【Source】　Volume 3 of “Shang Han Liu Shu” (Six Treatises on Cold Damage).

【Composition】　Chai Hu (Bupleurum Root), Ge Gen (Kudzu Root), Gan Cao (Licorice Root), Huang Qin (Scutellaria Baicalensis Root), Jie Geng (Platycodon Root), Shao Yao (Peony Root), Qiang Huo (Notopterygium Root and Rhizome), Bai Zhi (Angelica Dahurica Root), Shi Gao (Gypsum), Sheng Jiang (Fresh Ginger), Da Zao (Jujube Fruit). (11 herbs)

Note: The “Jie An Fang” version omits Shi Gao, Sheng Jiang, and Da Zao, while adding Qiang Huo and Bai Zhi.

【Category】　<Blood Tonifying>: Shao Yao; <Spleen and Middle Jiao Tonifying>: Da Zao, Gan Cao; <Acrid and Warm Exterior Releasing>: Sheng Jiang, Bai Zhi, Qiang Huo; <Acrid and Cool Exterior Releasing>: Chai Hu, Ge Gen; <Clearing Heat and Purging Fire>: Shi Gao; <Clearing Heat and Drying Dampness>: Huang Qin; <Transforming Phlegm>: Jie Geng.

【Analysis of Composition】　(1) Combines elements of <a href='https://whatsintcm.com/dt_articles/黃芩湯/’>Huang Qin Tang (Huang Qin, Shao Yao, Gan Cao, Da Zao) with Chai Hu and Ge Gen, plus Jie Geng, Qiang Huo, Bai Zhi, Shi Gao, and Sheng Jiang. <Acrid and Warm Exterior Releasing>: Sheng Jiang, Bai Zhi, Qiang Huo; <Acrid and Cool Exterior Releasing>: Chai Hu, Ge Gen; <Clearing Heat and Purging Fire>: Shi Gao; <Transforming Phlegm>: Jie Geng. The three assistants are Gan Cao, Sheng Jiang, and Da Zao. (2) Combines elements of Pai Nong Tang (Gan Cao, Jie Geng, Sheng Jiang, Da Zao) with Chai Hu, Ge Gen, Huang Qin, Shao Yao, Qiang Huo, Bai Zhi, and Shi Gao.

【Mnemonic】　(1) Formula name + Pai Nong Tang (Jie Geng + three assistants) + <a href='https://whatsintcm.com/dt_articles/黃芩湯/’>Huang Qin Tang (Huang Qin + Shao Yao + two assistants) + “Only snatch cake” (Bai Zhi, Qiang Huo, Shi Gao). Chai brother pushes away Huang person, only snatches cake. (2) Cai brother robs plane —- Cai brother snatches bride, urgently sweeps paper grass (Chai Hu, Ge Gen, Qiang Huo, Huang Qin, Jie Geng, Shao Yao, Bai Zhi, Gan Cao). (3) Cai Qin strongly leads dead pigeon to burn and stir-fry early to relieve hunger (Chai Hu, Huang Qin, ginger, Qiang Huo, Shi Gao, Ge Gen, Bai Zhi, Jie Geng, Da Zao, Shao Yao, Gan Cao, Chai Ge Jie Ji Tang).

【Functions】　Acrid and cool exterior releasing, disperses wind, clears heat, and releases muscles.

【Indications】　(1) External contraction of wind-cold with latent heat transformation, comprising the three Yang channels, manifesting as unreleased exterior symptoms with gradual decrease in chills and increasing fever, headache, limb pain, eye pain, dry nose, vexation, insomnia, aversion to cold without sweating, dry throat, deafness, orbital pain, thin yellow tongue coating, and superficial and slightly surging pulse. (2) Heat-induced headache and body aches, with upward-rushing epistaxis. When heat is congested in the upper part, it can lead to delirium and mania. Symptoms include headache, thirst, insomnia, dry nose, epistaxis, aversion to cold without sweating, and limb pain with a surging and rapid pulse. (3) Wind-induced fever in children, manifesting as sweating, fever, yawning, red and dry eyes, excessive sleep, aversion to wind, and rapid breathing.

　　From “Yi Fang”: Combination of Tai Yang and Yang Ming channels, with headache, eye pain, dry nose, insomnia, aversion to cold without sweating, and a superficial and slightly surging pulse.

　　From “Shan Bu”: Combination of the three Yang channels, with headache, fever, vexation, insomnia, dry throat, deafness, aversion to cold without sweating, and simultaneous presentation of symptoms from the three Yang channels.

【Pharmacological Actions】　Possesses antipyretic, sedative, analgesic effects, and promotes the production of antibodies.

【Indications for Use】　Common cold, influenza, external febrile diseases, fever, headache, gingivitis, pneumonia, and external fever in children caused by upper respiratory tract infections.

【Contraindications】　(1) Not suitable for conditions where the Tai Yang exterior syndrome has not yet entered the Yang Ming channel, as it may drive the pathogen deeper into the interior. (2) “Yi Xue Xin Wu” contains a formula called Chai Ge Jie Ji Tang, which is this formula with Qiang Huo, Bai Zhi, Jie Geng, Shi Gao, ginger, and jujube fruit removed, and Zhi Mu (Anemarrhena Rhizome), Sheng Di (Raw Rehmannia Root), and Dan Pi (Moutan Bark) added. It is indicated for illnesses during spring and summer fevers.

【Analysis of Formula Actions】　From “Yi Fang”: A formula for the Foot Tai Yang and Yang Ming channels. (1) When cold evil is in the channels, Qiang Huo disperses the evil of Tai Yang. (2) Bai Zhi and Ge Gen disperse the evil of Yang Ming. (3) Chai Hu disperses the evil of Shao Yang. (4) As the cold is transforming into heat, Huang Qin, Shi Gao, and Jie Geng are used to clear it. (5) Shao Yao and Gan Cao harmonize the actions.

From “Shan Bu”: This formula derives from Ge Gen and Bai Zhi to release the evil of Yang Ming channel diseases, Qiang Huo to release the residual evil of Tai Yang, and Chai Hu to release the initial invasion of Shao Yang. Shi Gao and Huang Qin are used to treat the heat in all channels, with a primary focus on clearing Yang Ming. Shao Yao is used to coordinate the dispersing herbs and prevent excessive sweating. Jie Geng guides all the herbs upward to the three Yang channels. Gan Cao harmonizes all the herbs and regulates the exterior and interior. It is applied to illnesses affecting the three Yang channels.

From “Cheng Fang Bian Du”: Chai Hu releases the exterior of Shao Yang, Ge Gen and Bai Zhi release the exterior of Yang Ming, and Qiang Huo releases the exterior of Tai Yang. Thus, the exterior evil has no place to reside. However, when exterior evil is abundant, it will inevitably accumulate internally and transform into heat, which in turn damages Yin. Therefore, Shi Gao and Huang Qin are used to clear the heat, Shao Yao and Gan Cao protect the Yin, and Jie Geng, with its ability to ascend and descend, can guide and promote the elimination of pathogens, leaving no residual evil inside or out. The use of ginger and jujube is merely to harmonize the Ying and Wei, generate fluids, and regulate the exterior and interior, so that the evil is expelled and the right Qi is restored.

From “Han Dian”: This formula targets patients with external contraction presenting with specific pathological conditions, where symptoms of Ma Huang Tang and Ge Gen Tang cannot be resolved, and the pathogen has entered the Shao Yang and Yang Ming channels, with severe thirst and limb pain. If Gui Zhi Tang or Ma Huang Tang are administered for exterior release but are ineffective, and without sweating leading to an increase in fever, even if Chai Hu symptoms appear but the exterior syndrome is not resolved, and there is thirst and Yang Ming symptoms that may resemble those of Bai Hu Tang. This formula combines Ge Gen Tang and Xiao Chai Hu Tang, with the addition of Shi Gao to treat the combined diseases of Tai Yang, Shao Yang, and Yang Ming. Chai Hu, Huang Qin, Ban Xia (Pinellia Rhizome), Shao Yao, and Gan Cao are used to alleviate discomfort in the epigastric region, liver, and hypochondrium, and to clear the heat of Shao Yang. Ge Gen, Gui Zhi, Ma Huang, and Shao Yao are used to clear the heat of Tai Yang, while Shi Gao clears the heat of Yang Ming.

【Adjustments】　From “Shan Bu”: (1) If there is thirst with a desire to drink, double the dose of Shi Gao and add Gua Lou Gen (Trichosanthes Root) to clear heat and generate fluids. (2) If there is severe aversion to cold with no sweating, reduce Shi Gao and Huang Qin and add Ma Huang, especially in spring and summer, to release Tai Yang cold. (3) If there is sweating, add Gui Zhi to release Tai Yang wind; this is always appropriate.

(1) If heat is strong and Yin is damaged, leading to dry mouth and tongue, add Zhi Mu and Hua Fen (Radix et Rhizoma Marusiae) to clear heat and generate fluids.

(2) If accompanied by cough with thick and sticky phlegm, add Gua Lou and Bei Mu (Fritillary Bulb) to transform phlegm and stop cough.

(3) If there is no aversion to cold or headache, Qiang Huo and Bai Zhi can be removed.

(4) If there is no sweating and severe aversion to cold, remove Huang Qin and add Ma Huang to enhance the effect of dispersing exterior cold. In summer and autumn, Ye Su (Perilla Leaf) is often used as a substitute.

(5) If the original symptoms include no sweating and severe aversion to cold, remove Huang Qin and add Ma Huang. Ma Huang is recommended in winter, used sparingly in spring, and omitted in summer and autumn, with Perilla Leaf being added instead.