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Whether in adults or children, if they contract epidemic pathogens and the heat pathogen enters the Pericardium (Heart Protector), resulting in coma and delirious speech, one can use Rhinoceros Horn (Xijiao), Antelope Horn (Lingyangjiao), Forsythia (Lianqiao), Honeysuckle (Jinyinhua), Scrophularia (Yuanshen/Shexuan), Rehmannia Root (Shengdihuang), Human Excrement Yellow (Renzhonghuang), and Raw Licorice (Shenggancao) to decoct a medicine, which is then taken with Zhibao Dan (Precious Treasure Pill). This often yields effective results. For those whose heat pathogen has penetrated deeply causing spasms, this method is also suitable. People today, encountering children suffering from this condition, wrongly attribute it to Wind-Convulsion (Jingfeng) and use needle pricking, which leaks the True Qi (Zhenqi) and causes Yin and Yang to rebel, leading to untreatable deterioration.

In the autumn of the Wuwu year of the Xianfeng reign, the granddaughter (aged twelve) of Wu Rongfeng, an instructor at Renhe County, contracted summerheat, resulting in coma, delirious speech, and spasms. I administered the aforementioned decoction. Wu’s wife subsequently invited a female physician, who diagnosed it as Wind-Convulsion and applied needle pricking. The next day, the child’s fever intensified, and she died. I was surprised by the lack of efficacy of the medicine and felt deeply remorseful. In the autumn of the Genshen year, while taking refuge in Beiche Tower Village, a child of the Chen family in the village presented with fever, coma, delirious speech, and spasms. I again used the previous prescription. After ingestion, the child slept soundly and sweated, showing signs of improvement. Suddenly, a relative who was a physician came to examine the child, diagnosed it as Wind-Convulsion, and pricked the chest and abdomen with needles. The sweating ceased immediately, the condition worsened, and the child died that night. At the same time, I treated two other patients with identical conditions using the same prescription, both recovered, and neither had undergone needle pricking. It was then realized that the deaths of the first two children were not due to the ineffectiveness of the medicine, but rather due to the misdiagnosis of Wind-Convulsion and the subsequent application of needle pricking. I record this specifically as a warning.

The ancient method for treating epidemics described in the *Neijing* (Inner Canon) using Xiaojindan (Little Golden Pill) cannot be employed today. Recently circulated prescriptions for treating plagues include Liu Songfeng’s *Wuwen Dan* (Five Plagues Pill). Its preparation involves designating a sovereign herb based on the heavenly stem of the year: Gancao (Licorice Root) for Jia/Ji years; Huangqin (Scutellaria Root) for Yi/Geng years; Huangbai (Phellodendron Bark) for Bing/Xin years; Zhizi (Gardenia Fruit) for Ding/Ren years; Huanglian (Coptis Rhizome) for Wu/Gui years. Ministers (assistant herbs) include Xiangfu (Cyperus Rhizome, cleaned of fine hairs), Zisuye (Perilla Leaf, selecting those with phoenix-head shape), Cangzhu (Atractylodes Rhizome, soaked in rice wash water), and Chenpi (Tangerine Peel). Additional ingredients include Mingxionghuang (Realgar, separately ground fine) and Zhusha (Cinnabar, separately ground fine). The method for preparing Gancao is as follows: On the Start of Winter (Lidong), take a large green bamboo stalk, cut off the nodes at one end, leave the node at the other end, insert raw Gancao inside, seal with wax, and immerse in a manure pit. Retrieve on the Winter Solstice (Dongzhi), dry, and set aside. Among the five sovereign herbs mentioned above, the one corresponding to the current year as sovereign should be doubled in quantity relative to the ministers. For example, if Gancao is 2 liang, the other eight herbs are used only 1 liang, and Realgar and Cinnabar are halved again to 5 qian. On the Winter Solstice, grind the nine herbs (including Gancao) into powder. Mix half of the Realgar and Cinnabar powders into the herbal powder to form pills, leaving the other half as the coating. Coat with gold leaf. Adult dosage: pills the size of wutong seeds. Pediatric dosage: pills the size of millet grains. Formulate with snow water and honey. Take 50 pills facing east. For mild and recent diseases, one dose suffices for cure; for deep-seated and chronic diseases, three to four doses suffice. Avoid all rich and greasy foods. This formula also treats various heat syndromes in summer months and resolves toxicity from smallpox/rashes. Wealthy families preparing these pills to distribute have boundless merit. As for plague prevention methods: grind Rush Xiang (Frankincense), Cangzhu, Xixin (Asarum), Sheng Gancao, Yunxiang (Rue), and Baitanxiang (White Sandalwood) into powder, form pills with jujube flesh, and burn them for fumigation. Also, soak Guanzhong (Cyathula Root) in kitchen water tanks. Alternatively, mix 2 liang of Realgar, 1 liang each of Dansha (Cinnabar), Guijiu (Podophyllum Rhizome), and Shichangpu (Acorus Rhizome) into powder, blend well with well water, and apply to the five centers (palms, soles, chest, abdomen), forehead, nostrils, and ear gates; this is very effective for repelling plague. If entering a plague-infested home, apply sesame oil to the nostrils; upon exiting, sneeze to expel pathogens, ensuring non-infection. These are all good methods. However, the essential principle is as Zhang Jingyue stated: One must regulate desires and avoid labor, and never endure hunger to welcome the qi. This is particularly appropriate.

When Yu Shiyu (name Lin) from Changzhou was residing in Zhongzhou, his father contracted an epidemic and was mistreated by many physicians. Upon returning for the funeral, he reviewed their prescriptions and found they all adhered to methods for treating Cold Damage (Shanghan). He pondered that there must be a way to save lives for this syndrome and published it to alleviate his hidden regret. Having read in the *Bencao* (Materia Medica) that Shigao (Gypsum Fibrosum) is cold in nature, clearly clearing Stomach heat, light and thin in flavor to release muscle heat, heavy and descending to drain excess heat, he suddenly realized that without Gypsum, one could not treat Heat Epidemics. Encountering such cases, his administration of Gypsum was invariably effective. Over thirty years, he saved many people, thus writing *Yizheng Yide* (One Gain in Treating Epidemic Diseases) in two volumes, preface dated and published in the 59th year of Qianlong. His main argument posits that Wu Keyou’s distinction between Cold Damage and Plague is clear: symptoms like headache, fever, and aversion to cold should not be mistaken for Cold Damage exterior syndromes; forcing sweat only damages exterior qi without reducing heat, and purging only damages Stomach qi. This captures the essence. However, the theory that pathogens enter via mouth/nose, do not transmit to the Stomach but to the Membrane Source (Moyuan), seems flawed. The use of Dayuan Yin and various Chengqi Decoctions still retains concepts of attaching interior/exterior dynamics. Only Xiong Renzhao’s initial use of Baidu San (Eliminate Toxin Powder), removing certain harsh ingredients, followed by Jiegeng Tang (Platycodon Decoction) as a carrier vessel to retreat heat from the chest/diaphragm and six channels, is indeed a brilliant method. Yu adopted this method, removing Mangxiao (Natrii Sulfas) and Dahuang (Rhubarb Root), because epidemic disease is a formless toxin, difficult to withstand猛烈 (violent) purgatives. By heavily using Gypsum, it directly enters the Earth element (Stomach/Spleen), destroying the nest of harm first, making the afflictions of the twelve channels easier to pacify. His formula is named Qingwen Baidu San (Clear Plague Eliminate Toxin Powder). Ingredients: Shigao (Large dose: 6-8 liang; Medium: 2-4 liang; Small: 8 qian - 1.2 liang); Xiaoshengdi (Small dose: 6 qian - 1 liang; Medium: 3-5 qian; Small: 2-4 qian); Wu Xijiao (Black Rhinoceros Horn) (Large: 6-8 qian; Medium: 2-4 qian; Small: 1-1.5 qian); Zhen Chuanlian (True Sichuan Coptis) (Large: 6-4 qian; Medium: 2-4 qian; Small: 1-1.5 qian); Sheng Zhizi, Jiegeng, Huangqin, Zhimu, Chi Shao, Yuanshen, Lianqiao, Zhuye (Bamboo Leaves), Gancao, Danpi. He believed that at the onset of epidemic disease, presenting with aversion to cold and fever, splitting headache, restlessness, delirium, body heat with cold limbs, prickly tongue, scorched lips, vomiting and diarrhea, and deep, fine, rapid pulse, one should use the large dose; if the pulse is deep and rapid, use the medium dose; if floating, large, and rapid, use the small dose. If macules/papules appear, use Daqingye (Isatis Leaf) with a small amount of Shengma (Cimicifuga Rhizome, 4-5 fen) to guide toxins outward. This is a method of internal resolution and external release, lowering turbidity and raising clarity. Treatment success rate is high, unlike lifting/releasing exterior methods which worsen the condition. His recorded cases all used several liang of Gypsum and several qian of Rhinoceros Horn and Coptis. Jiang Han Tun’s *Bihua Yijing* (Brush Flower Medical Mirror) records treating a contemporary epidemic using up to 14 jin of Gypsum before macules subsided, likely employing Yu’s method. Recently, Chen Zai’an also imitated this and achieved success. Wang Xuequan’s *Chongqing Tang Suibi* states: Wu Keyou treats epidemics primarily with Dahuang, discussing Wet-Warmth disease where dampness is earth qi, i.e., turbid pathogens attacking the lower jiao (formidable damp-turbidity), hence suitable for purgation rather than clearing. Yu Shiyu treats epidemics primarily with Shigao, discussing Summerheat-Heat disease where summerheat is heaven qi, i.e., clear pathogens attacking the upper jiao (formless dry-fire), hence suitable for clearing rather than purgation. Both gentlemen possess profound insight, representing two major schools for treating epidemics. Is this statement truly valid?