Library

On Cold Damage, On Worm Pain, and on Cholera

The Heavenly Master said: The method of "treating while hungry" means not feeding the patient to fullness, but waiting until they feel hungry before administering medication. This applies, for instance, when the pathogenic fire of cold damage (Shanghan, a disease caused by external cold pathogens) has just subsided, or in cases of worm pain when the stomach is empty. After the heat of cold damage dissipates and the pathogen scatters, the Stomach Qi begins to recover; it is most taboo to give food immediately. Once food is ingested, the movement of Stomach Qi becomes blocked and cannot be reopened. If purgative drugs are used at this time, it will severely injure Stomach Qi, causing the pathogenic fire to gather again, resulting in an incurable condition. It is better to prohibit eating so that the Middle Jiao (the spleen and stomach region responsible for transformation and transportation) can naturally resume its functions, gradually opening the pathways and facilitating transport, thus avoiding obstruction. The prescription consists of Chenpi (Tangerine Peel), 1 qian; Gancao (Licorice Root), 5 fen; Baishao (White Peony Root), 3 qian; Shenqu (Medicated Leaven), 5 fen; Zhiqiao (Aurantium Fructus), 5 fen; Houpo (Magnolia Bark), 5 fen; Zhizi (Gardenia Fruit), 1 qian; Fuling (Poria), 1 qian; and Maiya (Sprouted Barley), 2 qian. Decoct in water and take orally. (Commentary: Drink to eliminate pathogen and digest food.) The ingredients of this prescription are ordinary and seem unremarkable. However, this condition should not be treated with large doses of extraordinary drugs; such mild regulation can transform a complex situation into a harmless one. Yet, it must only be administered when the patient feels hungry. If taken during satiety, it will merely increase bloating and oppression.

Worm pain is characterized by pain relief after eating and exacerbation when fasting. One may test with a cup of Suanmei Tang (Sour Plum Soup): if the pain stops immediately upon ingestion, it is worm pain; if the pain worsens or slightly alleviates, it is not worm pain. The prescription uses Liangun (Root of Chinaberry Tree), 1 liang; Huanglian (Coptis Rhizome), 3 qian; Wumei Rou (Flesh of Mume Fruit), 3 qian; Wuzhuyu (Evodia Fruit), 3 qian; Chao Zhizi (Stir-fried Gardenia Fruit), 3 qian; Baiwei (Cynanchum Atratum Root), 1 liang; Baizhu (Atractylodes Macrocephala Rhizome), 2 liang; Fuling (Poria), 3 qian; Gancao (Licorice Root), 3 qian; and Biejia (Tartar Testudinis Carapax et Plastrum), 3 qian. Each is ground into powder, mixed with honey to form pills, each pill sized like a millet seed. Take 3 qian per dose. (Commentary: Pill to kill worms.) These pills must be given when the patient is hungry and craving food. After taking these pills, the pain will intensify significantly; do not provide water. This is because worms become active and thrive in water. The brilliance of this formula lies in killing worms while strengthening the Spleen. Since it contains vermifuges, why wait until hunger to kill them? When there is no food in the abdomen, worms lack nourishment, and their mouths turn upward seeking food. During hunger and emptiness, the heads of the worms face upward rather than downward. Upon being fed, they mistake it for food and swarm to eat. However, entering the mouth contradicts their nature, causing them to move chaotically and jump, thus intensifying the pain. Prohibiting water ensures that the medicinal qi permeates the entire body—ears, eyes, mouth, and nose—attacking from both inside and out, leading to the death of the worms. If one ignores this prohibition and provides water, the worms will use the water to thrash about, diluting the medicine. With little medicine and much water, the efficacy dissipates, killing only half the worms without eradicating the root cause. Therefore, one must endure the momentary pain to eliminate lifelong suffering. I urge people to bear this. This is the appropriate application of treating while hungry. Dahuang (Rhubarb Root and Rhizome) may also be added, 3 qian; it is optional. Do not add it if the pain is in the upper abdomen; add it if the pain is in the lower abdomen.

Master Zhang said: The methods of treating while hunger are limited to these two points, with nothing to add. Regarding the method of eliminating worms, I have another prescription to pass down to the world, which is convenient and effective. Regardless of what kind of worms are in the abdomen, simply consume Feizi (Torreya Seed), ten per day. Within three days, they will all dissolve into water. Alternatively, use Sheng Gancao (Raw Licorice Root), 1 liang, and Feizi (Torreya Seed), 2 liang, made into pills with rice flour. Take 5 qian with plain boiled water when hungry. The worms will be expelled via stool within five days. These remedies cost nothing and offer rapid relief, warranting urgent documentation.

Master Hua said: Agreed. However, I have another method. Cholera (Huoluan, a syndrome characterized by sudden vomiting and diarrhea) strikes suddenly and subsides shortly after. One must absolutely avoid giving food. Let the patient fast for one day, then treat with Chenpi (Tangerine Peel), 1 qian; Gancao (Licorice Root), 5 fen; Baizhu (Atractylodes Macrocephala Rhizome), 2 qian; Fuling (Poria), 3 qian; Shanzha (Hawthorn Fruit), 5 pieces; Xiangru (Elsholtzia Herb), 1 qian; Huoxiang (Patchouli Herb), 5 fen; Mugua (Chaenomelis Fructus), 1 qian; and Baishao (White Peony Root), 3 qian. This will prevent the recurrence of pain. Cholera is caused by the hot qi of summer heat. Summer heat combined with food gathers again and becomes intractable. Therefore, fasting is necessary to disperse the summer-heat pathogen completely. This is named Dingluan Tang (Stabilizing Chaos Decoction).

(Note: Parasites are generated by damp-heat. Thus, clearing heat is treating the branch, while drying dampness is the root; drying dampness treats the branch, while strengthening the Spleen is the root. Recorded by Li Zi Yong.)