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Yu Jiayan said: During the Yuanfeng era, the Heji Bureau was established to compile prescriptions from physicians' experiences. The section on heatstroke (Zhongshu) is particularly detailed. This is because summer heat syndromes have been tested effectively across various regions, and the method lies in generating body fluids to benefit the deficiency of stomach qi. Zhang Zihe's Guiling Ganlu Yin (Cassia Twig and Poria Decoction) uses Ren Shen (Ginseng), Gan Cao (Licorice), and Ge Gen (Kudzu Root) to eliminate turbidity; or one may use Shiwei Xiangru Yin (Ten-Ingredient Mosla and Elsholtzia Decoction), adding Ren Shen (Ginseng) and Huang Qi (Astragalus) to the five ingredients of the *Jufang* (Formulas of the Bureau) to eliminate damp-heat. Similarly, Li Dongyuan's Qingshu Yiqi Tang (Clear Summerheat and Benefit Qi Decoction) and Renshen Huangqi Tang (Ginseng and Astragalus Decoction) supplement the middle jiao and strengthen the defensive qi to address heatstroke. Heatstroke must manifest with restlessness, irritability, heat, and stifling sensation. Li Dongyuan imitated Zhang Zhongjing’s approach... [Text fragment] ...to treat Xiao Ke (Wasting-Thirst syndrome), where qi and blood are deficient, and stomach fire is excessive causing thirst.

Ingredients: Dan Zhuye (Lophatherum Leaf), Sheng Dihuang (Rehmannia Root), Huang Qi (Astragalus), Maidong (Ophiopogon Tuber), Dang Gui (Angelica Sinensis), Chuanxiong (Ligusticum Rhizome), Huang Qin (Scutellaria Root), Gan Cao (Licorice), Shaoyao (Peony Root), Renshen (Ginseng), Banxia (Pinellia Tuber), Shigao (Gypsum Fibrosum). Dosage: Each 2 qian for the first two, 1 qian for the rest.
Administration: Decoct in water and take orally.

Ke Yunbo said: When both qi and blood are deficient, yet stomach fire is excessively strong, a skilled physician employs both tonification and purgation. Cold-natured herbs are used without causing Yang collapse, and warm-tonic herbs are used without aggravating fire.

(Prepared by Yu. One commentary.)
Indications: Various types of qi stagnation and depression, flaccidity syndromes (Wei), wheezing, and vomiting.
Ingredients: Sang Ye (Mulberry Leaf, preferably frosted), Shigao (Gypsum Fibrosum, 2.5 qian, crushed), Gan Cao (Licorice, 1 qian), Renshen (Ginseng, 0.7 qian), Huma Ren (Sesame Seed, 1 qian, stir-fried and ground), Ejiao (Donkey-Hide Gelatin, de-haired, honey-fried, one piece).
Administration: Nine ingredients, decocted in one bowl of water until reduced to six-tenths. Take frequently while hot, divided into two or three doses. Add Bei Mu (Fritillaria Bulb) and Gualou (Trichosanthes Fruit) if phlegm is abundant; add Sheng Dihuang (Rehmannia Root) if blood is depleted; add [missing ingredient] if heat is severe.

Yu Jiayan said: Regarding qi stagnation belonging to the Lung, it is due to Lung dryness. Ancient and modern prescriptions for qi stagnation mostly use acrid-aromatic qi-moving herbs, which... [Text fragment] Generally, treatment focuses on the Stomach, as Stomach Earth is the mother of Lung Metal. Herbs like Tiandong (Asparagus Tuber) and Zhimu (Anemarrhena Rhizome) can clear Metal and nourish Water, but they are not used due to their bitter-cold nature. As for using bitter-cold herbs to descend fire... would the patient still have vitality? If one indeed imitates this prescription to adjust and save the Lung from dryness-induced complications, there might be hope.

Ke Yunbo said: Ancient prescriptions using aromatic-dry herbs to treat qi stagnation often fail because "fire follows dryness" (aggravating heat with dryness). Only Miao Zhongchun understood this, hence he used sweet-cool herbs... [Text fragment] When the child organ is diseased, the mother becomes deficient. Gan Cao (Licorice) is used to regulate and tonify the Middle Palace (Spleen/Stomach), the source of qi generation, so that Lung Metal has support. When Lung Metal is dry, Kidney Water cannot receive qi to generate mutually, leading to the mother failing the child. Ejiao (Donkey-Hide Gelatin) and Huma Ren (Sesame Seed), being black and connecting to the Kidney, nourish Yin to ascend and open the source of Water generation, so Lung Metal is not isolated. When the West (Lung/Metal) is deficient, the East (Liver/Wood) becomes excessive. Wood excess levels Metal. Pipa Ye (Loquat Leaf) inherits the color of the East, connects to the Liver, and responds externally to hair follicles; it is indeed a Lung herb within the Liver system. Is not frosted Sang Ye (Mulberry Leaf) a Liver herb within the Lung system? To damage the Lung is to benefit its Qi; Renshen (Ginseng) is sweet to tonify Qi. Excess Qi transforms into Fire, so Xing Ren (Apricot Seed) is added for its bitterness to descend Qi. When Qi descends, Fire also descends, restoring regulatory power. When Qi moves, stagnation resolves, and Wei, Chuan, and Ou (flaccidity, wheezing, vomiting) are eliminated. It must be known that in cases of qi stagnation, Lung Qi is severely deficient. If one sticks to the theory of "Lung heat injuring the Lung" and omits Renshen (Ginseng), stagnation will not resolve, fire will blaze, skin will gather, hair will fall, and wheezing will ceaselessly continue. This prescription is named "Saving the Lung," meaning it cools while tonifying. If one believes excess fire can merely be purged, and Xinqin (Scutellaria and Coptis) are taken long-term, they may transform into fire, and death will follow immediately! I therefore deeply adhere to and praise this prescription.