典藏书目

Treat Yangming disease (Yangming syndrome), presenting with tidal fever (periodic afternoon fever), continuous sweating of the hands and feet, delirious speech with excessive sweating, dryness in the stomach leading to muttering alone as if seeing ghosts, panting and dizziness preventing lying down, abdominal fullness and pain, and a slippery and solid pulse. Also indicated for cases where vision is blurred and the eyes are unresponsive. Additionally indicated for Shaoyin disease (Shaoyin syndrome) at its onset, characterized by dry mouth and throat. Also for spontaneous diarrhea of clear water, purely green in color, with pain in the epigastrium, dry mouth and tongue. And for cases lasting six or seven days, featuring abdominal distension and constipation.

Da Huang (Rhubarb Root and Rhizome, washed with wine) 4 liang, Hou Po (Magnolia Bark) 8 liang, Zhi Shi (Immature Bitter Orange, roasted) 5 pieces, Mang Xiao (Mirabilite) 3 he. The above four ingredients: use one dou of water, first decoct Hou Po and Zhi Shi to obtain five sheng of liquid, add Da Huang, decoct to obtain two sheng of liquid, remove the dregs; add Mang Xiao, heat again briefly for one or two boils, divide into two doses and take warm. Stop subsequent dosing once bowel movement occurs.

Da Huang (Rhubarb Root and Rhizome) 4 liang, Hou Po (Magnolia Bark, roasted, peeled) 2 liang, Zhi Shi (Immature Bitter Orange) 3 pieces. The above three ingredients: use four sheng of water, decoct to obtain one sheng and two he of liquid, remove the dregs, divide into three doses and take warm. After the first dose, bowel movement should occur; if not, administer the next dose. Use until bowel movement is achieved. Stop administration once bowel movement occurs.

[Collected Annotations] Ke Qin stated: All diseases arise from Qi dysfunction; the inability to expel turbid matter is due to the obstruction of Qi flow. Therefore, purgative agents must utilize herbs that regulate Qi, hence the name "Chengqi" (Inheriting Qi). There are two reasons for dividing the formula into Da Chengqi Tang (Major Inheriting Qi Decoction) and Xiao Chengqi Tang (Minor Inheriting Qi Decoction): When Hou Po is double the amount of Da Huang, the Qi-regulating herb is the sovereign drug, named Da Chengqi Tang; when Da Huang is double the amount of Hou Po, the Qi-regulating herb is the minister drug, named Xiao Chengqi Tang. The former has many ingredients and potent properties, with larger dosage intended for strong purgation, thus called "Major"; the latter has fewer ingredients and milder properties, with smaller dosage intended for mild harmonization of Stomach Qi, thus called "Minor." Furthermore, the decoction method holds profound meaning. For Da Chengqi Tang, one dou of water is used to decoct Zhi Shi and Hou Po to obtain five sheng, dregs removed, then Da Huang is added and decocted to obtain two sheng, followed by adding Mang Xiao. Why? Raw herbs have sharp Qi and act quickly, while cooked herbs have pure Qi and act gently. Zhang Zhongjing intended for Mang Xiao to first dissolve dry feces, Da Huang to subsequently unblock the intestinal tract, and finally Zhi Shi and Hou Po to eliminate痞满 (fullness and stuffiness). In contrast, Xiao Chengqi Tang decocts all three ingredients together without sequence. Although using the same Da Huang, the different decoction methods reveal Zhang Zhongjing's intent for mild harmonization. Yu Chang stated: "Jin Gui Yao Lue" treats spasm disease characterized by chest fullness, trismus (lockjaw), inability to lie flat with back arching, leg cramps, and teeth grinding, suggesting the use of Da Chengqi Tang, which is a method of seeking life amidst death. "Ling Shu" states that heat-induced spasm leads to death, manifesting as opisthotonos (back arching), clonic spasms, and teeth grinding. Here, "inability to lie flat" is a variation of opisthotonos, and "leg cramps" is a variation of clonic spasms. Moreover, with teeth grinding combined with chest fullness and trismus, heat pathogens fill the Upper, Middle, and Lower Jiao (Triple Burners), leading to imminent death. In Taiyang disease (Taiyang syndrome), abdominal fullness can be purged, but chest fullness cannot. However, when using this formula, one must understand that "chest fullness" refers to pathogenic factors still on the exterior, hence purging is contraindicated. This condition involves interior heat that is extremely deep and severe, incomparable to the former. Since extreme Yang heat causes immediate consumption of Yin blood, even slight purging may not suffice to overcome Yang heat and rescue Yin. Thus, this formula is chosen to inherit and preserve the remaining thread of Yin Qi. If Yin Qi is not robbed by Yang heat, many patients survive. The phrase "may be given" is flexible; it requires clinical judgment and is not a fixed rule. There is both a strict prohibition against purging which severely damages Yin, and a flexible method of purging to urgently rescue Yin. Scholars aiming for profound mastery must focus on this aspect.