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Treats the condition of Shanghan (Cold Damage) presenting with jaundice and fever.

Zhi Zi (Gardeniae Fructus, 15 pieces), Gan Cao (Licorice Root, 1 liang), Huang Bo (Phellodendri Cortex, 2 liang). Add four sheng of water, decoct to obtain one and a half sheng, remove the dregs, and divide into two warm doses.

(Wang Ang's *Yi Fang Ji Jie* cites Zhang Wenzhong's formula) Treats Shanghan-induced diarrhea, where the stool resembles rotten meat juice with red stagnation, caused by latent pathogenic qi leading to abdominal pain.

Add Xie Bai (Allii Macrostemonis Bulbus, 1 liang) to the original Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction).

Zhi Chi Tang treats Yangming exterior syndrome. (The exterior syndrome of Taiyang should be treated with warming dispersion; the exterior syndrome of Yangming should be treated with clearing and purging. Gegen Tang treats the exterior syndrome when Taiyang transmits to Yangming without sweating; Guizhi Jia Gegen Tang treats it with sweating; Shengma Gegen Tang treats the exterior syndrome of Yangming contracted independently without sweating; this Zhi Chi Tang treats the exterior syndrome of Yangming contracted independently with sweating.) The pulse is floating and tight, with dryness in the throat and mouth, fever, sweating, aversion to cold absent, asthma, chest fullness, and Ao Nao (restlessness and discomfort). (These are all Yangming exterior syndromes, not resulting from mis-treatment.) There is empty irritability, restlessness preventing sleep, chest obstruction and pain, and white tongue coating. (This occurs after sweating or purging, where righteous qi is depleted but pathogenic heat still disturbs the Upper Jiao, causing chest fullness to become obstruction and pain, and heart restlessness to become empty irritability and insomnia. However, these remain within the Yangming exterior, as indicated by the white tongue coating showing pathogenic heat in the Upper Jiao.) All the above conditions are suitable for treatment with Zhi Chi Tang. (*Ben Jing* states: Zhi Zi clears... [text missing/garbled]. Adding it to any formula indicates its primary indication falls within that scope. However, lay practitioners treating seasonal diseases often fail to distinguish between Shanghan and Warm diseases, or between sweating and non-sweating patterns, indiscriminately using Zhi Zi and Chi, which greatly deviates from the principle of formula formulation.) Gao Xuexiang stated that Zhi Zi Chi Tang is a method for clearing and purging Yangming, not an emetic agent. Observing several cases of Zhi Zi Chi Tang in *Shanghan Lun*, there is no mention of "vomiting," only that "patients with chronic loose stools should not take it," clarifying the nature of Zhi Zi. As for the instruction "stop taking after vomiting" at the end of the formula, how do we know it is not a textual error or misplaced text erroneously included by editors? Ke Yunbo argued that Zhi Zi's nature is bitter and cold, clearing heat, and is not an emetic; only the fermented odor of Chi steams upward to the Heart and Lungs, inducing vomiting, citing the use of Chi juice mixed with Gua Di San as evidence. He failed to realize that Gua Di itself is an emetic; the use of Chi juice is because Chi harmonizes the middle and descends qi, fearing that excessive vomiting would damage middle qi, not that Gua Di requires Chi to induce vomiting. According to analysis: Gua Di San indications include epigastric hardness and irritability, desire to eat but inability, desire to vomit but inability, indicating cold and food stagnation bound in the chest, thus requiring induction of vomiting. Zhi Chi Tang indications include heart restlessness, empty irritability, tongue coating, and head sweat, indicating damp-heat stifling in the lower chest, thus requiring bitter herbs to drain heat. One involves tangible pathogens amenable to vomiting; the other involves intangible pathogens not amenable to vomiting. How can they be confused as emetics? Testing shows boiling Gua Di alone induces vomiting, while Xiang Chi alone does not, making the distinction clear. Further discussion is in Volume 4 *Miscellaneous Sayings*. For the aforementioned symptoms (Ao Nao, empty irritability, tongue coating, etc.), if accompanied by vomiting, add Sheng Jiang (Fresh Ginger), named Zhi Zi Sheng Jiang Chi Tang. If there is shortness of breath (Shao Qi), add Gan Cao, named Zhi Zi Gan Cao Chi Tang. Vomiting is stopped by adding Sheng Jiang; shortness of breath is addressed by adding Gan Cao to tonify qi. Ancient physicians tailored treatments to manifestations accordingly. Remove Chi from Zhi Zi Gan Jiang Tang for mild lingering heat and vexation after purging. (Cold qi remains in the middle after purging, hence Gan Jiang; body heat and mild vexation require Zhi Zi; absence of Ao Nao means Chi is removed.) There is also Zhi Zi Hou Po Tang for post-purging heart vexation (Zhi Zi) and abdominal fullness/distension (Hou Po, Zhi Shi). Zhi Shi Zhi Chi Tang is suitable for relapse due to overexertion (Lao Fu). (Lao Fu occurs when qi is deficient after illness and residual pathogens remain unclear, triggered by exertion; symptoms vary, so specific forms are not detailed; light and clear herbs suffice to drain upper jiao pathogens. Later practitioners used tonification, leading to myriad complications.) For relapse due to improper diet (Shi Fu), especially severe cases, add Da Huang to eliminate stagnation. (If stored food is not severe, Zhi Shi suffices.) For Wine Jaundice with heart heat/pain and Ao Nao, Zhi Zi Da Huang Tang is also effective. (There are many methods for treating jaundice; this treats heart Ao Nao, heat, and pain.) For Shanghan with fever and yellowing of the body, Zhi Zi, Bo Pi (Huang Bo), and Gan Cao work excellently together, named Zhi Zi Bo Pi Tang. (Zhi Zi and Bo Pi use coldness to overcome heat and bitterness to dry dampness, grasping the essence of treating jaundice. Gan Cao is used gently because jaundice internally combines with Spleen-Taiyin damp transformation. If fever is present, heat is not stagnant inside but has a tendency to exit the exterior; sweating and purging are unnecessary. Instead, stabilizing Spleen earth allows damp-heat to separate, and jaundice resolves. Zhi Zi Hou Po Tang emphasizes heat; Zhi Zi Gan Jiang Tang emphasizes... pungent, unblocking, slippery, and lubricating, referring to Spleen deficiency...)