Library

On Difficulty in Digestion and Various Symptoms of Internal Injury

The Heavenly Master said: For conditions treated by the "Kingly Way" (Wang Dao, gentle and comprehensive treatment), one cannot use the "Hegemonic Way" (Ba Dao, aggressive and forceful treatment). One must employ the Kingly Way to ensure complete cure, and thus it should be respected and advocated. For instance, when a patient is nearly recovered but still experiences difficulty in digesting food, discomfort in the chest and diaphragm, acid regurgitation, loose stools, restlessness at night, or tidal fever during the day, all these should be treated with the Kingly Way, rather than relying on unorthodox prescriptions for quick victory. The prescription consists of Ren Shen (Ginseng Radix) 1 qian, Fu Ling (Poria) 2 qian, Bai Zhu (Atractylodis Rhizoma) 2 qian, Gan Cao (Licorice Root) 5 fen, Chen Pi (Citri Reticulatae Pericarpium) 5 fen, and Ban Xia (Pinelliae Rhizoma) 7 fen. This is Liu Jun Zi Tang (Six Gentlemen Decoction), which is most exquisite. If there is heat, add Huang Qin (Scutellariae Radix) 3 fen; if unable to sleep at night, add Huang Lian (Coptidis Rhizoma) 5 fen and Rou Gui (Cinnamomi Cortex) 5 fen; if there is tidal fever, add Chai Hu (Bupleuri Radix) 1 qian, Di Gu Pi (Lycii Cortex) 3 qian, and Dan Pi (Moutan Cortex) 1 qian; if feeling slight pain in the chest due to food stagnation, add Zhi Qiao (Aurantii Fructus) 5 fen and Shan Zha (Crataegi Fructus) 10 grains; if there is phlegm, add Bai Jie Zi (Sinapis Semen) 1 qian; if there is cough, add Jie Geng (Platycodonis Radix) 1 qian; if watery diarrhea occurs, add Che Qian Zi (Plantaginis Semen) 1 qian; if abdominal pain occurs, add Rou Gui (Cinnamomi Cortex) 5 fen and Bai Shao (Paeoniae Radix Alba) 1 qian; if dizziness occurs, add Man Jing Zi (Vittariae Spica) 1 qian and Chuan Xiong (Chuanxiong Rhizoma) 1 qian; if acid water regurgitates from above, add Bai Shao (Paeoniae Radix Alba) 3 qian and double the amount of Fu Ling (Poria); if feeling fullness, add Zhi Qiao (Aurantii Fructus) 5 fen. This is what is meant by the Kingly Way: broad and open, appearing ordinary, yet miraculous in application. Calculated daily, the benefit seems insufficient, but calculated yearly, it yields abundant results. Why must one use large doses of Ren Shen (Ginseng Radix) up to liang, adding Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata) to achieve extraordinary effects? This is the method of the Kingly Way.

Master Zhang said: The Heavenly Master usually favors Hegemonic methods in prescribing medicine. Here, he uniquely employs the Kingly Way to achieve extraordinary results, which is truly unfathomable. Physicians should observe carefully. Do not assume that because the Heavenly Master uses Hegemonic techniques, everyone should compete in using Hegemonic methods for novelty, thereby neglecting the Kingly Way. This would neither align with the Heavenly Master's intent nor fulfill the pursuit of distant masters.

Master Hua said: He did not transmit this to me.

On Extreme Thirst, Severe Vomiting, Profuse Diarrhea, Abdominal Fullness, and Back Carbuncles

The Heavenly Master said: For conditions requiring the Hegemonic Way, the Kingly Way cannot be used; it is employed out of necessity. When a patient's condition is critical, how can one continue to use formulas like Liu Jun Zi Tang (Six Gentlemen Decoction) and proceed slowly, hoping for rapid results? Doing so would inevitably lead to swift demise, akin to the fall of Duke Xiang of Song. Therefore, upon encountering symptoms such as extreme thirst, severe vomiting, profuse diarrhea, abdominal fullness, back carbuncles, or abscesses, where death may occur in an instant, one must not rely on the theory that "tonifying the righteous qi will cause the pathogenic factor to disperse spontaneously." Such an approach invariably leads to total failure and incurable states. Thus, large doses of drugs are necessary to remove toxins and pathogens effectively.

For Severe Vomiting: This is caused by cold pathogen directly invading the Kidney Palace, dragging out the fluids of the Spleen and Stomach. The hands and feet are cold, and lower abdominal pain is unbearable. Applying hot objects provides slight relief; otherwise, the patient feels as if dying of cold. The prescription uses Fu Zi (Aconiti Lateralis Radix Praeparata) 1 piece, Bai Zhu (Atractylodis Rhizoma) 4 liang, Rou Gui (Cinnamomi Cortex) 1 qian, Gan Jiang (Zingiberis Rhizoma) 3 qian, and Ren Shen (Ginseng Radix) 3 liang to rescue the patient. Upon swallowing, vomiting stops immediately; subsequent doses restore normalcy. (Commentary: Divine Pill for Stabilizing Vomiting. Lei Gong said: In this formula, Ren Shen (Ginseng Radix) is 3 liang. For severe vomiting caused by fire pathogen, drinking water causes hiccups, drinking tea causes vomiting, but eating does not. For vomiting persisting for two to three days, use Ren Shen (Ginseng Radix) 1 liang, Chao Zhi Zi (Gardeniae Fructus Preparatus) 3 qian, and Huang Lian (Coptidis Rhizoma) 3 qian, ground into powder, mixed with rice cake water. Take small amounts frequently. If vomiting continues, take more small amounts until it stops. This formula is named Zhi Tu Xie Huo Dan (Pill for Stopping Vomiting and Draining Fire). Vomiting always injures Stomach Qi. Using Ren Shen (Ginseng Radix) to save Stomach Qi naturally stops vomiting and diarrhea. Kidney Water nourishes humans; how can it overcome Heart Fire to kill? Only when Yin-Cold pathogen invades the Kidney Palace does Kidney Fire flee, allowing various pathogens to attack upward, disturbing the Heart Monarch. Thus, one must use Fu Zi (Aconiti Lateralis Radix Praeparata), Rou Gui (Cinnamomi Cortex), and Gan Jiang (Zingiberis Rhizoma)—a batch of pungent, spicy, and hot substances—and heavily use Ren Shen (Ginseng Radix) to stabilize the crisis. The distribution of herbs mimics the warming energy of spring, naturally dispersing cold pathogen and stopping vomiting. This is why the formula is both hegemonic and miraculous.)

For Profuse Diarrhea: This is fire pathogen driving out fluids and grain from the Bladder and Spleen, expelling everything without leaving a trace. Abdominal pain is severe, and the abdomen is tender to touch. Undigested food passes through, and anything swallowed is expelled rapidly like a galloping horse. Delay even slightly, and death follows instantly. This disease arises from summer-heat in summer and autumn. Upon exposure to cool wind, turmoil ensues, sweeping down like waves crashing against the shore. Without urgent treatment using large doses, adhering to the slow Kingly Way rarely avoids disaster. The prescription uses Da Huang (Rhei Radix et Rhizoma) 1 liang, Ren Shen (Ginseng Radix) 2 liang, Huang Lian (Coptidis Rhizoma) 5 qian, Che Qian Zi (Plantaginis Semen) 5 qian, and Gan Cao (Licorice Root) 1 qian, decocted in water. The miracle of this formula lies in the use of Da Huang (Rhei Radix et Rhizoma). Since it is fire diarrhea, why assist its momentum? The pathology of fire diarrhea involves fire lingering between the intestines and stomach. Without guiding the pathogen according to its trend, fire remains and fluids do not flow. Thus, Da Huang (Rhei Radix et Rhizoma) is essential for purgation. However, using only Da Huang (Rhei Radix et Rhizoma) without sufficient Ren Shen (Ginseng Radix) means attacking without tonifying, damaging true qi. Gan Cao (Licorice Root) is added to moderate the harshness of Da Huang (Rhei Radix et Rhizoma). Che Qian Zi (Plantaginis Semen) is added to drain dampness; if water does not enter the Bladder, the Large Intestine becomes overactive. Che Qian Zi (Plantaginis Semen) guides water back to its proper channel, preventing the land from becoming a swamp. This is another subtle application of the Hegemonic Way.

For Abdominal Fullness: This is pathogen stagnating in the Upper Jiao without dispersion. The prescription uses Zhi Qiao (Aurantii Fructus) 3 qian, Zhi Zi (Gardeniae Fructus) 3 qian, Gua Lou (Trichosanthis Fructus) 1 fruit, Tian Hua Fen (Trichosanthis Radix) 3 qian, Gan Cao (Licorice Root) 1 qian, Chen Pi (Citri Reticulatae Pericarpium) 3 qian, Hou Po (Magnoliae Officinalis Cortex) 1.5 qian, and Ban Xia (Pinelliae Rhizoma) 1 qian, decocted in water. The efficacy lies in Gua Lou (Trichosanthis Fructus), which best removes food stagnation in the chest and diaphragm and resolves upper Jiao phlegm. Assisted by Zhi Qiao (Aurantii Fructus) and Tian Hua Fen (Trichosanthis Radix), which resolve middle Jiao excess, and augmented by Hou Po (Magnoliae Officinalis Cortex) and Ban Xia (Pinelliae Rhizoma) to drive phlegm from the stomach entrance, the addition of Gan Cao (Licorice Root) keeps the herbs in the middle jiao longer, preventing rapid downward movement. This prevents pathogen retention, allowing natural dispersion and dissolution. This is another subtle application of the Hegemonic Way.

Extreme Thirst was detailed previously and is not discussed here.
Back Carbuncles were addressed earlier with established formulas and theories; refer to those sections.

Master Zhang said: These are profound and ingenious discussions on the Hegemonic Way. I have little to add, except that Profuse Diarrhea requires distinction. There is fire diarrhea and cold diarrhea. The Heavenly Master spoke of fire diarrhea but omitted cold diarrhea. I shall supplement. Cold diarrhea involves frequent bowel movements, dozens or hundreds per day. Abdominal pain may occur. Undigested food is expelled rapidly, leading to imminent death, often in summer and autumn. How to distinguish? By heat and pain. Fire diarrhea presents with thirst, dry tongue possibly with prickles, yellow-gray-black coating, and abdominal pain intolerant to touch. Cold diarrhea presents with no thirst, or mild thirst without desire for water, white slippery non-dry coating, and abdominal pain relieved by pressure. Can treatments be the same? No. Urgently use Qi-tonifying herbs to generate Stomach Qi, assisted by damp-draining agents. The prescription uses Ren Shen (Ginseng Radix) 1 liang, Bai Zhu (Atractylodis Rhizoma) 3 liang, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Fu Ling (Poria) 1 liang, Ze Xie (Alismatis Rhizoma) 3 qian, Zhu Ling (Polyporus) 3 qian, and Rou Gui (Cinnamomi Cortex) 2 qian, decocted in water. (Commentary: Pill for Stopping Diarrhea and Relieving Pain.) This formula is Wu Ling San (Five-Ingredient Powder with Poria) plus Ren Shen (Ginseng Radix). Its brilliance lies in adding Ren Shen (Ginseng Radix) to 1 liang, which rescues impending collapse. Bai Zhu (Atractylodis Rhizoma) and Fu Ling (Poria) drain dampness. Fu Zi (Aconiti Lateralis Radix Praeparata) and Rou Gui (Cinnamomi Cortex) tonify Ming Men Fire, generating Spleen Earth via Fire, restoring Bladder Qi transformation and water passage. Zhu Ling (Polyporus) and Ze Xie (Alismatis Rhizoma) further drain dampness. Naturally, stool solidifies and cold pathogen departs. This is another crucial aspect of Hegemonic treatment. The Heavenly Master has covered the rest thoroughly.

Master Hua said: It was transmitted jointly with me.

(Note: The Profuse Diarrhea formula is also excellent for treating Fire Dysentery. Li Zi Yong recorded this.)