Library

For all patients suffering from Shanghan (Cold Damage) or plague, if the pulse is surging (Hong), large, slippery, and rapid, yet with a moderate/slack quality within the rapidness, it is treatable. If the pulse is surging and large, but extremely tight and rapid, the condition is critical. If the pulse appears floating and large but is powerless upon deep palpation, tonification combined with exterior-releasing should be used. If the body is hot but the pulse is weak, pure tonification should be primarily employed, or combined with warming and dispersing methods. If the body is highly febrile, yet the pulse is deep, choppy, fine, and small, accompanied by cold feet, the condition is difficult to treat. In plague cases lasting four to five days, if there is fever, abdominal fullness with vomiting, and the pulse is fine, wiry, and strong, death will occur in twelve days. In plague cases of two to three days, if there is headache and abdominal fullness, and the pulse is straight and rapid, death will occur in eight days. In plague cases of eight to nine days, if there is no pain in the head or body, the complexion remains unchanged, but diarrhea persists unceasingly, the epigastrium is hard, the pulse does not beat vigorously, and occasionally becomes large, death will occur in seventeen days. If plague patients do not sweat, or if sweating does not reach the lower limbs, death will ensue. If plague patients suffer from dysentery with severe abdominal pain, death will ensue. The above fatal signs are merely a general overview; for all未尽 details, refer to the Shanghan section.

Since ancient times, treatment methods for Shanghan have been criticized for being vast and profound. Since my own research and exploration, having paid close attention for a long time, I find that when compiling methods, one may not encounter the corresponding disease; when facing a disease and seeing its manifestations, one may not find a matching formula. This shows that diseases have many variations, and rigid adherence is difficult to implement; only flexibility and grasping the essentials are valuable. Therefore, in my commentary on *Lei Jing* (Classified Classic), I listed six essential principles for treating Shanghan: Sweating (Han), Tonifying (Bu), Warming (Wen), Clearing (Qing), Vomiting (Tu), and Purgation (Xia). However, these were only mentioned in general terms without detail. Now, I present all these methods here to supplement the deficiencies in Shanghan treatment. If one wishes to seek the core methods of Zhang Zhongjing, one should read the original Shanghan texts. By cross-referencing both, one can achieve clarity where the main points govern the details, naturally attaining the wonder of comprehensive integration. Being both concise and exhaustive, the key to saving lives lies nowhere else than this.

Regarding the treatment of Shanghan, I have already analyzed the Six Essentials. Beyond these six essentials, there are Five Taboos. Why? Among the six methods, Sweating is primary, because recovery from Shanghan invariably occurs through sweating. Thus, although there are six methods, Sweating essentially encompasses them. The other five methods outside of Sweating are also essentially methods to induce sweating. However, inducing sweating relies on acrid dispersal, which is the normal approach. Why can all five methods induce sweating? Given the Six Essentials, why distinguish Five Taboos? Sweat is formed from body fluids, emerging from Yang, originating from Yin. If the skin and muscles are closed and dense, and Ying (Nutritive) and Wei (Defensive) Qi do not circulate, without acrid dispersal, the Xuanku (sweat pores) will not open, and sweat will not come out; this is the first case. Furthermore, if fire pathogen burns internally, causing blood dryness and fluid depletion, without cooling agents, Yin Qi cannot nourish, and sweat will not come out; this is the second case. Furthermore, if Yin pathogen is firmly closed, preventing Yang Qi from reaching, without acrid-warming agents, condensation will not disperse, and sweat will not come out; this is the third case. Furthermore, if Ying and Wei are insufficient, and the root is internally deficient, without potent tonification, Blood and Qi will not be充盈 (full), and sweat will not come out; this is the fourth case. Furthermore, if pathogen is in the Upper Jiao, blocking the pathway of clear Qi, without emetic methods, clear Qi will not ascend, and sweat will not come out; this is the fifth case. Furthermore, if pathogen enters the Yangming, causing stomach Qi stagnation, without purgative methods, turbid Qi will not resolve, and sweat will not come out; this is the sixth case. All these are ways to induce sweating, which constitutes the so-called Six Essentials.

What are the Five Taboos? First, when heat is in the exterior, and there is no excess fire internally, cold-cooling agents are strictly taboo. Cold causes Yin pathogen to stagnate and not disperse, leading to deeper pathogen penetration and daily decline of Yang Qi; failure to sweat results in death. Second, when Yuan Qi (Original Qi) is inherently weak and Zheng Qi (Upright Qi) cannot overcome the pathogen, agents that consume Qi are strictly taboo, especially fear of using tonification. Consumption leads to daily decline of Zheng Qi; lack of tonification leads to daily strengthening of pathogen Qi; those who are consumed become weaker, and those who are severe become more severe; inevitable failure to sweat results in death. Third, when excess pathogen is knotted internally, and latent fire flares up internally, warming-tonifying agents are strictly taboo. Warming increases dryness; tonification increases firmness; failure to sweat results in death. Fourth, when the Middle Jiao is deficient and Qi is weak, and the patient falls under the previous clauses regarding sweating taboos, dispersing agents are strictly taboo. Dispersal leads to Qi collapse; Qi collapse prevents sweat from coming out and prevents sweat from stopping; Qi collapse resulting in inability to control sweat results in death. Fifth, when the disease is not Yangming excess pathogen, and the patient falls under the previous clauses regarding purgation taboos, purgative agents are strictly taboo. Purgation leads to loss of Yin; Yin deficiency allows Yang pathogen to sink deeply; failure to sweat results in death. These constitute the so-called Five Taboos. To know the Six Essentials and avoid the Five Taboos is to master the treatment of Shanghan. However, false heat is common, while true heat is rare. To discern subtle distinctions between apparent and real conditions requires extraordinary insight. My earnest exhortations are directed solely at those who study with dedication.