《孫真人備急千金要方》Vol. 57

Essential Prescriptions Worth a Thousand Pieces of Gold by the Perfected Sun, Volume 57

Formulas for the Large Intestine

First: Discussion of the Large Intestine’s Pulse

The large intestine corresponds with the Lungs. Its condition can be observed from the shape of the middle of the bridge of the nose.

The Lungs and large intestine are paired. The large intestine is the organ that transports and excretes food waste. The ancients called it the “storehouse supervisor’s assistant.” They held that it weighed two jin and twelve liang, was one zhang and two chi long and six cun wide, and wound to the right beside the navel in a series of folds, making twelve bends. It could contain one dou and two sheng of food and water. It governs the circulation of the twelve time periods, keeping the blood vessels harmonized and the spirit at ease. The Thousand-Gold Clarification of the Hall of Light and the Outer Terrace cite the same account. The Classic of Difficulties gives a different description: the large intestine is two zhang and one chi long, four cun wide, and slightly more than one-third of a cun in diameter. It has sixteen bends and can contain one dou of grain and seven and a half sheng of water. The length of the nostrils can also be used to observe the condition of the large intestine.

If the Yang pulse at the right wrist, near the barrier position, is weak and cannot be felt, this indicates that the large intestine’s pulse is declining. The patient may feel short of breath, with a sensation like water beneath the heart. Around the beginning of autumn, coughing may occur. Needling the Hand Taiyin channel near Yuji can treat this condition.

If the Yang pulse at this position is full and forceful, this indicates excess in the large intestine. The patient feels intense pain in the intestines, as though being stabbed and cut with needles and knives, and the pain does not let up. Needling the Hand Yangming channel at the wrist, using the reducing method, can treat it.

When the large intestine is diseased, the intestines may hurt severely and rumble. If the patient is exposed to cold again in winter, diarrhea may result, with pain around the navel and an inability to stand for long. Diagnosis of this condition follows the same principles as diagnosis of stomach disorders. The Shanglian point of the Upper Great Void on the Foot Yangming Stomach channel may be needled.

If the intestines rumble like thunder and Qi surges upward to the chest and diaphragm, making it difficult to stand for long, this indicates that pathogenic Qi is in the large intestine. Needling the Yuan point of the Huang, Shanglian of the Upper Great Void, and Zusanli can treat it.

When the large intestine is distended and full, the intestines rumble and hurt. Exposure to cold causes diarrhea, and food that has been eaten cannot be digested.

Cold in the large intestine causes loose stools resembling duck droppings; heat in the large intestine causes the discharge of foul, slimy intestinal matter.

When undigested food has accumulated in the large intestine, the patient may feel cold and feverish at intervals, as in malaria.

Disease first affecting the Lungs can pass to the large intestine. If a Lung cough persists, coughing may cause involuntary defecation or diarrhea. If counterflow Qi remains in the large intestine, the patient may dream of fields.

The Lungs correspond with the skin. Thick skin indicates a thick large intestine; thin skin indicates a thin large intestine. Loose skin and a broad abdomen indicate a large intestine that is also loose and long; tight skin indicates a large intestine that is tight and short. Smooth, moist skin indicates a relatively straight large intestine; when the skin and flesh adhere tightly and are difficult to separate, the large intestine is also prone to stagnation.

Bian Que said: The Hand Taiyin Lung Channel and the Hand Yangming Large Intestine Channel are interiorly and exteriorly related (the two channels are interconnected). When the Large Intestine has an excess condition, it is affected by pathogenic heat. This heat causes abdominal fullness and distension, constipation, and sores in the mouth. After food enters the intestines, the Large Intestine may be in excess while Stomach Qi is weak; when food remains in the Stomach, the Stomach may instead be in excess while the intestines are deficient. Thus, the abdomen may feel distended and full without being so all the time. The condition shifts between excess and deficiency, and symptoms come and go.

When the Large Intestine is weak, it is affected by pathogenic cold. The intestines rumble, and the stools become loose and pale greenish-white, with diarrhea. The cause involves Qi and fluids, and the root of the disorder lies in the Large Intestine. (For the related formula, see “Treating Water Disorders.”) If the Large Intestine’s function fails completely, the condition cannot be treated. How can this be recognized? If diarrhea continues without stopping, the patient will eventually die.

The Hand Yangming Channel (Hand Yangming Large Intestine Channel) begins at the outer side of the tip of the index finger, beside the thumb. It runs upward along the upper edge of the index finger, passes through Hegu (the point between the thumb and index finger) and between the two bones, then enters between two tendons. It continues upward along the upper edge of the forearm to the outer elbow, then runs along the front outer side of the upper arm to the shoulder. It passes the front edge of the acromion and reaches the meeting point at the prominent bone at the back of the neck. From there it descends into the supraclavicular fossa (the hollow above the collarbone), connects with the Lung, crosses the diaphragm, and belongs to the Large Intestine.

A branch rises directly from the supraclavicular fossa to the neck, passes through the cheek, and enters between the lower teeth. It then emerges, curves around the mouth, and crosses at the philtrum: the channel on the left goes to the right, and the one on the right goes to the left. It then runs upward along both sides of the nostrils.

When this channel is disordered, it can cause toothache and swelling of the cheeks. It governs fluids. Related symptoms include yellowing of the eyes, dry mouth, nasal congestion or nosebleeds, a swollen and painful throat, pain in the front of the shoulder and upper arm, and pain or restricted movement in the index finger beside the thumb. When the channel Qi is abundant and in excess, the areas it passes through become hot and swollen; when it is weak, they become cold and cause chills. In excess, the pulse at Renying (the pulse at the carotid artery) is three times stronger than the pulse at Cunkou (the pulse at the wrist). In deficiency, the Renying pulse is weaker than the Cunkou pulse.

The Second Section on Large Intestine Deficiency and Excess (Pulse Signs, Formulas, and Moxibustion)

Large Intestine Excess Heat

When the Yang pulse before Qikou (the wrist pulse on the side nearer the wrist) is strong and full at the right Cunkou, this indicates a disorder of the Hand Yangming Channel. The patient often has abdominal distension, is prone to panting and coughing, has a flushed complexion and a fever, and feels as though something is lodged in the throat. This is called “Large Intestine Excess Heat.”

Ginger Decoction to Drain the Intestines: Used to treat abdominal distension, constipation, and sores in the mouth caused by Large Intestine Excess Heat. The ingredients are ginger, tangerine peel, green bamboo shavings, scutellaria root, gardenia seed, and atractylodes rhizome (three liang each); cassia bark (one liang); poria and mirabilite (two liang each); fresh rehmannia root (ten liang); and fourteen jujubes.

Add seven sheng of water to these eleven ingredients and boil until reduced to three sheng. Strain out the dregs, add mirabilite, and take in two doses.

A formula for treating persistent fullness and distension in the intestines

Moxa the Dachangshu point forty-nine times.

When the Large Intestine has Heat, symptoms may include rumbling intestines, abdominal distension, pain beside the navel, indigestion, panting, and inability to stand for long. The Shangjuxu point may be used for treatment.

Large Intestine Deficiency-Cold

On the right wrist, the pulse at the cun position is weak before the qikou position—the part of the cun pulse used to assess the Qi of the Spleen and Stomach. This indicates a disorder of the Hand Yangming channel, the Large Intestine channel.

The patient has panting in the chest, rumbling intestines, a dry mouth with empty thirst, dry lips, tautness of the eyes, easy fright, and passage of white stools. This is called “Large Intestine Deficiency-Cold.”

Huanglian Tonifying Decoction: A formula for Large Intestine Deficiency-Cold, with dysentery and passage of greenish-white stools, as well as rumbling and pulling sensations in the intestines.

Huanglian, four liang; Fuling and Chuanxiong, three liang each; five pieces of sour pomegranate peel; one piece of Fulonggan (stove-hearth earth, a Chinese medicinal substance), about the size of an egg; and Diyu, five liang.

Add seven sheng of water to these six ingredients and boil until reduced to two and a half sheng. Strain out the dregs, add powdered Fulonggan, and take in three doses.

A formula for rumbling and pulling sensations in the intestines, with dysentery

Moxa the Chengman point fifty times. This point is beside the Juque point, with five cun between them. Juque is one cun below the pit of the stomach. For moxibustion, use points two and a half cun to either side of Juque.

A formula for frequent rumbling in the intestines, with Qi surging upward to the chest and heart

Moxa the center of the navel.

Difficulty swallowing food, rumbling in the abdomen, abnormal bowel movements, and reddish-yellow urine may be treated by using the Yanggang point.

Abdominal distension and rumbling intestines, Qi surging up into the chest, inability to stand for long, abdominal pain with watery sounds, and diarrhea after exposure to cold in winter, accompanied by pain around the navel; wandering Qi between the intestines and Stomach, severe pain, indigestion and loss of appetite, swelling of the body, and tightness beside the navel may be treated by using the Tianshu point.

For rumbling intestines accompanied by pain, use the Wenliu point.

Chapter Three: On the Anus

The treatise says: The anus is responsible for bowel movements and is the area that reflects the Lung and Large Intestine. Ancient books call it the “Administrative Clerk of Passage.” They record its weight as twelve liang, its length as one chi and two cun, and its width as two cun and three fen, and consider it to correspond to the twelve double-hours. When the organs and bowels are affected by Heat, the anus may become obstructed, preventing the passage of stool; it may also swell, contract and retract inward, or develop sores. When the organs and bowels are affected by Cold, the anus may loosen, causing urgent diarrhea, or protrude and only retract after a while. Heat patterns are treated by promoting discharge; Cold patterns are treated with tonification.

The methods for regulating the deficiency and excess of the five Zang organs and six Fu organs follow the classical texts. The prescriptions are given in another volume.

Deficiency and Excess of the Skin (Part Four: Discussion and Prescriptions)

Discussion: Within the body, the five Zang organs and six Fu organs correspond to the bones and marrow; at the body’s surface, they are connected with the skin, hair, and muscles. When illness enters from outside, the skin and muscles may become blocked and constricted. When illness arises internally, the bones and marrow may ache. The relationships among Yin and Yang, the exterior and interior, the skin outside, and the marrow within are complex, so the root of the illness must be carefully discerned.

Weakness of the skin tends to manifest as cold, while excess in the skin tends to manifest as heat. The signs of skin deficiency and excess are chiefly associated with the Lung and Large Intestine, and symptoms appear in the skin and hair. When there is fever, the illness corresponds to a Zang organ; when there is cold, it corresponds to a Fu organ.

Shao-di-huo Steaming Decoction: For cold obstruction due to skin deficiency, chiefly involving the Large Intestine.

Three sheng of roots and leaves of shao-di-huo, a medicinal plant of the lu-ying group; two sheng of calamus leaves; three sheng of peach leaves, bark, and branches; one dou of fine bran; and five sheng of glutinous millet.

Add one shi and five dou of water to these five ingredients and boil until the millet is cooked. Pour the decoction into a large basin and place a small bamboo bed over it for the patient to sit on. Enclose the area with mats or similar coverings to keep out drafts, then cover the patient with clothes and bedding. If breathing feels restricted, make a small opening in the covering to let the steam escape. Continue until the whole body sweats, which takes about the time needed to eat two meals. Repeat this steaming for three days, reheating the decoction each time and keeping enough liquid in the basin. If the decoction is not hot enough, place charcoal beneath the basin. This method is used not only for cold conditions, but also for various forms of skin strain and discomfort from cold.

Gardenia Decoction: For heat conditions due to excess in the skin, chiefly involving the Lung.

Two liang each of gardenia seed, immature bitter orange, daqing, apricot kernel, bupleurum, and mirabilite; one sheng each of fresh rehmannia root and light bamboo leaves; five liang of fresh scrophularia root; and eight liang of gypsum.

Add nine sheng of water to these ten ingredients and boil down to three sheng. Strain out the herbs, add the mirabilite, and divide into three doses.

Cough (Part Five: Discussion, Symptoms, Prescriptions, and Moxibustion)

Discussion: The classical texts say that cough may arise from any of the five Zang organs or six Fu organs. The Lung lies high within the body, near the surface, and corresponds to the skin and hair. Because the skin and hair are easily affected by external pathogenic influences, the Lung is especially prone to cough. When pathogenic Qi enters the Lung, symptoms may include alternating cold and heat, Qi surging upward, panting, sweating, the shoulders and back moving with each cough, and sounds in the throat.

In severe cases, blood may be coughed up. If a lung cough—a cough associated with the lungs—does not heal after a long time, it may affect the large intestine, causing loss of bowel control during coughing. A kidney cough draws pain into the lower back; in severe cases, saliva is coughed up. If it persists, it may affect the bladder, causing loss of urinary control during coughing.

A liver cough causes pain in the left flank and, in severe cases, makes it impossible to turn the body. If it persists, it may affect the gallbladder, causing thin, bitter-tasting bile to be brought up during coughing. A heart cough draws pain into the heart area and makes the throat feel as though something is lodged in it. In severe cases, the throat becomes obstructed, swollen, and painful. If it persists, it may affect the small intestine, causing gas to pass during coughing. A spleen cough causes a dull ache in the right flank that extends into the shoulder and back. In severe cases, movement becomes impossible, and any movement worsens the cough. If it persists, it may affect the stomach, causing vomiting during coughing; when the vomiting is severe, roundworms may even be brought up. A cough that continues for a long time may also affect the Triple Burner—the upper, middle, and lower burners in traditional Chinese medicine—causing coughing, abdominal distension, and inability to eat.

These pathogenic influences all gather in the stomach and affect the lungs, making the person produce abundant nasal discharge and saliva, develop facial swelling, and experience Qi rising in the wrong direction. If the person encounters wind and cold out of season, or exposes the skin and body hair by loosening their clothing, the pathogenic influence may enter from the body’s surface and penetrate the internal organs, causing coughing and shortness of breath. If severe, unseasonable cold strikes suddenly, injuring the skin and combining with the lungs, it may cause coughing and shortness of breath, sometimes with pain pulling across the chest and flanks, and phlegm streaked with blood. This happens when heat encounters a sudden invasion of cold and cannot disperse gradually; instead, it sinks deep and congeals, making lung abscess likely. This is the condition indicated when warm medicines taken for a cough make it worse, followed by high fever, coughing up pus and blood, sweating, and aversion to cold. When unseasonable cold occurs, consult the prescriptions for the corresponding season without delay.

Question: Coughs are divided into ten types. Which are they? Answer: Wind cough, cold cough, branch cough, liver cough, heart cough, spleen cough, lung cough, kidney cough, gallbladder cough, and Jueyin cough. Question: How do the symptoms of these ten types differ? Answer: When coughing interrupts someone who is trying to speak so they cannot finish what they are saying, it is called wind cough. A cough brought on by cold drinks or cold foods is called cold cough. Hardness and distension below the heart, pain pulled by coughing, and an unusually slow pulse are called branch cough. A cough that draws pain beneath the ribs is called liver cough. Coughing up blood with involvement of the Hand Shaoyin channel is called heart cough. A cough accompanied by continuous saliva and pain drawn into the lower abdomen is called spleen cough. A cough that draws pain into the neck…

Coughing up saliva and foam is called “lung cough.” When the sound of a cough is unclear and it pulls at the lower back, extending to the center of the navel, it is called “kidney cough.” When coughing pulls at the head and causes pain and a bitter taste in the mouth, it is called “gallbladder cough.” When coughing pulls at the root of the tongue, it is called “Jueyin cough.” Wind cough should not be treated with purgation. Cold cough and “branch cough” (a cough that also affects areas such as the chest and flanks) are distinct types as well.

For treatment, needle Taichong on the foot for liver cough; Shenmen on the hand for heart cough; Taibai on the foot for spleen cough; Taiyuan on the hand for lung cough; Taixi on the foot for kidney cough; Yanglingquan on the foot for gallbladder cough; and Daling on the hand for Jueyin cough. These are all names of acupuncture points.

A cough that persists for a long time can become “water cough,” a cough associated with the accumulation of fluids in the body. If coughing is often accompanied by fever, and the pulse can be felt with light pressure—at the depth described as the weight of nine beans—this is not a deficiency condition but an excess of cold pathogenic influence in the chest, and it should be treated with emesis. “Nine beans” is an ancient way of describing the depth of the pulse; another version reads “suddenly taut.”

If a coughing patient has a taut pulse and emetic medicine is being considered, first assess the patient’s constitution and strength. Emesis is appropriate only when there is no fever. A taut pulse in a coughing patient indicates retained fluids, which can be purged with Ten Jujube Decoction (see below). Inability to lie flat is due to the Yin aspect being unable to bear the pathogenic influence. With cough caused by retained fluids, the patient may cough so badly that they cannot lie flat; the pain can extend to the neck, and the body may jerk during coughing as a child does in a convulsion. Coughing in someone who drinks heavily often leads to vomiting blood, as a result of prolonged excessive drinking.

Patients with a deep pulse must not be made to sweat. A cough that has lasted for years with a weak pulse can be treated; a full, large, rapid pulse indicates a poor prognosis. People with a deficient pulse are often prone to mental clouding and dizziness, because fluids are already lodged in the chest as “branch fluid.” Treat this as a fluid-retention disorder. Rebellious Qi with labored breathing, sweating, and coughing also belongs to this category. If a patient with fluid retention coughs and has free urination or urinary incontinence, do not induce sweating. After sweating, coldness of the hands and feet and rebellious Qi may occur.

A person who vomits blood, coughs with wheezing, and has Qi surging upward, a rapid, hot pulse, and an inability to lie flat is in danger of death. Someone constitutionally weak and cold who coughs with Qi surging upward and has a rapid pulse is also in danger of death, since this indicates that the body has already deteriorated. A large, scattered pulse indicates abundant Qi but deficient blood; this is called “exterior without interior.” When Qi surges upward, the face and feet swell, and the person breathes with an open mouth and raised shoulders while the pulse is floating and large, the condition is difficult to treat; diarrhea makes it more severe. Qi surging upward with agitation and labored breathing is “lung distention,” a condition involving obstruction of lung Qi, fullness in the chest, and urgent, wheezing breath. It signals that wind-water disease—a condition combining wind pathogen with edema—is about to develop; inducing sweating can bring improvement.

Minor Blue Dragon Decoction (Xiao Qinglong Tang): Used to treat coughing with rebellious Qi, persistent wheezing even while sitting propped up, and inability to lie flat. The ingredients are three liang each of Ephedra, Peony, Asarum, cinnamon bark, dried ginger, and licorice; and half a sheng each of Schisandra fruit and Pinellia.

Coarsely cut the eight ingredients above. Add one dou of water and first decoct the mahuang. Continue until the water has reduced by two sheng. Skim off the froth, add the remaining herbs, and decoct until three sheng remain. Strain out the dregs and divide the decoction into three doses. A person who is weak should take half a sheng at a time. If thirsty, omit banxia and add three liang of guālóu root. If there is mild diarrhea, omit mahuang and add yaohua, in an amount about the size of an egg. If swallowing food or drink feels obstructed, omit mahuang and add one fuzi. If urination is difficult and the lower abdomen feels distended, omit mahuang and add four liang of fuling. If there is wheezing, omit mahuang and add half a sheng of xingren.

After taking Qinglong Decoction, if the patient develops increased salivation and a dry mouth, a deep cun pulse and a faint chi pulse, cold and counterflow in the hands and feet, Qi surging upward from the lower abdomen into the chest and throat, numbness in the hands and feet, and intermittent facial flushing like drunkenness, followed by heat rushing down the inner thighs, difficulty urinating, and frequent spells of mental clouding, treat the upward surge of Qi with Fuling, Guixin, Gancao, and Wuweizi Decoction.

Four liang of fuling; two liang each of guixin and gancao; and half a sheng of wuweizi.

Coarsely cut the four ingredients above. Add eight sheng of water and decoct until three sheng remain. Strain out the dregs and divide the decoction into three warm doses.

If the upward surge of Qi eases but coughing and chest tightness then return, use Fuling, Gancao, and Wuweizi Decoction: omit guixin and add ganjiang and xixin to treat the cough and chest tightness.

Four liang of fuling; three liang each of gancao, ganjiang, and xixin; and half a sheng of wuweizi.

Coarsely cut the five ingredients above. Add eight sheng of water and decoct until three sheng remain. Strain out the dregs and take half a sheng warm, three times daily.

After the cough and chest tightness stop, if thirst returns and the upward surge of Qi recurs, the original text explains that this is because xixin and ganjiang are warming herbs. After taking the decoction, thirst should increase; if the thirst instead stops, this indicates “branch rheum”—a disorder in which retained fluids impede the movement of Qi. According to the original text, an episode of branch rheum should involve mental clouding. If vomiting occurs, add banxia to dispel the retained fluids.

Half a sheng each of banxia and wuweizi; four liang of fuling; and two liang each of xixin, ganjiang, and gancao.

Coarsely cut the six ingredients above. Add eight sheng of water and decoct until three sheng remain. Strain out the dregs and take half a sheng warm, three times daily.

After the retained fluids have cleared and the vomiting has stopped, if the patient is swollen all over, mahuang should in principle be added. But because the patient has already developed numbness, omit mahuang and add xingren.

Half a sheng each of apricot kernels, Schisandra fruit, and Pinellia; four liang of Poria; and three liang each of Asarum, dried ginger, and licorice.

Coarsely crush these seven ingredients. Boil them in one dou of water until three sheng remain, then strain out the dregs. Take half a sheng warm, three times a day. If ephedra is mistakenly added, the patient will certainly develop cold hands and feet. This is because the patient is already deficient in Blood, and ephedra disperses Yang Qi. If the face feels hot and turns red as if from drunkenness, this is due to Stomach Heat rising and steaming the face. Add rhubarb to promote downward passage and purge the Heat.

Formula with Added Rhubarb

Three liang each of rhubarb, dried ginger, Asarum, and licorice; four liang of Poria; and half a sheng each of Schisandra fruit, Pinellia, and apricot kernels.

Coarsely crush these eight ingredients. Boil them in one dou of water until three sheng remain, strain out the dregs, and take half a sheng warm, three times a day.

For cough with Qi surging upward, distention in the lungs, a floating pulse, fluid under the pit of the heart, and pain below the ribs that extends to the supraclavicular fossa—the hollow above the collarbone—if the condition is excess, the patient will certainly feel agitated and often need to lean forward or lie prone for relief. Treat this with Minor Blue-Green Dragon Decoction with Gypsum.

Two liang each of gypsum, dried ginger, cinnamon bark, and Asarum; three liang each of peony root and licorice; four liang of ephedra; half a sheng of Pinellia; and one sheng of Schisandra fruit.

Coarsely crush these nine ingredients. First boil the ephedra in one dou of water until two sheng have boiled away. Then add the remaining ingredients and boil until about two and a half sheng remain. Give one sheng to a person of robust constitution; reduce the dose as appropriate for someone frail. For children, give four ge. Zhang Zhongjing used this formula for lung distention, cough with rebellious Qi, agitation and panting, a floating pulse, and fluid under the pit of the heart. The same formula is recorded in the Essential Methods from the Imperial Library.

Lacquer Tree Decoction

Lacquer Tree Decoction treats Qi surging upward with a deep pulse.

Three jin of lacquer tree herb, finely sliced and boiled in five dou of flowing river water from the east until one dou and five sheng remain. Strain out the dregs and let the liquid settle until clear. Add half a sheng of Pinellia; five liang each of fresh ginger, aster root (another version gives “purple ginseng”), and white-front root; and three liang each of Scutellaria root, licorice, cinnamon bark, and ginseng.

Add the remaining ingredients to the lacquer tree decoction and boil until five sheng remain. Take five ge per dose, three times during the day and once at night.

Ophiopogon Decoction

Ophiopogon Decoction directs Qi downward and stops counterflow. It treats severe rebellious Qi, Qi surging upward, and obstruction of the throat.

(The name of the formula and its indications at the beginning are not included in this passage.) Three sheng of Ophiopogon juice, one sheng of pinellia, and three he of non-glutinous rice; two liang each of ginseng and licorice, and twenty jujubes.

Add one dou and two sheng of water to the six ingredients and decoct until six sheng of liquid remain. Strain out the dregs. Take half a sheng per dose, three times during the day and once at night.

Belamcanda and Ephedra Decoction: Used to treat coughing, Qi surging upward, and a sound in the throat like the call of a water frog.

Three liang each of belamcanda, asarum, coltsfoot flower, and aster; four liang each of ephedra and fresh ginger; seven jujubes; and half a sheng each of pinellia and schisandra.

Cut the nine ingredients into pieces. Decoct them in one dou and two sheng of east-flowing water. First boil the ephedra and skim off the foam, then add the other ingredients. Boil until three sheng remain, strain out the dregs, and divide into three doses, taken three times daily.

Magnolia Bark and Ephedra Decoction: Used for severe coughing, Qi surging upward, fullness in the chest, obstruction in the throat, and a sound like the call of a water frog; it is used when the patient’s pulse is floating.

Five liang of magnolia bark, four liang of ephedra, one piece of gypsum about the size of an egg, two liang each of asarum and dried ginger, one sheng of wheat, and half a sheng each of apricot kernels, pinellia, and schisandra.

Cut the nine ingredients into pieces. Add one dou and two sheng of water and boil the wheat first. When it is cooked, remove it, then add the remaining ingredients. Boil until three sheng remain, strain out the dregs, and divide into three doses, taken three times daily.

Ephedra and Gypsum Decoction: Used to treat Qi surging upward and fullness in the chest.

Four liang of ephedra, one piece of gypsum about the size of an egg, five liang of magnolia bark, one sheng of wheat, and half a sheng of apricot kernels.

Add one dou of water to the five ingredients and boil the wheat first. When it is cooked, remove it, then add the remaining ingredients. Boil until three sheng remain, strain out the dregs, and divide into three doses.

The Shenshi Formula uses this prescription to treat chronic upward surging of Qi accompanied by a sound in the throat like the call of a water frog, and calls it “Small Pouring Cup Decoction.” If there is coughing, add half a sheng each of schisandra and pinellia, and three lei of dried ginger.

Honey Locust Pod Pill: Used to treat coughing with upward surging of Qi and frequent expectoration of turbid phlegm, to the point that the patient can only sit and cannot lie down.

Grind eight liang of honey locust pods into a fine powder and use honey to form pills the size of Chinese parasol tree seeds. Take them with a decoction made with jujube paste, three pills per dose, three times during the day and once at night. The Bixiao Formula says the honey locust pods should first be roasted with butter.

For someone with zhi yin (a condition in which phlegm-fluid collects in places such as the chest and flanks), if coughing, distress in the chest, and chest pain occur, the illness has lasted a long time, but is not suddenly life-threatening, use Shizao Decoction. This formula may be used even when the illness has lasted a hundred days or a year.

Shizao Decoction: ten jujubes; equal parts Euphorbia kansui, kansui root, and Genkwa flower. Pound the three herbs into powder. Boil the jujubes in one sheng and five he of water until one sheng remains. Strain out the jujubes, then add the powdered herbs. A person of robust constitution should take one qianbi (a small ancient measure for powdered medicine); a person of weak constitution should take half a qianbi. Take the dose all at once. If it does not induce a bowel movement during the day, increase the dose by half a qianbi the following morning. After the bowels have moved, let the body recover naturally.

For coughing that pulls and causes pain beneath the flanks, use Shizao Decoction as well (see the formula above).

Wenpi Decoction: used for coughing after overeating.

Four liang of licorice and twenty jujubes. Coarsely chop the two ingredients and boil them in five sheng of water until one sheng remains. Divide into three doses and drink warm. If the throat is sore or there is a rattling sound in the throat, add one liang of dried ginger.

Baibugen Decoction: used for coughing so severe that the person cannot lie down, with the eyes bulging.

One jin each of baibu root and fresh ginger; three liang each of asarum and licorice; two liang each of fritillaria, schisandra, and atractylodes; four liang of cinnamon bark; and six liang of ephedra. Coarsely chop the nine ingredients and boil them in one dou and two sheng of water until three sheng remain. Strain out the herbs and divide into three doses. The formula recorded in Gujin Yanshi additionally includes four liang of apricot kernels and three liang of aster root.

Haizao Decoction: used for coughing with diarrhea, chest congestion, shortness of breath, frequent palpitations, reluctance to move the limbs, restless heat in the hands and feet, loss of appetite, shoulder and back pain, and occasional chills.

Four liang of seaweed; half a sheng each of schisandra and pinellia; one liang of fresh ginger; two liang of asarum; six liang of poria; and fifty apricot kernels. Coarsely chop the seven ingredients and boil them in one dou of water until three sheng remain. Strain out the herbs and divide into three doses, taken three times a day. Another version of the formula omits schisandra and fresh ginger.

Baixian Decoction: used for coughing, upward surging of Qi, swelling of the body, shortness of breath, and abdominal distension. Day and night, the person can only sit propped against a wall and cannot lie down; a sound like a frog croaking comes from the throat. The source text breaks off immediately after listing the herb names, so the quantities and instructions for preparation and use are not given here.

Daji (a toxic medicinal herb; the dosage here is given as “two liang each,” but the preceding herb names and dosages have not been fully preserved).

Coarsely chop the four ingredients above and soak them overnight in one dou of water. Boil them the next morning and collect three sheng of decoction. Take it in three doses.

Formula for Treating Nine Kinds of Qi Cough, Near-Fatal Cough, and a Hundred Diseases

Dried ginger, pinellia, asarum, aster, evodia, raohua (another version reads “yuanhua”), poria, licorice, kansui, fangku, ginseng, aconite, rhubarb, and apricot kernels (one fen each); tinglizi (two fen); croton seeds, magnolia bark, and baiwei (three fen each); schisandra, polygala, the root of peucedanum, calamus, immature bitter orange, Sichuan pepper, gleditsia pod, Chinese angelica, daji, and cinnamon bark (half a fen each).

Grind the twenty-eight ingredients above into powder and use honey to form pills the size of Chinese parasol tree seeds. Take two pills three times a day before meals. Adjust the dosage according to the body’s response after taking them; if they have no effect, increase the dose.

Ephedra Powder for Treating Upward Surging Qi and Cough

Ephedra (half a jin), one hundred apricot kernels, licorice (three liang), and cinnamon bark (one liang).

Sift the four ingredients into a fine powder. Grind the apricot kernels separately into a paste, then mix it with the powder. When Qi surges upward, take one fangcun spoonful (about one level spoonful using an ancient small measure). If the Qi has still not descended after a while, take another spoonful, up to a maximum of three. Take it as soon as an attack begins, and the attack will stop. Another formula omits the cinnamon bark and licorice.

Imperial-Use Sichuan Pepper Pills, Composed by Physician-in-Chief Wang Shuhe, Highly Effective for Treating Upward Surging Qi and Cough

Sichuan pepper (five fen); aconite, apricot kernels, calamus, and arsenic stone (another version reads “alum stone”) (one fen each); asarum, coltsfoot flower, and aster (three fen each); dried ginger, evodia, and ephedra (four fen each).

Grind the twelve ingredients above into powder and use honey to form pills the size of Chinese parasol tree seeds. Swallow two pills at bedtime. This is used to treat a chronic cough lasting twenty years; take no more than twenty pills.

Qi-Opening Pills

Used to treat chronic upward surging Qi and cough, as well as a fishy, foul smell in the throat; deficient Qi disturbing the heart and chest and causing pain; eye pain; noisy, ringing sounds in the ears; pathogenic wind and toxic influx; seasonal Qi (epidemic diseases that spread at particular times of year); and conditions in which eating does not build flesh, the chest feels obstructed, there is vomiting, abundant phlegm and saliva, nausea, hard swelling and fullness below the heart, and excessive drinking with difficulty eating…

【Formula for Reducing the Harm of Painful Urination and Dripping】

Take three sheng of maltose, two sheng of Sichuan pepper, one sheng of apricot kernels, five segments of centipede, five aconite tubers, four parts each of dried ginger and ginseng, six parts of cinnamon bark, seven parts of kusnezoff monkshood, and ten parts of asparagus root. Grind each ingredient separately. Pound the apricot kernels into a paste, then gradually mix in the powdered herbs. Pound the mixture a thousand times. Melt the maltose, add it to the mixture, and stir until evenly combined. Each time, hold a pill about the size of half a date in the mouth. Take it six or seven times during the day and three or four times at night, stopping when the chest feels warm.

If you dream of associating or eating and drinking with ghosts, use an entire centipede. If food is not digesting, add five he of apricot kernels. If the lower abdomen feels cramped and the lower back aches, add asparagus root and eucommia bark. For wind disorders, add three kusnezoff monkshood tubers and one aconite tuber, but do not add them after the beginning of summer. If fluids are retained in the body, add one liang of pepperweed seeds.

【Formula for Treating Cough and Upward Surging of Qi】

Take four parts each of Sichuan pepper, cinnamon bark, and sea clam shell; six parts each of kelp, seaweed, dried ginger, and asarum; and ten parts of lilyturf root. Grind to a fine powder and make pills with honey, each the size of a parasol tree seed. Take ten pills at a time, gradually increasing to twenty, three times a day.

This formula is said to cure people whose wind deficiency and internal cold cause fullness and distension in the chest, Qi surging upward, a whistling sound in the throat like air passing through a tube, rapid breathing, and upward surging of Qi that brings on coughing.

【Formula for Treating Cough, Distension in the Chest and Flanks, Excess Phlegm, and Upward Surging of Qi】

Take one part each of arsenic stone (some editions read “alum stone”) and sweet flag; one part of kusnezoff monkshood (one edition omits it); two parts each of asarum and yellow-ringed root; three parts each of coltsfoot flower, aster root, and apricot kernels; four parts of evodia fruit; five parts of dried ginger; and five he of Sichuan pepper. Grind to a fine powder and make pills with honey, each the size of a parasol tree seed. Take one pill at a time, hold it against the teeth, and swallow the medicinal liquid. Take it five or six times a day; for severe illness, keep holding the pill in the mouth.

Another formula: one and a half sheng of fresh ginger juice and five he of sugar. Simmer the ginger juice until reduced by half, add the sugar, simmer again, and take.

Note: The original text provides no formula after the words “Another formula.”

Gently heat five fen of white sugar until it melts. Add powdered Chinese honeylocust fruit (Gleditsia sinensis) — one square-inch spoonful, an ancient small measure for powdered medicine — and mix well. Roll into pills the size of small beans. Take two pills before meals.

Another formula: Soak two large Chinese honeylocust pods in one and a half sheng of wine overnight. Then boil until half a sheng remains, and divide into three doses. Take for seven days, observing the dietary restrictions prescribed for the medicine. If vomiting is excessive, eating three or four mouthfuls of rice mixed with vinegar should stop it.

Another formula: Prepare the croton seeds and remove their skins, taking care not to break the kernels inside. Swallow with rice water: take two seeds on the first day and three on the second.

Another formula: Take seven mustard-seed pills with wine mixed with oil.

Iris Decoction: A formula for coughing and upward-rushing wheezing

Two liang each of blackberry lily rhizome and coltsfoot flower; two fen each of purple aster root, asarum, mulberry root bark, prepared aconite, and licorice; one sheng each of white honey, bamboo sap, and ginger juice (another version uses five liang of dried ginger); and five liang of maltose syrup.

There are eleven ingredients in all. First place the blackberry lily rhizome in the white honey and bamboo sap, and boil for five or six bursts; then remove it. Cut the other six medicinal ingredients into pieces, soak them overnight in one sheng of water, then boil seven times, pausing briefly after each boil. Strain out the dregs. Add the maltose syrup and ginger juice, and cook until the mixture is porridge-like. Take an amount about the size of a jujube each time, three times daily. In severe cases, take two additional doses at night. If the effect seems insufficient, gradually increase the amount until it takes effect.

Apricot Kernel Decoction: A formula for cold-type coughing, upward-rushing wheezing, and nasal obstruction

Five ge of apricot kernels; three ge each of Schisandra fruit and coltsfoot flower; two liang each of purple aster root and dried ginger; three liang of cinnamon bark; four liang of licorice; and one jin of ephedra.

There are eight ingredients in all. First boil the ephedra in one dou of water and reduce the liquid to four sheng. Grind the other ingredients into powder, then add half a jin of maltose syrup and one jin of white honey. Mix with the decoction and cook until the mixture has the consistency of maltose syrup. Take before meals, about half a jujube-sized amount each time, three times daily. If the effect seems insufficient, gradually increase the amount until it takes effect.

Another formula: For sudden coughing, loss of voice, and inability to speak

One sheng each of apricot kernels, ginger juice, granulated sugar, and honey; three liang each of Schisandra fruit and purple aster root; four liang each of tetrapanax pith and fritillaria bulb; and five liang of white mulberry root bark.

The source text ends here and does not record the subsequent preparation or method of use. Note that these are prescriptions recorded in an ancient medical text. They include toxic or hazardous substances such as croton and aconite, and their doses and preparation methods should not be used as a basis for modern treatment.

Decoct the nine ingredients above, coarsely chopped, in nine sheng of water until three sheng remain. Strain out the dregs, then add the almonds, fat, ginger juice, honey, and maltose. Stir well and simmer over low heat until four sheng remain. At first, take three he each time, twice during the day and once at night; gradually increase the dose.

Tongsheng Gao Formula

Five-flavor berry, coltsfoot flower, and tetrapanax pith, three liang each; ginseng, asarum, green bamboo skin, cassia bark, and sweet flag, two liang each; almonds and ginger juice, one sheng each; white honey, two sheng; jujube paste, three sheng; butter, five sheng.

Coarsely chop the thirteen ingredients above and add five sheng of water. Simmer over low heat, bringing it to a boil three times, then strain out the dregs. Add the ginger juice, jujube paste, butter, and honey, and cook until evenly blended. Take with wine, two pills at a time, each about the size of a jujube.

Almond Drink Formula: For Sudden Attacks of Hot Cough

Forty almonds, one sheng of perilla seeds, one liang of tangerine peel, and four liang of bupleurum.

Coarsely chop the four ingredients above and decoct them in one dou of water until three sheng remain. Divide into three portions and take them. It may also be decocted regularly and taken as a drink.

Perilla Seed Decoction: For Coughing Due to Upward Qi

Perilla seeds, ginger juice, rehmannia juice, white honey, and almonds, two sheng each.

Pound the perilla seeds, pour the rehmannia and ginger juices over them, and squeeze out the liquid through silk cloth. Continue pounding the seeds, adding the juices, and squeezing out the liquid until their medicinal properties have been thoroughly extracted. Strain out the dregs. Cook the almonds until yellow-black, then grind them into a paste the consistency of oil. Pour the previously prepared liquid over the paste and squeeze it through silk cloth six or seven times, extracting as much of the medicinal properties as possible; strain out the dregs. Add the honey and mix well. Place the mixture in a copper vessel and cook it in a water bath until thick like maltose. Take one square-inch spoonful each time, three times during the day and once at night. Cui’s version does not use rehmannia juice.

Another Formula

Three liang of dried ginger powder and one jin of maltose.

Mix the two ingredients and steam them over five sheng of cooked rice. Once cooled, hold a piece about the size of a jujube in the mouth each time and swallow it slowly, five times during the day and twice at night.

Daphne Flower Decoction: For New or Long-Standing Cough

Daphne flowers and dried ginger, two liang each; white honey, two sheng.

Grind the first two ingredients into powder, mix them into the honey, and simmer over low heat until the mixture resembles thin porridge. Take an amount about the size of a jujube pit each time, three times during the day and once at night, adjusting according to improvement.

To strengthen the medicine’s effect and help the pathogenic influence pass through, take a larger dose. The Shen Shi Fang uses this method to treat cough caused by cold drinks, as well as chronic cough lasting thirty years: boil in five sheng of water.

Take three sheng of yuanhua. Boil it, then strain out the herbs. Add fresh ginger and honey, and boil them together until the mixture thickens to a paste. Take as directed.

Coltsfoot Flower Decoction

Its effects are the same as those of the preceding prescription.

Coltsfoot flowers, powdered dried ginger, and aster root (three liang each); schisandra berries (two liang); yuanhua (one liang, dry-fried until reddish).

Chop the five ingredients. First boil three of them in one dou of water until the liquid is reduced to three and a half sheng, then strain out the herbs. Add the yuanhua, powdered dried ginger, and three sheng of honey, mix well, and pour into the herbal liquid. Place in a copper vessel and simmer over low heat until as thick as syrup. Take an amount about half the size of a date, three times daily.

Prescription for a Cough Lasting Thirty Years

Whether the cough was caused by drinking cold liquids or by exposure to cold, this prescription can treat it, though the causes differ.

Asarum, coltsfoot flowers, siler root, and aster root (three liang each); veratrum root (two liang); Sichuan pepper (five ge).

Chop the six ingredients. Put the veratrum root in a copper vessel first, then add the aster root, asarum, coltsfoot flowers, and Sichuan pepper in that order. Thread one hundred jujubes among the herbs. Add one dou and two sheng of water and simmer over low heat until the liquid has boiled away. Remove the jujubes and dry them in the sun.

At cockcrow, take half a jujube. If there is no effect, take one jujube the following morning. Continue until warmth is felt in the chest. Those with a strong constitution who wish to bring on coughing and vomiting may increase the dose slightly; they may then bring up clotted masses of phlegm and pus. After vomiting, do not eat cold food or drink cold liquids. Stop taking the medicine once the cough is cured. Wait for its effects to subside before eating, or the vomiting may continue.

Prescription for a Chronic Cough Lasting Thirty Years

Take twenty jin of bai bu root. Pound it and extract the juice, then boil it down to a thick paste like malt syrup. Take one square-inch spoonful three times daily. The Waitai Miyao says to add one jin of malt syrup and boil into a paste, then take it mixed with warm rice porridge. The Shen Shi Fang says to add two sheng of white honey and boil for five or six rolling boils; take three he each time.

Another Prescription

Aster root (two liang) and coltsfoot flowers (three liang).

Grind the two ingredients into a fine powder. Before meals, take one square-inch spoonful with water, three times daily. Recovery may be expected in seven days.

Another Prescription

White honey (one jin) and fresh ginger (two jin, juiced).

First weigh the first two ingredients in a copper pot and record their weight. Add honey, weigh again, and record the new weight. Then add ginger juice and simmer over low heat until the juice has boiled away and only the honey’s original weight remains. Take one pill each morning. Each pill should be about the size of a jujube; hold it in the mouth. Take it three times a day. Avoid eating mixed foods.

Formula for treating a persistent cough

Rabbit droppings (49 pellets), sal ammoniac (two fen), and Huyanglü (one fen).

Grind these three ingredients into a fine powder, mix with honey, and form pills the size of parasol-tree seeds. Take three pills at a time with rice porridge liquid, three times a day. After taking them, phlegm and other fluids should be expelled. Once they have been completely cleared, the illness should be cured.

Formula for treating a cough lasting many years, with a rasping sound in the throat, whose attacks make it impossible to sit or lie down

Aster root, fritillary bulb, pinellia, white mulberry root bark, schisandra, blackberry lily, and stemona root (five fen each); coltsfoot flower, Chinese honey locust, dried ginger, tangerine peel, Ghost Messenger, and asarum (four fen each); white quartz and apricot kernels (eight fen each); centipedes (two).

Grind these sixteen ingredients into a fine powder and use honey to form pills the size of parasol-tree seeds. Take ten pills at a time with a drink, twice a day, gradually increasing to twenty pills.

The formula recorded by Cui does not include pinellia, blackberry lily, dried ginger, tangerine peel, Ghost Messenger, asarum, or white quartz. Instead, it uses two liang of ephedra and one and a half liang of the white bark of yuangen, taken with the liquid used to boil jujubes.

Coltsfoot pills: A formula for treating long-term upward surging of Qi, coughing, coughing up pus and blood, and wheezing so severe that the patient cannot lie down

Coltsfoot flower, dried ginger, Sichuan pepper, Evodia, cassia bark, and calamus (five fen each); ginseng, asarum, rice-flower root, aster root, licorice, platycodon, saposhnikovia, lilac daphne, poria, and Chinese honey locust (three fen each).

Grind these sixteen ingredients into a fine powder and use honey to form pills the size of parasol-tree seeds. Take three pills at a time with wine, three times a day.

Another formula

Coltsfoot flower, aster root, asarum, dendrobium, saposhnikovia, Ligusticum, ginseng, Chinese angelica, lovage root, licorice, Sichuan pepper, atractylodes, pinellia, Tianxiong, calamus, stalactite, cassia bark, and ephedra (three liang each); pubescent angelica (three liang), aconite, and lilac daphne.

The passage ends here. The quantities of the final two ingredients, aconite and lilac daphne, as well as the formula’s preparation and method of use, are not recorded.

Use one liang each of aconite (a medicinal herb in the Aconitum family), peach kernels (the seeds inside the peach pit), and Chinese dates; use twenty peach kernels and twenty dates.

Grind the twenty-four ingredients above together into a fine powder, then mix with honey and form pills the size of parasol tree seeds. Take twenty pills each time with wine, twice a day. If they have no effect, the dose may be increased. The pills may also be soaked in wine before taking.

Another formula

Coltsfoot flowers, dried ginger, and cinnamon bark: three fen each; asarum: two fen; apricot kernels, Chinese honeylocust, arsenolite (some versions read “alum stone”), sweet flag, and aconite: one fen each; Sichuan pepper: five ge; Evodia fruit: six ge.

Grind the twelve ingredients above together into a fine powder, then mix with honey and form pills the size of parasol tree seeds. Take five pills each time with wine, three times during the day and once at night. For a cough of less than twenty years’ duration, recovery should come within fifty days. Those with cough, rattling in the throat, and upward surging of Qi should recover after taking one course.

Formula for damage to the lungs, coughing up pus and blood, sluggish bowels, Qi stagnation in the back, inability to eat, sensitivity to wind, dim vision, and coldness in the lower legs

Colla corii asini and ginger: five liang each; cinnamon bark, ginseng, and aster root: two liang each; twenty Chinese dates; half a sheng of dried rehmannia root, sliced; two sheng of mulberry root bark, sliced; chuanxiong, hemp seed, and maltose: one sheng each; three sheng of barley.

Cut the twelve ingredients above into pieces. First boil the barley in one dou and five sheng of water until one dou remains, then remove the barley. Add the other ingredients and simmer until three sheng remain. Divide into five doses.

Schisandra Decoction: for pus and blood in the saliva, with pain pulling across the chest and flanks

Schisandra, platycodon root, aster root, licorice, and teasel root: two liang each; bamboo shavings: three liang; red azuki beans: one sheng; mulberry root bark and rehmannia root: five liang each.

Cut the nine ingredients above into pieces and simmer in nine sheng of water until two sheng and seven ge remain. Divide into three doses.

Bamboo Skin Decoction: for coughing with rebellious Qi and persistent coughing up of blood

Fresh bamboo skin: three liang; aster root: two liang; maltose: one jin; fresh rehmannia root, sliced: one sheng.

Cut the four ingredients above into pieces and simmer in six sheng of water until three sheng remain. Strain out the dregs and divide into three doses.

“Liang,” “sheng,” and “ge” are ancient units of measure. The term fuju means to cut or roughly pound medicinal ingredients. “The size of a parasol tree seed” describes the size of the pills.

Bai Bu Wan: A Formula for Treating Various Coughs, Difficulty Breathing, and Coughing Up Pus and Blood

Three liang of Bai Bu root, half a liang of Shengma, and one liang each of Guixin, Wuweizi, Gancao, Ziwan, and dried ginger.

Grind the seven ingredients into a fine powder, mix with honey, and form pills the size of wutong tree seeds. Take three pills each time, three times a day, until the condition shows improvement.

A Formula for Treating Upward surging of Qi, Cough, Wheezing, a Sensation of Something Blocking the Throat, and Coughing Up Blood

Two sheng each of fresh ginger juice and apricot kernels, one sheng each of sugar and honey, and two ge of pork fat.

First fry the apricot kernels in the pork fat until they turn yellow. Remove them, wipe them clean with paper, and pound them into a paste. Add the ginger juice, sugar, and honey, and boil together until the mixture can be formed into pills. Take one pill the size of an apricot kernel, six or seven times throughout the day and night, then gradually increase the amount.

A Formula for Treating Various Lung Ailments, Cough, Coughing Up Pus and Blood, and Persistent Coughing Up of Blood

Take thirty jin of high-quality clarified butter and refine it three times. Let it stand until it solidifies, then collect the essence extracted from the butter. Take one he each time, three times a day; stop once the illness has healed. The original text says that no other medicine compares with this remarkably effective formula.

Another Formula

Refine clarified butter three times. Take an amount the size of an egg yolk, bring it to a lukewarm temperature, and pour it into the nose. Use it twice a day, and once more at night.

Zhongru Qixing San: A Formula for Treating Exposure to Cold, Cough, Upward surging of Qi, Chest Tightness, and Coughing Up Pus and Blood (also called “Inhaled Powder”)

Zhongru, alum, Kuandonghua, and Guixin, in equal amounts.

Grind the four ingredients into a fine powder and sift it. Take an amount the size of a soybean and arrange it in the shape of the Big Dipper. Draw in the powder through a small tube, then swallow it with wine. Take it before meals, three times a day. If it has no effect, increase the amount. According to the original text, this method has proved effective many times; another account says to inhale it while standing by a well.

Another Formula

Zhongru, Xixin, Kuandonghua, Tianxiong, Ziwan, and Shigao, in equal amounts.

Grind the six ingredients into a fine powder and sift it. Take an amount the size of a soybean, arrange it in the shape of the Seven Stars as described above, and inhale it. Use it twice a day. Eat only porridge for seven days; stop once the cough has healed. If a soybean-sized amount has no effect, increase it slightly, but do not increase it too much.

Qixing San: A Formula for Treating a Cough Lasting Thirty Years

Kuandonghua, Ziwan, white mulberry root bark, daizhe, Xixin, and fulonggan (the yellow earth from the bottom of a stove), one liang each.

The original text breaks off here; the method of preparation and directions for use are not preserved.

Grind the six ingredients above into a fine powder and form it into small pills about the size of a lentil. Place the mouth of a bamboo tube against each pill, draw the pills into your mouth one at a time, and swallow them so they reach the stomach. Take them before meals, three times a day, three pills each time. After four days, make the medicine into seven small pills. Roast a piece of meat, then roll it back and forth over the pills so the powder coats the meat evenly. Lie on your back, chew the meat thoroughly, and slowly swallow the juices, allowing the medicine to take effect gradually. When you feel the medicine’s effects clearly in your throat, with a burning, prickling sensation, swallow the rest of the meat as well. Stop once the illness is cured. If it is not yet cured, repeat the procedure as before. Mutton, beef, or venison may be used; pork must not be used.

A fumigation method for treating cough

Spread a thin layer of prepared mugwort over a sheet of paper four inches wide, then spread a thin, even layer of sulfur powder over the mugwort. Take a reed stem as long as the paper, roll the paper around it, and make ten rolls. First light the lower end of one roll. When smoke from inside the reed emerges through the opening at the other end, inhale it and swallow it, continuing until vomiting is induced. The next morning, fumigate once or twice more as on the previous day. According to the original text, this is said to bring gradual recovery. During treatment, plain rice porridge may be eaten; avoid all other foods so they do not interfere with the effect. Sulfur, when exposed to fire, burns with a flame.

Another method: Take one liang of sulfur and grind it into a fine powder. Wrap it in waxed paper, mixing the wax and sulfur together, then roll it into a tube. Fumigate as described above, once or twice a day, until vomiting is induced. Continue for seven days, then rest for a while and afterward drink mutton soup to regain strength.

Another method: Take a piece of old blue cloth, four inches wide. Spread prepared mugwort on it, followed in turn by powdered green vitriol, a little sulfur powder, a little salt, and a little powdered fermented soybean. Roll it up tightly. Light it and place it in a dry jar, cover the jar’s mouth with paper, and pierce a small hole in the paper. Inhale the smoke through the hole and swallow it slowly, continuing until vomiting is induced. If your chest feels tight, pause for a while; stop once the fumigation is finished. Use this once or twice a day. If you have used three rolls and are still not cured, continue the treatment for twenty-one days and avoid fatty foods.

Discussion: Among illnesses in which Qi surges upward, some people recover after taking an emetic, while others are cured with acupuncture or moxibustion. The condition should be assessed carefully to determine which method is appropriate.

Moxibustion method: For a cough, apply one hundred moxibustion cones beneath each breast, at the boundary between the darker and lighter skin. This is said to cure the cough. Another method is to use a strip of rush to measure around a nipple, making sure the measurement is aligned evenly across the front and back of the body; apply ten moxibustion cones in the hollow at the center of the spine. In a further method, measure the width of the mouth with a cord, fold the cord in half, and use it to locate a point on the back for moxibustion. The original text ends here.

The fumigation, smoke inhalation, and moxibustion methods described here are recorded in ancient medical texts. Smoke produced by burning sulfur and other substances may be toxic, and inhaling it can harm the body.

Apply eighty moxa cones on each side, dividing the treatment into three sessions and completing it over three days. “Both sides” refers to the points corresponding to the mouth.

Starting from Dazhui (the point below the seventh cervical vertebra at the back of the neck), count downward. There is a point on the midline between the point below the fifth vertebra and the point above the sixth. Increase the number of moxa cones according to the person’s age. It treats upward surging Qi (Qi counterflowing upward).

Bend the arm and press at the bony tip on the outer side of the elbow crease. Find the tender spot and apply fourteen moxa cones for good results.

For upward surging Qi, cough, shortness of breath, chest oppression, or difficulty swallowing food, apply fifty moxa cones to the Lung Mu point.

For upward surging Qi, cough with counterflowing Qi, shortness of breath, wind-related consumptive disorders, and various other conditions, apply two hundred moxa cones to Jianjing.

For upward surging Qi, cough with counterflowing Qi, shortness of breath, and pain in the chest and back, apply one hundred moxa cones to Fengmen, also called Refu.

For upward surging Qi, cough with counterflowing Qi, shortness of breath, chest oppression, and pain radiating to the back, apply fifty moxa cones each to Juque and Qimen.

For upward surging Qi, cough with counterflowing Qi, shortness of breath, chest oppression, and abundant phlegm that is cold and sticky, apply fifty moxa cones to Feishu.

For upward surging Qi, chest oppression, shortness of breath, or cough with counterflowing Qi, apply fifty moxa cones to Yunmen.

For upward surging Qi, cough with counterflowing Qi, painful obstruction in the chest, or back pain, apply one hundred moxa cones to Xiongtang. The source text includes the character “not” here, making the meaning incomplete.

For upward surging Qi or cough with counterflowing Qi, apply fifty moxa cones to Danzhong.

For upward surging Qi, blocked Qi, cough with counterflowing Qi, a cold sensation in the throat, or hoarseness, apply fifty moxa cones to Tianqu. Tianqu is also called Tiantu.

Counterflowing Qi, consumptive weakness, injury from exposure to cold, sorrow and anger, painful contraction of the sinews and bones, cough with counterflowing Qi in the chest, diarrhea, “transmitted corpse” consumption (an infectious consumptive illness as understood in ancient times), abdominal distension, throat obstruction, stiffness of the neck, intestinal hemorrhoids, counterflowing Qi, bleeding hemorrhoids, contraction in the genital area, nosebleed, bone pain, difficulty passing urine or stool, dryness of the nasal passages, vexation, frantic running, and a tendency to pant: all twenty-two conditions may be treated by applying fifty moxa cones to Juegu. This point lies in the hollow three cun above the outer ankle.

—Sun Simiao, Essential Prescriptions for Emergencies Worth a Thousand in Gold, juan 57