《孫真人備急千金要方》Vol. 62

Essential Formulas for Emergencies Worth a Thousand Pieces of Gold by Master Sun, Scroll 62: Cholera, Chapter Six

Collated by Lin Yi and others, who held the titles of Court Gentleman of the Song, Acting Junior Director of the Court of Imperial Sacrifices, and Editorial Reviewer of the Hall of Scholarly Worthies.

This chapter discusses cholera, a term used in ancient times for illnesses involving sudden vomiting and diarrhea. It contains two discussions, four patterns of symptoms, twenty-eight prescriptions, and eighteen moxibustion methods.

The discussion states: On examining the causes of cholera, they are all due to improper eating and drinking; ghosts and spirits have nothing to do with it.

Some people eat their fill of meat and minced fish, then eat milk and cheese, sampling every delicacy from land and sea. They sleep on a cold mat and drink a great deal of cold liquid. The food in their stomach stagnates and fails to digest, while the Yin and Yang energies in the body become obstructed and disordered. Yang wants to rise, and Yin wants to descend; separated from one another and out of harmony, they bring on vomiting and diarrhea, splitting headaches, joints throughout the body that feel as if they are coming apart, and spasms in all the sinews and vessels. Judging by its symptoms, cholera may not seem to be a serious illness, yet among sudden-onset diseases it is one of the most frightening. Even standing at the edge of a deep abyss or walking through a dangerous place cannot compare with its peril. Those who understand how to preserve life should grasp this principle; perhaps then they can avoid an untimely death.

When cholera strikes, take care to keep warm and recuperate. If you become chilled, spasms may develop throughout the body. Once the illness has settled, it is best to eat nothing for a day; for the next three days, eat small amounts of porridge. After three days, you may eat and rest as needed, but for seven days it is best not to mix many different foods. This is to nourish the Spleen Qi—the transforming and transporting energy of the Spleen and Stomach.

In general, cholera often results from eating raw fish or meat, milk or cheese, or from eating too much, consuming too many different foods, and failing to exercise restraint. It may also be caused by sleeping without enough covering at night or by poor recuperation. Many people have died from it. Human life has its foundation in the Five Zang Organs. These organs correspond to the Five Phases; the Five Phases are within the body, while the five flavors correspond to what is outside it. Both the Five Phases and the five flavors need to be properly balanced and restrained. Therefore, food and drink in spring, summer, autumn, and winter should follow the seasons and never be excessive.

Foods that counteract the Five Zang Organs may cause illness; those that nourish them are generally harmless. An ancient text says: “In spring, do not eat pungent foods; in summer, do not eat salty foods; in late summer, do not eat sour foods; in autumn, do not eat bitter foods; in winter, do not eat sweet foods.” This does not mean they must be avoided altogether, only that one should not eat too much of them. The saying “A hundred illnesses arise from the mouth” is certainly no empty claim. Eating at dusk in any of the four seasons, and eating until overfull, can both cause illness. From the summer solstice to the autumn equinox, avoid rich, greasy foods. Yet in the hot months, people often crave cold foods. If they also eat large amounts of rich foods, fruits, and vegetables without restraint, then seek the cool, sleep in cold places, or bathe in cold water, the different flavors will counteract and harm one another. Even if one wishes to…

No one can live an entire life without illness. Illness and suffering are often brought about by people themselves, rather than caused by fate. An ancient book says, “People do not have their lifespans taken away by Heaven; they cut their own lives short.” This is the point it makes.

For cholera—a term used in ancient times for illnesses involving sudden vomiting and diarrhea—rice broth should always be avoided: once rice enters the stomach, the person may vomit without stopping. Give only a thick magnolia bark and kudzu drink, or a winter melon leaf drink. Use just a small amount to moisten the throat; do not let the person drink much. If a medicinal decoction is vomited up as soon as it is taken, wait until the vomiting stops before giving it again.

If the pulse is barely perceptible, decoct and drink cinnamon twig and kudzu. If there is vomiting and diarrhea, restlessness, heat in the muscles, no sweating, and no cramping, with a rapid, racing pulse, decoct and drink rhinoceros horn and kudzu. If vomiting and diarrhea continue without stopping, accompanied by fever, restlessness, and thirst, the person may drink a small amount of liquid made from rice flour. If the symptoms still do not stop, give a decoction of kudzu and jini, a medicinal herb similar to sweet balloon flower root.

Someone asked, “What are the symptoms of cholera?” The reply was, “Vomiting and diarrhea together are cholera.”

Someone else asked, “If a patient has fever, headache, pain throughout the body, and chills, while also vomiting and having diarrhea, what illness is this?” The reply was, “It should be cholera. After the vomiting and diarrhea stop, a cholera patient may develop a fever. In cold damage, the pulse is faint and sluggish. If an illness that began as cholera later turns into cold damage, after four or five days it may progress into the Yin channels and cause diarrhea. If the patient already has diarrhea, the illness is difficult to treat.”

Severe vomiting during cholera may lead to cramping. If the person is not thirsty, there will be a throbbing sensation above the navel. A throbbing sensation above the navel during cholera indicates that Kidney Qi is stirring. Treat this throbbing first with Zhizhong Decoction. Remove white atractylodes from the formula because it can weaken Qi; add cinnamon bark because the illness may progress into running-piglet syndrome, in which Qi surges upward from the abdomen.

Use Zhizhong Decoction for cholera accompanied by throbbing above the navel, severe vomiting, severe diarrhea, palpitations, thirst, abdominal pain, or simultaneous vomiting and diarrhea with a desire to drink.

Zhizhong Decoction treats vomiting, diarrhea, abdominal distension and fullness, indigestion, and pain in the chest and abdomen caused by cholera.

The formula consists of ginseng, dried ginger, white atractylodes, and licorice, three liang of each.

Cut the four ingredients into pieces, add eight sheng of water, and decoct until three sheng of liquid remain. Divide into three doses. If the illness has not resolved after taking them, continue with three more doses. To prevent cholera when traveling far, prepare the formula as pills the size of Chinese parasol tree seeds, following the method above, and take thirty pills at a time. It can also be made into a powder: take one square-inch spoonful, an ancient measure for medicines roughly equivalent to a spoonful, with wine.

If muscular spasms occur—sudden cramping or twitching—add three liang of gypsum. Zhongjing said, “If there is a pulsating sensation above the navel, this is Kidney Qi in motion.” In this case, remove Atractylodes and add four liang of cinnamon bark. For profuse vomiting, remove Atractylodes and add three liang of fresh ginger. For profuse diarrhea, use Atractylodes again. For palpitations, add two liang of Poria. For thirst and a desire to drink water, add Atractylodes, bringing the total amount in the original prescription to four and a half liang. For abdominal pain, add ginseng, bringing the total to four and a half liang. For aversion to cold, add dried ginger, bringing the total to four and a half liang. For abdominal fullness and distension, remove Atractylodes and add one aconite tuber.

After taking the medicine, wait about as long as it takes to eat a meal, then drink one sheng of hot rice porridge to warm the body slightly. Do not uncover yourself.

Guizhi Decoction is used when vomiting and diarrhea have stopped but bodily pain has not eased. Treatment should be adjusted with due regard to the condition: harmonize the exterior by gently regulating it with this decoction. The prescription is given in the Treatise on Cold Damage.

Sishun Decoction: A prescription for cholera with spasms of the sinews and vessels, cold muscles, sweating, and vomiting.

One liang of aconite; three liang each of ginseng, dried ginger, and licorice.

Cut the four ingredients into pieces. Boil them in six sheng of water until two sheng remain, then divide into three doses. Fan Wang says that for severe diarrhea, two liang of dragon bone may be added.

Sini Decoction: A prescription for severe cold patterns, cold reversal of the hands and feet, and a pulse that is almost imperceptible.

Eight liang of fresh ginger; three liang each of angelica, peony, asarum, and cinnamon bark; twenty-five jujubes; two liang each of tetrapanax pith and licorice; and two sheng of Evodia fruit.

Cut the nine ingredients into pieces. Boil them together in six sheng of water and six sheng of wine until five sheng remain, then divide into five doses. The older prescription used thirty jujubes; the number has now been reduced by five because cholera patients often have fullness and blockage. Two liang of kudzu root may also be used instead. For cholera accompanied by cold reversal of the hands and feet, add one ge of pinellia and one small aconite tuber. For aversion to cold, use a large aconite tuber.

Another prescription: For vomiting and diarrhea accompanied by sweating and free urination, or diarrhea of thin, undigested matter, with internal cold, external heat, and a pulse so weak it is almost interrupted. It is also used for fever, aversion to cold, stiffness and contraction of the limbs, and cold reversal of the hands and feet.

Two liang of licorice, one and a half liang of dried ginger, and one aconite tuber.

Cut the three ingredients into pieces. Boil them in three sheng of water until one sheng and two ge remain. Take warm.

People with more severe symptoms may take one additional dose and increase the Aconite by one piece and the dried Ginger to three liang. (The Guangji Fang says: if, after vomiting, the patient has shortness of breath and weak Qi, or if the abdomen becomes distended and full after diarrhea, one liang of Ginseng may be added.)

Tongmai Sini Decoction is used to treat cases in which vomiting and diarrhea have stopped, but sweating continues, the hands and feet are cold and withdrawn, the limbs are cramped and difficult to move, and the pulse is faint, as if about to cease.

One large piece of Aconite, one and a half liang of Licorice, and three liang of dried Ginger; for more severe symptoms, use four liang of dried Ginger.

Cut the three ingredients into pieces and boil them in three sheng of water. Reduce the liquid to one sheng and two ge, then divide it into two doses. The patient should improve once the pulse returns. If the face is flushed, add nine stalks of scallion white. If there is abdominal pain, omit the scallion white and add two liang of Peony. If there is vomiting and rebellious Qi, add three liang of fresh Ginger. If the throat is sore, omit the Peony and add one liang of Platycodon. If diarrhea has stopped but the pulse has not returned, omit the Platycodon and add two liang of Ginseng. Adjust the prescription according to the corresponding symptoms before taking it. (Zhang Zhongjing used the “Tongmai Sini Decoction with Pig Bile.”)

Bamboo Leaf Decoction is used to treat cholera (here referring to acute conditions such as vomiting and diarrhea): cases in which the heat signs do not subside after taking formulas such as Lizhong Decoction or Sishun Decoction.

One handful of Bamboo Leaves, one sheng of wheat, ten pieces of fresh Ginger, one liang each of Licorice, Ginseng, Aconite, and Peony, two liang each of Tangerine Peel, Chinese Angelica, and Cassia Twig, and three liang of Atractylodes.

Cut the eleven ingredients into pieces. First boil the Bamboo Leaves and wheat in one dou and five sheng of water. When the liquid has reduced to eight sheng, strain out the herbs, then add the remaining ingredients and boil until three sheng remain. Divide into three doses. If Qi surges upward, add half a sheng of Evodia; the patient should improve after taking it. Lizhong Decoction and Sishun Decoction are both formulas with strongly warming properties. If the patient shows signs of heat, use Bamboo Leaf Decoction instead. (The version recorded in the Gu Jin Lu Yan does not include Peony.)

Licorice Heart-Draining Decoction is used to treat women with cholera who vomit and bring up frothy saliva, and who develop fullness and blockage below the heart (an uncomfortable obstructed feeling in the pit of the stomach) after a physician mistakenly gives them a purgative. First address the frothy saliva with Minor Bluegreen Dragon Decoction. Once the saliva has stopped, treat the fullness and blockage with this formula.

Four liang of Licorice; three liang each of dried Ginger and Scutellaria; one liang of Coptis; half a sheng of Pinellia; and twelve jujubes.

Cut the six ingredients into pieces and boil them in one dou of water. Reduce the liquid to six sheng and divide it into six doses.

Xiaoqinglong Decoction can treat vomiting in women suffering from cholera. The specific prescription is given in Volume 18.

Aconite and Glutinous Rice Decoction

Used when cholera causes cold, rigid limbs, with little vomiting but frequent dry heaving.

Ingredients: one aconite tuber, five he of glutinous rice, half a sheng of pinellia, ten jujubes, one liang of dried ginger, and one liang of licorice. The original text notes that Zhang Zhongjing’s prescription does not include dried ginger.

Chop the six ingredients, add eight sheng of water, and boil until the rice is cooked. Strain out the dregs and take the liquid in three doses.

Ginseng and Atractylodes Powder

Used for older, frail people with pronounced internal cold, nausea, and difficulty digesting food, as well as distension and tightness in the chest and abdomen, shortness of breath, cholera with vomiting, cold, rigid limbs, agitation and oppressive discomfort in the chest, and sweating.

Ingredients: six liang each of ophiopogon and dried ginger; five liang each of ginseng, atractylodes, and licorice; and three liang each of aconite and poria.

Grind the seven ingredients into a fine powder. For each dose, take one fangcunbi (an ancient measure for medicinal powder, roughly a spoonful) with three he of hot water. It may be taken regularly. Alternatively, form pills the size of Chinese parasol tree seeds with honey, and take twenty pills at a time with wine.

Ginseng Decoction

Used for cholera caused by toxic cold, with symptoms including vomiting and diarrhea, agitation and dry heaving, spasms in the sinews and vessels, cold muscles, sweating, swollen fingers and toes, rapid breathing, near death, and inability to speak. The pulse cannot be felt, and other treatments have failed. Continue taking this decoction until the condition improves; if vomiting persists, continue the medicine and use moxibustion as well, the traditional practice of warming acupuncture points with burning mugwort.

Ingredients: two liang each of ginseng, aconite, magnolia bark, poria, licorice, tangerine peel, angelica, kudzu root, dried ginger, and cassia twig.

Chop the ten ingredients, add seven sheng of water, and boil down to two and a half sheng of liquid. Take in three doses.

Prescription for Treating Cholera, Gu Poisoning, Undigested Food, Accumulated Cold, and Distension and Oppression in the Chest and Abdomen

Take three sheng of very salty brine. While it is hot, drink one sheng, then stimulate the throat to induce vomiting so that all undigested food is expelled. If vomiting does not occur, drink more brine. After vomiting, drink again and induce vomiting in this way three times, then stop. The original text says that after resting quietly for a short while, this method is considered better than many other treatments. People often dismiss it as crude and do not use it, which may delay treatment. In such cases, this method should be tried first.

Prescription for Treating Cholera

Ingredients: one sheng each of hyacinth bean and fragrant solomon’s seal.

Add six sheng of water to the two ingredients and boil down to two sheng of liquid. Take in divided doses. Either ingredient may also be used on its own.

A remedy for cholera—a group of illnesses marked by sudden, severe vomiting and diarrhea—and for persistent diarrhea:

Take a handful of mugwort. Add three sheng of water and boil until one sheng remains. Drink it in one dose. It works well.

Another remedy: take a handful of elsholtzia. Add four sheng of water and boil until one sheng remains. Drink it in one dose. Qingmuxiang also works well.

A remedy for cholera with vomiting, diarrhea, and abdominal pain:

Boil peach leaves to make a decoction and drink one sheng. It will stop the symptoms at once. In winter, peach tree bark may be used instead.

A remedy for cholera with thirst and a desire to drink, when drinking water immediately brings on dry retching:

Take five liang of fresh ginger, chop it, and add five sheng of water. Boil until two and a half sheng remain, then drink in two doses. Galangal works very well.

Du Ruo Pills: For cholera; travelers about to set out should prepare them in advance.

Take equal amounts of du ruo, patchouli, white atractylodes, tangerine peel, evodia, dried ginger, ginseng, magnolia bark, costus root, clove, dianthus, cinnamon heartwood, mint, lady’s mantle, and fennel—fifteen ingredients in all. Grind them into a fine powder and use honey to form pills the size of parasol tree seeds. Take twenty pills with wine.

Pills for cholera, intended to prevent it from ever recurring:

Take two liang each of tiger palm and Wei Xian; three liang each of immature bitter orange, aconite, ginseng, betel nut, and dried ginger; six liang of magnolia bark; three cun of Chinese honeylocust; and five liang of white atractylodes.

Grind all ten ingredients into a fine powder and use honey to form pills the size of parasol tree seeds. Take twenty pills with wine, three times a day.

During the Wude era, a virtuous nun named Jingming suffered from this illness for a long time. It sometimes struck once a month, sometimes twice, and each attack put her life in danger. Even Jiang Xu, Gan Chao, and other imperial physicians at court could not identify its cause. I treated it as cholera and prescribed this remedy. She took it and recovered. I record the case here.

For anyone who has previously taken mineral medicines and then develops vomiting and diarrhea from cholera: after taking various warming medicines, the vomiting and diarrhea may stop, but the person then becomes weak and restless, with burning hands and feet, a dry mouth and thirst, nausea and retching, a tight, clouded feeling in the chest, and a rapid, hurried pulse. The following remedy may also be used to treat those whose lingering toxins from a prevailing febrile illness have not cleared and who, after developing cholera with vomiting and diarrhea, still have a fever and feel such heat and agitation in the chest that it seems ready to burst:

Take two liang each of Ji Ni, ginseng, magnolia bark, anemarrhena, trichosanthes root, poria, rhinoceros horn, indigo seed, immature bitter orange, platycodon, tangerine peel, kudzu root, scutellaria, and licorice.

Take the fourteen medicinal ingredients listed above, pound them into pieces, and boil them in one dou of water until the liquid is reduced to three sheng. Divide it into three doses and take them over the course of the day.

Treating Heatstroke-Type Cholera

If an attack of cholera is accompanied by fever, sudden diarrhea, agitation in the chest, a rapid pulse, and a desire to drink cold water, use water freshly drawn from a well. Drink one sheng at a time; the text says this can bring quick relief. Do not use this remedy if the stomach is already weak and cold.

Treating Cholera When Ordinary Remedies Fail

One secret remedy calls for menstrual cloth from a young woman, burned to ash together with the menstrual blood. Take the ash with wine, using about one square-inch spoonful—the capacity of a small ancient medicinal spoon. The text says to use this remedy when many other methods have failed.

Treating Muscle Cramps Caused by Cholera

“Muscle cramps” refers to sudden spasms and tightening of the muscles. Take a handful of knotweed, remove both ends, and boil it in two sheng of water until reduced to one sheng. Drink the entire amount at once. Another version gives “pear leaves” instead.

Another prescription is to burn an old wooden comb to ash, grind it into powder, and take a small pellet-sized amount with wine. The text says this brings a cure.

You can also take the oil from the opening of an axle and apply it to the soles of the feet.

If the cramps are severe and the spasms spread to the abdomen, prepare very salty water in a trough, warm it, and soak the body in it.

Another remedy is to boil blue cloth in vinegar and apply it hot to the affected area. Replace the cloth when it cools.

If the cramps do not stop, the text records that a man should pull on his genitals, while a woman should pull on the breast on the side nearest the affected area.

Acupuncture and Moxibustion

The chapter says that moxibustion may be used during an attack of cholera. Even if it does not bring an immediate cure, it should not lead to death. Moxibustion should not be applied indiscriminately: choose the points according to whether abdominal pain, vomiting, or diarrhea comes first.

• If heart pain or vomiting comes first, apply seven moxa cones at Jique, about one cun below the pit of the stomach. If there is no relief, repeat the same number.
• If abdominal pain comes first, apply twenty-one moxa cones at Taicang, four cun below the pit of the stomach and one cun above the navel. If there is still no relief, repeat the same number.
• If vomiting and diarrhea will not stop and the pulses at both wrists are rapid, apply moxibustion three cun below the xiphoid process, then three cun below the navel, using sixty or seventy moxa cones at each site.
• For retching, apply seven moxa cones on each side at Jianshi. This point lies three cun above the wrist crease, between two tendons. If it does not help, repeat the same number.
• For frequent vomiting, apply seven moxa cones on each side at Xinzhuzhu, roughly in the middle of the palm side of the wrist. If the vomiting continues, repeat the same number.
• If the hands and feet are cold, apply seven moxa cones on each side at Sanyinjiao. This point lies three cun above the tip of the inner ankle, along the edge of the shinbone. If there is no relief, repeat the same number.

A “zhuang” is an ancient unit for measuring moxibustion, referring to the amount of moxibustion produced by one burning moxa cone.

If diarrhea begins first, apply fourteen moxa cones to the “Grain Gate” point, an ancient acupuncture point located two inches beside the navel. Men should use the left side, women the right. This point is also called “Large Intestine Front-Mu.” If there is still no improvement, repeat the moxibustion once, using the same number of cones.

If the diarrhea does not stop, apply seven moxa cones to the “Great Metropolis” point. It is located behind the joint at the base of the big toe, where the white and red flesh meet on the inner side.

If the diarrhea causes severe distress, with agitation and pain so intense that the person seems near death, apply fourteen moxa cones to the “Compassion Palace” point. This point lies on either side of the transverse bone (the horizontal bone below the navel), two and a half inches from the midline.

If the muscles on both sides of the arms and in the chest cramp or spasm, apply seven moxa cones where the white and red flesh meet on the palm. Also apply moxibustion to Shanzhong, Zhongfu, Jueque, Weiguan, and Chize, among other points. The text says these methods can also treat tightness of the sinews and related symptoms in the head and feet.

If cramping occurs because of “Walking Belching,” a disorder in which food and drink descend abnormally, apply twenty-one moxa cones at each point where the white and red flesh meet around the heel and ankle. Then apply moxibustion at the center of the transverse bone below the lower abdomen, using a number of cones equal to the patient’s age.

If cramping is accompanied by coldness in the limbs, apply one moxa cone on each side where the black and white flesh meet at the roots of the breasts.

For cramping, apply six or seven moxa cones to Yongquan, located on the sole of the foot, above the main tendon of the big toe. Alternatively, apply one cone below the big toe, where the sinews are bound together.

If the cramping continues, apply seven moxa cones where the white and red flesh meet at the heel, where the sinews converge. The text says this will quickly stop the cramping.

If the cramping spreads to the abdomen and the pain is so severe that the person seems near death, have four people hold the patient’s hands and feet. Apply fourteen moxa cones one inch above the navel. Once the patient stops moving on their own, stop holding them down. Also apply moxibustion to the main tendon on the inner thigh, one inch from the genitals.

To treat cramping during cholera, have the patient lie face down with their arms extended alongside the body. Use a cord to measure the distance between the tips of both elbows. Using that length, locate points on either side of the spine, each one and a half inches from it, and apply one hundred moxa cones. The text says this treatment never fails, and identifies it as a method of Hua Tuo recorded in the Handbook of Prescriptions for Emergencies.

If a cholera patient has lost consciousness but the body is still warm, apply seven moxa cones to Chengjin. To locate the point, wrap a cord around the foot from the toes to the heel, then fold the cord in half. Place one end where the heel touches the ground and measure upward along the foot to the fold; the point directly beneath the fold is the location. The text says this can revive the patient. Salt may also be placed in the navel, followed by fourteen moxa cones.

Miscellaneous Supplements, Section Seven (one discussion, thirty prescriptions)

The discussion says that Peng Zu believed nothing was better than deer antler for strengthening the body and slowing aging, while preventing sexual activity from depleting one’s original vitality and physical strength or diminishing one’s appearance. To prepare it, scrape deer antler into powder and take ten liang together with one raw aconite tuber, washed down with wine. The dose is one square-inch spoonful, an ancient measure roughly equal to a small spoonful, taken three times a day. The text considers this method highly effective.

The medicine can also be boiled until it turns slightly yellow and taken by itself. This can help prevent premature aging, though it works more slowly than aconite. Another option is to mix the powdered medicine with sparrow eggs and form it into pills, which is more effective. After ten days of taking it, the results should be clearly noticeable.

Amber Powder: Used to treat various ailments caused by deficiency and exhaustion, including impotence, thin semen, lack of physical strength, difficulty urinating with symptoms resembling strangury, coldness in the brain, cold Qi congealing at Guanyuan (the Dantian below the navel), reduced semen and lingering dribbling after forced intercourse, pain in the lower back, heaviness in the limbs, dryness of the throat, thirst, loss of taste, lack of energy, blurred distance vision, palpitations and unease, as well as weakness of the five organs, Qi surging upward, and fullness and oppression in the chest.

The ingredients are amber, ground finely; turnip seeds, sesame seeds, plantain seeds, Chinese cuscuta seeds, dodder seeds, goji berries, Anemone seeds, and Ophiopogon, one sheng each; dried tangerine peel, cistanche, pine resin, and oyster shells, four liang each; pine nuts, arborvitae seeds, and perilla seeds, three sheng each; cassia bark, Pyrrosia, dendrobium, talc, poria, chuanxiong, ginseng, Asarum, teasel root, polygala, Chinese angelica, achyranthes, and moutan bark, three liang each; and tetrapanax pith, fourteen fen.

Process and sift each of the thirty ingredients separately into a fine powder, combine them, and pound the mixture two thousand times. Store it in a leather pouch. Take one square-inch spoonful before meals, three times a day, and once more at night. Boil it in cow’s or goat’s milk until cooked, then take it. According to the formula, long-term use can increase strength, make the body feel light and agile, replenish Qi, improve appetite, and help the body withstand cold and heat. It is also said to relieve many ailments and enrich Jing and Qi. After seventy days, sexual activity can be resumed. With prolonged use, even an old person can become young again: white hair turns black, and lost teeth grow back.

Cistanche Powder: Intended to make the body light, replenish Qi, strengthen the sinews and bones, and restore depleted marrow. It is also said to strengthen the Qi of Kidney Yin.

The ingredients are cistanche, schisandra, polygala, and licorice, one jin each; thirty jin of fresh rehmannia, from which the juice is extracted; and finely chopped Hylotelephium, paper mulberry seeds, and dry lacquer, two sheng each.

Soak the other ingredients overnight in the fresh rehmannia juice, remove them and dry them in the sun, then soak and dry them again until all the juice has been used. Grind the ingredients into a powder. Take one square-inch spoonful with wine on an empty stomach, three times a day. The formula claims that after thirty days, one’s strength will exceed its usual level; even frequent sexual activity will cause no depletion.

People who engage in sexual activity may take “Bald Rooster Powder” regularly without interruption. The formula contains eight ingredients—Cnidium seed, dodder seed, polygala root, saposhnikovia root, schisandra fruit, Morinda root, eucommia bark, and cistanche—two liang of each. Grind the ingredients into a fine powder. Take one square-inch spoonful (an ancient small-dose medicine measure) with wine each time. Those who do not engage in sexual activity should not take it.

“Heavenly Male Powder” is used to treat the five strains and seven injuries (a general term for various forms of overexertion and physical weakness), erectile dysfunction, and bodily debility. Use one liang each of Aconitum root, schisandra fruit, and polygala root; ten parts of cistanche; and six liang each of Cnidium seed and dodder seed. Grind all six ingredients into a fine powder. Take one square-inch spoonful with wine three times a day, over an extended period without interruption.

A formula for treating dampness and itching of the genital area, sores, involuntary seminal emission, and erectile dysfunction: use two liang each of five ingredients—Mongolian milkvetch root, dodder seed, arborvitae seed, Cnidium seed, and cistanche. Grind them into a fine powder. Take one square-inch spoonful with wine three times a day, and stop once it takes effect.

A formula for treating erectile dysfunction and thin, cold semen: use three liang each of seven ingredients—cistanche, stalactite, polygala root, Cnidium seed, teasel root, Chinese yam, and deer antler. Grind them into a fine powder. Take one square-inch spoonful with wine twice a day. To increase the frequency of sexual activity, double the amount of Cnidium seed; to strengthen the erection, double the amount of polygala root; to increase size, double the amount of deer antler; to increase seminal fluid, double the amount of stalactite.

A formula for treating the five strains and seven injuries and a general decline in bodily functions: use three fen each of Morinda root, Cnidium seed, Aconitum root, and Chinese yam; ten male silkworm moths; five fen each of schisandra fruit, dendrobium, and cistanche; and two fen each of dodder seed, Achyranthes root, and polygala root. Grind all eleven ingredients into a fine powder and take one square-inch spoonful with wine three times a day.

“Stone Sulfur Powder” is used to restore vitality in cases of sexual overexertion, coughing, and debility. Prepare equal amounts of eleven ingredients: stone sulfur, white quartz, deer antler, polygala root, Cnidium seed, schisandra fruit, Aconitum root, stiff silkworm, white horse penis, dodder seed, and female ginseng. Grind them into a fine powder. Take one square-inch spoonful with wine three times a day. Those who do not engage in sexual activity should not take it.

Another formula: six liang of milkweed vine, schisandra fruit, sour jujube seed…

Grind bai ziren, dried di huang, and gou qi gen pi—three liang of each—into a fine powder. Take one fangcunzhi measure, a small medicinal spoonful, with wine three times a day.

Another formula: Grind the stems, leaves, and roots of che qian cao into a fine powder. Take one fangcunzhi measure each time. It is said to strengthen penile function and replenish Jing and Qi.

A tonic for daily use

Take one jin of gou qi zi; three liang of tian xiong; eight liang each of rou cong rong, shi hu, and dried gan jiang; five liang each of tu si zi, yuan zhi, and xu duan; and ten liang of dried di huang. Grind all nine ingredients into a fine powder. Take one fangcunzhi measure with wine twice a day. There are no dietary restrictions while taking this medicine. After ten days, wait until the glans turns purple before having intercourse.

A formula for men with weakened Yin, pain in the lower back and spine, sensitivity to cold, penile atrophy, scant semen, dribbling after urination, seminal emission, dampness and itching around the scrotum, and general weakness. It is said to build up the body and make the skin full and supple.

Grind equal amounts of ba ji tian, tu si zi, du zhong, sang piao xiao, and shi hu into a fine powder. Take one fangcunzhi measure with wine once a day. Long-term use is preferable.

Another formula: Take five fen each of shu yu, ba ji tian, shan zhu yu, dan shen, and ren shen; four fen each of she chuang zi and wu wei zi; three fen each of tian xiong and xi xin; two fen of gui xin; and ten fen of dried di huang. Grind all eleven ingredients into a fine powder. Take one fangcunzhi measure with wine twice a day, and once more at night.

Another formula: Take two liang each of wu wei zi and she chuang zi; three liang each of xu duan and niu xi; and four liang each of che qian zi and rou cong rong. Grind all six ingredients into a fine powder. Take one fangcunzhi measure with wine twice a day.

Du Zhong Powder: Boosts Qi and replenishes deficiency. Used for men who are thin and weak, short of breath, have deficiency of the Five Viscera, lower back pain, or are unable to have intercourse.

Take six fen each of du zhong, she chuang zi, wu wei zi, and dried di huang; eight fen each of rou cong rong and yuan zhi; five fen of mu fang ji; seven fen of ba ji tian; and ten fen of tu si zi. Grind all nine ingredients into a fine powder. Take one fangcunzhi measure with wine before meals twice a day, and continue taking it long term.

These restorative formulas are used when Yang qi is insufficient. Symptoms include dampness and itching of the scrotum, lingering dribbling after urination, seminal emission, and difficulty achieving an erection.

Cistanche Powder is used to restore deficiency and strengthen Yang. It treats dampness and itching of the scrotum, lingering dribbling after urination, seminal emission, general debility, and difficulty achieving an erection due to insufficient Yang qi. The formula contains nine ingredients: cistanche, teasel root, cnidium seed, schisandra, tianxiong, Chinese yam, polygala root, dried rehmannia, and morinda root. Grind them into a fine powder and take it with wine. The original text prescribes one fangcun bi at a time—a small ancient measure for powdered medicine, roughly the amount held by a spoon—three times daily. It also suggests that these conditions may result from having intercourse after becoming drunk, eating to excess, or becoming overly fatigued.

White Horse Penis Pill is used for difficulty achieving an erection, lack of arousal even when stimulated, dry mouth and sweating, seminal emission, dampness and itching of the scrotum, lingering dribbling after urination, enlarged testicles with pulling pain, cold knees and aching legs, blurred vision, cramping in the lower abdomen, and stiffness in the lower back. The formula contains eighteen ingredients. Grind them into powder and use white honey to form pills the size of parasol tree seeds. Take four pills with wine twice daily, gradually increasing the dose to twenty pills. The original text claims that improvement will be apparent after seven days and that all the symptoms will be cured after one month.

Formulas for treating erectile dysfunction:

One formula uses the liver of a rooster and the gallbladder of a carp. Dry them in the shade for one hundred days, then grind them into a fine powder. Mix the powder with sparrow eggs to form pills the size of small beans. Swallow one pill at a time.

Another formula uses one sheng of dodder seed and three rooster livers. Dry them in the shade for one hundred days, then grind them into powder. Mix it with sparrow eggs to form pills the size of small beans. Take one pill at a time, three times daily.

A further formula uses three liang each of dry lacquer, atractylodes, licorice, dodder seed, cistanche, achyranthes, morinda root, schisandra, and cinnamon heart; one liang each of Chinese holly and ranunculus; and four liang of dried rehmannia. Grind the ingredients into a fine powder and mix with honey to form pills the size of parasol tree seeds. Take twenty pills with wine at a time, three times daily.

Another prescription: Burn a wasp’s nest to ash and apply it to the affected area at bedtime.

Another prescription: Take one sheng of unmated male silkworm moths. Dry them in the shade, remove their heads, feet, and wing hairs, then grind them into a fine powder. Mix the powder with white honey to make pills the size of parasol tree seeds. Take one pill each night at bedtime, washed down with salted broth.

Another prescription: Take five jin of magnetite, grind it into small pieces, and soak it in three dou of clear wine for fourteen days. Take three he each time, three times a day, and once more at night.

Another prescription: Regularly taking asparagus root is also beneficial.

Another prescription: Take one jin of fresh, high-quality Schisandra fruit. Pound it and sift it into a fine powder. Take one square-inch spoonful (an ancient small measuring spoon for medicine), washed down with wine. Continue for seven days, then gradually increase the amount until it reaches three times the original dose. There are no particular dietary restrictions while taking it; pork, fish, garlic, and strong vinegar may all be eaten. One course will bring results, which can also be seen during the day. Take it continuously without interruption, throughout all four seasons, and its effects will naturally become apparent.

Another prescription: Take equal amounts of common cnidium seed, dodder seed, and Schisandra fruit. Grind the three ingredients into a fine powder and mix with honey to make pills the size of parasol tree seeds. Take three pills each time, with a drink, three times a day.

Another prescription: Take five fen each of common cnidium seed, dodder seed, and eucommia bark; eight fen of cistanche; and four fen of Schisandra fruit. Grind the five ingredients into a fine powder and mix with honey to make pills the size of parasol tree seeds. Take fourteen pills each time, washed down with wine: twice during the day and once at night.

Another prescription: Take three liang of common cnidium seed and two he of dodder juice. Combine and use the two ingredients.

Another prescription: Take three fen each of common cnidium seed, cistanche, and polygala root, and one fen of aconite. Grind the four ingredients into a fine powder, form pills with saliva, and make them the size of parasol tree seeds. Use one pill each time.

Another prescription: Take three fen of common cnidium seed, two fen each of monkshood and polygala root, one fen of cassia bark, and one nutgall. Grind the five ingredients into a fine powder and use as prescribed.

Sun the Immortal’s Essential Prescriptions Worth a Thousand Gold for Emergencies, juan 62