Library

Treats cases where, after taking decoctions for Shanghan (Cold Damage), diarrhea persists unceasingly, accompanied by a sensation of fullness and hardness in the epigastrium. After having taken Xiexin Tang (Drain the Epigastrium Decoction), if other purgative medicines are administered again, the diarrhea does not cease but becomes more severe. Lizhong Tang (Regulate the Middle Decoction) regulates the Middle Jiao (Middle Burner); this diarrhea is located in the Lower Jiao (Lower Burner). This formula is indicated for it. If the diarrhea still does not stop after taking this formula, one should promote urination to treat it.

Chishizhi (Halloysitum Rubrum, Red Halloysite) [1 jin]
Taiyi Yuyuliang (Yuyuliang, Hematite) [1 jin]

Take the above two herbs, add six sheng of water, boil to obtain two sheng, remove the dregs, and divide into three doses.

Song says: Chishizhi and Yuyuliang each use one jin; this formula delights in treating Lower Jiao diarrhea. When Lizhong is ineffective, this method is suitable; filling the bottom of the stove, as heard from the ancients.

Zhanglingshao states: Stone minerals have a sinking nature, thus they are used to treat Lower Jiao diarrhea, not merely for astringency. The Lower Jiao separates clear from turbid fluids, allowing them to seep into the Bladder; therefore, disharmony in the Lower Jiao can also lead to a sensation of fullness.

Keyunbo states: Gancao (Licorice Root), Ganjiang (Dried Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Rhizome) can tonify the deficiency of Yuanqi (Original Qi) in the Middle Palace (Spleen/Stomach), but they are insufficient to secure the slippage of the Lower Jiao's essence. This diarrhea is in the Lower Jiao, formed by the condensation of Earth's essence. It solidifies the Stomach and astringes the intestines. Urgently treating the branch symptom in the Lower Jiao is actually cultivating the root in the Middle Palace. One must know that in this syndrome, Earth is deficient while Fire is not excessive; thus, Ganjiang and Fuzi (Prepared Aconite Root) are unsuitable. If dampness is severe and deficiency is not significant, yet diarrhea persists, then promoting urination is indicated. He further states: All herbal medicines inherit...

Treats cases after sweating, vomiting, or purging, where there is a sensation of fullness and hardness in the epigastrium and belching that does not cease. This formula is indicated.

Xuanfuhua (Inulae Flos, Inula Flower) [3 liang]
Daizheshi (Hematitum, Hematite) [1 liang]
Renshen (Ginseng Root) [2 liang]
Gancao (Licorice Root) [3 liang, honey-fried]
Banxia (Pinelliae Rhizoma, Pinellia Tuber) [0.5 sheng, raw]
Shengjiang (Zingiberis Rhizoma Recens, Fresh Ginger) [5 liang]
Dazao (Jujubae Fructus, Jujube Fruit) [12 pieces]

Take the above seven herbs, add ten dou of water, boil to obtain six sheng, remove the dregs, and decoct again to obtain three sheng. Take one sheng warm, three times daily. (Note: In Neitai Fang, Daizheshi is used in 5 liang, and Banxia is used only in 2 liang.)

Song says: Five liang of Shengjiang and half a sheng of Banxia; with three liang each of Gancao and Xuanfuhua, belching can be relied upon to cease. Two liang of Renshen and one liang of Daizheshi; twelve pieces of Dazao make the efficacy complete.

Yulinzhou states: This is a variation of Shengjiang Xiexin Tang (Fresh Ginger Drain the Epigastrium Decoction). Both clauses mention "fullness and hardness in the epigastrium," but Shengjiang Xiexin Tang focuses on Water-Qi flowing downward causing diarrhea, whereas Xuafu Daizhe Tang focuses on Stomach Deficiency carrying Phlegm-Fluid upward causing belching. To treat Water-Qi flowing downward causing diarrhea, one must use Shengjiang to disperse Water. For Stomach Deficiency carrying Phlegm-Fluid causing belching, one must use Daizheshi to suppress rebellion. Comparing these two clauses reveals the subtlety of Zhang Zhongjing's formula construction.

Luodongyi says: This formula is a sacred prescription for treating Zhengxu (Righteous Qi Deficiency) where Qi does not return to its origin, thereby governing the ascending and descending of Qi. Generally, after sweating, vomiting, or purging, although the pathogenic factor is gone, the Stomach Qi is significantly damaged. Since Stomach Qi is deficient, the Sanjiao (Triple Burner) also fails in its duties. Yang has no place to reside and cannot ascend; Yin has no place to receive and cannot descend. Thus, turbid pathogens remain stagnant, and latent Phlegm-Fluid rebels upward, resulting in epigastric fullness/hardness and persistent belching. In the formula, Renshen and Gancao nourish righteousness and tonify deficiency; Shengjiang and Dazao harmonize the Spleen and nourish the Stomach, thereby stabilizing the Middle Jiao to the utmost degree. Furthermore, Daizheshi, inheriting the sweetness of Earth and being heavy in nature, gathers floating Yang and suppresses rebellion, leading Renshen's Qi to descend. Xuanfuhua, being pungent and moistening, opens the Lungs and clears Phlegm-Fluid, assisting Banxia in eliminating Phlegm-Fluid above. Without these two herbs to coordinate the upper and lower, how could belching be eliminated and epigastric fullness resolved? Observing Zhang Zhongjing's treatment of Lower Jiao Water-Qi flooding upward causing tremors and a desire to fall, he uses Zhenwu Tang (True Warrior Decoction) to suppress it; for diarrhea in the Lower Jiao due to Large Intestine slippage, he uses Chishizhi Yuyuliang Tang to secure the Lower Jiao. Each method is exquisitely effective.