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Chou Du (Stench Poison), commonly known as Fa Sha (Epidemic Heat Toxin). It is all caused by the inherent deficiency of Middle Qi (Vital Energy of the Middle Jiao). Generally, the Spleen and Stomach favor aromatic and dry substances, but detest foul and dampness. Now, if the True Qi of the Spleen and Stomach is deficient, or if there is originally excessive dampness stagnation, it cannot govern and transform properly. Therefore, foul and evil Qi can invade directly without restraint. Upon onset, abdominal pain occurs, and the patient cannot eat. The pain may radiate upward to involve the entire head and forehead, or downward to involve the legs and Weizhong (BL40). In severe cases, there is a desire to vomit but unable to do so, or a desire to defecate but unable to do so. Alternatively, there may be cold limbs, cyanotic complexion, and a deep-hidden pulse; or high fever throughout the body, purplish-red complexion, and a firm pulse. These distinctions reflect whether one's constitution tends toward Fire Deficiency or Fire Excess. Some patients collapse in pain and lose consciousness, only to recover after a short while. Others experience intermittent upward attacking abdominal pain, inability to take in fluids, persisting for several days. To test if it is truly Chou Du, have the patient chew raw soybeans. If they taste sweet, it is Chou Du; if they taste fishy, it is not.

In the world, some methods include pouring water over the shoulders, back, arms, and hands (to draw out pathogens); scraping with Ramie fiber soaked in water; scraping with a porcelain bowl lubricated with oil; pricking Weizhong (BL40) with a porcelain shard to bleed; or using an oiled paper lamp to illuminate the back, identifying red spots, and cauterizing them. All these methods aim to open the Cou Li (interstices and skin pores). Other methods include swallowing dozens of Sichuan peppercorns with cold water, or taking 2-3 qian of raw-studied Alum dissolved in cold water. However, since Peppercorn has a pungent and dispersing nature, accidental ingestion does no harm. Alum has a sour and astringent nature; if it is not Chou Du, the harm caused will be profound. Many are misdiagnosed as Food Stagnation, treated repeatedly with purgatives without success, dragging on for ten days or half a month until death. It is common to see those who drink large amounts of cold water and subsequently develop Dysentery; or those whose water retention in the Lung leads to Edema; or those who accidentally ingest Alum water, resulting in persistent hiccups and vomiting; or those who bleed too much from Weizhong pricking and die shortly after; or those with Cold Damage Yin Syndrome abdominal pain who are mistakenly pricked at Weizhong and drink cold water, leading to untreatable conditions; or those with Internal Injury from Cold Food abdominal pain who are mistakenly pricked at Weizhong, causing the condition to worsen. This is truly pitiable.

According to this analysis, the abdominal pain is caused by Yin Evil and Filthy Qi suppressing the latent Fire within the Spleen and Stomach, with the two evils striking each other. It often recurs frequently, and medications are ineffective. Ancient methods suggest that upon initial onset, drinking Mugwort Decoction to induce vomiting can confirm the diagnosis. Another method involves drinking tea made from Silkworm Molt Paper and covering warmly to induce sweating. This is because Silkworms have properties to resolve Phlegm, dispel Wind, and open orifices, and the paper, having been salted, descends rapidly. I once stated that since this syndrome belongs to the decline of Earth Qi and internal invasion by Filthy Qi, one should use Qi-moving herbs to dissipate turbid filth, combined with a single herb: Cyperi Rhizoma (Xiangfu), soaked in Child's Urine, dried, powdered, and taken in one dose of 4-5 qian with warm water for immediate effect. Yueju Pill or Chenxiang Jiangqi San are also good options. Furthermore, if Spleen Deficiency with accompanying Fire combines with Filthy Qi invasion, it causes chaotic pain in the heart and abdomen, with blockage above and below. This is colloquially called Gan Huoluan (Dry Cholera), and in recent times, Jiaochang Sha (Intestinal Twisting Miasma). Because Filthy Qi is external, solidified and unscattered, and Fire Evil is internal, attacking but unable to break through, the syndrome is extremely urgent. Emergency treatment involves placing Salt on the head of a knife, heating it until red, quenching it in water, stirring well, and administering to induce vomiting, thereby lifting the trapped and closed Qi. Subsequently, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) should be given lukewarm. I have seen cases where hot herbal decoctions led to death, while others recovered with Yushu Dan or Suhe Xiang Wan. However, Salt Water mixed with Child's Urine is superior. Dian Yan Sha (Eye-Dotting Sand) is also effective.

Whenever there is foul-smelling abdominal pain, with pulses that are hidden, fine, small, tight, and choppy, or firm and beating against the finger with rapid and intermittent rhythms, these are signs of Yin Rebellion and Yang Trapping. One must not mistake this for Yin-Cold and administer Hot Herbs, which would agitate the Fire and cause immeasurable harm. Not only Hot Herbs are contraindicated, but also Amomi Fructus (Sharen) due to its pungent-warm and aromatic penetrating nature, Ginger Root (Shengjiang) due to its pungent-spicy and ascending nature, and Alcohol due to its pungent-hot and fire-assisting nature. All should be avoided. Hot soups should definitely not be given, and hot baths are particularly taboo. Heat causes upward rushing that cannot be controlled. If the patient presents with cyanotic face and black lips, a firm pulse beating against the finger, cold limbs, and panting, recovery is unlikely.