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Pepper (Hu Jiao): Flavor is extremely pungent, nature is hot, belonging to pure Yang, non-toxic. The flavor and nature are both very dense, representing Yang within Yang. Enters the Hand and Foot Yangming meridians. It directs Qi downward, promotes diaphragmatic movement, and primarily treats cold pain in the heart and abdomen, cholera with vomiting, deficiency-cold of the stomach opening, stabbing pain from cold Qi, and indigestion of retained food. It can also be used for cold-slippery conditions of the large intestine. (It must be assisted by other herbs; excessive dosage will scatter Qi.) Because it kills toxins from all kinds of fish, meat, turtles, and mushrooms, it is widely used in culinary seasonings. It removes cold-phlegm from the stomach and treats vomiting of clear fluid after eating. (In cases of cold-phlegm and cold accumulation causing limbs as cold as ice), the effect is very remarkable. Pungency moves Qi, heat assists Fire; it is only suitable for diseases of cold-dampness in the intestines and stomach. (Li Shizhen) Dysphagia (difficulty swallowing, obstruction in the chest and diaphragm) may arise from alcohol consumption, Qi stagnation, or Stomach fire. When the Three Yang meridians are knotted, food must regurgitate upwards. However, there are also cases where food enters but is vomited out immediately, belonging to a "no-fire" syndrome. There are also cases caused by phlegm-Qi knotting, temporarily opened by pungent-hot herbs; Pepper should not be universally prohibited. (Furthermore) Severe pain in the epigastrium. (This refers to pain in the stomach region corresponding to the heart, not true Heart pain.) Pepper 5 fen, Myrrh, Ying Mi...

[Discussion] Pepper is not Sichuan pepper (Zanthoxylum). It derives its name "Jiao" because its pungency resembles that of Sichuan pepper. It originates from remote southern regions and fruits during the time when the Fire element commands. However, for those with Yin deficiency and heat in the blood compartment, coughing with hemoptysis, dry throat and thirst, sudden rushing of hot Qi, blurred vision, foul breath, floating teeth, epistaxis, intestinal wind, internal toxicity, hemorrhoids, and fistulas, frequent consumption...

[Preparation] Those without wrinkled shells inside have greater potency; grind into powder using a stone mortar.

Bi Cheng Qie (Piper cubeba): Similar in category but different in species to Pepper, found in various foreign lands of Hainan. It is a climbing plant, blooming white flowers in spring and bearing black fruits in summer, slightly larger than wutong seeds, with a round pedicel. Another theory states that those growing towards the sun are Pepper, while those growing in the shade are Cheng Qie.
Flavor is pungent and bitter, nature is slightly warm. It directs Qi downward, aids digestion, treats all types of cold Qi and phlegm masses, warms the spleen and stomach, stops vomiting and hiccups, and addresses cholera with vomiting and diarrhea accompanied by abdominal pain. And... Stomach... After recovery, take Ping Wei San (Calm the Stomach Powder) three hundred doses. (One case involved vomiting black water containing green grass-like substances; this indicates extreme deficiency of Kidney and Liver Yang, manifesting the color of the Wood organ. From the treatment of this formula, one can reflect.) For hiccups due to Cold Damage, occurring day and night irregularly, use Bi Cheng Qie and Gao Liang Jiang (Galangal Rhizome) in equal parts, grind into powder, take 2 qian per dose, add six parts water, boil ten times, add a little vinegar, and take. (This belongs to cold syndromes, hiccups due to Yin excess. If it belongs to Yang rebellion, administering this is dangerous; careful examination is required.) For nasal congestion caused by Lung Qi attacking upwards, use Bi Cheng Qie 5 qian, Bo He Ye (Mint Leaf) 3 qian, Jing Jie Sui (Schizonepeta Flower Head) 1.5 qian, grind into powder, make honey pills the size of an euryale seed, hold in mouth and swallow frequently.

[Discussion] Bi Cheng Qie treats coldness of Kidney Qi and Bladder, somewhat resembling Shu Jiao (Sichuan Pepper); treating Yin rebellion and downward Qi obstruction, somewhat resembling Wu Zhu Yu (Evodia Fruit). Using warmth as tonification, it truly belongs to... Fu... Suo... Observing the Bi Cheng Qie pill for treating nasal congestion reveals its affinity for the Kidney and warming of the Bladder. It is the principle of Yang emerging from the earth, rooted at the extreme lower and reaching the extreme upper. Medical texts use Bi Cheng Qie for warming and tonifying to direct Qi downward, such as Tu Si Zi Wan (Dodder Seed Pill), treating Kidney Qi deficiency caused by injury from labor and fatigue, and also treating sudden cough due to Kidney deficiency. Like Huo Xiang Yang Wei Tang (Agastache Stomach-Nourishing Decoction), treating Yangming Stomach deficiency where sinews lack nourishment, leading to flaccidity syndrome. Again, Yu Qi Tang (Nourish Qi Decoction), treating inability to eat, used to unblock the hundred vessels, regulate the Spleen origin, tonify the Middle Jiao, benefit Qi Sea, dispel Yin cold, stop abdominal pain, and advance diet. This is a warming-tonic formula that also relies on its slight assistance in directing Qi downward. Such as Chen Fu Tang (Aquilaria and Aconite Decoction), treating rebellious Qi rushing upward, severe shortness of breath preventing sleep, using Fu Zi (Aconite Root) as the sovereign herb, Chen Xiang (Aquilaria Wood), La Gui (Cinnamon Bark), and Bi Cheng Qie to tonify Yang and guide it; borrowing Cong Chai (Cyperus Rhizome) to assist its downward movement. Again, Qing Mu Xiang Wan (Blue Musk Pill), treating chest and diaphragm obstruction, Qi stagnation not moving, vomiting and hiccups with phlegm reversal, loss of appetite; its efficacy lies in being similar to downward-directing formulas, merely borrowing Bi Cheng Qie to assist Gu Zhi (Psoralea Fruit) to return Kidney Qi and move it, serving as the pivot for all downward-directing agents. As for Zhong Man Fen Xiao Tang (Reduce Distension and Resolve Accumulation Decoction) treating cold distension, taking warming the middle and descending cold rebellion as the sovereign, resolving phlegm and moving Qi as the minister, assisting with pungent-hot herbs to benefit Kidney Qi and regulate Middle Qi, possessing flavors that raise clear and descend turbid, guiding the stagnation of Qi, and including Huang Lian (Coptis Rhizome) and Huang Bai (Phellodendron Bark) within, to drain heat generated from stagnation that does not dissipate with cold, allowing it to dissipate through pungent-heat. This does not solely rely on its warming-tonic properties, but further utilizes its Qi-directing function. Furthermore, Sheng Jin Gan Lu Yin (Generate Fluids and Sweet Dew Drink) treats Ge Xiao (Diaphragmic Thirst) with excessive drinking, red cracks on the tongue, and frequent urination. In the formula, draining heat and benefiting Qi uses Shi Gao (Gypsum Fibrosum) as sovereign; Lian Bai Zhi Zhi (Coptis, Phellodendron, Anemarrhena, Gardenia) drain heat and replenish fluids as ministers; Dang Gui (Angelica Sinensis), Xing Ren (Apricot Seed), Mai Dong (Ophiopogon Tuber), Lian Qiao (Forsythia Fruit), Quan Xie (Scorpion), Bai Kui Hua (White Sunflower Head), Lan Xiang (Costus Root), harmonize blood and moisten dryness as assistants; Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root) move the channels; Bi Cheng Qie, Bai Kou (Cardamom), Mu Xiang (Aucklandia Root), Huo Xiang (Patchouli Herb) act as counter-agents to achieve the effect. This formula treats heat with cold, incorporating heat agents; the previous formula treats cold with warmth, incorporating cold agents. All do not abandon Bi Cheng Qie. Thus, although this substance is said to be warming and tonic, in the Qi compartment, it seems able to move and promote flow, having subtleties preceding cold and heat.

[Preparation] Remove the stalk and wrinkled skin, soak in wine, steam for half a day, pound finely.