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(From Zhang Jiebin's *Xin Fang Ba Zhen*) Treats various critical conditions where Yin and Yang are on the verge of collapse.
Ren Shen (Ginseng Radix) [1-2 liang or several qian] Zhi Fu Zi (Prepared Aconiti Lateralis Radix) [2-3 qian] Pao Jiang (Prepared Zingiberis Rhizoma) [2-3 qian] Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) [1 qian] Shu Di Huang (Prepared Rehmanniae Radix) [5 qian or 1 liang]
Take in divided doses, warm.

Li Yin Jian (Decoction for Regulating Yin) consists of Dang Gui (Angelicae Sinensis Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gan Jiang (Zingiberis Rhizoma), and Di Huang (Rehmanniae Radix). This is a variation of Li Zhong Tang (Decoction for Regulating the Middle). When there is deficiency of the Spleen and Kidney with concurrent Yin depletion, harsh and drying agents are contraindicated; this treatment is appropriate. (Zhang Jingyue notes: "If affected by cold... if cold-purging agents are mistakenly used, the cold pathogen will worsen... add Xi Xin (Asari Radix) to warm and disperse... Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata)...")

Treats Shaoyin disease characterized by diarrhea with undigested food, internal cold with external heat, cold limbs, sweating accompanied by cold extremities, and dry retching due to cold fluid retention above the diaphragm; also treats Taiyang disease with fever, headache, and deep pulse; although body pain exists, the interior should be rescued first; also treats cases after Taiyang disease sweating therapy where excessive sweating occurs, fever persists, internal tension arises, limb pain ensues, accompanied by diarrhea, cold extremities, and aversion to cold. All these are suitable for this formula as the primary treatment.
Gan Cao (Glycyrrhizae Radix et Rhizoma) [2 liang, honey-fried] Gan Jiang (Zingiberis Rhizoma) [1.5 liang] Fu Zi (Aconiti Lateralis Radix) [1 piece, raw, sliced] Water 3 sheng, decoct to obtain 1.2 sheng, remove dregs, take in two divided warm doses.

For the same indications but with a faint pulse nearly imperceptible, this formula is appropriate.
The original Si Ni Tang (Four Reversal Decoction) uses 3 liang of Gan Jiang (Zingiberis Rhizoma), adding 9 stalks of Cong Bai (Allii Fistulosi Bulbus).

For Yin excess repelling Yang, characterized by cold limbs, faint pulse nearly imperceptible, red face, sore throat, and irritability, this formula is appropriate.
Tong Mai Si Ni Tang (Pulse-Rescuing Four Reversal Decoction) adds Zhu Dan Zhi (Porci Bile) half he. (After decocting all herbs, remove dregs, mix in the bile, and take.)

For aversion to cold, faint pulse, and recurrent diarrhea, where the cessation of diarrhea indicates loss of blood essence.
The original Si Ni Tang (Four Reversal Decoction) adds Ren Shen (Ginseng Radix) 1 liang.

For cases where the disease persists despite sweating or purging therapies, accompanied by irritability.
Si Ni Jia Ren Shen Tang (Four Reversal Decoction plus Ginseng) further adds Fu Ling (Poria) 4 liang.

Si Ni Tang (Four Reversal Decoction) contains Gan Jiang (Zingiberis Rhizoma), Fu Zi (Aconiti Lateralis Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma); it must be decocted urgently for treating cold extremities. (Note: The name "Si Ni" implies its use for reversing cold extremities. In *Shang Han Lun · Jueyin Chapter*... pulse is fine and slight, mouth not thirsty, because the zang organs have cold, so warming is unquestionable.) Cold fluid-induced dry retching is also applicable. (Cold fluid has no solid substance; warming disperses the cold, eliminates the fluid, and stops retching. Generally, warming methods are used for treating fluid retention.) Body pain and diarrhea with undigested food require warming the interior first. (Generally, exterior syndromes should be treated before interior ones; however, for diarrhea with undigested food, supporting Yang is urgent while the exterior syndrome is secondary. Even with body pain, one must first rescue the interior. Once the diarrhea stops and body pain remains, treat from the exterior.) Regardless of whether it involves the Three Yin meridians or the Taiyang meridian. (Wang Jin San in *Gu Fang Xuan Zhu* states: "Si Ni Tang (Four Reversal Decoction) is used for any Jue reversal in Three Yin and One Yang syndromes, thus... It is also used for sweating leading to Yang collapse because Shaoyin and Taiyin are the masters of Water and Fire. Without communicating the Qi of the Central Earth, true Yang cannot be restored internally. Therefore, raw Fu Zi (Aconiti Lateralis Radix) and raw Gan Jiang (Zingiberis Rhizoma) are used to welcome Yang back to its residence, connecting with the twelve meridians. Honey-fried Gan Cao (Glycyrrhizae Radix et Rhizoma) is repeatedly used to monitor this process because if Yang collapse does not involve profuse sweating, Yang may not be completely lost. Thus, a slow preparation retaining action in the middle serves as a good method to summon Yang from the outside.") External heat with internal cold and profuse sweating, combined with irritability, requires vigilance against Jue reversal. (Profuse sweating and irritability indicate external loss of Yang, posing a high risk of Jue collapse.) For Jue reversal with absent pulse, add Cong Bai (Allii Fistulosi Bulbus) (Named Tong Mai Si Ni Tang (Pulse-Rescuing Four Reversal Decoction); Cong Bai enters the Ying level to unblock vessels). For red face and sore throat, add Zhu Dan Zhi (Porci Bile) (Named Tong Mai Si Ni Jia Zhu Dan Zhi Tang (Pulse-Rescuing Four Reversal Decoction plus Porcine Bile); Porcine Bile is extremely bitter and slippery, capable of guiding Yang-tonifying drugs directly to the Lower Jiao, known as 'treating heat with cold'). There are also cases adding Ren Shen (Ginseng Radix) (Named Si Ni Jia Ren Shen Tang (Four Reversal Decoction plus Ginseng)), which is excellent for Yang collapse and blood loss. (This is Yang collapse compounded by blood loss, so Ren Shen (Ginseng Radix) is added to generate fluids and benefit blood.) Adding Fu Ling (Poria) further treats Kidney restlessness (Kidney restlessness refers to Yin restlessness. It requires guiding Kidney water upward, so Fu Ling (Poria) is added to calm it). The name Fu Ling Si Ni Tang (Poria and Four Reversal Decoction) becomes prominent. (This is a variation of Zhen Wu Tang (True Warrior Decoction), using heavy doses of Fu Ling (Poria) to calm and drain Kidney water.)