《孫真人備急千金要方》Vol. 32

The Essential Prescriptions Worth a Thousand in Gold for Emergencies by Master Sun, juan 32

(Edited by Lin Yi and others, who served as Gentleman of the Court of the Imperial Sacrifices, Acting Junior Vice Director of the Court of Imperial Sacrifices, and Collator of the Secret Pavilion.)

Miscellaneous Treatments for Cold Damage: Discussion, Prescriptions, and Moxibustion

Discussion: For clearing heat and resolving toxins, no medicines are more suitable than those with bitter or sour flavors. That is why Sophora root, green cockscomb, mugwort, gardenia fruit, pepperweed seed, bitter wine (vinegar), and smoked plum are often used. These are essential medicines for treatment. When the heat is intense, it is difficult to dispel without bitter and sour medicines. If pathogenic heat has already entered the body and is not treated promptly—and the treatment does not use these medicines—it is like trying to put out a fire without water: escape from danger will surely be difficult.

It is also said: Nowadays, treatments commonly use medicines with pungent or sweet flavors, such as ginger, cinnamon, and ginseng. These medicines are expensive and hard to obtain, and people often have to search far and wide for them, delaying treatment in the process. Sophora root, green cockscomb, pepperweed seed, and mugwort are available everywhere, and their ability to clear heat and resolve toxins is excellent, surpassing that of the costly medicines just mentioned. The first medicines listed may be used together. If the patient has internal heat, there is no need to follow a fixed order of treatment: green cockscomb, Sophora root, mugwort, and vinegar may be used directly. As long as they are taken in suitable amounts with brief intervals between doses, the symptoms will invariably ease.

Bian Que said: When illness is between the skin’s superficial layers, decoctions and warm compresses can treat it; when it is in the blood vessels, acupuncture and stone lancets can treat it; when it reaches the bone marrow, nothing can be done. Thus, it is absurd for a doctor treating an illness to say, “Wait until it has fully developed, then we can cure it all at once.” This principle should be explained in advance to the household and to the people under one’s charge, so that those who fall ill understand it. This is important.

Prescription for Treating a Critical Case of Warm-Qi Illness, Near Death

Take one liang of Sophora root and boil it in two sheng of wine until one sheng remains. Drink it all. If this induces vomiting, the toxic pathogen will be expelled. For various toxic illnesses, after taking this prescription, cover the patient with bedding to induce sweating; recovery will follow. (Zhang Wenzhong and the Handbook of Prescriptions for Emergencies say that this prescription treats critical illness caused by toxic heat-Qi, even cases in which the patient is thought to have died. It is called “Thousand-Gold Decoction for Breaking Open the Coffin.”)

Sophora Decoction: For Treating Heat Illness Lasting Five or Six Days or More

Three liang of Sophora root, two liang of Scutellaria root, and eight liang of rehmannia root.

Cut the three ingredients into pieces. Boil them in eight sheng of water until two sheng remain. Let the decoction cool to a suitable temperature and take one sheng per dose, twice daily.

Condensed-Snow Decoction: For Seasonal Epidemic Toxins Lasting Seven or Eight Days, with Pathogenic Heat Accumulating in the Chest and Agitation So Severe the Patient Is Near Death

This is an external application decoction used to revive the dying. The original text ends here, unfinished.

Boil one sheng of yuanhua with three sheng of water until reduced to one and a half sheng, then strain off the liquid. Soak an old piece of cloth in the liquid and apply it to the chest, no more than three times. Stop once the warmth subsides. Keep the limbs warm to prevent the hands and feet from becoming cold and numb.

Trichosanthes Decoction: A formula for treating cold damage and wind strike after five or six days or more, with restlessness and oppression in the chest and dry retching.

One trichosanthes fruit, three liang each of scutellaria and licorice, four liang of fresh ginger, twelve jujubes, and half a jin of bupleurum.

Coarsely cut the six ingredients. Add one dou and two sheng of water and boil until reduced to five sheng, then strain out the dregs. Let the liquid cool to a suitable temperature. Take one sheng at a time, three times a day.

Reed Root Drink: A formula for treating vomiting, hiccups, and regurgitation after cold damage, as well as dry retching and inability to eat.

One sheng each of fresh reed roots, sliced, and green bamboo shavings; three ge of polished rice; and three liang of fresh ginger.

First boil two “thousand-mile shoe soles” with seven sheng of water until reduced to five sheng, then let the liquid settle and take the clear portion. Add the herbs and boil until reduced to two and a half sheng. Drink as needed. If there is no improvement, prepare and take another decoction, continuing until the symptoms improve. “Thousand-mile shoe soles” is listed in the original as a decoction ingredient, but its precise meaning is unclear.

A Formula for Treating Vomiting and Hiccups after Cold Damage

Three liang of tetrapanax pith, one sheng of fresh reed roots, sliced, one liang of tangerine peel, and three ge of polished rice.

Coarsely cut the four ingredients. Add five sheng of water and boil until reduced to two sheng. Drink in small amounts as needed. If there is no improvement, prepare and take another decoction, continuing until the symptoms improve.

A Formula for Treating Weakness and Emaciation, Shortness of Breath, and Vomiting after Cold Damage

One sheng each of gypsum, ophiopogon, and pinellia; two handfuls of bamboo leaves; and two liang of ginseng.

Coarsely cut the five ingredients. Add one dou of water and boil until reduced to six sheng, then strain out the dregs. Add one sheng of polished rice and cook until the rice is done and the decoction is ready. Take one sheng at a time, three times a day. Another record says to add five liang of fresh ginger. The original also explains that this is Zhang Zhongjing’s Bamboo Leaf Decoction, already included in the “After Sweating” section of the previous volume, though the amount of licorice is not given there.

A Formula for Treating Heat Toxins Invading the Hands and Feet, Causing Redness, Swelling, Heat, and Burning Pain So Severe It Feels as Though the Limbs Might Fall Off

Boil horse or sheep dung to make a liquid, and use it to soak the affected area three times a day.

Another formula: Make a strong decoction of polygonum cuspidatum root, let it cool to a suitable temperature, and soak the hands and feet in it, immersing them to a point one chi above the ankles.

Another formula: Make an ash solution from the ashes of burned rice straw and soak the affected area.

Another prescription: Boil good-quality wine with ku shen, then use the wine to soak the affected area.

Another prescription: Mix lard with sheep droppings and apply it to the affected area. This is also effective.

Another prescription: Take changsi grass, squeeze out its juice, and soak and wash the affected area with it. Changsi grass is also called cang’er.

Loulu and Forsythia Decoction: Used to treat illnesses caused by epidemic heat toxin, such as reddening of the skin and the development of red, swollen, painful carbuncles, sores, and erythematous eruptions. The heat toxin may also cause a film to form over the eyes, obstructing vision.

Ingredients: loulu, forsythia, Scutellaria root, ephedra, atractylodes, cimicifuga, and licorice, one liang each; immature bitter orange and rhubarb, three liang each.

Cut the nine ingredients into pieces and decoct them in nine sheng of water. Reduce the liquid to three sheng and take it in three doses. Leave about as long as it takes a person to walk five li between doses. If the fever is very high, add two liang of mirabilite.

Pig Gallbladder Decoction: Used to treat spots and eruptions that appear five or six days after the onset of cold damage.

Ingredients: three ge each of pig bile and bitter wine, and one egg.

Combine the three ingredients and bring them to a boil three times. A person of robust constitution should take the entire dose at once. For someone of weak constitution, bring it to a boil six or seven times and take it in two doses. Recovery follows sweating.

Prescription for pea-like sores caused by epidemic heat illness in people and livestock:

Decoct millet stalks until the liquid is concentrated, then use it to wash the affected area. Millet stalks are also called ji stalks. If this brings no improvement and the sores turn black, crush garlic and apply it to the affected area.

Another prescription: Boil rapeseed and wash the affected area with the cooking water.

Prescription for pea-like sores following a febrile illness:

Add two liang of coptis to two sheng of water and decoct until eight ge of liquid remain. Take the entire dose at once.

Another prescription: Take a date-sized piece of genuine Persian indigo and swallow it with water. The illness will be cured.

Another prescription: Add two liang of green-costus root to three sheng of water and decoct until one sheng of liquid remains. Take the entire dose at once to be cured.

Another prescription: If the sores are reddish-black and have appeared about the size of scabies sores (another version reads “sudden fire”), boil sheep fat, then rub and apply it to the affected area.

Another prescription: Mix red bean flour with egg white and apply it to the affected area.

Another prescription: Wipe the affected area with a cloth soaked in menstrual blood.

Another prescription: If a child is ill, dilute menstrual blood with water and bathe the child in it.

Another prescription: Apply three moxa cones to the bony prominence at each wrist. Men should receive moxibustion on the left wrist, and women on the right.

Costus Decoction: Used to treat painful sores and ulcers accompanied by agitation and discomfort.

Ingredients: two liang of green-costus root; one liang each of frankincense, alum, and clove; and half a liang of musk.

Cut the five ingredients into pieces, add four sheng of water, and decoct until one and a half sheng of liquid remain. Take in two doses.

For severe, vigorous heat toxin, add one liang of rhinoceros horn. If rhinoceros horn is unavailable, substitute cimicifuga. For a milder condition, omit alum; the treatment is also highly effective.

Another prescription: Mix mirabilite with pig’s bile and apply it to the affected area. Do not disturb it. Once the scab falls off, no scar will remain. Afterward, the patient may continue lying on powdered yellow earth; this is beneficial. If the patient has painful, difficult urination with blood, the inside of the sores has already ulcerated, the scabs are covered with black spots, and no pus is produced, the patient will die; there is no cure.

Prescription for severe internal sores

Four ge of vinegar and one pig’s gallbladder.

Combine the two ingredients and bring them to a boil three times. Take one ge per dose, five times a day. This is quite effective.

Prescription for pox sores just beginning to appear and about to emerge

Boil five liang of rhubarb and take it; this will cure the condition.

Prescription for sores caused by seasonal epidemic illness

Take good-quality honey and apply it over all the sores on the body. Alternatively, boil cimicifuga with honey and apply the mixture, while also taking it frequently by mouth.

Prescription for nosebleeds during Cold Damage

Nosebleeds during Cold Damage are caused by excess heat in the lungs. Heat pathogen drives the blood upward, resulting in persistent bleeding. Use this prescription:

Two and a half liang of oyster shell and one liang and six zhu of gypsum.

Grind the two ingredients into a fine powder and sift it. Take one square-inch spoonful with wine, three or four times a day. It may also be made into honey pills the size of Chinese parasol tree seeds, to treat nosebleeds that occur after a severe illness has resolved when the patient exerts even slight effort.

Prescription for heat illness in Cold Damage, with painful, obstructed throat

One jin of fresh iris, chopped, and one jin of pig fat.

Boil the two ingredients together, then strain out the solids. Take a quantity of the medicinal paste about the size of half an egg, wrap it in thin cotton cloth, and place it at the back of the mouth near the throat. Swallow it slowly, continuing until the illness is cured.

Another prescription:

Three liang each of cimicifuga, peony, and antelope horn; four liang of tetrapanax pith; two liang of blackberry lily; and one sheng of fresh reed root, chopped.

Coarsely chop the six ingredients. Add seven sheng of water and boil until two and a half sheng remain. Divide into two doses.

Decoction for bitter taste in the mouth from heat illness, to direct Qi downward, clear heat, and ease throat rattling

Half a sheng of gypsum and one sheng of honey.

First boil the gypsum in three sheng of water until two sheng remain. Add the honey and continue boiling until the mixture thickens like maltose syrup. Hold a piece about the size of a jujube pit in the mouth until it dissolves, then take another. This is very effective.

Prescription for dry mouth, frequent spitting, and sore throat after heat illness in Cold Damage

Twenty jujubes and ten smoked plums.

Pound the two ingredients above together, mix them with honey, and shape the mixture into pills about the size of an apricot kernel. Hold a pill in the mouth and swallow the medicinal liquid gradually. This works very well.

Yu Yuliang Decoction: A patient with cold damage takes medicine and then develops persistent diarrhea, with a stuffy, hard sensation in the pit of the stomach. The patient takes Xiexin Decoction and is also treated with other purgative medicines, but the diarrhea still does not stop. The physician then gives the patient Lizhong Decoction, and the diarrhea becomes even worse. Lizhong Decoction treats the middle burner—the middle part of the digestive system—but this diarrhea is located in the lower burner, the lower part of the digestive system. It should therefore be treated with the following prescription:

Yu Yuliang and red halloysite, one jin each, pounded.

Add six sheng of water to the two ingredients and decoct until two sheng remain. Divide into three doses. If the diarrhea still does not stop, treat it by promoting urination.

Prescription for diarrhea with pus and blood after cold damage:

One liang of donkey-hide gelatin, two liang of phellodendron bark, four liang of coptis root, and fourteen gardenia fruits.

Cut the four ingredients into pieces. Add six sheng of water and decoct until two sheng remain. Strain out the dregs, add the donkey-hide gelatin, and continue decocting until it dissolves. Divide into three doses. The Jia Yi Formula does not include phellodendron bark and instead includes scutellaria root.

Prescription for bloody and pale dysentery with pus: A child with this illness may die within three days. The condition is caused by pinworms in the lower part of the body.

Take equal amounts of musk, alum, croton, aconite, pearl, and realgar.

Grind and combine the six ingredients. Take a mulberry twig as thick as an arrow shaft and three cun long. Wrap one end with cotton for two cun. Moisten and spread out the cotton with saliva, place the medicine on it, and insert it into the anus. Replace it after half a day, twice daily. It is said to work very well.

Ephedra and Cimicifuga Decoction: Treats severe, difficult cases occurring six or seven days after cold damage, when the patient has profuse diarrhea, a deep and slow pulse, cold hands and feet, no perceptible pulse in the lower part of the body, an obstructed throat, vomiting of pus and blood, and persistent diarrhea.

Three liang each of ephedra, anemarrhena, fragrant solomon’s seal (also written as calamus), and scutellaria root; two liang each of cimicifuga, peony, Chinese angelica, dried ginger, gypsum, poria, atractylodes, cassia twig, licorice, and ophiopogon.

Cut the fourteen ingredients into pieces. Add one dou of water and first decoct the ephedra until two sheng have boiled away. Skim off the foam, then add the remaining ingredients and decoct until three sheng remain. Divide into three doses of one sheng each. After taking it, the patient should sweat lightly, and the illness can be cured.

Treatment for warm toxins and cold damage: Suitable when the interior is weak and heat pathogens are present externally, and the heat pathogens attack the stomach, causing the discharge of yellow-red fluid or fluid resembling decayed flesh. It also applies to bloody and pale dysentery, abdominal pain caused by latent pathogens, and various heat toxins.

Take fourteen gardenia fruits, one sheng of fermented soybeans, and one handful of Chinese chives. First boil the gardenia fruits and chives in four sheng of water until cooked. Add the fermented soybeans and continue simmering until two and a half sheng of liquid remain. Divide into three doses and take them in succession until the illness is cured.

Prescription for treating swelling caused by weakness after an illness

Take five sheng of fermented soybeans and one dou of strong wine. Boil them together, bringing the mixture to a boil three times, then drink the whole amount while hot. Those who cannot tolerate alcohol may adjust the amount to suit themselves. After drinking, cover yourself well with a quilt and let your body sweat.

Prescription for treating persistent sweating

Chop three jin of fresh Rehmannia root, add one dou of water, and simmer until three sheng of liquid remain. Divide into three doses.

Another prescription: Boil leaves of white atractylodes in water and drink it as a beverage.

Another prescription: Take one square-inch spoonful of powdered white atractylodes with a drink.

Prescription for treating sudden, persistent sweating

Take beef fat or mutton fat with warm wine; this will cure the condition.

Another prescription: Take feces; this can also stop sweating.

Prescription for treating night sweats and irregular sweating

Take forty-nine Chinese chive roots, add two sheng of water, and simmer until one sheng remains. Drink it all at once, continuing until the sweating stops.

Another prescription: Soak one sheng of fermented soybeans in two sheng of wine and take it after three days. If there is no improvement, prepare and take another batch. At most, three doses will stop the sweating.

Another prescription: Burn the edge of a mat used for a corpse to ash. Boil the ash in water and use the liquid to wash the body; this will cure the condition.

Prescription for stopping sweat

Take equal amounts of Eucommia bark and oyster shell. Grind the two ingredients into a fine powder and sift it. Each night before bed, take five qian of the powder with water.

Another prescription: Take three liang each of oyster shell, thunder ball, and ephedra root, one liang each of dried ginger and licorice, and two sheng of rice flour. Grind all six ingredients into a fine powder and sift it. Apply the powder wherever sweat appears.

Oyster Shell Powder: for night sweats during sleep and wind-deficiency headaches

Take three liang each of oyster shell, white atractylodes, and fangfeng. Grind the three ingredients into a fine powder and sift it. Take one square-inch spoonful with wine twice a day. This will stop the sweating. This prescription can be taken for any kind of sweating or fluid leakage; its effects should be seen within three days.