Library

The Lingnan region is located in a hot and humid zone, bordering the sea. The terrain is low-lying, and the soil is shallow. Therefore, Yang Qi (Yang Energy) tends to dissipate, while Yin Qi (Yin Energy) is often deficient. Flowers bloom throughout the four seasons, and there is no frost or snow in winter. For more than half of the year, the weather is hot and sultry. Prolonged drought and clear skies may even necessitate fanning oneself. People living in this environment often experience upward stagnation of Qi, excessive sweating, and loose pores (Cou Li). This occurs primarily because Yang Qi fails to return to its root.

Once Yang Qi has dissipated, the body's fundamental Qi becomes insecure. Yang Qi fails to descend and floats upward instead. When Qi floats and lacks stability, the sweat gates open, and Body Fluids (Jin Ye) are easily lost. Consequently, syndromes characterized by internal cold and external heat, or upper heat and lower cold, arise from this mechanism. Treatment should focus on consolidating Yang Qi and strengthening the pores. If dispersing and releasing-the-exterior herbs are overused, Yang Qi will become further depleted, and Wind Pathogens will flourish; few cases will not be mishandled. If it is indeed an external pathogen causing the illness, Cangzhu Qinlian Tang (Atractylodes and Scutellaria Decoction) should be used to resolve the exterior.

During spring and autumn, when people contract mountain miasma and fog, they develop alternating chills and fever, chest and epigastric fullness, and loss of appetite. This is due to toxic vapors entering through the nose and mouth. Treatment should clear the Upper Jiao (Upper Burner), resolve internal toxins, move Qi, and descend phlegm. Sweating methods are contraindicated. For severe headache, remove Tong Cao (Tetrapanax Pith) and Huanglian (Coptis Rhizome), and add Gu Ben (Ligusticum Sinense), Cong Bai (Scallion White), and Dou Chi (Fermented Soybean).

If there is irregularity in cold and warmth, exposure of the body, and contraction of Wind-Cold, leading to Qi closure, fever, and headache, this falls under the category of Shanghan (Cold Damage). However, due to the warm climate in Lingnan which promotes sweating, these cases often resemble Malaria. In the South, Earth Qi rises; patients with this condition suddenly experience chest fullness, phlegm-saliva obstruction, and inability to eat. This differs from Northern Shanghan, where only the exterior is injured while the interior remains harmonious. Treatment should release the exterior, clear heat, descend Qi, and move phlegm, using Cangzhu Qianghuo Tang (Atractylodes and Notopterygium Decoction). For cases with internal food retention and external Wind-Cold contraction, Huoxiang Zhengqi San (Agastache Powder for Regulating the Qi) is indicated. For Spleen Qi deficiency presenting with alternating chills/fever and vomiting, Pingwei San (Stomach-Pacifying Powder) added with Banxia (Pinellia Tuber) and Muxiang (Aucklandia Root), named Buhuanjin Zhengqi San (Non-Exchanging Gold Upright Qi Powder), is used. For malaria-like alternating chills and fever caused by miasma, Cangzhu Chaihu Tang (Atractylodes and Bupleurum Decoction) is prescribed. For chronic malaria, add Renshen (Ginseng Root) and Danggui (Angelica Sinensis Root). For excessive sweating, replace Cangzhu with Baizhu (Atractylodes Macrocephala Rhizome) and add Shaoyao (Peony Root). Generally, prolonged illness with Qi and Blood deficiency inevitably leads to fever; Si Jun Zi Tang (Four Gentlemen Decoction) and similar formulas should be used to regulate and tonify the Spleen and Stomach. Once the Spleen and Stomach are strong, Qi and Blood will generate naturally. If one mistakenly assumes Blood deficiency and uses Chenyin (heavy and yin-nourishing) agents like Si Wu Tang (Four Substances Decoction), the Spleen Earth will be further damaged, leading to dysfunction of all Zang-Fu organs, a surge of deficiency syndromes, difficulty in treatment, and potentially death.

If dysentery develops after malaria, it should be treated as a deficiency syndrome using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If heat is present, add Huangqin (Scutellaria Root) and Huanglian (Coptis Rhizome); if food stagnation exists, add Muxiang (Aucklandia Root) and Sharen (Amomum Fruit). During warm and summer months, when the populace suffers from epidemic febrile diseases, treatment should employ heat-clearing and detoxifying agents, such as Cangzhu Baihu Tang (Atractylodes and White Tiger Decoction) added with Renzhonghuang (Human Coprolite). If seasonal heat transforms into jaundice, known as Wenyellow (Epidemic Jaundice), treatment should clear heat and promote dampness drainage using Yinchin Wuling San (Artemisia Capillaris and Five-Ingredient Poria Powder) added with Renzhonghuang, Lian (Huanglian), and Bo (Huangbai). If there is Middle Jiao Qi deficiency and cold, with cold limbs or edema and blackish-yellow complexion, Lizhong Tang (Regulate the Middle Decoction) added with Yinchin (Artemisia Capillaris), Guizhi (Cinnamon Twig), and Fuling (Poria) is used.

Fei Chou stated: In the western Guangdong area near Cochinchina, meats such as pork and chicken must be boiled, the broth discarded, and then cooked again before eating. Rice is treated similarly and should not be eaten in large quantities, as excess causes bloating and fullness. This is entirely due to the gradual accumulation of miasma toxins. At sunrise, the air smells like orchids; at noon, like jasmine; and at sunset, like freshly steamed rice. One must urgently cover the nose and mouth and refrain from speaking to avoid these three daily airs. Those who inhale them suffer from malaria-like chills and fever and die within three to four days. Those with slightly robust Yuan Qi (Original Qi) may survive a few days longer. In such emergencies, urgent administration of Huoxiang Zhengqi San or Cangzhu Qianghuo Tang can still save the patient. My relative served as an official there and survived only barely after three months, solely because his Original Qi was abundant. Nevertheless, he nearly died. Therefore, officials serving or travelers visiting that region must be fully aware of this; otherwise, all will suffer its harm.

Those infected by mountain mist experience inner restlessness, shortness of breath, headache, neck stiffness, dizziness upon rising, slight aversion to cold, trembling and unease, frequent chilling sensations, nausea, and dry retching without substance. This indicates that the position of Clear Yang has been invaded by turbid Yin pathogens. Methods that consume Qi and damage fluids are contraindicated. Instead, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction) added with Cong Bai (Scallion White) should be used to induce vomiting and disperse the pathogen. For severe headache, add Gu Ben (Ligusticum Sinense). For restlessness, add Muxiang (Aucklandia Root) and Huoxiang (Pogostemon Herb). Miao Zhongchun, in his *Jingshu*, used only Gu Ben and Muxiang decocted in water. Generally, evaporated pathogens strike the upper part and the exterior; therefore, inducing vomiting is appropriate. Ultimately, this condition does not involve the Zang-Fu organs.