《孫真人備急千金要方》Vol. 55

“On the Lung: Prescriptions for Qi Extremity, Chapter Four”

“Qi extremity” is generally associated with the lungs. The lungs govern Qi, and Qi corresponds to the lungs. It is also said that illness arising in autumn can produce “skin impediment”—numbness and obstruction of the skin. If this persists despite treatment and is then invaded by pathogenic Qi, the pathogen may enter the body and lodge in the lungs, allowing cold and damp Qi to invade the six bowels.

When the lungs are diseased, the first disturbance is in Qi: it surges upward into the chest, often causing vexation and anger. If wind pathogen strikes in autumn on a Geng or Xin day—days associated with the Five Phases—it can produce “lung wind.” Lung wind causes profuse sweating; if Yin Qi is injured, the person becomes afraid of cold. Cold weakens the body, and weakness causes Qi to rebel upward, bringing on a cough. The breath becomes short during coughing, and symptoms worsen toward evening. As Yin Qi grows stronger and dampness readily arises in the evening, the symptoms intensify. Yin Qi is averse to Yang Qi, so when Yang Qi is stronger during the day, the illness eases.

If Yang Qi is injured, fever develops. Fever makes the body overly replete, and Qi becomes labored and hurried, pressing upward into the chest. In severe cases, the person coughs up blood. However, a Yang illness should be treated through the Yin aspect, because Yin is the interior of Yang; a Yin illness should be treated through the Yang aspect, because Yang is the exterior of Yin. Treatment follows the roots of Yin and Yang, exterior and interior, and deficiency and excess. When Yang Qi is excessive, the Yin aspect should be opened and harmonized; when Yin Qi is deficient, it should be supported and guided. A skilled healer treats illness as soon as the pathogen enters the skin, flesh, or sinews. If treatment is delayed until it penetrates the six bowels and five viscera, the condition has already become critical.

Bian Que said, “When breathing stops, the patient pants—another version says ‘rushes’—and breaks out in a cold sweat, death will follow within two days.” Qi corresponds to the Hand Taiyin Lung Channel. When the Qi of Hand Taiyin is severed, the skin and body hair become dry and withered: Qi declines first, and then the skin and body hair lose their nourishment.

“Bell Milk Powder” treats the deficiency and cold caused by Qi extremity: the patient feels cold, is less affected during the day and worse toward evening, and has shortness of breath and difficulty breathing. This formula is also used for various other illnesses. It is said to strengthen the body, increase appetite, and dispel wind and cold pathogens.

Prescription: bell milk, ground separately into a fine powder; dried ginger, platycodon root, poria, asarum, cassia bark, aconite, and ginseng, each one liang and six zhu; atractylodes, one liang; saposhnikovia root, trichosanthes root, and oyster shell, each two and a half liang. Grind the twelve ingredients into a fine powder. Take one square-inch spoonful with wine three times a day, gradually increasing the dose to two spoonfuls. People over fifty may take it repeatedly; stop once its effects become apparent. The Supplement to the Essential Prescriptions Worth a Thousand Gold Pieces records: for cold conditions, add Sichuan pepper; for heat conditions, add scutellaria, three liang of each.

Astragalus Decoction: A formula for treating extreme Qi deficiency and bodily coldness, with dry, withered skin and hair, impaired fluid circulation, and weakness caused by consumptive illness or various diseases.

Four liang of astragalus; two liang each of ginseng, atractylodes, and cinnamon bark; eight liang of fresh ginger; ten jujubes; and thirty zhu of aconite (one version omits the aconite). Chop the seven ingredients, add eight sheng of water, and decoct until three sheng of liquid remain. Strain out the dregs and take in four divided doses.

Great Dew-Shelter Pills: A formula for extreme Qi deficiency and coldness, persistent skin numbness, and pathogenic influence invading the lungs. It also treats various disorders caused by cold entering the six bowels—the six fu organs in Chinese medicine—including abdominal distension, deficient fullness, aversion to cold, and accumulations.

Three liang each of arsenolite (the Handbook of Prescriptions for Emergencies gives “alum”), dried ginger, cinnamon bark, gleditsia fruit, platycodon root, and aconite. Grind the six ingredients into a fine powder and form pills with honey, each the size of a parasol tree seed. Take ten pills with wine three times a day, gradually increasing the dose. Avoid hot, dry surroundings while taking them, and do not go near a fire.

Sulfur Pills: A formula for extreme Qi deficiency and coldness, with fluid retention and copious phlegm in the chest, chest oppression, pain in the heart and abdomen, shortness of breath, and inability to eat.

Two liang each of sulfur, arsenolite, dried ginger, aconite, monkshood, cinnamon bark, asarum, atractylodes, platycodon root, and poria. Grind the ten ingredients into a fine powder and form pills with honey, each the size of a parasol tree seed. Take ten pills with wine three times a day, gradually increasing the dose up to what the body can tolerate.

The version recorded in the Handbook of Prescriptions for Emergencies omits the atractylodes, platycodon root, and poria, and instead uses evodia, Sichuan pepper, ginseng, gleditsia fruit, and Chinese angelica. These twelve ingredients are made into pills to treat people with extreme bodily coldness. Such people need warm food even in summer and are afraid to take off their clothes.

Great Bupleurum Decoction: A formula for Qi illness that has progressed to extreme heat, with rapid, labored breathing, Qi surging into the chest, and frequent urges to become angry. It also treats distension and pain in the heart and abdomen, signs of heat both inside and out, agitation, vomiting, and restlessness.

Eight liang of bupleurum; four liang each of pinellia, ephedra, and peony; five liang of fresh ginger; three liang of scutellaria; four zhi of immature bitter orange; and twelve jujubes. Chop the eight ingredients, add nine sheng of water, and decoct until three sheng of liquid remain. Strain out the dregs and take warm in three divided doses.

Bamboo Leaf Decoction: A formula for Qi illness that has progressed to extreme heat, with severe labored breathing, sometimes coughing or spitting blood, shortness of breath and weakness, loss of appetite, and a dry mouth and throat. The scripture gives no ingredients or preparation instructions here.

Bamboo leaves (two sheng), ophiopogon, wheat, and fresh rehmannia root (one sheng each); fresh ginger and gypsum (six liang each); ephedra (three liang); licorice (one liang); and ten jujubes.

Cut the nine ingredients into small pieces. Boil them in one dou of water until three sheng remain, then strain out the dregs. Divide the liquid into three doses.

Moxibustion

For vomiting with Qi surging upward, moxibustion may be applied at the Chize point. Apply three moxa cones; if the symptoms do not ease, increase this to seven. Chize is located at the crease of the elbow.

For rumbling in the abdomen, indigestion, and Qi surging upward, apply moxibustion one cun below the Shangwan point. This spot is also called Taicang. Apply seven moxa cones.

Accumulated Qi, Chapter Five: Discussion, Prescriptions, and Moxibustion

The discussion states that the “seven Qi” are cold Qi, hot Qi, anger, resentment, joy, worry, and sorrow. These seven kinds of Qi can gather into masses as hard as cups or plates and lodge below the heart or in the abdomen. They cause severe pain and prevent eating. The symptoms come and go, and each attack feels as though death is near, as if one had suffered a calamity or been troubled by ghosts. All these conditions are caused by the seven Qi.

Cold Qi causes vomiting and nausea. Hot Qi makes a person speak hurriedly, seeming impatient before finishing a sentence. Anger makes Qi surge upward intolerably, causing a burning pain in the chest and abdomen that rises toward the heart. The person becomes so short of breath that death seems imminent and cannot breathe freely. Resentment causes an accumulation below the heart and prevents eating. Joy makes a person unable to walk briskly or stand for long. Worry makes a person unable to do strenuous work and unable to sleep soundly when lying down at night. Sorrow makes a person forgetful and unable to make sense of what others say; after putting things down in different places, they cannot find them again. In severe cases, the limbs may swell, the tendons and vessels in the hands and feet may contract, and the person may be unable to grasp or lift things.

The text holds that sudden illness in men is often caused by irregular eating, while in women it is often associated with exposure to wind after childbirth and with other illnesses.

Prescription for the Seven Qi Pill

Aconite and rhubarb (seven fen each); aster root, pinellia, hog fennel root, asarum, salvia root, poria, cnidium, peach kernels (the Hu Qia version has apricot kernels), calamus (some versions give peony), gypsum, Evodia fruit, cinnamon bark, and platycodon root (three fen each); ginseng, licorice, and siler root (one liang each); dried ginger and Sichuan pepper (half a liang each).

Grind the twenty ingredients into a fine powder and form pills with honey, each the size of a wutong seed. Take three pills at a time with wine.

“Chize” and “Shangwan” are acupuncture and moxibustion points. A “zhuang” is a unit used to count moxibustion applications, usually referring to burning one moxa cone. The text’s “seven Qi” is an ancient medical category encompassing emotional states and factors such as cold and heat as causes of illness.

Take it three times a day, gradually increasing the dose to ten pills. Another formula omits pinellia and adds three fen of kansui.

(The Hu Qia version contains neither Salvia root nor licorice.)

Seven Qi Pills: Treats the Seven Qi. The Seven Qi are cold qi, hot qi, anger qi, resentment qi (the qi of resentment and anger), joy qi, worry qi, and sorrow qi. Illness caused by these forms of qi develops into accumulations, hard as a cup, with cramping pain in the heart and abdomen and inability to eat. The condition comes and goes; during an attack, the patient feels as if death is imminent.

The symptoms of cold qi are vomiting and fullness and oppression in the chest. Hot qi causes mental confusion, dizziness, and involuntary emission of semen. Anger qi causes unbearable burning pain, qi surging upward, tightness in the chest, and near inability to breathe. Resentment qi causes accumulation and fullness and oppression in the chest, with inability to eat. Joy qi makes it impossible to walk briskly or stand for long. Worry qi makes it impossible to work, and even when lying down, sleep is restless. Sorrow qi may leave a person looking normal, yet prone to anger, sudden joy, or forgetfulness, with swelling in the limbs and difficulty moving. This formula also treats lingering disorders after postpartum windstroke.

Two liang and a half of rhubarb; two fen each of ginseng, pinellia, Evodia fruit, bupleurum, dried ginger, asarum, balloon flower root, and sweet flag; three fen each of poria, chuanxiong (also called Sichuan lovage), licorice, Sichuan pepper (another version uses cinnamon bark), gypsum, and peach kernel.

Grind the fifteen ingredients into a fine powder and mix with honey to make pills the size of Chinese parasol tree seeds. Take three pills with wine each time, three times a day, gradually increasing the dose to ten pills. The formula in the Qianjin Yifang has only ten ingredients and omits poria, chuanxiong, licorice, gypsum, and peach kernel.

Seven Qi Decoction: Treats cold qi, hot qi, worry qi, fatigue qi, and sorrow qi, as well as qi congestion in the diaphragm caused by improper eating. It also treats damage to the five organs from overexertion, disharmony among the organs and bowels, and weakness due to qi deficiency.

Two liang each of dried ginger, baical skullcap, magnolia bark, pinellia, licorice, dried rehmannia, peony, and trichosanthes root. (In the Shenshi Formula, magnolia bark is replaced by cinnamon bark, and trichosanthes root by tangerine peel.) Three liang of Sichuan pepper. (The Shenshi Formula gives balloon flower root instead.) Five immature bitter oranges, one liang of ginseng, and five ge of Evodia fruit.

Cut up the twelve ingredients. Boil them in one dou of water until three sheng of decoction remain, then divide into three doses. Take three times a day.

Another Formula: Treats deficiency-cold, upward surging qi, fatigue qi, and related conditions.

One sheng of pinellia, ginseng, ginger…

One liang each of cinnamon bark and licorice.

Coarsely cut the five ingredients above. Boil them in one dou of water until three sheng of decoction remain. Divide this into three doses and take them three times daily.

Five Obstructions Pill: This treats the five disorders known as worry obstruction, Qi obstruction, food obstruction, fluid obstruction, and overexertion obstruction. These conditions may be triggered by grief, anger, excessive brooding, or improper eating; they are also prone to flare up after eating cold food or raw vegetables. Patients feel fullness and distension in the chest, with obstructed breathing and pain that pulls through to the back, like a needle prick. After eating, a hard, distended lump forms below the heart, shaped like a wad of cotton. The pain is severe and brings on the urge to vomit; the discomfort eases after vomiting. Food and drink are difficult to swallow. In severe cases, the hands and feet grow cold, Qi surges upward, and the patient develops coughing, rebellious Qi, wheezing, and shortness of breath. The formula is as follows:

Five liang each of Mai Men Dong and licorice; two liang each of Sichuan pepper, Polygala root, cinnamon bark, and Asarum; one and a half liang of aconite; four liang of ginseng; three liang of dried ginger.

Grind the nine ingredients above into a fine powder, mix with honey, and form pills, making the mixture slightly soft. Before meals, hold one pill in the mouth—the size of a pellet—and swallow it slowly. The medicine will produce a sensation of warmth in the throat and chest. When its effects begin to fade, take another pill in the same way. Take it three times during the day and twice at night. The condition should be cured after seven days. (As recorded in the Yan Nian Fang:)

If the pill cannot be held in the mouth, divide one large pill into seven small ones and swallow them all. In summer, increase the amounts of Mai Men Dong, licorice, and ginseng. (As recorded in the Hu Qia Fang:) The medicine may also be made into pills the size of parasol tree seeds. Take ten at a time with wine. The Jing Xin Lu uses Wu Zhu Yu in place of cinnamon bark and makes pills the size of parasol tree seeds; take five on an empty stomach with wine. This formula treats heart pain caused by cold, as well as the sensation of something lodged in the throat that can neither be brought up nor swallowed, accompanied by reduced appetite.

Formula for treating bound Qi, cold-induced masses lodged below the ribs, and conditions in which beriberi Qi surges upward to the lower abdomen, causing distension and fullness there:

Take three sheng of garlic, with the hearts and skins removed, and pound it until very fine. Add three sheng of water, mix well, and squeeze out the juice. Pound the pulp again, add three sheng of water, mix well, and squeeze out the juice. Repeat this process once more. Combine the juice from all three squeezings, yielding nine sheng in total. Discard the remaining pulp, which should be about the size of a peach. Simmer the juice over a low flame until three sheng remain. Add three sheng of cow’s milk and continue simmering until three sheng remain. At dawn, after rising and on an empty stomach, drink the full amount warm in one sitting. Eat again at the Shen hour (3–5 p.m.). Take this as one course for three consecutive days.

Take ten doses, then stop after ten days.

Garlic Decoction: Treats hernias and abdominal masses, accumulations and gatherings in the abdomen, cold-induced accumulations, and retained phlegm and fluid. It is also used for distension and fullness in the chest and abdomen, upward surging of Qi, coughing, stabbing pain, disorders caused by pathogenic wind, wind-induced convulsions (an ancient term for epilepsy and similar disorders), wind-related paralysis on one side of the body, lower back pain and cold knees, obstructed breathing, and various other conditions.

Take six jin and four liang of garlic, peel it, and slice it. Add four dou of water and boil until reduced to one dou, then strain out the solids. Add one sheng of butter to the garlic liquid, along with two sheng of cow’s milk; three liang each of long pepper, black pepper, and dried ginger; two liang each of rock sugar, asafoetida, and Rong salt; one liang each of sweet flag rhizome and costus root; and four liang of dried grapes.

Grind the twelve ingredients into powder and add them to the garlic liquid. Simmer in a copper vessel over low heat until reduced to one dou. Take one liang on an empty stomach, washed down with wine. After five days, gradually increase the dose to a maximum of three liang. After twenty days, if the limbs feel comfortable and at ease, gradually increase the dose to six liang. This formula is highly effective for various conditions caused by cold Qi.

Platycodon Qi-Breaking Pills: Treat obstruction and blockage of the movement of Qi upward and downward, and difficulty breathing.

Three fen each of platycodon root, tangerine peel, dried ginger, magnolia bark, immature bitter orange, asarum, and drab’s seed; six fen each of evodia fruit and atractylodes; seven fen each of black pepper, Sichuan pepper, and aconite; ten fen of long pepper; five fen each of ginseng, cinnamon bark, prepared aconite, poria, hogfennel root, Japanese siler root, and lovage root; eight fen each of licorice, rhubarb, areca nut, and Chinese angelica.

Grind the twenty-four ingredients into powder and mix with honey to form pills the size of parasol tree seeds. Take ten pills at a time with wine, three times daily. Those with heat conditions should take them on an empty stomach.

Areca Nut Decoction: Treats excessive, replete Qi and abdominal accumulations that make it difficult to eat and breathe.

Thirty-seven areca nuts, one aconite, one sheng of pinellia, one liang of asarum, and eight liang of fresh ginger; three liang each of rhubarb, aster root, and bupleurum; one liang each of tangerine peel, licorice, purple perilla (use perilla seeds in winter), and poria.

Cut the twelve ingredients into pieces. Add one dou of water and boil until reduced to three sheng. Divide into three doses.

Allow the time it takes to walk about ten li between each dose. If there is a hard mass in the abdomen, as solid as a stone, add two liang of turtle shell and two liang of Fang Kui. If Qi surges upward, add two sheng of sliced mulberry root bark, along with two liang each of Zhi Shi and Hou Po. Adjust the dose according to the patient’s strength. After taking two doses in succession, wait ten days, then take the earlier Platycodon Qi-Breaking Pill.

A formula for longstanding accumulated Qi with attacks that occur at regular intervals: Symptoms include sudden cramping pain in the heart and abdomen, a brief cessation of breath, and a hard, firm mass in the abdomen. Other physicians may be unable to treat the condition, and it may sometimes be mistaken for poisoning by a Gu curse.

Four to seven large, good-quality betel nuts; one aconite; one sheng of Pinellia; three liang of Bupleurum; eight liang of ginger; and two liang each of tangerine peel, licorice, cinnamon bark, Chinese angelica, and Zhi Shi.

Cut the ten ingredients into pieces and boil them in one dou of water. Reduce the liquid to three sheng and divide it into three doses. Take one dose every five days, for a total of three doses; this is said to remove the root of the illness completely.

Pinellia Decoction: For counterflow of Qi, distension and fullness in the heart and abdomen, Qi surging into the chest and flanks with pain, heart and abdominal pain caused by cold, vomiting or difficulty swallowing food, and Qi bound into accumulations by worry and brooding.

One sheng of Pinellia; five liang each of ginger and cinnamon bark; and four liang of tangerine peel.

Cut the four ingredients into pieces and boil them in seven sheng of water. Reduce the liquid to three sheng and divide it into four doses: three during the day and one at night. Those with greater strength may divide it into three doses. This is also used for vomiting, counterflow of Qi, and abdominal pain that persist after cholera.

Another formula: For counterflow of Qi, vexation and distension in the heart, oppression and discomfort from Qi, and Qi surging upward. The formula is in “Vomiting,” Volume 16: it is the four-ingredient formula given there.

Fritillaria Decoction: For Qi surging upward with panting, obstruction in the throat, shortness of breath that prevents lying flat, pain in the lower back and back, fullness in the chest, inability to eat, and a sallow complexion.

One liang of Fritillaria and five liang of ginger; two liang each of cinnamon bark, ephedra, gypsum, and licorice; thirty apricot kernels; and five he of Pinellia.

Cut the eight ingredients into pieces and boil them in one dou of water. Reduce the liquid to three sheng and divide it into three doses, taken three times daily.

Ephedra Decoction: For Qi surging upward with panting, a floating pulse, coughing with counterflow of Qi, a sound in the throat like a frog calling, labored breathing, and even difficulty breathing as if close to suffocation.

Eight liang of ephedra, four liang of licorice, and thirty jujubes.

Belamcanda (two pieces, each about the size of a weiqi piece) …

Coarsely chop the four ingredients listed above. First, boil the ephedra in one dou of well water, bringing it to a boil three times and skimming off the foam. Add the remaining ingredients and simmer until four sheng remain. Divide into four doses: take three times during the day and once at night.

Bengqi Decoction: Used to treat conditions in which the great Qi surges upward within the body, causing various disorders in the chest and diaphragm. During an attack, the chest feels full and tightly constricted, breathing becomes short, and lying flat is impossible. In severe cases, distress becomes unbearable and the person feels close to death. The abdomen is cold, dampness collects inside, the intestines rumble incessantly, and the flow of Qi becomes knotted and tangled.

Ingredients: one jin of fresh ginger; one sheng each of pinellia and Evodia; five liang of cinnamon bark; and three liang each of ginseng and licorice.

Coarsely chop the six ingredients. Simmer them in one dou of water until three sheng remain. Divide into four doses.

Zhishi Decoction: Used to regulate the flow of Qi and treat fullness and distress in the chest.

Ingredients: three zhishi fruits, two aconite roots, fourteen jujubes, five liang of pinellia, and two liang each of ginseng, licorice, atractylodes, dried ginger, and magnolia bark.

Coarsely chop the nine ingredients. Simmer them in seven sheng of water until two and a half sheng remain. Take eight he each time, three times a day.

Qi-Descending Formula: Used to regulate the flow of Qi and treat fullness and distension in the abdomen.

Ingredients: one sheng of pinellia, one jin of fresh ginger, one and a half liang of ginseng, and three liang of tangerine peel.

Coarsely chop the four ingredients. Simmer them in seven sheng of water until three sheng remain, then strain out the herbs. Divide into three doses and take three times a day. Another version omits the ginseng and uses only the other three ingredients.

Qi-Regulating Formula: Used to treat distension and tightness in both flanks, as well as disorders caused by wind and cold.

Ingredients: eight fen each of apricot kernel, poria, and fang Kui; five fen each of Evodia, tangerine peel, cinnamon bark, Saposhnikovia root, and Alisma; six fen each of atractylodes, belamcanda, peony, perilla seed, platycodon, and zhishi.

Grind the fourteen ingredients into powder and mix with honey to make pills the size of Chinese parasol tree seeds. Take ten pills with wine twice a day, gradually increasing the dose to thirty pills.

Formula for treating fullness and blockage of Qi, inability to eat, and labored breathing:

Take ten chebula fruits and grind them into powder. Mix with honey to make pills the size of Chinese parasol tree seeds. Take three pills after meals. No dietary restrictions are necessary. Stop taking them if they produce a laxative effect.

Formula for treating upward surging Qi, cough, and rebellious Qi:

One sheng of perilla seed, five he of schisandra berries, ephedra …

Asarum, aster root, ginseng, scutellaria root, and licorice (two liang each); cinnamon heart and angelica (one liang each); fresh ginger (five liang); pinellia (three liang).

Cut the twelve ingredients into pieces. Boil them in one dou of water until three sheng of decoction remain, then divide into three doses.

Secret prescription for Qi surging upward and inability to lie down

Tangerine peel, fresh ginger, perilla, ginseng, and schisandra (five liang each; another record gives platycodon in place of schisandra).

Cut the five ingredients into pieces. Boil them in seven sheng of water until three sheng of decoction remain, then divide into three doses.

Prescription for fever with Qi surging upward, severe shortness of breath, imminent danger of death, and inability to lie down

Cinnamon heart (half a liang); white quartz, lilyturf root, bitter orange, dittany bark, fritillaria, poria with hostwood, areca nut kernel, and asparagus root (two and a half liang each); plantain seed (two liang); ginseng, hogfennel root, tangerine peel, white peony, and apricot kernel (one and a half liang each); Chinese plum kernel (three liang); peach kernel (five fen).

Grind the seventeen ingredients into powder and mix with honey to make pills the size of parasol tree seeds. Take ten pills with bamboo-leaf decoction, twice daily, gradually increasing the dose to thirty pills.

How to prepare the bamboo-leaf decoction

Bamboo leaves and perilla seed (one sheng each); aster root and white peony root (two liang each); stemona root, licorice, and fresh ginger (three liang each).

Cut the seven ingredients into pieces. Boil them in eight sheng of water until three sheng of decoction remain. Drink it warm to swallow the pills described above. When the decoction is finished, prepare another batch according to the prescription.

Ginseng decoction: A prescription to settle the appetite, bring Qi downward, regulate the chest and flanks, and treat lingering heat

Ginseng, lilyturf root, dried ginger, angelica, poria, licorice, schisandra, astragalus root, peony, and bitter orange (two liang each); cinnamon heart (three liang); pinellia (one sheng); jujubes (fifteen).

Cut the thirteen ingredients into pieces. Boil them in nine sheng of water, strain out the solids, and collect three sheng of decoction. Take nine he each time, finishing the decoction between morning and afternoon. Always drink it hot; be sure not to drink it cold.

Seaweed and tangerine-peel pills: Used to bring Qi downward and treat distension of the limbs caused by wind and deficiency, as well as deficiency-cold of the bladder and Qi…

A formula for Qi surging upward into the lungs, causing rapid breathing and a tight feeling in the throat, with the breath alternately passing freely and becoming obstructed

Take three fen each of seaweed, tangerine peel, and Baiqian; five fen each of apricot kernels, poria, peony, and cassia bark; five ge of perilla seeds; two liang each of jujube flesh, white mulberry root bark, and kelp; and one liang each of Wu Zhu Yu, ginseng, Atractylodes, and tinglizi.

Grind these fifteen ingredients into a fine powder and use honey to form pills the size of parasol tree seeds. Take ten pills each time with water, twice daily, gradually increasing to fifteen pills, until urination flows freely.

A formula for treating Qi surging upward

Take equal parts of sal ammoniac, asarum, and Achyranthes root. Grind into a fine powder. When the Qi disorder flares up, take one square-inch spoonful of the powder with wine. Avoid wine for three days after taking the medicine; follow the other restrictions prescribed for taking the ingredients.

A formula for treating upward surging Qi

Use one sheng of high-quality butter and five cloves of single-bulb garlic. First fry the garlic in the butter. When the garlic turns yellow, remove it, then add one ge of fresh ginger juice and cook the mixture until done. While fasting, take one square-inch spoonful while warm.

A formula for treating upward surging Qi and vomiting

Grind two sheng of mustard seeds into a fine powder and use honey to form pills. At the hour of Yin (3–5 a.m.), take seven pills with clear water freshly drawn from a well that morning. Make the pills the size of parasol tree seeds and take them twice daily. Alternatively, take the powder while fasting, or soak it in wine before taking it. This formula is also used to treat cramping pain below the navel.

A formula for treating fatigue-related Qi

Pound three sheng of small mustard seeds into a fine powder and put it in a silk bag. Soak the bag in three dou of wine, seal it for seven days, then strain out the herbs. Drink half a sheng warm, gradually increasing to one and a half sheng. Prepare the medicine again after obtaining this formula; follow the restrictions prescribed for taking the ingredients.

A formula for treating upward surging Qi that has not healed in thirty years

Take one hundred jujubes, one hundred apricot kernels, one hundred and twenty fermented soybeans, and two hundred Sichuan peppercorns. First pound the apricot kernels and fermented soybeans finely, then add the jujubes and peppercorns and pound further. Form the mixture into pills the size of date pits. Hold them in the mouth and swallow slowly. Take them three times daily, with one additional dose at night.

A formula for treating severe, longstanding upward surging Qi that has not healed

Roast the henbane seeds until their color changes. Slice cooked lamb liver thinly and dry it in the sun. Take equal amounts of the two ingredients and pound them separately, then mix them with vinegar prepared on the seventh day of the seventh month until the powders bind together. After fasting overnight, take two square-inch spoonfuls while fasting. Afterward, one must also “pick up two needles” … (The source appears to be missing text here, so the full meaning cannot be determined.)

During meals, take two spoonfuls each of cold rice drink and plain rice porridge to stop the symptoms. Take this every other day, and recovery will be permanent. For forty days, turnips may be made into soup using the water in which rice has been cooked. All other foods must be avoided.

Formula for Bringing Qi Down

First formula: Five liang of fresh ginger and one sheng of wheat. Add seven sheng of water to these two ingredients and boil until one sheng of liquid remains. Take the whole amount at once.

Another formula: Twenty-seven jujubes and one sheng of chopped purple perilla stems and leaves. Add three sheng of wine to the ingredients and boil until one and a half sheng remain. Divide into two doses. Water may be used instead of wine. Another version adds half a liang of tangerine peel; the Zhouhou Fang says to omit the jujubes and use tangerine peel instead.

Formula for Treating Qi

First formula: Take two jin of peach tree bark, scrape away the yellow part, chop it, and boil it in five sheng of water until three sheng remain. Take one sheng per dose, and stop once the symptoms have cleared.

Another formula: Take two ge of donkey fat with wine, twice daily. Stop when recovered.

Another formula: Boil two sheng of yellow ox milk down to one sheng, then mix it with one sheng of fresh ox milk. Take on an empty stomach, twice daily.

Another formula: Take three ge of donkey milk for the first dose. After three days, take five ge daily, then gradually increase to seven ge. After seven days, increase the dose to one sheng. Avoid mallow, pork, fish, and fatty foods.

Another formula: Drink urine on an empty stomach for one hundred consecutive days, then stop. This may be used to treat various illnesses.

Another formula: Drink black ox urine on an empty stomach twice daily, gradually increasing the amount to three sheng per dose, then stop.

Formula for Replenishing Deficient Qi and Reversing Counterflow

Three sheng of jujubes; ten pieces of licorice peel, with the veins removed; two liang of dried ginger; and eight liang of dried Rehmannia.

Grind these four ingredients into a fine powder and sift. Soak the jujubes in four sheng of wine for three nights, then strain them out, reserving the wine for cooking the jujube juice. Put the jujubes in a steamer and steam over low heat until the jujube paste drips into the pot of wine. Then boil the wine until about two sheng remain. Stop heating when only the skins and pits are left in the steamer. Store the wine in a vessel, add the prepared powder while it is still hot, and stir until the mixture is roughly the consistency of sugar. Take two ge at a time with wine, twice daily.

This formula is not only used to replenish Qi; it is also effective for treating various kinds of shortness of breath and physical emaciation.

Formula for Greatly Replenishing Qi

Five liang of dried Rehmannia; one liang each of licorice and Sichuan pepper; four liang each of dried ginger, kelp, and goji root bark; and white atractylodes, cinnamon heart, and ginseng…

The source text breaks off at “ginseng”; the remaining quantities and preparation instructions are not provided.

Magnolia bark and seaweed, three liang each; four sheep’s kidneys, with the fat removed; and one sheep’s stomach, prepared as for ordinary cooking, with the fat and membranes removed.

Grind the thirteen ingredients into a coarse powder. Fill the sheep’s stomach with it, add the kidneys, and sew the opening closed. Steam until thoroughly cooked, then, while still hot, place it in a wooden mortar and pound everything together until the stomach, kidneys, and medicinal ingredients are fully blended. Dry in the sun, then pound into a powder. Take one square-inch spoonful each time with wine, twice daily.

White Quartz Powder: Said to improve eyesight, promote urination, regulate disorders of Qi, and replenish the body in cases of the “five taxations and seven injuries.” The original text claims that it “treats everything.”

Refine ten liang of white quartz. Whatever the quantity, first place the quartz on an anvil and break it with a hammer. In a well-lit place, pick out and discard pieces that are spotted, dark, yellowish, or reddish, keeping only those that are pure white. Pound the selected quartz, sift it through silk, and grind it in a porcelain vessel until very fine. Put it in a raw-silk bag and use the water-grinding and settling method in a copper vessel, processing it three times as one would when preparing a powder. After grinding, leave it to settle and gradually remove the water. Once the water is gone and the quartz has dried in the sun, discard the coarse, impure material, keeping only the good portion from the middle; also discard the coarse material at the bottom. Grind the remainder finely once more. Put the usable quartz in a clean white-silk bag, place it in a porcelain bowl, cover it with another porcelain bowl, and steam it beneath three dou of rice. When the rice is cooked, take out the bag, hang it up to dry, then grind the quartz in a porcelain vessel. It is then ready.

Dendrobium and cistanche, six fen each; alisma, poria, and tangerine peel, one liang each; dodder seed, three liang. Grind the seven ingredients into a fine powder, sift it into a porcelain vessel, mix thoroughly, and sift again. Take one square-inch spoonful each time with wine, twice daily; do not exceed this amount. While taking the medicine, avoid pork, fish, goose, duck, garlic, raw or cold foods, vinegar, and greasy or slippery foods.

Injury-Replenishing Powder: Used for damage to the Lungs accompanied by easy diarrhea and coughing, a tendency to startle or feel afraid, weakness of the sinews and bones with difficulty moving, inability to walk long distances or stand for long on the knees; also for sweating, a dry nose, shortness of breath, a tendency toward sadness, tightness and pain below the heart extending into the chest, restless sleep, a dazed and unsettled spirit with many dreams, alternating chills and fever, reddish-yellow urine, inability to see far, and blood in the saliva.

Asparagus root, one sheng; saposhnikovia, alisma, ginseng, and donkey-hide gelatin, one and a half liang each; snakegourd root, peucedanum root, peony, and gypsum. The original text ends here; the remaining quantities and method of administration are not recorded.

Dried ginger and soybean sprouts, two liang each; aster root and amur corktree bark, one liang each; cinnamon heartwood and white atractylodes, four liang each; dried rehmannia, licorice, Chinese yam, and Chinese angelica, two and a half liang each. Grind the ingredients into a fine powder and sift. Take before meals with wine, one level square-inch measure (an ancient medicine-measuring scoop) each time, three times daily.

White Quartz Pills: Nourishing Lung Qi

White quartz (some versions read “white halloysite”), common anthyllis, magnetite, Chinese dodder seed, cistanche, and dried rehmannia, two and a half liang each; dendrobium, trichosanthes root, white atractylodes, and schisandra, two liang each; saposhnikovia root and morinda root, five fen each; cinnamon heartwood and ginseng, one liang each; cnidium seed, half a liang.

Grind the fifteen ingredients into a fine powder and form pills with honey, each the size of a parasol-tree seed. Take with wine, fifteen pills each time, gradually increasing to thirty pills, twice daily.

Qi-Regulating Pills: For Qi Deficiency

Apricot kernel and cinnamon heartwood, one liang each; dried ginger and sharp-leaf galangal fruit, two liang each.

Grind the four ingredients into a fine powder and form pills with honey, each the size of a parasol-tree seed. Take three pills before meals, adjusting the amount according to what feels suitable for the body.

For Cold Qi and Shortness of Breath

Place five liang of Sichuan pepper in a silk bag and steep it in one dou of wine for fourteen days. Then drink as desired.

For Excessive Recitation, Overwork, and Fatigue

Ghee, oil, sugar, wine, and white honey, two sheng each.

Place the five ingredients in a bronze vessel and simmer over low heat. After it boils twenty times, remove it from the heat. The original phrase “take it down as the standard” may contain an omission or copying error, so its meaning is unclear. Finish the preparation over seven days and seven nights, taking care to avoid cold and raw foods.

Another formula:

Ginseng, licorice, poria, and Chinese angelica, two liang each; lycium root bark, Sichuan lovage, peony, dried rehmannia, and astragalus, three liang each; twenty jujubes.

Cut the ten ingredients into pieces and boil them in one dou of water until three sheng remain. Divide into three doses. Some versions add three liang of cinnamon heartwood.

For Sudden Shortness of Breath

Pound Chinese chives and extract the juice. Take one sheng; it is said to bring immediate relief. (The Zhouhou Fang records that this formula is also used when Qi suddenly surges upward, breathing becomes audible, and one feels close to suffocation.)

For Qi Deficiency

Fresh ginger and goji leaves, two liang each.

Grind the two ingredients mentioned above. Boil them in three sheng of water, reduce the liquid to one sheng, and drink it all at once.

A prescription for shortness of breath caused by excessive sexual activity in young men

Seven he of fermented soybeans and fourteen gardenia fruits.

Boil the fermented soybeans in two sheng of water until one and a half sheng of liquid remain, then strain out the beans. Add the gardenia fruits and boil again, reducing the liquid to eight he. Take half a sheng at a time. If the symptoms do not ease, another dose may be taken.

Moxibustion

When coldness is felt because Qi is rising upward in counterflow, with rumbling and rolling sounds in the abdomen, vomiting, nausea, and inability to eat, apply moxibustion to Taichong. The number of moxa cones is not fixed: continue until the pain stops, then continue until the pain returns, and stop at that point.

For Qi rising upward in counterflow with reversal, apply one hundred moxa cones to the center of the chest. This point lies between the breasts.

For Qi in the chest and diaphragm, apply moxibustion to Quèshū, using a number of moxa cones equal to the patient’s age. The Bian Que records that Quèshū lies below the fourth vertebra, one and a half cun to either side.

For various disorders of the heart and abdomen—including a hard, distended abdomen, vexation and pain, pent-up worry, exposure to cold, cholera, heart pain, vomiting, diarrhea, undigested food, and intestinal rumbling with loose stools—apply one hundred moxa cones to Taicang. Taicang is the stomach’s front-mu point. It lies four cun below the pit of the stomach, or one cun below the stomach tube.

When Qi gathers into a pouch and cannot be treated effectively with either acupuncture or medicine, apply moxibustion to Huangmu, using a number of moxa cones equal to the patient’s age. Huangmu consists of two points. Measure from the nipples to the navel and mark the midpoint; then measure from below the breast to that point. This is the location of the points.

When Qi counterflows downward, apply one hundred moxa cones to Feishu, then fifty to Taichong.

For cramping pain below the navel that extends to the genitals and occurs unpredictably, caused by cold Qi, apply one hundred moxa cones to Guanyuan. Guanyuan lies three cun below the navel.

For shortness of breath so severe that the person cannot speak, apply one hundred moxa cones to Tianjing, between the two tendons at the back of the elbow. Moxibustion may also be applied to Dazhui, using a number of moxa cones equal to the patient’s age; to Feishu, one hundred cones; to Ganshu, one hundred cones; and to Chize, one hundred cones. Apply seven cones to the connecting vessels between the little finger and ring finger, and ten cones in total to the tips of all ten fingers. For shortness of breath caused by excessive sexual activity in young men, apply fifty moxa cones to the upper end of Jiuwei. Moxibustion may also be applied with salt placed in the navel, using fourteen cones.

For deficiency of Qi and weakness, apply moxibustion below the fifth vertebra, using a number of moxa cones equal to the patient’s age.

Discussion

Sudden reversal with Qi rising upward, surging into both flanks and causing distension and pain at the pit of the stomach, accompanied by faint breathing that seems about to stop, is a condition called running-piglet Qi (Qi surging upward from the lower abdomen). Immediately prepare a hot decoction and have the patient immerse both hands and feet in it, changing the liquid frequently.

For running-piglet Qi, apply one hundred moxa cones to Qihai. Qihai lies one and a half cun below the navel.

Apply one hundred moxa cones at Guanyuan, three cun below the navel. To treat running-piglet qi, apply one hundred moxa cones at Qimen. Qimen is one and a half cun beside the ends of the second ribs, directly below the breasts.

If running-piglet qi is accompanied by abdominal swelling, apply one hundred moxa cones at Zhangmen. Also called Changping, Zhangmen consists of two points. They lie lateral to Daheng, level with the navel, at the ends of the lowest ribs.

If running-piglet qi surges upward into the chest and heart area, making it difficult to breathe, apply fifty moxa cones at Zhongji. Also called Yuquan, Zhongji lies four cun below the navel.

If running-piglet qi darts up and down, causing pulling pain in the abdomen and lower back, apply one hundred moxa cones at Zhongfu. Zhongfu lies above the breasts, in the third intercostal space.

If running-piglet qi darts up and down, apply fourteen moxa cones at each Siman point. The Siman points lie on either side of the Dantian (energy center), three cun apart. The Dantian lies eight cun below the pit of the stomach, at the transverse crease below the navel.

Here, “cone” is a unit for measuring moxibustion: it refers to the number of moxa cones used in a treatment.