[Source]

From “Xuan Ming Lun”, Volume 3.

 [Composition]

Fang Feng (Saposhnikovia Root), Lian Qiao (Forsythia Fruit), Ma Huang (Ephedra Herb), Bo He (Mentha Herb), Jing Jie (Schizonepeta Herb), Bai Zhu (Atractylodes Macrocephala Rhizome), Zhi Zi (Gardenia Fruit), Chuan Xiong (Sichuan Lovage Rhizome), Dang Gui (Angelica Sinensis Root), Bai Shao Yao (White Peony Root), Da Huang (Rhubarb), Mang Xiao (Glauber’s Salt), Shi Gao (Gypsum), Huang Qin (Scutellaria Baicalensis Root), Jie Geng (Platycodon Root), Gan Cao (Licorice Root), Hua Shi (Talc), Cong Bai (Green Onion Bulb), Sheng Jiang (Fresh Ginger)
(19)

 [Classification Group]

<Blood Nourishing>: Dang Gui, Shao Yao

<Tonifying Spleen and Middle Jiao>: Bai Zhu, Gan Cao

<Dispelling Wind and Releasing the Exterior (Cooling)>: Bo He

<Clearing Heat and Drying Dampness>: Huang Qin

<Purgatives>: Mang Xiao, Da Huang

<Dispelling Wind and Releasing the Exterior (Warming)>: Ma Huang, Sheng Jiang, Jing Jie, Cong Bai, Fang Feng

<Activating Blood and Dispelling Stasis>: Chuan Xiong

<Resolving Phlegm>: Jie Geng

<Clearing Heat and Reducing Fire>: Shi Gao, Zhi Zi

<Promoting Urination and Leaching Dampness>: Hua Shi

<Clearing Heat and Detoxifying>: Lian Qiao

[Explanation of Formula]

From “Yi Fang”: This formula addresses the exterior and interior meridians of the Foot Tai Yang and Yang Ming, utilizing herbs to regulate blood and Qi. (1) Fang Feng, Jing Jie, Bo He, Ma Huang: These herbs are light, floating, and ascending, releasing the exterior and dispelling cold. They facilitate the expulsion of wind-heat through sweat, dispersing it upwards. (2) Da Huang, Mang Xiao: These break accumulations and open the path to the lower body. (3) Zhi Zi, Hua Shi: These reduce fire and promote urination, expelling wind-heat downwards through bowel movements. (4) When wind invades internally, affecting the Lung and Stomach, Jie Geng and Shi Gao clear the Lung and drain the Stomach. (5) Wind as a pathogenic factor can affect the Liver; Chuan Xiong, Gui, and Shao harmonize blood and tonify the Liver. (6) Huang Qin: Clears heat from the middle and upper Jiao. (7) Lian Qiao: Dispels Qi stagnation and blood condensation. (8) Gan Cao: Moderates the potency of other herbs and harmonizes the Middle Jiao. (9) Tonifies the spleen and dries dampness. (10) By promoting dissipation and elimination from both the upper and lower body, and by treating both the exterior and interior, this formula disperses and drains while also providing gentle nourishment. Thus, it releases the exterior without damaging the body, and drains the interior without harming the body. From “Shan Bu”: Wu Kun states: Fang Feng and Ma Huang are exterior-releasing herbs that expel wind-heat from the skin through sweat. Jing Jie and Bo He are exterior-clearing herbs. Wind-heat at the crown of the head is expelled through the nose by Da Huang and Mang Xiao, which promote bowel movements. Wind-heat in the intestines and stomach is expelled from the rear by purgative herbs. Wind-heat in the intestines and stomach is expelled through the posterior by purgative herbs. Wind-heat in the channels and meridians is expelled through urination. When wind invades the diaphragm and affects the Lung and Stomach, Shi Gao and Jie Geng clear the Lung and Stomach, while Lian Qiao and Huang Qin expel wandering fire from various meridians. Wind as a pathogenic factor primarily affects the Liver; Chuan Xiong, Gui, and Shao harmonize Liver blood, while Gan Cao and Bai Zhu harmonize Stomach Qi and tonify the Spleen. Liu Shou Zhen was adept at treating fire-related conditions, and the principles of this formula are thorough and comprehensive. It is also used to treat conditions that arise after diarrhea or present with a rash. It addresses stagnation of fire in the Three Jiao. The full formula, excluding Mang Xiao and Huang Qin, is called “Shuang Jie San” (Dual Clearing Powder). It has exterior-clearing herbs like Fang Feng, Ma Huang, Bo He, Jing Jie, and Chuan Xiong, and interior-clearing herbs like Shi Gao, Hua Shi, Huang Qin, Zhi Zi, and Lian Qiao. Furthermore, Dang Gui and Shao Yao harmonize blood, while Jie Geng, Bai Zhu, and Gan Cao regulate Qi. With harmonious Ying and Wei (Nutritive and Defensive Qi), both the exterior and interior are unblocked, hence the name “Shuang Jie” (Dual Clearing). The name of this formula, “Tong Sheng,” signifies its profound efficacy. From “Han Dian”: The Da Huang, Mang Xiao, and Gan Cao in this formula are equivalent to “Tiao Wei Cheng Qi Tang,” which expels food toxins from the stomach and intestines. Fang Feng and Ma Huang open the skin and release pathogenic factors. Jie Geng, Zhi Zi, and Lian Qiao have effects of detoxifying and reducing inflammation. Jing Jie and Bo He leaves clear heat from the head. Bai Zhu and Hua Shi work together to excrete water toxins from the kidneys and bladder. Huang Qin and Shi Gao act to reduce inflammation and calm the spirit. Dang Gui and Shao Yao can regulate blood circulation. Patients with the aforementioned constitutions tend to have a strong tendency towards acidosis; this formula helps shift towards alkalosis. From the Taisho era to the early Showa period, Master Mori Doho frequently used this formula, achieving remarkable success in treating conditions arising from excessive meat consumption during that time.

 [Functions]

Releases the exterior and unblocks the interior, dispels wind, and clears heat.

 [Indications]

(1) External contraction of wind evil with internal accumulated heat, where both exterior and interior are replete; aversion to cold, fever, headache, dizziness, red and painful eyes, bitter and dry mouth, throat obstruction, chest and diaphragm stuffiness, cough, vomiting, fullness, constipation, and scanty, red urine. (2) Also for carbuncles, sores, swelling, and toxic masses, intestinal wind and hemorrhoids, red and itchy skin rashes. (3) Commonly used for obesity with a replete-type constitution prone to stroke. It is effective in expelling or detoxifying food toxins, water toxins, and various poisons that lead to hypertension and arteriosclerosis through urination, bowel movements, and sweat. From “Yi Fang”: (1) Treats all injuries from wind, cold, summer heat, dampness, hunger, fullness, labor, and internal/external pathogenic factors, leading to qi and blood stagnation, and replete conditions in the exterior, interior, and Three Jiao, with aversion to cold, alternating fever, headache, dizziness, and blurred vision. (2) Red and painful eyes, tinnitus, nasal obstruction, bitter taste, dry tongue, throat obstruction, sticky saliva and phlegm, coughing with qi rising, constipation, and red, difficult urination. (3) Sores, swelling, and toxic masses, injuries from falls or fractures, blood stasis with blood in stool, intestinal wind and hemorrhoids, involuntary tremors of hands and feet, delirium, manic behavior, red and itchy rashes. From “Shan Bu”: Primarily treats conditions with exuberant wind-heat affecting the exterior, interior, and Three Jiao.

 [Indications]

Headache, hypertension, cerebral hemorrhage, arteriosclerosis, obesity, fatty heart, chronic nephritis, diabetes, infectious diseases, acute purulent otitis media, acute tonsillitis, sore throat, lobar pneumonia, acute pelvic abscess, cerebral thrombosis, postpartum stroke, skin diseases, rosacea, flat warts, urticaria, furunculosis, alopecia areata, gonorrhea, hemorrhoids, and other conditions.

 [Contraindications]

(1) If the Stomach Qi is deficient due to prolonged illness or famine, caution is advised. Use only for conditions of extreme fullness and replete pathology. (2) Regardless of blood pressure, individuals who are emaciated and pale, with contracted or extremely relaxed abdominal muscles, should not use this formula. (3) If appetite significantly decreases or if uncomfortable diarrhea occurs after taking this formula, it should be discontinued.

 [Mnemonics]

<a href='https://whatsintcm.com/dt_articles/當歸散/’>Dang Gui San + Liang Ge San + Ma Xing Gan Shi Tang + Liu Yi San + <a href='https://whatsintcm.com/dt_articles/桔梗湯/’>Jie Geng Tang + Jing Jie, Fang Feng, Cong Bai, and Ginger.

 [Modifications]

From “Yi Fang”: (1) For diarrhea: Remove Mang Xiao and Da Huang. (2) For spontaneous sweating: Remove Ma Huang and add Gui Zhi (Cinnamon Twig). (3) For phlegmy cough: Add processed Ban Xia (Pinellia Tuber). (1) If exterior symptoms are mild, reduce the dosage of exterior-releasing herbs or remove Ma Huang. (2) If internal heat is not significant, remove Shi Gao. (3) If there is no constipation, remove Mang Xiao. (4) The qi-tonifying and blood-nourishing herbs in the formula can be added or reduced according to the specific symptoms.

 [Pharmacological Actions]

The herbs in this formula have antibacterial, antiviral, antipyretic, analgesic, anti-inflammatory, antiallergic, immunomodulatory, and laxative effects.