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Plague (Yi Wen) is essentially in the category of Cold Damage (Shang Han), yet there are slight differences. Because plague tends to occur in spring and summer, and due to the widespread circulation of seasonal epidemic qi, the manifestations are similar in severity; it is only after a sufficient number of days have passed that sweating occurs leading to resolution, which constitutes the syndrome of plague. Although ancient texts state that plague diseases affecting the Three Yang meridians are more common than those affecting the Three Yin meridians, one must not adhere rigidly to this. If yin syndromes and yin pulses are observed, it is a disease of the Three Yin meridians, requiring careful differentiation and treatment.

One: For plague affecting the Three Yang meridians, one must differentiate by meridian. If the pulse is floating, accompanied by headache, fever, and body pain, it is a Taiyang syndrome (syndrome caused by pathogenic invasion of the Taiyang channel); Jiwei Qianghuo Decoction (Nine-Ingredient Notopterygium Decoction) with modifications is appropriate. If the pulse is long, with dry nose, insomnia, and restlessness, it is a Yangming syndrome (syndrome caused by pathogenic invasion of the Yangming channel); Gegen Jieji Decoction (Pueraria Muscle-Releasing Decoction) or Shiwei Shenru Yin (Ten-Ingredient Ginseng and Perilla Drink) with modifications are appropriate. If the pulse is wiry and rapid, with chest and hypochondriac pain and deafness, it is a Shaoyang syndrome (syndrome caused by pathogenic invasion of the Shaoyang channel); Xiao Chaihu Tang (Minor Bupleurum Decoction) with modifications is appropriate. These treatments for the three yang meridians represent the general principles of ancient formulas for treating plague. However, such conditions encompass all types of cold, heat, deficiency, and excess; therefore, observation and treatment should follow previous guidelines without rigidity.

One: In the initial stage of plague, presenting with headache, body pain, aversion to cold and fever, and a tight, rapid, full, or slippery pulse, without other symptoms, Zheng Chaihu Yin (Correct Bupleurum Drink) initially is appropriate, or Baidu San (Defend Against Toxins Powder), or Shishen Tang (Ten-God Decoction). If warm plague begins with predominantly yin and little yang, and the pulse and signs show no deficiency, Shenzhu San (Divine Operation Powder) is appropriate. If plague causes fullness and oppression in the chest and diaphragm, Xiao Chaihu Tang (Minor Bupleurum Decoction) combined with Zhishi (Immature Bitter Orange) and Juhong (Aged Tangerine Peel) is used. If heat is internal, add Huanglian (Coptis Rhizome). If seasonal plague occurs during summer months with severe heat in both exterior and interior, Qinghuo Jiedu (Clearing Fire and Resolving Toxin) methods are suitable; Qianghuo Shengma Tang (Notopterygium and Ligusticum Decoction) is used. If plague fire is excessive, with a full, large pulse and severe heat and restlessness, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is used. If plague heat-toxin floats upward, causing swelling of the head and face, inability to open the eyes, dry mouth and tongue, and throat obstruction, Puji Xiaodu Yin (Universal Benefit Detoxification Drink) is used. If plague presents with a full, large pulse, restlessness, heat, and thirst, Baihu Tang (White Tiger Decoction) is used. If accompanied by vomiting, Zhang Zhongjing's Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. If plague leads to mania and delirium, with a full, large, slippery, and solid pulse, and constipation, Dachengqi Tang (Major Order the Qi Decoction) or Jizi Qing Yin (Egg White Drink) is used. If plague involves excess pathogens both internally and externally, with constipation, requiring simultaneous release of exterior and interior, Fangfeng Tongsheng San (Saposhnikovia Unblocking Heroic Powder) is used. If plague persists for eight or nine days without subsiding, presenting with macules and jaundice, provided the pulse is not deficient or tight-floating, and abdominal distension is present, Chengqi Tang (Order the Qi Decoction) and Wuling San (Five-Ling Powder) can be taken together to purge. If plague causes redness of the head and body, extreme limb heat, and unbearable restlessness, methods to resolve plague heat-toxin are appropriate, along with drinking Xini Jiang (Sydney Slurry - *Note: likely a transcription error in original text for a local remedy*) or mixing Yuquan San (Jade Spring Powder) well water; both are excellent. The aforementioned methods are all suitable for yang syndromes and excess pathogens based on time and condition. If the plague pulse is weak and powerless, or if the exterior appears excess while the interior is deficient, or if the patient dislikes cold drinks and has loose stools, it is not a yang syndrome. One must not assume it is fire merely because of fever and rapid pulse; even in summer, Lizhong Tang (Regulate the Middle Decoction), Liyin Jian (Nourish Yin Decoction), Dawenzhong Yin (Great Warm the Middle Drink), Dabuyuan Jian (Great Tonify Origin Decoction), and other warming and tonifying methods mentioned previously should be used according to the syndrome. This is the subtle method of abandoning temporal considerations in favor of syndrome differentiation. Moreover, summer often harbors latent yin; thus, when encountering such cases, one must first observe yin and yang, then differentiate deficiency and excess—this is the key. It must be deeply remembered.

Xu Donggao stated: If plague remains unresolved after six or seven days, leading to heat entering the Blood Chamber (Xue Shi), resulting in jaundice where the body looks like smoke, eyes appear golden, dry mouth, and heat accumulation, bi-sticking acupuncture at Quchi (LI11) to release bad blood, combined with Fangfeng Tongsheng San (Saposhnikovia Unblocking Heroic Powder) using both dispersing and purging methods, results in recovery. Sweating resembles yellow water, and stool resembles black paste. This refers to the "Da Han" (Beating Cold) method described in this formula. The technique involves stroking the upper arm to gather blood there, binding it tightly with cloth, then using a tendon clamp holding a porcelain edge to strike the large collateral near Quze (PC3) in the elbow, allowing evil toxins to exit with the bad blood. This is also a very swift method, extremely effective for the poor, though it is not actually the Quchi acupoint.