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Chapter 23, herbs for Shanghan disease



1. Mahuang jia Zhimu Tang (Mahuang and Zhimu: names of two herbs. Jia means to add).


This formula is used for the treatment of Shanghan disease without sweat, e.g. a Cold- and Wind-attack febrile disease, which is a concept in Chinese medicine. It refers to a group of diseases that are caused by attack of Cold and/or Wind Xie Qi from outside of body. The person feels initial cold/chilly feeling, with or without hot feeling. If the person has no sweat, but headache, pain or tightness on the neck or whole body, it is a Cold-invading Shanghan disease. If the person has sweat, the Shanghan is caused due to the invasion of Wind. If the person has no chilly feeling, or very little and/or only a flash of cold feeling, but soon he feels very hot/fever with sweat, the condition belongs to Summer-Hot disease or a Wen disease (infectious disease). The herbal formula used for these disease conditions are quite different. (Comment from translator: according to these definitions, it is apparently not correct to translate the Shanghan disease as the exogenous febrile disease).

麻黄(四钱) 桂枝尖(二钱) 甘草(一钱) 杏仁(二钱,去皮炒) 知母(三钱)
Mahuang 12 gram, Guizhi tip 6 gram, Gancao 3 gram, Xinren 6 gram (remove skin, fry), Zhimu 9 gram.

Cook the herb Mahuang first for five to six boiling with removal of upper floating foam. Then add other herbal ingredients in and continue to cook. Cover the person heavily to get mild sweat. No need to eat rise soup. For other requirement, see the paragraph for Guizhi Tang.

In the original Mahuang Tang, it indicated the need to remove the skin of the herb Guizhi. It does not mean to remove the skin on the herb branch. The ancient people, when use the herb Guizhi, used the tip part of young branch. They broke the branch to see if the skin and the inside stem is the same, e.g. hard to separate the skin and the inside stem. If the skin is clear from the inside stem, they would refuse to use it. This is what they meant to “remove skin”. The nephew of Dr. Chen Xiuyuan, Mr. Mingqi discussed this in detail.

The herbal formula of Mahuang Tang is originally listed behind the formula of Guizhi Tang in the Taiyang Chapter in the book
Shang Han Lun. Howevere in clinic, more cases are with the Mahuang Tang condition. There are about one to two out of ten cases with the Guizhi Tang condition, among the Shanghan disease. In addition, the name of the disease in Chinese is Shanghan and the Mahuang Tang is the main formula for the early stage of Shanghan disease. For these reasons, the Mahuang Tang is cited here first.

The exogenous febrile disease is attacked from the back of the body. The back is the area, which is governed by feet Taiyan meridian. Therefore, in the early stage of the disease, though the whole body may feel chilly, the back feels more chilly. The whole body may feel pain, the back as well as the leg would feel more severe pain. The reason for the tight pulse in the floating and deep position is that the Taiyang is the Yang Qi in the body surface for defense. It is suddenly attracted by Cold-Wind, which presses and pushes the Yang Qi sink inside. The sink Yang Qi combined with the pulse, causing strong pulse as waving feeling. The contracting force of the Cold (for anything, the hot makes it expand and the clod makes it contract.) contract the defense Qi deep and tight to press the pulse vessels, to prevent it from waving, so that the pulse became string and strong with power feeling. It is even unable to form waving, but curving left and right.  

Whenever the pulse is tight, it is also strong upon feeling. The pumping of the pulse is controlled and handled by the heart. Not only the heart, but also the Hot in various organs can also push the pulse to pump and to beat, as well as the Hot in the Ying-Qi and Wei-Qi layer of the body. In these cases, the pulse is, as the wave in water, has raising and falling form. The tight pulse, though strong, has no such waving form, due to the sealing by the Cold Qi. … So, in real tight pulse, the pulse feels as flatten and strong. If the tight pulse feels moving to the left and right, it indicates that the pulse is in full and is to spill. Mater Zhang Zhongjin used Mahuang Tang, for the aim to release the tight sealing and folding by the Cold Qi.

The herb Mahuang in the formula is hot in herbal nature and hollow in middle, so it goes into the Taiyang meridian and to the skin and hair. It expels the Cold through the sweat it created. Herb Guizhi is spicy and warm and slight sweet in herbal nature. It works with Gancao to warm the muscle, to enhance the fibro membrane, and help the Muhuang to expel the Cold out. Xingren is bitter and falling in herbal nature. It goes into the chest to suppress the reversed Qi and to solve asthma. In the original formula of Mahuang Tang, there are only these four ingredients. The reason for me to add herb Zhimu is that, after drink of the original formula, some person do not have improvement after having the sweat. It is not due to the amount of sweat is not enough, but to the remaining Fire, that has not been cleared off yet. The addition of Zhimu in the formula bears the meaning of Fire-clearing. By this way, there is no more chase, in which the condition is not improved after having sweat. This modified formula has been tested many times, so I know it it true and it works. It does not mean that I modified the bible formula without prudent.

It might be asked: the asthma is the disease in the lung. The Taiyang meridian has nothing to do with the lung. How the disorder in the Taiyang meridian is usually with slight asthma? Answer: The chest is also the governing area by the Taiyang meridian. The accumulated Qi in the chest is connected with the Qi in any part of the body, including the Wei-Qi. When the Wei-Qi is sealed by the invading Cold, the Big Qi in the chest is also suppressed. It would so be bloating to reverse up to push the lung, and so to cause the asthma. In addition, when the Wind and Cold invade in the skin and hair layer, it must come into the lung meridian. It will bring the phlegm-saliva to block the air tract in the lung. This is another reason for the asthma. The herb Mahuang can go into the hand Taiyin meridian, to expel the Wind and Cold in that meridian. It can also go directly into the lung, to expel its stagnation condition. For this reason, the herbs that can create sweat in the Taiyang meridian are not only the herb Mahuang. Master Zhang Zhongjing however used only the Mahuang, for the reason that, the Mahuang is the herb for the feet Taiyang meridian, its function covers the hand meridian too. This is the marvelous way by which the Master created his formula.

凡利小便之药,其中空者,多兼能发汗, 萹蓄、木通之类是也。发汗之药,其中空者,多兼能利小便,麻黄柴胡之类是也。太阳经病,往往兼及于膀胱,以其为太阳之腑也。麻黄汤治太阳在经之邪,而在腑者亦兼能治之。盖在经之邪,由汗而解,而在腑之邪,亦可由小便而解。彼后世自作聪明,恒用他药以代麻黄汤者,于此义盖未之审也。
Among the herbs that can promote urination, if it is hollow inside, it is usually also able to create sweat, such as the herb Bianxu and Mutong. Also, among the herbs that can create sweat, if it is hollow inside, it can also promote the urination, such as the herb Mahuang and Chaihu. The disorder in the Taiyang meridian is usually affecting the urine bladder, since the bladder is the organ of the Taiyang meridian. The formula Mahuang Tang solves the Xie Qi in the Taiyang meridian, so that in the urine bladder. The Xie in the meridian can be expelled through the sweat, and that in the organ, through the urine. Some later doctors believed them selves clever and replace the Mahuang with other herbs. They actually did not understand and meaning of the use of Mahuang here.

The formula Da Qinglong Tang works for Shanghan disease, in which the person has no sweat but agitated and jarred. This is a condition, in which there is Hot in the chest before the disease, that has no way to release yet. Upon the attack by the Cold and/or the Wind, it accumulated more in the chest, so as to cause agitate and annoyed. For this reason, the herb Shigao was added in the formula to clear the inside Hot. However, when the Mahuang and Shigao are used together, some person may have no sweat. If the formula here is used, with more Zhimu in it, the cooling and wetting nature of the Zhimu can, after come into the chest, develop liquid-fluid, which then follow the Mahuang and Guizhi to expel out of the body, so that the agitated and jarred are solved.


The Shanghan and the Wen disease are different in the early stage, but similar in the later stage. Because they are different in the early stage, it is needed the warm-hot herbs in the treatment of Shanghan disease, while it is needed the spicy-cooling herbs in the Wen disease. Because their later stages are the same or similar, after the disease passes into the Yangming stage, no matter it is from Shanghan or Wen disease, both need Cold-Cooling herb, but inhibit the use of Warm-Hot herbs. For this reason, in my book in the chapter for the Xie Qi expelling from body surface, it is cited some of the herbal formulas from the Taiyang Chapter of the book Shang Han Lun. They are explained little bit more, so that the beginners can understand that the therapy for the early stage of Shanghan disease is different from the Wen disease. So, the treatment of the Wen disease is different from the Shanghan disease. For the treatment of the three Yin stages in the Shanghan disease, though they are some different from those for Wen disease, the clinic cases are not common. In a broad speaking, whenever a disease is got due to the Cold attack, such as Cholera or skin bleeding conditions, they can be included in the Shanghan disease for the similar treatment. There are so many medical books, thousands and thousands of them, in detail or in broad discussion. For doctors who wish to really know the medicine, need to read the original books.



2. Jiawei Guizhi Dai Zhou Tang

This formula is used for Shanghan disease with sweat.

桂枝尖(三钱) 生杭芍(三钱) 甘草(钱半) 生姜(三钱) 大枣(三枚,掰开) 生黄芪 (三钱)知母(三钱) 防风(二钱)
Guizhi tips 9 gram, Baishao 9 gram, Gancao 4.5 gram, Fresh ginger 9 gram, Chinese date three granules (chop open), Huangqi 9 gram, Zhimu 9 gram, and Fangfeng 6 gram.

煎汤一茶盅,温服复被,令一时许,遍身 微似有汗者益佳。不可如水流漓,病必不除。禁生冷、粘滑、肉面、五辛、酒酪及臭恶等物。
Cook the herbal tea to one cup amount. Drink the herbal tea in warm. Cover the body for one hour to get mild sweat. Do not let the sweat as heavy as water flows. Other wise, the disease will not be solved. Inhibit the intake of non-cooked food, the sticky food, slippery food, meat, spicy food, wine-liquor, fermented food, strong odor food, etc.

This formula is for the Wind-attack Shanghan with sweat. Some translators said that when the body is invaded with the Wind, the body will have sweat. Or, they may say that, if the Ying-portion is weak, the body condition is vibrating with the out-coming Xie Qi. To such explanation, I doubt.

The Yin-portion and the Wei-portion of the body are both the defense layer of the body in the body surface. The Wei-portion is in the outside and the Qing-portion is inner side. How could a Xie Qi invade the Ying-portion by passing the Wei-portion? 

The Big Qi in the chest is connected always with the out layer of Wei-Qi. The Big Qi is located in the chest, so it bears strong inhaling power to tightly attract the Wei-Qi to the body, so that the Wei-Qi can seal the body to defense against the invasion of Xie Qi from outside. Even if the Xie Qi invades, it would stop at the out layer, not reach the Yin-portion. This is clear. If the Big Qi is not sufficient in the chest, it would not be able to attract the Wei Qi, the Wei Qi would be in a loosen, a dispersing matter, fail to defense the invading Xie Qi, so that the invading Xie Qi can reach the Ying-portion of the body directly. I know from my clinic experience that, when the person has Big Qi deficiency condition, or it even sink, the person usually has heavy sweat. In my formula of Shenxian Tang, there are some case reports. Readers can check there. It is so known that, person with the Guizhi Tang condition, due to Big Qi deficiency originally, has sweat escaping tendency. Upon attack of out Xie Qi in, the Xie Qi takes the advantage of weak Wei-Qi, penetrates directly into the Yin-portion of the body, to disturb the fluid-liquid part in the Ying-portion, making it escape or spill as sweat. In detail, the Wind and the Cold usually go together. Even it is Wind-attack condition, it bears kind of Cold Xie Qi too. Once it invades into the Wei-portion, it can cause stop of the sweat. So, in the Guizhi Tang, the main aim is to expel the Wind, as well as to expel the Cold.

Mr. Chen Guyu said: “the herb Guizhi is spicy and warm, belongs to the Yang. The Shaoyao is bitter-calm, belongs to the Yin. The Guizhi, accompanied by the spicy of the fresh ginger, the spicy nature works together, to adjust, to balance, or to harmony the Yang Qi in the whole body.  The Shaoyao, when accompanied by the Chinese date and Gancao, the sweet and the bitter meet, can create more fluid to the body Yin portion. By this way, both Yin and Yang of the body are nourished, so the source of the sweat is rich, which is the base to combat the invading Xie Qi. In the original formula, it is asked to eat soup after drinking of the herbal tea. The aim of it is to absorb the nutrition of the soup to create sweat, so that after sweat, the body liquid-fluid portion is not damaged. This is so called the way of always win, to ensure the success.”


Comments: the above explanation for the herbal formula is very good. However, the meaning of eating soup appears not explained completely. If to take the liquid-fluid from the food to make it into sweat, how, when man is without sick and when taking other sweat-creating herbs, it is not asked to drink the soup? In fact, the Guizhi Tang is mostly used in a person who is originally weak but attacked by out-invading Xie Qi. What means his weakness? He is weak in his Big Qi in chest. … The Big Qi is rooted from original life energy, but nourished by the late life nutrition actually.

The Guizhi Tang condition is used in Big Qi deficiency, which causes the loss or scatter of the Wei-Qi. When the Xie Qi invades, the Xie Qi so can pass the Wei portion and directly into the Ying-portion of the body. So, after drink of the herbal tea, it is needed to drink soup, to nourish the Big Qi in the chest. It can also distribute the ginger and Guizhi to expel the Xie Qi. This formula really means, once start the war, it must win. The doctors in later time are usually not understood this meaning, so they do not let the patient to drink soup. Therefore the formula does not work properly and causes the Xie Qi deeper. For this reason, Dr. Wang Qingren in his book Yi Lin Gai Cuocriticize the herbal formula of Guizhi Tang as no use. In fact, it does not mean it is no use, but doctor did not ask to drink soup. For this reason, whenever I used this formula, I added Huangqi in the formula to replace the soup to nourish the Big Qi; added Fangfeng to disperse the Ying-portion and Wei-portion, to replace the soup to disperse. After drink the modified Guizhi Tang, it is better also to drink soup, but it still worked even without the soup drink. The addition of Zhimu is to prevent the Hot side effect of the Huangqi.

按:凡服桂枝汤原方,欲其出汗者,非啜粥不效。赵晴初曰:族侄柏堂,二十一岁时,酒后寐中受风,遍身肌肤麻痹,搔之不知疼痒,饮食如常。时淮阴吴鞠通适寓伊芳家,投以桂枝汤,桂枝五钱、白芍四钱、甘草三钱、生姜三片、大枣两枚,水三杯,煎二杯,先服一杯,得汗止后服,不汗再服。并嘱弗夜膳,临睡腹觉饥,服药一杯,须臾啜热稀粥一碗,复被取汗。柏堂如其法,只一服,便由头面至足,遍身 得微汗,汗到处,一手搔之,辄知疼痒,次日病若失。观此医案,知欲用桂枝汤原方发汗者,必须啜粥,若不啜粥,即能发汗,恐亦无此功效。
Comments: when use the original Guizhi Tang with aim to create sweat, the person must drink soup. Mr. Zhao Qingchu said: my nephew Botang, when he was 21 years of old, got Wind-attack after drinking liquor. He felt numb in whole body, no itch or pain feeling on the skin, but had normal appetite. At that time, Mr Wu Shitong, who lived in Huaiyang city, visited my home by chance. He give the patient Guizhi Tang, using Guizhi 15 gram, Baishao 12 gram, Gancao 9 gram, fresh ginger three pieces, Chinese date two granules. The herbs were mixed with thee cups of water to cook until there is two cup left in the pot. The patient should drink one cup first. If he get sweat, he does not need to drink the remaining herbal tea. Prepare some soup for night. If he feels hungry before going to bed, let him drink one cup of the herbal tea, and after while, drink warm soup one bowl, followed by covering body to get sweat. The patient followed this requirement. Only one drink, he got sweat from the head to the feet, all over the body. When the sweat showed, the skin could feel  pain and itch upon scratch by hands. The next day, the disease almost cured. Referring to this case, it is known that, to apply the original Guizhi Tang to create sweat, the person must drink rice soup. If not, even if the person could also have sweat, the cure of the disease is doubted.


It might be asked: If the Guizhi Tang condition is due the weakness of the Big Qi in the chest, it should show the weak pulse in the Yang pulse position. Why the person’s pulse is floating in the Yang, but weak in the Yin position? Answer: the whole body of human is hold up by the Qi. In the Lower Jiao, this Qi is called Yuan Qi; in the Middle Jiao, it is called Zhong Qi; and in the chest, it is called the Big Qi. Though it is separated in such different zones, they are the same Qi. Therefore, no matter where is the Qi insufficiency, the pulse in all the position should show weakness. Now, the pulse in the Chun position is floating but not weak; the pulse in the Chi position remains mild weak. So, it is called the Yang floating and the Yin is weak. If the Yin weakness means the Yin deficiency in the Lower Jiao, the pulse should also feel frequent. However, in my life when I met such patient, their pulse was late, not up to four times per breath circle. It clearly indicates the Qi deficiency, not Yin deficiency. Even the so described mild chilly, mild dislike wind, and mild hot, such symptoms for the Guizhi Tang condition, all are the evidence for a Qi deficiency, not a Yin deficiency.



3. Conglong Tang (Cong here means to follow, or to mimic, in Chinese; Long here means Xiao Qinglong Tang. The meaning of the formula name means an herbal formula that is to be taken after the Xiao Qinglong Tang).

This formula is used for the phelgm and asthma due to Xie Qi invasion. The person has drunk the Xiao Qinglong Tang, but the disease was not cured completely; or it recurred after cure. In the later situation, drink this formula.

龙骨(一两,不用 捣) 牡蛎(一两,不用 捣) 生杭芍(五钱) 半夏(四钱) 苏子(四钱,炒捣)牛蒡子(三钱,炒捣)
Longgu 30 gram (no grind), Muli 30 gram (no grind), Baishao 15 gram, Banxia 12 gram, Souzi 12 gram (fry and grind), Niubangzi 9 gram (fry and grind).

If the person feels hot, add herb Shigao several gram to 30 gram.

When treat phlegm and asthma due to out-invading common cold, I always followed the way of modification of the formula Xiao Qinglong Tang, to remove herb Mahuang but add Xingren. If the condition is Hot, add Shigao. It worked always. However, from time to time, there was some case, which has been cured before, but recurred again and the previous formula no longer worked. After I set up this formula, I let patient use Xiao Qinglong Tang first to solve the problem, then asked them to drink this Conglong Tang one or two doses. Their diseases must be cured really. To term it Conglong Tang, is for its use after the Xiao Qinglong Tang.


It might be doubted: large amount of Longgu and Muli is used in the formula. They bear strong restraining herbal nature. To solve the common cold, at the time to expel the Xie Qi out of the body, they may hold the Xie Qi somehow in the body. Even if the person does not have asthma or cough at this movement due to the strong suppress by the two herbs, they may make the Xie Qi deeper and cause trouble later. Answer: if look at the Longgu and Mulin in this way, you look down the two herbs. Let’s see how the previous famous doctors said about them.

Mr. Xu Lingtai said: the Longgu is very sticky and glue-like. It can seal the Zheng Qi, e.g. the body defense Qi, or the body normal Qi. It can work in case with Heart spirit escaping, and stomach-intestine slippery conditions. It only restrains the normal Qi, but not the Xie Qi. Therefore, the Master Zhang Zhongjing, when the Xie Qi is not completely expelled out, use the Longgu and Muli together, such as in his Chaihu Jia Longgu Muli Tang and others. Whenever I meet the person with sthenic Fire, but weak pulse; palpitation or shacking feeling in heart, agitate in mode, etc. in various Shanghan disease or Wen disease, I used the Longgu and Muli, and the Shanyurou and Shigao. The disease can be cured always with the herbal tea used. (the herbal tea comes, the sick goes).  

My student, Mr. Gao, treated a person with Xie Qi-attack, that causes asthma and phlegm condition. The asthma was very severe and the pulse was very week. Doctors refused to treat him. Mr. Gao however used the Xiao Qinglong Tang to him, in which the Mahuang was removed but the Xingren and Shigao (30 gram), and wild Taishen 15 gram were added. One dose stopped the asthma. For fearing its recurrence, the patient was given this Conglong Tang, with addition of Renshen and Shigao. The disease was solved very soon.

In addition, my son treated Mr. Yu, who was 60 years of old. He suffered from out-coming Xie Qi attack and had asthma and phlegm. He could not have a sleep for ten days. Previous doctors used Xiao Qinglong Tang, but the condition became worse (when the pulse showed Hot, but the doctor dared to add more Shigao, so that the condition become worse). My son saw him. His pulse was up to 6 times per breath circle. He was very agitated; his tongue covering was white in whole tongue surface; and he had bowel movement two to three time a day, but not a slippery stool. According to the symptom and the pulse, it appeared hard to save him. However, he sued the Xiao Qinglong Tang, with removal of Mahuang, and with addition of Xingren, wild Taishen, Longgu, Muli, 15 gram each, and Shigao 45 gram. One dose made the patient’s condition calm down half. Another dose solved the condition completely.


Comments: in previous case report, the Qi-nourishing herbs were added in the Xiao Qinglong Tang. In the later case, the Qi-restraining herbs were added in the Xiao Qinglong Tang. It seemed that the young doctor was very reckless, however both ways in the use of the herbs saved life. It created an additional way to modify the Xiao Qinglong Tang.


Mr. Zheng, 50 years of old, was attacked by out-coming Xie Qi. He had asthma and phlegm very much. He tried Xie-expelling, Fire-clearing and Phlegm-removing herbs, but none worked for him. The condition has been last for twenty days and close to death. His nephew, Mr. Liu, studied medicine with me. When talk medicine with him, he was good at memory. After heard that his uncle was very sick, he went to have a greeting visit. Upon his arrive, the family was ready to have funeral clothes to the patient. Mr Liu used Tinglizi 12 gram (fold with gauze), Chinese date 5 granules (chop open) to prepare herbal tea for his uncle. After the tea was poured in the mouth, his uncle suddenly waked up. Later, one dose of the Xiao Qinglong Tang was given and the condition was solved. In this case, it is the stubborn phlegm that blocked the lung. No other herbal formula, except the Tinglizi Dazao Tang, could solve the problem. In addition, a long time of asthma usually causes weakness in body Yuan Qi. The addition of Wuweizi 6 gram is to restrain the Yuan Qi. It can also seal the Yuan Qi back in the Kidney, with the down-falling power of the Tinglizi. It is therefore known that, my Conglong Tang, can be drunk after the use of the Xiao Qinglong Tang, but can also be used after the use of Xie-expelling herbs, not always after the Xiao Qinglong Tang.



4. Liushui Shigao Yin (Liu

This formula is used for a person, who had had accumulated hidden Fire in the chest, then affected by out-coming Xie Qi. He feels agitated very much in the chest, has urgent asthma and short of breath. The pulse is floating, waving feeling and strong. It is not sthenic feeling when touched harder. His tongue covering is white in color, not in yellow yet.

石膏(二两,轧细) 甘草(三钱) 麻黄(二钱)
Shigao 60 gram (grind), Gancao 9 gram, Mahua 6 gram.

Cook the three ingredients in steam water for two to three boiling. Collect clear supernatant one big bowl. Separate the tea into six parts. Drink them as six times. For the first three times, drink it once every hour. For the later three times, drink it once every one and half hour. If the disease is cured, stop to drink it. Not need to finish all of them. If there is cold feeling in the Lower Jiao of the body, also stop to drink it. If there is no steam water, use Ganlan water in stead.


The way of preparing the Ganlan water: add water in a big basin. Lift the water up with a big spoon and pour it down. There would have some water bubble on the basin surface. Another person on the side to collect the bubble water, which is so called Ganlan water.


If this formula is used to treat Wen disease with above symptoms, the herb Mahuang is not suit to use. It should be used the Aspirin one tablet. Dissolve the aspirin in the soup to drink. If there is no aspirin, use Bohe (peppermint) leaves 6 gram.


Mrs. Qian in Fengtian city got the Shanghan disease in a winter. For four to five days, she had severe asthma and could not lie down. She felt annoyed and agitated in chest, crying again and again to cut open his chest. Her pulse was floating, waving and long. The pulse was not sthenic when touch harder. Her tongue covering is white and thick. It was considered that her condition, though in the Yangming stage yet, remained somehow in the Taiyang stage too. If the Xiao Qinglong Tang was to use to treat the asthma, it was feared too hot the herbs. If the Baihu Tang was used for the annoyed hot, it was feared to leave the Xie Qi in the Taiyang. After a long time consideration, I prescribed her this formula. The air-water, for its light and floating nature, was used to bring the Shigao float up to solve the annoying hot in the chest. The Gancao, for its sweet and buffering nature, can keep the Shigao not sink down, but focus on the upper part of the body. The little amount of Mahuang is used to dissolve the remaining Xie Qi in the Taiyang stage, as well as to deplete the lung to solve the phlegm, so as to solve the fullness in the chest. The herbal tea was given six times to drink, since the disease is localized in the Upper Jiao, to drink it all together might cause the herbal healing effect tend down and pass the diseased portion so affect the healing. After the third drink, her chest felt mild sweat and the disease was much improved. After fininsh the whole herbal tea, the condition was improved to about ninty percent. To touch her pulse, the Chun position felt kind of floating and waving. The asthma stopped already, only the previous cough remained. In the followed formula, herb Xuanshen 30 gram, Xingren 6 gram (peel), Gualuren 9 gram, Niubangzi 9 gram was used. After two doses, the cough was stopped too.



5. Tongbian Da Chaihu Tang (Tongbian here means to change, to modify, in Chinese; Da means big one; Chaihu is the name of a herb).

This formula is used in the Shanghan disease or Wen disease, in which the surface symptoms have not been solved, but the stool has turned hard.

柴胡(三钱) 薄荷(三钱) 知母(四钱) 大黄(四钱)
Chaihu 9 gram, Bohe (peppermint) 9 gram, Zhimu 12 gram, Dahuang 12 gram.

If this formula is used in Shanghan disease, use herb Fangfeng to replace the Bohe.

The Da Chaihu Tang in the book
Shang Han Luntreat the combined Shaoyang and Yangming stages. The herb Chaihu in the formula is to solve the Xie Qi in the meridian; the Dahuang, to solve the Hot in the Yangming stage. They are the main ingredients in the formula. The other herbs can be modified to make the whole herbs work better. It is more suit in the Shanghan disease. When used in the treatment of Wen disease, or if the surface symptoms are not in the Shaoyang meridian, the formula should be modified somehow.

It might be asked: if the surface symptoms are in the Shaoyang meridian, surely the Chaihu is needed. If they are not in the Shaoyang meridian, it should be enough to add Bohe or Fangfeng to expel the surface Xie Qi, why still needs the herb Chaihu? Answer: to use the bowel-cleansing herbs before the surface symptoms are not expelled or solved, there would have two possible results: first, the surface Xie Qi may penetrate deep inside the body, as indicated in the book, the person will feel fullness in the chest, fullness and hard in the upper abdomen, of has chest-fullness condition, after bowel-cleansing therapy. Second, the surface Xie sink deep, as the book said, the person will have continuous diarrhea. In this formula, use the herb Fangfeng and Bohe to expel the Xie Qi, to prevent the Xie Qi sink deep, and use the Chaihu to raise, and to prevent the Xie Qi sink downwards.


A man, 20 years of old, got the Shanghan disease for six to seven days. He felt headache, chilly, but hot in the heart, and spit stick saliva. Especially upon the evening, he would have cold-hot shift feeling with dizziness and the heart hot feeling became worse. His pulse was floating and string. It is strong when touch harder. He did not have bowel movement for five days. He was given this formula, with addition of Shigao 18 gram, Mangxiao 12 gram. He had bowel movement twice. He started to have sweat in the upper half body. Other conditions were also improved better, only still felt hot in the heart, but the pulse was not so floating-string, but it felt still strong when pressed harder. He was given the Baihu jia Renshen Tang, for fear of slippery diarrhear after the bowel movement, the herb Shanyao was used to replace the herb Gengmi. Two continuous herbal tea solved the whole condition.  



6. Jiawei Yuebi Jia Banxia Tang

 This formula is used for chronic cough and again attacked by out-comign Xie Qi again. The cough become worse, with asthma, or with heavy phlegm.

麻黄(二钱) 石膏(三钱, 捣) 山药(五钱) 麦冬(四钱,带心) 半夏(三钱) 牛蒡子(三钱,炒捣)玄参(三钱) 甘草(一钱五分) 大枣(三枚,擘开) 生姜(三片)
Mahuang 6 gram, Processed Shigao 9 gram (grind), Shanyao 15 gram, Meidong 12 gram (with kernel), Banxia 9 gram, Niubangzi 9 gram (fry and grind), Xuanshen 9 gram, Gancao 4.5 gram, Chinese date 3 (chop to open), fresh ginger 3 pieces.


In the book Shang Han Lun, there is formula of Guizhi Er Yuebi Yi Tang, for the treatment of Taiyang disease, in which the person feels hot and cold, but more hot than cold. In the book Jin Kui, there is formula Yuebi Tang, which is for Wind-attack swelling condition. There is also another one: Yuebi Jia Banxia Tang, to treat the Phlegm-Fire accumulation in the lung, due to the out-coming Xie Qi invasion, which makes the lung bloating and causing asthma. Now, for the formula here, it is used for person who have had chronic cough for a long time and affected by the Xie Qi invasion now. The Xie Qi is combined with the accumulated phlegm in the lung, stick each other, block the lung to cause more cough and severe asthma. This herbal formula works to expel the invading Xie Qi, with the addition of Shanyao, Xuanshen, Maidong, and Niubangzi to solve the chronic cough. This is a formula working for both inside and outside coming Xie Qi.

A man, 70 years of old, had long time of cough. In a early winter, the old disease recurred, together with new Xie Qi invasion. The phlegm accumulated in his chest, so that he almost felt hard to have a breath. When the condition was severe, he could loss consciousness with body bends reverse back. His pulse was floating-frequent and weak. He was given this formula. One dose made his breath smooth. After reduce Mahuang and Shigao to half, additional several doses solved the condition.

或问:子尝谓石膏宜生用,不宜熟锻用。以石膏寒凉之中,原兼辛散,锻之则辛散之力,变为收敛,服之转可增病。乃他方中,石膏皆用生者,而此独用锻者何也?答曰:此方所主之病,外感甚轻,原无大热。方中用麻黄以祛肺邪,嫌其性热,故少加石膏佐之。且更取 者,收敛之力,能将肺中痰涎凝结成块,易于吐出。此理从用锻石膏点豆腐者悟出,试之果甚效验。后遇此等证,无论痰涎如何壅盛、如何杜塞,投以此汤,须臾,药力行后,莫不将痰涎结成小块,连连吐出,此皆锻石膏麻黄并用之效也。若以治寒温大热,则断不可锻。若更多用,则更不可锻也(锻石膏用于此方,且止三钱,自无妨碍。然愚后来志愿,欲全国药局,皆不备锻石膏,后有用此方者,若改用生石膏四钱更佳)。

It might be asked: you said that, the herb Shigao should be used without any process, since the Shigao has cooling nature, as well as spicy-dispersing nature. If it is processed, its spicy-dispersing nature will turn into restraining, which may make disease worse. For  this reason, in other formula, the Shigao is the original form without any process. How in the formula here, it needs the processed form? Answer: this depends on the disease here: it is mild Xie-invading condition, originally no huge Fire in the body. The Mahuang in the formula is to expel the Xie in the lung. For fear its hot nature, add little Shigao to combat its hot side effect. For the use of the processed Shigao, it is to take its advantage of restraining property to make the phlegm in harder mass/clot, so easier to spit out. This is deduced from the mechanism, in which to use the Shigao to precipitate the Toufu (the Shigao can solidify the soy bean protein to become Toufu). After trying in clinic, it really worked. So later, whenever I meet such condition, no matter how much the phlegm it is, and how severe the phlegm block is in the lung, the use of this formula could very soon make the phlegm into small harder mass to spit out. This is the function of the combination of the Mahuang and the processed Shigao. The processed Shigao should however not be used in the treatment of Cold-Hot extreme Fire condition. This is true if the amount of Shigao needed in the formula. The amount of processed Shigao in this formula should be only 9 gram, there is not problem. However, the herb shops all over the country do not keep the processed Shigao. Later when this formula is used, the non-processed Shigao can be used to 12 gram. It works better.