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Attacking disease with purgation is something people also dislike hearing about. However, when accumulations and stagnations remain in the center, and cold-heat pathogens linger and knot inside, is it right to retain them? Is it right to expel them? The *Neijing* (Classic of Internal Canon) values only the free flow of Qi and Blood. Secular incompetent physicians value only obstruction and closure. Furthermore, they only know that "purgation" means draining; how could they know that what the *Neijing* calls "purgation" is actually what is called "tonification"? When old accumulations are removed, the intestines and stomach become clean; when masses (abdominal lumps) are exhausted, Ying and Wei (Nutritive and Defensive Qi) flourish. Within this non-tonifying approach, true tonification exists. Yet the common people do not believe that purgation can be used as tonification, largely because incompetent physicians recklessly administer purgatives: using heat for cold patterns and cold for heat patterns, failing to achieve even minor efficacy while turning into major harm, causing even intelligent individuals to lose faith. This is the reason.

Therefore, regarding purgation with cold herbs, Tiaowei Chengqi Tang (Regulate the Stomach Decoction) is the superior herb for draining heat; Dachengqi Tang (Major Order the Yellow Decoction), Xiaochengqi Tang (Minor Order the Yellow Decoction), and Tao Ren Chengqi Tang (Apricot Seed Order the Yellow Decoction) are next; Xianxiong Tang (Sunken Chest Decoction) is next again; Da Chaihu Tang (Major Bupleurum Decoction) is yet next. Regarding purgation with cool herbs, Bazheng San (Eight Correctness Powder) drains heat and promotes urination; Xixin San (Washing Heart Powder) extracts heat and treats head and eye conditions; Huanglian Jiedu San (Coptis Detoxification Powder) treats accumulated heat internally and externally, above and below, that cannot vent; Siwu Tang (Four Substances Decoction) cools blood and promotes menstruation; Shenxiong Wan (Spiritual Xiong Pill) resolves accumulated heat above and below and discharges it. Regarding purgation with warm herbs, Wuyou San (Carefree Powder) is the superior agent for descending various accumulations; Shizao Tang (Ten Dates Decoction) is the superior agent for descending various water fluids. Regarding purgation with hot herbs, there are Zhuhuang Wan (Boiled Yellow Pill), Chanjin Wan (Golden Coil Pill), etc. In acute cases, use decoctions; in chronic cases, use pills, or take pills with decoction. Measure the severity of the disease, stop when the disease is addressed, do not necessarily finish the dose; excess leads to error.

Zhongjing said: "The general principle is that autumn suits purging." This means that in autumn, Yang Qi is below, human Qi and pathogenic Qi are also below, so purging is suitable. This is Zhongjing speaking generally. If in spring and summer there are diseases suitable for purging, should one not purge? These are secular incompetent physicians who delay and procrastinate, harming people with serious illness. They all say: "How dare one use heavy drugs to drain Stomach Qi in summer?" Alas! How ignorant of the transformations of Nature they are! The *Neijing* states: "The depression of Earth and Fire manifests in the Qi of the four seasons." In the fifth month, first select the source of transformation, drain Earth and tonify Water. It also says: "When Earth is depressed, seize it." Wang Taipu annotated: "Seize means to purge, to remove obstruction." Then, in the fifth month, to prevent the onset of Earth obstruction, allowing people to undergo purgative seizure, is this not what the *Suwen* says? However, depending on the syndrome, purgative seizure is not always necessary; it depends on the skilled physician's discretion. I speak of this to correct secular views and avoid delaying the treatment of serious and sudden illnesses. Thus, seizing Earth depression, even using Dachengqi Tang causes no harm. Let us discuss the ingredients of Dachengqi Tang: Dahuang (Rhubarb Rhizome) is bitter and cold, opens the nine orifices, benefits large and small urination, removes accumulated heat from the five Zang and six Fu organs; Mangxiao (Mirabilite) is salty and cold, breaks phlegm, dissipates heat, moistens intestines and stomach; Zhishi (Immature Bitter Orange) is bitter and cold, serves as an assistant, disperses stagnant Qi, eliminates fullness and distension, removes abdominal bloating; Houpo (Magnolia Bark) is acrid and warm, harmonizes spleen and stomach, widens the middle and unblocks Qi. Although these four ingredients are purgatives, they have both draining and tonifying effects, possessing remarkable miraculous efficacy. Liu Hejian added Gancao (Licorice Root) to form Sanyi Chengqi Tang, using sweet herbs to harmonize the center, best capturing Zhongjing's secret. I once modified Dachengqi Tang into Tiaozhong Tang, adding Jiang (Ginger Rhizome) and Zao (Jujube Fruit) for decoction. Laypeople see Ginger and Jujube and think they tonify spleen and stomach, so they happily take it, unaware it contains Dahuang and Mangxiao. Disliking cold and liking warmth for tonification, thus from ancient times to now, the world is alike. This is the method of the *Neijing* being suppressed and unable to extend. This medicine treats patients with epigastric fullness, qi stagnation, and constipation; after 5-7 bowel movements, one feels neither tired nor weak; the next day, spirit is clear and pleasant, the chest feels empty, and appetite increases. The *Neijing* says: "Spleen acts as the envoy, Stomach acts as the market." Human food and drink, sour, salty, sweet, bitter, hundred flavors, scatter here, obstructed and not moving; sweeping away the old to renew the new, this is also what the spleen and stomach hope for. Especially considering people in the Central Plains who eat mixed foods and do not labor. The Central Plains is Earth, carrying the Four Symbols; Wood, Metal, Water, Fire all gather here. So for spleen and stomach diseases, why do doctors of the Central Plains not excel at clearing the granaries, leaving old accumulations unable to go? And still say: "I am good at tonifying." This is a great sin. This medicine has miraculous efficacy; everyone says taking it causes damage and ruin; these are those who prefer Dan (cinnabar/alchemy) over Su (plain medicine).

Some say: "Men should not be purged for long; women should not be vomited for long." What absurd论! If vomiting is indicated, vomit; if purging is indicated, purge. Does one ask about gender? For adults and children, whatever harmful substance is in the stomach, if the pulse in both hands is slow and slippery, it is internal excess, suitable for purging. How to distinguish? Those injured by leftover food hate food; those injured by wind hate wind; those injured by cold hate cold; those injured by wine hate wine. It is very easy to distinguish. Therefore, whenever leftover food is in the stomach, one may purge until the three positions of the pulse are level. If pressing the epigastrium feels hard and full, one should still purge. After severe sweating in Shanghan (Cold Damage), if relapse occurs due to repeated exertion, it is because heat was not fully cleared after purging; one should purge again. If miscellaneous diseases present with continuous abdominal fullness and pain, this is internal excess. The *Jingui Yaolue* says: "Pain with abdominal fullness, non-tender on pressure is deficiency, tender is excess." The *Nanjing* says: "Tender indicates excess; abdominal fullness and pain, internal obstruction indicates excess, so purging is suitable." Regardless of whether it is miscellaneous disease or Shanghan, urgent purging is suitable. Use Dachengqi Tang, or Dao Shui Wan (Water Guiding Pill), or Xie Shui Wan (Draining Water Pill), etc., resulting in more than ten bowel movements. If pain persists, one may take it again; stop when pain ceases. As for Shanghan after severe sweating, fever, deep and solid pulse, alternating chills and fever, occasional salivation and cough, use Da Chaihu Tang plus Danggui (Angelica Sinensis) for decoction and ingestion; after 3-5 bowel movements, immediate recovery. Postpartum must never be treated as various deficiencies; otherwise, it will transform into bone-steaming tidal fever, inability to eat, emaciation, and amenorrhea. The Classics say: "Cold decreases appetite; heat consumes muscle." People becoming emaciated are due to crude physicians using drugs to consume and burn. Alas! Do humans die because of fate? The *Nanjing* says: "Reinforce excess and deplete deficiency." Depleting the insufficient and benefiting the surplus—such deaths are killed by physicians!

As for yellow eyes, Jiudan (Nine Jaundices), and Shi Lao (Food Labor Disease), all belong to Spleen Earth, suitable for purging; use Yinchen Hao Tang (Artemisia Capillaris and Horsetail Decoction). Or use Dao Shui Wan, Yu Gong San (Yu Gong Powder), purging more than ten times, then follow with Wuling San (Five Ling Powder), Guiling Ganlu San (Cassia Twig and Poria Sweet Dew Powder), Baizhu Wan (Atractylodes Macrocephala Pill), etc.; taking them leads to cure. Or for waist, leg, and hip pain, use Gansui powder 2-3 qian, slice pig kidney thinly 7-8 pieces, mix medicine inside, wrap in wet paper several layers, cook with mild fire until done, chew finely before sleep, swallow with warm wine or rice soup. At dawn, seeing 10-20 bowel movements, do not be surprised; if wanting to stop diarrhea, drink water or fresh well water in one gulp, diarrhea stops immediately. Then take Tongjing Heshi Dingtong Wu Jin Wan (Meridian Unblocking, Qi Harmonizing, Pain-Stopping Black Gold Pill), Pianma Dan, etc., and it will heal. The *Neijing* mentions diseases arising externally not due to Qi movement; Taipu considers them miasma, evil spirits, insect poison, Feishi (Flying Corpse), ghost strike, impact, falling, wind-cold-warmth-dampness, cutting, shooting, peeling, cutting, bumping, striking, etc. As for falling from horses, falling into wells, beating, spraining, fractures, scalding, burning, cart crushing, dog bites, swelling and painful abscesses, crying day and night without stopping, I usually achieve great effect in casual conversation. One can severely purge 30-40 times, pain stops, swelling subsides, then use Tongjing San with Dao Shui Wan, etc. If water discharge is little, add decoction to purge, then take blood-harmonizing, swelling-reducing, detoxifying medicines; disease removed like sweeping. This method was obtained from Gao Shuoming and Hou Dehe of Suiyang, preventing external injuries from leading to disability and lameness. I dare not cover others' goodness; my intent is only to save lives!

Once a neighbor had a beating wound erupting with swelling and pain, spreading up and down, confused speech, frequent vomiting, not eating for days; all said incurable. I used Tongjing San 3-4 qian with Shenyou Wan over 100 pills, taken together; some were vomited out, but most passed the diaphragm! After a while, severe diarrhea several times, foul smell unbearable, pus, blood, saliva, phlegm, stasis toxin about 1-2 dou; the patient slept deeply unconscious for a day and night. Neighbor asked me. I said: Breathing is uniform and steady, swelling reduced, pain decreased, so he sleeps. Next morning, speech clear, appetite returned, healed in a few days. Saving those dying from beating wounds, between forty years two or three hundred; I recall all neighbors dying from beating wounds died in vain. Since then, whenever seeing unjustly punished people, urgently use Dao Shui Wan, Yu Gong San, make large doses, purge惊涎 (frightened saliva) one or two basins, no more swelling and pain. If Dao Shui Wan, Yu Gong San do not induce diarrhea, add Tongjing San, Shenyou Wan to purge. After purging, must avoid hot foods, only drink fresh well water one or two times; once diarrhea stops, immediately cured. As for those emaciated and weak from deposits for many years, do not suddenly use harsh attacking drugs; can take Chanji Dan, Sanleng Wan, etc. The *Neijing* says: "For heavy conditions, reduce gradually." If an elderly person is weak, with deficiency-center accumulation, only take Wanbing Wuyou San every five days. Thus, how can a disease of years be cured by one drug? It can be reduced and removed.

Examining the *Bencao*: Cold purgatives include Rongyan (Rock Salt) salty, Xijiao (Rhinoceros Horn) sour-salty, Cangyan (Blue Rock Salt), Zexie (Alisma) sweet-salty, Zhishi (Immature Bitter Orange) bitter-sour, Nifen (Calomel) acrid, Zeqi (Euphorbia Lathyris) bitter-acrid, Xingren (Apricot Seed) bitter-sweet; slightly cold purgatives include Zhudan (Pig Gallbladder) bitter; greatly cold purgatives include Yaxiao (Saltpeter) sweet, Dahuang (Rhubarb), Guali (Melon Tip), Qianniu (Pharbitis Seed), Ku Huazi (Bitter Bottle Gourd), Lan Zhi (Orchid Juice), Niudan (Cow Gallbladder), Yangtimiaogen (Shepherd's Purse Root) bitter, Daji (Euphorbia Pekinensis), Gansui (Kansui Root) bitter-sweet, Puxiao (Mirabilite), Mangxiao (Mirabilite) bitter-acrid; warm purgatives include Binglang (Areca Nut) acrid, Yuanhua (Genkwa Flower) bitter-acrid, Shimii (Honey) sweet, Zaojiao (Gleditsia Sinensis) acrid-salty; hot purgatives include Badou (Croton Seed) acrid; acrid-cool purgatives include Zhu Yangxue (Pig and Sheep Blood) salty; neutral purgatives include Yuliren (Prunus Armeniaca Kernel) sour, Taohua E (Peach Blossom Epicalyx) bitter. Of the above thirty items, only Qianniu, Daji, Yuanhua, Zaojiao, Yangtimiaogen, Ku Huazi, Guali have slight toxicity; Badou, Gansui, Nifen, Xingren have great toxicity; the rest are non-toxic.

If epidemic Qi, wind-strike, alcohol intoxication, pediatric rash, postpartum tidal fever, epigastric fullness, blood stasis, do not use Yinfen (Silver Powder), Xingren (Apricot Seed) great toxic drugs; purging will cause death, or critical condition. Take Binglang (Areca Nut), Xijiao (Rhinoceros Horn), Zaojiao (Gleditsia Sinopsis) as warm and neutral, can kill parasites, penetrate joints, remove wind-fire dryness in intestines; Dahuang (Rhubarb), Mangxiao (Mirabilite), Puxiao (Mirabilite) salty-cold, treat Shanghan heat disease, seasonal epidemic plague toxin, macules, bloody stool, dry heat mania; make large decoctions to sweep accumulated heat; Zexie (Alisma), Yangtimiaogen (Shepherd's Purse Root), Niudan (Cow Gallbladder), Lane Ye Zhi (Orchid Leaf Juice), Ku Huazi (Bitter Bottle Gourd) also bitter-cold, treat edema all over body, abdomen large as drum, difficult urination and defecation, yellow eyes, damp toxin, Jiudan (Nine Jaundices), Shi Lao (Food Labor Disease), Ganchong (Childhood Malnutrition Parasites), eating soil/raw rice, separate and benefit water-dampness, unblock large and small urination, sweep old grain fighting in intestines. Also Beiji Wan (Emergency Aid Pill), made of Badou (Croton Seed), Ganjiang (Dried Ginger), Dahuang (Rhubarb), honey-pilled, is also a purgative. But only applicable to hard laborers, poor people eating coarse/spicy food, or epigastric fullness, stabbing costal pain, sudden unceasing pain; take 5-7 or 10 pills, purge 5-7 times to save emergency. If applied to wealthy city dwellers, it is wrong; this drug treating malaria with Ashi Stone (Realgar/Arsenic) is similar, only for poor eaters. If Beiji Wan treats Shanghan wind-warmth, alcohol/wind strike, pediatric rash, postpartum fullness, taken below diaphragm, death or critical. And city dwellers, wealthy families, using this purgative, death or critical too! Why do mediocre physicians fear Dahuang (Rhubarb) but not Badou (Croton Seed)? Crude physicians like Badou but dislike Dahuang? Mediocre physicians do not fear Badou because it is hot, fear Dahuang because it is cold; crude physicians like Badou because dose is small, dislike Dahuang because dose is large; all due to ignorance of principle. Who knows among all toxins, Badou is the worst. Removing oil and sealing with wax, it still causes purging, drying up body fluids, retaining toxin, chest heat, mouth dryness, other diseases arise; thus Badou is forbidden in purgatives.

I once used the first ten-plus drugs as easily as the body uses the arm, the arm uses the hand. However, for various hole-diarrhea and cold-middle, do not purge; commonly called Xiuxi Li (Resting Dysentery). For Shanghan with floating pulse, do not purge. For exterior and interior both deficient, not suitable to purge. For Wupi Xin Syndrome in *Neijing*, not suitable to purge. For Jue with blue lips, cold hands and feet, deep internal heat, suitable to purge. For cold, not suitable to purge, distinguish by pulse. For children with internal diarrhea transforming into Slow Convulsion, staring eyes, fish-mouth breathing, also not suitable to purge. If twelve meridiments are severely damaged, not suitable to purge, only suitable to nourish and regulate, warm to harmonize; purging will surely harm the patient! For the rest, large accumulations and masses, major diseases with major constipation, major dryness and hardness, purgatives are tonics. I once said: Purging method combines tonifying method, precisely for this reason.