Library

Treats Huoluan (acute gastrointestinal disorder) with aversion to cold, a faint pulse, and recurrent diarrhea. The cessation of diarrhea indicates the depletion of Yin blood/fluids. This formula is indicated for this condition.
Sini Tang (Four Reversal Decoction) original formula plus Renshen (Ginseng Radix et Rhizoma) (1 liang).
The song states: Sini Tang originally saves Yang Qi; adding one liang of Renshen creates a formula to save Yin fluids. Although diarrhea has stopped, it is known that blood/fluids are depleted; one must seek transformation in the Middle Jiao. (The *Neijing* states that the Middle Jiao extracts juice, transforms it into red, and calls this blood. The formula uses Renshen to nourish the juice of the Middle Jiao, not to retrieve Yang.)
Wei notes: The Treatise says, "Aversion to cold, faint pulse, and recurrent diarrhea; cessation of diarrhea means no blood." It refers to Huoluan where diarrhea recurs. The symptoms include aversion to cold and a faint pulse, which implies the meaning of Yin depletion. The *Jingui Yaolue* states, "When water is exhausted, there is no blood," meaning internal exhaustion of body fluids. Therefore, Sini Tang is used to rescue Yang Qi, and Renshen is added to generate body fluids. Ke Yunbo doubted whether Renshen was originally in Sini Tang, not knowing that Zhang Zhongjing excluded this herb from formulas for retrieving Yang. Even if occasionally used, it was to moderate the excessive heat of other drugs. It is only added in formulas for rescuing Yin. Ke Yunbo's statement shows he had never dreamed of the *Shennong Bencao Jing*.

Treats Huoluan disease with vomiting and diarrhea, characterized by excess cold and no desire to drink water.
Renshen (Ginseng Radix et Rhizoma) (3 liang), Gancao (Licorice Root), Baizhu (Atractylodis Macrocephalae Rhizoma) (3 liang), Ganjiang (Dried Ginger) (3 liang).
The above four ingredients are crushed, sifted into powder, mixed with honey, and formed into pills the size of a chicken egg yolk. Dissolve one pill in several he of boiling water, crush, and take warm. Take three or four times daily, and once at night. If the abdomen does not feel warm, increase to three or four pills per dose. However, the decoction is more effective. For the decoction method, cut the four ingredients according to the specified weights, add eight sheng of water, boil to obtain three sheng, and remove the dregs. If diarrhea is severe, retain Baizhu; if palpitations occur, add Fuling (Poria) (2 liang); if thirsty and desiring water, increase Baizhu to 4.5 liang; if abdominal pain occurs, increase Renshen to 4.5 liang; if cold is prevalent, increase Ganjiang to 4.5 liang; if abdominal fullness occurs, remove Baizhu and add Fuzi (Aconiti Lateralis Radix Praeparata) (one piece). About the time of a meal after taking the medicine, drink about one sheng of hot porridge to maintain slight warmth, and do not uncover clothes or blankets. (Note: This is the same method as taking Guizhi Tang, indicating that patients with Shanghan [cold damage] are not restricted from eating.)
The song states: Use Lizhong Wan for vomiting, diarrhea, and abdominal pain; the dosages for both pill and decoction forms are identical at three liang each. Baizhu, Ganjiang, Renshen, and Gancao balance rigidity and softness; drinking hot porridge after administration contributes to the efficacy.
The song for modifications states: If there is beating above the umbilicus, avoid Baizhu; remove Baizhu and treat with Guizhi (Cinnamon Twig) (4 liang). If vomiting is frequent, also remove Baizhu; try adding Shengjiang (Fresh Ginger) (3 liang). If diarrhea is severe, keep Baizhu; remember its function of transporting fluids. Palpitations are caused by water qi harassing the heart; add Fuling (2 liang) as an assistant. If thirsty and desiring water, increase Baizhu; administer together totaling 4.5 qian. If abdominal pain occurs, add Renshen to reach 4.5 liang, sufficient for the previous requirement. If cold is present, add Ganjiang to the formula; the quantity is similar to adding Renshen. (Lingtai said: Drinking hot porridge with Guizhi Tang aims to assist the drug power to disperse outward; here, drinking hot porridge aims to assist the drug power to warm inwardly.)
Wei notes: The Treatise says, "Huoluan with headache, fever, and body pain, with heat predominance and desire to drink water, is treated with Wuling San (Five-Ingredient Powder with Poria)." "With cold predominance and no desire to drink water, Lizhong Wan is indicated." Huoluan is defined as vomiting and diarrhea. Headache, fever, and body pain indicate internal Huoluan combined with external cold injury. For heat and thirst, Wuling San assists the Spleen Earth to distribute fluid juices throughout the body. For cold without thirst, Lizhong Wan regulates the Middle Jiao to connect the upper and lower Yin and Yang. Generally, due to upper vomiting and lower diarrhea, regardless of cold or heat, treatment should focus on protecting the Middle Jiao. Wang Jin-san said: Renshen and Gancao are sweet to harmonize Yin; Baizhu and Ganjiang are acrid to harmonize Yang. Acrid and sweet assisting each other in the center allows Yin and Yang to naturally harmonize. This is the premier warming and tonifying formula. The Treatise mentions Si Ni category formulas, including this decoction. It also treats post-illness spitting of saliva. Those good at reading can deduce from "spitting saliva" that any Spleen-Stomach deficiency applies, revealing a good method for regulation. Cheng Jiaoqian said: Renshen, Baizhu, and Zhi Gancao (Honey-fried Licorice) consolidate the Central State. Ganjiang guards the center, relying on its flame like firewood under a pot to raise Yang Qi. Thus, grain enters the Yin, grows Qi in the Yang, transports upward to the Hua Gai (Lungs), and controls the Zhou Du (Bladder). The five zang and six fu organs all receive Qi. This is the essence of Lizhong.