少阴病。得之二三日以上。心中烦。不得卧。黄连阿胶汤主之。
少阴之热。有从阳经传入者。有自受寒邪。久而变热者。曰二三日以上。谓自二三日至五六
日。或八九日。寒极而变热也。至心中烦不得卧。则热气内动。尽入血中。而诸阴蒙其害矣。盖阳
经之寒变。则热归于气。或入于血。阴经之寒变。则热入于血。而不归于气。此余历试之验也。故
用黄连、黄芩之苦。合阿胶、芍药、鸡子黄之甘。并入血中。以生阴气。而除邪热。成氏所谓阳有
余。以苦除之。阴不足。以甘补之是也。
黄连阿胶汤方
黄连（四两） 黄芩（一两） 芍药（二两） 阿胶（三两） 鸡子黄（二枚）
上五味。以水五升。先煮三物。取二升。去滓。纳阿胶。烊尽小冷。内鸡子黄。搅令相得。温服
七合。日三服。
少阴病。四逆。其人或咳。或悸。或小便不利。或腹中痛。或泄利下重者。四逆散主
之。
四逆、四肢逆冷也。此非热厥。亦太阳初受寒邪。未郁为热。而便入少阴之证。少阴为三阴之
枢。犹少阳为三阳之枢也。其进而入则在阴。退而出则就阳。邪气居之。有可进可退时上时下之势
。故其为病。有
或咳。或悸。或小便不利。或腹中痛。或泄利下重之证。夫邪在外者。可引而散之。在内者。可下
而去之。其在外内之间者。则和解而分消之。分消者。半从外半从内之谓也。故用柴胡之辛。扬之
使从外出。枳实之苦。抑之使其内消。而其所以能内能外者。则枢机之用为多。故必以芍药之酸益
其阴。甘草之甘养其阳。曰四逆者。因其所治之病而命之名耳。而其制方大意。亦与小柴胡相似。四
逆之柴胡、枳实。犹小柴胡之柴胡、黄芩也。四逆之芍药、甘草。犹小柴胡之人参、甘草也。且枳
实兼擅涤饮之长。甘、芍亦备营卫两和之任。特以为病有阴阳之异。故用药亦分气血之殊。而其辅
正逐邪。和解表里。则两方如一方也。旧谓此为治热深发厥之药。非是。夫果热深发厥。则属厥应下
之之例矣。岂此药所能治哉。
四逆散方
柴胡 枳实（破水渍炙干） 芍药 甘草（炙）
上四味。各十分。捣筛。白饮和服方寸匕。日三服。
加减法
咳者。加五味子、干姜各五分。并主下利。
成氏曰、肺寒气逆则咳。五味子之酸收逆气。干姜之辛散肺寒。并主下利者。肺与大肠为表里
。上咳下利。治则颇同。
悸者。加桂枝五分。
悸者寒多。心脉不通则心下鼓也。桂枝辛温。入心通阳气。
小便不利者。加茯苓五分。
小便不利。水聚于下也。茯苓甘淡。利窍渗水。
腹中痛者。加附子一枚。炮令坼。
腹中痛。寒胜于里也。附子辛温。散寒止痛。
泄利下重者。先以水五升。煮薤白三升。煮取三升。去滓。以散三方寸匕内汤中。煮取一升
半。分温再服。泄利下重。寒滞于下也。薤白辛温。散寒通阳气。
少阴病。下利六七日。咳而呕渴。心烦不得眠者。猪苓汤主之。
少阴中寒。下利至六七日。寒变为热。而气复上行。为咳。为呕。为渴。为心烦不得眠。所谓
下行极而上也。夫邪气自下而上者。仍须从下引而出之。猪苓、茯苓、泽泻、滑石。并甘淡下行之
药。足胜导水泄热之用。然以阴病而属邪热。设非得阿胶之咸寒入阴。何以驭诸阳药而泄阴中之热
。导浮上之气哉。少阴病。下利咽痛。胸满心烦者。猪肤汤主之。
少阴之脉。从肾上贯肝膈。入肺中循喉咙。其支别者。从肺出络心。注胸中。阳邪传入少阴。
下为泄利。上为咽痛。胸满心烦。热气充斥脉中。不特泄伤本脏之气。亦且消烁心肺之阴矣。猪水
蓄而肤甘寒。其气味先入少阴。益阴除客热。止咽痛。故以为君。加白蜜之甘以缓急。润以除燥
而烦满愈。白粉之甘能补
中。温能养脏。而泄利止矣。
猪肤汤方
猪肤一斤。以水一斗。煮取五升。去滓。加白蜜一升。白粉五合。熬香。和相得。温分六服。
少阴病。咽中伤。生疮。不能语言。声不出者。苦酒汤主之。
少阴热气。随经上冲。咽伤生疮。不能语言。音声不出。东垣所谓少阴邪入于里。上接于心。
与火俱化而克金也。故与半夏之辛。以散结热止咽痛。鸡子白甘寒入肺。清热气通声音。苦酒苦酸
。消疮肿散邪毒也。
苦酒汤方
半夏十四枚。洗。破如枣核大。鸡子一枚。去黄。纳上苦酒。着鸡子壳中。纳半夏着苦酒中。
以鸡子壳置刀环中。安火上。令三沸。去滓。少少含咽之。不瘥。更作三剂服之。
少阴病。二三日。咽痛者。可与甘草汤。不瘥者。与桔梗汤。
此亦热传少阴。而上为咽痛之法。甘草汤甘以缓急。寒以除热也。其甚而不瘥者。则必以辛发
之。而以甘缓之。甘草、桔梗。甘辛合用。而甘胜于辛。治阴虚客热。其法轻重。当如是耳。
甘草汤方
甘草二两。以水三升。煮取一升半。去滓。温服七合。日二服。
桔梗汤方
桔梗（一两） 甘草（二两）
上二味。以水二升。煮取一升。去滓。分温再服。
少阴病。咽中痛。半夏散及汤主之。
少阴咽痛。甘不能缓者。必以辛散之。寒不能除者。必以温发之。盖少阴客邪。郁聚咽嗌之间
。既不得出。复不得入。设以寒治。则聚益甚。投以辛温。则郁反通。内经微者逆之。甚者从之之
意也。半夏散及汤。甘辛合用。而辛胜于甘。其气又温。不特能解客寒之气。亦能劫散咽喉怫郁之
热也。
半夏散及汤方
半夏（洗） 桂枝（去皮） 甘草（炙各等分）
上三味。各别捣筛已。合治之。白饮和服方寸匕。日三服。若不能散服者。以水一升。煎七
沸。内散两方。寸匕。更煎三沸。下火令小冷。少少咽之。
少阴病。发病两三天以上。出现心中烦乱。无法安卧的症状。应当用黄连阿胶汤来主治。
少阴经的热证，有从阳经传入的，也有因感受寒邪日久转化为热的。说“二三天以上”，是指从第二、三天到第五、六天，或者第八、九天，寒气极盛而转化为热邪。到了心中烦乱、无法安卧的地步，说明热气在内里躁动，全部进入血分，导致所有阴经都受到损害。大概阳经的寒邪转化，热邪归于气分，或者进入血分；阴经的寒邪转化，热邪直接进入血分，而不归于气分。这是我多次验证的经验。所以使用黄连、黄芩的苦味药，配合阿胶、芍药、鸡蛋黄的甘味药，共同进入血分，以滋生阴气，清除邪热。这就是成无己所说的“阳气有余，用苦味药清除它；阴气不足，用甘味药补益它”的道理。
黄连阿胶汤方
黄连（四两） 黄芩（一两） 芍药（二两） 阿胶（三两） 鸡蛋黄（两个）
以上五味药，用水五升，先煮前三味药，取药液二升，去掉药渣。放入阿胶，加热使其完全溶化，稍微冷却后，加入鸡蛋黄，搅拌均匀。每次温服七合，每天服用三次。
少阴病。出现四肢厥冷。有的病人伴有咳嗽，或者心悸，或者小便不通畅，或者腹部疼痛，或者腹泻且肛门有下坠重感。应当用四逆散来主治。
四逆，就是四肢逆冷。这不是热厥，也不是太阳经初受寒邪，尚未郁结为热就立即传入少阴的证候。少阴是三阴经的枢纽，就像少阳是三阳经的枢纽一样。邪气深入则进入阴分，外出则趋向阳分。邪气停留在这里，具有可进可退、时上时下的发展趋势。所以它的病症，有或咳嗽、或心悸、或小便不通畅、或腹部疼痛、或腹泻且肛门有下坠重感的表现。邪气在体表的，可以用发散的方法引邪外出；在体内的，可以用攻下的方法祛除邪气；在半表半里的，则用和解的方法分散消除。所谓分消，就是指一半从外解，一半从内消。所以使用柴胡的辛味，升扬使邪气从外排出；枳实的苦味，沉降使邪气从内消散。而之所以能兼顾内外，很大程度上归功于枢机的作用。所以必须用芍药的酸味来滋养阴气，用甘草的甘味来养护阳气。命名为“四逆”，是因为它所治疗的病症特征而得名。而这个方剂的大致思路，也和小柴胡汤相似。四逆散中的柴胡、枳实，相当于小柴胡汤中的柴胡、黄芩；四逆散中的芍药、甘草，相当于小柴胡汤中的人参、甘草。而且枳实兼有涤除痰饮的特长，甘草、芍药也具备调和营卫的职责。只是因为病情有阴阳的区别，所以用药也区分气血的不同。但它们扶助正气、驱逐邪气、和解表里的功效，这两个方子就像同一个方子一样。旧时说这是治疗热深厥深的药物，这种说法不对。如果真的是热深厥深，那就属于“厥应下之”的范畴了，哪里是这药所能治疗的呢？
四逆散方
柴胡 枳实（破开用水浸泡后炙干） 芍药 甘草（炙）
以上四味药，各取十分，捣碎过筛。用米汤送服一方寸匕的药粉，每天服用三次。
加减法
咳嗽的，加五味子、干姜各五分。同时也主治腹泻。
成无己说：肺寒气逆就会咳嗽。五味子的酸味可以收敛逆气，干姜的辛味可以疏散肺寒。同时主治腹泻，是因为肺与大肠互为表里。上面咳嗽下面腹泻，治疗原则大致相同。
心悸的，加桂枝五分。
心悸是因为寒邪较多，心脉不通畅导致心下部悸动。桂枝辛温，入心经通利阳气。
小便不通畅的，加茯苓五分。
小便不通畅，是水湿聚集在下焦。茯苓甘淡，能通利窍道渗出水湿。
腹部疼痛的，加附子一枚，炮制至裂开。
腹部疼痛，是因为寒邪胜过内部。附子辛温，能散寒止痛。
腹泻且肛门有下坠重感的，先用五升水，煮三升薤白，煮取三升药液，去掉药渣。将四逆散三方寸匕的药粉放入汤中，再煮取一升半药液，分两次温服。腹泻且肛门有下坠重感，是因为寒邪停滞在下焦。薤白辛温，能散寒通利阳气。
少阴病。腹泻六七天，伴有咳嗽、呕吐、口渴、心烦无法入睡的症状。应当用猪苓汤来主治。
少阴经受寒，腹泻到第六七天，寒邪转化为热邪，并且气机重新上行，导致咳嗽、呕吐、口渴、心烦无法入睡。这就是所谓的“下行至极点反而向上”。邪气自下而上，仍然需要从下方引导而出。猪苓、茯苓、泽泻、滑石，都是甘淡向下行的药物，足以胜任导水利尿、泄热的用途。然而因为是阴病却属于邪热，如果不是得到阿胶的咸寒之性入阴分，怎么能驾驭这些阳药来泄除阴分中的热邪，引导上浮的气机呢？
少阴病。腹泻、咽喉疼痛、胸部胀满、心烦的症状。应当用猪肤汤来主治。
少阴经脉，从肾脏向上贯穿肝脏和膈肌，进入肺中，沿喉咙走行。其分支从肺出来联络心脏，注入胸中。阳邪传入少阴，向下导致泄泻，向上导致咽喉疼痛、胸部胀满、心烦。热气充斥在脉管中，不仅耗伤本脏的气，而且消耗心肺的阴液。猪皮味甘性寒，其气味首先作用于少阴经，能滋补阴液、清除客热、止住咽喉疼痛，所以作为君药。加上白蜜的甘味来缓解急迫，滋润以去除燥热，那么烦闷感就会痊愈。米粉的甘味能补益中气，温性能滋养脏腑，那么腹泻也就停止了。
猪肤汤方
猪皮一斤，用水一斗，煮取五升药液，去掉药渣。加入白蜜一升，米粉五合，熬至香气溢出，混合均匀。分六次温服。
少阴病。咽喉受伤，生疮，不能说话，声音发不出来的症状。应当用苦酒汤来主治。
少阴经的热气，随着经脉上冲，导致咽喉受伤生疮，不能说话，声音发不出来。李东垣所说少阴邪气入里，上接于心，与火结合而克制肺金（金主声）。所以用半夏的辛味，来散结清热、止住咽喉疼痛；鸡蛋清甘寒入肺经，能清热气的阻滞、恢复声音；苦酒（醋）苦酸，能消除疮肿、散发邪毒。
苦酒汤方
半夏十四枚，洗净，破开如枣核大小。鸡蛋一个，去掉蛋黄，将剩下的蛋清放入蛋壳中，加入苦酒（醋），把半夏放入苦酒中。将装有药液的蛋壳放在刀环上，置于火上，煮沸三次。去掉药渣，少量含咽。如果不愈，再制作三剂服用。
少阴病。发病两三天，咽喉疼痛的，可以给予甘草汤。如果不愈的，给予桔梗汤。
这也是热邪传入少阴，向上导致咽喉疼痛的治疗方法。甘草汤用甘味来缓解急迫，用寒性来清除热邪。如果病情严重且不愈的，就必须用辛味药发散它，并用甘味药缓和它。甘草、桔梗，甘辛合用，而甘味胜于辛味。治疗阴虚导致的客热，方法的轻重应当如此。
甘草汤方
甘草二两，用水三升，煮取一升半药液，去掉药渣。温服七合，每天服用两次。
桔梗汤方
桔梗（一两） 甘草（二两）
以上两味药，用水二升，煮取一升药液，去掉药渣，分两次温服。
少阴病导致的咽喉疼痛，如果用甘味药不能缓解的，必须用辛味药来发散它；如果用寒性药不能清除的，必须用温性药来发散它。大概是少阴经受客邪侵袭，郁结聚积在咽喉之间，既不能排出，也不能摄入。如果用寒凉药治疗，郁结会更甚；投以辛温药，郁结反而通畅。这正是《内经》所说的“轻微的用逆治法，严重的用顺治法”的意思。半夏散及汤，甘辛合用，而辛味胜于甘味，其药气又是温性的，不仅能解除客寒之气，也能劫散咽喉部怫郁的热邪。
半夏散及汤方
半夏（洗） 桂枝（去皮） 甘草（炙，各等分）
以上三味药，分别捣碎过筛后，混合在一起。用米汤送服一方寸匕的药粉，每天服用三次。如果不能服用散剂的，用水一升，煎煮七沸，加入散剂两方寸匕，再煎煮三沸，熄火稍冷却，少量频服。
Shaoyin disease. After two or three days of onset, if the patient experiences mental restlessness (xin zhong fan) and inability to sleep (bu de wo), it should be treated with Huanglian Ejiao Tang (Coptis and Donkey-Hide Gelatin Decoction).
The heat syndrome in Shaoyin may transmit from Yang meridians, or it may arise from cold pathogenic factors lingering for a long time and transforming into heat. "Two or three days or more" refers to the period from the second or third day up to the fifth, sixth, or even eighth or ninth day, where extreme cold transforms into heat. When the condition progresses to mental restlessness and insomnia, it indicates that heat qi is agitating internally and fully entering the blood level, thereby harming all Yin aspects. Generally, when cold in Yang meridians transforms, the heat returns to the Qi level or enters the Blood level; however, when cold in Yin meridians transforms, the heat directly enters the Blood level without returning to the Qi level. This is an experience verified through repeated clinical practice. Therefore, the bitter properties of Huanglian (Coptidis Rhizoma) and Huangqin (Scutellariae Radix) are combined with the sweet properties of Ejiao (Asini Corii Colla), Shaoyao (Paeoniae Radix Alba), and Ji Zi Huang (Ovi Galli Albumen) to enter the blood level, generate Yin qi, and eliminate pathogenic heat. This aligns with Cheng Wuji's statement: "When Yang is in excess, use bitter substances to clear it; when Yin is deficient, use sweet substances to tonify it."
Huanglian Ejiao Tang Formula
Huanglian (4 liang), Huangqin (1 liang), Shaoyao (2 liang), Ejiao (3 liang), Ji Zi Huang (2 units).
Take the above five ingredients. Add 5 sheng of water, first decoct the first three ingredients until 2 sheng remains. Strain the dregs. Dissolve Ejiao completely while warm, then cool slightly. Add Ji Zi Huang and stir well to mix. Take 7 he of the decoction warm, three times daily.
Shaoyin disease characterized by Si Ni (cold extremities). The patient may also present with cough (ke), palpitations (ji), difficulty urinating (xiao bian bu li), abdominal pain (fu zhong tong), or diarrhea with a sensation of heaviness in the rectum (xie li xia zhong). It should be treated with Sini San (Four Counterflow Powder).
Si Ni refers to cold extremities. This is not Heat Jue (cold extremities due to deep heat); nor is it Taiyang disease where cold has just been acquired and entered Shaoyin before stagnating into heat. Shaoyin serves as the pivot of the Three Yin meridians, just as Shaoyang serves as the pivot of the Three Yang meridians. Pathogens advancing enter Yin, while retreating they move toward Yang. With pathogens residing here, there is a dynamic potential for advancement or retreat, moving up or down at different times. Consequently, symptoms may include cough, palpitations, difficulty urinating, abdominal pain, or diarrhea with rectal heaviness. For pathogens in the exterior, they can be guided out via dispersing methods; for those in the interior, they can be purged downward; for those between exterior and interior, harmonizing and distributing methods are used. "Distributing" implies resolving half from the exterior and half from the interior. Thus, Chaihu (Bupleuri Radix) with its acrid property lifts and guides pathogens outward, while Zhishi (Aurantii Fructus Immaturus) with its bitter property suppresses and resolves them inward. The ability to address both exterior and interior relies heavily on the function of the pivot mechanism. Therefore, Shaoyao (Paeoniae Radix Alba) with its sour property nourishes Yin, and Gancao (Glycyrrhizae Radix et Rhizoma) with its sweet property nourishes Yang. The name "Si Ni" is derived from the primary symptom it treats. The general principle of this formula resembles Xiao Chaihu Tang (Minor Bupleurum Decoction). Chaihu and Zhishi in Sini San correspond to Chaihu and Huangqin in Xiao Chaihu Tang; Shaoyao and Gancao in Sini San correspond to Renshen (Panacis Ginseng Radix) and Gancao in Xiao Chaihu Tang. Furthermore, Zhishi excels at clearing phlegm-fluids, while Gancao and Shaoyao harmonize Ying and Wei. Due to differences in Yin and Yang pathology, the medications differentiate between Qi and Blood effects. However, their functions in supporting healthy Qi, expelling pathogens, and harmonizing the exterior and interior make these two formulas functionally similar. Old theories claiming this formula treats "deep heat causing cold extremities" (Re Shen Fa Jue) are incorrect. If it were truly deep heat causing cold extremities, it would fall under the category requiring purgation ("Jue Ying Xia Zhi"), which this formula cannot treat.
Sini San Formula
Chaihu, Zhishi (broken, soaked in water, and dried after roasting), Shaoyao, Gancao (roasted).
Take the above four ingredients, each in ten parts. Pound and sieve them. Mix with rice water and administer one Fang Cun Bi (approx. 9 grams) per dose, three times daily.
Modifications
If coughing occurs, add Wuweizi (Schisandrae Fructus) and Ganjiang (Zingiberis Rhizoma) each in five parts. This modification also treats diarrhea.
Cheng Wuji stated: Lung cold with rebellious Qi causes cough. Wuweizi's sour astringency directs rebellious Qi downward, and Ganjiang's acridity disperses Lung cold. They simultaneously treat diarrhea because the Lung and Large Intestine are exterior-interior pairs. Upper cough and lower diarrhea share similar treatment principles.
If palpitations occur, add Guizhi (Cinnamomi Ramulus) in five parts.
Palpitations indicate excessive cold and blocked Heart vessels causing pulsation in the epigastrium. Guizhi is acrid and warm, enters the Heart meridian, and unblocks Yang Qi.
If difficulty urinating occurs, add Fuling (Poria) in five parts.
Difficulty urinating indicates water accumulation in the lower jiao. Fuling is sweet and bland, promoting diuresis through pore opening and fluid seepage.
If abdominal pain occurs, add Fuzi (Aconiti Lateralis Radix Praeparata) one piece, processed until cracked.
Abdominal pain indicates severe cold in the interior. Fuzi is acrid and warm, dispersing cold and relieving pain.
If diarrhea with rectal heaviness occurs, first decoct Xiebai (Allii Macrostemonis Bulbus) in 5 sheng of water using 3 sheng of Xiebai until 3 sheng remains. Strain. Add three Fang Cun Bi of Sini San powder to the decoction. Boil until 1.5 sheng remains. Divide into two warm doses. Rectal heaviness in diarrhea indicates cold stagnation in the lower jiao. Xiebai is acrid and warm, dispersing cold and unblocking Yang Qi.
Shaoyin disease with diarrhea lasting six or seven days, accompanied by cough, vomiting, thirst, mental restlessness, and insomnia. It should be treated with Zhu Ling Tang (Polyporus Decoction).
In Shaoyin cold damage, if diarrhea persists for six or seven days, the cold may transform into heat, and the Qi may rebel upward, causing cough, vomiting, thirst, mental restlessness, and insomnia. This is described as "extreme downward movement leading to upward reversal." Since the pathogen moves from below to above, it must still be guided out from below. Zhu Ling (Polyporus), Fuling (Poria), Zexie (Alismatis Rhizoma), and Huashi (Talcum) are sweet and bland herbs that descend, effectively guiding water and draining heat. However, since this is a Yin disease involving pathogenic heat, without the salty-cold nature of Ejiao (Donkey-Hide Gelatin) entering the Yin level, how could one harness these Yang-moving herbs to drain heat from the Yin and guide floating Qi downward?
Shaoyin disease with diarrhea, sore throat, chest fullness, and mental restlessness. It should be treated with Zhu Fu Tang (Pig Skin Decoction).
The Shaoyin meridian ascends from the Kidney, passes through the Liver and Diaphragm, enters the Lung, and follows the throat. A branch emerges from the Lung, connects to the Heart, and pours into the chest. When Yang pathogens transmit to Shaoyin, they cause diarrhea downward and sore throat, chest fullness, and restlessness upward. Heat qi fills the vessels, damaging the organ's Qi and consuming the Yin of the Heart and Lung. Pig skin (Zhu Fu) is sweet and cold; its flavor acts primarily on the Shaoyin meridian, nourishing Yin, clearing exogenous heat, and stopping sore throat, thus serving as the Sovereign herb. Adding Bai Mi (White Honey) soothes urgency and moistens dryness, resolving fullness and restlessness. Bai Fen (Rice Flour) is sweet and tonifies the Middle, while its warmth nourishes the organs, stopping diarrhea.
Zhu Fu Tang Formula
Zhu Fu (Pig Skin) 1 jin. Decoct in 1 dou of water until 5 sheng remains. Strain. Add Bai Mi (White Honey) 1 sheng and Bai Fen (Rice Flour) 5 he. Cook until fragrant, mix well. Divide into six warm doses.
Shaoyin disease with injury to the throat, formation of sores, inability to speak, and loss of voice. It should be treated with Ku Jiu Tang (Bitter Wine Decoction).
Shaoyin heat qi rushes upward along the meridian, injuring the throat and forming sores, leading to aphonia and voice loss. As Li Dongyuan stated, Shaoyin pathogens entering the interior connect with the Heart, combining with Fire to impair Metal (Lung, which governs voice). Therefore, Banxia (Pinelliae Rhizoma) is used for its acridity to dissipate nodulated heat and stop sore throat. Ji Zi Bai (Ovi Gallii Albumen) is sweet and cold, entering the Lung to clear heat and restore voice. Ku Jiu (Vinegar) is bitter and sour, reducing swelling and dispersing pathogenic toxins.
Ku Jiu Tang Formula
Banxia 14 pieces, washed and broken like dates. One egg, remove yolk. Place egg white in the shell, add Ku Jiu (vinegar), and put Banxia into the vinegar within the shell. Place the shell in a knife ring over fire. Boil three times. Strain. Gargle and swallow slowly. If not healed, prepare three more doses.
Shaoyin disease presenting with sore throat after two or three days. Give Gancao Tang (Licorice Decoction). If not relieved, give Jiegeng Tang (Platycodon Decoction).
This is the method for treating sore throat caused by heat transmitting to Shaoyin. Gancao Tang uses sweetness to relieve urgency and coldness to clear heat. If severe and unrelieved, acrid herbs must be used to disperse and sweet herbs to moderate. Gancao and Jiegeng (Platycodonis Radix) are combined, with sweetness predominating over acridity. This approach is appropriate for treating deficiency-heat from exogenous pathogens, balancing light and heavy treatments.
Gancao Tang Formula
Gancao 2 liang. Decoct in 3 sheng of water until 1.5 sheng remains. Strain. Take 7 he warm, twice daily.
Jiegeng Tang Formula
Jiegeng (1 liang), Gancao (2 liang).
Decoct the above two ingredients in 2 sheng of water until 1 sheng remains. Strain. Divide into two warm doses.
Shaoyin disease with sore throat. It should be treated with Banxia San Ji Tang (Pinellia Powder and Decoction).
For sore throat in Shaoyin disease, if sweetness fails to relieve urgency, acridity must be used to disperse. If coldness fails to clear heat, warmth must be used to vent. Exogenous pathogens in Shaoyin stagnate in the throat, unable to exit or enter. Using cold herbs would worsen stagnation; using acrid-warm herbs would open the stagnation. This reflects the Nei Jing principle: "For mild conditions, use contrary treatment; for severe conditions, follow the pathogen." Banxia San Ji Tang combines acrid and sweet flavors, with acridity prevailing, and possesses warm properties. It not only dispels exogenous cold but also vents stagnant heat in the throat.
Banxia San Ji Tang Formula
Banxia (washed), Guizhi (bark removed), Gancao (roasted), equal parts.
Pound and sieve each ingredient separately, then mix. Administer one Fang Cun Bi mixed with rice water, three times daily. If powder form is difficult to take, decoct in 1 sheng of water for seven boils. Add two Fang Cun Bi of powder. Boil three more times. Remove from heat, let cool slightly, and swallow slowly in small amounts.