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Fu Zi and Unpacking Si Ni Tang FU ZI AND UNPACKING SI NI TANG EBOOK Material Translated except where otherwise noted and Compiled by Sharon Weizenbaum Thank you for your interest in this ebook Through the writings here I believe that practitioners can learn some of the basic principles of working with Fu Zi All errors in translation are mine I appreciate any feedback Sharon Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang C i Y j on Humans are created in fire 4 KE QIN ON TRUE FIRE 4 Kan Trigram Explained 4 Li Trigram Explained 7 Two Fires Emperor and Minister Explained 8 Nurturing Yang and Yin 12 FU ZI 13 LI KE ON FU ZI 15 OTHER HERBS LIKE FU ZI 22 Chuan Wu 22 Rou Gui 23 As for formulas that include Rou Gui 31 1 Gui Fu Tang 31 2 Kan Li Dan 32 3 Da Hui Yang Yin 32 4 Gui Fu Li Zhong Tang 33 5 Yang Ba Wei Di Huang Wan 34 Rou Gui 35 Ba Ji Tian 36 Lu Jiao 39 Yin Yang Huo 40 Xian Mao 41 Zi Shi Ying 42 UNPACKING SI NI TANG 44 SI NI TANG 44 Original Text 44 Formula Analysis 46 CASES 48 Case Study 1 Cholera 48 Case Study 2 Constipation 50 Case 3 Phlegm cough GAN JIANG FU ZI TANG 52 55 Original Text 55 Formula Explanation 56 CASES 56 Case 1 Deficiency Cold Bleeding 56 Case 2 Cold Throat Pain 58 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang FU ZI GAN CAO TANG 59 ZHENG QINAN FORMULA 60 CASES 61 Case 1 Pediatric Red Swollen Eyes 61 Case 2 Geriatric Heart Palpitations and Shortness of Breath 63 GAN CAO GAN JIANG TANG 68 Original text Line 29 69 Formula explanation 70 Cases 71 Case 1 Nose bleed 71 Case 2 vomiting blood 73 Case 3 Taxation Lin 75 Case 4 bed wetting 77 Case 5 diarrhea 80 Case 6 Lung Atrophy 81 Case 7 Dispersion Thirst 83 Case 8 Dizziness 84 Case 9 Stomach Duct Pain 85 TONG MAI SI NI SAN Original Text Line 317 370 TONG MAI SI NI JIA DAN ZHU ZHI TANG Original Text Translated unless otherwise noted and Compiled by Sharon 2021 87 87 88 89

Fu Zi and Unpacking Si Ni Tang C i Y j on Humans are created in fire Original Publication Here Ke Qin on True Fire1 Kan Trigram Explained Kan trigram accounts for water it belongs to Yin and is blood True Yang resides within it The middle line is heaven Heaven one gives birth to water In the human body it is the kidneys A tiny bit of true Yang contained between the two Yin It resides in the realm of Zhi Yin It is the root and true seed of human life Various books call it True Yang As for the two words True Yang each one of the various books explain them differently Unfortunately the beginner who reads them for a short while can t comprehend This results in an inability to recognize disease clearly Following are the two words searched out in different places so that they can be referenced and studied True Yang appear under the following names minister fire gate of life fire dragon s thunder fire rootless fire Yin fire and empty fire When it is diseased it comes under the following descriptions Yuan original Qi does not receive original Yang scatters outwards true fire ascends upwards Kidney Qi does not receive Qi does not return to its origin solitary Yang surface upwards empty fire rushes 1 From The True Transmission of Chinese Medicine By Zhang Qinan Translated by and shared here with permission from Yaron Seidman Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang upwards etc all sorts of names all describing the one Yang in the middle of Kan trigram The origin of this one Yang has transformed from the pre heaven of Qian metal Therefore it has the name dragon One Yang lands in the midst of the two Yin and transform into water It establishes the extreme range of water Yang is then the root of water Water quality is to flow downward and this is Kan s fixed position in the post heaven arrangement It is an unchangeable principle One should know that the dragon at this time is the new born dragon dragon means the one Yang in the middle of Kan It is unable to soar to excite the clouds and scatter the rain It can only dive into the abyss where water becomes its residence With water s nature it succeeds in becoming peaceful in this lower position and it bows its head underneath With diseases where for example empty fire rushes upwards it clearly binds with the surging water water is Yin If the water over flourishes one fraction the dragon over flourishes as well one fraction dragon is fire If the water is higher one foot then the dragon is higher one foot as well The dragon is roaming because the water is over flourishing It is not that the dragon fails to dive and acts contrary to its normal state Therefore the classic states When the Yin is too full the Yang must also be weak One can realize that by the application of medicinals one must support the Yang and restrain the Yin And so as soon as the town doctor see an empty fire rushes upwards he doesn t even inspect the vital why and wherefore He opens his mouth and say nourish the Yin and descend fire Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang He self proclaims to have grasped the problem and not even think of the principle where when Yin surges Yin surges means that kidney water is exuberant Yang is deficient Yang deficient means that the emperor fire is weak And so he doesn t support the Yang and to the contrary nourish the Yin even more It is truly not less than adding frost to a snowfield Isn t this the common hand of medicine Whenever I see a disease such as empty fire rushes upwards where the patient loves to drink warm liquids and can t stomach anything cold it is self evident that nourishing the Yin is a mistake Also when I say that Gui and Fu cause the fire to return to its origin no one knows the meaning of it They don t know that cinnamon aconite and dry ginger are a pure ball of raging fire When fire is vigorous then Yin disappears on its own It is like the strong sun that scatters the clouds until they disappear Moreover the power of cinnamon and aconite can supplement the Yang in Kan and Li Their character is extremely upright and unyielding They can erase completely the Yin Qi that overstepped its authority When Yin Qi is completely erased then the great space opens up a wide corridor Above and below establish peace naturally and without breaking off to one side How can this not be seen as truly leading fire back into its origin All through history commentators didn t search out the reality under the surface where one Yang is being submerged in the water This caused later students ignorance with having nothing to depend on Countless people Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang died under nourishing Yin and descending fire Truly it is a corrupt practice through the ages and a great regret to the school of medicine Li Trigram Explained Li trigram account for fire it belongs to Yang and is Qi True Yin depends upon it The second middle line is the earth The earth s number two gives birth to fire In the body it is the heart A tiny bit of true Yin contained between the two Yang It resides in the southern position and it has the appearance of the sovereign It is the most respected among the twelve officials It is the servant of the ten thousand spirits and the master of the human body Therefore it is said Heart stores the spirit True Yang in Kan begins from Qian s origin this is One True Yin in Li begins from Kun s origin this is Two One becomes two and two become one each one serve as the root for the other It contains the meaning of husband and wife Therefore at the time of Zi the first Yang launches and it stirs true water upward to interact with the heart At the time of Wu the first Yin is newborn and it subdues the heart fire to interact downward with the kidneys One rises and one descends and they come and go endlessly and with that Xing and Ming have formed Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Two Fires Emperor and Minister Explained Following the principle emperor fire is ordinary fire while minister fire is true fire Ordinary fire is heart while true fire is Yang within the kidneys Ordinary fire resides above and dominates Yang It is where Yang is concentrated and Yin scarce and therefore its elevated residence serves as its usage this is why Li fire trigram has two Yang lines True fire resides below and dominates Yin It is where Yin is concentrated and Yang scarce and therefore its lower residence serves as its body this is why Kan water trigram has one Yang line Even though the two fires can be separated in reality they are one Qi the two Yang lines in Li and the one Yang line in Kan join together to create Qian heaven trigram Human life can be summarized as one breath of Qi Qi that comes from Qian heaven s origin It is because one fraction of Qian s Qi descending into Kun s palace that there is successful transformation into the post heaven world This is the origin of the two fires emperor and minister It is indeed Yin Yang s deciding factor Even though the two fires cannot be separated however the two fires cannot bear being united Therefore one is going and one is coming which becomes Zhong Qi both fires can generate earth Above gives birth to ordinary earth which is stomach Below gives birth to true earth which is spleen The two fires generate central earth and they are mutually dependent Thereupon the two Qi divide into three Qi therefore they are called the three origins or the San Jiao three Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang burners The classic states If there is no pre heaven then the post heaven cannot form If there is no post heaven then the pre heaven cannot be born as well This is the true meaning of pre and post and the three origins If the central palace lacks the two fires coming and going steaming action then food and drinks cannot breakdown and following diseases may occur indigestion of grains phlegm damp abdominal lumps and fullness one can see that the three sections top center and bottom are one ball of fire If the two fires above and below are both insufficient then the following occur If the rule is to go up there is contrarily hurrying downward For example heart disease goes to the small intestine and lung s disease go to the large intestine If the rule is to stay down there is contrarily galloping upwards For example tooth ache caused by empty fire coughing up blood with urgent panting facial edema and throat ailments Among these diseases it is most important to note that at times Yin Qi surges upwards but true fire doesn t surge upward with it At other times however Yin Qi surges upward and true fire surges upward with it One should be careful with this point If a mechanism of breaking away upward has already revealed itself its pulse is floating and empty urgent shortness of breath and one does not detect red face hot body and sweat then Yin Qi has surged but true fire didn t surge upward with it If Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang however one detects red face hot body and sweat then Yin Qi has surged and true fire did surge upward with it At this time the disease is truly about to break away Whenever one sees diseases where Yin Qi is surging upward one must not delay until the severe breaking away phase and instead one must utilize returning the Yang method The task is with seeing the opportunity early and immediately using all formulas to return the Yang calm it and receive it back One absolutely must not wait for the breaking away phase At the same time there is also a situation where Yang Qi hurries downward and the emperor fire doesn t descend with it At this hour one must not take things lightly If the mechanism of breaking away downward already exists the pulse is thin small and wants to disappear there is profuse bleeding with the bowels and urination or severe diarrhea with undigested food however despite the four extremities being cold the person does not feel cold and there is some control over the bowels and urination this is where Yang Qi descends in a hurry but the emperor fire doesn t descend with it If however the four extremities are freezing cold there is extreme diarrhea and frequent urination that can t be controlled it is Yang Qi descending in a hurry and emperor fire descending with it When disease has reached this stage it wants truly to break away When one sees diseases where Yang Qi descends he must Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang not expect to see the disease condition at the top and then begin using a reverse method The task at hand is to inspect the pre condition of the disease and begin reversing and benefiting Qi in order to save it This on its own can prevent the misfortune of breaking away disease And so when the going up is exhausted because of the bottom it is Yang breaking away the Yang line in the middle of Kan water trigram is the body of heaven and therefore it breaks away via the top When the bottom is exhausted because of the top it is Yin breaking away Yin in Li trigram is earth body and therefore breaks away from the bottom When Yang wants to break away supplement Yin in order to keep it with formulas like Du Shen Tang If Yin wants to break away supplement Yang in order to roll it up like with Hui Yang Yin There are also situations where Yang wants to break away and one should not nourish Yin because if Yin increases then Yang extinguishes There are also situations where Yin wants to break away and one shouldn t supplement Yang If Yang flourishes then Yin disappears All of these are variations of Yin Yang The student s task is to experience this carefully in order to attain the meaning of one origin separating and uniting Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Nurturing Yang and Yin Throughout the ages only Zhongjing knew the truth of one origin and the two Qi fullness and deficiency growth and decline Therefore when he saw a disease in three Yin spheres he immediately applied pungent hot It is because he knew that Yang was deficient and Yin was in excess and therefore emphasized returning Yang When he saw a disease in the three Yang spheres he immediately applied cool clearing because he knew that Yin was insufficient and Yang in excess Therefore he emphasized to preserve Yin One must know that first there is true fire and thereafter there is emperor fire True fire is the body body means root like the seed of fire inside the oven while emperor fire is the usage usage means the branches it means guarding the fire at the bottom of the pot in order to cook thoroughly the water and grains inside of it When true fire exists emperor fire also exists When true fire is extinguished emperor fire is also extinguished Look at Zhongjing when within the three Yin there is a Yin extreme syndrome he specifically uses Fu Zi in Si Ni Tang to rescue pre heaven true fire which is about to extinguish In addition he uses the pungent hot Gan Jiang to help it and only then can he bring the dead back to life How come it is not tonify wood to generate fire use herbs to tonify the heart When within three Yang there is a Yang extreme syndrome he specifically uses Da Huang of Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Da Cheng Qi Tang in order to save pre heaven true Yin which is about to extinguish In addition he uses the cold salty Mang Xiao to assist it and immediately he can recover the dead back to life How come it is not tonify metal in order to generate water using herbs to nurture Yin In Zhongjing methods exploring surge and decline finds itself entirely within pre heaven original Yin and original Yang It is explicitly not sought after in the post heaven five phases birth and control cycles Fu Zi and Da Huang are indeed the great pillars of the two syndromes Yin and Yang The world is declining in its moral values When a doctor is versed with one or two prescriptions and attains one or two methods he is considered a good doctor Yet at the end he does not know Zhongjing s heart method Fu Zi From Andy Ellis The best Fu Zi is from Jiang You county in Si Chuan That is the tradition However there are many other issues involved Often farmers ship their Fu Zi to Jiang You from other regions and sell it in the market there to get a better price Fu Zi is usually soaked in Dan Ba solution for several days or more to pickle it so it will not rot This happens right after harvest in the summer This Fu Zi is called Ni Fu Zi It is then sold to processors like the one that sells to Heiner a man named Mr Zhao Then it is usually soaked in water several times to get the Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Dan Ba out Then it is treated in one of several ways This stuff weighs much more than Fu Zi that is not treated with Dan Ba and thus the seller makes much more money Also it produces a better looking more translucent Fu Zi Unfortunately the Dan Ba is not good and also all the soaking to get it out depletes the Fu Zi If you purchase the Fu Zi without Dan Ba you must treat it right away or it will rot Both of my suppliers buy from farmers in Jiang You and then treat the herb right away so that it is not treated with Dan Ba and not rotted Often caustic chemicals are used to remove the outer skin of the Fu Zi These chemicals are not good for people Fu Zi is also sometimes sulfured after the Dan Ba treatment to prevent it from molding and to give it a lighter color While the best Fu Zi is from Jiang You that does not mean that one needs to use 5 times more of another kind to get the same results This is false reasoning When made into a concentrated granule what is the proper dose We don t know for sure but I can guarantee that it is not a simple issue because of the difference between the process of normal cooking on a stovetop and the complex process used in factories that make granules One cannot directly compare a fresh decoction to a reconstituted dry extract Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Do we know where other companies get their Fu Zi from How do we know that they don t get it from Jiang You How is it that there is only one correct method of treating Fu Zi Books record many many methods Zhang Zhong Jing did not treat it at all He just cooked it for a long time These issues should be discussed in a rational manner and blind allegiance to one brand or another is not a substitute for a true understanding of complex issues Also rumors are not a replacement for facts If there is anything we have learned in the last year it is that Li Ke on Fu Zi2 2 Well Known Physicians of the Fire God School Series 2016 Chinese Traditional Medicine Press Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Fu Zi is Li Ke s favorite herb to apply Its nature is like a thunderbolt and it can break through a closed doorway Its strength is to cleave Yin and return Yang It is the primary commander among herbs It is greatly pungent and greatly hot with a great toxin It dispels cold toxin and cleaves through congealed Yin It moves and does not guard It opens through the 12 channels both the inside and the outside there is no where it does not reach When it is used with Chuan Wu the strength is redoubled and it can break and thaw ice They are all conquering When it is combined with Gan Cao it moderates and supplements earth making fire go down With Gan Jiang s staying and not moving nature it can instantly save a life This is the profound meaning of Si Ni Tang In terms of treating disease with Chinese medicine The nature of Fu Zi tends to help it rescue the root Qi In Shaoyin Yang depletion there is great cold and great toxin Fu Zi is greatly pungent and greatly hot with a Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang great toxin This is sufficient enough to crack the cold I have come to realize that when a patient is dying with a diminished heart the toxin of Fu Zi will snatch the person from the jaws of death It is an elixir to save lives The medical sage established Si Ni Tang and clarified this theory From lecture notes of Li Ke s we know he had a unique way of clarifying this in his Fu Zi delivers Fluids discussion According to this Fu Zi is greatly pungent hot and toxic and yet it is able to deliver fluids This is unimaginably strange In his summary of using Xiao Qing Long Tang for those in eminent danger he quoted Zuo Ji from a section of his Collection of Shang Han Formula Families Shang Han Lei Fang Hui Can laying bare the subtleties of Yin and Yang Fu Zi s great pungency and great heat and like the formation of a cloud it moistens opening the pores and ventilating the fluids Fu Zi therefore creates moisture This is writing that succinctly clinches the point in a way our predecessors did not The Qi is what transforms water We can understand this theory so that when there is a red dry tongue without moss type of illness we can understand this in our hearts Within Si Ni Tang is the herb Fu Zi which through its pungency moistens thereby creating fluids and opening the Qi transformation It can steam up the five fluids of the kidneys so they spread out Yang is generated and so Yin expands This is the seeking Yin within Yang This is the theory of inexhaustible transformation Special Collection of Li Ke s Experience Li Ke Jing Yan Juan Yi Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 1 100 200g 24 1 3 500g 5 24 500g 2 1 Li Ke advocates the use of large dosages of Fu Zi to excel in treating critical cases of diminished heart and lungs He generally uses between 100 200 gm in a formula to be taken continuously day and night The patient will take 1 3 packages in 24 hours This is about 500 gm day He wrote Throughout my life more than 5 tons of Fu Zi was used to treat more than ten thousand patients These dying patients used more than 500 gm of Fu Zi in a 24 hour period and not one case was poisoned 2 For serious illness urgently boil up the Fu Zi As soon as you boil it give it to the critically ill patient with heart weakness Generally doctors are afraid of using a lot of Fu Zi They are fearful of the Fu Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Zi toxin But Fu Zi is the primary commander of strengthening the heart The toxic nature is what actually snatches people from the jaws of death When a person s heart is diminished the entire body function is exhausted The five Zang and six Fu the exterior interior and three Jiao there is layer upon layer of Yin cold surrounding them This is a critical junction in which life is hanging by a single hair When Yang returns there is life and when Yang leaves there is death One simply must break the rule and give large amounts of Fu Zi s pure Yang great pungency and great heat The connection cannot be broken Break the Yin and return the Yang thereby rescuing the life force from being cut off 1 24 1 3 1500mL 500mL 2 3 30g Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 60g 3 When looking at modern pharmacodynamic experimental research we see that when Fu Zi is boiled on high heat for an hour the toxin nature is broken down Because of this I have come to realize that when someone has diminished heart so that they are dying it is the strong toxin of Fu Zi that is the elixir that saves their life Because of this When Li Ke treated critical diminished heart diseases he mixed it with boiling water did a quick boil at high heat and as soon as it was boiled he gave it to the patient He would perhaps give it through the nose Day and night he would give it repeatedly 1 3 packages This is what saves the lives of those who are at the brink of death For chronic diminished heart diseases Fu Zi can be used Add it to 1500 ml of cold water Simmer it at low heat down to 500 ml and take it 2 3 times a day Li Ke said when looking over the history of applying Fu Zi formulas one can see that very many of the mishaps discomfort vomiting or diarrhea was the result of the gradual renewal of the source Qi coming up to do battle with the enemy inside the person s body The upright and the evil do battle with each other and this is the manifestation of the battle Sometimes a patient will take some Fu Zi and after 10 minutes they feel unwell They call me on the telephone sometimes 10 20 times I have my students explain to them and give them something about it in writing When they understand this they don t feel worried It is commonplace to use 30 gm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang of Fu Zi even if the original formula does not contain it 60 gm of Zhi Gan Cao is also added This has the effect of controlling Fu Zi s toxic nature The Fire God school uses large doses of Fu Zi 1 30g 60g 2 5g 10g 10g Li Ke uses it as follows 1 Classical Formula Amounts He gives often gives out 30 60 grams or even more 2 Gradually increasing the dosage Li Ke is really good at this method You establish the initial dose and afterwards increase it day by day by 5 10 gm If there is a feeling of numbness of the tongue or lips then stop At this time decrease the dose by 10 gm Then you can use the formula for a long period of time If there is numbness of the tongue or lips the dose of Fu Zi is too much I use this method for cancer or for chronic illness that requires long term treatment Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Other Herbs Like Fu Zi Chuan Wu3 1 2 150g 30g 2 30g 2500mL 500mL 3 3 The compatibility of medicinals I use herbs with deadly poisons like Chuan Wu combined with Hei Xiao Dou Fang Feng Gan Cao and Feng Mi to control the toxin I also cook it for 2 hours I ve not had a single case of poisoning Hei Dou not only resolves 100 toxins it also enters the kidneys and supplements deficiency It descends the Qi disperses distention vitalizes blood and treats sores Fang Feng master s great wind It is also a wind medicine that moistens It treats all Bi by dispelling damp and defeating 3 Well Known Physicians of the Fire God School Series 2016 Chinese Traditional Medicine Press Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang dampness It can relax the tendons and vessels to relax cramping and spasms It vitalizes the joints of the limbs and remove paralysis In addition is resolves the toxin of Wu Tou and Fu Zi Adding honey and Gan Cao resolves 100 toxins making Wu Tou Tang type formulas a sure bet If you put these altogether and cook them slowly for a long time you can act boldly Every toxic medicinal treats disease This fosters the gathering function of the spleen and kidneys From A Special Collection of Li Ke s Experience Li Ke Jing Yan Zhuan Ji When using Wu Tou formulas one must add 150 gm of Zhi Gan Cao and Feng Mi as well as 30 gm of Fang Feng and Hei Xiao Dou Long Cooking When cooking prescriptions that have more than 30 gm Wu Tou add it to 2500 ml of cold water and cook it over a low fire until it is 500 ml Take this 3 X a day The boiling time will be more or less 3 hours This will decompose the Wu Tou alkali toxin Rou Gui I was delighted when I found these writings on Rou Gui by the classic formula doctor Wu Pei heng I love his experiential formulas at the end of this piece 4 4 Well Known Physicians of the Sichuan School Collection Wu Peiheng Compiled by Shu Shanshan Chinese Traditional Medicine Press 12 2018 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Rou Gui The flavor is sweet and pungent and the Qi is fragrant The character is warm Rou Gui enters the foot Jueyin liver channel It warms the liver and heats the blood breaks stasis and disperses hard lumps expels damp and cold from the back and legs drives out abdominal and rib side pain strengthens the heart zang and warms and heats up cold damp in the blood level When deficiency fire floats upward Rou Gui will induce it to return to the source For presentations of tooth pain throat pain pain at the center of the stomach or sudden cough Rou Gui is quite useful Adding Jiang and Fu to Rou Gui greatly increases its strength This combination can snatch a person from the jaws of death For a person whose body is weak and deficient with Yang deficiency and kidney cold Rou Gui can be steeped in boiled water Taken like this it can prevent disease and prolong life By taking more the benefits increase For Yin dryness presentations Rou Gui can also be given It generates fluids and moistens dryness Rou Gui Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang is indescribably marvelous The liver is related to wood and it stores the blood Blood presides over the wood Qi Its character is warm Warm Qi rises and balmy warmth unfolds and spreads It accumulates and becomes the heat that transforms into heart fire With wood s warmth the Yang ascends by half With fire s heat Yang completely lifts When warm Qi is ample the Yang flourishes and the person is healthy When warm Qi is feeble Yin accumulates and the person is ill The return of Yang causes life and Yin accumulation causes death Life and death are not the same in terms of good and evil Yang and Yin have their own value regarding eminence and humility Even a wriggling insect knows about the preference for life over death yet the ordinary person does not understand the values of Yang in relation to Yin It is an eternal misfortune that there are age old schools of thought that value Yin over Yang If you wish to extend life you must return the Yang The returning the Yang method goes to the center of the Qi and blood fostering the root of the body If Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang the Yang root is feeble the children water and wood will be insufficient with nothing leftover These are the words of Huang Yuanyu When the liver and spleen rise up comfortably the warm Qi reaches ascension and transforms into Yang spirit Yang spirit is the commander and the Yin evil then has no power This is the Tao of preventing disease and prolonging life With the above in mind Rou Gui can warm the liver and heat the blood strengthen the heart and fortify the spleen It can treat disease presentations in women such as irregular menstruation abdominal and back pain during menstruation flooding and trickling leucorrhea pain in the center of the abdomen and postpartum deficiency cold It is effective for all sorts of deficiency cold presentations An Rou Gui is a tropical plant It is produced in Vietnam as well as in Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Guanxi on the mainland of China It is pungent hot and sweet It contains a beneficial oil high grade is better but regular is also good When a weak woman is pregnant and the fetal Qi is insufficient she will show symptoms such as poor appetite and low spirit Alternatively she may have symptoms such as chest or stomach pain with vomiting In this case taking the three flavors Gui Fu and Jiang will not only NOT harm the fetus but on the contrary they will strongly calm the fetus These are supremely miraculous medicinals Gui Jiang and Fu are contraindicated in warm disease summer heat disease and Yangming heat dryness presentations The Rou Gui bark is thick and oily It s character and flavor are also thick It guards and does not leave It focuses on cold of the heart liver spleen and blood level It dispels stasis and generates the new When taking it one should just soak it in water It should not be boiled If it is boiled the Qi vapor and oily substance volatilize and lose their effectiveness Gui Zhi s strength to subdue cold Qi is less than Rou Gui s but you can Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang replace Rou Gui with it On the other hand you cannot replace Rou Gui with Gui Zhi tips There is a red kind from Yunan Yuanyang district now that is a sticky Gui Although it is pungent and hot and has a warm character after it is put in water the sticky glue congeals into a ball and this blocks the stomach and intestines It is not easy to digest It makes the chest and stomach stuffy cold distended and uncomfortable I ve repeatedly tested this and find it to be unsuitable to use Curious Uses for Rou Gui 1 For summertime mushroom poisoning with vomiting and diarrhea 2 3 or 5 qian of Rou Gui can be taken Grind it into a fine powder and mix with water and there will be resolution 2 For cholera either true or false with lots of vomiting and diarrhea and abdominal pain in which the medicine has not been given in time urgently give 3 or 5 qian of Rou Gui Grind it into a fine powder and mix with water The results can be very good There is benefit without damage Then send for the doctor for diagnosis and treatment This is a first aide method 3 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang If one has come in contact with a lot of inclement weather so that the resistance is weakened This will often cause an acute cold presentation If medicinals are not conveniently available 1 2 3 up to 5 qian of Rou Gui can be taken until you can get medicine Grind it into a fine powder and mix with water and there will be an immediate effect as desired 4 If you are going to high mountains the frequent eating of Rou Gui powdered or put in water can ward off miasma or gastroenteristis with vomiting and diarrhea 5 If you are riding in an airplane and get dizziness with nausea and vomiting eat 5 fen to 1 qian of Rou Gui powder It will help immediately If you are going a long way on foot keep a bit of Rou Gui in your mouth It can generate fluids and keep you from panting It can also ward off thirst while you are journeying 6 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang If you ve taken Fu Zi Pian that has been undercooked and you develop numbness poisoning or restlessness immediately take 3 or 5 qian of Rou Gui mixed with water If it is mild it will resolve If it is serious it will gradually resolve By all means do not use a cold water stomach lavage This can cause death I have seen and heard of many cases like this You will be fortunate if you pay attention to this 7 If there is a stroke without speech and medicines cannot be given in a timely way feed the person 3 4 qian of good Rou Gui in water Immediately there will be an effect If they vomit clear spittle all the better It is temporary urgent care It strengthens the heart and transforms phlegm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 7 When there is a white moist tongue moss and lack of thirst with tooth pain throat pain pain at the center of the stomach or nausea with vomiting it is good to give 2 or 3 qian of Rou Gui mixed with water It is effective As for formulas that include Rou Gui 1 Gui Fu Tang Fu Pian 2 liang cooked well ahead of time Rou Gui 3 qian ground into a fine powder and infused in water This formula uses Fu Zi to warm the cold of the kidney water Rou Gui warms the liver wood constraint strengthens the heart and warms the cold within the blood Taking this makes water rise and fire descend Water and fire come into right relationship Ji Ji to connect the heart and kidney The soul becomes tranquil It is quite effective for heart Zang illness with palpitations fright and insomnia It is often given to weak people to prevent illness and prolong life Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 2 Kan Li Dan Fu Pian 2 liang cooked well ahead of time Rou Gui 5 qian ground into a fine powder and infused in water Ge Fen 4 qian Zhi Gan Cao 3 qian Gui Yuan Rou 8 qian is Long Yan Rou Sheng Jiang 8 qian This formula treats heart illness with restlessness The result is excellent 3 Da Hui Yang Yin Fu Pian 2 liang Gan Jiang 1 liang Rou Gui 4 qian Zhi Gan Cao 3 qian This formula is able to return the Yang and rescue rebellion It strengthens the heart consolidates the kidneys warms the middle and Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang smooths the liver It can treat any critical condition in which Yang is deficient and Yin has accumulated It can snatch a patient from the jaws of death As for ordinary weak patients with Yang deficiency without spirit I often give several packages It is easy to have this person return to health They get a new lease on life It prevents illness and prolongs life 4 Gui Fu Li Zhong Tang Ren Shen 3 qian to 1 or 2 liang one can replace with Dang Shen Gan Jiang 1 to 2 liang Bai Zhu 5 qian to 1 liang Gan Cao 3 5 qian Fu Pian 2 4 liang Rou Gui 3 5 qian This formula greatly supplements pre heaven heart and kidney along with post heaven spleen and kidney Yang It treats gastrointestinal illness such as chronic diarrhea and indigestion It is very effective Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 5 Yang Ba Wei Di Huang Wan Shu Di 1 liang Fu Ling 5 qian Zao Pi 3 qian Huai Shan Yao 5 qian Fen Dan 3 qian Ze Xie 3 qian Fu Pian 2 liang Rou Gui 4 qian This formula treats dual deficiency of the Yin and Yang of the kidneys It should be avoided for wind cold or for patterns in which there is Yin accumulation with Yang depletion If too much is taken it can cause swelling distention and collapse Rou Gui5 Rou Gui is sweet and pungent with great warmth It enters the Liver and Kidney It supplements the Ming Men ministerial fire It is good for deep and chronic cold It treats presentations such as reversal in the 4 limbs back and knee soreness and pain deficiency cold and bad food clear food diarrhea acute spasms blocked menstruation abdominal pain 5 Xia Guicheng s 15 Chapters on the Clinical Experience with Herbs and Formulas in Gynecology Beijing People s Press 4 2006 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Shan lumps inhibited urination and upper heat with lower cold It is as Li Yuansu says It supplements insufficiency of the lower jiao treats deep and chronic cold stabilizes diarrhea stops thirst dispels wind cold from the Ying Wei treats exterior deficiency spontaneous sweating Wang Haogu considers it to supplement insufficiency of the ming men boost fire scatter Yin I consider the major function of Rou Gui to be to warm and supplement the Ming Men and to treat lower warmer deep and chronic cold The character flavor and function of it is similar to Fu Zi and both of them are high ranking herbal substances They dispels cold and removes dampness warms and supplements the lower source In these ways Fu Zi and Rou Gui are basically the same This is how they are used in the Jin Gui s Ba Wei Wan Eight Flavor Pill or Ji Sheng Shen Qi Wan Cythula and Plantago Kidney Qi Pill However there are aspects of Rou Gui that are different than Fu Zi For example in the Shang Han Lun Treatise on Damage from Cold when there is great sweat with Yang depletion you must use Fu Zi and not Rou Gui The is because Rou Gui can induce sweating In the Ben Jing Classic of the Materia Medica Rou Gui primarily treats the middle It induces sweating and stops agitation So obviously Rou Gui is not the right herb for the sweating of Yang depletion However in addition to treating deep and chronic cold Rou Gui does synchronize the Ying and Wei and inspire the Qi and blood This all relates to Qi and blood cold stasis Within the synchronizing of Qi and regulating of blood Rou Gui warms Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang and illuminates When there is cold constraint blocked menstruation with abdominal pain this should be used Within the herbs to supplement the Qi and blood Rou Gui functions as an assistant and envoy in that inspires the qi and blood promoting the generation of Yang and the expansion of Yin From this we can know that Fu Zi enters the Qi level whereas the function of Rou Gui is more at the blood level This clarifies the differences and similarities between Rou Gui and Fu Zi Ba Ji Tian SNBCJ The Qi and flavor are sweet slightly warm and non toxic It governs great wind evil Qi impotence and failure of the penis to rise It strengthens the sinews and bone quiets the five Zang supplements the center increases the will and boosts the Qi By Chen Xiu Yuan Translated by Corrina Theisinger6 Ba Ji Tian inherits the wood Qi of heaven spring up bearing and enters the Jue Yin liver The flavor is acrid sweet non toxic By obtaining earth and metal these are the two flavors of earth which enters the Yang Ming dry metal stomach While the Qi and flavor have aspects of wood and earth their principal use is to gather and return warmth inwardly to the liver The SNBCJ uses the 3 words govern great wind as a key point that has 2 appearances One appears in Ba Ji Tian and the other appears 6 Reading of the Divine Farmer s Classic of Materia Medica by Chen Xiu Yuan translated by Corinna Theisinger Chinese Medicine Database 2016 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang in Fang Feng The Jin Gui Yao Lue said The wind is able to generate the 10 000 things and is also able to harm the 10 000 things Fang Feng governs the elimination of harmful wind Ba Ji Tian governs the receiving an increase of wind People who live with nature take advantage of the Qi in order to move breathe and cannot for a short moment eliminate wind Wind then is Qi and the Wind Qi communicates in the liver a breeze gives life to people while a storm kills people Ba Ji Tian s ability to govern great wind refers to the ability to transform a storm into a breeze Evil Qi is when the five phases and the right Qi cannot receive wind and lose their harmony If the wood is without wind then the absence subsequently affects the wood s ability to outthrust If fire is without wind then the absence subsequently affects the wood s upwardly flame If metal is without wind then the absence affects the formation of the body s fortification and strength If water is without wind then the tides cannot rise If earth is without wind then plants cannot flourish As soon as one obtains the use of Ba Ji Tian everywhere will be spring and the evil Qi will be eliminated When evil Qi is eliminated the five Zang are quiet there is nothing left to be said Moreover the Qi of liver Yang move in the ancestral sinew Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang and the Yin wilt will rise When the Qi of liver Yang moves in the kidney Zang the kidneys store the Zhi will and so the will increases the kidney governs the bones and the bones strengthen When the Qi of the liver Yang moves in the spleen Zang then the Zhen thunder and Kun earth will unite in virtue earth and wood are not harmed and the center can be supplemented By using Ba Ji Tian to boost and harmonize this wind if the Qi is harmonized then the wind will be harmonized and death can return to life Those who are not clear on the Dao of life and death decline and growth cannot speak of this Lu Jiao7 Lu Jiao is salty and warm and it enters the Liver and Kidney channels It has the function of moving the blood scattering swelling boosting the Kidneys and benefitting the Yang It treats swollen skin sores blood stasis leading to pain inner damage due to exhaustion and back and spine pain The Ben Cao Jing Shu Summarized Classic of Materia Medica says Fresh it is salty and warm By itself it dissipates heat moves the blood and disperses swelling It eliminates evil Qi The salty flavor is able to enter the blood and soften hardness while the warmth is able to move the blood and dissipate the evil When there are presentations such as malignant skin ulcers and swelling it dispels the 7 Xia Guicheng s 15 Chapters on the Clinical Experience with Herbs and Formulas in Gynecology Beijing People s Press 4 2006 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang noxious evil Qi In addition when there are presentations with static blood within the Yin with lower abdominal blood painfully knotted and malign blood from injury or back and spine pain due to Kidney deficiency The salty warmth enters the Kidney and supplements the Liver Because of this it is used for back and knee pain Qi belongs to the Yang category and therefore supplementing Yang is able to boost the Qi I consider Lu Jiao to be similar to Lu Rong However Lu Rong supplements the Yang and is not the same as Fu Zi and Rou Gui Rou Gui is able to warm the Yang and dispel stasis and its dry warm nature can easily scorch and dry fluids The grasses and wood are not sentient beings and it is difficult to generate the Jing of sentient beings with them Lu Rong on the other hand is made from the flesh and blood of a sentient being and so it can generate the luminous warmth It is special for supplementing deficiency and not just for dispelling evils and eliminating cold Lu Rong is the tender beginning of the Lu Jiao and it is filled with Jing and blood so that it can grow and develop into the antler Even though Lu Jiao and Lu Rong come from the same root they are not the same in their effect If you wish to supplement use Lu Rong For inducing ovulation use Lu Jiao Pian Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Yin Yang Huo SNBCJ Yin Yang Huo is pungent cold and non toxic It governs Yin wilt expiry damage and pain in the penis It also disinhibits urine boosts the power of Qi and strengthens the will Stir fry with goat fat By Chen Xiu Yuan Translated by Corrina Theisinger8 Yin Yang Huo s Qi si cold inheriting the Qi of winter and water and it enters the kidneys Its flavor is pungent and non toxic it obtains the metal flavor of earth and enters the lungs When one carefully considers the writing of the classics they all say that Yin Yang Huo mainly supplements the Zang of water The Yin is the ancestral sinew and the ancestral sinew belongs to wood When wood encounters intense sun it wilts but once it obtains the cold Qi of Yin Yang Huo then it is like obtaining sweet dew and the ancestral sinew can stand firm Expiry damage is when the collaterals and vessels expire and are not replenished The Jin Gui Yao Lue said The collaterals and vessels are where the Yin essence and the Yang Qi come and go Yin Yang Huo is cold and the flavor is pungent It possesses the Qi of heavenly water which circulates and moves and is able to replenish the collaterals and vessels 8 Reading of the Divine Farmer s Classic of Materia Medica by Chen Xiu Yuan translated by Corinna Theisinger Chinese Medicien Database 2016 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Xian Mao9 Xian Mao is pungent bitter and hot It has a slight toxin It enters the kidney and liver channels Its function is to warm the kidney and arouse the Yang strengthen the tendons and sinews and dispel cold damp It is an important herb for diminished Ming Men fire It is used for desiccated cold yang essence nocturnal emissions downpour diarrhea as well as kidney Yang deficiency urinary incontinence frequent urination cold damp Bi cold pain in the abdomen and perimenopausal syndrome It is as it states in the Kai Bao Ben Cao Xian Mao governs epigastric and abdominal cold Qi with an inability to eat low back and leg wind cold cramping and pain with an inability to walk deficiency taxation in men incontinence in the elderly lack of children It boosts the virtues of males The Ben Cao Xin Bian says putting piece of Da Huang in the mouth will resolve the toxin of Xian Mao You don t need a lot of Da Huang Modern people are very happy to take this type of herb The Ben Cao says it can benefit the Yang However it is completely unable to promote Yang It has a completely different nature than Fu Zi and Rou Gui Although it is warm it does not have the promoting Qi Xian Mao is hot and strongly drying It can damage Yin so use it carefully 9 Xia Guicheng s 15 Chapters on the Clinical Experience with Herbs and Formulas in Gynecology Beijing People s Press 4 2006 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Zi Shi Ying10 Zi Shi Ying is sweet and warm It enters the heart and Liver channels It down bears calms the spirit descends rebellious Qi and warms the womb It can treat deficiency fright rebellious cough with ascending Qi and infertility due to cold in the sea of blood The Ben Cao Jing Shu Summarized Classic of Materia Medica gives a relatively detailed discussion Zi Shi Ying is in the Yang category and its root is warmth When there is deficiency of Yang and depleted Qi the cold evil can multiply and it is possible for the Qi to rise as a rebellious cough or for the Qi to knot cold and heat causing heart and abdominal pain This herb is warm and is able to dispel cold It is sweet and is able to supplement the middle When the middle Qi is sufficient the Heart is supplemented and all presentations are healed Fright palpitations are in the category of Heart deficiency and one should use strength to press down When the Heart Qi is pressed down and absorbs the heaviness dispels timidity This is the principle herb for women with wind cold in their womb and this causes the womb to be cut off and there is no pregnancy This is because the woman is tethered to the fetus through the Kidney and the Heart wrapper collateral Xin Bao Luo These are all Yin Zang organs When there is deficiency the wind cold takes advantage and there is infertility With no warmth in the Qi there is not chance to dispel the wind cold and support nature s miracle This herb fills the lower Jiao 10 Xia Guicheng s 15 Chapters on the Clinical Experience with Herbs and Formulas in Gynecology Beijing People s Press 4 2006 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang moving to the Kidney and Xin Bao Luo It is pungent and warm and is able to dispel wind cold evil Qi and is therefore an important herb to warm a woman s womb It supplements the middle Qi and boosts the Heart and Liver opens through the blood vessels down bears the deficient fire making it return to the source Therefore this herb is able to stop dispersion thirst and scatter painful swellings The text moves on to say Zi Shi Ying has a down bearing character and is heavy Its Qi is warm and so it supplements and therefore when the Heart Shen is unsettled and the Liver blood is insufficient and there is infertility due to deficiency cold in the womb it is truly important for you to heed my words However you should only use Zi Shi Ying for a short period of time and not over a long period This is true of all stones and Zi Shi Ying is no exception Unpacking Si Ni Tang Si Ni Tang Fu Zi 1 piece 5 10 gm Gan Jiang 1 5 liang 4 5 gm Gan Cao 2 liang 6 gm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Original Text Line 91 In cold damage the doctor applies purging and then there is diarrhea If this becomes incessant with undigested food aching and pain over the body one should urgently rescue the interior If there is still pain over the body after bowel movement gets back to normal one should urgently and strongly treat the exterior disorder It is appropriate to use Frigid Extremities Decoction s n t ng to treat the interior disorder and Cinnamon Twig Decoction gu zh t ng to address the exterior disorder Line 92 There is an illness with fever and headache but the pulse is contrarily deep If there is no recovery and yet there is still aches and pain one should treat the interior Line 225 When the pulses are floating and slow this is heat on the exterior and cold in the interior There is clear food diarrhea Frigid Extremities Decoction s n t ng governs Line 323 There is Shao yin disease with a deep pulse A warming method should be used immediately Frigid Extremities Decoction s n t ng is appropriate Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Line 353 There is profuse sweating and the heat is unresolved Internally there are cramps and there is pain in the extremities Additionally there is diarrhea with the spread of a cold feeling from the hands and feet to the limbs and intolerance to cold Frigid Extremities Decoction s n t ng governs Line 354 There is a great sweat If there is diarrhea leading to the spread of a cold feeling from the hands and feet to the limbs Frigid Extremities Decoction s n t ng governs Line 372 There is diarrhea abdominal distention and fullness and pain over the body In this case one should first warm the interior and then address the exteriorf It is suitable to use Frigid Extremities Decoction s n t ng to warm the interior and Cinnamon Twig Decoction gu zh t ng to address the exterior Line 377 There is vomiting a weak pulse a slightly feverish body and yet normal urination If the patient has the spread of a cold feeling from the hands and feet to the limb it will be difficult to treat and Frigid Extremities Decoction s n t ng governs Line 389 There is diarrhea and vomiting and yet normal urination along with profuse sweating diarrhea with undigested food This is interior Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang cold and exterior heat The pulse is minute and about to expire Frigid Extremities Decoction s n t ng governs Formula Analysis 11 e 1 This formula primarily treats cold patterns of the three Yin It is a representative formula for returning the Yang and rescuing reversal It treats ordinary illness that develops into the three Yin stage The heart and kidney Yang are deficient and the Yin cold has accumulated internally to a serious level For example it can be used when there is abdominal pain and diarrhea Tai Yin illness in which the grain valley is exhausted and can t transform In Shao Yin illness there is a fear of cold with frigid extremities and a minute pulse and a desire to sleep Jue Yin illness presents with cold reversal of the hands and feet All three of the 11 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang presentations can be treated with this formula It is as in the Su Wen Great Treatise on the Most Reliable Chapter 74 When cold is excessive in the interior this is treated with pungent hot herbs and assisted by bitter sweet so that all is discharged Aconiti Radix lateralis preparata zh f z is very pungent and hot and its pure Yang has a toxin It is the principle herb for benefitting the pre heaven Ming Men fire and opening through the 12 channels It rapidly reaches the interior and exterior to dispel cold Zingiberis Rhizoma g n ji ng warms the middle Jiao Yang and dispels interior cold It assists the Aconiti Radix lateralis preparata zh f z in sending out the Yang Qi Glycyrrhizae Radix g n c o is able to resolve toxin and so is able to moderate the pungent intensity of the Zingiberis Rhizoma ji ng and Aconiti Radix lateralis preparata zh f z Altogether these herbs return the Yang and rescue reversal without causing violent scattering Fu Zi contains Zhu Wu Tou alkaloids In order to guard against this toxin when one is boiling this herb one should simmer for a long time in order to decrease it Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Cases Case Study 1 Cholera12 p E 2 Mr Chen was age 50 and he lived at the Great West Gate He had abdominal pain with vomiting and diarrhea erupt suddenly A doctor gave him Patchouli Agastache Powder to Rectify the Qi hu xi ng zh ng q s n and this made him vomit when he drank it He then took Caryophylli Flos d ng xi ng Amomi Fructus sh r n and Kaki Calyx sh d type herbs which were also not effective At dusk his four limbs would become cold which was especially acute in his two feet He had a cold dripping sweat and weak breathing His interest in life was faint 12 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang This was a critical disease and his family was very sad He came to me for treatment His face was ashen white and his eyes were suken His skin was withered and his breathing was weak His diarrhea looked like the water in which rice was washed without any rotten smell but with a fishy smell This corresponded to her pulse which was thin and minute as if it was about to expire This was Yin cold with the true Yang wanting to break away The Yin Qi overflowed like a haze that could extinguish the sunlight He was already critically ill I had to urgently rescue the Yang in order to pull up the setting sun I gave him a large dose of Si Ni Tang cold in two packages that I gave him that very night continuously He came the next morning for a consultation and the diarrhea and vomiting had stopped His limbs had become warm His pulse was thin so I switched to using Li Zhong Wan with Zhi Fu Zi added which returned him to health From 1978 24 Discussion Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Original Note Countless people die from cholera breakouts A doctor gains fame purely from luck when giving something like Huo Xiang Zheng Qi Tang or Liu He Tang These were given in vain The numbers of people who I have rescued with Si Ni Tang and Li Zhong Tang are many I have seen cholera break out twice during the time I have practiced medicine When this disease breaks out it does so with a violent strength Some people who were able in the afternoon were dead in the morning All of the deaths were due to Yin cold In Qing dynasty Wang Meng Ying s book Discourse on Cholera two types are differentiated one is cold and one is hot When treating this one should be careful to differentiate these Case Study 2 Constipation13 Dr Wang Yu Xian Mr Hao was 35 years old and had suffered from constipation for over 10 months In the beginning he took heat clearing herbs such as Huang Lian and Chuan Lian Zi to treat dizziness but they did not help His appetite became scanty and he developed constipation He body was emaciated and thin He only moved his bowels every other 10 days and it was dry and stagnant When he moved his bowel it was difficult and after he moved his bowel he would feel very weak and breathless He would toss 13 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang about with pain After half a day he would begin to feel better He had many treatments to open his bowels such as Chuan Lian Zi and Mang Xiao but this just made it worse and worse and resulted in him becoming very ill He came to me for treatment His face was dark and his eyes were small and sunken His tongue was dark and dry His pulse was deep and hidden His body felt cold and he just desired to sleep His abdomen was distended but not painful Based on the pulse and presentation I differentiated this as cold accumulation and congealed Yin with cold knotting the spleen and stomach This meant that the large intestine lacked the fluids to be moistened and lost its function to push out the stool The essence of this was due to Tai Yin earth and Shao Yin water not having the moisture to transform The Qi of water and grains did not have the Yang to help with transport Furthermore the dizziness a sign of Yin accumulation obstructing the Yang Looking at what treatments he had previously received did not want to give him any more opening and descending ingredients I only wanted to give him return the Yang formula to stimulate a steaming process in order to warm and open through what had become shut off I use 3 packages of Si Ni Tang Afterwards he felt that his bowel loosened slightly so I gave him 10 more packages He ate a lot and his health returned Even the dizziness was cured I continued then with Kidney Qi Pill from the Jin Gui Shen Qi Wan and all the illness was better From 1964 6 I 41 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Discussion When constipation is chronic and herbs to open through and down bear are given repeatedly not only does the constipation get worse and worse the Yang Qi also gets damaged The face became dark the body cold with a desire to sleep The pulse was deep and hidden The was related to spleen and kidney Yang deficiency and was cold constipation I used Si Ni Tang to warm the spleen and kidney Yang Qi and there was a cure Case 3 Phlegm cough Dr Tang Bu Qi Mr Liu age 52 This patient had a deficient body and suffered from cough and urgent panting Every morning he would cough and vomit a burst of phlegm The disease gradually became serious He presented with a dark facial complexion with slight yellowing He was fatigued with no spirit His voice was weak and he had heart palpitations He had lower back soreness and back pain with fear of cold and lack of thirst He had a poor appetite indigestion and stomach fullness There was spittle in his mouth His lips were Qing and his tongue body was pale red with white slightly yellow sticky moss His pulse was floating and slippery This was kidney Yang depletion with turbid water invading the lungs and the contraction of an external cold The treatment was to return the Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Yang to treat the root and dispel cold to treat the branch The exterior and interior can be treated together Si Ni Jia Ma Huang Tang was used Zhi Fu Pian 31 g Gan Jiang 31 g Zhi Gan Cao 31 g Ma Huang 12 g Second visit After two packages only the cough cleared The other symptoms did not decrease The illness was serious and the herbs were light The dosages were increased Zhi Fu Pian 62 g Gan Jiang 62 g Zhi Gan Cao 62 g Ma Huang 18 g Sheng Jiang 124 g Third visit After three packages the symptoms greatly decreased However there was still a poor appetite 62 g of Pao Jiang and 12 g of Sha Ren were added Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Fourth visit Two more packages were taken Again the symptoms decreased but there was still an aversion to cold Zhi Fu Pian 62 g Gan Jiang 62 g Zhi Gan Cao 62 g Fu Ling 24 g Fifth visit Two packages were given and then 15 g of Gui Zhi was added 12 packages of the same formula with additions and subtractions was given and there was a cure However there was still a fear of cold Fu Zi Sheng Jiang Yang Rou Tang was used to consolidate Discussion The Nei Jing says The five Zang and 6 Fu all can cause a person to cough However the key is the kidneys This is why the treatment in this case from start to finish utilized Si Ni Tang as the foundation Modifications were made according to the pattern Especially at the second visit the dosage was increased to stimulate the person After that the dosage decreased to regulate the middle Jiao Throughout Jiang and Fu were used even to the end with Yang Rou Without these hot herbs it is difficult to treat a heavy cold phlegm cough Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Gan Jiang Fu Zi Tang Gan Jiang Fu Zi Tang Gan Jiang 1 liang 3 gm Zhi Fu Zi Use raw remove skin cut into 8 slices 10 gm Cooking Boil the ingredients in 3 sheng of water and reduce to 1 sheng Strain and take a single dose Original Text Clause 61 After purging sweating is again promoted In the daytime the patient again suffers vexation agitation and an inability to sleep However in the nighttime they are quiet and peaceful with no vomiting or thirst or extreme symptoms The pulse is submerged and faint if there is no vigorous fever Gan Jiang Fu Zi Tang is used Formula Explanation14 The Yang Qi has been damaged and the Yin cold has accumulated internally The Yang Qi is deficient and the outside is disturbed and this 14 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang gives rise to vexation and agitation This vexation and agitation in the daytime with calm at night is an indication of Yang deficiency One should give treatment as for an emergency to return the Yang to avoid further damage Gan Jiang Fu Zi Tang is similar to Si Ni Tang however it does not contain Gan Cao Furthermore this formula is meant to be taken in a single dose The strength of this formula is concentrated and very focused with a speedy result When Gan Cao is added the speedy action of Zhi Fu Zi and Gan Jiang is slowed down and muddled This formula is for acute Yang deficiency with Yin accumulation and should be applied boldly and with confidence Cases Case 1 Deficiency Cold Bleeding 15 Dr Jian Xu Wei The patient has received damage from cold for several days with dry throat vexatious thirst and a wiry thin pulse The doctor induced sweating which blocked the blood Afterward the patient began to bleed from the navel The doctor became panic stricken and fled It is said that this is the effect of using strong diaphoresis in a Shao Yin pattern When there is a Shao Yin pattern one should not use a strong sweating method As Zhong Jing said clause 294 when a strong sweating 15 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang method is used in a Shao Yin presentation this will cause the blood to stir It is not known from which passage it will issue whether from the mouth and nose or from the ears This is known as upper reversal and lower exhaustion and is difficult to treat Zhong Jing did not give a treatment method herbs or formulas to treat this In this case the doctor gave several doses of Gan Jiang Fu Zi Tang and the bleeding stopped Later he had a slight sweat and was cured Discussion This is an original case of Dr Jian This was a case of Shao Yin presentation with wrongful sweating This caused the blood to move recklessly and spontaneously come out of the umbilicus If the patient had been given herbs to stop bleeding this would have only addressed the branch but not the root Because Shao Yin was the root treated the doctor gave Gan Jiang Fu Zi Tang and the bleeding stopped and the disease was dispelled Case 2 Cold Throat Pain16 Dr Li Zhao Xun The patient was Mr Li who was age 40 He came for his first visit on April 16th 1986 In the beginning the patient had a wind cold common cold The symptoms decreased when he was treated but there still remained throat pain He had taken both erythromycin and penicillin but 16 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang the throat pain persisted and had become more severe to the point that he could not take in food or speak His complexion was glossy white and his body was cold with an aversion to cold He has a bland taste in the mouth without thirst and did not want to eat or drink He had a slight cough and spit out a slight amount of white phelgm Inspection revealed that his throat was not red or swollen nor were the tonsils enlarged On the back wall of his throat there was foamy liquid proliferating His tongue was pale and the moss was white Hi pulse was deep and tight This was a case of Yang deficiency with external contraction of a cold evil that had stagnated and knotted in the throat The treatment method was to warm the Yang and scatter cold Gan Jiang Fu Zi Tang was used to treat this Gan Jiang Fu Zi Tang Gan Jiang 10 gm Zhi Fu Zi 15 gm two packages to be boiled and taken over time in small doses Outcome After the herbs the throat pain decreased dramatically He was able to eat and speak I advised him to continue until he finished the herbs at which point he was completely cured A follow up revealed that there was no recurrence Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Discussion The symptom of throat pain is almost always due to Yang abundance However there are rare cases throat pain can be due to cold If the principle pattern show that the throat is not red or swollen and there is no thirst or heat In this case the throat was painful due to cold damp evil accumulating in the throat The channels and network vessels were not circulating and the Yang Qi did not spread out For this reason pungent warmth was used to open in the form of Gan Jiang and Zhi Fu Zi These open through the channels and network vessels and scatter cold and damp to stop pain and so there was a cure Fu Zi Gan Cao Tang Fu Zi 1 liang Zhi Gan Cao 6 qian Zheng Qinan Formula17 Fu Zi Gan Cao Tang is a miraculous formula pre heaven and post heaven Fu Zi is pungent hot and able to supplement the true Yang of pre heaven while Gan Cao is sweet and able to supplement spleen earth of post heaven When earth receives fire is generated and center s Qi can recover Fu Zi tonifies pre heaven s fire When fire prospers it spontaneously gives birth to earth and therefore it is said that center s Qi 17 True Transmission of Chinese Medicine Principals by Zheng Qinan Learning Garden Press 3 2002 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang can recover For a person with chronic disease with fear of cold This is clearly related to insufficiency of pre heaven s true Yang They cannot match the qi of Yin cold and therefore are averse to cold Now they receive Fu Zi and pre heaven s true Yang revives they receive Gan Cao and post heaven s spleen earth prospers Where can there be a person fearing cold who will not recover There are many in the world who do not know the meaning of concealed fire and thus they can t reach to the miraculous application of herbs from the man of antiquity Zhang Zhongjing I will try to explain it here Nowadays people see fire as red and inflamed and they don t use ash to cover it up Although it flames it cannot last very long before it extinguishes When the fire is covered with ash fire attains concealment and it can last for a long time The ancients understood the fine details of Mother Nature When they used one herb or they established one prescription direction it contained profound meaning In this case there are two herbs Fu Zi and Gan Cao Fu Zi is fire while Gan Cao is earth The ancients said that nothing is hotter than Fu Zi and nothing is sweeter than Gan Cao They selected the extreme They supplemented the human being and established life by way of the extreme of the herb s nature When the two herbs rely on each other in their use Together they express the meaning of recovering Yang supplementing pre heaven and post heaven mutual generation and concealed fire One must know this Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Cases Case 1 Pediatric Red Swollen Eyes 18 1923 10g 3g 2 1 2 4 Fu Zi Gan Cao Tang was used to treat Mr Zhu s second son who was an infant at the time It was the 10th day of the 12th lunar month of 1923 The patient s eyes had suddenly become red and swollen He vomited after drinking milk and his stool was green He cried all night long His tongue was what and his finger vein was Qing colored The child s 18 Illustrative Case Examples with Commentary in the Fire God School Compiled by Zhang Cunti and Want Tiantang Chinese Traditional Medicine Press Beijing 3 2003 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang mother had cold and deficient bodies so the child s natural endowment was weak The spleen Yang was weak and the healthy transport was not managed The water could not be managed and hence the interior cold pressed on the liver Qi to become overbearing and insult the spleen The original Yang was submerged It enclosed the liver which consequently ascended to surge into the eyes This was due to deficiency Yang floating more and more It was appropriate to apply the principal to return the Yang to interior storage Fu Zi Gan Cao Tang was used with Sheng Jiang Fu Zi 10 gm Gan Cao 3 gm Sheng Jiang 2 small slices After one package the wailing stopped and after two packages the eye swelling dispersed His stool had changed to yellow Continuing like this after 4 packages there was a complete cure Discussion When one sees red swollen eyes generally one says fire yet this is actually incomplete The ophthalmology department has many names for this which generally do not depart from differentiating external contraction and interior damage methods It does not matter whether this problem is internal external contracted or damaged if the eyes are red swollen and painful with misty obstruction and photophobia the pattern names between deficiency and excess as well as hot and cold are not the same It must be differentiated according to the Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang six conformations and eight guiding principles Being entrenched in one method will bring ill fortune I am not one to treat eye disease arbitrarily The treatment methods have essential methods the classical methods are integrated with this From Wu Peiheng s Case Studies Case 2 Geriatric Heart Palpitations and Shortness of Breath19 77 60g 9g 3 6g 15g 3 19 Illustrative Case Examples with Commentary in the Fire God School Compiled by Zhang Cunti and Want Tiantang Chinese Traditional Medicine Press Beijing 3 2003 Translated by Sharon Weizenbaum Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang 60g 9g 15g 6g 15g 60g 15g 6g 9g 9g 9g 2 3 Mr Chang was age 74 He worked exceptionally hard Although he was old he still managed household chores In the past two months he began to feel heart palpitations and shortness of breath In recent days it had become more serious His urination was frequent and nasal mucous was flowing out He had been treated for this repeatedly without effect The examination showed an interrupted pulse and a white glossy tongue The patient reported as follows All of the doctors say that my illness is related to Yang deficiency but they give me formulas to return the Yang with added Rou Gui This made the heart palpitations worse Why is this I replied It is not bad to return the Yang with Jiang Fu Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang and Gui however without Jiang Fu Zi is not hot and without Gui it is not drying By adding Gui to a formula to return Yang the drying is greatly increased Pure Yang is quite aggressive If it is excessive one can t receive it However if it is adjusted so as to regulate it does not need to be avoided This pattern is obviously related to heart and kidney Yang deficiency with insufficient central Yang The original Qi is unable to be received on the interior When the heart Yang is deficient Yang spirit is not stored This is why there are palpitations and shortness of breath When there is kidney Yang deficiency the original Qi cannot be taken in Above the Yin fluids cannot control and hence there is flowing of fluids from the nose Below the bladder is not controlled so the urination is frequent Moreover the heart and kidney Yang communicate with each other and influence each other When one has kidney Yang deficiency it is easy for the heart Yang to be deficient and then the kidney Yang is even more deficient Of course this mutual communication function completely depends on the mediation of the middle Qi Zheng Qinan said the middle Qi regulates and harmonizes the upper and lower pivot mechanism The treatment for this illness is to supplement Yang in order to transport the middle The pre and post heaven are dealt with simultaneously However when applying herbs one must temper force with mercy It is for this reason there is Zheng Qinan s Fu Zi Gan Cao Tang Hei Fu Pian 60 gm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Zhi Gan Cao 9 gm The patient took three packages of the above formula and the disease condition changed for the better It was appropriate to add to the strength of the supplementing the middle function while supplementing the heart Qi Gao Lin Shen Korean Ginseng was added and then increased from 6gm to 15 gm He was given 3 more packages All of his pathology was greatly reduced He was quiet and peaceful The heart and kidney Yang had recovered As a way to consolidate the results the Yin and Yang had to be dealt with together I changed the formula to Bu Kan Yi Li Dan20 and Qian Yang Dan21 with added flavors The Bu Kan Yi Li Dan included Hei Fu Pian 60 gm Zhi Gan Cao 6 gm Gui Xin 9 gm Ge Fen 15 gm Sheng Jiang 15 gm The Qian Yang Dan included Hei Fu Pian 60 gm Zhi Gan Cao 9 gm 20 21 This formula includes Fu Zi 8 qian Gui Xin 8 qian Ge Fen 5 qian Zhi Gan Cao 4 qian Sheng Jiang 5 slices This formula includes Xi Sha Ren fried in ginger juice 1 liang Fu Zi 8 qian Bui Ban 2 qian and Gan Cao 5 Qian Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Gui Xin 9 gm Gui Jia 15 gm Sha Ren 6 gm Gao Lin Shen 9 gm Bu Kan Yi Li Dan is good at supplementing the heart and kidney Yang Ge Fen supplements the kidney Yin and inspires the lower Jiao water fluids to rise like a tide Jiang and Cao regulate the middle and are especially able to join the communication between above and below These are good to use together While Ge Fen benefits the Yin the sweetness of Gan Cao moderates Therefore not only do the greatly decrease the fierceness they also benefit the mutual joining of water and fire When above and below are misbehaving there will naturally be heart palpitations In Qian Yang Dan Gui Jia submerges the Yang and enriches the Yin Additionally it is good for supplementing the heart and kidney Yang The addition of Gao Lin Shen supplements and boost the source Qi Using Sha Ren with Gan Cao will rectify Qi and regulate the middle This will assist the joining and opening through of the Qi mechanism of above and below Water and fire are then synchronized and balanced After taking two packages of the above formula all the pathology resolved Compared to previously his spirit essence had increased From Dai Linsan s Case Studies Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Note In this illness pattern of heart and kidney Yang deficiency Rou Gui could not be endured due to its drying nature with Fu Zi Fu Zi Gan Cao Tang was used first to bring the Yang back This was rather ingenious The three formulas used are all from Zheng Qinan This elder was profoundly studious in the Fire God school It is more suitable to use Gui Xin rather than Gui Zhi Gui Xin is used in Bu Kan Yi Li Dan Gan Cao Gan Jiang Tang Licorice and Dry Ginger Decoction g n c o g n ji ng t ng Glycyrrhizae Radix preparata zh g n c o Zingiberis Rhizoma g n ji ng 4 liang 12 gm 2 liang 6 gm Cooking method Decoct the above ingredients in 3 sheng of water down to 1 sheng Remove the foam Divide into two doses to be taken warm twice in one day Original text Line 29 Shang Han the pulse is floating there is spontaneous sweating frequent urination there will be heart vexation a slight aversion to cold and cramps in the feet but Gui Zhi Tang is given to attack the exterior this is Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang a mistake Having given it there is jue the throat is dry and if there is vexation and agitation with vomiting due to reversal administer Licorice and Ginger Decoction g n c o g n ji ng t ng to restore the Yang If the jue recovers and the feet become warm then after administering Peony and Licorice Decoction sh o y o g n c o t ng the feet will then stretch Where the stomach qi is disharmonious if the speech is delirious give a little Regulate the Stomach and Order the Qi Decoction ti o w i ch ng q t ng Where heavy sweating was promoted if then there is repeated hot needling Frigid Extremities Decoction s n t ng governs Formula explanation 22 In the past when the Yin and Yang were both depleted often the ancient sages would first benefit the Yang and afterwards enrich the Yin This presentation uses Licorice and Ginger Decoction g n c o g n ji ng t ng to restore the Yang as well When the Yang is generated the Yin grows When the Yang is consolidated the Yin is preserved When all is said and done the symptoms of restlessness and dry throat appear like Yin damage One must consider this when warming the Yang This formula uses Glycyrrhizae Radix g n c o in double the amount of Zingiberis Rhizoma g n ji ng This is because warming the Yang of the middle 22 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang this way does not damage the lower Jiao Yin Later generations also use this formula for spleen and lung deficiency cold patterns For example it is used for spleen Yang deficiency depletion in which the spleen is unable to wrap the blood which leads to bleeding In this case Zingiberis Rhizoma g n ji ng should be changed to Zingiberis Rhizoma preparata p o ji ng to warm the spleen and increase the absorption of blood It can also be used for lung emaciation with deficiency cold in which the thin fluids are cold and the Qi becomes depressed In this case the up bearing does not control the down bearing causing vomiting of saliva dizziness and bedwetting In this kind of case this formula can be very effective Cases23 Case 1 Nose bleed Yue Mei Zhong Mr Yan was 21 years old The patient suffered from an ordinary nose bleed and at the beginning he did not mind it At a certain point he to a long journey of and after 3 days returned home At 6 00 his not began to bleed and after 5 hours it had not stopped His family were alarmed and did not know what to do In the middle of the night they came knocking He leaned his head on a pillow and the blood was still flowing ceaselessly 23 Sha ng Ha n Mi ng Yi Ya n A n Ji ng Xu an Selected Cases from Famous Physicians in the Shang Han Tradi tion Ed Che nMi ng Zha ngYi n She ng Xue Yua n Publishing Company Be iji ng China 1998 Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang He kept a basin under the bed and it was half full of blood The patient s face was as white as a sheet of paper Recently a cold Qi had entered and he could not get warm and did not speak His pulse was very faint Hi spirit was defeated I urgently gave him Licorice and Ginger Decoction g n c o g n ji ng t ng Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix preparata zh g n c o 9 gm Zingiberis Rhizoma preparata p o ji ng 9 gm The patient became warm in the limbs 1 2 an hour after taking the herbs His pulse gradually slowed and he was able to speak The bleeding also stopped The next day 12 gm of e jiao was added There was no reoccurrence Discussion This patient had an ordinary nose bleed and so the Yang networks were already damaged Because of recent unsatisfactory conditions his liver qi rose greatly This caused the blood to gush The Ling Shu Cold and Heat says When there is sudden disease with inner rebellion the liver and lung being very closely linked can lead to blood overflowing from the nose and mouth This is the mechanism of the above illness In this case the bleeding was profuse and the Yin fluids were suddenly lost and the Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Yang was without anything to attach to Although it was the middle of the night the Yin was spontaneously exuberant at the Yin time and the Yang was suddenly lost If someone had only used a method to nourish blood and stop bleeding the Yin would have been supported but the Yang would have finally been difficult to recover In order to change the course in a moment the only hope was to rescue the Yang The Jue was healed as the feet became warm and the pulse continued to issue forth Afterward he became of sound mind This formula carries out the plan slowly and gently by following this meaning Although Licorice and Ginger Decoction g n c o g n ji ng t ng is not a stop bleeding formula it was able to stop the bleeding This is because The nature of Yang is to protect the exterior by consolidating Yang consolidates and so the Yin is spontaneously calmed and guarded in the interior This means that when the dike is strong enough to hold back there is no worry of flooding over Case 2 vomiting blood Zhao Shou Zhen This patient was named Wang and he often had an illness of vomiting blood He was given clearing cold and astringent herbs to stop bleeding The past summer the illness returned He took the previous herbs with no effect and later took herbs to warm and supplement along with herbs to scatter stasis This was also to no avail When I saw him the Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang bleeding was sporadic but unceasing the color was dark and the substance was watery He also had a frequent cough and vomited clear fluid His mouth was bland he had a poor appetite and yellow urine His pulse was soft and moderate I did observation in order to determine the formula There was both cold and warmth However this was 1 not a heat presentation so Zhi Zi and Zhu Ling are not used This is also not 2 damage and depletion to the original Yang with the protective qi being weak and so Gui Zhi and Fu Zi type formulas are not suitable In this case the pulse is soft and moderate but there is not 3 the presence of sticky stool spleen deficiency There is a cough with clear fluids but 4 though the lung is cold it is not deficient When there is this presentation you could use Six Gentleman Decoction li j n z t ng with Platycladi Cacumen c b i y and jiao Schizonepetae Herba j ng ji These methods were used but the bleeding did not stop It was thought about for a long time but they failed to grasp the meaning The chapter on vomiting blood in the San Zi Jing by Xuan Yi and Chen Xiu Yuan says use the warming absorptive method of Cao and Jiang The four gentlemen with Ren Shen and Bai Zhu is too supplementing and is inferior to the use of Licorice and Ginger Decoction g n c o g n ji ng t ng to warm the lung and supplement the spleen This is why it is said that this formula supplements without consolidating and it warms without drying Formula Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix preparata zh g n c o 18 gm Zingiberis Rhizoma preparata p o ji ng 9 gm I gave the patient 4 packages and the vomiting decreased in frequency After 3 more packages it completely stopped After that I used food and drink to regulate and nourish and did not use other herbs Discussion The Qing dynasty writer Qin Bo Wei in his Qing Dai Tong Men Ji points out In chronic vomiting illness the root is deficiency and the qi is often cold and the power is moderate Therefore in terms of treatment the main principle will be to supplement and warm Blood flows along the channels When it meets warmth it moves and when it meets cold it congeals If you use cold and cool herbs in a knee jerk fashion it may stop the bleeding for a time but then suddenly the blood will flow out of the vessels and the cold will cause stasis and a lack of movement of the blood Over time there will be vomiting of blood that does not cease and cannot be cured In this case of vomiting blood there is evidence of spleen and lung deficiency cold We followed the words of Yi and Chen to use the warming and absorbing method of Jiang and Cao regulation Licorice and Ginger Decoction g n c o g n ji ng t ng Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang warms the Yang Qi of the Tai Yin It consolidated and absorbed the blood to move appropriately Case 3 Taxation Lin Zhao Shou Zhen The patient worked very hard on a summer day in the fields It was muggy and hot in a stifling way He rested wanting to sit down frequently Unavoidably damp heat made a sneak attack Thereupon he developed lin illness His urination was rough and painful It dripped and did not come out easily There was also blood seeping out He could barely stand the pain I felt his pulse and it was rapid and without strength He did not have thirst His tongue moss was with and sticky as well as slippery There was chest and epigastric oppression and a slight cough with abundant clear fluids The bowel moved easily From the interrogation I knew that the cause was extreme over work that caused the warm heat to be damaged This in turn damaged the blood However he was given lots of cold herbs to clear heat Heat was clear but damp stayed For treatment it was suitable to disinhibit urination enrich Yin course the channels and harmonize the blood I gave Polyporus Decoction zh l ng t ng with Achyranthis bidentatae Radix ni x and Trichosanthis Fructus gu l u I gave him 10 packages and although the bleeding and pain decreased the lin remained the same and the chest fullness and cough with phlegm got worse The explanation is Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang that the water damp has floated upward and the cold was generated in the lungs so that the upper orifices were not open through and the lower orifices found it difficult to be open This is why there was a cough with phlegm This was cold and not heat The lower Lin was not heat but rather fell into the category of damp The focus was not the lower jiao but was rather the upper two jiao For treatment it was appropriate to warm the lung and fortify the spleen However the two Zhu Atractylodis macrocephalae Rhizoma b i zh and Atractylodis Rhizoma c ng zh are warm and dry and damage the fluid Ma Xin San damage the lung Qi All of these are not what should be used Instead one should use Licorice and Ginger Decoction g n c o g n ji ng t ng Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o use the tip 24 gm Zingiberis Rhizoma preparata p o ji ng 9 gm I gave him 5 packages and the urination became longer and the bleeding stopped The chest also became comfortable and the watery fluids decreased Because the formula was being effective I gave him 5 more packages and the illness was cured Afterward I gave him herbs to boost the qi and fortify the stomach to regulate and recuperate Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Discussion This case is an example in which there was one mistake after another It was only by grasping the principle pattern that one can know how to treat this lin One cannot be constrained to the concept of warm heat The tip of Glycyrrhizae Radix g n c o is a lead herb for disinhibiting water and moving downward Case 4 bed wetting Zhao Shou Zhen Mr Liu was 30 years old He had been wetting the bed for a long time During the day there is a break between his urination but at night it is continuous The doctors agreed that his kidney qi was deficient and depleted In order to warm the kidney and enrich water Kidney Qi Pill sh n q w n was used Methods were also used to supplement the kidney and warm and astrict by using Stabilize the Yin Decoction g y n ji n Astragalus Decoction to Construct the Middle hu ng q ji n zh ng t ng and Tonify the Middle to Augment the Qi Decoction b zh ng y q t ng was also used to treat spleen and stomach deficiency cold He also tried herbs such as Cervi Cornu pantotrichum l r ng Hominis Placenta z h ch and Tian Sheng Huang He tried many things and there was some effect sometimes and sometimes there was no effect Over all though he still was left with the problem without an effective treatment method I could see that the previous formulas were Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang not conforming to the presentation and that all his efforts were in vain I carefully examined his pulse and his right side cun and guan pulses were weak His tongue was white and glossy without moss His mouth was bland He coughed with some thin fluids and his appetite was slightly diminished His urine was long and clear and extremely frequent at night His bowels were sticky In this case the 3 zang lung spleen and kidney were all ill However herbs to supplement the kidney and warm the spleen had been given repeatedly so I couldn t just tonify the lung now Instead I considered the dispersion thirst pattern The lungs are the upper source of water and in this case water was not transforming there This poured down the the Kidney with the result that the spleen and kidney were not able to keep the water within the banks What should have been closed was open wide The lungs had to be treated as the priority Why couldn t this be the root presentation As Jing Yue says Although a small amount of water is beneficial to the kidneys the kidneys also connect to the lungs If the lung qi has no strength the kidney will not be able to absorb water Therefore to treat the water one must treat the qi To treat the kidneys one must first treat the lungs The presentation in this case is related to the kidneys The treatment method is to warm the lungs and transform fluids In addition Licorice and Ginger Decoction g n c o g n ji ng t ng was originally for enuresis which is even more of a reason to use it in this case Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o 24 gm Zingiberis Rhizoma preparata p o ji ng 9 gm daily 2 doses After 3 days the enuresis had significantly decreased The excess saliva also became scanty I gave him 5 more packages and the pattern was no longer present Altogether he took 16 doses over 8 days This difficult to treat presentation was unexpectedly cured Honestly this exceeded my expectations Case 5 diarrhea Zhao Shou Zhen The patient Mr Dai had gone to the Dragon Boat Festival and had used indiscretion in eating and drinking That night he received a wind cold and the next day he had developed a fever and aversion to cold He also had abdominal pain and diarrhea He took some medicine to resolve the exterior and treat indigestion and the exterior resolved but the diarrhea did not stop Erroneously this was considered a deficiency pattern so he was given warming and supplementing herbs The diarrhea stopped but he had abdominal distention and pain He took laxative herbs but thereupon the diarrhea did not stop Then he came to see me He had intestinal sounds and each day he had diarrhea 5 6 times There was no Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang distention and no pain His mouth was bland with a tasteless flavor His tongue moss was thin and white It was not dry His pulses were weak and without strength I drew my conclusion about the disease condition determining it to be stomach cold without much spleen qi deficiency It was not appropriate to use Ginseng Radix r n sh n or Atractylodis macrocephalae Rhizoma b i zh to supplement It was also not an intestinal heat with stomach cold pattern so it was not appropriate to use the three Drain the Epigastrium Decoction xi x n t ng formulas for mixed cold and heat Although it was correct to say that this was a pattern of stomach cold with spleen deficiency Regulate the Middle Decoction l zh ng t ng uses Ginseng Radix r n sh n and Atractylodis macrocephalae Rhizoma b i zh If we take these out we have Glycyrrhizae Radix g n c o and Zingiberis Rhizoma g n ji ng This becomes Licorice and Ginger Decoction g n c o g n ji ng t ng This has the ability to warm the stomach yang and supplement the spleen deficiency Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o 24 gm Zingiberis Rhizoma preparata p o ji ng 9 gm Drink warm 2 large doses a day Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang The diarrhea decreased and after 2 more days of the herbs it stopped I used different herbs to regulate the interior and all was calmed Case 6 Lung Atrophy Dr Zhang Ying Rui This was a case of a 45 year old woman from the spring of 1951 She had difficulties since giving birth She gradually became emaciated and her facial color was very sallow He had dizziness and frothy saliva Her throat was dry and her mouth was bland At night she was not able to rest peacefully Her tongue had no moss and had slight fluids A previous doctor had mistakenly considered this a case of blood depletion and Yin damage and gave him large doses of herb to nourish blood and enrich Yin After 10 days the illness did not change and the frothy saliva increased Her spirit was despondent and her body was weak When I examined her her pulses were thin and moderate The right cun was weak This was a case of lung emaciation and I obeyed Zhong Jing s method I gave her Licorice and Ginger Decoction g n c o g n ji ng t ng to harmonize the middle and absorb fluids Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o 15 gm Zingiberis Rhizoma g n ji ng 6 gm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang After 1 dose in the morning by noon the saliva greatly decreased I gave her one more package and the saliva stopped She was able to peacefully sleep and did not wake up until the next day I continued with herbs to enrich the lungs and supplement Qi I regulated and nourished for a few days and she was cured Discussion Lung wilt can be from deficiency cold or deficiency heat and these must be differentiated In this case because there was vomiting of white saliva with a sallow complexion dizziness bland mouth thin moderate pulse with a weak cun position and because the patient had already been given large doses of herbs to enrich Yin with an opposite effect I knew this was lung wilt from deficiency cold This is why I gave her Licorice and Ginger Decoction g n c o g n ji ng t ng Case 7 Dispersion Thirst Dr Tao Zheng Zhui The patient was a man age 43 He was suffered from dispersion thirst and a previous doctor had diagnosed him with lack of movement of the middle Yang and lower warmer Yang deficiency He used the method of supplementing and warming the spleen and kidneys He used Regulate the Middle Pill l zh ng w n and Kidney Qi Pill from the Golden Cabinet j n gu sh n q w n with no effect It was then decided that he had middle fullness with indigestion Then he came to see me for a Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang diagnosis He had mouth thirst He would drink and drink but the thirst was difficult to bear His nose was dry without mucous His breath felt cold His tongue was pale with scanty fluids His pulse was slightly floating hesitant and thin This was a case of lung cold with dispirited Qi The fluids had become cold and congealed Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o 10 gm Zingiberis Rhizoma g n ji ng 10 gm I asked him to drink it like his usual tea He had his second visit after 10 days The thirst had diminished and the amount he drank decreased His nose was moist with mucous and his breath was warm I advised him to continue the formula until the end of the month and he recovered From Julin Zhong Yi Yao 1986 3 28 Discussion This illness was in the upper warmer but the treatment focused on the middle and lower and therefore it was ineffective We did use a warming method but applied a Zang Fu diagnosis as well This shows that Licorice and Ginger Decoction g n c o g n ji ng t ng treats lung cold with cold qi patterns For this it is truly effective Case 8 Dizziness Dr Zhu Yan Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Mr Wang was a 50 year old male who came for his first visit on April 12 1965 In the afternoon of the previous day he began to feel dizzy with a desire to vomit He asked a doctor to diagnose and treat him He was given Clear Dizziness Pill qing xuan wan without any results His pulse was hesitant at 47 beats minute His tongue was pale and he had a desire to vomit He had no thirst or fever His body temperature was 36 4 C He did not fear cold This was a cold pattern and treatment needed to warm and scatter I gave him Licorice and Ginger Decoction g n c o g n ji ng t ng Ginger and Licorice Decoction g n ji ng g n c o t ng Glycyrrhizae Radix g n c o 9 gm Zingiberis Rhizoma g n ji ng 9 gm Drink one package warm He returned for a visit the next day and the dizziness had stopped The vomiting also stopped His pulse was now 67 beats minute He was able to return to his job of building walls I gave him one more package of the original formula and there was no recurrence From Zhong Yi Za Zhi 1965 11 6 Discussion Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang In the Jing Yue Quan Shu Complete Works of Jing Yue chapter of dizziness it is pointed out that This case is due to cold deficiency of the middle jiao The clear Yang was unable to spread out Licorice and Ginger Decoction g n c o g n ji ng t ng warms the cold in the middle and spreads the clear Yang This cured the problem Case 9 Stomach Duct Pain Dr Hu Xue Ceng This is a case of a 16 year old young man After eating cold and raw food over a long period of time he developed stomach duct pain This was caused by cold and it would come and go Heat made it feel better This was accompanied by abdominal distention and a desire to vomit He vomited clear fluids He also had heart and chest vexation and oppression dizziness poor appetite weight loss and pasty stool His tongue was burned red with white moist moss His pulse was deep and wiry This was spleen and stomach Yang deficiency with cold fluids stopping internally The evil fluids were upwardly harassing It was suitable to fortify the spleen and stomach dispel cold and down bear rebellion I used Licorice and Ginger Decoction g n c o g n ji ng t ng with added flavors Ginger and Licorice Decoction g n ji ng g n c o t ng Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Glycyrrhizae Radix preparata zh g n 15 gm c o Zingiberis Rhizoma g n ji ng 8 gm Pinelliae Rhizoma preparatum zh b n 4 gm xi The illness resolved after two packages I gave him Xiang Xia Yang Wei Tang to consolidate the result From Tian Jian Zhong Yi 1986 4 14 Discussion In asking questions to determine the cause and differentiate the syndrome we can see that this case of stomach duct pain is due to spleen and stomach deficiency cold Licorice and Ginger Decoction g n c o g n ji ng t ng is Regulate the Middle Decoction l zh ng t ng without the sticky cloying Ginseng Radix r n sh n and Atractylodis macrocephalae Rhizoma b i zh This will make the formula s warm the middle action to be even more speedy The addition of Pinelliae Rhizoma preparatum zh b n xi warms the stomach and stops rebellion In this case it was effective Tong Mai Si Ni San Fu Zi 1 piece 5 10 gm Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Zhi Gan 2 liang 6 gm 3 liang 9 gm Cao Gan Jiang Original Text Line 317 370 In shao yin disease there is diarrhea with undigested food The interior is cold and the exterior is hot There is the spread of a cold feeling from the hands and feet to the limbs and a feeble pulse that is on the verge of expiry but the absence of intolerance to cold The patient presents with a red face or pain in the abdomen or dry heave or sore throat or the disappearance of diarrhea and expiry of the pulse Tong Mai Si Ni Tang should be prescribed Boil these three ingredients in 600 ml water to get 240 ml decoction then strain the decoction Divide the decoction into two portions and administer 120 ml decoction two times when it is lukewarm When the pulse returns shortly after taking the formula this indicates recovery If there is a red face add Cong Bai 9 stems if there is abdominal pain take out Cong Bai and add Bai Shao 6 g if there is vomiting add Sheng Jiang 6 g if there is sore throat take out Bai Shao and add Jie Geng 3 g if there is disappearance of diarrhea and expiry of the pulse take out Jie Geng and add Ren Shen 6 g Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang Only if the pathology corresponds with the function of the formula can the formula be prescribed Tong Mai Si Ni Jia Dan Zhu Zhi Tang Fu Zi 1 piece 5 10 gm Zhi Gan 2 liang 6 gm Gan Jiang 3 liang 9 gm Dan Zhu ge 10 ml Cao Zhi Original Text Line 390 Vomiting and diarrhea have stopped There is sweating the spread of a cold feeling from the hands and feet to the limbs constant spasm in the extremities and a feeble pulse that is about to expire Unblock the Pulse Tong Mai Si Ni Jia Zhu Dan Zhi Tang is indicated Boil the three herbs in 600 ml water to get 240 ml decoction then strain the decoction Add Zhu Dan Zhi Divide the decoction into two portions and administer 120 ml decoction two times when it is lukewarm The pulse should return shortly after taking the formula If Zhu Dan Zhi is not available goat s bile can serve as a replacement Translated unless otherwise noted and Compiled by Sharon 2021

Fu Zi and Unpacking Si Ni Tang The bile is bitter sweet and cold It open s the Yang Ming Shao Yang and nourishes Yin 4 gm of Huang Lian can be prescribed Zhu Dan Zhi contains vibrant energy which can first enter the heart and bring the pulse back with its bitter taste and then its juice can supply fluid to the middle burner which can be distributed to nourish tendons and muscles to relieve spasm In this way the combination of acrid and sweet flavors along with the combination of bitter and sweet flavors can mutually support and control each other leading to harmony of yin and yang in a short time This approach is similar to that of Si Ni Jia Ren Shen But compared to Ren Shen Pig s bile which is an animal agent rather than a plant agent contains vibrant energy and makes the formula work wonderfully Translated unless otherwise noted and Compiled by Sharon 2021