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11. If there is excess pathogenic factor in the interior, one should naturally seek to use Jun Chuan San (Jun Chuan Powder) or Shen You Wan (Shen You Pill). If there is deficiency in the interior, one should use Shi Pi Yin (Realize the Spleen Decoction), which consists of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhigancao (Prepared Licorice Root), Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Chuan Fuzi (Aconiti Lateralis Radix Praeparata), Dafuzi (Arecae Semen), Houpo (Magnoliae Officinalis Cortex), Caoguo (Tsaoko Fructus), and Chao Ganjiang (Stir-fried Zingiberis Rhizoma). If various warming and tonifying treatments yield no effect, yet purgative treatments are too harsh for the patient to bear, one must employ the "nine parts tonification, one part attack" method. Seeking recovery slowly and maintaining a bland diet will often preserve life.

[Note] "Interior excess" refers to cases where both stool and urine are obstructed; in such cases, directly apply Jun Chuan San and Shen You Wan. "Interior deficiency" refers to cases where stool and urine are unobstructed; these patients are suitable for Shi Pi Yin, composed of Renshen, Baizhu, Fuling, Zhigancao, Muxiang, Mugua, Chuan Fuzi, Dafuzi, Houpo, Caoguo, and Chao Ganjiang. Edema diseases belonging to deficiency-cold patterns naturally warrant the use of warming and tonifying medicines. However, if these prove ineffective, it indicates that there must be excess pathogenic factors amidst the deficiency. While one wishes to use purgatives, the patient's constitution may not tolerate them; yet without attacking the pathogen, there is no other solution. Therefore, the "nine parts tonification, one part attack" method must be employed. This involves administering tonifying medicines for nine days, waiting for an opportunity to purge, and then using laxatives for one day to attack the pathogen. However, purgative medicines should initially be given in small doses; if the patient cannot tolerate them, the dose should be gradually increased. One must carefully examine whether the medicine matches the patient's Yuan Qi (Original Qi), ensuring that the pathogen is expelled without damaging the healthy qi; this constitutes the correct method. Subsequently, one might tonify for seven days and attack for one day, or tonify for five days and attack for one day, or tonify for three days and attack for one day, seeking recovery gradually until痊愈 (cure) is achieved. If one can abstain from salt and soy sauce and maintain a bland diet for one hundred days, many patients will survive.

1. In summer, injury by Shu heat (Summerheat) causes the pathogen to reside within the Ying (Nutritive) level; in autumn, exposure to cold wind allows the pathogen to dwell with the Wei (Defensive) level. At this time, if bound by external pathogens, Shu sweat cannot exit, leading to the disease known as Nue (Malaria).

[Note] The Classics state: "All types of Nue arise from Wind." This means that malaria occurring in any season invariably results from external constriction by Wind-Cold and internal retention of Shu heat. It is also said: "Nue is caused by the irregularity of Wind-Cold qi." This refers to malaria contracted at the specific time. Furthermore: "Injury by Shu in summer leads to Nue in autumn." And: "Those who do not sweat out Shu in summer develop Wind-Nue in autumn." This implies that when injured by Shu in summer, those with severe pathogens fall ill immediately with Shu disease, while those with mild pathogens lodge within the Ying level. Upon re-exposure to autumn cold wind, which resides with the Wei level, the Shu and Wind-Cold combine to form the pathogenic factor, resulting in Nue disease. Those who do not immediately contract Shanghan (Cold Damage) do so because Shu pathogen was previously latent in the Ying level. Generally, with only Wind and no Shu, only Wind disease occurs; with only Shu and no Wind, only Shu disease occurs. Only when Wind and Shu combine does Nue disease manifest.