with borborygmus, spontaneous diarrhea and sweating, undigested food in stool, coldness of hands and feet.
Bibo (Long Pepper Fruit), Rougui (Cinnamon Bark) (each 6.5 liang), Ganjiang (Dried Ginger), Liangjiang (Galangal Rhizome) (each 10 liang).
Grind the above into powder, make pills with wheat paste the size of paulownia seeds. Take 20 pills each time, swallow with rice water. Take before meals.

[Sini Tang] (Decoction for Reversal of Yin) treats spontaneous diarrhea without thirst caused by Shanghan (Cold Damage). Unceasing vomiting and hiccups, or simultaneous vomiting and diarrhea. Urine may be scanty or free-flowing. Or excessive sweating. Pulse is faint and nearly imperceptible. Abdominal pain and distension, coldness of hands and feet extending upwards. And all kinds of deficiency-cold causing reversal coldness. It is suitable to take this prescription.
Gancao (Licorice Root) (honey-fried, 2 liang), Ganjiang (Dried Ginger) (1.5 liang), Fuzi (Aconite Lateralis Radix Praeparata) (raw, peeled, navel removed, finely sliced, 0.5 liang).
Cut the above into small pieces. Take 3 qian each time, add 1.5 sheng of water, decoct until 0.8 sheng remains, remove dregs, take warm. Take at any time.

In the summer of the sixth month of the Jisi year of Zhiyuan, I resided in Shangdu. Qianyuan Dong Yancheng, aged over forty, due to excessive labor and fatigue, suffered from incessant irritability and thirst. He drank milk excessively. Then he injured himself with cold foods. Subsequently, he developed spontaneous diarrhea, borborygmus, and abdominal pain. His four limbs were cold, cold sweat came out spontaneously, and the breath from his mouth and nose was also cold. The six pulses were as fine as spider threads. He occasionally fell into a state of confusion and unconsciousness. The Imperial Physicians discussed the case. They used scallion moxibustion on the lower abdomen. They also prescribed Sini Tang (Decoction for Reversal of Yin) 5 liang, fresh ginger 20 slices, scallion white with roots 9 stalks, water 3 sheng, boiled down to 1 sheng, dregs removed, taken cool. By midnight, body temperature rose, body became hot, and he desired porridge and drinks. By dawn, he recovered. The *Yu Ji Zhen Zang Lun* states: Fine pulse, cold skin, shortness of breath, diarrhea, inability to eat. This is called "Five Deficiencies". If gruel enters the stomach, then the deficient patient will survive. Truly so. Mr. Xu Luzhai heard of this and sighed, saying: Diseases have severity, prescriptions have size, treatments have urgency. For the Qianyuan's condition, only a large prescription applied urgently can cure it. The *Zhi Yao Da Lun* states: Tonifying the lower and treating the lower requires urgent preparation. Urgency implies strong flavor and potency. This is what is meant.

Wu Deqing from Zhending Prefecture, aged forty-six. In March of the Bingzi year of Zhiyuan, due to worry, thought, labor, and fatigue, and irregular diet, he contracted a disease characterized by cold limbs. The breath from his mouth and nose was also cool. Cold sweat appeared on his forehead. He occasionally fell into confusion. A physician diagnosed it as Wind Syndrome and intended to purge him with Xuanfeng San (Wind-Dispersing Powder). I recalled Qian Yi's pediatric theories regarding the formulation of Xuanfeng San, which states that children suffering internal injury to the Spleen and Stomach, with either vomiting or diarrhea, if prolonged, wind pathogen sinks into the Stomach causing unformed stools (Sunxie). There is accumulation within the powder, fearing transmission to slow convulsions. Xuanfeng San guides out the wind pathogen. The *Neijing* states: Long-standing wind leads to Sunxie. This is precisely what is meant. Now, Wu Deqing's signs and symptoms indicate Excess of Yin and Deficiency of Yang. Bitter-cold agents are not suitable. The *Neijing* states: Excess of Yin Qi leads to profuse sweating and coldness of the body. The *Yin Yang Ying Xiang Da Lun* states: Excess of Yin leads to coldness of the body, sweating, constant feeling of cold, frequent shivering and chills, chills leading to reversal coldness. The *Tiao Jing Pian* also states: Excess of Yin generates internal cold. Qibo said: Reversal Qi moves upward, Cold Qi accumulates in the chest and does not dissipate. If it does not dissipate, Warm Qi departs, leaving Cold alone. Thus, Internal Cold arises. Li Dongyuan explained: This is insufficiency of the Spleen and Stomach, physical labor injuring the Middle Jiao Ying Qi, eventually transmitting to Internal Cold. Only tonifying Yang is appropriate. Therefore, Lizhong Tang (Regulate the Middle Decoction) plus Hei Fuzi (Black Prepared Aconite) was used. Each dose was 5 qian, decocted with abundant scallion white in mutton soup, taking one large cup of clear liquid to mix and take. By evening, the four limbs gradually warmed, sweating decreased. Taken again late at night. The next day, spirit returned, the six pulses showed life. After several doses, he recovered. I once remembered Li Sishun saying: Zheng (signs/symptoms) are evidence. Disease manifestations are internal, Zheng manifests externally. Anyone learning medicine who does not study the *Neijing*, does not seek the source of disease, guesses symptoms arbitrarily, and clings to specific formulas. These are all pursuits that abandon the root for the branch. Their errors are numerous. One should ponder carefully.