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Heatstroke presents with a pulse that is surging (Hong) yet empty upon pressure.

Garlic and Fresh Well Water Prescription
Method for treating heatstroke.
Take one bunch of garlic, grind it thoroughly together with fresh yellow earth. Mix with freshly drawn well water, filter out the dregs, and administer orally to restore consciousness. For those injured by heatstroke, cold substances must not be administered immediately. Wait until the patient regains slight consciousness before administering cold substances; this ensures the movement of Middle Qi (Middle Jiao energy) without causing harm.

Dried Field Mud Circle Around Umbilicus Method
Emergency method for treating heatstroke-induced vertigo, severe oppression, and impending collapse.
Take dried mud from fields, form it into a circle, and pile it on the patient's abdomen. Have a young, robust person urinate into the center of the mud circle over the umbilicus; the patient will revive within a short time. Afterwards, do not drink cold liquids; warm rice soup must be ingested.

Luffa Leaf and White Frost Plum Prescription
Treating heatstroke-induced cholera-like vomiting and diarrhea.
Luffa leaf (one piece), White frost plum (one piece, including the kernel).
Grind these two ingredients together until extremely fine. Mix with freshly drawn well water and take orally. Recovery occurs immediately upon ingestion. Do not drink hot liquids.

Tangerine Peel and Agastache Decoction
Prescription for acute heatstroke-induced cholera with sudden vomiting and diarrhea.
Chenpi (Aged Tangerine Peel, 5 qian), Huoxiang (Patchouli, 5 qian).
Use two cups of clarified well water, decoct to one cup, and administer for immediate recovery.

Lablab Bean Drink
Treating heatstroke.
Extract juice from Lablab bean leaves, take one bowl orally for immediate recovery.

Salt and Ginger Decoction
Treating heatstroke-induced cholera where there is inability to vomit or defecate, accompanied by cold sweat and imminent danger.
Table salt (1 liang), Fresh ginger (5 qian, sliced).
Stir-fry together until color changes. Decoct in one large bowl of water and administer. Spontaneous recovery follows vomiting. Do not take hot. After recovery, do not eat solid food immediately; wait until extreme hunger before consuming thin porridge.

Method for Obtaining Fresh Well Water (All found in *Zhongfu Tang*)
Emergency treatment for heatstroke-induced vertigo and severe oppression.
Dig a pit three chi deep. Pour fresh well water into the pit, stir until turbid, and drink several mouthfuls for recovery.

(Swelling [Zhong] refers to external skin edema; distension [Zhang] refers to internal abdominal fullness. These two conditions should be viewed separately. However, since they are interrelated, they should also be viewed together.)
Swelling refers to enlarged skin. The ancients distinguished between Qi and Water. In reality, Qi stagnation leads to Water stasis, and Water stasis exacerbates Qi stagnation; the two cause disease mutually. In the *Shuizhang* chapter of the *Ling Shu*, pressing the abdomen leaving an indentation that does not rise is called Qi swelling; pressing the abdomen where the indentation rises immediately, resembling a bag wrapped around water, is called Water swelling. Zhang Jingyue reversed this theory, stating that for Water syndromes, if pressing leaves an indentation that does not rise, it is because water is in the flesh, resembling dregs or mud, not necessarily like a water bag; if it rises immediately upon release, it is due to deficient emptiness of Qi. Having extensive clinical experience, I know neither theory should be rigidly adhered to. Generally, mild swelling rises immediately upon pressure, while severe swelling does not. Areas such as the hypochondrium and joints rise immediately upon pressure; the dorsum of the foot and medial knee/thigh do not. Differentiation of symptoms should not rely solely on this. One should differentiate Yin and Yang based on the patency or obstruction of urination. Differentiate Cold and Heat based on whether the body exhibits more heat or cold, and whether the pulse is surging/large or thready/fine. Differentiate Deficiency and Excess based on whether the disease arose suddenly or developed gradually, and whether the patient is elderly and sickly or young and robust. Differentiate favorable and unfavorable progression based on whether swelling starts in the abdomen then spreads to limbs, or vice versa. Zhang Jingyue stated: Water and Qi belong to the same category. Those treating Water must simultaneously regulate Qi, for when Qi transforms, Water transforms; those treating Qi must simultaneously promote Water flow, for when Qi moves, Water moves. This condition should be referenced alongside Lin Syndrome (dysuria/retention).
For initial onset of swelling with asthma and inability to lie flat, Wupi Yin (Five-Peel Decoction) is the primary prescription. This formula treats skin with skins, avoiding damage to Middle Qi, which makes it excellent.
If swelling is accompanied by distension and difficult urination, Weiling Tang (Gastrodia and Atractylodes Macrocephala Decoction) should be used. Alternatively, Siling San (Four-Ling Powder) combined with half-cooked garlic pills is extremely effective.

Wupi San (Five-Peel Powder)
Note: For upper body swelling, induce sweating by adding Perilla Leaf, Schizonepeta, and Gentian Root each at 1.5 qian; for lower body swelling, promote diuresis by adding Adzuki Bean and Akebia Stem each at 1.5 qian, and Stephania Root at 1 qian.
For thirst, excessive heat, and difficult urination (Yang Water), add Talc, Akebia Stem, Plantago Seed, and Ophiopogon Root each at 1.5 qian, and Aucklandia Root at 0.5 qian.
For no thirst, spontaneous normal urination, and excessive cold (Yin Water), add Atractylodes Macrocephala Rhizome and Atractylodes Lancea Rhizome each at 2 qian, Aconite Lateral Root and Dried Ginger each at 1 qian, and Aucklandia Root at 1 qian.
For slippery/excess pulse, abdominal distension, and hypochondriac fullness, add Radish Seed at 1.5 qian, White Mustard Seed at 0.8 fen, Immature Bitter Orange at 1 qian, and Pinellia Tuber at 2 qian.
For women with irregular menstruation and swelling, where blood transforms into water (Water Division), add Safflower at 0.8 fen, Peach Kernel and Cyperus Rhizome each at 1.5 qian. For women whose menstruation just ceased followed by swelling, where water transforms into blood (Qi Division), add Angelica Sinensis Root at 3 qian, Dysentery Flower Pollen (Vitality Fat) vinegar-fried at 1.5 qian, and Cyperus Rhizome at 1.5 qian.
Note: After recovery with this formula, consolidate results with modified Shenqi Wan (Kidney Qi Pill) or Liujunzi Tang (Six-Gentlemen Decoction).

Weiling San (Gastrodia and Atractylodes Macrocephala Powder) (Found in *Miaoyong*)
Siling San Modified Pills
Atractylodes Macrocephala Rhizome (1 liang, stir-fried), Poria (2 liang), Polyporus (1 liang), Alisma Rhizome (1 liang).
Grind into powder, make pills with half-cooked garlic, size of mung beans. Take 3-5 qian with boiled water.

Swelling syndromes develop gradually and persist for long periods. Symptoms include asthma, thirst, inability to lie flat, abdominal distension, scanty urine, and loose stools. All critical conditions are primarily treated with Xue Shi Jiawei Shenqi Wan (Xue’s Modified Kidney Qi Pill).
Zhang Jingyue said: The *Nei Jing* states: "The Kidney is the gate of the Stomach; if the gate is obstructed, water accumulates following its kind." Why is the gate obstructed? The *Jing* says: "The Bladder is the official of the capital, storing fluids; transformation allows them to exit." This so-called transformation refers to Qi within the Kidney, i.e., Fire within Yin. Without Yang within Yin, Qi cannot transform, leading to blocked water pathways and overflow causing swelling. Therefore, those treating Qi must first treat Water; those treating Water must first treat Qi. If Qi cannot transform, Water will certainly not drain. Only when the True Qi of the Lower Jiao moves can transmission and transformation occur. Only when the True Water of the Lower Jiao assumes its proper position can clarity be restored. Seeking ancient methods, only Mr. Xue Lizai’s Modified Kidney Qi Pill is truly appropriate. I have used it frequently with consistent efficacy.

Xue Shi Jiawei Shenqi Wan (Xue’s Modified Kidney Qi Pill)
Prepared Rehmannia Root (4 liang), Poria (3 liang), Cornus Fruit, Chinese Yam, Moutan Cortex, Achyranthes Root, Alisma Rhizome, Plantago Seed, Cinnamon Twig (each 1 liang), Prepared Aconite Root (5 qian).
Make pills with refined honey, size of paulownia seeds. Take 3 qian per dose with boiled water, twice daily. If the constitution is inherently Yang-excessive with abundant fire in the Three Jiao, presenting with irritability, thirst, red face, asthma/cough, and slippery/excess pulse, indicating damp-heat and Yin deficiency, remove Cinnamon Twig and Aconite Root, and add Ophiopogon Root.
*Molecular Awakening* states: For Lower Jiao damp-heat, removing Cinnamon Twig and Aconite Root and adding Phellodendron Bark and Clam Shell Powder is most excellent.

Mahuang Fuzi Tang (Ephedra and Aconite Decoction) (Formula seen in *Jingui Yaolue*)
Remove Aconite Root, add Apricot Seed and Gypsum, named Xingzi Tang (Apricot Seed Decoction).
Furthermore, *Mingyi Zhizhang* states: When swelling is too severe, connecting internally to the Bladder and externally to the scrotum, causing tightness and blocking pathways, even with diuretic agents, there is no passage. How can the disease leave? One must open the bowels to expel water, tonifying as one purges, so the disease leaves while the Spleen remains intact. Gradual regulation may lead to survival. Do not adhere to old rules of mere diuresis. If swelling is not severe, diuresis remains the best strategy.
Note: This method is only suitable for robust youths for occasional use; otherwise, it should not be tried lightly.