Library

(Jie'an's self-note says: This is Sini Tang (Four Reversal Decoction).) It treats cold pathogen invading the three Yin meridians. In the early stage, there is no fever, no headache, aversion to cold with shivering, cold limbs, a desire to cover oneself with clothes, curled-up posture with heaviness, abdominal pain accompanied by vomiting and diarrhea, and no thirst in the mouth. Alternatively, the fingernails and lips may turn cyanotic, saliva may be vomited, or the pulse may be imperceptible, slow, and weak. (The absence of fever and headache at the onset indicates no exterior pathogenic factor; the pathogen is not in the Yang meridians. Aversion to cold and cold limbs indicate that cold has penetrated inward, and Yang Qi fails to warm the limbs. The desire to cover oneself and the heavy, curled-up posture indicate cold invading the Shaoyin meridian. Abdominal pain, vomiting, diarrhea, and lack of thirst indicate cold invading the Taiyin meridian. Cyanosis of the nails and lips, and spitting of saliva, indicate cold invading the Jueyin meridian. As for the deep, slow, or absent pulse, it signifies that Yin-cold has reached an extreme severity. Shivering can belong to Yin patterns, where Yang is deficient and Yin is excessive, leading to internal struggle between Yin and Yang, with righteous Qi failing to overcome the pathogen; thus, the heart feels cold, the feet curl up, the jaw chatters, limbs are cold, and the whole body trembles. It can also belong to Yang patterns, where true Yang recovers, righteous Qi mobilizes, struggles externally against the pathogen, and wins; thus, the body shakes, followed by resolution through profuse sweating.)

Prepared Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Renshen (Ginseng Radix et Rhizoma, 5 fen), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium, 7 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 3 fen).
If diarrhea is severe, add Shengma (Cimicifugae Rhizoma).

When cold invades the three Yin meridians, excess Yin leads to deficient Yang. Therefore, pungent and hot herbs such as Fuzi, Ganjiang, and Rougui are used to dispel Yin-cold. Meanwhile, warming and tonifying herbs from Liujunzi Tang (Six Gentlemen Decoction) are employed to assist Yang Qi.

(From *Jin Gui Yao Lue*) Treats difficulty in urination with water retention and thirst in the patient. Gualougen (Trichosanthis Radix, 2 liang), Fuling (Poria), Shuyu (Dioscoreae Rhizoma, 3 liang), Prepared Fuzi (Aconiti Lateralis Radix Praeparata, one piece), Qumai (Dianthi Herba, 1 liang). Form into pills with refined honey. Take orally; efficacy is indicated when urination becomes smooth and the abdomen feels warm. Because there is heat in the Stomach and cold in the abdomen, the formula modifies the structure of Bawei Wan (Eight-Ingredient Pill with Rehmannia Root). Heat in the Stomach necessarily leads to rapid digestion and hunger, hard stools, and frequent urination. This presents as stranguria accompanied by thirst. Gualougen clears heat and generates fluids, while Fuling and Qumai promote diuresis. However, the cold-water Qi from the Kidney ascends into the abdomen... The text below states: "Efficacy is indicated when urination is smooth and the abdomen is warm." The rationale behind this prescription can be deduced and contemplated.