《孫真人備急千金要方》Vol. 29

The Book of Changes (Yijing) says that Heaven and Earth are in constant transformation, and that the myriad things each grow according to their own nature. The patterns of change in Heaven and Earth are inexhaustible, and a person’s endowment and fate are likewise difficult to predict. Thus, all kinds of changes arise between Heaven and Earth: heat and cold, wind and rain, darkness, floods and droughts, unusual calamities, insect infestations, and more. Each of the four seasons and eight seasonal divisions has its own climate; the seventy-two pentads follow one another in turn, and the movements of the sun and moon each have their proper rhythms. Only at the end of the year is the yearly cycle complete.

If even Heaven and Earth undergo such changes, then people living between them cannot avoid life’s ups and downs. A person’s fate may be favorable or adverse, and the times may be good or bad. Life brings fortune and misfortune, suffering and joy, safety and danger, as well as happiness and anger, love and resentment, life and death, worry and fear. Each day brings many concerns, and new ways of planning for daily life are constantly devised. There is no year in which Heaven does not experience heat and cold, and no day in which people do not experience worry or joy.

For this reason, when an epidemic spreads and people fall ill, it is an epidemic Qi formed by changes in Heaven and Earth’s climate. This is an unavoidable phenomenon of natural change. Although sages have the virtue to govern the world and establish its principles, they cannot make this phenomenon disappear entirely. They cannot eliminate it, but they can respond to it in ways that accord with reason. Virtuous people are skilled at nourishing life: they understand restraint and adapt to changes in the seasons, thereby preserving their health.

Where miasmas and epidemics exist between Heaven and Earth, medicines that can prevent and treat them also grow. Knowing these methods is called “knowing the remedy”; once one has learned how to respond, illness is less likely to take hold. Yet people commonly call this kind of illness a “sudden affliction.” Many do not know how to treat it and say only that it will pass once its course has run. Perhaps half the people in the world die as a result. As soon as one begins to feel unwell, treatment should be sought without delay. Once the illness improves, one should gradually resume eating and recuperation, weakening the disease and restoring the body. Never let the illness run its course unchecked, helplessly waiting for death; that is to delay treatment.

We have now gathered methods widely from the classics of various schools and compiled them into two volumes, so they may be kept at hand in full. Those who wish to nourish life may consult them carefully.

The Minor Formula says: “From ancient times to the present, people have held that cold damage is a difficult illness to treat. Seasonal epidemics, meanwhile, are illnesses caused by epidemic toxins. Yet those who discuss treatment often fail to distinguish cold damage from seasonal epidemics…”

What is called “epidemic disease” is simply an abnormal seasonal influence. Some say that “cold damage” is the refined term used by educated people, while “seasonal illness” and “epidemic disease” are the names used by country folk. In fact, these are only different names; they do not mean that the illnesses are the same. A study of the various classics shows that these diseases do differ in nature, and that the appropriate treatments also differ. The main points are briefly explained here.

The classics say that spring is mild, summer hot, autumn cool, and winter bitterly cold. These are the normal climatic changes of the four seasons. When winter is bitterly cold, all things lie deep in hiding. If people take care to preserve their health and guard against the cold, they will not be invaded by cold pathogens. But if they expose themselves to the cold and become chilled, they will contract cold damage.

The climate of any season can cause illness, but cold damage is called “toxic” because the cold pathogen is especially fierce and harmful. If illness begins immediately after exposure to cold, it is called cold damage. If it does not begin at once, the cold pathogen remains hidden between the muscles and bones, transforming into warm disease in spring and summer-heat disease in summer. Summer-heat disease brings extremely intense heat and is more severe than warm disease. Thus, people who labor hard often suffer warm disease or heat disease in spring and summer because they were exposed to cold in winter, not because of an abnormal seasonal influence spreading at the time.

“Seasonal epidemic illness” refers to outbreaks in which spring, which should be warm, is instead bitterly cold; summer, which should be hot, is instead very cold; autumn, which should be cool, is instead very hot; or winter, which should be cold, is instead unusually warm. When such weather occurs in a season when it should not, people of all ages fall ill with very similar symptoms throughout the year. This is caused by the influence of the abnormal season.

The course of cold damage changes from day to day, so treatment must be matched to the stage of the illness with different prescriptions. Nowadays, some people contract cold damage but receive no timely treatment at first, or remain unwell after treatment. Only after many days, when the illness has become severe and entrenched, do they seek a physician. If the physician follows a fixed sequence and prescribes mechanically, the treatment often fails to address the condition. The prescription must instead be adjusted in light of the patient’s condition at the time.

Hua Tuo said: On the first day of cold damage, the pathogen is at the surface of the skin. Apply a medicinal ointment and use heated compresses; the illness will then be cured. If it is not cured, on the second day the pathogen has entered beneath the skin. Acupuncture may be used as before, together with Jieji San, a prescription that helps release pathogens from the body’s exterior and induce sweating. Once sweating occurs, the illness will be cured. If it is still not cured, on the third day the pathogen has reached the muscles; induce sweating once more and the illness will be cured. If it remains uncured, stop and do not continue inducing sweat. On the fourth day, the pathogen has reached the chest. Take Lilu Wan to induce mild vomiting, and the illness will be cured. If the illness is severe and Lilu Wan does not induce vomiting, take Xiaodou Guadi San to induce vomiting; the illness will then be cured.

Examine the patient. If they have not yet regained consciousness, treat them again with another needling method. By the fifth day of illness, the pathogenic influence is in the abdomen; by the sixth, it has entered the stomach, and only then may purgation be used. If the toxic heat is still on the body’s surface and has not entered the stomach, using purgation first will let the heat take advantage of the body’s weakness and enter the stomach, where it may even damage the stomach lining. Once the heat has entered the stomach, however, purgation must be given promptly; it should not be allowed to remain there. When excess heat in the stomach causes illness, roughly three out of ten people die and one survives. If the stomach is already weak, heat entering it will damage its lining. With milder heat, red patches appear; in such cases, about five out of ten die and one survives. With severe heat, black patches appear; about ten out of ten die and one survives. Yet people differ in constitution and strength, and illnesses vary in how difficult they are to treat, so outcomes can differ greatly.

If, after falling ill, a person has no fever but speaks incoherently and is restless, with disordered awareness and speech and an inability to respond normally, do not force treatment with fire methods. Give only one square-inch spoonful of Zhuling Powder (about a small spoonful of medicine), and make the patient drink one or two sheng of freshly drawn well water. Then stimulate the throat with a finger to induce vomiting; the illness will often ease at once. If the patient cannot vomit, do not force more water down, or it may collect below the stomach and stagnate, causing further illness. Instead, use another medicine to induce vomiting, and help the patient regain the ability to respond normally; otherwise, the condition will worsen. Such patients often die quickly if Zhuling Powder is not given promptly to induce vomiting and expel the pathogenic influence. It may also work better to first give a toxin-clearing medicine and use needling alongside it.

Illnesses involving accumulated fluids between the chest and diaphragm, with internal congestion and excess, are very difficult to treat: roughly three out of ten people die and one survives. If purgation is not given promptly after the illness begins, even after the proper time for it has passed, the heat cannot be expelled. It may then damage the stomach lining and cause skin eruptions.

In spring and summer, do not induce forceful vomiting or purgation; in autumn and winter, do not induce heavy sweating. In winter and during the severe cold of early spring, one may take Shendan Pills or apply a medicinal massage ointment and use cauterization. In late spring, summer, and early autumn, when the weather is hot, avoid cauterization and do not cover the patient heavily. Liuwu Qing Powder may be taken; Cui Wenxing’s Duzhang Powder, Chisan, and Xuejian are also effective. If no pills, powders, or decoctions are available, simply boiling several liang of Bupleurum and drinking it can also treat cold damage and epidemic illness by inducing sweat.

If sweating has been induced once or twice without effect, give a decoction. If the pathogenic influence is excessive, follow with purgation. A pulse that is rapid both morning and evening indicates accumulated, congested fluid retention (pi); a pulse that is calm in the morning but rapid in the evening does not indicate pi. In the latter case, a purgative decoction may be given relatively early, but in a small dose. Do not make the patient purge heavily; after giving a small dose, wait a while before giving more.

As for the various forms of vexation due to deficiency…

A feverish illness may look like cold damage, but the patient is not averse to cold and has no bodily pain, so it can be judged not to be cold damage. The head does not hurt, and the pulse is neither tight nor rapid, showing that the pathogenic influence has not penetrated deeply into the body and formed an excess pattern. In this situation, neither the exterior nor the interior should be treated with forceful measures. If one insists on attacking the illness, the body will become even more depleted. Many patients have died this way, and few have been saved.

This illness is a case of “deficiency vexation”—feverish discomfort and agitation caused by bodily weakness—and should be treated only with Bamboo Leaf Decoction. If there is vomiting, the patient may take one dose of Tangerine Peel Decoction. If the condition still does not improve, stronger medication may then be considered. This treatment is commonly used and highly effective. The decoction is also suitable for deficiency vexation that appears after cold damage.

Wang Shuhe says: when Yang Qi is in excess and Yin Qi is deficient (the Waitai Miyao reads “the exterior is harmonized, while the interior is ill”), inducing sweating will cause death, while purging will bring recovery. When Yang Qi is deficient and Yin Qi is in excess (the Waitai Miyao reads “the interior is harmonized, while the exterior is ill”), purging will cause death, while inducing sweating will bring recovery. Given this, how could one mistakenly use the miraculous elixir for inducing sweat? And how could one casually use Gansui to force a purge? Patterns of deficiency and excess, exterior and interior, differ; the appropriate treatment may be completely opposite, and fortune can turn to disaster as swiftly as a shadow follows its form.

Thus, after Cinnamon Twig Decoction is taken, a pattern of Yang excess may put the patient’s life at risk. When Chengqi Decoction enters the stomach, a patient with a pattern of Yin excess may likewise die. (At these two points, the Waitai Miyao reads “if the exterior is harmonized, death follows” and “if the interior is balanced, death follows.”) The interplay of Yin and Yang, deficiency and excess, is marked by extremely subtle signs. But if sweating, vomiting, or purging is used inappropriately, disaster comes quickly. A doctor with shallow skill who cannot distinguish the patterns will, after the patient dies, say it was fate. Thus wrongful deaths fill the roads of the underworld, and corpses lie across the wilderness. How could anyone with a compassionate heart see this and not grieve?

Cold damage arises when wind and cold enter the interstices between the skin and muscles and contend with the body’s vital Qi, obstructing Ying and Wei—the Qi that circulates within and around the body and protects it—and impeding the flow of Qi and blood. After one or two days, the pathogenic influence remains in the openings and beneath the skin. The patient therefore has a headache, aversion to cold, and a stiff, heavy sensation in the lower back and back. Since the pathogen is on the exterior, inducing sweat can cure the illness. After more than three days, the pathogen floats upward and gathers in the upper body, obstructing the chest and the area around the heart. This causes headache and fullness in the chest; inducing vomiting should then bring recovery. After more than five days, the pathogen settles and binds in the organs and bowels, causing abdominal distension, a heavy sensation in the body, and pain in the joints. Purging should then bring recovery.

The illness and its signs must be examined carefully. Do not prescribe carelessly and damage the stomach Qi. The medical classics say that when the pulse is faint, one must not induce vomiting; when the pulse is weak and fine, one must not purge. They also say that in summer…

Purgation should not be used. The pulse may be deep or floating, and it may also change as the illness develops. This is a point that physicians must treat with particular caution.

Some people wait several days after falling ill before telling a physician. Although they say they have only just begun to feel unwell, the illness may already have been building inside them for days. The pathogenic influence may have gathered and taken hold, so sweating or releasing the muscles alone may no longer be enough to dispel it. The physician should assess the pulse and the course of the illness at the time, then try to treat the patient and avert danger. One must not cling to a fixed sequence of steps: missing the right moment for treatment can bring calamity.

According to the usual progression of cold damage, certain conditions within the first three days of illness may be treated by inducing sweat. Examples include becoming ill from exposure to cold after taking off one’s clothes in the wind or sleeping uncovered at night, or becoming ill when a seasonal epidemic is spreading and pathogenic winds are transmitted from person to person. But if eating too much raw or cold food has caused food stagnation in the abdomen and impaired digestion, with headache, fever, and a forceful, large pulse, the patient may be treated by inducing vomiting or purgation; sweating should not be used.

Chen Linqiu said: “Someone asked what to do when a patient has taken decoctions one after another to induce sweating, yet still cannot sweat.” He replied that the Medical Classic says that repeatedly inducing sweat without producing any is a dangerous condition. He thought the patient might be treated by steaming and fumigation: as in the treatment of windstroke, warm vapor is brought close from the outside, which may be enough to induce sweat.

Later, he asked Zhang Miao about this. Zhang Miao said that there had once been a person who, after overexerting himself, sweated and then slept on a bare bamboo mat. He caught cold and fell ill, feeling only chills and fatigue. Several physicians gave him pills, powders, and decoctions, and induced sweating eight times over four days, but he still did not sweat. Zhang Miao had people heat the ground and cover it with peach leaves, then steamed and fumigated the patient. The patient broke into a heavy sweat under the covers. While his body was still damp, they applied powder to dry him as much as possible. When he got up, he had recovered. Zhang Miao later used this method many times to induce sweating, and it always brought the sweat out. People naturally differ in how easily they sweat; this is not always due to illness. With steaming and fumigation, no one remains unable to sweat.

Conditions involving fever and chills with a floating, forceful, large pulse are suited to treatment by inducing sweat. During the treatment, warm powder may be applied to the body, and exposure to wind should be avoided. But if the patient has lost blood or has just had severe diarrhea, they must not be made to sweat heavily. Instead, give small amounts of Cinnamon Twig Decoction repeatedly, enough to keep the body slightly moist and produce a steady trickle of sweat. Continue for several days, and the illness will then ease on its own.

The text also says that as soon as people feel even slightly unwell, or notice that they are different from usual, they should tell a physician promptly. If they endure it without treatment and hope it will go away by itself, a short time may be enough for the illness to become chronic. Children and women are especially prone to worsening. Greater care and protection are needed when seasonal weather is abnormal or epidemic influences are out of balance.

At the first sign of discomfort, treatment should begin immediately. Determine the source of the pathogenic influence and whether it remains in the Couli—the fine spaces between the skin and muscles. When treatment is timely and early, the illness is rarely beyond cure. If patients endure their symptoms for several days before speaking up, the pathogenic influence may enter the internal organs, where it is difficult to control. At that point, even a renowned physician such as He Huan would be powerless. Carbuncles, deep abscesses, boils, throat obstruction, and Kewu—sudden illness in children caused by fright or an external pathogenic influence—are especially dangerous. Treating these conditions promptly is an important principle of nourishing life.

When decocting and taking medicinal broth, there is no need to worry about the time of day or whether the date is auspicious. As soon as pain is noticed, begin treatment; do not wait until morning or evening. The illness will then be easier to cure. Take the medicine according to the prescribed method. If you disregard the physician’s instructions at will, there is no point in continuing treatment.

Cold damage is often caused by wind and cold. The pathogenic influence first attacks the body’s exterior; if it enters the body, it is difficult to dispel. Even keeping the patient warm and covered may not disperse it. After someone has suffered for five or six days from a seasonal epidemic illness, they may become thirsty and want to drink, yet be unable to drink much. In that case, do not give them too much water. The heat in the abdomen is not yet strong enough to process a large amount, and drinking too much may cause further illness. By the seventh or eighth day, if the patient is extremely thirsty and wants water, give it according to their condition, but do not let them drink freely. For example, if they say they can drink one dou, give them five sheng. If drinking causes abdominal distension, difficulty urinating, shortness of breath, or hiccups, do not give them any more water. If they suddenly sweat profusely, the illness may soon resolve on its own. A sick person’s desire to drink water may also be a sign that the illness is about to improve.

Warm diseases can be treated by needling fifty-nine acupuncture points. There are 655 acupuncture points in all; thirty-six should not be treated with moxibustion, and needling seventy-nine can be harmful.

The treatise says: In seeking prescriptions and studying medicine, the essential thing is to be able to treat emergencies quickly. Therefore, those who nourish life should prepare suitable medicines in advance, ready for sudden emergencies. The relevant prescriptions are given below.

Ward Off Epidemics, Part Two (the second section on preventing epidemic febrile illness, also discussing patterns of dampness-related disease)

Tusu Wine: It is said to dispel epidemic influences and protect people from warm diseases and cold damage. This is a prescription for drinking on New Year’s Day, the first day of the first lunar month.

Fifteen zhu of rhubarb, eighteen zhu of atractylodes, fifteen zhu of platycodon, fifteen zhu of Sichuan pepper, eighteen zhu of cassia bark, six liang of monkshood, and twelve zhu of smilax.

Cut the seven ingredients into small pieces and place them in a red cloth bag. At noon on the last day of the twelfth lunar month, suspend the bag in a well, letting it sink close to the mud at the bottom. At dawn on the first day of the first lunar month, take out the bag and put the herbs into wine…

At a door or window facing east inside the house, boil the medicine several times, then take it. Tusu wine, a medicinal wine drunk during the Spring Festival and said to prevent epidemics, should be drunk starting with the youngest person in the household. Each person may decide how much to drink. If one person drinks it, the whole family will be immune; if the whole village drinks it, the whole village will be immune. After drinking the medicinal wine for three days, put the leftover herbs into a well. If you drink it every year, you will remain free of illness year after year. Put the leftover herbs into every well in and around the house; it is said that this drives away the Qi of epidemic disease. Another formula adds one liang of Fangfeng.

Taiyi Flowing Gold Powder (a formula for driving away the Qi of epidemic disease)

Three liang of realgar, two liang of orpiment, one liang of alum mineral, one and a half liang of ghost-arrow bamboo, and two liang of antelope horn, all charred before use.

Grind these five ingredients into a fine powder and sift it. Put one liang into each triangular red cloth sachet. Wear one on the chest and hang one on the door. In a year of severe epidemic, on the first day of the month wrap one knife-measure of the powder in blue cloth and burn it in the center of the courtyard. If someone in the household has a febrile illness, it may also be burned to fumigate the house.

Realgar Powder (a formula for driving away the Qi of epidemic disease)

Five liang of realgar; two liang each of cinnabar (one version reads “red wood”), calamus, and ghost-garlic.

Grind these four ingredients into a fine powder and sift it. Apply it to the crown of the head, the palms of both hands, the soles of both feet, the forehead, nose, philtrum, and the openings of the ears.

Cypress Branch Powder (a formula for preventing illness caused by seasonal imbalance and the spread of disease)

Take a branch from the southeast side of a cypress tree beside a south-facing house. Dry it in the sun and pound it into powder. Take one square-inch spoonful with wine. The original text calls this method “divinely effective,” meaning that it works very well.

Body Powder (a commonly used formula for preventing febrile illness)

Chuanxiong, Baizhi, and Gaoben, in equal amounts.

Grind these ingredients into a fine powder and sift it. Mix it into rice powder and dust it over the whole body.

Ghost-Killing Incense (a formula for driving away the Qi of epidemic disease)

One jin each of realgar, cinnabar, and orpiment; three liang each of antelope horn (which may be replaced with billy-goat horn), elm seeds, tiger bone, ghost-garlic, ghost-arrow bamboo, wild elder, stone longevity herb, pig dung, and horse hoof sheaths; eight liang each of blue-goat fat, calamus, and white atractylodes; and eight jin of beeswax.

Grind the sixteen ingredients into powder, mix it with the beeswax, and shape it into pills about the size of a pellet. Burn them over a low fire in front of the door morning and evening, and once at night.

Tiger-Head Ghost-Killing Pill (a formula for driving away epidemic disease)

Five liang of tiger head; one and a half liang each of cinnabar, realgar, and orpiment; ghost-garlic, soap pod…

Wuyi (one liang each).

Grind the seven ingredients above into a fine powder. Mix evenly with honey and wax, form into pills the size of a pellet, and place them in a red pouch. Men should wear the pouch on the left arm, women on the right. It may also be hung at the four corners of a house. At midnight on the last day of the lunar month and around the full moon, burn one pill in the courtyard.

Pills for Averting Epidemics and Driving Away Ghosts: A formula for fumigating away various ghosts and malign influences

Two liang each of realgar and orpiment; seven liang each of goat horn and tiger bone; three liang each of dragon bone, tortoise shell, pangolin scales, and hedgehog skin; fifteen chuchi insects; one liang of kongqing; five liang each of chuanxiong and pearls; and one liang of chicken heads from the eastern gate.

Grind the thirteen ingredients above into a fine powder. Add twenty liang of melted wax and knead together by hand while hot. Form into pills the size of parasol tree seeds. On the morning of the first day of the first lunar month, burn one pill in front of the gate. Wear another pill on your person, on the left for men and the right for women. When sleeping alone, attending a funeral, or visiting the sick, swallow one pill about the size of a small bean. On overcast or foggy days, burn one pill in front of the doors and windows for better effect.

Realgar Pills

In the third year of the Jianyan reign of the Han dynasty (as dated in the original), an epidemic was raging and many people were dying. A scholar named Ding Jihui came east from Mount Qingcheng in Shu. Passing through Nanyang, he entered through the West Market Gate and saw many people suffering from the epidemic. He took pills from his pouch and handed them out. It is said that everyone who took one recovered. Hundreds of plague ghosts were in the market; when they saw the scholar dispensing medicine, they were terrified and fled. The Ghost King saw that the scholar possessed the Dao arts and was personally administering the medicine, causing the ghosts to flee in terror. He approached and asked to be taught the arts. The scholar said he had no Dao arts, and simply showed the Ghost King the medicine in his pouch. On seeing the pills, the Ghost King panicked, kowtowed, and begged for mercy, then fled.

It is said that carrying this formula into the mountains can ward off tigers, wolves, snakes, and insects; entering the water can ward off water spirits, jiao dragons, and shen dragons.

One liang each of realgar, orpiment, zengqing, ghost tree, pearls, cinnabar, tiger skull, platycodon, atractylodes, nüqing, chuanxiong, angelica root, ghost messenger, wuyi, ghost arrow, veratrum, calamus, and gleditsia.

Grind the eighteen ingredients above into a fine powder. Use honey to form pills the size of a pellet, then place them in a silk pouch. Men should wear one on the left, women on the right. When suddenly exposed to malign influences or an epidemic, swallow one pill about the size of a parasol tree seed. The original text breaks off here.

Burn one pill and place it inside a gate the size of a slingshot.

Red Powder: A Formula to Ward Off Epidemic Qi and Treat Cold Damage and Febrile Illness

One liang each of li lu and azalea flowers; one liang and six zhu each of moutan bark and Chinese honeylocust; six liang each of aconite, cinnamon bark, and pearls; eighteen zhu each of asarum and dried ginger.

Grind the nine ingredients into powder. Grind the pearls separately, then combine them with the rest. Each time, take one square-inch spoonful and put it in a red pouch to wear: men wear it on the left, women on the right. Carry it with you. If you feel you are becoming ill, put a small amount of the powder, about the size of a millet grain, into your nose. Also take one coin-sized spoonful with wine, then cover yourself with a quilt and sweat. Take it three times a day, until you have sweated once.

Another formula: On the first day of the first lunar month, take a root from a mulberry tree growing eastward. Cut off a piece about the length of a finger, roughly seven cun long. Coat it with cinnabar and hang it on the doorway, or wear it on your person.

A Formula to Prevent Febrile Illness from Spreading Between People

Cut a seven-cun length from the rope used to draw water from a well. Secretly place it beneath the sick person’s sleeping mat; this is said to work.

Another formula: Measure the width of the doorway with a rope, then break the rope. It is said to prevent contagion.

A Formula to Prevent Febrile Illness from Spreading Between People

Grind the droppings of insects that bore into peach trees into powder, and take one square-inch spoonful with water.

Another formula: Use equal parts atractylodes and fermented black beans. Soak them in wine and take the mixture; it is said to be very effective.

Another formula: On the morning of the first day of the first lunar month, swallow fourteen hemp seeds and fourteen red beans. Then toss seven more red beans into a well.

Another formula: Put one sheng of red beans in a new cloth bag and place it in a well for three days. Take it out and have each member of the household eat fourteen beans.

Another formula: Grind pine needles into powder and take one square-inch spoonful with wine, three times a day.

Another formula: On the seventh day of the seventh lunar month each year, have the whole household face the sun and swallow fourteen red beans each.

Another formula: On the seventh day of the seventh lunar month each year, men swallow seven soybeans and women swallow fourteen small red beans.

Another formula: It is said that an immortal taught people to give everyone in the household, young and old, warm pickled turnip juice to drink on the gengzi day after the Beginning of Spring. There is no limit to the amount.

A Formula to Prevent Febrile Illness from Spreading Repeatedly, Causing the Death of the Whole Household and Spreading to Outsiders Who Have No One to Care for Them

Two liang each of small red beans, winged euonymus, ghost parasol, and realgar. Grind the four ingredients into powder, mix with honey, and form pills the size of small red beans. Those who take the medicine may share a bed with the sick and wear their clothes.

A Formula to Prevent Febrile Illness from Spreading Between People

Put one sheng of soybeans in a new cloth bag and soak it overnight in a well. Take it out and eat the beans.

Seven pills.

Remedy for Plague

Take two medicinal seeds, grind them into powder, and swallow with water.

Another remedy: Mix one liang of fine cinnabar powder with white honey. At daybreak on the Tai Sui day (the day corresponding to Tai Sui in the traditional calendar), adults and children alike should fast. Stand facing east and swallow twenty-one pills, each the size of a hemp seed. Do not let your teeth touch the pills as you take them. Swallow seven red beans as well, then cast them into well or spring water. Never forget this method for the rest of your life.

Another remedy: When epidemic diseases are prevalent, on the fifteenth day of each month chop up peach branches that grow eastward and boil them in water for bathing.

Remedy for Miasma

Crush five cloves of garlic, with their skins on, and take one portion from the center of a batch of fermented black beans. Boil these two ingredients five or six times in two sheng of stool from a five-year-old boy. Strain out the solids and drink the liquid; it is said to be effective.

Another remedy: Take two sheng of green bamboo shavings (the scraped inner layer of green bamboo), add four sheng of water, and boil until three sheng remain. Divide into three doses.

Remedy for Affliction by Mists

This applies to restlessness and discomfort in the chest, shortness of breath, headache, stiffness at the back of the neck, dizziness and near-fainting upon standing, slight fever, trembling and agitation, occasional chills, and feeling nauseated without being able to vomit.

Take two and a half sheng of fresh pig dung and add one sheng of good wine. Stir it apart, squeeze out the liquid through an unbleached cloth, then filter it through cotton cloth and drink it all at once. Next, prepare a warm place on the ground to lie down, cover yourself with bedding, and light a fire at the foot of the bed so that you continue to sweat. Once you have sweated, slowly remove your outer garment, taking care not to let your chest become cold; exposure to cold will make recovery difficult. Wait until the sweat dries naturally before getting up, and avoid cold drafts. This remedy is also recorded as a treatment for malaria, wind-related consumption, and gu poison.

Remedy for Liver Warm Disease and Yin-Yang Poison

This applies to pain from taut tendons on both sides of the neck and back, chills followed by fever, stiffness and tightness in the lower back, and spots appearing before the eyes.

One liang of cinnamon bark; three liang each of white atractylodes, mirabilite, isatis leaf, and gardenia; five liang of bupleurum; eight liang each of gypsum and ginger; and one sheng each of raw rehmannia root and fermented black beans.

Chop the ten ingredients, add nine sheng of water, and boil until three sheng remain. Divide into three doses.

Remedy for Liver Warm Disease and Yin-Yang Poison

This applies to chills followed by fever, taut and contracted tendons in the neck, a red or yellow complexion, and a rigid body.

One liang of scrophularia root; two liang of asarum; three liang each of gardenia, baical skullcap root, cimicifuga, and mirabilite.

Note: This is a modern-language rendering of an ancient medical prescription. The listed substances and methods should not be used for self-treatment; some, including cinnabar and feces, pose serious safety risks by modern standards. The final prescription is incomplete in the source.

Gypsum, eight liang; bamboo leaves, five sheng, chopped; plantain herb, two sheng, dried in the sun and then chopped.

Coarsely chop the nine ingredients above. Boil the bamboo leaves and plantain herb in one and a half dou of water until reduced to seven sheng, then strain out the dregs. Add the remaining medicines and boil until reduced to three sheng. Divide the mirabilite into three portions and take them separately.

A formula for treating warm disease in the heart and Yin-Yang toxins, with shivering and trembling, an unsettled spirit, fright, and agitation:

Isatis leaf, Scutellaria, gardenia, anemarrhena, and mirabilite, three liang each; ephedra, four liang; Scrophularia, six liang; gypsum and fresh kudzu root, eight liang each; fresh Rehmannia, one sheng, sliced.

Coarsely chop the ten ingredients above. Boil them in nine sheng of water until reduced to three sheng, then strain out the dregs. Add the mirabilite and take in three portions.

A formula for treating warm disease in the spleen and Yin-Yang toxins, with a heavy head, a stiff neck, numbness of the skin and flesh, or a faintly raised swelling:

Isatis leaf, antelope horn, cimicifuga, blackberry lily, and mirabilite, three liang each; gardenia, four liang; calcite, five liang; Scrophularia, eight liang.

Coarsely chop the eight ingredients above. Boil them in seven sheng of water until reduced to three sheng. Take in three portions.

A formula for treating warm disease in the lungs and Yin-Yang toxins, with uninterrupted coughing, an unceasing voice, vomiting, or rebellious Qi:

Ephedra, gardenia, aster, Isatis leaf, Scrophularia, and kudzu root, three liang each; cassia bark and licorice, two liang each; apricot kernel and Peucedanum, four liang each; gypsum, eight liang.

Coarsely chop the eleven ingredients above. Boil them in nine sheng of water until reduced to three sheng. Take in three portions.

A formula for treating warm disease in the kidneys, with pain throughout the body and face like needle pricks, a lower back that feels as if it is about to break, and heat toxin injuring the interior:

Capillary wormwood, gardenia, and mirabilite, three liang each; Sophora root and fresh kudzu root, four liang each; fresh Rehmannia and gypsum, eight liang each; scallion whites and fermented soybeans, one sheng each.

Coarsely chop the nine ingredients above. Boil them in nine sheng of water until reduced to two and a half sheng. Add the mirabilite and take in three portions.

Yu Wei Decoction treats wind-warm disease: the pulse is floating at both the superficial and deep levels; there is sweating, heaviness of the body, and necessarily panting with the breath; the limbs feel numb, the person is quiet and withdrawn, and wants only to sleep. If purgation is used to treat it…

This may lead to difficulty urinating. If, after sweating therapy, the patient becomes confused and speaks incoherently, then is treated with heated needles, deafness and difficulty speaking may result. If treatment relies only on inducing vomiting and purging, it may cause loss of control over urination and defecation. For conditions of this kind, the following formula is suitable.

Two liang each of Yuanzhi, Baiwei, Mahuang, Duhuo, Xingren, Chuanxiong, Gancao, and Qingmuxiang; three liang of Shigao.

Chop the nine ingredients, simmer them in eight sheng of water, and reduce the liquid to three sheng. Strain out the dregs and take the decoction in three doses, aiming to induce sweating. If the patient alternates between chills and fever, add one fen of Puxiao and three liang of Dahuang to purge downward. If Qingmuxiang is unavailable, one fen of Musk may be used instead. (From the Xiaopin Fang.)

The Xiaopin Fang says: Yuanzhi Decoction treats seasonal febrile illness that occurs out of season in winter, as well as fever, headache, dry throat, a stiff tongue, aching joints and muscles, chest tightness, and stiffness in the lower back and spine caused by wind invasion or cold damage in spring. It is also used to treat wind-warmth.

The symptoms of zheng disorders may resemble those of lily disease, fox-and-wild-dog disease, dampness disorders, wind-warmth disease, and illnesses attributed to ghosts. The seasonal qi should therefore be examined carefully. Such illnesses often arise when the pathogenic qi of an old illness clashes with that of a new one.

Sun Simiao’s Essential Prescriptions for Emergencies, fascicle 29.