Library

The book *Er Fen Xi Yi* records a prescription called Peizhen San (Compensation and Relief Powder), using Dahuang (Rhei Radix et Rhizoma) as the Jun (Monarch) herb, assisted by Jiangcan (Bombyx Batryticatus), Chantui (Cicadae Periostracum), and Jianghuang (Curcumae Longae Rhizoma). The herbs are ground into powder and taken with honey and wine to treat thirty-six types of febrile epidemics. Generally, only one formula can treat multiple diseases; this is true for Wanying Gao (Ten-Thousand-Indications Plaster), and Guangdong wax pills also claim similar efficacy. However, those pills must specify a specific Yin Jing Yao (Meridian-Guiding Herb) to be taken with the formula according to the specific symptom. Although it is the same formula, the guiding herb varies with the disease, making the role of the guiding herb crucial, which is incomparable to formulas without guiding herbs that claim to treat multiple conditions simultaneously. Moreover, epidemics differ from miscellaneous diseases; there are differences in transmission between exterior and interior, distinctions among meridians, fu-organs, zang-organs, and stomach, variations in age and constitution strength, and differences in heavenly timing and local geography. How can one formula treat thirty-six different conditions?

When I first obtained this book, during a year when epidemics were rampant, I prepared a dose for backup use. Later, upon returning home, my granddaughter suffered from an epidemic. Her family members administered the medicine to her, but she subsequently developed diarrhea, lethargy, and worsened symptoms. Brother Yungu stated that this formula was effective for treating throat ailments like Ru E (Milk Throat/Tonsillitis). Upon careful reflection, the reason my granddaughter’s condition worsened after taking the medicine is that the pathogenic factor remained in the exterior, and the presence of Dahuang (a bitter-cold purgative) made it unsuitable for her body. As for treating throat diseases where heat-toxin might be appropriate, surely among the thirty-six conditions there would be at least one applicable case?

The book also contains prescriptions such as Da Xiao Fu Su Yin Zi (Large and Small Revival Decoction), Da Xiao Qing Liang Di Yi San (Large and Small Clearing-Cooling Epidemic-Purging Powder), Jing Yi Yin (Pacify-Epidemic Decoction), and Qu Yi Yin (Expel-Epidemic Decoction). All these use Huanglian (Coptidis Rhizoma) as the Jun (Monarch) herb, mixed with various cold and bitter drugs as assistants, some containing up to twenty ingredients. I firmly dare not use them.

The explanations in various sections of *Jing Yue Quan Shu* (Complete Works of Zhang Jingyue) are extremely detailed and profound, except regarding epidemics... This is because he conflated Shang Han (Cold Damage) and Wen Yi (Epidemic Fevers), failing to distinguish them clearly. His discussion on epidemics states: "Epidemics are essentially Shang Han; they are merely diseases caused by external pathogens, contracted through seasonal qi, affecting people of all ages similarly; this is what is meant by epidemics." However, Shang Han is caused by cold injury, or forced by cool rain, stimulated by wind and snow, falling into water, sudden exposure of clothing, or sleeping in the wind, resulting in headache, aversion to cold, high skin fever, stiff spine, and absence of sweat; this is defined as Shang Han. This is a self-inflicted illness affecting only one person, whereas epidemics affect many. Epidemics, however, occur suddenly without any of the aforementioned exposures, affecting multiple people in a village who present similar symptoms. Their symptoms include headache, body heat, stiff spine, but with profuse sweating, consistently manifesting as heat syndromes. This is radically different from Shang Han, and the treatment methods differ accordingly. How can one say epidemics are essentially Shang Han? If they are essentially Shang Han, establishing a separate category for epidemics would be redundant. Furthermore, if they are essentially Shang Han yet contracted via seasonal qi, I do not know whether one is first injured by cold and then infected by seasonal qi, or infected by seasonal qi and then injured by cold, or both accumulate simultaneously in one person. Ultimately, this stems from a failure to clearly distinguish between Shang Han and Wen Yi, akin to a candidate for the imperial examinations misinterpreting the topic and writing incorrectly from the start. Although the language may be ornate, it misses the point, amounting to stale rice and mud soup; how can it be considered good writing?

The two principles I most strongly disagree with are vigorous sweating and drastic tonification. Does one not realize that epidemics cannot be resolved by forceful sweating? And how can drastic tonification be applied to individuals suffering from heat-toxin? Only after sweating or purging, or when deficiency syndromes appear, or when extremely weak and chronically ill individuals contract an epidemic, is the use of tonification methods indispensable.