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In the Jiuzhong Decoction (Rescue the Middle Decoction), Ren Shen (Ginseng Root) and Jiaoyi (Malt Sugar) are removed because it is feared that they will cause Qi stagnation and possess a static nature. Nongpu (Magnolia Bark) is added to drain turbid Qi from dampness, Binglang (Areca Seed) to dissipate stagnant Qi, allowing the medicinal effect to reach directly to the Lower Jiao (Lower Burner). Guangpi (Tangerine Peel) circulates Qi through the Twelve Meridians. Therefore, it is renamed Jiuzhong Decoction, aiming to rapidly expel Turbid Yin pathogens, thereby rescuing the True Yang of the Middle Jiao. The Jiutong Wan (Nine Pain Pill) simultaneously supports healthy Qi and expels pathogenic factors; its efficacy in expelling pathogens is the most rapid, so it can also be taken. Regarding the previous discussion on cholera with vomiting and diarrhea, there are two syndromes: Yin and Yang. Gan Huoluan (Dry Cholera) presents purely with Yin syndrome without Yang, resembling the obstruction of Heaven and Earth's Qi, leading to closure akin to winter, which corresponds to the meaning of the Pi Hexagram (Obstruction) in the I Ching. If speech is disordered, it indicates pathogens interfering with the Pericardium (Heart Protector), so Zhibao Dan (Treasure of Life Pill) is used first to expel pathogens from the Pericardium.

Jiuzhong Decoction Formula (Bitter-Acrid Unblocking Method)
Shujiao (Stir-fried until oil sweats out, 3 qian) Dansheng Jiangyan (Pale Dried Ginger, 4 qian) Nongpu (Magnolia Bark, 3 qian) Binglang (Areca Seed, 2 qian) Guangpi (Tangerine Peel, 2 qian)
Boil five cups of water until reduced to two cups. Divide into two doses for administration. If accompanied by muscle cramps (Zhuanjin), add Guizhi (Cinnamon Twig, 3 qian), Fangji (Stephania Root, 5 qian), and Yiren (Coix Seed, 3 qian). If cold extremities (Jue) occur, add Fuzi (Prepared Aconite Root, 2 qian).

Jiutong Wan Formula (Treating Nine Types of Heartache, Bitter-Acrid-Sweet-Hot Method)
Fuzi (Prepared Aconite Root, 3 liang) Sheng Ye Langya (Raw Wild Wolf's Tooth Herb, 1 liang) Renshen (Ginseng Root, 1 liang) Ganjiang (Dried Ginger, 1 liang) Wuzhuyu (Evodia Fruit, 1 liang) Badou (Croton Seed, peeled and cored, boiled and ground into paste, 1 liang)
Form pills the size of wu zi (Chinese quince seeds) using honey. Administer with wine. For strong individuals, start with three pills, three times daily; for weak individuals, take two pills.
It additionally treats sudden onset of evil qi (Zhong E), abdominal distension and pain, inability to speak; chronic accumulated cold flowing into the heart and chest causing pain; cold qi rushing upward; injuries from falling off horses or carriages resulting in blood stasis syndromes. Dietary restrictions follow standard protocols.

[Formula Commentary] The *Neijing* (Classic of Internal Medicine) mentions heartache arising from the Five Zang organs and the Stomach Fu organ, combined with phlegm, parasites, and food accumulation, constituting the nine pains. The causes of heartache are either Wind or Cold. Thus, Ganjiang and Fuzi are used to dispel cold and strengthen Yang. Wuzhuyu descends turbid Yin from the Liver. Sheng Ye Langya dispels floating Wind. Badou expels phlegm, parasites, and old accumulations. Renshen nourishes healthy Qi while assisting in expelling pathogens. Since these herbs enter both Qi and Blood levels, containing both tonifying and purgative properties, they treat conditions like Zhong E with abdominal distension and pain.

Appendix: Zouma Tang (Running Horse Decoction) from *Waitai Miyao*, treating Zhong E, heartache, abdominal distension, and constipation. This belongs to the Bitter-Acrid-Hot method. Shen Munan commented: Zhong E, commonly known as "Jiaochang Wu Sha" (Intestine-Twisting Black Miasma), refers to foul and toxic qi entering directly through the mouth and nose into the heart, chest, stomach, intestines, and zang-fu organs, obstructing healthy Qi and preventing its circulation, resulting in heartache, abdominal distension, and constipation. This is an Excess syndrome. It differs from invasion by the Six Climatic Factors (Liu Yin), which have distinctions between exterior/interior and clear/turbid. Therefore, Badou, an extremely hot, highly toxic, and potent agent, is used to urgently attack the pathogen. Xingren (Apricot Seed) assists in benefiting Lung and Large Intestine Qi, allowing pathogens to exit via the posterior orifice, clearing everything away so the disease resolves. If delayed even slightly, healthy Qi becomes blocked, Ying-Wei (Nutritive-Defensive) and Yin-Yang mechanisms cease, leading to death. This follows the principle that "unblocked means no pain."
Badou (Remove heart and skin, boil, 2 seeds) Xingren (Apricot Seed, 2 seeds)
Crush the above two ingredients wrapped in cotton. Add two he of hot water, squeeze to extract white juice, and drink. Diarrhea should ensue. Adjust dosage according to age and strength of elderly, children, and robust/frail individuals. Universally treats Feishi Guiji diseases (sudden severe illnesses attributed to evil spirits).

According to *Yifang Jijie* (Collection of Medical Formulas), treating Huoluan with Yin-Yang Water has the meaning of harmonizing Yin and Yang to prevent conflict. Treating Gan Huoluan with Salt Soup inducing vomiting is suitable for extreme obstruction cases; besides acupuncture, no method unblocks Yang more rapidly than emesis. Vomiting relates to Jueyin (Liver/Pericardium) Qi; cold pain relates to Taiyang (Bladder) Cold-Water Qi; the Pi Hexagram represents Winter. In Winter, when Taiyang Cold-Water Qi prevails and Jueyin Wind Qi arrives, wind rises, allowing One Yang to open and release, bringing vitality to all phenomena. Acupuncture treats diseases most rapidly but can also bring disaster quickly; one should seek methods in the *Jia Yi Jing*. Only skilled acupuncturists should perform needling.

Lisheng Dan (Life-Creating Pill) (Treating Heatstroke, Huoluan, Sha Syndrome, Malaria, Dysentery, Diarrhea, Heartache, Stomachache, Abdominal Pain, regurgitation of sour fluid, all Yin-Cold syndromes, Jie Xiong (Chest Binding), and Infantile Cold Spasms)
Mu Dingxiang (Clove, 1 liang 2 qian) Chenxiang (Agarwood, 4 qian) Mao Cangzhu (Atractylodes Rhizome, 1 liang 2 qian) Ming Xionghuang (Realgar, 1 liang 2 qian)
Grind into fine powder. Dissolve Chan Su (Toad Venom, 8 qian) in a copper pot with a small cup of rice wine. Mix with the powder and form pills the size of mung beans. Take two pills per dose, one pill for children, with warm water. Also effectively expels dead fetus. For scorpion or bee stings, apply topically for immediate effect. Contraindicated in pregnancy.
The brilliance of this formula lies in adding aromatic, meridian-penetrating herbs to rigid and drying agents. Toads are the essence of Earth, corresponding to the moon; they are turbid yet spiritual substances. Their venom enters collaterals, attacking toxicity with toxicity, and the formula includes controlling agents, ensuring prompt efficacy.

Dusheng San (Single Victory Powder) (Treating acute Jiaochang Sha pain, cyanosis of nails and lips, critical condition imminent)
Ma Fen (Horse Manure) (Older is better)
No specific dosage. Roast on tiles until dry and grind into powder. Take 2-3 qian mixed with aged wine. If ineffective, administer again.
The merit of this formula lies in using turbidity to attack turbidity. Horses are vigorous and fast-moving, corresponding to the Qian Trigram. Manure is formed of turbid Yin, round in shape and penetrating in nature, thus able to rub away turbid Yin pathogens, expelling them through the lower orifices. Recalling past years in Jinan, when Fang An served as Prefect of Jiujiang, before his departure, a young woman suddenly suffered from Sha syndrome, rolling on the ground screaming hoarsely. Fang An said, "Perhaps due to careless date selection, offending Red Sha?" I urgently prescribed this formula, but could not find horse manure; used mule manure instead, not aged, yet achieved immediate results.