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(Zhang Zhongjing created this formula, also known as Sanwu Nongpo Decoction.) It is used to treat Yangming syndrome in cold damage, manifesting as delirium, hard stool, tidal fever, and panting, as well as upper jiao (upper burner) stuffiness and fullness due to miscellaneous diseases.

Da Huang (Rhei Radix et Rhizoma, 4 liang) Nong Po (Magnoliae Officinalis Cortex, 2 liang, stir-fried with ginger juice) Zhi Shi (Aurantii Fructus Immaturus, 3 pieces, stir-fried with bran). Add four sheng of water. Boil until reduced to one sheng and two he, remove the dregs, and divide into two warm doses.

Pathogenic factors in the upper jiao cause fullness; in the middle jiao, they cause distension; excess heat in the stomach leads to tidal fever. (Tidal fever is like the tide, arriving at regular intervals. The Yangming channel belongs to Dry Metal, which is prosperous during the Shen and You hours.) The true yin of the lower jiao... (Yangming syndrome includes Zhengyang Yangming, Taiyang Yangming, and Shaoyang Yangming. If pathogenic factors transmit from the Yangming channel to the stomach fu-organ, presenting with aversion to cold absent, abdominal fullness, and hard stool, Da Chengqi Tang should be used for purgation. If there is profuse sweating, fever, and slight aversion to cold, the exterior pattern is not yet resolved; since the fever is not tidal, Chengqi formulas are contraindicated. If there is significant abdominal fullness and obstruction, Xiao Chengqi Tang may be used to mildly harmonize the stomach qi, avoiding severe purgation. This indicates that Yangming disease can reside in the channels without fully entering the fu-organs, requiring particular caution. Yangming disease often transmits from Taiyang. Cheng Wuji stated: Transmission from Taiyang and Shaoyang is commonly known; transmission from the Three Yin channels is rarely recognized. There are many cases in the Three Yin channels requiring urgent purgation; is this not Zhang Zhongjing's profound intent? The Classic says: In cold damage, if the pulse is floating and slow, and hands and feet are warm, the disease is related to Taiyin, and jaundice should develop. If urination is free, jaundice will not develop. After seven or eight days, if the stool becomes hard, it is a Yangming disease. Cheng Jiaoqian said: This condition is called Taiyin-Yangming. Yangming disease originates from stomach excess. Not only do the Three Yang channels transmitting pathogens convert to Yangming, but the Three Yin channels can also convert to Yangming. By extension, the three major Chengqi patterns in Shaoyin and the minor Chengqi pattern in Jueyin, are they not all diseases converting to Yangming?)

Jingui Yaolue uses this to treat chest fullness caused by Zhi Yin (fluid retention), renaming it Nong Po Da Huang Decoction. (Xu Zhongke said: Mentioning Zhi Yin implies the pathology is somewhat lateral. However, if it does not radiate pain to the hypochondrium... here corresponds... upper jiao unobstructed... solid...)