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Spleen Qi is injured by overwork and fatigue. Yuan Qi (Primordial Qi) sinks downward. If one rigidly adheres to the principle of "using sweet and warm herbs to eliminate fever," and instead uses tonifying methods, it will lead to stagnation and transformation into heat, resulting in an incurable condition.

The syndrome where epidemic disease (Yi) and dysentery occur simultaneously is most critical. Epidemic disease primarily involves the Stomach; it must be resolved through purgation. Dysentery primarily involves the Large Intestine. When the Large Intestine is diseased, it loses its function of transportation and transmission, so feces do not pass, and pus and blood are discharged. Therefore, food previously ingested remains stagnant and accumulated in the Stomach. Only when the pathogenic factors in the Large Intestine recede and Stomach Qi flows freely can the accumulated feces be expelled downwards. Now that the Large Intestine has failed in its duty and feces cannot move downward, how can it assist the Stomach in carrying out toxins? Since the toxins cannot move downward, they severely damage and deteriorate Stomach Qi. Toxins residing in the Stomach cause harm day by day and moment by moment, consuming Qi and congealing Blood. Once Shen Qi (Spiritual Qi) is exhausted, death ensues. In cases where epidemic disease is complicated by dysentery, the dysentery aspect is particularly urgent. The appropriate formula is Binglang Shunqi Tang (Betel Nut Decoction for Directing Qi).

Binglang Shunqi Tang (Betel Nut Decoction for Directing Qi)
Da Huang (Rhei Radix et Rhizoma), Houpo (Magnoliae Officinalis Cortex), Shaoyao (Paeoniae Radix Alba), Binglang (Arecae Semen), Zhishi (Aurantii Fructus Immaturus), Shengjiang (Zingiberis Rhizoma Recens).
These six ingredients are decocted in water and taken warm.

In pregnant women suffering from seasonal epidemics, if San Chengqi Tangs (Three Decoctions of Inheriting Qi: Tiaowei Chengqi Tang, Xiao Chengqi Tang, Da Chengqi Tang) need to be used, treatment must be administered according to the specific syndrome without excessive worry. One must not be confused by theories regarding using Ren Shen (Ginseng Radix) to calm the fetus. Patients often feel alarmed and suspicious when seeing Chengqi Tangs prescribed, and if laypersons with superficial medical knowledge chatter nearby, it inevitably hinders treatment, leading to misfortune for both mother and child. If a syndrome requires purgation but tonics are used instead to calm the fetus, the heat and toxins will become more intense, making the fetus even more unstable, consuming Qi and congealing Blood, leaving the fetal house without support. Thus, ancient physicians used the metaphor of a hanging bell: if the beam rots, the bell inevitably falls. Only by using Chengqi Tangs to drive out pathogens, dissipating fire and toxins, turning inflammation into coolness, and restoring Qi flow, can the fetus be naturally secured. In such syndromes, Da Huang becomes the holy medicine for calming the fetus. Historical treatments confirm this, ensuring safety for both mother and child. However, if abdominal pain and lower back pain appear, miscarriage is inevitable, and this must be forewarned.

Women suffering from epidemics are no different from men, except during menstruation (just starting or just ending), metrorrhagia (profuse uterine bleeding), and postpartum periods. When menstruation just starts, pathogens do not enter the Stomach but enter the Blood Sea (Chong and Ren meridians/Uterus). There is no pathogen in the chest and diaphragm, so one should not use harsh purgatives for fullness in the Stomach. Heat will resolve itself as it follows the menstrual blood downward. The appropriate prescription is Xiao Chaihu Tang (Minor Bupleurum Decoction) added with Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), and Chi Shao Yao (Paeoniae Radix Rubra). If symptoms resemble Jie Xiong (Chest Binding), it is because blood is bound by pathogens; puncture Qimen (LR14). When menstruation just ends, the Blood House is empty, and pathogens enter due to deficiency, making it difficult to treat. This differs from the "just started" scenario in terms of excess and deficiency; Chaihu Yangying Tang (Bupleurum Nourishing Ying Decoction) is appropriate. For new postpartum hemorrhage, Chong and Ren meridians are empty; for those with chronic metrorrhagia and long-term deficiency of Jing Qi, this same decoction is used. If the medicinal action stagnates, add Sheng Jiang to harmonize its nature. If Middle Qi is deficient and fails to transport, add Ren Shen to assist movement. During epidemic times, if children present with eyes rolling upward, convulsions, spasms, curved fingers, and opisthotonos, do not diagnose it as Wind-Stroke (Jing Feng). Treat it similarly to adults, but with lighter and smaller dosages.

For syndromes requiring purgation, after purging, the pulse should be calm and the body cool. If fever persists, it is because the obstruction has opened, Qi flows, and suppressed Yang suddenly extends; this will subside shortly. If it does not, residual pathogens remain. After purging, if lying quietly for two to three days, or four to five days, sweating continues with slight fever, this still belongs to Heat, indicating residual pathogens on the Exterior. Sweating stops when pathogens are exhausted. If sweating persists, use Xiao Chaihu Tang added with Guang Pi (Citri Reticulatae Pericarpium); if vomiting occurs, add Ban Xia (Pinelliae Rhizoma); if deficient, add Ren Shen. Adjust accordingly. Do not use Cang Zhu (Atractylodis Rhizoma) or Bai Zhu (Atractylodis Macrocephalae Rhizoma). If the pulse is calm and body cool, but night sweats occur days later, mild tonification is appropriate. The distinction between excess and deficiency lies in the presence or absence of Heat.

After purging, if pathogens are gone and vomiting stops, but vomiting recurs, this indicates Stomach Deficiency. Administer small amounts of rice gruel to regulate.

If a person was eating meat when illness struck, causing stagnation in the Stomach, and Chengqi Tang is used continuously for purging, only foul fluid leakage may occur, and the illness will not retreat. One must add Ren Shen. Then, decades of stagnation will immediately clear. If purgation is indicated but missed, causing slight deficiency of True Qi, or if after taking Chengqi Tang, sweat appears on the forehead, roots of hair itch, extremities become cold, shivering occurs, restlessness and agitation resembling mania ensue, this is called "Medication Irritation" (Yao Fan). It indicates Middle Qi is depleted and cannot withstand the drug's force. In such cases, add more Sheng Jiang to the prescription and administer in divided doses twice or thrice to prevent vomiting.

Diseases may relapse due to overwork (Lao Fu), improper diet (Shi Fu), or spontaneous recovery (Zi Fu). For Lao Fu, use tonification and nourishment. For Shi Fu, light cases require dietary restriction, severe cases require purgation. For Zi Fu, adjust previous prescriptions up or down for spontaneous recovery.

When Cold Damage (Gan Mao) complicates an epidemic, treat the Cold Damage first, then the epidemic. When Malaria complicates an epidemic, treating the epidemic resolves the malaria.

The nine transmissions of Plague-Epidemic diseases.