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Chenpi (Citri Reticulatae Pericarpium) and Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi circulates Sha Qi (pathogenic factors associated with "Sha" syndrome), while Qingpi attacks Liver Qi. For cases where Sha Qi is congested, obstructed, and stagnated without moving, these two herbs are indispensable for promoting flow. Zhike (Aurantii Fructus) and Zhishi (Aurantii Fructus Immaturus), break Sha Qi, drive out toxic vapors, eliminate distension, and direct food Qi downward. For conditions of accumulation and congestion, these two are essential for opening the blockage. Zhike has a mild nature, whereas Zhishi acts rapidly; each has its specific indications. Jingjie (Schizonepetae Herba), penetrates the muscle layer to release the exterior and dissipates Sha toxins. For cases where Sha vessels are faintly visible but fail to erupt, this herb is necessary for manifestation. Fangfeng (Saposhnikoviae Radix), penetrates the muscle layer to release the exterior, serving as an assistant or envoy herb. For alternating chills and fever, and Sha toxins that are congested, stagnant, and suppressed from erupting, this herb is required for clearing. Chaihu (Bupleuri Radix), harmonizes the exterior and interior, specifically treating alternating chills and fever in the Shaoyang Gallbladder channel. Qianhu (Peucedani Radix), disperses wind, eliminates phlegm, and treats coughs; suitable for exterior heat. Gegen (Puerariae Lobatae Radix), disperses pathogenic factors in the Yangming Stomach channel and also relieves thirst. Zhipu (Magnoliae Officinalis Cortex), expands the middle jiao to treat vomiting, eliminates phlegm, and directs Qi downward. Bohe (Menthae Haplocalycis Herba), pungent and cool, benefits orifices, reduces swelling, resolves toxicity, clears Qi, and soothes the throat. Zisu (Perillae Folium), disperses wind and regulates Qi; should be used when there is body heat. Duhuo (Angelicae Pubescentis Radix), disperses and treats heat; its action reaches only to the neck and does not extend further, preventing excessive dispersion, and it can invigorate blood and resolve Sha toxins, making it one of the most important herbs. Xixin (Asari Radix et Rhizoma), is a miraculous herb for penetrating orifices and dispersing Sha toxins; do not doubt it due to its pungent taste.

(Fen) Commentary: Xixin is extremely dispersing and can deplete True Qi; overdose can be fatal. For robust individuals with severe Sha syndrome, the dose should generally not exceed one qian (approx. 3-5g); for the elderly, children, or those who are weak, the dosage should be reduced accordingly.

Jiegeng (Platycodonis Radix), enters the Lung channel; its nature moves upward and then downward, thus it can guide Zhike to break Qi stagnation in the highest part of the chest. Xiangfu (Cyperi Rhizoma), moves Qi within the blood. Because of its aromatic dryness, it requires processing: wine-fried to move blood, vinegar-fried to astringe blood. Yanhusuo (Corydalis Rhizoma), invigorates blood and moves Qi, regulating pain caused by blood and Qi stagnation; Wulingzhi (Trogopterori Faeces), excels at eliminating old blood; for blood clots that are stagnant and do not disperse, this herb is necessary to break them. Yujin (Curcumae Longae Radix), enters the Heart channel to dissipate depression and resolve stasis; for Sha toxins attacking the Heart, this herb is essential for efficacy (currently, due to high cost, Jianghuang [Curcumae Longae Rhizoma] is often used as a substitute, but it is ultimately inferior). Muxiang (Aucklandiae Radix), moves stagnant Qi, dries dampness, drives out cold, and opens depression; for post-Sha abdominal pain that persists, this is a key herb. Sharen (Amomi Fructus), smooths Qi, opens depression, disperses Sha, and aids digestion; it can be used throughout the course of treatment. Wuyao (Linderae Radix), excellently moves Qi throughout the body; wherever Sha syndrome causes obstruction, this herb reaches all places. Qinjiao (Gentianae Macrophyllae Radix), invigorates blood, dispels wind, and eliminates Sha toxin-induced bone and joint pain; for robust individuals with unresolved pathogens, this herb is necessary for relief. Lianqiao (Forsythiae Fructus), eliminates Sha toxins, clears fire pathogens in all channels, clears heat without causing stagnation, and is a key herb for treating Sha syndrome. Zhizi (Gardeniae Fructus), cools the Heart and removes fire; usable for macules eruption and red Sha roots. Beimu (Fritillariae Bulbus), Chuanbeimu specifically treats hot phlegm, Tubei also breaks blood stasis. Baijiexi (Sinapis Semen), reaches phlegm under the hypochondrium; this herb is necessary for its effect. Tandong (Asparagi Radix) and Maidong (Ophiopogonis Radix), moisten the Lung and eliminate phlegm; one treats the root, the other the branch (remove the heart). Xingren (Armeniacae Semen Amarum), drains the Lung, moistens the intestines and stomach, promotes Qi movement, and eliminates phlegm saliva (remove skin and tips). Sangbaipi (Mori Cortex) and Dudiling (Aristolochiae Manshuriensis Radix), treat coughs and drain the Lung.

(Fen) Commentary: Dudiling clears heat and descends Qi, but is strictly contraindicated for deficiency of the Lung with cold. I have heard physicians say: When treating coughs, Hezi (Terminalia Chebulae Fructus) and Dudiling are forbidden.

Chishao (Paeoniae Radix Rubra), usable for blood heat causing macules. Chenxiangyuan, usable for breaking knotted Qi. Danshen (Salviae Miltiorrhizae Radix), is also a blood-invigorating agent; ShanZha (Crataegi Fructus), Laofuzi (Raphani Semen), Maiya (Hordei Fructus Germinatus), Shenqu (Massa Medicata Fermentata), for Sha caused by food congestion, excel at digestion without being violent. Honghua (Carthami Flos), Qiancao (Rubiae Cordifoliae Radix), and Yinhua (Lonicerae Japonicae Flos), invigorate blood and resolve Sha toxins. Taoren (Persicae Semen), breaks stasis and invigorates blood; for blood stasis blocking flow, this herb is necessary for circulation. For Sha caused by blood stagnation, this herb ensures smoothness. Sumu (Sappan Lignum), no other herb matches it for removing foul blood and fresh stasis. Sanleng (Sparganii Rhizoma) and Ezhu (Curcumae Rhizoma), suitable for food accumulation causing heart pain and Sha toxin obstruction leading to fullness and oppression. Niuxi (Achyranthis Bidentatae Radix), invigorates blood and guides Sha Qi downward. Xiangru (Elsholtziae Herba), connects the upper and lower, promotes urination, and is a key herb for summerheat injury (details in Jin San Fang). Niubangzi (Arctii Fructus), resolves Sha toxins, clears the throat, and is a key herb in Sha syndrome. Liujinu (Artemisiae Annuae Herba), disperses blood stasis, resolves Sha toxins, and directs Qi downward.

Chan Zhi Yao Po Wei Ming Tang Shan Jia Li Xia Xue Qing Re Tian Xian Zi

Commentary: Jingjie, Xixin, Fangfeng: The chills and fever in Sha syndrome are not caused by external contraction; the toxin enters via the nose and battles the muscle layer. Jingjie and Xixin excellently penetrate orifices, allowing toxins that entered via orifices to exit through them. Fangfeng serves as an assistant/envoy, unlike Mahuang (Ephedrae Herba) and Qianghuo (Notopterygii Rhizoma et Radix) which focus solely on releasing the exterior, thereby avoiding the risk of raising fire toxins.