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(These) three herbs, with one dou of water, first decoct Ephedrae Herba (Mahuang, 麻黄) until the liquid reduces by two sheng, remove the foam on the surface, add the remaining herbs, decoct to obtain three sheng of liquid, filter out the dregs, take one sheng warm, three times a day.

Shaoyin disease (Disease of the Shaoyin channel), occurring two to three days after onset, presents with mild sweating; Mahuang Fuzi Gancao Tang (Cinnamon Twig and Aconite Decoction) is used to induce mild sweating. Since there are no interior syndromes (such as diarrhea or vomiting) after two to three days, mild sweating is indicated.

Mahuang Fuzi Gancao Tang Formula

Ephedrae Herba (Mahuang, 麻黄) two liang; Fuzi (Prepared Radix Aconiti Lateralis, 附子) one piece (processed, skin removed, broken into eight pieces); Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted).

(These) three herbs, with seven sheng of water, first boil Ephedrae Herba for one or two boils, remove the foam, add the other herbs, decoct to obtain three sheng of liquid, filter out the dregs, take one sheng warm, three times a day.

Shaoyin disease, occurring more than two to three days after onset, presenting with vexation in the heart and inability to sleep, is primarily treated with Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction).

Huanglian Ejiao Tang Formula

Coptidis Rhizoma (Huanglian, 黄连) four liang; Scutellariae Radix (Huangqin, 黄芩) two liang; Paeoniae Radix Alba (Baishao, 芍药) two liang; Asini Corii Colla (Ejiao, 阿胶) three liang; Ovi Gallus Album (Jizihuang, 鸡蛋黄) two pieces.

(These) five herbs, with six sheng of water, first decoct the first three herbs to obtain two sheng of liquid, filter out the dregs, add the gelatin until completely dissolved, let it cool slightly, add the egg yolk, stir well to mix, take seven ge warm, three times a day.

Shaoyin disease, occurring one to two days after onset, with a normal sensation in the mouth but aversion to cold on the back, should be treated with moxibustion, and Fuzi Tang (Aconite Decoction) is primarily indicated.

Fuzi Tang Formula

Fuzi (Prepared Radix Aconiti Lateralis, 附子) two pieces (processed, skin removed, broken into eight pieces); Poria (Fuling, 茯苓) three liang; Ginseng Radix et Rhizoma (Renshen, 人参) two liang; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) four liang; Paeoniae Radix Alba (Baishao, 芍药) three liang.

(These) five herbs, with eight sheng of water, decoct to obtain three sheng of liquid, filter out the dregs, take one sheng warm, three times a day.

Shaoyin disease, presenting with body pain, cold hands and feet, bone and joint pain, and a deep pulse, is primarily treated with Fuzi Tang. (Formula see above.)

Shaoyin disease, with a weak and thready pulse, and body pain as if being pulled, is due to disharmony of Ying and Wei (Nutritive and Defensive Qi); Guizhi Xini Tang (Angelica Sinensis Decoction for Reversal Cold) is primarily indicated.

Guizhi Xini Tang Formula

Danggui Radix (Danggui, 当归) three liang; Paeoniae Radix Alba (Baishao, 芍药) three liang; Cinnamomi Ramulus (Guizhi, 桂枝) three liang; Asari Radix et Rhizoma (Xixin, 细辛) three liang; Tetrapanacis Medulla (Mutong, 木通) three liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Zizyphi Fructus (Dazao, 大枣) twenty-five pieces (split).

(These) seven herbs, with eight sheng of water, decoct to obtain three sheng of liquid, filter out the dregs, take one sheng warm, three times a day.

Shaoyin disease, presenting with diarrhea and pus-blood in the stool, is primarily treated with Taohua Tang (Peach Flower Decoction).

Taohua Tang Formula

Hongshizhi (Red Halloysite, 赤石脂) one jin (half used whole, half sifted into powder); Shengjiang (Dried Ginger, 干姜) one liang; Oryza Sativa (Jingmi, 粳米) one sheng.

(These) three herbs, with seven sheng of water, cook the rice until soft, filter out the dregs, take seven ge warm, mixed with one fangcun chi (square-inch spoonful) of Hongshizhi powder, three times a day. If cured after one dose, do not take the remainder.

Shaoyin disease, progressing from two to three days to four to five days, presenting with abdominal pain, difficult urination, incessant diarrhea, and pus-blood in the stool, is primarily treated with Taohua Tang. (Formula see above.)

Shaoyin disease, presenting with diarrhea and pus-blood in the stool, can be treated by acupuncture at the Foot-Yangming channels.

Shaoyin disease, presenting with vomiting, diarrhea, cold reversal of hands and feet, and extreme irritability as if about to die, is primarily treated with Wuzhuyu Tang (Evodia Decoction).

Wuzhuyu Tang Formula

Evodiae Fructus (Wuzhuyu, 吴茱萸) one sheng; Ginseng Radix et Rhizoma (Renshen, 人参) two liang; Zingiberis Recens Rhizoma (Shengjiang, 生姜) six liang (sliced); Zizyphi Fructus (Dazao, 大枣) twelve pieces (split).

(These) four herbs, with seven sheng of water, decoct to obtain two sheng of liquid, filter out the dregs, take seven ge warm, three times a day.

Shaoyin disease, presenting with diarrhea, sore throat, chest fullness, and vexation, is primarily treated with Zhufu Tang (Pig Skin Decoction).

Zhufu Tang Formula

Porcis Cutis (Zhufu, 猪肤) one jin.

(This) single herb, with one dou of water, decoct to obtain five sheng of liquid, filter out the dregs, add one sheng of white honey, five ge of white powder (rice flour), cook until fragrant, mix well, divide into six warm doses. (White powder refers to rice flour.)

Shaoyin disease, with sore throat for two to three days, may be given Gancao Tang (Licorice Decoction); if not improved, give Jiegeng Tang (Platycodon Decoction).

Gancao Tang Formula

Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang.

(This) single herb, with three sheng of water, decoct to obtain one and a half sheng of liquid, filter out the dregs, take seven ge warm, twice a day.

Jiegeng Tang Formula

Jiegeng Radix (Jiegeng, 桔梗) one liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang.

(These) two herbs, with three sheng of water, decoct to obtain one sheng of liquid, filter out the dregs, divide into two warm doses.

Shaoyin disease, with injury to the throat, sores, pain radiating to the sides of the throat, inability to speak, and loss of voice, is primarily treated with Kujiu Tang (Bitter Wine Decoction).

Kujiu Tang Formula

Banxia (Pinelliae Tuber, 半夏) fourteen pieces (washed, broken like a jujube pit); Ovi Gallus Ovum (Jizi, 鸡蛋) one piece (remove yolk, place bitter wine in the shell).

(These) two herbs, place Banxia in the bitter wine, use the eggshell as a container, place in a knife ring over fire, boil three times, filter out the dregs, hold and swallow slowly. If not improved, prepare three more doses.

Shaoyin disease, with sore throat and a floating pulse, is primarily treated with Banxia San and Tang (Pinellia Powder and Decoction).

Banxia San Formula

Banxia (Pinelliae Tuber, 半夏) (washed); Cinnamomi Ramulus (Guizhi, 桂枝); Gancao (Prepared Radix Glycyrrhizae, 甘草) (roasted).

(These) three herbs, in equal parts, separately pounded and sifted, then mixed. Take one fangcun chi with white drink (rice gruel), three times a day. If unable to take the powder, boil one sheng of water for seven boils, add two fangcun chi of powder, boil three more times, let cool slightly, and swallow slowly.

Shaoyin disease, presenting with diarrhea, is primarily treated with Baitong Tang (White Onion Decoction).

Baitong Tang Formula

Congbai (Scallion White, 葱白) four stems; Shengjiang (Dried Ginger, 干姜) one liang; Fuzi (Raw Radix Aconiti Lateralis, 附子) one piece (raw, skin removed, broken into eight pieces).

(These) three herbs, with three sheng of water, decoct to obtain one sheng of liquid, filter out the dregs, divide into two warm doses.

Shaoyin disease, presenting with diarrhea and a faint pulse, is given Baitong Tang; if diarrhea persists, with cold reversal, absence of pulse, dry retching, and vexation, Baitong Jia Zhudanji Tang (White Onion Decoction with Pig Bile) is primarily indicated. After taking the decoction, if the pulse suddenly emerges, death ensues; if the pulse gradually returns, survival is expected.

Baitong Jia Zhudanji Tang Formula

Congbai (Scallion White, 葱白) four stems; Shengjiang (Dried Ginger, 干姜) one liang; Fuzi (Raw Radix Aconiti Lateralis, 附子) one piece (raw, skin removed, broken into eight pieces); Urina Hominis (Ren Niao, 人尿) five he; Suis Fel (Porcine Bile, 猪胆汁) one he.

(These) five herbs, with three sheng of water, first decoct the first three herbs to obtain one sheng of liquid, filter out the dregs, add human urine and porcine bile, mix well, divide into two warm doses. If bile is unavailable, it may be omitted.

Shaoyin disease persisting for two to three days, progressing to four to five days, presenting with abdominal pain, difficult urination, heavy and painful limbs, and spontaneous diarrhea, indicates accumulation of fluid-dampness. Among these patients, some may have cough, or difficult urination, or diarrhea, or vomiting; Zhenwu Tang (True Warrior Decoction) is primarily indicated.

Zhenwu Tang Formula

Poria (Fuling, 茯苓) three liang; Paeoniae Radix Alba (Baishao, 芍药) three liang; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) two liang; Zingiberis Recens Rhizoma (Shengjiang, 生姜) three liang (sliced); Fuzi (Prepared Radix Aconiti Lateralis, 附子) one piece (processed, skin removed, broken into eight pieces).

(These) five herbs, with eight sheng of water, decoct to obtain three sheng of liquid, filter out the dregs, take seven ge warm, three times a day. If coughing, add Schisandrae Fructus (Wuweizi, 五味子) half sheng, Asari Radix et Rhizoma (Xixin, 细辛) and Shengjiang (Dried Ginger, 干姜) one liang each; if difficult urination, add Poria (Fuling, 茯苓) one liang; if diarrhea, remove Paeoniae Radix Alba (Baishao, 芍药), add Shengjiang (Dried Ginger, 干姜) two liang; if vomiting, remove Fuzi (Aconite, 附子), add Zingiberis Recens Rhizoma (Shengjiang, 生姜) sufficient to make half a jin.

Shaoyin disease, presenting with undigested food in diarrhea, interior cold with exterior heat, cold reversal of hands and feet, faint pulse nearly imperceptible, body paradoxically not averse to cold, flushed complexion, or abdominal pain, or dry retching, or sore throat, or cessation of diarrhea with absent pulse, is primarily treated with Tongmai Sini Tang (Pulse-Returning Four Reversals Decoction).

Tongmai Sini Tang Formula

Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Fuzi (Raw Radix Aconiti Lateralis, 附子) one large piece (raw, skin removed, broken into eight pieces); Shengjiang (Dried Ginger, 干姜) three liang; Ginseng Radix et Rhizoma (Renshen, 人参) two liang.

(These) four herbs, with three sheng of water, decoct to obtain one and two he of liquid, filter out the dregs, divide into two warm doses. Recovery occurs when the pulse returns. For flushed complexion, add nine stems of Congbai (Scallion White, 葱白); for abdominal pain, remove Congbai, add Paeoniae Radix Alba (Baishao, 芍药) two liang; for vomiting, add Zingiberis Recens Rhizoma (Shengjiang, 生姜) two liang; for sore throat, remove Paeoniae Radix Alba (Baishao, 芍药), add Jiegeng Radix (Jiegeng, 桔梗) one liang; for cessation of diarrhea with absent pulse, remove Jiegeng Radix (Jiegeng, 桔梗), add Ginseng Radix et Rhizoma (Renshen, 人参) two liang.

Shaoyin disease, presenting with cold reversal of limbs, among which some have cough, or palpitations, or difficult urination, or abdominal pain, or diarrhea with heaviness in the rectum, is primarily treated with Sini San (Four Reversals Powder).

Sini San Formula

Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Fuzi (Radix Aconiti Lateralis, 附子) one large piece; Shengjiang (Dried Ginger, 干姜) one and a half liang; Ginseng Radix et Rhizoma (Renshen, 人参) two liang.

(These) four herbs, pounded and sifted, taken with white drink (rice gruel) one fangcun chi. For cough, remove Ginseng Radix et Rhizoma (Renshen, 人参), add Schisandrae Fructus (Wuweizi, 五味子) and Shengjiang (Dried Ginger, 干姜) five fen each, also treating diarrhea; for palpitations, add Cinnamomi Ramulus (Guizhi, 桂枝) five fen; for difficult urination, add Poria (Fuling, 茯苓) five fen; for diarrhea with heaviness in the rectum, first boil Xiebai (Allii Macrostemonis Bulbus, 薤白) three liang in five sheng of water to obtain three sheng of liquid, filter out dregs, add three fangcun chi of powder to the soup, boil to obtain one and a half sheng, divide into two warm doses.

Shaoyin disease, presenting with diarrhea for six to seven days, cough and vomiting, thirst, vexation, and insomnia, is primarily treated with Zhuling Tang (Polyporus Decoction).

Zhuling Tang Formula

Polyporus (Zhuling, 猪苓) one liang (skin removed); Poria (Fuling, 茯苓) one liang (skin removed); Asini Corii Colla (Ejiao, 阿胶) one liang; Alismatis Rhizoma (Zexie, 泽泻) one liang; Talcum (Huashi, 滑石) one liang.

(These) five herbs, with four sheng of water, first decoct the first four herbs to obtain two sheng of liquid, filter out the dregs, add gelatin until dissolved, take seven ge warm, three times a day.

Shaoyin disease, occurring two to three days after onset, with dry mouth and throat, requires urgent purgation; Dachengqi Tang (Major Order the Qi Decoction) is appropriate.

Dachengqi Tang Formula

Stellariae Fructus (Zhishi, 枳实) five pieces (roasted); Magnoliae Officinalis Cortex (Houpo, 厚朴) half a jin (skin removed, roasted); Rhei Radix et Rhizoma (Dahuang, 大黄) four liang (washed); Natrii Sulfas (Mangxiao, 芒硝) three he.

(These) four herbs, with one dou of water, first decoct Stellariae Fructus (Zhishi, 枳实) and Magnoliae Officinalis Cortex (Houpo, 厚朴) to obtain five sheng of liquid, filter out dregs, add Rhei Radix et Rhizoma (Dahuang, 大黄), boil to obtain two sheng, filter out dregs, add Natrii Sulfas (Mangxiao, 芒硝), boil one or two more times, divide into two warm doses. If bowel movement occurs after one dose, stop subsequent doses.

Shaoyin disease, with spontaneous passage of clear green water, severe epigastric pain, and dry mouth/throat, can be purged; Dachengqi Tang (Major Order the Qi Decoction) is appropriate. (Formula see above.)

Shaoyin disease, persisting for six to seven days, with abdominal distension and constipation, requires urgent purgation; Dachengqi Tang (Major Order the Qi Decoction) is appropriate. (Formula see above.)

Shaoyin disease, with a deep pulse, requires urgent warming; Sini Tang (Four Reversals Decoction) is appropriate.

Sini Tang Formula

Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Fuzi (Raw Radix Aconiti Lateralis, 附子) one large piece (raw, skin removed, broken into eight pieces); Shengjiang (Dried Ginger, 干姜) two and a half liang; Ginseng Radix et Rhizoma (Renshen, 人参) two liang.

(These) four herbs, with three sheng of water, decoct to obtain one and two he of liquid, filter out dregs, divide into two warm doses.

Shaoyin disease, with immediate vomiting upon eating, or a warm sensation in the heart with urge to vomit but inability to do so, initial cold hands and feet, and string-taut slow pulse, indicates excess in the chest; purgation is contraindicated, emesis is indicated. If there is cold-fluid retention in the diaphragm with dry retching, emesis is contraindicated, warming is indicated; Sini Tang (Four Reversals Decoction) is appropriate. (Formula see above.)

Shaoyin disease, with diarrhea, faint and choppy pulse, vomiting and sweating, frequent defecation but small volume, should be treated by warming the upper part with moxibustion.

Differentiation of Jueyin Disease Pulse and Syndromes

The Jueyin disease syndrome includes: excessive thirst (Xiaoke), qi rushing up to the heart, burning pain in the heart, hunger without desire to eat, vomiting of roundworms upon eating, and if purged, diarrhea will not cease.

In Jueyin wind-strike, a faint and floating pulse indicates impending recovery; non-floating indicates not yet recovered.

The time for resolution of Jueyin disease is from Chou hour to Mao hour.

In Jueyin disease, if the patient desires water, give small amounts to drink, and they will recover.

For all cases of cold reversal (Nijue), purgation is contraindicated; this applies equally to those with deficiency constitutions.

In Shanghan (Cold Damage), if cold reversal precedes fever and diarrhea, the diarrhea will cease spontaneously; if cold reversal recurs, diarrhea will recur.

In Shanghan, initial fever for six days, followed by cold reversal for nine days with diarrhea; generally, those with cold reversal and diarrhea cannot eat. If they can eat now, it may be "Chu Zhong" (removal of middle qi, a false sign of stomach qi exhaustion). Feed them plain cake; if no fever ensues, stomach qi remains, and recovery is certain. Fear is that sudden heat comes and goes quickly. On the third day, if the pulse shows continued heat, recovery is expected at midnight of the next day. This is because originally fever was six days, cold reversal nine days, plus three more days of fever totals nine days, matching the cold reversal days, hence recovery at midnight. On the third day thereafter, if the pulse is rapid and heat persists, this indicates excess heat, likely leading to carbuncle and pus.

In Shanghan, six to seven days, with a slow pulse, if mistakenly given Huangqin Tang (Scutellaria Decoction) to clear heat, since slow pulse indicates cold, using Huangqin Tang again removes heat, leaving the abdomen cold. If the patient can eat now, this is named "Chu Zhong," and death is certain.

In Shanghan, if cold reversal precedes fever, diarrhea ceases spontaneously. If sweating occurs instead, with sore throat, the throat becomes bi (obstructed). If fever occurs without sweating, diarrhea ceases spontaneously; if it does not cease, pus-blood in stool will occur, and the throat will not become obstructed.

In Shanghan, from one to two days to four to five days, if cold reversal occurs, fever must follow. Previous fever leads to subsequent cold reversal; deeper cold reversal implies deeper heat; milder cold reversal implies milder heat. Cold reversal should be treated with purgation; if mistakenly treated with sweating, oral lesions and redness will occur.

In Shanghan disease, if cold reversal lasts five days and fever five days, assuming cold reversal would return on the sixth day, if it does not, the disease heals itself. Cold reversal does not exceed five days; with five days of fever, self-healing is known.

Generally, cold reversal (Jue) occurs when Yin and Yang qi fail to connect smoothly. Cold reversal manifests as cold hands and feet.

In Shanghan, with faint pulse and cold reversal, progressing to seven or eight days, with cold skin, restlessness without respite, this is Zang Jue (Visceral Cold Reversal), not Tui Jue (Roundworm Cold Reversal). In Tui Jue, the patient vomits roundworms. Now the patient is quiet but occasionally vexed, indicating visceral cold causing roundworms to ascend to the diaphragm, causing vexation, which stops shortly. Vomiting and vexation after eating indicate roundworms responding to food odor, and the patient will vomit roundworms. Tui Jue is primarily treated with Wumei Wan (Mume Pill), which also treats chronic diarrhea.

Wumei Wan Formula

Mume Fructus (Wumei, 乌梅) three hundred pieces; Asari Radix et Rhizoma (Xixin, 细辛) six liang; Shengjiang (Dried Ginger, 干姜) ten liang; Coptidis Rhizoma (Huanglian, 黄连) sixteen liang; Angelicae Sinensis Radix (Danggui, 当归) four liang; Fuzi (Processed Radix Aconiti Lateralis, 附子) six liang (processed, skin removed); Sichuan Pepper (Shujiao, 蜀椒) four liang (sweated); Cinnamomi Ramulus (Guizhi, 桂枝) six liang (skin removed); Ginseng Radix et Rhizoma (Renshen, 人参) six liang; Phellodendri Cortex (Huangbai, 黄柏) six liang.

(These) ten herbs, separately pounded and sifted, mixed together. Soak Mume Fructus (Wumei, 乌梅) in vinegar overnight, remove pits, steam over five dou of rice. When rice is cooked, pound into paste, mix with herbs, place in mortar with honey, pound two thousand times, form pills the size of paulownia seeds. Take ten pills before meals with drink, three times a day, gradually increase to twenty pills.

Avoid raw, cold, slippery, and foul-smelling foods.

In Shanghan, with slight heat and mild cold reversal, cold fingertips, silence, lack of appetite, and vexation, if after several days urination is clear and white, heat has cleared, appetite returns, and the disease heals. If cold reversal with vomiting and chest/hypochondriac fullness/vexation occurs, blood in stool will follow later.

If the patient has cold hands and feet, no chest binding, lower abdominal fullness, and tenderness on pressure, this is cold binding at the Bladder Guan Yuan point.

In Shanghan, fever for four days, cold reversal for three days, then fever for four days; less cold reversal and more heat indicates healing. From fourth to seventh day, if heat persists, pus-blood in stool will occur.

In Shanghan, cold reversal for four days, fever for three days, then cold reversal for five days; the disease progresses, with more cold and less heat, indicating decline of Yang qi.

In Shanghan, six to seven days, with faint pulse, cold hands and feet, and vexation, moxa Jueyin; if cold reversal does not resolve, death ensues.

In Shanghan, with fever, diarrhea, cold reversal, and restlessness preventing lying down, death ensues.

In Shanghan, with fever, severe diarrhea, and unceasing cold reversal, death ensues.

In Shanghan, six to seven days without diarrhea, sudden fever with diarrhea, and unceasing sweating, death ensues. This is due to Yin without Yang.

In Shanghan, five to six days, no chest binding, soft abdomen, deficient pulse, and recurrent cold reversal, purgation is contraindicated; this is blood loss, and purgation leads to death.

In Shanghan, with fever and cold reversal, progressing to seven days with diarrhea, is difficult to treat.

In Shanghan, with rapid pulse and cold hands and feet, moxibustion is contraindicated.

In Shanghan, with slippery pulse and cold reversal, interior heat is present; Baihu Tang (White Tiger Decoction) is primarily indicated.

Baihu Tang Formula

Anemarrhenae Rhizoma (Zhimu, 知母) six liang; Gypsum Fibrosum (Shigao, 石膏) one jin (crushed, wrapped in cotton); Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Oryza Sativa (Jingmi, 粳米) six he.

(These) four herbs, with one dou of water, cook until rice is soft, strain, take one sheng warm, three times a day.

In Shanghan, with cold reversal of hands and feet and thready pulse nearly absent, Danggui Sini Jia Renshen Fuzi Tang (Angelica Decoction for Reversal Cold with Added Ginseng and Aconite) is primarily indicated; if there is long-standing interior cold, Danggui Sini Jia Wuzhuyu Shengjiang Fuzi Tang (Angelica Decoction for Reversal Cold with Added Evodia, Ginger, and Aconite) is primarily indicated.

Danggui Sini Jia Renshen Fuzi Tang Formula

Angelicae Sinensis Radix (Danggui, 当归) three liang; Cinnamomi Ramulus (Guizhi, 桂枝) three liang (skin removed); Paeoniae Radix Alba (Baishao, 芍药) three liang; Asari Radix et Rhizoma (Xixin, 细辛) three liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Tetrapanacis Medulla (Mutong, 木通) two liang; Zizyphi Fructus (Dazao, 大枣) twenty-five pieces (split); Ginseng Radix et Rhizoma (Renshen, 人参) three liang; Fuzi (Processed Radix Aconiti Lateralis, 附子) one piece (processed, skin removed, broken into eight pieces).

(These) nine herbs, with eight sheng of water, decoct to obtain three sheng of liquid, filter out dregs, take one sheng warm, three times a day.

Danggui Sini Jia Wuzhuyu Shengjiang Fuzi Tang Formula

Evodiae Fructus (Wuzhuyu, 吴茱萸) two sheng; Zingiberis Recens Rhizoma (Shengjiang, 生姜) half a jin; Fuzi (Processed Radix Aconiti Lateralis, 附子) one piece (processed, skin removed, broken into eight pieces); Angelicae Sinensis Radix (Danggui, 当归) three liang; Cinnamomi Ramulus (Guizhi, 桂枝) three liang (skin removed); Paeoniae Radix Alba (Baishao, 芍药) three liang; Asari Radix et Rhizoma (Xixin, 细辛) three liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted); Tetrapanacis Medulla (Mutong, 木通) two liang; Zizyphi Fructus (Dazao, 大枣) twenty-five pieces (split).

(These) ten herbs, with six sheng of water and six sheng of clear wine, decoct to obtain three sheng of liquid, take one sheng warm, three times a day.

With profuse sweating, persistent heat, internal tension, limb pain, accompanied by diarrhea, cold reversal, and aversion to cold, Sini Tang (Four Reversals Decoction) is primarily indicated.

Sini Tang Formula

Ginseng Radix et Rhizoma (Renshen, 人参) two liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang; Shengjiang (Dried Ginger, 干姜) one and a half liang; Fuzi (Raw Radix Aconiti Lateralis, 附子) one piece (raw, skin removed, broken into eight pieces).

(These) four herbs, with three sheng of water, decoct to obtain one and two he of liquid, filter out dregs, divide into two warm doses. For strong constitutions, use one large Fuzi (Aconite, 附子) and two liang of Shengjiang (Dried Ginger, 干姜).

With profuse sweating, or profuse diarrhea with cold reversal, Sini Tang (Four Reversals Decoction) is primarily indicated. (Formula see above.)

If the patient has cold hands and feet and a suddenly tight pulse, pathogenic factor is bound in the chest, with epigastric fullness and vexation, hunger but inability to eat, the disease is in the chest, and emesis is required; Genti San (Melon Seed Powder) is appropriate.

Genti San Formula

Gentis Fructus (Genti, 瓜蒂); Adzuki Bean (Chixiaodou, 赤小豆).

(These) two herbs, in equal parts, separately pounded and sifted, mixed in mortar. Separately, cook one he of Black Soybean Paste (Xiangchi, 香豉) with seven he of hot water into a thin porridge, filter, take juice, mix with one qian chi of powder, take warm in one dose. If no vomiting, increase slightly until vomiting occurs, then stop. Contraindicated in blood loss and deficiency constitutions.

In Shanghan, with cold reversal and epigastric palpitations, water retention should be treated first with Fuling Gancao Tang (Poria and Licorice Decoction), then treat the cold reversal. Otherwise, water will soak into the stomach, causing diarrhea.

Fuling Gancao Tang Formula

Poria (Fuling, 茯苓) two liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) one liang (roasted); Zingiberis Recens Rhizoma (Shengjiang, 生姜) three liang (sliced); Cinnamomi Ramulus (Guizhi, 桂枝) two liang (skin removed).

(These) four herbs, with four sheng of water, decoct to obtain two sheng of liquid, filter out dregs, divide into three warm doses.

In Shanghan, six to seven days, after severe purgation, with cun pulse deep and slow, cold reversal of hands and feet, absence of pulses in the lower body, throat obstruction, spitting of pus-blood, and incessant diarrhea, is difficult to treat; Renshen Fuzi Tang (Ginseng and Aconite Decoction) is primarily indicated. If not improved, give Renshen Ganjiang Tang (Ginseng and Dried Ginger Decoction).

Renshen Fuzi Tang Formula

Ginseng Radix et Rhizoma (Renshen, 人参) two liang; Fuzi (Radix Aconiti Lateralis, 附子) one piece; Shengjiang (Dried Ginger, 干姜) two pieces (processed); Banxia (Pinelliae Tuber, 半夏) half sheng; Asini Corii Colla (Ejiao, 阿胶) two liang; Biye (Cacumen Platycladi, 柏叶) three liang.

(These) six herbs, with six sheng of water, decoct to obtain two sheng of liquid, filter out dregs, add gelatin until dissolved, take one sheng warm, twice a day.

Renshen Ganjiang Tang Formula

Ginseng Radix et Rhizoma (Renshen, 人参) two liang; Fuzi (Radix Aconiti Lateralis, 附子) one piece; Shengjiang (Dried Ginger, 干姜) three liang; Cinnamomi Ramulus (Guizhi, 桂枝) two liang (skin removed); Gancao (Prepared Radix Glycyrrhizae, 甘草) two liang (roasted).

(These) five herbs, with two sheng of water, decoct to obtain one sheng of liquid, filter out dregs, take warm in one dose.

In Shanghan, four to five days, with abdominal pain, if gas moves downward toward the lower abdomen, diarrhea is imminent.

In Shanghan, originally having cold-type diarrhea, if the doctor mistakenly uses emesis and purgation, cold rejection causes further reverse vomiting and diarrhea; Mahuang Shengma Tang (Ephedra and Cimicifuga Decoction) is primarily indicated. If food is vomited immediately upon entry, Ganjiang Huangqin Huanglian Renshen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction) is primarily indicated.

Mahuang Shengma Tang Formula

Ephedrae Herba (Mahuang, 麻黄) two and a half liang (nodes removed); Cimicifugae Rhizoma (Shengma, 升麻) one liang; Anemarrhenae Rhizoma (Zhimu, 知母) one liang; Scutellariae Radix (Huangqin, 黄芩) one and a half liang; Cinnamomi Ramulus (Guizhi, 桂枝) two liang; Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) one liang; Gancao (Prepared Radix Glycyrrhizae, 甘草) one liang (roasted).

(These) seven herbs, with one dou of water, first decoct Ephedrae Herba (Mahuang, 麻黄) to remove foam, add other herbs, decoct to obtain three sheng of liquid, filter out dregs, take one sheng warm, three times a day.

Ganjiang Huangqin Huanglian Renshen Tang Formula

Shengjiang (Dried Ginger, 干姜) three liang; Scutellariae Radix (Huangqin, 黄芩) three liang; Coptidis Rhizoma (Huanglian, 黄连) three liang; Ginseng Radix et Rhizoma (Renshen, 人参) three liang.

(These) four herbs, with six sheng of water, decoct to obtain two sheng of liquid, filter out dregs, divide into two warm doses.

In diarrhea, with slight heat and thirst, and weak pulse, spontaneous recovery is expected.

In diarrhea, with rapid pulse, slight heat, and sweating, recovery is expected; with tight pulse, unresolved.

In diarrhea, with cold hands and feet and absent pulse, if moxibustion does not warm and pulse does not return, but slight panting occurs, death ensues. If the Shaoyin pulse is weaker than the Dubo pulse, it is favorable.

In diarrhea, with cun pulse floating and rapid, and chi pulse choppy, pus-blood in stool is certain; Bo Ye Ejiao Tang (Biye and Gelatin Decoction) is primarily indicated.

Bo Ye Ejiao Tang Formula

Biye (Cacumen Platycladi, 柏叶) three liang; Asini Corii Colla (Ejiao, 阿胶) two liang; Shengjiang (Dried Ginger, 干姜) two liang (processed); Mudan Pi (Cortex Moutan, 牡丹皮) three liang.