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(Discourses, three pieces)
The discourse states: The *I Ching* (Book of Changes) says that heaven and earth undergo changes, each establishing its own nature and destiny. However, the traces of change are unpredictable, and the efficacy of life is difficult to fathom. Thus, there are fluctuations in heat and cold, feelings of oppression, wind and rain, darkness and obscurity; water and drought disasters, demonic calamities, insect and locust plagues, and strange anomalies. The transformations of the four seasons and eight solar terms vary greatly, and the movements of the seventy-two pentads and the sun and moon differ individually. Only after completing the measurement of shadow lengths can a year be finished; this is called the completion of the annual cycle. If heaven and earth are thus, how much more so for humans? Therefore, humans live between heaven and earth; their fate encounters various circumstances, and their times experience obstruction or smoothness, auspiciousness or misfortune, regret or disgrace, bitterness or joy, safety or danger, anger or joy, love or hatred, survival or death, worry or fear. Concerns arise by the thousand each day, and strategies for self-preservation emerge by the ten thousand at times, just to get through one day. Thus, there is no year without cold and heat, and no day without worry and joy. Therefore, Tianxing Wenyi (Tianxing Warm Epidemic / Seasonal Warm Infectious Disease) exists; those who fall ill are part of the qi of heaven and earth's changes. This is a necessary principle of creation, impossible to eliminate. Even if sages possess the virtue of mending the sky and establishing the pole, they cannot abolish it. Although they cannot abolish it, they can control it with the Dao. Secondly, virtuous people who are good at preserving life know moderation, adapt with the changing seasons, and can also preserve themselves. When heaven and earth have such miasma and pestilence, they use things produced by heaven and earth to prevent them. This is called knowing the method (Zhi Fang), so that pathogens cannot invade. However, this disease is commonly called "Heng Bing" (Sudden/Unexpected Illness) by laypeople. Most do not understand how to treat it, claiming it will heal itself when the days are full. Because of this, most victims die prematurely across the world. Whenever one first feels unwell, immediate rescue and treatment are required. Until recovery, soups and foods should be continuously administered to reduce the toxic pathogenic force, leading to natural healing. One must never allow the pathogenic qi to attack the body freely while doing nothing and waiting for death; this is an error. Now, extensively collecting from various classics into two volumes, providing comprehensive preparations, those who enjoy preserving life can learn in detail.

The *Duan Ju* (Short Treatise) states: Since ancient times, it has been passed down that Shanghan (Cold Damage) is a difficult-to-treat disease, and Shixing Wenyi (Seasonal Warm Epidemic) is caused by toxic qi. Those discussing treatment often fail to distinguish whether Shanghan and Shixing Wenyi stem from different qi, claiming Shanghan is the term used by scholars, while Tianxing Wenyi is the term used by peasants, without discussing the differences or similarities of the diseases. Examining various classics, they are actually quite different, and the appropriate treatments differ; therefore, the explanations of formulas should be distinguished. Hence, I briefly outline the essentials. Classics state: Spring qi is mild and harmonious, summer qi is hot and sultry, autumn qi is cool and clear, winter qi is icy and biting. This is the order of the correct qi of the four seasons. In winter, severe cold causes all things to hide deeply. A gentleman who is careful and meticulous will not be injured by cold. If one touches or offends it, then it becomes Shanghan. Injury by the qi of the four seasons can all cause illness, but Shanghan is considered the most toxic because it is the most lethal qi. If one contracts it and falls ill immediately, it is named Shanghan. If one does not fall ill immediately, the cold toxin hides in the muscles and bones. By spring, it transforms into Wenbing (Warm Disease); by summer, it transforms into Shubing (Summer Heat Disease). Shubing is extremely hot and more severe than Wenbing. Therefore, hardworking people often suffer from Wenbing and Rebing (Heat Disease) in spring and summer, all caused by contracting cold during winter, not by seasonal epidemic qi. Any "Shixing" (Seasonal Epidemic) occurs when spring should be warm but is instead severely cold, summer should be hot but is instead severely cold, autumn should be cool but is instead severely hot, and winter should be cold but is instead severely warm. This is having the qi out of season. Thus, throughout the year, patients of all ages show similar symptoms; this is the Seasonal Epidemic Qi. The disease of Shanghan is treated according to the daily progression and depth. Nowadays, people with Shanghan either do not treat it early, or treat it incorrectly, or delay telling the physician until they are exhausted after many days. If the physician merely follows the sequential formulas without adjusting, it will not cure the disease. One must adjust the formula temporarily based on the situation to be effective.

Hua Tuo said: When Shanghan is first contracted, on the first day the pathogen is in the skin; applying ointment and moxibustion/fire warming will cure it. If unresolved, on the second day it is in the flesh; one can follow the method of acupuncture and take Jiema Sanfa Han (Muscle-Releasing Sweating Powder); sweating will cure it. If unresolved, by the third day it is in the muscles; another sweat-inducing treatment will cure it. If unresolved, stop inducing sweat again. By the fourth day, it is in the chest; taking Licui Wan (Veratrum Pill) to induce mild vomiting will cure it. If the patient is critically ill and Licui Wan cannot induce vomiting, take Xiaodou Gaidi San (Adzuki Bean and Melon Seed Dispersant) to induce vomiting, which will cure it. Observe if the patient is still unconscious; once awake, apply another acupuncture method. By the fifth day, it is in the abdomen; by the sixth day, it enters the Stomach. Only when it enters the Stomach can purgative methods be used. If the heat toxin is external, or if the Stomach has excess heat causing illness, even one in ten survivors may not recover. If the Stomach is deficient and heat enters, rotting the Stomach occurs. If the heat is slight and red macules appear, this prognosis is five deaths to one survival. If severe and black macules appear, this prognosis is ten deaths to one survival. It depends on the strength of the person and the difficulty of the disease; efficacy varies significantly. If one contracts the disease without fever, only experiencing delirium, irritability, restlessness, and disjointed speech, do not use fire forcing. Instead, take Zhuling San (Polyporus Powder), one square-inch scoop, and force drinking one or two sheng (approx. 200-400ml) of fresh well water. Stimulate the throat with a finger to induce vomiting; the disease will heal immediately. If unable to vomit, do not force water, as stagnant water will knot in the epigastrium. Use other medicines to induce vomiting instead. Ensure the patient can tolerate it; otherwise, it leads to danger. For such illnesses, failing to use Zhuling San to induce vomiting promptly accelerates death. Alternatively, removing toxic substances and using acupuncture is even better. Cases of phlegm-fluid retention in the diaphragm are difficult to treat, representing a prognosis of three deaths to one survival. If the patient does not receive timely treatment over several days, heat cannot dissipate, leading to stomach rot and macule eruption. In spring and summer, avoid strong purging and vomiting; in autumn and winter, avoid strong sweating. For sweating methods: in winter and early spring during severe cold, Shen Dan Wan (Divine Elixir Pill) is suitable, or applying ointment and fire warming. In late spring, summer, and early autumn, during hot months, avoid fire warming and heavy covering; instead, take Liuwu Qing San (Six-Ingredient Green Powder). Cuwen Xingdu Zhang San, Chi San, or Xue Jian are also good. If pills, powders, or decoctions are unavailable, simply decoct Chaihu (Bupleuri Radix) for several liang. For Shanghan or seasonal epidemics, one may also take it to induce sweating. If sweating fails after repeated attempts, administer a decoction; if excess, switch to purgatives. If the pulse is rapid morning and evening, it indicates excess. If calm in the morning and rapid in the evening, it is not excess; purgative decoctions can be given earlier, but in small amounts to avoid severe purging. Give small amounts frequently. Various cases of deficiency-related vexation and heat resemble Shanghan. However, since there is no aversion to cold and no body pain, it is known not to be Shanghan, so sweating is contraindicated. If there is no headache and the pulse is not tight and rapid, it is known not to be interior excess, so purging is contraindicated. Thus, neither exterior nor interior attacks are possible; forcing an attack will lead to depletion and death. For this deficiency vexation, only Zhuye Tang (Bamboo Leaf Decoction) should be given. If vomiting occurs, give Jupi Tang (Tangerine Peel Decoction) for one dose; if not cured, repeat. This method is very effective when used repeatedly. Deficiency vexation after Shanghan is also suitable for this decoction.

Wang Shuhe said: Yang excess and Yin deficiency (as noted in *Waitai Miyao*: Exterior harmonious, Interior diseased), sweating causes death, purging cures. Yang deficiency and Yin excess (as noted in *Waitai Miyao*: Interior harmonious, Exterior diseased), purging causes death, sweating cures. Thus, how can Shendan be mistakenly induced to sweat, or Gansui be recklessly attacked? The treatment of deficiency and excess differs by a thousand miles; the mechanism of auspiciousness and misfortune responds like an echo. Once Guizhi Tang (Cinnamon Twig Decoction) is swallowed, if Yang is excess, death ensues (as noted in *Waitai Miyao*: if Exterior is harmonious, death ensues). Once Chengqi Tang (Stomach-Filling Decoction) enters the stomach, if Yin is excess, demise occurs (as noted in *Waitai Miyao*: if Interior is balanced, demise occurs). If such interweaving of Yin-Yang and deficiency-excess occurs, the signs are subtle, and the opposite effects of sweating, vomiting, and purging bring disaster quickly. Physicians with shallow knowledge, unaware and ignorant, cause patients to perish, believing it to be their fate. Now, vengeful ghosts fill the underworld, and premature deaths fill the wilderness. How can benevolence not grieve upon witnessing this? Shanghan disease originates from Wind-Cold, entering the Couli (interstices of skin and hair), competing with Jing-Qi (Essence-Qi), causing stagnation between Ying and Wei (Defensive and Nutritive Qi), blocking circulation. On the first to second day, the qi is between the orifices and skin; thus, the patient suffers headache, aversion to cold, and stiffness/heaviness in the waist and back. This pathogen is in the Exterior; sweating cures it. After three days, the qi floats upward, filling the chest and heart; thus, headache and chest fullness occur. Vomiting cures it. After five days, the qi sinks and knots in the Zang organs; thus, abdominal distension, body heaviness, and bone/joint soreness occur. Purging cures it. One must clearly observe the condition and not randomly administer decoctions, which would damage Stomach Qi. Classics state: If the pulse is faint, do not vomit; if deficient and thin, do not purge. Also, do not purge in summer; this is a major medical prohibition. Pulses float, sink, and transform. Some patients wait several days before seeing a doctor; although they claim it is the beginning, the disease has accumulated. The rash and tuberculosis-like formations are not removed by re-sweating or muscle-releasing; one must diagnose the pulse and save the patient according to the current situation. Do not rigidly stick to sequence, losing the key opportunity, which leads to disaster. This sequence of Shanghan: sweating within three days applies to cases where one exposed oneself to wind, undressed, slept uncovered at night, suffered temperature extremes, or was infected by epidemic thief-wind qi. As for individuals eating too much raw/cold food, causing abdominal organ indigestion, slight difficulty moving, headache, warm body, and excess-large pulse, vomiting and purging are suitable, not sweating.

Chen Linqiu said: Someone asked: If one takes medicine to sweat continuously but no sweat comes out, what should be done? Answer: Medical classics say, continuous sweating with no sweat output indicates a fatal disease. I pondered: One could steam the patient as in the method for steaming Wind-Stroke. Hot and warm qi from outside will meet it, and sweat must come out. Later, I asked Zhang Miao. Zhang Miao said: Once, someone worked to exhaustion, sweated, lay on a bamboo mat in the cold, and fell ill, suffering from cold chills. Various physicians gave pills, powders, and decoctions, inducing sweating eight times in four days, yet no sweat came out. Zhang Miao ordered heating the floor and spreading peach leaves to steam the patient. Immediately, profuse sweat occurred. The patient applied powder while under the blanket, dried completely, got up, and healed. Subsequently, using this method for sweating always produced sweat. Human nature naturally has difficulty sweating; it is not only the disease that causes this. Steaming ensures sweating. For all diseases with fever, aversion to cold, and floating-hong pulse, sweating is appropriate. Apply warm powder, avoid wind, and induce sweating. However, if the person has recently lost blood or suffered severe diarrhea, strong sweating is contraindicated. Administer Guizhi Tang (Cinnamon Twig Decoction) in small amounts frequently, making the body moist with a slight sweat over consecutive days; it will resolve spontaneously.

Discourse states: Whenever a person feels slightly unwell compared to normal, they must seek help early. If they endure it without treatment, hoping for spontaneous recovery, in a moment it becomes a chronic disease. This is especially true for children and women. If the seasonal qi is discordant, one must be cautious. If there is slight discordance, treat it immediately. Find the pathogen source while it is in the Couli (skin interstices) and treat it early; few will not heal. If the patient endures for several days before speaking, the pathogen enters the Zang organs and becomes hard to stop. Even He Huan (the legendary physician Bian Que) would be powerless. Boils, carbuncles, ding swellings, throat bi (obstruction), and ke wu (alien invasion) are particularly urgent; this is essential for self-preservation. When preparing decoctions, do not avoid mornings, nights, or auspicious/inauspicious dates. Upon sensing illness, treat immediately, regardless of time; this facilitates healing. Take medicine according to the method. If one willfully disobeys the master, do not treat them. Generally, Shanghan is mostly contracted from Wind-Cold. Initially, Wind-Cold is in the Exterior; if it enters the Interior, it will not dissipate. There is no case where covering with warmth fails to dissipate it. For seasonal qi diseases, if on the fifth or sixth day the patient desires water but drinks little, do not give it. Why? Because the internal heat is still insufficient to digest it; giving it would create further illness. If by the seventh or eighth day the patient is extremely thirsty and desires water, give it according to the syndrome, but do not let them drink excessively. If they can drink one dou (approx. 2 liters), give five sheng (approx. 1 liter). If after drinking the abdomen becomes full, urination is difficult, or there is wheezing or hiccups, do not give water. Sudden profuse sweating indicates impending self-healing. If a patient with disease can drink water, it indicates desire for recovery. For all Wenbing (Warm Diseases), fifty-nine acupoints are suitable for acupuncture. Of the 655 acupoints on the body, thirty-six are harmful if moxa-ed, and seventy-nine... [Text cuts off]

Discourse states: The essence of seeking formulas is speed in rescue. Therefore, families practicing preservation of life should always prepare mature medicines in advance for emergencies, as listed below.