fu zi 9 bai zhu 6 fu ling 9 bai shao 9 sheng jiang 9
The most complex and variable syndromes are those that pertain either to diseases of the pivot, and diseases in which water plays a key role.
There are three pivots and two sources.
Pivot one is the shao yang, pivot two is the shao yin, and pivot three is the earth. The two sources are the earth as post-heaven and shao yin kidneys as pre-heaven.
In this post I will discuss line 316 from the Shan Han Lun.
Line 316 When shao yin disease has not ceased after two or three days, and at four and five days there is abdominal pain, inhibited urination, heaviness and pain in the limbs, and spontaneous diarrhea, it means there is water qi and the person may cough, or have uninhibited urination, or diarrhea, or retching, therefore zhen wu tang governs.
Tai yang rules water, it is the extreme yang within yang. Shao yin is the storage of water and fire. Water and fire together are referred to as shao yin.
Water and fire must remain co-joined and interdependent in the body. They should never separate from each other. Water and fire together are the yin and yang.
Zhen wu tang is the representative formula of the northern direction. It restores the yang qi so it can once again descend into water, so it can once again rise to the heavens.
When shao yin disease has not ceased after two or three days, and at four and five days there is abdominal pain, inhibited urination, heaviness and pain in the limbs, and spontaneous diarrhea, it means there is water qi and the person may cough,
Cold and fluids have accumulated which gives rise to abdominal pain. The cold has closed off the bladder. Yang qi fails to reach and warm the extremities which belong to earth. Yang fails to warm the interior and fluids drop out the bottom as diarrhea. Fluids can accumulate in the lungs giving rise to cough. This is water qi.
Line 316 modifications, If there is a cough add wu wei zi, xi xin and gan jiang. Wu wei zi, xi xin, and gan jiang are the core trio to treat fluid accumulation is the lungs due to cold.
or have uninhibited urination,
Obviously the bladder is not always closed in this pattern. Line 316 modifications, If the urine is uninhibited remove fu ling.
or diarrhea,
Line 316 modifications, If there is diarrhea remove bai shao and add gan jiang.
Removing the bai shao makes the formula more pungent and dispersing. Its sour collecting nature calms internal movement as wind. Bai shao also nourishes fluids and blood which will make the diarrhea worse. Gan jiang introduces dryness into the yang ming domain.
or retching
Line 316 modifications, If there is retching remove fu zi and add sheng jiang.
This modification is interesting because it illustrates that the yang levels, tai yang, yang ming, and shao yang, need to be functioning first before progressing to the yin levels. Retching indicates the accumulation of cold and fluids in the yang ming stomach organ. This prevents yang ming from descending into tai yin to warm the interior. The cold and fluids prevent the exchange of qi between the upper and lower burners. Sheng jiang restore the pivot of earth.
Comparison
Zhen wu tang, fu zi 9 bai zhu 6 fu ling 9 bai shao 9 sheng jiang 9
Fu zi tang, fu zi 9 bai zhu 12 fu ling 12 bai shao 9 ren shen 6
Si ni tang, fu zi 6 gan jiang 4.5 zhi gan cao 6
These formulas open the southern direction. It is fu zi that brings fire to water.
Si ni tang is treating mostly cold.
Zhen wu tang and fu zi tang are both treating cold and fluid accumulation with the addition of bai zhu and fu ling.
Zhen wu tang is more dispersing with the addition of sheng jiang. Fu zi tang it tonifying and nourishing with the addition of bai shao and ren shen.