典藏书目

If the pathogenic factor remains lingering in the Qi level throughout, one may hope for its expulsion through *Zhan Han* (Shivering Sweat), a method suitable for benefiting the Stomach, allowing the pathogen to exit with the sweat, heat to reach the exterior and pores to open, so that the pathogen leaves via sweating.

After resolution, the Stomach Qi is temporarily empty, leading to cold skin for about one day and night; once Qi returns, warmth will normalize as usual. This is because after resolution by shivering sweat, the pathogen retreats but Zheng Qi (Upright Qi) is deficient, and Yang Qi escapes with the sweat, hence the gradual cooling of the skin; this does not necessarily constitute a Collapse Syndrome immediately. At this time, the patient should rest quietly and comfortably to nourish the recovery of Yang Qi. Bystanders must not panic or frequently call out, disturbing the Yuan Qi (Original Qi). One should only examine the pulse: if it is weak, soft, and slow, although the patient lies tiredly without speaking, sweats, and has cold skin, it is not a Collapse Syndrome; however, if the pulse is rapid and urgent, accompanied by restlessness and inability to lie down, along with cold sweat, then it is indeed a Qi Collapse Syndrome. Furthermore, when the pathogen is excess and Zheng Qi is deficient, resolution may not occur after a single episode of shivering sweat; the condition may linger for one or two days before resolving upon a subsequent episode. This point must be understood.

Regarding Qi-level diseases that do not transmit to the Blood level but remain lingering in the San Jiao (Triple Burner), this is analogous to Shaoyang disease in Cold Damage disorders. In Shaoyang disease, the method is to harmonize the half-exterior and half-interior; here, the method is to distribute and eliminate the pathogenic factors from the upper, middle, and lower aspects. Treatment methods vary according to the syndrome: such as using modern common herbs like Xing Ren (Apricot Seed), Hou Po (Magnolia Bark), Ling Zhu (Poria), etc.; or formulas like Wendan Tang (Warm Gallbladder Decoction) which have a draining and dispersing action. Since the pathogen remains in the Qi level, there is still a pathway for expulsion via shivering sweat and a mechanism for transformation into malaria-like paroxysms.

Furthermore, if the San Jiao pathogen does not resolve from the exterior, it will inevitably lead to internal binding. Where does this internal binding occur? It occurs in the Yangming Stomach and Intestines. The purgative method (Xia Fa) must also be employed; one cannot claim it is inadvisable simply because the pathogen is in the Qi level rather than the Blood level. However, in Cold Damage, heat pathogens in the interior consume body fluids, so purgatives should be used vigorously; whereas in Damp-Warmth diseases, damp-heat usually clumps internally, so purgatives should be used mildly. In Cold Damage, loose stools indicate the pathogen has been exhausted, and purgatives should not be used again; in Damp-Warmth, loose stools indicate the pathogen is not yet exhausted, and purgation should only cease when the stool becomes hard, indicating the absence of dampness.

Regarding the human body, the Wan (Epigastrium) is located above the abdomen, in the central position. If pressing causes pain, or spontaneous pain, or a sensation of fullness and distension, bitter-draining methods (Ku Xie) should be used because the location is close to the abdomen. Tongue diagnosis is essential: if the coating is yellow or turbid, Xiaoxianxiong Tang (Small Trap Chest Decoction) or Xiexin Tang (Drain Heart Decoction) can be administered according to the syndrome. If the coating is white but not dry; or a mixture of yellow and white; or gray-white without thirst, bitter-draining drugs must absolutely not be given indiscriminately. Among these cases, some involve external pathogens unresolved while internal binding has already occurred; some involve stagnant pathogens unable to extend; some involve patients with inherent Spleen-Stomach cold; even if there is epigastric stuffiness and pain, an opening and draining method should be used to circulate Qi stagnation and guide it back to the Lung, using light, slightly bitter, and slightly acrid herbs with mobile properties, such as Xing Ren (Apricot Seed), Dou Kou (Cardamom), Ju Pi (Tangerine Peel), Jie Geng (Platycodon Root), etc., commonly used in recent times.

As mentioned earlier, if the tongue coating is yellow or turbid, Xianxiong Tang or Xiexin Tang should be used, provided the yellow color is rooted (firmly attached). If the tongue surface is smooth, it indicates formless damp-heat and signs of Middle Jiao deficiency; the aforementioned methods are strictly contraindicated. The area above the navel is the Greater Abdomen. If there is fullness, distension, or pain, the pathogen has definitely entered the interior, and exterior syndromes are likely absent or present in only 10-20%. Tongue diagnosis is also required here: if the coating is deeply yellow; like沉香 (Agarwood) color; like gray-yellow; old yellow; or has cracks in the center, purgatives should be used, such as Xiao Chengqi Tang (Minor Order the Qi Decoction), containing Bing Lang (Areca Seed), Qing Pi (Aged Tangerine Peel), Zhi Shi (Immature Bitter Orange), Yuan Ming Fen (Mirabilite), Sheng Shou Wu (Raw Polygonum Multiflorum), etc. If these tongue signs are not present, these drugs should not be used. There may be cases where dampness gathers in the Taiyin causing fullness; or cold-dampness complex causing pain; or Qi obstruction causing distension, which require different treatments.