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Miscellaneous Prescriptions

Dongyuan Qingzao Tang (Clearing Dryness Decoction): Treats flaccidity syndrome caused by damp-heat. The pathogenesis involves the Metal element (Lung) being invaded by damp-heat pathogens, severing the source of generation for Water (Kidney). When the source is severed, Kidney deficiency occurs, leading to severe flaccidity and cold extremities, manifesting as flaccid paralysis below the waist and inability to move.

Herbs: Huangqin (Scutellariae Radix, 1.5 qian), Cangzhu (Atractylodis Rhizoma, 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma), Jupi (Citri Reticulatae Pericarpium), Zexie (Alismatis Rhizoma, each 0.5 qian), Wuweizi (Schisandrae Fructus, 9 berries), Renshen (Ginseng Radix), Baifuling (Poria with Hostwood, Shengma (Cimicifugae Rhizoma, each 0.3 fen), Maimendong (Ophiopogonis Radix), Dangguishen (Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix), Qumò (End of Shenqu), Jiu Huangbai (Phellodendri Cortex processed with wine), Zhuling (Polyporus, each 0.2 fen), Chaihu (Bupleuri Radix), Huanglian (Coptidis Rhizome), Zhigancao (Glycyrrhizae Radix et Rhizoma processed with honey, each 0.1 fen).

Preparation and Administration: Coarsely crush the above herbs. For each dose of half liang, decoct in water and take hot on an empty stomach.

Jianbu Wan (Leg-Strengthening Pill): Treats weakness in the knees, inability to flex and extend, heaviness in the lower back, back, legs, and feet, and difficulty walking.

Herbs: Qianghuo (Notopterygii Rhizoma et Radix), Chaihu (Bupleuri Radix), Chao Huashi (Talcum processed), Zhigancao (Glycyrrhizae Radix et Rhizoma processed with honey), Gualougen (Trichosanthis Radix washed with wine, each 0.5 qian), Fangfeng (Saposhnikoviae Radix, 3 qian), Zexie (Alismatis Rhizoma, 3 qian), Jiu Kushen (Sophorae Flavescentis Radix processed with wine), Chuanwu (Aconiti Radix Lateralis Preparata, each 1 qian), Rougui (Cinnamomi Cortex, 0.5 qian), Jiu Fangji (Stephaniae Tetrandrae Radix processed with wine, 1 liang).

Preparation and Administration: Grind the above herbs into a fine powder. Use wine paste to form pills the size of paulownia seeds. Take 70 pills on an empty stomach, delivered with Yufeng Tang (Wind-Resolving Decoction).

Sanyin Jiawei Sijin Wan (Three Causes Modified Four-Yang Pill): Treats Kidney and Liver deficiency with excessive internal heat, resulting in weak sinews and bones that cannot support the body.

Herbs: Congrong (Cynomorii Herba soaked in wine), Niuxi (Achyranthis Bidentatae Radix soaked in wine), Tianma (Gastrodiae Rhizoma), Gan Mugua (Chaenomelis Fructum dried), Lurong (Cervi Cornu Pantotrichum scalded to remove hair, sliced, and roasted with suet oil), Tusizi (Cuscutae Semen soaked in wine until soft, separately ground finely), Shudihuang (Rehmanniae Radix Preparata), Wuweizi (Schisandrae Fructus soaked in wine, each 1 fen).

Preparation and Administration: Grind the above herbs into powder. Use honey to form pills the size of paulownia seeds. Take 50 pills before meals, delivered with warm wine or rice drink.

Commentary: This prescription mentions "excessive heat within" yet employs warming tonification. Why? Because Yin blood is deficient and fails to nourish the sinews, causing them to relax and fail to support the body; simultaneously, Yang dryness and heat are excessive within. Therefore, this formula is used to nourish Yang and Yin. When Yin is sufficient, Kidney Water ascends and Heart Fire descends, achieving balance.

The *Neijing* states: "Wind is the chief of all diseases." It also says: "Excess wind causes movement/tremors." It further states: "Treacherous winds and false evils first affect the Yang aspect." And: "Those injured by wind, the upper part receives it first."

Commentary: Wind belongs to Yang pathogens; thus, it is prone to change and easily damages Yang. Therefore, various conditions follow the principle of similarity attracting similarity.

The *Maijing* states: "A pulse that is floating and large indicates wind."

The *Shanghan Lun* states: "In Taiyang disease, if the pulse is floating and slow, it is named Zhongfeng (Wind Strike)." It also says: "In Taiyang Zhongfeng, the Yang pulse is floating and the Yin pulse is weak."

The discussion notes that the transmission of Shangfeng (Wind Injury) and Shanghan (Cold Injury) through the Six Channels is identical.

Chen Wuyue states: "The *Neijing* records 'Spring injury from wind,' which aligns with the sequence of the four seasons. If there is wind strike at the exterior, the pathogen flows through the meridians and transmits day by day, similar to Shanghan. However, Cold congeals blood, resulting in no sweat and aversion to cold; Wind disperses Qi, resulting in sweat and aversion to wind. These are differences. Zhang Zhongjing distinguished between Shanghan and Shangfeng in the Taiyang channel, but later compilers did not categorize them separately, referring to all Taiyang diseases as Shanghan. Now, a separate category for Shangfeng is established, following the ancients' approach starting with the Taiyang channel and annotating the Six Channels. Scholars should understand this."

Commentary: This method of differentiating Shangfeng treatment according to the Six Channels can be said to supplement the inadequacies of previous schools. For the Foot-Taiyang Bladder Channel, Guizhi Tang (Cinnamon Twig Decoction) is used; for the Foot-Yangming Stomach Channel, Xingzi Tang (Apricot Seed Decoction); for the Foot-Shaoyang Gallbladder Channel, Chaihu Jia Guizhi Tang (Bupleurum Plus Cinnamon Twig Decoction); for the Foot-Taiyin Spleen Channel, Guizhi Shaoyao Tang (Cinnamon Twig Plus Peony Decoction); for the Foot-Shaoyin Kidney Channel, Guifu Tang (Cinnamon Plus Aconite Decoction); for the Foot-Jueyin Liver Channel, Bawu Tang (Eight Substances Decoction). These formulas are based on Guizhi Tang plus herbs specific to each channel, all being acrid-warm dispersing agents. Since it is stated that transmission is similar to Shanghan, these six formulas can cover its variations. Scholars should seek the methods of Zhang Zhongjing for regulation and treatment. The specific formulas are not recorded here (see detailed text elsewhere).

Careful Review: Regarding the syndrome of Shangfeng, Zhang Zhongjing discussed it together with Shanghan. Although the medicines differ (e.g., Mahuang vs. Guizhi), after transmission, they were not strictly differentiated. Discussions by various authors are mixed with those on common cold, four qi, and Zhongfeng, using similar treatments. Only Chen Wuyue established a separate prescription for Shangfeng, placing it first among the four excesses, and followed the Shanghan model starting from Taiyang to annotate the Six Channels, which is detailed and rigorous. However, since wind is an external pathogen, most prescriptions use exterior-releasing methods. Yet, the source of disease varies. Wind is the vast energy of heaven and earth, subject to changes of the eight winds across four seasons, yet humans do not always get injured. Those who are injured do so because they fail to maintain purity and stillness, leading to loose interstices (couli) and deficiency of superficial Yang. The *Neijing* states: "Purity and stillness close the internal interstices; even with great wind and severe toxins, harm cannot occur." There are also cases where internal phlegm-heat causes Qi stagnation, making the body susceptible to external wind binding. If exterior deficiency leads to wind invasion, using only exterior-releasing drugs will cause excessive sweating and loss of Yang. If internal phlegm-heat accompanies wind invasion, both interior and exterior must be treated; one cannot focus solely on releasing the exterior. Some ask: "Is the 'exterior deficiency' mentioned here the same as Cheng Wuji's commentary on Taiyang Zhongfeng exterior deficiency?" I say: No. He refers to Taiyang Zhongfeng, distinguishing deficiency and excess based on presence or absence of sweat, adding Mahuang for excess and Gegen for deficiency, both for releasing the exterior. Here, 'exterior deficiency' implies securing the Defensive Qi while dispersing wind.