Library

Great heat damages the body's Qi (vital energy), resulting in a deficient pulse and bodily heat. Extreme heat consumes Yin essence, causing solitary Yang to fly upward and disperse. In such cases, purgation is contraindicated as well as ascending methods; dispersing is contraindicated as well as draining methods. There lies profound meaning within this, which only high-level physicians can truly grasp.

This chapter discusses eye diseases caused by Summerheat (Shu). Summerheat is one of the Six Qi (Six climatic factors); both static and dynamic states can lead to human infection. If one stays in deep halls and high pavilions, overexposes oneself to cool winds, or consumes melons, pears, and fresh fruits, eating too many raw foods, Yin cold can suppress Yang, preventing heat from extending outward. This inevitably leads to headache, surface heat, soreness and pain in limbs and joints, irritability, vomiting and diarrhea, aversion to cold, and absence of sweating. This is known as "obtained while at rest" or Yin Summerheat (Ni Shu), primarily treated with Da Shun San (Great Smooth Powder). If ineffective, add Renshen (Ginseng) and Fuzi (Prepared Aconite Root). If merchants travel during midday sun, or elderly and weak farmers labor under intense heat and steam, they deplete Yuan Shen (Primordial Spirit) while forcing True Fire to rise. The disease manifests as bodily heat, headache, extreme thirst with desire for drinks, profuse sweating, aversion to heat. This is "obtained while in motion" or Zhong Shu (Heatstroke). In severe cases, one may faint and lose consciousness, with hands, feet, dorsal sides of hands/feet, and heart area slightly cold, accompanied by vomiting, diarrhea, panting, or foaming at the mouth. Immediately administer Er Qi Dan (Two Qi Pill) mixed with Su He Xiang Wan (Styrax Pill). If unavailable, crushed garlic water mixed with Xiang Ru Yin (Mosla Decoction) is also acceptable. Once the condition subsides slightly, combine with previous symptoms and treat mainly with Ling Sha Yi Yuan San (Cinnabar and Crystal Sand Powder) or Cang Zhu Bai Hu Tang (Atractylodes White Tiger Decoction). If the constitution is inherently deficient and previous medications are unsuitable, it is appropriate to switch to Qing Shu Yi Qi Tang (Clear Summerheat and Boost Qi Decoction) or Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). Nowadays, people often take Yi Yuan San and Xiang Ru Yin to prevent Summerheat diseases, calling it prevention, but this actually attracts Summerheat. To avoid harm in daily life, Sheng Mai San (Generate the Pulse Powder) is most suitable for summer.

Summerheat disease resembles Heat disease, but the distinction lies in the pulse: Heat disease presents with a full/surging pulse, while Summerheat disease presents with a deficient pulse. Treatment should focus on nourishing and regulating Yuan Qi (Primordial Qi) assisted by resolving Summerheat. If a patient vomits excessively, the condition is critical, unable to retain water or food, vomiting immediately upon ingestion, urgently use 1 qian of Renshen (Ginseng), 3 fen of Huanglian (Coptis Rhizome), and 1 spoonful of Oryza Sativa Germ (Glutinous Rice), decoct strongly, let cool, and swallow slowly. After finishing a small cup, if vomiting stops, medication and food can be administered. Alternatively, drinking a cup of water boiled with roasted salt is also effective.

Winter shrouds in fog, spring suffers from rain, laborers wade through empty rivers, autumn and summer bring fierce heat across vast waters, stone springs collect sweat, tea resolves intoxication. From outside to inside, deeply affected by Dampness (Shi), when Yuan Qi is deficient, Damp pathogens enter. Entering the Lung causes wheezing and fullness; entering the Spleen forms swelling; entering the Liver causes body pain with Wind-Damp binding; entering the Kidney brings heavy body and thin Cold-Damp; long-term Damp entering the Heart transforms into Damp-Heat, still causing swelling, pain, and Malaria. Dampness flooding the intestines and stomach causes loose stools (Ru Xie); Damp blocking Qi and Blood causes extreme fatigue; Damp in the skin causes stubborn numbness; stiffness and insensitivity reside in the meridians; Damp pathogen rising upstream causes eyelid erosion, or slight swelling/pain with incomplete discharge of eye secretion. Alas! How should physicians handle such Dampness? Clearing, warming, and draining reveal the true mechanism.

This chapter discusses diseases caused by Dampness. There is Dampness from Heaven, such as rain, dew, and fog. Heavenly Damp originates from Qi, thus first affecting the exterior Ying (Nutritive) and Wei (Defensive); there is Dampness from Earth, such as mud and water. Earthly Damp originates from form, thus first damaging flesh, blood, sinews, and bones; there is Dampness from diet, such as tea, wine, milk, and cheese. Food enters the Sea of Water and Grain, having entry and exit; receiving it should not cause disaster naturally. However, if it overflows and soaks, how can it transform and move instantly? Thus, it damages the Spleen and Stomach. There is Dampness from sweat, referring to sweat-soaked clothes not changed promptly. Sweat shirts dry and moisten alternately; wearing them without changing is hardest to endure, thus damaging muscle and vessels. Furthermore, there is Dampness from blood, urine, and genital immersion, and Dampness naturally produced by Spleen Earth. When Yang is excess, Fire is excess, transforming into Damp-Heat. When Yin is excess, Water prevails, transforming into Cold-Damp. Symptoms generally include fever and aversion to cold, heavy body, spontaneous sweating, bone and joint pain, urinary retention, loose stools, lower back pain unable to turn or side, edema of the dorsum of foot with flesh like mud, pressing leaves an indentation that recovers slowly. The Classic says: "Due to Dampness, the head feels wrapped." Dampness steaming upward causes heavy head. Damp damages sinews, so large sinews shorten and small sinews elongate. Shortening leads to spasm/cramping; elongation leads to flaccidity. Excess Damp causes loose stools, hence watery stool. Watery stool leads to scanty urine. Damp flows downward, hence edema. All Dampness causing swelling and fullness leads to abdominal distension and flesh like mud. Damp entering Kidney, water follows damp, seeking its kind, hence lower back pain. Treatment methods: For Damp above, induce sweating. The Classic says: "When Dampness dominates, assist Wind to calm it," using Qiang Huo Sheng Shi Tang (Notopterygium Decoction to Overcome Dampness). It also says: "For those below, lift them up," healing occurs when Yang Qi ascends, using Sheng Yang Chu Shi Tang (Raise Yang and Remove Dampness Decoction). It also says: "For those below, promote urination," using Si Ling San (Four Poria Powder). Dong Yuan also said: "Treating Damp without promoting urination is not the correct treatment." Also: "For those below, draw and exhaust them." My opinion is that Damp entering from outside originally damages Yang. Overusing diuretic/damp-draining substances further exhausts Yang. When Yang is exhausted, spirit becomes listless, and illness lingers. Instead, use pungent-warm mild agents, such as Ping Wei San (Peace the Stomach Powder), Huo Xiang Zheng Qi San (Patchouli Powder to Rectify the Qi), Li Zhong Tang (Regulate the Middle Decoction), Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), etc., to tonify. Naturally, Dampness will be eliminated day by day. Damp generated internally has many variations, impossible to enumerate. But it always involves soreness, pain, constipation, and obstruction. Skilled physicians should seek understanding through intuition, verify with pulses, and adjust previous prescriptions based on the condition. For Damp-Heat jaundice or accompanying syndromes, further deliberation is needed. Regarding so-called Phlegm-Damp, Wang Jiezhai said: The root of Phlegm is Water, originating from the Kidney. The movement of Phlegm is Damp, due to the Spleen. Pang Anchang said: When Yin Water is insufficient, Yin Fire rises, insulting the Lung, preventing clear descending, thus fluids become turbid, generating Phlegm instead of Blood. When Kidney deficiency fails to grasp Qi returning to the source, Qi exits without return, accumulating; accumulation without dispersion generates Phlegm. From this, we see that Phlegm is merely a disease name and manifestation, arising with disease and disappearing with disease, not inherent to the human body. Although it comes quickly and changes greatly, it merely borrows power to act evil. If one does not seek the root but treats the branch, attempting to attack and eliminate it completely, coughing and expectoration will likely appear together.