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Summer-heat epidemic, where toxic qi attacks the interior, results in phlegm and wheezing (Tan Chuan) or blood stasis (Xue Yu). The patient experiences heavy coma and loss of consciousness. If the primordial qi is robust and the interior is not invaded by pathogenic factors, the toxins will be dispersed to the surface of the skin, muscles, and flesh, manifesting as swelling and distension. It is contraindicated to drink hot soup or hot wine. One should puncture the sha veins at the popliteal fossa (Tui Wan) and the tips of the ten fingers to release toxic blood, and internally administer Baohua San (Precious Flower Powder). (This is a celestial prescription for treating sha syndrome.)

Jinyu (Curcumae Radix, 1 qian), Xixin (Asari Radix et Rhizoma, 3 qian), Jiangxiang (Sappan Lignum, 3 qian), Jingjie (Schizonepetae Spica, 4 qian).
Grind all into fine powder, mix with clear tea water, take three spoonsful, and consume cold.

Taoren Honghua Tang (Peach Kernel and Safflower Decoction) (For treating blood coagulation.)

Taoren (Peach Kernel, peeled and tip removed), Honghua (Carthami Flos), Sumu (Sappan Lignum) (each 1 qian), Qingpi (Aurantii Fructus Immaturus Pericarpium, 8 fen), Wuyao (Linderae Radix, 4 fen), Duhuo (Angelicae Pubescentis Radix, 6 fen), Baijili (Tribuli Fructus, thorns removed and ground to powder, 1.2 qian).
Decoct in water and take orally.

Zipu Tang (Magnolia Bark Decoction) (For sha syndrome accompanied by excessive food stagnation and qi obstruction.)

Nongpu (Magnoliae Officinalis Cortex, stir-fried with ginger juice), Shanzha (Crataegi Fructus), Puzi (Breadfruit Seed? Note: likely a local variant or typo for another seed, kept as Puzi), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Zhishi (Aurantii Fructus Immaturus, bran-fried), Lianqiao (Forsythiae Fructus, septum removed), Qingpi, Chenpi (Citri Reticulatae Pericarpium), Xixin.
Equal parts, decoct in water, and consume cold.

The symptoms begin with lower abdominal pain. Treated like Yangmao Ding (Wool Carbuncle) by pricking, if no blood is released, purple nodules appear subsequently. The hands and feet become numb; if the numbness progresses to unconsciousness, death ensues. Immediately, someone should press firmly on the "Three Passages" pulse points of the patient's hand (left hand for males, right hand for females) without releasing pressure, until the limbs cease to be numb and the patient feels heat rising from the heart region, then release. The disease will heal spontaneously. If released too early, even after recovery, the condition may linger. The Three Passages pulse refers to the Cun Kou pulse location on both wrists.

This syndrome is something that officials and their secretaries must know. If one encounters a person who died from this illness but stubbornly claims they were coerced into suicide, is that acceptable? This case could supplement an entry in *Xi Yuan Lu* (Collected Cases of Injustice Rectified).
I heard from the old physician Zang Meiji: When I was young, my ancestor told me that anyone who commits suicide by hanging without cause suffers from Kouben Wen (Neck-Buckling Plague). At that time, I did not understand and asked for details, but later, upon reviewing medical texts, I found no such description. In the Xin Si year, a person came to tell me: In his hometown, there was a woman who usually had ample wealth, her children were grown, and she lived harmoniously with her husband. Suddenly, one day, she attempted suicide by hanging almost to death and was saved. Upon inquiry, she had no apparent reason, only feeling depressed every day. She hid a rope in her sleeve and hanged herself whenever she was alone. After Luo Shou treated her for over a month, her diet, speech, and movements were normal, and she recounted this seeking treatment. I recalled what I had heard in my youth and deduced that perhaps due to weak blood and exhausted qi, the pores opened, allowing pathogenic qi to enter and contend with righteous qi. Instead of knotting in the hypochondrium, it knotted in the Jueyin meridians of the hands and feet, and involved a combined disease of the three zang organs of the Hand Taiyin (Lung). The *Neijing* states: Danzhong (Conception Vessel point/Renal Center concept), the official of the minister, gives rise to joy and pleasure. Now, because of the illness, there is sorrow and grief. It can be known from the *Ci Mie Lun* (Discussion on Acupuncture for Malaria): Jueyin malaria involves fear and apprehension, and a gloomy feeling in the abdomen. Furthermore, Liver malaria involves frequent sighing, and the appearance resembles death. Also, Lung malaria involves being easily startled, as if seeing things. Since malaria presents thus, plagues can be inferred analogously. Therefore, I prescribed a formula using Xiangfu (Cyperi Rhizoma), Jinyu (Curcumae Radix), and Xionghuang (Realgar) to make Jiuxi Wan (Nine Qi Pill), to open the depression in Danzhong, plus Erchen Tang (Two-Cured Decoction) to open phlegm in the diaphragm, plus Qianghuo (Notopterygii Rhizoma et Radix) and Xixin (Asari Radix et Rhizoma) to warm the liver and expel wind, Guijianyu (Ardisiae Caulis), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), and Chixiaodou (Vigna Semen Rubrum) to unblock the Pericardium and drain fire pathogenic factors, decocted with fresh ginger. After taking it, the patient actually experienced headache, fever, and body pain, exhibiting all symptoms of a plague. She took out the rope from her sleeve herself and said: Who put this in me? I told her it was for hanging, but she had no memory of it. After lying ill for seven days, she took a sweating medicine and recovered. Only then did I realize that this syndrome also belongs to the category of epidemics or Baihe Bing (Lily Disease).
Commentary: Since it is stated to be an epidemic disease, why would one choose to throw oneself into fire, jump into water, or cut one's neck, rather than necessarily hanging oneself? My guess is that Taiyin pathogenic qi transmits to Jueyin, causing excessive Wind-Wood. Thus, one does not desire Metal, Fire, or Water, but exclusively desires Wood. Because Lung Metal stores Po (Corporeal Soul), Liver Wood stores Hun (Ethereal Soul), Spleen Earth stores Yi (Intellect), and Heart君主 (Monarch) stores Shen (Spirit), which is the master of the body. The Pericardium acts as the ministerial envoy, executing orders on behalf of the Heart Monarch, and governs joy and pleasure. Now, the Hand Jueyin Pericardium is diseased first; the ministerial envoy loses its function of joy, thereby disturbing the Spirit of the Heart Monarch. The Ministerial Fire fails to generate Earth, transmitting to Foot Taiyin Spleen, resulting in unclear intellect; Earth fails to generate Metal, transmitting to Hand Taiyin Lung, resulting in sorrow and grief; Metal fails to control Wood, transmitting to Foot Jueyin Liver, resulting in depression and anger. Lung Metal bears the weight of what it cannot overcome, while Wood lacks fear, so Wind-Wood becomes excessive. Moreover, the Hun of the Liver, carrying the Po of the Lung, does not rest in its dwelling and comes out to cause havoc, hence the desire for Wood and hanging. This is not possession by a spirit, but rather the Hun, Po, Yi, and Zhi acting as pathogens. Suhe Wan (Styrax Pill) or Niuhuang Qingxin Wan (Calculus Bovis Clearing the Heart Pill) might also be applicable, but unfortunately, I did not examine the pulse and complexion. This syndrome was originally named Kouben Shanghan (Neck-Buckling Cold Damage), but it has nothing to do with cold diseases, so it was renamed Wenbing (Plague Disease), which fits both name and reality.