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The Heavenly Master said: "Urgent treatment" refers to conditions that cannot be delayed for even a moment. This includes symptoms such as wheezing and distension caused by external pathogens, or inability to breathe; or cases where cold pathogenic factors directly invade the Yin meridians, causing cold limbs, cold pain in the lower abdomen, and extreme suffering bordering on death; or sudden severe heart pain, where touch is intolerable, accompanied by stifling breath and extreme suffering. When a person suddenly contracts wind-cold, and cold enters the Lung Meridian, causing sudden shoulder-shrugging panting, rebellious Qi with phlegm that cannot be expectorated, and an inability to lie down, this also falls into this category. The prescription uses Chai Hu (Bupleuri Radix) 1 qian, Fu Ling (Poria) 2 qian, Dang Gui (Angelicae Sinensis Radix) 1 qian, Huang Qin (Scutellariae Radix) 1 qian, Mai Dong (Ophiopogonis Tuber) 2 qian, She Gan (Belamcandae Rhizoma) 1 qian, Jie Geng (Platycodonis Radix) 2 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) and Ban Xia (Pinelliae Rhizoma) each 1 qian. Decoct in water and take orally. (Annotation: Mie Xie Tang / Evil-Extinguishing Decoction). The brilliance of this formula lies in using Chai Hu, She Gan, and Jie Geng to diffuse and disperse the Qi of the Metal element (Lungs); using Ban Xia to eliminate phlegm; and using Huang Qin to clear heat. Since external cold pathogens inevitably transform into internal heat syndromes, Huang Qin is used here to clear and resolve this heat. However, using only Huang Qin, although it clears fire, may inadvertently suppress and restrain the fire energy. The ingenuity lies in combining Jie Geng, She Gan, and Chai Hu, which are acrid and dispersing in nature, thereby dissipating the fire and extinguishing the pathogen. This is one method of urgent treatment.

The syndrome of "Direct Invasion of Yin Cold" occurs when cold pathogens directly enter the Kidney Meridian, bypassing the skin and hair to enter Ying and Wei, and not passing through Ying and Wei to reach the Zang-Fu organs. The Yin-cold pathogen strikes directly at the center of both kidneys, leaving no place for the Fire of the Gate of Vitality (Ming Men) to reside. Consequently, the vital fire scatters and flees. The cold pathogen takes advantage of this escape of true Yang, chasing and driving it away. If the cold enters the abdomen, it causes abdominal pain; if it enters the Liver, the Liver fails; if it enters the Heart, death ensues. This is an extremely critical time, and medication must not be delayed for a moment. The prescription uses Ren Shen (Ginseng Radix) 5 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 1 liang, Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian, Rou Gui (Cinnamomi Cortex) 1 qian, and Gan Jiang (Zingiberis Rhizoma) 0.5 qian. Decoct in water and take orally. (Annotation: Zhu Han Hui Yang Tang / Driving-out-Cold and Restoring-Yang Decoction). The brilliance of this formula lies in the use of Ren Shen and Bai Zhu. One might argue that since cold has invaded directly, only Fu Zi and Rou Gui should be used to drive it out, so why use Ren Shen and Bai Zhu, and in large quantities? It is unknown that when cold pathogens directly assault the Palace of the Kidneys, the Original Yang escapes into the Spleen and Stomach region, where only a faint thread of vital Qi remains. Without Ren Shen to rescue this Qi, how can it be called back from non-existence? Without adding ample Bai Zhu, how can the waist and umbilical region be unblocked to restore Yuan Qi? Therefore, Fu Zi and Rou Gui are added to disperse the cold pathogen.

Sudden severe heart pain, intolerable to touch, is caused by Fire Pathogens assaulting the Heart. If the fire is not urgently relieved, internal burning of the Zang-Fu organs will occur, leading to death. The prescription uses Zhi Zi (Gardeniae Fructus) 3 qian, Bai Shao (Paeoniae Radix Alba) 5 qian, Gan Cao 1 qian, Liang Jiang (Alpiniae Officinarum Rhizoma) 0.3 qian, Tian Hua Fen (Trichosanthis Radix) 2 qian, Cang Zhu (Atractylodis Rhizoma) 1 qian, and Guan Zhong (Cyrtomii Rhizoma) 1 qian. Decoct in water and take orally. (Annotation: Xie Huo Ding Tong Tang / Draining-Fire and Relieving-Pain Decoction). The brilliance of this formula lies in using Zhi Zi to clear fire. Some may question: Heat in the Heart Meridian should be cooled with Huang Lian (Coptidis Rhizoma). Why use Zhi Zi instead? While using Huang Lian for heart fire is appropriate, Huang Lian is drying in nature. When heart fire is in a state of dryness and intensity, applying a drying herb to a dry condition is abhorrent to the Heart; it not only fails to remove the fire but exacerbates the flames. It is better to use Zhi Zi to drain the Wood element (Liver), for when the mother (Wood) weakens, the child (Fire) also weakens. By not directly draining heart fire, one effectively drains it. Moreover, Zhi Zi can drain stagnant fire in all six meridians; it does not exclusively enter the Liver Meridian but also enters the Heart Meridian. One herb serves two purposes, demonstrating the subtlety of herbal medicine. Furthermore, combined with Bai Shao to drain the Liver, and a small amount of Liang Jiang to guide the action into the Heart, along with Tian Hua Fen to expel hot phlegm, the removal of phlegm naturally dissipates the fire and soothes stagnant Qi. This is treating the Liver urgently to treat the Heart urgently. This is another method of urgent treatment, and other cases can be inferred similarly.

Master Zhang said: The methods of urgent treatment are excellent, but I have additional methods. The three methods for Phlegm Strike, Evil Strike, and Qi Strike must also be discussed. For Phlegm Strike: Use Ren Shen 3 qian, Bai Zhu 3 qian, Fu Ling 3 qian, Fu Zi 1 qian, Tian Nan Xing (Arisaematis Rhizoma) 1 qian, and Ban Xia 2 qian. Decoct in water and take orally; improvement is immediate upon swallowing. Phlegm arises from Qi deficiency, and Qi deficiency arises from coldness in the Zang-Fu organs. Thus, Ren Shen and Bai Zhu are used to tonify righteous Qi, Ban Xia, Tian Nan Xing, and Fu Ling to dispel phlegm, and Fu Zi to warm the interior. Hence, the sound of phlegm subsides and clarity returns immediately. For Evil Strike: Use Ren Shen 3 qian, Bai Zhu 3 qian, Ban Xia 3 qian, Zao Jiao Mo (Gleditsiae Sinensis Fructus Powder) 1 qian, and Chen Pi (Citri Reticulatae Pericarpium) 1 qian. Decoct in water and take orally. (Annotation: Kai Qiao Xiao Tan Yin / Orifice-Opening and Phlegm-Resolving Drink). The brilliance of this formula lies in Zao Jiao's ability to open the body's orifices, guiding Ren Shen, Bai Zhu, and Ban Xia directly into the Heart Meridian, thereby completely resolving obstructed phlegm. Once phlegm is gone, what evil remains? For Qi Strike: Use Ren Shen 1 liang, Bai Zhu 5 qian, Fu Ling 5 qian, Gan Cao 1 qian, Chen Pi 1 qian, Fu Zi 1 qian, Ban Xia 3 qian, and Tian Nan Xing 3 qian. Decoct in water and take orally. (Annotation: Zhu Qi Hui Sheng Yin / Qi-Assisting and Life-Restoring Drink). This formula is similar to the Phlegm Strike formula but superior due to higher dosages and the addition of Gan Cao and Chen Pi to harmonize the middle and resolve internal stagnation. These three methods offer significant assistance to physicians.

Master Hua said: I have heard from the Heavenly Master regarding two additional syndromes. One is wheezing preventing lying down, not caused by external contraction; the other is unbearable abdominal pain, not caused by internal injury. When a person suffers from wheezing unable to lie flat, expectorating phlegm like a gushing spring, with a non-dry tongue and mild wheezing that worsens upon lying down, this is not external wind-cold, but cold qi within the Kidneys. If there is no fire in the Kidneys, water lacks nourishment and floods upward to become phlegm, utilizing stomach water to fuel its surging momentum, which becomes unstoppable. The treatment should employ Liu Wei Di Huang Wan Tang (Six-Ingredient Rehmannia Pill Decoction) with added Fu Zi and Rou Gui in large doses. This warms the Kidney Palace, giving water a destination. Once water returns to the palace, the rebellious wheezing settles, allowing for lying down. Sleep requires the interaction of Kidney Qi and Lung Qi to ensure the safety of the airway. By tonifying Kidney fire in the formula, rest is achieved because the Kidney is the Child of the Lung; when the Child is calm, the Mother (Lung) is also peaceful. Lung Metal Qi returns to the Kidney Palace to nourish depleted Qi. Thus, tonifying Kidney fire is precisely nurturing Lung Metal. Moreover, Liu Wei Di Huang Wan is a divine agent for tonifying Kidney Water; tonifying both Water and Fire ensures Lung Metal is secure, and with Lung and Kidney in harmony, lying down becomes comfortable.

When a person suffers from severe abdominal pain that worsens upon pressure, this is caused by Fire Pathogens combined with Phlegm and Food Stagnation. Treating this as Direct Cold invasion would lead to immediate death. The prescription uses Gan Cao 1 qian, Fu Ling 3 qian, Bai Shao 5 qian, Zhi Shi (Aurantii Fructus Immaturus) 1 qian, Zhi Zi 3 qian, and Shan Zha (Crataegi Fructus) 20 grains. Decoct in water and take orally. Add Chai Hu 1 qian. (Annotation: Fen Jie San / Conflict-Resolving Powder). This formula possesses the wonder of resolving conflicts; it was a method not transmitted by the Heavenly Master, likely learned from other schools.

Master Qi said: Indeed, it was not transmitted. Sun Simiao (Sun Zhen Jun) had a formula for treating heart pain. Yan Hu Suo (Corydalis Rhizoma) 3 qian, Ru Xiang Mo (Frankincense Powder) 2 qian, Bai Shao 3 qian, Chao Zhi Zi (Stir-fried Gardeniae Fructus) 3 qian, and Gan Cao 0.5 qian. Decoct in water and take orally. Pain ceases after one dose. This formula specifically treats Fire Pain and is miraculous for patients who cry out and feel thirsty.