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The contraindication for Ginseng Radix (Renshen, 人参) applies only to *Li Zheng* (Interior Syndrome). When the pathogenic factor is in the Exterior or at the Half-Exterior and Half-Interior level, its administration is not harmful. For cases where an external pathogen resides in the Exterior, ancient formulas such as Shen Su Yin (Ginseng and Perilla Decoction), Xiao Chai Hu Tang (Minor Bupleurum Decoction), and Bai Du San (Detoxification Powder) contain ginseng. For conditions at the Half-Exterior and Half-Interior level, such as chronic malaria complicated by deficiency, using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) not only causes no hindrance but also yields therapeutic effects. Even in acute malaria where the pathogenic factor is vigorous, improper administration of ginseng will not cause abdominal distension because there is no Interior Syndrome.

The term "Interior Syndrome" (*Li Zheng*) refers not only to Taiyang Cold Damage (*Shang Han*) or Warm Epidemic (*Wen Yi*) transmitting to the Stomach, but also includes miscellaneous diseases involving Qi stagnation (*Qi Yu*), Blood stagnation (*Xue Yu*), Fire stagnation (*Huo Yu*), Dampness stagnation (*Shi Yu*), Phlegm stagnation (*Tan Yu*), and Food stagnation (*Shi Yu*). In these cases, administering ginseng leads to abdominal distension because it fills excess with excess.

Currently, after purgative treatment for a warm epidemic, if there is a temporary passage, ginseng is immediately administered, resulting in no abdominal distension. Physicians and patients believe that although no obvious improvement is seen after taking ginseng, avoiding harm is considered a blessing; thus, they administer it indiscriminately. They fail to realize that Ginseng Radix is a tonic that acts within the blood level. Although the bowels are temporarily clear after purgation, residual pathogens remain. Repeated administration aids the pathogens and creates solid excess, causing previous symptoms to recur and misfortunes to follow.

Occasionally, patients suffer from depletion of Qi and Blood due to missed purgation, or those who have undergone multiple purgations due to vigorous pathogens, or massive purgation leading to deficiency, may receive ginseng. They should feel refreshed and mentally alert. Physicians and patients consider this a success. However, if administered repeatedly on subsequent days, complications arise. Initially, after purgation, the Stomach (*Wei Jia*) is temporarily deficient, and the tonification brings comfort. However, one must not overlook that residual pathogens are not yet cleared. Indiscriminate administration leads to gradual congestion and closure, reigniting pathogenic fire. The more it is administered, the more complications increase. Therefore, after purgation, while the pathogen slows down, the deficiency becomes urgent. Consequently, the effect of tonification is rapid, while the harm of aiding the pathogen is slower. This explains the difference in benefits and harms before and after.

After purgation, or even after several purgations, if residual pathogens in the Mo Yuan (Membrane Source) have not fully transmitted to the Stomach, and pathogenic heat binds with Wei Qi (Defensive Qi), fever cannot be eliminated instantly. One should wait for two days in a relaxed manner, allowing residual pathogens to gather in the Stomach, and then purge again. It is appropriate to use Chai Hu Qing Zao Tang (Bupleurum Clearing Dryness Decoction), a mild formula, for regulation.

Chai Hu Qing Zao Tang (Bupleurum Clearing Dryness Decoction)
Ingredients: Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Hua Fen (Tetrastigmatis Caulis), Zhi Mu (Anemarrhenae Rhizoma).
Preparation and Administration: Decoct with Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus).