Library

In the 21st year of Chenghua (1485), a plague broke out on a large scale in Xinye. There was no day without deaths. The neighbors, Fan Zi and his wife, had been bedridden for several days. Since I began studying medicine, hearing sounds from their home resembling that of slaughtered sheep, I hurried to examine them. I saw several people covering the woman with cotton quilts and placing a basin of fire under the bed to induce sweating. The woman's face was red, her voice hoarse, and she was nearly dead. I scolded them, saying, "Quickly remove the covers, or she will die." The crowd still did not obey. So, I forcibly pulled away the covers. The woman jumped up and leaned against the wall to sit, unable to speak. I asked her, "Do you want to drink cold water?" She nodded. I gave her a bowl of water, which she drank in one gulp, after which she could finally speak. She asked for more water, which I gave her again. After drinking, she sweated profusely. The next day, she recovered. Someone asked me the reason. I said, "She had been feverish for several days and had not eaten, so her intestines were dry and depleted. Steaming her with fire would only hasten death; how could there be sweat? Now, because the heat was extreme, I administered water to her. This is what is called 'Water and Fire in Mutual Interaction' (Shui Huo Ji Ji). How could she not sweat? Consider a dry tripod being heated by fire: although it becomes red, steam does not rise. When water is poured into it, steam naturally arises. Those who encounter such syndromes must understand this principle."

Yu Hengde treated a woman, aged twenty-nine. In March, she contracted a plague syndrome. After three days of illness, her menstruation happened to start, and the fever became more severe. By the seventh or eighth day, the condition worsened. Qi stagnated in the chest causing pain, making it impossible to lie down. All physicians were at their wits' end. At night, Yu was invited to treat her. The patient sat on the bed leaning back against a cotton bag, while a maid continuously massaged her chest. All six pulses were faint, rapid, and irregular, resembling the movement of a shrimp swimming. Yu asked, "I fear that premature purging has led to Jie Xiong (Chest Binding) syndrome." The owner replied, "Not yet." Yu said, "The menstruation started on the third day of illness, leading to deficiency of Middle Qi descending with the blood. Therefore, I used Huanglong Tang (Yellow Dragon Decoction), Siwu Tang (Four Substance Decoction), and Xiaoxianxiong Tang (Small Trap in Chest Decoction), combined into one dose, decocted with ginger and jujube. The owner asked, 'What is this medicine called?' Yu said, 'It is Sanhe Tang (Three Combined Decoction).' After one dose, all symptoms subsided, allowing her to lie down. After another dose, the fever receded and the patient stabilized. Later, due to overeating porridge, fever returned, attributed to internal injury. Treatment used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), modified as needed, and she recovered after regulation."

Wang Shishan treated a young man who had just reached adulthood. After sexual exertion, he suddenly felt aversion to cold, spontaneous sweating, and fever. His head, back, and epigastrium all hurt. His lips were red, tongue stiff, and he vomited. His eyelids were bluish. A physician prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). In the afternoon, he developed delirium and aversion to heat, with long urination. On the first day, the pulse was fine, weak, and rapid. On the second day, it was floating, wiry, and rapid. The physician pressed below the umbilicus and found pain, proposing purgation. Wang said, "This is an epidemic disease. The epidemic involves both exterior and interior (Liang Gan), with heavy internal injury and light external contraction. Pain below the umbilicus indicates deficiency of Kidney Water. Using draining medicines would kill him. The ancients said that epidemic diseases are treated with tonification, descending, and killing methods. Here, we should combine tonification and descending methods. Use Qingshu Yiqi Tang (Clear Summerheat and Augment Qi Decoction), removing Cangzhu (Atractylodis Rhizoma), Zexie (Alismatis Rhizoma), and Wuweizi (Schisandrae Fructus), adding Shengdi (Rehmanniae Radix), Huangqin (Scutellariae Radix), and Shigao (Gypsum Fibrosum). After taking more than ten doses, he stabilized."

Huxian Weng treated Zhang Weibo, a scholar, who suffered from unresolved wind-heat. At that time, a plague was rampant. Other physicians diagnosed his pulse as hidden in both hands, stating, "This is a Yang syndrome presenting with Yin pulse, which is untreatable." They intended to use Yangdu Shengma Tang (Yang Toxin Ephedra and Ligusticum Decoction) to raise and lift. Huxian Weng said, "This is extreme wind-heat. Excessive fire causes the pulse to hide; it is not a Yin pulse. Lifting it would cause death." Ultimately, he used Lianqiao Liangge San (Forsythia Cooling Diaphragm Powder), and the patient recovered after one dose.

In the fourth month of Taihe Year 2, many people suffered from plagues. Initially, they felt aversion to cold, high fever, and body heaviness. Then, swelling spread to the head and face, eyes could not open, upper body wheezed, throat was obstructed, tongue was dry, and mouth was parched. Commonly known as "Big Head Cold" (Datou Shanghan). Various mixed treatments failed to cure it. It gradually became critical. Li Dongyuan said, "The upper half of the body corresponds to Heaven's Qi. Pathogenic heat lodges between the Heart and Lung, attacking upward to the head and face, causing swelling." He used Puji Xiaodu San (Universal Benefit Detoxification Powder). Following the method, many lives were saved. People at the time called it "Heaven's Formula" (Tian Fang).

Luo Qianfu treated Yao Gongmao, Right Vice Director of the Secretariat, aged sixty-seven. He had a history of "Shidu" (Seasonal Toxin). In the spring of Wuchen year of Zhiyuan era, it relapsed due to alcohol consumption. The head and face swelled and pained, especially around the ears. The chest was vexed and stuffy, throat obstructed. The lower half of the body was cold, especially the calves. Consequently, two beds were connected to form a pit; the upper half slept on the bed, and the lower half slept in the pit. Food intake decreased, spirit was fatigued, and the body was weak. Luo was summoned. The pulse was floating and rapid, but deep pressure revealed wiry and fine qualities, clearly indicating Upper Heat and Lower Cold. The *Neijing* states, "Excess heat causes swelling." It also says, "Spring Qi diseases affect the head." The *Nanjing* states, "Accumulation leads to swelling and heat, requiring Bian stone puncture." This was done to facilitate dispersion. Approximately fifty pricks were made on the swollen area, releasing dark purple blood like dewdrops. Soon, swelling and pain subsided. Then, Bai Zhuang Moxibustion (one hundred moxa cones) was applied to Qihai (CV6) to assist Lower Jiao Yang deficiency and dispel Yin cold. Next, thirty-seven moxa cones were applied to each Zusanli (ST36) point to treat cold feet, also guiding heat downward. A prescription named Jiji Jiedu Tang (Ji Ji Detoxification Decoction) was formulated. Commentary: Heat is treated with cold. However, diseases have high and low locations, and treatments have near and far applications; one must not exceed standard protocols. Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma), bitter-cold and wine-fried, clear upper heat as Sovereign herbs. Jiegeng (Platycodonis Radix) and Gancao (Glycyrrhizae Radix et Rhizoma), acrid-sweet-warm and ascending, assist the bitter herbs to initiate heat dispersion as Minister herbs. Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma), bitter-pale and thin-flavored, represent Yang within Yin, dispersing upper heat as Assistant herbs. Lianqiao (Forsythiae Fructus), bitter-acrid-pale, dissipates nodules and reduces swelling. Danggui (Angelicae Sinensis Radix), acrid-warm, benefits blood and stops pain. Wine-baked Dahuang (Rhei Radix et Rhizoma), bitter-cold, guides the formula upward to the vertex and drives heat downward as Envoy herb. After administration, swelling subsided, pain reduced, and stool became free. In the next dose, Dahuang was reduced. Speech was moderated, diet controlled, and recovery occurred within ten days.

Chen Tongye, a judicial official, had inherently weak Yuan Qi. The pulse was fine, minute, and hidden. Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Xiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), and Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) were used to raise and uplift Yang Qi. Niubangzi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), and Jiegeng (Platycodonis Radix) were used to resolve heat toxins. After two doses, swelling instantly subsided, and the pulse recovered. If one mistakes the fine/minute pulse for pure Yin syndrome and the swelling for pure Yang syndrome, medication rarely avoids error.

Jiang Huangnan treated You Ringxi, a Censor. In the first month of Renzi year of Jiajing era, he suddenly contracted Datou Feng (Big Head Wind) syndrome. It started with neck swelling. Contemporary physicians considered it an external contraction and mistakenly used exterior-releasing methods. Later, they considered it internal injury and mistakenly used tonifying methods. The face turned red, all three Yang meridians swelled, the vertex felt like splitting, the body sweated profusely, and delirium occurred during sleep. This persisted for three days, with urgent wheezing and coughing. His relative, Wang Zijie, used Zhuru Ju Pi Tang (Bamboo Shavings and Tangerine Peel Decoction), followed by Chuanxiong Chatiao San (Ligusticum Tea-Powder Regulating the Head), combined with Baihu Tang (White Tiger Decoction), removing Renshen (Ginseng Radix et Rhizoma). One dose reduced symptoms. The next day, harsh cold medicines were removed from the previous formula. By evening, it gradually stabilized. Several blisters formed on the earlobes, and other swelling subsided. Only swelling behind the ears and on the left cheek persisted. The following day, Danggui Liu Huang Tang (Danggui Six Yellow Decoction) was used as the main formula, plus detoxifying herbs. Twenty days later, a lump the size of an egg remained protruding on the vertex, and residual cheek swelling persisted, accompanied by occasional headaches and loose stools. It was mid-February when Jiang arrived. The left pulse was floating, small, and rapid; the right pulse was floating, large, and fast, showing vigorous momentum. Analyzing pulse and symptoms, Jiang determined treatment should target Fire. Sheng Huangqi (Astragali Radix) 8 fen, Baizhu (Atractylodis Macrocephalae Rhizoma) and Yiyiren (Coicis Semen) 1.5 qian each, Fuling (Poria), Pian Huangqin (Scutellariae Radix) 8 fen each, Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) 3 fen were decocted with Tongbian (Child's Urine). The next day, the pulse flattened slightly, but cheeks remained red, and morning headaches occurred, indicating residual fire was not fully cleared. Huangqi was increased to 1.2 qian, Yiyiren to 2 qian. The vertex lump gradually subsided. Later, Sheng Huangqi was increased to 2 qian, along with mung bean soup and child's urine. Five doses resulted in recovery.

In the spring of Jingkang Year 2, a major plague struck the capital. An unusual person wrote a prescription. For any swelling caused by plague, it was effective. The formula used Douhei (Sojae Semen Nigrum) 2 he, stir-fried until fragrant, Gancao (Glycyrrhizae Radix et Rhizoma) 2 cun, honey-roasted. Two cups of water, decocted to half. Sip frequently.

In the Renwu and Guiwei years of Chongzhen era, epidemics prevailed, corpses littered the roads. Among sweating and harmonizing internal medicines, those containing Renshen (Ginseng Radix et Rhizoma) mostly saved lives.