典藏书目

After deliberation, among the herbs listed in the aforementioned prescriptions, Mangxiao (Natrii Sulfas) must absolutely not be used. As for Daihzshi (Haematitum), it may be used before the third month of pregnancy but should not be used after that. Although the remaining herbs are all usable, it is ultimately advisable to first use Baihu Tang (White Tiger Decoction) or Baihu Jia Renshen Tang (White Tiger Decoction plus Ginseng) instead of Chengqi Tang (Purgative Decoctions). Even if complete cure is not achieved initially, subsequent use of Chengqi Tang will be more effective.

I once treated a woman who was over five months pregnant and contracted Shanghan syndrome (Cold Damage disease). After eight or nine days, her pulse was surging, forceful, and full; she experienced internal heat with irritability and restlessness, and had not had a bowel movement since the onset of illness. There seemed to be hardened feces above her umbilicus, which caused slight pain upon pressure. Due to excessive internal heat, I first administered Baihu Jia Renshen Tang to clear the heat. After taking two doses, the internal heat significantly decreased, yet the area above the umbilicus appeared more swollen and painful even without pressure. It became evident that purgative herbs were necessary. However, having taken two doses of Baihu Jia Renshen Tang, I knew that although her stool was hard, it was not extremely dry. A mild purgative treatment should suffice. Therefore, I prescribed a formula containing Dahuang (Rhei Radix et Rhizoma) and Yetairenshen (Wild Panax ginseng C. A. Mey.) each at 3 qian, Zhen Ejiao (Donkey-hide Gelatin, prepared separately by stewing and added to the decoction), and Tiantong (Asparagi Radix) each at 5 qian. The decoction was taken orally. Immediately after ingestion, she felt relief above the umbilicus. One hour later, the pain ceased. Half an hour later, she passed over ten pieces of hardened feces, followed by loose stools, and she recovered completely. Her fetal qi remained undisturbed, and she delivered successfully at term.

Regarding the rationale of this prescription: Dahuang can purge hardened feces, while Renshen controls its action, preventing damage to the fetus. Ejiao is added as an assistant herb because it is excellent for stabilizing the fetus and moistening the intestines, thereby alleviating intestinal dryness. Tiantong is used for its cool, moistening, and slightly acrid nature (which reveals an acrid taste when chewed thoroughly); it descends effectively to moisten dryness and resolve stasis, while also counteracting the heating properties of Renshen.

The Yangming channel originally belongs to Dry Metal; thus, its diseases often manifest as dry-heat. Baihu Tang and various Chengqi Tang formulas are designed to resolve Yangming dry-heat. However, while dry-heat is the standard pathology of Yangming, damp-heat occasionally occurs as a variant pathology. What exactly is this variant pathology? It refers to the jaundice syndromes described in the Yangming chapter of the Shanghan Lun. Let us discuss this in further detail.

The original text of the Shanghan Lun states: "In Yangming disease, if there is fever and sweating, this indicates that the heat is venting outward, and jaundice will not occur. If there is only sweating on the head, no sweating on the body, and the sweating stops at the neck, accompanied by dysuria and thirst prompting the intake of fluids, this indicates stagnant heat trapped inside, and jaundice will inevitably develop. Yinchen Hao Tang should be used to treat this."

When Yangming disease presents with fever and sweating, the heat vents outward, and dampness follows suit, so jaundice does not occur. If the heat does not vent outward but remains internally accumulated, combined with dysuria and excessive water intake, dampness and heat will combine to produce jaundice, resulting in yellowing of the entire body. Yinchen Hao Tang is indicated because it excels at resolving damp-heat.

[Yinchen Hao Tang Formula] Yinchen Hao (Artemisiae Scopariae Herba) 6 liang, Zhizi (Gardeniae Fructus) 14 fruits (split), Dahuang 2 liang (peeled).
Take the three ingredients, add one dou of water, first decoct Yinchen Hao until the volume reduces by six sheng, then add the other two ingredients, and decoct until three sheng remain. Strain the dregs, and divide into three warm doses. After administration, urination will increase, urine will resemble sapogen juice and appear bright red, abdominal distension will decrease overnight, and the jaundice will exit via urination.

Yinchen has a cold nature and bitter taste, possessing a rising and dispersing qi. Its coldness overcomes heat, and its bitterness overcomes dampness. Its rising and dispersing quality drives internally accumulated damp-heat outward, making it the principal herb for damp-heat jaundice. Zhizi and Dahuang serve as assistant herbs because they are also bitter and cold. Furthermore, Zhizi guides heart fire downward through convoluted pathways to promote diuresis. The pigment of Dahuang penetrates directly into the bladder (whenever Dahuang is taken, the urine takes on the color of Dahuang, which is clear evidence of its diuretic effect); thus, even in small doses, it promotes diuresis well. Although Yinchen possesses ascending and dispersing properties, the Mingyi Bielu also states it promotes diuresis. The combination of these three herbs guides internally accumulated heat out through urination, ensuring immediate efficacy upon administration.

The original text of the Shanghan Lun states: "After seven or eight days of Cold Damage, if the body is yellow like the color of an orange, accompanied by dysuria and slight abdominal fullness, Yinchen Hao Tang should be used."

Body yellowing like an orange, abdominal fullness, and dysuria indicate that the condition arises from damp-heat; therefore, Yinchen Hao Tang is also the appropriate treatment.