11. When the Taiyang disease is about to resolve, it occurs from the time of Si to Wei..
Zi Ji states: The interaction between heaven and humanity; Taiyang represents Yang Qi. During the time from Si to Wei, Yang Qi is at its peak, which assists the Taiyang’s force, leading to recovery. If the illness does not improve, it will inevitably worsen. Therefore, when resolution is desired, it can also indicate a severe condition.
12. In cases of Wind, if the exterior resolves but the condition remains unclear, recovery occurs in twelve days..
Zi Ji states: In cases of Wind, although the fire of interaction is not stored, it is weak, and the fluids are not severely harmed. The exterior resolves while waiting for the fluids to recover; recovery occurs in seven days for Taiyang, and in twelve days for Jueyin when the fluids return.
13. If the patient has a high fever but desires to be close to clothing, the heat is on the skin, and the cold is in the marrow;
14. If the body is very cold but does not desire to be close to clothing, the cold is on the skin, and the heat is in the marrow..
Zi Ji states: There are true cold, true heat, false heat due to true cold, and false cold due to true heat. These should be distinguished by the symptoms. A high fever with a desire for clothing indicates that Yang Qi is excessive externally while the essence is insufficient, with internal cold and external heat, indicating false heat and true cold. A very cold body that does not desire clothing indicates excessive obstruction in the Xuanfu, preventing Qi from dispersing, indicating true heat and false cold. True conditions should be treated according to their nature, while false conditions should be treated according to their appearance; true cold with false heat should not be treated with heat, and false cold should not be treated with cold. True heat with false cold should not be treated with cold, and false heat should not be treated with heat.
15. In cases of Taiyang wind, with Yang floating and Yin weak, Yang floating indicates spontaneous heat, while Yin weakness indicates spontaneous sweating, aversion to cold, aversion to wind, fever, nasal congestion, and dry retching, Gui Zhi Decoction is the main treatment.
Zi Ji states: Taiyang wind is the initial stage of warm disease. At this time, although the fire of interaction is not stored, it has not yet burned the fluids. The mouth is harmonious and does not show thirst. Due to the invasion of wind and cold, the Taiyang Xuanfu is closed, leading to aversion to cold. Because the fire of interaction is not collected, it is closed and stagnant, causing internal heat to break through the Xuanfu, leading to sweating. Fever indicates a floating pulse. Yang floating indicates fever, while Yin weakness indicates fluid deficiency; the floating pulse is the Yang pulse, and the deep pulse is the Yin pulse. Fever with sweating and aversion to wind and cold indicates that although there is fever, the sweating prevents it from being severe. The Xuanfu opens, fearing the invasion of wind and cold, with Yin and Yang both affected, the fire of interaction surges upward, causing nasal obstruction, runny nose, dry retching, and Gui Zhi Decoction is the main treatment. Gui Zhi (Cinnamon Twig) is the branch of the cinnamon tree, which is good at dispersing and supplementing Qi, relieving the muscles. Bai Shao (White Peony) helps to moderate and gather the fire of interaction, consolidating the liver Qi and replenishing the fluids. Sheng Jiang (Fresh Ginger), Gan Cao (Licorice), and Da Zao (Jujube) nourish Yin and distribute throughout the body. The collection of fire and the removal of wind and cold, along with the generation of fluids, leads to recovery.
Gui Zhi Decoction FormulaGui Zhi three liang (peeled) Bai Shao three liang Gan Cao two liang (roasted) Sheng Jiang three liang (sliced) Da Zao twelve pieces (split)Combine the five ingredients, crush and mix three of them, add seven sheng of water, and simmer on low heat to obtain three sheng, strain, adjust to a suitable temperature, and take one sheng. After taking, consume a warm, thin porridge of one sheng to assist the medicinal effect, and cover to allow for a slight sweating for about an hour. If there is a slight sweat, it is better; it should not flow like water, or the illness will not be resolved. If after one dose there is sweating and the condition improves, stop taking further doses; it is not necessary to finish the entire prescription. If there is no sweating, continue to take as before. If there is still no sweating, take a small amount in between, for about half a day, until three doses are completed. If the condition is severe, take one dose every day and night, observing the situation. If one dose is completed and the symptoms persist, take another dose. If there is no sweating, take up to two or three doses. Avoid raw and cold foods, sticky and slippery foods, meat, five pungent foods, alcohol, dairy, and foul-smelling items.Zi Ji states: Wind is a mild symptom of warm disease; the fire of interaction has already arisen, but the fluids have not yet been harmed. It is essential to quickly gather the fire of interaction and generate fluids. The human body operates automatically, following the natural way. When the fire of interaction gathers Yang Qi, the functions will naturally recover. Therefore, the treatment method must adjust this balance to await the automatic recovery.Gui Zhi Decoction functions like clouds and rain, gathering the fire of interaction and providing rain and dew. Gui Zhi and Gan Cao combine to promote Yang, which transforms Qi; it emerges from Yin and manifests in Yang. Any deficiency in Yang transformation can be addressed with this decoction.
Bai Shao and Gan Cao combine to promote Yin, which forms the body; it gathers from Yang and consolidates into Yin. The external is Yang, and the internal is Yin. Anything that moves from the inside out, from the heart to the extremities, is considered promoting Yang, while anything that moves from the outside in, from the extremities back to the heart, is considered promoting Yin. Gui Zhi and Gan Cao paired with Zhi Shi (Bitter Orange) open and strengthen the Yang, which is known as Mo Pan Decoction, and can strengthen the Yang of the heart and stomach. Bai Shao and Gan Cao with Fu Zi (Aconite) warm the blood, known as Qu Zhang Decoction, which can transform stagnant blood. Gui Zhi Decoction is a formula that harmonizes Yin and Yang, and is the primary formula for febrile diseases; understanding its principles leads to understanding all formulas.
One jin in Han is equal to sixteen liang, approximately 256 grams today, and one liang is about 16 grams. The Gui Zhi Decoction formula is divided into three doses, each dose being about 16 grams, which is one liang. The dosage for febrile diseases is based on one liang per dose, adjusted according to the symptoms. Today, the dosage can be simplified; for all two liang, use 5 grams, making Gui Zhi three liang equal to 15 grams, prepared as a decoction and taken at once. This constitutes one dose, boiled twice and taken at once, discarding the dregs; this is the amount for one prescription.
The key to replenishing fluids: Gan Cao and Da Zao supplement the middle and benefit Qi, generating fluids, utilizing the power of Sheng Jiang to distribute throughout the body; this is a minor replenishment of fluids. Bai Shao gathers the fire of interaction, consolidating blood into the liver, using Gan Cao’s sweet and sour properties to transform Yin, replenishing the spleen essence, and utilizing Gui Zhi’s power to distribute fluids throughout the body; this is a moderate replenishment of fluids. Ren Shen (Ginseng) greatly supplements the true source, maintaining the internal Qi, replenishing fluids in the Yin of the organs, while Huang Qi (Astragalus) nourishes Qi and circulates throughout the body, replenishing fluids in the Yang of the extremities. Gan Di Huang (Rehmannia) is the source of fluids, while Shan Zhu Yu (Cornus) sourly consolidates into the kidney water; this is a strong replenishment of fluids. Di Huang strongly replenishes fluids while Fu Ling (Poria) circulates water to assist; it is like irrigating with water. Ren Shen greatly replenishes fluids while Shi Gao (Gypsum) cools and descends; it is like heavy rain pouring down. Bai Shao moderately replenishes fluids while Gui Zhi disperses; it is like light rain nourishing the earth. Gan Cao and Da Zao generate fluids with the assistance of Sheng Jiang, or like the moisture of dew.
In all instances where Ren Shen is mentioned in the Treatise on Febrile Diseases, it refers to the use of Dang Shen (Codonopsis).
16. In cases of Taiyang disease, with headache, fever, sweating, and aversion to wind, Gui Zhi Decoction is the main treatment.
Zi Ji states: Taiyang wind, with sweating and aversion to wind, indicates Taiyang cold damage, while without sweating and aversion to cold indicates a different condition. If these symptoms are present, Gui Zhi Decoction should be used.17. In cases of Taiyang disease, with stiffness in the neck and back, sweating, and aversion to wind, Gui Zhi Jia Ge Gen Decoction is the main treatment.Zi Ji states: The neck and back are governed by the Du Mai (Governing Vessel), where the fluids from the kidneys receive heat from the small intestine, ascending along the Taiyang Du Mai, passing through the back and entering the head and neck, where it regulates the heat of the water vapor. If there is sweating and aversion to wind, this indicates Taiyang wind; if there is stiffness in the neck and back, it indicates insufficient fluids. Ge Gen (Kudzu) promotes Yin Qi, transforming the water Yin and ascending to assist the rise of fluids, thus alleviating the stiffness in the neck and back.Gui Zhi Jia Ge Gen Decoction FormulaGe Gen four liang Gui Zhi three liang (peeled) Bai Shao three liang Sheng Jiang three liang (sliced) Gan Cao two liang (roasted) Da Zao twelve pieces (split)Combine the six ingredients, add one dou of water, first boil the Ge Gen, reduce by two sheng, remove the foam, add the other herbs, and boil to obtain three sheng, strain. Warmly take one sheng, cover to induce slight sweating; no need for porridge, and follow the same rest and dietary restrictions as with Gui Zhi Decoction.Zi Ji states: Use three liang of Gui Zhi Decoction as the base, with each dose being one liang. Ge Gen promotes Yin Qi as the monarch, with a dosage of four liang. The dosage for febrile disease is based on three liang, adjusted accordingly.
18. In cases of Taiyang disease, if after purging the Qi rises, Gui Zhi Decoction can be used as before;if it does not rise, it should not be used..
Zi Ji states: In Taiyang disease, if there are exterior symptoms, the first step is to resolve the exterior. If the physician purges, the abdominal pressure will decrease, and the stored energy in the Xuanfu will follow the Qi inward, possibly leading to chest obstruction, or distension, or hidden accumulation. If the organs’ Zheng Qi (upright Qi) is still sufficient, the stored energy will not be enough to form an internal blockage. Even after purging, if the Zheng Qi still wishes to push outward, the Qi will rise, and Gui Zhi Decoction should still be used to assist Yin and Yang, expelling the pathogen outward; if sweating occurs, it can still be resolved. If the Qi does not rise, the pathogen has already entered the interior, and treatment should be based on the symptoms.
19. In cases of Taiyang disease, after three days, if sweating, vomiting, purging, or warming needles do not resolve the condition, this indicates a serious illness; Gui Zhi Decoction should not be used. Observe the pulse and symptoms to determine the appropriate treatment..
Zi Ji states: In Taiyang disease, after three days, it may still be in Taiyang or have progressed to Shaoyang; regardless of whether it is Taiyang or Shaoyang, the pathogen is still in the Yang. Sweating should be induced. If the physician uses vomiting or purging, or warming needles to force sweating, this is a misdiagnosis; the illness will not resolve, indicating a serious condition. This is the physician’s fault, and Gui Zhi Decoction should not be used. It is essential to understand the nature of the condition and treat according to the symptoms.
20. Gui Zhi Decoction is primarily for relieving muscle tension; if the patient’s pulse is floating and tight, with fever and no sweating, it should not be used; it is essential to recognize this to avoid mistakes..Zi Ji states: Gui Zhi Decoction is the primary formula for mild warm disease, harmonizing Yin and Yang, indicated by sweating and aversion to wind, with a floating and relaxed pulse. If the pulse is floating and tight, with fever and no sweating, this indicates Taiyang cold damage, and Ma Huang Decoction is indicated; Gui Zhi Decoction should not be used. This is common knowledge and should not be mistaken. If Gui Zhi Decoction is indicated and sweating occurs, the Xuanfu is already open; using Ma Huang Decoction again to open the exterior will lead to excessive sweating and loss of Yang.