大头瘟者。此天行之厉气也。其湿热伤高巅之上。必多汗气蒸。初憎寒壮热体重。
头面肿甚。目不能开。上喘。咽喉不利。舌干口燥。不速治。十死八九。宜普济消毒散。
如大便硬。加酒蒸大黄一二钱。缓缓服。作丸噙化尤妙。若额上面部 赤。面肿脉
数者。属阳明。本方加石膏。内实加大黄。若发于耳之上下前后。并额角旁红肿者。
此少阳也。本方加柴胡栝蒌根。便实亦加大黄。若发于头脑项下。并耳后赤肿者。
此太阳也。荆防败毒散。去人参。加芩、连。甚者砭针刺之。
普济消毒散
黄连 黄芩（酒炒） 人参 黑参 甘草（生） 桔梗 连翘 牛蒡子（炒研） 升麻 白芷 马勃（各一钱）
僵蚕（炒七分）
蓝根（如无以青黛代之） 柴胡（各二钱）
上为末。半用水煎去滓。食后徐服。半用蜜丸。噙化就卧。以令药性上行也。
节庵于普济消毒散中。去人参、升麻、白芷、黑参、马勃、僵蚕、蓝根。加川芎、羌活、防
风、荆芥、射干、姜汁、竹沥。名芩连消毒饮。
捻颈瘟者。喉痹失音。颈大腹胀。如虾蟆者是也。宜荆防败毒散。
荆防败毒散
羌活 独活 前胡 柴胡 人参 甘草（人中黄更妙） 枳壳 桔梗
茯苓 川芎 牛蒡子（炒研） 薄荷 荆芥 防风
上诸药各一钱。惟防风加五分。水煎缓服。加金汁一杯尤效。
Da Tou Wen (Big Head Plague) is caused by Tian Xing Li Qi (pestilential qi with strong infectivity). The damp-heat pathogen invades the highest part of the body (the head and face), inevitably leading to sweating and steaming heat. In the initial stage, it presents with aversion to cold and high fever, heavy body, severe swelling of the head and face, inability to open the eyes, upward panting, throat obstruction, dry tongue, and dry mouth. If not treated promptly, eight or nine out of ten patients will die. Pu Ji Xiao Du San (Universal Benefit Detoxification Powder) is suitable. If the stool is hard, add Jiu Zheng Da Huang (Wine-processed Rhubarb) 1-2 qian, taken slowly. Making pills for sucking is even better. If the forehead and facial area are red, with facial swelling and a rapid pulse, it belongs to the Yangming channel; add Shi Gao (Gypsum) to the original formula; if there is internal excess, add Da Huang (Rhubarb). If redness and swelling occur around the ears (above, below, front, back) and beside the frontal angle, this is Shaoyang channel involvement; add Chai Hu (Bupleurum) and Gua Lou Gen (Trichosanthes Root) to the original formula; if the stool is solid, also add Da Huang (Rhubarb). If redness and swelling occur at the back of the head and neck and behind the ears, this is Taiyang channel involvement; use Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity), remove Ren Shen (Ginseng), add Huang Qin (Scutellaria) and Lian Qiao (forbidden in text as 'Qin', likely Huang Qin based on context of clearing heat, but text says 'Qin, Lian' -> Huang Qin, Huang Lian); for severe cases, use Bian Shi (stone needle) acupuncture to bleed.
Pu Ji Xiao Du San (Universal Benefit Detoxification Powder)
Ingredients: Huang Lian (Coptis Rhizome), Huang Qin (Scutellaria Root, wine-fried), Ren Shen (Ginseng Radix et Rhizoma), Hei Shen (Scrophulariae Radix, i.e., Xuan Shen), Gan Cao (Licorice Root, raw), Jie Geng (Platycodon Root), Lian Qiao (Forsythia Fruit), Niu Bang Zi (Arctii Fructus, fried and ground), Sheng Ma (Cimicifugae Rhizoma), Bai Zhi (Angelicae Dahuricae Radix), Ma Bo (Pteridis Spora, each 1 qian), Jiang Can (Bombyx Batryticatus, fried 0.7 qian), Lan Gen (Isatidis Radix, replace with Qing Dai if unavailable), Chai Hu (Bupleuri Radix, each 2 qian).
Preparation and Administration: Grind the above herbs into powder. Half is decocted in water, strained, and taken slowly after meals. The other half is made into honey pills for sucking while lying down, to facilitate the ascending action of the medicinal properties.
Jie An removed Ren Shen (Ginseng), Sheng Ma (Cimicifuga), Bai Zhi (Angelica dahurica), Hei Shen (Scrophularia), Ma Bo (Pteridium spore), Jiang Can (Bombyx batryticatus), and Lan Gen (Isatis root) from Pu Ji Xiao Du San, and added Chuan Xiong (Ligusticum Chuanxiong Rhizome), Qiang Huo (Notopterygii Rhizoma et Radix), Fang Feng (Saposhnikoviae Radix), Jing Jie (Schizonepetae Herba), She Ye (Belamcandae Rhizoma), Jiang Zhi (Zingiberis Rhizoma Juice), and Zhu Li (Bambusae Caulis in Taedia). This was named Qin Lian Xiao Du Yin (Scutellaria and Coptis Detoxification Decoction).
Nian Jing Wen (Twisted Neck Plague) manifests as Hou Bi (sore throat) with loss of voice, enlarged neck, abdominal distension, resembling a toad. Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity) is suitable.
Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Decoction to Overcome Toxicity)
Ingredients: Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Qian Hu (Peucedani Radix), Chai Hu (Bupleuri Radix), Ren Shen (Ginseng Radix et Rhizoma), Gan Cao (Licorice Root, Ren Zhong Huang is better), Zhi Ke (Aurantii Fructus), Jie Geng (Platycodon Root), Fu Ling (Poria), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Niu Bang Zi (Arctii Fructus, fried and ground), Bo He (Menthae Haplocalycis Herba), Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix).
Preparation and Administration: Each of the above herbs is 1 qian, except Fang Feng which is 0.5 qian. Decoct in water and take slowly. Adding Yi Jin (Human Excrement Juice/Golden Juice) one cup is especially effective.