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After studying medical texts, I paid attention to medicine and fortunately received the true transmission, becoming quite familiar with formulas and pulse diagnosis. Later, I was summoned to the South to study this specific condition.

The local people say that any illness is called "Zhang" (Miasma), and they generally do not take medicine, but only worship spirits and gods.

However, "Zhang" as a disease is similar to "Shanghan" (Cold Damage); how can one sit idly by without treatment?

I have often seen cases where delayed or ineffective Traditional Chinese Medicine treatment led to untreatable conditions.

Once past Guilin to the south, medical resources are scarce. Moreover, people living in the South often sweat excessively, leading to a pattern of excess above and deficiency below (Shang Shi Xia Xu). Therefore, the three methods of sweating (Diaphoresis), vomiting (Emesis), and purging (Catharsis) cannot be used.

Local physicians are few and often incompetent; some recklessly use sweating, vomiting, or purging methods, which constitutes "making the deficient more deficient" (Xu Xu).

Medical books state that the southern climate is warm and humid, and the earth's qi is stagnant and steaming. Yin qi tends to be closed and solidified, while Yang qi tends to dissipate. Plants and water sources all absorb evil qi. Humans living there have unstable Yuan Qi (Original Qi), and upon contracting pathogens, they fall ill, which is called "Zhang".

In mild cases, there is alternating chills and fever, resembling malaria, called "Leng Zhang" (Cold Miasma).

In severe cases, there is deep-seated heat accumulation, feeling as if lying in ashes and embers day and night, called "Re Zhang" (Hot Miasma).

In the most severe cases, loss of voice occurs immediately upon onset, for unknown reasons, called "Ya Zhang" (Mute Miasma).

Medical books claim: Leng Zhang is never fatal; Re Zhang becomes fatal after a long time; Ya Zhang is always fatal. This is the view in medical literature.

However, in my opinion, what is called "Ya Zhang" is not merely the loss of voice due to Shanghan? Nor is it the aphasia due to Zhongfeng (Wind Stroke)? If treated correctly, many can survive; how can it be said that none survive?

As for "Re Zhang", it occurs in mid-summer and early autumn. Thorns grow on narrow paths; when people walk through them, heat steams and stagnates. Without trees to shade the sun or springs to quench thirst, latent summerheat becomes severe, leading to disease.

Some may drink alcohol without restraint, or consume fried and roasted foods accumulating internal heat, accidentally contracting this condition.

The fever persists day and night. If delayed by two or three days, blood coagulation occurs, making it untreatable.

Locals call this "Zhong Jian" (Arrow Strike) or "Zhong Cao Zi" (Grass Seed Strike).

However, there is a method to treat "Cao Zi": pricking the forehead, upper and lower lips with needles, and wiping the tongue with Broussonetia papyrifera leaves until bleeding occurs, followed by slowly using herbal medicine to resolve internal heat, resulting in immediate recovery. How can it be said to be fatal after a long time?

Regarding "Leng Zhang", there may be more chills than fever, or more fever than chills, or it may occur every other day. Upon recovery, sores may appear on the lips. Verifying the symptoms, it corresponds to malaria from other regions.

It is not originally a severe disease, but often leads to disaster due to misdiagnosis and mistreatment. It should not be ignored simply because it is said to be fatal.

If the pulse is extremely faint and Yuan Qi is indeed deficient, administering Fuzi Tang (Aconite Decoction) will lead to recovery. If cold-natured medicines are mistakenly administered, as stated, "Chengqi entering the stomach, yin excess leads to death."

If the pulse is洪盛 (surging and full) and the syndrome indicates excess heat, harmonizing medicines should be taken for gradual treatment. If hot-natured medicines are mistakenly administered, as stated, "Guizhi entering the throat, yang excess leads to death."

The key lies in palpating the pulse and examining the syndrome for deficiency/excess and cold/heat to treat accordingly; no case will fail to heal.

People say that the toxic earth qi of water, springs, plants, and grass in Lingnan causes anyone traveling or serving as an official there to contract Zhang and face danger.

It is also said that natives, having grown up there, are accustomed to the local earth and water qi. Outsiders entering the South will inevitably fall ill, though severity varies. If one stays long enough to adapt, one may avoid illness.

While this argument seems reasonable, if one prepares proper nourishing methods and uses mild herbs to detoxify, one can ensure no illness, or if ill, easy recovery.

Moreover, among those contracting Zhang, natives often suffer more severely, while outsiders often suffer less.

This is because natives indulge in sexual activity, weakening the Lower Yuan (Kidney essence), bathe in streams catching colds, and eat raw, cold, alcoholic, and rich foods without restraint. Thus, their condition is severe.

Therefore, those contracting Zhang should not solely blame the difference in wind and earth; rather, it is due to their own failure to maintain disciplined health preservation.

When a gentleman resides in such a region, he must be cautious with daily routines, moderate his diet, and adapt to temperature changes. Avoiding excess in morning wine and evening meals, if discomfort arises, taking one or two doses of Zhengqi San (Righteous Qi Powder) will strengthen the Spleen and Stomach, promote smooth flow of Qi and Blood, rapidly disperse minor pathogens, leaving no room for Zhang.