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(Regarding the method mentioned previously of) separating fluids to guide toxic pathogens outward for resolution, this is a treatment method of internal transformation and external release, with turbid qi descending and clear qi ascending. Treating one case results in one cure, treating ten cases results in ten cures; compared to those using lifting and releasing methods which exacerbate the condition, why not adopt this insight from common people?

Wang Shixiong's Note: Observing this theory, it is unnecessary to use the method of "cutting claws and teeth" (metaphor for aggressive intervention or cutting off the disease's root too early) at the onset. Additionally, Qin Huangshi treated macules/rashes using Shengma (Cimicifugae Rhizoma), Huanglian (Coptidis Rhizoma), Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), and Mutong (Akebiae Caulis), naming it Shengma Qingwei Tang (Cinnamon Twig Clearing Stomach Decoction). This formula is light, cool, and clears blood heat, also being a wonderful method for resolving macules and rashes. For those who mistakenly consumed meat or fish, add Shanzha (Crataegi Fructus) and Sharen (Amomi Fructus Rotundus).

In the Jiashen year of the Qianlong reign, I was staying in Zhongzhou. My father accidentally contracted an epidemic pathogen and was misdiagnosed by many physicians, leaving him with lifelong regret. When will this suffering end? Reflecting on this syndrome, there must be a way to save lives. I wish to publish it to the world to alleviate my guilt. Upon reading *Bencao* (Compendium of Materia Medica), it stated that Shigao (Gypsum Fibrosum) is cold in nature and greatly clears stomach heat; its taste is bland and aroma thin, capable of relieving muscular heat; its substance is heavy and nature descending, capable of draining excess heat. I had a sudden enlightenment: only Gypsum Fibrosum is sufficient to treat febrile epidemics. Whenever I encountered such syndromes, I administered it, achieving desired results without fail. For thirty years, I have been confident in this approach, saving countless patients who were deemed untreatable; the details are beyond what pen and ink can describe. However, the power of one person to save others is limited, whereas extending this knowledge to all is infinite. Therefore, I wrote *Yizhen Yide* (One Gain from Epidemic Rashes) and published it to the world, so that all suffering from this epidemic may rise from death to life and attain longevity, allowing my heart to find some peace. Written casually by Yu Lin from Tongcheng.

Wu Zhongzhi said: In the summer of the Jiyin year, there was no rain for a long time, and summer heat prevailed. Many people fell ill, and illness meant certain death. Physicians were all helpless. Shi Yu (Yu Lin's courtesy name) prescribed formulas containing Gypsum Fibrosum and Coptidis Rhizoma, all of which took immediate effect. Those who received it lived, and those who did not died, in numbers too great to count. Among my disciples, the brothers of the Kui family, one survived while the other died prematurely, which is particularly clear evidence. Yet, as the number of survivors increased, so did the slander against Shi Yu. They claimed he could not prescribe without Gypsum Fibrosum, which is a slander against the person. Even worse, due to slandering Shi Yu, they claimed Gypsum Fibrosum should absolutely never be used, which is a slander against the herb. Slandering a person is unacceptable; believing the slander against the herb leads the foolish to believe it and the reckless to spread it. Even when encountering critical heat syndromes, they still use Chaihu (Bupleuri Radix) and Gegen (Puerariae Lobatae Radix). If ineffective, they administer Mudanpi (Moutan Cortex) and Huangqin (Scutellariae Radix). If still ineffective, they administer Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), and Fuzi (Aconiti Lateralis Radix Praeparata).

Wang Shixiong's Note: The skills of crude physicians are generally like this. They continue to make mistakes until death occurs. The physician then proudly claims, "It is not my fault; it is fate!" Thus, due to slandering Shi Yu, innocent people are implicated, and their lives and deaths are disregarded. Is this not truly lamentable!

Zhu Zhitng said: The dosages in this formula are too heavy. In clinical practice, one may酌情 (discretionarily) reduce one or two herbs or lower the dosages. For example, Gypsum Fibrosum can range from 3-5 qian to 2-3 liang and still be effective. Wang's Note: Gypsum Fibrosum is heavy in weight; using only 3-5 qian seems too little.

Wang Shixiong's Note: After treating Case Qi, Mr. Yu stated: Doctors dare not use this formula, patients dare not take it, and even pharmacies dare not sell it. With these "three fears," countless epidemic cases die due to misdiagnosis. Lord Ji Wenda witnessed Shi Yu's methods personally in the Guichou year, saving countless lives, yet claimed that his use of Gypsum Fibrosum reached eight liang in one dose and four jin for one person, suspecting it was due to specific celestial influences (Si Tian Yun Qi) and not a general rule. Mr. Yu's book also lists theories of celestial influences. Then, how come the treatment methods in cases from different years (Jiazi, Jiashen, Wuzi, Bingwu, Guichou, Jiayin) with different annual movements are identical? This proves that Si Tian (Heavenly Stem) and Zai Quan (Earthly Branch) theories cannot be rigidly applied. One should rely on observing droughts and floods of the time and whether the symptoms match the treatment. In the Daoguang era, Jiang Bihua from Gui'an treated an epidemic with macules, using up to fourteen jin of Gypsum Fibrosum before the macules emerged, deeply mastering Shi Yu's method. However, Wang Yuzhong, Grand Secretary, in his *Baitian Ji*, wrote *Shigao Bian* (Discussion on Gypsum Fibrosum), stating he witnessed many harmed by Gypsum Fibrosum and deeply believed Miao Zhongchun and Yuan Ti'an should not be imitated. Even sages act thus; no wonder vulgar ears and eyes slander Shi Yu. There are many deaths caused by food stagnation; how can we blame grain, claiming Shennong and Houji started this trend, and tell everyone to fast? Moreover, among substances, none is more neutral than grain. Yet in Huoluan (Cholera-like disorder) and Shazhang (Sha distension), swallowing a mouthful of rice soup makes rescue difficult. Each disease has its own indications and contraindications. Used appropriately, Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) can be considered tonics; if contraindicated, Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) are no different from arsenic. Therefore, one must not ignore the deficiency/excess and cold/heat of the disease, nor solely judge based on the purity or impurity of drug properties to distinguish good from toxic. Correcting biases and saving disasters requires timing and precision, relying on the physician's ability to identify the disease. Discuss the disease first, then the medicine; hitting the target makes it good medicine. Wang's Note: Any medicine can cure disease but kill if misused. Renshen and Baizhu are no different from Xiaoshi and Dahuang; the key lies in hitting the target. Yet people without disease prefer taking medicine, and when sick, they discuss medicine rather than the disease. Physicians want their methods accepted to make a living, conforming to worldly trends. Occasionally, independent scholars reject popular opinions and innovate, like Shi Yu, yet are viewed as monsters by the crowd. How can medical prosperity be achieved? These words are excellent advice for physicians and standards for prescribing. I hope physicians of the world will read them repeatedly. However, reading is to understand principles, and understanding principles is to apply them. If one digests nothing, errors and prejudices will cause endless harm, not just regarding Gypsum Fibrosum. Gentleman Shen, after extensive reading, often dabbles in Traditional Chinese Medicine literature, writing books or advising relatives/friends on illnesses. People, trusting his Confucian knowledge, trust his medical knowledge too. Who knows that discussing war on paper causes deep harm; Lü Wancun is a prime example. Where can we find someone like Xu Huixi to critique them one by one! Wang's Note: Huixi wrote about the dangers of dabbling in medical books, hitting the mark, serving as a warning. His book *Yiguan Bian* (Critique of Medical Canon) is particularly beneficial to medicine. Unfortunately, vulgar people who revere Wancun refuse to believe it. Lamentable.

Xile San (Tin-Type Powder)
Xiangya Xie (Tussock Bone Chips, roasted) - 3 fen
Zhenzhu (Pearl, ground separately) - 3 fen
Fei Qingdai (Fly Azurite) - 6 fen
Meihua Bingpian (Plum Blossom Borneol) - 3 li
Bi Qian (Spider Web Nest, commonly called Xi'er Ke, 20 pieces, from mud walls only, not wooden boards) - 20 pieces
Xi Niuhuang (Western Calculus Bovis)
Ren Zhijia (Human Nails, female nails for male patients, male nails for female patients, matched accordingly) - 5 li each
Grind into extremely fine powder, seal tightly in porcelain bottles to prevent leakage. Specifically treats rotting throat epidemic syndromes, Ru'e (Swallow Throat/Angina), Ya Gan (Gum Gangrene), and oral/tongue ulceration. For any pathology caused by external evil where other medicines fail, insufflate into the affected area; even near-death cases can survive.

Wang Shixiong's Note: This formula was appended by You Heyan in *Jingui Yi* (Wings of the Golden Cabinet), stating Zhang Ruifu transmitted this formula, saved a life, and gained a son, hence I named it "Xile San". Its efficacy is remarkable and cannot be fully described.

Zhusha Anshen Wan (Cinnabar Calming Spirit Pill)
Touming Zhusha (Transparent Cinnabaris, ground separately) - 5 fen
Huanglian (Coptidis Rhizoma) - 5 fen
Shengdi (Rehmanniae Radix) - 3 qian
Danggui (Angelicae Sinensis Radix) - 2 qian
Gancao (Glycyrrhizae Radix et Rhizoma) - 2 qian
Grind into fine powder. Soak in wine, steam with steamed wheat cake pills, size of hemp seeds. Coat with Cinnabar. Take 30 pills per dose, swallow with saliva before sleep.

Ye Zhongjian said: The Classics state: "Spirit resides in the Heart, spirit and mind are complete." Also: "The Heart is the root of life and the residence of spirit." The Heart is the official of the sovereign; if its governance is unclear, essence and qi become chaotic. If spirit is overworked, soul and魂魄 (hunpo) scatter, causing restless sleep and strange dreams. Mild cases present with palpitations and anxiety; severe cases manifest as dementia, delirium, or mania. Cinnabar possesses a luminous nature, red color connects to the Heart, heaviness calms fear, coldness overcomes heat, sweetness generates fluids, suppresses floating yin fire, and nourishes upper jiao primordial qi, making it the premier herb for calming the spirit. The Heart dislikes heat; paired with the bitter-cold Huanglian to drain heart heat. Assisted by sweet Gancao to drain heat. The Heart governs blood; Danggui's sweet-warm nature returns blood to the heart, assisted by cold Dihuang (Rehmanniae Radix Preparata) to tonify. When heart blood is sufficient, the Liver stores hun and the soul rests; when heart heat resolves, the Lung performs its function and the form becomes correct.

Jiling Gao (Collecting Spirit Paste)
Renshen (Ginseng Radix) - 1 jin
Gouqizi (Lycii Fructus) - 1 jin
Tiantong (Asparagi Radix) - 28 liang
Maidong (Ophiopogonis Radix) - 28 liang
Shengdi (Rehmanniae Radix) - 28 liang
Shudi (Rehmanniae Radix Preparata) - 28 liang
Huai Niuxi (Achyranthis Bidentatae Radix, steamed in wine) - 4 liang
Simmer in a clay pot with sweet water to make paste. Near completion, add 6 liang of refined white honey, boil briefly to finish. Take mixed with plain water or wine.

Wang Shixiong's Note: My grandfather said: This formula first appeared in *Guang Biji* (Notes from Broad Records), said to originate from the Imperial Palace. It is also recorded in *Zhifa Hui* (Compilation of Treatment Methods) without Niuxi. The postscript notes: For blood deficiency, add Danggui 4 liang. For weak spleen, add Baizhu 4 liang or half a jin. It states it treats all cases of dual deficiency of qi and blood, weakness, and cough, with universal efficacy. For youths feeling weak, fatigued, low in fluids, with deficient fire flaming upward, it should be taken urgently. Later, Wei Yuheng excelled in using this formula; *Xu Mingyi Leian* (Continued Cases of Famous Physicians) highlights its efficacy extensively. It is essentially Ren Shen Gu Ben Tang (Ginseng Root-Securing Decoction) with modifications. Sometimes Xianlingpi (Epimedii Folium) is added. I consider this formula unsurpassed for severely nourishing liver and kidney yin. For those with leukorrhea or spermatorrhea, remove Niuxi and add Huangbai (Phellodendri Cortex). For those prone to loose stools, remove Niuxi and heavily add Sheng Yiren (Coicis Semen). *Lixu Yuanjian* (Original Mirror for Consumptive Diseases) treats consumptive cough using this formula minus Renshen and Niuxi, adding Xuanshen (Scrophulariae Radix) and Ganjie (Licorice and Platycodon).

Maidong Tang (Ophiopogon Decoction)
Maidong (Ophiopogonis Radix, processed) - 1 liang
Gancao (Glycyrrhizae Radix et Rhizoma) - 2 liang
Xian Zhuye (Fresh Bamboo Leaf) - 15 leaves
Beizao Rou (Northern Jujube Flesh) - 2 pieces
Grind into fine powder. Take 5 qian per dose. Decoct in half a cup of Jingmi (Oryza Sativa Germ) soup until reduced to one cup. Take warm. If unable to swallow, soak in cotton and apply to the mouth. Adding Renshen is even better.

Wang Shixiong's Note: This is a formula from Hai Zang (Zhang Congzheng). It is *Jinkui*'s Maidongmen Decoction minus Banxia (Pinelliae Rhizoma), plus Zhuye (Bamboo Leaf). It treats exhaustion of qi due to sexual fatigue, showing great efficacy. However, *Waitai* (External Mirror) advocates a single-herb formula of Zhupi (Bamboo Skin) for this condition, as bamboo skin is tough, capable of securing qi and fluid loss, and clearing deficient heat; it seems indispensable in the formula. Additionally, Gouqizi is purely sweet and juicy, replenishing consumption of spirit, qi, and blood. For those with panting, rapid breathing, and failing roots, adding approximately 1 liang is superior to Renshen and Shudi. Even for those not suffering from sexual fatigue but having dual deficiency of qi and fluids, unable to tolerate strong tonics, I use this method to sustain their faint vitality, often achieving success. Extending this, it can nourish heart ying (nutritive level), moisten lung dryness, Wang's Note: For cough syndromes where the lung is deficient but pathogens remain, Maidong should be used cautiously. It can soften liver urgency and tonify spleen yin. Its uses are numerous; it should be renamed "Small Fu Mai Tang" (Minor Pulse-Restoring Decoction).