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Huangqin (Scutellariae Radix, one qian, stir-fried with wine) Huanglian (Coptidis Rhizoma, one qian, stir-fried with wine) Jiegeng (Platycodonis Radix, one qian) Gancao (Glycyrrhizae Radix et Rhizoma, raw, five fen) Chaihu (Bupleuri Radix, five fen) Shengma ( Cimicifugae Rhizoma, seven fen)
Liaoqiao (Forsythiae Fructus, one qian) Guishen (Angelicae Sinensis Radix, one qian, washed with wine) Dahuang (Rhei Radix et Rhizoma, one qian, stir-baked with wine)
Add two zhan of water, decoct to one zhan, take warm slowly.

Discussion states: For heat syndromes, cold-natured herbs should be used; however, diseases have differences in location (high or low), and treatments have differences in distance and urgency, but one must not exceed established principles. Using the bitter-cold nature of Huangqin and Huanglian, processed with wine and stir-fried, as the principal drugs (Jun Yao) to drain upper-heat. Jiegeng and Gancao are acrid-sweet-warm and ascending, assisting the various bitter herbs to treat heat. Chaihu and Shengma are bitter-pale, with thin flavors, representing Yang within Yin, capable of dispersing upper-heat, serving as Deputy drugs (Chen Yao). Liaoqiao is bitter-acrid-pale, capable of dissipating nodules and reducing swelling. Danggui is acrid-warm, harmonizing blood and relieving pain; Dahuang, after wine baking, is bitter-cold, guiding the bitter property upward to the vertex, driving out heat and causing it to descend, serving as Envoy drugs (Shi Yao). After administration, swelling subsides and pain decreases; upon unimpeded bowel movement, reduce the dosage of Dahuang for subsequent doses. Caution speech, regulate diet, and recovery will occur within ten days.

The Commander-in-Chief was over seventy years old. In the autumn of Wuwu year, during a southern campaign, passing through Yangzhou, he captured over ten thousand people, selecting four beautiful girls near adulthood to serve him. I remarked, "The Commander leads an army of one hundred thousand deep into enemy territory, which is no trivial matter. Moreover, at his advanced age and weakened constitution, he must be cautious. Newly captured individuals harbor fear and anxiety internally; combined with irregular diet, this often leads to disease. Proximity facilitates the transmission of pathogenic factors, posing great harm." The Commander smiled without answering. His Vice Commander, who was present, later summoned me saying, "Since I joined the army at thirteen to campaign against the Huihu, I have extensive experience in such matters. Your words are highly credible." By the twelfth month, upon returning from the campaign, heavy snow fell for three days. The newly plundered people could not endure the cold and hunger, suffering from headache, cough, abdominal pain, and diarrhea, leading to many deaths. Upon arriving in Bianjing in the first month of spring, people along the route came with gifts to congratulate. The Commander, due to several bouts of heavy drinking, fell ill. His pulse was deep, fine, and wiry, pausing every three or four beats. Symptoms included headache, cough, abdominal pain, and diarrhea, similar to those of the new captives, but the pulse was short and choppy, indicating depleted Qi and severe illness. He died three days later. Pathogenic factors harming people can cause such disasters. The *Neijing* states: "When encountering the deficiency of the year, the emptiness of the moon, and the loss of seasonal harmony, if one contracts pathogens, the Qi penetrates to the bone." It also says: "Avoid pathogens as one would avoid arrows and stones." Qian Zhongyang also said: "Dirty shoes should not be near infants, as they often cause Tian Diao Jing Feng (convulsions), because the Righteous Qi is still weak and cannot overcome pathogens." From this, we see that the words of sages are indeed true.

In the twenty-first year of Chenghua, a plague broke out extensively in Xinye, with daily deaths. My neighbors Fan Zi and his wife had been bedridden for several days. Returning from school, hearing their family's cries like slaughtering sheep, I hurriedly went to visit without changing clothes. I saw several people covering the woman with cotton quilts and placing a basin of fire under the bed to induce sweating. Her face was red, voice hoarse, nearly lifeless. I scolded, "Let go immediately, or she will die." They did not listen, so I forcibly removed the quilts. She jumped up, leaned against the wall, unable to speak. I asked, "Do you want cold water?" She nodded. I gave her a bowl of water, which she drank in one gulp, enabling her to speak. She asked for more, which I provided. After finishing, she sweated profusely and recovered the next day. When asked why, I explained: "She had fever for several days and ate nothing, leaving her intestines dry. Steaming with fire would only accelerate death; how could there be sweat? Now, due to extreme heat, administering water achieves 'Water and Fire Mutual Interaction' (Shui Huo Ji Ji), allowing recovery without sweating! Consider a dry tripod heated by fire until red but lacking rising Qi; adding water causes Qi to rise naturally. Those encountering such syndromes must understand this."

Jiang Huangnan treated You Rangxi, a Censor, in the first month of Renzi year (Jiajing era). He suddenly contracted Da Tou Feng (Big Head Wind), starting with neck swelling. Previous physicians mistakenly treated it as external contraction using diaphoresis, then as internal injury using tonification. His face turned red, Taiyang channels swelled, head felt like splitting, body sweated excessively, he spoke deliriously while sleeping, lasting three days with urgent panting and coughing. His relative Wang Ziji first used Zhuru Jupi Tang, followed by Chuanxiong Chatiao San combined with Baihu Tang (without Renshen). One dose reduced symptoms. The next day, using the previous formula but removing harsh cold medicines, symptoms gradually settled by evening. Blisters appeared around the eyes, other swelling subsided, but swelling behind the ears and on the left cheek persisted. The following day, Danggui Liuhuang Tang was used as the main formula with detoxifying herbs. After twenty days, a lump the size of an egg remained on the vertex, facial swelling persisted, occasional headaches occurred, and stools were loose. In mid-February, Jiang examined the pulse: left pulse was floating, small, and weak; right pulse was large and rapid, showing vigorous momentum. Based on pulse and symptoms, Jiang determined treatment should focus on Fire. He used Sheng Huangqi (Astragali Radix) 8 fen, Baizhu (Atractylodis Macrocephalae Rhizoma) and Yiyiren (Coicis Semen) 1.5 qian each, Fuling (Poria), Pian Huangqin (Scutellariae Radix) 8 fen each, Sheng Gancao (Glycyrrhizae Radix et Rhizoma) 3 fen. Decocted with Tongbian (Child's Urine). The next day, the pulse stabilized slightly, but cheeks remained red, with morning headaches, indicating residual heat. Huangqi increased to 1.2 qian, Yiyiren to 2 qian. The vertex lump gradually subsided. Later, Sheng Huangqi was increased to 2 qian, along with Moutun Tang (Mung Bean Decoction) and Tongpiao (Child's Urine). Five doses led to recovery.

Su Jingzhan's Note: Yangming pathogenic heat combined with Shaoyang Minister Fire causes disease. Observe where the pathological trend lies and treat according to the channel. Treatment should be gentle; do not use heavy doses that exceed the disease site. Yangming pathogen causes head swelling; Shaoyang pathogen affects areas before and after the ears. In my practice, I initially use Liangge San, followed by Xiaodu Yin, achieving immediate cures.

In the Jiwu year of Jiajing, between May and July, epidemic hot plagues spread throughout Jiangnan and Huaibei, infecting households similarly. Using Renshen Baidu San, doubling Renshen (Panacis Ginseng Radix) and removing Qianhu (Peucedani Radix) and Duhuo (Angelicae Pubescentis Radix), all patients recovered completely without error.

In the sixteenth year of Wanli, a major plague struck Nanjing, causing many deaths. I resided at Jiming Temple. The abbot suffered from plague for over ten days. Several doctors advised fasting, even forbidding rice water. The patient was extremely hungry and begged for food. I stated, "Depriving food leads to death." Although this saying exists, it refers to internal injury from diet! The proverb says, "Starvation does not kill Shanghan (Cold Damage)." This is because pathogenic heat fails to digest grains; even without eating, death does not ensue. The Classics state: "Those who can digest grain survive." Especially when the disease involves internal deficiency, prohibiting food exacerbates deficiency, leading inevitably to death. If giving thin porridge without overfilling the stomach, and administering Buzhong Yiqi Tang, recovery occurs. Such cases are numerous. I rarely prohibited food and saved many lives. I often see officials in the capital mentioning only "Wind-Cold," failing to distinguish internal injury or deficiency/excess, uniformly prohibiting food. Some endured over twenty days with no food or drink allowed, even after pathogens were cleared, resulting in starvation deaths. I record this to warn against such customs.

In Wuzi and Jichou years of Wanli, epidemics prevailed. All who used Renshen Baidu San for release via sweating survived. Jiang Yingsu treated Chen's son, aged seventeen, with plague: extreme thirst, high fever, bursting headache, frequent diarrhea, and surging pulses in all six positions. He administered Sanhuang Shigao Tang, three doses daily, increasing Shigao (Gypsum Fibrosum) to one liang. Recovery in three days.

He's servant contracted epidemic plague, unable to recognize people, speaking wildly. Treated with Dijiang (Earth Slurry) and Tongzi Xiaobian (Child's Urine) soaked with Baitou Jing Diuqiu (White-headed Earthworm), pounded finely, filtered with fresh well water. Drinking one or two bowls restored consciousness; cured in three days.

Huxianweng treated Scholar Zhang Weibo, suffering from unresolved Wind-Heat during a plague outbreak. Other physicians found both hands' pulses hidden (Fu Mai) and declared it "Yang syndrome showing Yin signs," incurable. They intended to use Yangdu Shengma Tang to lift Yang. Huxianweng said, "This is extreme Wind-Heat; excessive Fire causes hidden pulses, not Yin pulses. Lifting will cause death." He ultimately prescribed Liaoqiao Liangge agents, resolving the condition with one dose.

Juquanweng treated a man with swelling and惡寒 (aversion to cold) in the head, face, neck, and throat. Physicians suspected unusual sores. Juquanweng said, "No, this is Shi Du (Seasonal Toxin) resembling Shanghan." Danxi said, "Untreated for five days, it kills." Urgently, he used Baidu San combined with Liaoqiao, Niubangzi (Arctii Fructus), and Dahuang to purge. Cured in three days.

The condition commonly known as Fa Sha (Sha Eruption) was previously unknown in Jiangnan but now appears everywhere, yet is not recorded in medical texts. Initially presenting with chills, limb flaccidity, headache, and fever, resembling Shanghan or malaria. Treatments include applying hot water to arms and scraping with Ramie (Zhuma); severe cases involve pricking fingers/toes for bleeding or cauterizing red spots on the back with oil lamps. These methods open pores and smooth blood vessels. Moxibustion is also used, with "Sha" (sand-like rash) being favorable. However, some die from pus and blood flow after moxa, which is pitiable. Yong Chengjie's printed formula suggests testing with Ai Tang (Mugwort Decoction) to induce vomiting; if vomited, it confirms the diagnosis. Immediately take one piece of mulberry paper from May silkworm molting, crush and decoct in a bowl, cover tightly with a plate, soak in hot water for half a bowl, seal edges with paper to prevent air leakage. Drink hot after a while, lie down covered with blankets to induce sweating and cure.

A fat woman from Wu frequently suffered from Fa Sha. Scraping with Ramie cured her temporarily, but relapsed within two to three days. Doctors used Siwu Tang, worsening epistaxis. Jiang used Xiangfu (Cyperi Rhizoma), Fuxiong (Ligustici Chuanxiong Rhizoma), Huangqin, and Zhizi (Gardeniae Fructus) to open stagnation, descend fire, and clear heat. A few doses cured her without recurrence. (These two items are case studies.)

In Renwu and Guiwei years of Chongzhen, epidemics raged, corpses littering roads. Physicians across regions used diaphoresis and harmonizing formulas. Those who exclusively used Renshen achieved the most recoveries.