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(This condition is caused by contracting the pathogenic qi of epidemic toxins from the four seasons. Subsequently, it manifests on the nose, face, ears, nape, and throat, presenting with redness and swelling without a head, or forming nodules with roots. It is accompanied by aversion to cold, fever, and headache, resembling Taiyang disease (Taiyang syndrome). This is due to the damp-toxin qi of seasonal epidemics manifesting on the head and face, known as "Da Tou Wen" (Great Head Plague). Because it can suppurate and discharge toxins, it is classified under Surgery.)

Li Puting, Vice Minister, suffered from Shi Du (Seasonal Epidemic Toxin). After using diaphoretic drugs, his Yuan Qi (Primal Qi) was depleted. The affected area did not subside; he experienced fatigue, aversion to cold, poor appetite, and dry mouth. He was treated with Yiqi Tang (Qi-Supplementing Decoction) plus Jiegeng (Platycodonis Radix), and Tuoli Xiaodu San (Interior-Supporting and Toxin-Resolving Powder), resulting in recovery.

Chen Tongye, Official of Autumn, suffered from Shi Du. His Yuan Qi had been weak since childhood, and his pulse was faint, fine, and deep. This indicates deficiency in both form and disease. He was prescribed Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium), Chaihu (Bupleuri Radix), Shengma (Cimicifugae Rhizoma), and Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) to raise and uplift Yang Qi. Niubangzi (Arctii Fructus), Xuanshen (Scrophulariae Radix), Lianqiao (Forsythiae Fructus), and Jiegeng were used to resolve heat toxins. After two doses, the swelling subsided instantly, and the pulse recovered. If one were to classify the faint and fine pulse as Yin syndrome and the redness and swelling as Yang syndrome, treating them separately, few would avoid error.

A woman suffered from Shi Du after ulceration. The redness and swelling did not subside; she had poor appetite and fatigue. The pus was clear and white, indicating deficiency of Spleen and Lung Qi. She was first treated with Liujunzi Tang (Six-Gentlemen Decoction) plus Jiegeng, Chuanxiong, and Danggui. Later, she was treated with Yiqi Tang plus Jiegeng, leading to wound contraction and healing.

The younger sister of Yuan Guxu, Official of Spring, suffered from Shi Du. Due to excessive use of exterior-releasing methods, the swelling became hard and painless. Her pulse was floating and large but short upon deep pressure, indicating exhaustion of True Qi. Treatment was declined, and she subsequently died.

A man suffered from this condition with swelling, pain, fever, thirst, a full pulse, and constipation. He was purged with Wuli Dahuang Tang (Five-Benefits Rhubarb Decoction), after which all symptoms receded. He was then treated with Gegen Niubangzi Tang (Kudzu and Arctopus Decoction) for four doses, resulting in recovery.

A man suffered from this condition where exterior and interior symptoms had resolved, yet swelling and pain persisted. He was treated with Gegen Shengma Tang (Kudzu and Cimicifuga Decoction) for two doses, after which the swelling subsided.

A man suffered from this condition with swelling, pain, chills, and fever. His pulse was floating and rapid. He was treated with Jingfang Baidu San (Schizonepeta and Saposhnikovia Powder to Overcome Toxicity) for two doses, showing slight improvement. He was then treated with Renshen Baidu San (Ginseng Powder to Overcome Toxicity) for two doses, reducing the severity by half. After another two doses, he recovered.

A man suffered from this condition with redness, swelling, and pain in the ears and face, dry throat, fever, and a floating, rapid pulse. He was first treated with Jingfang Baidu San for two doses, reducing the severity by more than half. He was then treated with Gegen Niubangzi Tang for four doses, resulting in recovery.

A woman suffered from this condition where exterior pathogens had resolved, but swelling persisted. Palpation revealed a slippery and rapid pulse, indicating that blood stasis was about to suppurate. She was treated with Tuoli Xiaodu San to promote suppuration and recovery.

A man suffered from this condition with swelling, pain, thirst, irritability, fever, and constipation. His pulse was rapid and particularly firm upon deep pressure. He was given Fangfeng Tongsheng San (Saposhnikovia and Gentian Powder to Unblock the Whole Body) for one dose, after which all symptoms receded instantly. He was then treated with Jingfang Baidu San plus Xuanshen, Niubangzi, and Huangqin (Scutellariae Radix) for two doses, resulting in recovery.

An elderly man suffered from severe swelling, pain, and constipation in the head, face, ears, and nape during winter. His pulse was full. This was a condition of excess in both exterior and interior. Drinking Fangfeng Tongsheng San yielded no result. Consequently, Bian stones (stone lancets) were used to puncture the affected area to release dark blood. Upon resuming the previous medication, it took effect immediately. He was further treated with Jingfang Baidu San and healed. The reason the previous medication failed was that toxic blood was condensed in the upper meridians, preventing the medicinal power from reaching the site. Once the evil blood was removed, the medicine naturally worked. If one adheres strictly to the principle of avoiding cold medicines in cold seasons ("Han Yuan Han") or fears using Mangxiao (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) due to advanced age, opting instead for interior-supporting methods or ordinary remedies, and fails to use Bian stones to drain the toxin, relying solely on medicinal power, danger is rarely avoided. (Xu Lingtai stated: Fangfeng Tongsheng San is a formula for treating simultaneous exterior and interior heat, known as the "Dual Resolution Method." It must be applied only after carefully confirming symptoms of simultaneous exterior and interior heat. He also stated: Jingfang Baidu San is the main formula for Shi Du, but Renshen should not be used lightly.)

A man suffered from this condition where exterior and interior symptoms had resolved, leaving only swelling. He was treated with Tuoli Xiaodu San for four doses. Once pus formed, it was lanced, leading to recovery.

A woman suffered from this condition with swelling and pain. After being purged with medicines containing Mangxiao and Dahuang, the pain eased slightly, but returned the next day. Palpation revealed that exterior pathogens had retreated, indicating that blood stasis was recurring into suppuration. She was treated with Tuoli Xiaodu San to promote suppuration and recovery.

A man suffered from head and face swelling and pain. After taking medicines containing Mangxiao and Dahuang to resolve toxicity, his condition worsened. Palpation revealed a floating and rapid pulse, indicating that pathogens were still in the exterior. He was treated with Jingfang Baidu San for two doses, reducing the severity by more than half. He was then treated with Gegen Niubangzi Tang for four doses, resulting in recovery. The *Neijing* states: Swelling above the middle of the body is caused by Heavenly Qi; swelling below the middle of the body is caused by Earthly Qi. Here, pathogens lodge between the Heart and Lungs, attacking upward to the head and eyes, causing swelling. This is caused by contracting abnormal Qi of the four seasons, differing from conditions caused by accumulation of heat from rich foods. Medicines containing Mangxiao and Dahuang should only be used when there is solid constipation. If the cause is not examined, and deficiency/excess and exterior/interior are not distinguished, indiscriminate purging will inevitably lead to error. It is common during famines that people of low status suffer from this, due to damage to Stomach Qi allowing pathogens to act. This must be carefully observed. Generally, for pathogens in the exterior, Gegen Niubangzi Tang, Renshen Baidu San, or Puji Xiaodu Yinzi (Puji Toxin-Resolving Decoction) are used. For pathogens in the interior, Wuli Dahuang Tang or Zhizi Ren Tang (Gardenia Seed Decoction) are used. For unresolved exterior and interior, Fangfeng Tongsheng San is used. For resolved exterior and interior with persistent swelling, Xijiao Shengma Tang (Rhinoceros Horn and Cimicifuga Decoction) is used. For severe swelling, Bian stones are used to puncture the affected area and release evil blood to drain toxin, or Tongqi San (Ventilation Powder) is used to induce sneezing to drain toxin. It heals spontaneously after ten days; if pus and blood are sneezed out, it heals immediately. To promote suppuration, Tuoli Xiaodu San is used; to promote contraction, Tuoli San (Interior-Supporting Powder) is used. This method is the most secure. If after five to seven days the throat swells shut, speech is lost, the head and face do not swell, and taste is absent, it is incurable. (This is due to damp-toxin qi of seasonal epidemics manifesting on the head and face, known as "Da Tou Wen". Because it can suppurate and discharge toxins, it is classified under Surgery.)

A man suffered from this condition. After taking exterior-releasing medicines, his condition intensified with fever and constipation. Palpation revealed a deep and full pulse, indicating pathogens in the interior. He was purged with Dahuang Tang (Rhubarb Decoction), after which interior symptoms receded. He was then treated with Gegen Niubangzi Tang, and edema subsided. Only redness and swelling remained. He was further treated with interior-supporting medicines to promote suppuration and recovery. Qi Shi said: Shi Du is contracted by humans from the pathogenic qi of epidemic toxins of the four seasons. Subsequently, it manifests on the nose, face, ears, nape, and throat, presenting with redness and swelling without a head, or forming nodules with roots, causing aversion to cold, fever, and headache. Or, if limb pain is severe, the mind becomes unsettled, and the throat closes. Ignorant practitioners may mistake it for Shanghan (Cold Damage) and administer resolving medicines. Only after one or two days does the swelling increase before they realize their mistake and seek a surgeon. Originally, this condition had no formulas or discussions in ancient texts. Secularly, it is commonly called Dan Liu (Dan Tumor). Patients dislike the term "Shi Du" for fear of contagion. Examining the classics: Sudden reddening of the body, resembling painted cinnabar, is called Dan Du (Dan Poison). This is caused by wind-heat and evil toxicity, specifically different from Shi Du. Generally, Shi Du begins resembling Shanghan. Within five to seven days, it can be fatal. Practitioners must distinguish it carefully. First, palpate the pulse: slippery, rapid, floating, full, deep, tight, wiry, or choppy are all indicators. Floating and rapid indicate pathogens in the exterior; deep and choppy indicate pathogens are deep. In persons with strong Qi, Huadu Dan (Toxin-Transforming Pill) should be taken urgently to attack the pathogen. If heat is full and bowel movements are obstructed, Dahuang Tang is used to purge. If exterior symptoms exist, Jiedu Shengma Tang (Toxin-Resolving and Cimicifuga Decoction) is used to induce sweating. For those who are elderly and have weak Qi, Wuxiang Lianqiao Tang (Five-Aromatics and Forsythia Decoction) is the primary treatment. Additionally, Tongqi San is blown into the nose to induce over ten sneezes. Caregivers daily use medicine to induce sneezing to prevent contagion. Patients also use sneezing medicine three to five times daily to drain heat toxins. This is an excellent method for treating Shi Du. If unresolved after three or four days, drastic purging should not be used; reconciliation is still appropriate, such as taking Xijiao Lianqiao San (Rhinoceros Horn and Forsythia Powder). By the seventh or eighth day, if urination and defecation are obstructed, and the head and face are swollen, high, and red, Tuoli San and Huangqi San (Astragalus Powder) can be taken. It is advisable to lance and bleed to drain toxic vapors. After ten days, it heals spontaneously without treatment. If within five days the spirit is confused, the throat is closed, speech is lost, the head does not swell, and taste is absent, death is certain, and treatment is futile. However, this disease has Yin and Yang aspects, and can be treated with sweating or purging. Commonly, crude physicians merely say "heat toxin" and use cold-cooling medicines, unaware that diseases vary in severity and treatments have contrary and conforming approaches. This must be carefully considered.

Xu Kaogong, over thirty years old, suffered from ear and facial swelling, chills, fever, and limb stiffness. His pulse was floating and full. This was Shi Du. With pathogens in the exterior, he was treated with Jingfang Baidu San plus Niubangzi and Xuanshen, gradually improving. He was then treated with Shengma, Gegen, Lianqiao, Jiegeng, Chuanxiong, Yinhua (Lonicerae Japonicae Flos), and Niubangzi, leading to complete recovery.