典藏书目

Indicated for Shaoyin disease presenting with diarrhea of undigested food, internal cold with external heat, cold limbs (Jue Ni), and a pulse so faint as to be nearly imperceptible. The body may paradoxically not feel aversion to cold, and the patient's face may appear red. It is also indicated if accompanied by abdominal pain, dry retching, sore throat, or if the diarrhea stops but the pulse remains absent. For Jueyin disease presenting with diarrhea of undigested food, internal cold with external heat, sweating, and cold limbs, this formula is also indicated.

Dried Ginger (Gan Jiang) 3 liang (4 liang for robust individuals), Honey-fried Licorice Root (Zhi Gan Cao) 2 liang, Raw Aconite Root (Sheng Fu Zi, peeled) one large piece. These three ingredients are decocted in 3 sheng of water until 1.2 sheng remains. Strain the dregs and divide into two warm doses. If the pulse returns, the patient will recover. If the complexion is red, add 9 stalks of Scallion White (Cong Bai). If there is abdominal pain, remove the Scallion White and add 2 liang of Peony Root (Bai Shao). If there is vomiting, add 2 liang of Fresh Ginger (Sheng Jiang). If there is a sore throat, remove the Peony Root and add 1 liang of Platycodon Root (Jie Geng). If the diarrhea stops but the pulse does not emerge, add 2 liang of Ginseng Root (Ren Shen).

[Annotation] Regarding formulas that support Yang and suppress Yin: When cold injury causes Yang Qi to become weak and unable to reach the exterior, Si Ni Tang (Four Counterflow Decoction) is indicated. When both interior and exterior are cold and Yang Qi is extremely deficient, Aconite Root (Fu Zi) [contextually implying formulas heavily relying on Fu Zi, such as Tong Mai Si Ni Tang] is indicated. When Yin excess is at the lower jiao and repels Yang to the upper jiao, Bai Tong Tang (White Pass Decoction) is indicated. When Yin excess is within and repels Yang to the outside, Tong Mai Si Ni Tang (Pulse-Resuscitating Four Counterflow Decoction) is indicated. Thus, it can be known that Si Ni Tang circulates Yang Qi; [formulas emphasizing] Fu Zi warms and tonifies Yang Qi; Bai Tong Tang unblocks Yang Qi between the upper and lower; and Tong Mai Si Ni Tang unblocks Yang Qi between the interior and exterior. Now, with a pulse faint as if absent and internal cold with external heat, this indicates Yin excess in the Kidney repelling Yang to the exterior; hence, this formula is indicated. By doubling the Dried Ginger and adding Licorice Root to assist Aconite Root, and renaming it Tong Mai Si Ni Tang, it is because it greatly strengthens the Primordial Yang, governs the interior and exterior, and collectively draws the external heat back into the interior. At this time, the vital Qi has already dispersed, and death is imminent. If soft and slow Licorice Root were used as the Sovereign herb, how could it swiftly call back the external Yang? Therefore, Dried Ginger is changed to be primary. However, Licorice Root must be added in equal proportion to Dried Ginger, fearing that amidst the dispersion of residual Qi, the fierce nature of Dried Ginger and Aconite Root cannot nourish the Primordial Qi; this is what is meant by "a disciplined army." If the face is red, add Scallion White to unblock Yang repelled to the upper part. If there is abdominal pain, add Peony Root to harmonize Yin within. If there is vomiting and counterflow, add Fresh Ginger to stop vomiting. If there is a sore throat, add Platycodon Root to benefit the throat. If diarrhea stops, the pulse does not emerge, and Qi is deficient, double the dose of Ginseng Root to generate Primordial Qi and restore the pulse.