[Source]

Treatise on Cold Damage Disorders

 [Composition]

Kudzu root, (fried) Licorice root, Scutellaria root, Coptis root
(4)

 [Category]

<Tonify Spleen and Middle Jiao>: Licorice root

<Dispel Exterior with Pungent Coolness>: Kudzu root

<Clear Heat and Dry Dampness>: Coptis root, Scutellaria root

[Analysis of the Formula]

“Medical Prescriptions”: This formula is for the Taiyang and Yangming meridians. When the exterior symptoms are still present, but the patient is mistakenly treated with purgatives, the evil enters the Fu of the Yangming. If sweat is released externally, Qi rushes upwards, causing panting; if it sinks downwards, it causes diarrhea. Therefore, Gui Zhi is omitted and Ge Gen is used to specifically treat the exterior of the Yangming.

Huang Qin and Huang Lian are added to clear the interior heat, and Gan Cao is used to harmonize the stomach Qi. Diarrhea stops without specific treatment for it, and panting stops without specific treatment for it. This is also a method for resolving both Taiyang exterior and interior. “Synopsis and Supplement”: The pulse for Gui Zhi syndrome is originally slow, but after mistaken purgation, it becomes rapid, indicating heavy Yang Qi, suggesting the evil is bound to the exterior and Yang is disturbed internally.

Therefore, panting and sweating, and continuous diarrhea, indicate a sudden outpouring and downward urging, belonging to heat. Thus, the sovereign herb, Ge Gen, with its clear Qi and light quality, is used to release the muscles and stop diarrhea. The assistants, Huang Qin and Huang Lian, with their bitter cold and clearing power, are used to stop sweating and relieve panting. Gan Cao is added to harmonize the Middle Jiao.

Ge Gen is decocted first, and then other herbs are added. This allows the muscle-releasing effect to be slow, while the power of clearing the Middle Jiao is sharp, which is different from the method of tonifying the Middle Jiao and expelling evil. It is also said: The pulse and symptoms in the upper section indicate Yang deficiency, where there is external evil heat but internal deficiency cold; the pulse and symptoms in the lower section indicate Yang excess, with continuous diarrhea but both exterior and interior being repleted.

The same condition of “concomitant heat and diarrhea” and “exterior and interior not resolved” requires different treatments based on cold-heat, deficiency-excess, and tonifying-dispersing. The former formula, Rizhong Tang plus Gui Zhi, has Gui Zhi at the head of Ren Shen. The latter formula, Xie Xin Tang plus Ge Gen, has Ge Gen at the head of Huang Qin and Huang Lian. It is not called Rizhong Xie Xin Tang because the exterior has not yet been resolved. Tonifying the Middle Jiao can also dispel the exterior, and cooling the Middle Jiao can also scatter stagnation.

Tonifying the Middle Jiao can also resolve 痞 (sensation of fullness), and cooling the Middle Jiao can also stop diarrhea. The dual-resolution formulas created by Zhong Jing are miraculous. “Han Dian”: The combination of Ge Gen and Gan Cao in the formula can relax muscle tension; combined with Huang Lian and Huang Qin, it can also regulate gastrointestinal motility. Huang Lian and Huang Qin both clear interior heat and have anti-inflammatory, stomach-strengthening, and intestine-regulating effects.

 [Functions]

Release the exterior and clear heat, stop diarrhea and dysentery.

 [Indications]

(1) Exterior symptoms of exogenous diseases not yet resolved, with heat evil entering the interior, manifesting as body fever and diarrhea, foul-smelling stools, chest oppression, vexation, or panting with sweating, red tongue with yellow coating, and rapid pulse. (2) This formula is derived from San Huang Xie Xin Tang by removing Da Huang and adding Ge Gen and Gan Cao. It is used for conditions similar to San Huang Xie Xin Tang when there is exterior heat but no signs of interior repletion.

 [Clinical Applications]

Acute and chronic gastroenteritis, gastrointestinal cold, bacillary dysentery with heat pattern, diarrhea, amebic dysentery, infantile indigestion, infant autumn diarrhea, rectal prolapse, leukorrhea, and other conditions.

 [Mnemonics]

(1) Formula name + fried Cao. (2) Qin Lian GE Cao (Huang) Qin (Huang) Lian GE (Gen) GAN (Cao). (Qin = Huang Qin, Lian = Huang Lian, GE = Ge Gen, Cao = Gan Cao)

 [Modifications]

(1) For heat dysentery with urgency and tenesmus, add Mu Xiang and Bing Lang to move Qi and relieve tenesmus. (2) For abdominal pain, add stir-fried Bai Shao to soothe the liver and stop pain. (3) For accompanying vomiting, add Ban Xia to descend rebellious Qi and stop vomiting. (4) For accompanying food stagnation, add Shan Zha, Mai Ya, and Shen Qu to resolve food stagnation.

 [Pharmacology]

Has antipyretic, antibacterial, antiviral, anti-hypoxia, immune-enhancing, anti-arrhythmic, and bronchodilating and intestinal smooth muscle relaxant effects.