Library

Chen Shiduo states: The term "Yang treatment" refers to the therapeutic methods for Yang syndromes. There are numerous types of Yang syndromes, which cannot be exhaustively listed; therefore, I shall briefly discuss a few major ones.

In cases where *Shanghan* (Cold Damage) manifests as internal eruption of macules, accompanied by body heat burning like fire, intense thirst with a desire to drink water, panting, dry tongue, and restlessness such as waving hands and kicking off covers, this is one type. Alternatively, in cases of heatstroke caused by excessive summer-heat qi, characterized by extreme thirst requiring gallons of water without relief, profuse sweating like rain, loud shouting and狂呼 (frantic calling), with symptoms worsening during the day and improving at night, this is another type. These all result from Yang fire burning within the stomach region, with smoke rising and momentum urgent, fierce and unstoppable. These are all Yang syndromes. At this stage, even a cup of water is insufficient to overcome them; only large doses of cold-natured herbs can extinguish the fire. Even after using cold herbs to suppress the fire, residual embers and faint flames may remain. It requires torrential rain, filling eaves and ditches with nourishing moisture, so that the fire energy dissipates and the household can be restored. Thus, treating Yang syndromes is more difficult than treating Yin syndromes. The prescription uses Xuanshen (Scrophulariae Radix) 3 liang, Shengma (Cimicifugae Rhizoma) 2 qian, Huangqin (Scutellariae Radix) 1 liang, Maidong (Ophiopogonis Radix) 3 liang, Fangfeng (Saposhnikoviae Radix) 3 qian, Tianhuafen (Trichosanthis Radix) 3 qian, Zisuye (Perillae Folium) 1 qian, Qingdai (Indigo Naturalis) 3 qian, Sheng Gancao (Glycyrrhizae Radix et Rhizoma Preparatum) 3 qian, Shengdi (Rehmanniae Radix) 1 liang, and Sangbaipi (Mori Cortex) 5 qian. One dose eliminates most symptoms, and two doses lead to complete recovery. (Annotation: Pangtuo Tang / Torrential Rain Decoction). The brilliance of this formula lies in Xuanshen acting as the sovereign herb; it not only clears floating fire but also purges heat in the stomach, while its moistening nature is key. Although macule eruption is due to heat-fire unable to vent outward, it is also because there is insufficient fluid in the chest to provide lubrication, causing stagnation and preventing emergence. By using Xuanshen to moisten, the fire finds it difficult to reside. Furthermore, Huangqin greatly cools the chest and diaphragm, while Shengma and Fangfeng guide and disperse the pathogenic fire. Assisted by Maidong and Shengdi to cool blood and clear lung qi, the energy naturally descends in clarity, and the fire in the middle jiao is completely eradicated.

Regarding heatstroke, it is also a condition of blazing Yang fire pathogens. The method employs Qinghao (Artemisiae Annuae Herba) 5 qian, Shigao (Gypsum Fibrosum) 5 qian, Maidong (Ophiopogonis Radix) 5 qian, Banxia (Pinelliae Rhizoma) 1 qian, Huanglian (Coptidis Rhizoma) 1 qian, Renshen (Ginseng Radix et Rhizoma) 3 qian, Gancao (Glycyrrhizae Radix et Rhizoma) 1 qian, Fuling (Poria) 5 qian, and Zhuyeh (Bambusae Folium) 50 leaves, decocted in water and taken orally. (Annotation: Xiaoshu Zhishen Tang / Summer-Heat Eliminating Supreme Spirit Decoction). The efficacy of this formula lies in using Qinghao to remove summer-heat; adding 2 qian of Xiangru (Elsholtziae Herba) allows the summer-heat qi to transform naturally. Shigao pacifies and drains the pathogenic fire in the stomach; once the pathogenic fire is gone, Stomach qi begins to rotate, allowing fluids to descend rather than accumulating in the Bladder, instead dispersing into the four limbs. Moreover, does Fuling not guide this descent? Concerned that fire might damage the Heart, Huanglian is added to rescue the Heart, and Renshen to rescue the Lung. With each zang organ stabilized, the Stomach pathogens must retreat. This is a brilliant method for treating Yang syndromes.

Master Zhang says: Brilliant discussions are inexhaustible. While Yang syndromes are numerous, these two conditions are the most urgent, hence Chen Shiduo specifically highlights them as paradigms. I will further expand upon this, noting two additional conditions.

The first is hematemesis caused by summer-heat injury. When a person contracts summer-heat qi and suddenly vomits blood copiously, people often attribute it to Yin deficiency. However, hematemesis due to Yin deficiency differs from that due to Yang excess (note: text contrasts Yin def vs Yang heat patterns). In Yin deficiency hematemesis, the patient is necessarily quiet, unlike the restlessness seen in Yang syndromes. Yang syndromes present with high fever, thirst, desire for cold water, and prickles on the tongue, unlike Yin syndromes where there is no thirst and the tongue coating is slippery. The treatment should clear Stomach fire without forcibly stopping the bleeding. The prescription uses Shigao (Gypsum Fibrosum) 3 qian, Qinghao (Artemisiae Annuae Herba) 5 qian, Xiangru (Elsholtziae Herba) 3 qian, Jingjie (Schizonepetae Spica) 1 qian, Danggui (Angelicae Sinensis Radix) 3 qian, and Renshen (Ginseng Radix et Rhizoma) 3 qian, decocted in water and taken orally. (Annotation: Qushu Zhi Xue Tang / Summer-Heat Dispelling Blood-Stopping Decoction). This formula is a divine agent for treating hematemesis in true Yang syndromes. Although it contains herbs that resolve summer-heat, it tonifies righteous qi more than it resolves pathogens. Removing Xiangru, this formula can actually treat bleeding from various Yang syndromes. However, this formula should only be used for one or two doses, after which Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) should be switched to, to nourish Kidney Yin. Once fluids are sufficient, Yang fire will naturally subside.

The second is "fire diarrhea" resulting from Yang syndromes. Undigested food passes through immediately after swallowing, occurring ten, dozens, or even hundreds of times a day or night. People assume this is due to heat. However, why does this heat arise? It stems from the decline of Water in the Kidney failing to control Fire, causing the "gate" of the Stomach Earth to fail in guarding the upper and lower openings, leading to direct entry and exit. Given the urgency and rushing nature of the diarrhea, one might think symptomatic treatment (treating the branch) is appropriate. Yet, treating the branch cannot rapidly reduce the fire. One must urgently tonify the Water in the Kidney, providing a residence for the Fire so it does not ascend. The prescription uses Shudi (Prepared Rehmanniae Radix) 3 liang, Shanzhuyu (Corni Fructus) 1 liang, Cheqianzi (Plantaginis Semen) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 1 liang, Fuling (Poria) 1 liang, Baishao (Paeoniae Radix Alba) 3 liang, and Rougui (Cinnamomi Cortex) 3 fen, decocted in water and taken orally. This is a Kidney-tonifying decoction, not an anti-diarrheal per se, yet its miracle in stopping diarrhea is as swift as a drumstick striking a drum. As soon as Kidney Water is generated, Kidney Fire descends, with effects seen instantly. This is not mere eccentric talk but based on solid principles. If treated merely as Stomach deficiency with fire, there may be some effect, but nothing compares to the speed of this formula. Jiyue Wan (Spley-Restriction Pill) is also good, but how can it match the divinity of this formula?

Master Hua says: It aligns with my views; no need for further discussion.

Lord Lei says: Every discussion is wonderful.