典藏书目

Cinnamon Twig (Guizhi) four liang, Licorice Root (Gancao) four liang, Ginseng Root (Renshen) three liang, Atractylodes Rhizome (Baizhu) three liang, Dried Ginger (Ganjiang) three liang. Use nine sheng of water, first decoct the initial four herbs, reduce to five sheng, then add Cinnamon Twig and decoct until three sheng remain. Take twice during the day and once at night.

Pueraria Root (Gegen) half jin, Coptis Rhizome (Huanglian) three liang, Scutellaria Root (Huangqin) three liang, Roasted Licorice Root (Zhi Gancao) two liang. Use eight sheng of water, first decoct Pueraria Root until the volume decreases by two sheng; then add the remaining herbs and decoct until two sheng remain. Divide into two doses and take warm.

[Collected Annotations] Ke Qin stated: The persistence of external heat indicates that the exterior syndrome is not resolved; the continuous dysentery indicates that the interior syndrome is not resolved. Although the etiology is the same, one presentation features a faint pulse with epigastric fullness and hardness, signifying deficiency of righteous qi and excess of pathogenic factors. The other presentation features a rapid-intermittent pulse accompanied by panting and spontaneous sweating, signifying excess in the pulse but deficiency in the condition. The differentiation of exterior/interior and deficiency/excess must be based on the pulse. When a faint pulse appears after multiple erroneous purgative treatments, the epigastric fullness and hardness are due to deficiency. Therefore, the acrid-sweet-warm tonifying method of Lizhong Tang (Regulate the Middle Decoction) is used to stop dysentery and dissipate epigastric fullness, combined with Cinnamon Twig to release the exterior. By decocting the first four herbs first and adding Cinnamon Twig later, the power to harmonize the middle is robust, while the energy to release the muscle layer is sharp; this embodies a flexible approach within simultaneous resolution of both layers. The pulse for Cinnamon Twig syndrome should originally be slow; after erroneous purgation, it becomes rapid-intermittent, indicating excessive yang. It can be inferred that pathogens are constrained at the exterior while yang is disturbed internally. Thus, panting, sweating, and unceasing dysentery—characterized by sudden diarrhea with tenesmus—belong to heat. Therefore, Pueraria Root, which has a clear and light nature, is used as the sovereign herb to release the muscle layer and stop dysentery; bitter-cold and clarifying Scutellaria Root and Coptis Rhizome are used as assistant herbs to stop sweating and relieve panting; Licorice Root is added to harmonize the middle. By decocting Pueraria Root first and adding other herbs later, the power to release the muscle layer is mild, while the clearing heat energy is sharp, differing significantly from methods that tonify the middle to expel pathogens. Furthermore, the pulse and symptoms in the preceding case indicate yang deficiency; although there is accompanying external heat, the interior is deficient and cold. The pulse and symptoms in the following case indicate yang excess; although there is continuous dysentery, both exterior and interior are excess. Both present as heat-accompanied dysentery with unresolved exterior and interior, yet the treatments for cold/heat, deficiency/excess, tonification, and purgation differ. The former formula is Lizhong Tang plus Cinnamon Twig, with Cinnamon Twig listed before Ginseng Root; the latter formula is a Xiexin Tang-type formula plus Pueraria Root, with Pueraria Root listed before Scutellaria Root and Coptis Rhizome. They are not named Lizhong Tang or Xiexin Tang because the primary reason is that the exterior remains unresolved. Tonifying the middle can also release the exterior; cooling the middle can also disperse exterior pathogens; tonifying the middle can also dissipate fullness; cooling the middle can also stop dysentery. Zhang Zhongjing’s formulation of these dual-resolution formulas demonstrates such divine transformation.