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Treats Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang channel) where the exterior symptoms have not subsided, yet purgation has been applied multiple times. Consequently, this leads to *xie re li* (diarrhea accompanied by fever). The diarrhea persists incessantly, there is epigastric fullness and hardness, and neither the exterior nor the interior pathogens are resolved.

Guizhi (Cinnamon Twig) [4 liang], Renshen (Ginseng Root) [3 liang], Baizhu (Atractylodes Rhizome) [3 liang], Ganjiang (Dried Ginger) [3 liang], Gancao (Licorice Root) [4 liang].
The above five herbs. Use nine sheng of water. First decoct the first four herbs, obtain five sheng of liquid. Add Guizhi, decoct again to obtain three sheng of liquid. Remove the dregs. Take one sheng warm. Administer twice during the day and once at night.
Song says: Ren Shen Tang is identical to Lizhong Tang. After adding Guizhi and decocting, it treats epigastric fullness and diarrhea. In the formula, Guizhi and Gancao are both four liang. Baizhu, Renshen, and Ganjiang are each three liang.
Wei's commentary: When Taiyang exterior symptoms remain unresolved but purgation is applied repeatedly, deficiency inevitably results. Interior deficiency causes exterior heat to sink inward, thus causing persistent *xie re li*. "Xie" means combination. Yang Qi sinks to the lower part due to erroneous purgation, while Cold-Water Yin Qi occupies the Yang position, resulting in epigastric fullness and hardness. This can be cross-referenced with the text on Ganxiao Xiexin Tang: "This is not a heat knot, but rather stomach deficiency with rebellious hostile Qi, hence the hardness." The formula uses Ren Shen Tang to treat interior deficiency and Guizhi to resolve exterior pathogens. The decoction method specifies adding Guizhi last, intending for it to emerge from the interior-treating medicines to the exterior to dispel pathogens.
Shen Dancai said: This condition is similar to Gegen Lian Huang Qin Tang in that both result from erroneous purgation leading to persistent diarrhea. However, their cold-heat natures differ, and they represent opposing excess-deficiency patterns; they can be compared here. The former involves excess-heat treated by clearing pathogens; this case involves deficient-pathogens treated by tonifying righteous Qi. The former achieves relief from wheezing and sweating via Huangqin and Huanglian; this case resolves epigastric fullness and hardness via Lizhong Tang. The former stops diarrhea by using Gegen to raise sinking Qi; this case stops diarrhea by borrowing Guizhi to resolve exterior pathogens.

When presenting with symptoms resembling Guizhi Tang syndrome, but without headache or stiff neck, with a slightly floating pulse at the Cun position, epigastric fullness and hardness, and Qi rushing upward to the throat causing respiratory difficulty, this indicates the presence of Cold. Purging via emesis should be employed.
Gua Di (Thistle Fruit) [1 fen, stir-fried until yellow], Chi Xiao Dou (Adzuki Bean) [1 fen].
The above two herbs. Grind separately into powder, sift, and mix. Take one qian bi (measure) of the powder. Use Xiang Chi (Prepared Soybean) one he, add seven he of hot water, boil into a thin porridge. Remove dregs. Mix the juice with the powder. Take warm in one dose. If vomiting does not occur, gradually increase the dose slightly until vigorous vomiting ensues, then stop. Patients who have lost blood or are constitutionally deficient must not take Gua Di San. (Note: Neitai Fang states that patients with confusion/dizziness also cannot undergo emesis.)
Song says: Pathogen in the chest disrupts Qi mechanism, causing throat obstruction and difficult-to-resolve fullness. Equal parts Gua Di and Chi Xiao Dou mixed with Xiang Chi make an excellent emetic when the Cun pulse is slightly floating.
Wei's commentary: The Taiyang channel connects to Fengfu and ascends to the head and neck. Since there is no pain or stiffness, the pathology is not in the channel. Taiyang Qi enters and exits the heart and chest. The description of epigastric fullness and hardness, with Qi rushing to the throat causing breathing difficulty, indicates that pathogenic Qi desires to ascend and disperse along with Taiyang Qi. A slightly floating Cun pulse is the sign of Qi attempting to ascend. However, since it cannot immediately disperse, the Cold-Water Qi resides neither in the channel nor on the exterior, but solely in the chest; hence, it is called "Cold in the Chest." The formula employs the bitter property of Gua Di to induce vomiting, assisted by Chi Xiao Dou (red in color, descending nature) and Xiang Chi (black in color, ascending nature), facilitating the interaction between Heart and Kidney. Even during intense vomiting, the spirit remains intact. This demonstrates the divine efficacy of the emetic method. Another discussion states: When patients present with cold extremities, sudden tightness of the pulse, pathogen in the chest, epigastric fullness and irritability, hunger but inability to eat, and cold limbs, resolving the pathogen in the chest is extremely simple and effective.