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On Wei Syndrome (Flaccidity Syndrome), on Kidney Deficiency presenting as symptoms similar to Baihu Tang Syndrome, on Profuse Sweating Unstoppable, on Direct Invasion of Yin Meridians, on Treating Fire in the Yangming Channel.

The Heavenly Master said: The so-called "Great Treatment Method" refers to treating the whole body comprehensively when diseases affect all parts, addressing both upper and lower, left and right. For instance, when Qi and Blood are completely deficient, causing multiple illnesses throughout the body; or when headache persists while bone pain follows; or when abdominal pain continues while pain spreads to all four limbs—these are such cases. Although these diseases often involve Wei Syndrome, it is appropriate to specifically treat the Fire of the Stomach in the Yangming channel. However, since Stomach Fire is flourishing, causing emaciation of the entire body, upper and lower, and four limbs, one cannot focus solely on treating the Stomach meridian. The prescription uses Ren Shen (Ginseng Radix) 3 qian, Fu Ling (Poria) 3 qian, Yi Yi Ren (Coicis Semen) 5 qian, Dang Gui (Angelicae Sinensis Radix) 3 qian, Huang Qin (Scutellariae Radix) 3 qian, Gan Ju Hua (Chrysanthemi Flos) 1 qian, Xuan Shen (Scrophulariae Radix) 5 qian, Mai Dong (Ophiopogonis Tuber) 1 liang, Chen Pi (Citri Reticulatae Pericarpium) 5 fen, Shen Qu (Massa Medicata Fermentata) 5 fen, Bai Jie Zi (Sinapis Semen) 3 qian, Bai Shao (Paeoniae Radix Alba) 3 qian, Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang. Decoct with three large bowls of water until one bowl remains, then take orally. (Commentary: Shuang Bu Zhi Shen Dan - Double Tonifying Supreme Spirit Elixir.) Logically, for flourishing Yangming Fire, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) should be used. Yet here it is not used; instead, Ren Shen, Fu Ling, Huang Qin, and Shu Di Huang are employed as sovereign drugs to tonify Qi and Blood. Why? Because excessive Stomach Fire has already scorched and consumed Qi and Blood. Using Baihu Tang (White Tiger Decoction) might temporarily quell the raging fire, but it would lead to severe damage ("scorched head and ruined forehead"), inevitably causing a massive loss of Body Fluids. It is better to use large doses of Qi- and Blood-tonifying herbs, decocted heavily, so that sufficient fluids naturally extinguish the fire. The prescription appropriately includes Xuan Shen, Mai Dong, and Gan Ju Hua, which are purely clearing Yangming heat; even if Yangming Fire rages like a prairie fire, they can extinguish it. Moreover, heavy use of Dang Gui and other blood-nourishing agents nourishes the source of transformation. However, if the dosage of these herbs is too small, it will not only be ineffective but also exacerbate the soaring fire. This is the subtlety of the "Great Treatment Method." Generally, the Great Treatment Method is most suitable for deficiency syndromes. When applied at the onset, when Stomach Fire is still abundant, administering large doses can turn defeat into victory. If one delays, hesitates, and dares not use large doses initially, waiting until Stomach Qi declines before regretting and using large doses, it will be too late. For conditions requiring large doses, such as Back Carbuncle and Ulcers (Fa Bei Yong Ju), small treatments must be strictly avoided; large doses are especially indicated. There are specialized discussions elsewhere, so I will not elaborate further.

Master Zhang said: The "Great Treatment Method" actually addresses ailments caused by Yangming Stomach Fire. It applies not only to Back Carbuncles and Ulcers but also to cases where symptoms resemble Kidney Deficiency with boiling Fire, presenting as Baihu Tang syndrome; these should also be treated with large doses of Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). Furthermore, in cases where Kidney Water overflows upward, causing profuse expectoration of phlegm like a pouring basin, Liuwei Dihuang Tang added with Fu Zi (Aconiti Lateralis Radix Praeparata) and Rou Gui (Cinnamomi Cortex) should be used. Decoct several bowls, drink from large bowls, and recovery ensues. Such cases must not be treated with small doses. In any deficiency of Kidney Water or Kidney Fire, although Heat symptoms appear in the Upper Jiao, the tongue coating remains slippery and moist, unlike Yang syndromes which present with extreme dryness and prickliness. Additionally, there are cases of profuse sweating, where sweat flows like rain and cannot be stopped, accompanied by faint breath and lethargy. This is not a febrile mania; without urgent administration of large tonic doses, death from collapse of Yang will occur instantly. The prescription uses Ren Shen 3 liang, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 4 liang, Dang Gui 3 liang, Sang Ye (Mori Folium) 10 leaves, Mai Dong 3 liang, Bei Wu Wei Zi (Schisandrae Chinensis Fructus) 3 qian, Huang Qi (Astragali Radix) 3 liang. Decoct with water and take orally. (Commentary: Zhi Han Ding Shen Dan - Stop Sweat Calm Spirit Elixir.) This prescription consists entirely of Qi-tonifying herbs. When Qi is sufficient, sweating stops, and Yang returns to the Palace of Mingmen (Gate of Life). If treated with small doses, how can one replenish the vital Qi from the realm of non-being? I see only immediate death. There are also cases of direct invasion of Yin meridians, where Yin-Cold energy cuts through defenses directly into the Kidney palace, causing the Fire of Mingmen to flee and nearly escape the body shell. Without large doses of Fire-tonifying herbs, how can scattered Yuan Yang (Original Yang) be retrieved and returned to its home? The prescription uses Ren Shen 1 liang, Bai Zhu 3 liang, Fu Zi 2 qian, Rou Gui 1 qian, Gan Jiang (Zingiberis Rhizoma) 2 qian. Decoct with three bowls of water and take orally. One dose brings cure. (Commentary: Shen Zhu Fu Gui Tang - Ginseng, Atractylodes, Aconite, and Cinnamon Decoction.) The use of Ren Shen and Bai Zhu in this formula is ingenious. In cold-dispelling formulas, without these two herbs, once the cold is expelled, Qi will follow it out. Therefore, these two must be used, and in large amounts, so that Yuan Yang can be retained in moments of near-extinction. These are all methods of Great Treatment, which must not be unknown.

Master Hua said: The Heavenly Master did not transmit this; I have an essay for reference. The Fire of Yangming is the most vigorous and urgent. If large doses of fire-clearing herbs are not administered, Kidney Water will be dried up immediately. However, excessive use of cold and bitter herbs will inevitably damage Stomach Qi. Once Stomach Qi is damaged, Stomach Fire becomes even stronger. Although Shi Gao (Gypsum Fibrosum) in Shigao Tang contains Ren Shen to rescue Stomach Qi, it ultimately cannot withstand the fierce attack. My opinion is: if Shi Gao is used in 1 liang, Ren Shen must also be used in 1 liang; or if Shi Gao is increased to 2–3 liang, Ren Shen absolutely cannot remain at 1 liang; it must be increased significantly. Even if one dares not increase it to 3 liang, it must be increased to 1.5 liang. Rather than administering Ren Shen after the fire subsides, is it not better to double the dose while the fire is raging? Combining attack and tonification allows the fire to subside without damaging Stomach Qi, which is optimal. In my treatment of flourishing Yangming Fire, success is often rapid because Ren Shen and Shi Gao are used together without bias toward either side. This is my unique secret. Since Yuan Gong is beloved by the Heavenly Master, I do not hesitate to transmit it fully and without reservation. I hope Yuan Gong listens carefully: Ren Shen must be used concurrently with Shi Gao, regardless of weight proportions. I ask the Heavenly Master and Changsha Gong (referring to Zhang Zhongjing) to comment on this passage. (Commentary: Lei Gong said: Master Hua's words are extremely appropriate.)

The Heavenly Master said: Brilliant discourse, unchangeable.

(Note: For various diseases where Stomach Qi is weak, medication should not be given in large doses; this must be known. In cases of sudden illness with Cold invasion, pulse faint and nearing extinction, and cold limbs, emergency administration of raw Fu Zi and Gan Jiang, each 5 qian, is required initially; Ren Shen and Bai Zhu are secondary. This view originates from Yu Jia Yan (Yu Chang). Recorded by Li Ziyong.)