Inheriting the fire of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
1Overview 1. The first book in China that discusses syndrome differentiation and treatment is “Shang Han Lun” written by the great physician Zhang Zhongjing (Zhang Ji) during the late Eastern Han Dynasty. It laid the foundation for syndrome differentiation and treatment, marking the establishment of the theoretical system of syndrome differentiation and treatment.
2. Zhang Zhongjing is revered as the “Sage of Medicine” by later generations. 3. Zhang Zhongjing diligently studied medicine, “He diligently sought knowledge, collected various prescriptions, compiled the “Suwen”, “Nine Volumes”, “Eighty-One Difficulties”, “Yin Yang Great Theory”, “Fetal Medicine Record”, and pulse diagnosis to create the “Shang Han Za Bing Lun” consisting of sixteen volumes.” 4. “Shang Han Za Bing Lun” includes two parts: “Shang Han” and “Jin Kui”. The “Shang Han” mainly discusses externally contracted febrile diseases, while also discussing internal injuries and miscellaneous diseases; the “Jin Kui” mainly discusses internal injuries and miscellaneous diseases, while also discussing externally contracted febrile diseases. 5. The entire “Shang Han Lun” consists of ten volumes, with a total of 397 sections, 22 chapters, and 113 formulas (actually 112 formulas, one formula only has a name without any herbs). 6. There are two editions of “Shang Han Lun”: one is the Song edition, and the other is the Cheng annotation edition. The original Song edition has been lost, and there is now a reprint from the Ming Dynasty by Zhao Kai Mei, also known as the Zhao edition. The Cheng annotation edition is annotated by Cheng Wuji in the Jin Dynasty. The miscellaneous diseases section of the original book was later organized into “Jin Kui Yao Lue”. 7. The value of “Shang Han Lun” is: first, it established the system of six meridian syndrome differentiation. Second, it laid the foundation for syndrome differentiation and treatment. Third, it has rigorous laws and exquisite prescriptions, serving as a model. 8. “Shang Han” has both broad and narrow meanings. The broad meaning refers to all externally contracted febrile diseases, as stated in the “Nei Jing”: “All febrile diseases are classified as Shang Han.” The “Nan Jing” states: “Shang Han has five types: wind stroke, Shang Han, damp warmth;” the narrow meaning of Shang Han refers to diseases caused by the invasion of cold evil, which manifest immediately. It is one of the five types of diseases. As stated in “Shang Han Lun”: “Tai Yang disease, whether fever has occurred or not, must have aversion to cold, body aches, vomiting, and a pulse that is tight in both yin and yang, is called Shang Han.” 9. The six meridians refer to Tai Yang, Yang Ming, Shao Yang, Tai Yin, Shao Yin, and Jue Yin. 10. The six meridians of “Shang Han Lun” serve as both the guidelines for syndrome differentiation and the principles for treatment. 11. The guidelines for the six meridian disease syndromes are: Tai Yang disease manifests as a floating pulse, with a stiff neck and aversion to cold. (2) Yang Ming disease manifests as fullness in the stomach and intestines. (3) Shao Yang disease manifests as bitter mouth, dry throat, and dizziness. (4) Tai Yin disease manifests as abdominal fullness and vomiting, inability to eat, and occasional abdominal pain. If purged, there will be hardness below the chest. (5) Shao Yin disease manifests as a fine pulse, with a desire to sleep. (6) Jue Yin disease manifests as thirst, qi rushing to the heart, heat in the heart, hunger without desire to eat, and if food is taken, it will cause vomiting and diarrhea. 12. The eight principles are: yin and yang, exterior and interior, cold and heat, deficiency and excess, with yin and yang as the general principle, exterior, excess, and heat belonging to yang, while interior, deficiency, and cold belong to yin. 13. The relationship between six meridian syndrome differentiation and eight principles syndrome differentiation is that six meridian syndrome differentiation serves as the guidelines for syndrome differentiation and treatment, while eight principles syndrome differentiation provides a general summary of the disease’s location and nature. The two complement each other and cannot be separated. For example, Tai Yang, Yang Ming, and Shao Yang are the three yangs, and the three yang diseases belong to heat syndrome and excess syndrome. Tai Yin, Shao Yin, and Jue Yin are the three yins, and the three yin diseases belong to cold syndrome and deficiency syndrome. As stated in “Shang Han Lun”: “If the disease has fever and aversion to cold, it is classified as yang; if there is no fever and aversion to cold, it is classified as yin.” 14. Transmission refers to the general and abnormal development of Shang Han disease. “Transmission” refers to the transmission of the meridians (“meridians” refers to the six meridian diseases of Shang Han), meaning that the disease develops according to certain rules, such as Tai Yang transmitting to Yang Ming or transmitting to Shao Yang. “Change” refers to changes in the disease that exceed the rules, such as yang syndrome transforming into yin syndrome or transforming into other mixed cold and heat syndromes. 15. Factors affecting the transmission of diseases include three: first, the strength or weakness of the righteous qi; second, the severity of the evil qi; third, the appropriateness of the treatment. 16. Transmission through the meridians refers to following the order of the six meridians (Tai Yang → Yang Ming → Shao Yang → Tai Yin → Shao Yin → Jue Yin). 17. Transmission across meridians refers to not following the order of the six meridians but rather transmitting across meridians. 18. Direct invasion refers to the pathogenic evil directly invading the three yin meridians without passing through the three yang meridians. 19. Interior syndrome manifesting as exterior syndrome refers to the pathogenic evil transforming from the three yin meridians to the three yang meridians. 20. Combined disease refers to the simultaneous appearance of symptoms from two or three meridians. 21. Concurrent disease refers to the situation where one meridian’s disease has not resolved, and another meridian’s disease arises, which is called concurrent disease. 22. Two evils refer to the simultaneous invasion of two meridians, such as Shao Yin and Tai Yang. 23. Bad disease refers to the worsening of the condition after inappropriate treatment, which is referred to as “bad disease, which is a transformed syndrome.” 24. Tai Yang governs the ascent, Yang Ming governs the combination, and Shao Yang governs the pivot. (Tai Yang governs the exterior, Yang Ming governs the interior, and Shao Yang governs both exterior and interior). 25. The treatment principles for six meridian diseases are: support the righteous qi and expel the evil. Supporting the righteous qi means supporting yang qi and preserving yin fluids. 26. The five one parts refer to: one part of aversion to cold corresponds to one part of exterior syndrome; one part of white coating corresponds to one part of exterior syndrome; one part of yang qi corresponds to one part of vitality; one part of fluid corresponds to one part of vitality; preserving one part of blood corresponds to preserving one part of life. 27. The four long terms refer to: long illness enters the collaterals, long illness enters the blood, long illness enters the kidneys, and long illness leads to deficiency. 28. Seven symptoms and one pulse refer to: alternating chills and fever, fullness in the chest and hypochondria, disinterest in food and drink, irritability with a tendency to vomit, bitter mouth, dry throat, and dizziness. (Xiao Chai Hu Tang) with a wiry pulse. 29. The treatment principles for six meridian diseases are: support the righteous qi and expel the evil, which means supporting yang qi and preserving yin fluids. The three yang diseases primarily focus on expelling evil: Tai Yang disease uses sweating; Yang Ming disease uses clearing and purging methods; Shao Yang disease uses harmonizing methods. The three yin diseases primarily focus on supporting the righteous qi: Tai Yin disease uses warming methods; Shao Yin disease uses cold transformation to support yang and suppress yin, while heat transformation nourishes yin and clears heat; Jue Yin disease uses both cold and warm methods. 30. The treatment principles for concurrent exterior and interior diseases are: first treat the exterior before the interior, which is the common method; second treat the interior before the exterior, which is the transformation method, indicating that if the interior syndrome is urgent, the interior should be treated first; third, for concurrent exterior and interior diseases, if treating the exterior does not resolve the interior, and treating the interior does not relieve the exterior, both should be addressed, treating lightly and heavily as appropriate.2. Differentiating Tai Yang Disease Pulse Patterns and Treatment 1. Yang disease – belongs to exterior syndrome. Its pathology: wind and cold invade, the defensive yang is obstructed, and the nutritive yin is stagnant, resulting in Shang Han exterior excess syndrome (due to cold evil); if the defensive and nutritive are disharmonious, with a strong defensive and weak nutritive, it is a wind stroke exterior deficiency syndrome (due to wind evil). Its syndrome types include: Tai Yang exterior syndrome and Tai Yang interior syndrome (Tai Yang meridian syndrome and Tai Yang bowel syndrome). 2. Classification of Tai Yang disease’s main syndrome – first, Tai Yang wind stroke syndrome, which resolves muscle and expels wind, harmonizes the nutritive and defensive, using Gui Zhi Tang. Second, Tai Yang Shang Han syndrome, which uses pungent and warm sweating, disperses the lung and calms wheezing, using Ma Huang Tang. Third, light exterior stagnation syndrome, which uses mild pungent sweating, using Gui Ma Ge Ban Tang (Gui Ma Ge Ban Tang is good for wind rash). 3. Light exterior stagnation syndrome – an exterior syndrome that has persisted for a long time without sweating, presenting with intermittent fever and aversion to cold. 4. The outline of Tai Yang disease pulse patterns – Tai Yang disease has a floating pulse, with a stiff neck and aversion to cold. 5. Floating pulse – easily felt with light pressure, slightly reduced with heavy pressure but not empty, and has a surplus when lifted, indicating exterior syndrome and also indicating deficiency syndrome. 6. The location of the cun pulse – the high bone at the back of the palm is called the guan, the front of the guan is yang (cun pulse), and the back of the guan is yin (chi pulse). The left hand corresponds to the heart, liver, and kidneys, while the right hand corresponds to the lungs and spleen. The upper corresponds to the upper body, the middle corresponds to the middle body, and the lower corresponds to the lower body. Floating indicates yang, while sinking indicates yin. 7. The essentials of pulse diagnosis – Shua Shou (Shua Bo Ren) in “Zhen Jia Shu Yao” states: “The essentials of holding the pulse have three: lifting, pressing, and seeking. Lightly holding it is called lifting, pressing heavily is called pressing, and neither light nor heavy, seeking it in a winding manner is called seeking. Lifting is floating; pressing is sinking; seeking is middle. 8. Classification of Tai Yang disease – there are three: first, wind stroke (as per item 2); second, Shang Han (as per item 3); third, warm disease (as per item 6). 9. The main pulse patterns of Tai Yang wind stroke syndrome – Tai Yang disease, fever, sweating, aversion to wind, and a slow pulse are called wind stroke (exterior deficiency syndrome). 10. Severe aversion to cold, light fever indicates exterior cold syndrome; heavy fever, light aversion to cold indicates exterior heat syndrome; light fever, aversion to wind, and spontaneous sweating indicates Tai Yang wind stroke syndrome (exterior deficiency syndrome). 11. Slow pulse – one pulse per four breaths, coming and going slowly, indicating dampness and also indicating spleen and stomach deficiency. A slow pulse indicates spleen deficiency, a slow pulse indicates dampness, and a slow pulse indicates deficiency. 12. The main pulse patterns of Tai Yang Shang Han syndrome – Tai Yang disease, whether fever has occurred or not, must have aversion to cold, body aches, vomiting, and a pulse that is tight in both yin and yang, is called Shang Han. 13. Tight pulse – the pulse comes tight, resembling a taut rope, indicating cold, pain, and retained food. 14. The main characteristics of warm disease – Tai Yang disease, fever and thirst, without aversion to cold, indicates warm disease. 15. Dry belching, food odor – belching is the same as eructation, dry belching, and food odor means belching with the taste of food. 16. Differentiating disease arising from yang and disease arising from yin – if the disease has fever and aversion to cold, it arises from yang; if there is no fever and aversion to cold, it arises from yin. 17. Differentiating transmission and desire to resolve – if Shang Han lasts one day, and Tai Yang is affected, if the pulse is quiet, it is not transmitted. If there is a desire to vomit, if there is agitation, and the pulse is rapid, it is transmitted. If Shang Han lasts two or three days, and Yang Ming and Shao Yang syndromes are not seen, it is not transmitted. 18. The main syndrome of Tai Yang disease – includes wind stroke exterior deficiency syndrome; Shang Han exterior excess syndrome; light exterior stagnation syndrome. 19. The main symptoms of wind stroke exterior deficiency syndrome – Tai Yang disease, headache, fever, sweating, aversion to wind, Gui Zhi Tang is the main treatment. 20. Gui Zhi Tang syndrome (concurrent syndrome) – Tai Yang wind stroke, yang is floating and yin is weak, yang floating means heat is self-generated, yin weak means sweating occurs, with aversion to cold, aversion to wind, and a feeling of heat in the nose and dry vomiting, Gui Zhi Tang is the main treatment. 21. Yang floating and yin weak – lightly pressing to feel yang, heavily pressing to feel yin, indicating the pulse is floating and slow. 22. The efficacy of Gui Zhi Tang – resolves muscle and expels wind, harmonizes the nutritive and defensive. 23. The pathology of Gui Zhi Tang – wind evil attacks the exterior, and the nutritive and defensive are disharmonious. 24. The precautions for Gui Zhi Tang – there are five: first, drink warm porridge; second, keep warm with clothing and blankets; third, stop medication when the disease resolves; fourth, if the disease is severe, medication can be taken day and night, even up to two or three doses; fifth, avoid raw and greasy foods. 25. Experiences in applying Gui Zhi Tang – first, this formula can be used for self-sweating due to disharmony of the nutritive and defensive; second, it can be used for nasal inflammation with sweating and aversion to wind; third, this formula is both a pungent and warm exterior resolving agent and an important formula for strengthening the spleen and stomach; fourth, this formula can be used for confusion after a cold (wind family, resolving the exterior and becoming unclear, usually resolves in twelve days). Fifth, this formula is a good remedy for headaches, but if wind evil is predominant, it can be added with wind-expelling herbs like Qiang Huo. However, if it is predominantly warm, it can be appropriately added with Wu Mei and Wu Wei Zi. 26. The mechanism of sweating in Tai Yang wind stroke syndrome – Tai Yang disease, fever, and sweating, this is due to the weakness of the nutritive and the strength of the defensive, hence sweating occurs. To save from the evil wind, Gui Zhi Tang is appropriate. 27. Xu Da Chun said: “Gui Zhi Tang is the holy medicine for expelling wind.” 28. In cases of severe evil qi in Tai Yang wind stroke syndrome – if Tai Yang disease, after taking Gui Zhi Tang, the patient becomes agitated and does not resolve, first needle Feng Chi and Feng Fu, then use Gui Zhi Tang to resolve. 29. Experiences in learning item 24 – first, this item mentions the method of using acupuncture and medicine together for severe diseases; second, patients with colds can use massage and cupping at Feng Chi and Feng Fu points for treatment. Third, Feng Chi and Feng Fu are key points of the Tai Yang meridian, and the medicinal power should not be transmitted, so acupuncture should be used. Fourth, if the patient becomes agitated and does not resolve, do not mistakenly think it is a transformed syndrome (Bai Hu Tang syndrome), the distinguishing point is that the Gui Zhi Tang syndrome is still present, only adding one agitation, which belongs to a severe disease with light medicine. 30. Tai Yang disease, with a floating weak pulse – if Tai Yang disease, the exterior syndrome has not resolved, and the pulse is floating and weak, it should be treated with sweating, Gui Zhi Tang is appropriate. 31. Experiences in learning item 42 – first, after the exterior syndrome is treated with sweating, if the pulse is floating and weak while still having the exterior syndrome, Gui Zhi Tang is appropriate, with the aim of not sweating too much; second, Tai Yang disease, headache, stiff neck, aversion to cold, and a floating weak pulse, Gui Zhi Tang is appropriate. It warns future generations that if the pulse changes, do not use Ma Huang Tang again. 32. Comparison of large and small sweating formulas – Da Qing Long Tang induces severe sweating, Ma Huang Tang induces large sweating, Gui Ma Ge Ban Tang induces small sweating, and Gui Zhi Tang induces slight sweating. 33. Gui Zhi Tang for floating and rapid pulse treatment – if Shang Han has been treated with sweating and resolves, after half a day, if the agitation returns and the pulse is floating and rapid, it can be further treated with sweating, Gui Zhi Tang is appropriate. 34. Experiences in learning item 57 – ① the main treatment: it is the only choice; ② appropriate means it can be selected first, not the only treatment; ③ half a day later, if agitation returns, the clinical manifestation is discomfort or chest tightness; ④ the main pulse of Gui Zhi Tang is floating, and floating and rapid pulse can still use Gui Zhi Tang; ⑤ using Gui Zhi Tang to treat chest tightness is based on the premise that it can treat chest tightness that appears after a cold; ⑥ the addition and subtraction of Gui Zhi Tang: if there is vomiting, add Ban Xia; if there is loss of appetite, add Mai Ya. 35. Treatment prohibitions for exterior syndrome – if Tai Yang disease, the exterior syndrome has not resolved, do not purge, purging is counterproductive. To resolve the exterior, Gui Zhi Tang is appropriate. 36. Experiences in learning item 44 – ① if there is an exterior syndrome, do not attack downwards as a common method; ② Zhang Zhongjing warns that attacking downwards causes the evil qi to penetrate inward, which is an incorrect treatment method; ③ generally, exterior syndromes often present with fever, do not mistakenly use cold and cooling products like Niu Huang Jie Du Wan; ④ patients with externally contracted febrile diseases often have constipation, at this time, the focus should be on resolving the exterior; ⑤ it can both resolve the exterior and unblock the bowels without allowing the evil to enter the interior, the ascending and descending powder from “Han Wen Tiao Bian” can be selected (the ascending and descending powder contains Jiang Can, Chan Tui, Jiang Huang, and Da Huang). 37. The method of mistakenly using purging when the exterior syndrome is still present – if Tai Yang disease, first induce sweating without resolution, and then purge, if the pulse is floating, it will not resolve, floating indicates it is still outside, hence it will not resolve. Now the pulse is floating, hence it is still outside, and it must be resolved externally to recover, Gui Zhi Tang is appropriate. 38. Experiences in learning item 45 – generally, if there is an exterior syndrome, mistakenly using purging will cause the evil qi to penetrate inward, if the pulse is floating, the exterior syndrome is still present, and the method of resolving the exterior can still be used, Gui Zhi Tang is appropriate. 39. Differentiating exterior and interior syndrome treatment – if Shang Han has not had a bowel movement for six or seven days, and there is a headache with heat, use Cheng Qi Tang. If the urination is clear, it indicates it is not in the interior, but still in the exterior, hence sweating must be induced. If there is a headache, it must be treated with Gui Zhi Tang. 40. Experiences in learning item 56 – the key to differentiating exterior and interior syndrome is whether the urination is clear or turbid; if clear, it is in the exterior, if turbid, it is in the interior. 41. The manifestation of exterior syndrome mistakenly purged, and the evil qi has not penetrated inward – if Tai Yang disease, after purging, if the qi rises, Gui Zhi Tang can be used, using the previous method; if it does not rise, it cannot be used. 42. Experiences in learning item 15 – ① if there is an exterior syndrome and mistakenly purged, if the qi rises, it indicates the evil qi is still outside, Gui Zhi Tang can be used; ② if there is heart disease with qi rising to the chest, it is caused by water and can use Gui Zhi Tang plus Gui Zhi or Gui Zhi Tang combined with Ling Gui Zhu Gan Tang. (Ling Gui Zhu Gan Tang is for water and heart palpitations). 43. The pathology and treatment of self-sweating – if a patient often sweats, it indicates the harmony of the nutritive qi; if the harmony of the nutritive qi is disrupted, the defensive qi does not harmonize with the nutritive qi, hence sweating occurs. The nutritive qi circulates in the meridians, while the defensive qi circulates outside. If sweating occurs, the harmony of the nutritive and defensive will resolve, Gui Zhi Tang is appropriate. 44. Experiences in learning item 53 – ① disharmony of the nutritive and defensive can be seen in both externally contracted exterior syndromes and internally injured miscellaneous diseases; ② self-sweating can be caused by external contraction, and internal injury can also cause it; external contraction is due to wind evil, while internal injury is due to disharmony of the nutritive and defensive, and the pathogenesis is the same, all belong to disharmony of the nutritive and defensive; ③ Xu Da Chun said: “Self-sweating and induced sweating are different; self-sweating is due to the separation of the nutritive and defensive, while induced sweating causes the nutritive and defensive to harmonize.” ④ Zhang Xi Ju said: “The defensive is yang, the nutritive is yin, yin and yang must harmonize; if the nutritive and defensive are not harmonious, it is like a couple not being in harmony.” ⑤ Gui Zhi Tang can be used for self-sweating without fever and aversion to wind, without any additions or subtractions. 45. The pathology and treatment of fever and sweating – if a patient has no other diseases, and often sweats, self-sweating that does not resolve indicates disharmony of the defensive qi. If sweating occurs at the right time, it will resolve, Gui Zhi Tang is appropriate. 46. The ancients said: “If the cun pulse is weak, do not induce sweating, as sweating will deplete yang; if the chi pulse is weak, do not induce sweating, as sweating will deplete yin.” 47. Experiences in learning item 54 – ① this disease is in the defensive and not in the nutritive; ② inducing sweating at the right time means before sweating occurs, it is like taking medicine two hours before a malaria attack. ③ if sweating occurs again after sweating, it can lead to excessive sweating, damaging the righteous qi. 48. Prohibitions for Gui Zhi Tang – there are five: first, for exterior excess syndrome, it cannot be used: “Gui Zhi is primarily for resolving muscles; if the pulse is floating and tight, with fever and no sweating, it cannot be given. One must recognize this to avoid mistakes.” Second, for damp-heat trapped internally, it cannot be used: “If a patient is a drinker, it cannot be given, as it will cause vomiting due to the drinker’s preference for sweetness.” Third, for interior heat syndrome with purulent blood, it cannot be used: “If one takes Gui Zhi Tang and vomits, they will surely vomit purulent blood afterward.” Fourth, for evil heat penetrating inward, Gui Zhi Tang cannot be used: “After sweating, if sweating occurs and there is wheezing without high fever, Gui Zhi Tang cannot be used again.” Fifth, for bad disease, Gui Zhi Tang cannot be used again: “If Tai Yang disease lasts three days, has already been treated with sweating, if there is vomiting, purging, or warming needles, and it still does not resolve, this is a bad disease, Gui Zhi Tang should not be used, observe the pulse and symptoms to know what is wrong, and treat according to the symptoms.” 49. The original text of syndrome differentiation and treatment – “Observe the pulse and symptoms, know what is wrong, and treat according to the symptoms.” 50. Experiences in learning the prohibitions of Gui Zhi Tang – ① floating and tight pulse of exterior excess syndrome cannot be used; ② damp-heat trapped internally (yellow greasy tongue coating) cannot be used; ③ interior heat syndrome with sweating cannot be used; ④ vomiting after taking Gui Zhi Tang cannot be used; ⑤ bad disease cannot be used. 51. Gui Zhi with neck and back stiffness syndrome – “Tai Yang disease, neck and back stiffness, and sweating with aversion to wind, Gui Zhi plus Ge Gen Tang is the main treatment.” 52. The efficacy of Gui Zhi plus Ge Gen Tang – resolves muscle and expels wind, promotes fluids and relaxes the meridians. 53. Experiences in applying Gui Zhi plus Ge Gen Tang – ① this formula is indicated for sweating with aversion to wind, neck and back stiffness; ② there is no need to consume porridge when taking this formula; ③ Ge Gen has the effect of promoting fluids and relaxing the meridians; ④ this formula can be used for neck pain with sweating and aversion to wind. 54. Gui Zhi with wheezing syndrome – for wheezing, Gui Zhi Tang plus Hou Po and Xing Ren Tang. 55. Experiences in applying Gui Zhi plus Hou Po and Xing Ren Tang – ① this formula can be used for coughing with sweating and aversion to wind; ② this formula can be used for elderly patients with cough and wheezing; ③ this formula can be used for wheezing patients. 56. Gui Zhi with yang deficiency syndrome – Tai Yang disease, sweating, leading to continuous leakage, with aversion to wind, difficulty urinating, and limbs slightly cold and difficult to bend, Gui Zhi plus Fu Zi Tang is the main treatment. 57. Experiences in applying Gui Zhi plus Fu Zi Tang – ① this formula can be used for yang deficiency self-sweating; ② it can be used for wind stroke exterior deficiency syndrome with cold limbs; ③ this formula can be used for excessive sweating with aversion to wind; ④ this formula can be used for rheumatoid arthritis with pain in finger joints. 58. Gui Zhi with chest fullness syndrome – Tai Yang disease, after purging, if the pulse is rapid and there is chest fullness, Gui Zhi minus Shao Yao Tang is the main treatment. 59. Experiences in applying Gui Zhi minus Shao Yao Tang and Gui Zhi minus Shao Yao plus Fu Zi Tang – ① for rapid pulse and chest fullness in heart disease, Gui Zhi minus Shao Yao Tang can be used; ② for cold and heat, cough, Gui Zhi minus Shao Yao plus Xing Ren Tang is the main treatment; ③ for headache, thirst, cough, aversion to cold, Gui Zhi minus Shao Yao plus Xing Ren and pollen is the main treatment; ④ for cold evil causing constipation, abdominal distension and pain, Gui Zhi minus Shao Yao plus Fu Zi Tang can be used; ⑤ for hard stools and self-benefiting urination, Gui Zhi minus Shao Yao plus Fu Zi Tang can be used. 60. Gui Zhi with insufficient nutritive qi and body pain syndrome (Xin Jia Tang) – after sweating, if there is body pain and a sinking slow pulse, Gui Zhi plus Shao Yao, Sheng Jiang each one liang, Ren Shen three liang Xin Jia Tang is the main treatment. (Zhong Jing Xin Jia Tang, Gui Zhi plus Ren Shen). 61. Experiences in learning Xin Jia Tang – ① after sweating, body pain indicates lack of nourishment; ② a sinking slow pulse indicates, as stated in the “Nei Jing”: “the sinking pulse indicates weak nutritive qi,” and “the slow pulse indicates insufficient nourishing qi and blood;” ③ this formula can be used for pain worsening after using dispersing herbs or wind-damp herbs; ④ this formula can be used for joint pain after childbirth or abortion; ⑤ if there is hardness in the chest and a lack of strength in the lower abdomen, using purgatives still leads to constipation, this formula can be used. 62. Gui Zhi plus Ren Shen Jian Zhong Tang and Xin Jia Tang clinical differentiation – both are used for joint pain due to lack of nourishment after childbirth or abortion. The difference is: Gui Zhi plus Ren Shen Jian Zhong Tang is indicated for heat in the hands and feet in summer and cold in winter or with pale complexion and stomach pain. No pain after sweating; Xin Jia Tang is indicated for pain worsening after sweating or pain worsening after using wind-damp herbs. 63. Shang Han exterior excess syndrome (Shang Han Eight Syndromes, Ma Huang Eight Syndromes) – Tai Yang disease, headache, fever, body pain, low back pain, joint pain, aversion to wind, no sweating and wheezing, Ma Huang Tang is the main treatment. 64. The pathology of Shang Han exterior excess syndrome – wind and cold bind the exterior, obstructing the defensive yang, and stagnation of the nutritive yin. 65. Experiences in learning item 35 – ① Ke Yun Bo said: “Tai Yang governs the tendons, ‘all tendons belong to the joints,’ hence joint pain;” ② the meridians passing through the waist include five: Chong, Ren, Du, Dai, and the foot Tai Yang bladder meridian, hence low back pain, while also understanding the principle of menstrual pain and low back pain; ③ when taking Ma Huang Tang, there is no need for porridge; ④ this formula is a pungent and severe sweating agent, and clinical application should not be excessive to prevent damage to the righteous qi. 66. Regarding different pulse types for using Ma Huang Tang – first, “if the pulse is floating, the disease is in the exterior, sweating can be induced, Ma Huang Tang is appropriate”; second, “if the pulse is floating and rapid, sweating can be induced, Ma Huang Tang is appropriate.” 67. Experiences in learning items 51 and 52 – ① Ma Huang Tang does not necessarily require a floating pulse; both floating and rapid pulses can be applied; ② the contraindicated pulse types for Ma Huang Tang are: thin and rapid pulse; ③ when using Ma Huang Tang, it must be the eight syndromes, the key is no sweating. The dosage should be 6g, with 3g of licorice. If the stomach qi is weak, ginger slices and jujubes can be added. 68. Possible reactions after taking Ma Huang Tang – Tai Yang disease, pulse floating and tight, no sweating, fever, body pain, if it does not resolve after eight or nine days, and the exterior syndrome is still present, sweating must be induced, if the medicine has slightly reduced it, and the person becomes agitated and has closed eyes, severe cases will lead to bleeding, which is a resolution. This is because the yang qi is heavy. Ma Huang Tang is the main treatment. 69. Closed eyes – refers to lazily closing the eyes, not liking strong light stimulation. 70. Experiences in learning item 46 – ① after taking Ma Huang Tang, if there is nosebleed, it is a sign of resolution, commonly known as red sweat, and cold water should not be applied to the head; ② this formula is used for wind rash; ③ in cases of wind-cold exterior syndrome, if there is bleeding, it is a sign of recovery, as stated in item 47: “Tai Yang disease, pulse floating and tight, fever, and no sweating with spontaneous bleeding indicates recovery.” 71. The treatment method for Tai Yang and Yang Ming combined disease, with Tai Yang as the main treatment – if Tai Yang and Yang Ming are combined diseases, with wheezing and chest fullness, do not purge, Gui Zhi Tang is appropriate. 72. Experiences in learning item 36 – ① “Yi Zong Jin Jian” states: “If Tai Yang and Yang Ming are combined diseases, if there is diarrhea without vomiting, it indicates that the interior qi is solid and not affected by evil; if there is wheezing and chest fullness, it indicates that the exterior evil is strong and the qi is obstructed in the lungs. The evil is in the high exterior, not in the chest, hence do not purge, use Ma Huang Tang to resolve the exterior and open the lungs, and the wheezing will resolve.” 73. The contraindications for Ma Huang Tang – ① “if the throat is dry, do not induce sweating.” ② “if there is a history of bleeding, do not induce sweating, as sweating will lead to bleeding.” ③ “if there is a history of sores, even if there is body pain, do not induce sweating, as sweating will lead to sores.” ④ “if there is a history of nosebleeds, do not induce sweating, as sweating will lead to sinking of the forehead, tight pulse, and inability to open the eyes, leading to insomnia.” ⑤ “if there is blood loss, do not induce sweating, as sweating will lead to cold and trembling.” ⑥ “if there is sweating, excessive sweating will lead to confusion and heart disturbance, with painful urination and food intake.” ⑦ “if the patient has cold, and then sweats again, the stomach will be cold, leading to vomiting.” ⑧ “if the pulse is tight, the method should be to treat the body pain, and if the pulse is thin, do not induce sweating, as it indicates insufficient nourishing qi and blood.” 74. Experiences in learning the contraindications for Ma Huang Tang – ① the throat is a pathway for the three yin meridians; “the pulse of the foot Tai Yin meridian passes through the throat, the pulse of the foot Shao Yin meridian circulates through the throat, and the pulse of the foot Jue Yin meridian circulates behind the throat, all of which are pathways of the three yin meridians; hence, if the three yin’s essence and blood are deficient, they cannot nourish the throat, hence “if the throat is dry, do not induce sweating.” ② The symptoms of a history of bleeding are very similar to a cold, do not treat it as a cold; ③ for sores, even if there is body pain, it is due to insufficient nourishment, hence do not induce sweating; ④ for nosebleeds, do not induce sweating, as “blood and sweat share the same source.” ⑤ for blood loss, do not induce sweating, as “losing blood leads to no sweating, losing sweat leads to no blood; losing blood and inducing sweating will lead to both yin and yang being deficient, hence cold and trembling.” ⑥ if there is heat without sweating, do not induce sweating; ⑦ if there is cold in the stomach, do not induce sweating; ⑧ if both qi and blood are deficient, do not induce sweating, as stated by Chang Lu Yu: “if the pulse is thin, do not use Ma Huang Tang to induce sweating, but frequently use Xiao Jian Zhong Tang instead.” 75. Cold with neck and back stiffness syndrome (Ge Gen Tang syndrome) – Tai Yang disease, neck and back stiffness, no sweating, aversion to wind, Ge Gen Tang is the main treatment. 76. Experiences in applying Ge Gen Tang – ① this formula can be used for psoriasis, especially in the head (the head is the upper body); ② this formula can be used to treat shoulder periarthritis; ③ the dosage of Ma Huang in Ge Gen Tang should not be too large, generally 6g is appropriate, usually less than the dosage of Gui Zhi. 77. Tai Yang and Shang Han combined vomiting and diarrhea syndrome – if Tai Yang and Yang Ming are combined diseases, there must be diarrhea, Ge Gen Tang is the main treatment; if Tai Yang and Yang Ming are combined diseases, there is no diarrhea but vomiting, Ge Gen plus Ban Xia Tang is the main treatment. 78. Experiences in learning items 32 and 33 – ① if Tai Yang and Yang Ming are combined diseases, with exterior evil entering the interior, the evil invades the intestines and stomach, leading to diarrhea, the interior pressure on Yang Ming leads to vomiting, and diarrhea and vomiting have the same pathogenesis, hence Ge Gen Tang is used to disperse the evil, adding Ban Xia to reverse the qi. 79. Tai Yang Shang Han combined with interior heat syndrome (Da Qing Long Tang syndrome) – Tai Yang wind stroke, pulse floating and tight, fever, aversion to cold, body pain, no sweating and agitation, Da Qing Long Tang is the main treatment. 80. The contraindications for Da Qing Long Tang – if the pulse is weak, sweating and aversion to wind, it cannot be taken, as it will lead to counteraction, causing muscle tension and pain, which is counterproductive. 81. The pathology of Da Qing Long Tang – wind and cold bind the exterior, with internal heat stagnation. 82. The syndrome type of Da Qing Long Tang – exterior cold with internal heat, both are solid (cold wrapping fire). 83. The efficacy of Da Qing Long Tang – pungent and warm exterior resolving, while also clearing internal heat. 84. The treatment of Tai Yang Shang Han combined with wind-damp syndrome – if Shang Han has a floating and slow pulse, the body is not painful but heavy, with occasional lightness, and no Shao Yang syndrome, Da Qing Long Tang is used to induce sweating. 85. Experiences in learning Da Qing Long Tang syndrome – ① this formula is indicated for agitation without sweating; ② this formula is characterized by exterior cold with internal heat (cold wrapping fire); ③ the dosage of Ma Huang in this formula is 18g, Sheng Shi Gao 15g, Gui Zhi 6g, Gan Cao 6g, Sheng Jiang three slices, Da Zao five pieces, and it is used to induce sweating while also clearing internal heat, just like the dragon rising and rain falling. ④ this formula should not be taken for a long time, as it induces severe sweating, which can damage the yang qi. ⑤ if there is agitation in the chest, feeling of tightness, and a large pulse, Da Qing Long Tang plus Tian Hua Fen can be used; ⑥ if there is a headache like a splitting pain, body pain as if beaten, agitation without sweating, red eyes, and dry mouth, Da Qing Long Tang plus bamboo leaves can be used. ⑦ this formula can be used for wind-damp diseases; ⑧ for elderly patients, the dosage of this formula must be small. 86. Tai Yang Shang Han combined with water retention syndrome (Xiao Qing Long Tang syndrome) – if Shang Han exterior does not resolve, with water qi in the heart, dry vomiting, fever and cough, or thirst, or diarrhea, or difficulty urinating, fullness in the lower abdomen, or wheezing, Xiao Qing Long Tang is the main treatment. (Xiao Qing Long Tang treats water qi, cough, and dry wheezing, with ginger, cinnamon, Ma Huang, Shao Yao, and Xi Xin, Ban Xia combined with Wu Wei Zi). 87. The efficacy judgment criteria for Xiao Qing Long Tang – if Shang Han, with water qi in the heart, cough and slight wheezing, fever without thirst. After taking the soup, if the patient is thirsty, it indicates that the cold has been removed and wants to resolve, Xiao Qing Long Tang is the main treatment. 88. Experiences in applying Xiao Qing Long Tang – ① this formula is indicated for exterior cold with internal fluid, i.e., fullness in the stomach, cough, and wheezing; ② the dosage of this formula is particularly important, with 3g being appropriate, and Xi Xin 1.5g; ③ since the symptoms caused by this formula include dry vomiting, thirst, diarrhea, and difficulty urinating, all of which are due to water retention, there is no need to add medications to stop thirst or promote urination; ④ the ancients said: thirst and no thirst can distinguish the cold and heat of the interior; the differentiation of deficiency and excess can be seen, hence “after taking the soup, if thirsty, it indicates that the cold has been removed and wants to resolve.” ⑤ in summer, if bathing in water causes coughing, and the cold worsens, Xiao Qing Long Tang is the main treatment, while San Piao Tang is used for the root cause. 89. Experiences in applying Gui Ma Ge Ban Tang – ① this formula is clinically used to treat wind rash, presenting with redness on the face and itching; ② the dosage of Ma Huang in Gui Ma Ge Ban Tang is in a ratio of 1:1, not half of Ma Huang Tang and half of Gui Zhi Tang, but rather taking 1/3 of Ma Huang Tang and 1/3 of Gui Zhi Tang. 90. Experiences in applying Gui Er Ma Yi Tang – ① this formula can be used for aversion to cold and fever, resembling malaria, with two attacks a day; ② this formula can be used for aversion to cold and trembling, headache, low back pain, cough with little phlegm, white thick and slippery tongue coating, and floating tight pulse, first use Gui Er Ma Yi Tang, after the medicine, the cold and heat have been removed, but if there is tightness in the lower abdomen and loss of appetite, switch to Xiao Jian Zhong Tang. (Xiao Jian Zhong Tang has more Shao Yao, Gui Jiang, Gan Cao, Da Zao, and adds honey to replenish the middle qi, for deficiency and cold, it can be used for recovery). 91. Experiences in applying Gui Zhi Er Yue Bi Yi Tang – ① this formula is a combination of Gui Zhi Tang and Yue Bi Tang in a 2:1 dosage; ② wind water: the onset is sudden, with a fierce attack, and edema starts from the head and face, then spreads throughout the body, with the swelling being more pronounced above the waist (wind, excess, lung); ③ yin water: the onset is gradual, with edema starting from the feet and face, then spreading throughout the body, with the swelling being more pronounced below the body (deficiency, spleen, kidney); ④ Gui Er Yue Bi Yi Tang is used to treat wind water (yang water), with a preference for cases where wind evil is predominant. 92. The “Nei Jing” states: “All excesses should be cut off, and those with astringency indicate that yang qi is excessive, leading to body heat without sweating. Therefore, if the pulse is astringent, it indicates that yang qi is obstructed and sweating is not thorough.” 93. Differentiating deficiency and excess – after sweating, if there is aversion to cold, it indicates deficiency. If there is no aversion to cold but heat, it indicates excess, and should harmonize the stomach qi, using Tiao Wei Cheng Qi Tang. (Tiao Wei Cheng Qi Tang contains Da Huang, Mang Xiao, and Gan Cao). 94. Experiences in learning item 10 – ① You Zai Jing said: “If sweating occurs and there is aversion to cold, it indicates that yang is insufficient and is deficiency, hence Shao Yao, Gan Cao, and Fu Zi are used; if sweating occurs and there is no aversion to cold but heat, it indicates that the evil has entered the interior and formed excess, but it should not be attacked severely, only harmonizing the stomach qi with Tiao Wei Cheng Qi Tang.” 95. The differentiation of true cold and heat – if the patient has great heat but desires clothing, it indicates that the heat is on the skin, while the cold is in the marrow; if the patient has great cold but does not desire clothing, it indicates that the cold is on the skin, while the heat is in the marrow. 96. The treatment principles for exterior and interior – if Shang Han, the physician purges, and if there is continuous diarrhea with clear stools, and body pain, it is urgent to save the interior; if the body pain resolves and the clear stools self-regulate, it is urgent to save the exterior. To save the interior, use Si Ni Tang, and to save the exterior, use Gui Zhi Tang. (Si Ni Tang contains ginger, Fu Zi, and licorice, for the three yin counteracting the sinking of Tai Yang). 97. Zhi Zi Chi Tang syndrome – after sweating, vomiting, and purging, if there is deficiency and restlessness, if severe, it will lead to reversal, and the heart will feel depressed, Zhi Zi Chi Tang is the main treatment. 98. Heart depression – refers to a feeling of extreme frustration and helplessness. 99. Deficiency depression – a syndrome name, where depression indicates heat, and depression indicates heart frustration; deficiency does not refer to the deficiency of righteous qi, but rather to the contrast with tangible excess evil. Deficiency depression, although there is no tangible evil, still has the heat of stagnation, hence it can also be called “stagnation frustration.” 100. Ma Xing Shi Gan Tang syndrome – after sweating, if Gui Zhi Tang cannot be used again, if sweating occurs and there is wheezing without high fever, Ma Huang, Xing Ren, Gan Cao, and Shi Gao Tang is the main treatment. (Heat wheezing Ma Xing Shi Gan Tang, lung heat cough is good for this formula). 101. Experiences in learning Ma Xing Shi Gan Tang – ① this syndrome has sweating and wheezing, not Gui Zhi plus Hou Po and Xing Ren Tang, as the sweating here is due to heat forcing the fluids to leak out, hence Gui Zhi Tang cannot be used; ② the purpose of using Ma Huang is primarily to disperse the lungs, and pairing with Shi Gao transforms its pungent and warm nature into cooling and clearing heat, but if internal heat is excessive, it can restrain Ma Huang’s pungent warmth, and also clear heat. 102. Bai Hu plus Ren Shen Tang syndrome – after taking Gui Zhi Tang, if there is excessive sweating, great thirst that does not resolve, and a large pulse, Bai Hu plus Ren Shen Tang is the main treatment. 103. Experiences in learning this item – ① after taking Gui Zhi Tang, if there is excessive sweating, the pulse is large, it can be treated with either Gui Zhi Tang or Bai Hu plus Ren Shen Tang, the distinguishing point is whether there are the four great symptoms and one yellow symptom; ② the four great symptoms and one yellow symptom are: great sweating, great heat, great thirst, and a large pulse; ③ Bai Hu plus Ren Shen Tang can be used to treat diabetes. 104. Interior heat with diarrhea syndrome (Ge Gen Qin Lian Tang syndrome) – Tai Yang disease, Gui Zhi syndrome, if the physician mistakenly purges, leading to continuous diarrhea. If the pulse is rapid, it indicates that the exterior has not resolved, and if there is wheezing and sweating, Ge Gen, Huang Qin, and Huang Lian Tang is the main treatment. 105. The exterior evil has not resolved, and there is also internal heat with diarrhea. (Xie Re Li) Ge Gen, Huang Qin, Huang Lian Tang, Gan Cao treats the two yangs, resolves the exterior, clears the interior, and harmonizes the stomach, ensuring health and safety. 106. The differentiation between Ge Gen Tang and Ge Gen Qin Lian Tang – both are Tai Yang and Yang Ming combined diseases, both treat diarrhea, Ge Gen Tang focuses on exterior excess syndrome, the key to differentiation is no sweating, allowing the exterior to resolve and the interior to harmonize; Ge Gen Qin Lian Tang focuses on internal heat, the key is sweating. 107. Experiences in applying Ge Gen Qin Lian Tang – ① used for heat dysentery (diarrhea with discomfort, burning sensation in the anus, pulse is slippery and rapid); ② can be used for both exterior syndrome and diarrhea; ③ can treat acute bacterial dysentery; ④ can be used for pediatric toxic enteritis. 108. Heart yang deficiency syndrome – there are four formulas: first, Gui Zhi Gan Cao Tang syndrome; (heart yang deficiency palpitation syndrome): has the effect of tonifying heart yang, “excessive sweating leads to the person feeling cold in the heart, with palpitations in the heart, desiring to press on it, Gui Zhi Gan Cao Tang is the main treatment”; second, Gui Zhi Gan Cao Long Gu Mu Li Tang syndrome, (heart yang deficiency irritability syndrome), has the effect of tonifying heart yang and calming the spirit. “If the fire is forced down, leading to irritability, Gui Zhi Gan Cao Long Gu Mu Li Tang is the main treatment.” Third, Gui Zhi minus Shao Yao plus Shu Qi Mu Li Long Gu Jiu Ni Tang syndrome (loss of heart yang leading to panic syndrome): has the effect of tonifying heart yang and calming the spirit: “If Shang Han, the pulse is floating, and the physician uses fire to force it down, leading to loss of yang, it will surely lead to panic, and the person will be restless, Gui Zhi minus Shao Yao plus Shu Qi Mu Li Long Gu Jiu Ni Tang is the main treatment.” Fourth, Gui Zhi plus Gui Tang syndrome (heart yang deficiency leading to panic syndrome): has the effect of warming and unblocking heart yang, and calming the counterflow: “If the burning needle causes sweating, and the needle site becomes cold and red, it will surely lead to panic, with qi rushing from the lower abdomen to the heart, Gui Zhi plus Gui Tang, with an additional two liang of Gui Zhi.” 109. Counterflow of fire – refers to the counterflow caused by fire, i.e., the transformation syndrome caused by the misuse of fire therapy. 110. Panic – is a syndrome name, where the patient feels a sudden rush of qi from the lower abdomen to the chest, causing a feeling of suffocation and extreme discomfort, with episodes of onset and cessation. 111. Experiences in learning Gui Zhi Gan Cao Tang – ① this formula is for treating light heart yang deficiency, indicated by palpitations desiring to press on it; ② this formula contains 18g of Gui Zhi and 9g of Gan Cao taken in one dose; ③ the ancients had the saying that pungent and sweet transform yang, sour and sweet transform yin. 112. Experiences in learning Gui Zhi Long Gu Mu Li Tang – ① this formula can be used for irritability and insomnia caused by insufficient heart yang; ② as stated in the “Nei Jing”: “yang qi nourishes the spirit, and softness nourishes the tendons,” hence yang deficiency leads to irritability. 113. Experiences in learning Gui Zhi plus Gui Tang – ① the dosage of Gui Zhi plus Gui Tang is: 15g of Gui Zhi, 10g of Bai Shao, three slices of Sheng Jiang, 12 pieces of Da Zao, and 6g of Gan Cao; ② this formula can be used for palpitations caused by qi rushing from the lower abdomen to the heart; ③ this formula can be used for rheumatic diseases, often presenting with coldness in the lower limbs, followed by the whole body, often with a plump tongue and white slippery coating. Based on this, Gui Zhi plus Gui is a dispute between cinnamon and Gui Zhi, establishing the push qi powder, which consists of Gui Zhi, cinnamon, sliced ginger, and licorice; if the spleen yang is severely deficient, add cloves, and if there is diarrhea, combine it with Jin Zheng Qi San. (Ping Wei San + Huo Xiang, Ban Xia). 114. Yang deficiency with water qi syndrome (Ling Gui Zhu Gan Tang syndrome) – after sweating, if the person feels palpitations below the navel, desiring to panic, Ling Gui Zhu Gan Tang is the main treatment. 115. The efficacy of Ling Gui Zhu Gan Tang – warms and unblocks heart yang, transforms qi and circulates water. 116. Experiences in applying Ling Gui Zhu Gan Tang – ① this formula is often combined with other formulas, such as Xiao Chai Hu Tang combined with Ling Gui Zhu Gan Tang, which contains Ling Gui Zhu Gan Tang (Xiao Chai Hu Tang has harmonizing effects, while Ban Xia, Dang Shen, and Gan Cao are added; plus Huang Qin, Sheng Jiang, and Jujube, treating the disease of Shao Yang). Ping Wei San contains Chen Pi, Huo Xiang, and Ban Xia, which are effective for drying dampness and strengthening the spleen. 117. Ling Gui Zhu Gan Tang syndrome – if Shang Han, whether vomiting or purging, if there is fullness in the heart, qi rushing to the chest, leading to dizziness, a sinking tight pulse, if sweating causes movement, the body shakes, Ling Gui Zhu Gan Tang is the main treatment. 118. The “Jin Kui” states: “If the pulse is sinking, it indicates water.” 119. The “Jin Kui” states: “If the disease is phlegm and fluid, it should be treated with the appropriate medicine.” 120. Experiences in applying Ling Gui Zhu Gan Tang – ① this formula is indicated for fullness in the stomach, qi rushing upwards, and dizziness; ② if the person feels cold in the back like a palm, Ling Gui Zhu Gan Tang is the main treatment; ③ this formula is often combined with Xiao Chai Hu Tang. 121. Thick Ginger Gan Ban Shen Tang syndrome – after sweating, if there is abdominal fullness, Thick Ginger Gan Ban Shen Tang is the main treatment. (Thick Ginger Gan Ban Shen Tang contains Dang Shen, which is effective for spleen deficiency and qi stagnation causing abdominal fullness). 122. Experiences in applying Thick Ginger Gan Ban Shen Tang – ① this formula is used for virtual cold abdominal fullness, with excellent results; ② the indications for virtual cold abdominal fullness; the “Jin Kui” states: “If there is abdominal fullness, pressing it does not hurt, it is virtual; if it hurts, it is real;” ③ this formula can be used for postoperative gas retention; ④ this formula is contained in Xiao Chai Hu Tang. 123. Xiao Jian Zhong Tang syndrome – if Shang Han lasts two or three days, with palpitations and irritability, Xiao Jian Zhong Tang is the main treatment. 124. The compatibility characteristics of Xiao Jian Zhong Tang – this formula is made by doubling Bai Shao in Gui Zhi Tang and adding honey. It has the effects of regulating the spleen and stomach, harmonizing yin and yang, and nourishing the nutritive blood, harmonizing the exterior and interior, and has the wonderful effect of addressing both exterior and interior. 125. Experiences in applying Xiao Jian Zhong Tang – ① this formula is the main formula for treating deficiency; ② deficiency means that both qi and blood are deficient, and nourishing qi hinders nourishing blood, nourishing blood hinders nourishing qi; nourishing yin hinders nourishing yang; nourishing yang hinders nourishing yin; hence, in the view of Jing, building the center should be the main focus, as the spleen and stomach are the source of qi and blood production, and when qi and blood are restored, yin and yang will be nourished. 126. Gui Zhi Ren Shen Tang syndrome (spleen deficiency with exterior syndrome) – if Tai Yang disease, the exterior syndrome has not been resolved, and there is repeated purging, leading to heat and diarrhea, with fullness in the heart and unresolved exterior, Gui Zhi Ren Shen Tang is the main treatment. 127. Harmonizing heat and diarrhea – harmonizing means to combine and unify. Heat refers to the exterior heat not being resolved, leading to diarrhea. 128. The efficacy of Gui Zhi Ren Shen Tang – warms the interior and resolves the exterior. 129. Experiences in applying Gui Zhi Ren Shen Tang – ① this formula is Gui Zhi Tang plus Ren Shen; ② this formula can be used for diarrhea due to spleen and stomach deficiency with mild exterior syndrome (Li Zhong Wan is the main formula for regulating the middle, containing Gan Cao, Ren Shen, Bai Zhu, and Gan Jiang, for vomiting, diarrhea, and abdominal pain due to severe yin deficiency, or add Fu Zi to support yang). 130. Zhen Wu Tang syndrome – Tai Yang disease, after sweating, if sweating does not resolve, the person still has fever, palpitations in the heart, dizziness, and the body shakes, Zhen Wu Tang is the main treatment (Zhen Wu Tang strengthens kidney yang, containing Fu Ling, Bai Zhu, Shao Yao, Fu Zi, and Sheng Jiang). 131. Body shaking – refers to the muscles of the body twitching. 132. Shaking and wanting to fall – refers to the body trembling, unsteady standing, and wanting to fall to the ground. 133. The mechanism of body shaking – as stated in the “Nei Jing”: “yang qi nourishes the spirit, and softness nourishes the tendons.” Yang deficiency cannot warm and nourish the tendons, hence body shaking (i.e., muscle twitching). 134. The difference between Ling Gui Zhu Gan Tang and Zhen Wu Tang – both belong to yang deficiency with water retention, but Zhen Wu Tang focuses on the kidneys, with a more severe condition, having Shao Yin yang deficiency syndrome; Ling Gui Zhu Gan Tang focuses on the heart and spleen, with a lighter condition, primarily with qi rushing upwards. 135. Heart yin and yang deficiency syndrome treatment (Zhi Gan Cao Tang syndrome) – if Shang Han, with a knotty pulse, heart palpitations, Zhi Gan Cao Tang is the main treatment. 136. Experiences in applying Zhi Gan Cao Tang – ① this formula can be used for premature beats; ② this formula can be used for rheumatoid arthritis, primarily with wrist joint pain. 137. Tai Yang water retention syndrome – Tai Yang disease, after sweating, if there is excessive sweating, the stomach is dry, and the person is restless and cannot sleep, desiring to drink water, give small amounts to drink, to harmonize the stomach qi will resolve. If the pulse is floating, urination is not smooth, and there is slight heat and thirst, Wu Ling San is the main treatment. 138. Water counterflow syndrome – if wind stroke causes fever, lasting six or seven days without resolution, with both exterior and interior symptoms, thirst and desire to drink water, if water enters, it causes vomiting, this is called water counterflow, Wu Ling San is the main treatment. 139. Water counterflow – is a manifestation of severe water retention syndrome, which can be seen with difficulty urinating, thirst and desire to drink water, and if water enters, it causes vomiting. 140. Experiences in learning water retention syndrome – ① thirst does not necessarily indicate yin deficiency; thirst due to water retention should be treated with Wu Ling San; ② thirst due to fluid damage should not be treated with large amounts of water, but rather small amounts to harmonize the stomach qi will resolve; ③ wind-damp diseases have both external dampness and internal dampness; external dampness is resolved by sweating, while internal dampness is resolved by purging, which can be treated with Wei Ling Tang. 141. Water retention syndrome – if Tai Yang disease does not resolve, with heat binding the bladder, if the person is manic, bleeding from below will resolve, while the exterior not resolving indicates it cannot be attacked, and only after resolving the exterior can the lower abdomen be attacked, using Tao He Cheng Qi Tang. (Tao He Cheng Qi Tang contains Tao Ren, Da Huang, and Gan Cao, with Tao Ren and Gui Zhi added). 142. The difference between water retention syndrome and blood retention syndrome – water retention syndrome occurs when the exterior evil enters the interior, and the evil combines with water, obstructing the bladder’s qi transformation; blood retention syndrome occurs when heat enters the lower jiao blood division, and the evil heat combines with stagnant blood; difficulty urinating indicates water retention; self-benefiting urination indicates blood retention. 143. Chest knot syndrome – when asked: what is the condition of chest knot and hidden knot? The answer is: pressing it causes pain, the cun pulse is floating, and the guan pulse is sinking, which is called chest knot. 144. Hidden knot – a syndrome name, its symptoms are similar to chest knot, but the nature of the disease is different, it is a condition of the organ qi being trapped, with yin and cold condensing. 145. Da Xian Xiong Tang syndrome – if Shang Han lasts six or seven days, with chest knot heat excess, the pulse is sinking and tight, with pain in the heart, pressing it feels hard, Da Xian Xiong Tang is the main treatment. (Da Xian Xiong Tang contains Da Huang, Mang Xiao, and is effective for clearing heat and breaking water). 146. The three symptoms of chest knot – the pulse is “sinking and tight,” “pain in the heart,” and “pressing it feels hard.” 147. The contraindications for chest knot syndrome – if the pulse is floating and large, do not purge, as purging will lead to death. 148. Xiao Xian Xiong Tang syndrome (small chest knot syndrome) – if there is a small chest knot disease, located in the heart, pressing it causes pain, and the pulse is floating and slippery, Xiao Xian Xiong Tang is the main treatment. (Xiao Xian Xiong Tang contains Lian Qiao and Xia Luo, which open the chest and resolve phlegm). 149. Experiences in applying Xiao Xian Xiong Tang – ① this formula is indicated for pain located in the heart, pressing it causes pain, and the pulse is floating and slippery; ② this formula can be used for stomach pain; ③ this formula combined with Xiao Chai Hu Tang can be used for coronary heart disease, myocarditis, named Xiao Chai Hu plus Gua Lou Tang. 150. Pi syndrome – a type of disease characterized by a feeling of fullness in the heart, primarily with fullness and obstruction in the stomach area. 151. Da Huang Huang Lian Xie Xin Tang syndrome – if there is fullness in the heart, pressing it feels slippery, and the pulse is floating above, Da Huang Huang Lian Xie Xin Tang is the main treatment. 152. Experiences in applying Da Huang Huang Lian Xie Xin Tang – ① this formula is used for heat pi; ② later generations added Huang Qin to this formula, named San Huang Xie Xin Tang. 153. Fu Zi Xie Xin Tang syndrome – if there is fullness in the heart, and there is aversion to cold with sweating, Fu Zi Xie Xin Tang is the main treatment. 154. Experiences in applying Fu Zi Xie Xin Tang – ① this formula is used for heat pi with yang deficiency syndrome, i.e., internal heat and external cold; ② this formula should be boiled for one hour, as Fu Zi is toxic. 155. Ban Xia Xie Xin Tang syndrome – if Shang Han lasts five or six days, with vomiting and fever, if the Xiao Chai Hu Tang syndrome is present, and other medications are used to purge, if Xiao Chai Hu Tang is still present, it should be used again. Although it has been purged, purging is counterproductive, leading to agitation and sweating, and if the heart is full and hard, this is a chest knot. Da Xian Xiong Tang is the main treatment, but if it is full and not painful, this is pi, and Xiao Chai Hu Tang should not be used, but Ban Xia Xie Xin Tang is appropriate. 156. Experiences in applying Ban Xia Xie Xin Tang – ① this formula is indicated for fullness without pain, which is pi; ② this formula can be used for diarrhea, especially for diarrhea caused by mixed cold and heat, with heat being predominant; ③ this formula can be used for chronic colitis caused by diarrhea; it can be added with Zhi Shi 10g. 157. Sheng Jiang Xie Xin Tang syndrome – if Shang Han has sweating, after resolving, if the stomach is not harmonized, with fullness in the heart, dry belching with food odor, and rumbling in the abdomen, if there is diarrhea, Sheng Jiang Xie Xin Tang is the main treatment. 158. The ancients said: “Belching is the gas of fullness, which is the same as eructation.” 159. Experiences in applying Sheng Jiang Xie Xin Tang – ① this formula is indicated for dry belching, food odor, rumbling in the abdomen, and diarrhea; ② it can be used for acute gastroenteritis. 160. The differences in clinical applications of Ban Xia Xie Xin Tang, Sheng Jiang Xie Xin Tang, Gan Cao Xie Xin Tang, Fu Zi Xie Xin Tang, and Da Huang Huang Lian Xie Xin Tang – Ban Xia Xie Xin Tang is indicated for fullness in the stomach, diarrhea, and vomiting; Sheng Jiang Xie Xin Tang is indicated for rumbling in the abdomen and diarrhea; Gan Cao Xie Xin Tang is indicated for diarrhea, dry belching, and irritability; all three belong to the syndrome of mixed cold and heat, characterized by vomiting, diarrhea, and fullness; Da Huang Huang Lian Xie Xin Tang is used for heat pi; Fu Zi Xie Xin Tang is used for internal heat and external cold with concurrent yang deficiency. 161. Water pi syndrome treatment – if the heart is full, with diarrhea, and the pulse is not resolved, it indicates that the heart is full, and the treatment should be to resolve the heart, hence the use of Xie Xin Tang. 162. Experiences in learning this item – ① thirst and difficulty urinating do not necessarily indicate yin deficiency and fluid damage, but rather water retention; ② thirst due to fluid damage should not be treated with large amounts of water, but rather small amounts to harmonize the stomach qi will resolve; ③ wind-damp diseases have both external and internal dampness; external dampness is resolved by sweating, while internal dampness is resolved by purging, which can be treated with Wei Ling Tang. 163. Phlegm qi pi syndrome treatment (Xuan Fu Dai Zhi Tang syndrome) – if Shang Han has sweating, if there is vomiting, if the heart is full and hard, and the belching does not resolve, Xuan Fu Dai Zhi Tang is the main treatment. 164. Experiences in applying Xuan Fu Dai Zhi Tang – ① this formula can be used for belching, and can also be used for vomiting, and can also be used for hiccups; ② this formula is indicated for belching that does not resolve. 165. Upper heat and lower cold syndrome (Huang Lian Tang syndrome) – if Shang Han, with heat in the chest, and evil qi in the stomach, desiring to vomit, Huang Lian Tang is the main treatment. 166. Experiences in applying Huang Lian Tang – ① the so-called “heat in the chest” clinically refers to tooth pain, throat pain, mouth sores, and bitter mouth; ② the so-called “evil qi in the stomach” refers to pain in the stomach area; ③ this formula can be used for duodenal bulb ulcers, switching to Jin Tui Huang Lian Tang. 167. The difference between Huang Lian Tang and Ban Xia Xie Xin Tang – Huang Lian Tang is Ban Xia Xie Xin Tang minus Huang Qin and adding Gui Zhi; although the two differ by one herb, their main treatments are different; Ban Xia Xie Xin Tang treats mixed cold and heat pi syndrome, focusing on vomiting and diarrhea, with cold herbs predominating; Huang Lian Tang treats abdominal pain with a desire to vomit, using more warm herbs than cold herbs, hence cold predominates and heat is less, Huang Lian Tang; heat predominates and cold is less, Ban Xia Xie Xin Tang. 168. Yin deficiency syndrome should avoid moxibustion – a pulse that is slightly rapid should not be moxibustioned, as fire is evil, leading to counterflow; pursuing deficiency and chasing excess will scatter blood in the pulse, and even if the fire is slight, it can still attack strongly, injuring the bones and muscles, making it difficult for blood to recover. 169. Experiences in learning the counterflow of fire in item 116 – a pulse that is slightly rapid should not be moxibustioned, not only referring to the use of moxibustion, but also indicating that patients with yin deficiency should be cautious with warm and hot medications, otherwise it can lead to injury to the bones and muscles, making it difficult for blood to recover.