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Da Qianghuo Tang (Great Notopterygia Decoction) by Haizang
Ingredients: Qianghuo (Rhizoma et Radix Notopterygii), Duhuo (Radix Angelicae Pubescentis), Fangji (Radix Stephaniae Tetrandrae), Fangfeng (Radix Saposhnikoviae), Huangqin (Radix Scutellariae), Huanglian (Rhizoma Coptidis), Cangzhu (Rhizoma Atractylodis Chinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), Gancao (Radix Glycyrrhizae Preparata, roasted), Chuanxiong (Rhizoma Chuanxiong), Xixin (Herba Asari) — each 3 qian; Zhimu (Rhizoma Anemarrhenae), Shengdihuang (Radix Rehmanniae Preparata) — each 1 liang.
Preparation and Administration: The herbs are cut into small pieces. Each dose of half liang is decocted in water and taken hot. If the pathogen is not resolved, take one or two more doses. Any residual symptoms should be managed according to the methods of Zhang Zhongjing.

Commentary: This prescription originates from examples for Taiyang disease (disease of the Taiyang channel). However, Lianggan (simultaneous involvement of exterior and interior channels) in Shanghan (Cold Damage) may also involve wind or dampness, and present with differences such as both exterior and interior being deficient or excess. *Baoming Ji* states: "Lianggan can be treated because the qi affected is different." For instance, those with wind attacking the exterior and cold injuring the interior can be treated with Jiawei Xiao Qinglong Tang (Modified Minor Blue Dragon Decoction); those with exterior heat and interior cold should be treated with harmonizing methods. This formula is suitable for cases with wind attacking the exterior and heat inside. For cases with dampness on the exterior and cold inside, cold on the exterior and dampness inside, or simultaneous exterior and interior syndromes, the formula's scope should be expanded. Generally, Lianggan often presents with both exterior and interior deficiency. Therefore, Yilao (Li Dongyuan) said: "One must carefully palpate the pulse to discern compliance or rebellion, thereby predicting auspiciousness or misfortune." The pathogenic factors of Lianggan exist in all three Yin and three Yang channels. If the pulse follows Yang, it is treatable; if it follows Yin, it is difficult to treat. This refers to "Yang generates life, Yin leads to death."

Huisheng Shengao (Resuscitating Divine Ointment) for treating Yindu Shanghan (Yin Toxin Cold Damage)
Ingredients: Muli (Concha Ostreae), Lianfen (Refined Rice Flour), Jiangjiang (Sliced Ginger Rhizome) — equal parts.
Preparation and Administration: Grind the ingredients into a fine powder. For male patients, mix with female saliva, rub between hands until warm, and tightly cover both testicles. Cure upon sweating. For female patients, mix with male saliva and cover both breasts to induce sweating.

Daijiu Tuni Gao (Moxibustion-Substitute Umbilical Paste)
Ingredients: Fuzi (Radix Aconiti Lateralis Preparata), Malizi (Fructus Iris Pseudacorus), Shechuangzi (Fructus Cnidii), Muxiang (Radix Aucklandiae), Rougui (Cortex Cinnamomi), Wuzhuyu (Fructus Evodiae).
Preparation and Administration: Grind the six herbs into equal parts powder. Mix with white flour paste and fresh ginger juice to form a ointment. Spread on paper in circles approximately 3 cun in diameter. Apply to Guan Yuan (CV4) and Qi Hai (CV6) below the umbilicus, from evening until morning.

For Yindu Shanghan causing cold limbs (Si Zhi Ni):
Ingredients: Wuzhuyu (Fructus Evodiae) — any amount.
Preparation and Administration: Grind into powder, mix evenly with warm wine, place in a raw silk bag, heat, and moxa-compress the soles of the feet until circulation is smooth and cured. Alternatively, decoct for washing the feet to restore limb warmth.

Ash Bag Compress Method for Lower Jiao Accumulated Cold with Upper Jiao Excess Heat, where warming herbs are difficult to administer:
Preparation and Administration: Take about 2-3 sheng of good vinegar mixed with plant ash, adjusting moisture content appropriately. Stir-fry in a pan until the ash is hot. Wrap in cloth and compress below the umbilicus. Frequently replace the ash bags to maintain constant heat. Continue until the abdomen is no longer distended or painful. If bowel movements occur 2-3 times, urination increases, or slight sweating occurs, this indicates the outward expulsion of Yin pathogenic factors.

Moxibustion Methods (with Commentary on Moxibustion Theory)
Qi Hai (CV6): Located 1.5 cun below the umbilicus. Treats Yin Jue (cold extremities due to Yin excess) and faint/absent pulses.
Shi Guan (ST25? Note: Text says Shi Guan, likely referring to a specific point or typo, but strictly translating text): One point, located 2 cun below the umbilicus.
Guan Yuan (CV4): One point, located 3 cun below the umbilicus. Treats Zang Jie (Zang organ knotting) which cannot be purged, as well as continuous Yin sweating, abdominal distension, borborygmus, dark complexion, and cyanotic fingernails. Moxa 100 zhuang.
Yang Ling Quan (GB34): Two points, located 1 cun below the knee joint. Jiegu (Zhang Yuansu) stated: For irritability, fullness, and retraction of the scrotum, moxa this point.
Tai Xi (KI3): Two points, located in the depression anterior to the medial malleolus and posterior to the calcaneus, where the arterial pulse is felt. Moxa 7 zhuang. Treats Shaoyin syndrome with vomiting and diarrhea, cold limbs turning warm, and absent pulse.

Commentary: Details on Shanghan moxibustion points are found in *Zisheng Jing*, so they are not fully recorded here. Generally, points unsuitable for needling are suitable for moxibustion. There are three reasons: first, deep-seated cold and stubborn cold; second, absence of pulse indicating Yang exhaustion; third, tight abdominal skin indicating sinking of Yang. Apart from these three conditions, moxibustion should generally be avoided to prevent adverse reactions. The following moxibustion methods are appended.

*Yixue Faming* cites *Zhen Jing*: "When vessels sink, apply moxibustion." In heaven and earth, there is nothing but Yin and Yang Qi. Yang is outside and above; Yin is inside and below. "Sinking" refers to Yang Qi sinking into Yin Blood, where Yin erroneously occupies the upper position and covers Yang. When pulse and symptoms indicate cold on the exterior, moxibustion is applied. *Yifa Fangyi Lun* states: "People in the North are suited for moxibustion KT [textual error/abbreviation], because winter cold is vigorous, hiding Yang inside; thus, moxibustion is suitable." According to *Zhi Li Lun*, the Kidney governs the Zang organs and stores Yang Qi internally; the three winter months govern closure and storage. This is correct. If Yang is excessive, illness indeed requires moxibustion KT. This describes Yang sinking into Yin Water, which is difficult to treat. *Nan Jing* states: "For internal heat diseases, select Hui points to access Qi, as Yang has sunk into Yin. Select acupoints connecting Yang to Heaven, using fire to guide fire and lead it out. This is suitable for moxibustion KT." If all sick people are indiscriminately moxa-ed, would this not be an error? Zhang Zhongjing said: "With a faint and rapid pulse, moxibustion must be cautious. Fire becomes a pathogen, causing irritability and rebellion, chasing deficiency and pursuing excess, scattering blood in the vessels. Although the fire energy is slight, its internal attack is powerful, scorching bones and damaging sinews, making blood restoration difficult." He also said: "If the pulse is floating, resolution via sweating is appropriate. Using fire/moxa prevents the pathogen from exiting; due to fire, the condition worsens, and heaviness and bi-syndrome occur from the waist down, named Huoni (Fire Rebellion)." If the pulse is floating with severe heat and moxa is applied, this is "treating excess with excess" and "deficiency with deficiency," causing fire to move, leading to dry throat and spitting blood. He also said: "The body has 365 acupoints. Thirty are harmful if moxa-ed; seventy-nine are disastrous if needled, potentially piercing the marrow." This is from Zhang Zhongjing's *Shanghan Li*.

According to *Mingtang Zhen Jing*, the contraindications under each entry are clear. *Nei Jing* states: "Where the pulse is seen, there is the pathogen. Deep pulse indicates pathogen inside; floating pulse indicates pathogen on the exterior." Physicians of the world know only pulse theory but ignore symptom contraindications. If exterior cold syndrome is present, with sweating, frequent chills/cold sensation, thirstlessness, desire for thick clothing, aversion to cold, cold limbs, and dry skin, the pulse will be deep, thin, and slow. If one or two of these symptoms appear, moxibustion is suitable due to sinking Yang. If there is body heat, aversion to heat, occasional irritability, red or yellow face, dry throat/mouth, yellow-red tongue, thirst, and sore throat, these are heat pathogens on the exterior. If one or two of these appear, moxibustion is unsuitable. The pulse will be floating and rapid, or merely rapid without floating; do not moxa. Disaster will arise immediately. If there is anosmia, clear nasal discharge, itchy eyelids, yawning, sneezing, and aversion to cold, the pulse will be deep, indicating correspondence between pulse and symptoms. Or, if a light touch reveals string-tight pulse, this is Yin suppressing Yang. Even with a red face, moxibustion is suitable; do not restrict moxibustion solely based on facial redness.