典藏书目

Baitong Decoction (White Tongue Decoction) and Sini Decoction (Frigid Extremities Decoction) both use dried ginger (Zingiberis Rhizoma Preparatum) and prepared aconite root (Aconiti Lateralis Radix Preparata), and are both formulas for supporting yang qi and suppressing yin cold. However, Baitong Decoction aims to unblock yang qi, thus using scallion white (Allii Fistulosi Bulbus); it is indicated for patients with cold extremities accompanied by diarrhea and a faint pulse. Sini Decoction aims to rescue the interior deficiency, thus using licorice root (Glycyrrhizae Radix et Rhizoma); it is indicated for patients with cold extremities and persistent diarrhea containing undigested food (Complete Grain Diarrhea). As for Tongmai Sini Decoction (Pulse-Reviving Sini Decoction), it advances to follow yang qi in order to gather dispersed external heat; whereas Baitong Decoction added with human urine (Ren Niao) and pig bile (Zhu Danzhi), retreats to align with yin in order to eliminate repelling cold.

Sweating accompanied by wheezing, without significant high fever, indicates that the pathogenic factor is not in the meridians and skin-collaterals, but within the lungs; therefore, Guizhi Tang (Cinnamon Twig Decoction) cannot be used to induce sweating and release the exterior. Mahuang (Ephedrae Herba) and Xingren (Armeniacae Semen Amarum) are acrid and sweet, entering the lungs to disperse pathogenic qi; since the lungs are constrained by pathogens generating heat, Shigao (Gypsum Fibrosum) is acrid and cold, entering the lungs to clear hot qi; Gancao (Licorizae Radix et Rhizoma) is sweet and warm, stabilizing middle qi, and assisting in dispersing pathogens and clearing heat. This is the specific formula for treating wheezing caused by pathogenic factors in the lung organ.

After vomiting or purgation in Shanghan (Cold Damage), if there is fullness and rebellious qi below the heart, with qi rushing up to the chest, etc., this analysis suggests it is not a typical Shanghan syndrome, but belongs to patients with fluid retention (Yin Jia). The *Jingui Yaolue* states: "Fluid retention obstructing the diaphragm causes wheezing and fullness, with hardness and stuffiness below the heart; if persisting for dozens of days and failing to improve after physician-induced vomiting or purgation, Mufangji Tang (Stephania Tetrandra Decoction) should be the primary treatment." It further states: "If the patient trembles and shakes, there must be latent fluid retention." And again: "Fluid retention below the heart manifests as distending fullness in the chest and hypochondrium, and dizziness." Cheng Wuji considered this to be interior deficiency with rebellious qi, and believed that using this medicine harmonizes the meridians, benefits yang, and dissipates qi, which is likely inaccurate.

When symptoms resemble Guizhi Tang syndrome, but the head does not hurt and the neck is not stiff, with the cun pulse slightly floating, stuffiness and hardness in the chest, and qi rushing up to the throat causing difficulty breathing, this is due to cold-fluid retention in the chest. It should be treated by inducing vomiting, preferably using Gouti San (Melon Seed Powder). Here, "cold" refers to cold-fluid retention, not exogenous cold pathogen. This also falls under the category of phlegm-fluid retention mimicking Shanghan. The *Heren Shu* states: "Phlegm-fluid retention can cause increased aversion to cold and fever, resembling Shanghan, except that the head does not hurt and the neck is not stiff."

Excessive sweating leads to intensified heat, while scanty sweating leads to difficult defecation. Some suspect that scanty sweating intensifies heat, while excessive sweating causes constipation. The *Taiyang Chapter* states: "When the yang pulse is faint and sweating is scanty, it indicates self-harmonization; excessive sweating indicates excess." If the yang pulse is solid, and excessive sweating was induced, this is also excess. Excess leads to yang isolation within, depletion of body fluids, and consequently hard stools. Cheng Wuji's view that scanty sweating leaves pathogenic heat unresolved and depletes fluids is incorrect.

In Taiyang disease, ten days have passed, the pulse is floating and fine, and the patient desires to lie down; this indicates the exterior has resolved. If chest fullness and hypochondriac pain are present, Xiaochaihu Tang (Minor Bupleurum Decoction) should be given; if the pulse is merely floating, Mahuang Tang (Ephedra Decoction) should be given. This means: if the pulse is merely floating without being fine, and the patient is lethargic, the pathogen remains on the exterior, suitable for Mahuang Tang; if the pulse is floating and fine, without lethargy, but with chest fullness and hypochondriac pain, the pathogen is in Shaoyang, suitable for Xiaochaihu Tang. This does not mean resolving the exterior first and then applying harmonizing or releasing methods.

In Taiyang disease, with a floating-tight pulse, absence of sweating, fever, and body pain, persisting for eight or nine days without resolution, with exterior symptoms still present, sweating should be induced. After taking medicine, symptoms may slightly subside, but the patient becomes irritable and closes their eyes; in severe cases, epistaxis (nosebleed) will occur, and the disease resolves through bleeding. This occurs because yang qi is heavily constrained; Mahuang Tang is the primary treatment. Note: The phrase "Mahuang Tang is the primary treatment" should logically follow "sweating should be induced here." It implies that after taking Mahuang Tang, although the illness may not fully resolve, irritability and eye closure may appear; in severe cases, due to excess yang pathogen ascending, epistaxis will occur to resolve the condition. It does not mean inducing sweating with Mahuang Tang *after* epistaxis has already occurred. However, one must assess the severity. If the patient intends to bleed but blood does not flow, or bleeds but the pathogen remains, sweating induction is still appropriate. Zhang Zhongjing stated: "In Shanghan with a floating-tight pulse, if sweating is not induced leading to epistaxis, Mahuang Tang is the primary treatment," which supports this interpretation.

Shanghan with a floating-slippery pulse indicates heat on the exterior and cold on the interior, treated with Baihu Tang (White Tiger Decoction). However, the *Yangming Chapter* states: "Shanghan without high fever, dry mouth and thirst, irritability, and slight aversion to cold on the back, treated with Baihu Tang." The *Jueyin Chapter* states: "Shanghan with a slippery pulse and cold extremities indicates heat on the interior, treated with Baihu Tang." Examining these, the original text likely contains a transcription error and should read "heat on the interior, cold on the exterior"; the "exterior cold" refers to cold extremities and slight aversion to cold on the back. This is likely a scribal error and should not be forced into interpretation.

The section on "Symptoms resembling Yangdan" seems to repeat the previous point in a Q&A format, but the logic is disjointed, suggesting it may be a later addition. Ancients noted that the *Kaogong Ji* did not align with the *Rites of Zhou*; I hold a similar view regarding this passage.

Diarrhea with undigested food and sweating inevitably leads to abdominal distension, due to damage to yang qi and failure of qi movement. Cheng Wuji's attribution to fluid depletion is incorrect.

For Cold-Excess Juxiong (Chest Binding) without heat signs, Sanwu Xiaoxianxiong Tang (Three-Ingredient Minor Chest-Penetrating Decoction) is mentioned, or Bisan (White Powder) may be taken. It should read: "For Cold-Excess Juxiong without heat signs, Sanwu Baisan (Three-Ingredient White Powder) should be given." The old version is erroneous. Since it is Cold-Excess, how could one use cold herbs like Gualou Fructus (Trichosanthis Fructus) and Huanglian Rhizoma (Coptidis Rhizoma)?