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Gancao (Radix Glycyrrhizae) has yellow skin and reddish interior, confirming it as a herb entering the Heart and Spleen meridians. However, the Qi of the Five Zang and Six Fu organs all derives from the Spleen, and the Heart is the sovereign of the body. Gancao possesses an extremely sweet taste and a very neutral nature; therefore, its effects can extend from the Heart and Spleen to other Zang and Fu organs, reaching everywhere and dispelling all pathogenic factors. Its efficacy lies entirely in its sweetness: sweetness tonifies and sweetness moderates. In all formulas by Zhang Zhongjing used for tonifying deficiency and relieving urgency, roasted Gancao is invariably employed; for clearing heat, raw Gancao is used, though even in clearing heat, there is an element of moderation. For instance, treating sore throat and lung abscess often involves fire in the Upper Jiao. Since Gancao enters the Heart, Ganxixin Decoction (Cordate Licorice Decoction) is used to drain Heart epigastric fullness (Pi), not Heart fire. To resolve fullness, herbs like Huanglian (Rhizoma Coptidis), Huangqin (Radix Scutellariae), and Banxia (Rhizoma Pinelliae) are used; Gancao here merely tonifies the Stomach, hence the roasted form is used. The fact that a formula using roasted Gancao is named after Gancao highlights the significant role played by this herb.

Li Dongyuan stated: Raw Gancao drains Heart fire, while cooked (roasted) Gancao disperses exterior cold. Among formulas for dispersing exterior cold, Guizhi Tang (Cinnamon Twig Decoction) and Mahuang Tang (Ephedra Decoction) are paramount. Patients with spontaneous sweating have exterior deficiency; thus, Guizhi Tang uses Guizhi (Ramulus Cinnamomi) and Baishao (Radix Paeoniae Alba) to disperse wind pathogens, and Shengjiang (Rhizoma Zingiberis Recens) and Dazao (Fructus Jujubae) to harmonize Ying and Wei. Patients without sweating have exterior excess; thus, Mahuang Tang uses Mahuang (Herba Ephedrae) and Guizhi to dispel cold, augmented with Xingren (Semen Armeniacae Amarum). However, if exterior resolution neglects the Middle Jiao, a depletion of Middle Qi will lead to subsequent ailments. Therefore, both formulas contain roasted Gancao to stabilize the Middle. Since exterior excess and exterior deficiency differ, the dosage of Gancao varies between the two. This demonstrates that roasted Gancao is used to support and pacify righteous Qi, not to assist in destructive attacks. Li Dongyuan’s lack of distinction fails to provide students with accurate guidelines.

Li Dongyuan further claimed: When Heart fire invades the Spleen, causing abdominal urgency and pain with muscle contraction, Gancao should be doubled. Examining Xiaojianzhong Tang (Minor Construct the Middle Decoction), which treats internal urgency and abdominal pain, uses roasted Gancao, yet this condition is not Heart fire invading the Spleen. Raw Gancao drains Heart fire but does not treat abdominal pain caused by Heart fire invading the Spleen. The *Shennong Bencao Jing* states Huanglian (Rhizoma Coptidis) treats abdominal pain; specifically for Heart fire invading the Spleen, one should use Zhang Zhongjing’s Huanglian Tang (Coptis Decoction). Li Dongyuan’s statement is indeed inconsistent. Liu Qianjiang elucidated the meaning of Heart fire invading the Spleen and praised it deeply. Zou then cited Li’s statement to justify the use of Gancao in Zhizi Ganchi Tang (Gardenia, Licorice, and Fermented Soybean Decoction) for treating vexation and insomnia. How can insomnia be attributed solely to Spleen disease? These three were renowned masters, yet their failure to distinguish Gancao’s nuances so thoroughly is incomprehensible.

Wang Haicang stated: Gancao is used in Fuzi Lizhong Tang (Aconite Decoction to Regulate the Middle) to prevent Fuzi (Radix Aconiti Lateralis Preparata) from flaming upward. Gancao is used in Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) to prevent rapid purgation. However, *Shanghan Lun* does not list "Fuzi Lizhong Tang"; adding Fuzi to Lizhong Tang (Regulate the Middle Decoction) occurs only when abdominal fullness arises. Adding Fuzi for abdominal fullness implies it is indispensable for regulating the Central Palace (Middle Jiao). If one fears Fuzi flaming upward, consider Baitong Tang (White Onion Decoction), which uses Fuzi for Shaoyin syndrome with diarrhea, yet contains no Gancao. Regarding the choice of raw over roasted Gancao, there is inherent logic. In cold-dominant Huoluan (Cholera-like disorder), heat may still be present. While Ganjiang (Rhizoma Zingiberis), Renshen (Radix Ginseng), and Baizhu (Rhizoma Atractylodis Macrocephalae) warm the middle and tonify deficiency, adding raw Gancao provides slight coolness, aligning with *Bencao Jing Jiu*’s description of relieving vexation and fullness, and Li Dongyuan’s concept of nourishing Yin blood. When applied to Xinbi (Chest Bi), raw Gancao addresses Qi stagnation in the chest, avoiding excessive retention. Tiaowei Chengqi Tang treats internal excess due to Stomach Qi disharmony; its method of "regulating the Stomach" is subtle. By discarding Zhishi (Fructus Aurantii Immaturus) and Zhiike (Pericarpium Citri Reticulatae) and selecting roasted Gancao, it pairs with Dahuang (Radix et Rhizoma Rhei) and Mangxiao (Natrii Sulfas) in a complementary tonifying and draining manner...

Wang Haicang also stated: Gancao is used in Fengsui Dan (Phoenix Marrow Pill) to moderate Kidney urgency and generate Yuan Qi. I believe this is incorrect. The origin of this formula is unknown. *Mingyi Fanglun* states it treats nocturnal emission and spermatorrhea or sexual intercourse with spirits. *Yifang Jijie* states it treats excessive Heart fire and insecure Kidney essence prone to leakage. No one has explored its profound principles. Yuan Yin obeys Yuan Yang, and Yuan Yang obeys Tianjun (Heart). Thus, blazing Heart fire affects the Kidney; upon stimulation, Yang moves and Yin follows inevitably. Huangbai (Cortex Phellodendri) calms fire in the Kidney and prevents water from flooding; if fire does not flare, Yang remains dormant; if water does not overflow, Yin remains firm. Sharen (Fructus Amomi Rotundus) gathers Fire and Earth Qi into Water, allowing the Kidney to store securely. However, Heart and Kidney communicate easily; treating only the Kidney without addressing the Heart is incomplete. Raw Gancao drains Heart fire and calms the Spirit. Sweetness is the true flavor of Earth and can suppress fire rising from overflowing Kidney Water (Huíxī’s words). The phrase in *Jijie* regarding "treating excessive Heart fire" actually utilizes Gancao and Renshen. Both tonify Middle Qi and harmonize formulas, but Zhang Zhongjing distinguishes their usage strictly. Consider two examples: In Jueyin syndrome with vomiting, Shaoyang involvement is treated by pivoting Shaoyang, often using Ganjiang and Huanglian together (as detailed under Ganjiang). Ganjiang Huanglian Renshen Tang modifies Xiao Chaihu Tang but replaces Gancao with Renshen, which is puzzling. Does it not say "vomiting immediately after eating"? Shaoyang ascending Qi rejects food instantly; urgency cannot wait. Gancao’s cloying sweetness cannot bear this burden. Renshen, with balanced sweet and bitter properties, is the specific herb for harmonizing Shaoyang; once the pivot functions, food descends naturally, making Gancao unsuitable. Conversely, when Gancao replaces Renshen: Zhichi Chi Tang treats vexation and insomnia; if accompanied by shortness of breath, Zhizi Ganchi Tang is indicated. Crude practitioners would likely use Renshen to tonify Qi. Yet, Renshen tonifies and ascends Qi. The vomiting in Zhichi Chi Tang results from the mutual agitation of ascending and descending actions of its ingredients; adding Renshen disrupts this balance, and its tonifying nature may obstruct pathogens. "Ao'ao" refers to severe restlessness; "shortness of breath" here is severe restlessness damaging Qi, not Yuan Qi deficiency. Zhichi can expel pathogens via vomiting but cannot calm Qi. Thus, Zhang Zhongjing chose sweet, neutral Gancao to clear Heart fire, excluding Renshen.

Zou argued that Huangqi Guizhi Wuwu Tang targets the lower body, requiring urgent action, hence removing Gancao and increasing dosages. Guizhi Jia Huangqi Tang targets the upper body, requiring slow action, hence adding Gancao and reducing dosages. In Blood Bi syndrome, he isolated "slight tightness at the Chi pulse" as evidence of lower pathology, citing the first line of the chapter to support treating the lower. He ignored that the next line mentions "numbness of the body," implying pathology exists. The first line of the chapter is irrelevant to this disease; moreover, if Chi pulse tightness indicates lower pathology, does Guan pulse tightness also indicate lower pathology? In Yellow Sweat syndrome, he isolated "sweating above the waist" as evidence of upper pathology, citing the second line. He ignored that the next line mentions "loosening pain in the lower back and difficulty urinating," implying lower pathology. Citing the second line, which describes different symptoms like swelling and sticky sweat, proves his selective interpretation flawed. You Zhu’s commentary on "suitable to needle and guide Yang Qi" is precise. Huangqi Guizhi Wuwu Tang harmonizes Ying stagnation and assists Wei movement, reflecting the intent of guiding Yang Qi. The Classic states: "When Yin, Yang, Form, and Qi are all deficient, do not needle; regulate with sweet herbs." Applying this to the formula fits perfectly. Blood Bi affects the exterior, not the interior. Using sweet herbs instead of needles regulates the exterior. Huangqi, Guizhi, Shengjiang, and Dazao combine sweet and pungent flavors to tonify deficiency and disseminate Yang. Shaoyao assisting Guizhi enters Ying to regulate blood. Removing Gancao and increasing Shengjiang avoids interior retention and promotes exterior resolution. Such nuance exists in Gancao’s use. It is not a modification of Guizhi Tang, hence not named Guizhi Jia Huangqi Tang. However, one must reflect on Guizhi Tang when considering Guizhi Jia Huangqi Tang. Huangqi is integral to Guizhi Tang; how can it be removed? Reducing Guizhi and Shaoyao but keeping Gancao constant shows that Yang deficiency differs from wind pathogens. Zou failed to understand Zhang Zhongjing’s formulation principles, offering subjective speculations riddled with errors, which is meaningless.