Library

Kuang Han (Manic Sweating) refers to the situation where latent pathogens are disintegrating within the body, and the healthy Qi attempts to resolve the disease through sweating. Because the patient's constitution is robust and the Yang Qi has strong impulsive power, but the Cou Li (skin pores) cannot open immediately, the patient suddenly becomes restless in sitting or lying down, exhibiting manic and irritable behavior. After a short while, profuse sweating occurs, the manic and irritable symptoms cease instantly, the pulse becomes calm, the body turns cool, and the patient recovers abruptly.

If pathogens remain in the Blood level, causing stagnation and closure of the interior Qi, the latent pathogens cannot penetrate outward to form macules (ban). If purgatives are used, the internal stagnation is unblocked, and the Wei Qi (Defensive Qi) also becomes smooth and free-flowing. The pathogens may then emerge from the exterior as macules, and the toxic pathogens will thereby be resolved from the outside. If macules gradually appear after purgation, one must not use harsh purgatives again; even if there are indications for purgation, only a small amount of Chengqi Tang (Cathartic Decoction) should be given to gently promote bowel movement. If heavy purgation is repeated, the Middle Qi will fail, macule toxins will sink inward, and the condition will become critical. In such cases, Tuoli Jubang Tang (Interior-Supporting Macule-Raising Decoction) is appropriate.

Tuoli Jubang Tang: Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis) (each 1 qian), Shengma (Rhizoma Cimicifugae) (0.5 qian), Baizhi (Radix Angelicae Dahuricae), Chaihu (Radix Bupleuri) (each 0.7 qian), Chuanshanjia (Squama Manis) (2 qian, stir-fried until yellow). Decoct with water and fresh ginger. If macules gradually appear after purgation, but heavy purgation is repeated, causing the macule toxins to re-conceal, and symptoms such as Xun Yi Mo Chuang (involuntarily grasping at bedclothes) and Cuo Kong Li Xian (fingers picking at empty air as if tracing lines) appear, with the pulse gradually becoming faint, this is a critical sign. Add 1 qian of Renshen (Radix Ginseng) to this formula; if the deficiency cannot be adequately replenished, death will ensue. If macules appear first without prior purgation, and there are still indications for purgation, give a small amount of Chengqi Tang, ensuring gentle purgation.

When purgation is necessary due to incomplete elimination of pathogens, it may be performed multiple times. During this process, if the eyes become dry and gritty, the tongue becomes dry and withered, fluids fail to reach the throat, and lips and mouth crack due to dryness, it is because the patient’s constitution is of the "Yang Zang" type, prone to fire and Yin deficiency. Heavy loss of body fluids from repeated purgation necessitates the use of Qingzao Yangrong Tang (Dryness-Clearing and Nutritive-Qi-Enriching Decoction). If heat and thirst persist and interior signs remain, Chengqi Yangrong Tang (Cathartic and Nutritive-Qi-Enriching Decoction) is appropriate.

Yiwen (Plague) is a heat disease. Pathogens are internally constrained, preventing the proper distribution of Yang Qi. Accumulated Yang transforms into fire, and Yin blood is often combated by heat. After abrupt resolution, residual heat remains, and Yin blood has not yet recovered. It is strictly forbidden to use Renshen (Radix Ginseng), [text missing, likely referring to Yin-nourishing herbs], and Baizhu (Rhizoma Atractylodis Macrocephalae); using them will instead exacerbate stagnation and constraint, allowing residual pathogens to linger. This not only prolongs the current illness but will inevitably lead to other complications later, such as generalized pain and bi-syndrome, limb spasms and cramps, flowing fire condensing into phlegm, widespread sores and ulcers, severe pain in both legs, chronic cough with copious sputum, or qi-toxicity flowing and accumulating. Or phlegm nodules may perforate and leak. All these are harms caused by sudden tonification. For those with Yin exhaustion and blood dryness, Qingzao Yangrong Tang is appropriate. However, for patients who generally have much phlegm, or for youths who were previously obese and robust, this formula may cause greasiness and obstruct the diaphragm/stomach; thus, its use requires careful consideration. Generally, after recovery from epidemic diseases, regarding conditioning agents, improper prescription is less harmful than failing to rest quietly and regulate diet, which is the primary measure.

Qingzao Yangrong Tang: Zhimu (Rhizoma Anemarrhenae), Tianhuafen (Radix Trichosanthis), Dangguishen (Corpus Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Dihuangzhi (Jus Rhizomatis Rehmanniae Recens), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae). Decoct with Dengxincao (Medulla Junci). If residual heat remains in the exterior, Chaihu Yangrong Tang (Bupleurum and Nutritive-Qi-Enriching Decoction) is appropriate.

Chaihu Yangrong Tang: Chaihu (Radix Bupleuri), Huangqin (Radix Scutellariae), Chenpi (Pericarpium Citri Reticulatae), Gancao (Radix Glycyrrhizae), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Shengdi (Radix Rehmanniae Preparata), Zhimu (Rhizoma Anemarrhenae), Tianhuafen (Radix Trichosanthis). Decoct with fresh ginger and jujube. If interior signs are not fully resolved, Chengqi Yangrong Tang (Cathartic and Nutritive-Qi-Enriching Decoction) is appropriate.

Chengqi Yangrong Tang: Zhimu (Rhizoma Anemarrhenae), Danggui (Radix Angelicae Sinensis), Shaoyao (Radix Paeoniae), Shengdi (Radix Rehmanniae Preparata), Dahuang (Radix et Rhizoma Rhei), Zhishi (Fructus Aurantii Immaturus), Nongpu (Rhizoma Magnoliae Officinalis). Decoct with water and fresh ginger. If phlegm-fluids surge excessively and the chest and epigastrium feel unclear, Loubei Yangrong Tang (Trichosanthes and Fritillaria and Nutritive-Qi-Enriching Decoction) is appropriate.

Loubei Yangrong Tang: Zhimu (Rhizoma Anemarrhenae), Huafen (Radix Trichosanthis), Beimu (Flos Fritillariae Cirrhosae), Gualoushi (Fructus Trichosanthis), Juhong (Exocarpium Citri Reticulatae Rubrum), Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis), Zisuzi (Semen Perillae). Decoct with water and fresh ginger.