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There are such miasmas in Quanzhou, Guilin, Wuzhou, and Pingle. Between the eighth and ninth lunar months, the aroma is like that of osmanthus flowers. This type of miasma is the most acute; upon contact with its odor, one may immediately collapse. This is classified as intermediate miasma (Zhong Zhang). Companions must dig a hole near the victim's nose to allow ventilation from the earth, which offers a chance of survival. However, symptoms include abdominal pain, fullness, dizziness, and nausea. Severe cases face immediate danger, while mild cases can be saved by administering Pingwei Zhengqi San and Yu Shu Dan. Those skilled at avoidance, seeing black mist-like clouds indicating the approaching odor, will dig a ground pit, lie prone with their mouth and nose directed into the soil cavity, preventing the odor from entering, thus resolving the danger. The odor dissipates within a short time. Therefore, locals traveling on an empty stomach consume garlic and strong liquor to ward off the miasma. Alternatively, inserting Xingjun San into the nasal cavity is also effective.

Additionally, in areas near Yunnan and Cochinchina, there is an odor resembling glutinous rice; exposure causes illness or coma, commonly known as Jiangmi Zhang (Glutinous Rice Miasma). It can be treated similarly.

In the second, third, and fourth lunar months, when muddy waters flood, exposure leads to abdominal distension and pain, with green veins appearing coiled on the abdomen like earthworms, forming raised ridges. For mild cases, crushed garlic juice and mud slurry are applied to the abdomen, along with Yu Shu Dan, Zijin Ding, and ginger juice administered orally. Subsequently, Suhhe Qixiang Wan is given to unblock the qi mechanism.

From the third to the seventh lunar months, during the mating season of Boas, foul odors flow downstream with water. Exposure causes severe chest and abdominal pain and a fishy smell from the mouth and nose. Mild cases treated with Zijin Ding, Yu Shu Dan, Xingjun San, and Suhhe Wan may survive. Severe cases result in death within one or two days.

Generally, the principle of treatment dictates using hot herbs for cold syndromes and cold herbs for heat syndromes, a fact well known to all. This is akin to the easier task of answering the direct question in an examination versus the harder side approach. There are cases where exterior signs suggest excess but interior deficiency exists, or where interior reality is excess but exterior signs mimic deficiency; Yang syndromes may resemble Yin, and Yin syndromes may resemble Yang. The subtle and profound nuances mean that a slight deviation leads to great error. Although miasmas arise from mountain and earth qi according to seasonal changes, disease occurs only when it exploits underlying human deficiency. In individuals with Yang deficiency and fire decline, initial miasma exposure may go unnoticed due to mild symptoms, eventually transforming into internal disease characterized by deficiency-cold abdominal fullness, diarrhea, aversion to cold, and cold extremities. In those with Yin deficiency and fire hyperactivity, mild miasma exposure goes unnoticed, later manifesting as dizziness, thirst, fever, abdominal distension, nausea, and dark urine. One must also consider the inherent strength or weakness of the five zang and six fu organs, applying this logic analogously. Careful consideration of summer-autumn labor, travel, and living conditions regarding weather and dampness is essential for success. Regarding miasma pulse: initially, it is surging and rapid; in deficiency, it is large and hollow (Kou); in excess, it is wiry and slippery. Over time, it changes, but generally, forceless indicates deficiency, and forceful indicates excess.

Yu Zhen notes: The formulas used by San Nong to treat miasma differ slightly from ancient prescriptions. They will be published in "Ancient and Modern Experienced Formulas Annotated," so they are not recorded here. Compatible treatments that merely follow ancient formulas are not recorded.

Our Wu region suffers from Sha Qi (Sha Qi), more common in summer. Symptoms include abdominal pain, distension, fainting, and if untreated, immediate death. This condition closely resembles miasma. Scraping, bloodletting, applying Xingjun San to the eyes, and administering Sha medicine or Zijin Ding into the throat can lead to immediate recovery. This is not a difficult syndrome, nor does it require a separate category. However, some exaggerate its nature. For instance, Wang Yangwu's "Xi Wei Bu Hua Quan Shu" proposes sixty-four hexagram-based formulas, claiming various miscellaneous diseases stem from Sha Qi transformations. While rich in case records, the methods essentially involve dispersing wind, clearing summerheat, resolving phlegm, eliminating stasis, and breaking qi stagnation, merely attributing them to Sha Qi, causing confusion. This is no different from Wu Youke's "Wen Yi Lun," which attributes miscellaneous diseases to epidemic febrile diseases; both are forced associations.