Library

When a pregnant woman contracts an epidemic disease, if the San Chengqi Decoction (Three Purging Formulas) is indicated, treatment must be administered flexibly according to the specific syndrome. One must not worry excessively and should strictly avoid being misled by the notion that Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) are used to stabilize the fetus. When the family sees the use of Chengqi formulas, they often become alarmed and suspicious, or bystanders may create confusion, inevitably hampering the physician's actions, which brings great misfortune to both mother and child. If a case requires purgation but tonics are instead used, pathogenic fire will become congested and stagnant, heat toxicity will intensify, and the fetus will become increasingly unstable. The pathogen may transmit from the Qi level to the Blood level, leaving the fetal sac without support. Therefore, ancients used the metaphor of a hanging bell: when the beam rots, the bell inevitably falls. Only by using Chengqi Decoction to expel the pathogen can the fire and toxicity dissipate, inflammation turn cool, Qi mechanism recover, and the fetus naturally stabilize. In such syndromes, Dahuang (Rhei Radix et Rhizoma) is regarded as a sacred herb for stabilizing the fetus; every application has been effective, ensuring safety for both mother and child. However, if abdominal pain feels like piercing and lower back pain feels like breaking, these are signs that the fetus is about to miscarry or is in the process of miscarriage. At this stage, medication is futile. Even if Chengqi Decoction is administered, it can only cure the disease and preserve the mother. Ignorant people attribute the miscarriage to the doctor and blame them accordingly.

Someone might question me: "If a pregnant woman takes Chengqi Decoction and the pathogen is not expelled, but the fetus is damaged first, what should be done?" I reply: "The accumulation of dry feces and stasis-heat belongs to the intestines and stomach. The fetus attaches to the spine, outside the intestines and stomach, residing within the uterus. The medicine reaches the stomach first; once the stasis-heat is cleared, the fetal Qi immediately receives nourishment and relief. Thus, benefit is promoted and harm removed in an instant. What is there to fear? However, when using toxic herbs to treat disease, once the illness has receded by seventy or eighty percent, the remaining pathogens will resolve themselves. One must be cautious not to overdose."

In all cases of epidemic disease during pregnancy, if one of the "Four Damages" (severe deficiencies) occurs, standard curative methods should not be applied. Instead, treatment should follow the principle of regulating the deficiency. The same method applies postpartum. If non-deficiency conditions are mistakenly treated with tonics, death is inevitable. (Details on the "Four Damages" are found later in the section on "Syndromes Requiring Tonification".)

Regarding pediatric cases of wind-cold invasion, malaria, dysentery, etc., these are well-known. However, when children contract epidemic diseases, they are difficult to diagnose, leading to many delays. Why? First, pediatrics focuses primarily on smallpox, measles, vomiting, diarrhea, convulsions, malnutrition (Gan syndrome), and miscellaneous disorders, while knowledge of Shanghan (Cold Damage) and epidemic diseases is scant. Second, ancient texts refer to pediatrics as the "Mute Department" because infants cannot fully articulate their suffering, making it difficult for physicians to accurately apply pulse diagnosis and inquiry. Physicians may observe fever but miss headache and body pain; they may see loss of appetite and chest distension, suspecting food stagnation, rather than recognizing the transmission of epidemic pathogens to the Stomach. They may observe vomiting, nausea, thirst, and diarrhea, dismissing them as common infant issues, rather than identifying heat-coupled dysentery. Under such circumstances, how can one consider the possibility of an epidemic disease? This constitutes the second reason. Children have delicate Shen (Spirit) and Qi, and soft bones and tendons. Once infected with an epidemic, delayed or incorrect treatment can lead to upward deviation of the eyes, frequent convulsions, limb spasms, hooking of the fingers, and even opisthotonos. Physicians often misdiagnose these as slow convulsive wind (Man Jing Feng) based on familiar symptoms, administering pills such as Baolong Wan (Dragon-Holding Pill) or Anshen Wan (Spirit-Calming Pill), exhausting all treatments for convulsions. The condition worsens. Seeing the child silent and unresponsive, practitioners may indiscriminately moxa points such as Shenmen and Meixin. Although the moxa fire is slight, its internal attack is urgent. The interaction of two Yangs is like adding oil to fire or charcoal to a red-hot furnace. Many deaths have occurred, causing deep sorrow. Today, when epidemic toxins prevail, adults can be infected; why should children be exempt? The pathogen received is the same, but due to the delicacy of their Qi, Blood, bones, and tendons, the symptoms manifest differently. Treatment must seek the pathogen, so the herbal prescriptions are similar to those for adults. For children aged five and above, the dosage should be halved; for those aged two to three, one-quarter of the adult dose is appropriate. Furthermore, children's intestines and stomachs are delicate; any error leads to rapid disaster, so clinical caution is paramount.

Xiao'er Taiji Wan (Children's Supreme Ultimate Pill)
Tianzhuhuang (Calamiform Beech Pollen, 5 qian)
Danning (Arisaema cum Bile, 5 qian)
Dahuang (Rhei Radix et Rhizoma, 3 qian)
Shexiang (Moschus, 3 fen)
Bingpian (Borneolum Syntheticum, 3 fen)
Jiangcan (Bombyx Batryticatus, 3 qian)
Grind the above ingredients into a fine powder. Prepare on the noon hour of the Dragon Boat Festival (Duanwu). Pounded with glutinous rice paste into pills the size of a water caltrop. Coat with Cinnabar (Zhusha). For any epidemic syndrome, dissolve one pill in Ginger Decoction (Jiang Tang) and administer. It yields miraculous effects.