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Dadouwen (Big Head Plague) is a disease contracted by humans due to the influence of epidemic heat-toxin qi circulating in nature. It is also known as Shidu (Seasonal Toxin) or Yidu (Epidemic Toxin). Its symptoms manifest on the nose, face, ears, neck, and throat, presenting as redness and swelling without distinct abscess heads, or as hard nodules with deep roots. In the early stage, it resembles Taiyang disease (disease of the Bladder and Small Intestine channels), causing aversion to cold, fever, headache, severe limb pain, mental restlessness, and throat obstruction. If left untreated for five to seven days, it can be fatal. However, if the condition persists beyond ten days, it often resolves spontaneously. Treatment requires careful differentiation. First, examine the pulse: slippery-rapid, floating-vast, deep-tight, or wiry-choppy pulses are all indicative signs. A floating-rapid pulse indicates pathogenic factors at the exterior; Xijiao Shengma Tang (Rhino Horn and Cimicifuga Decoction) should be used to release them. A deep-choppy pulse indicates deep-seated pathogens; if the toxin is vigorous, Huadu Dan (Toxin-Transforming Pill) should be taken urgently to attack the toxin. For cases with excess heat and constipation, Dahuang Tang (Rhubarb Decoction) is used for purgation. For elderly patients with deficient qi and stagnation, Wuxiang Lianqiao Tang (Five-Aromatic Forsythia Decoction) is the primary formula. Additionally, Tongqi San (Air-Vent Powder) can be insufflated into the nostrils; producing more than ten sneezes indicates efficacy. If no sneezing occurs after medication, the case is difficult to treat; if pus and blood are expelled through sneezing, recovery is certain. Caregivers should use the sneeze-inducing powder daily to prevent transmission; this must be remembered. Patients should use the sneeze-inducing medicine three to five times daily to vent heat-toxin; this is an excellent method for treating epidemic diseases. If the condition does not resolve after three to four days, excessive purgation should be avoided; instead, harmonizing methods should be employed, using Xijiao San (Rhino Horn Powder), Qinlian Xiaodu Yin (Scutellaria and Coptis Toxin-Clearing Drink), or Lianqiao Tang (Forsythia Decoction) for severe cases. By the seventh or eighth day, if bowel movements are clear but head and facial swelling remains high and red, Tuoli San (Support Interior Powder) or Tuoli Huangqi Tang (Support Interior Astragalus Decoction) may be given. If swelling is severe, phlebotomy with a bi stone (stone lancet) on the affected area to release evil blood is appropriate to vent the toxin. If, within five days of onset, the patient exhibits mental confusion, throat obstruction, inability to speak, red and swollen head and face, and difficulty swallowing liquids, it is a sign of inevitable death, and treatment will be futile. One must understand that this disease has Yin and Yang patterns; some are suitable for diaphoresis, others for purgation. Incompetent physicians merely claim that heat-toxin requires cold medicines, failing to realize that diseases vary in severity and treatments have contrary and compliant approaches. Tao Jie'an stated: In cases of Big Head Wind-cold, if redness and swelling start on the nose and forehead, causing both eyes to swell shut, along with facial redness and swelling, it belongs to the Yangming channel. With high fever, panting, dry mouth and tongue, painful and obstructed throat, and a rapid-large pulse, Puji Xiaodu Yin (Universal Benefit Toxin-Clearing Drink) is indicated; for severe internal excess heat, Tongsheng Xiaodu Yin (Unimpeded Success Toxin-Clearing Drink) is used. If swelling occurs around the ears (upper, lower, front, back) and temporal regions, it belongs to the Shaoyang channel. With muscle heat, afternoon tidal fever, alternating chills and fever, bitter taste, dry throat, eye pain, and hypochondriac fullness, Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Tianhua Fen (Trichosanthes Root), Qianghuo (Notopterygium Rhizome), Jingjie (Schizonepeta Spike), Lianqiao (Forsythia Fruit), Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome) is appropriate. If swelling affects the top of the head, back of the neck, and behind the eyes, it belongs to the Taiyang channel; Jingfang Baidu San (Schizonepeta and Saposhnikovia Detoxifying Powder) is indicated. If all three Yang channels are affected, involving the head, face, ears, eyes, and nose, Puji Xiaodu Yin is administered, with Qingliang Jiuku San (Cooling and Suffering-Relieving Powder) applied externally. Generally, treatment should not be too harsh; harshness causes pathogenic factors to resist and counterattack internally, harming the patient. Since the head and face are hollow areas where pathogens easily settle, treatment should begin gently and become urgent later, ensuring the pathogen submits. The gentle approach involves clearing heat and detoxifying. For deficient individuals, support the Yuanqi (Primal Qi); for those with weak stomach qi and poor appetite, assist the stomach qi. Only when fecal heat accumulation occurs should Dahuang (Rhubarb) be used for purgation to extract the root of the toxin; this is the method of "gentle first, urgent later." This toxin typically swells the nose and forehead first, then the eyes, then the ears, spreading from the ears to the head and connecting to the occiput, stopping when nodules form; if unresolved, suppuration will occur. Folk wisdom says: During Big Head Epidemics, relatives do not visit each other because infection rates are high and mortality is great. During the Taihe era, many suffered from this. Physicians used Chengqi Tang (Chengqi Decoction) with Banlangen (Isatis Root) for purgation, which provided slight relief, but the next day the illness remained; repeated purgation offered little relief, and the condition worsened until critical. Li Dongguan examined the patient and said: The upper half of the body corresponds to Heaven's Qi, and the lower half to Earth's Qi. This heat-toxin lodges between the Heart and Lung, attacking the head and face causing massive swelling. Using Chengqi Tang to purge Stomach excess heat would be punishing the innocent (damaging healthy Qi). Thus, he formulated Puji Xiaodu Yin Zi (Universal Benefit Toxin-Clearing Decoction), saving many lives.

Baotou Huodan Du (Head-Binding Fire-Dan Toxicity) is also caused by contracting epidemic heat-toxin, but its presentation is slightly milder than Dadouwen. Early symptoms include chills and fever, thirst, dry tongue, a rapid-large pulse, and redness with halos on the head and face. Treatment uses Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction), or herbs such as Lingyangjiao (Antelope Horn), Didengcao (Vincetoxicum Herb), Yinhua (Honeysuckle Flower), Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), Shihu (Dendrobium Stem), Xuanshen (Scrophularia Root), Danpi (Moutan Bark), Zhimu (Anemarrhena Rhizome), and Lianqiao (Forsythia Fruit). If the tongue coating is greasy with white fur, Huanglian Jiedu Tang (Coptis Detoxification Decoction) is indicated; externally, Ruyi Jinhuang San (Ruyi Golden Yellow Powder) mixed with honey water should be applied for cure. This condition is not contagious.