Cold or Flu That Just Won’t Get Better — and the Sweat Won’t Come Out? Doctor Zhang Jingyue’s Six Chai Hu Yin (Bupleurum Drinks) from His “Scattering Formation”: When External Pathogens Invade, Dispersing Them Matters — but Tonifying Deficiency Matters Just as Much (Chai Hu Yin No. 1–5 and Zheng Chai Hu Yin Explained)

What people search for: cold that won’t get better / can’t sweat out a cold / how to treat a cold with weak constitution / yin-deficiency cold / qi-deficiency cold that drags on / Chai Hu Yin No. 1–5 / Zheng Chai Hu Yin granules / ginseng during a cold — yes or no / Zhang Jingyue scattering formation / eight formations of new formulas / Doctor Zhang Jingyue cold treatment

Medical terms for this condition: external contraction (wai gan) / exterior syndrome (biao zheng) / dispersing the pathogen (san xie) / supporting upright qi (fu zheng) / xie zhi suo cou, qi qi bi xu (wherever the pathogen gathers, the qi there must be deficient) / acrid-cool exterior release (xin liang jie biao) / heat entering the blood chamber (re ru xue shi) / wind-cold exterior (feng han biao zheng) / cold-dispersion vs. warm-dispersion / Three Yang channels (san yang jing)

💬 Note from Doctor Luo: Dear friends, good morning, everyone. Today we continue talking about the famous Ming-dynasty physician Doctor Zhang Jingyue and his way of composing formulas. He created the “Eight Formations of New Formulas” (Xin Fang Ba Zhen) — eight battle formations of prescribing. Today we talk about the Scattering Formation (San Zhen) — “scatter” as in dispersing outward. Why disperse? Because when external pathogens arrive, how do we push this evil qi out? That is the problem the Scattering Formation is meant to solve.

To Open: When It Comes to Treating Colds, Doctor Zhang Jingyue Lays Out a “Bupleurum Banquet”

Colds and flu arrive wave after wave. Many people, when they catch a cold, only know one move: “disperse” — sweat it out, drive the pathogen away. But in the eyes of the great Ming physician Doctor Zhang Jingyue, when external pathogens arrive, dispersing them is certainly important — but tonifying deficiency is just as important. Two people may both have “a cold,” yet the correct treatment can be completely different. He wrote this thinking into the “Eight Formations of New Formulas” in his book Jing Yue Quan Shu (Complete Works of Zhang Jingyue); within the “Scattering Formation,” the most famous group is the six Chai Hu Yin (Bupleurum Drinks): Chai Hu Yin No. 1, No. 2, No. 3, No. 4 and No. 5, plus the Zheng Chai Hu Yin — the patent-medicine granules called “Zheng Chai Hu Yin Chong Ji” sold in pharmacies today come straight from this formula.

💬 Note from Doctor Luo: In treating external contraction and exterior syndromes, doctors generally follow the framework of Doctor Zhang Zhongjing: Taiyang syndrome uses ephedra (ma huang), Yangming syndrome uses cimicifuga (sheng ma) and the Pueraria Decoction (Ge Gen Tang), Shaoyang syndrome uses the Minor Bupleurum Decoction (Xiao Chai Hu Tang), and so on. Later generations treated external contraction almost entirely by Zhang Zhongjing’s route. But there are things worth pondering carefully and developing further — and Zhang Jingyue was exactly the man who pondered them.

The General Framework of Dispersion: Starting from Zhang Zhongjing’s Three Formulas

Zhang Jingyue’s treatment of external contraction is still grounded in Zhang Zhongjing: Taiyang syndrome uses ephedra, Yangming syndrome uses cimicifuga and the Pueraria Decoction, Shaoyang syndrome uses the Minor Bupleurum Decoction. But he reminds us: when using herbs you must know their strength, their flavors and their channel entries. Herbs that all “disperse outward” are by no means equal in power —

Ephedra (ma huang), cinnamon twig (gui zhi): drastic dispersion (jun san). They disperse outward with fierce, violent force — the most powerful of all.
Saposhnikovia (fang feng), schizonepeta (jing jie) and the like: mild dispersion (ping san). Gentler and more moderate; today these are what we usually use for external contraction — along with perilla (zi su) and similar herbs.
Asarum (xi xin), angelica dahurica (bai zhi), fresh ginger (sheng jiang): warm dispersion (wen san). Warm herbs dispersing outward.
Bupleurum (chai hu), kudzu root (ge gen), mint (bo he): cool dispersion (liang san). Dispersing outward with coolness — Zhang Jingyue considered bupleurum a cool-dispersing herb; this is his personal clinical insight.
Notopterygium (qiang huo), atractylodes lancea (cang zhu): able to move through the channels, dispel dampness and disperse at the same time. They push outward while freeing the channels and removing dampness — one herb, several jobs.
Cimicifuga (sheng ma), ligusticum (chuan xiong): able to raise sunken qi upward — they lift the qi that has sunk down and also disperse a little along the way.

💬 Note from Doctor Luo: Not that many people genuinely use ephedra. Sometimes a severe illness requires it; a mild illness — or a weak constitution — may not. There is a measure to all this.

Ephedra Is a Sharp Sword — but You Don’t Draw Your Sword at Every Enemy

When Zhang Jingyue discusses the Scattering Formation, the first herb he addresses is ephedra: “The qi of ephedra is valiant and fierce. Whenever the yin pathogen of the Taiyang channel lodges in the exterior and cold poison takes up residence in the body, nothing reaches it but this herb.” — What does that mean? When external pathogens and cold arrive, ephedra’s medicinal qi is vigorous and fierce. When the cold pathogen sits at the body surface, the condition is severe and the cold is deep — then ephedra is a must.

💬 Note from Doctor Luo: But it is not true that every external contraction requires ephedra. Sometimes you use it and the medicinal force overshoots — the pathogen was not that severe, the drug force was too fierce, and it can rebound and injure upright qi. Ephedra-induced sweating has its contraindications: sometimes sweating too violently is not acceptable. So this herb is replaceable: for Yangming there are cimicifuga and kudzu root, because kudzu root does not stay confined to Taiyang and Shaoyang; for Shaoyang use bupleurum, which likewise does not enter Taiyang and Yangming — bupleurum can vent pathogens outward from all three yang channels. So to wield herbs properly you must know their strength, their flavors and their channel entries.

Drink No. 1: Yi Chai Hu Yin — “Heaven Generates Water First”: the Cold for the Yin-Deficient Person

Yi Chai Hu Yin — “one” is the number of water: heaven generates water first (tian yi sheng shui); one represents water. So this formula is “cold dispersion” (han san) — dispersing outward by cold methods, the same line of thinking as the acrid-cool exterior release (xin liang jie biao) of the later Warm Disease school.

What does it treat? Whenever one catches the unseasonable pathogenic qi of the four seasons — an external infection that shows as fever, or alternating chills and heat, or brought on by overwork or anger, or in women heat entering the blood chamber (re ru xue shi — heat entering the uterus), or catching wind-cold after childbirth or during the period, causing malaria-like alternating chills and fever — these are its indications. What is really going on? An external pathogen combined with internal heat should be dispersed with coolness (wai you xie er nei jian huo zhe, yi cong liang san): the exterior has caught a pathogen, and inside it has transformed into heat; and behind most heat patterns lies yin deficiency and insufficient fluids. So this is a heat-type situation.

💬 Note from Doctor Luo: This formula uses cool, acrid-cool exterior release: bupleurum (chai hu) 2–3 qian (6–9 g) to release the exterior, skullcap (huang qin) to clear lung heat, white peony (bai shao) to constrain liver yin and nourish yin blood, raw rehmannia (sheng di) to nourish yin and generate fluids — do you see it? It starts from nourishing yin and generating fluids, letting the heat be cleared; that is the idea. Its main indication: yin deficiency with external contraction. If the heat is severe, add raw gypsum (sheng shi gao). These days, when we meet yin-deficient external contraction, we might casually use a bit of Sheng Mai Yin (Generate the Pulse Drink) with a white-peony decoction for adjustment; but if you really want a proper formula, Doctor Zhang Jingyue’s Yi Chai Hu Yin is the one to use — generate fluids, nourish yin, add a little heat-clearing and outward-venting action; the huang qin vents a little too. That is why it is called Yi Chai Hu Yin — the formula is like water, cold and seeping.

Drink No. 2: Er Chai Hu Yin — “Two Is Fire”: People with Pronounced Cold Must Never Use Cold Herbs

Er Chai Hu Yin — “two” is the number of fire; in the Five Elements sequence one-two-three-four-five correspond to water, fire, wood, metal, earth, so two is fire. Thus this formula is warm dispersion (wen san) — it is a warm one.

💬 Note from Doctor Luo: For ordinary external contraction in a person whose original qi is full, whose visceral qi is normally balanced and who has no fire — you need not clear fire; or when the condition falls into the pronounced-cold category and there is fundamentally no internal heat syndrome — the person has caught cold, the cold pathogen is quite obvious, and then you must never casually use cold herbs. If you charge in with “clear heat and resolve toxins,” using cold medicines, you will injure the body. So the Er Chai Hu Yin is opened — this formula is warm.

The composition: tangerine peel (chen pi) 1.5 qian (4.5 g) to regulate qi and open the lung qi; pinellia (ban xia) to resolve phlegm; asarum (xi xin) — warm, freeing the channels and dispersing cold; magnolia bark (hou po) to remove dampness — dispelling the dampness from the stomach and intestines and stirring them up; fresh ginger (sheng jiang) 3–7 slices; bupleurum (chai hu) 1.5–3 qian (4.5–9 g); licorice (gan cao). Within the formula, fresh ginger, asarum and bupleurum are the key players — dispersing the pathogen and the cold; chen pi, ban xia and hou po help regulate qi, remove dampness and transform phlegm-dampness.

💬 Note from Doctor Luo: Zhang Jingyue adds later: if the cold pathogen is severe, you can add notopterygium (qiang huo), angelica dahurica (bai zhi), saposhnikovia (fang feng) and perilla (zi su); if the yin-cold qi is even heavier, add ephedra (ma huang) and cinnamon twig (gui zhi). This formula is only a foundation — on top of it you pile warm, hot herbs to disperse the cold outward. You see: the earlier one cleared heat, this one disperses cold — one represents water, two represents fire; the water and fire formulas are not the same.

Drink No. 3: San Chai Hu Yin — When Blood Deficiency Means the Sweat Won’t Come, First Nourish the Blood

San Chai Hu Yin — “three” is the number of wood, entering from the blood aspect of the liver channel.

💬 Note from Doctor Luo: What does that mean? Some people are chronically short of yin and blood — the liver channel has little blood. When such a person catches external cold and the pathogen has not entered deeply, what do you do? You can nourish blood on one side and disperse outward on the other. Or take a woman with postpartum cold — after childbirth the blood is depleted; she has caught cold and you have no choice but to disperse outward, so you nourish blood and disperse at the same time. So San Chai Hu Yin treats: blood deficiency and insufficient liver blood allowing external pathogens to invade; at that point you nourish liver blood and disperse outward together, pushing the pathogen out on a tide of blood.

The composition: bupleurum (chai hu) 2–3 qian (6–9 g) to vent the external pathogen (it treats all three yang channel conditions and vents evil qi outward), white peony (bai shao) 1.5 qian (4.5 g) to nourish blood, constrain yin and nourish liver yin, honey-fried licorice (zhi gan cao) to tonify the spleen and harmonize, tangerine peel (chen pi) 1 qian (3 g) to regulate qi and open the lung, helping to disperse the pathogen, fresh ginger (sheng jiang) 3–5 slices — warm, Chinese angelica (dang gui) 2 qian (6 g) to nourish blood and push the pathogen outward. In this formula, dang gui and bai shao nourish the blood — when the blood is truly nourished to sufficiency, then you sweat, then you vent outward, the pathogen is expelled, and the external contraction is cured.

💬 Note from Doctor Luo: Zhang Jingyue’s thinking here is very distinctive and inspiring for treating external contraction: some people are simply blood-deficient — the sweat will not come no matter how many dispersing herbs you throw at them. You have to nourish their blood — once the blood is nourished, the sweat appears at once. So using herbs like dang gui and prepared rehmannia (shu di) is absolutely necessary.

Drink No. 4: Si Chai Hu Yin — for the Qi-Deficient Person, Ginseng Must Be Used When It Must Be Used

Si Chai Hu Yin — “four” is the number of metal, entering from the lung (qi aspect). Whenever original qi is insufficient, or one has endured hunger and overwork, or caught wind-cold, and the six pulses have no strength, when upright qi cannot overcome the pathogen (zheng qi bu sheng xie), you must build up and support the original qi — in essence, tonify lung qi. When lung qi is insufficient — a qi-deficient person — and an external pathogen enters, you truly cannot push it out.

💬 Note from Doctor Luo: This formula uses bupleurum paired with dang gui and ginseng, plus licorice and fresh ginger. Here bupleurum is paired with ginseng — and in fact Zhang Zhongjing already included ginseng in the Minor Bupleurum Decoction (Xiao Chai Hu Tang) — precisely to support upright qi and tonify lung qi. Some later practitioners lost the thread and said, “You can’t use ginseng during an external contraction — that’s nonsense!” When the deficiency shows itself, you use it. When blood is deficient you use dang gui; when qi is deficient you use ginseng. Zhang Zhongjing’s Xiao Chai Hu Tang contains ginseng.

Ginseng (ren shen) 2–3 qian (6–9 g), or 5–7 qian — 7 qian is 21 g, a substantial dose; most of us would never need that much. What is the ginseng for? To tonify upright qi. Doctor Luo Dalun says: what Zhang Jingyue said is correct. Once you ponder these Chai Hu Yin drinks through, you realize that during an external contraction, a qi-deficient person genuinely needs a bit of ginseng to tonify up — once the person rallies, he can resist the external pathogen and reverse the course of the illness.

💬 Note from Doctor Luo: Otherwise the illness sometimes gets stuck in place — it simply will not improve, the fever will not break, and the person stays listless and cannot recover. What then? At that point you really do need a little ginseng. Si Chai Hu Yin is the metal number — it enters the lung and tonifies the lung; ginseng tonifies the qi of heart and lung, which is why it is added. You could add astragalus (huang qi) instead and it would still be fine, but ginseng acts faster — so Zhang Jingyue added ginseng. This is exactly the thinking of the Minor Bupleurum Decoction: bupleurum paired with ginseng.

Drink No. 5: Wu Chai Hu Yin — Tonify the Spleen and Stomach, Support Upright Qi Across the Board: the Thinking Behind Severe Pandemic Cases

Wu Chai Hu Yin — “five” is the number of earth, entering from the spleen and stomach. Spleen earth is the root of the five organs — whenever middle qi is insufficient and the external pathogen will not resolve, tonification is mandatory. If the spleen and stomach are weak, the pathogen cannot be pushed out; at that point you must support upright qi and fill the spleen and stomach to sufficiency.

💬 Note from Doctor Luo: This formula and Si Chai Hu Yin are paired, front and back: Si Chai Hu Yin only adjusts the qi aspect, while Wu Chai Hu Yin also adjusts the blood — it supports more comprehensively, so it may actually be used more often. Si and Wu are frequently used together, or alternated.

The composition of Wu Chai Hu Yin: bupleurum (chai hu) 1–3 qian (3–9 g) to disperse the pathogen, Chinese angelica (dang gui) 2–3 qian (6–9 g) to nourish blood, prepared rehmannia (shu di) 3–5 qian (9–15 g) to tonify kidney essence, atractylodes (bai zhu) 2–3 qian (6–9 g) to tonify the spleen, white peony (bai shao) 1.5 qian (4.5 g) to constrain the liver and nourish liver blood, licorice (gan cao), tangerine peel (chen pi) to regulate qi. The core herb is bai zhu — it tonifies the spleen; five is the earth number, corresponding to the spleen and stomach.

💬 Note from Doctor Luo: When I use this formula, I usually add Huai yam (huai shan yao), 30 g or more — a generous helping: if you want to tonify the spleen and stomach, tonify them well. I may add lotus seeds (lian zi rou) too — I add everything, because this is about supporting upright qi. When do you use this formula? When the person’s upright qi is severely depleted — not merely the spleen and stomach. Notice how he added blood-nourishing herbs and everything else: the upright qi is truly badly depleted, the pathogen cannot be expelled, and the body is in that scorched, stuck state: “Why won’t this illness turn around? I look again and it still hasn’t improved — why is the medicine not working well?” — because upright qi is insufficient. How do you tonify insufficient upright qi? If you have the skill to see which organ is at fault, you can add specifically: blood deficiency gets blood-nourishing herbs, yin deficiency gets yin-nourishing herbs. But sometimes you cannot tell — because once qi and blood are depleted they collapse together; yin deficiency and blood deficiency are both there. What then? Be comprehensive. So Wu Chai Hu Yin is the right idea for a person who is deficient AND has caught an external contraction. It is absolutely not true that “you can’t use tonics during an external contraction — tonify and you’re ruined.” Not at all. When there is a real external pathogen and insufficient upright qi to expel it, you must support upright qi.

This thinking deserves special attention in pandemic conditions: why do so many people become severely ill, and why does the disease spiral out of control? It is the total collapse of upright qi — qi and blood both depleted; at that point you must tonify. Wu Chai Hu Yin is quite comprehensive: support the whole, bring the body’s upright qi back up, and reverse the course. Once upright qi is supported, the illness reverses at once; when the body’s upright qi is sufficient, the pathogen is pushed out and the body recovers.

💬 Note from Doctor Luo: Otherwise some people’s external pathogen never fully disperses — they stay in that listless state: “Oh, my cold hasn’t gotten better; I’m tired every day, lying in bed, the cold drags on and on.” Some external contractions genuinely drag on for weeks. What does that tell you? Insufficient upright qi. Give Wu Chai Hu Yin and, usually within one or two doses, the person revives, the illness reverses, and the external pathogen is driven out. This is very important.

Drink No. 6: Zheng Chai Hu Yin — the Pharmacy’s Popular Version, a Gentle Little Formula

Zheng Chai Hu Yin is quite famous; many pharmacies sell it as granules, a ready-made patent medicine. What does it treat? External wind-cold with fever and aversion to cold, headache and body aches, and the early stage of malaria — in short, when qi and blood are balanced and mild dispersion is appropriate, this formula governs: the person’s qi and blood are still normal; he has simply caught external pathogens and cold, with a bit of fever, aversion to cold, headache and body pain — use this formula.

💬 Note from Doctor Luo: The formula is very simple: bupleurum (chai hu) and saposhnikovia (fang feng) — clearing and venting outward; tangerine peel (chen pi) to regulate qi and open the lung; white peony (bai shao) to constrain liver yin and nourish liver blood; licorice (gan cao) to harmonize all the herbs and the middle; fresh ginger (sheng jiang) to help disperse the external cold. It is an exceptionally gentle little formula. If your body is normal and your qi and blood are not yet depleted, and you catch an external contraction — wind-cold — use this formula to vent a little. Usually at the very start of a cold, while the body is still normal, drink two sachets of Zheng Chai Hu Yin granules and the pathogen should be pushed right out. It is the popular version — anyone can drink it when they catch wind-cold.

How to Choose? Six Chai Hu Yin Drinks Are Six Keys

Zhang Jingyue’s six Chai Hu Yin drinks each lay out, from a different angle, a strategy for dealing with external cold once it has entered the body. Doctor Luo Dalun says: you may not study these formulas in depth or use them yourself, but you must grasp the thinking — because every person catches external pathogens differently:

The yin-deficient person who catches a cold (red tongue, no coating, dry mouth and thirst): when hot, muggy weather arrives, or cold turns to heat — you need to replenish fluids, nourish yin, and then vent the external pathogen outward — the thinking of Yi Chai Hu Yin. In daily life, Sheng Mai Yin plus white peony, sour-sweet generating yin (suan gan hua yin), will do.
The person who caught cold: Er Chai Hu Yin — Zhang Zhongjing’s approach, no need to elaborate.
The person with blood deficiency and insufficient liver blood (sweat will not come at all): nourish blood plus vent the pathogen — San Chai Hu Yin; dang gui and prepared rehmannia are absolutely necessary. Very many of these cases are caused by emotion — also soothe the liver and regulate qi.
The person with qi deficiency, insufficient spleen and lung qi: tonify qi — Si Chai Hu Yin, ginseng, astragalus may be added; the thinking of the Minor Bupleurum Decoction.
The person whose upright qi is depleted across the board: Wu Chai Hu Yin for comprehensive support.
The person with balanced qi and blood: Zheng Chai Hu Yin — the popular version.

💬 Note from Doctor Luo: I often say: it is usually the yin-deficient person whose body fluids are insufficient — like a defense system whose moats hold little water, whose channels hold little water. When the weather turns hot and they sweat profusely, the water dwindles further, the defense troops cannot reach their posts, and the external pathogen invades. What to do? Replenish their fluids, replenish their body fluids — Sheng Mai Yin with white peony, or white peony with licorice, sour-sweet generating yin — it is all the same line of thinking. If you tell me you have an external contraction and your lung qi is particularly strong, I am rather skeptical — usually the spleen and lung qi are insufficient, the upright qi is deficient, and that is why the external pathogen found an opening. You both went out shopping together — why is the other person fine and you are not? Because you have a deficit. The qi-deficient person lacks the strength to push qi and blood along; the defense troops cannot reach their assigned positions — so such a person must tonify qi.

So: when external pathogens arrive, dispersing them is important; but tonifying deficiency is just as important — once upright qi is sufficient, the pathogen is naturally pushed out. That is precisely the lesson Zhang Jingyue’s Scattering Formation leaves us: study the thinking of the ancient physicians and apply it to today’s epidemic prevention and cold prevention — it is extraordinarily beneficial.

💬 Note from Doctor Luo: The ancients thought deeply about these things; ponder them bit by bit and your understanding of preventing and treating external-contraction illness will grow. Well, dear friends, that is all for today — thank you for listening. Tomorrow we will continue with Doctor Zhang Jingyue’s thinking on regulating the body. Thank you, and see you tomorrow.

Compiled from Doctor Luo Dalun’s lectures on Doctor Zhang Jingyue’s medical cases; the cases come from Jing Yue Quan Shu (Complete Works of Zhang Jingyue), published in 1624.