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Qianghuo (Notopterygii Rhizoma et Radix, 1 liang) Fangfeng (Saposhnikoviae Radix, de-lusted) Cangzhu (Atractylodis Rhizoma, wine-soaked, skin removed) Huangqi (Astragali Radix), Renshen (Ginseng Radix et Rhizoma) (each 1 qian) Shengma (Cimicifugae Rhizoma, 7 fen) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) Duhuo (Angelicae Pubescentis Radix), Chaihu (Bupleuri Radix) (each 5 fen) Chuanxiong (Ligustici Chuanxiong Rhizoma, for headache) Huangbai (Phellodendri Cortex), Chenpi (Citri Reticulatae Pericarpium), Gaoben (Ligustici Jingweii Rhizoma) (each 3 fen) Zexie (Alismatis Rhizoma, de-needled, 1 fen) Zhuling (Polyporus, de-black skin), Fuling (Poria) (each 2 fen) Huanglian (Coptidis Rhizoma, de-needled, 1 fen)

Crush the above herbs into coarse particles. For each dose, weigh 3 qian or 5 qian, add two zhan of water, decoct until one zhan remains, remove the dregs, and take it slightly warm. Adjust usage according to the patient's deficiency or excess.
If the symptoms are not entirely consistent, apply modifications according to the addition and subtraction rules.

The pulse is wiry, surging, and slow; upon deep pressure at the middle and lower levels, a occasional choppy quality is felt. The manifestations include: fullness and stuffiness in the four limbs, vexing pain in the joints, difficulty in flexion and extension, heaviness of the body, mental restlessness, fluctuating weight (sudden fatness or thinness), lassitude of the four limbs, loss of taste in the mouth, abdominal discomfort and inability to stretch, clear urination and defecation but frequent, or drinking water above and excreting below, or constipation with difficult passage occurring once every one or two days, diarrhea with undigested food in summer, blood or white pus after defecation, chest fullness and shortness of breath, obstruction in the diaphragm and throat, thick and sticky phlegm-cough, excessive salivation in the mouth, regurgitation of food after eating, tinnitus and deafness, sensation of fire flowing in the eyes, blurred vision, red filaments in the eyelids, heat congestion in the head and eyes, inability to lie down peacefully, lethargy and weakness, lack of appetite. Tiaozhong Yiqi Tang (Regulate the Middle and Boost Qi Decoction) is the primary formula.

Huangqi (Astragali Radix, 1 qian) Renshen (Ginseng Radix et Rhizoma, de-lusted, omit if coughing) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma), Cangzhu (Atractylodis Rhizoma) (each 5 fen) Chaihu (Bupleuri Radix) (This single herb addresses insufficiency of upper qi; sinking of stomach and spleen qi is treated by tonifying upper qi, drawing from yin to guide yang.)
Chenpi (Citri Reticulatae Pericarpium) (If qi movement in the abdomen is obstructed, add 1 fen more) Shengma (Cimicifugae Rhizoma) (each 2 fen) Muxiang (Aucklandiae Radix) (1 fen or 2 fen)

Cut the above herbs to the size of hemp seeds. Combine as one dose, add two large zhan of water, decoct until one zhan remains, remove the dregs, and take it while hot. Administer after residual food in the stomach has digested. Maintain calmness and cease overthinking; the medicinal effect will be miraculous, as the disease resides in the vessels of the four limbs, and taking it on an empty stomach in the morning is optimal.
If there is frequent heat and irritability in the head, this is steaming from yin-fire in the lower origin. Add Shengdihuang (Rehmanniae Radix, 2 fen) and Huangbai (Phellodendri Cortex, 3 fen); omit if these symptoms are absent.
If there is tenesmus (feeling the need to defecate without success) or incomplete evacuation with constant abdominal pressure, this indicates blood deficiency and stagnation. Add Dangguishen (Angelicae Sinensis Radix, 3 fen). If the body feels heavy, even with frequent urination, also add Fuling (Poria, 2 fen), Cangzhu (Atractylodis Rhizoma, 1 qian), Zexie (Alismatis Rhizoma, 5 fen), and Huangbai (Phellodendri Cortex, 3 fen) to temporarily dispel dampness. Do not use long-term. Since the Foot-Taiyin Spleen channel is already diseased and its pulse connects to the heart, damp-heat combines causing vexation. If stomach qi is disharmonious, add Banxia (Pinelliae Rhizoma, washed with water, 5 fen) and Shengjiang (Zingiberis Rhizoma Recens, 3 slices). If coughing, add Shengjiang (Zingiberis Rhizoma Recens) and Shengdihuang (Rehmanniae Radix, 2 fen) to moderate the toxicity of Banxia. If there is phlegm-jue headache, only Banxia can resolve it; this is caused by the Foot-Taiyin Spleen. If accompanied by irritability and heat, add Huangbai (Phellodendri Cortex) and Shengdihuang (Rehmanniae Radix, 2 fen each). If none of the above symptoms exist, take only the previous prescription. In summer, add Baishao (Paeoniae Radix Alba, 3 fen). In spring, if there is abdominal pain, addition is especially suitable.
If there is aversion to heat and thirst, or abdominal pain, add Baishao (Paeoniae Radix Alba, 5 fen) and Sheng Huangqin (Scutellariae Radix, 2 fen).
If there is aversion to cold and abdominal pain, add Rougui (Cinnamomi Cortex, 3 fen) and remove Huangqin (Scutellariae Radix); this is called Guizhi Shaoyao Tang (Cinnamon Twig and Peony Decoction), added to the Shaoyao Tang for simultaneous decoction. In winter, do not use Baishao (Paeoniae Radix Alba) as it is a great cold medicine. Use Ganjiang (Zingiberis Rhizoma, 2 fen) instead, or add Banxia (Pinelliae Rhizoma, 5-7 fen) moderated by a little Shengjiang (Zingiberis Rhizoma Recens).
In autumn and winter months, if the four pathways of the stomach pulse are reversed by the Chong Mai (Penetrating Vessel), and the two pathways of the Shaoyang pulse under the hypochondrium reverse upward, the disease is named Jue Ni (Jue-Ni). The *Neijing* states: "Upward reversal of qi fills the pulses and separates from the form; when the seven spirits become confused and severed, death occurs as the spirit leaves the form." Symptoms include: qi rushing up to the throat preventing breathing, rapid panting with sound, inability to lie flat. Add Wuzhuyu (Evodiae Fructus, 5 fen or 1.5 qian), washed with water to remove bitterness, using the amount based on the degree of jue qi.
If this occurs in summer, it is due to great heat. This disease varies with the seasons' cold, heat, warmth, and coolness. Use Jiuhuanglian (Coptidis Rhizoma processed with wine), Jiuhuangbai (Phellodendri Cortex processed with wine), and Jiuzhimu (Anemarrhenae Rhizoma processed with wine) in equal parts, ground into fine powder, and made into pills with hot water. Size of Sophora japonica seeds. Take 200 pills per dose with plain warm water, on an empty stomach. Drink plenty of hot soup afterwards. Shortly after taking the medicine, consume delicious food to suppress the gastric retention, guiding the medicine down to the lower origin to drain the pathogenic factors of the Chong Mai (Penetrating Vessel). Generally, diseases obtained from diet and overwork are deficiency-fatigue and Seven Damages syndromes; they should be treated with warm, neutral medicines that are sweet and pungent, which is the fundamental method.
If there are alternating chills and fever at the upper level, it corresponds to the four seasons, or improper management, excessive alcohol and food, illness caused by spicy-hot foods, illness caused by cold foods, or staying in extreme heat/cold environments aggravating the condition. One must adapt to the time and temporarily use great cold or great heat treatments to achieve effect; this is a provisional measure. Do not use them long-term just because they work, or it will lead to difficult-to-treat conditions.
The *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) states: "For conditions rising from below, guide them away." "For insufficiency of upper qi, push and elevate it." Upper qi refers to the qi of the Heart and Lungs in the Upper Jiao. Yang disease in Yin requires drawing from Yin to guide Yang. Use medicines entering the Kidney and Liver Lower Jiao to guide sweet-and-pungent medicines to raise and develop Spleen and Stomach qi, and expel pathogenic factors from the couli (interstices) and skin/hair. It also states: "Where there was previous pain, often select points first." This means using Mi Ci (Mistaken Puncture) to drain stagnation in the collaterals, because blood coagulates and does not flow; thus, remove this first, then treat other diseases.