《葛仙翁肘后备急方》Vol. 1

First: Methods for Rescuing Sudden Death from Zhong'e

All cases of sudden death, or of people who ordinarily suffer from illness or have been bedridden for years and then suddenly stop breathing, belong to what is called zhongsi—that is, what the ancients called zhong'e, a sudden attack caused by evil Qi. The rescue methods are as follows.

One method: take the yellow center of a scallion and insert it into the patient's nose—left for men, right for women—to a depth of seven or eight cun. If blood can be made to come from the eyes, the effect is even better. Bian Que's method is the same. Afterward, one should also use a scallion tube to blow into the ears; because the author, Ge Hong, calls this practice “blowing the nose,” it is listed separately as another method.

Another method: have two people cover the patient's mouth with clothing and blow air into both ears, the more forcefully the better. One may also blow through a bamboo tube. At the same time, lift the patient's shoulders and turn him onto his side; the rescuer should move away and must not bend over and press on the body of the supposedly dead person.

Another method: insert a scallion leaf into the ear. If blood flows from the ear or nose, do not be alarmed; if there is no blood, rescue is difficult; blood is a sign of hope. During rescue, one should likewise lift the patient and keep away from his body.

Another method: likewise insert a scallion leaf into the ear; the bleeding is as above. During rescue, lift the patient with both hands and suddenly let him down; after a while the supposedly dead person will raise a hand to grasp someone and say it hurts, and only then should one stop. For men insert into the left nostril, for women the right, making the scallion enter more than seven or eight cun; the effect is very good. This method can also treat self-hanging (the original text has a character that should be yi, “hanging”; it is a scribal error), and it is the same as Bian Que's method.

Another method: soak cotton wadding in good wine; after a while put it into the nose of the supposedly dead person and press with the hand so that the wine juice flows into the nose. At the same time hold his hands and feet, and take care not to startle him.

Another method: inspect the inner side of the patient's upper lip. If there are string-like lines and white spots the size of millet grains, prick them open with a needle and remove them.

Background note: Ge Hong was a Daoist and physician of the Eastern Jin period. Most of what this book records were emergency rescue methods popular at the time; their thinking is related to later treatments for “corpse-like syncope” (shijue) and “sudden death” (baosi). Among them, methods such as pricking the nose and blowing into the ears lack scientific basis. Today, if someone suddenly falls to the ground and loses consciousness, one should immediately call emergency services and perform CPR according to protocol; these methods should not be copied.

This passage describes several methods the ancients used to rescue acute emergencies such as sudden death, drowning, and fainting. They mainly involve opening the orifices, applying moxibustion to acupoints, and using animal blood, feces, or urine to rouse the patient.

Blowing Air to Open the Orifices

A thin tube is used to blow air into the patient’s mouth and nose or lower body so that the Qi can pass through the body. Several people blow in turn, and once the Qi is unobstructed, the person can live. In another method, a piece of Gleditsia pod—a kind of pod containing saponins, used medicinally to open the nose—is put into the nostril and blown in; if the patient sneezes, the Qi is opened. The ancients regarded “the Qi passing through” as the key to revival, which resembles the later approach of artificial respiration.

Moxibustion at Acupoints to Restore Consciousness

Apply moxibustion to Chengjiang, in the central depression below the lower lip, for ten cones (a cone is the counting unit for moxa; one moxa cone counts as one unit), with marked effect. Apply moxibustion to Renzhong below the nose for three cones. Apply moxibustion to the hairy margin beside the root of the big toenail on both feet for seven cones. This is the method of Hua Tuo, a famous physician of the Eastern Han; another account says twenty-one cones.

Using Blood, Feces, Urine, and Similar Substances

Cut the neck of a male chicken, take its blood, and smear it on the patient’s face; when it dries, smear it again, and at the same time scatter a ring of ash around the body. Take a male duck and press it over the patient’s mouth; cut off the duck’s head and drip the hot blood into the mouth, while using a bamboo tube to blow into the patient’s lower body; if the Qi passes through, the patient lives. Take moist cow or horse dung, squeeze out its liquid, and pour it into the mouth, making the patient swallow. If the jaw is tightly clenched, pry it open with an implement; if it cannot be pried open, tap below the teeth. If there is no fresh cow or horse dung, thoroughly dried human urine may be used, with its liquid extracted for use. This method is said to come from Bian Que, a famous physician of high antiquity. Take a white dog, split it open, and cover the chest with it; if there is no white dog, a white parrot will also do.

Measuring Acupoints with a Rope

Use a rope to measure the patient’s elbow-and-wrist area; for men on the left and women on the right, wrap it once around. Then measure downward from Dazhui on the back, the acupoint at the upper end of the spine, and then measure half a rope’s length horizontally on each side. Apply moxibustion at these locations in sequence, three cones at each, three times in total, and the person will awaken.

Pinching Renzhong and Moxibustion of the Hands and Feet

First pinch the patient’s Renzhong with a fingernail to revive them. If they do not wake, bend their hand and apply moxibustion at the wrist crease; the number of moxa cones depends on the patient’s age.

Background Note

These methods come from ancient experience. Many of them—such as cutting a chicken to obtain blood, or administering animal blood, feces, or urine by mouth—have no scientific basis, and some carry a risk of infection; they should not be copied in modern emergency care. The standard modern management of cardiac arrest or drowning is to call emergency services immediately and perform cardiopulmonary resuscitation, that is, chest compressions and artificial respiration. The ancient idea that “when the Qi passes through, the patient lives” roughly corresponds to the modern maintenance of a clear airway and artificial ventilation.

Another method: apply moxibustion at the navel for one hundred zhuang. (Zhuang is a unit for counting moxa cones; burning one moxa cone is called one zhuang.)

According to another method of Bian Que: cut off a piglet's tail and take its blood for the patient to drink; at the same time, bind the piglet and let the patient use it as a pillow. A person who has suffered sudden death will revive in a short while. (The rare variant character, written with the dog radical plus tun, according to the context should mean piglet.)

Another account says: grind Pinellia ternata (a Chinese medicine whose tuber is used medicinally) into powder about the size of a soybean and blow it into the nose.

Another prescription: pound Nuqing (a medicinal herb) into fragments, about one qianbi (the amount of a small spoonful); pry open the patient's mouth and pour it into the throat, then take it with water or bitter wine (vinegar), and the patient will revive immediately.

Commentary: The four methods for rescuing sudden death above, as well as the later treatments for "shijue" (sudden collapse and loss of consciousness, resembling rigor mortis), all come from what the Zhengyi (Orthodox Unity) Zhenren related in the Biography of Physician Wei. Bian Que once received secret methods from Master Changsang, but this biography appeared more than twenty years after Ge Hong, so Ge Hong could not have seen it. It is therefore clear that these methods had long circulated in the world. Hence some accounts mention the King of Chu, others the King of Zhao, and the order of the text also differs slightly.

Also, among Zhang Zhongjing's Various Essential Formulas there is a method: pound xie (a plant resembling a small scallion) to obtain its juice and pour it into the nose.

Another prescription: cut and take blood from the comb of a red rooster and blow it into the nose through a tube.

Another prescription: smear the patient's face with the rooster comb and rooster blood, surround him with plant ash, and the patient will get up.

Another prescription: take lard about the size of an egg, add one sheng of bitter wine (vinegar), boil, and pour it into the throat.

Another prescription: take fourteen soybeans, mix them evenly with egg white and wine, and swallow it all.

For rescuing sudden death with fever over the whole body: use half a jin of alum, add one and a half dou of water, boil until dissolved, and use it to soak the feet; the water should cover the ankles.

For rescuing sudden death with both eyes tightly closed: have someone ride on a cow's back facing the patient (this sentence is rather obscure; the exact posture or ritual is unknown). Pound xie to obtain juice and pour it into the ears, then blow soap pod (Chinese honey locust) into the nose; the effect is rapid.

For rescuing sudden death with eyes wide open and tongue protruding: apply moxibustion behind the nails of the hands and feet and of the two toes, for a full fourteen zhuang, then have the patient take the "Wudu Zhu Gao San" (Five Poisons Various Ointment Powder; a Daoist formula containing several toxic drugs) containing croton (a toxic purgative).

For rescuing sudden death with limbs flaccid and incontinence of urine and feces: use one sheng of horse dung and three dou of water, boil down to two dou, and use it to wash the affected area. Also take one sheng of cow dung (the original text says "niudong," perhaps an error for "niushi," cow dung; this is uncertain), pour it into the mouth with warm wine, and afterward likewise take the Wudu Zhu Gao San containing croton.

Rescuing Sudden Death and Corpse Syncope

Rescuing Sudden Death with Limbs Unable to Move and Incontinence of Urine and Feces

Take one sheng of horse dung, add three dou of water, boil down to two dou, and use it to wash the body. Then take one sheng of thin cow dung, mix it with warm wine, and pour it into the mouth. Apply moxibustion to three points—one cun below the pit of the heart, three cun above the umbilicus, and four cun below the umbilicus—using one hundred cones at each point, and the illness will be cured. (Sudden death here refers to sudden fainting and cessation of breath; zhuang refers to the number of moxa cones, one cone being one zhuang; cha is the same as chai, meaning recovery from illness.)

Rescuing a Child Who Suddenly Collapses as if Dead, with Vomiting and Diarrhea

If the disease is not known, take one pill of horse dung, squeeze out its liquid, and have the child swallow it. If the child has no damp pattern, boil horse dung in water, take the liquid, and administer it.

On the Principles of Rescue

The book says that the three-ingredient pill and powder for emergencies and Pei Gong ointment are recorded in the emergency medicine entries later on; they are especially effective in rescuing patients who have suddenly collapsed as if dead, and they may also be used together as needed. All cases of sudden death, zhong’e (attack by evil qi), and corpse syncope (a state of sudden collapse resembling death) arise because the yin-yang qi of heaven and earth and of the human body suddenly lose harmony, the qi mechanism becomes blocked and unable to pass through, and one side is excessively depleted. Therefore, even when a person is close to death, it is still possible to rescue them, because the vital qi has not yet been completely exhausted. At such times, if ghosts or spirits are also interfering, one may likewise protect the body with talismans and incantations and thereby obtain rescue.

Appended Formulas

Bian Que said: the symptoms of zhong’e, sudden death, and ghost strike are similar. In rescuing those who have already died, all these methods may be consulted. Pound fresh calamus root, squeeze out the juice, and pour it into the mouth; the effect is immediate. In corpse syncope—sudden collapse as if dead while the pulse still beats, with a faint speaking-like sound heard in the ear when one listens closely, and warmth still present between the thighs—this formula may also be used for treatment. Sun Zhenren (Sun Simiao)’s method for rescuing sudden death: blow Gleditsia pod powder into the nose.

Method for Rescuing Corpse Syncope

In corpse syncope, the person suddenly collapses as if dead, but the pulse still beats, there is a continuous whistling sound in the ears, and the area between the thighs is still warm. Although there is a whistling sound in the ears, the pulse is still beating; therefore one should treat it as corpse syncope. The method is to use a tube to blow into the left ear three times, then blow into the right ear three times, and the person will revive.

This passage discusses the ancient methods for rescuing someone from “shijue” (corpse-like collapse: sudden fainting, loss of consciousness, and an appearance of stopped breathing).

Dried calamus (a medicinal herb that opens the orifices) is crushed, and a lump the size of a jujube pit is placed under the tongue. Another prescription is moxibustion at Renzhong, the point below the nose (the groove between the nose and upper lip). If the ears ring and the pulse is still beating, this shows that a thread of life remains; this is shijue, and it should be treated as shijue.

The rescue method is to point a thin bamboo tube at the patient’s left ear and blow air into it three times in succession, then blow into the right ear three times; the person will revive.

Another prescription: likewise have the patient hold calamus under the tongue; apply moxibustion at Renzhong for seven cones (each burning of a moxa cone counts as one zhuang); then apply moxibustion one cun below the scrotum for one hundred cones. If the patient is a woman, apply it between the breasts instead. It is also said that pinching Renzhong with a fingernail for a long time, or inserting a needle at Renzhong toward the teeth, will make the person stand up immediately.

The author says that most of these methods come from Bian Que’s methods as recorded in the Wei Daifu Zhuan (Biography of Doctor Wei). Bian Que was a famous physician of the Warring States period; what the original text calls “the affliction of the crown prince of Zhao” refers to the story of his saving a crown prince. According to the Shiji (Records of the Grand Historian), the one he saved was the crown prince of Guo. Zhang Zhongjing, a famous physician of the Eastern Han, also said that shijue is when the pulse is still moving but there is no breath, the Qi mechanism is blocked and unable to pass, and the person dies quietly.

Calamus powder is blown into the nostrils, and the patient is made to hold cinnamon bark powder under the tongue. It is also said that Bian Que’s method once cured the King of Chu and was very effective.

Another prescription: cut two cun of hair from the left temple, burn it to ashes, and pour it into the throat with wine; the person will immediately stand up.

Another prescription: tie a cord around the wrist—the left for men and the right for women; pass the cord over Dazhui (the highest protrusion at the back of the neck, below the seventh cervical vertebra) and down along the spine; then apply moxibustion to the end of the cord for fifty cones, and the person can be revived. This is Bian Que’s secret method.

Another prescription: apply hot compresses beneath both flanks, take black earth from the center of the stove (stove soot) the size of a pellet, and mix and administer it with jiangshui (fermented rice water, commonly used in ancient times). After a while, blow into the ears with a fine tube; three or four people may take turns blowing. Also blow into the nostrils with a small tube, blowing accumulated dust from the roof beam, the size of a bean, into the openings; the illness will then be cured.

Another prescription: fourteen hairs from the tail of a white horse and one “eye” from the front hoof of a white horse (the meaning of “eye” is unclear) are burned together, blended with vinegar (bitter wine), and made into pills the size of small beans. Pry open the patient’s mouth and have them swallow two pills; after a while, take one more.

The preceding section: Acupuncture and Moxibustion

Another method: needle the Baihui acupoint (the center of the vertex). With the needle tip directed toward the center of the nose, insert at a point about five cun below the hairline to a depth of three fen, using the reinforcing method. Then needle the fleshy area on the medial side below the nail of the big toe, about three fen from the nail; above the nail of the middle toe, puncture three fen deep; on the medial side of the big toe near its tip, at a place about the width of a leek leaf. At the sharp bone at the end of the Hand Shaoyin channel (the bony prominence on the ulnar side of the wrist), puncture one fen deep at each point.

Another method: apply moxibustion to the Danzhong acupoint (on the midline of the sternum, between the breasts) for twenty-eight cones. “Cone” means one burning of a moxa cone.

Section Three: Methods for Rescuing Sudden Death from Ke-Wu

This section discusses methods for rescuing someone who has suddenly collapsed into deathlike unconsciousness from “ke-wu.” Ke-wu—which the ancients regarded as an acute condition caused by a sudden collision with external evil Qi—is similar to “zhong’e.” It was often contracted in yin-evil places such as outside Daoist temples. The patient suffers abdominal pain, abdominal distention, and rebelling Qi attacking the heart; if not treated promptly, it can be fatal.

For treatment, moxa Renzhong: apply thirty cones to the Renzhong acupoint in the midline below the nose, just beneath the nasal columella. Then soak japonica rice in water and give the patient one or two sheng of the rice wash to drink. If the jaw is tightly clenched, pry the mouth open with an implement. In the ink-water method, crush ink and mix it with water, then take one qianbi (an ancient measure, about one small spoonful). For the hot-vessel abdominal compress, fill a bronze or earthenware vessel with hot water and place it against the abdomen. When the vessel cools, loosen the clothing and apply the vessel directly to the skin; if it becomes very cold, replace it with fresh hot water. Stop once there is improvement. In the method of burning cogon grass through cloth, cover the abdomen with three layers of clothing, place a bronze vessel on the cloth, and burn a small amount of cogon grass in the vessel. Add more after it burns out, but do not put in too much at once, until the patient improves. In rope-measured four-point moxibustion, measure the width of the patient’s mouth with a rope; using that length, measure one point in each direction around the umbilicus. Apply three cones at each point and ignite all four at the same time; recovery follows. In rope-measured moxibustion below the heart, measure the mouth width with a rope and fold it in half. Place one end of the fold below the heart, and moxa the other end for five cones. In the cinnabar-honey method, take one fangcunbi of zhen dan (that is, cinnabar, whose main component is mercuric sulfide; it is toxic and must not be taken casually) and mix it with three ge of honey, then administer it. If the jaw is clenched, pry open the teeth and pour it in.

Note: Bian Que (a famous physician of the Warring States period), in treating this illness, also applied three cones at each point and lit all four at once; recovery followed.

Another method: measure the mouth width with a rope and fold it in half. Place one end of the fold below the heart, and moxa the other end for five cones.

This section records various methods for treating “sudden assault by evil” (zhong e). The ancients referred to acute conditions of sudden fainting, loss of consciousness, and weak breathing, believing they were caused by a sudden invasion of pathogenic qi (“evil”); this roughly corresponds to acute syncope or stroke-like conditions today.

First, cinnabar combined with human blood and cockscomb blood into pills. Take one fangcunbi (a small spoonful) of true cinnabar—that is, cinnabar, whose main component is mercuric sulfide and which is toxic; the ancients mistakenly believed it could calm the spirit—and mix it evenly with three ge of honey before administering. If the jaws are clenched, pry them open and pour it in. Another method uses cockscomb blood to mix cinnabar into pills the size of small beans, which are placed in the mouth; after taking three or four pills, recovery follows. Use human blood to mix cinnabar into two pills the size of parasol-tree seeds, pry open the teeth, place them in the throat, and make the patient swallow.

Second, external applications and insufflations to awaken the spirit and open the orifices. Pound fresh sweet-flag root, squeeze out the juice, and hold it in the mouth; the effect is immediate. For those who have collapsed as if dead and cannot speak, take two roasted platycodon roots, grind them to powder, and administer. There is also a method of grinding asarum and cinnamon bark in equal parts and placing the powder in the mouth. If the jaws are clenched, grind raw aconite (highly toxic and requiring processing) into powder, put it into a bamboo tube, and blow it under the tongue; the effect is immediate.

Third, moxibustion. Hua Tuo’s method is: when someone suddenly suffers an evil assault, is short of breath, and is near death, apply moxibustion to the hair tufts behind the nails of both big toes, fourteen cones at each site (a cone refers to one burning of a moxa pellet), and recovery can be achieved; if not cured, apply fourteen more cones. Ge Hong notes that among the earlier formulas for rescuing sudden death there was already a moxibustion method of three-seven (twenty-one) cones.

Fourth, decoctions. Zhang Zhongjing’s formula: ephedra four liang, apricot kernels seventy pieces, and licorice one liang; add eight sheng of water and decoct down to three sheng, then swallow slowly in divided doses. It can generally treat fainting caused by various externally contracted pathogenic qi.

Fifth, using a comb to divine life or death, and the fermented soybean decoction. Take one handful of Chinese chive roots, twenty smoked plums, and half a jin of evodia; add one dou of water and boil. Put the patient’s comb into the decoction and boil it three times: if the comb floats, the patient can be saved; if it sinks, saving is difficult (this is an ancient divinatory superstition). After boiling down to three sheng, give it to the patient to drink. Another formula uses cinnamon one liang, fresh ginger three liang, gardenia fourteen pieces, and fermented black beans five ge; crush them, stir with three sheng of wine, heat over a gentle fire, strain off the residue, and administer in one dose.

Flying Corpse Galloping Horse Decoction (Feishi Zouma Tang): Take two croton seeds and two apricot kernels (croton seed is a harsh purgative and toxic; it should not be taken casually today). Wrap them in cotton cloth, pound them to pieces, and place them in two ge of hot water. Rub and twist them with the fingers so that the medicinal juice seeps out, then have the patient drink it at once. If taken as a single dose within the time it takes to cook rice, recovery can be achieved. The dose should be small. This formula can generally treat all kinds of “flying corpse” (feishi) and “ghost strike” (guiji) conditions.

There are also various pills and powders, all recorded in the Beiji Yaofang (Emergency Formulary). The so-called “guest” refers to qi coming from outside; “opposition” means offense, that is, external pathogenic qi invading the human body. These are mostly caused by noxious qi and are generally curable. Although this formula can also treat various “flying corpse” and “ghost strike” conditions, such illnesses result from sudden invasion by ghost-poison, pestilential qi, and the like. As soon as they meet the body’s healthy qi, their force weakens; therefore they cannot be treated exactly like ordinary natural noxious qi. When pathogenic qi invades the body, it damages the five zang and six fu organs and the channels and network vessels. After recovery, treatment should still be continued in order to eliminate residual pathogenic force. Otherwise the pathogenic evil rapidly turns into a chronic illness and frequently relapses.

Appended Formulas

Waitai Miyao: For sudden kewu (guest-opposition) with the patient lying as if dead and unable to speak, take equal amounts of Asarum (xixin) and cinnamon heart (guixin) and insert them into the patient’s mouth.

Another formula: Roast two liang of Platycodon (jiegeng), grind it into a fine powder, and take it with rice broth; at the same time swallow musk the size of a soybean. The effect is very good.

Guangli Fang: For sudden kewu (guest-opposition) on the verge of death, take one qian of musk, grind it finely, mix it into two ge of vinegar, and administer; recovery follows.

Formulas for Sudden Ghost Strike (Fourth)

The illness of “ghost strike” has no gradual onset; it strikes suddenly, as if one has been stabbed with a knife. There is gripping pain inside the chest, hypochondria, and abdomen, so severe that it is unbearable, and the area cannot be pressed by hand. Some people immediately vomit blood, bleed from the nose, or pass blood in the stool. It is also called “ghost thrust” (guipai). The treatments are as follows:

Apply one cone of moxa at Renzhong (the philtrum below the nose); the effect is immediate. If not yet cured, apply several more cones.

Another formula: Cimicifuga (shengma), Angelica pubescens (duhuo), and cinnamon bark (mugui) in equal amounts; grind into powder and take one square-inch spoonful with wine; the effect is immediate.

Another formula: Apply one cone of moxa 1.2 cun below the navel (near the Guanyuan point); the effect is immediate. If not yet cured, apply several more cones.

Another formula: Cimicifuga (shengma), Angelica pubescens (duhuo), and cinnamon bark (mugui) in equal amounts; grind into powder and take one square-inch spoonful with wine; the effect is immediate.

Ge Xianweng’s Emergency Prescriptions Kept at the Elbow (compiled by Ge Hong in the Eastern Jin; because it could be carried on one’s person, it was called “at the elbow”) records the following therapeutic methods: apply moxibustion one cun below the navel, using two zhuang (“zhuang” means one burning of a moxa cone; one moxibustion treatment is one zhuang); apply seven zhuang one cun above the navel, then apply moxibustion at the junction of the white flesh on both heels, and the illness will immediately be cured (“chai” is the same as “chou,” meaning recovery from illness); take three balls of prepared mugwort about the size of a duck egg, add five sheng of water, boil down to two sheng, and take it all at once; take one sheng of salt, add two sheng of water, stir well, and drink, while at the same time spraying the patient with cold water, but do not let him vomit immediately—after a short while, when he vomits, he will recover. (The practice of inducing vomiting with salt water is very dangerous; a large amount of salt can cause severe poisoning, and it should not be imitated.)

The text also says to take a pinch of rice flour, stir it into water, and drink it; blow undiluted strong wine into both nostrils; take a white male dog, cut its throat, and while the blood is still warm take one sheng and drink it; cut blood from a chicken’s comb, drip it into the patient’s mouth and make him swallow it, then split open the chicken and place it below the pit of the stomach, and after the chicken has cooled throw it away by the roadside—if a black chicken is used, the effect is even better (here “mituo” can be understood as “even more”).

It further prescribes taking one sheng of cow dung, adding three sheng of wine, boiling and taking it; the dung of a large ox may also be used; burning a three-cun piece of knife sheath until charred, grinding it into powder, and taking it with water; and burning rat droppings and grinding them into powder, with each dose the size of a millet grain. If the patient cannot swallow it, the original text has two versions: one says to use a black chicken instead, and the other says to pour a small amount of water into the mouth. The ninth, tenth, and eleventh prescriptions above are repeated in the original text.

In addition, the original text mentions that the various pills and powders are all collected in the section “Emergency Medicines.” The author says that he personally saw, when shamans performed their rites, people suddenly being troubled by ghosts and spirits—either because they had offended the gods, encountered conflicting taboos, were physically weak and mentally scattered, or had brought calamity upon themselves through their own faults. Those with mild illness were thereby saved, while most of those with severe illness died. Records of such cases, such as those concerning “Yanjian” (whose referent is unclear), are not empty words. It is not necessarily possible to save someone who is certain to die, but ultimately one cannot simply stand by and do nothing.

The appended prescription cites the Gujin Luyan (Recorded Examinations of Ancient and Modern [Prescriptions]): a formula for treating possession by malevolent spirits or “cat ghosts” when the patient refuses to tell the truth. Take deer antler, file it into shavings, and pound it into powder; take one fangcun bi (about one small spoonful) with water, and the patient will then tell the truth.

The final line, “Prescriptions for Treating Sudden Nightmares and Unconsciousness from Sleep, No. 5,” is the title of the fifth section, meaning “prescriptions for treating sudden nightmare and sleep from which one does not awaken”; here it is only a title, and the main text is not included.

If someone collapses and suddenly becomes unconscious and cannot be roused, do not use firelight to examine him, because the firelight can harm the person. You should bite and pinch hard at his heel and at the base of his big toenail, and spit several times into his face; he will then regain consciousness. There are several other methods.

One method is to grind Chinese honey locust fruit—the fruit of the Gleditsia sinensis tree—into a fine powder and blow it through a tube into both nostrils; the person will then wake, and it may be blown again within three or four days. Also use a hair to stimulate the nostrils: for a man insert it on the left, for a woman on the right, twisting it in repeatedly.

Another method is to blow medicine into both ears through a reed tube. Take fourteen of the patient’s hairs, twist them into a fine cord, and insert it into the nostril. Draw blood from a rooster’s comb and blow it through a tube into the throat; the effect is very good.

Another method is to grind yellow earth from beneath the stove into powder and blow it into the nose; also grind realgar, a mineral medicine, together with cinnamon bark into powder and blow it into the nose. Both are effective.

Another method is to take mud from the bottom of a well and smear it on the patient’s eyes; have him lower his head into the well, call his name, and he will get up.

Another method is to pound Chinese chives, extract the juice, and blow it into the nostrils. In winter, dig up chive roots, extract the juice, and pour it into the mouth.

Another method is to have the patient drink salt water, the amount depending on the circumstances.

Another method is to place the patient on the ground and use a sharp knife to draw a circle on the ground, beginning at the shoulder—on the left for a man, on the right for a woman—and continue until the circle goes around the patient’s face. Then use the tip of the knife to make a small cut in the patient’s nose, about one fen deep. After that, hold him down tightly and do not let him move. The patient will speak and beg for mercy as if possessed by a ghost or spirit; at this point ask, “Who are you? Why have you come?” Let it ask to leave on its own. Then use a finger to wipe away the line previously drawn on the ground, starting a few inches from the shoulder, so that the ghost or spirit will depart. When questioning, you must ask clearly.

Another method is to cover the patient’s face with an earthenware steamer, a pottery vessel used for steaming rice, and have someone suddenly smash the steamer; the patient will then wake.

This passage records a variety of folk remedies for treating “yan.” “Yan” refers to crying out in sleep, nightmares, and an inability to move the body; the ancients believed it was caused by ghosts and evil influences, and in popular usage it is also called “the ghost pressing on the bed.” These prescriptions come from the Zhouhou Beiji Fang (Handbook of Prescriptions for Emergencies) by the Eastern Jin Daoist scholar Ge Hong (Ge Xianweng, the Immortal Elder Ge), and belong to empirical therapies grounded in the idea that ghosts and evil influences cause illness.

One remedy is to place an ox hoof or horse hoof near the affected person; this can also be used to rescue someone who has suddenly fainted and appears to have died, with the hoof of a black ox being especially effective. Another is to grind realgar, sift it into a fine powder, and blow it into both nostrils through a tube; cinnamon powder is also effective. Realgar is an arsenic-containing mineral and is toxic, so it must not be taken internally. Another is to grind “wanpu” (the identification is unclear; it may be a medicinal such as sweet flag) into powder, blow it into both nostrils, and place some under the tongue. Another is to take the strap from a steamed-rice steamer and tie it to a man’s left elbow or a woman’s right elbow, use the remaining part to twist it slightly tight, and then bind both feet with hemp rope. One then asks the patient about the cause, admonishes and restrains the ghost involved, and unties the rope. Another person is sent to sit at the head of the bed as a guard, while someone inside the door calls the patient’s name; if the patient answers, “Yes, I am here,” he or she will awaken.

For someone suddenly seized by “yan” and unconscious, one moxas the hairy area beside the root of the toenail on the outer side of the big toe (the Dadun point), using twenty-one cones. A “cone” is a unit for counting moxa cones; one cone means burning a single moxa cone. For people easily affected by “yan” or prone to nightmares, one takes dead ashes from the stove, puts them in the shoes, and places the shoes beside the pillow. One may also wear realgar, with men wearing it on the left and women on the right. The method of moxaing the Dadun point on the big toe with twenty cones is mentioned again. A small piece of genuine musk may be placed at the head of the bed; musk comes from the gland of the musk deer, and today it is mostly synthetic or restricted. A pillow made from a tiger’s head is considered best. As a method for preventing “yan” and nightmares, one takes realgar the size of a date pit and ties it under the left armpit; it is said that this can keep a person from ever being affected by “yan” for life. A red woolen blanket may be placed under the pillow. A pillow made of rhinoceros horn is considered best, and qingmuxiang may be put into the pillow and worn on the person at the same time.

These methods mostly rely on the ghost-and-spirit beliefs of the time and lack scientific basis. Realgar contains arsenic and is toxic, so it should not be touched or ingested. Modern people who experience repeated nightmares or abnormal sleep should consult a doctor.

I. Treating Sudden “Yan” by Ghosts and Unwaking Stupor

There is another formula that can treat people who are suddenly afflicted by “yan” — in folk usage, the state of being pressed by a ghost in sleep or lying unconscious and unable to wake — as well as those who sleep for a long time and do not wake. The method is to write a talismanic incantation on paper, burn it until it is charred black, mix it with a small amount of water, and pour it into the patient’s mouth. Then hang a mirror in front of the patient’s ear and strike it, and call the patient’s name; within half a day the person can awaken.

Those who remain unconscious after being afflicted by yan have, in most cases, had their hun and po souls leave the body and wander about; trapped by evil qi, they wish to return but cannot find the way. It is taboo to shine firelight on the patient, because once the firelight shines on them, the souls can no longer return to the body. Those who are afflicted by yan while under lamplight are likewise affected because their souls originally emerged from a bright place and simply have not returned into the body.

Appendix formula: The Qianjin Fang (Essential Prescriptions Worth a Thousand in Gold), a medical work by Sun Simiao of the Tang dynasty, records that to treat ghost-yan with unconsciousness, one uses the powder of soap pods (the fruit of the Gleditsia sinensis tree), taking one dao gui — an ancient small measuring spoon, about one small spoonful.

II. Treating Sudden Affliction by the “Five Corpses”

The “Five Corpses” are five types of disease-causing evil qi recognized by the ancients: feishi (Flying Corpse), dunshi (Escaping Corpse), fengshi (Wind Corpse), chenshi (Sinking Corpse), and shizhu (Corpse-Transmission). This formula treats these conditions together. The symptoms are abdominal pain, distension, and urgency; difficulty breathing; qi rushing upward into the heart and chest and attacking both hypochondriac regions to the sides; or knotted masses protruding in the abdomen; or pulling and spasmodic pain in the lower back and back. The treatment is mainly moxibustion, that is, burning mugwort floss at acupoints: at a point three cun behind the nipples, apply fourteen zhuang (a zhuang is a unit for counting moxa cones; burning one cone is one zhuang). Men are treated on the left side and women on the right. If the pain does not stop, increase the number of cones until recovery.

Another formula: apply moxibustion three cun below the pit of the stomach, sixty zhuang.

Another formula: apply moxibustion one cun below the nipple; depending on whether the pain is on the left or the right, apply several more cones, and recovery follows.

Another formula: using four fingers — the ancients used the patient’s own fingers as a measuring tool, called “tongshencun,” proportional cun — measure three cun below the painful area and apply sixty zhuang.

Another formula: as above, apply moxibustion one cun below the nipple, with several more cones, and recovery follows.

Another formula: from the painful area downward, measure with four fingers and apply several cones below the fingers, enough to make the patient feel pain; then pinch upward at the Renzhong acupoint below the patient’s nose, and also pinch one cun below the heart, and apply several more cones until recovery.

Another formula: break a chicken egg and take the white, swallowing it in one gulp. If the patient’s jaw is clenched shut, send the egg white into the throat and shake the patient so that it is swallowed; the effect is immediate.

Another formula: break chicken eggs and take the whites, swallowing seven at one time; do not take them again.

The above reflects ancient medical practitioners’ understanding of yan disorder and the Five Corpses; it differs from modern medical explanations of cause, and one should not use it to treat oneself on this basis.

Another formula: boil pokeweed root, put it into a cloth bag, and apply it alternately as a hot compress to the affected area, changing it when it cools.

Although all are called the “Five Corpses” (wushi), their onset is broadly similar, though the details differ slightly. The ancients believed that corpse ghosts in the body cause mischief, invade the zang-fu organs, and bring on illness; these diseases all belong to this category. Feishi (Flying Corpse) moves beneath the skin and can penetrate the zang-fu organs; each attack is sharply painful, and the condition changes unpredictably. Dunshi (Retreating Corpse) clings to the bones and drills into the muscles, boring into the blood vessels; during an attack the patient cannot be near others, and seeing a funeral or hearing wailing can trigger it. Fengshi (Wind Corpse) roams wildly through the four limbs, so that the patient cannot tell where the pain is; each attack brings clouded, dazed consciousness, and encountering wind or snow can trigger it. Chenshi (Sinking Corpse) becomes entangled within the zang-fu organs and surges upward to strike the heart and both hypochondria; each attack brings severe gripping pain, and exposure to cold can trigger it. Shizhu (Corpse Infusion) causes heaviness throughout the body, mental confusion, and frequent drowsiness and weakness; it worsens with changes of the seasonal nodes and is severe. This category has a separate treatment method and requires the hot-compress method described later.

Overall, the Five Corpses are all caused by corpse ghosts within the body and are highly harmful. Although the classics contain treatment methods, not everyone can master them, so the author reorganized their essentials to remedy the omissions of earlier writers. The formulas are as follows.

First formula: take one liang of realgar and one liang of garlic, pound and blend them into a pellet-sized bolus, place it in two ge of warm wine, and take it; recovery comes quickly. If there is no improvement, it may be taken again. Those who have already suffered from this illness should keep this medicine on hand.

Second formula: take equal amounts of dried ginger and guixin (the bark of cinnamon), grind them into powder, add a little salt, take one pinch of the mixture, stir-fry until it turns greenish, then grind it fine and take it mixed with water; this brings recovery.

Third formula: pound Tribulus fruit, form it into honey pills, and take two pills each time, each the size of a fava bean, three times a day.

The following are several folk remedies (the phrase “another prescription” means “one more formula”):

Japonica rice porridge: Take two sheng of japonica rice, add six sheng of water, bring to a boil once, and then take it.

Lard and vinegar preparation: Take eight ge of lard, heat it in a bronze vessel until it just simmers, add eight ge of bitter wine (that is, vinegar), mix thoroughly, and take it all at once; recovery follows.

Water from a pit: Dig a small pit, fill it with clear water, stir it until muddy, then take the liquid and drink it.

Thatch fumigation-heating: Take thatch from the four corners of the roof and place it in a bronze vessel. Cover the abdomen with three red cloths, place the vessel on the cloths, and ignite the thatch so that it produces heat. Move it over the painful area as it fumigates and heats; when diarrhea occurs and the itching disappears, the illness is cured. If the house is tile-roofed, shave wood from the four corner pillars and burn it; the effect is the same. The original text says this method is extremely effective.

Cinnamon, ginger, and croton poultice: Take one liang each of cinnamon and ginger and three croton seeds, grind them to powder, mix with bitter wine (vinegar) into a paste, and apply it to the affected area; when it dries, recovery follows.

Chinese tallow tree root decoction: Take two sheng of Chinese tallow tree root, boil until thick, remove the dregs, then boil again to about five sheng; each time take from five ge to one sheng.

Honeysuckle decoction: Chop a large amount of honeysuckle stems and leaves, boil them down to a thick decoction, strain off the liquid, and boil it down further; each time take an amount the size of one chicken egg, two or three times a day.

Burned hair and apricot kernel pills: Burn tangled human hair and roast apricot kernels in equal amounts, pound them into a paste, and form pills; each time take three pills the size of parasol-tree seeds with wine, five or six times a day.

Dragon bone and Veratrum pills: Take three fen of dragon bone, two fen of Veratrum, and one fen of croton seeds, pound them together, and form pills the size of hemp seeds; take them with well-flower water (well water drawn at dawn).

Lacquer leaf powder: Dry lacquer tree leaves in the sun, grind them to powder, and take the powder with wine.

Stove liver: Cook one whole “stove liver,” slice it, and eat it all; it may also be eaten mixed with mashed garlic. (What “stove liver” refers to is still disputed among scholars.)

Note: Croton seeds, Veratrum, Chinese tallow, lacquer leaves, and the like all contain relatively strong toxicity; people today should not copy these and take them on their own.

There is another formula: cut off the head of a soft-shelled turtle, burn it to ash, and take it with water in three divided doses. After taking it, if the flesh-like substance has not been completely expelled, it will recur later.

Another formula: realgar one fen (an ancient unit of measure), gardenia fruit fifteen pieces, and peony root one liang; add three sheng of water, boil down to one and a half sheng, and divide into two doses.

Another formula: fourteen gardenia fruits, burned to ash and taken.

Another formula: dried ginger and aconite each one liang, cinnamon two fen, and croton seed thirty pieces (remove the heart). The ingredients are all used raw; pound and sift them, mix with honey, and pound ten thousand times. Take two pills each time, each the size of a small bean. This medicine treats all ailments.

Another formula for treating “flying corpse” entering the abdomen and causing piercing pain that can be fatal: rhinoceros horn, shewang, and Wuzhu Pill—all fine medicines—each two fen, and croton seed thirty pieces (remove the heart). The ingredients are all used raw; pound and sift them, mix with honey, and pound ten thousand times. Take two pills each time, each the size of a small bean. This medicine treats all ailments.

There is also a formula for “flying corpse” entering the abdomen and causing fatal piercing pain; rhinoceros horn, shewang, and Wuzhu Pill are all fine medicines, and are also found among the major formulas. The following treats a sudden foreign body under the skin, shaped like a toad, which after one night sinks into the abdomen, becomes hard like a cup and immovable, causing unbearable pulling pain, and after several days causes death. The formula is as follows:

Croton seed fourteen pieces, gentian one liang, pinellia and tugua seed each one liang, and cinnamon one and a half jin; pound them together, put them into a double-layered cloth bag, steam until hot, and apply alternately as a hot compress to the affected area. It may also be boiled in water and taken in small amounts several times.

This formula was originally recorded in the “Miscellaneous Treatments” chapter; the disease is called “yin corpse,” and most patients die.

Formula Seven for Treating Shizhu and Guizhu: the formula for treating shizhu and guizhu, listed as the seventh.

Background supplement: Ge Xianweng refers to Ge Hong, a Daoist of the Eastern Jin; Zhouhou Beiji Fang (Handbook of Prescriptions for Emergency Use) is the collection of emergency medical formulas he compiled. Feishi, shizhu, guizhu, and yinshi are terms the ancients used to describe certain acute and severe illnesses. They believed these were caused by “corpse worms” or ghostly pathogens, an explanatory system that blended sorcery and medicine. Croton, aconite, realgar, and pinellia all have relatively strong toxicity; these formulas are records from historical documents and must not be taken by following the text.

Ge Hong believed that illnesses such as shizhu (corpse-injection) and guizhu (ghost-injection) were the shizhu among the “Five Corpses” (Daoism holds that the human body contains five harmful corpse-worm spirits, and shizhu is one of them), mixed with harm from various ghosts and evil influences. Such illnesses are highly variable, with symptoms ranging from thirty-six to ninety-nine kinds. Generally, they cause chills and fever, continuous discharge, mental clouding, and silence or paucity of speech; the patient cannot say clearly where the discomfort is, yet feels uncomfortable everywhere. The course lasts for months or years, gradually becoming sluggish and heavy, and ultimately leads to death. After death, it can still infect others and may even exterminate the entire household. Anyone who notices such signs should seek treatment quickly. The formulas are as follows:

Take white mulberry bark, air-dry it, and burn it to ash, obtaining about two dou. Put it into a zeng (a wooden steamer for cooking rice) and steam until the steam has penetrated thoroughly, then remove it. Use three or four dou of boiling water from the pot to pour repeatedly over the ash, three times in all, until the leachate is extremely concentrated. After it has settled and cleared, take two dou of the ash liquid and use it to soak two dou of adzuki beans (a type of small red bean) overnight, then sun-dry them. Soak them repeatedly again in the remaining ash liquid until the liquid is exhausted, then steam-cook them by moist steaming. Cook mutton or venison into a stew and eat it with this bean-rice. At first eat one to two sheng each time, stopping when full. Mild cases recover after eating three or four dou; severe cases require seven or eight dou. When the illness is about to leave, the body will spontaneously feel continuous pain and itching of the skin. If the root of the illness has not been eliminated, prepare it once more; it is said to be very effective.

(The phrase “again this bean-rice” in this passage of the original duplicates the preceding text and is not translated again.)

Another formula: take fifty peach kernels, crush and grind them fine, boil them in water to make four sheng of decoction, and take it all at once; one should vomit out the pathogenic evil. If not all is vomited, take it again after two or three days. If there is no vomiting after taking it, this indicates that it is not shizhu.

Another formula: Duhu one liang, stem one liang, ginseng about half a liang, fourteen bottle gourds, six zhu of pine lichen (the zhu is an ancient weight unit; twenty-four zhu make one liang), and fourteen adzuki beans; pound them into a fine powder. At dawn take one fangcunbi with warm water (a fangcunbi is an ancient small spoon used to measure medicinal powder); by evening one should vomit various things. If not completely vomited, take it again afterward.

Another formula: one otter liver; shade-dry it, pound it into powder, and take one fangcunbi with water three times a day. If after finishing one liver there is still no recovery, prepare another. The Yao family states that this formula is extremely effective; it may also be taken again afterward.

Another formula: Take one otter liver, shade-dry it, pound it into powder, and take one fangcunbi (an ancient medicine-measuring spoon, about one small spoonful) with water three times daily. If the illness is not cured after one liver has been consumed, prepare another and take it. Master Yao said this formula is very effective.

Another formula: Take one liang each of cinnabar and realgar, half a liang each of guijiu and wangcao (the drug referred to as wangcao remains unidentified), forty croton seeds with their hearts and skins removed, and two centipedes. Pound them together, mix with honey, and form pills. Each time take pills the size of small beans. If there is no purging after taking them, take two more pills; one must also persist in taking them over a long period. Another method from Master Yao is this: burn hair into ash; fry apricot kernels until purple; pound equal amounts of the two into a paste, mix with lard, and take pills the size of wutong seeds with wine three times daily; the illness will then be cured.

(Note: Cinnabar and realgar contain substances such as mercury and arsenic, and croton is a drastic purgative; all are toxic. These are records of ancient drug use, and people today must not follow these formulas and take them.)

There are also various major formulas such as Hua Tuo’s Ligu Powder, Dragon Tooth Powder, and Sheep-Fat Pills, all of which are recorded in books of major formulas; there is also the Huainan Pill obtained by Emperor Cheng of Han. All of these can treat the condition called “zhuyi that exterminates a household.” Zhuyi is a class of infectious diseases that the ancients believed could bring disaster to an entire family. Women and children often suffer from the conditions known as “zhuanche” and “zhuanchuan,” meaning attacks that occur while riding in a carriage or boat, manifesting as oppression in the chest, headache, and vomiting. Those with such symptoms should take preventive measures according to apotropaic methods.

Take several liang each of Plantago seed, the root bark of the plum beneath the cart, Shichangsheng, and Xu Changqing, in equal amounts; coarsely pound them into a preparation and put it into a small bag holding about half a ge. Tie it to the belt or wear it on the head. If the condition is zhuanchuan, wear these drugs together with a little wood scraped from the boat planks. Before boarding the boat, scrape off a little of the boat plank, burn it to ash yourself, and take it with water.

Supplementary formulas

Zimu Milu: To treat corpse-injection (shizhu). Burn a clump of disordered hair about the size of an egg, grind it into powder, and take it with water; the patient will be cured. (This entry appears twice in the original, with identical content.)

Shiyi Xinjing: To treat transmitted corpse disease, ghost qi (what the ancients regarded as pathogenic qi), cough, xuanpi (abdominal masses), zhu qi, obstruction of blood and qi, and progressive emaciation. Take one liang of peach kernels, remove the skins and tips, pound them, boil them in one and a half sheng of water, and strain to obtain the juice; then cook rice with this juice to make porridge and eat it on an empty stomach.

Formula Eight for Treating Sudden Heart Pain

To treat sudden pain at the pit of the heart. Boil the white bark of the peach tree to make a decoction and take it on an empty stomach.

Another formula: Cinnamon powder or dried ginger powder—either drug may be used alone—take one fangcunbi with warm wine, taking it six or seven times within a short period, and the patient will be cured.

Donkey Dung Juice Formula: Take donkey dung and squeeze out five or six ge (an ancient unit of volume) of juice. Take it all at once while hot; it works quickly.

Peach Branch Wine Decoction Formula: Take a handful of peach branches growing out toward the east, cut them into small pieces, and boil them in one sheng of wine until half a sheng remains. Take it all at once; the effect is very good.

Raw Oil Formula: Take half a ge of raw oil (unprocessed vegetable oil), warm it, and take it; the illness will be cured.

Coptis Decoction Formula: Take eight liang of Coptis (huanglian), add seven sheng of water, and boil down to one sheng and five ge. Strain off the dregs and take five ge warm, three times a day.

Sitting-at-the-Door Water Formula: The patient sits at the doorway. If the patient is male, have a woman give him a cup of water to drink; if the patient is female, have a man give her a cup of water. Fresh well water just drawn is even better. Another method: take one part honey and two parts water, and drink it while likewise sitting at the doorway; this is even more beneficial to the patient.

Burnt Cloth Ash Formula: Take worn-out cloth, wrap it around a guan (an ancient basin vessel), burn until red, grind it into powder, and take it with one cup of wine.

Salt Water Formula: Bring water to a boil three times, take one sheng, add one ge of salt, stir evenly, and drink. If no fire is available to boil water, raw water may also be used directly.

Holding the Breath and Pressing the Heart Formula: Hold the breath and endure for several tens of repetitions, while stretching the thumb straight and pressing the depression below the heart, until the illness is cured.

White Mugwort Decoction Formula: Take three sheng of mature white mugwort, add three sheng of water, and boil down to one sheng. Strain off the dregs and take it all at once. If one has been injured by external pathogenic influence (keqi), this should be used to vomit out the parasites in the body.

Vinegar and Egg Formula (1): Take one cup of bitter wine (that is, vinegar) and one egg, put them in a bowl, and stir thoroughly. Add three sheng of water, boil down to one sheng, strain off the dregs, and take it all at once. If one has been injured by external pathogenic influence, likewise use it to vomit out the parasites in the body.

Vinegar and Egg Formula (2): Take one cup of bitter wine and one egg, stir them together in a bowl until evenly mixed, and drink. Good wine may also be used instead of vinegar.

Hot Ash Compress Formula: Take hot ash from under the stove, sift out the charcoal pieces, put it in a cloth bag, and heat it until hot to the touch. Apply it alternately as a hot compress to the painful area. When the ash cools, reheat it and use it again.

Another method: Put steamed or boiled soybeans into cloth bags and apply them alternately as a hot compress to the painful area; when a bag cools, replace it with another.

Another method: Take half a sheng of fresh ginger or dried ginger, add two sheng of water, boil down to one sheng, remove the dregs, and take it in one dose.

Another method: Apply moxibustion three cones at the tip of the middle finger. (Moxibustion is the burning of moxa at acupoints; a “cone” is the unit for counting moxa cones, and burning one cone is one zhuang.)

Another method: Take good cinnamon, peel off the outer bark, crush and sift it, and take three fangcunbi with warm wine. (A fangcunbi is an ancient small spoon for measuring medicinal powder, about one small spoonful.) If the illness has not improved, after a while take it six or seven more times. If cinnamon is unavailable, substitute dried ginger powder; it is also effective.

Another method: Use the patient’s own finger to measure horizontally the width between the corners of the mouth, break off a piece of that length as a measure, measure starting from below the pit of the stomach, and then, on the head, apply moxibustion three cones at the point indicated by this length. (This method is the same as the preceding one; perform it again as usual.)

Another method: Prepare dried ginger in accordance with the numbers of the Five Phases (Wuxing); the effect is very good.

Another method: Take soil from the center of the ground, add one sheng of water, stir well, and have the patient drink it. (Soil belongs to the “Earth” among the Five Phases; the ancients took “central earth” as medicine.)

Another method: Evodia (Wuzhuyu) two sheng, fresh ginger four liang, and douchi one sheng (douchi is a fermented black soybean product); add six sheng of wine, boil down to three and a half sheng, and divide into three doses.

Another method: Ginseng, cinnamon heart, gardenia (peeled and split open), licorice (roasted), and Scutellaria one liang each; add six sheng of water, boil down to two sheng, and divide into three doses. The effect is very good.

Another method: Take seven peach kernels, remove the skin and tips, crush and grind them finely, mix with water, and take in one dose. The effect is very good, and it can also be used to treat a stubborn illness lasting as long as thirty years.

Another method: Aconite two liang (must be used after preparation; raw aconite is toxic) and dried ginger one liang; crush them and make into honey pills. Take four pills each time, the size of wutong seeds, three times daily.

Another method: Evodia one and a half liang; dried ginger and cinnamon heart one liang each; Atractylodes two liang; ginseng, tangerine peel, Sichuan pepper (remove the closed ones along with their seeds and impurities), and licorice—make into pills the size of wutong seeds and take three times daily.

Take one and a half liang of Evodia fruit (wu zhuyu), a pungent, warming herb; one and a half or two liang each of dried ginger, cinnamon inner bark, and white atractylodes; and one liang each of ginseng, tangerine peel, pepper (remove the unopened fruits and the seeds inside), honey-fried licorice, skullcap, angelica, and platycodon; plus one and a half liang of fuzi (aconite), processed to reduce toxicity. Pound and sieve into a fine powder, mix with honey, and form pills the size of wutong seeds. Take three times daily, beginning with a small amount and gradually increasing to ten to fifteen pills, taken with wine; either before or after meals is acceptable. It is said to be effective.

Take eight liang of cinnamon inner bark, add four sheng of water, boil down to one sheng, and divide into three doses.

Take three liang of Sophora root (kushen), use one and a half sheng of bitter wine (in ancient usage, vinegar), boil down to eight ge, and divide into two doses. It may also be decocted in water. If it is not decocted, raw use is also acceptable.

Take four liang of gentian (longdan), use three sheng of wine, boil down to one and a half sheng, and take in a single dose.

Take five ge of Evodia fruit and one liang of cinnamon, use two sheng of wine (water may also be used), and decoct by the same method as above; it may also be used raw without decoction.

The gentian formula is identical to the fourth prescription.

Take five ge of Evodia fruit and one liang of cinnamon, use two and a half sheng of wine, decoct down to one sheng, and divide into two doses; it is effective.

Take two sheng of Evodia fruit, four liang of fresh ginger, and one sheng of dan douchi (fermented soybean), use six sheng of wine, boil down to two and a half sheng, and divide into three doses.

Take one white chicken; after preparing it in the usual way, boil it in three sheng of water and take two sheng. Remove the chicken and keep only the broth; measure out six ge, add six ge of bitter wine, then add one qian (an ancient weight unit, about 3.7 g) of pearl, and decoct down to six ge. Then add musk powder about the size of two soybeans and take it in one dose.

Take one liang each of cinnamon inner bark and angelica, and fourteen gardenia fruits; pound them into a powder and take it with wine, one fangcunbi (an ancient spoon for medicinal powder, about the amount that fills one square cun), three to five times daily. It may also be used to treat heart pain from chronic illness that occurs at fixed times.

Take two liang of cinnamon inner bark and one liang of wutou (aconite); pound and sieve into a powder, mix with honey, and form pills. Begin with three pills each time, the size of wutong seeds, and gradually increase the dose.

Note: Wutou and fuzi contain aconitine and are highly toxic; the ancients needed to process them and strictly control the dosage, and these ancient formulas should not be copied directly.

Sudden Stabbing Pain in the Heart and Abdomen

To treat sudden heart and abdominal pain like needle pricks: use Sophora flavescens (kushen) and gentian (longdan) two liang each, cimicifuga (shengma) and gardenia (zhizi) three liang each; add five sheng of bitter wine (vinegar), decoct until two sheng remain, and divide into two doses. After taking it, there will be profuse vomiting; once vomiting occurs, recovery follows.

Heart Hernia Attack

To treat an attack of heart hernia—a kind of intermittent severe colic—with unbearable pain: take equal amounts of zhen shewang (a drug name whose exact identification is still under study) and wuzhuyu (evodia), grind into a fine powder, mix with honey to form pills of the size specified in the original text, and divide into two doses. After taking them, there will be profuse vomiting; after vomiting, recovery follows.

Another Dosing Method for Heart Hernia

For the same symptoms, again use equal amounts of zhen shewang and wuzhuyu, grind to a powder, and make honey pills the size of hemp seeds. Take two pills each time, three times daily. During treatment, avoid hot-natured foods.

Moxibustion Method

Another method is to apply moxibustion to the point one cun below Jiuwei, which is one cun below the pit of the stomach (i.e., Juque), as well as to points one cun to its left and right; moxa each point with one hundred moxa cones. Then, in the same manner, measure the positions according to the acupoints on the neck and back so that the left and right sides are directly opposite each other, and moxa six sites in total.

Chronic Pain and Heaviness of the Head

To treat long-standing chronic pain, inability to eat or drink, and heaviness in the head: use wutou (aconite) six fen, huajiao (Sichuan pepper) six fen, and dried ginger four fen; grind to a powder, make honey pills, and take them with wine—about four pills the size of soybeans each time. After the symptoms ease, the dose may be gradually increased. (Note: wutou is a plant of the same family as fuzi and is highly toxic; its dosage must be strictly controlled, and it should not be compounded on one’s own.)

Pinellia Formula

Another formula: banxia (pinellia), xixin (asarum) five fen each; dried ginger two fen; ginseng three fen; fuzi (aconite) one fen. Grind to a powder, mix with bitter wine (vinegar), and form pills the size of wutong seeds. Take five pills with wine, three times daily. (This also contains fuzi, which is toxic; use caution.)

Contracture, Pulling, and Oppressive Pain Below the Heart

To treat contracture and pulling in the epigastric region with restless, oppressive pain: guizhi (cinnamon twig) three liang, fresh ginger three liang, and zhishi five pieces; add five sheng of water, decoct until three sheng remain, and divide into three doses. One may also add baizhu two liang and half a jin of maltose (jiaoyi).

Injury to the Heart and Lungs, with Cold Pain

To treat injury to the heart and lungs and pain caused by cold: guixin (cinnamon heart) two liang and two pig kidneys; add eight sheng of water, decoct until two sheng remain, and divide into three doses.

Fragments

The final two entries are supplementary material for the “sixteen formulas” section: mainly fuzi two liang and dried ginger one liang made into honey pills, four pills per dose, the size of wutong seeds. The second entry duplicates the first, differing only in the frequency of administration; the combination of pig kidney, guixin, and other ingredients is the same as in the formula for injury to the heart and lungs caused by cold above.

A formula for treating cardiac impediment (xinbi) and heart pain: one liang of Sichuan pepper (huajiao), stir-fried until slightly yellow and ground into a fine powder, is mixed with dog’s heart blood and formed into pills the size of wutong seeds. Take five pills each time, five times a day.

For hard, painful masses below the heart, with a lump as large as a bowl and edges like a turning plate, called “qi fen,” which is an accumulation formed after drinking water: use seven roasted zhi shi (immature bitter orange) and three liang of bai zhu (Atractylodes macrocephala), add one dou of water, boil down to three sheng, and divide into three doses. The mass will gradually soften.

If accumulation below the heart forms knots that come and go with unremitting pain, use one sheng of evodia powder and one piece of genuine shewang (a medicinal substance) the size of a pellet. Pound the two together, mix with egg white, and form into pills the size of small beans. Take two pills each time, and recovery will follow.

For heart pain accompanied by excessive salivation, as if there were worms in the abdomen, take the hearts of the six domestic animals (cattle, sheep, pig, dog, chicken, and so on), cut them raw into fourteen pieces, making one vertical and one horizontal cut in each, then grind one liang of cinnabar into a fine powder and sprinkle it into the cut heart flesh. Swallow it all the next day. If realgar and musk (shexiang) are added, the effect is even better.

For heart pain that occurs when hungry, called “hunger hernia” (ji shan), use equal portions of gentian, aconite, and coptis, pound and sift them, and take one qianbi each time, three times a day.

Appendix Formulas

From the Treatise on Medicinal Properties: It treats heart pain and zhong’e (sudden fainting caused by attack of pathogenic qi), or pain extending to the waist and navel. Use salt the size of an egg, wrap it in blue cloth, burn it until red, put it into wine, and drink it in one dose; foul matter will be vomited out.

From the Preface to the Collected Supplements: Corydalis (yanhusuo, yuanhu) can stop heart pain. Grind it into powder and take it with wine.

From the Formulas of Sagely Grace: For chronic heart pain that attacks at no fixed time, with vomiting of clear water and inability to eat, use two liang of realgar and two sheng of good vinegar. Simmer over a gentle fire into a paste, then combine with dried steamed cake and form into pills the size of wutong seeds. Take seven pills each time, swallowed with ginger decoction.

Another formula, for treating nine types of heart pain and chest tightness with irritability and fullness: take one fen of cassia bark (the bark of the cinnamon tree, a Chinese medicine), grind it into a fine powder, decoct it with one large cup of wine until half a cup remains, remove the dregs, and take it slightly warm; the effect is rapid.

Another formula, for heart pain caused by cold hernia (in Chinese medicine, abdominal pain and hernia-like conditions caused by cold pathogen), cold limbs, and complete lack of appetite: take two liang of cassia bark, grind it into a powder, and at any time mix one qianbi with warm wine and take it (a bi is an ancient small spoon for taking medicine; one qianbi is about one small spoonful).

The formula in Waitai Miyao, for sudden heart pain: grind dried ginger into powder, mix it with water, and take one qianbi.

Another formula, for heart pain: grind Chinese angelica into powder and take one fangcunbi with wine (about a medicine spoon one square cun in size).

Also according to Bixiao, for “juan” heart pain: take bear gall the size of a soybean, dissolve it in water, and take it; the effect is very good.

Another formula: take eel, roast it plainly until cooked, and have the patient eat one or two; the illness will be cured, and eating until full is even better.

Jingyan Fang, for people whose heart pain has not healed for forty years: use the water from washing broomcorn millet, take it warm, with no fixed limit.

Jingyan Houfang, for heart pain: take one liang of turmeric and three liang of cassia bark, grind them into powder, and take one qianbi with vinegar-water.

Jianyao Jizhong, for nine types of heart pain as well as accumulations in the abdomen and hypochondrium and qi stagnation: take two liang of dried lacquer, crush it and stir-fry until it smokes, grind it fine, use vinegar-cooked flour paste as a binder, and knead it into pills the size of parasol-tree seeds. Take five to seven pills each time, swallowed with warm wine; vinegar-water may also be used, and they may be taken at any time.

Yao Hezhong, for sudden heart pain: take twenty-one bush-cherry seeds, chew them thoroughly, and swallow them with freshly drawn well water; if one also drinks some warm water, so much the better, and the pain will stop before long. Afterward, boil a little lightly salted water and sip it hot in small mouthfuls.

Bingbu Shouji, for unbearable heart pain in people who have suffered from it for five or ten years, effective immediately: cook small garlic together with strong vinegar, take it all at once, and eat until full, without adding salt.

The last sentence, “Formula for Treating Sudden Abdominal Pain, No. 9,” is the title of the next section and means “Formula for treating sudden abdominal pain, ninth.”

Formula for Treating Sudden Abdominal Pain (for sudden-onset abdominal pain)

For the first formula, write the character “wind” with the tongue; this is suitable for people who have had wind disease for five years and is said to take effect immediately. Alternatively, cook small garlic (garlic) in strong vinegar until done, take it all at once, and eat until full, without adding salt.

For the second formula, draw a picture of two centipedes crossing on paper and swallow it.

For the third formula, pound cinnamon bark and grind it into powder; take three cun-spoonfuls (a cun-spoon is a small spoon used for measuring medicinal powders). If bitter wine (vinegar), ginseng, and high-quality dried ginger are added, the effect is even better.

For the fourth formula, take two sheng of japonica rice, add six sheng of water, boil until it has come to a boil twice, and drink it.

For the fifth formula, take a large handful of table salt and wash it down with plenty of water; the patient will vomit, and recovery follows the vomiting.

For the sixth formula, dig a small earthen pit, fill it with water, stir until muddy, and drink the liquid.

For the seventh formula, take one sheng of rice flour, add two sheng of water, mix evenly, and drink.

For the eighth formula, have the patient lie face down; one person straddles the patient’s back, lifts the patient’s abdomen with both hands, and has the patient use his own strength to raise his body about three chi off the bed, then lower him again, repeating this fourteen times. Afterward, press along the spine from the tailbone all the way to the top of the head; if not cured, repeat.

For the ninth formula, raise the pillow to about one chi high, press a knee against the patient so that the abdomen tightens and the breath sinks into the chest, then pinch and press three cun above the navel, and recovery will follow. If the patient can dry-swallow and swallow qi (vital energy) several dozen times, the effect is even better. This method also treats heart pain; its principle belongs to what Daoists call “Fuqi (hidden qi),” that is, using intention to guide the breath and make the qi sink downward.

Formula for Treating Sudden Onset of Various Hernias (symptoms are pulling pain in the lower abdomen and genital region, pain like a knife twisting, cold sweats, and near fainting to death)

Pound sha shen (Glehnia root), grind it into a fine powder, sift it, and take one square-inch spoonful; it takes effect immediately.

Note: This formula originally appears in the Miscellaneous Treatments chapter, where it is called “cold hernia” and also “yin hernia.” If this method is ineffective, one may take various purgative pill medicines or use “Zouma Tang” (Galloping Horse Decoction), a strong purgative.

Formula for Abdominal Pain Due to Cold Hernia

The original sentence “when food and drink go down, [the patient] simply does not feel them pass” is textually corrupt; the gist is that the patient feels that food and drink do not pass smoothly as they go down. Use one square-inch spoonful of huajiao (Sichuan pepper); it takes effect immediately.

Background note: These formulas mostly come from ancient empirical practice, and their medicinal effects have not been verified by modern testing. Practices in the fifth formula (a large handful of salt), the eighth formula (lifting off the bed and setting down), and the ninth formula (pressing the abdomen) carry obvious risks and may cause electrolyte imbalance or internal organ injury; they should not be copied directly. Abdominal pain has many causes; if severe pain, vomiting blood, fever, or persistent lack of relief occurs, medical attention should be sought promptly.

In the various miscellaneous treatments, this entry is called “cold hernia,” also known as “yin hernia.” If this method does not cure it, one may take various purgative pills to attack and purge the cold pathogen; alternatively, one may prepare “Zouma Tang” (Riding-Horse Decoction; a strongly purgative formula), which is also effective.

The following are formulas for treating cold hernia with abdominal pain. Cold hernia is pain caused by cold pathogen stagnating in the lower abdomen and genital region.

For cold hernia with abdominal pain, where after food and drink are swallowed one does not feel them moving: use two ge of Sichuan pepper and four liang of dried ginger, add four sheng of water, decoct down to two sheng, remove the residue, add one jin of maltose syrup (a sweet syrup such as malt sugar), decoct again until about half a sheng remains, and take frequently in divided doses.

Another formula: one sheng of Pinellia, one handful of cinnamon (the original text says “eight liang of cinnamon”), and one sheng of fresh ginger; add six sheng of water, decoct down to two sheng, and take in two doses.

For cold hernia that comes and goes, with severe gripping pain during each attack: three liang of evodia, four liang of fresh ginger, and two ge of fermented soybean; decoct in four sheng of wine down to two sheng, and take in two doses.

Another formula: one piece of aconite, two hundred grains of Sichuan pepper, half a liang of dried ginger, ten pieces of Pinellia, thirty jujubes, and one sheng of polished rice; add seven sheng of water, cook until the rice is done, remove the residue, and take one sheng each time until finished.

Another formula: one jin of cassia bark, half a sheng (ten pieces) of evodia, and one sheng of polished rice; add seven sheng of water, cook until the rice is done, remove the residue, and take one sheng each time until finished.

Another formula: one jin of cassia bark and half a sheng of evodia; add five sheng of water, decoct down to one and a half sheng, and take in two doses.

Another formula: two liang each of oyster shell, licorice, and cinnamon; add five sheng of water, decoct down to one and a half sheng, and take in two doses.

Another formula: take one black-boned chicken slaughtered the night before, cut it finely, mix it with seven jin of raw Rehmannia, place it in a steamer, and collect the juice that drips out in a copper vessel. Take it in the early morning and finish by afternoon. During treatment it will purge various accumulated cold-type masses (phlegm accumulations caused by congealed cold pathogen); after the purging is finished, one may drink plain white rice porridge and eat slowly. If it is a long-standing hernia, three doses are required.

Appendix: This is a heading indicating that other formulas are appended below.

Bojifang (a Song-dynasty formulary): Treats disharmony of cold and heat Qi, lack of appetite for food and drink, or abdominal pain with a [missing character] stabbing sensation. Use equal parts of gardenia fruit and Sichuan aconite; pound raw into powder, mix with wine into a paste, and form pills the size of parasol-tree seeds. Take fifteen pills each time, swallowed with a decoction of stir-fried ginger.

Citing the Boji Fang (Formulas for Universal Relief), a Song dynasty formula book: It treats disharmony of cold and heat qi, loss of appetite, and abdominal pain or stabbing pain. Take equal amounts of gardenia fruit (shan zhizi) and Sichuan aconite (chuan wutou; the mother root of aconite, highly toxic and requiring processing), pound them raw, and grind into a fine powder. Mix with wine into a paste and make pills the size of parasol-tree seeds. Take fifteen pills each time, swallowed with a decoction of stir-fried ginger. If the pain is due to qi in the small intestine, take twenty pills with stir-fried fennel and scallion mixed with wine, as appropriate.

Citing the Jingyan Fang: It treats long-standing stirring of lower-jiao yuan qi (the region in the abdomen where original qi resides), with sensations of cold, abdominal pain, weakness, and diarrhea.

Emergency, Highly Effective Yufen Dan (Jade Powder Elixir): Use five liang of raw sulfur and one liang of qingdai (indigo naturalis; the original text reads “qingguan”). Grind together into a fine powder, form pills with steamed dough, and make them the size of mung beans. Take five pills each time on an empty stomach with warm wine; after taking them, press down the medicinal qi with food.

Citing the Zimu Milu (Secret Record of Mother and Child), an ancient formula book on gynecology and pediatrics: It treats lower abdominal pain with bluish-black discoloration, or disordered qi and difficulty breathing. Use one liang of Sophora flavescens root (kushen), add one and a half sheng of vinegar, decoct down to eight ge, and divide into two doses.

Citing the Sheng Hui Fang (Taiping Shenghui Fang, an imperially compiled Song dynasty formula book): It treats cold shan (cold hernia), with pulling pain in the lower abdomen and genital region, accompanied by spontaneous sweating. Use one liang of Salvia miltiorrhiza root (danshen), pound into a powder, and each time take two qian-bi mixed with warm wine; it is effective.

Formula for Treating Simultaneous Pain in the Heart and Abdomen (No. 10): It treats a critical condition in which the pit of the stomach and abdomen are distended and painful at the same time, with shortness of breath verging on exhaustion, or even fainting. Take fourteen gardenia fruits and seven ge of fermented soybean (dandouchi). First boil the fermented soybean in two sheng of water, take one sheng and two ge, strain off the residue, then add the gardenia fruits and decoct down to eight ge. Strain again and take half a sheng. If not yet recovered, take the whole amount.

Another formula: Take washed old clothing and drink one or two sheng of the liquid from it; recovery follows.

Another formula: Cut two liang of cassia twig (guizhi) into pieces, add one sheng and two ge of water, decoct down to eight ge, remove the residue, and take it all at once. If cassia twig is unavailable, dried ginger may be substituted and is also effective.

Another formula: Fourteen wumei (dark plums), boiled in five sheng of water; then add fourteen large coins and cook until two and a half sheng remain. A strong person may take it all at once; a weak person should divide it into two doses. After taking it, diarrhea will occur, and the illness will promptly heal.

Another formula: Zhuyu (that is, Wuzhuyu, Evodia rutaecarpa) two liang, fresh ginger four liang, douchi (fermented soybean) three ge, and wine four sheng; cook until two sheng remain, divide into three doses, and the illness will improve.

Another formula: Dried ginger one liang and badou (croton seed) two liang; crush them and make pills with honey. A weak person may divide the dose into two. (Another version says: take two pills the size of small beans each time; after taking them, vomiting or diarrhea should occur, and the illness will improve.) Badou is a drastic purgative and is toxic; in modern times it must not be taken at will.

Formula for treating connected heart and abdominal [pain] with frequent distention and pain: Langdu two liang and fuzi (prepared aconite) half a liang; crush and sift, then make honey pills the size of parasol tree seeds. On the first day take one pill daily; on the second day take two pills; from the third day take three pills; afterward increase by one pill, and by the sixth day take three pills. After that, take between one and three pills according to the usual regimen, and the illness will improve. Langdu and fuzi are both toxic medicinal materials; they must be processed and used under a physician’s guidance.

Another formula: Wuzhuyu one ge, dried ginger four fen, and fuzi, xixin, and ginseng two fen each; crush and sift, make honey pills the size of parasol tree seeds, and take five pills each time, three times a day.

General discussion: Whenever there is heart and abdominal pain, if it is not caused by a sudden attack of pathogenic qi or by cholera (acute vomiting and diarrhea), it is mostly due to cold or heat accumulated in the body over a long time. These formulas may be used for emergency relief. After the condition has eased, comprehensive regulation is still necessary to eliminate the root of the illness.

Appendix formula (from Meishi Fang): For treating heart and abdominal distention and fullness, hard pain, and restlessness. When the patient has not yet vomited or purged but the condition is critical, use salt five ge (the original “guan” is suspected to be an error for “yan,” salt), add one sheng of water, decoct until dissolved, and take it in one dose. After taking it, food will naturally be vomited or purged, and the illness will settle; if there is no vomiting, one more dose may be taken.

Master Sun’s Formulas: For treating simultaneous pain in the heart and abdomen. Wrap Sichuan pepper in cloth, spread it into a thin layer, and place it on the affected area; then apply hot-ironing with fire so that the pepper’s medicinal power is released through sweating. The effect is excellent. (Master Sun is Sun Simiao, the famous Tang dynasty physician.)

The Shiquan Formulas: For treating pain of the heart and spleen. Take galangal (the rhizome of a plant in the ginger family), cut it finely, stir-fry it, and pound it into a fine powder. Take one qianbi (an ancient medicine-measuring implement, about a pinch of medicinal powder) with rice broth; the pain stops as soon as the medicine is taken.

Formula Ten for Treating Sudden Restlessness and Fullness of the Heart and Abdomen: For treating sudden restlessness, stuffiness, distention, and fullness in the heart and abdomen.

Another formula treats chest and hypochondriac pain so severe that death seems imminent: heat water until very hot and soak the hands and feet; when the water cools, replace it with hot water. This is a secret formula.

Further formulas (the following are several simple formulas, in the order of the original text):

Take one square cun of blue cloth, three fen of deer horn, and two qianbi of ashes from burnt human hair; add two sheng of water, boil down to about one sheng and five ge, remove the residue, and take the whole amount.

Cut Job’s tears root into pieces, decoct it thickly, and take three sheng of the juice.

Take twenty bilun qian (generally considered to be elm seeds, the fruit of the elm tree), add five sheng of water, and boil until it has come to a boil three times; divide it into three doses to be taken daily.

Pound coriander and extract one or two sheng of its juice; boiling dried ginger in water is also very good.

Prepare it according to the method for the Zhizi Chi Decoction used earlier to treat heart pain, and take three sheng of the juice.

Take one liang of Scutellaria baicalensis, twenty apricot kernels, and one liang of oyster shell; add three sheng of water, boil down to one sheng, and take it in a single dose.

(The remaining entries duplicate the preceding text.)

Formula for Treating Jue Reversal, Restlessness and Fullness, and Frequent Desire to Vomit: Take small grass (i.e., Polygala tenuifolia, yuanzhi), cassia twig, asarum, dried ginger, and Sichuan pepper, two liang each, and processed aconite, two liang. Pound them together, mix with honey to form pills, and take four pills each time, each the size of a paulownia seed.

Formula for Treating Sudden Vomiting and Counterflow: Apply moxibustion one cun below the nipple; seven cones will cure it. (A zhuang is a counting unit for moxibustion; one moxa cone is one zhuang.)

Moxibustion Method (I)

Apply moxa to the first transverse crease on the inner side of both thumbs, behind the nail, one zhuang to each; then moxibust one zhuang below the nails of both middle fingers, and recovery will follow. (A zhuang is a unit of measurement in moxibustion: one complete burning of a moxa cone counts as one zhuang.)

General Discussion

This is the author’s explanation of the above moxibustion method. This prescription belongs to the general category of “miscellaneous treatments.” The condition it targets is similar to “cholera with phlegm obstruction,” and one should also consult the treatment methods under the cholera entry. Cholera is an acute condition of sudden vomiting and diarrhea, but actual cases are not numerous; most are concurrent with other illnesses, for example: cold-damage disease has not yet resolved; after the vomiting and diarrhea of cholera, body fluids have been depleted and there is deficiency dryness; in people with consumption and strain, after taking various tonics, stuffiness and fullness appear (distension and oppression in the epigastrium); contraction of cold and heat pathogenic qi; food poisoning; or improper use of medicines. All these situations should be treated by tracing each to its own root cause; one must not rely solely on this single method of moxibusting the fingers.

Supplementary Formulas

Qianjin Fang (Sun Simiao’s Beiji Qianjin Yaofang, Essential Formulas for Emergencies Worth a Thousand Gold Pieces): Treats epigastric and abdominal distention and fullness with shortness of breath. Use one liang of caodoukou (Alpinia katsumadai, a warming herb that dispels cold), remove the peel, grind into a fine powder, and take half a qian with a decoction of papaya and ginger.

Doumen Fang: Treats men and women who have long suffered from qi-induced distention, chest oppression, and inability to eat. It is often caused by improper diet, with cold and heat pathogens clashing with each other, leading to epigastric and abdominal distention and fullness. The formula uses houpo (Magnolia bark): first dry it over fire, then dip it in ginger juice and roast until scorched black, grind and sift into a fine powder, and take two qianbi (qian-spoonfuls) with aged rice-water three times a day. The original text states that the effect is excellent; it can also be used to treat regurgitation and to stop diarrhea.

Jingyan Fang: Treats food accumulation and qi stagnation, leading to generalized edema with yellowing, panting, inability to eat, and chest oppression with abdominal fullness. The formula uses zaojiao (Gleditsia sinensis fruit) that has not been damaged by insects; remove the peel and seeds, coat it with good vinegar, roast until scorched yellow, grind into powder, and take one qianbi. The subsequent words, such as “badou (croton seed), seven,” are missing from the original text, so the dosage and combination can no longer be determined. The original text says its antidiarrheal effect is very good.

Jingyan Fang (repeated entry): It records only the symptoms “food-qi causing generalized yellow swelling … fullness and oppression in the chest and epigastrium,” and does not attach any formula or medicinals.

I. Formula from Ge Xianweng’s Zhouhou Beiji Fang (Handbook of Prescriptions for Emergencies)

Select insect-free gleditsia pods (zaojiao), remove the outer skin and seeds, coat them with vinegar, and roast until scorched yellow. Grind into a fine powder and take one qianbi (about one tablespoon). Separately take seven croton seeds (badou) and remove the oil membrane. Mix the two ingredients with dilute vinegar and ground ink, and form pills the size of sesame seeds. Take three pills per dose, taken after meals with a decoction of aged tangerine peel, three times daily. Every other day, add one pill, with free bowel movement as the endpoint. If taken regularly, it can resolve accumulations and stagnation from wine and food.

(Note: Croton seed is drastic and toxic, with a very strong purgative effect. Ancient formulas used extremely small doses; modern people should not take it on their own according to this formula.)

II. Formula from the Meishi Fang

For patients with abdominal distention who are unable to take medicine. Roast ginger over a fire until hot, wrap it in cloth, and place it on the lower abdomen. When it cools, replace it with another piece.

III. Formula from the Shenghui Fang

For symptoms of stagnant heat in the lungs with restlessness and unease. Take four liang of fresh lily bulbs, add half a cup of honey, mix well, and steam until soft and thoroughly cooked. At any time, hold in the mouth an amount the size of a large jujube and slowly swallow the saliva.

Emergency Methods for Treating Sudden Cholera (Twelfth)

Cholera (here referring to an acute illness of sudden onset characterized mainly by severe vomiting and diarrhea) is mostly caused by intemperate eating and drinking: eating raw, cold, and miscellaneous foods; consuming greasy foods; drinking alcohol; eating raw fish slices; or walking in the wind, treading on wet ground, sitting in the open with insufficient clothing, or sleeping at night without being properly covered by a quilt.

At the onset of illness, the first priority is to warm the patient quickly. Charcoal fire may be placed under the bed where the patient lies, adding more as the heat diminishes. Quilts and padded clothes may also be steamed hot and wrapped around the patient, replacing them with hot ones when they cool. One may also heat the ground, pour hot water on it, spread a thin cloth over it, and have the patient lie on it, then cover the patient thickly. Alternatively, pour hot soup into a jar and have the patient soak the feet up to the knees, or apply a copper vessel filled with hot water to the abdomen with cloth underneath, changing it when it cools. An iron may also be filled with fire and used to press the abdomen through clothing.

If there is still no improvement after such treatment, moxibustion should be applied promptly. But it must be done in the order of the acupoints; one must not apply moxa indiscriminately. Moxibustion should be applied according to the symptoms, only when the corresponding symptoms are present; do not apply it in advance when there are no symptoms. Even if there is no immediate effect after moxibustion, do not stop for that reason; if one persists, life can be preserved, and death will not occur.

Moxa for cholera: The moxa cones need not be made very large, nor need the number of cones be great. This prescription considers seven cones relatively appropriate; even using forty or fifty cones is harmless, for under the power of fire life can be saved. For the old oral prescriptions, use Lizhong Pill, along with magnolia bark, fermented soybean, and Tongmai Banxia Decoction. The medicinal materials used by predecessors are difficult to obtain; now I list only effective moxibustion methods and a few simple prescriptions, which are effective in practice and not inferior to precious medicines. Even those who have died recently can still be treated with moxibustion.

Other medicines are inherently difficult to prepare completely, but Lizhong Pill and the various Sishun Houpo decoctions can be prepared in advance; every autumn, one should regularly buy them and carry them on one’s person.

Background note: “Cholera” in the text is an ancient general term for acute diseases of vomiting and diarrhea, and is not fully equivalent to modern medical cholera (caused by Vibrio cholerae). Modern treatment centers on prompt oral or intravenous rehydration; if severe vomiting and diarrhea, dehydration, or other symptoms occur, medical attention should be sought as soon as possible, and the ancient methods described in this passage should not be relied on alone.

If someone suddenly contracts cholera and abdominal pain appears first, moxa fourteen cones above the navel; this point is named Taicang and is located four cun below the pit of the stomach. Afterwards, measure once more to locate it.

If diarrhea appears first, moxa one cun beside the navel, on the left for men and the right for women, fourteen cones on each. In severe cases, increase to thirty or forty cones. This point is named Dachangmu (Large Intestine Mu); for diarrhea, the reducing method should be used.

If vomiting appears first, moxa fourteen cones two cun below the pit of the stomach. This can also treat unremitting dysentery and symptoms of Qi rebelling upward; for Qi rebellion, moxa fifty cones. This point is named Juque and is one cun below the tip of the pit of the stomach.

If coldness of the hands and feet appears first, moxa the pointed bone above the inner malleolus of both feet (that is, Sanyinjiao), seven cones on each foot; if it does not heal, increase the number of cones. This point is named Sanyinjiao and is three cun above the tip of the inner malleolus.

For cramping (muscular twitching and spasm), moxa the center of the sole, that is, on the raised tendon knot below the big toe, six to seven cones; this point is named Yongquan. In addition, moxa one cone at approximately the middle position below the big toe, and there will be efficacy.

(This passage duplicates the preceding passage.)

Another method: moxa the root of the nail above the big toe, seven cones.

For cramping that causes abdominal pain, have four people hold the patient’s hands and feet respectively; moxa fourteen cones two cun to the left of the navel, then moxa on the large tendon in the middle of the thigh, one cun from the genital region.

If there is dry retching with sound, moxa at the first transverse crease of the wrist (Lizhong), seven cones; this point is named Xinzhu (Pericardium) and is located opposite the middle finger.

For unremitting diarrhea, moxa the inner side of the base of the big toe, at the boundary between white flesh and red flesh, seven cones on each side; this point is named Dadu.

For dry retching, moxa three cun behind the dorsal side of the wrist, between the two tendons, seven cones on each side; this point is named Wenshi. If there is sudden coldness of the four limbs and unremitting vomiting, moxaing it will free the flow and relieve it.

The above content comes from the Xiaopin Fang, which is said to have the effect of reviving the dying.

For vomiting together with diarrhea, moxa at the position where the line between the two nipples meets the outer side of the areola, near the boundary with the white flesh of the abdomen, seven cones each; it may also be increased to fourteen cones.

If vomiting stops but diarrhea still does not, moxa one fu below the navel (a cun measuring unit for locating points, about one cun), seven cones. Another account says one cun below the navel, fourteen cones.

If there is vexation and oppression in the chest, with fullness and obstruction, moxa three cun below the pit of the stomach, seven cones; this point is named Weiguan.

Moxibustion and Decoction Therapies for Acute Cholera

Navel Moxibustion and Guanyuan Moxibustion

Fill the navel with salt and apply moxibustion on the salt for fourteen cones (“two sevens,” that is, fourteen). If there is cramping pain and tension around the navel, moxibust instead the Guanyuan point three cun below the navel for twenty-one cones; the effect is good. (The character guan is suspected to be a scribal error for yan, “salt.”)

“Weiguan” Moxibustion

This passage is fragmentary. Its general meaning is that the point is located by measuring in cun and is moxibusted for seven cones; this point is called “Weiguan” (Stomach Tube).

Moxibustion by Horizontal Measurement of the Abdomen and Back

Use a string to measure horizontally across the patient’s body, from the pit of the stomach and the Jiuwei point downward, and apply moxibustion in sequence: first at the midline, then horizontally to the left and right. Then, on the back, mark out a position with the string, aligning it with the part of the back corresponding to the pit of the stomach, and moxibust seven cones at points one cun to either side of the spine (Jiaji), so that moxibustion is applied at three sites in total on the abdomen and back.

Roof-top Soul-Summoning and Moxibustion Behind the Elbow

It is said that when Hua Tuo treated patients who had already died of cholera, he first climbed onto the roof to call back the soul (an ancient custom of summoning the soul), but even after all other methods had been used, they still had no effect. He then used another method: have the patient lie prone with the arms stretched out, use a string to measure from the tip of the elbow to the side of the large bones on both sides of the spine, and moxibust at this location for one hundred cones. If the patient was still not cured, he could moxibust the bony joint behind the elbow. It is claimed that this was tried on several hundred people, and after the moxibustion all were able to sit up. Hua Tuo passed this method to his descendants, who kept it secret from generation to generation.

Emetic and Decoction Formulas

The following are oral formulas for treating distension and pain in the heart and abdomen, restlessness, shortness of breath, and inability to vomit or purge spontaneously caused by cholera.

For the salt decoction to induce vomiting, use two sheng of salt (about 400 mL; one sheng in the Han dynasty was about 200 mL), add five sheng of water, boil down to two sheng, and take it in one dose; vomiting brings recovery.

For the ginger decoction, chop one to two sheng of fresh ginger or dried ginger, add six sheng of water, bring to a boil three times, and take it in one dose. If there is no effect, boil it again and take it once more. When no fresh medicine is available, the already-boiled ginger residue may be boiled again and used.

For bitter wine—bitter wine is vinegar—drink three sheng of good vinegar; those who are weak or elderly need only one or two sheng.

For wax in warm wine, put a pellet-sized piece of wax into one or two sheng of warm wine and drink it after the wax has completely melted. If wax is unavailable, substitute two fangcunbi (about two small spoonfuls) of salt.

Zhuanjin refers to sudden cramping, spasms, and painful contractions of the muscles of the limbs. This section records several folk remedies for treating zhuanjin, most of which use readily available plants and foodstuffs. One is to mix half a sheng of crushed cinnamon bark with two sheng of warm drinking water and take it all at once. Another is to decoct bamboo leaves very strongly into five or six sheng of liquid and use it to wash the cramped area with the hot decoction. Take a palm-sized piece of nanmu or camphor wood, shave it into thin slices, add three sheng of water, bring to a boil three times, remove the residue, and use the liquid to wash the affected area. Take five or six sheng of the above decoction and also use it to wash the cramping area. This prescription is the same as the third and is recorded again. Take three fangcunbi of dried ginger powder; a fangcunbi is an ancient small measuring spoon, about the capacity of one cubic cun.

Take two sheng of finely chopped tender smartweed leaves (smartweed being a pungent herb), add five sheng of water, bring to a boil three times, and take it at once. If fresh smartweed is unavailable, substitute dried perilla leaves or fresh perilla juice; this is also effective. Take one sheng of small garlic (a wild onion-type plant), chop it, add three sheng of water, decoct to one sheng, and take it at once. Soaking about five sheng of small garlic in warm water and taking the liquid is also acceptable. Mix human blood with a medicinal pill and take two pills each time, each the size of a parasol-tree seed. Take one jin of fresh ginger, chop it, add seven sheng of water, decoct to one sheng, and divide into three doses.

Take oily grime from the loom of an itinerant street performer, the size of a parrot’s egg, and take it with warm wine; the illness will immediately heal. This prescription is the same as the twelfth and is recorded again. Drinking a small amount of bamboo juice (the liquid that flows when green bamboo is roasted) can also be effective. Take two liang of dried ginger, two liang of licorice, and one liang of aconite (the daughter root of wutou, which is toxic and must be processed before use in medicine), add three sheng of water, decoct to one sheng, then add one ge of pig bile and mix well; divide into three doses. Take a large handful of the fuzz from reed plumes, decoct it strongly, drink two sheng, and recovery follows.

Background: Zhuanjin (cramp) refers to sudden muscular twitching and spasm, most often occurring in the calves and feet. The ancients often associated it with acute conditions complicated by vomiting and diarrhea. Ge Hong (known as Ge Xianweng, Immortal Ge) wrote Zhouhou Beiji Fang (Emergency Formulas to Keep Up One’s Sleeve), a concise and practical emergency formulary that collects easily obtained drugs and methods.

Methods for Treating Cramp

Cauterization by Burning: Heat iron until red, and along the edge of the white flesh on the back of the heel—near the heel—burn a mark following the shape of the foot, producing a sore; do this on both feet. After a while, if hot qi enters the abdomen and the cramps no longer occur, the illness is cured. If iron is unavailable, a burnt shrimp tail may be used instead.

External Application: Boil vinegar (bitter wine) three times and use it to rub the affected area; adding a little fine powder is even better. Soak cotton wadding in the medicine and wrap it around the area from below the knee all the way down to the foot.

Internal Administration: Take fourteen charred gardenia fruits, grind them into powder, and ingest. Take equal amounts of cinnamon bark and Pinellia, grind them into powder, take one fangcunbi (a small spoonful) of the medicinal powder, mix it with one sheng of water, and take it; this brings immediate cure. Grind raw soybeans, mix one fangcunbi with wine, and take it. Burn centipedes into a paste and apply it to the affected area; this also cures it.

For cramps entering the intestines: Take one cun of the white portion of chicken feces, add six ge of water, bring to a boil three times, and administer as a single dose; do not let the patient know the ingredients. Another method is to boil cotton wadding in vinegar and wrap it hot over the cramped area; taking three pinches of charred woven straw rope with wine, or taking the black ash from the bottom of a pot with wine, may also cure it.

For cramps already in the abdomen: Have the patient hang upside down, head down and feet up, until the abdomen returns to normal.

For cramps of the arms, legs and feet, and chest and hypochondrium: Take one and a half sheng of salt, add one dou of water, boil until hot, and soak the hands and feet while hot; if the cramps are in the chest and hypochondrium, wash those areas with the hot liquid. For cramps entering the abdomen, likewise have the patient hang head down until the abdomen returns to normal.

For critical cases: The patient pulls the genitals downward with the hand, the scrotum retracts, and death is near; but if breath remains, hanging upside down may still offer a chance of rescue.

For unremitting diarrhea and dysentery with cramps entering the abdomen: Take one liang of fresh ginger; stop taking it once the abdomen returns to normal.

Note: Many methods in the book—such as burning, taking chicken feces, and hanging the patient upside down—reflect ancient experience and the medical understanding of the time and do not fully accord with modern medicine. Today, if someone experiences cramp, especially when accompanied by severe vomiting, diarrhea, or dehydration, they should seek medical attention promptly and replenish fluids and electrolytes.

For a critically ill patient, if the symptoms of pulling at the penis with the hand and contraction of the genitals appear, these are mostly signs of impending death; if there is still a trace of breath, the patient may be lifted upside down and treated, and perhaps may still survive.

If diarrhea and dysentery do not stop and at the same time there are calf cramps (zhuanjin) spreading toward the abdomen, the condition becomes life-threatening.

Take one liang of fresh ginger (about a dozen grams), break it into pieces, add one and a half sheng of wine, bring to a boil three or four times, and take it in one dose; recovery follows.

The following is a formula for treating irritability, oppression, distention, and fullness in the heart and abdomen after cholera (acute vomiting and diarrhea):

Take fourteen gardenia fruits, add three sheng of water, and boil down to two sheng; then add seven ge of light fermented soybean (chi is a fermented black-bean product) and boil down to one sheng; take it in one dose. If there is accompanying vomiting, add two liang of tangerine peel; if the oppression and irritability are more severe, add one sheng of fermented soybean, one liang of licorice, and one sheng of honey, with another two sheng of water, and divide into five doses.

To treat restlessness and inability to lie still after cholera: take twenty scallion whites and twenty jujubes, add three sheng of water, boil down to two sheng, and take it in one dose.

To treat severe thirst after the vomiting and diarrhea of cholera, when drinking too much water can be fatal: take five sheng of yellow millet, add one dou of water, boil down to three sheng, and let it settle clear; drink it slowly in small amounts, and do not drink anything else.

The Lizhong Pill recorded by Cui (a formula for warming the middle and dispersing cold): licorice three liang; dried ginger, ginseng, and white atractylodes one liang each. Crush and sift, then mix with honey into pills the size of a bullet. If vomiting and diarrhea still do not stop after one pill, take another; if after a short while there is still no improvement, take it with one dou of warm water or with thick porridge, repeating three to five times until the illness is cured. It may also be taken with wine.

Sishun Decoction: treats dry retching in the abdomen after vomiting and diarrhea, with hands and feet persistently cold. Dried ginger, licorice, ginseng, and aconite two liang each; add six sheng of water, boil down to three and a half sheng, and divide into three doses. If diarrhea still does not stop, add one liang of dragon bone; if abdominal pain is severe, add two liang of angelica. In the formula of Hu Qia, aconite is used as one piece, and one liang of cinnamon is added. If cholera occurs without vomiting or diarrhea, with only deep, hidden pulses in the limbs, cold muscles, cold sweat, and thirst, taking this brings immediate recovery.

Houpo Decoction: treats restlessness, vomiting, and abdominal distension.

Take four liang of Houpo (magnolia bark), roasted over fire to reduce its drying nature; two liang of Guizhi (cassia twig); five pieces of Zhishi (immature bitter orange) (the original text reads “Zhushi,” i.e., “Zhishi”); and three liang of Shengjiang (fresh ginger). Add six sheng of water, decoct until two sheng remain, and divide into three doses.

All four of these decoctions can treat the various symptoms of cholera and must be kept on hand. Cholera is a condition of sudden, severe vomiting and diarrhea. If heart pain is also present and especially severe, this indicates that the pathogenic qi carries toxic qi, and one must simultaneously use the method for treating “Zhong’e” (an ancient term for sudden fainting and abruptly critical conditions, believed to be caused by the invasion of evil qi).

Appended Formulas

Sun Zhenren Treats Cholera (Sun Zhenren is the famous Tang dynasty physician Sun Simiao): use thirty to forty grains of black pepper and take them with warm water.

Doumen Fang Treats Cholera: take yellow fir wood, split it into slices, about one handful; boil it in water into a thick decoction, reduce to one cup, and take it.

Waitai Miyao Treats Cholera with Restlessness (Waitai Miyao is a medical text compiled by Wang Tao of the Tang dynasty): take tangled hair, burn it into an egg-sized mass, mix it with three sheng of salt water, and take it. If vomiting does not occur, take another dose.

Another Formula for Cholera with Abdominal Pain, Vomiting, and Diarrhea: take three sheng of peach leaves, chop them, add five sheng of water, boil until one sheng and three ge remain, and take warm in two doses.

Meishi Fang Treats Cholera with Heart Pain and Diarrhea without Sweating (Meishi Fang is a Tang dynasty formula book): take a large handful of pear tree leaves and branches, add three sheng of water, decoct to one sheng, and take it.

Another Formula for Restlessness and Unease after Cholera: take twenty scallion whites and twenty jujubes, add three sheng of water, decoct to two sheng, and take in divided doses.

Bingbu Shouji for Emergency Treatment of Cholera Is Quite Effective: take slightly sour jiangshui (fermented rice broth), decoct it with dried ginger powder, and sip in small mouthfuls. For abdominal discomfort in summer, decoct and take it and it will heal.

Sun Yonghe Treats Severe Diarrhea and Unceasing Cholera (Sun Yonghe’s dates are unknown): take one heavier piece of aconite (Fuzi), decoct it, then add dried ginger powder, and sip in small mouthfuls. For abdominal discomfort in summer, decoct and take it and it will heal.

This passage records a number of formulas for treating acute conditions, mainly cholera-like vomiting and diarrhea (huoluan) and zhuanjin (severe muscular cramps and spasms).

The first formula is the Fuzi Formula. Take one aconite root (Fuzi), about seven qian in weight; after processing, remove the outer skin and the tip of the root, and grind it into powder. For each dose, take four qian, add two cupfuls of water and half a qian of salt, decoct down to one cupful, and take it warm; the symptoms can be relieved immediately. The Jixiao Fang records that this formula can treat patients with unremitting vomiting and diarrhea. Such patients commonly present with cold limbs, reversal cold of the hands and feet, and clouded consciousness; after taking the medicine, the limbs gradually warm and consciousness clears accordingly.

The second is Huiyang San (Returning Yang Powder). Grind Tiannanxing (Arisaema, a toxic herb) into powder. For each dose, take three qian, add three jingzao (large jujubes), decoct in one and a half cupfuls of water down to eight fen, and take it warm. If the patient is still not conscious, give another dose.

The third is a formula from the Shenghui Fang. It treats huoluan with zhuanjin in patients in critical condition. Take a handful of worn-out cattail mat, cut it into pieces, boil it in one cupful of jiangshui (fermented rice broth), strain the liquid, and take it warm in a single dose.

The fourth is another formula, for zhuanjin due to liver deficiency. Take three ge of the chopped stems and leaves of red smartweed (Chiliao, an herbaceous plant), add one cupful of water and three ge of wine, decoct down to four ge, remove the residue, and take it warm in two divided doses.

The fifth is another formula, for zhuanjin entering the abdomen due to liver wind and deficiency. Boil half a jin of salt in water for a short while, then soak the affected area while hot; the effect is good.

The sixth is a formula from Sun Shangyao, for leg cramps and painful contractures. Cut one liang of pine knot into rice-grain-sized pieces and one qian of frankincense; stir-fry them over a slow fire in a silver or stone vessel until scorched yellow, retaining three-tenths of the medicinal nature and removing the fire toxicity, then grind finely. Take one to two qian each time, swallowed with warm wine infused with mugua (Chaenomeles fruit). The original text states that this formula is effective for various tendon disorders.

The seventh is from the Gujin Luyan Fang. It treats huoluan with zhuanjin. Take a handful of smartweed, remove both ends, add two and a half sheng of water, boil down to one and a half sheng, and take it in one dose.

The eighth, Formula Thirteen for Treating Cold Damage, Seasonal Qi, and Pestilential Diseases, is a chapter title; the next line is the only main text in this passage: it is used to treat patients with cold damage, seasonal qi and pestilential diseases (seasonal qi means epidemic disease), as well as headache, high fever, a surging large pulse, and illness that has just reached one full day.

Background note: in ancient times, “zhuanjin” mostly referred to the muscle cramps that accompany acute vomiting and diarrhea; from a modern perspective, it may be related to dehydration and electrolyte imbalance. Both aconite (Fuzi) and Tiannanxing in the text contain toxic components. The dosages and processing methods of ancient formulas require professional expertise and should not be copied for personal use.

This group of scripture texts records several formulas for treating acute illnesses, mostly using emesis and sweating as the principal methods; they belong to the empirical therapies of the ancients.

The first formula: take the roots and leaves of “Zhidui” (the identity of this drug is unknown), pound them together to about three sheng, add one liang of Zhen Dan (that is, cinnabar, whose main component is mercuric sulfide and which is toxic), then add one sheng of water and boil together; wring out the juice and take it in one dose. If the patient vomits, that is good. If the patient has high fever and a full, large pulse, it is appropriate to use this formula for only one day.

The second formula: the same as the preceding formula. If the condition is severe, take the entire one sheng of juice, then cover with a thick quilt to induce sweating, and recovery will follow.

The third formula: take one sheng of small garlic (that is, small-root garlic), pound it and obtain two ge of juice, and take it in one dose; after no more than two doses, recovery will occur.

The fourth formula: take fourteen black plums and five ge of salt, add three sheng of water, boil down to one sheng, remove the residue, and take it in one dose.

The fifth formula: take “shengzi wood” (tree species unknown), shave off the black bark, finely cut one sheng of the white inner wood, add two sheng and five ge of water, decoct, remove the residue, and take eight ge each time; after three doses, recovery will occur.

The sixth formula: take fourteen wooden pills (that is, soapberry; the fruit contains saponin and has emetic and purgative effects), add five sheng of water, knead until the juice is thick and concentrated, remove the residue, and take the whole amount; there will be vomiting or diarrhea, and the illness will be cured.

The seventh formula: first break one egg into half a sheng of cold water and stir it evenly; separately boil three sheng of water to boiling, then use the wooden-pill juice from the sixth formula, and likewise take the whole amount; there will be vomiting and diarrhea, and recovery will follow.

The eighth formula: pour the egg-and-cold-water liquid into boiling water, stir rapidly and evenly, wait until the temperature is moderate, and take it in one dose; after taking it, induce sweating.

The ninth formula: smear Zhen Dan all over the body, sit facing a fire, cause the body to sweat, and recovery will follow.

The tenth formula: take the roots and leaves of fresh ranghe (a Zingiberaceae plant), pound them together and wring out the juice, and take three or four sheng.

The eleventh formula: take three jin of dried mugwort leaves, add one dou of water and boil down to one sheng, remove the residue, take it in one dose, and induce sweating.

The twelfth formula: take one sheng of salt and eat it, then wash it down with hot liquid; there will be cramping pain and vomiting in the abdomen; immediately cover with a quilt and induce sweating, and the illness will be cured.

Note: The Zhen Dan (cinnabar) in these formulas contains mercury and is toxic; it must not be taken internally or applied externally at will. The dosages and effects of drugs such as soapberry and black plum also vary from person to person. In cases of poisoning or acute illness, one should seek medical treatment promptly and should not self-treat according to these formulas.

Another formula: take 157 bishu coins (copper coins used in ancient gambling games to tally wins and losses), boil them in one dou of water until seven sheng remain, and drink the entire decoction. After a while, add five sheng of water, boil down to one sheng, then add two sheng of water and mix so that the total is three sheng. Remove the coins and drink the decoction; this will cause the toxic substances in the body to be vomited out.

Another formula: take a pellet-sized amount of lard, warm it, and take it three times a day, for a total of nine doses over three days.

Another formula: take thirty dark plums, remove their pits, add one sheng of chi (a fermented soybean product, namely douchi) and three sheng of bitter wine (that is, vinegar), and boil down to one and a half sheng. Strain out the dregs and take it all in one dose.

Another entry: Shanghan (a general term for externally contracted febrile diseases) has several types, and ordinary people find it difficult to distinguish among them. If one wishes to deal with it using a single formula, then when the illness has lasted one or two days, when headache is first felt, the body is feverish, and the pulse is flooding and large, one may take Congchi Tang (Scallion and Fermented Soybean Decoction). Take one tiger’s-mouth (about a handful) of scallion whites and one sheng of chi, add three sheng of water, and boil down to one sheng; take it in one dose to induce sweating. If there is no sweating, add two liang of Gegen and three liang of Shengma (two Chinese medicinals), decoct in five sheng of water down to two sheng, and take in two doses; this will surely induce sweating. If there is still no sweating, add two liang of Mahuang (a Chinese medicinal with a relatively strong sweating-inducing effect). Separately, take two ge of rice ground with scallion decoction, add one sheng of water, and cook together; after a little while add salt and chi, finally add scallion whites, simmer over gentle heat down to three sheng, and take in divided doses to make the patient sweat.

Another formula: take one sheng of chi and three sheng of boys’ urine, decoct down to one sheng, and take in two doses to induce sweating.

Another formula: take four liang of Gegen, decoct in one dou of water down to three sheng, then add one sheng of chi, decoct down to one and a half sheng, and take it in one dose. If fresh Gegen is pounded to extract its juice and one to two sheng are taken, the effect is also very good.

If sweating does not stop and it has already lasted three or four days, with vexation and fullness in the chest and a desire to vomit, and if one wants to induce vomiting in the patient, use three sheng of fermented soybean (a food made by fermenting black beans) and seven sheng of water. Boil until two and a half sheng remain, strain off the dregs, add one liang of honey, bring to a boil three times, and give it all in one dose. Have the patient lie quietly; vomiting should occur. If there is no recovery, take another dose, until recovery occurs. This is a secret formula, passed down to sons and grandsons.

Another formula: take three jin of raw rehmannia (fresh rehmannia, a Chinese medicinal), cut it finely, add one dou of water, and boil until three sheng remain; divide into three doses. One may also take Hualu Emetic Powder (an emetic powder made with Hualu, i.e., Veratrum) and Kushen Longdan Powder (a powder made with Kushen and Longdan).

If the illness has already lasted more than five or six days:

The patient may drink a larger amount of green bamboo juice (the liquid collected by roasting green bamboo). Boil it briefly to reduce it slightly, drink it frequently, and cover the patient with a thick blanket to induce sweating.

Another formula: take rhubarb, coptis, phellodendron (i.e., Huangbo), and gardenia, half a liang each; add eight sheng of water and boil until it has bubbled up six or seven times. Then add bamboo juice, simmer briefly to reduce it, drink frequently, and cover the patient with a thick blanket to induce sweating.

Another formula: likewise take rhubarb, coptis, phellodendron, and gardenia, half a liang each; add eight sheng of water and boil until it has bubbled up six or seven times. Add one sheng of fermented soybean and seven scallion whites, boil until three sheng remain, and take in divided doses; it is suitable for both old and young.

Another formula: take two liang of Kushen, two liang of Scutellaria, and half a jin of raw rehmannia; add eight sheng of water and boil until one sheng remains; divide into two doses. If vomiting or diarrhea has been caused by mistakenly taking poison, taking this can also bring recovery.

If the illness has already lasted six or seven days, with extreme high fever, vexation and fullness at the chest, delirious speech, and the patient seeing ghosts and wanting to get up and run:

Use three sheng of dried evodia (Wu Zhuyu, a fragrant Chinese medicinal), add two sheng of water, boil until one sheng remains, remove the dregs, and take it when suitably warm or cool; sweating will bring recovery. This formula will not fail; it is certain to work and is a secret formula.

Another formula: take one sheng of large earthworms, remove impurities, and boil them until thoroughly soft in human urine; remove the dregs and take it. The juice may also be squeezed out directly, or water may be added and it may be decocted; both are effective. In addition, squeeze out the juice of feces and drink from several ge to one or two sheng; this is called “Yellow Dragon Decoction,” and the longer it is stored, the better its effect.

Another formula: take a white dog, split it open from the back, and collect the blood, as much as possible. Apply it hot over the chest, and remove it when cool; it is said that this can revive a dying person. If no white dog is available, other solid-colored dogs may also be used.

Note: The above are all ancient folk empirical therapies, most of which lack scientific basis and are not suitable to be copied today. If high fever persists or mental abnormalities appear, medical attention should be sought promptly.

Another formula: Take paulownia bark, scrape off the blackened outer layer, tear it finely, cut it into lengths of about four cun, and tie them into a bundle. Heat it with five ge of wine and place the medicinal bundle on the chest; remove it when it cools. This can save a dying person. If no white dog (the animal used in the preceding formula) is available, other dogs of a uniform coat color may be used instead. (Tong bark is paulownia bark; ge is an ancient unit of capacity, and ten ge make one sheng.)

Another formula: Prepare paulownia bark in the same way, boil it with five ge of wine and one sheng of water until one sheng remains, remove the dregs, and take it all at once. After taking it, the patient will vomit and discharge several sheng of greenish-yellow fluid, and the illness will be cured.

Another formula: Take three eggs, add one fangcunbi of mirabilite (a small spoon used in ancient times for measuring medicinal powder) and three ge of wine, stir until the mirabilite is completely dissolved, and take it. (Mirabilite is a mineral drug containing sodium sulfate and has a purgative effect.)

Another formula: Use three liang of Huanglian (Coptis chinensis), two liang each of Huangbo (i.e., Phellodendron amurense) and Huangqin (Scutellaria baicalensis), and fourteen gardenia fruits; add six sheng of water and decoct until two sheng remain; take it in two doses. It can treat restlessness, vomiting, and insomnia. To treat cases in which seasonal qi (an epidemic disease prevalent at the time) has brought the patient to the brink of death, take one liang of Sophora flavescens, cut it into pieces (there is a lacuna in the original text here), boil it in two and a half sheng of wine until one and a half sheng remain, remove the dregs, and when the temperature is suitable, take it all. After taking it, the patient will successively vomit glue-like toxic matter, and the illness will be cured. (The phrase “Po Guan Qian Jin Zhu Tang” is obscure and suspected to be a textual error; it is not explained here.)

Another formula: Take one hundred large copper coins, add one dou of water, and boil until eight sheng remain. Then add musk the size of a large plum (“Dangmenzi” refers to the scent gland from the abdomen of a male musk deer, that is, the raw musk mass), grind it into powder, and slowly feed it to the patient until it is finished, either to induce sweating or to induce vomiting.

The “Black Paste” formula for treating warm-toxin skin eruptions (skin rashes caused by epidemic toxin) and severe epidemics that are difficult to cure: cut half a jin of fresh Rehmannia into pieces, and take one sheng of good fermented black beans and two jin of lard; decoct them together for five or six boils, until two-thirds remain, then wring out and remove the dregs.

Another Black Paste formula, also for warm-toxin skin eruptions: To the above Black Paste, add realgar and powdered musk, each the size of a large soybean, mix evenly, and take it all; the toxic qi will emerge through the skin, and the illness will be cured. (Realgar consists mainly of arsenic sulfide and is toxic.)

Another formula: Take a live toad, immediately cut open its belly and remove the intestines, pound it into a paste, and swallow it. If one obtains a toad collected on the Dragon Boat Festival (the fifth day of the fifth month) and dried in the air, burning it into ash and taking the powder is also effective. (The ancients believed that medicines collected and prepared on the Dragon Boat Festival had stronger medicinal power.)

These formulas come from ancient medical books and record the empirical practices of their time; they should not be copied directly today. Practices such as realgar containing arsenic, swallowing raw toads, and using large doses to induce vomiting all carry clear risks, and modern medicine should be the standard.

What Heinu Pill is, and what this passage is about (the following is a plain-language explanation):

Heinu Pill is a honey pill made from several medicinal ingredients, also known as “Shuijie Pill” (Water-Release Pill). There is another formula that adds one liang of wheat heibo (wheat smut), called “Mainu Pill” (Wheat Slave Pill). Here the character “nu” (slave) is a textual variant in the original edition and does not affect understanding.

The Formula and Use of Heinu Pill

Take ephedra, rhubarb, and Scutellaria each in specified amounts, mirabilite (mangxiao, that is, Glauber’s salt) one liang, soot from the bottom of a cauldron, soot from the inner wall of a chimney, and dust accumulated on roof beams. Pound them into powder and make honey pills the size of a bullet. To take it, swallow one pill at once with five ge of freshly drawn well water. If the patient is thirsty, give only water to drink. After a while the body feels cold, then sweating follows, and the illness is cured. If after taking the medicine daily there is still no sweating, take another pill. This formula is used to treat “bad disease”—a critical condition formed after mistreatment or after a change in the illness—when the illness has lasted five or six days, with great heat in the chest and locked jaw.

Daqing Decoction Formula

Use Daqing four liang, licorice and donkey-hide gelatin each two liang, and light fermented soybean (dandouchi) eight ge. Add one dou of water and boil Daqing and licorice; obtain three and a half sheng of liquid. Remove the dregs, add the fermented soybean, and boil for three boils. Remove the dregs, then add the donkey-hide gelatin, and divide the liquid into four doses. It may also be taken together with the previous formula. This formula is used when the illness has reached seven or eight days, when sweating does not resolve it, or when there is still high fever after vomiting and diarrhea; it works very well.

Another Pill Formula

Use rhubarb, ephedra, and licorice each in specified amounts, thirty apricot kernels, mirabilite, Scutellaria, and twenty prepared croton seeds. Pound them into powder and make honey pills the size of soybeans. Take three pills; this should purge the toxic pathogen downward. If the purging does not stop, stop it with rice broth. When family members care for the sick person, they may also first take this pill to purge, which can help avoid transmitting the illness to one another. This pill can be prepared in advance and kept on hand.

Ephedra Decoction Formula

Ephedra can release pathogenic factors from the muscle surface, and it can be taken in the first one or two days of illness. Another formula uses ephedra, licorice, Cimicifuga, peony root, and gypsum each one liang, thirty apricot kernels, and three cowrie shells. Grind into powder, add three sheng of water, boil down to one sheng, and take it in one dose; cover up with a blanket to induce sweating, and once sweat appears the illness is cured. Afterward, one may eat some douchi porridge to supplement deficiency.

Note: This passage is a collection of ancient formulas for treating epidemic diseases (heat diseases) and belongs to historical literature. The dosages, drugs, and methods in it are only for understanding ancient texts; do not use them to take medicine on your own. Modern medication must follow a physician’s instructions.

One formula: use two liang of mahuang (Ephedra), one liang of huangqin (Scutellaria), one liang of guizhi (cinnamon twig), and three liang of fresh ginger; add six sheng of water, decoct until two sheng remain, and take it in four divided doses. After taking it, one may also drink some douchi porridge—a thin porridge made from fermented soybeans—to supplement and nourish weakness; this is very suitable.

Another formula, Gegen Jieji Tang (a decoction centered on gegen and used to release the muscle layer and reduce heat): four liang of gegen (kudzu root), two liang of shaoyao (peony root), and one liang each of mahuang, daqing, gancao (licorice), huangqin, shigao (gypsum), and guizhi, plus four jujubes. Add five sheng of water, decoct until two and a half sheng remain, remove the dregs, and take it in three divided doses; after taking it, there should be a slight sweat.

If the exterior has still not been resolved after three days or more, up to seven or eight days, one may take Xiao Chaihu Tang (Minor Bupleurum Decoction, a classic formula for harmonizing Shaoyang and treating alternating chills and fever): eight liang of chaihu (Bupleurum), three liang each of ginseng, gancao, and huangqin, eight liang of fresh ginger (or three liang of dried ginger if fresh ginger is unavailable), five liang of banxia (Pinellia, washed with water), and twelve jujubes. Add nine sheng of water, decoct until two and a half sheng remain, and take it in three divided doses. After taking it, cover up with a blanket and allow a slight sweat for about half a day; recovery will come quickly. If the effect is not ideal, decoct another dose.

If there is excess heat, and after sweating the condition is still unresolved, with fullness and pain in the chest and hypochondrium, restlessness, and a desire to speak deliriously, one may take Da Chaihu Tang (Major Bupleurum Decoction, a formula for draining interior heat): half a jin of chaihu, two liang of dahuang (rhubarb), three liang of huangqin, two liang of shaoyao, ten pieces of zhishi (Aurantium), five liang of banxia (washed), five liang of fresh ginger, and twelve jujubes. Add one dou of water, decoct until four sheng remain, and take it in four divided doses; after taking it, there should be a mild purge.

This section discusses several prescriptions for treating acute “shanghan” (cold damage; in ancient usage, a broad term for acute febrile illness caused by external pathogens).

It begins by saying that among these prescriptions, the most urgent and the first to be mastered is the one below. If the needed medicinals can be obtained, there is no need to seek other methods, and the worry of death can basically be avoided. The various other small prescriptions are only supplements for when medicinals are lacking. If the illness is delayed or remains unhealed after treatment for more than ten days, it is called “bad disease” (a condition that has worsened and is difficult to rescue), and one can only take the Major and Minor Biejia Tang (Turtle Shell Decoction). Although these two prescriptions are small in dosage, they contain many medicinals and are not something a household can stock for emergencies, so they are not recorded here.

When using sweating therapy to treat shanghan, one must never cause excessive or unceasing sweating. After one dose, a slight sweat is enough; once sweating stops, that is sufficient. If it still does not stop, dust the body with powder to stop sweating, and avoid exposure to wind.

Yang Toxin Attack: When one has just contracted shanghan, if there is generalized heaviness, pain in the lower back and back, restlessness and oppression, a floating pulse, a red face with spots like a brocade pattern, sore throat, or diarrhea, or mental disturbance with a desire to run about, this is “yang toxin” (a type in which heat-toxin is predominant). It can be treated within five days of onset; after five days it will lead to death. One should take the following prescription:

Realgar, licorice, cimicifuga, angelica, pepper, and cinnamon, one portion each. Add five sheng of water and decoct down to two and a half sheng; divide into three doses. Cover with a warm quilt to induce sweating. If there is no sweating after taking it, decoct another dose.

Yin Toxin Attack: If there is generalized heaviness, stiffness of the back with pain as if beaten by a whip, abdominal pain, contraction and hardness below the sternum, shortness of breath, vomiting, bluish lips, a dark complexion, cold limbs, and a pulse that is deep and thin yet also tight and rapid (the coexistence of cold signs and a rapid pulse, a presentation of yin excess repelling yang), this is “yin toxin” (a type in which cold-toxin is predominant). It can be treated within five days of onset; after that it is fatal. One should take the following prescription:

Licorice and cimicifuga, two portions each; angelica and pepper, one portion each; turtle shell, one liang. Add five sheng of water and decoct down to two and a half sheng; divide into three doses. Cover with a warm quilt to induce sweating. If there is no sweating, decoct another dose.

For yin-toxin cold damage with coldness of the mouth and nose, take dried ginger and cassia (cinnamon twig), one fen each, grind them into powder, and administer three ge with warm wine. After taking it, there should be great heat and sweating, and the illness will be cured. When illness is caused by either yin toxin or yang toxin, it does not necessarily take this form immediately after onset; in some cases it changes into this only after one or two days. All such cases should be treated according to the above formula and medicine; otherwise most patients will die.

For patients with unremitting febrile disease, severe diarrhea, and such heaviness and lethargy that they are near death, administer Daqing Decoction: Daqing (Isatis) four liang, licorice three liang, donkey-hide gelatin two liang, fermented soybean (douchi) eight ge, and red halloysite three liang. Boil in one dou of water, reduce to three sheng, and divide into three doses. After finishing it, decoct another dose according to the formula; take two doses over one day and one night, and the illness will be cured.

Another formula: use five sheng of water, one sheng of fermented soybean, fourteen gardenia fruits, and one handful of the white parts of Chinese chives; boil down to three and a half sheng and divide into three doses.

Another formula: pound half a jin of dragon bone (fossilized bones of ancient animals, with astringent and antidiarrheal effects) into pieces, boil in one dou of water down to five sheng, cool until very cold, and drink slowly; during the interval, decoct it again down to three and a half sheng and divide into three doses.

Another formula: pound half a jin of dragon bone into pieces, boil in one dou of water down to five sheng, cool until very cold, and drink slowly. If sweating occurs while it is being taken, the illness will be cured.

Another formula: Coptis root and Chinese angelica two liang each, dried ginger one liang, and red halloysite two liang; form pills with refined honey, each the size of a wutong seed. Take twenty pills each time, three times during the day and once at night.

Another formula: Coptis root two liang and prepared mugwort about the size of a duck egg; boil in two dou of water down to one sheng and take it in one dose. The dysentery will stop immediately.

To treat seasonal epidemic dysentery (tianxing, referring to an epidemic prevalent at the time, often an epidemic intestinal infectious disease), this formula is chiefly used for all kinds of dysentery: Coptis root three liang; Phellodendron bark, Chinese angelica, and dragon bone two liang each. Boil in six sheng of water down to two sheng, remove the residue, add seven ge of honey, then simmer over a gentle fire down to one and a half sheng, and divide into three doses; it is effective.

To treat epidemic toxic disease with accompanying fever, abdominal pain, and diarrhea, use Cimicifuga rhizome, licorice, Coptis root, Chinese angelica, peony root, and cassia. Boil in six sheng of water down to two sheng, remove the residue, add seven ge of honey, then simmer over a gentle fire down to one and a half sheng, and divide into three doses; it is effective.

For seasonal epidemic disease accompanied by a heat pathogen, with abdominal pain and dysentery, use Cimicifuga rhizome, licorice, Coptis rhizome, Angelica sinensis root, peony root, cinnamon heart, and Phellodendron bark (huangbo), half a liang of each. Add three sheng of water, decoct down to one sheng, and take it; it should prove effective.

For an epidemic that has lasted four or five days, with profuse hot dysentery, use Coptis rhizome and Phellodendron bark, three liang each; dragon bone, three liang; and mugwort leaf, about the size of an egg. Add six sheng of water, decoct down to two sheng, and divide into two doses. Avoid eating pork (the original mistakenly reads cai rou, an error for zhu rou, “pork”) and avoid cold water.

If pus and blood continue to discharge without stopping, use halloysite, one jin; dried ginger, one liang; and japonica rice (the original mistakenly has geng mi for jing mi), one sheng. Add seven sheng of water and cook until the rice is done. Strain off the dregs and take seven ge each time, twice daily.

Another formula: halloysite, one jin; dried ginger, two liang. Add five sheng of water, decoct down to three sheng, and divide into two doses. If there is cramping pain around the navel, add Angelica sinensis root, one liang, and peony root, two liang, plus another sheng of water.

If the stool is dry, bound, and does not pass, the original text is damaged here; only the dosing frequency “twice daily” can be made out.

This is the same as the fourth paragraph; it is a duplicated formula.

If the stool is dry, bound, and does not pass, and one wishes to make it pass, use rhubarb, four liang; magnolia bark, two liang; and bitter orange, four pieces. Add four sheng of water, decoct down to one sheng and two ge, and divide into two doses. Stop taking it once the stool passes freely.

If there has been no bowel movement for more than ten days, take Chengqi Pill. Use rhubarb and apricot kernel, two liang each; bitter orange, one liang; and mirabilite, one ge. Pound them together, mix with honey into pills the size of a pellet, and take six or seven ge of the pills with warm water. If the bowels still do not move, take it again.

If there is dysentery and the patient cannot eat, use Coptis rhizome, one sheng, and black plum, twenty pieces. Roast them dry and pound them together into powder. Cut wax into pieces the size of chess pieces and melt it together with one sheng of honey over a low fire. Knead the mixture to a consistency suitable for making pills, then form pills the size of parasol-tree seeds. Take two pills each time, in divided doses over the day. If there is still no improvement, take them again.

Treating Dysentery with Inability to Eat

If diarrhea is severe and the patient cannot eat, take one sheng of Coptis (Huanglian) and twenty dark plums (Wumei), dry and roast them until dry, then pound them together into a fine powder. Separately take a small piece of beeswax about the size of a chess piece, add one sheng of honey, melt over gentle heat, blend with the medicinal powder, and knead into pills the size of parasol-tree seeds. Take two pills each time, three times a day.

Treating Lower Abdominal Distension and Fullness with Blocked Urination

Take finely powdered orpiment, an arsenic-containing mineral drug that is toxic and must be used with caution, mix with honey into a pill about the size of a date pit, and insert it about half a cun into the urethral opening. Alternatively, use a bamboo tube to inject the medicine into the anterior yin, causing a slight stinging sensation; urination will then become free.

Another Formula for Promoting Urination

Take three liang of talc, a mineral drug that promotes urination and clears heat, and one ge of Tinglizi, the seed of a cruciferous plant that drains water and promotes urination. Add two sheng of water, boil down to seven ge, and divide the dose for administration.

Another Formula for External Application

Pound raw scallion and apply it to the lower abdomen. When the scallion dries, replace it with fresh scallion, repeating the change.

Treating Fullness and Stuffiness in the Chest and Hypochondrium, Oppression at the Pit of the Stomach, and Rapid Breathing with Panting

Use one liang each of ginseng and Atractylodes macrocephala (Baizhu), two liang of “Genshi,” a medicinal substance whose identity is difficult to determine today, and one liang of dried ginger. Pound them together, blend with honey into pills, and take one pill each time. If cough is present, add two liang of Gualou (Trichosanthes); if vomiting is present, add two liang of Muli (oyster shell). Take five or six pills each day and night; if not yet cured, continue taking them.

Treating Swelling and Pain of the Throat Caused by Toxic Illness

Take Phytolacca root, called “Danglu” in the original text, a toxic plant root that reduces swelling when used externally. Slice it, roast until hot, place a cloth pad over the throat, and place the hot slices on the cloth. Replace them when they cool.

Another Formula for Holding in the Mouth and Chewing

Take “true eggplant,” whose plant identity is difficult to determine today, in an amount about the size of a fingernail, put it in the mouth, and chew until juice is released. Hold the juice to moisten the throat. A slight unusual sensation indicates that it is effective.

Treating Pathogenic Toxin Attacking the Eyes After Toxic Illness

Boil honeycomb, that is, exposed honeycomb, which has detoxifying and swelling-reducing effects, and take the liquid to wash the eyes six or seven times a day.

Another Formula for Cold Compress

Soak a piece of blue cloth in cold water and cover the eyes with it.

If a Corneal Opacity or Membrane Forms in the Eye

Take fourteen grains of douchi, light fermented soybean, burn them charred, grind them into powder, and blow the powder into the nose with a bamboo tube. A slight unusual sensation indicates that it is effective.

Formula for Treating Persistent Vomiting Due to Cold-Damage

Use one liang of licorice root, half a liang of cimicifuga (shengma, a medicinal herb), three liang of fresh ginger, and two liang of tangerine peel (that is, aged tangerine peel). Add three sheng of water and decoct until two sheng remain. Take it all at once, and the illness will be cured.

Another formula: dried ginger six fen and aconite four fen. Grind into a fine powder, mix with bitter wine (that is, rice vinegar), and form pills the size of parasol-tree seeds (about the size of a soybean). Take three pills each time, three times a day. (Shanghan, or cold-damage, broadly refers to acute febrile diseases caused by wind-cold and the like.)

Formula for Treating Dry Retching and Incessant Hiccups Due to Cold-Damage

Use three liang of licorice root and one sheng of tangerine peel. Add five sheng of water and decoct until three sheng remain. Divide into several doses and take three times a day until cured.

Another formula: grind prepared pinellia (a medicinal tuber) into a fine powder. Take one qian each time (an ancient unit of weight, about 3 grams).

Another formula: take one handful of perilla (red perilla), add three sheng of water, and decoct until two sheng remain. Drink slowly in divided doses.

Record of “Captive Sores”

In recent years an epidemic has been prevalent. When it occurs, sores appear on the head, face, and whole body, quickly spreading over the entire body. They resemble burns, and each sore top contains white serous fluid. Once squeezed or broken, new sores keep forming. If not treated promptly, most severe cases die. Even after recovery, the scars are purplish-black and take several years to fade. This is a virulent, noxious qi.

Folk accounts say that in the fourth year of Yonghui (653), these sores spread from west to east and reached the Haizhong region. People boiled mallow and ate it mixed with mashed garlic, and this could stop them. At the first onset, eat it promptly; eating less rice and taking it together with the vegetables is also effective. During the Jianwu era of the Eastern Han, while attacking the enemy at Nanyang, this disease was found among captives, and so it was called “captive sores.” Physicians jointly studied it and drew up the following treatments, which were verified as effective.

Take top-quality honey and smear it over the whole body; one may also decoct shengma with honey and take it repeatedly.

Another formula: decoct shengma strongly in water, dip cotton cloth in the medicinal liquid, and wash the affected areas. Soaking in bitter wine (vinegar) is more effective, but it causes unbearable pain.

For the treatment of the remaining conditions, one may still follow the Shanghan (Cold Damage) methods, but should take extra precautions to prevent invasion by toxic pathogens. Dihuang black paste may also be used, and it is effective as well.

For the formula treating seasonal epidemic jaundice: Yinchen (Artemisia capillaris) six liang, Dahuang (rhubarb) two liang, and Zhizi (gardenia fruit) twelve pieces. Add one dou of water, first boil the Yinchen down to five sheng, remove the dregs, then add the Dahuang and Zhizi and boil down to three sheng. Divide into four doses. One may also use other methods for treating jaundice at the same time, and the illness will be cured.

In recent years another disease has appeared, called “Luhuang disease” (“Lu” was the ancient name for northern peoples and is used here as a disease name). At first the patient only feels heaviness and discomfort in the limbs; soon the eyes begin to turn yellow, the yellow gradually spreads to the face, and finally the whole body becomes yellow. At this point the patient should promptly be made to urinate on white paper. If the paper is stained a color like that of Huangbo (Phellodendron) juice, it indicates that heat toxin has penetrated deeply into the body, and treatment must be given immediately. If it is discovered at the very onset, a powder made from melon stalk (Gua Di) and red adzuki beans may be insufflated into the nostrils (melon stalk has an emetic effect); if several sheng of yellow fluid flow from the nose, most patients can recover. If the illness is already relatively deep, one should inspect both sides under the tongue for faintly visible white veins and cut them open with a reed knife (Lu Dao), releasing several sheng of purple blood; the condition will then also be alleviated. But this method must be performed by someone skilled in cutting techniques. If an inexperienced person mistakenly injures the blue veins under the tongue, the bleeding will not stop and will cause death.

In addition, one may heat a fangling iron (an iron implement whose exact form is unknown) until red-hot and cauterize these veins until they are charred black; at the same time, take pills made by pounding melon stalk and croton seeds (Badou), and yellow fluid will also be discharged with the stool and urine. After cauterization, all kinds of miscellaneous foods must be avoided. Some also say that similar conditions such as “Huangzuo” and “Huangfu” need to be distinguished.

The following are several formulas: One formula is to cut bamboo into pieces, boil them in water, and drink the liquid like tea at any time. Another formula is to mash fresh melon root, squeeze out the juice, and drink one to three sheng. Another is to soak eggs in vinegar overnight and swallow several egg whites. Another is to take five sheng of cut bamboo leaves, seven sheng of wheat, and three liang of gypsum ground to powder, wrap them in cotton cloth, add one dou and five sheng of water, and boil down to seven sheng; take one sheng each time, and when all of it has been taken, recovery will follow.

Oral formulas

This set of prescriptions from the Zhouhou Beiji Fang treats swelling and pain of the hands and feet caused by “toxin” (referring to heat toxin and sore toxin) with both oral and external formulas.

For the first oral formula, pound fresh kudzu root (the root of a vine, cool in nature and able to clear heat) to obtain two sheng of juice. Add one sheng of good-quality light douchi (made by fermenting black beans; it clears heat and relieves restlessness), twenty-one gardenia fruits (the fruit of a shrub, cold in nature and able to drain fire), and one sheng of chopped yinchen (an Artemisia herb that clears heat and drains dampness). Add five sheng of water, decoct until three sheng remain, strain out the residue, then add the kudzu juice and divide into five doses.

For the second, take a yellow-footed hen, collect its blood, and handle it as in ordinary cooking. Then add one sheng of cooked douchi, twenty-one gardenia fruits, and one sheng of chopped yinchen; add five sheng of water, decoct until three sheng remain, strain out the residue, add the kudzu juice, and divide into five doses.

For the third, follow the same method and eat all the chicken meat and broth. If this is not enough, prepare another batch. When taking it, it is best to add a little salted douchi.

External washing and topical formulas

Chop Japanese knotweed root (the root of a perennial herb, which invigorates blood and disperses stasis) and boil it; when the liquid is suitably warm, soak both feet in it until a little reddish seepage appears above the ankles, then stop.

Soak the feet in the alkaline liquid leached from the ashes of burned rice straw.

Boil kushen (Sophora flavescens, a leguminous herb that is cold in nature and clears heat and dries dampness) in wine, take the liquid, and soak the feet; this cures the condition.

Pound salted douchi together with one sheng of sheep urine into a paste and apply it to the affected area.

Take five jin of huangbo (Phellodendron bark; its bark is used medicinally and it clears heat and dries dampness), chop it finely, add three dou of water, boil, and use the liquid to soak the affected area; it can also treat swelling and pain of the genital region.

Dig a pit about three chi deep and large enough to hold both feet; heat it, pour wine into it, then squat over the pit wearing wooden clogs and cover it with something so the hot vapor does not escape; this is a fumigation method.

Boil yangtao (a vine) and use the liquid to soak the affected area; adding a little salted douchi improves the effect.

Soak the feet in the liquid from boiled horse dung or sheep dung.

Mix lard with sheep dung and apply it; the effect is also good.

Wrap the swollen area with beef; the swelling subsides and the pain stops.

Pound Changsi grass (the name of a medicinal herb), wring out the juice, and soak both feet in it.

Boil one pig trotter with scallions, strain out the residue, add a little salt, and use the broth for soaking.

Sores on the lower body

When a toxin disease develops on the lower body and sores form, heat an instrument and insert it into the opening of the sore to draw out the pus and toxin, no more than three times.

Another formula: apply raw lacquer (the natural sap tapped from the lacquer tree) to cotton wadding and insert it into the affected area.

Another formula: roll moxa floss into a large ball and use moxibustion to warm the lower region. This refers to a method for when one is poor and has no medicine available.

Another formula: take three sheng of earthworms, add five sheng of water, decoct down to two and a half sheng, and take it all.

Another formula: boil peach tree bark, decoct until thick like maltose, dip cotton wadding in it, wrap it, and insert it into the affected area.

Another formula: pound water fringe into a paste, wrap it in cotton wadding, and insert it; change it five times a day, and the illness will be cured.

Another formula: combine elm bark (zelkova bark) and oak bark, boil them to make a decoction, reduce until thick like syrup, and use it for insertion into the affected area. In addition, strongly decoct peach tree bark and take it; this is most effective.

Another formula: pound mock strawberry to obtain its juice and take three ge each time, three times a day. At the same time, soak black plums in water until the liquid is strong, add cliff honey (wild honey produced on cliffs), and drink it frequently.

If the patient’s teeth lose their luster, the tongue becomes white, or the patient tends to sleep, is drowsy and muddled, cannot tell where the pain or itch is, or suffers from diarrhea and dysentery, the lower region should be treated promptly. The medicinal decoction should be concentrated, and it should be taken frequently together with cliff honey.

For the same symptoms, the lower region should be treated urgently. People who do not understand this principle treat only the upper part and pay no attention to the lower region; then worms will develop in the lower region. The worms burrow into and eat the anus, and the anus ulcerates to the point that the five viscera can be seen; the patient will then die. The treatment methods are as follows:

Take egg white, mix and stir it evenly with raw lacquer, pour it back into the eggshell, tilt the head back, and swallow it; when worms are vomited, the patient will recover.

Another formula: burn horse hoof into ash, grind it into a fine powder, mix it with lard, apply it to cotton wadding, and insert it into the lower region several times a day; the illness will be cured.

Another formula: fifteen peach kernels, two sheng of vinegar, and one ge of salt; boil them together until six ge remain, and take it.

Another formula: burn moxa in a bamboo tube and fumigate so that the smoke enters the lower region, adding a small amount of realgar and other medicinal substances. This formula is designed for “Xiwen” (an ancient disease name), so it also employs the treatment method for that disease.

There are also patients suffering from unceasing □ below; use two liang of aconite, one liang each of nüwei and yunshi, and two fen of cinnamon; make them into honey pills the size of tongzi seeds; take five pills with water each time, three times a day.

Note: These are ancient external and oral formulas, mostly empirical records that have not been verified by modern medicine. Raw lacquer, realgar, and aconite are all toxic; do not imitate or use them. If you have symptoms in the lower region, seek medical attention promptly.

First formula: For treating sudden pain in the lower body (referring to the anterior and posterior yin and other lower-body areas), with piercing pain like being pecked by a bird. Take one sheng each of adzuki beans and soybeans, pound them together, steam until cooked, then divide into portions and use honey to form pills the size of wutong seeds. Take five pills each time with water, three times a day.

Second formula: To treat the same illness, pound one sheng each of the above two beans together, divide the mixture into two cloth bags, steam until thoroughly hot, then sit alternately on the bags to apply hot fomentation; recovery will follow.

These two formulas were originally collected under the category of “Miscellaneous Treatments,” because this type of illness is also caused by the pathogenic toxin of cold damage. There are therefore many formulas for treating cold damage. Among them, more than twenty formulas—such as Mahuang, Gegen, Guizhi, Chaihu, Qinglong, Baihu, Sishun, and Sini—are all very important, but their medicines are difficult to assemble completely, and diagnosis and pattern differentiation must be clear and detailed; one should consult them separately in the major formulas. Here only the first four formulas are recorded, because they are the most urgent. “Yellow Paste and Red Powder” is recorded in the chapter “Avoiding Disease” (preventing epidemic pestilence and averting pathogenic qi); it can be prepared in advance, and as soon as one feels any bodily illness, it should be taken immediately.