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Decoction of Bupleurum with Seasonal Modifications to Retreat Deficient Heat of the Five Zang Organs

During the three winter months, add: Chai Hu (Bupleuri Radix, 8 fen), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 8 fen), Chen Pi (Citri Reticulatae Pericarpium, 5 fen), Da Fu Bing Lang (Arecae Cathayensis Pericarpium, including peel and seed, four pieces), Sheng Jiang (Zingiberis Rhizoma Recens, 5 fen), Jie Geng (Platycodonis Radix, 7 fen).
During the three spring months, add: Zhi Shi (Aurantii Fructus Immaturus); reduce: Bai Zhu (total six ingredients).
During the three summer months, add: Sheng Jiang (3 fen), Zhi Shi (5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen, total eight ingredients).
During the three autumn months, add: Chen Pi (3 fen, total six ingredients).
The above ingredients are each chopped, divided into three doses. One dose is boiled in three sheng of water to obtain two sheng, taken in three warm doses. Administer one dose at intervals equivalent to walking for four or five li.
If there is stagnation in the four limbs, add a small amount of Gan Cao. Divide each dose into three smaller doses. Each small dose is boiled in one sheng of water to obtain seven ge, taken warm. The dregs are then combined for another dose, re-boiled, resulting in a total of four doses (suspected not to be a formula by Zhang Zhongjing).
[Commentary] The syndrome indicated by this formula does not match; therefore, it is not explained.

Formula for Long-term Use of He Li Le Pills
He Li Le (Terminalia Chebulae Fructus), Chen Pi, Hou Po (Magnoliae Officinalis Cortex, each 3 liang).
The above three ingredients are powdered, mixed with refined honey to form pills the size of paulownia seeds. Take twenty pills with wine, increasing up to thirty pills.
[Commentary] This formula should have been placed under "Excess of Grain Qi" in the previous chapter.

San Wu Bei Ji Wan (Three-Ingredient Emergency Preparedness Pill)
Da Huang (Rhei Radix et Rhizoma, 1 liang), Gan Jiang (Zingiberis Rhizoma, 1 liang), Ba Dou (Crotonis Fructus, peeled and cored, roasted, ground externally to a paste-like consistency, 1 liang).
The above medicines must be fresh and pure. First, pound Da Huang and Gan Jiang into powder, then mix in the ground Ba Dou. Process together for one thousand pestle strikes. Use as a powder, or mix with honey to form pills. Store in a sealed container to prevent loss of potency. It treats sudden acute diseases of the heart and abdomen, such as being afflicted by evil influences or hostile spirits, abdominal distension and fullness, sudden pain like needle pricking, shortness of breath, locked jaw, or sudden death resembling corpse paralysis. Administer three or four pills (size of soybean) with warm water or sour vinegar. If unable to swallow, prop up the head and force the medicine down. Recovery should occur shortly. If not recovered, administer three more pills. Abdominal borborygmus will follow, leading to vomiting or purging, and recovery. If the jaw is locked, teeth must be pried open to administer the medicine.
[Explanation] The name "Bei Ji" (Emergency Preparedness) refers to preparing for sudden abdominal fullness, acute pain, affliction by evil influences, locked jaw, or sudden death. The instruction to pry open teeth if locked indicates the urgency to prevent death from lack of immediate rescue, though later methods of blowing medicine into the nose are considered superior.
[Collection of Explanations] Li Xun stated: Sudden fatal illnesses are caused by toxic, malignant, yin, and abnormal qi. These three ingredients work together to purge evil and stabilize righteous qi, inducing vomiting or purging to eliminate turbid qi from above and below, truly sufficient for emergencies.

Zi Shi Han Shi San (Purple Stone Cold Food Powder) to Treat Typhoid Fever Preventing Recurrence
Zi Shi Ying (Fluorite, 10 parts), Bai Shi Ying (White Fluorite, 10 parts), Chi Shi Zhi (Halloysit Rubrum, 10 parts), Zhong Ru (Stalactite, pounded and refined, 10 parts), Gua Lou Gen (Trichosanthis Radix, 10 parts), Fang Feng (Saposhnikoviae Radix, 10 parts), Jie Geng (10 parts), Wen Ge (Meretricis Concha, 10 parts), Gui Jiu (Podophylli Fructus, 10 parts), Tai Yi Yu Liang (Kaolin, burned, 10 parts), Gan Jiang (10 parts), Fu Zi (Aconiti Lateralis Radix Praeparata, processed, peeled, 4 parts), Gui Zhi (Cinnamomi Ramulus, peeled, 4 parts).
The above thirteen ingredients are pounded into a powder. Take one cun bi (square-inch measure) with wine.
[Commentary] The rationale of this formula is unclear; therefore, it is not explained.

Shi Jue (Corpse Coma), characterized by pulsating pulse but absence of vital qi. Qi blockage prevents flow, resulting in stillness and apparent death. Treatment formula:
Insert A Pu Xie (Rhizoma Acori Tatarinowii) powder into both nostrils and blow it in; place Gui Xie (Cinnamomi Ramulus powder) under the tongue.
[Note] When the body appears healthy but the pulse is irregular despite the presence of qi, it is called "Walking Corpse." Sudden death with unconsciousness, absence of qi, but persistent pulsating pulse is called "Shi Jue" (Corpse Coma). Shi Jue occurs when righteous qi is suddenly blocked by pathogenic qi, causing stillness resembling death. Inserting A Pu into the nose and placing Gui under the tongue opens the heart spirit and arouses yang qi.
Another Formula:
Take one square cun of hair from the left temple, burn it to ash, mix with wine, and pour into the throat. Immediate revival ensues.
[Explanation] If blowing A Pu into the nose and placing Gui under the tongue fails, this method is used. Hair is the surplus of blood, and blood is generated by the heart. Burning releases yang, and wine promotes blood and qi circulation. Using the patient's own hair ensures resonance of qi.

Rescue Formula for Sudden Death
Grind Xie (Allii Macrostemonis Bulbus) to extract juice and instill into the nose.
[Explanation] Sudden coma is essentially Shi Jue. Xie Bai resembles garlic but is smaller. Northerners call it "Xiao Gen Cai," Southerners call it "Diao Qiao." Its flavor is extremely pungent. Grinding and instilling into the nose aims to open orifices and induce sneezing.
Another Formula:
Cut blood from the comb of a rooster, use a tube to blow it into the nostrils.
Pig lard (size of an egg), bitter wine (Ku Jiu, 1 sheng), boil and pour into the throat.
Apply chicken liver and blood to the face, surround with ash, and immediate revival occurs.
Fourteen soybeans, mixed with egg white and wine, swallowed entirely.
[Explanation] Rooster comb blood, liver, egg white, pig lard, soybeans, wine, and vinegar are all yang substances used to overcome yin malevolence. Blowing into the nose involves holding the blood or warm wine in the mouth of a healthy person, inserting a reed or pen tube into the patient's nostril, and blowing air along with the medicine so it swallows naturally, opening the locked jaw through qi unblocking.

Rescue Formula for Sudden Death with High Fever
Fan Shi (Alumen, 0.5 jin). Boil in 1.5 dou of water until dissolved. Soak feet in the solution up to the ankles.
[Note] Coma with high fever is Yang Jue (Yang Reversal) involving the fu organs. Soaking feet in alum water helps collect and restrain yang qi, as reversal originates from the lower body.
[Collected Notes] Cheng Lin stated: Unrestrained jue-yang leads to sudden death and high fever. Qibo stated: When blood and qi rush upward together, it causes Great Jue, leading to sudden death. Alumen is an astringent agent; soaking feet with it收敛s the rebellious qi.

Rescue Formula for Sudden Death with Closed Eyes
Have someone ride a horse facing the patient's face. Grind Xie juice and instill into the ears. Blow Zao Jiao Fen (Gleditsiae Sinensis Spina powder) into the nose. Immediate effect.

Rescue Formula for Sudden Death with Open Mouth and Opisthotonos
Moxibustion on the posterior aspect of the nails of both hands and feet, fourteen moxa cones per site. Then drink Wu Du Zhu Gao San (Five-Toxin Various Ointment Powders, containing Ba Dou).
[Note] For sudden death with open mouth and opisthotonos, moxibustion is used to unblock yang qi, followed by drinking the Five-Toxin ointment powder.

Rescue Formula for Sudden Death with Flaccid Limbs and Incontinence
One sheng of horse manure, boiled in three dou of water to obtain two dou. Wash the body with this decoction. Also, take one sheng of cow dung (liquid feces), mix with warm wine, and pour into the mouth. Moxibustion on points Yiju (one cun below the heart center), Shenque (three cun above the umbilicus), and Guanyuan (four cun below the umbilicus), one hundred cones each. Recovery ensues.
[Note] Shi Jue with closed eyes, open mouth, incontinence, opisthotonos, and flaccid limbs is Yin Jue (Yin Reversal) involving the zang organs. The method of riding a horse facing the patient suppresses evil. Instilling Xie juice into ears and blowing Zao Jiao into nose opens the orifices. Moxibustion on the nails unblocks external yang. Horse manure induces vomiting. Moxibustion on Zhongwan and Guanyuan unblocks internal yang.

Rescue Formula for Children Sudden Death with Vomiting and Diarrhea of Unknown Cause
One pill of dog feces, squeeze out juice and administer. If dry feces are unavailable, boil in water to extract juice.
[Explanation] All feces can stimulate yang qi; using dog feces also aims to stimulate yang qi.

Huan Hun Tang (Return Soul Decoction) is the main formula for Sudden Death and Affliction by Hostile Spirits. Formula:
Ma Huang (Ephedrae Herba, nodes removed, 3 liang), Xing Ren (Armeniacae Semen Amarum, skin and tips removed, 70 seeds), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 1 liang).
The above three ingredients are boiled in eight sheng of water to obtain three sheng. Strain and allow the patient to swallow gradually. It treats all cases of affliction by hostile spirits.
[Note] For affliction by evil influences with constipation and interior excess, Zhang Zhongjing uses Bei Ji Wan. For exterior excess with no sweating, Bei Ji Wan should not be used to purge the interior; instead, Huan Hun Tang should be used to release the exterior. Purging the interior suppresses yin qi; releasing the exterior supports yang qi. Ignorant people believe Ma Huang only induces sweating in the Taiyang channel. They do not know that without covering for sweat, it enters the Taiyin channel to unblock yang. Once yang qi moves, the soul returns.
Another Formula:
Jiu Gen (Chinese Chive Root, one handful), Wu Mei (Mume Fructus, 27 seeds), Wu Zhu Yu (Evodiae Fructus, stir-fried, half sheng).
Boil these three ingredients in one dou of water. Place the patient's comb in the boiling liquid for three boils. If the comb floats, the patient lives; if it sinks, the patient dies. Boil down to three sheng, strain, and drink in portions.
[Explanation] The treatment with Jiu Gen, Wu Zhu Yu, and Wu Mei is also a method to gather yang qi. Floating represents yang, sinking represents yin, illustrating the principle that where yang grows, yin dies.

Rescue Formula for Hanging Death
Death by hanging from morning to evening, even if cold, can certainly be treated; from evening to morning, it is slightly difficult. This is likely due to the abundance of yang qi. However, in summer, nights are shorter than days and it is hot, so treatment should still be effective. It is also said that if the epigastrium is slightly warm, treatment is possible even after more than a day. Formula:
Slowly untie the victim; do not cut the rope. Lay the victim on bedding. One person steps on both shoulders, gently pulling the hair taut without relaxing. Another person presses and rubs the chest repeatedly. A third person massages and extends the arms and legs. If stiff, gradually force flexion and press the abdomen. After about the time it takes to cook a meal, qi exits the mouth, breathing resumes, and eyes open. Continue gentle pressure and do not exhaust the victim. Shortly after, offer small amounts of Gui Zhi Tang (Cinnamon Twig Decoction) or rice gruel to moisten the throat. As swallowing improves, have two people blow air into both ears using tubes. This method is most effective and rarely fails.
[Note] Morning to evening has abundant yang qi, which governs life, so treatment is effective even if cold. Evening to morning has abundant yin qi, which governs death, making it harder. Victims who can be saved likely died from anger where qi was abundant and not dispersed. Summer heat and short nights provide abundant yang, aiding recovery. If the epigastrium is warm, treatment is possible even after a day. Zhang Zhongjing's earnest warnings show his benevolence, fearing people might avoid treatment due to complexity. This method has an 80-90% success rate. "Xian Xian" means tight. Chest rubbing, abdominal pressing, and limb manipulation guide qi.

For Sudden Death from Heatstroke, Do Not Allow Cooling
Allowing cooling leads to death. Treatment Formula:
Wrap a bent grass belt around the navel. Have two or three persons urinate into it to generate warmth. Alternatively, use hot mud mixed with bent grass, or press a warm tile bowl bottom or warm axle against the body. Urine must flow away. This applies when hot water is unavailable. To warm urine, have multiple persons urinate. If hot water is available, use it; do not use mud or axles as they may be cold. In summer, hot mud or warm axles can be used.
[Note] Heatstroke victims should not be placed in cool places to avoid trapping heat inside, just as frozen victims should not be poured with hot water to avoid trapping cold inside, which would cause greater harm.

Rescue Formula for Drowning
Bury the victim from head to foot in over two dan of ashes from a stove. Water will exit from the seven orifices, and the victim revives. Experimentally, flies drowned in water revived when buried in stove ash.
[Collection of Explanations] Li Xun stated: Stove ash possesses the generative energy of fire and earth. Burying the victim warms the defensive qi externally and渗s water-dampness internally, allowing water to exit the orifices and restoring life.

Formula for Falling from Horses and All Bone and Tendon Injuries
Da Huang (Rhei Radix et Rhizoma, sliced, soaked in decoction to yield juice, 1 liang), Fei Bo (Red Silk, burned to ash, size of a hand), Luan Fa (Tangled Hair, burned to ash, size of an egg), Jiu Yong Chui Dan Bu (Old Cooking Cloth, burned to ash, one chi), Bai Pu (Decayed Cattail, one handful, three cun), Tao Ren (Persicae Semen, skin and tips removed, roasted, 49 seeds), Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, cut, size of middle finger joint).
The above seven ingredients are decocted in urine from a young boy (quantity adjusted). Add one large cup of wine, then add Da Huang. Strain and divide into three warm doses. First, decoct half a decayed cattail mat for bathing. Cover the patient with clothing and bedding. After a short while, several bowel movements will occur, and pain will immediately cease. Reddish discharge and bathwater are normal, indicating expelled blood stasis.
[Note] External bathing disperses stasis, while internal administration purges stasis, achieving both goals.
[Collected Notes] Xu Bin stated: For falls from height, treating bone and tendon injury is primary. However, trauma inevitably causes internal and external blood stasis. If stasis is not removed, qi cannot move, and injuries do not heal. Thus, Tao Ren and Da Huang are used primarily to expel stasis. Fei Bo (related to red flower) and Luan Fa (surplus of blood) combined with child's urine eliminate blood stasis. Bathing activates whole-body qi and blood. Since bone and tendon stasis involves stagnant heat, the old cooking cloth, which absorbs much qi and is easily dissolved, is used to dissipate stagnation and promote qi flow, following its nature. A small amount of honey-fried Gan Cao tonifies the middle and harmonizes the herbs.