《孫真人備急千金要方》Vol. 37

Essential Prescriptions Worth a Thousand Gold for Emergencies by Master Sun, juan 37, “Formulas for the Liver: Extreme Tendon Disorder, Part Four” (discussion, formulas, and moxibustion methods)

The text was collated by Lin Yi and others, who held such posts as Gentleman of the Court of Imperial Sacrifices, Acting Vice Minister of Imperial Sacrifices, and Collator of the Secret Pavilion.

The discussion says: The six “extremes”—severe patterns of illness that arise when the five viscera are afflicted by pathogenic influences—are linked to the Qi of Heaven and Earth. The Qi of Heaven connects with the lungs, and the Qi of Earth with the throat. Wind corresponds to the liver; thunder stirs in the heart; the Qi of grain resonates with the spleen; and rain moistens the kidneys. In the Suwen, the character for “grain” is also written with a variant form. The six channels are like rivers, the intestines and stomach like the sea, and the nine orifices like channels through which water flows. Qi corresponds to the nine orifices. Thus, when the five viscera are afflicted and damaged by pathogenic influences, the six bowels develop patterns of “extreme” illness. This is why they are called the “five viscera and six extremes.”

The discussion also says: Tendon extreme disorder is chiefly associated with the liver. The liver corresponds to the tendons, and the tendons are joined with the liver. When the liver is diseased, the effects also show in the tendons.

It also says: An illness contracted in spring may develop into “tendon impediment,” in which pathogenic influences obstruct the tendons and channels. If tendon impediment does not resolve and the person is then exposed to further pathogenic influences, these influences may lodge in the liver. At this point, Yang Qi moves inward while Yin Qi disperses outward. When Yin Qi disperses, it becomes deficient; when it is deficient, the tendons also become weak. A person with weak tendons is prone to sadness, and a bluish-white color appears below the eyes. If the person is then exposed to cold, the tendons can no longer move freely. The fingers and nails all hurt, and cramping of the tendons often occurs. The root of this illness lies in pathogenic influences contracted in spring on a Jia or Yi day. If wind harms the tendons, this is liver-deficiency wind.

If Yang Qi becomes active inside the body, an excess pattern develops. The tendons also become excessive, and a person with excessive tendons is prone to anger and dryness of the throat. If heat harms the tendons and channels, it causes coughing. When coughing, the person feels pain beneath both sides of the ribs and cannot turn the body; the soles of the feet also become swollen and painful. This is called liver-excess wind.

In treatment, when the illness is mild, the pathogenic influences should be dispersed outward; when it is severe, the condition should be eased; and when it is declining, its changes between deficiency and excess should be identified and brought to light. Yin and Yang should be carefully distinguished to assess whether the illness is mild or forceful. Treat Yang illness through Yin, and Yin illness through Yang. A skilled healer treats illness while the pathogenic influences are still in the skin, flesh, and tendons and channels; next, the six bowels are treated. If the pathogenic influences penetrate deeply into the five viscera, the condition is already critical, with survival and death equally likely.

Bian Que says: Once the tendons and channels are severed, the condition cannot be treated, and death will follow in nine days. How can this be recognized? The fingernails and toenails turn bluish-black, the person cries out and curses without stopping, and the mouth cannot rest. The tendons correspond to the Foot Jueyin channel, the liver channel. When Qi in the Foot Jueyin channel is cut off, the tendons contract and pull on the testicles and tongue; the tendons and channels are therefore the first to fail.

Tangerine Peel Qi-Opening Decoction: Treats coughing caused by tendon-excess extreme disorder. During coughing, there is constricting pain beneath both sides of the ribs; when the pain is severe, the person cannot turn the body. The ingredients are:

Four liang of tangerine peel; five liang each of Atractylodes and gypsum.

Asarum, Angelica, cinnamon heart (the medicinal part of cinnamon bark).

Poria (three liang each), fermented black soybeans (one sheng).

Chop the eight ingredients. Boil them in nine sheng of water until reduced to three sheng, then strain out the herbs. Divide into three doses.

Salvia Powder

Used to treat extreme sinew excess, a pattern described in ancient texts as a type of sinew disorder. The soles of both feet feel swollen and painful, making long-distance travel impossible. The centers of the feet feel as if cut by a knife; the sinews seem as though they have snapped, and the pain is unbearable.

Salvia root (three liang); cnidium (Chuanxiong), Eucommia bark, teasel root, and Chinese wolfberry root bark (two liang each); dried Rehmannia root, Angelica, rice-paper plant pith, cimicifuga, Ophiopogon root, limonite, and ephedra (one liang and eighteen zhu each); Achyranthes root (two liang and six zhu); licorice and cinnamon heart (one liang and six zhu); fresh ginger, sliced, stir-fried until dry and golden brown; and oyster shell (two liang and a half each).

Grind the seventeen ingredients into a coarse powder and sift through a fine sieve. Place the powder in a silk bag. For each dose, take two square-inch spoonfuls, boil in two sheng of well water, and lift and agitate the bag several times during cooking. When reduced to one sheng, take the whole dose at once, twice daily.

Rehmannia Decoction

Used to treat extreme sinew excess: some fingernails and toenails turn blue, yellow, or black, with a dull discoloration; the sinews and vessels in the limbs tighten and contract; and the chest feels troubled and distended.

Fresh Rehmannia juice (three sheng); fresh kudzu juice and fresh Scrophularia juice (one sheng each); rhubarb and cimicifuga (two liang each); ephedra, gardenia seed, and rhinoceros horn (three liang each); gypsum (five liang); and peony root (four liang).

Chop the ten ingredients. First boil seven of them in seven sheng of water until reduced to two sheng, then strain out the herbs. Add the Rehmannia juice and bring to a boil once or twice. Next add the kudzu juice and cook until reduced to three sheng. Divide into three doses and take twice daily.

Five-Plus-Ash Wine

Used to treat extreme sinew deficiency, a pattern described in ancient texts as a type of sinew disorder. The sinews and vessels feel numb; the person is prone to sadness and worry; the complexion is pale; the limbs feel short of Qi; the hands and feet contract, and extending and bending them both feel urgent; and there are intermittent pains in the abdomen.

Five-plus-ash bark (one jin); coix seeds (half a sheng); trifoliate orange thorn (two sheng); hemp seeds (three sheng); prickly ash root bark; Salvia root (eight liang); dried ginger and cnidium (five liang); cinnamon heart, Angelica, and licorice (three liang); and Chinese aconite, Sichuan pepper, white fresh root, and rice-paper plant pith (four liang).

The source text ends here and does not include the preparation method or the remaining text for this formula.

The fifteen ingredients above should be roughly chopped, placed in a silk bag, and steeped in four dou of clear wine. Steep for four days in spring and summer, and six or seven days in autumn and winter. Begin with six or seven he per dose, then gradually increase the amount as the body can tolerate it.

Ginseng Wine: Used for extreme weakness of the sinews and vessels, when they can no longer move properly. The nails of all ten fingers may hurt, with frequent cramping. Or, after excessive sexual activity, or intercourse before an illness has fully healed, the body’s original Qi and the sinews and vessels may be damaged. Symptoms include tightness and cramping of the sinews and vessels, a curled tongue, bluish lips, retraction of the testicles, pain and tightness in the sinews and vessels of the calves, abdominal cramping, and even near-fainting and inability to eat. The prescription is as follows:

Ginseng, fangfeng, poria, asarum, Sichuan pepper, astragalus, Chinese angelica, achyranthes, and platycodon (one and a half liang each); dried rehmannia, red sage root, Chinese yam, stalactite, and alum (three liang each); Chinese yam root and ligusticum (two liang each); atractylodes and ephedra (two and a half liang each); thirty jujubes; one sheng of “five-addition” bark; and two sheng each of fresh ginger, sliced and stir-fried until dry, and black sesame, crushed.

Roughly chop the twenty-two ingredients above. Place the stalactite in a separate small bag and steep it in two and a half dou of clear wine for five days. Take three he warm, twice a day. If the effect seems insufficient, increase the amount as appropriate. Another version omits the black sesame and uses one and a half liang of eucommia bark instead.

Prescription for sexual injury, retraction of the testicles, and cramping of the sinews and vessels: Burn a woman’s menstrual cloth to ash and take one square-inch spoonful each time.

Prescription for severed sinews and vessels: Stir-fry crab brain, legs, and marrow, then apply them to the wound. The original text says this will reconnect the sinews and vessels.

Moxibustion:

• For fatigue, cold Qi rising upward, cold pain and numbness in the lower back and hips, and difficulty bending or straightening the legs and feet: apply one hundred moxa cones at Yangqiao, a point associated with the Yang Qiao vessel, in the small hollow below the outer ankle, about the size of a fingernail.
• For difficulty turning the lower back, spasms and numbness of the sinews and vessels, and cramping: apply moxa at the twenty-first vertebra, with the number of cones determined by the person’s age.
• For cramping, tightness in the sinews and vessels of all ten fingers, and inability to bend or straighten the fingers: apply seven moxa cones above the outer ankle bone.
• For seminal emission, cramping of the sinews and vessels, and contraction of the genitals into the abdomen accompanied by pulling pain: apply fifty moxa cones at Zhongfeng, located in the hollow between the tendons in front of the inner ankle.
• Another account recommends applying fifty moxa cones at each of the Xiaoman points. The number may be increased for older people; for children, determine it according to age.
• Another account says the two points above may also be used for a swollen, painful throat, counterflow reversal, disorders associated with the five organs, and abdominal distension.
• For cramping and unbearable pain in the shinbone: with the knee bent, apply three moxa cones below the knee and above the transverse tendon.

For abdominal distension and cramping, apply moxibustion one inch above the navel for fourteen cones (each cone refers to one moxa cone being lit).

Hard Masses and Accumulations, Chapter Five (Discussion, Prescriptions, and Moxibustion)

The text asks: “There are illnesses called ‘accumulations’ and ‘gatherings.’ How are they distinguished?” The answer is: “Accumulations belong to Yin Qi, while gatherings belong to Yang Qi. Yin Qi sinks and lies hidden; Yang Qi floats and moves. Qi that has built up is called an ‘accumulation’; Qi that has gathered is called a ‘gathering.’”

Thus, accumulations arise in the Five Zang organs, while gatherings form in the Six Fu organs. An accumulation belongs to Yin Qi. At its onset, it has a fixed location, and the pain—or, in another reading, the illness—does not move from that place. Its course has a definite beginning and end, extending upward and downward, with fixed boundaries on the left and right. A gathering belongs to Yang Qi. At its onset, it has no fixed root or location: it does not remain in one place above or below, and the site of pain is not fixed. This is called a “gathering.” These features can therefore be used to distinguish accumulations from gatherings.

When the channels and collaterals are invaded by pathogenic influences, and these enter the intestines and stomach, the Five Zang organs may develop accumulations, including Fuliang, Xiben, Feiqi, Piqi, and Bentun. How does an accumulation develop, from its beginning to its final formation? The answer is: an accumulation begins when exposure to cold obstructs the movement of Qi. If the obstruction persists, an accumulation forms.

How can one tell whether someone is prone to accumulations in the intestines? The answer is: the person’s skin is thin and lacks luster, and their muscles are soft and weak. Such a person’s intestines and stomach are easily damaged. When they are damaged, pathogenic influences remain there, and accumulations form. Accumulations in the intestines and stomach arise when cold and heat are out of balance and pathogenic influences gradually lodge there. If these influences build up without dispersing, a large accumulation eventually forms.

There is an illness in which the body, waist, hip, thigh, and lower leg all swell, while the area around the navel is painful. What illness is this? The answer is: it is called “Fuliang,” a type of accumulation, and its root is caused by Wind. It must not be touched or disturbed; doing so may cause edema and difficulty passing urine.

When the lower abdomen is distended and feels as though there is a fixed root on both sides and above and below, this is Fuliang. Pus and blood are enclosed outside the intestines and stomach, so the condition cannot be treated lightly. Repeatedly pressing hard on it may cause death. If the illness descends, pus and blood may be discharged through the genitals; if it ascends, it may reach the upper stomach and form an abscess between the diaphragm and the stomach. This is a chronic illness and is difficult to treat. Fuliang lies above the navel and is a counterflow condition. It must not be touched, lest the body’s vital Qi be rapidly depleted and the pathogenic influence spill into the large intestine and attach to the Huang, a region inside the body associated with the organs. The source point of the Huang lies below the navel, which is why pain occurs around the navel.

The Santai Pill treats accumulations caused by cold or heat in the Five Zang organs, abdominal distension, intestinal rumbling, and belching, as well as emaciation and failure of the muscles to grow. In severe cases, vomiting may also occur. If symptoms remain after recovery from cold damage or cold malaria…

(The preceding passage begins mid-sentence and ends incomplete.) When the condition recurs, take five pills after meals; those who drink a lot of alcohol should take ten pills. Taken regularly, it can make a person…

Formula to Regulate Bowel and Urinary Function and Build Muscle

Rhubarb (stir-fried) and peucedanum root, two liang each; saltpeter, lepidium seed, and apricot kernels, one sheng each; magnolia bark, aconite, asarum, and pinellia, one liang each; poria, half a liang.

Grind the ten ingredients into a fine powder, mix with honey, and pound five thousand times. Form pills the size of parasol tree seeds. Take five pills at a time, gradually increasing to ten, according to the body’s response.

Five-Mineral Aconite Pill

This formula is used to treat various illnesses in men and women, as well as weakness, exhaustion, cold, long-standing accumulated cold, masses, and abdominal lumps. It is also used for vomiting, difficulty swallowing food, rheumatic disorders, and related conditions. The source states that this formula can treat all these ailments.

Refined stalactite, sulfur, alum, purple fluorite, red halloysite, immature bitter orange, licorice, atractylodes, aster, cornus fruit, saposhnikovia, baiwei root, balloon flower root, monkshood, Chinese honeylocust, asarum, cistanche, ginseng, aconite, and veratrum, one liang and six zhu each; ophiopogon, dried ginger, Sichuan pepper, evodia, and cassia twig, two and a half liang each; aconite, three liang; magnolia bark, polygala, and poria, one and a half liang each; Chinese angelica, two liang; jujube paste, five he; dried rehmannia, one liang and eighteen zhu.

Grind the thirty-two ingredients into a fine powder, mix with honey, and pound five thousand times. Form pills the size of parasol tree seeds. Take ten pills with wine three times daily, gradually increasing the dose.

Aconite Pill

This formula is used to treat cold-induced abdominal accumulations in men and women, pathogenic influences that come and go, cold limbs, Qi surging upward into the chest and heart, heart pain, chest tightness, and persistent vomiting or diarrhea. It is also used for women who are physically weakened after childbirth.

Fifteen aconite tubers; evodia, Sichuan pepper, dried ginger, and cassia twig, two and a half liang each; dried rehmannia, one and a half liang; peucedanum root, asarum, ginseng, ligusticum, and atractylodes, one liang and six zhu each; Chinese honeylocust, aster, baiwei root, and peony, eighteen zhu each.

Grind the fifteen ingredients into a fine powder and mix with honey to form pills the size of parasol tree seeds. Take ten pills with wine three times daily, gradually increasing the dose according to the body’s response.

(Liang, sheng, he, and zhu are ancient units of measure; “the size of parasol tree seeds” describes the size of the pills. The original phrase “take five pills … those who drink a lot, ten pills” continues from the preceding passage. Since that passage is missing, the formula it refers to cannot be determined.)

A formula for treating hernias in the chest and abdomen, abdominal masses, and fullness, hardness, pain, and accumulations of cold beneath the ribs and in the lower abdomen. When cold enters the abdomen, it makes the inside feel cold. In severe cases, Qi surges upward and strikes the chest, leaving it full of Qi and making food easy to vomit.

Rhubarb and poria, one and a half liang each; cinnamon bark, scutellaria, evodia, asarum, ginseng, Sichuan pepper, and dried ginger, one liang and six zhu each; ash of a man’s hair, half a liang; moutan bark, licorice, chuanxiong, cistanche, and ground beetle, eighteen zhu each; peony root, fangkui, gadfly, magnolia bark, and pinellia, one liang each.

Grind the twenty ingredients into a fine powder and mix with honey to make pills the size of parasol tree seeds. Take five pills twice a day, gradually increasing the dose.

Hengshan Pills: For pathogenic Qi accumulating beneath the ribs, with alternating attacks of chills and fever resembling warm malaria.

Hengshan, Sichuan lacquer, baiwei, cinnamon bark, tortoise shell, atractylodes, aconite, soft-shelled turtle shell, ground beetle, and shell of the cowrie, one and a half liang each; gadfly, six zhu.

Grind the eleven ingredients into a fine powder and mix with honey to make pills the size of parasol tree seeds. Take five pills three times a day with rice-washing water.

Another formula: Heat soil from a mouse hole and apply it to the abdomen as a warming compress, replacing it when it cools. For severe abdominal pain, fry half a sheng of salt until yellowed, put it into hot water, and drink it to induce vomiting; the illness will then be cured. For pain in the hands and feet, burn blue cloth in a small-mouthed vessel and use the smoke to fumigate the painful area.

Shenming Duoming Pills: For longstanding accumulations in the abdomen, blocked urination and defecation, Qi surging upward and striking the chest, and abdominal fullness that interferes with eating.

Rhubarb and peony root, two liang each.

Grind the two ingredients into a fine powder and mix with honey to make pills the size of parasol tree seeds. Take four pills three times a day. If there is no response, increase the dose to six or seven pills, stopping when a response occurs.

A formula for treating accumulations associated with various illnesses:

Gather tribulus fruit in the seventh or eighth lunar month, in any quantity. Add water and boil until thoroughly cooked. Remove the dregs, dry them in the sun, pound them, and sift the powder. Mix it with honey to make pills the size of parasol tree seeds. Take seven pills with wine, stopping when a response occurs. The liquid from boiling the herb may also be reduced to a syrup and taken.

Chest-Opening Decoction: For accumulations in the chest and below the heart that prevent food from being digested.

Trichosanthes fruit, rhubarb, and coptis, one liang each; licorice, one liang. The source ends here and gives no further instructions for preparation or use.

Coarsely chop the four ingredients listed above. Boil them in five sheng of water until two sheng and five he of liquid remain, then divide it into three doses.

Great Unity Spirit-Manifesting Ice-Trapping Pill (Taiyi Shenming Xianbing Wan) is used to treat various ailments, including zhengji (abdominal masses), fullness below the heart, alternating chills and fever, guizhu (an illness that people in ancient times believed was caused by ghostly forces), chronic illness, coughing with rebellious Qi, excessive saliva, and belching. It is also used to expel malign forces, disperse clumped Qi in the chest, and relieve obstruction in the throat. If symptoms come and go, there is a dull pain around the navel that shifts up and down, and pressing the area feels as though something is stirring in the palm of the hand, while the heart feels agitated as if insects are crawling inside, people in ancient times regarded this as an illness in which “poisonous influences pass from person to person and can infect the whole household.” This formula is also used to treat it.

Ingredients: realgar, boiled in oil for one day; cinnabar; alum; Chinese angelica; and rhubarb, two liang each; croton, one liang; rhinoceros horn, guijiu, shewang, and veratrum, one liang each; pearl and aconite, one and a half liang each; musk, bezoar, and ginseng, half a liang each; one centipede and one lizard; five yuanqing beetles; eight monkshood roots; forty apricot kernels; seven blister beetles; twenty-one chuji beetles and twenty-one didang beetles; and three liang of cassia bark.

Grind the twenty-four ingredients into a fine powder, mix with honey, and pound thirty thousand times. Form into pills the size of small beans. Take two pills with water before meals, twice daily; if they produce no effect, gradually increase the dose. It is also said that placing two pills above a doorway will keep all kinds of malign beings from approaching the home. When visiting a sick person, walking alone at night, or lodging alone, take two pills; it is said that malign beings will then not dare approach. The text says that for cold damage, no one who takes this formula fails to recover immediately. (This formula duplicates one in the “Corpse Infestation” section.)

Lizard Pill (Xiyi Wan) is used to treat hard abdominal masses, edema, and ailments described in ancient times as feishi, baizhu, dunshi, and shizhu. It is also used for illnesses said to spread between bone and blood, malign influences, guowu (illness believed to result from being afflicted by ghosts), gu poison, the coming and going of malign Qi, abnormal experiences that seem to occur both in dreams and while awake, and retained fluids and accumulations. The text also states that this formula can be used for tiger or wolf bites, bites from rabid dogs, and poison from the zhen bird entering the five viscera. It is said to resolve undigested food and dispel ailments that women describe as attacks by evil ghosts.

Ingredients: two lizards and two centipedes; fifty didang beetles; thirty zhe beetles, thirty horseflies, and thirty apricot kernels; fourteen dung beetles; one liang and eighteen zhu each of mirabilite and croton; and eighteen zhu each of coltsfoot flower, rhinoceros horn, peach fruitlets, zeqi, sangchiji, and guiduyou.

(The original text ends here; the ingredient list is incomplete.)

Take one and a half liang each of peony and tiger bone; one liang each of licorice and dried ginger; and six zhu of kansui.

Grind the twenty ingredients above into a fine powder. Prepare the croton seeds and apricot kernels separately: pound them into a paste, then add the powder and grind everything together until evenly mixed. Blend with honey and pound twenty thousand times. Form into pills the size of hemp seeds. Take three pills once daily before meals. If they have no effect, gradually increase the dose. Those so weak that they dare not risk vomiting or diarrhea should take one pill.

A person suffering from a mass caused by Wind-Cold had a hard lump that would not disperse and had been ill for twenty years. After taking this formula, the person recovered. (This formula also appears in the “Corpse Infestation” chapter of the Essential Prescriptions Worth a Thousand Gold, where the text of the formula is repeated.)

Great Five Brightnesses Wolfbane Pill is used to treat hard masses and lumps located between the chest and ribs, or in the region of the heart and abdomen.

Four liang each of wolfbane and dried rehmannia; one liang each of aconite, rhubarb, cistanche, ginseng, Chinese angelica, asarum, Sichuan pepper, schisandra, and lyu-ru, with the lyu-ru fried until the smoke has cleared; two liang of pinellia; one and a half liang each of dried ginger and cinnamon bark; half a liang each of genkwa, mangcao, magnolia bark, fangji, and inula flower; thirty apricot kernels; and twenty-four croton seeds.

Grind the twenty-one ingredients above into a fine powder. Mix with honey and form into pills the size of parasol tree seeds. Take two pills each time, twice during the day and once at night, continuing until the medicine takes effect.

Small Wolfbane Pill has the same function as the formula above.

Three liang of wolfbane; two liang each of aconite, inula flower, pinellia, lyu-ru, and white aconite.

Grind the six ingredients above into a fine powder. Mix with honey, pound five thousand times, and form into pills the size of parasol tree seeds. Take three pills with a drink, gradually increasing to ten pills, three times daily. The Handbook of Prescriptions for Emergencies omits pinellia, white aconite, and lyu-ru, using only three ingredients.

Wolfbane Pill is used to treat hard masses.

Five liang of wolfbane; three liang each of pinellia and apricot kernels; four liang of cinnamon bark; and two liang each of aconite, Sichuan pepper, and asarum.

Grind the seven ingredients above into a fine powder. Pound the apricot kernels separately, then mix with honey and form into pills the size of soybeans. Take two pills with a drink.

Kansui Decoction is used to treat lumps that arise suddenly and persist without dispersing, as well as hard masses in the abdomen.

One liang each of kansui, scutellaria, mirabilite, cinnamon bark, and asarum; three liang of rhubarb.

Cut the six ingredients above into pieces. Add eight sheng of water and boil until two and a half sheng of liquid remain. Divide into three doses.

For a sudden attack of abdominal mass disease, with a hard lump in the abdomen as solid as stone and pain like being cut by a knife or pierced by needles, accompanied by crying and shouting day and night: without treatment, the patient will certainly die within a hundred days. The method is to take two jin of Achyranthes root, chop it into small pieces and dry it in the sun. Soak it in one dou of wine, seal the mouth of the vessel, and boil until only half remains. Take half a sheng at a time. After one dose, the patient will vomit and bring up accumulated old food. The effect is remarkable.

Another prescription for sudden-onset abdominal mass disease: pound the root of pokeweed, steam it until cooked, and place fresh cloth over the abdomen. Spread the medicine on the cloth, cover it with clothing, and replace it when it cools. Continue for several days, without stopping in the morning or evening.

Another prescription: ten cloves of garlic, taken from a plant hung above a doorway on the fifth day of the fifth month and peeled; twelve inches of cinnamon; and a piece of yellow stove earth the size of an egg. Pound these three ingredients together and mix them with strong bitter wine (vinegar). Spread the mixture on cloth and apply it over the affected area. The hard lump will disperse within three days. Ordinary garlic may also be used. (The version in the Zhouhou Fang does not use cinnamon.)

Wild kudzu plaster for sudden-onset abdominal mass disease: one foot of wild kudzu; one liang each of Chinese angelica, aconite, orpiment (boiled in oil for a day), and asarum; half a liang of Sichuan pepper; two liang of monkshood; and one hundred croton seeds. Chop these eight ingredients and soak them overnight in concentrated vinegar. Then add two jin of lard and simmer together until the aconite turns yellow. Strain out the herbs, add powdered orpiment, and stir until the mixture sets. Spread it on cloth and cover the affected area. Lay a layer of oiled cloth and ten layers of paper over it, then place an iron heated with charcoal on top. Keep it warm throughout: three times during the day and twice at night, until the plaster dries.

The Great Xiaoshi Pill treats all twelve types of abdominal masses, as well as vaginal discharge in women and infertility. Those who wish to take Cold-Food Powder (an ancient mineral powder with drying and heating effects) but have a firm abdominal mass should first take this Great Pill to purge the accumulated mass, and only then take Cold-Food Powder. This pill does not purge food and fluids; it attacks only the pathogenic accumulation and does not leave the patient exhausted. The prescription uses six liang of xiaoshi (piao xiao may also be used), eight liang of rhubarb, and two liang each of ginseng and licorice. Grind these four ingredients into powder. Take three sheng of bitter wine aged for three years and pour it into a copper vessel. Stand a bamboo chopstick inside and mark the level at one sheng; mark all three levels in this way. Set the copper vessel over the fire, add the rhubarb first, and stir continuously, using a little force.

Bring it to a boil and simmer for another quarter of an hour. Add the remaining ingredients and simmer for a further quarter of an hour, then cook over the lowest possible heat for another quarter of an hour, until the medicine can be formed into pills about the size of an egg yolk.

Before preparing the medicine, observe a fast for one night. Do not let children, women, or servants see the preparation. When giving it to a patient, use two pills. If the large pills are difficult to swallow, they may be divided into smaller ones, but no more than four should be taken. Make the pills as large as possible rather than too small; it is best not to divide them. Those who are weak may take less, and those who are strong may take more. The phrase “five doses in twenty days” in the original is unclear. The medicine is usually expelled about half a day after it is taken.

After taking the medicine, a woman may expel material resembling chicken liver or rice gruel, dark red or black in color, in an amount of one or three sheng. Afterward, she should avoid exposure to wind and cold, first eat a cup of porridge, then take nourishing soup and meat, and be cared for as a woman in childbirth would be. The original says that pregnancy will occur six months after taking the medicine. Avoid raw fish, pork, and pungent vegetables. If taking Cold-Food Powder, follow that medicine’s instructions; the directions here do not apply. Take once daily.

Tu Gua Pills: Used to treat cold in the internal organs, accumulations and distention, and Gu poison contracted through food. They are also used for illnesses caused by accidentally eating living creatures or the eggs of aquatic insects, or by insects and snakes entering the abdomen, as well as retained fluids from fish and turtle, and undigested food. They are used for various conditions in women, including postpartum abdominal masses and vaginal discharge, as well as obstruction between Yin and Yang, irregular urination and bowel movements, injury and miscarriage, intermingled chills and fever, dry, blackened lips, wasting, drowsiness, poor appetite, frequent nightmares, lingering pathogenic influences in the womb after childbirth, heat on the inner thighs, and cramping, knotted pain in the lower abdomen that radiates to the genitals.

Ingredients: half a sheng each of tu gua root and platycodon root, ground into powder; one sheng of apricot kernels; and one jin of rhubarb, steamed over two dou of rice and then dried in the sun.

Grind all four ingredients into a fine powder and form pills with honey, each the size of a wutong seed. Take three pills on an empty stomach with water, three times daily. If they have no effect, gradually increase the dose until they do.

A remedy for food that has stagnated and will not digest:

Take some of the same food that was eaten, burn it to ash, and swallow one square-inch spoonful with wine. This will induce vomiting and expel the accumulated, undigested food, curing the illness. If eating peaches causes the illness and no fresh peaches are available, look among the trees for a dried, shriveled peach. Burn it and take it; the material causing the illness will soon be vomited up, with good results.

A remedy for sudden indigestion that is about to form an abdominal mass:

Simmer mugwort into a thick juice until it is as sticky as malt syrup. Take half a sheng at once, and vomiting will follow, expelling the stagnant material.

A Proven Remedy for Retained Food (from Collected Proven Prescriptions from Ancient and Modern Times): Take one bundle of white mugwort five chi around and a large handful of coix roots. Boil the two ingredients together.

A prescription for treating abdominal masses caused by accumulated fish, meat, and other foods, and for treating various toxic influences: Burn five sheng of dog feces to ash and powder it. Wrap the powder in cotton cloth and soak it in one dou of wine for two nights. Strain off the clear wine and divide it into ten doses. Take it three times a day, finishing it in three days; the masses should then be expelled.

A prescription for treating undigested food from mixed meals, with hardness and pain in the chest and abdomen: Boil one sheng of white salt in three sheng of water until the salt dissolves. Divide it into three doses. It may induce vomiting, expelling the accumulated food, and is also used to treat masses that appear suddenly.

A prescription for treating a hard mass below the heart, as large as a cup, that prevents eating; if food is forced down, the abdomen swells and the chest and abdomen suffer cramping pain: Take two liang each of lepidium seed and rhubarb, and four liang of stachys. Grind the lepidium seed separately into a paste, and pound the other two ingredients five hundred times. Add honey and pound another thousand times, then form pills the size of Chinese parasol tree seeds. Take five pills at a time. If they have no effect, increase the dose. Take three times a day.

A prescription for treating a hard, distended lower abdomen as large as a tray, fullness in the chest, undigested food, and emaciation in women: Take hair ash with warm water, one square-inch spoonful at a time. Take another dose after seven days, then apply moxibustion at the ends of the ribs. Moxibustion is a traditional therapy that warms acupuncture points with burning mugwort.

Another prescription: Take a square-inch spoonful of fine fermented grain powder with wine, three times over seven days. Then apply moxibustion at Sanjiaoshu, an acupuncture point on the back. Determine the number of moxa cones according to the patient’s age, and continue until the illness is cured.

A prescription for treating Fuliang Qi, a type of illness involving an accumulation in the abdomen: Collect white horse urine in a bronze vessel and drink one sheng each morning.

A prescription for treating abdominal masses: Boil the white bark of an oak tree until it forms a medicinal paste that can be rolled into pills. Take it and observe how the illness changes; if the condition improves, reduce the dose.

Pepper Fomentation: Used for masses, or for swellings in the abdomen shaped like melons, the sun, or the moon. Some are to the left or right of the navel, or above or below it; some resemble a soft-shelled turtle beneath the ribs, while others lie at the pit of the stomach and are as large as a box. First prick the feet with needles, then treat the affected area with a pepper fomentation. Take a new basin that holds one dou and drill 120 holes in its base. Place three he of pepper over the holes, cover it with a layer of paper, and put one sheng of cold ash on the paper. Place half a sheng of hot ash on top of the cold ash, then set one jin of glowing charcoal on the very top. After the time it takes to eat a meal, when the bottom of the basin has become thoroughly warm, place it on the affected area: first lay down a layer of felt, then set the brazier on it. If the brazier is too hot, add more layers beneath it gradually, up to three layers.

Pause briefly and take a sip of a cold drink. When the “fire” within the body has subsided by about two tenths, stop this treatment. Do not repeat it for three days. By the seventh day, the illness should be clearly healed.

A formula for treating masses in the abdomen: Take one sheng of tinglizi seeds, dry-fry them, then soak them in five sheng of wine for seven days. Take three he per dose, three times a day.

A formula for treating snake-shaped masses in the abdomen: Cut white horse tail hair into lengths of five fen and swallow it with wine, using one square-inch spoonful (an ancient medicinal measuring unit). After a large mass is expelled, take another square-inch spoonful at a dose of two fen; after a medium-sized mass is expelled, take another square-inch spoonful at a dose of three fen. Small masses will also be expelled. Do not take the whole medicine at once, or it will be fatal. (Some versions write “horsehair” instead of “horse tail.”)

Rhubarb Decoction for treating snake-shaped masses in the abdomen: Take half a liang each of rhubarb and poria (one version gives “skullcap”); two cuttlebones; six pig’s-tusk-shaped gleditsia pods; one chi of licorice, about as thick as a finger; and one mirabilite crystal, about the size of an egg. Cut up the six ingredients, boil them three to five times in six sheng of water, and strain out the dregs. Add the mirabilite, then drink the entire decoction once it has cooled to a suitable temperature. Take one dose every ten days, decocting it as described above. Do not eat the night before; take it on an empty stomach the next morning. The text says the root of the illness will be expelled with the stool.

A formula for treating turtle masses: hard swellings in the abdomen, as large as a basin, that prevent sleep. The ancients believed these were caused by food and that the hard mass lay below the heart, in the upper abdomen. Take one jin of indigo plant, pound it, add three sheng of water, and squeeze out the juice. Take one sheng per dose, twice a day.

Another formula: Take a handful of the white root bark of elder, grind it to extract the juice, mix with water, and drink it all at once.

Another formula: Take one sheng of white horse urine and three chicken eggs, using only the egg whites. Mix and cook until the liquid is reduced to two he, then take it all at once on an empty stomach. The text says vomiting will soon follow, expelling the diseased matter.

Another formula: Take one sheng of chicken droppings and dry-fry until yellow. Measure out five he and soak them in one sheng of wine. Pound half of this mixture into powder, then take one square-inch spoonful with the medicated wine, twice a day. Three days make one course.

For treating dragon disease: On the eighth day of the third month in the sixth year of the Kaihuang era, someone ate celery and fell ill. During the attacks, the illness resembled epilepsy, and the person’s complexion turned blue and yellow, because…

(If too much cold-food malt syrup is eaten, a thing will be vomited up in the shape of a horned dragon, with a head and tail.)

Taking three dou of cold-food malt syrup produces a striking effect.

People living in the wilds have sometimes bitten off lice and swallowed them. The lice then grow inside the abdomen, forming what was called “lice accumulation,” a kind of abdominal mass described by the ancients. The treatment is:

One old bamboo comb and one old hair comb.

Break each item in half. Burn one half of each to ash and grind it into powder. Take the remaining halves, add five sheng of water, and boil until one sheng remains. Drink the decoction, then take the powdered ashes. The lice will then be expelled.

Some people constantly crave rice. If they cannot get any, clear fluid appears in the chest; this is called “rice accumulation.” The treatment is:

One sheng of chicken droppings and five ge of white rice.

Fry the two ingredients together until the rice is scorched, then pound them into powder. Add two sheng of water and drink the whole amount at once. After a short while, the pathological substance will be vomited up, resembling crushed rice. If there is no rice, phlegm will be brought up instead. From then on, the person will be repelled by rice and will no longer eat it.

Some people constantly crave meat and still want more after eating. This is called “meat accumulation.” The treatment is:

Drink three sheng of white horse urine on an empty stomach. Chunks of meat will then be vomited up; if they are not, the person will die.

Sometimes people do not notice that hair has entered their stomach with their food. Over time, it feels as though a worm is moving up and down in the chest. They crave only oil, drinking as much as two or three sheng a day, and want no other food. This is called “hair accumulation.” The treatment is:

Take one sheng of oil and boil it with fragrant hair oil. Once it boils, pour it into a large pot and place it beside the patient’s head, with the patient’s mouth and nose facing the surface of the oil. Do not let the patient drink any. Entice them with the smell of the oil, but do not give them any, even when they cry out for it. Once they are utterly exhausted and fall into a deep sleep, the hair accumulation will emerge from the mouth. Have someone keep watch, and prepare a packet of lime. When the pathological substance appears, dust your hands with lime, grasp it, and pull it out until it is completely removed. It is hair. When it first emerges from the abdomen, it resembles a thick vegetable soaked in water; it is as long as the hair itself.

Another method: Boil two sheng of pork fat in three sheng of wine. After it has boiled three times, drink one sheng, twice a day. White horse urine is also effective; if it is unavailable, white ox urine can be used.

Moxibustion

To treat abdominal masses, apply moxibustion to the hollow behind the inner ankle, using a number of moxa cones equal to the patient’s age; then apply one hundred cones to the Qihai point.

To treat long-standing cold, as well as abdominal masses in women, intestinal rumbling and diarrhea, and cramping around the navel, apply moxibustion to Tian… [the original text ends here].

Moxibustion at the Shu points beside the navel, two cun on either side, with one hundred cones, divided into three sessions. These points must not be needled.

For hard accumulations and fullness in the abdomen, apply one hundred cones of moxibustion at the Spleen Mu point. This point is at Zhangmen, at the end of the lowest rib.

For a hard accumulation below the pit of the stomach accompanied by coldness and fullness, apply one hundred cones of moxibustion at Shangguan, divided into three sessions. This point is one cun below Juque.

For a hard accumulation as large as a plate, accompanied by coldness and fullness, apply two hundred cones of moxibustion at Weiguan, divided into three sessions. This point is two cun below Juque.

Sun Simiao’s Essential Prescriptions Worth a Thousand in Gold for Emergencies, Volume 37.