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Treats the condition of Taiyang disease (Disease of the Taiyang channel) presenting with a knotted and intermittent pulse (Jiedai Mai, a pulse with irregular rhythm and pauses) and palpitations (Xin Dong Ji), for which this formula is indicated.

Gancao (Radix Glycyrrhizae Preparata, 4 liang, prepared by honey-frying), Guizhi (Ramulus Cinnamomi, 3 liang), Shengjiang (Rhizoma Zingiberis Recens, 3 liang), Renshen (Radix Ginseng, 2 liang), Ejiao (Colla Corii Asini, 2 liang), Dazao (Fructus Jujubae, 12 pieces, split).

Take the above nine ingredients. Add 7 sheng of clear wine and 8 sheng of water. First decoct the first eight ingredients to obtain 3 sheng of liquid. Strain to remove the dregs. Add Ejiao and heat until completely dissolved. Take 1 sheng warm, three times a day.

The rhyme states: For a knotted and intermittent pulse, use four liang of Gancao; thirty Dazao, three liang each of Guizhi and Shengjiang. Half a sheng of Huma Ren, one jin of Maidong, one jin of Dihuang. Two liang each of Renshen and Ejiao, nurtured by water and wine.

Commentary by Wei: Zhou Yuzai stated that since the text does not mention external signs, it can be inferred that exterior cold-heat symptoms have resolved. Since it does not mention internal signs, it can be inferred that bowel and bladder functions are normal. The condition arises from prolonged illness depleting righteous Qi (Zheng Qi). Therefore, soft and moistening herbs such as Ejiao, Maidong (Radix Ophiopogonis), Dazao, and Huma Ren (Semen Cannabis) are used to nourish Yin fluids. It is necessary to employ the acrid nature of Guizhi and Shengjiang to circulate Yang Qi, so that the knotted and intermittent pulse may recover. Particularly important is the single herb Zhi Gancao, which supports Stomach Qi to nourish the root of the pulse. Clear wine is added as an assistant to facilitate rapid circulation through the pulse channels. The decoction method uses seven sheng of wine and eight sheng of water.

This formula is used to restore the knotted and intermittent pulse; it is not intended to treat cases of pulse disappearance or collapse. Students must not rigidly adhere to the name of the formula, lest they mismanage critical conditions. By extension, Sun Simiao’s Shengmai San (Life-Preserving Powder) was also created because its name was perhaps too grandiose; vulgar physicians followed suit, causing significant harm.

Note by Yuanxi: This condition is certainly caused by excessive sweating. Sweat is the fluid of the Heart. When Heart fluids are damaged, blood deficiency fails to nourish the Heart, resulting in palpitations. Heart fluid... [Text cuts off]

Treats Yangming disease (Disease of the Yangming channel) characterized by severe excess and fullness, constipation, abdominal pain with high fever, and a deep, forceful pulse, for which this formula is indicated. (This formula is largely similar to that in Neitai Fangyi.)

Mangxiao (Natrii Sulfas, 3 he; Neitai Fangyi records 3 liang), Dahuang (Radix et Rhizoma Rhei, 4 liang, washed with wine), Zhishi (Fructus Aurantii Immaturus, 5 pieces, prepared by honey-frying), Houpo (Cortex Magnoliae Officinalis, half a jin, bark removed).

Take the above four ingredients. Add one dou of water. First decoct Zhishi and Houpo to obtain five sheng of liquid. Strain to remove dregs. Add Dahuang and decoct to obtain two sheng of liquid. Strain to remove dregs. Add Mangxiao and boil slightly.

The rhyme states: Four liang of Dahuang, half a jin of Houpo; five Zhishi, three he of Mangxiao, urgent purgation is said. Decoct Houpo and Zhishi first, add Dahuang later. Remove dregs, add Mangxiao, and simmer slightly over fire.

Commentary by Wei: Chengqi Tang has the power to revive the dying. Only those who skillfully study Zhang Zhongjing’s works can appreciate its subtleties. Vulgar physicians consider lubricating agents like Sesame Oil and Danggui (Radix Angelicae Sinensis) safe, while regarding harsh purgatives as taboo. Consequently, True Yin fails to recover, and patients often die after stool evacuation. Thus, everyone warns each other: "Lubricating intestinal agents can even kill people, let alone Da Chengqi Tang." The efficacy of Da Chengqi Tang is entirely obscured by mediocre and unrefined physicians.

Zhang Yin'an stated: Among the Six Channels of Shanghan, only Yangming and Shaoyin have urgent purgation indications. This is because Yangming possesses fierce and hot Qi, and Shaoyin transforms via Ministerial Fire... [Text cuts off]

...there are few who can survive. Moreover, I have heard it said: One should only purge when all five syndromes—Pi (stuffiness), Man (fullness), Zao (dryness), Shi (excess), and Jian (hardness)—are present. Alas, when purgation is indicated, it depends entirely on more than just these five syndromes... [Text cuts off]