Library

(From Zhang Jiabin's *Xin Fang Ba Zhen*) Treats Yangming warm-heat diseases and summerheat, presenting with extreme thirst, high fever, exhaustion of body fluids (Jinye), and Yin deficiency leading to an inability to sweat.
Danggui (Angelica sinensis Radix) (3–5 qian) Gan Ge (Puerariae Lobatae Radix) (2–3 qian). Decoct in water. Soak in cold water until cool, and take slowly. Once sweating occurs, the condition resolves.
Gui Ge Yin must be soaked in cold water because the pathogenic factors of Yangming warm-heat and summerheat are severe. Yin deficiency with no sweat, accompanied by thirst and irritability; after taking this formula, profuse sweating occurs, demonstrating its unique efficacy. (Xu Gao notes: Gegen Tang uses Shaoyao to astringe Yin, which monitors/restrains the sweating action of Mahuang and Gegen; here, Danggui nourishes blood to assist Gan Ge in generating sweat. In Gegen Tang syndrome, the exterior still presents with aversion to cold, so the medication is warming and dispersing; in this syndrome, both interior and exterior present with heat, so the medication is taken chilled. As the saying goes, generating fluids naturally leads to sweating; clearing the interior also releases the exterior. This is a major principle for treating warm-heat and summerheat. This is a variation of Gegen Tang and a preliminary step before Baihu Tang.)

Treats excess accumulation and cold phlegm blocking the upper epigastrium (Shangwan), causing chest stuffiness and hardness, a slightly floating pulse at the Cun position, rebellious Qi rushing up to the throat obstructing breathing; or fullness and irritability below the heart, hunger but inability to eat, cold extremities, and a pulse that suddenly becomes tight; or vomiting immediately upon swallowing food, a sensation of nausea in the heart without ability to vomit, cold extremities at onset, and a string-tight (Xuan) and slow (Chi) pulse; as well as sudden jaundice, chest fullness, panting, and imminent death. All these conditions are suitable for this formula.
Gua Di (Thladianthae Fructus, fried yellow) Chi Xiao Dou (Vigna umbellata Seed) (equal parts). Pounded separately into powder. Take one qian bi (a spoonful measure) of the powder. Use Xiang Chi (Fermented Soybean) one he, add seven he of hot water, boil into a thin porridge, strain, take the liquid to mix with the powder, and take warm in one dose. During vomiting, keep eyes closed and tightly bind the abdomen. If vomiting does not stop, resolve it with Cong Bai Tang (Scallion White Decoction). If vomiting does not occur after a long time, hold a piece of rock sugar in the mouth to induce vomiting. All patients with blood loss, deficiency constitutions, the elderly, and postpartum women must not take this. (This is a harsh/potent agent, hence such detailed cautionary instructions. Note: Gua Di is not recorded in Li Shizhen's *Bencao Gangmu*, so later generations did not know what it was, leading to the abandonment of this herb. Many died because they should have been induced to vomit but were not. How sorrowful! It is unknown that Gua Di is the stalk of the bitter gourd mentioned in *Shennong Bencao Jing*, which treats edema of the face, eyes, and limbs, promotes urination, and induces vomiting. It is exactly this substance, specifically one type of summer vegetable melon with a bitter taste. The pulp and stalk are removed and soaked in sauce, serving as a common side dish for porridge. There are sweet and bitter varieties; only the stalk of the bitter melon induces vomiting. Yang family in East Gate, Wuxi, sells medicine for edema and jaundice, instructing patients to inhale it through the nose; discharge of yellow fluid cures the disease, showing remarkable efficacy. I suspect this is the same thing. Modern so-called famous doctors do not know how to use it, and even if they know, they dare not use it. Alas! What is their mindset?)
In Gua Di San, combined with Chi Xiao Dou and Xiang Chi, expelling pathogens and inducing vomiting is truly miraculous. (This is a heavy agent of sour-bitter upward purging, used to vomit out cold pathogens from the chest. Pathogens are knotted in the chest, not involving Taiyang exterior excess. Only three ingredients are made into powder, boiled into a thin porridge, lingering in the Middle Jiao to induce vomiting, completing the task. Gua Di has an ascending nature, bitter taste, and induces vomiting; Chi Xiao Dou has an astringent nature, bitter taste, and drains downward. Fearing it may not necessarily disperse and ascend, we again use the stale/fermented nature of Xiang Chi Tang to develop excess pathogens, ensuring they will definitely ascend and be vomited. Truly a miraculous formula!) Excess accumulation and cold phlegm block the upper epigastrium, chest stuffiness and hardness, string-tight and slow pulse (String-tight or suddenly tight pulse indicates cold-excess). Hunger but no desire to eat, cold extremities, wanting to vomit but unable to do so, lacking peace (All due to cold obstruction above, preventing heat from venting outward). These are all manifestations for Gua Di San; patients with blood loss and deficiency must strictly avoid using it. (Inducing vomiting in patients with blood loss and deficiency causes deficient Yang to float upward, creating danger of collapse/Jue). There is also acute jaundice (Sudden jaundice is named "Acute Jaundice") and edema; this medicine can be blown into the nose. (Adding Dingxiang [Caryophylli Flos] for nasal insufflation is even better). For pathogens located above, inducing vomiting yields rapid effects ("For pathogens above, follow the trend and purge them"; faster than sweating or purgation methods). After Changsha (referring to Zhang Zhongjing), few people know it. (Doctors after Zhang Zhongjing only knew sweating and purgation methods but not vomiting methods; those who understood the subtleties of vomiting methods were merely a few individuals.)