Shigao (Gypsum Fibrosum, 石膏) (2 liang), Mahuang (Ephedrae Herba, 麻黄) (7.5 qian, nodes removed), Gancao (Licorizae Radix et Rhizoma, 甘草) (prepared with honey), Shengma (Cimicifugae Rhizoma, 升麻) (0.5 liang each). The above ingredients are processed into coarse powder. For each dose, take 5 qian, add 1 cup of water and 0.5 he of Chidou (Sojae Semen Preparatum, 豉), decoct until 80% remains, remove the dregs, and take hot. If after three to five doses wind aversion persists, add Mahuang (Ephedrae Herba, 麻黄) 0.5 liang and Shigao (Gypsum Fibrosum, 石膏) 1 liang.

Shaoyao Tang (Peony Decoction): Gancao (Licorizae Radix et Rhizoma, 甘草) (prepared with honey, 0.5 liang), Shaoyao (Paeoniae Radix, 芍药) (1 liang), Shigao (Gypsum Fibrosum, 石膏) (3 liang), Jingjiesui (Schizonepetae Spica, 荆芥穗) (1 liang). The above ingredients are processed into coarse powder. For each dose, take 5 qian, add 1 cup of water and one piece of Shengjiang (Zingiberis Rhizoma Recens, 生姜), decoct until 70% remains, remove the dregs, and take hot. If after three to five doses wind aversion persists, add one piece of Shengjiang (Zingiberis Rhizoma Recens, 生姜) to each dose for simultaneous decoction.

Zhimu Tang (Anemarrhenae Decoction): Zhimu (Anemarrhenae Rhizoma, 知母) (1 liang), Shigao (Gypsum Fibrosum, 石膏) (2 liang), Mahuang (Ephedrae Herba, 麻黄), Shengma (Cimicifugae Rhizoma, 升麻) (1 liang each), Zhi Gancao (Licorizae Radix et Rhizoma, 甘草) (prepared with honey, 0.5 liang). The above ingredients are processed into coarse powder. For each dose, take 5 qian, add 1 cup of water and one piece of Shengjiang (Zingiberis Rhizoma Recens, 生姜), decoct until 70% remains, remove the dregs, and take warm. If after three to five doses wind aversion persists, add Mahuang (Ephedrae Herba, 麻黄) and Shengma (Cimicifugae Rhizoma, 升麻) 0.5 liang each.

The preceding three sections treat Wind-Stroke (Zhong Feng, 中风) and Cold Damage (Shang Han, 伤寒) with the same method. Practitioners, because patients initially present with both pulse and symptom manifestations, if they administer resolving agents, it will certainly not lead to recovery; therefore, these former formulas are established to be treated with the same method. Zhang Zhongjing stated: In diseases of Cold Damage (Shang Han, 伤寒), a slow pulse indicates Wind-Strike (Zhong Feng, 中风), while a tight pulse is named Cold Damage (Shang Han, 伤寒). Why distinguish these two ends now? Initially, due to the toxic Qi of winter cold invading the person, the internally latent Yang sinks and hides within the bone marrow. Whenever it erupts in spring or summer, it may be triggered by external cold injury drawing out internal pathogens, or by external wind injury drawing out internal pathogens. Once the internal pathogens emerge, the disease becomes identical. The ancients stated that establishing these two distinctions is to prevent later generations from suspecting that tight and slow pulses require different treatments. If Wind-Strike (Zhong Feng, 中风) and Cold Damage (Shang Han, 伤寒) have different pulses, why did Zhang Zhongjing not use different treatment methods? This is because later generations failed to investigate Zhang Zhongjing’s intent. When patients first contract the disease, from one to two days up to five or six days, if exterior pulses and exterior symptoms persist, medication can still be administered based on the pulse and symptoms. Whenever administering exterior-resolving or exterior-releasing medicines, one may drink three doses per day; if symptoms are severe, up to five doses may be taken. One must not take all doses at once. If symptoms do not resolve, repeat the administration the next day based on the previous protocol. If symptoms remain unresolved according to the previous pattern, one may administer hot millet gruel, adding Congbai (Allii Fistulosi Bulbus, 葱白) to the gruel. If sweating occurs, do not cover with thick clothing to avoid excessive sweating leading to Yang Collapse (Wang Yang, 亡阳证).

Hai Zang stated: In Han Shi’s Wei Zhi, the chapter on Sweating includes the method of harmonizing according to time. It states that the pulse of Cold Damage (Shang Han, 伤寒) has a small head and large tail, while the pulse of Wind Strike (Shang Feng, 伤风) has a large head and small tail. Li Sixun’s Bao Ming Xin Shu also distinguishes Cun and Chi positions, consistent with Zhang Zhongjing. This differs from predecessors who generally stated that Cun and Chi pulses are both floating and tight (indicating Cold Damage without sweating) or both floating and slow (indicating Wind Strike with spontaneous sweating). There are cases of Wind Strike with sweating and Cold Damage without sweating where pulses differ mutually and contradict symptoms, which predecessors had fully explained. Only Han and Li stated that a small head and large tail indicates Cold Damage (Shang Han, 伤寒), while a small tail and large head indicates Wind Strike (Shang Feng, 伤风). Occasionally, patients’ pulses and symptoms do not manifest clearly in the Cun and Chi positions; thus, Han and Li described the method of harmonizing according to time. Fearing later generations would doubt this does not align with former sages, they established several modification rules within the main formula, which did not exceed the intent of predecessors. How appropriate! These two gentlemen lived during the peak of the Song Dynasty; thus, they warned against lightly using Mahuang (Ephedrae Herba, 麻黄) and Guizhi (Cinnamomi Ramulus, 桂枝), recommending instead the milder agents Shigao (Gypsum Fibrosum, 石膏), Shengma (Cimicifugae Rhizoma, 升麻), Gegen (Puerariae Lobatae Radix, 葛根), and Chaihu (Bupleuri Radix, 柴胡). This was suitable for their time but not necessarily the eternal path. As times change, so do methods. In the chapter on Sweating, if following the decoction and responding to symptoms, there are fixed regulations; even the wise cannot transgress them.

Furthermore, a small Cun Kou pulse caused by drinking cold liquids or injury from fog and dew is treated as a Middle Jiao disorder. Now, Han Yun stated that a small Cun in Cold Damage (Shang Han, 伤寒) should not be mistaken as being the same as injury from drinking cold or fog/dew, lest one harm the unity of the condition. Injury from drinking cold or fog/dew results in no pulse sensation upon lifting or pressing at Cun Kou, indicating Yin Qi in the stomach is disharmonious and Yang Qi cannot ascend and transcend. A small Cun Kou in Cold Damage (Shang Han, 伤寒) is seen only from the Guan position down to the Bladder (Pang Guang, 膀胱) primary region. Although the Cun Kou is small, it is merely minute upon lifting and present upon pressing, unlike the complete absence upon lifting and pressing in cold/fog injury. If the Cun Kou is indeed completely absent upon lifting and pressing, exterior resolution is contraindicated; only warming the Middle Jiao is appropriate. This must not be overlooked.