【Source】

Collection of Cold Damage Formulas

 【Composition】

Poria cocos, Cinnamon Twig, White Atractylodes Rhizome, Honey-fried Licorice Root
(4)

 【Classification】

<Tonify Spleen and Middle Jiao>: White Atractylodes Rhizome, Licorice Root

<Dispel Exterior with Acrid-Warm Herbs>: Cinnamon Twig

<Tonify Spleen and Promote Urination>: Poria cocos

【Formula Analysis】

From *Medical Formulas*: This is a formula for the Foot Tai Yin channel. (1) Poria cocos: Treats phlegm-fluid retention, dispels kidney evil, and promotes urination. (2) Cinnamon Twig: Opens the yang qi, unblocks the meridians, and harmonizes the营卫 (Ying and Wei qi). (3) White Atractylodes Rhizome: Dries dampness and phlegm, resolves distention and fullness, and treats wind-dizziness. (4) Licorice Root: When combined with Poria cocos, it does not lead to stagnation but rather to dispersion. Therefore, the Materia Medica states that Licorice Root can descend qi and relieve vexation and fullness. This condition is caused by phlegm-fluid obstructing the yang qi, thus using yang-tonifying herbs to ascend yang and transform qi. From *Compilation and Supplement*: Zhao Liang states that the *Ling Shu* mentions that when the pericardial channel pulses, it causes fullness and distention in the chest and hypochondria. This implies that phlegm-fluid accumulates in the pericardium, leading to these symptoms. Dizziness occurs when phlegm-fluid obstructs the yang qi in the chest, preventing it from circulating to the upper part of the body. Poria cocos, with its bland flavor and diuretic properties, helps to discharge the fluid through the lower orifices, thus resolving the retention. Therefore, it is used as the chief herb. Cinnamon Twig promotes the circulation of yang and directs water to the skin and pores, resolving it through sweating, and thus serves as the deputy herb. White Atractylodes Rhizome dries dampness, assisting Poria cocos in resolving phlegm to relieve distention and fullness. Licorice Root tonifies the middle jiao, assisting Cinnamon Twig in strengthening the earth to control the water evil. Shortness of breath with subtle fluid retention is due to the accumulation of water and fluid, leading to difficulty in respiration. *Golden Chamber* presents two formulas for this, highlighting their subtle meanings. For shortness of breath upon exhalation, Ling Gui Zhu Gan Tang, with its light and clear properties, is used to unblock yang. When yang transforms into qi, urination can occur. For shortness of breath upon inhalation, Shen Qi Wan, with its heavy descending properties, is used to unblock yin. When kidney qi is unblocked, the gate of the lower orifices functions properly. Wind-water is yang water; stone-water is yin water. Yang water is mostly substantial, while yin water is mostly deficient. Yang water is located in the upper body, hence it often causes panting; yin water is in the lower body, hence it causes distention. Therefore, yang water is treated with dispersing and purging methods, while yin water is treated with warming and tonifying methods. However, yin must contain yang, and this formula treats yin water that is in the yang aspect and located in the upper body. Shen Qi Wan treats yin water that is in the yin aspect and located in the lower body. From this, we can infer that yang must also contain yin, hence the treatment principles of Xiao Qing Long Tang and Wu Ling San. Currently, people worldwide indiscriminately use Jin Gui Shen Qi Tang for all conditions, regardless of yin or yang, deficiency or excess. When it proves ineffective, they do not change their approach, often leading to death from vomiting blood, which is truly lamentable. From *Han Dian*: This formula is composed of Poria cocos, Cinnamon Twig, Atractylodes Rhizome, and Licorice Root. Poria cocos and White Atractylodes Rhizome regulate the distribution of body fluids, increasing urination. Cinnamon Twig and Licorice Root treat palpitations and hypertension.

 【Functions】

Strengthen the spleen and promote urination, warm and transform phlegm-fluid.

 【Indications】

(1) Phlegm-fluid retention disease, presenting with distention and fullness in the chest and hypochondria, dizziness, palpitations, or shortness of breath with cough, a white and slippery tongue coating, and a wiry or tight-deep pulse. (2) This formula is indicated for stagnation of water and phlegm in the epigastrium, decreased urination, and symptoms such as dizziness, trembling sensation, and palpitations due to upward rushing of qi. While these symptoms may resemble those treated by Zhen Wu Tang, Zhen Wu Tang is for yin patterns, whereas this formula is for yang patterns. Therefore, the pulse is strong, and even if a splashing sound is heard in the abdomen, there is abdominal strength and no weakness. From *Medical Formulas*: “Phlegm-fluid in the epigastrium, with fullness and distention in the chest and hypochondria, and dizziness (Golden Chamber, Phlegm-Fluid).” From *Compilation and Supplement*: “Phlegm-fluid in the epigastrium, with fullness and distention in the chest and hypochondria, and dizziness. Also states: Shortness of breath with subtle fluid retention should be eliminated through urination, for which Gui Ling Gan Zhu Tang is indicated.”

 【Applications】

Gastroptosis, gastric atony, and other conditions causing neurosis (especially dizziness, palpitations, and trembling sensation), dizziness and palpitations caused by heart disease, and various eye diseases.

 【Mnemonic】

The name of the formula itself is the mnemonic.

 【Modifications】

(1) For vomiting of phlegm and saliva, add Pinellia Tuber, White Mustard Seed, and Tangerine Peel to regulate qi and transform phlegm. (2) For severe spleen qi deficiency, add Codonopsis Root and Astragalus Root to tonify qi and strengthen the spleen. (3) For epigastric fullness or fluid sounds in the abdomen, add Immature Bitter Orange to promote stagnation, as the movement of qi leads to the movement of water. (4) Removing Cinnamon Twig and adding Dried Ginger results in Licorice Root and Dried Ginger Ling Zhu Tang, also known as Shen Zhu Tang (from *Golden Chamber Essentials*). Its function is to warm the spleen and overcome dampness, treating kidney encumbration due to cold-dampness injuring the spleen. Symptoms include heaviness of the body, cold pain below the waist, a heavy waist as if wearing five thousand coins, normal appetite, no thirst, spontaneous urination, a pale tongue with a white coating, and a deep or slow-deep pulse.