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The *Huoren Shu* (Book of Vitality) discusses the treatment methods for Shanghan (Cold Damage) in both children and adults: generally, they are the same, but with smaller dosages and slightly cooler medicinal properties. Question: Why does sweating occur only on the head? Answer: When the exterior is excess and the interior is deficient, and the Yuan Fu (the lower jiao organs governing primal qi, such as the kidneys and bladder) fails to open, Yang Qi ascends, causing sweat to appear only on the head. In cases of head sweating alone, the five zang organs are dry and depleted internally, the Bao Zhong (lower jiao cavities or fluid-excreting pathways like the bladder) is empty, and body fluids are scarce. One must absolutely avoid purgative methods; using them constitutes "double deficiency" (making the deficient even more deficient). However, head sweating presents several syndromes: If, after five or six days of Shanghan, there is head sweating, slight aversion to cold, cold hands and feet, fullness in the epigastrium, lack of desire to eat, hard stools, and a fine pulse, this is termed "Yang Wei Jie" (slight Yang binding). There is both an exterior syndrome and an interior syndrome; a deep pulse indicates an interior condition. Sweating occurs due to slight Yang binding. If it were pure Yin binding, there would be no exterior symptoms remaining, as all would have entered the interior; this is considered half-exterior and half-interior. Although the pulse may be deep and tight, it cannot be diagnosed as Shaoyin disease. The reason is that Yin syndromes typically do not present with sweating; since there is head sweating here, we know it is not Shaoyin. (Treat with Xiao Chai Hu Tang / Minor Bupleurum Decoction.) If, after five or six days of Shanghan, following sweating or purging therapies, there is fullness in the chest and hypochondrium, slight binding, difficulty in urination, thirst without vomiting, head sweating only, alternating chills and fever, and irritability, this indicates the exterior syndrome has not yet resolved. (Treat with Chai Hu Gui Zhi Gan Jiang Tang / Bupleurum, Cinnamon Twig, and Dried Ginger Decoction.) If a patient has head sweating only, no sweating on the body, sweat stopping at the neck, difficulty in urination, and thirst prompting intake of water or liquids, this is Stagnant Heat in the interior, and jaundice will certainly develop. (Treat with Wu Ling San / Five-Ingredient Powder with Poria and Yin Chen Hao Tang / Artemisiae Scopariae Decoction.) After purgative therapy for Yangming disease, if there is heat on the exterior, warm hands and feet, no formation of Jie Xiong (Chest Binding), mental restlessness and oppression in the heart, hunger but inability to eat, and head sweating only, (Treat with Zhi Zi Chi Tang / Gardenia and Fermented Soybean Decoction.) If there is tight fullness in the epigastrium, no significant heat, and head sweating, (Treat with Fu Ling Tang / Poria Decoction. Zhang Zhongjing stated: In Shanghan, tight fullness in the epigastrium without significant heat and head sweating only is named Water Binding in the Chest and Hypochondrium. Differentiating this from other binding syndromes by the presence of head sweating, treat with Xiao Ban Xia Jia Fu Ling Tang / Minor Pinellia Decoction plus Poria.)

*Huoren Shu* records Zhang Zhongjing's Xiao Chai Hu Tang (Minor Bupleurum Decoction):
Chai Hu (Bupleuri Radix, 4 liang) Huang Qin (Scutellariae Radix, 1.5 liang. If abdominal pain exists, remove Huang Qin and add Shao Yao/Paeoniae Radix Alba, 1.5 liang. If palpitations in the epigastrium and difficulty in urination exist, remove Huang Qin and add Fu Ling/Poria, 2 liang)
Ren Shen (Ginseng Radix et Rhizoma, 1.5 liang. If there is no thirst and slight heat on the exterior, remove Ren Shen and add Gui Zhi/Cinnamomi Ramulus, 1.5 liang, cover with blankets to induce slight sweating for cure. If coughing exists, remove Ren Shen and Zao/Jujubae Fructus, add Wu Wei Zi/Schisandrae Fructus, 1.1 liang, and Gan Jiang/Zingiberis Rhizoma Recens, 1 liang)
Gan Cao (Glycyrrhizae Radix et Rhizoma, 1.5 liang) Ban Xia (Pinelliae Rhizoma, 1.1 liang, washed with boiling water. If vexation in the chest without vomiting exists, remove Ban Xia and Ren Shen, add Gua Lou Shi/Benincasae Fructus, half a fruit, using one-quarter of the amount. If thirst exists, remove Ban Xia, increase Ren Shen by 0.3 liang, and add Gua Lou Gen/Trichosanthis Radix, 2 liang)
Zao (Jujubae Fructus, 6 pieces. If hardness and fullness under the ribs exist, remove Zao and add Mu Li/Ostrea Concha, 2 liang, stir-fried)
Crush the above herbs to the size of hemp seeds. For each dose, scoop 5 qian bi (approx. 15-20g depending on era standard, literally "five money scoops"), add 4 slices of Sheng Jiang/Zingiberis Rhizoma Recens, 1 Zao, and 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Take three times daily.

*Huoren Shu* records Zhang Zhongjing's Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon Twig, and Dried Ginger Decoction):
Chai Hu (Bupleuri Radix, 2 liang) Gui Zhi (Cinnamomi Ramulus, peeled) Huang Qin (Scutellariae Radix, 1.5 liang each) Gua Lou Gen (Trichosanthis Radix, 2 liang) Gan Jiang/Zingiberis Rhizoma Recens Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) Mu Li (Ostrea Concha, stir-fried, 1 liang each)
Crush the above herbs to the size of hemp seeds. For each dose, scoop 5 qian bi, add 1.5 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Take again shortly after eating.

*Huoren Shu* records Zhang Zhongjing's Wu Ling San (Five-Ingredient Powder with Poria); see the section on Spontaneous Sweating in Shanghan.

*Huoren Shu* records Zhang Zhongjing's Yin Chen Hao Tang (Artemisiae Scopariae Decoction):
Yin Chen Hao (Artemisiae Scopariae Herba, tender parts, 1.5 liang) Da Huang (Rhei Radix et Rhizoma, 0.5 liang, peeled) Zhi Zi (Gardeniae Fructus, large ones, 3.5 pieces)
Crush the above herbs to the size of hemp seeds. Use two large white cups of water. First boil Yin Chen Hao until reduced by half a cup, then add the other two ingredients. Boil until reduced to 0.8 portion, strain, and take warm. Take three times daily. Once urination becomes smooth, the urine will resemble soap pod juice, bright red in color. After one night, abdominal distension decreases, and the yellow pathogen exits via urination.

*Huoren Shu* records Zhang Zhongjing's Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction):
Fei Zhi Zi (Gardeniae Fructus, plump ones, 14 pieces, broken) Xiang Chi (Fermented Soybeans, 4 he)
Crush the above herbs to the size of hemp seeds. For each dose, use 5 qian, add 1 sheng of water. Boil until reduced to 0.8 sheng, strain, and take warm. Stop administration once rapid vomiting/diarrhea occurs.

*Huoren Shu* Chi Fu Ling Tang (Red Poria Decoction):
Chi Fu Ling (Poria cum Radix, red part) Chen Pi (Citri Reticulatae Pericarpium, soaked in boiling water, white pith removed, dried) Ren Shen (Ginseng Radix et Rhizoma, radix tip removed, 1 liang each) Ban Xia (Pinelliae Rhizoma, washed seven times with boiling water, slippery substance removed) Chuan Xiong (Ligustici Chuanxiong Rhizoma) Bai Zhu (Atractylodis Macrocephalae Rhizoma, processed, 0.5 liang each)
Grind the above medicines into coarse powder. For each dose, use 4 qian, add 1.5 zhong of water and 5 slices of Sheng Jiang. Boil until reduced to 0.7 portion, strain. Take warm at any time.

*Huoren Shu* Xiao Ban Xia Jia Fu Ling Tang (Minor Pinellia Decoction plus Poria):
Ban Xia (Pinelliae Rhizoma, 5 liang, soaked in boiling water and washed seven times) Bai Fu Ling (Poria, 3 liang, black soft skin removed)
Crush the above herbs to the size of hemp seeds. For each dose, use 0.5 liang, add 3 sheng of water. Boil until reduced to 1 sheng. Weigh 4 qian of Sheng Jiang, extract its natural juice, add to the decoction, and boil for one or two boils. Drink hot, at any time.