Library

The theory of epidemic diseases has been discussed in the first volume, divided into two routes of origin, three routes of progression, and five treatment methods, which is detailed and comprehensive.

General principles: The qi of heavenly epidemics enters through the meridians and collaterals; the symptoms include headache and fever, suitable for mild dispersal, using Xiangsu San (Perilla and Cyperus Powder) to disperse it. Pathogenic qi transmitted via contagion enters through the mouth and nose; the symptoms include vomiting, nausea, and chest fullness, suitable for resolving turbidity, using Shenzhu San (Atractylodes Powder) to harmonize it. If the pathogenic factors from both routes merge into the interior, resulting in abdominal distension and fullness, delirium, mania, cracked lips, and thirst, use Zhiyi Qingliang San (Epidemic-Cooling Clearing Decoction) to clear them. If there is constipation with inability to pass stool, add Dahuang (Rhubarb Root) to purge them. Among the ingredients of Qingliang San, Renzhonghuang (Human Manure Processed with Bamboo) is a crucial herb for reducing fever and a miraculous elixir for resolving turbidity. If physicians lack or do not prepare this ingredient, how can they expect efficacy? Furthermore, for individuals with deficiency constitution contracting an epidemic, or for patients whose condition transforms into deficiency due to the disease itself, or due to improper treatment leading to deficiency, herbs such as Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), and Danggui (Angelica Sinensis Root) must be added to the clearing medicines to support the righteous qi. If the pathogenic qi gradually recedes but the righteous qi is severely deficient, the primary approach should be tonifying the righteous qi. Beyond the four methods of dispersing, resolving turbidity, clearing the middle, and purging downward, employing the method of tonification to manage these situations is a strategy that ensures complete efficacy. I have once used Maidong (Ophiopogon Tuber) and Shengdi (Rehmannia Root) each in amounts of one liang, adding 2-3 qian of Renshen (Ginseng Root) to rescue fluid depletion. I have also used Renshen Tang (Ginseng Decoction) to administer Jiawei Zhizhu Wan (Modified Atractylodes and Immature Bitter Orange Pill) to treat conditions of deficiency constitution with stagnant heat and constipation. With the pathogenic qi receding and the primal qi stabilized, I regard this as a flexible method kept in my sleeve. I earnestly advise my colleagues to internalize this. Additionally, for cases of massive swelling of the head and face, termed Datou Wen (Big Head Plague), and coarse swelling of the neck, termed Xia Wa Wen (Toad Plague), the ancient formula Puji Xiaodu Yin (Universal Benefit Detoxification Decoction) is indicated for both. However, if the head swelling is extreme, needle pricking (Bian Fa) is required. If physicians do not investigate the rationale, or if patients fear the procedure and refuse it, it often leads to ulceration, rupture, putrefaction, and untreatable outcomes. If the neck swelling is extreme, Chuhong (Tangerine Peel) and light salt water should be used to induce vomiting to expel phlegm, followed by the aforementioned formula with doubled Jiegeng (Platycodon Root) and Gancao (Licorice Root). Early treatment is essential; do not neglect this.

Xiangsu San (See Taiyang Syndrome section)
Shenzhu San (See Stroke-like Syndromes section)

Zhiyi Qingliang San Composition: Qinjiao (Gentiana Macrophylla Root), Chishao (Red Peony Root), Zhimu (Anemarrhena Rhizome), Beimu (Fritillaria Bulb), Lianqiao (Forsythia Fruit) (each 1 qian), Heye (Lotus Leaf) (0.7 qian), Danshen (Salvia Miltiorrhiza Root) (5 qian), Chaihu (Bupleurum Root) (1.5 qian), Renzhonghuang (Human Manure Processed with Bamboo). Decoct in water and take orally.

If chest fullness is caused by food stagnation, add Maiya (Barley Sprout), Shanzha (Hawthorn Fruit), Luobozhi (Radish Seed), and Chenpi (Aged Tangerine Peel); if there is hypochondriac mass, add Biejia (Turtle Shell) and Zhike (Immature Bitter Orange); if there is mental confusion and delirium, add Huanglian (Coptis Rhizome). If heat is severe with great thirst and ability to consume large amounts of water, add Shigao (Gypsum Fibrosum), Tianhuafen (Trichosanthes Root), and Renshen (Ginseng Root). If there is constipation with abdominal pain and distension, add Dahuang (Rhubarb Root) to purge. For deficient individuals with spontaneous sweating, double the amount of Renshen (Ginseng Root). For depleted fluids, add more Maidong (Ophiopogon Tuber) and Shengdi (Rehmannia Root). If it is a seasonal cold epidemic, cool medicines should not be used lightly; instead, carefully consider using Puji Xiaodu Yin (Universal Benefit Detoxification Decoction).

Bian Fa (Needle Pricking Therapy) (See Headache section)
Jiawei Zhizhu Wan (Modified Atractylodes and Immature Bitter Orange Pill) (See Abdominal Pain section)

Method for Preparing Renzhonghuang (Human Manure Processed with Bamboo): Take a bamboo tube, leaving nodes at both ends. Scrape off the green skin, make a hole, and pack it full of Gancao (Licorice Root). Plug the hole with wood shavings, seal it with melted rosin, and tie it securely with rope. On the first day of the twelfth lunar month, submerge it in a latrine tank. After one month, retrieve it, wash it with water, split open the bamboo tube, dry the Gancao (Licorice Root), and store it for use.

Question: Xiangsu San (Perilla and Cyperus Powder) and Shenzhu San (Atractylodes Powder) are aromatic herbs, while Renzhonghuang (Human Manure Processed with Bamboo) has a foul odor. Why are all of them used to resolve epidemic toxins and eliminate turbidity? Answer: It is unknown that when pathogens lodge in the Upper Jiao (Upper Burner), which is a clear and empty region, aromatic herbs are used to resolve them. When pathogens lodge in the Middle and Lower Jiao (Middle and Lower Burners), which are regions of turbid yin, epidemic toxins condense into filth there. In such cases, aromatic herbs alone cannot resolve the issue; one must use filth to attack filth for the turbidity to be cleared. This is why the use of Renzhonghuang (Human Manure Processed with Bamboo) is so appropriate. Diseases have sequences, locations, and transformations, and medications must follow accordingly to constitute flexible methods. Physicians must constantly recognize this, not only in the context of treating epidemics.