一○○、燥伤胃阴，五汁饮主之，玉竹麦门冬汤亦主之。
五汁饮（方法并见前）
玉竹麦门冬汤（甘寒法）
玉竹（三钱） 麦冬（三钱） 沙参（二钱） 生甘草（钱）
水五杯，煮取二杯，分二次服。土虚者，加生
扁豆。气虚者，加人参。
一○一、胃液干燥，外感已净者，牛乳饮之。
此以津血填津血法也。
牛乳饮（甘寒法）
牛乳（杯）
重汤炖熟，顿服之，甚者日再服。
一○二、燥证气血两燔者，玉女煎主之。
玉女煎方（见上焦篇）
一、风温、温热、温疫、温毒、冬温，邪在阳明久羁，或已下，或未下，身热面赤，口干舌燥，甚
则齿黑唇裂，脉沉实者，仍可下之；脉虚大，手足心热甚于手足背者，加减复脉汤主之。
温邪久羁中焦，阳明阳土，未有不克少阴癸水者，或已下而阴伤，或未下而阴竭。若实证居多，
正气未至溃败，脉来沉实有力，尚可假手于一下，即《伤寒论》中急下以存津液之谓。若中无结
粪，邪热少而虚热多，其人脉必虚，手足心主里，其热必甚于手足背之主表也。若再下其热，是竭其
津而速之死也。故以复脉汤复其津液，阴复则阳留，庶可不至于死也。去参、桂、姜、枣之补阳，加
白芍收三阴之阴，故云加减复脉汤。在仲景当日，治伤于寒者之结代，自有取于参、桂、姜、枣，复脉
中之阳；今治伤于温者之阳亢阴竭，不得再补其阳也。用古法而不拘用古方，医者之化裁也。
二、温病误表，津液被劫，心中震震，舌强神昏，宜复脉法复其津液，舌上津回则生；汗自出，
中无所主者，救逆汤主之。
误表动阳，心气伤则心震，心液伤则舌蹇，故宜复脉其津液也。若伤之太甚，阴阳有脱离之象，
复脉亦不胜任，则非救逆不可。
三、温病耳聋，病系少阴，与柴胡汤者必死，六、七日以后，宜复脉辈复其精。
温病无三阳经证，却有阳明腑证（中焦篇已申明腑证之由矣）三阴脏证。盖脏者藏也，藏精者
也。温病最善伤精，三阴实当其冲。如阳明结则
脾阴伤而不行，脾胃脏腑切近相连，夫累及妻，理固然也，有急下以存津液一法。土实则水虚，浸假
而累及少阴矣，耳聋不卧等证是也。水虚则木强，浸假而累及厥阴矣，目闭痉厥等证是也。此由上及
下，由阳入阴之道路，学人不可不知。按温病耳聋，《灵》《素》称其必死，岂少阳耳聋，竞至于死耶？经
谓肾开窍于耳，脱精者耳聋，盖初则阳火上闭，阴精不得上承，清窍不通，继则阳亢阴竭，若再以小
柴胡汤直升少阳，其势必至下竭上厥，不死何待！何时医悉以陶氏六书，统治四时一切疾病，而不究
心于《灵》《素》《难经》也哉！瑭于温病六、七日以外，壮火少减，阴火内炽耳聋者，悉以复阴得效，曰
宜复脉辈者，不过立法如此，临时对证，加减尽善，是所望于当其任者。
四、劳倦内伤，复感温病，六、七日以外不解者，宜复脉法。
此两感治法也。甘能益气，凡甘皆补，故宜复脉。服二、三帖后，身不热而倦甚，仍加人参。
五、温病已汗而不得汗，已下而热不退，六、七日以外，脉尚躁盛者，重与复脉汤。
已与发汗而不得汗，已与通里而热不除，其为
汗下不当可知。脉尚躁盛，邪固不为药衰，正气亦尚能与邪气分争，故须重与复脉，扶正以敌邪，正
胜则生矣。
六、温病误用升散，脉结代，甚则脉两至者，重与复脉，虽有他证，后治之。
此留人治病法也。即仲景里急，急当救里之义。
七、汗下后，口燥咽干，神倦欲眠，舌赤苔老，与复脉汤。
在中焦下后与益胃汤，复胃中津液，以邪气未曾深入下焦。若口燥咽干，乃少阴之液无以上供，
神昏欲眠，有少阴但欲寐之象，故与复脉。
八、热邪深入，或在少阴，或在厥阴，均宜复脉。
此言复脉为热邪劫阴之总司也。盖少阴藏精，厥阴必待少阴精足而后能生，二经均可主以复脉
者，乙癸同源也。
加减复脉汤方（甘润存津法）
炙甘草（六钱） 干地黄（六钱）
按地黄三种用法∶生地者，鲜地黄未晒干者也，可入药煮用，可取汁用，其性甘凉，上中焦用以退热存津；干地黄
者，乃生地晒干，已为丙火炼过，去其寒凉之性，本草称其甘平；熟地制以酒与砂仁，九蒸九晒而成，是又以丙火、丁
火合炼之也，故其性甘温。奈何今人悉以干地黄为生地，北人并不知世有生地，佥谓干地黄为生地，而曰寒凉，指鹿为
马，不可不辨。
生白芍（六钱） 麦冬（不去心，五钱） 阿胶（三钱） 麻仁（三钱，按柯韵伯谓∶旧传麻仁者误，
当系枣仁。彼从心悸动三字中看出传写之误，不为无见，今治温热，有取于麻仁甘益气，润去燥，故仍从麻仁）
水八杯，煮取八分三杯，分三次服。剧者加甘草至一两，地黄、白芍八钱，麦冬七钱，日三夜一服。
救逆汤方（镇摄法）
即于加减复脉汤内去麻仁，加生龙骨四钱，生牡蛎八钱，煎如复脉法。脉虚大欲散者，加人参二钱。
九、下后大便溏甚，周十二时三、四行，脉仍数者，未可与复脉汤，一甲煎主之；服一二日，大
便不溏者，可与一甲复脉汤。
下后法当数日不大便，今反溏而频数，非其人真阳素虚，即下之不得其道，有亡阴之虑。若以复
脉滑润，是以存阴之品，反为泻阴之用。故以牡蛎一味，单用则力大，即能存阴，又涩大便，且清在里
之余热，一物而三用之。
一甲煎（咸寒兼涩法）
生牡蛎（二两，碾细）
水八杯，煮取三杯，分温三服。
一甲复脉汤方
即于加减复脉汤内，去麻仁，加牡蛎一两。
十、下焦温病，但大便溏者，即与一甲复脉汤。
温病深入下焦劫阴、必以救阴为急务。然救阴之药多滑润，但见大便溏，不必待日三、四行，即
以一甲复脉法，复阴之中，预防泄阴之弊。
十一、少阴温病，真阴欲竭，壮火复炽，心中烦，不得卧者，黄连阿胶汤主之。
按前复脉法为邪少虚多之治。其有阴既亏而实邪正盛，甘草即不合拍。心中烦，阴邪挟心阳独
亢于上，心体之阴，无容留之地，故烦杂无奈；不得卧，阳亢不入于阴，阴虚不受阳纳，虽欲卧得乎！此
证阴阳各自为道，不相交互，去死不远，故以黄芩从黄连，外泻壮火而内坚真阴；以芍药从阿胶，内
护真阴而外捍亢阳。名黄连阿胶汤者，取一刚以御外侮，一柔以护内主之义也。其交关变化神明
不测之妙，全在一鸡子黄，前人训鸡子黄，佥谓鸡为巽木，得心之母气，色赤入心，虚则补母而已，
理虽至当，殆未尽其妙。盖鸡子黄有地球之象，为血肉有情，生生不已，乃奠安中焦之圣品，有甘草
之功能，而灵于甘草；其正中有孔，故能上通心气，下达肾气，居中以达两头，有莲子之妙用；其性和
平，能使亢者不争，弱者得振；其气焦臭，故上补心；其味甘咸，故下补肾；再释家有地水风火之喻，
此证大风一起，荡然无余，鸡子黄镇定中焦，通彻上下，合阿胶能预熄内风之震动也。然不知人身阴
阳相抱之义，必未能识仲景用鸡子黄之妙，谨将人身阴阳生死寤寐图形，开列于后，以便学人入道
有阶也。
黄连阿胶汤方（苦甘咸寒法）
黄连（四钱） 黄芩（一钱） 阿胶（三钱） 白芍（一钱） 鸡子黄（二枚）
水八杯，先煮三物，取三杯，去滓，纳胶烊尽，再纳鸡子黄，搅令相得，日三服。
十二、夜热早凉，热退无汗，热自阴来者，青蒿鳖甲汤主之。
夜行阴分而热，日行阳分而凉，邪气深伏阴分可知，热退无汗，邪不出表而仍归阴分，更可知矣，故曰热自阴分而
来
，非上中焦之阳热也。邪气深伏阴分，混处气血之中，不能纯用养阴，又非壮
火，更不得任用苦燥。故以鳖甲蠕动之物，入肝经至阴之分，既能养阴，又能入络搜邪；以青蒿芳
香透络，从少阳领邪外出；细生地清阴络之热，丹皮泻血中之伏火；知母者，知病之母也，佐鳖甲、青
蒿而成搜剔之功焉。再此方有先入后出之妙，青蒿不能直入阴分，有鳖甲领之入也∶鳖甲不能独出阳
分，有青蒿领之出也。
青蒿鳖甲汤方（辛凉合甘寒法）
青蒿（二钱） 鳖甲（五钱） 细生地（四钱） 知母（二钱） 丹皮（三钱）
水五杯，煮取二杯，日再服。
十三、热邪深入下焦，脉沉数，舌干齿黑，手指但觉蠕动，急防痉厥，二甲复脉汤主之。
此示人痉厥之渐也。温病七、八日以后，热深不解，口中津液干涸，但觉手指掣动，即当防其痉
厥，不必俟其已厥而后治也。故以复脉育阴，加入介属潜阳，使阴阳交纽，庶厥不可作也。
二甲复脉汤方（咸寒甘润法）
即于加减复脉汤内，加生牡蛎五钱，生鳖甲八钱。
十四、下焦温病，热深厥甚，脉细促，心中 大动，甚则心中痛者，三甲复脉汤主之。
前二甲复脉，防痉厥之渐；即痉厥已作，亦可以二甲复脉止厥。兹又加龟板名三甲者，以心中
大动，甚则痛而然也。心中动者，火以水为体，肝风鸱张，立刻有吸尽西江之势，肾水本虚，不能
济肝而后发痉；既痉而水难猝补，心之本体欲失，故 然而大动也。甚则痛者，“阴维为病主心
痛”，此证热久伤阴，八脉丽于肝肾，肝肾虚而累及阴维故心痛，非如寒气客于心胸之心痛，可用温
通。故以镇肾气补任脉通阴维之龟板止心痛，合入肝搜邪之二甲，相济成功也。
三甲复脉汤方（同二甲汤法）
即于二甲复脉汤内，加生龟板一两。
十五、既厥且哕（俗名呃忒），脉细而劲，小定风珠主之。
温邪久踞下焦，烁肝液为厥，扰冲脉为哕，脉阴阳俱减，则细，肝木横强则劲，故以鸡子黄实土
而定内风；龟板补任（谓任脉）而镇冲脉；阿胶沉降，补液而熄肝风；淡菜生一咸水之中而能淡，外
偶内奇，有坎卦之象。能补阴中之真阳，其形翁阖，故又能潜真阳之上动；童便以浊液仍归浊道，用以
为使也。名定风珠者，以鸡子黄宛如珠形，得巽木之精，而能熄肝风，肝为巽木，巽为风也。龟亦有
珠，具真武之德而镇震木。震为雷，在人为胆，雷动未有无风者，雷静而风亦静矣。亢阳直上巅顶，
龙上于天也，制龙者，龟也。古者豢龙御龙之法，失传已久，其大要不出乎此。
小定风珠方（甘寒咸法）
鸡子黄（生用，一枚） 真阿胶（二钱） 生龟板（六钱） 童便（一杯） 淡菜（三钱）
水五杯，先煮龟板、淡菜得二杯，去滓，入阿胶，上火烊化，纳鸡子黄，搅令相得，再冲童便，顿服之。
十六、热邪久羁，吸烁真阴，或因误表，或因妄攻，神倦螈 ，脉气虚弱，舌绛苔少，时时欲脱者，大定风珠主
之。
此邪气已去八、九，真阴仅存一、二之治也。
观脉虚苔少可知，故以大队浓浊填阴塞隙，介属潜阳镇定。以鸡子黄一味，从足太阴，下安足三阴，
上济手三阴，使上下交合，阴得安其位，斯阳可立根基，俾阴阳有眷属一家之义，庶可不致绝脱欤！
大定风珠方（酸甘咸法）
生白芍（六钱） 阿胶（三钱） 生龟板（四钱） 干地黄（六钱） 麻仁（二钱） 五味子（二钱） 生
牡蛎（四钱） 麦冬（连心，六钱） 炙甘草（四钱） 鸡子黄（生，二枚） 鳖甲（生，四钱）
水八杯，煮取三杯，去滓，再入鸡子黄，搅令相得，分三次服。喘加人参，自汗者加龙骨、人参、小
麦，悸者加茯神、人参、小麦。
十七、壮火尚盛者，不得用定风珠、复脉。邪少虚多者，不得用黄连阿胶汤。阴虚欲痉者，不得
用青蒿鳖甲汤。
此诸方之禁也。前数方虽皆为存阴退热而设，其中有以补阴之品，为退热之用者；有一面补
阴，一面搜邪者；有一面填阴，一面护阳者；各宜心领神会，不可混也。
十八、痉厥神昏，舌短，烦躁，手少阴证未罢者，先与牛黄紫雪辈，开窍搜邪；再与复脉汤存阴，
三甲潜阳，临证细参，勿致倒乱。
痉厥神昏，舌蹇烦躁，统而言之为厥阴证。然有手经足经之分，在上焦以清邪为主，清邪之后必
继以存阴；在下焦以存阴为主，存阴之先，若邪尚有余，必先以搜邪。手少阴证未罢，如寸脉大，口
气重，颧赤，白睛赤，热壮之类。
十九、邪气久羁，肌肤甲错，或因下后邪欲溃，或因存阴得液蒸汗，正气已虚，不能即出，阴阳
互争而战者，欲作战汗也，复脉汤热饮之。虚盛者加人参；肌肉尚盛者，但令静，勿妄动也。
按伤寒汗解必在下前，温病多在下后。缚解而后得汗，诚有如吴又可所云者。凡欲汗者，必当
先烦，乃有汗而解。若正虚邪重，或邪已深入下焦，得下后里通；或因津液枯燥，服存阴药，液增欲
汗，邪正努力纷争，则作战汗，战之得汗则生，汗不得出则死。此系生死关头，在顷刻之间。战者，阳
极而似阴也，肌肤业已甲错，其津液之枯燥，固不待言。故以复脉加人参助其一臂之力，送汗出表。
若其人肌肤尚浓，未至火虚者，无取复脉之助正，但当听其自然，勿事骚扰可耳，次日再议补阴未迟。
Article 100: When dryness pathogen damages the Stomach Yin, Wu Zhi Yin (Five Juices Decoction) is the primary formula; Yu Zhu Mai Men Dong Tang (Polygonatum and Ophiopogon Decoction) may also be used.
Wu Zhi Yin (Method seen previously).
Yu Zhu Mai Men Dong Tang (Sweet-Cold Method).
Rhizoma Polygonati Odorati (San Qian / 3 qian), Fructus Ophiopogonis (San Qian / 3 qian), Radix Glehniae (Er Qian / 2 qian), Radix Glycyrrhizae Preparata (Sheng Gan Cao / 1 Qian / 1 qian).
Boil five cups of water to obtain two cups; divide into two doses. For those with Spleen Qi deficiency, add Rhizoma Dioscoreae Hypoglaucae (Sheng Bian Dou / Raw Coix Seed); for those with Qi deficiency, add Radix Ginseng (Ren Shen / Ginseng Root).
Article 101: When Stomach fluids are dry and exterior pathogens have been cleared, drink Cow's Milk.
This method uses Jin-Ye (Body Fluids) and Xue (Blood) to replenish Jin-Ye.
Niu Nai Yin (Cow's Milk Drink) (Sweet-Cold Method).
Cow's Milk (One Cup).
Steam thoroughly in a double boiler and take in one dose; for severe cases, take twice daily.
Article 102: In Dryness syndromes where Qi and Blood are simultaneously scorched by heat (Qi Xue Liang Fan), Yu Nu Jian (Jade Woman Decoction) is the primary formula.
Yu Nu Jian Formula (See Upper Jiao Chapter).
Article 1: For Wind-Warmth, Warmth, Warm Plague, Warm Toxin, and Winter-Warmth, if the pathogen lingers in the Yangming channel for a long time, or has been purged, or not purged, presenting with fever, red face, dry mouth and tongue, even black teeth and cracked lips, and a deep, solid pulse, purgation may still be used; if the pulse is empty and large, and heat in the palms and soles is more severe than in the dorsal hands and feet, Jia Jian Fu Mai Tang (Modified Pulse-Recovering Decoction) is the primary formula.
When warm pathogen lingers in the Middle Jiao, Yangming (Yang Earth) inevitably overacts on Shaoyin (Gui Water). Whether Yin injury results from prior purgation or Yin exhaustion from lack thereof, if excess patterns predominate and Zheng Qi (Upright Qi) has not collapsed, and the pulse is deep, solid, and forceful, purgation can still be employed—this is what the Shang Han Lun refers to as "urgent purgation to preserve Jin-Ye." If there is no dry stool accumulation, and pathogenic heat is slight while deficient heat is predominant, the pulse will likely be empty. Since the palms/soles govern the interior, their heat will exceed that of the dorsum/exterior. Further purgation would exhaust Jin-Ye and hasten death. Therefore, Fu Mai Tang is used to restore Jin-Ye; once Yin is restored, Yang is retained, preventing death. By removing Ren Shen, Gui Zhi, Sheng Jiang, and Da Zao (which tonify Yang) and adding Bai Shao (to gather Yin of the Three Yin channels), it is called Modified Pulse-Recovering Decoction. In Zhang Zhongjing's time, treating pulse irregularities due to Cold damage required Ren Shen, Gui Zhi, Sheng Jiang, and Da Zao to restore Yang in the pulse; now, treating Yang hyperactivity and Yin exhaustion due to Warm damage, one must not further tonify Yang. Using ancient methods without rigid adherence to ancient formulas is the physician's discretion.
Article 2: If Warm disease is mistakenly treated with diaphoresis, leading to Jin-Ye depletion, palpitations, stiff tongue, and coma, use the Fu Mai method to restore Jin-Ye; life is possible if tongue moisture returns. If spontaneous sweating occurs with a sense of emptiness in the chest, Jiu Ni Tang (Rescue Against Peril Decoction) is indicated.
Mistaken diaphoresis disturbs Yang; Heart Qi injury causes palpitations, Heart Fluid injury causes tongue stiffness, hence the need to restore Jin-Ye via Fu Mai. If damage is too severe, showing signs of Yin-Yang separation, Fu Mai is insufficient, and Jiu Ni Tang is necessary.
Article 3: In Warm disease with deafness, the pathology involves Shaoyin. Prescribing Chai Hu Tang will result in death. After six or seven days, formulas similar to Fu Mai should be used to restore Jing (Essence).
Warm diseases do not present with Taiyang, Yangming, or Shaoyang channel syndromes, but rather with Yangming Fu-organ syndromes (explained in Middle Jiao chapter) and Three Yin Zang syndromes. Zang organs store Jing. Warm pathogens easily injure Jing, affecting the Three Yin channels most severely. Yangming stagnation injures Pi Yin (Spleen Yin), affecting the Spleen-Stomach pair. Earth excess leads to Water deficiency, subsequently affecting Shaoyin (deafness, inability to lie down). Water deficiency leads to Wood hyperactivity, subsequently affecting Jueyin (closed eyes, spasms, convulsions). This is the pathway from upper to lower, Yang to Yin, which students must understand. Although Ling Shu and Su Wen state deafness is fatal, does Shaoyang deafness truly lead to death? The classics state the Kidney opens into the ears; essence depletion causes deafness. Initially, Yang fire blocks upward transmission of Yin Jing, obstructing clear orifices; later, Yang hyperactivity and Yin exhaustion occur. Using Xiao Chai Hu Tang to ascend Shaoyang would cause lower exhaustion and upper collapse. Modern physicians blindly apply Tao Hua’s Six Books to all seasonal diseases without studying Ling Shu, Su Wen, or Nan Jing. Wu Tang observes that for deafness after six-seven days due to declining vigorous fire and blazing deficient fire, restoring Yin yields results. "Using Fu Mai category" implies establishing this principle, allowing flexible modification based on symptoms.
Article 4: For internal injury from fatigue compounded by Warm disease, unresolved after six-seven days, use the Fu Mai method.
This is the treatment for simultaneous contraction of Exterior and Interior. Sweet flavors tonify Qi; thus, Fu Mai is appropriate. If after two-three doses fever subsides but fatigue worsens, add Ren Shen.
Article 5: If Warm disease persists despite sweating and purging, with fever remaining after six-seven days and a rapid, restless pulse, administer Fu Mai Tang heavily.
Failure to sweat after diaphoresis and failure to reduce fever after purging indicate incorrect application. A rapid, restless pulse shows pathogen remains undiminished and Zheng Qi still struggles against it. Heavy use of Fu Mai supports Zheng Qi to defeat the pathogen; victory brings survival.
Article 6: If mistaken use of acrid-warm dispersing agents causes knotted and intermittent pulse, or even pulse beating twice per respiration, administer Fu Mai Tang heavily. Treat other symptoms afterwards.
This is the method of "preserving the person to treat the disease," aligning with Zhang Zhongjing’s principle of urgently treating the interior when interior urgency exists.
Article 7: After sweating and purging, if dry mouth/throat, mental fatigue, drowsiness, red tongue, and old coating appear, give Fu Mai Tang.
In Middle Jiao, post-purgation, Yi Wei Tang restores Stomach fluids since pathogen hasn't reached Lower Jiao. Dry mouth/throat indicates Shaoyin fluids failing to nourish upwards; drowsiness resembles Shaoyin’s "desire to sleep." Hence, Fu Mai is given.
Article 8: If heat pathogen penetrates deeply, whether into Shaoyin or Jueyin, Fu Mai is indicated.
This states Fu Mai is the general remedy for heat pathogen depleting Yin. Shaoyin stores Essence; Jueyin relies on Shaoyin Essence for generation. Both being governed by Fu Mai reflects the common source of Yi (Wood/Liver) and Gui (Water/Kidney).
Jia Jian Fu Mai Tang Formula (Sweet-Moisturizing to Preserve Jin-Ye Method).
Zhi Gan Cao (Liu Qian / 6 qian), Gan Di Huang (Liu Qian / 6 qian).
Note on Di Huang usage: Sheng Di Huang is fresh Di Huang un-dried, sweet-cool, used in Upper/Middle Jiao to clear heat and preserve fluids. Gan Di Huang is dried Sheng Di, processed by fire, losing cold nature, becoming sweet-neutral. Shu Di Huang is steamed nine times and sun-dried nine times with wine and Amomum, becoming sweet-warm. Confusing Gan Di Huang with Sheng Di Huang is erroneous.
Sheng Bai Shao (Liu Qian / 6 qian), Mai Dong (Wu Qian / 5 qian, heart removed), E Jiao (San Qian / 3 qian), Ma Ren (San Qian / 3 qian). Note: Ke Yunbo argued Ma Ren was a transcription error for Suan Zao Ren due to "palpitations," but Ma Ren is retained here for its sweet, moistening properties in Warm diseases.
Boil eight cups of water to obtain three-eighths cup; divide into three doses. For severe cases, increase Gan Cao to 1 liang, Di Huang and Bai Shao to 8 qian, Mai Dong to 7 qian; take day and night.
Jiu Ni Tang Formula (Settling and Anchoring Method).
Based on Jia Jian Fu Mai Tang, remove Ma Ren, add Sheng Long Gu (Si Qian / 4 qian) and Sheng Mu Li (Ba Qian / 8 qian). Boil similarly. If pulse is empty, large, and dissipating, add Ren Shen (Er Qian / 2 qian).
Article 9: After purging, if loose stools occur frequently (3-4 times in 12 hours) with a rapid pulse, do not immediately use Fu Mai Tang; use Yi Jia Jian (Single Shell Decoction). After one-two days, if stools normalize, use Yi Jia Fu Mai Tang.
Post-purgation should result in constipation; frequent loose stools suggest underlying Yang deficiency or improper purging, risking Yin collapse. Fu Mai’s slippery nature might exacerbate diarrhea. Yi Jia Jian uses only Mu Li to astringe intestines, preserve Yin, and clear residual heat.
Yi Jia Jian (Salty-Cold with Astringent Method).
Sheng Mu Li (Liang Er / 2 liang, finely ground).
Boil eight cups of water to obtain three cups; divide into three warm doses.
Yi Jia Fu Mai Tang Formula.
Based on Jia Jian Fu Mai Tang, remove Ma Ren, add Mu Li (Yi Liang / 1 liang).
Article 10: For Lower Jiao Warm disease with merely loose stools, immediately give Yi Jia Fu Mai Tang.
Deep Lower Jiao Warm disease depletes Yin; saving Yin is urgent. Since Yin-tonifying herbs are slippery, Yi Jia Fu Mai is used at the first sign of loose stools to prevent fluid loss while restoring Yin.
Article 11: In Shaoyin Warm disease, with impending True Yin exhaustion and blazing vigorous fire, causing irritability and insomnia, Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) is indicated.
Fu Mai treats excess-deficiency imbalance with predominance of deficiency. Here, Yin is depleted but Excess Pathogen is strong; Gan Cao is unsuitable. Irritability stems from Yin pathogen accompanying Heart Yang hyperactivity; insomnia from Yang failing to enter Yin and Yin failing to receive Yang. This critical state requires Huang Qin and Huang Lian to clear external vigorous fire and strengthen internal True Yin; Bai Shao and E Jiao to protect True Yin and resist Yang hyperactivity. The name reflects using hardness (E Jiao) to defend externally and softness (Huang Lian/E Jiao mix) to protect internally. The secret lies in Ji Zi Huang (Egg Yolk): it represents the earth, nourishes the Middle Jiao like Gan Cao but more effectively, connects Heart and Kidney via its central pore, balances extremes, supplements Heart (via odor) and Kidney (via flavor), and prevents internal wind when combined with E Jiao.
Huang Lian E Jiao Tang Formula (Bitter-Sweet-Salty-Cold Method).
Huang Lian (Si Qian / 4 qian), Huang Qin (Yi Qian / 1 qian), E Jiao (San Qian / 3 qian), Bai Shao (Yi Qian / 1 qian), Ji Zi Huang (Two Eggs).
Boil first three ingredients in eight cups of water to obtain three cups, strain, dissolve E Jiao, then stir in egg yolks. Take three times daily.
Article 12: For night fever, morning coolness, no sweat upon cooling, indicating heat originating from Yin, Qing Hao Bie Jia Tang (Artemisia and Turtle Shell Decoction) is indicated.
Night fever/morning coolness indicates pathogen hidden in Yin. No sweat upon cooling confirms pathogen remains in Yin, not exterior. It is not Upper/Middle Jiao Yang heat. Pathogen mixes with Qi and Blood in Yin; pure Yin tonification is inappropriate, nor is bitter-dryness. Bie Jia enters Liver/Yin to nourish and search for pathogen; Qing Hao aromatically opens collaterals to guide pathogen out via Shaoyang; Xi Sheng Di clears Yin collateral heat; Dan Pi drains latent blood fire; Zhi Mu assists in searching out pathogen. Qing Hao cannot enter Yin alone (guided by Bie Jia); Bie Jia cannot exit Yang alone (guided by Qing Hao).
Qing Hao Bie Jia Tang Formula (Acrid-Cool combined with Sweet-Cold Method).
Qing Hao (Er Qian / 2 qian), Bie Jia (Wu Qian / 5 qian), Xi Sheng Di (Si Qian / 4 qian), Zhi Mu (Er Qian / 2 qian), Dan Pi (San Qian / 3 qian).
Boil five cups of water to obtain two cups; take twice daily.
Article 13: If heat pathogen deeply invades Lower Jiao, with deep-rapid pulse, dry tongue/black teeth, and finger twitching, urgently prevent spasms/convulsions with Er Jia Fu Mai Tang (Two Shells Pulse-Recovering Decoction).
This warns of impending spasms/convulsions. After seven-eight days, deep heat and dry fluids cause finger twitching; prevention is key. Fu Mai nourishes Yin; shells anchor Yang to prevent convulsions.
Er Jia Fu Mai Tang Formula (Salty-Cold Sweet-Moist Method).
Based on Jia Jian Fu Mai Tang, add Sheng Mu Li (Wu Qian / 5 qian) and Sheng Bie Jia (Ba Qian / 8 qian).
Article 14: For Lower Jiao Warm disease with deep heat/cold limbs, fine-rapid pulse, severe palpitations, or chest pain, San Jia Fu Mai Tang (Three Shells Pulse-Recovering Decoction) is indicated.
Er Jia prevents/prevents spasms; San Jia adds Gui Ban (Turtle Plastron) for severe palpitations/chest pain caused by Liver Wind disturbing Heart and Kidney Water failing to nourish Liver. Gui Ban anchors Kidney, supplements Ren Mai, and alleviates Yin Wei vessel pain.
San Jia Fu Mai Tang Formula (Same as Er Jia).
Based on Er Jia Fu Mai Tang, add Sheng Gui Ban (Yi Liang / 1 liang).
Article 15: For convulsions and hiccups with thin, wiry pulse, Xiao Ding Feng Zhu (Small Wind-Calculating Pearl) is indicated.
Long-term Lower Jiao warmth scorches Liver fluids (convulsion) and disturbs Chong Mai (hiccups). Thin/wiry pulse indicates Liver Wood hyperactivity. Ji Zi Huang stabilizes Earth/calms internal wind; Gui Ban calms Chong Mai; E Jiao settles and extinguishes Liver wind; Dan Cai supplements True Yang within Yin; Tong Bian guides turbid fluids downward. Name "Ding Feng Zhu" refers to Egg Yolk resembling a pearl, calming Liver Wind (Xun/Wind). Gui Ban calms Zhen Wood (Thunder/Gallbladder).
Xiao Ding Feng Zhu Formula (Sweet-Cold Salty Method).
Ji Zi Huang (Raw, One Egg), Zhen E Jiao (Er Qian / 2 qian), Sheng Gui Ban (Liu Qian / 6 qian), Tong Bian (One Cup), Dan Cai (San Qian / 3 qian).
Boil Gui Ban and Dan Cai in five cups of water to obtain two cups, strain, dissolve E Jiao, stir in egg yolk, mix well, add Tong Bian, take in one dose.
Article 16: If heat lingers, consuming True Yin, due to mistaken sweating or purging, causing fatigue, spasms, weak pulse, crimson tongue/scanty coating, and imminent collapse, Da Ding Feng Zhu (Great Wind-Calculating Pearl) is indicated.
Pathogen is mostly gone; True Yin is nearly exhausted. Large amounts of rich, heavy Yin-nourishing and shell-anchoring herbs are used. Ji Zi Huang harmonizes Upper and Lower Jiao Yin/Yang.
Da Ding Feng Zhu Formula (Sour-Sweet Salty Method).
Sheng Bai Shao (Liu Qian / 6 qian), E Jiao (San Qian / 3 qian), Sheng Gui Ban (Si Qian / 4 qian), Gan Di Huang (Liu Qian / 6 qian), Ma Ren (Er Qian / 2 qian), Wu Wei Zi (Er Qian / 2 qian), Sheng Mu Li (Si Qian / 4 qian), Mai Dong (Liu Qian / 6 qian, heart included), Zhi Gan Cao (Si Qian / 4 qian), Ji Zi Huang (Raw, Two Eggs), Bie Jia (Si Qian / 4 qian).
Boil eight cups of water to obtain three cups, strain, add egg yolk, mix well, divide into three doses. Add Ren Shen for asthma; Long Gu, Ren Shen, Xiao Mai for spontaneous sweating; Fu Shen, Ren Shen, Xiao Mai for palpitations.
Article 17: If vigorous fire is still abundant, avoid Ding Feng Zhu and Fu Mai. If pathogen is slight and deficiency predominant, avoid Huang Lian E Jiao Tang. If Yin deficiency threatens spasms, avoid Qing Hao Bie Jia Tang.
These are contraindications. Some formulas tonify Yin to clear heat; some tonify Yin while searching pathogen; some fill Yin while protecting Yang. Understand their distinctions.
Article 18: For spasms, convulsions, coma, short tongue, irritability, with Hand-Shaoyin syndrome unresolved, first use Niu Huang Zi Xue (Calculus Bovis and Frozen Thunder) to open orifices and search pathogen; then use Fu Mai to preserve Yin and San Jia to anchor Yang. Consult carefully.
Spasms/coma are generally Jueyin syndromes. Upper Jiao focuses on clearing pathogen then preserving Yin; Lower Jiao focuses on preserving Yin, searching pathogen first if residual pathogen exists. Hand-Shaoyin signs include large cun pulse, heavy breath, malar flush, white sclera redness, high fever.
Article 19: If pathogen lingers, causing skin roughness, or post-purgation pathogen seeks exit, or Yin preservation induces sweat, with deficient Zheng Qi unable to expel pathogen immediately, causing shaking battle (Zhan Han), give Fu Mai Tang hot. Add Ren Shen for severe deficiency; if muscles are robust, keep patient quiet.
Cold diseases sweat before diarrhea; Warm diseases often sweat after. Sweating follows resolution of binding. Preceding irritability precedes sweating. If Zheng is weak/pathogen strong, or pathogen deep in Lower Jiao, post-purgation intestinal clearance, or fluid restoration induces sweat, Zheng and Pathogen struggle, causing Zhan Han. Success brings life; failure brings death. This critical moment requires Fu Mai plus Ren Shen to support Zheng Qi and drive sweat out. If constitution is strong, allow nature to take its course; tonify Yin next day.