43. “For those with heat in the Taiyang stage, sweating leads to aversion to cold, body heat, and thirst; Bai Hu Jia Ren Shen Tang (White Tiger Decoction with Ginseng) is the treatment.”
The Taiyang stage can present with wind stroke or cold damage, and here we encounter a case of “heat in the Taiyang stage.” In section 42, it was mentioned that “heat” refers to the invasion of summer heat into the Taiyang stage, with symptoms including: “fever, aversion to cold, body heaviness and pain, and a wiry, thin, and slow pulse.” These are the basic symptoms, and it also has very typical symptoms: “sweating, aversion to cold, body heat, and thirst; Bai Hu Jia Ren Shen Tang is the treatment.” Here, a clear formula is presented: Bai Hu Jia Ren Shen Tang, indicated by the term “主之” (is the treatment).
What are its symptoms? There is sweating, aversion to cold, and body heat with thirst. Bai Hu Jia Ren Shen Tang is mentioned in the “Shang Han Lun” (Treatise on Cold Damage), where it describes a dry tongue and irritability, with a desire to drink several liters of water. The patient exhibits extreme thirst, not only with a dry tongue but also dryness in the lips and throat, leading to a sensation of dryness throughout the mouth, with red and dry lips. Thus, the patient desires to drink several liters of water, but even after drinking, the thirst is not quenched; this is the type of thirst treated with Bai Hu Jia Ren Shen Tang.
Here, sweating and aversion to cold appear. Why does sweating lead to aversion to cold? It is because “when the heat is deep, the aversion to cold is also deep.” When the body has reached a certain level of heat, it can switch to the opposite direction, leading to symptoms like aversion to cold and cold hands and feet. This occurs because the heat has reached a certain level, causing a reversal to its opposite; thus, aversion to cold and sweating can occur. However, this is not a superficial syndrome; it is a manifestation of deep heat and deep aversion to cold, indicating that the heat has reached its peak, followed by symptoms resembling aversion to cold and fear of cold. This fear of cold arises because the internal heat has reached an extreme point.
In section 42, it states: “If urination is scanty, the hair stands on end, and the hands and feet are cold.” This coldness in the hands and feet is also similar; it occurs when the heat has reached a certain level, leading to coldness in the extremities, and also when body fluids are depleted to a certain extent. Because the heat continues to cause sweating and the expulsion of body fluids, coldness can also occur. When heat reaches a certain level, it can switch to its opposite; this indicates that cold and heat are actually one entity. There is no heat without cold, and no cold without heat; it depends on which is dominant at that moment. Of course, we often say that the human body is primarily cold, while heat is often a false heat. This is a general principle, but at this moment, the heat is dominant, and it is a manifestation of deep heat and deep aversion to cold, indicating that when heat reaches its limit, it can manifest as cold, and when cold reaches its limit, it can manifest as heat.
Therefore, cold and heat are constantly transforming, with cold as the base. However, at a certain moment, the body is hot. If we could freeze that moment, it would be extremely hot. What should we do at that time? The patient experiences body heat and extreme thirst, desiring to drink several liters of water. If we could extend that moment indefinitely, we could temporarily alleviate this symptom with Bai Hu Jia Ren Shen Tang.
There are many clinical cases of this. The cases are not strictly heat in the Taiyang stage; rather, they arise after patients take Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (Angelica Sinensis Decoction for Cold Extremities with Evodia and Ginger), leading to a transformation into Yangming disease or a manifestation of heat in the Taiyang stage.
What are the manifestations? The mouth and tongue are dry, desiring to drink several liters of water. Some describe their throat as dry and smoking, as if they have walked in the desert for days without water, feeling as if their throat and mouth are filled with sand, dry to the point of being gritty. Some describe their tongue as stiff and unable to move, dry to the extent that it resembles cracked earth under the scorching sun, making a cracking sound, feeling as if it could break with a touch.
At this point, there are two choices. Many have experienced this; I tell them they can continue taking Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang. The reason for this is that there is a long-standing cold within the body that is thousands of times greater than this dryness. If they continue taking it, as soon as that long-standing cold dissipates even a little, the dryness will resolve. The patient understood and continued taking it. On the second day, the dryness persisted, but by the third day, the dryness was alleviated, and the sensation of dry mouth and tongue was resolved, preventing sleeplessness and constant thirst. The patient resolved the symptoms through the use of Dang Gui. However, this requires a certain level of faith and perseverance.
Others, when reaching this level, truly resort to cold foods, ice pops, and cold noodles, feeling comfortable temporarily. However, this comfort is short-lived; they still need to drink water, and they must drink large amounts of water, leading to a state of constant urination. Thus, they spend the night doing nothing but drinking and urinating. When not drinking or urinating, they feel restless, caught in a state of extreme agitation, even experiencing delirium, alternating between confusion and clarity. When reaching this state, many feel frightened. What should be done at this time? Use Bai Hu Jia Ren Shen Tang to temporarily alleviate the symptoms. This is what we refer to as deep heat and deep aversion to cold, or deep heat and deep aversion to cold, reaching a peak state. At this time, Bai Hu Jia Ren Shen Tang can alleviate the symptoms, or Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang can be used, but very few choose the latter, as they are already extremely frightened. Thus, 99% of patients will choose to use Bai Hu Jia Ren Shen Tang to alleviate their symptoms.
I am no exception; I have encountered this situation several times. In one or two cases, I used Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang to resolve it, but in the remaining cases, I could not resist the anxiety and tension of the patients and their families, so I had to use Bai Hu Jia Ren Shen Tang to alleviate the current symptoms. This is Bai Hu Jia Ren Shen Tang, which indeed leads to body heat and thirst, truly thirst, sweating and aversion to cold, and body heat with sweating.
Patients describe it this way: when they drink water, they sweat profusely as if they have just taken a shower. When not drinking, it is slightly better. However, they cannot avoid drinking water because they are thirsty, and they must drink hot water. Upon drinking hot water, they sweat, and after drinking, they are still thirsty, leading to frequent urination. This is the state they are in. They sweat so much that they change clothes multiple times a day. In this state, after sweating, if they catch a chill, their throat hurts, leading to a cycle of sweating, catching a chill, throat pain, thirst for hot water, urination, and repeating this cycle. They also experience some asthma, which they say is not severe, but when the symptoms are resolved, they realize that the asthma is actually quite serious, though not as severe as the sweating. At this time, sweating is the primary concern, and thirst is also extreme, with nothing quenching it. Drinking so much water leads to so much sweating, requiring many changes of clothes, resulting in throat pain and fear of wind and cold, caught in this repetitive cycle. This is resolved with Bai Hu Jia Ren Shen Tang. In Bai Hu Jia Ren Shen Tang, the gypsum is used in its original quantity, which is quite large. The patient took the first dose during the New Year and felt it was effective. I said to continue taking it, and they asked if they should take it until they are no longer thirsty, not sweating so much, and not urinating so frequently. I said that is about right; just continue taking it. The gypsum was used in its original quantity, 240 grams per dose, and after taking three to five doses, they had consumed several kilograms of gypsum. The patient had exhausted the supply of gypsum in their local herbal pharmacy, and during the New Year, they had to travel further to buy more gypsum. They took about six or seven doses, and their symptoms were resolved. Bai Hu Jia Ren Shen Tang can indeed be incredibly powerful, pulling you back from the edge of suffering at the most critical moment.
There have been many cases where taking Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang led to the emergence of Bai Hu Jia Ren Shen Tang symptoms, not just one or two cases. In fact, continuing to take it can resolve the symptoms, but this hurdle is too difficult to overcome, so many patients succumb to the Bai Hu Jia Ren Shen Tang phase. Of course, after experiencing this, they can move forward. When they take Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang again, they will remember the experience of extreme thirst. If they encounter this symptom again, they might consider continuing with the original dose of Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang to see what effect it has. If it becomes unbearable, they can return to Bai Hu Jia Ren Shen Tang. They must go through this several times to truly overcome this hurdle. This is Bai Hu Jia Ren Shen Tang. Of course, this is not the pure heat in the Taiyang stage; generally, it is in a state of high fever and heat stroke. However, my experiences have all been cases where taking Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang led to the emergence of Bai Hu Jia Ren Shen Tang symptoms, rather than strictly heat in the Taiyang stage. The formulas are the same, but the disease names differ; one is Yangming disease, and the other is heat stroke. This is a characteristic of Traditional Chinese Medicine, where different diseases can be treated with the same formula. This is the case with Bai Hu Jia Ren Shen Tang. Therefore, when encountering heat in the Taiyang stage, especially during summer heat stroke, this formula has a significant chance of being effective, with symptoms aligning with those of Bai Hu Jia Ren Shen Tang, often described as body heat, sweating, aversion to cold, thirst, or a dry tongue, with a desire to drink several liters of water, possibly accompanied by irritability and restlessness. This is Bai Hu Jia Ren Shen Tang. Many cases have emerged from taking Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang, so patients must be mentally prepared. If you take Dang Gui for an extended period, you will eventually experience these symptoms. If you have heard this audio, you may not be too frightened. If you have not, you may directly use Bai Hu Jia Ren Shen Tang to alleviate it. However, this hurdle must be crossed eventually, and once you do, your understanding of Dang Gui will deepen. This is what I previously referred to as deep heat and deep aversion to cold.
Angel Network Diagnosis: Compassionate Care Mini Program
I dream of a day when everyone knows Zhang Zhongjing, and every family uses the “Shang Han Lun”.
Compiled by: Qi Qi
Edited by: Angel Golden Chamber Editorial Team
