《葛仙翁肘后备急方》Vol. 2

The ancients regarded Shanghan (cold damage), shixing (seasonal epidemics), and wenyi (warm epidemics) as the same class of illness; their names differ only because the source of onset differs slightly.

Contracting cold in winter, or being exposed to wind and cold during strenuous labor or profuse sweating, with onset in summer, is called “Shanghan.” When winter is not very cold, there is much warm qi and frequent west winds, causing the sinews and bones to slacken and leading to laziness and illness, with onset in spring, it is called “shixing” (a disease that prevails according to the season). If in a given year there is pestilential qi, mixed with ghostly pathogenic and toxic qi that infect one another, it is called “wenbing” (warm disease). These illnesses have similar symptoms and diagnostic bases, while the term “Shanghan” is more refined and orthodox, so they are collectively called “Shanghan”; popular usage continues the name “shixing.” The “Five Warm” diseases spoken of in Daoist arts such as Fulu (talismans and registers) also differ from one another, but in the end they follow the same path. Their differences lie mainly in patterns such as Yangming, Shaoyang, yin toxin, and yang toxin (Yangming and Shaoyang are the levels where pathogenic qi resides in six-channel pattern identification). Shaoyin disease (pathogen entering the Shaoyin channel) generally does not produce fever but presents with abdominal distention and fullness and diarrhea, and is the most difficult to treat.

Supplementary Formulas

The Bixiao Fang (a Tang dynasty formulary) treats patients with tianxing disease (epidemic seasonal qi disease) of one or two days’ duration: take one liang of mahuang (Ephedra), remove the nodes, add four sheng of water; after bringing to a boil, skim off the froth; decoct to obtain two sheng; remove the dregs; then add one spoonful of rice and douchi (fermented soybeans), cook into a thin congee, and take one sheng of the relatively thick liquid. First prepare hot water, use it to bathe and pour over the head more than a hundred times; then take the congee and cover with a thick quilt to induce sweating. Taking it at night is most effective.

The Meishi Fang (a Tang dynasty formulary), for Shanghan that remains unresolved after sweating, already three or four days, with vexation and oppression in the chest and a desire to vomit: take one sheng of douchi and one ge of salt, add four sheng of water, decoct until one and a half sheng remain, and take in divided doses; after taking it, vomiting should occur.

The Shenghui Fang (the Taiping Shenghui Fang, an officially compiled Northern Song formulary), for Shanghan on the fourth day, when vomiting has already occurred and emesis is again indicated: same as above; take one sheng of douchi and one ge of salt, add four sheng of water, decoct until one and a half sheng remain, and take in divided doses; after taking it, vomiting should occur.

The Shenghui Fang: for Shanghan on the fourth day, when vomiting has already occurred and emesis is still indicated: take Kushen (Sophora root) ground into powder, take two qian with wine; once vomiting occurs, the illness is cured.

The following are several formulas from Ge Xianweng’s Zhouhou Beiji Fang.

The first treats heat toxin caused by seasonal epidemic qi, with symptoms of mental restlessness, agitation, and irritability: take half a large spoonful of lantan (that is, dianhua, a blue dye that can also be used as medicine) and wash it down with one cup of freshly drawn well water.

The second treats headache that does not stop due to seasonal qi: take three liang of puxiao (that is, mangxiao, a sulfate mineral medicine), crush and grind it into a fine powder, mix it with raw sesame oil into a paste, and apply it to the top of the head.

The third treats irritability, heat, and thirst caused by seasonal qi: take one medium cup of fresh lotus-root juice, add one ge of raw honey, mix well, and take it in two doses.

The Shengjin Fang records: for seasonal epidemic febrile illness with mental confusion, delirious speech, and internal agitation, take any amount of kushen (Sophora root), stir-fry until yellow, and grind into a fine powder. Take two qian each time, add one cup of water, decoct down to eight-tenths, and take warm. Decoct and take three times in succession; whether or not sweating occurs, complete recovery will follow.

The Boji Fang (a Northern Song medical text) records the “Heilong Dan” (Black Dragon Pill) for treating yin-toxin and yang-toxin Shanghan (cold damage; the ancients divided Shanghan according to the nature of the illness into the two toxins, yin and yang). The first method of use is: take any amount of imported high-quality sulfur, stir-fry until yellow, and grind fine. Take two qian each time, add one cup of water, decoct down to eight-tenths, and take warm. Take it three times in succession; whether or not sweating occurs, improvement will follow.

The second method of preparing Heilong Dan is more elaborate: take one liang of imported sulfur and grind it with a willow-wood pestle for three days; take one liang of croton seeds (badou), recording the number of seeds while they are still in their shells. Use a small pot with a two-sheng capacity. First spread the sulfur on the bottom of the pot, put in the croton seeds, and cover them with another layer of sulfur. Pour in about half a sheng of rice vinegar and soak thoroughly. Cover tightly with a bowl, wrap the outside with layer upon layer of wet paper, and seal firmly so that no vapor escapes; when the paper dries, moisten it again with vinegar. Simmer slowly over alternating gentle and fierce heat, and someone must watch over it. When the bursting sounds of the croton seeds in the pot have reached the halfway count, immediately remove from the fire and quickly pour into a stone mortar and pound fine. Then add a small amount of rice vinegar and steamed cake (a wheat-flour food used here as a binder) and pound together until evenly mixed. After it cools, roll it into pills the size of a chicken head. For yin toxin, take forty-nine Sichuan peppercorns and two scallion whites, add one cup of water, decoct down to six-tenths, and take one pill; for yang toxin, take forty-nine fermented black beans and two scallion whites, decoct them together, and swallow one pill; do not chew it.

Note: Croton seed is a drastic purgative with strong medicinal action and is toxic. Combinations of this kind in ancient formulas are for documentary reference only and should not be used as a basis for self-preparation or ingestion.

Sun Yonghe’s Formulas: For treating Yang toxin (a severe heat-type pattern in the ancient cold-damage doctrine) that has invaded the stomach. Take nine pills of the medicine, two scallion whites, and one cup of water; decoct down to six fen and take one pill. If it is Yang toxin, use forty-nine fermented black beans, two scallion whites, and one cup of water; decoct them together and swallow one pill without chewing it.

Sun Yonghe’s Formulas: For treating Yang toxin entering the stomach, with frequent bloody stools and unbearable abdominal pain. Take five larger curcuma tubers (yujin; a Chinese medicine, the tuberous root), one piece of cow bezoar (niuhuang; a precious Chinese medicine from ox gallstones) about the size of a Gleditsia seed, grind each separately into a fine powder, and mix them into a powder. For each dose, take one cup of vinegar-water (a liquid made by mixing vinegar and water), decoct together for three boils, and take it warm.

Sun Zhao’s Oral Formulas: A formula for treating Yin toxin cold damage (a severe cold-type pattern in the ancient cold-damage doctrine), with cold hands and feet, a deep and fine pulse, headache, and heaviness in the waist; it also treats cough with counterflow Qi (cough due to upward reversal of Qi) and other conditions caused by Yin toxin.

Take equal amounts of Sichuan aconite root (chuanwutou; the mother root of aconite, toxic and requiring processing) and dried ginger. First make them into a coarse powder, stir-fry until the color changes, let cool, and then pound into a fine powder. For each dose take one qian (about three grams), add one cup of water and a small pinch of salt, decoct to half a cup, and take it warm.

Another formula: For treating cold damage in which Yin predominance repels Yang (excessive Yin-cold Qi causes Yang Qi to be repelled outward, so there is internal dry heat but no desire to drink). The method is the same as above: take one qian of the medicine, one cup of water, and a pinch of salt; decoct to half a cup and take it warm.

Another formula: This also treats cold damage in which Yin predominance repels Yang. The patient will invariably have dry heat and no desire to drink water, and should take Pili Powder (“Thunderbolt Powder”). Take one piece of aconite, burn it into ash while retaining its medicinal nature, grind it into a powder, and take it mixed with honey water; one dose brings recovery. This method uses the medicinal power to drive out and disperse the cold Qi, allowing the internal heat to rise upward; after sweating, the illness is cured.

The Sheng Hui Fang: For treating Yin toxin cold damage with icy cold limbs, a hot compressing method is appropriate. Take one sheng of evodia fruit (wuzhuyu), mix it evenly with wine, put it into two damp silk bags, steam until very hot, and apply it to the soles of the feet. Stop the application once Qi and blood flow freely and the limbs become warm. This method has repeatedly proved effective.

A formula by Cui Yuanliang of the Tang dynasty: For treating seasonal illness with jaundice, with manic agitation, restlessness and heat in the chest, clouded consciousness, and failure to recognize people. Take one large yellow Trichosanthes fruit (gualou), soak it in nine ge of freshly drawn well water, wash and extract its juice, then add half a large ge of honey and eight fen of puxiao (mirabilite, a mineral drug). Stir until completely dissolved and take it in two doses; recovery follows.

The Waitai Miyao records: To treat Tianxing disease (seasonal epidemic pestilence, referring to an epidemic febrile illness) of four or five days, with binding accumulation in the chest, fullness, oppression, and pain, high fever, and generalized heat, take Kushen (Sophora root) one liang, chopped, add vinegar two sheng, decoct down to one sheng and two ge, and take the whole amount at once; after taking it, vomiting will bring recovery. For toxic Tianxing disease, if medicines such as Kushen and vinegar are not used, it is difficult to resolve; one may also cover up warmly and induce sweating to recover.

Another formula: For emergency treatment of vomiting with counterflow after Tianxing disease, inability to eat, and vomiting immediately upon eating, take sheep liver, cook it by the usual method, and prepare it as a bland food without salt, vinegar, or other seasonings; it will stop within three eatings.

Another formula: Take one chicken egg, boil it for three to five boilings, remove it, and soak it in cold water; when the shell has cooled but the inside is still warm, swallow it; the effect is good.

The Shenghui Fang records: To treat seasonal qi (that is, Tianxing disease) with vomiting with counterflow and inability to eat, use Banxia (Pinellia) half a liang, soak and wash it seven times in hot water to remove its slippery saliva (Banxia contains irritating components and must be processed), chop it together with fresh ginger one liang, add one large cup of water, decoct until six fen remain, remove the dregs, and take it warm in two doses, without restriction of time.

The Shenshi Fang records: To treat cold damage disease with incessant vomiting, cook Banxia until done, wash it clean, dry it, and grind it into a fine powder; take one qianbi (about one small spoonful) with ginger decoction.

The Jianyao Jizhong records: To treat cough caused by cold damage, incessant belching, and hiccup, use Xiang one liang and dried persimmon calyx one liang (persimmon calyx is good at descending counterflow and stopping hiccups); roast dry, pound into a fine powder, and take one qian with ginseng decoction, without restriction of time.

Treating Pestilence and Other Febrile Diseases

In epidemic diseases of toxic heat, if there is bleeding from the nose, it is caused by toxic heat. If several sheng of blood flow out, one may take ink powder (finely ground ink). Alternatively, make pills with egg white the size of parasol-tree seeds (about the size of a soybean) and take ten to twenty of them with raw rehmannia juice; after the patient has walked about five li, take another dose.

This also treats Cold Damage that has lasted eight or nine days to more than ten days, with great restlessness and thirst, abundant heat pathogen, and sores arising in the Triple Burner (the upper, middle, and lower regions, here referring generally to the whole body). There are often such symptoms as diarrhea, open mouth with protruding tongue, rapid breathing, ulceration of the eyes, sores in the mouth and nose, groaning and delirious speech, and failure to recognize people. This formula clears toxic heat and stops dysentery.

Formula One for Stopping Dysentery (from Waitai Miyao, also found in Meishi Fang)

Dragon bone (a traditional medicine, usually fossilized bones of ancient mammals), half a jin, crushed, with one dou of water added, decocted down to four sheng, then placed at the bottom of a well to cool. Take five ge each time, gradually increasing the amount; it may be drunk freely as desired, and is especially suitable for the elderly and children.

Formula Two for Stopping Dysentery (from Meishi Fang)

Treats unceasing dysentery with pus and blood after febrile disease, with inability to eat. Take white dragon bone ground into powder and administered with rice broth in the amount of one square-inch spoon.

Treating Cold Damage with Toxic Heat and Bloody Stool (from Shiliao)

Take powdered antelope horn; it takes effect immediately. It also treats hernia.

Treating Lower-Body Ulceration (from Shenghui Fang)

Treats huhuo disease caused by Cold Damage (a condition in which insect toxin causes ulceration of the mouth and lower body). The toxic pathogen erodes the lower body, and outside the anus it appears as though something has grown there, with unceasing pain and itching. Take half a liang of realgar. In a wide-mouthed bottle, put charcoal ash; place the realgar on top and burn it like incense. When the smoke rises, fumigate the affected area.

Another formula: Treats sores on the lower body after Cold Damage. Take three liang of smoked plum flesh, stir-fry until dry, pound into powder, and make pills the size of parasol-tree seeds with refined honey. Take ten pills before meals with a decoction of pomegranate root bark.

Treating Cold Damage with Hands and Feet So Painful They Seem About to Fall Off (from Waitai Miyao, Cui Family Formula)

Take sheep dung and boil it into a decoction to administer as a draught; the illness will stop. It also treats seasonal illness with heat and swelling of the scrotum and penis, and one may also wash the area with a decoction of Phellodendron bark (huangbo, also called huangbai).

The Meishi Fang records: To treat pea-shaped sores that appear after cold damage and have not yet suppurated, grind mangxiao (mirabilite, a mineral drug containing sodium sulfate) into a fine powder, mix it evenly with pig bile, and apply it to the sores; this is effective.

The Jingyan Houfang records: This treats pea-shaped sores and red sores caused by seasonal acute febrile illness.

Another entry in the Jingyan Houfang: If pea-shaped sores and red sores have not erupted properly, and the patient is restless and confused, manic and agitated, short of breath, raving, or even seems to see ghosts and spirits, grind one qian of longnao (borneol, about 3 g) into a very fine powder, then immediately drip pig heart blood into it and mix it into pills the size of a euryale seed (qianshi, literally “chicken-head flesh”). Take one pill each time, swallowed with a decoction of zi cao (Arnebia or Lithospermum). Before long the mind becomes calm, the patient can sleep, and the sore poison comes out; afterward, if cared for in the usual way, there will be no danger.

The Yaoxing Lun (a Tang dynasty work on materia medica) says: Hu zhang (Polygonum cuspidatum, Japanese knotweed) can treat high fever and restlessness, quench thirst, promote urination, and clear and resolve various heat toxins. In summer, decoct it together with licorice; the decoction is amber-colored, pleasing, and sweet-tasting. Put the strained decoction in a bottle, lower it into a well until thoroughly chilled, then pour it into white porcelain or silver vessels and sip it slowly like tea. People of the time called it “cold drink” (lengyinzi); it was even better than tea. It can also break through blocked menstruation in women: pound it, steep it in wine, and take it regularly. Pregnant women, however, must not take it, because it can break the blood.

Formulas for Treating Various Relapses and Exhaustion after Seasonal Epidemic Disease (Fourteen)

This section discusses the dietary and restorative prohibitions after recovery from an acute febrile infectious disease (a “poison disease”), as well as rescue formulas for when a severe illness has just arisen, or when early rising and work, or excessive eating and drinking, bring the patient to the point of death.

For anyone who has had a poison disease, within one hundred days after recovery he must avoid pork, dog meat, mutton, and all kinds of blood foods; he must also avoid fatty fish, fish that has been kept a long time and turned greasy, and dried fish. Eating these will certainly cause severe diarrhea, and once the diarrhea begins it is difficult to rescue. He should also avoid wheat-flour foods, garlic, Chinese chives, Chinese scallion (jiao tou, Allium chinense), raw vegetables, shrimp, and the like. Eating these mostly leads to relapse, makes the disease hard to cure, and causes repeated attacks over many later years.

Formula for treating the first onset of severe illness, or early rising and labor, or excessive eating and drinking that may lead to death: calcine turtle shell (the dorsal shell of a soft-shelled turtle) and take one square-inch spoonful (fangcunbi, about one small spoonful). Another formula: take a small amount of hu fen (lead powder) with water; it is toxic and must be used with caution.

Another formula: take three sheng of rice flour (fen means flour ground from grain), mix it with warm water, and take it; then cover with thick quilts to induce sweating.

Another formula: take one handful of dried perilla (su), add five sheng of water, boil down to two sheng, and drink it all. If dried perilla is unavailable, fresh may also be used; additionally add four liang of fresh ginger and one sheng of douchi (fermented black beans).

Another formula: take fourteen mouse droppings pointed at both ends and five ge of douchi (ge is an ancient capacity unit; ten ge make one sheng), add three sheng of water, and decoct until half remains; take it in one dose. After taking it, cover with blankets to induce sweating, and recovery will follow. If hemp seed kernels are available, add one sheng, plus another sheng of water; the effect is better. One may also add zhishi (bitter orange) and a tiger’s-mouth quantity of scallion whites.

Another formula: take eggshells from eggs incubated by a hen, break them up, stir-fry until yellow and black, grind into a fine powder, take one ge with hot water, and cover with blankets to induce sweating.

Another formula: take two liang each of dahuang (rhubarb) and mahuang (ephedra), fourteen zhizi (gardenia fruits), and one sheng of douchi; add five sheng of water, boil down to three sheng, and divide into two doses. Some sweating or diarrhea should occur.

Another formula: decoct ganpi in a strong concentration and take it; lugen (reed rhizome) is also good.

If the illness relapses and occurs repeatedly, charred rice may be sifted and ground into powder; taking one fangcun bi (about one small spoonful) is best.

The above methods are used to treat laofu (recurrence due to overexertion after recovery) caused by excessive sexual activity, swelling of the scrotum, or retraction of the scrotum into the abdomen with abdominal colic, or sudden fainting.

Another formula: burn a woman’s menstrual cloth and take one fangcun bi orally.

Another formula: take one □zi, strike it thirty-six times, place it in the doorway, and make it pant to the utmost; then pierce its hypochondrium, take one sheng of blood, mix it with one sheng of wine, and drink. If the blood cannot be obtained at the moment, taking the blood alone is also acceptable, but under no circumstances should it be allowed to become cold. A jia □ should be used.

Another formula: take clothing worn by a woman who has had sexual intercourse and cover the man with it; after the time it takes to eat a meal, he will revive.

Another formula: Take the shin bone of a boar—the original character is illegible—together with its blood, mix with wine, and administer; the illness will immediately be cured.

Another formula: Scrape two sheng of the green inner layer of fresh bamboo (bamboo shavings), add three sheng of water, boil until it has bubbled five or six times, then wring out and remove the residue, and take the bamboo-shaving decoction warm.

Another formula (the same as the preceding one).

Another formula: Scrape two sheng of green bamboo shavings, add three sheng of water, boil until five or six ebullitions, then strain out the residue and take the decoction warm. This formula can also be used to treat “lao fu” (relapse caused by overexertion after illness).

Another formula: Take one part alum and three parts xiaoshi (that is, saltpeter), grind into a fine powder, mix with the clear supernatant of barley gruel, and administer one fangcunbi; the heat toxin in the body will then be discharged with urine and stool.

Another formula: Take a large handful of Polygonum seeds, add water, rub and knead to extract the juice, and drink one sheng. If the dried product is used, decoct it strongly and take the juice. Separately pound scallion bulbs, mix with bitter wine (vinegar), and administer; this is also effective.

Another formula: Take several sheng of earthworms, wring out the juice, and administer; the effect is very good.

After recovery from illness, if a sick man has sexual intercourse with a woman, or a sick woman with a man, the healthy person who has intercourse with the patient will be infected; this is called “yin yi.” The patient will relapse, and one who relapses will certainly die.

Sudden yin yi disease means that after men and women have recovered from a warm disease (febrile illness), even if several tens of days have passed, their blood vessels are not yet harmonized and residual heat toxin remains in the body. A person who has intercourse with them will contract the disease, which is called “yin yi.” This disease is even more lethal than seasonal epidemics, and it should be treated promptly.

The symptoms of this disease are: heaviness of the body, acute heat in the lower abdomen, swelling of the upper body, chest tightness and distension, a head so heavy that it cannot be lifted, a film forming over the eyes, cramping and painful spasms of the knees and calves, and a condition close to death. The treatment is as follows:

Cut off the crotch portion (the part near the genital area) of a woman’s undergarment worn close to the body, burn it to ash, and administer one fangcunbi each time, three times a day. When urination becomes free and there is slight swelling of the genital area, this indicates that the illness is about to resolve. Using a virgin girl’s trousers is even better. If the patient is female, one may also use the crotch portion of a man’s undergarment, likewise burned to ash and administered.

Another formula: Take fourteen pieces of rat feces pointed at both ends and one handful of indigo plant (a herb from which indigo can be extracted), add five sheng of water, decoct down to two sheng, and take the whole amount; then cover with a quilt to induce sweating.

Another prescription: take twenty-four earthworms (dilong), add one dou of water (an ancient capacity unit, about two thousand milliliters), boil down until three sheng remain, and take it all at once. After taking it, induce sweating; the effect is very good.

Another prescription: take four liang of dried ginger powder, mix it with hot water, and take it all at once. Cover with a blanket to keep warm and induce sweating; stop once the illness is cured.

Another prescription: when a man has just begun to feel unwell, apply moxibustion to the genital region for twenty-one cones (in moxibustion, a cone of mugwort is burned at the point; one burning is called one cone). If the moxa cones have already been used up, one may continue moxibustion up to one hundred cones, and he will recover. There is no need to worry about the eyes; the sores and ulcers on the external genitalia will also return to normal.

“Two men and two women do not exchange with each other; thus the name yi means the exchange of yin and yang”: this means that when two men and two women do not exchange with one another, it is called “yi,” referring to the mutual transformation of yin and yang.

For anyone who wishes to treat the illness, applying moxibustion up to one hundred cones will bring recovery; the eyes will not be affected, and the sores and ulcers on the external genitalia will also heal.

If the patient remains uncured after long treatment, take ten fingernails and ten toenails from a woman, then take one chi of a woman’s lower skirt sash and burn it to ashes; take it with wine or rice broth.

After recovery from a serious illness, even slight exertion may cause nosebleed.

Take ten parts calcined oyster shell (the shell is calcined before use as medicine and has an astringent, sweat-checking effect) and five parts gypsum (a mineral drug that clears heat), grind them into a fine powder, and take one fangcunbi (a small spoonful) with wine, three or four times daily. They may also be made into honey pills the size of wutong seeds and taken in the same way.

After recovery from a serious illness, if there is much spontaneous sweating, as well as sweating from the eyes, the following prescription may be used.

Take equal amounts of Eucommia bark and oyster shell, take them with water before sleep, and stop after taking five spoonfuls; if the sweating still does not stop, take one more dose.

Another prescription: take two liang of licorice root and two liang of gypsum, grind them into powder, and take one fangcunbi with jiangshui (a slightly sour fermented rice broth), twice daily; this will cure it.

Another prescription: grind dragon bone (ancient animal fossils, with an astringent, sweat-checking effect), oyster shell, and ephedra root into powder, mix with rice powder, and dust it on the body; the effect is very good.

Also, if after recovery there is still deficiency restlessness and inability to sleep soundly, grind two liang of gypsum into powder and take one fangcunbi with jiangshui, twice daily; this will cure it.

Another prescription: as above, grind dragon bone, oyster shell, and ephedra root into powder, mix with rice powder, and dust it on the body; the effect is very good.

Also, if after recovery there is still deficiency restlessness, inability to sleep soundly, eye pain, and vexation and distress, take seven ge of fermented black beans (a ge is a capacity unit; ten ge make one sheng) and fourteen black plums, add four sheng of water, first boil the black plums until two and a half sheng remain, then add the fermented black beans and boil until one and a half sheng remain; divide into two doses. If black plums are unavailable, fourteen gardenia fruits may be used instead.

Another formula: four liang of Coptis root, two liang of peony root, one liang of Scutellaria root, and three small pieces of donkey-hide gelatin (Ejiao, gelatin made from donkey hide); add six sheng of water and decoct until three sheng remain, then divide into three doses. Two egg yolks (the original text reads “ruzi huang”) may also be added.

Another formula: take one shi of thousand-li flowing water (river water that has flowed far from human habitation, which the ancients regarded as the purest), stir it repeatedly ten thousand times, and take out two dou and a half. Add two liang of washed Pinellia tuber, one dou of shu millet (sticky broomcorn millet), and four liang of Poria; boil together until five sheng remain, and divide into five doses.

Supplementary Formulas

The Meishi Fang (Master Mei’s Formulas), a Tang-dynasty formula book by Mei Shi, records: for cold damage (a febrile illness caused by externally contracted cold pathogen) that relapses after recovery because of sexual intercourse, with the patient so exhausted as to be near death, unable to open the eyes, and unable to speak, the formula is: thirty gardenia fruits; add three sheng of water, decoct to one sheng, and take.

Chapter Fifteen: Various Formulas for Treating Miasmic Qi, Pestilential Epidemics, and Warm Toxins

This chapter records various formulas for treating miasmic qi (toxic qi in the hot, damp mountain forests of the south), pestilential epidemics (contagious plague), and warm toxins (epidemic diseases of the heat-toxin type).

Pestilence-Averting Medicinal Dry Powder: one liang each of hemp seed (Huomaren, i.e., Cannabis seed), arborvitae seed (Baiziren), dried ginger, and Asarum; half a liang of aconite (prepared aconite, to reduce toxicity). Pound and sift into a powder. On the early morning of the first day of the first lunar month, take it with well-flower water (the first well water drawn at dawn); each member of the household takes one fangcunbi (the amount of a one-square-inch medicine spoon). When an epidemic is severe, take it three times daily; at ordinary times, take it once daily.

Lord Lao’s Divine-Clarity White Powder: one liang of Atractylodes, three liang of aconite, four liang of Aconitum root (Wutou), two and a half liang of Platycodon root, and one liang of Asarum; pound and sift. On the first day of the first lunar month, take one qianbi (a small spoonful). If the whole household prepares and takes it together, then all the people of the entire neighborhood will not fall ill, and pathogenic qi encountered when going out or traveling will also disperse. If others have already fallen ill, take one fangcunbi with warm wine; this is also effective. If the illness has already lasted four or five days, decoct the powder in three sheng of water, take one sheng, and cover with a blanket to induce sweating.

Several formulas in Ge Xianweng’s Zhouhou Beiji Fang (Emergency Formulas to Keep Up One’s Sleeve) were mainly used to prevent and treat pestilence, miasma in mountain forests, and epidemics among cattle and horses. The medicines were mostly made into powders or pills and used together with inhalation, administration with warm wine, and covering with blankets to induce sweating.

Chisan Formula (Red Powder): Take mudan pi (tree peony root bark) five fen, zaojia (Chinese honeylocust pod) five fen (first roasted), xixin (Asarum), ganjiang (dried ginger), and fuzi (aconite) each three fen (fuzi is the daughter root of wutou; it is highly toxic and must be prepared), rougui (cinnamon) two fen, zhenzhu (pearl powder) four fen, and zhizhu (sheep rhododendron, toxic) four fen; pound and sift into a fine powder. As soon as one feels head distension and chest oppression, inhale a little of the powder into the nose and sneeze to expel turbid matter; then take one fangcunbi (about a small spoonful) with warm wine, cover up and sleep to induce sweating, and the illness will be cured. When going out in the morning or evening or visiting the sick, one may also carry a small quantity and dust the powder onto the body. To treat pestilence among cattle and horses, place one bi under the tongue, mix with urine (the original text writes “ni” for urine), and administer by drenching, three or four times a day; the effect is very good.

Duzhang Powder (Miasma-Crossing Powder): Used to avoid mountain miasma (damp-hot toxic qi in southern mountain forests). If black fog fills the air, or a warm wind blows from the southwest, both are regarded as signs that epidemic pestilence is about to arrive. The formula uses mahuang (Ephedra) and huajiao (Sichuan pepper) each five fen, wutou three fen, and xixin, baizhu, fangfeng, jiegeng, gui, and ganjiang each one fen; pound and sift into powder. In the early morning, take one zhanbi with wine; it can ward off all kinds of toxic miasma and evil qi, and is especially suitable to take when going out into fog.

Taiyi Liujin Formula: Xionghuang (realgar; an arsenic sulfide mineral, toxic) three liang, cihuang (orpiment; also an arsenic compound, toxic) two liang, fanshi (alum) and guijian (winged branches of Euonymus) each one and a half liang, and guyangjiao (ram’s horn) two liang; pound into a fine powder. Take one liang of the powder, put it into a triangular crimson silk pouch, wear it over the heart, and also hang it above the door. On the first day of every month, wrap a daogui (a very small amount) of the powder in blue cloth and burn it in the courtyard to fumigate; fumigate the patient in the same way, and recovery will follow.

Formula for Warding Off Seasonal Epidemics and Pestilence: Take equal parts xionghuang, dansha (cinnabar; contains mercury, toxic), badou (croton seed; strongly purgative, toxic), fanshi, fuzi, and ganjiang; pound and make into pills with honey. In the early morning, facing the sun, swallow one pill the size of a sesame seed; take for nine consecutive days and then stop; this can keep a person free from illness.

It should be noted that xionghuang, cihuang, and dansha in these formulas contain arsenic and mercury, while badou, wutou, fuzi, and zhizhu are all highly toxic. The therapeutic effects claimed in the original formulas lack modern evidence; people today must not imitate them and should rely on proper medical care.

Background: The Zhouhou Beiji Fang is traditionally attributed to Ge Hong of the Jin dynasty and was later supplemented by Tao Hongjing of the Southern Dynasties; it mostly collects simple and readily available emergency formulas and medicines. “Immortal Ge” in the title refers to Ge Hong.

Powder for Warding Off Warm Disease: A powder for preventing warm disease (referring to epidemic febrile disease and plague). Take one part each of pearl and cinnamon, and three parts of fritillaria; roast or stir-fry the fritillaria, then fry egg white until it turns yellow-black (take three parts), pound everything together, and sift. On the first day of the first lunar month each year, take one square-inch spoonful (about one small teaspoon). If epidemic disease is prevalent that year, take it once each on the first and fifteenth of every month. For those already ill, taking it should also produce a clear effect.

Tiger-Head Demon-Killing Formula: A formula for driving away evil and averting malevolent influences. Take five liang of tiger skull bone; one and a half liang each of cinnabar, realgar, and orpiment; and one liang each of guijiu (Dysosma), zaojia (Gleditsia pod), and wuzhuyu (Evodia; the original text reads “wuyu”). Pound and sift, blend with beeswax and honey, and knead into pills the size of a slingshot pellet. Place them in red cloth bags and tie them to the arm (men on the left arm, women on the right arm). In the home, hang them at the four corners of the room. At midnight on the first and fifteenth of each month, burn one pill in the courtyard. Another formula uses calamus and veratrum in place of tiger skull, guijiu, and zaojia, and is made into a powder to be carried on the person. (This passage is repeated in the original and has been merged here in translation.)

Zhao Quan’s Yellow Paste Formula: A paste used both externally and internally to treat wind pathogen. Take one liang each of rhubarb, aconite, asarum, dried ginger, Sichuan pepper, and cassia twig, and eighty croton seeds (remove the heart and skin). Pound them fine and soak in vinegar overnight; then fry them in two jin of lard from the twelfth lunar month. After three risings and three fallings, filter out the dregs and store in a honey jar. When redness and heat of the skin are first felt, take one pill the size of a parasol-tree seed; if there is no effect, it may be taken again. It may also be heated over fire and rubbed repeatedly on the body several hundred times, with very good effect. It can treat “thief wind” (in ancient usage, external pathogenic wind that suddenly invades the body) and wind pathogen that wanders through the skin. It may be prepared in advance and kept for use.

Note: Croton seed, aconite, realgar, and orpiment are all toxic medicinal materials. The dosages and processing methods of ancient formulas are difficult to master; do not prepare or use them on your own according to this text.

Separately Recorded Simple Methods: Take the southeast-side branch of a cypress beside the earth-god altar to the southwest, dry it in the sun, grind it to powder, and take one square-inch spoonful; it takes effect immediately. Another method: on the first yin day of the first lunar month, pound nüqing (a medicinal herb) into powder, put it in a triangular cloth bag, and hang it on the door or before the bed curtain; this is extremely auspicious. Another method: pound matimu (the wood referred to is unidentified), take two liang of the shavings, put them in a red cloth bag, and wear it, left for men and right for women. Another method: at dawn on the first day of the first lunar month, and in the seventh month, swallow fourteen grains each of hemp seed and adzuki bean; also throw fourteen grains each of hemp seed and adzuki bean into a well; then use two aconite roots (the original text does not state the method of use).

Another formula: take horse-hoof wood (a type of tree), pound it into fragments, two liang, put it into a red cloth bag, and wear it on the body; men wear it on the left, women on the right.

Another formula: on the early morning of the first day of the first lunar month and in the seventh month, swallow fourteen grains each of hemp seed kernels and small beans. In addition, throw fourteen grains each of hemp seed kernels and small beans into a well. Also, take two aconite roots and seven small beans, and have a woman throw them into the well.

Another formula: on the day of the winter solstice, take a rooster with red plumage, make it into cured meat, and at the Beginning of Spring (Lichun) boil it thoroughly and eat it all; do not share it with others. On a certain day in the second month, take a mulberry root growing eastward, as thick as a finger, hang it above the door, or have each person wear it on the body.

Another formula: bury one magpie in front of the latrine.

To block the spread of warm disease (acute infectious febrile disease, namely epidemic plague) so that people do not infect one another: cut hair, keep it seven cun long, and secretly place it under the sick person’s sleeping mat.

Another formula: use a rope to measure the length of the dwelling’s wall, then fold the rope in half and tie a knot.

Another formula: secretly use moxa sticks (dried mugwort, lit for moxibustion of acupoints) to apply one moxa cone (one zhuang) at each of the four corners of the patient’s bed; do not let the patient know, and the effect will be good.

Another formula: take small beans, put them in a new cloth bag, place them in a well, and after three days take them out; all males in the household take ten grains, and females take twenty grains.

Another formula: peach—use moxa to apply one cone at each of the four corners of the patient’s bed; do not let the patient know, and the effect is good.

Another formula: take small beans, put them in a new cloth bag, place them in a well, and after three days take them out; all males in the household take ten grains, and females take twenty grains.

Another formula: insect frass from peach wood, grind into a fine powder, and take one square-inch spoon (fangcunbi, the amount held by a one-cun-square spoon).

Another formula: burn abalone head into ash, take a three-finger pinch, add seven small beans, grind together into powder, and take; for women use twenty-seven small beans.

Another formula: after stir-frying fermented black beans, soak them together with soil in wine, and take frequently.

Another formula: secretly place a crucian carp under the patient’s bed; do not let the patient know.

Another formula: arborvitae seed kernels, asarum, [missing character] rice, and dried ginger, three fen each; aconite, one fen; grind into a fine powder, take one square-inch spoon with wine, three times daily for ten consecutive days.

Another formula: use malt, fu-[missing character] rice, and dried ginger; another account says hemp seed kernels may be used. All three methods may be taken.

Supplementary formula:

The plague-warding formula in the Waitai Miyao (Secret Essentials of the Outer Terrace) (a formula for warding off epidemic plague).

Note: Most of what is recorded in this passage consists of folk techniques by which the ancients prevented and treated epidemics through sorcery, apotropaic rites, and symbolic correspondences. The materials and practices reflect the beliefs and experiences of that time and should not be used as a basis for modern medical treatment.

Volume Three, Opening: Formula Sixteen for Treating Various Malarial Fevers with Chills and Fever

(This volume collects medicinal formulas for treating various types of malaria with alternating chills and fever; this entry is the sixteenth formula.)

Take high-grade cinnabar (a red mineral medicine containing mercury, regarded by the ancients as an important raw material for elixirs), and use malt (sprouted wheat grains, that is, malt) … take … rice, dried ginger … Another account says to make the medicine into pills the size of hemp seeds and take them in three divided doses.

Supplementary Formula

The Biwang Formula (Plague-Repelling Formula) from the Waitai Miyao (Arcane Essentials from the Imperial Library), a compendium of medical formulas compiled by Wang Tao in the Tang dynasty:

Take one liang of high-grade cinnabar (in antiquity one liang was roughly a little over ten grams today), grind it into an extremely fine powder, and mix it with white honey to form pills the size of hemp seeds. On every Taisui day (a specific auspicious day calculated according to the sexagenary cycle), early in the morning, all members of the household, old and young, should eat no other food, stand facing east (in the original text, “shu” is interchangeable with “dong,” east), and each swallow three or seven pills; then they will forever be free from plague.

Note: Cinnabar contains mercury and is toxic. The ancient formula is described only for understanding ancient medical thought and should not be taken on this basis.

Prescription for treating malaria (that is, malaria with attacks at regular times and alternating chills and fever): take fourteen woodlice (pill bugs) and fourteen fermented soybeans (douchi), pound them together into a paste, and mix well. Before the malaria attack begins, take two pills; when the attack is about to begin, take one more pill.

Another prescription: take one handful of sweet wormwood (a medicinal herb of the Asteraceae family), soak it in two sheng of water, wring out the juice, and drink it all.

Another prescription: place single-headed garlic (a garlic consisting of a single clove) on white charcoal (thoroughly burned charcoal), roast it, grind it into powder, and take one fangcunbi (a small spoon used for measuring medicinal powder).

Another prescription: on the fifth day of the fifth month, take one peeled clove of garlic and one handful of sweet wormwood, soak them in two sheng of water, wring out the juice, and drink it all.

Another prescription: hollow out a clove of garlic, insert one croton seed (croton is a potent purgative) with its core and outer skin removed, close the garlic up again, clamp it between bamboo slips, and heat it over a fire. Pound it into three pills. Take one pill before the malaria attack; if it does not stop, take one more.

Another prescription: put a spider into a reed tube, seal both ends, tie the tube around the neck, and untie it only after the time of the attack has passed.

Another prescription: just as the sun rises, face east and bow twice to the sun. Then kneel upright in the formal long-kneeling posture, face the sun, cross the hands, and hold the breath. Use ink to put seven drops into each ear canal, then write on the tongue with cinnabar and recite aloud, “Zi-day death.” When finished, bow again, turn and leave without looking back, lie down quietly, and eat nothing. Once the time of the attack has passed, you will recover.

Another prescription: cook plenty of douchi soup, drink several sheng, and make yourself vomit copiously; the illness will then be cured.

Another prescription: put a spider in cooked rice, shape it into a pill, and swallow it.

Another prescription: when the attack is near, pound large aconite root (a toxic medicinal root), sift it into powder, mix it with bitter wine (vinegar), and spread it on the back.

Another prescription: take four woodlice, wrap each in maltose (malt sugar), form them into pills, and take them; the illness will stop completely and be cured.

Another prescription: pound Changshan (a medicinal herb with emetic action), sift it, take three liang of the powder, mix it together with large aconite powder and bitter wine (vinegar), and spread it on the back.

Another prescription: take four woodlice, wrap each in maltose (malt sugar), form them into pills, and take them; the illness will stop completely and be cured.

1. Take changshan (a medicinal plant used in antiquity to treat malaria), crush it, sift it into a fine powder, three liang; add one liang of zhendan (that is, cinnabar), blend with white honey, pound again about a hundred times, and roll into pills the size of wutong seeds. Take three pills before the attack comes, three more when it comes, and three at bedtime; there is no case in which it does not root out the illness. It is commonly effective.

2. Open the mouth and use a cord to measure the distance from the upper and lower lips to the pit of the heart; apply moxa for one hundred zhuang (a zhuang being the unit of counting moxa cones) at the place where the end of the cord falls; then apply fifty zhuang at the midpoint of the spine. When the attack arrives, apply twenty zhuang more.

3. Take a single soybean, remove its skin, and split the bean into two halves; write the character "sun" on one half and "moon" on the other. Hold the "sun" half in the left hand and the "moon" half in the right, swallow them, and recovery is immediate. Take them facing the sun, and do not let anyone else know. (This is a talismanic procedure with no medicinal effect.)

4. Gleditsia (a plant whose pods contain saponin and which can be used as medicine) three liang, peeled and roasted; croton (a violently toxic purgative) one liang, with the heart and skin removed. Pound the two together, form pills the size of a soybean, and take one each time.

5. One croton seed, with heart and skin removed, together with an equal quantity of shegan (the original character is corrupt; this reading is inferred from the sense of the passage), plus one pitted jujube, pounded together into pills; each person takes one pill, of the size of a wutong seed, before the attack.

6. Equal quantities of changshan, zhimu, licorice, and ephedra, pounded and blended with honey into pills the size of a soybean; take three pills, finishing them before the attack comes. (The latter sentence is the same as in formula 5, and the method of preparation is as above.)

7. Equal quantities of changshan, zhimu, licorice, and ephedra, pounded and blended with honey into pills the size of a soybean; take three pills, finishing them before the attack comes.

8. Changshan three liang, licorice half a liang, with half a sheng each of water and wine added, boiled together down to half a sheng. Take one dose before the attack, then divide the remainder into three doses to be finished before the attack.

9. Changshan three liang, pounded, steeped in three sheng of wine for two or three days. In the early morning take three ge first (the ge being a unit of capacity); if you feel like vomiting, let it come up; near the time of the attack take two ge more, and the illness can be rooted out. Well-aged wine is better; in urgent cases it may also be boiled and taken.

10. Changshan three liang, three hundred grains of shu millet (a glutinous variety of millet), with six sheng of water added, boiled down to three sheng, and taken in divided doses, to be finished at the time of the attack.

Background note: Changshan contains antimalarial constituents, so the ancients had some basis for using it against malaria; but croton is highly toxic and cinnabar contains mercury, and many of the methods recorded in this book should not be copied and used on one's own. Malaria is an infectious disease that requires prompt diagnosis and treatment; modern care should be based on proper medical treatment.

Another formula: If the malarial attacks are irregular and there is vexing heat at the pit of the stomach, take two ge of old wine at the time of the attack, and the illness will stop. Aged old wine is more effective; if needed urgently, it may also be heated and taken.

Another formula: Take Changshan (Dichroa root, a toxic herb often used by the ancients to treat malaria but no longer a routine modern medication) three liang and three hundred grains of glutinous millet; add six sheng of water, boil down to three sheng, and take in divided doses, finishing before the attack.

Another formula: If the attacks are irregular and there is vexing heat at the pit of the stomach, take Changshan two liang and licorice root one and a half liang; add six sheng of water, boil down to two sheng, and take in two doses. Vomiting should occur soon after taking it, after which the illness will stop; do not eat or drink while taking the medicine.

To treat chronic malaria that has long failed to heal, use Changshan three liang, turtle shell one liang (roasted), Cimicifuga rhizome one liang, aconite one liang (aconite is also a toxic medicinal substance), and cuttlefish bone one liang; steep them in six sheng of wine and keep warm by a fire overnight, and it is ready. Take one ge each time; as the attack approaches, it may be taken several times.

Another formula: Take Hualu (Veratrum) and Gleditsia pod one liang each (roasted), and twenty-five Croton seeds (Croton seed is rather toxic); pound them together, stir-fry until yellow, then pound fine according to the method, and make honey pills the size of small beans. Take one pill on an empty stomach, one pill before the attack, and another pill when the attack is about to come; do not eat or drink while taking the medicine.

Another formula: Chop one handful of the stems and leaves of Achyranthes (Niuxi) and decoct them in three sheng of wine; take it so as to produce a slight wine feeling. If it does not stop immediately, it may be taken again, but it should be stopped after no more than three doses.

Another formula: One fangcunbi (about one small spoonful) of dragon-bone powder; one shichen (a traditional two-hour period) before the attack, boil it three times in one and a half sheng of wine, take it all while hot, cover with quilts to keep warm and induce sweating, and it will take effect quickly.

Another formula: Changshan three liang, licorice root half a liang, and Anemarrhena rhizome one liang; pound them, make honey pills, and stop after no more than three doses.

Another formula (the same as the preceding dragon-bone formula): as above.

Another formula: Changshan three liang, licorice root half a liang, and Anemarrhena rhizome one liang; pound them and make honey pills. Take before the attack: first take ten pills the size of wutong (parasol tree) seeds, then reduce successively to seven or eight pills, and finally take five or six pills, and the illness will be cured.

Another formula: Two shichen before the attack, use a charcoal fire under the bed to make the back and feet very warm, cover well with quilts, and continue until the time of the attack has passed. This method is suitable for malaria that begins with chills and then turns to fever.

Another formula: First roast turtle shell until yellow (zhi means roasting or processing with auxiliary ingredients such as wine or vinegar), pound it into powder, and take one fangcunbi each time (an ancient small measure for powdered medicine, roughly the amount held by a one-square-cun spoon). When the malarial attack comes, divide the dose into three parts and finish them; after taking it, warm the body by fire to induce sweating, and the malaria can be cut off.

Another formula: Take Changshan (a Chinese medicine with an action of checking malaria), three liang (in the ancient system, one liang was roughly equivalent to more than ten grams), pound and sift it, and mix it with egg white to make pills. Take thirty pills on an empty stomach; take another thirty pills before an attack, at a time rather long after a meal; take thirty pills at the time of the attack. After taking them, one may vomit or may not. From the time of taking the medicine until the attack time has passed, do not eat or drink.

For warm malaria with inability to eat: Use Anemarrhena (Zhimu), roasted turtle shell, and Changshan each two liang; Digupi (Lycium root bark) three liang (cut up); bamboo leaves one sheng (cut up); and gypsum four liang. Add seven sheng of water, boil down to two sheng and five ge, and take in three warm doses. Avoid garlic, hot noodles, pork, and fish. (Warm malaria refers to malaria with fever and relatively mild chills.)

For miasmic malaria: Zhang refers to the damp-heat toxic qi in the mountains and forests of the south. Use Changshan, Coptis (Huanglian), and fermented soybeans (douchi; used after decocting) each three liang, and aconite two liang (used after processing to remove toxicity). Pound and sift, and make honey pills. Take four pills on an empty stomach; when an attack is about to come, take three more pills, swallowed with water. After taking the medicine and until the attack time has passed, do not eat.

If there is also various dysentery: Use Coptis and rhinoceros horn (an ancient commonly used medicinal) each three liang; oyster shell and fermented soybeans each two liang (both should be roasted or stir-fried); and dragon bone four liang. Pound and sift, make honey pills, and take forty pills each time, twice a day, swallowed with water.

For attacks without a fixed time: Use Changshan two liang, licorice one and a half liang, and fermented soybeans five ge (wrapped in cloth). Add six sheng of water, boil down to three sheng, and take in two doses; after taking, induce vomiting. Another version is to pound the above medicines and sift them, make honey pills, and take forty pills each time, twice a day, swallowed with water. (This passage is repeated once in the original text.)

Regardless of how many years the illness has lasted, even thirty years can be treated: Use Changshan and Coptis each three liang, soak them overnight in one dou of wine, and the next morning boil them in an earthenware pot to obtain six sheng. Take eight ge each time before an attack, and it may be taken three times. When there is fever, it should cause vomiting; when there is aversion to cold, it should cause purging (diarrhea). Taken according to this formula, there is no case that is not cured; half a dose is enough.

Treating Chronic Malaria That Does Not Heal (Exhaustion Malaria)

Use one large “tiger’s-mouth” measure of large Achyranthes root (niuxi; the large root of Achyranthes, generally wild or thicker roots), add six sheng of water, and decoct until two sheng remain. Take one dose on an empty stomach, and take another dose when the malaria is about to attack.

Apotropaic Method: Expelling Various Kinds of Malaria

On the day of an attack, hold a rooster in your bosom and let it crow loudly for a time; it is said that there is no case that does not heal.

Another Formula: The Method of Writing the Character “Ghost”

Before the malaria attack, lie down with your head facing south. With a finger or a pen, at the five centers (the centers of both palms and both soles, or the chest/heart and the hands and feet—accounts differ among sources), the forehead, and the tongue—seven places in all—hold your breath and write one “ghost” character at each place.

Incantation Method

On the day of an attack, pick up a stone by the water and recite the incantation in one breath: “Yuan-yuan, yuan-yuan, travel by road is no hardship; seize the malaria ghost and deliver it to the River Official; swiftly, swiftly, as by statute and ordinance.” After reciting, throw the stone into the water and do not look back. (“Swiftly, swiftly, as by statute and ordinance” is a common ending in Daoist talismans and incantations, meaning to act quickly according to the command.)

Treating All Malarias: Black Plum Pill (Wumei Wan)

Use licorice, roasted black plum flesh, ginseng, cinnamon heart, Cistanche, Anemarrhena, and Moutan bark, two liang each; and Dichroa root, Cimicifuga rhizome, peach kernel (remove the skin and tip, then roast), and black soybean skin (roast until a film forms, then take the skin), three liang each. Grind the peach kernels finely and add them; pound and sift, then make into pills with honey. Pound ten thousand times in a stone mortar, then take them as follows: on the day of an attack, at the fifth watch take thirty pills with wine; at dawn take forty; when the attack is about to come, take forty. On days without an attack, take forty pills on an empty stomach and thirty at night. There is no case that does not heal; afterward, take it gradually. After ten-odd days, eat fatty meat to provoke a malarial attack.

Malaria Formula [□]

Roasted white donkey hoof, two fen; rhubarb, four fen; mung bean, three fen (ground to powder); arsenic trioxide, two fen; Guangming sha, half a fen; and realgar, one fen. Pound evenly and make into honey pills the size of wutong seeds. On the morning of the day of an attack, take two pills with cold water; for seven days avoid greasy food.

Note: Arsenic trioxide, realgar, and Guangming sha (cinnabar) all contain toxic components; arsenic trioxide is highly toxic and must not be taken on one’s own. Malaria today requires proper medical diagnosis and treatment.

Appendix Formula

This is the title of an appended formula; the main text does not appear in this passage, so its specific contents cannot be interpreted.

Waitai Miyao Fang: For malaria that has not healed over a long time. Take dried ginger and galangal (a pungent, warming herb) in equal parts, grind into a fine powder, and take one qian (about 3 g) each time. Decoct it in one medium cup (about one small cup) of water until reduced to seven-tenths, and take it warm.

Shenghui Fang (I): For chronic malaria, exhaustion and consumptive damage, miasma (illness caused by the damp-heat qi of southern mountains and forests), and similar conditions. Take three liang of soft-shelled turtle shell, coat it with su (an oil made from cow’s milk or animal fat), and roast it; then combine it with equal parts dried ginger and galangal, grind into a powder, and take one qian each time. Decoct it in one medium cup of water until reduced to seven-tenths and take it.

Shenghui Fang (II): Also treats chronic malaria and similar illnesses. Take three liang of soft-shelled turtle shell, coat it with su, and roast until it turns yellow; remove the skirt-like rim, and grind into a fine powder. When the malaria attack occurs, mix and take two qianbi (an ancient measuring spoonful, about one qian) with warm wine.

Formula for Treating Malaria (Peach Kernel Pill): Take one hundred peach kernels, remove the skin and tips, and grind them finely in a mortar into a paste; it must not come into contact with unboiled water. After the paste is formed, add three qian of huangdan (lead oxide, a red mineral medicine), and knead it into pills the size of parasol tree seeds. On the day the malaria is about to occur, take three pills each time, facing north, and take them with warm wine; if one does not drink alcohol, well-flower water (the first well water drawn at dawn) may be used instead. It must…

Another Formula: Take three sheng of langdangzi (the seeds of a toxic herb, containing hyoscyamine) and steep them in five sheng of wine; then remove and dry them in the sun. Once the wine has been fully absorbed, pound them into a powder and take one qianbi (the amount held on a coin-sized spoon) each time, three times a day. It must not be taken in excess; an overdose will only intensify the madness.

Another: the "Langdang Powder for Madness" from the Xiaopin: Grind three sheng of langdangzi into powder and steep in one sheng of wine for several days. Remove and mash them, blend with the steeping liquid, twist out and strain away the dregs, then heat over water until the mixture can be rolled into pills. Take three pills the size of small beans, three times a day. If after taking it the mouth and face feel drawn tight, if there seems to be something crawling in the head, and red patches appear on the forehead, hands and feet, this is the sign that the drug has taken effect and the illness will be cured. If no such reactions occur, the whole course should be finished.

Another Formula: Grind fangkui (a medicinal herb) into powder and take it with warm wine, one daogui (roughly the tip of a small spoon), increasing to two or three daogui, with slight moisture of the body and mild numbness as the mark of its efficacy.

Another Formula: Take the rope with which a hanged person hanged himself, burn it to ash, and take the amount pinched up with three fingers.

In all cases of dian disorder: at the onset of an attack the patient falls to the ground, foams at the mouth, loses consciousness, and claws and strikes out wildly; after the attack has passed he remains as if insane, sometimes to the point of losing control of urine and stool. Conditions of this kind are difficult to cure.

Formula for Treating Sudden Mania: Roast a toad, pound it into a fine powder, and take it with wine, one fangcunbi, three times a day.

Another Formula: Have the patient lie face upward on the ground and pour cold water over his face all day without stopping.

Formula for Treating Sudden Wild Raving, as if Speaking with Ghosts: Insert a needle beneath the nail of the patient's big toe; insert only slightly and then stop.

Another Formula: Bind the patient's hands tightly with the straps of a steamer basket, then apply moxa to both flanks and to the heads of the elbows, seven cones at each point. Before long the patient will himself declare the ghost's name and beg it to leave; question him slowly at that point, and only then untie his hands.

Whenever Mania Erupts: if the patient wishes to run about, or believes himself to be of noble rank and calls himself a sage or a god, one should have the various moxa methods at hand—only then can the root of the illness be cured.

If the Patient Weeps and Moans: this is the work of malevolent spirits (xiemei) and is not mania; it should be treated according to the methods for driving out evil influences. The Jinxiaofang states that burning silkworm paper to ash and taking it with wine or water can cure wind-dian.

Appended Formulas: "Fufang" (appended formulas) is the heading for supplementary prescriptions; the following are additional formulas.

Ge Xianweng’s Emergency Formulas Kept Up One’s Sleeve

Treating Malevolent Spirit Influence (Not True Madness)

The Doumen Fang records that when a patient is deluded by pathogenic qi rather than truly mad, the condition should be treated by the methods for evil spirits. The Jinxiao Fang says that raw silkworm paper burned to ashes and taken at will with wine or water can cure wind-dian.

Supplementary Formulas

Treating Epilepsy (Doumen Fang)

Take moxa floss and apply moxibustion to the acupoint below the scrotum and in the midline before the anus (the “grain passage”); the number of cones is calculated according to the patient’s age, one cone for each year.

Treating Various Wind-Dian Conditions (Qianjin Fang)

Take four sheng of hemp seed (maren), add six sheng of water, and boil over high heat until the seeds split open. Strain off the residue and decoct to seven ge of liquid. Take it on an empty stomach early in the morning. After taking it, there may or may not be an attack, or reactions such as excessive talking may appear; do not be alarmed. Simply have the patient repeatedly massage the hands and feet to calm them. After three doses in total, recovery can be achieved.

Another formula: For manic evil that breaks out at no fixed time, with disheveled hair, loud shouting, a desire to injure people, and disregard for danger from water and fire, grind Sophora root into powder, add honey, and make pills the size of parasol-tree seeds. Take ten pills each time with mint decoction.

Treating Wind-Xian (Waitai Miyao)

For wind-xian causing pulling pain in the ribs and hypochondrium, vomiting during attacks, and a cicada-like ringing in the ears, take asparagus root (tiandong), remove the core and skin, sun-dry, pound, and sift. Take one fangcunbi (about one small spoonful) with wine. If taken over a long period, it can also prolong life.

Treating Wind-Xian Due to Heart Heat (Guangli Fang)

For the same symptoms as above, with a cicada-like ringing in the ears, use asparagus root, prepared and taken as above.

Another formula (Guangli Fang): For wind-xian due to heart heat, take decayed dragon horn (“dragon horn” is an ancient drug name, usually referring to medicinal materials from fossilized bones and horns of ancient animals), pound it, and grind it into a thick juice. Take two ge before meals, twice a day.

Treating Chronic Wind-Xian (Jingyan Houfang)

Treats adults and children with long-standing wind-xian, with phlegm and saliva congested in the throat, cough, wind rash over the whole body, and, when attacks are acute, saliva in the mouth surging like the tide.

Background Note: The “wind-xian” and “wind-dian” in the book roughly correspond to what is called epilepsy today, but the disease names and understandings of etiology differ between ancient and modern times. The formulas in the book are mostly historical records and have not been validated in modern clinical practice. If treatment for epilepsy is needed, it should be based on proper medical diagnosis.

Formula for Inducing Salivation with Melon Peduncle

Ge Xianweng—that is, Ge Hong, a Daoist scholar and physician of the Eastern Jin and author of Zhouhou Beiji Fang—records that if after taking the medicine the vomiting is not severe and only oral saliva is brought up, a child need take only a small pinch (one “zi,” roughly the amount dabbed on a fingertip). The amount of melon peduncle is not fixed; grind it into a fine powder. Adults take one zi, while those under fifteen or the elderly and weak take half a zi. In the early morning, take it with well-flower water (the first well water drawn at dawn, which the ancients regarded as the purest); while taking it, hold a piece of sugar in the mouth, and after a short while the saliva will pour out like water. When the saliva is nearly exhausted, sometimes a cloth-like sticky saliva is also vomited; after this the saliva is cleared away and the mouth feels fresh. Once the saliva has stopped, eat thin congee for a day or two to recuperate. If the vomiting is excessive and the body feels weary and uncomfortable, drink one cup of musk decoction to stop the vomiting. The musk must be finely chopped and taken mixed with warm water.

Formerly, Minister Tianping (Tianping Shangshu, a Tang official title) felt dizzy and his vision blurred; after taking this formula he vomited saliva, and the effect was pronounced.

Medical Case from Minghuang Zalu

Minghuang Zalu (Miscellaneous Records of Emperor Ming) records that during the Kaiyuan era of Emperor Xuanzong of Tang, there was a famous physician named Ji Peng who could judge the severity of an illness by observing the patient’s complexion and manner of speaking and behaving, without needing to take the pulse. When Xuanzong heard of him, he summoned him into the palace and had him examine a palace woman in Yeting (the quarters of consorts and palace maids). Every afternoon this palace woman would alternately laugh loudly, sing, cry, and wail, as if mad, and both her feet could not touch the ground to walk. After examining her, Ji Peng said, “This is because she ate too much and strained herself too hard, then fell to the ground, and so it came to this.” He then gave her mica decoction and made her sleep peacefully. When she awoke, all her pain was gone. On inquiry, the palace woman said: On Princess Taihua’s birthday, a grand singing and dancing celebration was held in the palace, and she was responsible for the singing. Worried that her voice would not be clear and sustained enough, she ate her fill of [missing character] hoof soup, and afterward sang the Daqu (Grand Melody) at the banquet. When the song ended, she felt hot and irritable in the chest, so she played on the steps, fell from a height, and was unconscious for a long time before waking. From then on she suffered from this madness, and her feet could not touch the ground.

Formula for Sudden Fright-Deviation and Mental Distraction (No. 18)

This section records formulas for treating sudden fright and mental distraction.

Formula for treating vacuity palpitations below the heart: take equal amounts of Ephedra (mahuang) and Pinellia (banxia), pound them, and make honey pills. Take three pills the size of soybeans each time, twice daily; if the effect is not obvious, gradually increase the dose. The Pinellia must first be washed with hot water to remove its slippery mucilage, dried, and then used.

Treating Fright, Anxiety, and Fear

This formula treats people who have been frightened or are fearful, or who are thrown into panic by the loss of property, or who become melancholy from intense anger, so that their heart Qi is disordered, their heart-spirit is unsettled, and they cannot find calm.

Formula One: Dragon Bone, Polygala, Fushen, Saposhnikovia, and Oyster Shell, two liang each; Licorice, seven liang; and seven jujubes. Boil in eight sheng of water down to two sheng, divide into two doses, and decoct and take daily until recovery.

Formula Two: Poria and dried Rehmannia, four liang each; Ginseng and Cinnamon, three liang each; Licorice, two liang; Ophiopogon root, one sheng, with the pith removed; Pinellia, six liang, washed to remove its slippery quality; and fresh ginger, one jin. Use one dou of water. Separately kill one black-boned chicken, and cook its blood, liver, and heart together with the other ingredients, reducing to three sheng. Divide into four doses: three in the daytime and one at night. During treatment, eat sparingly and keep the diet regulated; three doses should bring recovery.

Formula Three: Take one white rooster and clean and prepare it as for eating; crush four liang of pearl; and take four liang of xiebai (Chinese garlic chive bulbs). Boil in three sheng of water down to two sheng. Do not eat the previous evening; the next morning eat all the chicken and drink all the broth.

There are also various pills for calming the heart and stabilizing the will, which are recorded among the major formulas.

Treating Sudden Struck-by-Evil with Mental Confusion, Trembling Body, and Locked Jaw

Apply moxibustion to the Renzhong point below the nose and to the base of the thumbnail on both hands and the base of the nail on both big toes. Place moxa cones on the points and apply seven cones at each site; if the condition is not stopped, moxa up to fourteen cones, and recovery will follow. This method was originally recorded in the “Miscellaneous Treatments” chapter.

Treating Women Who Have Sexual Relations with Evil Entities, Speak Alone, Laugh Alone, and Are Sorrowful and Dazed

Grind one liang of realgar into powder, melt two liang of pine resin and mix it in, then stir evenly with a “tiger’s claw” (a stirring tool; the original text says this), and knead into pellets the size of a sling pellet. At night, place them in a fire basket and burn them; have the woman sit above the fire basket, cover her tightly with a quilt from the body upward, leaving only the head exposed, and let the smoke fumigate her. If one treatment does not cure her, no more than three treatments will be needed; afterward the evil entity will naturally be cut off.

Background note: In the text, “cu zhong” in ancient usage refers to sudden onset of illness, not to what modern medicine calls stroke (zhongfeng). The ancients often explained mania and mental abnormalities as “evil ghosts” or “evil entities”; this was the mode of understanding at the time. Moxibustion and fumigation were also ancient therapeutic methods. Today, if someone experiences mental abnormality, sudden fainting, or numbness in the limbs, they should seek medical attention promptly, and modern medical diagnosis should be taken as authoritative.

Another formula: take one liang of realgar (a mineral medicine containing arsenic), one liang of ginseng, one liang of fangfeng (Saposhnikovia root), and one sheng of schisandra fruit. Grind and sift into a fine powder. Each morning take one square-inch spoonful (about one small teaspoon) with well water; after three doses, recovery will be achieved.

Immortal Ge (Ge Xianweng)—that is, the Eastern Jin Daoist Ge Hong, honored in Daoism as Immortal Ge—treated mania as follows: first insert five needles into the patient’s topknot. Fill a vessel with water, cover it with three layers of new red cloth, and lay a large knife horizontally on top. The practitioner, with a solemn and dignified manner, then calls the patient. The patient will usually want to get up and flee; at this point do not let him go, but seize the opportunity to spray water at him and blow breath toward him. Do this three times. When his mind has settled slightly, wipe the water from his face. Flick the patient’s forehead near the hairline with a finger and ask, “Do you want to get better?” The patient will surely not answer; flick fourteen times (“two sevens,” that is, fourteen) before he is willing to reply. Then insert a needle into the medial side of the Renzhong point (the groove in the center below the nose, an acupuncture point) and leave it in briefly; then insert and retain needles at the pulsating areas in front of the roots of both ears. Next insert a needle straight above the bridge of the nose, one cun within the hairline, and insert another needle transversely. Repeat this procedure until the patient can answer questions clearly and gradually becomes lucid; then stop the treatment.

If men or women are prone to dreaming of ghosts and spirits and are mentally unsettled, saw deer antler into shavings and take them with wine, one pinch each time (about the amount picked up with three fingers), three times daily.

Associated formulas: Zhang Zhongjing’s formula—Zhang Zhongjing was an Eastern Han physician honored as the “Medical Sage”—treats palpitations below the heart. Use equal parts banxia (Pinellia) and mahuang (Ephedra), grind into powder, and make honey pills the size of small beans; take three pills each time, three times daily. The Jianyao Jizhong Fang, an ancient formula book, treats heart restlessness, palpitations, forgetfulness, and wind-heat in the upper jiao with phlegm stagnation. Use one liang of white quartz and one liang of cinnabar, grind together into a powder, and take half a qian after meals and at bedtime, taken with a gold-and-silver decoction. It is indicated for those with lodged heat in the heart, qi stagnation below the ribs, frequent morning sorrow and discontent, and accompanying palpitations. Another formula: take two jin of cyperus rhizome, chop it, stir-fry until fragrant, put it into a raw silk bag, and steep it in three large dou of ashless clear wine. In spring, steep for one day and it is ready to drink.

Note: Realgar and cinnabar contain toxic components such as arsenic and mercury. The above is only a historical record of ancient medical formulas and should not be used for self-medication or treatment on that basis.

Interpretation of the Wind-Stroke Emergency Treatment Chapter in Ge Hong's Zhouhou Beiji Fang (Emergency Prescriptions Kept Up One's Sleeve)

I. Cyperus Root Wine and Cyperus Root Pills

Take two large jin of xiangfuzi (cyperus root, i.e., nutgrass rhizome), cut into pieces, briefly stir-fry until fragrant, place in a raw silk bag, and steep in three large dou of clear wine made without plant ash. (Ancient winemaking commonly used plant ash to aid clarification; "ash-free wine" refers to wine not treated by this method.) In spring, steep for one day before drinking; in winter, after the tenth month, steep for seven days, preferably in a warm place. Each time, drink one small cup on an empty stomach, three or four times daily, keeping the effects of the wine continuously present in the body, gauged by one's own sensations.

If one cannot drink wine, take ten liang of cyperus root, add five liang of cinnamon heart and three liang of evodia (the original text reads "wuyu," which is evodia), pound together into a powder, then blend with honey to form pills, pounding one thousand times, and roll into pills the size of parasol tree seeds. Each time, take twenty pills on an empty stomach with wine or ginger-honey decoction, gradually increasing to thirty pills, until the illness is cured.

II. Treating Various Acute Wind-Stroke Conditions

"Wind-stroke" in ancient times broadly referred to sudden collapse, facial paralysis, and limb immobility—acute conditions. Moxibustion is the burning of mugwort on acupuncture points; "zhuang" is a counting unit, with each burning counted as one zhuang.

• Sudden confusion, restlessness, and a sensation of impending death: Apply moxibustion at the center of the transverse crease below the great toe, with the number of zhuang determined by the patient's age. There is also a Xuming Tang (Life-Renewing Decoction) formula.
• Severe illness preventing walking, with cramped and contracted sinews: For inner-side tendon contraction, apply moxibustion at the inner ankle; for outer-side contraction, apply moxibustion above the outer ankle—twenty zhuang each. If accompanied by swelling, numbness, and bodily weakness, take two fen of baillian and one fen of aconite, pounded into powder, taking half a daogui each time (a daogui being the small amount scooped by a medicine spoon), three times daily. Aconite is a toxic medicinal substance and must be properly processed with careful dosage; it should not be taken casually on one's own.
• Drooping eyelids: Apply moxibustion at both sides of the eye corners, three zhuang.
• Unclear consciousness and failure to recognize people: Apply moxibustion at the ends of the lowest ribs (the tips of the lowest rib on both sides), seven zhuang each.
• Inability to speak: Apply moxibustion above the second or fifth vertebra, fifty zhuang. There is also a "formula for inability to speak," see the following chapter.
• Another formula: One sheng each of fermented black beans and evodia, add five sheng of water, boil down to two sheng, and drink slowly in divided doses.
• Upward-rolling eyes, locked jaw, and severe abdominal pain: Apply moxibustion at the first transverse crease below the scrotum, fourteen zhuang. There is also a formula for applying medicinal plasters.
• Violent agitation with intent to harm others or oneself, ceaseless cursing, and speech resembling ghostly utterances: This describes the state of mental derangement during wind-stroke or acute conditions; the original text records no specific treatment here.

Background: This passage comes from Ge Hong's Zhouhou Beiji Fang (Emergency Prescriptions Kept Up One's Sleeve) of the Eastern Jin. It records ancient folk medical methods, most of whose drugs were taken from everyday objects; their efficacy lacks verification by modern medicine and should not be copied directly.

Moxibustion method: At the junctions between both corners of the mouth and the red flesh of the lips, apply one zhuang to each side (a zhuang is a counting unit for moxa cones; burning one cone is one zhuang); then apply five zhuang to each bend of the elbows; apply three zhuang between the two shoulder blades on the back. Repeat the moxibustion once every three days, for three sessions in total. This is the secret method of Cang Gong (Chunyu Yi, a famous physician of the Western Han; because he served as Grand Granary Keeper, he was called Cang Gong). In addition, apply thirty zhuang at the perineal raphe below the scrotum.

Methods for treating mania and evil influences:

If a person becomes manic: take grease from the wheel hub (the axle sleeve at the center of a wheel), in an amount the size of an egg, dissolve it in warm pure bitter wine (that is, rice vinegar), stirring continuously until the grease is completely dissolved, and have the patient ingest it all.

If there is vexation, mental confusion, abdominal distension and pain, or frequent fainting followed by revival: take five sheng of earth from beneath the stove cauldron, pound and sift it, mix it with cold water, and have the patient take it all.

Another method (for the same symptoms): take five sheng of earth from beneath a cauldron (earth beneath the stove cauldron), pound and sift it, mix it with eight sheng of cold water, take the clarified liquid, and have the patient drink it all. If the patient's jaws are clenched, force them open, pour the liquid in through a bamboo tube, and make the patient swallow; the patient will recover, with very good results.

If the whole body is in opisthotonos (the neck and back arch backward like a bow), the four limbs cannot move, and the patient is restless and near death: take five sheng of clear wine and one sheng of white chicken droppings (the white portion of chicken feces), pound and sift them, mix, stir and agitate repeatedly over a thousand times, and then drink. Adults take one sheng each time, three times a day; children take five ge, and will recover.

If there is no place on the whole body that does not hurt, with confusion and agitation, and the patient is about to die: take one piece of scalp dirt (dirt from the scalp) the size of a soybean and ingest it. In addition, fill cloth bags with soybeans, steam them, and apply them in turn as hot compresses to the painful areas; preparing two cloth bags and alternating them gives the best effect. If soybeans are unavailable, one may also steam rat-hole earth (earth from a rat hole) and use it for ironing (hot compressing).

If there is only colicky pain in the abdomen: take half a jin of salt, roast it until thoroughly dry, hold it in the mouth, then drink two sheng of hot water; spit it out and one will recover.

Another prescription: take six fen of aconite and three liang of fresh ginger, chopped; boil them in two sheng of water until reduced to one sheng, and take it in two doses.

For inability to move the hands and feet: burn blue cloth to produce smoke, and fumigate the painful area in a small-mouthed vessel.

Douchi Formula: Take three sheng of douchi (cooked and fermented soybean product), add nine sheng of water, boil down to three sheng, and divide into three doses. Separately take one sheng of douchi, slightly scorch it by stir-frying, put it into a cloth bag, steep it in three sheng of wine for three nights, then warm and drink it; drinking until slightly intoxicated is best.

For treating spasmodic pulling pain of the body, numbness and loss of sensation, and limbs that cannot move freely: Knead dried mugwort leaves into a small ball and place it at the bottom of an earthenware zeng steamer. Block the other openings and leave only one hole. Position the painful area over this hole, ignite the mugwort leaves below, and fumigate by burning; after some time recovery will occur.

Another formula: Take decayed wood, shave it into shavings, boil it in water into a thick decoction, and while hot scald the painful area; this is effective.

For treating lockjaw (tightly clenched jaw): Take five sheng of soybeans, stir-fry until yellow-black, steep them in five sheng of wine, and extract the juice. Use an implement to pry open the mouth and pour it in; after administering, cause the patient to sweat.

Another formula: Use four liang of Duhuo (Angelica pubescens root) and two liang of cassia bark; the method of combining them with soybeans and wine is the same as the preceding formula. After administering by pouring, induce sweating.

Yet another formula: Take four liang of Duhuo and two liang of cassia bark, add wine and water totaling two sheng, boil down to one and a half sheng, and divide into three doses. Pry open the mouth and pour it in, then cover the patient warmly and have them lie in bed; warm them by a fire to induce sweating.

For treating bodily stiffness, inability to bend, stretch, or turn over: Take yellow-white bark of the Chinese scholar tree (Sophora japonica), cut it into pieces, add wine and water totaling six sheng, boil down to two sheng, remove the dregs, and after it reaches a suitable temperature, take it slowly.

Another formula: Scrape one sheng of bark of the trifoliate orange tree, steep it in one sheng of wine overnight, and take five ge to one sheng each time. When the wine is finished, prepare more; recovery will follow.

For treating deviated mouth and eye (mouth deviation): Use moxa fire to cauterize the transverse crease between the corner of the mouth and the lips (moxibustion is the therapy of burning moxa wool to heat and cauterize acupoints or affected areas). When heat is felt, remove the moxa fire, and recovery will occur; do not burn the moxa completely, for burning it out is excessive. If the mouth deviates to the left, moxa the right corner of the mouth; if it deviates to the right, moxa the left corner. In addition, moxa one cone of moxa on the middle finger joint: if the mouth deviates to the right, moxa the left hand; if it deviates to the left, moxa the right hand. There is another moxibustion method for treating mouth deviation, recorded later.

Excerpted Interpretation of Ge Xianweng’s Handbook of Emergency Prescriptions Kept Up One’s Sleeve

1. Several External Treatments for Deviated Mouth and Eyes

This passage records several external therapies for treating “deviated mouth” (mouth and eye deviation, mostly referring to stroke or facial paralysis).

For moxibustion, use moxa fire. Take the sensation of “emptiness accompanied by heat” as the criterion; as soon as the heat sensation appears, remove the moxa fire, and recovery follows. Do not let the moxa burn out; if it burns out, the moxibustion has gone too far. If the mouth deviates to the left, moxa the right corner of the mouth; if it deviates to the right, moxa the left corner. In addition, one may moxa a point on the first joint of the middle finger; if the deviation is to the right, moxa the left hand. The book also mentions other methods of moxibustion for deviated mouth, recorded later.

For taking kongqing powder by mouth, kongqing (azurite) is a natural copper ore. Grind it into a fine powder and hold it in the mouth; once the powder is swallowed, recovery follows.

For the spider-egg rubbing method, take spider eggs and rub them repeatedly on the cheek on the side that is tight and twitching (near the Jiache point, that is, at the angle of the mandible). Stop when the face appears to have returned to symmetry; one may also warm it by fire and then rub.

For an external application, pound equal parts of oyster shell, alum, aconite, and yellow earth from a wall corner or under the eaves into a fine powder, mix it evenly with blood from the comb of a three-year-old rooster, and apply it to the affected side. Place a bowl of water nearby; when the face is seen to be about to return to normal, immediately wash off the medicine and do not apply it again, and recovery follows.

For external application of turtle shell and wild aconite, apply turtle shell and wild aconite to the affected area; once the face returns to normal, remove the medicine.

2. Cold Limbs, Vomiting Clear Water, Tossing and Turning While Crying Out in Pain

Take one liang of gui (cassia twig or cinnamon bark), chop it, add three sheng of water, boil down to two sheng, remove the dregs, and take the whole amount at one time when it is moderately warm.

3. Joint Pain

Take eight liang of cattail pollen (Puhuang) and one liang of prepared aconite, grind them into powder, and take one qian-spoonful each time, three times a day, gradually increasing to one square-inch spoonful.

For pain and restlessness in the bones and joints, inability to bend or stretch, pain at the slightest touch, shortness of breath, sweating, or impending swelling, use two liang of aconite, four liang of cinnamon, three liang of atractylodes (Baizhu), and two liang of licorice; add six sheng of water, boil down to three sheng, and divide into three doses. Recovery follows sweating after taking it.

4. Sudden Wind (Acute Stroke)

Sweating like water is called “white sweat.” Crush equal parts of gypsum and licorice, and take one square-inch spoonful with wine. Take it once every stretch of about one zhang (roughly a short interval).

5. Chronic Wind (Chronic Hemiplegia)

This is the disease heading for the following entry: being struck by chronic wind, with the four limbs unable to contract or move.

Background note: The “sudden wind” and “chronic wind” in the book are ancient classifications of stroke. Aconite and wild aconite are both toxic medicinal materials; in ancient times they required special processing before use, and a slight error in dosage could cause poisoning. Such content belongs to historical literature and should not be used as a basis for self-medication.

Take three sheng of fermented black beans (douchi), add nine sheng of water, and boil down until three sheng remain. Divide into three doses; decoct and take twice a day. It may also be soaked in wine and then boiled for drinking.

If there is sudden wind-stroke (zhongfeng), with paralysis of half the body or the whole body, loss of voluntary movement, inability to speak, and clouding of consciousness or coma, Chen Yuan Ligu Gao is the most important medicine; it is recorded in the Bei Ji Yao Fang (Formulas for Emergency Preparedness).

Appended Formula: For head wind and headache.

Jingyan Fang (Experiential Formulas): To treat acute wind-stroke in patients whose eyes are tightly closed, whose jaws are tightly clenched, and into whose mouth medicine cannot be poured. Take the powder of this medicine, dip the middle finger into it, and rub the teeth twenty or thirty times; then rub the large teeth on both sides. The mouth will open by itself, after which the medicine can be poured in.

Kaiguan San (Open the Gates Powder): Pound Arisaema (Tiannanxing; toxic and must be processed before use in medicine) into powder, mix it in equal portions with white borneol (i.e., bingpian), and grind evenly. Prepare it at noon on the fifth day of the fifth lunar month. Each dose is from one zi to half a qian, depending on the severity of the illness.

Jianyao Jizhong (Brief Essentials for Relieving the Masses): A method for treating wind-stroke with tightly clenched jaws and drooling of saliva. Take one piece of Gleditsia sinensis pod (zaojiao), remove the skin, coat it with lard, roast until yellow, and grind into powder. Each dose is one qian-spoonful, taken at any time with warm wine. If the patient’s qi is replete and the pulse is large and forceful, the dose may be increased to two qian-spoonfuls. If the jaws are tightly clenched, first rub the teeth with white plum; once the mouth opens, immediately administer the medicine, so that the wind-phlegm and saliva are vomited, and the illness will be cured.

To treat wind-stroke with loss of consciousness and locked jaw: Take one liang of Veratrum (lilu; a toxic medicinal substance), remove the root head, decoct to a thick preparation, then soak and wash it in Fangfeng decoction, roast dry, cut into pieces, stir-fry until slightly brown, and pound into powder. Each dose is half a qian, mixed with warm water for administration; effectiveness is shown by vomiting of wind-saliva. If, after the time it takes to walk two li, there has still been no vomiting, another dose may be taken. (The ancients often used the time needed to walk one li to estimate how quickly a medicine would act.)

It also treats gallbladder wind and noxious qi, with disharmony of deficiency and excess, marked by mental dullness and drowsiness: Take one liang of sour jujube seed (Suanzaoren), used raw, and two liang of jin ting la cha (the exact identity of which remains to be verified). Smear them with fresh ginger juice and roast until slightly scorched, then pound and sift into a powder. For each administration, effectiveness is judged by vomiting of wind-saliva after taking it; if there is no vomiting, take another dose.

Formulas from Ge Xianweng’s Zhouhou Beiji Fang (Emergency Formulas to Keep Up One’s Sleeve)

Take one liang of sour jujube seed, used raw; and two liang of golden-stick wax tea (identity unclear, pending verification). Smear the latter with fresh ginger juice, roast until slightly scorched, pound, and sift into a fine powder. Take two qian each time, decoct seven fen of water down to six fen, and take it warm as needed.

Discourse from Sun Shangyao

This is a sudden-onset wind-stroke. The patient’s consciousness is clouded as if drunk, the body is heavy and dull, and the limbs cannot move. Some patients cannot stand steadily and fall; others do not fall but show deviation of the corner of the mouth and slight drooling. If treatment is delayed, the condition will become severe and endanger life. The ancients held that this is caused by wind pathogen and phlegm-saliva congesting the upper jiao (above the diaphragm), obstructing the free flow of qi and blood. The following formula is suitable for treatment.

Emergency Xixian San (Powder to Thin Phlegm)

Take four pieces of pig-tooth gleditsia (a kind of honey locust pod), choosing thick, fleshy ones free of worms, and scrape off the black skin; take one liang of Jin alum (i.e., bright alum), choosing shiny, transparent pieces. Pound the two ingredients together, sift into a fine powder, and grind again into a fine medicinal powder. The patient takes half a qian; for severe cases, take three spoonfuls, mix with warm water, and administer by pouring it down. After taking it, do not induce violent vomiting; the aim is only to thin the phlegm and saliva so that it is slightly discharged, or to cause the vomiting of one or two sheng. After the patient gradually regains consciousness, care should be gradual and moderate; do not use excessively drastic medicine all at once, lest life be harmed. This formula has been repeatedly verified and has marked effects, which cannot be enumerated one by one.

Discourse from Mei Shi Fang (Master Mei’s Formulas)

It treats tanhuan wind (that is, conditions such as hemiplegia and half-body paralysis), with symptoms of drooping and dragging of the hands and feet, deviation of the mouth and eyes, impaired speech, and unsteady walking.

Shenyan Wulong Dan (Miraculously Effective Black Dragon Elixir)

Take Sichuan aconite (remove the skin and the umbilical part) and Wulingzhi (Trogopterus dung), five liang of each, grind into powder, add borneol and musk, grind until fine and uniform, and make into pellet-sized pills with water. Each time, first dissolve one pill in fresh ginger juice, then take it with warm wine, twice a day, once on an empty stomach and once before the evening meal. To treat one person, usually thirty pills are required; after taking five to seven pills, the patient will feel that the hands can be raised and the feet can move; after about ten pills, the patient can move about on his own.

Discourse from Sheng Hui Fang (Formulas of Sagely Grace)

It treats various wind ailments. If taken over a long period, it can make the body light and agile, the eyes bright, the temple hair black, and the countenance youthful.

Background Supplement

Ge Hong was an Eastern Jin Daoist and physician. Zhouhou Beiji Fang is a formula book centered on emergency treatment and was often used for folk emergencies. In ancient texts, “wind” broadly refers to various sudden neurological symptoms, and “wind-stroke” roughly corresponds to today’s stroke, including sudden collapse, hemiplegia, and deviation of the mouth and eyes. Sichuan aconite belongs to the aconite family of medicinals and contains highly toxic constituents; the dosages and processing methods in ancient formulas are difficult to assess by modern standards. Such content is suitable only for historical documentary research and must not be followed for self-medication.

1. Southern Candle Tree Formula (for treating all wind disorders)

Take the branches and leaves of the Southern Candle Tree (Wufan tree); gather the branches and leaves in spring and summer, and the root bark in autumn and winter. After cleaning, cut them finely. Take five sheng, add five dou of water, and simmer slowly over a gentle fire until reduced to two dou; filter out the dregs. In another clean pot, continue heating over a low fire until it reaches the consistency of a thin maltose syrup (a thick malt-sugar syrup), then store it in a porcelain bottle. Each time take one spoonful with warm wine, three times a day. Prolonged use makes the body light and the eyes bright, and makes the hair and beard less likely to turn white.

2. Mutianliao Wine Formula (for treating wind disorders, with rapid effects)

Take one jin of Mutianliao (silver vine, a climbing plant), peel it and cut it finely, put it into a raw silk bag, and steep it in two dou of good wine. In spring and summer steep for seven days; in autumn and winter steep for fourteen days before opening. Each day, on an empty stomach, at noon, and in the early night, warm and drink one cup each time; the elderly and children should increase or decrease the amount according to circumstances. If used over the long term, only one cup each morning is needed.

3. Croton Seed Palm-Application Method (for treating wind-stroke with deviation of the mouth and eyes)

“Wry mouth” refers to deviation of the mouth and eyes. Take seven croton seeds, remove the shells, and mash them. If the mouth deviates to the left, apply the medicine to the right palm; if it deviates to the right, apply it to the left palm. Then bring a cup of warm water close to the palm; after a short while the deviation can be corrected. The elderly and children should increase or decrease the amount according to circumstances; for long-term use, apply once each morning. Another method is to wash off the medicine once its effect appears and repeatedly pull the middle finger. (Croton seed is strongly toxic; the ancients mostly used it externally.)

4. Cicada Slough Powder (for treating dizziness and spinning)

Take two liang of cicada slough, lightly fry it, and grind it into a fine powder. Take one qianbi (about one small spoon) with warm wine as needed.

5. Cinnamon Heart Compress Method (from the Qianjin Fang, for treating wind-stroke with facial deviation, locked jaw, and an inflexible tongue)

Take cinnamon heart (the inner bark of cinnamon), boil it in wine, and extract the juice. Moisten a cloth with it and apply it to the affected area; it takes effect immediately. If the mouth deviates to the left, apply it to the right; if it deviates to the right, apply it to the left. This method is commonly used and very effective.

6. Pine Needle Wine Formula (for treating wind-stroke unresolved for three years)

Take one jin of pine needles, cut them finely, boil them in one dou of wine until reduced to three sheng, and take it all at once. After sweating, recovery comes quickly.

Plain-Language Explanation of the Various Formulas for Stroke and Wind Disorders in Ge Xianweng’s Emergency Formulas Kept Up One’s Sleeve

(Ge Xianweng is the Eastern Jin Daoist Ge Hong; Emergency Formulas Kept Up One’s Sleeve is a collection of emergency medical formulas he compiled.)

Another formula treats swelling of the head and face caused by sudden stroke (zhongfeng—that is, sudden-onset emergencies such as fainting and hemiplegia). Pound apricot kernels into a paste and apply it like a plaster to the affected area.

Another formula treats wind disorders of the head and face. Cut the medicinal ingredients finely, decoct them in one dou of wine until three sheng remain, and take the whole dose at once to induce sweating; the symptoms will then resolve.

This entry is identical to the preceding one.

Another formula treats wind disorders of the head and face, with eye [missing character], nasal congestion, dim vision, and cold tears.

Take three sheng of apricot kernels, grind them into a fine powder, add water, and bring to a boil four or five times. Use the liquid to wash the head until cold sweat appears; after three washings the condition will be cured.

According to Waitai Miyao (Secret Essentials from the Imperial Library, a Tang-dynasty medical text compiled by Wang Tao): to treat sudden stroke causing deviation of the mouth and eyes, take five liang of zaojiao (Chinese honeylocust fruit), peel it, grind it into powder, and mix it with three-year-old aged vinegar. If the deviation is to the right, apply it to the left; if to the left, apply it to the right. When the medicine dries, apply it again, and the condition will be cured.

Another formula treats hemiplegic wind (wind disorder affecting one side of the body) and all kinds of wind disorders. Take one large sheng of tender mulberry twigs newly grown this year, add one large dou of water, and decoct until two large sheng remain. In summer, it is best to use water from deep at the bottom of a well so that the decoction does not turn sour. Take one small cup on an empty stomach each day; when it is finished, decoct again and continue taking it. This can prevent hemiplegic wind for life. If used for prevention, taking one large sheng is even more effective.

Another formula treats wind pathogen causing the body to feel numb and itchy as if insects were crawling. Take one dou of salt and one dan of water, decoct until reduced by half, clarify, and wash with the warm liquid three to five times; this treats all kinds of wind disorders.

Master Ge’s formula: to treat lockjaw (literally “straight mouth and clenched jaw”) and clouded consciousness caused by stroke, externally contracted cold pathogens, or pestilential qi, take one sheng of the white portion of chicken dung, roast it until yellow, and while it is very hot add water and decoct until reduced by half. Clarify and wash with the warm liquid three to five times; this treats all kinds of wind disorders.

Another use of Master Ge’s formula (the same formula as above): still take one sheng of the white portion of chicken dung, roast it until yellow, mix and stir it with three sheng of wine, remove the residue, and take it.

According to Qianjin Yifang (Supplement to the Thousand Ducat Formulas, a Tang-dynasty medical text compiled by Sun Simiao): to treat heat-wind with sweating and vexation in the chest, take mica (a mineral medicine) mixed with water. No more than two doses are needed for immediate effect.

According to Qiezhong Fang (Formulas from the Box): to treat head-wind and unbearable pulling pain in the brain, rub and apply a medicinal ointment (mo gao, an ointment for topical application) to the affected area.

Burdock Paste Liniment Formula (treats wind toxin and also seasonal headache)

Take the stems and leaves of burdock, pound them into a mash, and press out two sheng of thick juice. Add one sheng of wine to which no lime has been added (the ancients often used lime to clarify wine; here its omission is emphasized), then add one spoonful of salt flowers (fine salt crystals). Simmer over fire until thick and paste-like, and apply it to the painful area; the wind-toxin pathogen will then disperse by itself. This formula can also treat “seasonal epidemic headache,” that is, headache caused by seasonal epidemic disease. When applying and rubbing it in, massage vigorously so that the area becomes hot, which brings faster results. In winter, when there are no leaves, the root can be used instead.

Inula Flower Pill (treats wind-stroke and qi-blood obstruction)

The Jingyan Houfang (Experiential Later Formulas), a formula book supplemented by later authors, records: it treats wind-stroke and qi-blood obstruction. Wash the dust from inula flower (a plant in the Asteraceae family, also called jinfeicao), pound it into a fine powder, mix it with refined honey, and form pills the size of wutong seeds. Before sleep, take five to seven pills with tea; at most, up to ten pills.

Another formula, recorded as “You Fang,” uses the same ingredients and states that this medicine can resolve wind-heat, clear accumulated heat and wind-pathogen obstruction, aid digestion, regulate the qi mechanism, and guide blood movement, thereby strongly relieving qi and blood blockage.

Rhubarb and Pharbitis Seed Pill (a strong purgative bowel-moving formula)

Use four liang of rhubarb and four liang of pharbitis seed (also called heichou, a purgative), half used raw and half roasted, and grind them into a fine powder. Form pills with refined honey, the size of wutong seeds. Take ten pills each time with tea; if a slight bowel movement is desired, take fifteen pills. It is suitable to take in winter and does not cause abdominal pain or churning.

It should be noted that rhubarb and pharbitis seed are both strong purgatives; in modern times one should not simply follow this formula on one’s own.

Borneol Sweet Dew Pill (treats wind-heat restlessness and poisoning)

The Jiyan Fang (Collected Tested Formulas) records: it treats restlessness of the heart, dry mouth, delirium, and high fever throughout the body caused by wind-heat, as well as poisoning of various kinds. In this formula, first calcine half a jin of hanshuishi (a mineral containing calcium sulfate) for half a day, place it in a clean earthen pit, cover it with a basin, seal the sides with wet earth, and remove it after one night. Then add two liang each of licorice powder and tianzhuhuang (a concretion of bamboo secretions, effective for clearing heat and resolving phlegm), and two fen of borneol (bingpian, an aromatic orifice-opening medicine). Make pills the size of a pellet with glutinous rice paste; grind and dissolve them in honey water before taking.

Cured Bear Meat Formula (treats wind-stroke, wind-bi, and sinew-vessel flaccidity)

The Shiyi Xinjing (Mirror of the Dietary Physician), a dietary therapy work written by Meng Shen of the Tang dynasty, records: it treats wind-stroke with wind-heat in the heart and lungs and loss of control of the hands and feet; and wind-bi causing limb weakness, flaccidity of sinews and vessels, mental clouding, and restlessness. Take one jin of bear meat, cut it into pieces, season it in the usual way and cure it into preserved meat; eat it on an empty stomach.

Another note states that this formula can also treat contracture, tension, and hemiplegia of the limbs caused by wind pathogen, as well as poor circulation of blood and qi.

Note: A few characters in the original are suspected to be erroneous. Based on the meaning, “lingzheng” should be “lingjing,” and “fengsui” is suspected to refer to a type of paralysis caused by wind pathogen.

【Wild Goose Fat Formula】

Take four liang of wild goose oil, render it, and strain it clean. Each morning on an empty stomach, take one cupful with warm wine as the vehicle, and at the same time take one small spoonful of the oil. The Ge Xianweng Zhouhou Beiji Fang (Master Ge’s Handbook of Prescriptions for Emergency Use, a folk emergency remedy book compiled by Ge Hong in the Eastern Jin) states that this formula can treat “Lijie Feng” (a condition chiefly characterized by red, swollen, painful joints) and various wind pathogens; it may be used by those whose bone and joint pain is unbearable day and night.

【Myrrh Powder】

Grind half a liang of myrrh (a resinous medicinal material) into powder; take three liang of tiger skull (used medicinally in ancient times; its trade is now prohibited), smear it with butter/ghee, roast until yellow, first pound it, then sift it into powder, and grind it together with the myrrh until extremely fine. Each time take two qian mixed with warm wine, three times daily; the results are very good.

【Formula from the Sheng Hui Fang】

To treat Lijie Feng, with unbearable pain in the hundred joints. Take one tiger skull, smear it with butter/ghee, roast until yellow, pound it, put it into a silk bag, steep it in two dou of clear wine for five nights (five evenings), and drink it warmed according to one’s capacity for alcohol; the effect is excellent.

【Formula from the Waitai Miyao Fang】

To treat the various symptoms of Lijie Feng, with unbearable aching pain in all the joints. Use thirty jin of pine resin, refine it repeatedly fifty times (if this is not possible, twenty times will do), then stir it together with three sheng of butter/ghee and three sheng of mild pine resin until very thick. On an empty stomach in the early morning, take one fangcun bi (about one small spoonful) with wine, three times daily, and it is best to eat plenty of soft congee. During the period of taking the medicine, for one hundred days avoid bloody and fishy foods, raw and cold foods, sour foods, and fruit; only then can recovery occur.

【Pine Knot Wine Formula】

This is another prescription, chiefly for Lijie Feng, when the limbs ache as if they are about to fall off. Use twenty jin of pine knots, steep them in five dou of wine for fourteen days, and take one ge each time, five or six times daily.

【Formula from the Doumen Fang】

To treat Baihu Feng (a recurrent and severely painful wind-dampness bi syndrome). This formula may be used by patients who have suffered for many years, for whom treatment has failed, and whose pain is unbearable: take nao (camphor), musk, maple and willow bark, and other medicinal materials, in unspecified amounts, cut them up, dry them by roasting, steep them in wine, and drink frequently, to the point of drunkenness; then recovery can occur. The text mentions that the “maple” that parasitizes maple trees (that is, a parasitic plant on the maple) has a better medicinal effect, and its leaves can also be refined into arsenic powder (arsenic is a highly toxic arsenic compound; the ancients mistakenly used it as medicine), with especially good results.

【Formula from the Jingyan Houfang】

To treat Baihu Feng, with pain that moves about unpredictably and both knees hot and swollen.

The following interprets the original entries one by one; places where the original text is damaged are noted.

For treating liyang wind (a traditional skin ailment; tiger bone and aconite formula), use one liang each of tiger shin bone (the lower leg bone of a tiger, smeared with ghee and then roasted and stir-fried) and black aconite (processed until it splits open, with the skin and navel removed—that is, the outer skin and central part of the root tuber removed; aconite contains aconitine-type alkaloids and is highly toxic). Grind into a fine powder. Each time take about two qian mixed in warm wine, twice daily.

As recorded in Waitai Miyao (Arcane Essentials from the Imperial Library): for treating liyang wind, including cases that have lasted as long as three years, grind cuttlefish bone (cuttlebone) with vinegar. First place a cloth underneath while grinding, and when it grinds to a reddish color, apply it to the affected area.

Another treatment for liyang wind (sulfur formula): grind one liang each of sulfur and another medicine (the name is damaged in the original) with vinegar, grind to powder, and each time take two qian in warm wine, twice daily.

Another formula: grind sulfur with vinegar and apply it to the affected area; the symptoms then cease.

Shenghui Fang (Formulas of Sagely Benevolence) for liyang wind: take the root of yangti vegetable (that is, sorrel, a wild vegetable), grind it on raw iron with good vinegar, slowly scrape up the medicinal juice produced by grinding, and apply it to the affected area. If it is still not cured, add a little sulfur and grind and apply together.

Jiyan Fang (Collected Tested Formulas) for baibo (white patches): for white patches on the neck and face that gradually spread and resemble tinea but have no ulceration to treat, first rub away the epidermis at the affected area, scrape until it is dry and painful, then apply the fat paste of eel. One application may be effective; in severe cases no more than three.

Shenghui Fang for baibo: burn snake slough into ash powder, mix evenly with vinegar, and apply to the affected area; the effect is good.

Another formula, for irritability and heat caused by wind-stroke, with sores and itching on the skin: use four liang of tihu (the refined essence made from milk, regarded as a precious substance in antiquity), take it mixed in wine; the dosage is damaged and illegible, so it cannot be determined.

Jiyan Fang for skin itching: for itching that does not stop when wind-pathogen invades the skin, take honeycomb, roast it, and with an equal portion of cicada slough, grind to powder; take one qian-spoonful mixed in wine, two or three times daily.

Another formula: equal portions of cicada slough and bohe (that is, mint; a variant writing), grind to powder; take one qian-spoonful mixed in wine, three times daily.

As cited in Beimeng Suoyan (Miscellaneous Words from the Northern Dream): the book records that a court official visited Imperial Physician Liang to request diagnosis and treatment; after this the text is damaged and cannot be translated.

Note: Tiger bone in the text is a protected animal product, and drugs such as aconite and sulfur are highly toxic. People today must not imitate their use. The above is intended only for understanding the documentary background of ancient medical formulas.

This passage compiles remedies from successive dynasties for treating “head wind” (recurrent headache, which the ancients generally associated with wind pathogen).

The Beimeng Suoyan (Miscellaneous Tales from the North Dream), a notebook by Sun Guangxian of the Five Dynasties, records that a court official asked Imperial Physician Liang (fengyu, an official in charge of medicine) to diagnose and treat him. Liang said, “The wind illness is already deep; please go home quickly.” The court official then asked Zhao E, a horse doctor from Fuzhou (around present-day Fuxian, Shaanxi), to examine him again. Zhao also said the condition was critical, the same as Liang had said, and offered the only method: the court official should eat xiaoli pears (a kind of pear with fine, soft flesh) without limit, and whatever he could not finish eating he should squeeze into juice and drink. After the court official went home, for about ten days he ate only xiaoli pears, and his illness improved.

The Qianjin Fang (Sun Simiao’s Beiji Qianjin Yaofang) treatment for head wind and headache: roast three sheng of soybeans until they stop crackling; take a bottle that holds one dou and two sheng and put in nine sheng of clear wine; while the beans are still hot, drop them into the wine; seal the mouth with a paste of honey and mud; after seven days, take it warm. Master Sun (an honorific for Sun Simiao) had another formula: decoct douchi (fermented black beans) into a liquid, wash the head with it, and avoid wind; the headache will then heal.

The Qianjin Yi (Sun Simiao’s Qianjin Yifang) treatment for head wind: pound tinglizi (a medicinal seed), pour hot water over it to obtain the liquid, and wash the top of the head with it. Another formula is a hair-washing method: take two sheng of wuzhuyu (Evodia rutaecarpa), add five sheng of water, boil down to three sheng, dip a cotton cloth in the liquid, and wipe the roots of the hair.

The Shenghui Fang (the Taiping Shenghui Fang, an officially compiled formulary of the Northern Song) treatment for head-wind pain, which mostly occurs on cloudy and rainy days or before the wind rises: take one liang of guixin (the inner bark of cinnamon), grind it into a fine powder, mix it with wine into a paste, and apply it to the top of the head and the temples.

Chen Zangqi’s Shiyi Xu (Chen Zangqi was a Tang dynasty pharmacologist; this refers to his Bencao Shiyi) says: for a severe headache that nearly kills the patient, grind xiaoshi (a mineral drug) into powder and blow it into the nostrils, and the patient will recover.

Ri Huazi (the Ri Huazi Bencao, a Tang dynasty pharmacopoeia) says: to treat headache, mix jue ming zi (cassia seed, a medicinal seed) with water and apply it to the temples. Another formula is to make a pillow with jue ming zi; its effect surpasses that of black beans, and it can treat head wind and also improve eyesight.

The Waitai Miyao (by Wang Tao of the Tang dynasty) treatment for severe headache that feels as if the head will split: take two liang of danggui (Angelica sinensis), boil it in one sheng of wine down to six ge (about 600 milliliters), and divide it into two doses.

The Sun Zhao Koujue (a work of oral formulas by the Song physician Sun Zhao) says: beans (the original text does not specify the variety) can treat head wind and also improve eyesight.

The Ge Xianweng Zhouhou Beiji Fang (Emergency Prescriptions Kept Behind the Elbow, a collection of medical formulas attributed to the Jin-dynasty Daoist Ge Hong).

The Waitai Miyao (Arcane Essentials from the Imperial Library), a medical work compiled by Wang Tao in the Tang dynasty, records a formula for severe headache that feels as if the head is about to split: take two liang of danggui (Chinese angelica), add one sheng of wine, and decoct until six ge remain (about one-sixth of a sheng); divide into two doses and drink.

The Sun Zhao Koudjue (Oral Formulas of Sun Zhao), by the Song physician Sun Zhao, says: the following are formulas for treating headache.

Take equal amounts of fuzi (aconite, poisonous and requiring prior processing) and shigao (gypsum, calcined), grind them into a fine powder, add a small amount of longnao (borneol) and shexiang (musk), and take it with tea or wine, half a qian each time (an ancient weight unit, about half of one qian).

The Doumen Fang, a Song dynasty formulary, records a treatment for sudden headache: grind baijiangcan (white silkworm) into powder, remove the threads, and take two qianbi (a small spoon used for taking medicine) of the powder with warm boiled water; it takes effect immediately. Another formula, for migraine: cut jingxiong (that is, chuanxiong, Ligusticum) finely, soak it in wine, and take it; the effect is very good.

The Boji Fang, a Song dynasty formulary, records a treatment for migraine called “Zhiling San” (Powder of Ultimate Efficacy): equal amounts of xionghuang (realgar, poisonous) and xixin (Asarum), ground into a fine powder; each dose should not exceed one “zi” (a small pinch). If the pain is on the left, blow the powder into the right nostril; if it is on the right, blow it into the left nostril; it takes effect immediately.

The Jingyan Houfang records an extremely effective treatment for migraine: grind bibo (long pepper) into powder and have the patient hold warm water in the mouth. If the pain is on the left, have the left nostril inhale one zi of the powder; if it is on the right, have the right nostril inhale one zi; the effect is immediate.

The Jiyan Fang records a treatment for migraine and headache: grind one liang of gujingcao (Eriocaulon) into powder, mix it with white flour, spread it on paper to make a plaster, and apply it to the painful area; change it when it dries.

Formula for migraine: fill a clam shell with raw radish juice, lie face up, and drip the juice into the nose. If the pain is on the left, drip it into the left nostril; if on the right, into the right; if both sides hurt, drip into both. It is very effective. (This entry has the same content as the preceding one.)

The Waitai Miyao records a formula for head wind (toufeng) with white flakes on the scalp like bran from wheat husks: choose hard, solid paper-mulberry (chumu, that is, Broussonetia) wood to make a pillow, and replace it with a new one every sixty days.

Formulas for Sudden Wind-Stroke and Loss of Voice (Twentieth):

Formula for sudden inability to speak: boil melon seeds in bitter wine (vinegar), apply the cooked seeds in a circle around the neck, then wrap the area with clothing. After a full day and night, unwrap it, and the illness will be cured.

Another formula: boil soybeans, then concentrate the liquid until it is as thick as maltose (yi), and hold it in the mouth. One may also simply boil soybeans into a very thick decoction and drink it directly.

This passage is a set of prescriptions from Ge Hong’s Zhouhou Beiji Fang (Emergency Prescriptions Kept Up One’s Sleeve) for treating sudden loss of voice and hoarseness; most entries duplicate earlier text. Another prescription: boil douchi (fermented black beans) to make a juice and take it in divided doses over one day; or stir half a sheng of good wine into the douchi juice and take it in three doses. Another prescription: take fresh, good cinnamon bark, scrape off the outer bark, pound and sieve it, take a pinch held between three fingers, place it under the tongue to dissolve, and swallow. Another prescription: cut the branches and leaves of the gu tree (the plant referred to is difficult to identify) into pieces, boil them in wine, and when the medicinal foam floats up, drink an amount according to the severity of the illness. For sudden loss of voice, use the same method as the cinnamon-bark prescription above. The next entry is the same as the gu-tree prescription; the original text repeats it. For sudden loss of voice with a choking sensation in the throat and inability to make sound, take five liang of tangerine peel, add three sheng of water, boil down to one sheng, remove the residue, and take it all at once. Another prescription: decoct bitter bamboo leaves strongly into a juice; it takes effect after being taken. Another prescription: pound the root of ranghe (a ginger-family plant), add wine, wring out the juice, and drink it; the original notes that this prescription comes from the “Miscellaneous Treatments” chapter. Another prescription (for zhongfeng): tongcao, dried ginger, aconite, and fushen, half a liang each; fangfeng, cinnamon, and gypsum, two liang each; ephedra, one and a half liang; atractylodes, half a liang; and thirty apricot kernels—ten ingredients in all. Pound them, sieve into a powder, and make honey pills the size of soybeans; take seven pills each time and gradually increase the dose. The original notes that these prescriptions “all treat zhongfeng” and that there are also various decoctions such as bamboo juice; although this prescription uses few drugs, it is directed at the condition, and if one dose does not take effect, it should be continued.

Another prescription: needle the point one and a half cun lateral to Dazhui (on the back of the neck), then needle below it, and retain the needles. Another prescription: grind alum and cinnamon bark into powder, wrap it in silk floss to the size of a date pit, place it under the tongue, and spit out the saliva whenever it collects in the mouth. Another prescription: heat the iron bit of a horse’s bridle until red-hot, put it into one sheng of bitter wine (vinegar), break in one egg, stir well, and drink. If sudden exposure to cold (“sudden attack by cold”) causes hoarseness, use one liang of licorice together with alum, cinnamon powder, and other drugs; the content that follows is the same as the two preceding prescriptions.

Background note: “Zu” means sudden onset; “zhongfeng” in ancient times broadly referred to acute conditions such as sudden fainting, loss of speech, and half-body paralysis, a wider range than modern medical stroke. The book repeatedly uses aconite, a fairly toxic medicinal material that the ancients processed before use; it should not be taken on one’s own. These are ancient therapeutic experiences and cannot replace modern medicine. If symptoms such as sudden loss of speech, drooping of the mouth or facial deviation, or weakness of the limbs occur, one should seek medical attention immediately.

If a person suddenly suffers a wind-stroke caused by cold, with a hoarse voice, use one liang of licorice, two liang of cinnamon heart, two liang of schisandra, thirty apricot kernels, and eight liang of fresh ginger (sliced). Add seven sheng of water and decoct until two sheng remain; divide into two doses and take.

Appended formulas:

The Jingyan Houfang records a treatment for inability to speak after wind-stroke: use one liang of duhuo (Angelica pubescens), crushed, add two sheng of wine, and decoct until one sheng remains. Separately take five ge of soybeans (about half a sheng) and roast them until they crackle. While they are hot, pour the medicinal wine over the beans, cover, and let them steep for a while; then take three ge warm. If not fully recovered, take one more dose.

Another formula treats inability to speak after wind-stroke, with a sawing sound in the throat and saliva and froth flowing from the mouth: take one fen of Veratrum (lilu; it is toxic, so the dosage must be used with caution) and one Arisaema rhizome (tiannanxing). Remove the outer coarse skin and hollow out a small pit at the top; pour one large spoonful of aged vinegar into the pit and roast over fire from all sides until it turns yellow. Then pound the ingredients together and grind them extremely fine. Make pills with fresh honey, the size of red beans, and take three pills each time, washed down with warm wine.

The Sheng Hui Fang records that for wind-stroke with throat discomfort and a coarse, loud speaking voice, the method is the same as above: pound and grind fine, make pills the size of red beans with raw honey, and take three pills each time, washed down with warm wine.

Another formula from the Sheng Hui Fang treats wind-stroke with throat discomfort: take two liang of mioga ginger (ranghe, a ginger-family plant) root, pound it, and squeeze out the juice. Add one large cup of wine and mix evenly; take half a cup warm, with no fixed time for taking it.

The twenty-first formula is for leg weakness, itching and fullness, and upward qi caused by wind toxin.

Foot qi disease—an ancient disease mainly characterized by lower-limb pain and numbness, weakness, swelling, and qi counterflow—first originated in Lingnan (present-day Guangdong and Guangxi) and later gradually spread northward to Jiangdong. Its onset often lacks a clear gradual progression. Sometimes there is only slight pain and numbness in the calves, or slight swelling of both lower legs, or sudden weakness of the legs while walking, or loss of sensation in the lower abdomen, or alternating cold and heat; these are all its signs. If it is not treated promptly, the pathogenic factor will move upward into the abdomen, causing qi counterflow to rush upward and even causing death. In treating this disease, decoctions, medicinal wines, and externally applied plasters are often used. There are many effective formulas, more than just one prescription; here only those methods that are effective when used alone have been selected, to be used in combination with moxibustion.

I. Symptoms and Initial Treatment

(In patients with jiaoqi, or foot qi,) sometimes feeling cold and sometimes feeling hot are both signs of the disease’s progression. If treatment is not given promptly, pathogenic Qi will move upward and enter the abdomen. Once pathogenic Qi enters the abdomen and the Qi mechanism becomes disordered, it can cause death. In treatment, decoctions, medicinal wines, liniments, and plasters are often used; after repeated trials, more than one formula has proved markedly effective. Here only single-ingredient effective formulas are selected, to be used together with moxibustion (burning acupoints with mugwort fire).

II. Fermented Soybean Wine Formula

Take one sheng of good-quality fermented soybeans (douchi), steam them three times and sun-dry them three times, then steep them in three dou of good wine for three nights before drinking. The amount to drink should be determined according to the individual. For prevention, one need not wait until the disease appears; at any time, boil the fermented soybeans in wine and take it. If the legs have already become weak and powerless, then after slight improvement one may take other formulas as well and apply moxibustion.

III. Duhuo Wine Formula

Take five liang of duhuo (Angelica pubescens) and five liang of raw fuzi (aconite; used raw and sliced), steep them in one dou of wine, and take after three nights. Initially take one ge each time; the appropriate dose is the amount that produces slight numbness in the body after taking it.

IV. Alum Formula

Take two jin of alum stone (baifanshi; powdered stalactite may also be substituted), three liang of fuzi (aconite; ground into powder), and three sheng of fermented soybeans; steep them in three dou of wine for four or five days, then drink gradually. If the patient also has rebellious Qi, add two sheng of suzi (purple perilla seeds).

V. Sulfur and Cow’s Milk Formula

Grind three liang of good-quality sulfur into a fine powder and use five sheng of cow’s milk. First bring the five sheng of cow’s milk to a boil, then add the sulfur and simmer until three sheng remain; take three ge each time. One may also simmer sulfur directly in cow’s milk without adding water. If cow’s milk is unavailable, goat’s milk may be used.

VI. Diaphoretic Formula

First simmer three sheng of cow’s milk down to half; each time take five ge and simultaneously take one liang of sulfur powder. After taking it, cover the body with a thick quilt to induce sweating, and take care not to be exposed to wind. Take another dose in between, and another in the evening. If sweating has already occurred, there is no need to take more; simply rest and recover carefully. If the illness is not yet cured, the formula may be used again after several days. If long-term use is required, the medicine may be prepared as pills. Northerners often obtain good results using this formula to treat jiaoqi, but the sulfur must be of the highest quality and should be prepared in advance.

If the lower legs are severely swollen and a finger pressed into them leaves a depression that does not immediately spring back (edema), have the patient drink two or three sheng of urine from a black calf to promote free urination, and the swelling will gradually subside. It is best to collect freshly voided urine in a bronze vessel. If no black calf is available, a pure yellow cow may also be used.

Another formula: take Qianniuzi (the seed of the morning glory; a Chinese materia medica that promotes water metabolism and bowel movement), crush it, and make pills with honey. Take five pills at a time, each the size of a small bean, to promote free urination. The seeds may also be swallowed whole. Qianniuzi is black and closely resembles the pit of a qiu fruit; it is also sold in the market.

Another formula: take Sanbai root (a medicinal herb with a white rhizome), crush it, and take it with wine.

Another formula: boil soybeans in wine or water and drink the broth.

Also, eating small beans (adzuki beans) is beneficial. Also, grind raw sesame into powder, mix it with wine, and take it; the illness will be cured.

Another formula: take three sheng of soybeans, add one dou of water, boil down to nine sheng, add nine sheng of clear wine, and simmer again down to nine sheng. Drink it slowly. Urination will become free, the swelling will subside, and its liquid may also be drunk.

Other decoctions such as Fengyin Decoction, Baiji Decoction, Zhuli Decoction, and Duhuo Decoction, as well as powders such as Bafeng Powder, Shihu Powder, and Gouji Powder, are recorded separately among the major formulas. Jinya wine is a key formula for treating this illness; its formula is recorded as follows.

Sichuan pepper (huajiao produced in Sichuan), Yinyu, Jinya, Xixin, Wangcao, dried Rehmannia, Fangfeng, aconite, Difu, Shuodiao, and Shengma, four liang each; ginseng, three liang; Qianghuo, one jin; and Niuxi, five liang—fourteen ingredients in all. Chop them, steep them in four dou of wine for seven days, and drink two or three ge each time, gradually increasing the dose. This wine can also treat inability to speak and difficulty in flexing and extending the legs, with very good results. There is also Cezhi wine (made with the small lateral tuber that grows beside the aconite root), which is likewise effective.

This section discusses brewing medicinal wine from baqia (Smilax china, a climbing vine also known as Jingangteng), as well as the use of several moxibustion points.

Poor farming families can make this medicine themselves. Baqia, pine knots, and pine needles can all be used. Wash and chop the baqia, take one hu (an ancient capacity unit, roughly ten dou), add three hu of water, and boil it down to nine dou. Use the medicinal decoction to steep the wine starter; take another hu of the decoction to soak rice, then steam the rice. Next, ferment it according to the usual winemaking method, and once mature it can be drunk. The amount drunk is unrestricted, and three to five hu can be brewed at a time. Pine knots and pine needles can be used in the same way, and the more concentrated the medicinal decoction, the better. This wine can treat contracted legs, inability to walk for many years, contracture, spasm, and numbness of the lower back and spine, as well as tight, knotted conditions in the abdomen; after three to five courses it can bring recovery. If baqia is unavailable, pokeweed (Shanglu, Phytolacca; a toxic herb that must be used with caution) growing near water can be used as a substitute.

There are many points for moxibustion, and because people may not be able to master them all, only the essential ones are listed here. Moxibustion must always begin from the upper part of the body. If one directly moxas the feet, the qi may rise upward without being able to disperse, which is dangerous; therefore one first moxas Dazhui (below the prominent vertebra at the lower back of the neck).

At the place where the bone joint on the neck protrudes, moxa one point above it. If rebellious qi is not flowing freely, one may first moxa Baihui (the depression at the center of the crown) for fifty zhuang (a moxibustion count unit; one cone burned through is one zhuang).

Next, moxa Jianjing one hundred zhuang on each side, located in the depressions of both shoulders near the neck; pinch with the fingers to locate them, and make the moxa align directly over the points.

Next, moxa Shanzhong for fifty zhuang, located between the breasts, at the junction of the sternum and ribs. Press with a finger; if a faint movement of qi is felt, that is the point. Another account holds that it is a single point right in the center of the chest.

Next, moxa Juque, located one cun below the heart-pit bone (the xiphoid process), measured with a red thread.

Moxaing these five points together is already enough to regulate the qi. If one can also moxa Baihui, Fengfu, Weiguan, and the five Zang shu (the back points corresponding to the five viscera), the effect will be even better, depending on whether the illness is urgent or slow. The detailed locations of the various points are found in the Moxibustion Classic (Jiu Jing), and cannot all be listed here.

Next, moxa Fengshi for one hundred zhuang. Fengshi is located on the outer sides of both thighs; when one stands naturally with both hands hanging down, the place reached by the tip of the middle finger is the point.

Next, apply moxibustion to Fengshi (Wind Market) with one hundred cones. Fengshi is located on the lateral side of the thigh. To locate it, the patient stands naturally upright with both hands hanging down and pressed against the sides of the thighs; the spot touched by the tip of the middle finger, at the large tendon, is the point. If pinched with the fingers, one will feel a sensation of comfort.

Next, apply moxibustion to Zusanli (Leg Three Miles) with two hundred cones. To locate it, measure using the patient’s own hand placed horizontally; the width of four fingers held together is called “one fu.” Measuring from below the kneecap, the point is where the middle joint of the finger falls, close to the lateral side of the tibia; pressing and pinching with the finger reveals a depression.

Next, apply moxibustion to Shanglian (Shangjuxu) with one hundred cones. Then apply moxibustion to the point one fu below Zusanli.

Next, apply moxibustion to Xialian (Xiajuxu) with one hundred cones. Xialian is one fu below Shanglian.

Next, apply moxibustion to Juegu (Xuanzhong) with two hundred cones. Juegu is more than three cun above the lateral malleolus. To locate it, begin at the upper border of the malleolus and measure four cun with the fingers bent; it is opposite Xialian, with one point lying between the two. The above eighteen points are all important points; in addition, there are points such as Futu and Dubi. The number of cones need not be completed in one session; completing them in divided sessions within three days is sufficient.

Another prescription: take two jin of Konggongnie (a medicinal substance) and five liang of Shihu (Dendrobium), steep them in two dou of wine, and drink it.

Supplementary Prescriptions

Doumen Fang (a Song dynasty formulary): For sudden-onset wind-toxin with swelling, shortness of breath, and pain. Take one jin of white willow bark, chop it, boil it with wine until hot, wrap it in cloth, and apply it as a hot compress to the swollen area; when it cools, boil and replace it again. The effect is very good.

Shenghui Fang (i.e., Taiping Shenghui Fang): For migratory wind-toxin pain. Grind white mustard seed into powder, mix it with egg white, and apply it to the affected area.

Jingyan Houfang: For pain caused by wind-toxin invading the bone marrow. Grind two fen of peony root and one liang of roasted tiger bone into powder, put it into a silk bag, and soak it in three sheng of wine for five days; take two ge each time, three times a day.

Shiyi Xinjing: It can be used to eliminate various wind-dampness arthralgias and to treat contracture of the limbs with inability to extend.

Grind three liang of Xanthium fruit (cang’erzi) into powder; boil it in one sheng of water, then place it in a silk bag and steep it in three sheng of wine for five days. Take two ge each time, three times a day.

The Shiyi Xinjing (Heart Mirror of Dietary Medicine, a Tang-dynasty work on dietary therapy) says that this formula can expel all kinds of wind-dampness bi syndromes and treat contracture and curling of the four limbs.

Also, grind three liang of Xanthium fruit into powder, add one and a half sheng of water, decoct down to seven ge, remove the dregs, and sip slowly.

It can also treat contracture of the sinews and vessels and longstanding wind-dampness bi pain; it can cause qi to descend, remove pathogenic qi from the bones, free the intestines and stomach, and reduce edema. Taken over the long term, it can lighten the body and boost qi.

Grind one sheng of Coix seed (yiyiren) into powder. Each time take two spoonfuls, add two sheng of water, cook into porridge, and eat on an empty stomach.

It is also said to supplement deficiency and dispel wind-dampness bi pain. Take two liang of tihu (an ancient refined food made from milk, similar to ghee), mix it evenly with one cup of warm wine, and drink one spoonful each time.

Jingyan Fang: To treat skin pain all over the body, grind Polygonum multiflorum (heshouwu) into powder, mix it with ginger juice into a paste, apply it to the painful area, wrap it externally with cloth, and then press it with a heated shoe sole; the effect is very good.

The formula of Sun Zhenren (referring to Sun Simiao): To treat jiaoqi (leg qi, an ancient disease name, commonly characterized by swelling, pain, and numbness of the feet, and in severe cases by qi rushing upward to the heart) and upward qi (panting with qi rushing upward), take one relatively long crucian carp, cut it into raw fish slices, and eat them raw; one or two meals will cure it.

Qianjin Yi (Supplement to the Thousand Gold Pieces, by Sun Simiao): To treat jiaoqi rushing to the heart, take two liang of alum, add one dou and five sheng of water, boil for three to five boils, then soak and wash both feet; the effect is good.

Guangli Fang: To treat jiaoqi rushing upward with restlessness, oppression, mental confusion, and failure to recognize people, take one sheng of soybeans, add three sheng of water, decoct until thick, and strain the juice. Take half a sheng at one time. If the symptoms are not reduced, take another half sheng, and it will settle.

Su Gong says: For anyone suffering from jiaoqi, every morning one may eat one’s fill as one wishes; eat less in the afternoon and do not eat at night. If hungry, one may eat douchi porridge (a thin porridge made with fermented soybeans). If food remains undigested after nightfall, it may provoke cholera.

I. Formula for Treating Jiaoqi (Foot Qi)

Take two liang of galangal (a pungent, warming medicinal), crush it, add three sheng of water, and boil it down to one sheng. Take it all at once, and the illness will subside. When hunger comes, eat a bowl of thin congee; this medicine is best taken on an empty stomach. If galangal cannot be found at the moment, use one liang of mother ginger (that is, fresh ginger) instead, add one sheng of clear wine, and boil until extremely soft; eat it together with the residue. Although its effect is not as good as that of galangal, it still has a clear therapeutic effect.

The Tang Bencao commentary says that these formulas are used to treat jiaoqi (foot qi), a condition chiefly marked by swelling, pain, numbness, and weakness of the lower limbs.

Use hongcao (a Polygonaceae plant, that is, a kind of red knotweed) decocted into a thick juice to soak and wash the affected area; in most cases it proves effective.

II. From the Jianyao Jizhong: Formula for Jiaoqi Extending to the Legs with Swelling and Fullness That Has Long Failed to Heal

Take one liang of black aconite, remove the skin and the hard stem at the root, use it raw, pound it into powder, mix it with fresh ginger juice into a paste, and spread it on the swollen area. When the medicine dries, mix and apply it again until the swelling subsides.

III. Formula for Sudden Attacks and Critical Conditions After Taking Five Minerals Powder (No. 22)

Whenever someone takes Five Minerals Powder (an elixir popular in the Wei and Jin periods, also called Cold-Food Powder; its medicinal nature is dry and fierce, and after taking it one is prone to fever and poisoning), stalactite Cold-Food Powder, or similar substances, if the method of taking is improper and moderation is lacking, it will cause old illnesses to relapse and produce all sorts of strange symptoms. If the attack comes abruptly rather than gradually, it is due to the surging of the drug’s power and should be treated promptly. If various abnormal pains appear in the four limbs or on the body surface:

Wash repeatedly with cold water several hundred times to dissipate the heat toxin; or soak a cloth in cold water and apply it to the affected area, then immediately press, rub, and tap it; or use a stone soaked in cold water to warm-compress the affected area. At the same time, drink warm wine and walk about slowly.

If there are various abnormal pains within the chest and abdomen, with vexation, oppression, and confusion, urgent treatment is required: first take cold water or warm water; if a hot drink is desired, use warm wine, one or two sheng each time, gradually increasing the amount. After feeling somewhat relieved, eat cold food. Heart pain is the most urgent; if the limbs are cold and the jaws are clenched, simply pry open the teeth and pour in hot wine, and it will take effect.

If there are masses in the abdomen, stagnant heat, or chronic accumulations that cause many diseases to arise, urgently use a purgative method to attack and remove them.

This passage comes from Ge Xianweng’s Zhouhou Beiji Fang (Emergency Formulas Kept Up One’s Sleeve), and most of it consists of emergency formulas of the purgative and detoxifying kind. Some of the drugs listed below are toxic—for example, yuanhua (Daphne genkwa) and badou (Croton seed)—and the ancient doses and methods of administration must not be copied directly.

In the first formula, take fourteen gardenia fruits (zhizi) and five ge of fermented soybeans (douchi), add two sheng of water, boil down to one sheng, and take it in a single dose. If the heat signs are severe and sores have already formed, add two liang of huangqin (Scutellaria baicalensis). In the second, if retained food is still undigested, or if one has eaten something unsuitable and has an aversion to cold, one may purge once more. In the third, take one sheng of rhubarb powder (dahuang) in a single dose. If the heat signs are severe and sores have already formed, likewise add two liang of huangqin. In the fourth, if retained food is still undigested, or if one has eaten something unsuitable and has an aversion to cold, purge again.

In the fifth formula, take half a sheng of rhubarb powder, half a sheng of mangxiao (mirabilite), two liang of licorice (gancao), and one portion each of banxia (Pinellia), huangqin, and yuanhua. Pound them into a powder and keep it in a sealed vessel. When it is to be taken, boil twenty jujubes in eight sheng of water until soft, take four sheng of the liquid, remove the jujubes, add five fangcunbi (square-inch spoonfuls) of the medicinal powder, and stir evenly. Place it over the fire, and during boiling lift it and set it down three times; after decocting, divide it into three doses. The first dose is taken in the morning. If the stool has already become free, stop the medicine; if it is still not relieved, take one more dose. After purging, immediately drink wine gruel and eat two sheng; then nourish oneself with shuisun (water-softened rice gruel). One must eat immediately after purging because the stomach is empty after the purge, and if external pathogens enter while it is empty, they can cause death.

In the sixth formula, after purgation one should keep the following medicines on hand for long-term use: one ge each of rhubarb, tingli (Descurainia seed), and fermented soybeans, and thirty pieces each of apricot kernels (xingren) and badou. Pound them, mix with honey to make pills the size of a hu bean (fava bean), and take two pills daily. If the stool is passed too freely, reduce the dose; if there is abdominal distention and fullness (pi), increase the dose.

This passage discusses the regimen and precautions after taking medicines of the “milk stone” type—mineral-based elixirs popular from the Wei-Jin through the Tang, such as Five Minerals Powder—and appends several therapeutic formulas.

After taking such a medicine, one should keep the body cool, and any medicines used should preferably be detoxifying and cold in nature. Once the drug’s effect becomes evident and the symptoms subside, one may stop taking it, resuming only after twenty or thirty days. In daily life one should regularly do physical labor, and must not fast or go hungry, nor eat spoiled rice or foul-smelling fish or meat. It is inadvisable to drink hot soup, wear thick clothing, sit close to a fire, travel far in summer heat, or expose oneself to wind and cold. The general principle is to keep the body robust and solid, able to endure labor. If the symptoms have already broken out, one has no choice but to force oneself to take the medicine in order to suppress them. If after taking the medicine the mineral drug still remains lodged and uneliminated, or if vexing heat persists, this indicates improper regulation; one should prevent and treat it according to the methods above.

The author further says that these methods are mostly used by the rich and noble, whereas poor people have fewer reactions after taking the medicine, because their long exposure to cold and toil makes their bodies more able to endure it. The author worried that people in emergencies would not know what to do, and therefore briefly recorded these few items for use when time is short; detailed contents are found in the major formularies.

Among the appended formulas, the Sheng Hui Fang treats an outbreak of milk-stone reaction with congested accumulated heat inside, manifesting as chest oppression and vomiting blood. Fresh thistle is pounded to extract its juice; take three ge each time, add a little honey, stir well, and take it. The Shiliao treats an outbreak of heat toxin after taking cinnabar or mineral elixirs. The root of wild rice, that is, the root of jiaobai, is boiled together with crucian carp into a soup and eaten; two or three meals should bring recovery.

For sudden upward Qi and cough—“sudden upward Qi” means an abrupt counterflow of Qi, and “cough” means cough—one formula is: pound Chinese chives to obtain juice and drink about one sheng; it takes effect immediately. Another formula: take three sheng of finely cut white mulberry root bark, three liang of fresh ginger, and half a sheng of Evodia fruit; add seven sheng of water and five sheng of wine, bring to a boil three times, strain, and take the whole dose. As soon as one sheng enters the mouth, the Qi descends. It is noted as coming from a secret formula in the Qianjin. Another formula: take two sheng of Evodia and three liang of fresh ginger, add seven sheng of water, decoct down to two sheng, and divide into three doses.

1. Formula for Relieving Cough and Calming Wheezing (I)

Another formula: Ephedra 4 liang; cinnamon twig and licorice 2 liang each; apricot kernels 50 pieces. Stir-fry together until slightly yellow, then grind into a fine powder. Take one square-inch spoonful (fangcunbi, an ancient small measuring spoon holding about one square inch of medicinal powder) with warm boiled water, three times daily.

2. Ginseng Formula

Another formula: Grind ginseng into a fine powder. Take one square-inch spoonful each time, five or six times daily.

3. Formula for Chronic Cough

To treat qi cough (cough accompanied by wheezing), regardless of how long the illness has lasted, taking this formula brings recovery.

4. Tangerine Peel Pill Formula

Aged tangerine peel, cinnamon heart (the inner layer of cinnamon bark), and apricot kernels that have had their tips and skins removed and been stir-fried: take equal amounts of the three ingredients, pound them, and make pills with honey. Take twenty pills after meals with tea decoction, and avoid raw scallions. This formula was transmitted by Vice Minister Shi. It is likewise suitable for those with long-standing cough, who recover after taking it. (This formula appears repeatedly in the original text, with identical content.)

5. Formula for Sudden Syncope and Counterflow Qi Rushing Upward

For sudden syncope, counterflow qi rushing upward, and distending pain, fullness, and oppression below both chest and hypochondria, with the patient nearly suffocating. Soak both feet and both hands in hot water (hot enough to be almost scalding to the hand), repeatedly replacing the water.

6. Bentun Disease and Rescue Decoction Formula

This disease is called “Bentun” (qi rushing upward from the lower abdomen like a running piglet), and it often arises from sudden fright, fear, or oppressive worry. The qi surges upward from below and rushes to the area between the chest and the navel, throbbing and attacking as if a wall were being pounded up. If not treated promptly, it can cause death. The various formulas use many ingredients and also require treatment according to the specific pattern; only the following decoction is simple and easy to prepare.

Licorice 2 liang, ginseng 2 liang, cinnamon heart 2 liang, evodia fruit 1 sheng, fresh ginger 1 jin, and pinellia 1 sheng. Add 1 dou of water and decoct until 3 sheng remain; divide into three doses. This medicine should be prepared in advance, so that once an attack occurs it can be mixed and taken immediately.

7. Ephedra and Apricot Kernel Powder Formula

Another formula: Ephedra 2 liang and apricot kernels 1 liang, stir-fried until slightly yellow, pounded into a powder. Take one square-inch spoonful with wine; after several doses, recovery occurs.

8. Formula for Sudden Qi Depletion and Rapid Breathing

For sudden insufficiency of qi, inability to continue breathing, rapid breathing, and shoulder-raising panting.

Dried ginger 3 liang, chopped, steeped in 1 sheng of wine. Take 3 ge each time, three times daily.

9. Moxibustion Method

Another method: Use the patient’s own thumb to measure a point below the heart (using the patient’s thumb as the standard). Apply moxibustion at that point with three cones (each cone being one moxa treatment), and recovery will occur.

Another formula: Take ephedra three liang; first decoct it and skim off the foam (ephedra readily produces foam during decoction, which should be removed first). Then add licorice two liang, use three sheng of water, decoct until one and a half sheng remain, and divide into three doses.

After recovery, if you wish to prevent recurrence, take the ephedra and licorice above, add fifty stir-fried apricot kernels (that is, “xingren”), grind them into powder, mix with honey, and form pills. Take four or five pills each time, each pill the size of a wutong seed, three times a day, until fully cured.

Another formula: Ephedra two liang, cinnamon twig and licorice one liang each, apricot kernels forty pieces; use six sheng of water, decoct until two sheng remain, and divide into three doses. All three formulas above may be taken in small amounts from a small cup, divided into several doses. If there is also a “qi rash” pattern, the medicines may also be pounded into a powder and taken over a long period. If cold signs are obvious, add dried ginger three liang; if there is copious phlegm, add pinellia three liang.

Formula for treating “great galloping” (violent running) and rushing about until panting and exhausted, followed by immediately drinking cold water, causing upward qi (qi rushing upward) and fever:

Take bamboo leaves three jin and tangerine peel three liang; use one dou of water, decoct until three sheng remain, remove the residue, and divide into three doses. Take one dose every three days; the effect is very good.

Formula for treating, in hot weather, excessive fatigue, or eating hot cakes and then drinking a large amount of cold water, so that water-qi rushes upward to the throat and cannot disperse immediately, causing stagnation of the qi mechanism and panting:

Use equal amounts of rhubarb, dried ginger, and croton seed; grind into a fine powder and take half a qianbi (a qianbi is an ancient small spoon for measuring medicinal powder, roughly one small spoonful). If vomiting or diarrhea occurs, the illness will be cured.

If there still feels to be stagnation in the chest and diaphragm, with an uncomfortable sensation:

Melon pedicel two fen, Duheng (Asarum) three fen, ginseng one fen; pound and sift, and take one qianbi with hot water, two or three times a day. It is effective.

Formula for treating lung wilt (a chronic cough and panting condition caused by weakness of the lungs and depletion of fluids), with cough, expectoration of frothy saliva, a vaguely warm and unsettled feeling in the chest (irritability and unease), and restlessness without thirst:

Fresh ginger five liang, ginseng two liang, licorice two liang, jujube eleven pieces; use three sheng of water, decoct until one and a half sheng remain, and divide into two doses.

Another formula: Licorice two liang… (The original text is incomplete; only the indication it treats is visible—“vague unease, restlessness without thirst”—and the formula is incomplete.)

Note: The above are records from ancient formula books. Ancient and modern weights and measures and medicinal specifications differ considerably; the dosages in these books should not be copied directly. Please follow a physician’s advice for medication.

Formula One (Fresh Ginger and Ginseng Decoction): Take five liang of fresh ginger, two liang of ginseng, two liang of licorice, and eleven jujubes; add three sheng of water and simmer until about one and a half sheng remain, then take in two doses. Ginseng supplements Qi, while fresh ginger and jujube harmonize the spleen and stomach; this specifically treats Qi counterflow with cough and wheezing.

Another Formula (Licorice Decoction): Use only two liang of licorice; add three sheng of water and simmer down to one and a half sheng, then take in two doses.

Another Formula (Tianmendong Paste): Pound fresh Tianmendong (Asparagus root) to obtain one dou of juice; add one dou of wine, one sheng of maltose syrup, and four ge of Aster root (a cough-suppressing herb). Place in a copper vessel and slowly decoct in a water bath into a paste, then roll into apricot-sized pills. Take one pill per dose, up to three times a day.

Another Formula (Licorice and Dried Ginger Decoction): Two liang of licorice, three liang of dried ginger, and twelve jujubes; add three sheng of water and simmer down to one and a half sheng, then take in two doses. Dried ginger warms the middle and disperses cold, making it suitable for cough and wheezing caused by exposure to cold.

Treating “Sudden Cold with Upward Qi” (sudden exposure to cold, wheezing and cough with counterflow Qi): Three liang of dried perilla leaf and four liang of aged tangerine peel; add four sheng of wine and simmer down to one and a half sheng, then take in two doses. Perilla leaf disperses wind-cold, while tangerine peel regulates Qi and transforms phlegm.

Treating “Sudden Cough”: One method uses one fen of hearth earth (aged stove earth from the bottom of a pot) and seven fen of fermented soybean; crush and make into pills the size of parasol-tree seeds, and take fourteen pills each time. Another method uses one black-boned chicken, slaughtered and cleaned in the usual way, soaked in good wine for half a day; remove the chicken and drink the wine. Another account says to cook a white chicken in one dou of bitter wine (i.e., vinegar) until it reduces to three sheng, take it in several doses, and eat the chicken; avoid adding salt, for a better effect. Yet another method: after preparing a black-boned chicken as above, soak it in good wine for half a day, drink the wine, and eat the chicken in three portions, without salt.

Moxibustion Methods: Moxa a single point in the space between the fifth and sixth vertebrae below the Dazhui acupoint; the number of moxa cones is calculated according to the patient’s age (“according to the year”). “Zhuang” means one burning of a moxa cone, i.e., one cone. This method also treats Qi counterflow with cough and wheezing. Moxa at the junction between the areola and surrounding skin below both breasts, one hundred cones on each side; this can also treat wheezing. Moxa at a point on the chest directly opposite the nipples, likewise according to the patient’s age.

Peach Kernel Wine Formula: Take three sheng of peach kernels, peel and crush them, place in a container, seal the opening, and steam for the time it takes to cook a meal. Sun-dry, then place in a silk bag and steep in two dou of wine for six or seven days. Drink four or five ge each time, then gradually increase to one sheng.

Background note: These are mostly ancient folk formulas. Peach kernels contain amygdalin, which is toxic in large amounts, and the dosage and concentration of wine infusions cannot be measured by modern standards, so they should not be copied directly. If cough and wheezing symptoms persist or worsen, seek medical attention promptly.

Another prescription: take six liang of maltose (malt syrup, anciently called yi) and six liang of dried ginger, grind them into powder; and two liang of fermented soybean (dandouchi). First boil the fermented soybean in one sheng of water; after it has boiled three times, remove the residue, then add the maltose and let it dissolve, add the dried ginger powder, and take it in three divided doses.

Another prescription: mix maltose with minced fresh ginger, place it on rice steamed from three dou of rice, steam until cooked, form into pill-sized balls, and take them ten times day and night.

Another prescription: cut two pig kidneys into fine pieces, grind three liang of dried ginger into powder, boil them in seven sheng of water, and take in three divided doses.

Another prescription: mix maltose with minced fresh ginger, place it on rice steamed from three dou of rice, steam until cooked, form into pill-sized balls, and take them ten times day and night.

Another prescription: cut two pig kidneys into fine pieces, grind three liang of dried ginger into powder, add seven sheng of water and boil down to two sheng; take in small divided doses, and after taking it cover with a quilt to induce a slight sweat.

Another prescription: roast the “black heart” and eat it; the effect is good. (Interpretations of “black heart” differ among commentators; most explain it as the heart of a black chicken.)

Another prescription: mix fresh ginger juice with the juice of Baibu (Stemona root, a perennial herb whose tuberous roots are used in medicine) and decoct them together; take two ge each time (an ancient capacity unit).

Another prescription: take four liang of Baibu root, soak it in one dou of wine for two nights, heat it, and take it warm, one sheng each time, twice daily.

Another prescription: pound two hundred Sichuan peppercorns into powder; roast two hundred apricot kernels (the kernels inside apricot pits); and pit one hundred jujubes. Combine the three and pound them until extremely fine, roll into jujube-pit-sized pills, and take them.

Another prescription: pound three liang of fresh ginger to extract the juice; take three liang of dried ginger shavings; and take one sheng of apricot kernels, peel them and roast them. Combine and pound into pills; take three pills each time, five or six times daily.

Another prescription: pound one sheng of yuanhua (Daphne genkwa, a deciduous shrub whose flowers are toxic and used in medicine mainly to drain water) to extract the juice; take three liang of dried ginger shavings; and take one sheng of apricot kernels, peel them and roast them. Combine and pound into pills; take three pills each time, five or six times daily.

Another prescription: take one sheng of yuanhua, add three sheng of water, boil down to one sheng, remove the residue, add fourteen jujubes, and decoct until the liquid is absorbed; eat once daily, and stop after three consecutive days.

Another prescription: take one liang of Tinglizi (the seed of a cruciferous plant; cold in nature, used by the ancients to descend qi and move water), roast it and pound it; take three dried jujubes and three sheng of water. First boil the jujubes, obtain one sheng, remove the jujubes, add the Tinglizi, and decoct down to five ge; adults take it in three divided doses, children in four.

Five-Cough Pill (Hua Tuo’s formula): Take equal amounts of roasted Chinese honey locust pods (the fruit of a leguminous plant, used medicinally), dried ginger, and cinnamon twig; crush them, and make honey pills the size of wutong seeds. Take three pills each time, three times a day.

Another formula: Take one fen of pine shavings, two fen of cinnamon twig, and two liang of Chinese honey locust pods. Roast the pods, remove the skin and seeds, crush them together with the other ingredients, and make honey pills the size of wutong seeds. Adults take fifteen pills each time; children (the original text writes “small elder brother,” which is a mistake for “small child”) take five pills, once or twice a day.

Another formula: Grind white clam shells taken from the roof into a fine powder and take one fangcunbi (an ancient measure for medicinal powder, about one small teaspoon) with wine. The shells may also be roasted, stripped of their outer layer, crushed, and made into honey pills in the same way, taken by the same method as above.

Another formula: Use only the powder of white clam shells and take one fangcunbi with wine.

Another formula: Grind “Fusan stone” (fusanshi) into powder and take it; it may also be made into honey pills.

Another formula: Take one portion of pork, cut it into thin slices, cook it thoroughly in bitter wine (vinegar), and eat it all. Take no more than twice.

Another formula: Take two liang of Daphne genkwa (yuanhua), add two sheng of water, bring to a boil four times, then strain off the residue. Add one jin of white sugar, and take a piece the size of a jujube each time. While taking it, avoid salty and sour foods. This formula can also treat chronic cough.

Treating chronic cough with upward Qi: The above formulas are mainly used to treat prolonged cough and the symptom of “upward Qi” (Qi rebelling upward, with panting and shortness of breath).