《孫真人備急千金要方》Vol. 74

Sun Zhenren's Essential Prescriptions Worth a Thousand in Gold for Emergencies (Beiji Qianjin Yaofang), Scroll 74, "Prescriptions for Detoxification, Section Four: Gu Poison"

Gu poison (gudu) takes more than a thousand forms, and its conditions differ from case to case. Some patients vomit fresh blood. Some like to hide in dark places and sleep, avoiding the light. Some have erratic tempers, growing angry or joyful by turns. Others feel heaviness in the limbs and aching in every joint. These symptoms are so varied that they cannot all be listed.

Some who contract gu poison die within three years. In acute cases, death comes within a month or a hundred days. At the point of death, the poison is expelled through the nine orifices of the body or through the flesh beneath the ribs. For this reason, when going out, one should often carry substances believed to drive off evil, such as realgar (xionghuang), musk (shexiang), and "divine elixir" (shendan), so that the various gu insects, cat demons, foxes, and other spirits dare not harm a person. Those who cultivate their health should be especially mindful of this.

Folk practice also includes moxibustion. When someone has just been afflicted, one may press below the heart to locate the point and apply a large moxa cone one hundred times (zhuang). This method is also used for cat demon affliction, and it is said that moxibustion cures it. Three moxa should also be applied at the tip of the little toe. If the poison came from wine, the moxa wound will discharge wine. If it came from rice, the wound will discharge rice, and if from meat or vegetable dishes, it will discharge those foods. Once the substance is expelled, recovery follows, and the method is said to be efficacious. All of the substances described above come out through the moxa wound.

Anyone afflicted by gu poison feels the heart and abdomen wrenched as if twisted, as though something were gnawing inside. There may also be vomiting of blood or bloody stools, with the expelled blood resembling rotten flesh. If left untreated, the poison erodes the five viscera and eventually causes death. The text also proposes a test: have the patient spit saliva into water. If the saliva sinks, it indicates gu poison; if it does not, the illness is not gu poison.

If a person has been ill for many years and often passes stools as black as lacquer, with the stools being either hard or loose and sometimes faintly reddish, the text holds that all of these may be signs of gu poison.

If bleeding from the bowels arises suddenly, and the condition worsens after treatment with hemostatic methods, the text considers this possibly a case of gu poisoning.

Sudden bloody dysentery, with red or black blood passed in any quantity, is likewise considered by the text to possibly be gu poison. If a careless practitioner treats it as ordinary dysentery with antidysenteric medicines, the error is grave.

Some unskilled physicians, seeing a patient with a swollen abdomen and generalized edema, yet with limbs that appear normal and urination not markedly obstructed, treat the condition as dropsy. For more than fifty consecutive days they give the patient medicines for dropsy, believing these will cure it. The illness grows steadily worse, and the patient ultimately dies suddenly.

These claims vary, so physicians studying prescriptions should examine the meaning of each formula carefully and use them with discretion to avoid errors. There are over a thousand volumes of medical prescriptions, and their principles cannot be exhausted, so they cannot all be described in detail.

That is the general idea.

Whenever someone has been struck by gu poisoning, meaning that someone has used gu poison to harm them, once the patient has taken medicine and learned the name of the person who cast it, the patient should call out that person's name so that they will remove the poison. To determine the name of the person who cast the gu, the source records a method of burning the skin of a worn-out drum into powder and having the patient take it with water. It is said that this will make the afflicted person call out the name on their own. Afterward, the patient can be told to have that person remove the poison, and they will recover. Another account holds that someone made a gu medicine from snake saliva and mixed it into food and drink, causing the victim to develop abdominal masses and similar illnesses. Both kinds of illness drag on for years before they prove fatal, and each has its corresponding prescription. In the mountains of Jiangnan, people believe in and practice this kind of gu sorcery, so it should not be lightly assumed to be nonexistent.

Taishang Wugu Wan (Supreme Five-Gu Pills): According to the source, this formula treats all kinds of gu poisoning, as well as vomiting blood, heart injury, qi stagnation in the chest and abdomen, blockage of the throat, loss of speech, shortness of breath near death, inability to eat, vomiting, and rising qi. It is also said to cure illnesses that recur as though possessed by ghosts, swelling of the body, vexation and pain in the heart, chills, dreaming of intercourse with ghosts, fox possession, sudden heart pain, and pain in the chest and flanks as if pierced by a knife, even cases of illness lasting many years with the patient bedridden.

The original formula lists xionghuang (realgar), jiaomu (prickly ash seeds), badou (croton), mangcao (a toxic herb), yuanhua (daphne flower), zhenzhu (pearl; the Waitai Miyao records muxiang, costus root, in its place), guijiu (asarum-like rhizome), fanshi (alum), lilu (veratrum), fuzi (aconite), ta gan (otter liver), wugong (centipede), and banmao (blister beetle). The source also records methods for making the pills, taking them, and gradually increasing the dose. It states that the dose should be carried to the point of diarrhea, and that after the gu material is expelled, the patient should rest for seven days before taking another dose. It further claims that the pills can eliminate hundreds of illnesses that have accumulated over many years, and that the patient should avoid the five pungent foods during the course of treatment.

Taiyi Zhuiming Wan (Taiyi Pursuing-Life Pills): According to the source, this formula treats a wide range of illnesses, including sudden attack by malign qi, distension of the heart and abdomen, difficulty breathing, heart pain, accumulations, abdominal swelling, hernia, abdominal masses, undigested food, vomiting, chills and fever, scrofula, gu poisoning, and the lingering conditions women experience after childbirth. The formula includes centipede, cinnabar (dansha), aconite (fuzi), and other ingredients. The scripture as transmitted breaks off at this point.

These prescriptions contain several highly toxic or harmful ingredients, and the efficacy and methods of administration described in the original text should not be taken as guidance for actual treatment.

Fanshi (alum stone; some editions have "yushi"), xionghuang (realgar), lilu (veratrum), and guijiu (mayapple), one part each, and badou (croton seed), two parts, make eight parts of medicinal material in all. Grind them into a fine powder and form pills the size of a hemp seed with honey. Take two pills each time, once a day. If shanghan (cold damage) has lasted a day or two, take one pill, which is said to bring on sweating. Alternatively, wrap two pills in cotton cloth and plug them into both ears. For diarrhea, take one pill, or insert one pill into the anus. For gu poisoning (gu du), take two pills. If the illness appears on the surface of the body, mix the medicine into a paste and rub it on the affected area. If the illness lies above the diaphragm (ge), it is said to cause vomiting; if it lies below, it is said to cause diarrhea. When sores form on the affected area, apply one pill, and the poison is said to leave the body on its own. For lingering illness after childbirth, take one pill. For deafness, wrap a pill in cotton and place it in the ear.

Remedy for Accidentally Taking Medicine Mixed with Gu Poison

Six banmao (blister beetles), guixin (cinnamon bark core), and lilu, each about the size of a finger, along with soot from the bottom of a cooking pot, about the size of a pellet. These four ingredients are ground into a fine powder, sifted, and taken with water in a dose of one qian. The source states that after taking it, the patient will expel gu insects, snakes, toads, and dung beetles.

Wanbing Pill Formula (Pill for Ten Thousand Ailments)

This formula treats what is called "gu zhu" (gu infusion): swelling of the limbs, wasting of the flesh, coughing with counterflow qi, and a belly swollen like a body of water. The source also says that when the patient dies, the illness passes to the family members. This formula is also called the "Guzhang Fang" (Gu Distension Formula), and the Xiaopin Fang calls it the "Xionghuang Pill" or the "Wanbing Pill."

Xionghuang, badou, mangcao (Illicium), and guijiu, four liang (taels) each, and three wugong (centipedes). The five ingredients are ground into a fine powder and mixed with honey. They are pounded three thousand times and shaped into pills the size of a small bean, then sealed for storage so the medicinal qi does not escape. Before taking the medicine, the patient fasts the night before. The next morning, on an empty stomach, one pill is taken. If no reaction appears after the time of one meal, a second pill is added. The source states that the patient first expels clear water, then gu insects and snakes several cun long, or matter resembling a spoiled egg or a paste. After the treatment, the patient should recover with congchi zhou (fermented soybean and scallion porridge), and should keep warm and rest.

Remedy for Gu Poisoning Within the Body

This is used for conditions in which the abdomen is hard as stone, the complexion is greenish-yellow, urination is painful and difficult, and the illness changes unpredictably. Marginal notes state that both the Zhouhou Fang and the Gujin Luyan Fang record the following: make pills from iron essence and the liver of a black-boned chicken, shaped to the size of a wutong seed, and take them with wine, three pills each time, twice a day. Even in severe cases, the course does not exceed ten days. The same notes point out that the Qianjin Yaofang uses the following formula, and suspect that the Qianjin Yaofang may contain an error at this point.

Gu yang pi (a male sheep's hide, about five cun square), xijiao (rhinoceros horn), shaoyao (peony root), huanglian (coptis), and mudan (tree peony root bark), one liang each; rangHe (Zingiber mioga), four and a half liang; and seven zhizi (gardenia) kernels.

The seven ingredients listed above are roughly chopped and decocted in nine sheng of water until reduced to three sheng. The decoction is taken in three equal doses.

The formulas attributed to Ge Hong and to Master Cui are the same as this one, except that they omit Chinese peony root (shaoyao), tree peony bark (mudan), and gardenia fruit (zhizi), and substitute sophora root (kushen), cimicifuga rhizome (shengma), and Chinese angelica root (danggui).

Rhinoceros Horn Pills: a formula for treating gu poison, the hundred ailments, sudden severe abdominal pain, and swelling caused by "flying corpse" foul qi

Rhinoceros horn shavings, dysosma rhizome shavings, cinnamon bark powder, and saiga antelope horn shavings (each four qian and seven fen); processed aconite root (tianxiong), mangnolia-like caoshu (mangcao), pearl, and realgar (each one liang); cowrie shells (five, roasted); centipedes (five segments); croton seeds (fifty); musk (two fen); and one shewang (about the size of an egg yolk). The thirteen ingredients are ground into a fine powder, mixed thoroughly, and kneaded with honey into pills the size of small beans. One pill is held in the mouth and swallowed, twice a day. If there is no reaction, the dose may be increased slightly. In cases of sudden bloating or a sense that a "flying corpse" is at work, two pills the size of peas may be taken. For swelling caused by foul qi, the powder may be mixed with vinegar and applied externally.

The medicine may also be sealed in a small pouch and tied to the left arm. It is said to ward off inauspicious qi, ghostly afflictions, and gu poison, and it may be used as an emergency measure.

A Formula for Gu Poison

Madder root and rangHe root (ranghe, each three liang).

Roughly chop the two ingredients and decoct them in four sheng of water until reduced to two sheng. Drink it all at once. (From the Elbow Reserve Prescriptions.)

The Elbow Reserve Prescriptions states that this formula treats vomiting or bloody stools after being struck by gu poison, where the blood resembles rotten liver. It is said that the patient can also learn the name of the person who cast the gu.

Another Formula

Hedgehog skin ash and tangled hair ash (each one fangcun spoon, about one spoonful), five sheng of fresh hemp seed juice, and white bark from the shaded side of an oak tree and peach root bark (each five liang).

First decoct the oak bark and peach root bark to obtain one sheng of concentrated liquid, then mix it with the hemp seed juice and the hair and hedgehog ashes. The patient should eat lightly the evening before, then drink one large sheng the next morning. Afterward, place a basin of water beside the patient and stir the water with a chicken feather. The text says the patient will soon vomit, and what comes up may resemble cow saliva, a calf's fetus, or various kinds of worms.

Another Formula

Take a large handful of white bark from the shaded side of an oak tree, about five cun long. Decoct it in three sheng of water until reduced to one sheng, and drink it on an empty stomach. The text says that worms will be expelled after taking it, and that it may also be used for bloody stools after gu poisoning.

Another Formula

Burn hedgehog skin to ash, and take one fangcun spoon with water. The text says this also expels worms.

Another Formula

Euphorbia kansui root and Spanish fly (banmao), one fen each.

On the fifth day of the fifth month, gather peach bark (the Biyao Fang specifies branches growing toward the east, dried over a fire; use four fen of each).

Grind the above three ingredients into a coarse powder. Take it on an empty stomach in the early morning, swallowing it with about the amount of water that fills an egg-sized vessel. Take eight pinches of the powder, gathered between two fingers held together, and swallow it all at once. If the powder is taken with two fingers apart, the dose may be excessive and could harm the patient. (The Zhouhou Fang says that if the illness has not healed after taking the medicine, it may be taken once more after ten days. The Biyao Fang says to take half a fangcun spoonful, and the poison will be expelled; if it is not expelled, take it again. Li Raozhou says that if the poison came from wine, it should be taken with wine, and if it came from food, it should be taken with a drink.)

A prescription for treating snake gu (when snake venom enters vegetables or fruit and a person who eats it falls ill, this is called "snake gu"):

Grind soybeans into a powder, soak them in wine, squeeze out the liquid, and take half a sheng.

A prescription for treating any kind of heat poison or gu poison in which bleeding occurs from the nose or mouth, a condition physicians considered incurable:

Take seven tips of human feces, burn them until red-hot, drop them into water and grind them, then drink immediately. It is said that this will cure the illness. This method is also used to counter all kinds of poisons, including the poison of epidemic heat diseases, and it is said to be very effective when taken.

A prescription for gu poisoning that brings on vomiting or bloody discharge:

Take elm bark (five cun wide and one chi long) and reed root (about five cun long, roughly as thick as a thumb; the Xiaopin Fang uses rose root instead).

Chop the above two ingredients into pieces, decoct them in two sheng of water until one sheng remains, and drink it all at once. It is said that this will expel a large amount of the gu poison.

A prescription for bleeding every day, dozens of times, after being struck by gu:

Take croton (twenty-seven seeds), yuanqing, veratrum, aconite, and alum (two fen of each).

Grind the above five ingredients into a powder. Treat the croton separately, then sift it together with the other powders and mix thoroughly. Wrap the mixture in cotton to form pills about the size of a soybean, insert one into the anus, three times a day. It is said that this will cure the illness.

Another prescription: Take one bitter gourd, decoct it in two sheng of water until one sheng remains, and drink it in small amounts several times. It is said that the gu poison will be expelled along with it, and one may vomit or pass things resembling toads or tadpoles. The poison is said to be fully expelled only after a month. (Fan Wang's Fang says that bitter gourd is toxic and should be used in measured amounts when needed; the Zhouhou Fang says to decoct it in one sheng of bitter wine.)

A prescription for bleeding in the form of chicken liver and severe, unbearable cramping in the abdomen:

Take madder root, cimicifuga, and rhinoceros horn (three liang of each); platycodon, yellow bark, and scutellaria (two liang of each).

Note: The original text does not yet give the subsequent preparation and dosage methods at this point.

Dìyú (Sanguisorba root) and white ránghé (both medicinal herbs; white ránghé is the rhizome of the ginger-family plant ránghé, which the ancients believed could neutralize gu (gǔ) poison), four liǎng each. Chop the above eight ingredients (several other herbs precede these) finely, decoct them in nine shēng of water until reduced to two and a half shēng, and take the decoction in three doses. This formula treats gu poisoning accompanied by bloody stools and dysentery.

Another formula: Platycodon root and rhinoceros horn (no longer used today, but in antiquity valued for clearing heat and detoxifying), in equal parts, two ingredients in all. Grind them into a fine powder and take one fāng cùn bǐ (a small spoon for measuring medicine, about one cùn square) with wine, three times a day, for seven consecutive days. If the patient cannot take the medicine alone, pry open the mouth and pour it in. After the medicine goes down, the patient will first feel oppressed in the chest, and within a short while will settle naturally into calm. Once the seven days are complete, stop the medicine, and during this period the patient may eat pig's spleen to nourish the body. This formula can treat bleeding from the lower body caused by gu poisoning, and it may be used for patients whose blood flows like chicken liver, day and night without stopping, and who are close to death.

A formula for treating "intestinal gu": The illness first passes red matter, and later passes yellowish-white mucus, persisting for years without improvement. Take one liǎng of niúxī (Achyranthes root), pound it and cut it finely, and soak it in one shēng of rich, clear rice wine overnight. Take it the next morning on an empty stomach. A second dose will cure the illness.

"Běidì Tàishǒu Jiǔ" (Beidi Governor's Wine) treats all kinds of gu poisoning, wind-qi disorders, and fever with chills. Its ingredients are: wūtóu (aconite), licorice, chuānxiōng (Ligusticum root), huángqín (Scutellaria root), guìxīn (cinnamon bark, with the coarse outer skin removed), líulú (Veratrum root), and fùzǐ (processed aconite), four liǎng each; báiliǎn (Ampelopsis tuber), jiégěng (Platycodon root), bànxià (Pinellia tuber), bǎizǐrén (arborvitae seed), and qiánhú (Peucedanum root), in amounts not specified here; and màimendōng (ophiopogon tuber), six liǎng. Using these thirteen ingredients, together with ten jīn of wine yeast made in the seventh month and one hú of glutinous millet (sticky sorghum or sticky grain), brew the wine by the usual method. Place the chopped herbs in a silk bag and sink it to the bottom of the wine jar. Once the wine is made, filter out the lees, then remove the herb residue and place it in a blue cloth bag, sinking it again into the wine. Seal the jar mouth with clay. Let it stand for seven days in autumn, five in summer, and ten in winter. Take one gě on an empty stomach, three times a day, until the effect appears. Because the herbs are toxic, they are kept in a blue cloth bag. The medicine must not be stopped midway. After twenty days, the major illness within the body will be expelled, its appearance as black as lacquer. After fifty days, the illness will be completely cured.

The text records several cases. A fifty-year-old woman had long-standing masses in her abdomen for many years, with disharmony of cold and heat, frequent cramping pain, and tightness around the navel. Her qi rose adversely, and she had chest fullness for more than twenty years. After fourteen days of this medicine, she passed three or four shēng of foul matter and recovered. Another woman suffered from hemiplegia. After twenty days of treatment, she vomited a black substance resembling a sword-belt, about three chǐ long, and recovered at once; she even bore a child that same year. A woman who had contracted epilepsy in her youth was cured after eighteen days of treatment, during which she lost two and a half shēng of blood. A person who had suffered a beating and bled, with blood stasis remaining within the body, was bedridden for nine years. After thirteen days of treatment, he expelled two or three shēng of black blood and recovered. Another person had been deaf for seventeen years and took this medicinal wine……and afterward also showed improvement.

After thirty-five days, three sheng of blood flowed from the nose and five sheng of yellow fluid from the ears, and the illness was cured. The ancient formula is recorded as saying: "In the second year of Xiping, the Grand Administrator of Beidi, your servant Guang, submits this memorial." This prescription is used mainly to treat gu poisoning (harm caused by gu insects or gu sorcery, as the ancients understood it). Anyone afflicted with gu poisoning who took it was cured without exception. Even when the condition was extremely difficult to treat, the effect appeared within fourteen days at the latest, and all of its efficacy is recorded in full.

Once there was a woman in her forties who was paralyzed on one side of her body. She was emaciated, could not get up, had been bedridden for a long time, was deaf and could hear nothing, and could not move either hand. This had lasted three years. I compounded medicine for her, and she later recovered her normal condition. In another case, a man was afflicted with gu poisoning and had also previously suffered from wind disease. After taking wine steeped in yinyu (a medicinal wine prepared by soaking yinyu and other herbs in liquor), he vomited violently and brought up several dozen gu worms, and his illness was cured. How much more so, when this medicinal wine is inherently capable of expelling gu poisoning? I judge its efficacy to be extraordinary, and so I have deliberately recorded it in detail.

Osmidrosis (Foul Underarm Odor) and Underarm Discharge, Chapter Five (Discussion and Prescriptions)

The discussion holds that some underarm odor is congenital, while some is acquired through contagion from others. Congenital underarm odor is harder to treat, and contagious odor is easier to cure. However, one must apply alum powder (a powder made from alum and other materials) mixed with vinegar as an external poultice continuously for three years, and at the same time take the Five Fragrances Pills (described in the sixth fascicle above). Only then is a cure possible. Do not assume that a single application will bring recovery; a single application often produces only a temporary effect. While undergoing treatment, a person with underarm odor should avoid eating rapeseed greens (cole vegetables) and the five pungent foods (five strongly aromatic, spicy foods). Otherwise, even with continuous treatment, a cure will be difficult to achieve.

Lime Powder, a Prescription for Underarm Odor

One sheng of lime; two liang each of fengxiang (the original edition variously gives chenxiang, agarwood), clove, styrax (xunlu xiang), and green sandalwood (qingmuxiang); four liang of alum; and three liang each of tangerine peel and yangqi stone.

Grind the above eight ingredients into a fine powder and pass it through a sieve. Roll cotton into strips about the thickness of a finger and about four cun long. Spread the powder over them, wrap them in a silk pouch, and clamp them under the armpits. Before use, first rub the underarms with a cloth until they feel slightly painful, and then clamp the medicinal strips in place.

Another prescription: Mix three-year-old vinegar with the lime and apply it to the affected area.

Prescription for Underarm Odor

Two liang each of xinyi (magnolia flower buds), xiongqiong (ligusticum), xixin (asarum), duheng (asarum-like herb), and gaoben (ligusticum-like rhizome).

Chop the above five ingredients finely and soak them overnight in pure bitter wine (concentrated vinegar). Then decoct them and take the resulting liquid to apply to the affected area. Apply it before going to sleep, and use it repeatedly until the condition is cured.

Another prescription: Two liang each of green sandalwood, aconite (fuzi), and white lime. The original text breaks off here, and the method of preparation is not recorded.

White alum (baifan), half a liang (banliang).

Grind these four ingredients into a fine powder, mix it into a powder preparation, and dust it frequently under the armpits. (The Handbook of Prescriptions for Emergencies (Zhouhou Fang) does not include white alum.)

Another formula: take copper filings, mix them with vinegar, and fry them in a silver vessel until very hot. Wrap them in cloth and apply the warm packet to the armpits, replacing it once it cools.

Another formula: finely chop a handful of oak leaves, take three sheng, and boil them in five sheng of water until one sheng remains. Use this liquid to wash the armpits. Then burn a white bitter gourd until it smokes, and fumigate the armpits with the smoke. Repeat this treatment many times.

Another formula: take magnolia flower buds, asarum, ligusticum, and costus root, four fen of each. Grind the four ingredients into a powder and sieve it. First fumigate the armpits with it, then dust the powder on afterward.

Another formula: take a bundle of purslane, pound it, and mix it with honey into a ball. Place the ball in a silk bag, wrap the outside with mud paper half an inch thick, and dry it in the sun. Then bake it over a fire until cooked. Remove the medicinal ball, mix in a little more honey, and apply it while still warm, without letting it cool. First wipe the armpits with unbleached cloth, then clamp the medicine under the armpits. The application will cause pain, which should be endured as much as possible; if it becomes unbearable, grip both arms with the hands.

Another formula: equal parts of cattle tallow and hufen (lead powder). Boil the two together until the mixture can be shaped into pills, then smear it under the armpits. It will be effective after one night; use it no more than three times. (The Handbook of Prescriptions for Emergencies says to add Sichuan pepper before applying it.)

Another formula: make a paste of fulongan (hearth-center earth, the soil from the center of a stove) and apply it to the affected area.

Six-Ingredient Powder: used to treat conditions in which the armpits, soles of the feet, palms, genitals, and inner thighs are constantly soaked with sweat and emit a foul odor. Take dried wolfberry root, dried rose root (the Handbook of Prescriptions for Emergencies gives "livestock root" instead), and licorice, half a liang each, along with phytolacca root, lead powder, and talc, one liang each. Grind the medicines into a powder and sieve it. Mix small amounts at a time with bitter wine (vinegar) and apply. The skin should sweat slightly, after which change clothes and apply it once more. No more than three applications are needed for a cure. Sometimes the condition recurs a year later, in which case apply it again when it flares up.

Another formula: mercury and lead powder (the Essential Secrets from the Imperial Library (Waitai Miyao) gives "frost powder" instead). Grind the two together with face cream, mix well, and apply. The effect is very good.

Another formula: three sheng of lime and one sheng of silver filings (some versions give "copper filings"). Mix the two, place them in a silk bag, and dust them on while sweating. The effect is very good.

Another formula: on New Year's Day, wash the armpits with urine. The effect is remarkable.

Another formula: burn yellow alum stone until all its liquid is exhausted, grind it into a powder, put it in a silk bag, and dust it under the armpits. The condition will be cured.

Anus (Part Six: Prescriptions and Moxibustion)

The anus corresponds to the lung. When heat builds up in the lung, the anus also becomes hot, and when heat-evil blocks the passage, the stool cannot pass.

Prescription for swelling, contraction, or sores of the anus

Take three sheng of white honey and simmer it until the water has evaporated. Once it has cooled, mix it with cold water and roll it into pills. Shape the pills to six or seven cun in length and insert them into the anus. Have the patient lie with the body face up and the head lowered, and remove the pills after a while. Once the pills have melted for a short time, the anus will open and the stool will pass.

Pig Liver Powder: for prolapse of the anus

The anus corresponds to the large intestine. When the large intestine is chilled, the anus also turns cold, and this produces diarrhea and a prolapse in which the anus cannot hold itself closed.

One jin of pig liver, dried over a fire; two liang each of coptis, donkey-hide gelatin, and ligusticum (that is, chuanxiong); one liang of mugwort leaf; and five liang of smoked plum flesh.

Grind the six ingredients into a fine powder. Take it with one sheng of warm clear rice wine, a dose of half a fangcun spoon (an ancient measure of powdered medicine, based on the fangcun spoon). Take it twice a day. If the patient cannot drink wine, it may instead be taken with clear rice gruel.

Wall-Earth Powder: for prolapse of the anus

Take one sheng of earth from the east wall of an old house and pound it fine. Take three sticks of gleditsia pod, each one foot two cun long.

First pound the wall earth into a powder and apply it to the prolapsed tip of the anus. Then warm the gleditsia pods and take turns pressing them against the area until the anus has drawn back in.

Another remedy: heat the sole of an old hemp shoe and press it against the prolapsed part to push it back in. Repeat the pressing until it retracts. It is said that this will cure the condition.

Seaweed, gentian, sea clam, akebia stem, kelp, yushi (in some editions written as "alum stone"), and Chinese club moss, three fen each; wheat malt, four fen; and pinellia, two fen.

Grind the nine ingredients into a fine powder and take one fangcun spoon with wine, three times a day. While taking this medicine, avoid fish, pork, pungent foods, raw vegetables, and other foods that are hard to digest. The effect should appear within ten days, and a cure within twenty.

Another remedy:

One dou of wheat flour, one jin of seaweed, and ten liang of raw yushi.

Soak the wheat flour in vinegar that has been stored for three years, then dry it in the sun. Grind each of the three ingredients into a separate powder, then combine them. Take one fangcun spoon at a time, four or five times a day. Hold the medicine in the mouth first, and swallow it only after the flavor has fully spread. While taking it, avoid raw ginger, pungent foods, pork, fish, and raw vegetables. Also avoid shouting, blowing hard, chanting aloud, and speaking loudly.

Another remedy:

Kelp, Chinese club moss, and seaweed, three liang each; cinnamon bark, sea clam, akebia stem, and ampelopsis root, two liang each.

The original text ends here. The preparation and dosage of these medicines are not given in the passage provided.

Another formula: finely grind the seven ingredients listed above into a coarse powder, and take one fangcun spoon (a small square-inch measure used in antiquity to dose medicine) with wine, three times a day.

Another formula: take three liang each of seaweed (haizao) and sea clam shell (haige), and one liang each of pinellia (banxia), tugen (Tuguagen, ground-cherry root), and pine lichen (songluo), plus two liang each of akebia stem (tongcao), bailian (ampelopsis root), and gentian (longdan). Grind these ten ingredients into a coarse powder, and take one fangcun spoon with wine, twice a day. Do not increase the dose.

Another formula: take two liang of kelp, wash it clean, and cut it into pieces the size of a finger. Soak them in vinegar, then hold them in the mouth and slowly swallow the liquid until it is all gone. It is said that this will cure the condition.

Another formula: take one jin of seaweed (for a small dose, use three liang) and one sheng of wheat qu (a fermented starter). Mix the two powdered ingredients with one sheng of aged vinegar, form the mixture into a dough, and dry it in the sun. Then repeatedly mix it with vinegar and dry it in the sun until the vinegar is used up. Afterward, pound everything together into a powder, and take one fangcun spoon at a time with wine, three times a day. While taking this medicine, avoid overexertion. Master Cui said this formula can cure goiter-tumors of thirty years' duration.

The Five Goiter Pills formula: two liang of calamus; one liang each of clam shell, baili an, xuduan (Dipsacus root), seaweed, pine lichen, cinnamon bark, Sichuan pepper, daoguacao (a medicinal herb), and pinellia; three liang of fermented medicinal leaven (shenqu); and one hundred sheep thyroids (the thyroid gland of the sheep). Grind the twelve ingredients into a fine powder, form them into pills with bone marrow from cattle or fat from sheep, and make the pills the size of a wutong seed. Take three pills a day.

Another formula: take a deer thyroid (the thyroid gland of the deer), submerge it completely in good wine, then dry it over a fire and return it to the wine, repeating the roasting until it is fragrant. Hold it in the mouth and swallow the juice. When the flavor is gone, switch to another piece, and continue until ten pieces have been used. It is said that this will cure the condition.

Moxibustion (the traditional therapy of applying burning mugwort to acupoints):

For goiter accompanied by foul-smelling qi, moxibustion may be applied to Tianfu (Celestial Storehouse) point for fifty zhuang. ("Zhuang" is the unit of counting for moxa cones. The Qianjin Yifang states that one may also moxa Xiongtang (Chest Hall) point for one hundred zhuang.)

For goiter accompanied by rebellious qi and shortness of breath, moxibustion may be applied to Feishu (Lung Shu) point for one hundred zhuang.

For goiter accompanied by rebellious qi and chest oppression, moxibustion may be applied to Yunmen (Cloud Gate) point for fifty zhuang.

For goiter accompanied by fatigue and deficiency of qi, moxibustion may be applied to Chongyang (Surging Yang) point, with the number of zhuang calculated according to the patient's age.

For goiter accompanied by facial swelling, moxibustion may be applied to Tongtian (Penetrating Heaven) point for fifty zhuang.

For goiter, moxibustion may be applied to Tianqu (Heavenly Ravine) point for three hundred zhuang, applied at three sites spaced one cun apart horizontally.

Moxibustion may also be applied to Zhongfeng (Middle Seal) point, with the number of zhuang calculated according to the patient's age. This point is located on the dorsum of both feet, in the depression in front of the ankle where the bone curves.

For all types of goiter, moxibustion may be applied to Jianyu (Shoulder Bone) point, located in the paired depressions on the left and right shoulders. For men, apply eighteen zhuang on the left and seventeen on the right; for women, apply eighteen zhuang on the right and seventeen on the left. This may be repeated one to three more times, until the condition resolves.

Moxibustion may also be applied to Fengchi (Wind Pool) point for one hundred zhuang, located on either side of the back of the neck. Alternatively, one hundred zhuang may be applied to the hairline behind each ear.

Moxibustion is also applied at the point Touchong (Head Rushing; some editions read Jingtou Chong, "Neck-Head Rushing"). To locate it, the patient lies face up with both arms stretched straight forward so that they rest close to the head. The point lies where the arm corresponds to the nose. The number of moxa cones for each session depends on the patient's age. The Qianjin Yifang (Supplement to the Thousand Gold Prescriptions) states that this point is also called Binao (Upper Arm).

Fleshy growths (routumour) should generally not be treated. Treatment may be fatal, so great caution is required. The Zhouhou Fang (Prescriptions for the Elbow Reserve) states that they must not be pierced with needles or treated with moxa.

Xianzhong San (Powder for Sinking Swellings): This formula treats goiter (yingliu, neck swelling), bone growths, fatty growths, stone-like growths, fleshy growths, pus-filled growths, blood growths, and polyps as large as a cup, basin, sheng, or dou measure. When these conditions persist for twenty or thirty years, they may ulcerate and discharge pus, leaving the patient emaciated. The masses may be hard or soft and may burst, causing palpitations, restless sleep, and convulsive spasms. Even when the condition improves, it may flare up again. The formula is as follows.

Cuttlefish bone (wuzei gu) and sulfur (shi liuhuang), one fen each; white quartz (bai shiying), purple quartz (zi shiying), and stalactite (zhongru), two fen each; salvia root (danshen), three fen; amber (hupo), aconite (fuzi), swallow dung (hu yanshi), rhubarb (dahuang), and dried ginger (ganjiang), four fen each.

Grind these eleven ingredients into a fine powder, sieve it, and store it in a leather pouch sealed tightly so that the medicinal qi does not escape. If the sore is moist, apply the powder directly. If it is dry, mix the powder with lard and apply it, three or four times a day, until the area dries. If pus has not fully drained, the treatment may be continued for five or ten doses. This medicine prevents the patient from feeling pain. If the mass still does not subside, adding two liang of mirabilite (mangxiao) gives better results.

Formula for Treating Goiter

Kelp (kunbu), cinnamon bark (guixin), and willow catkins from willow growing by reversing water (nixuliu shui liuxu), one liang each; seaweed (haizao) and dried ginger (ganjiang), two liang each; and seven sheep thyroid glands (yangye, the thyroid of the sheep), dried in the shade.

Grind these six ingredients into a fine powder and form it with honey into small pills about the size of a pellet. Each dose is a single pill, which the patient holds in the mouth so that the medicinal liquid is swallowed slowly with saliva.

Another Formula

Alum (fanshi), ligusticum (xiongqiong), angelica (danggui), rhubarb (dahuang), coptis (huanglian), scutellaria (huangqin), ampelopsis root (bailian), and peony root (shaoyao), two fen each; and evodia fruit (wuzhuyu), one fen.

Grind these nine ingredients into a fine powder, sieve it, and mix it with egg yolk. Spread the paste on old, fine cloth and apply it to the swelling, sized and thickened to match the tumor. Replace the cloth when the medicine dries. Once the medicine takes effect, the site should suppurate, and pus should slowly seep out through the openings. After the pus and blood have drained, apply raw meat paste (shengrou gao). If the pus has not drained completely, the tumor may grow back and return to its former state.

Raw Meat Paste (shengrou gao): This paste treats carbuncles and tumors that have ulcerated and discharge pus, as well as traumatic wounds and various sores. The listed ingredients are angelica (danggui), aconite (fuzi), and licorice (gancao).

Angelica dahurica (baizhi), Ligusticum chuanxiong (chuanxiong, also called chuan xiong, one liang each), Allium bulb (xiebai, two liang), and fresh rehmannia root (shengdihuang, three liang).

Chop the above seven ingredients finely and simmer them in three and a half sheng of pig lard. Once the angelica turns yellow, strain out the herbal residue. Take a little of the resulting salve and spread it over the affected area, three times a day.

Another formula calls for dog feces and addled chicken eggs, mixed together and applied to the affected area. The method for draining pus is the same as described in the previous formula.

Apply "raw flesh salve" (shengrou gao) until the condition heals. The formula is given earlier, in Volume 22.

Yin Tui, Chapter Eight (Discussion and Formulas)

The treatise states that tui (tui, referring to a group of conditions involving scrotal swelling) has four types: intestinal tui, egg distension, qi tui, and water tui. Intestinal tui and egg distension are difficult to cure, whereas qi tui and water tui are more readily treated with acupuncture and moxibustion.

Pill for Treating Tui

Peach kernel and spider (fifty of each); cinnamon bark, tribulus fruit (ciliji), kochia fruit (dijifu), alisma, saposhnikovia root, schisandra berry, tangerine peel, poria, cynanchum root (fangkui), and peony root (each two liang); moutan bark, asarum, and seaweed (each one liang); and fox genitalia (one fox's reproductive organ).

Grind the above sixteen ingredients into a fine powder and bind them with honey into pills the size of a Chinese parasol-tree seed. Take ten pills per dose, gradually increasing to thirty. The original text next says to place the pills at the "two claw corners" and apply half a pill to each side, then moxibustion of seven cones will bring a cure. The exact location indicated by "claw corners" is not clearly described in the original.

For yin tui, moxibustion of ten cones may also be applied to the middle of the lines on the sole beneath the big toe, along with moxibustion on the swollen side. The Elbow Reserve Prescriptions (Zhouhou Fang) states that five cones should be applied at the center of the transverse crease beneath the second joint of the big toe. Master Yao states that three cones should be applied at the base of the big toe.

To treat tui in children, first take the child to the rice-pounder's head (the stone mortar used for husking rice) and address it with this incantation: "I have you sit here because the child, so-and-so, has a swollen scrotum, so I give you twenty-one cones of moxibustion." After the moxibustion, lead the child to the pounder's shaft and position the child so that the head of the sparrow faces downward, close to the seam of the scrotum. Apply seven cones of moxibustion along this seam. It is said that the swelling will then subside. The author states that this method has been verified as effective, and that the moxa cone should be about the size of a hedgehog's hairpin tip.

In general, for treating tui in men, the patient may sit astride the pounder's shaft, stretch the penis straight along the shaft so that it aligns with the front tip of the shaft, and then apply moxibustion to the wooden shaft. The number of cones is calculated according to the patient's age.

The treatise also states that some people have suffered from dry ringworm (ganxuan) beneath the genitals since childhood. Such cases should be treated according to the formulas for ringworm. If itching and dampness of the genital area result from the Five Exhaustions and Seven Injuries (a general term for excessive fatigue and depletion), and scratching leads to yellow discharge, a tonifying pill or powder should be used, together with external application of medicinal preparations.

Some men also develop "jealousy-essence sores" (dujing chuang), for which the prescriptions for jealousy-essence sores may be used. These sores grow at the junction just below the head of the penis, or inside the vaginal opening in women. They resemble chancroids (gan chuang, an ancient term for a type of ulcer), forming pits and eroding the surrounding tissue. Jealousy-essence sores cause severe pain, whereas chancroids do not.

Jilizi Decoction (Jilizi Tang): Deficiency heat, heat caused by taking mineral drugs, or invasion by wind, cold, or dampness that damages the skin can all cause heat to accumulate in the body, developing into febrile disease or edema. The patient may experience abdominal distension, rapid breathing, and difficulty with urination and defecation. The swelling feels like a water-filled bladder that sloshes when moved. The penis becomes hard and swollen, develops sores, and discharges fluid. Prescription texts hold that these conditions are all related to kidney heat and deficiency, forcing sexual intercourse, and damage to the spleen and stomach from wind and dampness.

In treatment, take the appropriate prescription internally to promote urination. Externally, wash the four limbs with this decoction, then apply scallion-white ointment. The penis should be washed separately with a pig's trotter decoction.

Jilizi Decoction formula (Jilizi Tang fang): Caltrop fruit, scallion core, green tangerine peel, and adzuki beans, one sheng each; Chinese cabbage seed, two sheng; Sambucus javanica (dwarf elder), five sheng; one croton seed (with its shell). Chop these six ingredients, add two dou of water, and boil down to eight sheng. Use the liquid to wash the swollen area.

Pig's Trotter Decoction (Zhu Ti Tang): Used for fever after taking mineral drugs, and for penile swelling caused by exhaustion, intense heat, or sleeping outdoors and being exposed to wind.

One pair of pig's trotters, three sheng of Sambucus javanica, one sheng of caltrop fruit (crushed), five he of tingli seed, five he of huangbo (Phellodendron bark), and dilong (Sanguisorba root). Chop these six ingredients, add one and a half dou of water, and boil down to six sheng. Strain out the dregs and wash the sore while the liquid is still warm, twice a day. Boiling only the huangbo for the wash also works well.

Sun Zhenren's Essential Prescriptions Worth a Thousand in Emergencies (Beiji Qianjin Yaofang), juan 74