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Use Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), remove the rice sprouts, add Yinchen Hao (Artemisiae Scopariae Herba, 6 liang) and Dahuang (Rhei Radix et Rhizoma, 2 liang) to treat Gu Dan (Grain Jaundice). The disease presents with alternating chills and fever, anorexia, dizziness immediately after eating, and discomfort in the chest and epigastrium. Over time, jaundice develops, which is termed Gu Dan. It is also used for Yangming disease where there is sweating only on the head, no sweating on the body, sweat stopping at the neck, and inevitable jaundice; as well as for Cold Damage (Shanghan) lasting seven or eight days, presenting with jaundice like the color of an orange, difficulty in urination, and slight abdominal fullness. Cheng Wuji stated: "For mild heat, use cool herbs to harmonize it; for severe heat, use cold herbs to purge it." The bitter-cold nature of Yinchen Hao and Zhizi is used to drive out gastric dryness-heat, while the great-cold nature of Dahuang is used to purge excess heat downward.

If the presentation resembles Guizhi Tang syndrome (Cinnamon Twig Decoction syndrome), but without headache or stiffness of the neck, with a slightly floating pulse at the cun position, oppression and hardness in the chest, and qi rushing up to the throat causing dyspnea, this indicates phlegm-fluid retention (cold pathogen) in the chest. One should use Gouti San (Melon Pedicle Powder): Gouti (Melonis Fructus Semen, 1 fen, stir-fried until yellowish, bitter and cold) and Chixiaodou (Vigna Angularis Seed, 1 fen, sour and warm). These two herbs are separately pounded and sifted into powder, then mixed. Take one fangcun bi (a measure roughly equivalent to a square inch) of the powder, mix with Xiangchi (Perillae Fructus, 1 he) and hot water (7 he), boil into a thin porridge, strain, take the decoction, mix with the powder, and drink warm in one dose.

Note: Cheng Wuji quoted Hua Tuo saying: "If the pathogen has been in the chest for four days, emesis can be induced. This is the method of intercepting and depriving the pathogen." The Qianjin Fang states: "When qi floats upward, filling the chest and epigastrium, causing chest fullness and qi rushing to the throat preventing respiration..."

That is, the previous formula uses only Gouti (14 pieces), boiled in one sheng of water to obtain five he, strained and taken in one dose. It treats Summerheat stroke characterized by fever, pain, and heaviness, caused by consuming cold water in summer, leading to water-dampness remaining in the skin and interstices. It also treats Cold Damage after three or four days, where the patient feels fullness and hardness in the heart/epigastrium, heat in the palms and soles, progressing to refractory jaundice. Grind Gouti into fine powder. Use one zi (a small measure) insufflated into the nose to discharge yellow fluid. The remaining powder is taken orally with water. If one or two sheng of yellow fluid is vomited or discharged, the disease is cured.

Use Gouti (14 pieces), Dingxiang (Caryophylli Flos, 1 piece), and Shumi (Panicum Miliaceum Grain, 49 grains) ground into fine powder. Moisten with water, hold in mouth, and insufflate one zi into the nose to draw out yellow saliva.

Note: Yan Yi states: "Gouti is the pedicle of the sweet melon. When ripe, it falls naturally. Harvest the pedicle attached to the vine stem, dry it in the sun, grind into fine powder regardless of quantity. Based on the severity of the illness, insufflate a small amount into the nose."

It also treats chronic lateral or frontal headache unresponsive to various medicines and acupuncture, due to dampness in the head. Use single herb Gouti ground into fine powder, insufflate a small amount into the nose to draw out clear fluid and yellow saliva.

Phlegm-fluid located above the chest and diaphragm all emerge with the tidal flow of saliva and heat. Palpate the upper chest; masses may be felt moving down the throat.