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The chest protrudes upward, and vomiting of blood resembling juice occurs; this is the presentation of *Gua Rang Wen* (Melon Rind Plague). Use *Sheng Xi Yin* (Raw Rhinoceros Horn Decoction).
Sha's Commentary: This indicates pathogenic factors in the Middle Jiao causing injury to blood heat due to severe epidemic toxins. Therefore, the treatment principle is to clear the Ying (Nutritive) level and detoxify.

Purple patches appear all over the body suddenly; this is *Mei Chuang* (Mold Sore). Prick the patches to bleed them; it is appropriate to clear heat and detoxify using *Ren Zhong Huang Wan* (Human Waste Pill).
Sha's Commentary: In this condition, toxin and blood stasis reside in the Blood level. The *Cang Zhu* (Atractylodis Rhizoma) used in *Ren Zhong Huang Wan* is drying and acrid, acting specifically on the Qi level; *Fang Feng* (Saposhnikoviae Radix) is pungent and dispersing, acting specifically on the Liver Meridian. This seems inappropriate. One should add herbs such as *Jin Yin Hua* (Lonicerae Japonicae Flos) for detoxification and ensure the Blood level is unblocked. If *Qing Re Jie Du Tang* (Heat-Clearing and Toxin-Resolving Decoction) uses *Qiang Huo* (Notopterygii Rhizoma et Radix), *Ge Gen* (Puerariae Lobatae Radix), and *Sheng Ma* (Cimicifugae Rhizoma), these are merely exterior/body surface drugs that cannot unblock the San Jiao. All plague symptoms should be treated according to the Upper, Middle, and Lower San Jiao, not limited by the boundary of Exterior and Interior. Although *Cang Zhu* in *Ren Zhong Huang Wan* can aromaticize and expel turbidity, it is excessively drying and should be used with discretion.

Lumps like tumors emerge on the body and wander all over; if death occurs from morning to evening, this is *Ruan Jiao Wen* (Soft Leg Plague). Use a three-edged needle to puncture the *Weizhong* (BL-40) acupoint at a depth of 0.5 cm (1 cun/3 fen) to release blood, and administer *Ren Zhong Huang San* (Human Waste Powder).
Sha's Commentary: The condition of lumps was prevalent in Beijing during the 16th year of Chongzhen. Patients died within moments, and the treatment method was the same as described here, recorded in *Shuo Ling*. At that time, there was also *Yang Mao Wen* (Sheep Hair Plague); upon onset, there must be red spots on the back. After pricking them, a strand of sheep hair appears inside; survival was impossible, with deaths numbering in the millions. One should extensively consult books such as *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold), *Wai Tai Mi Yao* (Secret Essentials of the Outer Chamber), and *Sheng Ji Zong Lu* (General Records of Holy Relief) to find treatment methods.

Borborygmus (bowel sounds), abdominal pain, dry retching, and watery diarrhea without cessation occur; this is the presentation of *Shi Wen* (Damp-Warmth). Employ induced vomiting; it is appropriate to use *Shuang Jie San* (Double Resolution Powder).
Sha's Commentary: In this condition, there is mutual rejection between the upper and lower parts, resulting in blockage and obstruction. Urgently induce vomiting; once vomited, the Qi mechanism may flow freely, offering a chance for survival. However, this damp-toxin often stagnates in the Lower Jiao, resembling *Gan Huo Luan* (Dry Cholera). *Bei Ji Wan* (Emergency Pill) from *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) can also be used.

Clear urination, white loose stools, and swollen feet difficult to move occur; this is the presentation of *Shi Wen* (Damp-Warmth). It is appropriate to use *Cang Zhu Bai Hu Tang* (Atractylodes White Tiger Decoction).
Sha's Commentary: Damp-heat lies hidden in the Lower Jiao, and the Spleen fails to transport and transform. *Cang Zhu Bai Hu Tang* is used to clear damp-heat. Like the previous clause, this involves pathogens in the Lower Jiao. The previous clause involved Cold-Dampness with Middle Jiao symptoms; this clause involves Warmth-Heat, purely constituting a Lower Jiao condition.