《葛仙翁肘后备急方》Vol. 3

For chronic cough lasting ten or twenty years that no medicine has cured, this formula may be used. Take three pig pancreases, one hundred red jujubes, and three sheng of wine; soak for several days. Each time take two or three ge, gradually increasing to four or five ge. After taking it for a short time, the illness will be cured.

Another formula: Take one live turtle and place it in a pit. Pour urine over it so that it is submerged. After the turtle dies, let it soak for another three days, then remove it, burn it to ash, and mix the ash with one sheng of pure wine into a paste the consistency of cooked rice. Take it in one dose. Before long there will be violent vomiting, expelling phlegm, saliva, and other foul matter, and the illness will be cured. Children may take half a sheng.

Another formula: Take three live turtles, process them as above, remove the internal organs, and boil them in five sheng of water down to three sheng of liquid. Use this to soak wine starter, then brew wine in the usual way with four sheng of glutinous millet, a sticky variety of broomcorn millet. Drink two sheng and finish it all; it is said that this can permanently eradicate the root of the illness.

Another formula: Take a bat, remove its head, roast it until scorched yellow, remove the internal organs, and boil it in five sheng of water down to three sheng of liquid. The rest of the procedure is the same as above. Drink two sheng and likewise finish it all; it is said that this can also permanently eradicate the root of the illness.

Another formula: Take a bat, remove its head, roast it until scorched yellow, grind it into powder, and take it with wine.

Appendix Formulas

Sun Zhenren’s Formula (traditionally attributed to the famous Tang physician Sun Simiao): To treat cough. Burn soap pods and grind them; take two qianbi, about the amount of one qian, and take it with a decoction of fermented black soybeans.

From the Shiquan Bojiu Fang: To treat cough. Take one large Arisaema, roast it in fire until it splits, and grind it into a fine powder. Each time take the amount of one large qian, add one cup of water and three slices of fresh ginger, decoct until five fen remain, and take it warm. Take it once on an empty stomach, once at noon, and once toward evening, daily.

From the Qiezhong Fang: Gan Gao Wan for treating cough. Take one liang of Tinglizi from Caozhou, place it on paper, and stir-fry it slowly until black. Then add one liang each of Zhimu and Beimu. Pound the three ingredients together and sift. Add half a liang of jujube flesh; separately melt one and a half liang of cane sugar into the medicinal powder and knead it into pills the size of bullets. Each time wrap one pill in fresh cotton and hold it in the mouth, slowly swallowing the saliva. For severe cases, take no more than three pills. Physicians today also often use this formula.

I. Sanwu Wan (Three-Ingredient Pill; a formula for relieving cough by holding it in the mouth)

Grind the three medicinal ingredients together and sift them (the original text does not list the names of the drugs). Separately take half a liang of jujube flesh, then dissolve one and a half liang of shatang (that is, sucrose), mix it all into the medicinal powder, and knead it into pills the size of pellets. Each time it is taken, wrap one pill in new cotton cloth, hold it in the mouth, and slowly swallow the saliva. For patients with severe illness, take no more than three pills. Physicians of that time also often used this method.

II. Cui Zhiti’s Fumigation Method for Treating Chronic Cough

Every morning, take coltsfoot flower (a Chinese medicine, also known as donghua) in an amount about the size of an egg, mix it evenly with a small amount of honey so that it is slightly moist, and place it in a one-sheng-capacity iron pan (a flat-bottomed iron pan). Separately take an earthenware bowl, bore a small hole in it, insert a small bamboo tube into the hole (a writing-brush tube will also do), and make the bamboo tube somewhat long. Turn the earthenware bowl upside down over the iron pan so that the two fit together, and seal the joint tightly with wet mud so that no smoke escapes. Light a fire beneath the iron pan to heat it. After a while, the smoke of the coltsfoot flower will emerge from the bamboo tube; put the mouth to the bamboo tube, inhale the smoke, and swallow it. If the chest feels slightly congested, raise the head, pinch the opening of the bamboo tube with the fingers to prevent the smoke from escaping, and then continue inhaling until the smoke is completely exhausted. Do this once every five days; on the sixth day, eat a meal of mutton botuo (a kind of noodle soup), and the illness will be cured.

III. Treatment Method from the Shengjin Fang

The Shengjin Fang records a formula for treating chronic cough, sudden cough (cough that comes on abruptly), and consumptive cough (cough caused by overwork and depletion), called Jinsu Wan (Golden Millet Pill).

Orpiment Formula (from Ge Xianweng’s Emergency Prescriptions Kept Up One’s Sleeve)

Take one liang of leaf orpiment (that is, arsenic trisulfide, an arsenic-containing mineral that is highly toxic) and grind it into a fine powder. Using clay mixed with paper fibers, coat and seal a small porcelain box inside and outside, then let it dry; the clay should not be applied too thickly. Put the powdered medicine into the box, seal the opening with halloysite (a mineral drug) mixed with water, then seal it again with clay and wait for the clay to dry. Place the box on the ground and pack broken tile pieces around it so that the box and tiles form a large mound; heap ten jin of charcoal on top and set it firmly, place a fire-filled iron at the top as a heat source, cover it with a hood, and let the fire gradually burn strongly from above. When the heat has decreased by one third, check whether the tile pieces have been heated through, then remove the fire and let it cool naturally.

Open the box and take out the medicine; the medicine should be mirror-bright and red in color. Grind the medicine finely in a mortar, mix it with hot water, and knead it into pills the size of millet grains. Take three to five pills each time, with water decocted from licorice; sleep for a while after taking them, and the effect is excellent.

Note: Orpiment contains arsenic and is a highly toxic substance. This formula is for textual/documentary interpretation only and must not be reproduced or taken.

Pear Formula (from Cui Yuanliang’s Sea-Top Formulas, for cough)

Single formula from Cui Yuanliang’s Sea-Top Formulas: Take a good pear, remove the core, and pound it to obtain one teacup of juice. Add forty Sichuan peppercorns, bring to a single boil, strain off the residue, then add one large liang of dark maltose (a dark malt syrup) and let it dissolve. Hold it in the mouth and swallow slowly; the effect is rapid.

Meng Shen’s account: it treats sudden-onset cough.

One method: take one pear, pierce fifty holes, insert one Sichuan peppercorn into each hole, wrap it in dough, bury it in hot ashes and roast until cooked, take it out, let it cool, remove the peppercorns, and eat it.

Another method: remove the core of a pear, fill it with ghee (butter oil) and honey, wrap it in dough, and roast until thoroughly cooked before eating.

A third method: take pear flesh, simmer it in ghee, let it cool, and eat it.

A fourth method: pound pears to obtain one sheng of juice, add one liang of ghee, one liang of honey, and one sheng of raw Rehmannia juice; simmer over low heat and hold it in the mouth and swallow slowly in small amounts.

Ge Xianweng’s Zhouhou Beiji Fang (Handbook of Prescriptions for Emergencies)

The basic principle for treating cough is to wait until the panting and wheezing have subsided before eating, because eating hot food right after coughing and wheezing will instead harm the body. If it is a cold-type cough, the condition will be more severe and harder to treat. At such times, one may eat one full bowl of mutton soup with wheat cakes (mutton soup noodles), then lie down and rest for a short while.

Qianjin Fang (the Bei Ji Qianjin Yaofang, compiled by Sun Simiao of the Tang dynasty)

To treat cough with Qi rising upward in adults and children (cough and counterflow Qi rushing upward): take three sheng of apricot kernels, remove the skin and tips, stir-fry until slightly yellow, and pound into a paste. Add one sheng of honey and divide it into three portions. First add one portion to the apricot paste and pound evenly; then add another portion and pound into a paste; finally add the remaining portion and pound until thoroughly blended. Take it before meals by holding it in the mouth and slowly swallowing the medicinal juice.

Yang’s Chanru (Recipes for Childbirth and Lactation)

To treat counterflow Qi rushing upward, acute distension and fullness in the chest, and restlessness when sitting or lying down: take one da liang of turtle shell (the carapace of the soft-shelled turtle, a Chinese medicine), roast it until slightly yellow, and grind it into a fine powder. Separately take one handful of rush pith, add two sheng of water, and decoct until reduced to five ge. Before meals take one qianbi (about one small spoonful) of the medicinal powder; after meals take one qianbi of it with honey water.

Liu Yuxi’s Chuanxin Fang (Liu Yuxi was a Tang dynasty poet; the Chuanxin Fang is a collection of medical formulas recorded by him)

It records that Li Ya used this formula to treat various kinds of cough and conditions of counterflow Qi rushing upward.

Prescription for Treating Cough (honey pills made with dried ginger, Chinese honey locust pod, and cinnamon heart)

Take dried ginger (the best from Taizhou must be used), Chinese honey locust pod (first processed to remove the skin and seeds; choose plump, large pods without wormholes), and cinnamon heart (purple in color and pungent in smell, with the outer bark scraped off). Pound the three ingredients separately, sift them, and weigh out equal portions; the amount may be adjusted as desired. After mixing, pound and sift once more, add refined white honey, mix, and pound ten to twenty times to make small pills. Each dose is three pills; the pills may be slightly larger, about the size of a Chinese parasol-tree seed. Take them regardless of whether before or after meals, as soon as a cough occurs, three to five times a day. During treatment, avoid scallions, oil, salty foods, strong-smelling and fishy foods, and hot noodles; the effect is miraculous.

A certain Liu and a certain Li both served on the staff of the Huainan Jiedushi. Li often prepared medicine for others but would not disclose the formula. When someone mocked him for being stingy, Li spoke frankly: “When people in the world suffer from cough, most take cold and cooling medicines. If they saw that the ingredients in this formula are on the warm-hot and dry-pungent side, they would refuse to take it. That is why I simply give them the prepared medicine, which works very well.” After people tried it, they were convinced.

Prescription from Jianyao Jizhong: Treating Lung Qi Panting and Cough

Aristolochia fruit (madouling, the fruit of a medicinal plant in Chinese medicine), two liang: use only the seeds inside and remove the outer shells. Put half a liang of ghee (fat refined from cow’s or sheep’s milk) in a bowl, mix it thoroughly with the seeds, and stir-fry over gentle heat until dry. Licorice, one liang, roasted. Grind the two ingredients into a fine powder. For each dose, take one qian, add one cup of water, decoct until reduced to six fen, and take it warm in slow sips. Alternatively, hold the powder in the mouth and swallow it when saliva forms; this is equally effective.

Treating Phlegm Cough with Panting and Rapid Breathing That Will Not Settle

Platycodon root (jiegeng), one and a half liang: pound and sift into a powder. Use half a sheng of boy’s urine (the urine of a young boy), decoct until reduced to four ge, remove the dregs, and take warm.

Yang Wenwei’s Formula for Phlegm Cough That Soothes and Frees the Chest and Diaphragm

Choose large, plump, firm Trichosanthes fruit (gualou). Cut it open, remove the pulp, and wash it clean; scrape off the outer skin, cut into pieces, and dry by heat. Pinellia (banxia), forty-nine pieces: wash ten times in hot water, pound to break them, dry by heat, then pound and sieve into powder. Then take the hot water used to wash the gualou, together with the gualou pulp, and decoct it into a paste; grind the powder fine with it and form pills. This is used to soothe and free the chest and diaphragm.

Ge Xianweng’s Emergency Formulas to Keep Up One’s Sleeve

Take a large, plump Trichosanthes kirilowii (gualou, a Cucurbitaceae plant), split it open, remove the seeds, wash it clean, crush it, scrape off the outer skin, cut it into fine pieces, and dry it by gentle heating. Separately take forty-nine pieces of Pinellia ternata (banxia, a medicinal in the Araceae family; toxic when raw and requiring processing), wash them ten times with hot water, crush them, dry them by gentle heating, and pound them into a fine powder. Then use the hot water in which the gualou was washed, together with the pulp, to decoct a paste; grind the powder fine and form it into pills the size of wutong seeds. Take twenty pills with ginger decoction.

Formulas of Master Shen

To treat chronic cough, upward rebellion of qi, generalized edema, shortness of breath, and chest and abdominal fullness so severe that the patient sits leaning against the wall day and night and cannot lie down, with a sound in the throat like the call of a water chicken, use Baiqian Decoction as the main formula.

Baiqian (the root and rhizome of an Asclepiadaceae plant; an antitussive and expectorant medicine), two liang; Ziwan and Pinellia (washed), three liang each; Daji (a toxic purgative, cut into sections), seven ge. Soak the four ingredients in one dou of water overnight; the next day, boil down to three sheng and divide into three doses. During treatment, avoid mutton and xing (yitang, that is, malt sugar and similar sweets); the results are excellent.

Formulas of Master Mei

To treat chronic cough with a phlegmy sound in the throat that prevents sleep, take Baiqian, pound it into a fine powder, and take two qianbi (about one small spoonful) mixed with warm wine.

Another formula treats upward qi cough, wheezing with a xia-xia sound in the throat, and expectoration of sticky phlegm. Take the leaves of the indigo plant, soak them in water for a long time, pound them to a pulp, squeeze out one sheng of juice, and take it all at once on an empty stomach. Soon afterward, grind apricot kernels (xingren), extract their juice, cook porridge with it, and eat; rest for a day or two. Following the previous method, take it once more until the phlegm is completely expectorated; the illness will then be cured.

Handy Collection of the Ministry of War

To treat cough with counterflow and shortness of breath in children and adults, with a “xixi” sound in the chest and coughing up sputum and saliva, until foul pus is coughed out and purulent sputum dries up, use one ge of light bamboo juice (the clear liquid that flows from bamboo after it is roasted over fire; it clears heat and transforms phlegm), taken three to five times a day; for adults, one sheng each time.

Formulas of Sagely Grace

To treat damage to the middle burner, contracture of the sinews and vessels, and upward qi with cough, take twenty large jujubes, remove their pits, add four liang of su (ghee), and simmer over a gentle fire so that the ghee drips into the date flesh. When the ghee has been fully absorbed, hold one in the mouth each time and swallow it slowly.

Jingyan Houfang

To treat wheezing and resolve phlegm and saliva.

Ge Xianweng Zhouhou Beiji Fang (Master Ge’s Emergency Prescriptions Kept in the Sleeve): a medical formulary written by Ge Hong, also known as Zhouhou Fang; it takes its name from being convenient to carry on one’s person and intended for emergency treatment.

Take forty-nine pig’s-hoof shells, wash them clean, and drain. Into each shell place one “zi”—an ancient measure meaning a small pinch—each of Banxia and Bai Fan. Put them into a jar, seal the opening so that no smoke escapes, calcine over fire until the jar is red-hot, withdraw the fire, and after it has cooled grind the contents into a fine powder; then add one qianbi of musk (about one small spoonful). If someone suffers from upper-jiao wheezing with reversed qi and congested phlegm and saliva, taking this will resolve it.

Take forty-nine pig’s-hoof shells, wash them clean, and drain. Into each shell place one “zi” each of Banxia and Bai Fan; put them into a jar, seal the opening so that no smoke escapes, calcine over fire until the jar is red-hot, withdraw the fire, and grind into a fine powder; add one qianbi of musk. If someone has wheezing and cough, it may be taken with glutinous rice broth; children take half the dose. The effect is extremely good.

Lingyuan Fang: treats cough, reversed qi with acute wheezing, coughing blood, and vomiting blood.

Take good ginseng (a qi-tonifying herb), pound it into a fine powder, and take three qianbi each time, mixed with egg white and swallowed. Take the first dose at the fifth watch (3–5 a.m.) and then sleep; when sleeping, remove the pillow and lie face up. One dose is enough to cure it. In chronic cases, it may be taken once more. During treatment, avoid fishy and strong-smelling foods, salty foods, salted fish, sauces, wheaten foods, and the like; also do not drink excessively or overeat. With good rest, the effect is even better.

Xi Yanchang (a physician’s name): treats internal deficiency with heat, cough with pus and blood, and dryness of the mouth, tongue, and throat, when cold-cooling medicines cannot be used.

Take four liang of good Huangqi (Astragalus) and one liang of Gancao, grind into a fine powder, and take three qian each time. It may be infused and taken like tea, or stirred into soups and congee.

Du Ren Fang: treats heat in the upper jiao, sores in the mouth, tongue, and throat, and cough with pus and blood.

Take one liang of Jiegeng and two liang of Gancao, grind into a fine powder; each time take two qian, decoct with one cup of water down to six fen (about sixty percent), remove the dregs, and take warm.

Du Ren Fang (another version): same as the above formula; after decocting and removing the dregs, take it warm, sipping slowly in small mouthfuls after meals. This formula can also treat congestion and stagnation in the lungs.

Jingyan Fang: treats people with severe cough, or cases with fresh vomiting of blood.

Take one jin of white bark from the mulberry root, soak it for three nights in a rice-water vessel (a container used for holding rice wash or for soaking), scrape off the outer yellow bark, cut it finely, add four liang of glutinous rice, roast dry, and pound together into a fine powder. Mix with rice broth and take one or two qian each time.

Formula for Stopping Bleeding (Doumen Fang): Treats damaged lung tissue and sudden, unstoppable coughing of blood. Take one large slice of Haixi Gao (an externally applied medicinal paste), roast it over fire until browned and scorched, and while hot smear it with su (a medicinal substance resembling refined butterfat); roast and smear again until the paste is thoroughly roasted through. Grind it into a fine powder, mix three large qianbi with hot water, and have the patient take it (one qianbi is about the amount of one qian); the bleeding will stop. The original text says that the “water glue” used is precisely this kind of medicine, and its effect is evident.

Several formulas from Shiyi Xinjing (Heart Mirror of Dietetic Medicine):

Peach-Kernel Porridge: Treats chest oppression, panting, cough, and upward Qi (Qi rebelling upward). Take three liang of peach kernels, remove the skins and tips, grind them with one sheng of water and extract the juice; add two ge of polished rice (jingmi, ordinary rice) and cook together into porridge to eat.

Su Decoction Formula: Treats various lung diseases and unceasing cough with pus and blood. Take five jin of high-quality su, refine it three times, and collect the coagulated portion, finally obtaining tihu (refined su, regarded by the ancients as a prized tonic). Take one ge each time.

Radish-Seed Decoction: Treats chronic upward Qi cough, profuse phlegm, panting, and expectoration of pus and blood. Take one ge of radish seeds, grind them, decoct them into a soup, and take after meals.

Formulas for sudden edema of the whole body or face:

Carp in Pure Wine Formula: Take one large carp and three sheng of good wine; cook until the wine is completely absorbed, then eat the fish. Do not add vinegar, salted fermented black beans, or other seasonings. It will be cured in no more than three doses.

Moxibustion Method: Apply three zhuang of moxa to the white flesh below the inner ankle (a zhuang refers to the number of moxa cones), and it will be cured.

Soybean Decoction: Take one dou of soybeans and boil them thoroughly; consume the bean broth together with the beans. Repeated use brings cure, and small beans are even more effective.

External Application Formula: Mix egg yolk and egg white and apply to the swollen area; when it dries, apply again. Another method is to chop apricot leaves, boil them into a thick decoction, and while hot steam and wash the swollen area; it can also be taken internally.

Plum-Kernel Porridge: Take ten kernel meats of roadside plums (fruit of plum trees growing by the road), grind them to a paste, add three ge of polished rice and four sheng of water, and cook down to two sheng of porridge to take. Increase the number of plum kernels with each dose.

The Ge Xianweng Zhouhou Beiji Fang (Emergency Prescriptions Kept Up One’s Sleeve), traditionally attributed to the Eastern Jin Daoist Ge Hong (sobriquet Baopuzi, Master Who Embraces Simplicity; revered as Ge Xianweng), is a concise formulary meant to be carried on one’s person for emergency use; hence the title “behind the elbow,” that is, kept up one’s sleeve. The following formulas all address “swelling” (edema) and abdominal distention and fullness.

Soybean Congee Cooked with Wine

The two passages before and after are largely the same, with only slight differences in the method of administration. Take one sheng of soybeans, add five sheng of water, and boil down to two sheng. Remove the beans, then add eight sheng of wine and continue boiling down to nine sheng. Divide into several portions and cook into congee, leaving only two sheng; take it in three doses. Another passage says to take it in three or four doses. If thirst occurs after the edema subsides, be cautious and do not drink much.

Yellow Ox Urine Formula

Take three sheng in a single dose. If the symptoms are relieved but not yet completely resolved, take another dose.

Shanglu and Mutton Soup

Take one jin of shanglu (written “zhanglu” in the original; that is, Phytolacca root, a toxic medicinal herb with water-draining effects), peel it, and cut it into thin slices. Boil until thoroughly cooked, strain off the dregs, add one jin of mutton, then scallions, fermented black beans, and salt; prepare a soup by ordinary cooking methods and eat it freely. After the swelling has subsided, it may also be prepared in this way. One may also regularly pound shanglu and steam it with an equal amount of rice into cakes to eat.

Pig Kidney and Gansui Formula

Cut one pig kidney into seven pieces; take one fen of gansui (Euphorbia kansui, a drastic water-draining drug). Coat the gansui with powder and roast it over fire until cooked. Eat once a day; by the fourth or fifth time there should be borborygmus in the abdomen and flanks, and urination should become free. If no effect is seen, increase the dose. When the kidney pieces are thoroughly heated through, remove the skin and eat them; it is best to eat them all. Avoid salt.

Shanglu Soaked in Wine

Chop two sheng of shanglu, soak it in three sheng of wine for three nights, and take five ge to one sheng each time, three times a day.

Daji and Wuchi Formula

Take two liang each of daji (Euphorbia pekinensis, a water-draining drug) and wuchi (the drug referred to is difficult to identify today). Pound and sift into powder, mix with honey, and take five ge to one sheng each time, three times a day. Another method is to form the powdered medicine with honey into pills the size of tongzi seeds; take two pills early each morning. When the purgation gradually subsides, resume taking them until the swelling disappears.

The above formulas chiefly treat “swelling entering the abdomen, with distressing fullness and urgency, impairing eating and drinking”—that is, the qi of edema has invaded the abdomen, producing distention, fullness, and urgency that interfere with food and drink. The original text states: “In all such fullness, whether it is due to deficiency qi, wind-cold qi, or water-rheum qi, these formulas all treat it”—meaning that regardless of whether the abdominal fullness is caused by deficiency qi, wind-cold qi, or water-rheum qi, these formulas can be used.

Note: Gansui, daji, and shanglu in the text are all toxic, drastic purgative water-draining drugs; a slight error in dosage or preparation can injure the body. These are records of ancient medical formulas and should not be copied for self-treatment. Edema requires clear identification of its cause, and one should promptly seek diagnosis and treatment at a licensed medical institution.

Another Formula: Take ten liang of Tinglizi (the seeds of Descurainia, which, like Jiaomu, the seeds of Sichuan pepper, have the effect of promoting urination and reducing swelling), three liang of Jiaomu, three liang of Zhuling, and two liang of Wuzhuyu. Crush them, mix with honey, and form pills the size of tongzi. Take ten pills each time, three times a day.

Another Formula: Take one carp weighing about five jin, boil it in two dou of water until one and a half dou remain, then remove the fish. Add five liang of Zeqi (a plant of the Euphorbiaceae family, toxic; the ancients used it to promote urination), three liang of Fuling, three sheng of finely chopped Sanggen Baipi (mulberry root bark), and five liang of Zexie. Boil until four sheng remain, and take in four doses. After taking it, urination should become free, and the swelling will gradually subside.

Another Formula: Remove the skin of Gengjia (Gleditsia pods), roast until yellow, chop finely, and take three sheng. Soak in one dou of wine, place in an earthenware vessel, and boil. Take one sheng each time, three times a day; prepare a fresh batch after it is used up.

If the swelling bulges in only one place, mix plant ash with water and apply it to the affected area; when it dries, apply again, and the swelling will subside.

Another Formula: Pound Chixiaodou (adzuki beans) together with Mazi (hemp seed) into a paste and apply it to the swollen area.

Another Formula: Boil Badou (croton seeds; Badou is violent in nature and toxic, and the ancients mostly used its drastic effect) in water, then dip a cloth in the medicinal liquid and wipe the swollen area.

As Described by Master Yao: Take thirty Badou seeds, crush them without removing the skins, add five sheng of water, and boil until two sheng remain. Wipe the swollen area with it five times a day, and reduction will be seen immediately. Be careful not to let it touch the eyes or the genitals. This formula is used to treat sudden swelling of the body as if it were inflated by wind.

If It Is Only Ordinary Swelling: Chop scallions, boil them until thoroughly soft, and use them to soak the affected area, two to four times a day.

Another Formula: Take one sheng of Tusizi (dodder seed), soak it in five sheng of wine for two or three nights, and take one sheng each time, three times a day. Stop when the illness is cured.

If edema begins at the feet and gradually spreads upward, it becomes fatal once it reaches the abdomen. The treatment is: take one hu of small beans (adzuki beans; an ancient unit of capacity, ten dou make one hu), boil them until extremely soft, and obtain four or five dou of juice. Warm it and soak the area below the knees, twice a day; after several days the swelling will subside. If the edema has already entered the abdomen, stop soaking; simply boil small beans and eat them. Do not at the same time eat rice, fish, or “guan” (probably a mistake for “zu,” meaning pickled vegetables and other sour or salty foods), and drink only small-bean juice. If small beans are unavailable, soybeans may be used. Only one in ten patients with this illness survives, so treatment must be given as quickly as possible.

Another formula: pare off the wood of the tuo tree or paulownia, boil it to obtain a liquid, and use it to soak the affected area; at the same time drink a small amount. If small beans are added and eaten together, the effect is better. The dietary restrictions are the same: rice, fish, and pickled vegetables should not be eaten, and one should drink only small-bean juice. If small beans are unavailable, soybeans may also be used. Only one in ten patients with this illness survives, so emergency treatment is required.

Another formula: the same method as above; adding small beans makes it more effective.

Another formula: take one fresh pig liver, cut it finely, and eat it all at once, but it must not be eaten with pickled vegetables; seasoning it with vinegar (bitter wine) gives a very good effect.

Another formula: boil fermented soybean (douchi) to make a broth and drink it, and apply the soybean residue to the feet.

Supplementary Formulas

Formulas for Emergency Preparedness: To treat sudden generalized swelling and distension. Pound elm bark into fragments, add an appropriate amount to rice, and cook porridge to eat; urination will then become free.

Yang’s Childbirth and Lactation: To treat generalized edema and difficult urination. Take five liang of Polyporus umbellatus, pound and sift it, and decoct it in three ge of water. Each time, mix and take one square-inch spoonful, gradually increasing to two spoonfuls.

Dietary Physician’s Mirror of the Mind: Mainly treats shortness of breath, edema, and difficult urination. Take one liang of apricot kernels, remove the tips and skin, stir-fry until cooked, and grind them; cook with rice into a very soft porridge and eat two ge on an empty stomach.

This passage is not the main text but the collation notes to Ge Xianweng Zhouhou Beiji Fang (Master Ge’s Emergency Prescriptions Kept Up One’s Sleeve). Using the Ming Wanli printed edition as a reference, the author points out, item by item, the differences in characters and phrases in the Daozang base text and explains where the text has been changed according to the Wanli edition.

For notes on variant readings, expressions such as “yao: the Wanli edition reads zhu” and “ri er: the Wanli edition reads ri san” indicate that the Wanli edition has different characters at these points, and the collator notes this here. For notes on corrected characters, an expression such as “ze: originally ju, corrected according to the Wanli edition” indicates that the original character in the base text was erroneous and has been corrected following the Wanli edition. In drug names and dosages, characters such as fuling (Poria), gui (cinnamon), mo (medicinal powder), zhi (juice), wan (pill), and jizi (egg) mostly concern the drugs and amounts used in prescriptions. The collation here is chiefly to make the prescription wording accurate so that readers can prepare the medicine according to the formula. The phrase “according to the meaning of the text” in item 26, where jiao should be xiao, shows that the collator relied not only on editions but also on context. Items 20 to 23 appear repeatedly in the original text; this should be duplication from typesetting or transcription and does not affect the general meaning.

In short, these collation notes record textual differences among editions. They belong to the work of identifying errors in the editing of ancient books, and their purpose is to make the text of Zhouhou Beiji Fang more reliable.

This passage is not the main text of the Ge Xianweng Zhouhou Beiji Fang but collation notes written by later editors, recording differences between the original text and other editions.

Book title and edition: The Zhouhou Beiji Fang is a medical formulary written by Ge Hong of the Eastern Jin; later generations attributed it to “Immortal Master Ge” (Ge Xianweng). The “Wanli edition” refers specifically to the Daozang (Daoist Canon) edition published during the Wanli reign, which was the main reference edition used in collation.

Methods of correction: There were mainly three. The first is “changing according to the Wanli edition,” that is, taking the characters of the Wanli edition as authoritative; the second is “changing according to the meaning of the text,” that is, judging by the sense of the context; the third is “changing according to the table of contents and the Wanli edition,” that is, consulting both the table of contents at the front of the book and the Wanli edition.

Handling of doubtful cases: For example, “44 ‘smoke’ (yan): suspected to be ‘throat’ (yan)” indicates that the collator suspected the original character was erroneous but had not yet determined this, so it was recorded only as a conjecture.

Readings left unchanged: For example, “42 ‘satiated’ (bao): the Wanli edition has ‘bowl’ (wan)” merely notes the variant reading and retains the original character.

The purpose of collation notes is to let readers see which characters have been changed and on what basis, making it easier to compare texts of different editions.

This section is a formula for treating “sudden massive abdominal water disease”—a type of edema marked by sudden onset and abdominal distension like a drum.

Early signs of the illness: At first there is swelling above the eyelids, shaped like a lying silkworm; the face is red, and the pulse at the forehead throbs; the inner thighs feel cold, the lower legs are distended and full, and pressing with a finger leaves a deep pit that can bury the fingertip; when the abdomen moves, there is the sound of water. These are the signs that the illness is developing. If it is not treated promptly, the whole body soon becomes slightly swollen and the abdomen becomes extremely distended. When pressed, it no longer springs back immediately, showing that the illness has become established, but it can still be treated.

Cause: It is mostly brought on by prolonged illness and weakness, or after dysentery, or after childbirth in women. The water that is drunk cannot be dispersed in time; the Sanjiao (Triple Burner—the upper, middle, and lower regions described in Chinese medicine, the passages for the movement of qi and fluids in the body) is affected by pathogenic factors, urination becomes difficult, and water fluids and pathogenic factors congeal with one another and gradually accumulate, then flow into the various channels and network vessels.

Treatment: Take one sheng of Tinglizi, dry-fry it, pound it to pieces in a mortar, then add fresh blood from the comb of a newly killed rooster (the line corresponding to “cut the live male…” is textually defective and is understood here according to context), pound together ten thousand times, and make into pills. Each time take five pills the size of parasol-tree seeds, gradually increasing to ten. During treatment, avoid salt. Ordinarily one may eat more small red bean rice and drink small red bean juice; snakehead fish (black fish) is also beneficial.

First, take one liang each of Fangfeng (Saposhnikovia root), licorice, and Tingli (the seed of a herb that the ancients used to promote urination and reduce swelling). Crush them, mix with bitter wine (that is, vinegar), and form pills about the size of parasol-tree seeds. Take three pills each time, three times a day, over the long term until the edema subsides.

Second, take six fen of realgar, three fen of musk, two fen each of Kansui (Euphorbia kansui), Yuanhua (Daphne genkwa), and ginseng (Kansui and Yuanhua are both potent, toxic drugs that purge water and drive out retained fluids), and add one liang of Tingli. Crush everything together, mix with bitter wine (vinegar), and form pills the size of parasol-tree seeds. Take three pills each time, three times a day, over the long term until the edema subsides.

Third, take six fen of realgar, three fen of musk, and two fen each of Kansui, Yuanhua, and ginseng. Crush them, mix with honey, and form pills. Take about two pills the size of a bean each time, gradually increasing to four pills, and the illness will be cured.

Fourth, use five sheng of spring wine to soak two sheng of Tingli seeds. After one night, slowly drink one ge (about a small cup) each time, and urination will become free.

Fifth, take one liang of Tingli and twenty apricot kernels, stir-fry them together until yellow, crush them, and divide into ten doses. After urine is passed, the illness will immediately be cured.

Sixth, this formula comes from Hu Qia’s Formulary. It powerfully treats edema and promotes urination (the same is also recorded in the Yao family formulary). The original formula uses one sheng each of Tingli and pepper seeds (the seeds of Sichuan pepper), six liang of mirabilite (Glauber’s salt), and ten liang of mercury. First boil the mercury in water for three days and three nights, then pound and grind it together with the other medicinal ingredients sixty thousand times, mix, and form pills the size of a large soybean. Take them three times a day and increase the dose by one pill each day; after reaching ten pills, begin again from one pill. After recovery, one may eat more beef and mutton to nourish the body and gradually restore strength.

Seventh, take a large amount of branch bark from the Ke tree, chop it, and boil it vigorously over high heat to a thick decoction, reducing it until it can be formed into pills; make pills the size of parasol-tree seeds. First take three pills; after a short while take one more, at which point watery fluid should be passed. Afterward take three pills daily, three times a day. This tree is also called “Wooden Slave”; people in the south use its wood to build boats.

Background note: The drugs used in these ancient formulas—realgar (which contains arsenic), mercury, Yuanhua, Kansui, and others—are strongly toxic. Mercury and arsenic compounds can accumulate in the body and, in severe cases, endanger life. Ancient methods of administering drugs are very far from modern medical safety standards. Edema should be treated promptly by a physician; do not take these formulas on your own.

Another formula: Take equal parts of true storax (an aromatic medicinal substance), mercury (i.e., quicksilver), and white powder (usually lead powder). Mix with honey and form into pills. Take two pills each time, each the size of a soybean, three times a day. After taking it, fluids should be discharged; one should restrict drinking water and take good care to recuperate. If storax is unavailable, this ingredient may be omitted.

Another formula: Take twenty pieces of fully mature grass-hemp rope, remove the outer skin, grind into powder, and dissolve in water to obtain three ge. Take once daily. Around midday, vomiting or diarrhea should occur, discharging various fluids. If not completely discharged, take thirty pieces after three days; if still not complete, take one more dose. After recovery, restrict fluids and avoid salty foods and the like.

Another formula: Take one sheng of small beans and one white chicken. Prepare them as one would cook food, add three dou of water, and cook thoroughly. Eat the solids and drink the broth, finishing slowly.

Another formula: Take a blue-green male duck, add five sheng of water, and cook down until one sheng of broth remains. Drink it slowly to the end, then cover with a thick quilt to induce sweating; the effect is better after sweating.

Another formula: Take the yolks from Hu swallow (i.e., swallow) eggs and swallow ten at one time; or take the residue together with the liquid and finish it slowly.

Another formula: Take Halou (i.e., mole crickets), roast them thoroughly, and eat ten each day.

Another formula: If there is only abdominal swelling, with a water sound when shaken, and the skin is dark, this is called “water gu” (abdominal water accumulation). Take ninety croton seeds, remove the skin and hearts; take sixty apricot kernels, remove the skins and tips; stir-fry the two together until yellow, mash, and mix. Each dose is one pill the size of a small bean, until fluids are discharged. It may be taken with wine, which gives a better effect.

Another formula: Pound guishan (i.e., shegan) and squeeze out the juice. Take an amount the size of one chicken egg, and fluids will be discharged; if water gu occurs again, take this medicine again. Alternatively, grind hemp seeds with hot water and take the juice.

Another formula: Take thirty jin of cimicao and three shi of zi (referent unclear). Boil to obtain one shi of juice, remove the residue, then heat it in a water bath until it can be formed into pills. Each dose is one pill the size of a Gleditsia seed, ranging from twenty-seven to five or six pills; fluids are discharged with urine. Afterwards, drink thin gruel to recuperate the body.

Note: The above are records of ancient formulas. Drugs such as croton seed are toxic; they must be used with extreme caution and should not be replicated in practice.

Formula One: White Cogongrass Root and Small Beans

Take one large handful of white cogongrass root and three sheng of small beans, add three sheng of water, and boil until the water is dry. Remove the cogongrass root, pound the beans into medicinal pills, and take pills the size of a Gleditsia seed each time, three to five or six pills. The fluid will be discharged with urine; afterward, regulate the body with thin gruel. (White cogongrass root is the rhizome of Imperata cylindrica, a grass in the Poaceae family; small beans are adzuki beans; Gleditsia seeds are the seeds of the Chinese honey locust; thin gruel is watery porridge.)

Formula Two: White Cogongrass Root and Small Beans (Decoction Method)

The method is similar to the preceding formula: boil white cogongrass root and small beans together; after the liquid has boiled dry, remove the cogongrass root and eat only the beans. The fluid will be discharged with urine.

Formula Three: Sage and Verbena

Take ten jin each of sage and verbena, add one dan of water (an ancient unit of capacity; one dan is about ten dou), and boil down to five dou. Remove the dregs and continue simmering until thick; mix in medicinal powder and form pills. Take two pills each time, each the size of a soybean, gradually increasing to four or five pills. During treatment, avoid fatty meat and raw or cold foods. (Sage and verbena were both herbs commonly used in ancient times.)

Formula Four: White Mulberry Bark

If the body is swollen and distended with edema, take one handful of the white bark of the white mulberry tree (that is, the mulberry tree), add two sheng of water, and boil down to five ge (about half a sheng). Then add the finely ground powder of two larger white areca nuts and decoct together until it boils three to five times. When the medicine is ready, add a small amount of Red Snow and take it. (Red Snow is a medicinal substance used in ancient formulas.)

General Notes

This passage is the author's supplementary explanation. Methods such as ox urine, pokeweed, mutton soup, and Xiangrou decoction are recorded under the entry "Swelling and Fullness"; larger formulas such as the Ten Waters Pill are collected in another volume. If edema is only in the skin and there is not yet accumulated fluid in the abdomen, one may take a diaphoretic; sweating will bring about recovery, but special care must be taken to avoid wind and cold. If there is only abdominal distention and diuresis is ineffective, one may insert a needle several fen deep two cun below the umbilicus to drain the accumulated fluid; the needle hole will close only after the abdominal swelling subsides.

Supplementary Formula: Li Jiang, Bingbu Shouji Fang (Hand-Collected Formulas from the Ministry of War)

Li Jiang, a man of the Tang dynasty, records in the Bingbu Shouji Fang: for treating water disease, regardless of how long the illness has lasted or whether it is mild or severe, and even if the pulse is poor, this formula may be used.

The formula uses one large liang each of daji (Euphorbia root), angelica, and tangerine peel. Chop them, add one large sheng of water, and boil down to seven ge; take it in a single dose. This can cause two or three dou of fluid to be discharged. There is no need to be alarmed after taking it; if one dose does not cure the condition, take one more dose and recovery will follow. For one year after taking it, avoid toxic or stimulating foods. After the accumulated fluid is discharged, take one more dose, and there will be no recurrence. This formula comes from Zhang Shangke. (Li Jiang was a Tang dynasty figure; daji, angelica, and tangerine peel were all commonly used medicinal materials in ancient times.)

Waitai Miyao (Arcane Essentials from the Imperial Library)

This is the title of the cited source. It indicates that the formulas and medicines listed below come from the medical work Waitai Miyao, compiled by Wang Tao of the Tang dynasty, and are intended for treating water qi (edema). The original text contains only this title, so only a brief explanation is provided.

Note: The above are all medical experiences of the ancients, recorded in an era different from today. Modern people who encounter edema should promptly seek medical attention to determine the cause and should not directly copy these ancient formulas.

This passage records several methods for treating “water disease” (edema, abdominal distension, difficult urination, and similar conditions), mostly using dietary remedies or decoctions of simple medicinal substances.

Shanglu Root Congee

Take the root of Shanglu (Phytolacca root, a toxic diuretic medicinal), peel it, and cut it into pieces the size of small beans, about one large cup. Add three sheng of water and decoct down to one sheng. When the decoction has cooked down thoroughly, add one large cup of millet and cook into a thin congee. Take it on an empty stomach. If taken twice a day, there is concern that it may cause too much diarrhea, so take it only once daily, sufficient to produce slight diarrhea. During treatment, do not eat other miscellaneous foods.

Carp Prescription (One)

Take one very large carp, remove the head and tail, and cook it for eating. The method of administration is the same as above: once daily, with slight diarrhea as the endpoint. During treatment, do not eat other miscellaneous foods.

Carp and Adzuki Bean Soup

Take one large carp, remove the head, tail, and bones, keeping only the flesh. Add two dou of water and cook together with one large sheng of adzuki beans until about two sheng of liquid remain. Filter through cloth to remove the residue and take it all at once. If you cannot finish it, divide it into two doses, and drink the second dose warm. After taking it, there will be diarrhea; once the purging is complete, recovery follows.

Bitter Bottle Gourd Prescription

This is a prescription for sudden swelling and fullness. The original text describes a patient who first has swelling of the feet, which gradually spreads to the knees so that the feet cannot touch the ground, and then the edema spreads over the head, face, and whole body. Take the white flesh of a bitter bottle gourd (ku hu), knead it into pieces the size of soybeans, wrap them in dough, boil once, and swallow seven pieces on an empty stomach. By noon, about one dou of water will be discharged; within three days water will continue to drain away, and recovery occurs only after the body has become thin. After recovering, one should keep the diet light for three years. When selecting the bitter bottle gourd, one must choose a perfect one, with no spots on the surface, fine dense texture, and regular shape; otherwise it is toxic and must not be used.

Badger Meat Congee from the Sheng Hui Fang

The Sheng Hui Fang (a Song dynasty medical text) records: to treat the ten kinds of water disease, even when the illness is severe and the patient is critically ill, it can still bring rescue. Take half a jin of badger meat (hu meat), cut it into pieces, add three ge of japonica rice (about half a sheng), three sheng of water, and also scallion, Sichuan pepper, fresh ginger, and douchi; cook together into congee and eat it.

Mole Cricket Powder

Treats swelling and fullness caused by water disease, with panting and inability to lie flat. Take five mole crickets (commonly called “earth dogs”), dry them in the sun, and grind them into powder. Before meals, mix half a qianbi to one qianbi with hot soup and take it. A qianbi is an ancient measuring tool for medicinal powders, about one small spoonful. Free urination indicates that it has taken effect.

Prescription from the Shiyi Xinjing

The Shiyi Xinjing (a Tang dynasty work on dietary therapy) records: to treat the ten kinds of water disease, use scallion, Sichuan pepper, fresh ginger, and douchi to cook congee and eat it. Another prescription is the same as the mole cricket powder above: for water disease with swelling and fullness, panting, and inability to lie down, grind mole crickets into powder and take it mixed with soup before meals; free urination means it is effective.

Shiyi Xinjing records: To treat the ten kinds of water disease (edema-like conditions), even when the illness is severe and the patient is near death, it can be cured. Take one green-headed duck (a duck with a greenish-blue head), slaughter and prepare it in the usual manner, cut it into fine pieces, and cook it together with rice and the five-flavor seasonings until extremely soft; make it into a porridge and eat it on an empty stomach.

Another formula: It is indicated for water-qi distention and fullness, edema, and difficult, scanty urination. Take one white duck, remove the feathers and intestines, wash it clean, take half a sheng of cooked rice, add ginger and Sichuan pepper and mix well, stuff this into the duck’s belly, sew it up, steam it in the usual way until thoroughly cooked, and then eat it.

Yangshi Chanru records: To treat generalized swelling and fullness, acute water-qi, and inability to lie flat. Take one large ge (an ancient unit of volume) of yuliren (seeds of the bush cherry, Prunus japonica), grind into a fine powder, mix with wheat qu (a wheat-based fermentation starter), add water, and knead into small cakes; have the patient swallow them. After taking it, the bowels move freely, the qi mechanism becomes smooth, and the illness is cured.

Meishi Fang records: To treat edema in which the patient cannot sit or lie comfortably and the head, face, and whole body are swollen. Take branches of the eastward-growing flowering mulberry (a type of mulberry), burn them to ash, and use the liquid obtained by leaching the ash to cook adzuki beans. Eat them on an empty stomach until full; when hungry, eat again until they are finished. During this period, rice must not be eaten.

Another formula: To treat edema with difficult urination. Use one sheng of yellow ox urine. Within one day, by nightfall, urination will become free and the illness will be cured. Avoid salt.

Another formula: To treat water below the heart (the epigastric region). Baizhu (Atractylodes macrocephala; a medicinal that strengthens the spleen and promotes water movement) three liang and Zexie (Alisma; a water-disinhibiting medicinal) five liang. Chop them, add three sheng of water, decoct down to one and a half sheng, and take in divided doses; recovery follows. Avoid salt.

Another formula: To treat water below the heart. Baizhu three liang and Zexie five liang. Chop them, add three sheng of water, decoct down to one and a half sheng, and take in divided doses.

Qianjin Yi records: To treat difficult urination with water-qi stagnation in the bladder. Take duckweed, dry it in the sun, and grind it into powder. Take one fangcunbi each time (an ancient spoon for measuring medicinal powders, about one small spoonful); once or twice a day is best.

Jingyan Fang: This is a formula handed down in the Pei family of Hedong. It is said to be effective and is used to treat edema and sudden swelling.

Diuretic Formula in Ge Hong’s Zhouhou Beiji Fang (Emergency Formulas to Keep Up One’s Sleeve)

Take three liang of Tinglizi and pound it with a pestle six thousand times, until it becomes like mud. Then add four liang of powdered Han Fangji, a Chinese medicinal. Take a green-headed duck, cut open its head in the mortar, and let the blood flow into the mortar until the blood is completely drained. Then pound the duck head together with the medicinal paste another five thousand times, and roll the mixture into pills the size of wutong seeds. For severe cases, take ten pills on an empty stomach with warm boiled water; for milder cases, take five pills and repeat frequently, then stop after five days. This formula promotes urination and has a marked effect.

Edema Therapy from Wei Zhou’s Duxing Fang

This formula treats edema. Edema begins at the feet; if it enters the abdomen, it can cause death. Take one dou of adzuki beans and cook them until very soft. Take four to five sheng of the broth, warm it, and soak the area below the knees. If the edema has already entered the abdomen, eat only the adzuki beans, without mixing them with other foods, and it can also cure the condition. Bingbu Shouji Fang, compiled by Li Jiang of the Tang dynasty, also records this method, and it is indeed effective.

Formula for Treating Sudden Hard Masses in the Abdomen

“Sudden hard mass in the chest and abdomen” refers to a hard mass that appears suddenly in the abdomen. The patient has a stone-like hard object in the abdomen, with unbearable piercing pain, crying day and night. If untreated, death occurs within one hundred days. This formula has been verified as effective.

The main formula is to take two jin of Achyranthes root and soak it in one dou of wine. Seal the container and warm it in hot ashes. After the medicinal aroma is released, take five ge to one sheng each time, adjusting the dose according to one’s own capacity. Another formula uses Sambucus root in place of Achyranthes root, with the same method and an even better effect. Master Yao considered the Achyranthes wine to be highly efficacious. For external application, take a generous amount of Danglu root, pound it, and steam it until hot. Place a new cloth over the abdomen and spread the medicine on the cloth; do not apply it directly to the skin. Change it when the medicine cools, without stopping day or night. Another formula: on the fifth day of the fifth month, take ten jin of peeled garlic, add one chi and two cun of cinnamon, and add one duck-egg-sized piece of yellow earth from the stove. Pound everything together evenly, mix with vinegar, and apply it, covering the affected area with cloth. Generally, recovery occurs within no more than three applications.

Note: The above are all ancient folk formulas recorded in old texts. For modern treatment of abdominal masses, edema, and similar symptoms, one should seek medical attention promptly and rely on a doctor’s diagnosis.

Another formula: take linmu wood, burn it to ash, and leach it with water to obtain eight sheng of liquid; use this liquid to brew wine from one hu of rice. After the wine is ready, begin taking it. Start with half a ge (a very small amount); if there is no reaction, gradually increase to one or two sheng. It is not necessary to finish a whole course; the illness will be cured. This ash can also be used to dye a crimson color and can also be used for brewing wine.

All zhengjia (hard masses and accumulations in the abdomen) generally form gradually. If one suddenly notices them, they have already become hard and enlarged, and are then difficult to treat. If there is a mass in the abdomen, it obstructs eating and drinking, and the person gradually becomes emaciated. In treating this kind of illness, one commonly uses drastic major prescriptions such as Xianbing, Yuhu, and Badu; here I select only simple medicines that are easy to obtain. Take the root of Japanese knotweed (Polygonum cuspidatum), being careful not to take one that grows by the water with its shadow reflected on the water’s surface; obtain about more than one shi, pound it thoroughly, and boil it into a juice, which can be made into pills. Then cook five or six sheng of glutinous millet into rice; during the day, after applying the medicine, eat it, and one will be cured.

Another formula: also take one sheng of Japanese knotweed root, pound it a thousand times, steep it in wine, and take it starting from a small amount, three times daily. This medicinal wine treats zheng masses with better effect than the various major prescriptions.

Another formula: take one shi of silkworm feces, burn it with mulberry wood into ash, leach it with water five times, and take a live soft-shelled turtle about one chi long, put it into the liquid, and boil until thoroughly soft. Remove the bones, tear and cut it finely, then boil it down until it can be kneaded into pills. The pills should be the size of wutong seeds; take seven pills each time, three times daily.

Another formula: take two liang of shewang, three hundred grains of Sichuan pepper, grind into powder, and mix with egg white to make pills the size of large hemp seeds. First take one pill, gradually increase to pills the size of a soybean, with a limit of one to three pills.

Another formula: take one large pig heart, remove the blood, and pound it into powder. Sew realgar, five musk pods (musk sacs), and one hundred croton seeds (remove the shells and skins and use them raw) together with the pig heart, place the whole in a small copper vessel, and decoct it in good wine. The wine should cover the pig heart; when it is about to boil dry, add wine successively until a total of three sheng has been added. When the pig heart has cooked to a pulp, continue simmering until the mixture can be rolled into hemp-seed–sized pills. Take three pills each time, three times daily. If the wine is used up before the pig heart is thoroughly cooked, take it out, mash it, mix it with honey, and form pills; this is equally effective.

Another formula: rhubarb half a jin, puxiao (mangxiao, a mineral purgative) three liang, and honey one jin. Cook them together over hot water until the mixture can be rolled into wutong-seed–sized pills. Take ten pills each time, three times daily.

The above two formulas are used to treat “turtle syndrome.” Turtle syndrome is a condition of abdominal masses; the mass is shaped like a turtle and located below the heart. On palpation the patient can feel something like a turtle’s head and feet, and it frequently wriggles.

Another formula: take a pair of white hens and fast them overnight. The next morning, feed them rice fried in grease or oil and collect their droppings, regardless of amount. Place the droppings in a copper vessel, mix them with urine, and evaporate over fire until they can be pounded into powder. Take one fangcunbi (a small spoon used to measure medicinal powder) each time, four to five times daily, and continue until the mass has completely disappeared. Normally, these chickens are used to collect the droppings; after the illness is cured, kill the chickens and eat them by themselves. This is the same as Yao’s record.

To treat a condition in which there is a mass below the heart, as large as a cup, and the patient is unable to eat, use the following formula: Tingli seeds two liang (roasted), rhubarb two liang, and Zeqi four liang (a medicinal herb). Crush and sieve them into powder, mix with honey, pound repeatedly a thousand times until fine, and form pills. Take two wutong-seed–sized pills each time, three times daily, gradually increasing the dose.

There are also various pill formulas such as “Xian □ Bing Zhe Gui”; see the major formulas for details.

To treat a condition of qi binding below both flanks, use the following formula: Langdu two liang (a toxic herb), Xuanfuhua one liang, and prepared aconite two liang. Crush and sieve them into powder, mix with honey, and form pills. Take two wutong-seed–sized pills each time, gradually increasing to three pills.

Hot Compress Method (1): Take a copper vessel that can hold about two sheng, pour in fish oil (fish fat) to a depth of two or three cun, then make six or seven thick, large wicks and light them so that the oil becomes hot. Cover the affected area (zheng, referring to a mass in the abdomen) with several layers of thick paper, and apply the vessel of hot oil against the paper for hot compressing. The dosage is increased gradually from small to large, from about two pills to three.

Hot Compress Method (2): The method is the same as above. Use a copper vessel for the hot compress without stopping day or night; when the oil is used up, add more.

Another Formula: Take three sheng of Evodia rutaecarpa (zhuyu, a pungent and aromatic medicinal herb), crush it, mix it with wine and cook it until done, wrap it in cloth, and apply it hot to the mass. When it cools, change it; use the compresses alternately and repeatedly, and the mass will gradually shift, disperse, and recede. One may also take fine powder of high-quality Evodia, mix it with egg white, and take it.

Another Formula: Take one sheng of earth from the center of a cooking stove, crush it finely, and mix it with other medicinal ingredients. Pour bitter wine (vinegar) over it until moist, first spread it on one side of a cloth, and apply it to the affected area. When the cloth dries, replace it, until the mass subsides and recovery is complete.

Treating a Woman’s Mass Below the Navel: The patient has a hard mass below the navel the size of a cup or a sheng or dou measure; menstruation is blocked, the symptoms occur intermittently, and there are also diarrhea and emaciation. This illness is called “qi jia” (an abdominal accumulation caused by stagnation of qi). If, on pressure, the mass is hard and fixed, as if growing within the flesh, it is called “rou jia” (flesh jia) and cannot be cured; if it has not yet hardened into form, it can be treated.

Dried Lacquer Formula: Take one jin of dried lacquer (the substance formed when lacquer-tree resin is dried in the sun) and thirty jin of raw Rehmannia; crush the Rehmannia and squeeze out its juice, then cook the dried lacquer over fire until it can be rolled into pills. Take after meals, three pills the size of parasol-tree seeds each time, three times daily, and recovery will follow.

Supplementary Formula: The Waitai Miyao Fang (a medical book compiled by Wang Tao of the Tang dynasty) records that this formula can treat old accumulations between the heart and abdomen, as well as suddenly arising masses.

One: Formula for Feeding Cinnabar to a Chicken and Collecting Its Droppings

Take cinnabar (a red mineral medicine containing mercury sulfide), grind it finely, and mix it into rice so that the rice is dyed vermilion red. Select a rooster, starve it for three days first, then feed it the cinnabar rice. Place the chicken on a wooden board, collect its droppings, dry them in the sun, and grind them into powder. Take it with warm clear wine, each dose from one square-inch spoon to two qian (ancient measures, roughly one small spoonful to several fen), three times daily. Severe cases may take it six times over day and night. If the droppings from one chicken are not enough, feed another chicken until there is enough. Stop the medicine once the illness is cured.

Two: Formula for Treating Abdominal Masses and Various Toxic Qi Caused by Eating Fish and Meat

Take five sheng of dog feces, burn them into ash powder, wrap them in cotton cloth, and steep them in five sheng of wine. After two nights, take the clear liquid on top and divide it into ten doses, taking it twice daily. Thereafter take it three times daily until finished. The abdominal masses will be expelled accordingly.

As Recorded in the Qianjin Fang: Treating [Illness from] Eating Fish

Shengjin Fang: A formula for treating "Qi outside the membrane" (referring to Qi stagnation in the abdomen with distention and fullness, and even the formation of Qi masses). Take any amount of Corydalis (Yanhusuo), grind it into a fine powder; cut one whole pig pancreas into small pieces, roast until cooked, then dip them in the medicinal powder and eat.

Formula for Treating Cold in the Heart and Abdomen with Accumulation of Food and Drink Forming Pi Masses (No. 27)

It chiefly treats pi masses caused by cold in the abdomen (hard masses formed in the abdomen), stagnation of water and grain, retained phlegm below the heart, fullness, distention, and oppression in both hypochondria, with a shifting water sound on pressure, and food and drink reversing upward and being difficult to digest.

The first formula uses one large toad, skinned and with the viscera removed, cut into small segments. It is combined with mangxiao (mirabilite): for robust adults use one sheng, for middle-aged persons seven ge, and for the weak five ge. Add six sheng of water and boil down to four sheng; take one sheng each time. If there is no purging after taking it, take another sheng; after purging, it may be repeated after nine to ten days.

The second formula uses eight liang of zhuyu (evodia fruit), one sheng of xiaoshi (niter), and one jin of fresh ginger, boiled together with five sheng of wine and reduced to four sheng. First take one sheng; if no pain is felt, stop taking it and do not take more. After the pathogenic evil has been purged, take good care to recuperate.

The third formula uses eight liang of rhubarb and four liang of tingli, stir-fried together until cooked; four liang of mangxiao are boiled until the liquid is completely dried up. Pound all together, mix with honey into pills the size of wutong seeds. Take three pills after meals, gradually increasing to five pills.

The fourth formula uses three liang of langdu, one liang of fuzi, and three liang of xuanfuhua. Crush them, mix with honey into pills the size of wutong seeds. Take three pills before meals, three times a day.

The fifth formula uses thirty croton seeds (badou) with the hearts removed and twenty apricot kernels, stir-fried together until cooked; six fen of platycodon, four fen of lilu, and three fen of zaojia are all roasted and pounded together with them, then mixed with honey into pills the size of hu beans (broad beans). Take one pill before meals, twice a day; if one wishes to purge the pathogenic evil, two pills may be taken. With long-term care and regulation, recovery may be achieved after one hundred days.

Note: These ancient formulas mostly use drastic and toxic drugs (such as badou, langdu, lilu, and fuzi; toad is also toxic). The quality of medicinal materials, processing methods, and dosages differ greatly between ancient and modern times. They are for documentary reference only and should not be taken on one's own.

Formula One: Take two liang of fritillaria (the bulb of a lily-family plant; it transforms phlegm and stops cough), two liang of platycodon (a root that stops cough and expels phlegm), one liang of alum stone (a mineral of the alum type), and one liang of croton seed (a drastic purgative with fierce medicinal action). Remove the shell and the center of the kernel from the croton seed, use it raw without roasting, pound it together with the other medicinal materials one thousand times, mix with honey, and form pills the size of wutong seeds. Take two pills each time; afterward one must maintain prolonged quiet rest and regulate the breath, and within one hundred days one may recover.

Another formula: The ingredients are the same as in the preceding formula, but take two pills each time; after the condition improves, gradually reduce the amount taken.

Another formula: Take one liang of poria and three liang of evodia, pound them, and use honey to make pills the size of wutong seeds. Take five pills each time, three times a day.

Another entry: This formula is used to treat sudden stagnation of retained food, lingering fluid that does not disperse, and accumulations in the abdomen causing trouble. Take three liang each of rhubarb, poria, and mirabilite, and one fen of croton seed; pound them and make honey pills the size of wutong seeds. Take two pills each time, and stop once the abdominal pain ceases.

Another formula: Take two liang of zanthoxylum seeds (the seeds of Sichuan pepper) and one liang of croton seed; remove the skin and heart, stir-fry or roast, then pound. Use jujube paste to make pills the size of eight hemp seeds. Take two pills; after purgation the abdominal pain stops.

Another formula: Take one croton seed, remove the heart and skin, and stir-fry or roast it; fourteen zanthoxylum seeds; and sixteen fermented soybeans. Pound them together into pills. After taking two pills, vomiting and diarrhea will be induced. If the vomiting and diarrhea are not complete, take two more pills.

Another passage: Taking Sishen Pill for drastic purgation is also effective. “Zhonghou Black Pill” is used to treat various kinds of abdominal masses, clumped phlegm-fluid, and sores and ulcers; the original text calls it the first excellent formula.

Another formula: Take four fen of platycodon, four fen of cinnamon, eight fen of croton seed (remove the heart and skin), five fen of apricot kernel (remove the skin), and twelve fen of yuanhua (toxic flower buds, often used as a purgative). Stir-fry them together until purple. First pound the first three ingredients into a fine powder; then pound the croton seed and apricot kernel into a paste, combine them with the powder, pound two thousand more times, and make pills the size of broad beans (fava beans). Take one pill, with purgation as the criterion; in severe cases one may take up to two or three pills. For infants ten days after birth who are about to develop seizures (convulsions), give each one or two pills the size of millet grains. Whenever there is abdominal discomfort or the body feels ill, take it; after one or two purgings it will resolve.

Background note: In these formulas, croton seed and yuanhua are both drastic purgatives that are violently toxic. The dosages and processing methods in ancient formulas are difficult to master. What is recorded in the book can only serve as documentary material for understanding ancient medical formulas; one must not prepare or take them on this basis, and they are especially dangerous for infants and young children.

Sulfur Pill

This formula is extremely hot in nature and is used to treat severe cold conditions within the body. It may also be taken by people who, even in summer and after warm food and drink, still refuse to loosen their clothing and fear the cold.

The formula uses twelve ingredients—sulfur, alum, dried ginger, evodia, cinnamon twig, wild aconite, aconite root, Sichuan pepper, ginseng, asarum, gleditsia pod, and angelica—combined in their respective amounts, crushed, and mixed with honey to form pills the size of wutong seeds (about the size of peas). Take ten to twenty pills each time, three times daily. For cold dysentery, add halloysite and fossilized bone (dragon bone), and recovery will follow.

Open-Air Sleeping Pill

This formula treats illness caused by sleeping in the open and contracting cold, with cold pathogen accumulating in the body.

Use alum, dried ginger, cinnamon, platycodon, processed aconite root, and gleditsia pod, three liang of each. Crush and sift, mix with honey to form pills the size of wutong seeds. Take ten pills with wine, gradually increasing to fifteen.

Supplementary Formulas

The following formulas are cited from the Waitai Miyao (Secret Essentials of an Official, a medical work compiled by Wang Tao of the Tang dynasty).

1. Open-Air Sleeping Pill: Same as the formula above; the original repeats it.

2. Treating abdominal masses (pi): Take rhubarb, ten liang, crush and sift, mix evenly with three sheng of vinegar, add two spoonfuls of white honey, and boil until it can be formed into pills the size of wutong seeds. Take thirty pills each time with ginger decoction, stopping when purgation and free bowel movement occur. Reduce the dose for the weak.

3. From the Shenghui Fang, for Fu Liang qi (a mass below the heart that gathers and does not disperse): Take taonu, two liang, grind into a fine powder, and take two qian on an empty stomach mixed in warm wine.

4. From the Jianyao Jizhong, for chronic accumulated cold, inability to eat, persistent vomiting, and cold accumulation in the stomach: Take pinellia, five liang, wash and grind into a fine powder; take two qian each time. Separately take one liang of white flour, add water and mix evenly, cut into small chess-piece-sized pieces, boil in water until cooked, then season with ginger and vinegar and eat together with the pinellia powder.

Various Formulas for Treating Phlegm Accumulation above the Chest and Diaphragm, Twenty-Eighth

This is the chapter title, meaning “various formulas for treating phlegm-rheum conditions above the chest and diaphragm, number twenty-eight.”

Treating Sudden Headache

Used to treat sudden headache as if the head were splitting. This condition is caused neither by cold pathogen nor by wind-stroke. The formula uses four fen of cauldron-bottom soot, three fen of aconite root, and one fen of cinnamon; crush and sift, and take one fangcunbi (a small measuring spoon) with cold water. Vomiting should occur after taking it. Another formula omits the cinnamon.

This section records several emetic prescriptions used to treat headaches, loss of appetite, and similar symptoms caused by excessive phlegm in the chest and rebellious Qi rushing upward. The ancients believed that such illnesses arose when turbid phlegm stagnated in the chest and diaphragm and rebellious Qi rose upward; they called this “jue” (reversal). Once the turbid phlegm was vomited out, the headache would be relieved.

One prescription uses equal amounts of Kushen (Sophora root), Gui (cinnamon), and Banxia (Pinellia). Pound and sift them, mix with bitter wine (vinegar), and apply to the affected area; once the pain disappears, the patient is cured. Another method uses three parts Kushen, three parts Banxia, and one part Gui; pound and sift, then take one fangcunbi (about one small spoonful) with cold water. After taking it, one should vomit. Another version omits Gui.

Thirty Wumei (smoked plums), a three-finger pinch of salt (the original text has guan, “wash,” but according to context it should be “salt”), and three sheng of wine are boiled down to one sheng; remove the residue and take it all at once. After taking it, one should vomit, and the illness will be cured.

Simply cook rice into a thick rice broth and drink two or three sheng at a moderate temperature; not long after drinking, vomiting will occur. After vomiting, drink again, repeating this several times. For severe cases, one should continue until bile is vomited and then stop; this will not harm the body, and the illness will be cured.

For abundant phlegm in the chest with headache, lack of appetite, or drinking alcohol: take Changshan (Dichroa) two liang, Gancao (licorice) one liang, Songluo (Usnea) one liang, and Guadi (melon pedicel) thirty-seven pieces; add one and a half sheng each of wine and water and boil down to one and a half sheng. First take seven ge to induce vomiting. If vomiting is incomplete, divide the remainder into two doses; afterward one may take Banxia decoction.

The “Fenge Tang” (Powder-Separating Decoction) recorded in Hu Qia’s work: one liang of alum, add two sheng of water, boil down to one sheng, add half a ge of honey, and take it all at once. If there is no vomiting after a short while, one may drink a small amount of hot water.

Duheng (Asarum) and Songluo, three liang each, and thirty pieces of Guadi are soaked in one sheng and two ge of wine for two nights; remove the residue and take five ge warm. If there is no vomiting after one dose, take another dose in the evening. The prescription below is the same as this one.

Guadi one liang and Chixiaodou (adzuki bean) four liang are pounded into a fine powder and mixed with three ge of warm water for administration. After taking it, lie down quietly to rest; if one wishes to induce vomiting but does not vomit, take one more dose.

Background note: The drugs mentioned in the text—such as Changshan, Guadi, Fanshi (alum), and Wumei—mostly have emetic effects, but many of them are toxic and their dosages are difficult to determine. These are records from ancient medical books and should be used only as a reference for understanding history; people today should not use these prescriptions on their own. The ancient practice of treating phlegm by inducing vomiting was also gradually adopted less in later times because of its relatively high risks.

Several Emetic and Phlegm-Fluid Formulas from Ge Hong’s Zhouhou Beiji Fang (Emergency Formulas to Keep Up One’s Sleeve)

Shengshu Tang Emetic Formula

First boil one sheng of the medicinal decoction, then add one sheng of water; this is called “Shengshu Tang” (Raw-and-Cooked Decoction). If one has accidentally ingested three ge of salt, take it with this decoction; after a short while, when the urge to vomit arises, induce vomiting. If vomiting is not complete, take another two ge. After drinking two sheng of the decoction, if it is still needed, it may be taken again until vomiting ceases.

Changshan Honey Decoction Formula

Take four liang of Changshan (Dichroa, an emetic herb) and half a liang of licorice, add seven sheng of water, boil down to three sheng, remove the dregs, add half a sheng of honey, and take one sheng each time. If there is no vomiting after taking it, one may take another dose. It is also acceptable without honey.

Summary on Phlegm-Fluid and the Xuanfuhua Formula

In formula books, if one can take one of these formulas once a month, one will not suffer from stagnation of phlegm-fluid, water, and dampness. There is also a Xuanfuhua formula for treating the “Five Retained Fluids,” recorded in the major formula books. If there is stuffiness and oppression in the chest, coldness, and shortness of breath, likewise add half a sheng of honey and take one sheng each time; if there is no vomiting, take it again; it is also acceptable without honey.

Licorice, Poria, and Apricot Kernel Formula

Two liang of licorice, three liang of Poria, and fifty apricot kernels. Crush the apricot kernels, add one dou and three sheng of water, boil down to six sheng, and divide into five doses.

Guizhi Zhu Fu Tang

Another formula: four liang of cinnamon twig; two liang each of white atractylodes and licorice; processed aconite. Add six sheng of water, boil down to three sheng, and divide into three doses.

Veratrum and Croton Pill

This formula is used to treat accumulation and binding in the diaphragm, with a subjective sense of palpitations and unease in the heart and chest that does not disperse for a long time. Take one liang of Veratrum (Lilu), roasted and ground into powder, and half a liang of Croton (Badou), peeled, cored, and first simmered. First pound the croton into a paste, add the veratrum powder, pound ten thousand times more, and make into honey pills the size of hemp seeds. Take one pill each time, up to two or three pills.

Background Note: Gaohuang was the term the ancients used for the area between the heart and the diaphragm, which they regarded as a place that pathogens find difficult to reach. The original text is damaged here, so only the recognizable portions can be interpreted. Veratrum and croton are both toxic drugs; ancient formulas used them to induce vomiting and purge, with strict requirements for dosage and processing. People today should not imitate them.

The disease in the diaphragm is called “gaohuang.” The medicinal power of decoctions and pills moves too quickly, and acupuncture and moxibustion cannot reach the diseased site. Therefore the medicine is made into pills to be held in the mouth, allowing the medicinal qi to slowly penetrate the affected area. This is the formula for “Wuge Wan” (Five Diaphragms Pill).

(Diaphragm: refers to the area of the diaphragm between the thoracic and abdominal cavities; the ancients believed that diaphragm diseases mostly occur in the chest-diaphragm region. Gaohuang: in ancient times this referred to the deep area between the heart and diaphragm, and it is often used to describe a difficult-to-treat disease location.)

Wuge Wan Formula: Ten fen of Ophiopogon tuber (core removed), ten fen of roasted licorice, and six fen each of Sichuan pepper, Polygala, prepared aconite, dried ginger, ginseng, cinnamon, and asarum. Crush and sift, then knead with fine honey into pills the size of a bullet. Each time hold one pill in the mouth, slowly swallow the juice, three times a day. It mainly treats shortness of breath (rapid breathing and insufficient qi), distension and fullness in the chest and heart, and hardness below the heart; these are caused by cold qi.

There are more than ten formulas for this type of illness, and most are similar. This pill is the best. Although it uses many ingredients, it does not fit the name “Five Diaphragms.” The so-called Five Diaphragms are the worry diaphragm, qi diaphragm, anger diaphragm (a diaphragm disorder arising from rage), and cold diaphragm; each has different causes and symptoms. Among the major formulas there is also the “Seven Qi Formula,” which is broadly the same, with only minor differences.

Supplementary Formulas:

In the Sheng Hui Fang, for phlegm-counterflow headache (headache and syncope caused by upward counterflow of the phlegm pathogen): use ten smoked plums, take the flesh, add two qian of salt and one medium cup of wine, decoct together until reduced to seven-tenths, remove the dregs, and take warm at any time; vomiting will bring relief.

Another formula treats nausea caused by cold phlegm-fluid retention: use one liang of long pepper (bibo), grind into powder, and before meals mix with clear rice-porridge liquid and take half a qian.

Another formula treats phlegm obstruction with vomiting and counterflow, fullness and oppression in the chest and heart, and lack of appetite: use one liang of magnolia bark, coat with ginger juice and roast until slightly yellow, grind into powder, and take two qian-spoonfuls with rice-porridge liquid at any time.

The Qianjin Yifang states: For treating phlegm-fluid retention with vomiting of water, regardless of season, the root cause lies in drinking too many cold beverages, which weakens the spleen and stomach and leaves them unable to digest food and drink. After food and drink enter the stomach, they all turn into cold water, and repeated vomiting does not stop; Chishizhi San (Red Halloysite Powder) should be used as the main treatment.

(The passage from the Sheng Hui Fang appears repeatedly in the original; here it is interpreted only once.)