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Peach Kernel (San Liang) [3 liang] Perilla Seed Frost (Er Liang) [2 liang] Trogopterus Dung (Wulingzhi, 五灵脂) (Er Liang) [2 liang] Lignum Dalbergiae Odoriferae (Jiangzhenxiang, 降真香) (Er Liang) [2 liang] Dried Resin of Melia Toosendan (Ganqi, 干漆) (Er Liang) [2 liang] Cauda Angelicae Sinensis (Dangguiwei, 当归尾) (Si Liang) [4 liang] Myrrh (Moyao, 没药) (Er Liang) [2 liang] Radix Paeoniae Alba (Baishao, 白芍) (Si Liang) [4 liang] Apricot Seed (Xingren, 杏仁) (San Liang) [3 liang] Rhizoma Cyperi (Xiangfumie, 香附米) (Er Liang) [2 liang] Fructus Evodiae (Wuzhuyu, 吴茱萸) (Er Liang) [2 liang] Rhizoma Corydalis (Yuanhusuo, 元胡索) (Er Liang) [2 liang] Leech (Shuizhi, 水蛭) (Er Liang) [2 liang] Ferula (Awei, 阿魏) (Er Liang) [2 liang] Charred Fructus Foeniculi (Xiaohuixiangtan, 小茴香炭) (San Liang) [3 liang] Rhizoma Chuanxiong (Chuanxiong, 川芎) (Er Liang) [2 liang] Olibanum (Ruxiang, 乳香) (Er Liang) [2 liang] Rhizoma Alpiniae Officinarum (Liangjiang, 良姜) (Er Liang) [2 liang] Charred Folium Artemisiae Argyi (Aitan, 艾炭) (Er Liang) [2 liang] Extract of Motherwort (Yimucao Gao, 益母膏) (Ba Liang) [8 liang] Prepared Rehmannia Root (Shudihuang, 熟地黄) (Si Liang) [4 liang] Colla Testudinis et Cornu Cervi (Biejiajiao, 鳖甲胶) (Yi Jin) [1 jin] Rhubarb (Dahuang, 大黄) (Ba Liang, grind together into fine powder, boil with one and a half jin of sorghum vinegar until thick, dry and grind into powder, add vinegar again and boil, repeat this process three times, dry and grind into powder).

Grind the above medicines into a fine powder. Mix evenly with the gels from Biejia (Colla Testudinis), Yimucao Gao (Extract of Motherwort), and Dahuang (Rhubarb). Add refined honey to form pills, each weighing one qian five fen (approx. 5-6 grams). Seal with wax skin for protection. Take with warm water on an empty stomach; for severe blood stasis syndromes, take with yellow wine.

Indications:
1. Treats Qi stagnation without pain.
2. Treats severe pain during the onset of carbuncles and sores.
3. Treats Blood Bi syndrome (Blood Stasis Obstruction).
4. Treats Dry Blood Consumption in women belonging to excess syndromes.
5. Treats Malaria Mass (splenomegaly due to chronic malaria) with left hypochondriac pain and alternating chills and fever.
6. Treats premenstrual abdominal pain, historically known as Dysmenorrhea.
7. Treats women experiencing chills and fever just before menstruation.
8. Treats women experiencing abdominal pain due to consuming raw or cold foods just before menstruation.
9. Treats Amenorrhea in women.
10. Treats menstrual blood that is purple-black, even forming clots.
11. Treats lower back pain caused by traumatic blood stasis.
12. Treats postpartum blood stasis with lower abdominal pain and tenderness upon pressure.
13. Treats fainting and near-death states due to trauma.
14. Treats traumatic injuries (knife wounds, club wounds) with blood stasis obstruction.

8. When Dryness pathogen lingers in the Lower Jiao without binding with blood, and in elderly patients with emptiness of the Eight Extraordinary Vessels, Huazheng Huisheng Dan should not be used; instead, Fuheng Dan should be the primary treatment.

The nature of Metal is heavy and settling; if it lingers long without dispersing, only warming and unblocking the collaterals can resolve it. Since it does not bind with blood to form hard masses, presenting with painful distension and visible signs during attacks but no signs when pain subsides, it must not injure the healthy Ying (Nutrient) Blood. Therefore, methods to transform stasis are inappropriate. The principle of Fuheng Dan lies in "extreme peeling leads to return, and return leads to prosperity." Its formula combines warming nourishment with warming drying. Generally, warming-drying formulas are suitable for short-term use, not long-term. Moreover, although chronic illness often involves Yang deficiency, Yin cannot be sufficient alone. In elderly patients with emptiness of the Eight Extraordinary Vessels, protecting Yin is crucial. Thus, Shi Liuhuang (Stalagmite Sulfur) is used to tonify the True Yang of the Lower Jiao, serving as the Sovereign herb, paired with herbs that do not injure Yin. Assistant herbs include Lurong (Deer Antler), Gouqizi (Goji Berry), Renshen (Ginseng), Fuling (Poria), and Rongrong (Cistanche) to tonify upright Qi. Only Danggui (Angelica Sinensis), Huixiang (Fennel), Jiaojiao (Sichuan Pepper), Guizhi (Cinnamon Twig), Dingxiang (Clove), and Bibai (Dioscorea Hypoglauca) are used to unblock pathogenic factors in the Chong and Ren vessels and the Liver and Kidney. According to *Jie Chan Nan*, there is already a formula called Tongbu Qijing Wan for unblocking and tonifying the Extraordinary Vessels, so this formula need not be recorded. However, that formula focuses primarily on unblocking and tonifying the Eight Extraordinary Vessels, whereas this formula combines warming nourishment and warming drying, acting as a counterpart to the previous clause, so it is included here. According to *Nan Jing*: Disease of the Ren vessel causes Seven Hernias in men and Zha Ju (masses) in women. Zhu Danxi defined the Seven Hernias as: Cold Hernia, Water Hernia, Sinew Hernia, Blood Hernia, Qi Hernia, Fox Hernia, and Scrotal Hernia. *Xiu Zhen Fang* defines them as: Jue, Pan, Han, Scrotal, Fu, Pulse, and Qi. Zha refers to blood disease, i.e., hernias in women. Later generations defined Eight Zha as: Snake Zha, Fat Zha, Green Zha, Yellow Zha, Dry Zha, Fox Zha, Blood Zha, and Turtle Zha. Since the Ren vessel is the source of Tian Gui (reproductive essence), it often harbors有形 (formative) accumulations. Generally, formative excess syndromes suit the former formula, while formless deficiency syndromes suit this formula.

Regarding diseases left by Dryness Metal, such as Malaria Hernia, they are mostly found in the Cold-Damp and Damp-Warm sections of the Lower Jiao chapter. Many more should be included in the Dryness section of medical texts, but due to space limitations, they cannot all be recorded. The path has been shown; students should infer the rest.

**Fuheng Dan Formula (Bitter-Warm, Sweet-Pungent Method)**
Wo Liuhuang (Stalagmite Sulfur) (Ten parts; note: Wo Liuhuang refers to Stalagmite Sulfur; sulfur from soil and water must absolutely not be used)
Lurong (Deer Antler) (Eight parts, prepared with wine)
Gouqizi (Goji Berry) (Six parts)
Renshen (Ginseng) (Four parts)
Yun Fuling (Poria) (Eight parts)
Dan Congrong (Cistanche) (Eight parts)
Annangui (Annam Cinnamon) (Four parts)
Quan Danggui (Angelica Sinensis) (Six parts, soaked in wine)
Xiaohuixiang (Fennel) (Six parts, soaked in wine, stir-fried black with Danggui)
Chuanjiaotan (Charred Sichuan Pepper) (Three parts)
Bixie (Dioscorea Hypoglauca) (Six parts)
Zhi Guiban (Prepared Tortoise Shell) (Four parts)

Mix with Yimucao Gao (Extract of Motherwort) to form pills, size of small paulownia seeds. Take two qian per dose, twice daily; gradually increase to three qian in winter, taken with boiled water.

Previous scholars claimed that Dryness does not cause disease, either mixing Cold-Dryness into one category or mixing it into Dampness. This is because Dryness is the beginning of Cold and resembles Cold, leading to its inclusion in the Cold category. Also, since Dryness governs the upper aspect of the Yangming channel, which internally connects to Taiyin, and Yangming transforms via its middle Qi, it is easily confused with Dampness. However, medical practitioners must have clear distinctions and restore the original teachings of *Nei Jing* to maintain correct judgment and adhere to principles.

**Pili San Formula**

Main indications: Middle Dryness causing vomiting, diarrhea, and abdominal pain; severely, cold limbs, muscle twitching/cramps, leg pain, limb numbness, restlessness, irritability, absence of pulse in all six positions, Yin toxicity with macules, hernias, and Zha Ju, as well as all types of congealed cold and stubborn cold accumulations. For mild cold, do not take excessively; for severe cold, do not take insufficiently; stop when cured. Do not take unless the patient has truly received pure Yin pathogens of Dampness, Dryness, and Cold.

Guizhi (Cinnamon Twig) (Liu Liang) [6 liang]
Gong Dingxiang (Clove) (Si Liang) [4 liang]
Caoguo (Black Cardamom) (Er Liang) [2 liang]
Chuanjiao (Sichuan Pepper) (Stir-fried, Wu Liang) [5 liang]
Xiaohuixiang (Fennel) (Stir-fried, Si Liang) [4 liang]
Xiebai (Macrostemon Bulb) (Si Liang) [4 liang]
Liangjiang (Alpinia Officinarum Rhizome) (San Liang) [3 liang]
Wuzhuyu (Evodia Fruit) (Si Liang) [4 liang]
Wulingzhi (Trogopterus Dung) (Er Liang) [2 liang]
Jiangxiang (Dalbergia Odorifera Lignum) (Wu Liang) [5 liang]
Wuyao (Lindera Root) (San Liang) [3 liang]
Ganjiang (Dried Ginger) (San Liang) [3 liang]
Shichangpu (Acorus Rhizome) (Er Liang) [2 liang]
Fangji (Stephania Root) (San Liang) [3 liang]
Binglang (Areca Seed) (Er Liang) [2 liang]
Bidengqie (Long Pepper Fruit) (Wu Liang) [5 liang]
Fuzi (Aconite Lateralis Radix Praeparata) (San Liang) [3 liang]
Xixin (Asarum) (Er Liang) [2 liang]
Qingmuxiang (Vitalroot Rhizome) (Si Liang) [4 liang]
Yiren (Coix Seed) (Wu Liang) [5 liang]
Xionghuang (Realgar) (Wu Qian) [5 qian]

Grind all medicines into a fine powder. Take with boiled water. Adults: 3 qian per dose; severe cases: 5 qian. Children: half dose. For severe cases, take multiple times consecutively until pain stops, cold reverses, or diarrhea stops and cramps cease.

[Formula Commentary] According to *Nei Jing*, there are Five Plagues. Extreme imbalance of the Five Elements can all lead to plague. Although epidemic qi often presents with Fire symptoms, epidemics of Dryness-Metal, Cold, and Dampness also occur frequently. Wind, Fire, and Summer-Heat are Yang pathogens; mixed with turbid foul qi, they become Warm Plague. Dampness, Dryness, and Cold are Yin pathogens; mixed with turbid foul qi, they become Cold Plague. Current symptoms often include limb numbness and cramping, cold extremities, vomiting, diarrhea, abdominal pain, hypochondriac pain, and even aversion to heat with excessive thirst for cool drinks. The classic states: Mist injures the upper; Dampness injures the lower. This syndrome is caused by Dryness-Metal, Cold, and Dampness qi (The classic states: Yangming's upper aspect is governed by Dryness, internally connecting to Taiyin; Yangming transforms via middle Qi). It directly attacks the sinew channels, entering through major and divergent collaterals, damaging the Zhen (True) organs of the Three Yin channels internally. Hence, cramping spreading to the abdomen leads to death. Vomiting and diarrhea indicate reversal and chaos of Yin and Yang. Various pains result from the struggle between Dryness-Metal and Damp-Earth qi. Thirst for cool drinks indicates Shaoyin deficiency (as stated in the Shaoyin chapter: self-diarrhea with thirst belongs to Shaoyin deficiency, seeking water to save itself). Redness of the head and face indicates Yin pathogens forcing Yang upward, preventing Yang from descending, known as Dai Yang (Floating Yang). Aversion to heat and preference for coolness throughout the body indicates Yin pathogens entrenched internally, with Yang having no attachment and wanting to scatter. Yin disease presenting with Yang symptoms is known as "Water extreme resembling Fire," indicating particularly heavy Yin pathogen invasion. Although all Yang symptoms appear, severe pain at the navel with tenderness and refusal to press indicates Pure Yin within Yang, representing a True Yin syndrome. This point must not be mistaken. Therefore, the formula gathers pungent, dry, bitter, and hot herbs of the Three Yin channels to urgently warm the organ Zhen and protect Yang. Heavy use of aromatic herbs urgently drives out turbidity. One path goes from organ Zhen through divergent and major collaterals, exiting through sinew channels and meridians to reach the skin and hair; another path goes from organ collaterals to fu collaterals, unblocking the Six Fu organs and reaching the nine orifices externally. Thus, turbid Yin pathogens are resolved immediately. Essentially, this supports Yang and suppresses Yin, like the sun shining in the sky causing all Yin to retreat. Furthermore, after the Tang and Song dynasties, physicians failed to recognize this as caused by Dryness qi. Any case with these symptoms was commonly called "Sha" (plague/toxin). Recently, some have written certificates for "Sha," grasping at shadows, chaotic and disorganized, harming people deeply. Even discussing Sha, none arises without interacting with Heaven and Earth qi. The specific qi affected cannot be precisely identified, hence the formulas lack accuracy. The error lies in previous scholars claiming Dryness does not cause disease and that Dryness transforms into Fire. Tang was also misled by this, so in the first edition, he expressed doubts, debating in the Miscellaneous Sayings chapter, while the main text only contained Fire syndromes of transformed Qi, lacking Cold syndromes of overcoming Qi. The error of "Dryness does not cause disease" stems from a missing line in the *Yin Yang Ying Xiang Da Lun* chapter: "Autumn injury by Dryness"; "Late Summer injury by Dampness" was mistakenly written as "Autumn injury by Dampness," leading to the belief that there were no Dryness syndromes. Ignoring chapters like *Tian Yuan Ji*, *Qi Jiao Bian*, *Wu Yun Xing*, *Wu Chang Zheng*, and *Liu Wei Zhi*, which list the Six Qi equally, shows that Dryness pathology is the same as other Qi. How could Dryness not cause disease! The classic says: Wind is the chief of a hundred diseases. Wind belongs to Wood, governing Benevolence. The *Great Yi* says: Yuan is the chief of goodness, possessing the mechanism of life generation, opening the source of transformation and generation. Even so, it causes many diseases; how much more so for Metal, which is the Qi of killing and severity? Ouyang said: Shang means injury, governing Righteousness, Gathering, Punishment, and Killing. Its injury to humans is fastest and most violent, sometimes causing death within a day. Tang witnessed this with heartbreak, thus emphasizing it repeatedly.