论曰阳气独盛,阴气暴衰,阴为阳所胜,内外皆阳,故为阳毒伤寒,有初得病便成阳毒
者,有服汤药经五六日以上不瘥,变成阳毒者,以病本属阳,或以火劫发其汗。或因灸
KT阳气转盛,阴气内消所致,其候面赤发躁,狂走妄言,发斑如锦纹,咽喉疼痛,涕唾脓
血,
或下利黄赤,其脉洪实滑促是也。
治伤寒一二日,便成阳毒,或服药吐下之后,变成阳毒,腰背痛,烦闷不安,面赤狂言,
或见鬼神,或下利,脉浮大数,面赤斑纹如锦,咽喉痛,吐脓血,五日可治,七日不可治。
升麻汤方
升麻 犀角(镑) 射干 黄芩(去黑心) 人参 甘草(炙锉各一分)
上六味,锉如麻豆大,每服五钱匕,水一盏半,煎至八分,去滓温服,食顷再服,温覆
出汗,未汗再服。
治阳毒伤寒未解,热结在内,恍惚如狂者。大黄汤方
大黄(锉炒一两半) 桂(去粗皮三分) 甘草(炙锉) 木通锉 大腹皮锉各一两 桃
仁
(二十一枚汤浸去皮尖双仁麸炒) 芒硝二两
上七味,粗捣筛,每服四钱匕,水一盏半,煎至八分,去滓温服,不拘时,以利为度。
治阳毒伤寒壮热,百节疼痛。栀子仁汤方
栀子仁 赤芍药 大青 知母(锉各一两) 甘草(炙锉半两) 石膏(碎) 杏仁(汤
浸去
皮尖双仁麸炒) 升麻 黄芩(去黑心各二两) 柴胡(去苗一两半)
上一十味,粗捣筛。每服四钱匕,水一盏半,生姜一枣大拍碎,豉一百粒,煎至八分,
去滓温服,不拘时。
治时行热病,六七日未得汗,脉洪大或数,面赤目张,身体大热,烦躁狂言欲走渴甚,
又五六日以上不解,热在胸中,口噤不能言,心下尚暖,灌药下咽、即活,兼治阳毒及发斑。
黑
麦奴(小麦未熟时、丛中有不成者、上有黑衣、即麦奴也、刮取一两) 麻黄(去根节
煎
掠去沫焙干三两) 釜底煤(研) 黄芩(去黑心) 芒硝 灶突煤(研) 梁上尘(各一
两) 大
黄(二两)
上八味,捣研为细末,炼蜜丸如弹子大,每服一丸,新汲水研下,渴者但与冷水,尽量
饮之,须臾当寒,寒过汗出即瘥,若日移五尺不汗,再服一丸,瘥即止,须微利,此药须病
人大渴倍常躁盛者,乃可与之,不尔不可与。
治伤寒七八日内,热不解。葶苈苦酒汤方
葶苈(一合纸上炒研膏) 苦酒(米醋是也一升半) 生艾汁(半升无生艾煮熟艾汁或
用艾
根捣取汁)
上三味,同煎取七合,作三服。
治阳毒伤寒,腰背疼痛烦闷,面赤狂言妄走,或见鬼,下利无常,赤斑如锦纹,喉咽痛,
唾脓血。升麻汤方
升麻 雄黄(醋煮研各半两) 当归(切焙) 桂(去粗皮各一分) 甘草(炙锉三分)
鳖甲
(醋炙去裙 一两)
上六味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓温服,日二,不拘时。
治阳毒伤寒,头痛壮热,狂言妄语,似见鬼神。泻心汤方
石膏(一两) 芍药 葛根锉 黄芩(去黑心各半两) 大黄 黄连(去须各三分)
上六味粗捣筛,每服五钱匕,水一盏半,生姜一枣大拍碎,煎至八分,去滓温服日二,
不拘时。
治阳毒伤寒,烦躁不解,或下利危困。大青汤方
大青(二两) 秦艽(去苗土一两) 犀角(镑) 山栀子仁 甘草(炙锉) 黄连(去
须各半
两)
上六味,粗捣筛,每服五钱匕。水一盏半,入豉一百粒,薤白七寸,煎至八分,去滓食
前温服。
治阳毒伤寒,口舌干燥。解毒汤方
麻黄(去根节) 人参 赤茯苓(去黑皮) 桂(去粗皮各半两) 麦门冬(去心焙) 葛
根
(锉各三分) 杏仁(汤浸去皮尖双仁炒) 甘草(炙锉各一分)
上八味,粗捣筛,每服五钱匕,水一盏半,生姜一枣大拍碎,煎至八分,去滓温服,不
拘时。
治阳毒伤寒,发热烦躁。五解汤方
山栀子仁 黄芩(去黑心) 甘草(炙锉) 大黄(锉醋炒各一分) 朴硝(二钱)
上五味粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓空心温服。
治阳毒伤寒,初得身体大热,眼赤小便黄,心闷头痛,烦渴不止,四肢酸疼,心中闷绝,
言语错乱,睡中多惊。犀角汤方
犀角(镑一两) 人参(三分) 赤茯苓(去黑皮) 茵陈蒿 细辛(去苗叶) 陈橘
皮(汤浸
去白炒) 麻黄(去根节) 甘草(炙锉各半两)
上八味,粗捣筛,每服五钱匕,水一盏半,生姜一枣大拍碎,煎至八分,去滓温服。
治阳毒伤寒,头痛壮热未解,身体疼痛。葛根汤方
葛根(锉) 龙胆 大青(各三分) 桂(去粗皮) 葳蕤 芍药 黄芩(去黑心) 升
麻石
膏(碎) 麻黄(去根节) 甘草(炙锉各半两)
上一十一味,粗捣筛,每服五钱匕,水一盏半,生姜一枣大拍碎,煎至八分去滓,不拘
时温服。
治阳毒伤寒,身热如火,头痛燥渴,咽喉干痛。葛根散方
葛根(锉三分) 山栀子仁 黄芩(去黑心) 大黄(锉醋炒) 甘草(炙锉各半两) 朴
硝
(一两)
上六味,捣罗为散,每服二钱匕,不拘时,温熟水调下。
治阳毒伤寒,心躁闷乱,烦热狂语,口干不止。秦艽汤方
秦艽(去苗土) 黄芩(去黑心) 甘草(炙锉) 木通 枳壳(去瓤麸炒) 玄参(各
半两)
芍药 桔梗(炒)吴蓝 山栀子仁(各一两) 枇杷叶(三分拭去毛姜汁炙)
上一十一味,粗捣筛,每服五钱匕,水一盏半,煎至八分,去滓温服不拘时。
治阳毒伤寒,口干烦躁,大渴发汗。清凉散方
葛根(锉二两) 大黄(锉炒) 黄芩(去黑心) 朴硝 麻黄(去根节) 甘草(炙
锉各一两)
桂(去粗皮三分)
上七味,捣罗为散,每服二钱匕,新汲水调下。
治阳毒伤寒六七日间,服热药过度,致使阳气内伏,身体微热,眼目爪甲尽黄,心下硬
痛,语涩舌干昏躁。琥珀丸方
琥珀(研一分) 黄连(去须) 黄柏(去粗皮) 大黄(煨锉各半两) 巴豆(去皮
心膜出油
取霜二钱)
上五味,捣罗四味为细末,与巴豆霜拌匀,煮薄面糊和丸,如绿豆大,每服十丸,柳枝
汤下,不拘时。
治阳毒伤寒,遍身壮热,大喘上气燥闷。妙应汤方
甘草(炙锉) 人参 赤茯苓(去黑皮各一两) 大黄(煨锉) 山栀子(去皮) 麻
黄(去根
节各半两) 陈橘皮(去白炒) 木香(各一分)
上八味,粗捣筛,每服三钱匕,水一盏,入蜜一匙,生姜汁少许,煎至八分,去滓冷服,
不拘时。
治阳毒伤寒,发狂妄走者。铁粉散方
铁粉 朴硝(各一两) 天竺黄(半两) 龙脑(一分)
上四味,研令匀细,每服二钱匕,鸡子清和水调下,不拘时。
Discussion states: When Yang qi alone becomes hyperactive and Yin qi suddenly declines, with Yin being overcome by Yang, both the interior and exterior present a state of excess Yang heat; thus it is termed Yang Du Cold Damage (Yang Toxicity in Cold Damage). Some patients manifest Yang Du immediately upon contracting the disease, while others develop Yang Du after taking herbal decoctions for five or six days without improvement. This occurs because the disease fundamentally belongs to the Yang category, or due to forced sweating via fire therapy, or because moxibustion causes Yang qi to become even more hyperactive, leading to the consumption of internal Yin qi. The clinical manifestations include facial flushing, restlessness, manic running, delirious speech, skin eruptions resembling brocade patterns, sore throat, purulent blood in nasal discharge and saliva, or diarrhea with yellow-red stools. The pulse is surging (Hong), firm, slippery, and rapid (Cu).
For treating Cold Damage that develops into Yang Du within one or two days, or transforms into Yang Du after emetic or purgative treatments, presenting with lower back and back pain, vexation and oppression, facial redness, delirium, visual hallucinations (seeing ghosts/spirits), diarrhea, floating-large-rapid pulse, facial redness with brocade-like rashes, sore throat, and vomiting of purulent blood: treatment is feasible within five days but difficult after seven days.
Shengma Tang (Cinnamon Twig Decoction) Formula
Ingredients: Shengma (Rhizoma Cimicifugae), Xijiao (Cornu Rhinocerotis, sliced), Shegan (Radix Belamcandae), Huangqin (Radix Scutellariae, black heart removed), Renshen (Radix Ginseng), Gancao (Radix Glycyrrhizae, honey-fried and chopped, each 1 fen).
The above six herbs are chopped like hemp seeds. Each dose consists of 5 qianbi (approx. 2-3 grams), boiled in 1.5 sheng (approx. 300ml) of water until reduced to 0.8 sheng. Strain and take warm. Repeat after a short interval. Cover with blankets to induce sweating. If no sweat occurs, administer again.
Dahuang Tang (Rhubarb Decoction) Formula
Indication: For unresolved Yang Du Cold Damage with heat accumulation internally, presenting with mental confusion resembling mania.
Ingredients: Dahuang (Radix et Rhizoma Rhei, chopped and stir-fried, 1.5 liang), Gui (Ramulus Cinnamomi, bark removed, 3 fen), Gancao (Radix Glycyrrhizae, honey-fried and chopped), Mutong (Caulis Akebiae, chopped), Dafupi (Pericarpium Citri Reticulatae Viride, chopped), each 1 liang; Taoren (Semen Persicae, 21 kernels, soaked in hot water, peeled, remove tips and double-kernels, bran-fried); Mangxiao (Natrii Sulfas, 2 liang).
The above seven herbs are coarsely crushed and sifted. Each dose is 4 qianbi, boiled in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm at any time. Continue until bowel movement is achieved.
Zhizi Ren Tang (Gardeniae Semen Decoction) Formula
Indication: For Yang Du Cold Damage with high fever and pain in all joints.
Ingredients: Zhizi Ren (Semen Gardeniae), Chishaoyao (Radix Paeoniae Rubra), Daqing (Folium Isatidis), Zhimu (Rhizoma Anemarrhenae, chopped), each 1 liang; Gancao (Radix Glycyrrhizae, honey-fried and chopped, 0.5 liang); Shigao (Gypsum Fibrosum, crushed); Xingren (Semen Pruni Armeniacae, soaked in hot water, peeled, remove tips and double-kernels, bran-fried); Shengma (Rhizoma Cimicifugae); Huangqin (Radix Scutellariae, black heart removed), each 2 liang; Chaihu (Radix Bupleuri, stems removed, 1.5 liang).
The above ten herbs are coarsely crushed and sifted. Each dose is 4 qianbi, boiled with 1.5 sheng of water, one date-sized piece of fresh ginger (crushed), and 100 grains of Chi Dou (Semen Sojae Praeparatum) until reduced to 0.8 sheng. Strain and take warm at any time.
For seasonal febrile diseases where no sweat has occurred after six or seven days, with a surging or rapid pulse, facial redness, staring eyes, high body heat, restlessness, delirium, desire to run, extreme thirst, and unresolved heat in the chest after another five or six days, accompanied by trismus (lockjaw) inability to speak, yet warmth remains in the epigastrium: if medicine is administered and swallowed, life can be saved. This also treats Yang Du and macular eruptions.
Ingredients: Heimai Nu (Black Wheat Slave, scraped from immature wheat clusters, 1 liang); Mahuang (Herba Ephedrae, roots and nodes removed, boiled to remove foam, dried, 3 liang); Fudi Mei (Soot from cooking pot bottom, ground); Huangqin (Radix Scutellariae, black heart removed); Mangxiao (Natrii Sulfas); Zaotu Mei (Soot from chimney flue, ground); Liangshang Chen (Dust from roof beams), each 1 liang; Dahuang (Radix et Rhizoma Rhei, 2 liang).
The above eight herbs are pounded and ground into fine powder. Form pills the size of bullet seeds using refined honey. Take one pill per dose, grinding it down with fresh well water. For those thirsty, provide cold water only, drinking as much as possible. Within a short time, chills should occur; after the chills pass, sweating will ensue and recovery follows. If no sweat occurs after a significant time, administer another pill. Stop when recovered. Mild diarrhea is expected. This medicine is strictly indicated only for patients with extreme thirst and severe agitation; otherwise, do not use.
Tingli Kujiu Tang (Descurainiae Semen and Vinegar Decoction) Formula
Indication: For unresolved heat in Cold Damage after seven or eight days.
Ingredients: Tingli (Semen Descurainiae, 1 he, stir-fried on paper and ground into paste); Kujiu (Vinegar, 1.5 sheng); Sheng Ai Zhi (Fresh Mugwort Juice, 0.5 sheng; if unavailable, use juice from boiled mugwort or pressed mugwort root).
The above three ingredients are decocted together to obtain 0.7 sheng. Divide into three doses.
Shengma Tang (Cinnamon Twig Decoction) Formula
Indication: For Yang Du Cold Damage with lower back pain, vexation, facial redness, delirium, manic running, hallucinations, irregular diarrhea, red brocade-like rashes, sore throat, and expectoration of purulent blood.
Ingredients: Shengma (Rhizoma Cimicifugae); Xionghuang (Realgar, vinegar-boiled and ground, each 0.5 liang); Danggui (Radix Angelicae Sinensis, sliced and dried); Gui (Ramulus Cinnamomi, bark removed, each 1 fen); Gancao (Radix Glycyrrhizae, honey-fried and chopped, 3 fen); Biejia (Carapax et Plastrum Testudinis, vinegar-fried, skirt removed, 1 liang).
The above six herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm. Twice daily, at any time.
Xiexin Tang (Drain the Epigastrium Decoction) Formula
Indication: For Yang Du Cold Damage with headache, high fever, delirium, and visual hallucinations.
Ingredients: Shigao (Gypsum Fibrosum, 1 liang); Shaoyao (Radix Paeoniae Alba/Rubra); Gegen (Puerariae Radix, chopped); Huangqin (Radix Scutellariae, black heart removed), each 0.5 liang; Dahuang (Radix et Rhizoma Rhei); Huanglian (Rhizoma Coptidis, whiskers removed), each 3 fen.
The above six herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water and one date-sized piece of fresh ginger (crushed) until reduced to 0.8 sheng. Strain and take warm. Twice daily, at any time.
Daqing Tang (Isatis Root Decoction) Formula
Indication: For Yang Du Cold Damage with persistent restlessness or critical diarrhea.
Ingredients: Daqing (Folium Isatidis, 2 liang); Qinjiao (Radix Gentianae Macrophyllae, stems and soil removed, 1 liang); Xijiao (Cornu Rhinocerotis, sliced); Shanzhizi Ren (Semen Gardeniae); Gancao (Radix Glycyrrhizae, honey-fried and chopped); Huanglian (Rhizoma Coptidis, whiskers removed), each 0.5 liang.
The above six herbs are coarsely crushed and sifted. Each dose is 5 qianbi. Add 100 grains of Chi Dou (Semen Sojae Praeparatum) and 7 cun of Xiebai (Bulbus Allii Macrostemonis) to 1.5 sheng of water. Decoct until reduced to 0.8 sheng. Strain and take warm before meals.
Jiedu Tang (Detoxification Decoction) Formula
Indication: For Yang Du Cold Damage with dry mouth and tongue.
Ingredients: Mahuang (Herba Ephedrae, roots and nodes removed); Renshen (Radix Ginseng); Chifuling (Poria with Red Hosta, black skin removed); Gui (Ramulus Cinnamomi, bark removed), each 0.5 liang; Maimendong (Radix Ophiopogonis, core removed and dried); Gegen (Puerariae Radix, chopped), each 3 fen; Xingren (Semen Pruni Armeniacae, soaked, peeled, tips/double-kernels removed, fried); Gancao (Radix Glycyrrhizae, honey-fried and chopped), each 1 fen.
The above eight herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water and one date-sized piece of fresh ginger (crushed) until reduced to 0.8 sheng. Strain and take warm at any time.
Wujie Tang (Five-Resolving Decoction) Formula
Indication: For Yang Du Cold Damage with fever and restlessness.
Ingredients: Shanzhizi Ren (Semen Gardeniae); Huangqin (Radix Scutellariae, black heart removed); Gancao (Radix Glycyrrhizae, honey-fried and chopped); Dahuang (Radix et Rhizoma Rhei, chopped and vinegar-fried), each 1 fen; Pu Xiao (Natrii Sulfas, 2 qian).
The above five herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm on an empty stomach.
Xijiao Tang (Rhinoceros Horn Decoction) Formula
Indication: For early-stage Yang Du Cold Damage with high body heat, red eyes, yellow urine, chest oppression, headache, incessant thirst and vexation, sore limbs, central obstruction, confused speech, and frequent startles during sleep.
Ingredients: Xijiao (Cornu Rhinocerotis, sliced, 1 liang); Renshen (Radix Ginseng, 3 fen); Chifuling (Poria with Red Hosta, black skin removed); Yinchenhao (Herba Artemisiae Scopariae); Xixin (Herba Asari, stems and leaves removed); Chenpi (Pericarpium Citri Reticulatae, soaked, white pith removed, fried); Mahuang (Herba Ephedrae, roots and nodes removed); Gancao (Radix Glycyrrhizae, honey-fried and chopped), each 0.5 liang.
The above eight herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water and one date-sized piece of fresh ginger (crushed) until reduced to 0.8 sheng. Strain and take warm.
Gegen Tang (Kudzu Root Decoction) Formula
Indication: For Yang Du Cold Damage with unresolved headache, high fever, and body pain.
Ingredients: Gegen (Puerariae Radix, chopped); Longdan (Radix Gentianae); Daqing (Folium Isatidis), each 3 fen; Gui (Ramulus Cinnamomi, bark removed); Weirui (Rhizoma Polygonati Odorati); Shaoyao (Radix Paeoniae); Huangqin (Radix Scutellariae, black heart removed); Shengma (Rhizoma Cimicifugae); Shigao (Gypsum Fibrosum, crushed); Mahuang (Herba Ephedrae, roots and nodes removed); Gancao (Radix Glycyrrhizae, honey-fried and chopped), each 0.5 liang.
The above eleven herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled with 1.5 sheng of water and one date-sized piece of fresh ginger (crushed) until reduced to 0.8 sheng. Strain and take warm at any time.
Gegen San (Kudzu Root Powder) Formula
Indication: For Yang Du Cold Damage with body heat like fire, headache, dry thirst, and dry painful throat.
Ingredients: Gegen (Puerariae Radix, chopped, 3 fen); Shanzhizi Ren (Semen Gardeniae); Huangqin (Radix Scutellariae, black heart removed); Dahuang (Radix et Rhizoma Rhei, chopped and vinegar-fried); Gancao (Radix Glycyrrhizae, honey-fried and chopped), each 0.5 liang; Pu Xiao (Natrii Sulfas, 1 liang).
The above six herbs are pounded and sieved into a powder. Each dose is 2 qianbi, taken at any time mixed with warm cooked water.
Qinjiao Tang (Gentian Root Decoction) Formula
Indication: For Yang Du Cold Damage with mental restlessness, oppression, irritability, delirium, and incessant dry mouth.
Ingredients: Qinjiao (Radix Gentianae Macrophyllae, stems and soil removed); Huangqin (Radix Scutellariae, black heart removed); Gancao (Radix Glycyrrhizae, honey-fried and chopped); Mutong (Caulis Akebiae); Zhike (Fructus Aurantii, pulp removed, bran-fried); Xuanshen (Radix Scrophulariae), each 0.5 liang; Shaoyao (Radix Paeoniae); Jiegeng (Radix Platycodonis, fried); Wu Lan (Folium Isatidis/Wu Lan Ye); Shanzhizi Ren (Semen Gardeniae), each 1 liang; Pipaye (Folium Eriobotryae, 3 fen, brushed clean of hairs, fried with ginger juice).
The above eleven herbs are coarsely crushed and sifted. Each dose is 5 qianbi, boiled in 1.5 sheng of water until reduced to 0.8 sheng. Strain and take warm at any time.
Qingliang San (Cooling Powder) Formula
Indication: For Yang Du Cold Damage with dry mouth, restlessness, extreme thirst, and need for sweating.
Ingredients: Gegen (Puerariae Radix, chopped, 2 liang); Dahuang (Radix et Rhizoma Rhei, chopped and fried); Huangqin (Radix Scutellariae, black heart removed); Pu Xiao (Natrii Sulfas); Mahuang (Herba Ephedrae, roots and nodes removed); Gancao (Radix Glycyrrhizae, honey-fried and chopped), each 1 liang; Gui (Ramulus Cinnamomi, bark removed, 3 fen).
The above seven herbs are pounded and sieved into a powder. Each dose is 2 qianbi, mixed with fresh well water.
Hupo Wan (Amber Pill) Formula
Indication: After excessive intake of hot medicines during Yang Du Cold Damage (6-7 days), causing internal entrapment of Yang qi, slight body heat, yellowing of eyes/nails, epigastric hardness/pain, slurred speech, dry tongue, dizziness, and agitation.
Ingredients: Hupo (Electrum, ground, 1 fen); Huanglian (Rhizoma Coptidis, whiskers removed); Huangbo (Cortex Phellodendri, coarse bark removed); Dahuang (Radix et Rhizoma Rhei, baked and chopped), each 0.5 liang; Badou (Semen Crotonis, peeled, heart/membrane removed, oil expressed to leave residue, 2 qian).
The first four herbs are pounded into fine powder and mixed evenly with the Badou residue. Bind with thin flour paste to form pills the size of mung beans. Take 10 pills per dose with Willow Branch Decoction (Liuzhi Tang) at any time.
Miaoying Tang (Wonderful Response Decoction) Formula
Indication: For Yang Du Cold Damage with generalized high fever, severe dyspnea, upward rushing of qi, dryness, and oppression.
Ingredients: Gancao (Radix Glycyrrhizae, honey-fried and chopped); Renshen (Radix Ginseng); Chifuling (Poria with Red Hosta, black skin removed), each 1 liang; Dahuang (Radix et Rhizoma Rhei, baked and chopped); Shanzhizi (Fructus Gardeniae, peeled); Mahuang (Herba Ephedrae, roots and nodes removed), each 0.5 liang; Chenpi (Pericarpium Citri Reticulatae, white pith removed, fried); Muxiang (Radix Aucklandiae), each 1 fen.
The above eight herbs are coarsely crushed and sifted. Each dose is 3 qianbi, boiled in 1 sheng of water with one spoonful of honey and a little ginger juice until reduced to 0.8 sheng. Strain and take cold at any time.
Tiefen San (Iron Powder Powder) Formula
Indication: For Yang Du Cold Damage with mania, wandering, and running.
Ingredients: Tiefen (Plumbum Carbonicum); Pu Xiao (Natrii Sulfas), each 1 liang; Tianzhu Huang (Calculus Bovis/Tianshu Huang, 0.5 liang); Longnao (Borneolum Syntheticum, 1 fen).
The above four herbs are ground uniformly to a fine powder. Each dose is 2 qianbi, mixed with egg white and water. Take at any time.