麻黄(去节)三两 芍药三两 五味子半升 干姜二两 甘草(炙)三两 半夏(洗
)半升 桂枝三两 细辛三两
右八味,以水一斗,先煮麻黄、减二升,去上沫,内诸药,煮取三升,去滓,温服一
升。加减法:若渴,去半夏加栝蒌根三两。若噎者,去麻黄加附子一枚(炮)。若小
便不利,少腹满,去麻黄加茯苓四两。若喘,去麻黄加杏仁半升(去皮尖)。若微利
,去麻黄加荛花如一鸡子,熬令赤色。
【按】
加荛花如鸡子大,熬令赤色,此必传写之误。盖本草荛花、即芫花类也。用之攻水,
其力甚峻。五分可令人下行数十次。岂有治停饮之微利,而用鸡子大之荛花者乎?似
当改加茯苓四两。
【方解】
太阳停饮有二:一中风有汗为表虚,五苓散证也;一伤寒无汗为表实,小青龙汤证也
。表实无汗,故合麻桂二方以解外。去大枣者,以其性滞也;去杏仁者,以其无喘也
,有喘者,仍加之;去生姜者,以有干姜也,若呕者,仍用之。佐干姜细辛,极温极
散,使寒与水俱得从汗而解;佐半夏逐痰饮,以清不尽之饮;佐五味收肺气,以敛耗
伤之气。若渴者,去半夏加花粉,避燥以生津也;若微利与噎,小便不利,少腹满,
俱去麻黄,远表而就里也。加附子以散寒,则噎可止;加茯苓以利水,则微利止,少
腹满可除矣。此方与越婢汤同治水饮溢于表,而为腹胀水肿,宜发汗外解者,无不随
手而消。越婢治有热者,故方中君以石膏,以散阳水也;小青龙治有寒者,故方中佐
以姜桂以散阴水也。
【集解】
柯琴曰:两青龙俱治有表里证,皆用两解法。大青龙是里热,小青龙是里寒,故发表
之药相同,而治里之药则殊也。此与五苓同为治表不解,而心下有水气。然五苓治水
之蓄而不行,故专渗泻以利水,而微发其汗,使水从下而去也;此方治水之动而不居
,故备举辛温以散水,而大发其汗,使水从外而出也。仲景发表利水诸法,精义入神
矣。
赵良曰:溢饮之证,『金匮』云:当发其汗,小青龙汤治之。盖水饮溢出于表,荣卫
尽为之不利,必仿伤寒荣卫两伤之法,发汗以散其水,而后荣卫行,经脉通,则周身
之水可消,必以小青龙汤为第一义,于此可类推矣。
@@@
伤寒,心中有水气,咳而微喘,发热不渴。服汤已,渴者,此寒去欲解也,小青龙汤
主之。
【按】
「小青龙汤主之」六字,当在发热不渴之下,始与服汤已渴者之文义相属。岂有寒去
欲解,而更服小青龙汤之理乎?
【注】
伤寒,心下有水气,咳而微喘,发热不渴,此为外伤寒邪,内停寒饮,宜以小青龙汤
两解之。服汤汗解已后渴者,乃已汗寒去内燥之渴,非未汗饮停不化之渴,故曰:寒
去欲解也。当少少与水饮之,以滋其燥,令胃和自可愈也。
【集注】
成无己曰:咳而微喘者,水寒射肺也。发热不渴者,表证未罢也。与小青龙汤发表散
水,服汤已渴者,里气温,水气散,为欲解也。
方有执曰:发热不渴,寒胜也,故以服汤已而渴,为寒去欲解,大意与上条相彷,故
治亦同。
程知曰:此明水寒未解,治宜小青龙也。心下有水气,寒在膈上也。故喘咳,发热不
渴,服汤已而渴,则水寒解矣。此解水气之法,当用小青龙,非谓解后仍用小青龙也
。
张璐曰:风寒挟水饮,为病在表者,故不渴。服汤后而渴者,是为寒去津伤欲解之征
,所以虽渴而不必服药,但当静俟津回可也。咳而微喘,为水饮上逆。今水去而渴,
与水逆而渴不同。世本小青龙汤主之在寒去欲解也之下,错简也。
汪琥曰:上条云渴,是未服汤而渴,乃水停津液不化而渴;此条云渴,是服汤已而渴
,乃汗后津液既亡而渴。渴既不同,岂可仍用上药小青龙主之?当在服汤已之上可知
。
@@@
下之后,复发汗,必振寒,脉微细,所以然者,以内外俱虚故也。
【注】
发汗当于未下之先。今下之后,复发汗,必振寒,脉微细者,表里皆虚也。所以然者
,以下之失宜,则内守之阳虚,故脉微细也。以汗之失宜,则外固之阳衰,故振寒也
。
【集注】
郑重光曰:治伤寒先汗后下,此定法也。若下后外邪不尽,不得已而复汗之,邪虽去
而内外俱虚,是以脉细振寒,所伤滋大矣。
@@@
下之后,复发汗,昼日烦躁不得眠,夜而安静,不呕不渴,无表证,脉沉微,身无大
热者,干姜附子汤主之。
【注】
此承上条互详脉证,以出其治也。既下之以虚其里,复发汗以虚其表,阴阳两虚,阳
无所附,夜而安静,不呕不渴,是内无阳证也;无表证,身无大热,脉沉微,是外无
阳证也。表里无阳,内外俱阴,惟有昼日烦躁不得眠,一假阳证,则是独阴自治于阴
分,孤阳自扰于阳分,非相胜乃相离也,故以干姜附子汤,助阳以配阴。盖以阴虽盛
而未相格,阳气微而自不根据附也。
【集注】
喻昌曰:上条但言振寒及微细之脉,未定所主之病,以虚证不一也。然振寒脉微细,
阳虚已见一班,设昼日烦躁不得眠,其为虚阳扰乱可知;夜反安静,不呕不渴,则虚
阳扰乱不兼外邪可知。脉沉微,身无大热,则烦躁,为亡阳之诊,干姜附子在所必需
。由此而推,日中安静,夜而烦躁,则为阴病而阳不病,又可知矣。
程应旄曰:下之后,复发汗,昼日烦躁不得眠,虚阳扰乱,外见假热也。夜安静,不
呕不渴,无表证,脉沉微,身无大热,阴气独治,内系真寒也。宜干姜附子汤,宜从
阴中回阳,不当于昼日烦躁,一假热证狐疑也。
【小青龙汤方】
麻黄(去节)三两 芍药三两 五味子半升 干姜二两 甘草(炙)三两 半夏(洗)半升 桂枝三两 细辛三两
以上八味药,用水一斗,先煮麻黄,水量减少二升,撇去水面上的浮沫,加入其余药物,煎煮至剩余三升,滤去药渣,每次温服一升。加减法:如果口渴,去掉半夏,加入栝蒌根三两。如果出现噎塞感,去掉麻黄,加入一枚炮附子。如果小便不利,少腹部胀满,去掉麻黄,加入茯苓四两。如果气喘,去掉麻黄,加入杏仁半升(去皮尖)。如果轻微腹泻,去掉麻黄,加入荛花如鸡蛋大小,炒至变红。
【按语】
“加入荛花如鸡蛋大小,炒至变红”,这必定是传抄过程中的错误。因为《本草》中记载的荛花,属于芫花一类。用它来攻逐水饮,药力非常猛烈。五分量的荛花就可以让人腹泻几十次。哪有治疗停饮引起的轻微腹泻,却使用鸡蛋大小的荛花的道理呢?似乎应当改为加入茯苓四两。
【方解】
太阳病伴有水饮停留有两种情况:一种是中风且有汗出,属于表虚证,对应五苓散证;另一种是伤寒且无汗出,属于表实证,对应小青龙汤证。表实无汗,所以合并使用麻黄汤和桂枝汤两个方剂以解除表邪。去掉大枣,是因为其性质滞涩;去掉杏仁,是因为没有气喘症状,如果有气喘,仍然加上;去掉生姜,是因为方中已有干姜,如果出现呕吐,仍然使用生姜。用干姜、细辛作为佐药,极温极散,使寒邪与水饮都能通过汗液排出;用半夏驱逐痰饮,以清除残留的水饮;用五味子收敛肺气,以敛摄耗伤之气。如果口渴,去掉半夏加入天花粉,是为了避开燥性以生津液;如果是轻微腹泻、噎塞感、小便不利、少腹胀满,都去掉麻黄,是为了远离表证而转向治疗里证。加入附子以散寒,则噎塞可止;加入茯苓以利水,则轻微腹泻停止,少腹胀满可消除。此方与越婢汤同样用于治疗水饮溢于体表,导致腹胀水肿,适宜发汗从外解的情况,没有不随手消除的。越婢汤治疗有热者,所以方中以石膏为君药,以发散阳水;小青龙汤治疗有寒者,所以方中以干姜、桂枝为佐药,以发散阴水。
【集解】
柯琴说:大青龙汤和小青龙汤都治疗有表里证的疾病,都采用表里双解的方法。大青龙汤是里有热,小青龙汤是里有寒,所以发表的药物相同,但治疗里的药物则不同。此方与五苓散同为治疗表证不解,而心下有 water qi(水气)。然而五苓散治疗的是水蓄积而不流动,所以专门利用渗泻来利水,并微微发汗,使水从下面排出;此方治疗的是水动而不居留,所以备举辛温药物以散水,并大发其汗,使水从外面排出。仲景发表利水的各种方法,精义已入神妙境界。
赵良说:溢饮的病证,《金匮要略》说:应当发汗,用小青龙汤治疗。大概水饮溢出于体表,营卫全都因此不利,必须仿效伤寒营卫两伤的方法,发汗以消散水饮,然后营卫运行,经脉通畅,那么周身的水饮可以消除,必须以小青龙汤为首选原则,由此可以类推了。
@@@
伤寒,心中有水气,咳嗽且轻微气喘,发热但不口渴。服药后,感到口渴的,这是寒邪去除、病情将要解除的表现,(原条文此处有误,应为小青龙汤主治发热不渴之证)。
【按语】
“小青龙汤主之”这六个字,应当放在“发热不渴”之下,才与“服药后感到口渴”的文义相衔接。哪有寒邪去除、病情将要解除,反而再服用小青龙汤的道理呢?
【注】
伤寒,心下有水气,咳嗽且轻微气喘,发热但不口渴,这是外受寒邪,内停寒饮,适宜用小青龙汤表里双解。服药汗解之后出现口渴的,乃是已经发汗、寒邪去除后内部干燥引起的口渴,不是未发汗、水饮停滞不化引起的口渴,所以说:寒邪去除,病情将要解除。应当少量多次给予饮水,以滋润内部干燥,令胃气调和自然痊愈。
【集注】
成无己说:咳嗽且轻微气喘,是水寒射肺所致。发热但不口渴,是表证尚未罢除。给予小青龙汤发表散水,服药后感到口渴的,说明里气温和,水气消散,是病情将要解除的表现。
方有执说:发热但不口渴,是寒邪盛的表现,所以认为服药后感到口渴,是寒邪去除、病情将要解除,大意与上一条相似,所以治疗方法也相同。
程知说:这里阐明水寒未解,治疗适宜用小青龙汤。心下有水气,寒在膈上。所以气喘咳嗽,发热但不口渴,服药后感到口渴,则水寒已解。这是化解水气的方法,应当用小青龙汤,并不是说解除了水寒之后仍然使用小青龙汤。
张璐说:风寒挟带水饮,病位在表,所以不口渴。服药后感到口渴的,这是寒邪去除、津液受伤、病情将要解除的征兆,所以虽然口渴也不必服药,只当静待津液回复即可。咳嗽且轻微气喘,是水饮上逆所致。现在水饮去除了而感到口渴,这与水逆导致的口渴不同。世传本将“小青龙汤主之”放在“寒去欲解也”之下,是错简。
汪琥说:上一条说口渴,是未服药时口渴,乃水停津液不化而致渴;这一条说口渴,是服药后口渴,乃发汗后津液既亡而致渴。口渴既然不同,岂可仍用上药小青龙汤主治?应当放在“服药后”之上可知。
@@@
误用攻下法后,又再次发汗,必然出现身体颤抖恶寒,脉象微细,之所以这样,是因为内外都虚的缘故。
【注】
发汗应当在攻下之前进行。如今在攻下之后,又再次发汗,必然出现身体颤抖恶寒,脉象微细,这是表里皆虚。之所以这样,是因为攻下失宜,导致内守的阳气虚弱,所以脉象微细;因为发汗失宜,导致外固的阳气衰败,所以身体颤抖恶寒。
【集注】
郑重光说:治疗伤寒,先汗后下,这是定法。如果在攻下后外邪未尽,不得已而再次发汗,邪气虽去但内外俱虚,因此脉细、身体颤抖恶寒,所受的损伤更加深重了。
@@@
误用攻下法后,又再次发汗,白天烦躁不得入睡,夜间反而安静,不呕吐、不口渴,无表证,脉象沉微,身体没有大热的,用干姜附子汤主治。
【注】
这是承接上一条详细阐述脉证,以提出治疗方法。既然用攻下法使其里虚,又用发汗法使其表虚,阴阳两虚,阳气无所依附,夜间安静,不呕吐、不口渴,说明内无阳证;无表证,身体没有大热,脉象沉微,说明外无阳证。表里无阳,内外俱阴,只有白天烦躁不得入睡,这是一种假阳证,则是独阴在阴分自治,孤阳在阳分自扰,不是相互克制而是相互离决,所以用干姜附子汤,扶助阳气以配纳阴气。大概因为阴气虽盛但未相互格拒,阳气微弱而不能依附。
【集注】
喻昌说:上一条只说了身体颤抖恶寒及微细的脉象,未确定主治的疾病,因为虚证有多种。然而身体颤抖恶寒、脉微细,阳虚已显现出一斑,假如白天烦躁不得入睡,可知其为虚阳扰乱;夜间反而安静,不呕吐、不口渴,则可知虚阳扰乱不兼夹外邪。脉象沉微,身体没有大热,则可知烦躁是亡阳的诊断,干姜附子汤在所必需。由此推论,白天安静,夜间烦躁,则为阴病而阳不病,也可知了。
程应旄说:误用攻下法后,又再次发汗,白天烦躁不得入睡,是虚阳扰乱,外见假热。夜间安静,不呕吐、不口渴,无表证,脉象沉微,身体没有大热,是阴气独治,内系真寒。适宜用干姜附子汤,应当从阴中回阳,不应当在白天烦躁这种假热证面前犹豫不决。
[Formula of Xiao Qing Long Tang]
Mahuang (Ephedrae Herba, removed nodes) 3 liang, Shaoyao (Paeoniae Radix Alba) 3 liang, Wuweizi (Schisandrae Fructus) half sheng, Ganjiang (Zingiberis Rhizoma) 2 liang, Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) 3 liang, Banxia (Pinelliae Tuber, washed) half sheng, Guizhi (Cinnamomi Ramulus) 3 liang, Xixin (Asari Radix et Rhizoma) 3 liang.
The above eight herbs are boiled in ten dou of water. First, boil Mahuang until the volume decreases by two dou, skim off the foam on the surface, then add the remaining herbs. Boil until three sheng remains, strain the dregs, and take one sheng warm each time.
Modifications: If there is thirst, remove Banxia and add Gualougen (Trichosanthis Radix) 3 liang. If there is a sensation of choking, remove Mahuang and add one Pao Fuzi (Aconiti Lateralis Radix Praeparata). If there is difficulty in urination and fullness in the lower abdomen, remove Mahuang and add Fuling (Poria) 4 liang. If there is wheezing, remove Mahuang and add Xingren (Armeniacae Semen Amarum, skin and tips removed) half sheng. If there is mild diarrhea, remove Mahuang and add Raohua (Daphnes Genkwa Flower) the size of a chicken egg, stir-fried until red.
[Commentary]
"Add Raohua the size of a chicken egg, stir-fried until red" must be a transcription error. According to Bencao (Materia Medica), Raohua belongs to the same category as Yuanhua (Daphnes Genkwa Flos). Used to attack fluid retention, its potency is very fierce. A dose of five fen can cause dozens of bowel movements. How could one use a chicken-egg-sized dose of Raohua to treat mild diarrhea caused by retained fluid? It seems appropriate to change it to adding Fuling 4 liang.
[Analysis of the Formula]
There are two types of Taiyang disease with retained fluid: one is Wind-stroke with sweating, representing Exterior Deficiency syndrome, corresponding to the Wuling San (Five-Ling Powder) syndrome; the other is Cold Damage without sweating, representing Exterior Excess syndrome, corresponding to the Xiao Qing Long Tang (Minor Blue Dragon Decoction) syndrome. Since the Exterior Excess presents with no sweating, it combines the formulas of Mahuang Tang and Guizhi Tang to release the exterior. Dazao (Jujubae Fructus) is removed because its nature is cloying; Xingren is removed because there is no wheezing, but if wheezing occurs, it is added back; Shengjiang (Zingiberis Rhizoma Recens) is removed because Ganjiang is already present, but if vomiting occurs, Shengjiang is used again. Ganjiang and Xixin are used as assistants, extremely warming and dispersing, allowing cold and fluid to be resolved through sweating. Banxia is used to expel phlegm-fluid and clear residual fluid; Wuweizi is used to astringe Lung Qi and conserve depleted Qi. If there is thirst, Banxia is removed and Huafen (Trichosanthis Radix) is added to avoid dryness and generate fluids. For mild diarrhea, choking sensation, difficulty in urination, and lower abdominal fullness, Mahuang is removed to shift focus from the exterior to the interior. Adding Fuzi disperses cold, stopping the choking; adding Fuling promotes diuresis, stopping mild diarrhea and relieving lower abdominal fullness. This formula, along with Yebiao Tang (Yuebi Decoction), treats fluid overflowing into the exterior causing abdominal distension and edema, suitable for resolution via sweating. Both work effortlessly. Yebiao Tang treats cases with heat, using Shigao (Gypsum Fibrosum) as the sovereign herb to disperse Yang-water; Xiao Qing Long Tang treats cases with cold, using Ganjiang and Guizhi as assistant herbs to disperse Yin-water.
[Collected Interpretations]
Ke Qin said: Both Da Qing Long Tang and Xiao Qing Long Tang treat diseases with both exterior and interior syndromes, employing a method of simultaneous release of both. Da Qing Long Tang involves interior heat, while Xiao Qing Long Tang involves interior cold. Thus, the herbs for releasing the exterior are the same, but those treating the interior differ. This formula, like Wuling San, treats unresolved exterior syndrome with water qi (fluid accumulation) under the heart. However, Wuling San treats stagnant and immobile water, focusing on渗泻 (percolation and purgation) to promote urination and slightly induce sweating to eliminate water from below. This formula treats moving and unsettled water, utilizing acrid-warm herbs to disperse water and vigorously inducing sweating to eliminate water from the outside. Zhongjing's methods for releasing the exterior and promoting diuresis are profound and divine.
Zhao Liang said: Regarding Yi Yin (Overflowing Fluid) syndrome, "Jinkui Yaolue" states: "It should be treated by inducing sweating," using Xiao Qing Long Tang. Generally, when fluid overflows to the exterior, Ying and Wei (Nutritive and Defensive Qi) are all obstructed. One must imitate the method for Cold Damage injuring both Ying and Wei, inducing sweating to dissipate the fluid. Only then will Ying and Wei circulate, meridians unblock, and fluid throughout the body dissipate. Therefore, Xiao Qing Long Tang is the primary choice, and this principle can be extrapolated.
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In Cold Damage, if there is water qi in the heart region, causing cough with slight wheezing, fever, but no thirst: After taking the decoction, if the patient becomes thirsty, this indicates that the cold has departed and the disease is about to resolve. [Note: The phrase "Xiao Qing Long Tang Zhu Zhi" belongs before "fever but no thirst".]
[Commentary]
The six characters "Xiao Qing Long Tang Zhu Zhi" (Xiao Qing Long Tang governs it) should be placed after "fever but no thirst" to align with the meaning of "becoming thirsty after taking the medicine." How could one administer Xiao Qing Long Tang after the cold has departed and the disease is resolving?
[Annotation]
In Cold Damage, if there is water qi under the heart, causing cough with slight wheezing, fever, but no thirst, this is external cold pathogen combined with internal retention of cold fluid. It is appropriate to use Xiao Qing Long Tang for simultaneous exterior and interior resolution. Thirst appearing after sweating resolves the condition indicates dryness inside due to resolved cold, not thirst from stagnant fluid failing to transform. Hence it says: "Cold has departed, disease is about to resolve." One should give small amounts of water frequently to moisten dryness; once Stomach Qi harmonizes, recovery will occur naturally.
[Collected Annotations]
Cheng Wuji said: Cough with slight wheezing is due to cold water attacking the Lung. Fever without thirst indicates the exterior syndrome has not yet ceased. Administering Xiao Qing Long Tang releases the exterior and disperses water. Thirst after taking the medicine indicates interior warmth and dispersion of water qi, signifying impending resolution.
Fang Youzhi said: Fever without thirst indicates dominance of cold. Thus, becoming thirsty after taking medicine signifies cold departing and impending resolution. The general idea resembles the previous clause, so the treatment is the same.
Cheng Zhi said: This clarifies that when cold-fluid is unresolved, Xiao Qing Long Tang is indicated. Water qi under the heart implies cold in the diaphragm area. Hence wheezing, cough, fever, and no thirst. Thirst after taking medicine indicates resolution of cold-fluid. This is the method to resolve water qi using Xiao Qing Long Tang; it does not mean continuing to use Xiao Qing Long Tang after resolution.
Zhang Lu said: When wind-cold carries fluid retention with pathology at the exterior, there is no thirst. Thirst after taking medicine signals cold departure, fluid injury, and impending resolution. Although thirsty, medication is unnecessary; wait quietly for fluid return. Cough with slight wheezing indicates counterflow of fluid retention. Now that fluid is gone and thirst exists, it differs from thirst caused by fluid counterflow. In modern editions, placing "Xiao Qing Long Tang Zhu Zhi" after "cold departed, disease resolving" is a textual error (cuojian).
Wang Hu said: The previous clause mentions thirst before taking medicine, caused by stagnant fluid failing to transform fluids. This clause mentions thirst after taking medicine, caused by fluid loss after sweating. Since the causes of thirst differ, how can Xiao Qing Long Tang still be used? It should be placed before "after taking medicine," which is evident.
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After erroneous purgation followed by repeated sweating, chills and tremors occur, with a faint and fine pulse. This is because both interior and exterior are deficient.
[Annotation]
Sweating should precede purgation. Purging first, then sweating, leads to chills and tremors with a faint, fine pulse, indicating deficiency of both exterior and interior. This occurs because improper purgation damages the interior-guarding Yang, resulting in a faint pulse; improper sweating damages the exterior-guarding Yang, resulting in chills and tremors.
[Collected Annotations]
Zheng Zhongguang said: Treating Cold Damage requires sweating first, then purging. If pathogens remain after purging and sweating is不得已 (unavoidably) repeated, although pathogens leave, both interior and exterior become deficient. Thus, fine pulse and chills indicate greater damage.
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After erroneous purgation followed by repeated sweating, restlessness during the day preventing sleep, but quietness at night, no vomiting, no thirst, no exterior syndrome, deep and faint pulse, and no significant body heat: Gan Jiang Fu Zi Tang (Dry Ginger and Aconite Decoction) governs it.
[Annotation]
This elaborates on the pulse and symptoms from the previous clause to propose treatment. Purging empties the interior; sweating empties the exterior. Yin and Yang are both deficient, with Yang having no anchor. Quietness at night, no vomiting or thirst, indicates no Yang syndrome internally. No exterior syndrome, no significant heat, and deep/faint pulse indicate no Yang syndrome externally. With no Yang in interior/exterior and pure Yin, daytime restlessness is a false Yang syndrome. This represents solitary Yin governing itself in the Yin aspect and lone Yang disturbing itself in the Yang aspect, indicating separation rather than conflict. Therefore, Gan Jiang Fu Zi Tang is used to assist Yang to harmonize with Yin. Although Yin is abundant, it does not repel Yang; Yang is weak and fails to attach.
[Collected Annotations]
Yu Chang said: The previous clause only mentioned chills and faint/fine pulse, not specifying the disease, as deficiency syndromes vary. However, chills and faint/fine pulse reveal Yang deficiency. If daytime restlessness occurs, it indicates disturbance by deficient Yang. Nighttime quietness, no vomiting/thirst, shows deficient Yang disturbance without external pathogens. Deep/faint pulse and no significant heat confirm restlessness as a sign of Yang collapse, making Gan Jiang Fu Zi Tang essential. By inference, daytime quietness and nighttime restlessness indicate Yin disease without Yang involvement.
Cheng Yingmao said: After purging and sweating, daytime restlessness is false heat from disturbed deficient Yang. Nighttime quietness, no vomiting/thirst, no exterior syndrome, deep/faint pulse, and no significant heat indicate true cold from dominant Yin. Gan Jiang Fu Zi Tang is appropriate to retrieve Yang from Yin. One should not hesitate due to the false heat of daytime restlessness.