Library

Old Man of Cold Years (Suihan Jushi) has long admired Confucian classics and has always studied medicine. He does not rely on others' heat (does not flatter the powerful), disregards worldly criticism, prescribes according to symptoms, seeking only what is correct, and often achieves remarkably miraculous effects. One day, he showed me a volume of his own writings, *Medical Miscellaneous Essays* (*Yixue Zazhuo*). It sweeps away superficial rhetoric, highlighting only profound principles, critically addressing pain points, and prescribing remedies that hit the mark. Although I have not seen the whole leopard (the complete work), one spot reveals the pattern. I therefore encouraged him to have it carved on pear wood (printed) and released to the world. This is what is meant by medical practice being a benevolent art; it is also an expression of compassion that cannot be stopped. How could it be for the sake of fame?

Preface by Zhao Yongnian of Yangzi, respectfully written in early summer of the Gui Chou year.

Shu He's family learning was passed down for three generations; Yan Bo gathered miraculous prescriptions in one cabinet. In old age, writing books while indulging in market seclusion, he did not treat Hongbao (immortal elixirs) as examples like King Huainan. Protecting infants should begin with caring for the elderly; human hearts of kindness and filial piety are originally the same. Please include Peng's longevity techniques into Zhuang's compilation for children's blessings. This is not about the fickleness of human relations, but the heart's spirit naturally feels moved. Recognize that there is medicine within temperament; Yi He and Yi Huan possessed true prescriptions. Thanks to your piece of a heart that revives people, like binding leather strips three times, every word is gold. Facing guests, do not hesitate to play ancient tunes; everywhere at the edge of the sky, there are those who understand.

Inscribed by Xie Fengyuan, Mountain Dweller of Quanshi, on the Sufu Day of the Gui Chou year.

Excluding fathers, brothers, teachers, and friends, no one does not know medicine. From childhood, through hearing and seeing, I slightly recognized the threshold. Since middle age, wandering in four directions to make a living. I casually browsed prescription books, peering into the subtle meanings of *Suwen* and *Lingshu*. When family members were ill, I borrowed this to self-treat. When relatives and friends invited me, I could not firmly refuse. With many troubles in the world, I abandoned the scholar's cap (Confucian studies). For twenty years, my experience deepened. Thus, I expressed my insights to inform patients. I dare not flatter current trends, nor dare I violate former sages. It is merely to provide reference!

Written by Old Man of Yufeng at Wumen Market's Market Seclusion Studio, in the fourth lunar month of the Gui Chou year.

Ancient saying: Prescribe medicine according to the disease. Then, whether medicine matches the disease is clear. Diseases have cold, heat, deficiency, and excess; thus medicines have warming, cooling, attacking, and tonifying properties, as well as sweating, vomiting, purging, and harmonizing methods. If it matches the disease, the disease will leave itself. There has never been a case where, without investigating the cause or asking about symptoms, one generally uses a dozen or so medicines that are irrelevant and lack distinct cold/heat properties, applying them uniformly, and expecting to cure the disease. However, patients are accustomed to hearing this saying, thinking it is a safe prescription. Doctors are happy to hide their incompetence and sell their deception, also thinking it is a safe prescription. Thus, Mulberry Leaf (*Sangye*), Moutan Bark (*Danpi*), Gardenia (*Zhizi*), and Fermented Soybean (*Douchi*) gather under the wrist without moving the brush. Little do they know these few ingredients (can be taken if the disease is mild, or can be omitted); even if taken by the healthy, they cause no harm. If a disease must be cured by medicine, yet only these are used, delaying for a long time, making the disease deeper, worse with each treatment, until incurable, who will bear the blame? Alas, habits are deeply rooted and unbreakable. Even if there are medicines targeting the disease, the timid are frightened, the foolish are confused, the arrogant discuss, and the jealous slander. This is why the disease becomes incurable.

Bing notes: Mulberry Leaf is acrid and cool, venting the exterior, dispelling wind and draining fire. Moutan Bark is acrid, bitter, and slightly cold, entering the Foot-Jueyin and Hand-Jueyin meridians, draining latent heat in the blood, treating wind-stroke and convulsions, removing irritability and heat, retreating bone-steaming without sweat, and is a necessary medicine for hematemesis and epistaxis. Gardenia, stir-fried black, is bitter and cold, draining pathogenic heat from the Heart and Lungs, treating irritability and insomnia. Examination: Mulberry Leaf is light and clear, treating the Qi level of the Upper Jiao, mainly governing wind-heat, which is also wind-warmth. (Rarely used in ancient formulas.) As for Moutan Bark and Gardenia, Zhang Zhongjing used them in many formulas; how can one rigidly insist these three are absolutely unusable? Too stubborn!

The most strange thing is that regardless of the disease, all are called "rashes," and all use Douchi and Doujuan to disperse via sweating. Until more than ten doses are not enough, forcing the patient to sweat profusely, tongue turns black depleting fluids, spirit becomes confused with heat sinking. Reluctantly, then Zixue Dan (Purple Snow Pill) or Zhibao Dan (Treasure of Life Pill) are used to open and drain, but it is already incurable. If it is an occasional feeling of fever and chest oppression, clearing the heat can cure it. Why must rashes appear? The reason for insisting on rashes is likely to frighten the patient to use Douchi etc.! Who knows that current Douchi and Doujuan are mostly processed with Mahuang Tang, which is distinctly different in warmth and coolness from the ancient method of processing Sangye with well water. If rashes truly appear, using Mahuang to warm, is it acceptable or not? This is why warm diseases turn progressively severe. Moreover, what they point to as rashes are all prickly heat (commonly known as prickly heat), mosquito bites, or crystal vesicles. So they do not say "ban" (macules) but exclusively say "zhen" (papules/rashes), taking advantage of the confusion. Otherwise, rashes arise from heat and must clear interior heat; they certainly should not use warming dispersal to assist heat. Ancient formulas exist, Materia Medica can be verified; why revere Douchi and Doujuan as the supreme miracle for treating rashes?

Bing notes: Doujuan soaked in Mahuang is mentioned in *Wu Yi Hui Jiang*, but this is also hearsay. Shao Buqing's *Six Season Disease Mechanisms* records: A single decoction of Doujuan treats dampness causing whole-body pain; after taking it and sweating, heat resolves and pain leaves; it is effective. Lightly fermented Douchi is salty and cold, resolving heat; combined with Scallion White (*Congbai*) and Perilla Leaf (*Zhu Ye*) it releases the exterior; combined with Human Placenta Ash (*Renzhong Huang*) and Honeysuckle (*Yinhua*) it resolves epidemic toxins; combined with Allium Macrostemon (*Xiebai*) it treats dysentery; beaten fresh with Rehmannia Root (*Shengdi*) named Black Paste (*Heigao*), it treats heat entering the Ying level, fluid dryness preventing sweating, nourishing Yin to aid sweating. All above are verifiable methods; do not look down on Douchi as useless. Like Doulin Wine postpartum, it can treat postpartum deficiency evil body heat, resolving heat after sweating. Soybean sprouts in vegetables, if mistakenly eaten by someone with external sores, causes eruption like chicken/fish sores. This is the inconceivable change of investigation.

Now there are those famous for Shanghan (Cold Damage) who, seeing two or three days of fever, must point and say: This is Shanghan. But looking at the prescribed formula, it is still Douchi, Doujuan; or else Niu Bang Zi (Arctium Fruit), Chan Yi (Cicada Slough); or else Fu Ping (Duckweed), Sangye (Mulberry Leaf), Pi Pa Ye (Loquat Leaf), assisted by Chen Pi (Tangerine Peel), Ban Xia (Pinellia), Huo Xiang (Patchouli), Hou Po (Magnolia Bark), advanced by Shi Hu (Dendrobium), Sha Shen (Glehnia), and their skills are exhausted, their methods ended. Their disease will also become incurable. Yet there remains a last stand: Zixue Wan, Lianzhu Powder, Zhibao Dan, Niuhuang Wan.

Bing notes: This speaks of Wen Zheng (Warm Pathogen Syndrome), what kind of Warm Disease? It does not specify. Rashes are seasonal warm diseases; when heat enters the Ying level, rashes appear. Rashes are flat with the skin, dense all over. Sand-rash (Sha Zi) is mostly in children, shape like rashes, but touching the skin reveals slightly pointed granules; this is wind-heat transmitting from Lung/Stomach Qi level to Ying collaterals. Bai Bo (White Vesicles) look like Lianzhu (pearls), crystal clear and bright. Appearing at the beginning of illness, it is due to dampness stagnating in the Wei level and incomplete sweating. Should regulate Qi level pathogens. If long-standing heat does not resolve and white vesicles appear, although pathogens want to reach the exterior, Qi and fluids are injured; must obtain sweet/moistening to nourish the center. Rash color should not be purple/withered; white vesicles should not be white like dead bones. When rashes/sand-rash are fully erupted, heat decreases, spirit clears, chest oppression relaxes, cough flows freely, spirit is calm and sleeps—this is auspicious. If irritable and unable to sleep, coarse breathing (sign of panting), chest oppression with burning heat, all belong to dangerous/incurable categories. Eruptive formulas divide into cold/warm; sand-rash is the same. Not necessarily using Douchi/Doujuan. And these two medicines act independently; definitely not used together by association.

Not knowing that the theory of Shanghan was initiated by Zhongjing. Shanghan formulas were also transmitted from Zhongjing. Those treating Shanghan should surely follow Zhongjing. Shanghan exterior-releasing agents include Guizhi Tang, Mahuang Tang, Gegen Tang, Chaihu Tang. Shanghan interior-clearing agents include Qinlian Tang, Baihu Tang, Chengqi Tang. Shanghan damp-draining agents include Wuling San, Zhuling Tang, Fuling Gancao Tang. Shanghan middle-warming agents include Sini Tang, Lizhong Tang, Zhenwu Tang, Fuzi Tang. Current Shanghan practitioners do not use these.

Bing notes: Luo Qianfu treated Winter-Warmth, stating autumn dryness residual qi attacks Metal of the Lung, Yin qi is first injured. Thus pathogens enter the Shaoyin meridian. Heat causes Qi to leak, cold causes Qi to contract; these two energies are originally opposite. Used Congchi Tang plus Pipa Ye, Xing Ren, Xiang Bei, Huafen, Ganjie. If first Winter-Warmth, strictly bound by severe cold, body heat, panting/cough, facial swelling, throat feeling blocked. Only Zhongjing's Maxingshigan Tang one formula, disperses exterior cold, clears interior heat. Because Mr. greatly dislikes light/clear medicines, he cites this example.

Zhongjing's *Shanghan Lun* begins: Shanghan Ying level no sweat, release exterior with Mahuang Tang; Wind injuring Wei level with sweat, use Guizhi Tang to resolve muscle; Wind-Cold injuring both Ying and Wei, irritability no sweat, use Da Qinglong Tang, dual-resolving Wind-Cold. This speaks of Taiyang meridian disease patterns and prescriptions. Gegen, Yangming exterior medicine. Chaihu, Shaoyang harmonizing medicine. Clearing interior, Qin/Lian clear Heart/Stomach heat. Baihu, clears Yangming meridian heat. Chengqi, purges Yangming fu stagnation to descend pathogenic heat. Wuling, Zhuling, Fuling, Gancao tangs are diuretic agents. Lizhong warms the middle. Sini, Zhenwu, Fuzi three formulas are rescue reversal methods. Now the disease is not standard Shanghan, should not use this method, hence not used.

Yet exclusively using Zhizi Chi Tang. Not knowing that Zhizi in Shanghan formulas is raw, used to induce vomiting, not to induce sweating. Later generations changed to scorched Zhizi, no longer ancient method. However, using it to clear Lung and drain heat, it belongs to good products for treating warmth. Recent times replaced it with Mahuang-water processed Douchi, then drug nature changes greatly, benefits/harms are vastly different. Yet Shanghan practitioners regard it as an indispensable ancestral offering. If indeed Shanghan is in Taiyang meridian, using it to replace Mahuang, though not orthodox method, is still harmless; once transmitting to Yangming, it cannot be used. How much less to treat warm-heat? Yet why, regardless of sweating/no-sweating, much/little sweat, and regardless of Wind/Cold/Summerheat/Dampness/Dryness/Fire six excesses, Joy/Worry/Anger/Thought/Sorrow/Fear/Fright seven emotions, nor labor injury/sores miscellaneous diseases, claim that Zhichi one decoction, Doujuan, Sangye few flavors can treat hundred diseases. And suitable for four seasons, is there such logic? This is not my slander. Please observe prescriptions buying medicine in shops, how many do not say releasing rash? How many do not use these few flavors? Can laugh silently.

Bing notes: Scorched black Zhizi used to remove irritability and resolve heat, letting Heart/Lung pathogens resolve via urine. Also no doctor views Zhichi as an exterior agent. Douchi not soaked in Mahuang Tang, no need to chatter. Also haven't seen Wu doctors regardless of warm disease six qi/seven emotions, sweating/no-sweating, much/little sweat, three causes internal/external, all use Zhichi Tang. Doujuan, Sangye can treat four seasons hundred diseases, truly slandering, no facts, Mr. should also laugh silently.

Or says: Truly as you say, disease definitely has no rash? I say: No. Light ones are rashes, originating in Lung; heavy ones are macules, originating in Stomach. These are all Lung/Stomach heat-toxin accumulation. Otherwise, forced out by warm-dry medicines. However, this syndrome is also rare; treatment should use Shigao (Gypsum), Xijiao (Rhinoceros Horn - note: substitute with Buffalo Horn in modern practice), Shengdi (Rehmannia), Yuanshen (Scrophularia), Shengma (Cimicifuga), Daqing (Isatis Root) etc., to clear fire, penetrate macules, transform rashes. Zhongjing's Baihu Huaban Tang, *Huoren* Yuan Shen Shengma Tang, Jie'an Qingdai Xiaoban Yin, are all ancestor formulas for treating macules/rashes. Which one does not use cooling/detoxifying products? Which one uses warming/dispersing/sweating medicines? Now people mention macules/rashes, all say cooling medicines cannot be taken; taking them blocks macules/rashes from emerging. Patients hear this often, believe firmly. Doctors then write large Douchi, Doujuan; patients also eat large amounts of Douchi, Doujuan. Light becomes heavy, heavy becomes death. Until death still say sweat not smooth, macules/rashes not transparent. Alas! Originally should not sweat, yet must劫 (rob/coerce) sweat; originally no macules/rashes, yet must emit them. Using a person who plays the zither with glued bridges (rigid/stubborn), performing carving sword on boat (rigid/stick to rules) technique, although wanting not to die from medicine, is it possible? When not yet dead, if someone advances Shigao etc., patients will be greatly surprised and refuse medicine; crowd of doctors will circle gaze and rise, considering it shifting blame. Until hopeless, then slightly take it, then medicine error is deep, medicine power insufficient, finally incurable. Thus mutually abuse, take as warning. One voice, none can distinguish. Who would ruin own reputation, for not closely concerned person, fight group doubts, to save dying life? Then only stand and watch death.

Then, why don't patients realize? I say: There is a reason. What patients hear is nothing but releasing rash, dispersing exterior, sweating much. Outside this, never heard. This doctor says yes, that doctor also says yes. This prescription's medicine is right, that prescription's medicine is also right. Even relatives/friends browsing prescription books, also similar to contemporary doctors' views. Gathering mosquitoes forms thunder, accumulating wrong makes right. How expect them to listen clearly? Therefore in today's world, to make medical way proceed, must intentionally cater to people. However, those with slight learning and ambition, definitely will not do. People will dislike their stubbornness. And clever talkers, fine colors, flattering compliance, thus name day increases, price day rises. Not bearing responsibility, sitting collecting profit. Below average people, who does not enjoy doing? Those bribing servants, connecting shamans, let alone. World is all like this, how not be deceived? Xu Huixi said: People mistaking medicine and dying, half due to Heaven's Mandate, half due to patients. Doctors only follow obedience/disobedience to fate to complete death, not the conspirators. So killing crime, doctors do not receive it, isn't it so?

Human spirit sufficient, Qi/Blood peaceful, is called no disease. Where need take medicine? As for taking medicine, must have imbalance/unbalanced parts. Doctor should view the imbalanced part and remedy it, making it achieve balance. Warm/cool/attack/tonify, applied according to disease, no preconceived notions, aiming only to match the disease. How allow hesitation? Like fierce bandits, should suppress not suppress, bandits will be uncontrollable; like starving people, should soothe not soothe, people will join chaos. Current treating disease, is it not similar? Furthermore, there is a type of village honest man among doctors, specifically using servant-like medicines, neither warm nor cool, neither attacking nor tonifying, as evading/flattering technique. Patients often happily interact with them. Who knows medicines that cannot kill people, definitely cannot revive dead to life. Delaying causing error, how is it not killing? And world-called able-to-kill medicines, are Shigao, Dahuang, Mahuang, Rougui, Fuzi, Renshen etc. Now all discarded, dare not use. Even if citing ancient formulas, only take one or two unimportant flavors, saying inheriting certain method, using certain formula, actually never inherited method, used formula. More do not know full formula. Like Xuanfu Daizhe Tang, Zhuye Shigao Tang, Xiao Chaihu Tang etc. do not know contain Renshen. Heigao Tang only know have Shengdi, Douchi two flavors, do not know also have Zhufu, Xionghuang, Shexiang three flavors. (Recorded in *Waitai Miyao* to treat Yangdu Faban.) Others like warm combining tonify, like Lizhong Tang combining Jiang/Fu with Renshen. Clear combining tonify, like Baihu Tang combining Shigao adding Renshen. Dispersing combining tonify, like Qingshu Yiqi Tang combining Sheng/Gegen with Renshen/Maidong. Cold/Heat using together, like Xiexin Tang's Qin/Lian/Jiang/Fu, Zuojin Wan's Huanglian/Wuyu. Exterior/Interior dual resolving, like Da Qinglong Tang's Ma/Gui/Shigao, Baihu Tang adding Guizhi/Chaihu. Sweat/Purgative running together, like Da Chaihu Tang's Chaihu/Dahuang, also Chaihu Jia Mangxiao Tang, Guizhi Jia Dahuang Tang. More like clearing heat drying dampness using Cangzhu Baihu Tang, attacking/purging harmonizing middle using Tiaowei Chengqi Tang etc., too many to enumerate. Key is formula matching disease. What medicine cannot be used, and deliberately suspicious? Current doctors, discuss medicine not disease, use formula not medicine. Only say certain medicine too tonifying, certain medicine too purging, certain medicine too warm, certain medicine too cool, certain medicine too hot, certain medicine too exterior, certain medicine too dispersing, certain medicine too drying, certain medicine too cloying, certain medicine too attacking, certain medicine too dissolving. Removing imbalance, achieving harmony, truly nothing better than porridge/rice! Why take medicine? This is all not knowing medicine is set for disease, specifically for correcting imbalance saving disadvantage reasons.

Thus there are cases of using when should not use causing error, not using when should use causing error, using lightly when should use causing error, using heavily when should not use causing error. Error depth different, for not knowing disease condition is one. Now disease names different, then treating disease formula and medicine, naturally cannot be same. If say disease cold cannot warm, disease heat cannot cool, disease deficiency cannot tonify, disease excess cannot attack, is it consistent? If say disease cold contrary suitable cool, disease heat contrary suitable warm, disease deficiency contrary attack, disease excess contrary tonify, is it consistent? If say disease regardless cold/heat/deficiency/excess, I will use non-warm/non-cool/non-attack/non-tonify medicine, roughly treat, and can completely remove attack/tonify/warm/cool flavors, is it consistent? Then inconsistent theory, in inconsistent people hearing believing, originally not surprising. Most strange, called consistent people, also believe inconsistent words. Then no wonder inconsistent theories fill universe, and daily kill innocent, no one cares.

Now suppose disease heat person here, regardless deficiency heat/excess heat, exterior heat/interior heat, only use medicine to sweat, not think inappropriate. Where know exterior cold can sweat, exterior no cold cannot sweat, cannot sweat yet sweating, is further emptying exterior, and heat further blazing.

Originally wanted to clear heat, instead making increase heat, patients also can realize, however not realize. Especially deficiency heat suitable using sweet-warm to retreat, more no one can understand. Like women postpartum, lochia flowing smoothly, blood deficiency generating heat, cannot sweat. Sweating then exterior deficient and heat sinks; cannot clear, clearing then heat not resolving and transformation syndromes emerge. Xionggui, Dushen, Sijun, Siwu, Bazhen, Shiquan Dabu Tang so becoming postpartum good agents. Like children post-illness, Zangfu empty, Yin-cold generating heat, day light night heavy, cannot sweat, cannot clear, same as postpartum. Light then Zhuhan Dangjing Tang, heavy then Jiawei Lizhong, Fugui Bawei, Shiquan Dabu etc. tangs, to retreat deficiency heat. Formulas inside moreover heavily use Jiang, Gui, Ding, Fu hot products. Those only see exterior heat, not observing interior deficiency, solitary Yang no transmission, extreme cold resembling fire, not surprise as strange matter? Although, warm-tonifying agents, if not matching disease, disaster very fierce, cannot not carefully examine. Should view color, listen to voice,