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The pathogenic factors of the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), although infecting people through the same pathways, cause different diseases in different individuals. Why is this? It is because people's constitutions vary in thickness and thinness, their Zheng Qi (Vital Energy) differs in strength and weakness, and their Zang-Fu organs differ in cold and heat. The pathogenic factors received often transform according to the Qi of the person's Zang-Fu organs; thus, the diseases produced are different. Therefore, some transform into deficiency patterns, some into excess patterns, some into cold patterns, and some into heat patterns. This is like the relationship between water and fire: when water is abundant, fire is extinguished; when fire is abundant, water is consumed. When one aspect is dominant, it dictates the transformation; this is the natural principle. If one truly understands this, what is there to doubt? Should one be surprised that Yang pathogens transmit to Yin meridians, transforming from cold to heat or vice versa?

From the Later Han Dynasty to the present day, spanning a thousand years, people have claimed that Cold pathogens of the Three Yin meridians do not transmit. Furthermore, they refer to Yin pathogens transmitting via the meridian sequence in Shanghan (Cold Damage) as "Direct Invasion" (Zhizhong, where pathogens bypass the Three Yang meridians and directly invade the Three Yin meridians). Little do they know that "Direct Invasion" refers to the syndrome of Cold Strike, not transmission via meridians! These errors arise from a failure to thoroughly study the works of Zhang Zhongjing. For instance, in the Treatise, it states: for symptoms of diarrhea, abdominal fullness, and body pain, one should first warm the interior, then attack the exterior. Warming the interior is suitable with Sini Tang (Frigid Extremities Decoction), and attacking the exterior is suitable with Guizhi Tang (Cinnamon Twig Decoction). This is an example of Yang pathogens from the Three Yang meridians transmitting to Taiyin, where the pathogen transforms into a cold pattern following the nature of the Yin meridian. Again, for Shaoyin disease presenting with diarrhea, Baicong Tang (Scallion Decoction) is the primary treatment; this is a cold pattern where Taiyin cold pathogens transmit to Shaoyin. If there is diarrhea with undigested food, interior cold with exterior heat, sweating, and cold extremities, Tongmai Sini Tang (Pulse-Recovering Frigid Extremities Decoction) is the primary treatment; this is a cold pattern where Shaoyin cold pathogens transmit to Jueyin. All these are well-documented. How can one claim that Yin meridians do not transmit to each other in Shanghan, denying the principles of Yang transforming into Yin or Yin transforming into Yang?

Taiyin belongs to Wet Earth and is a purely Yin organ. Therefore, once a pathogen enters Taiyin, transformations following the Yin nature are common, while those following the Yang nature are rare. Transformations following the Yin nature include, as stated in the Treatise: abdominal fullness, vomiting of food, spontaneous diarrhea, lack of thirst, naturally warm hands and feet, and occasional spontaneous abdominal pain. These are suitable for treatment with Lizhong Wan (Regulate the Middle Pill) or Sini Tang. Transformations following the Yang nature include, as stated in the Treatise: after sweating, if the disease persists with abdominal fullness and pain, urgent purgation is required, suitable for Dachengqi Tang (Major Order the Qi Decoction); if there is significant abdominal fullness and severe pain, Guizhi Jiadahuang Tang (Cinnamon Twig Decoction with Added Rhubarb) is the primary treatment. This is because the Spleen and Stomach reside together in the abdomen, so both abdominal fullness and pain occur. However, abdominal fullness is the principal disease of Taiyin, while subcostal/fullness in the heart region (epigastrium) is the principal disease of Yangming. Although Yangming also presents with abdominal fullness, it transforms with Heat; thus, it must be accompanied by tidal fever, spontaneous sweating, and constipation. This differs from Taiyin, which transforms with Dampness, presenting with jaundice, sudden irritability, and diarrhea of foul-smelling waste. If one carefully examines the deficiency and excess at the sites of abdominal pain, severe pain, and fullness, and judiciously applies warming or purging methods, nothing will be left unaddressed. Thus, summarizing these points allows one to grasp the essential methods of Taiyin disease.

The outline syndrome of Taiyin disease is: abdominal fullness with vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain. If treated with purgation, it will inevitably lead to hardness and knotting below the chest.

[Commentary] Wu Renju said: The phrase "worsening spontaneous diarrhea" should follow the sentence "inevitably leads to hardness and knotting below the chest." His view is correct. If placed after "vomiting and inability to eat," it implies that vomiting and inability to eat have already occurred, followed by worsening diarrhea. Then Zhang Zhongjing adds, "if treated with purgation," which would be meaningless.

[Annotation] Taiyin refers to the Spleen Meridian. Its vessels spread through the stomach and connect to the throat. When Cold pathogens transmit to Taiyin, abdominal fullness and occasional spontaneous abdominal pain occur. When Cold pathogens follow the vessels to invade the Stomach, vomiting and inability to eat occur. This is a syndrome of Taiyin interior deficiency with pathogen transforming into cold, suitable for warming with Lizhong Wan or Sini Tang. If there is abdominal fullness, dry throat, constipation, and severe pain, this is a syndrome of Taiyin interior excess with pathogen transforming into heat, suitable for purging with Guizhi Jiadahuang Tang. If one mistakes the fullness and pain of Taiyin deficiency-cold for excess-heat and uses purgation, Cold and Deficiency will contend, leading to Zang-Jie (organ knotting) and痞硬 (stiff palpitations/knotting), as well as worsening spontaneous diarrhea. This is the outline for the entire chapter on Taiyin disease; subsequent mentions of Taiyin disease refer to this syndrome.

[Collected Annotations] Cheng Yingmao said: Yang pathogens can also cause abdominal fullness. If vomiting relieves the fullness and allows eating, that is one case. Now, with abdominal fullness, vomiting, and inability to eat, the fullness is due to Cold distension, and vomiting is due to Cold rejection. Yang pathogens can also cause diarrhea and abdominal pain. If pain decreases after defecation, that is one case. Now, with diarrhea and occasional spontaneous abdominal pain, the diarrhea is due to Cold, and the pain is due to Cold. "Below the chest" refers to Yin pathogens knotting in the Yin portion below the chest, distinct from Yang pathogens knotting in the chest, and painful upon pressure. "Knotting and hardness" occurs because without Yang to transform Qi, it becomes hard Yin, distinct from Pi (glutinous softness) which is soft. Those (Yang knotting) involve Yang sinking from above and stagnating; this involves Yin rising from below and failing to return. The distinction between Cold and Heat is great.

Wu Renju said: Spontaneous diarrhea occurring at times with spontaneous abdominal pain is not like accumulated constant pain. If one treats all pain as excess and uses purgation, the fullness will worsen, inevitably causing the area below the chest to become knotted and hard, and the spontaneous diarrhea will worsen.

In Shanghan disease, on the fourth or fifth day, if there is abdominal pain and gas moving downward toward the lower abdomen, this indicates impending spontaneous diarrhea.

[Annotation] On the fourth or fifth day of Shanghan disease, the pathogen enters Taiyin. Abdominal pain without gas moving downward toward the lower abdomen belongs to Yangming. Now, with abdominal pain and gas moving downward toward the lower abdomen, this is a sign that Taiyin is about to produce spontaneous diarrhea. This is Zhang Zhongjing indicating that one should not treat all pain as excess and recklessly use purgation.

[Collected Annotations] Fang Youzhi said: Abdominal pain with gas moving downward indicates interior deficiency unable to hold, with Cold pathogens pressing downward.

Zhang Lu said: Abdominal pain can also belong to Fire (Heat), in which case the pain attacks upward from below. If the pain trends downward from above, it is undoubtedly Cold pain.

Wei Litong said: This clause focuses on preventing diarrhea, rather than distinguishing Cold from Heat. Examining the words "if" and "impending" reveals that distinguishing Cold pathogens has its own methods.

Spontaneous diarrhea without thirst belongs to Taiyin, because the Zang organs have Cold. It should be warmed, and Sini Tang-type decoctions are suitable.

[Annotation] Generally, spontaneous diarrhea with thirst indicates Heat in the interior and belongs to Yang. Spontaneous diarrhea without thirst indicates Cold in the interior and belongs to Yin. Now, spontaneous diarrhea without thirst indicates Cold in the original Taiyin Zang, so it should be warmed. "Sini Tang-type" refers to Sini Tang, Lizhong Wan, Fuzi Tang, etc.

[Collected Annotations] Cheng Zhi said: This states that Taiyin spontaneous diarrhea is Cold and suitable for warming. Shaoyin belongs to Kidney Water; Heat invading consumes Water, causing spontaneous diarrhea with thirst. Taiyin belongs to Spleen Earth; Cold invading follows Dampness, causing no thirst but diarrhea. Thus, Taiyin spontaneous diarrhea requires warming.

Cheng Yingmao said: The Three Yin meridians all belong to Zang Cold. Shaoyin and Jueyin have thirst syndromes, but Taiyin alone does not, because the Cold is in the Middle Jiao and is unrelated to Dragon-Liver Fire. Shaoyin contains Dragon Fire; when interior Cold is severe, Dragon Fire rises, causing spontaneous diarrhea with thirst. Jueyin contains Thunder Fire, hence polydipsia. In Taiyang, thunder stops when sunlight appears; thus, fever stops diarrhea, but cold extremenss brings back diarrhea.

Wei Litong said: The term "spontaneous diarrhea" refers to cases formed without prior mistaken purgation, sweating, or vomiting, indicating that the Zang originally had Cold.

Lizhong Wan Formula
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Root, honey-fried), Ganjiang (Dried Ginger Rhizome) (each 3 liang).
Crush and sieve the four ingredients. Mix with honey to form pills the size of chicken egg yolks. Dissolve one pill in a few he of boiling water, crush, and take warm. Take 3-4 times daily and 2 times at night. If warmth is not felt in the abdomen, increase to 3-4 pills per dose. However, this is less effective than the decoction. For the decoction method, cut the four ingredients according to the specified weights. Use 8 sheng of water, boil to obtain 3 sheng, remove dregs, and take 1 sheng warm, three times daily.
Modifications: If there is throbbing above the navel, it indicates Kidney Qi movement; remove Baizhu and add Guizhi (Cinnamon Twig) 4 liang. If vomiting is excessive, remove Baizhu and add Shengjiang (Fresh Ginger Rhizome) 3 liang. If diarrhea is excessive, retain Baizhu; if palpitations occur, add Fuling (Poria) 2 liang. If there is desire to drink water, increase Baizhu to total 4.5 liang. If there is abdominal pain, increase Renshen to total 4.5 liang. If Cold is severe, increase Ganjiang to total 4.5 liang. If there is abdominal fullness, remove Baizhu and add Fuzi (Aconite Lateralis Radix Praeparata) 1 piece. After taking the medicine, approximately the time it takes to eat a meal, drink about 1 sheng of hot porridge to induce slight warmth. Do not uncover clothes or blankets.

[Collected Explanations] Cheng Yingmao said: The movement of Yang begins with warmth. When warm Qi functions, grain essence is transported; when grain Qi rises, Middle Qi is sufficient. Hence it is called "Regulate the Middle," actually bestowing regulating power to give Yang Qi to the Middle Jiao. Yang deficiency means Middle Qi fails to hold; Danzhong loses its dispersing function, and the Six Fu organs lose their sprinkling and arranging function. It is like a stove losing its flame, leading to undigested stool below and loss of taste above, with the Five Zang organs plundering each other, giving rise to various syndromes. Renshen, Baizhu, and honey-fried Gancao guard the Central State. Ganjiang is pungent and warms the middle; it must be used to ignite the stove fuel and raise Yang Qi. Thus, grain enters Yin, grows Qi in Yang, transports upward to the Huagai (Lungs), and controls the Zhoudou (Bladder), nourishing all Five Zang and Six Fu organs. This is the essence of Lizhong. If Water and Cold compete, Spleen and Kidney should be warmed simultaneously; adding Fuzi benefits the Mingmen (Gate of Life) and warms the Mother of Earth (Spleen). Baizhu tonifies Spleen but causes Qi stagnation when combined with Renshen; thus, it is removed for umbilical throbbing, excessive vomiting, and abdominal fullness. Add Guizhi to suppress Kidney pathogens, Shengjiang to stop vomiting, and Fuzi to eliminate Yin. Excessive diarrhea indicates Dampness excess; retain Baizhu to dry Dampness. Desire to drink water indicates fluid retention causing thirst; add Baizhu to transform fluids and generate Jin-Ye. Palpitations below the heart indicate water retention; add Fuling to guide out water. Abdominal pain requires doubling Renshen for deficiency pain. Severe Cold requires increasing Ganjiang.

In Shanghan disease, if the patient originally had Cold-type diarrhea, and the physician mistakenly used emesis or purgation, Cold rejection may cause further reversal of vomiting and diarrhea. If food is vomited immediately upon entering the mouth, Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction) is the primary treatment.

[Commentary] The classic texts do not mention "Cold-type diarrhea" as a disease or text. Examining the following text, "Cold rejection causes further reversal of vomiting and diarrhea," it is clear that the character "Xia" (down/purgation) in "Han Xia" should be "Ge" (rejection). Only then does the meaning connect. Commentators interpret it as Stomach Cold causing diarrhea, which disconnects the text and contradicts the properties of Huangqin and Huanglian.

[Annotation] The Classic states: "Rejection leads to vomiting and reversal." Ge (Rejection) is the name of the vomiting-reversal disease. Vomiting food eaten in the morning until evening indicates Spleen Cold rejection; vomiting food immediately upon entry indicates Stomach Heat rejection. "Originally having Cold Rejection" means the person inherently suffers from morning-eating-evening-vomiting Cold Rejection. Now, contracting Shanghan, the physician sees indications for emesis or purgation and rigidly applies these methods, causing Cold Rejection to reverse further due to emesis/purgation. One should warm Taiyin with Lizhong Tang and add Dingxiang (Clove) to descend Cold reversal. If food is vomited immediately upon entry, it is not Cold Rejection but Heat Rejection. One should use Ganjiang and Renshen to calm the Stomach, and Huanglian and Huangqin to descend Stomach Fire.

Ganjiang Huanglian Huangqin Renshen Tang Formula
Ganjiang (Dried Ginger Rhizome), Huanglian (Coptis Rhizome), Huangqin (Scutellaria Root), Renshen (Ginseng Radix et Rhizoma) (each 3 liang).
Boil the four ingredients in 6 sheng of water to obtain 2 sheng. Remove dregs and divide into two warm doses.

In Shanghan disease, if the physician uses purgation, leading to continuous diarrhea with undigested food and body pain, urgent rescue of the interior is required. Later, if body pain persists but bowel movements normalize, urgent rescue of the exterior is required. Rescuing the interior is suitable with Sini Tang; rescuing the exterior is suitable with Guizhi Tang.

[Annotation] In Shanghan disease, if the physician fails to distinguish exterior/interior, cold/heat, deficiency/excess and mistakenly uses purgation, leading to continuous diarrhea with undigested food, this indicates Interior Cold. Although exterior body pain remains, continuous diarrhea with undigested food indicates severe Interior Cold. According to the law, one must urgently rescue the interior. Wait until bowel movements normalize and body pain persists, then rescue the exterior. Rescuing the interior uses Sini Tang to warm the middle and overcome Cold; rescuing the exterior uses Guizhi Tang to harmonize Ying and Wei.

[Collected Annotations] Wang Sanyang said: This syndrome should consider Xiere Li (Diarrhea with协同 Heat). One must examine the color of the diarrhea and the urgency of the condition; do not lightly administer Sini Tang or Guizhi Tang.

Yu Chang said: Attacking the interior usually requires resolving the exterior first to avoid reverse actions. Only when Interior Yin Cold is extremely severe is it necessary to urgently rescue the interior. Once the interior syndrome stabilizes, rescue the exterior again. This means rescuing the interior before rescuing the exterior.

Diarrhea with undigested food prohibits attacking the exterior; sweating will inevitably cause abdominal fullness.

[Annotation] This elaborates on the previous clause regarding not rescuing the interior first but attacking the exterior, clarifying the syndrome of simultaneous Taiyin and Shaoyin disease. Diarrhea with undigested food indicates Taiyin Cold pathogens have transmitted to Shaoyin. Even with body pain, one must not attack the exterior. If one mistakenly attacks the exterior, causing sweating, Taiyang exterior resolves but Taiyin Cold congeals, inevitably leading to abdominal fullness.

For diarrhea, abdominal fullness, and body pain, first warm the interior, then attack the exterior. Warming the interior is suitable with Sini Tang; attacking the exterior is suitable with Guizhi Tang.

[Annotation] This expands on the previous clause to clarify the treatment of treating interior first, then exterior. Diarrhea and abdominal fullness indicate Interior Cold pathogens; body pain indicates Exterior Cold pathogens. Whenever Exterior and Interior Cold pathogens present simultaneously, warming the interior is urgent. Thus, one must first warm the interior, then attack the exterior. Warming the interior uses Sini Tang; attacking the exterior uses Guizhi Tang.

[Collected Annotations] Fang Youzhi said: Interior deficiency and Exterior excess. Because of deficiency, one must treat it first; because of excess, one can treat it later.

After sweating, if abdominal fullness occurs, Nongpo Shengjiang Banxia Gancao Renshen Tang (Magnolia Bark, Fresh Ginger, Pinellia, Licorice, and Ginseng Decoction) is the primary treatment.

[Annotation] After sweating, if the exterior is resolved but abdominal fullness remains, this is Taiyin interior deficiency distension. Therefore, Nongpo Shengjiang Banxia Gancao Renshen Tang is used to dissipate distension, relieve fullness, tonify the middle, and descend rebellion.

[Collected Annotations] Cheng Wuji said: Fullness after vomiting and fullness after purgation are both excess, indicating pathogens entering the interior due to deficiency to become excess. After sweating, the exterior is resolved; abdominal fullness is known not to be interior excess. It arises from Taiyin insufficiency and Spleen Qi blockage, leading to stagnation and fullness. This decoction harmonizes Spleen and Stomach and descends rebellious Qi appropriately.

Wang Hu said: This clause describes abdominal fullness due to Qi deficiency after sweating. Although the patient feels full, there is no internal excess form. Thus, using Renshen and honey-fried Gancao, sweet-warm tonics, is unquestionable.

Zhang Xiqiu said: This describes damaging Spleen Qi through sweating. The Spleen governs the abdomen, so abdominal fullness is the principal disease of Taiyin. After sweating, abdominal fullness indicates the person's Spleen Qi was originally deficient. Now, with further Spleen Qi deficiency, transport fails, turbid Qi does not descend, clear Qi does not ascend, resulting in fullness.

Nongpo Shengjiang Banxia Gancao Renshen Tang Formula
Nongpo (Magnolia Bark, honey-fried, skin removed, half jin), Shengjiang (Fresh Ginger Rhizome, sliced, half jin), Banxia (Pinellia Tuber, washed, half sheng), Gancao (Licorice Root, honey-fried, 2 liang), Renshen (Ginseng Radix et Rhizoma, 1 liang).
Boil the five ingredients in 1 dou of water to obtain 3 sheng. Remove dregs and take 1 sheng warm, three times daily.

If sweating fails to resolve the disease, and abdominal fullness and pain occur, urgent purgation is required, suitable for Dachengqi Tang. If abdominal fullness does not decrease, or decreases insignificantly, purgation is required, suitable for Dachengqi Tang.

[Annotation] This elaborates on the previous clause to distinguish treatments. After sweating, if the exterior is resolved and there is abdominal fullness without pain, it is "fullness that occasionally decreases and returns," a deficiency fullness, suitable for warming with Nongpo Shengjiang Banxia Gancao Renshen Tang. Now, after sweating, if the exterior is unresolved and there is significant abdominal fullness and severe pain, it is "fullness that does not decrease, or decreases insignificantly," an excess fullness, requiring purgation with Dachengqi Tang. This is because of interior urgency; attack the interior first, then harmonize the exterior.

[Collected Annotations] Yu Chang said: The phrase "decreases insignificantly" vividly describes abdominal fullness. Seeing fullness reach ten parts, reducing it by one or two parts is insufficient to curb its momentum. This is why, despite unresolved exterior pathogens, purgation is undoubtedly indicated!

Cheng Yingmao said: If purgation leaves abdominal fullness unchanged, even reducing it by one or two parts does not count as reduction. Purgation may be repeated until fullness is completely eliminated.

Liu Hongbi said: There is no method for purgation in Taiyin disease. If in the meridians, no meridian has a basis for purgation; in the Zang organs, Taiyin especially cannot accept purgation. Is Guizhi Jiadahuang Tang not doubtful? One must understand that Spleen and Stomach are exterior-interior partners. Taiyang mistaken purgation harms Taiyin. If the Stomach has retained food, the Spleen becomes excess due to the Stomach's excess, and pain arises from Taiyang pathogens. Since there is major fullness and severe pain, forming Stomach excess, this decoction cannot treat it; thus, Dachengqi Tang is suitable.

In Taiyin disease, if the pulse is floating, sweating may be used, suitable with Guizhi Tang.

[Annotation] In Taiyin Meridian disease, the pulse should be floating and slow; in Taiyin Zang disease, the pulse should be deep and slow. Now, with pathogens reaching Taiyin, the pulse is floating but not slow, indicating Taiyang exterior pathogens have not fully subsided. Thus, even with one or two symptoms like vomiting, diarrhea, anorexia, abdominal fullness, and occasional pain, if the pulse is floating rather than deep, one can use Guizhi Tang to sweat and resolve the exterior first. Wait for exterior resolution before regulating the interior. From this, we know that in the Treatise, cases of body pain, abdominal fullness, and diarrhea requiring urgent interior rescue have pulses that are definitely not floating.

[Collected Annotations] Wang Kentang said: In Taiyang disease with floating pulse and no sweating, Mahuang Tang is suitable. Here, with floating pulse, there should also be no sweating, but it is not mentioned because Yin meridians do not typically sweat, so it need not be said. Guizhi Tang is used instead of Mahuang Tang. Generally, for Three Yin diseases with exterior involvement, heavy sweating is inappropriate. Note that Guizhi Tang can be used even without sweating.

Cheng Zhi said: This discusses dispersing in Taiyin. Taiyin disease refers to syndromes with abdominal pain and diarrhea. Taiyang pulse is floating at both Cun and Chi positions. Now, with floating pulse, pathogens returning to the exterior are evident, so Guizhi is suitable for dispersion. Mahuang is not used because Yin diseases should not be heavily sweated; Guizhi Tang contains the intent of harmonizing the interior.

Cheng Yingmao said: This is Taiyang within Taiyin. Although there is interior disease, treating it from the Taiyang exterior prevents drawing pathogens into the Zang.

Originally Taiyang disease, if the physician mistakenly uses purgation, leading to abdominal fullness and occasional pain, it belongs to Taiyin. Guizhi Jiashaoyao Tang (Cinnamon Twig Decoction with Added Peony) is the primary treatment. For severe excess pain, Guizhi Jiadahuang Tang (Cinnamon Twig Decoction with Added Rhubarb) is the primary treatment.

[Annotation] Originally Taiyang Wind Strike disease, if the physician fails to use Guizhi Tang to sweat and mistakenly uses purgation, pathogens sink into the interior. With no other symptoms except abdominal fullness and occasional pain, this belongs to Taiyin interior deficiency pain. Thus, Guizhi Jiashaoyao Tang is suitable to externally resolve Taiyang exterior and internally regulate Taiyin interior deficiency. If there is major fullness and excess pain, it belongs to Taiyin heat transformation and Stomach excess pain. Thus, Guizhi Jiadahuang Tang is suitable to externally resolve Taiyang exterior and internally attack Taiyin interior excess.

[Collected Annotations] Zhao Sizhen said: There are three types of Taiyin abdominal fullness: pathogens transmitting sequentially via meridians, Cold pathogens directly entering the middle, and pathogens sinking inward after purgation. These must be distinguished.

Yu Chang said: Mistaken purgation in Taiyang disease results in changes above the chest and hypochondrium. Here, mistaken purgation leads to abdominal fullness and occasional pain without chest/hypochondrium symptoms, indicating pathogens have entered Yin positions, thus belonging to Taiyin. Still using Guizhi to resolve muscle layer raises Taiyang pathogens; doubling Shaoyao regulates Taiyin Qi. Not adding any new herbs to the base formula is divine! Major excess and fullness require urgent purgation, but since Yang pathogens initially sink into Taiyin, harsh purgation is inadvisable. Adding a little Rhubarb to Guizhi Tang divides and reduces pathogens (7 parts exterior, 3 parts interior), similar to the meaning of Xiaochaihu Tang.

Cheng Yingmao said: Mistaken purgation of Taiyang leading to abdominal fullness and occasional pain reveals Taiyin syndromes. However, exterior pathogens sinking and stagnating in Taiyin is not a Zang Cold disease. Still use Guizhi Tang to raise Yang pathogens, but double Shaoyao to harmonize. If major excess and pain seem suitable for urgent purgation, it is Yin excess, not Yang excess. Still follow Guizhi example to raise Yang pathogens, but add Rhubarb to break stagnation, giving both exterior and interior pathogens an exit. Cold goes with excess, warming itself without added heat. Although these two syndromes belong to Taiyin, they originate from Taiyang transmission, so the pulse must still be floating.

Guizhi Jiashaoyao Tang Formula
In the Guizhi Tang formula, add Shaoyao (Peony Root) 3 liang, totaling 6 liang with the previous amount. Follow the rest of the Guizhi Tang method.

Guizhi Jiadahuang Tang Formula