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In cities, villages, and market towns, plague is often transmitted, leading to numerous deaths. The symptoms invariably include headache and dizziness (Tóu tòng xuàn yùn), distension in the chest and diaphragm (Xiōng gé péng zhàng), expectoration of yellow phlegm (Kǒu tǔ huáng tán), and flow of turbid nasal discharge (Bí liú zhuó shuǐ). Alternatively, there may be red rashes on the body (Shēn fā hóng bān), skin turning black like scorched material (Fā rú jiāo hēi), vomiting saliva resembling red blood (Ǒu xián rú hóng xuè), abdominal enlargement like a round winnowing basket (Fù dà rú yuán jī), ulceration of the tongue with significant swelling (Shé làn tóu dà), pain in the hypochondrium and heart region (Xié tòng xīn téng), among other varied manifestations. Named after their shapes, people attribute this to heavenly disasters, yet they fail to realize that it is all caused by human factors (Rén shì). Although these symptoms are bizarre and cannot be discussed rigidly, they are all due to the accumulation and stagnation of heat-fire toxicity (Huǒ rè zhī dú) that fails to disperse. Fire naturally flares upward; when stagnant, its energy cannot extend freely. Suppressed and constrained, it accumulates within the abdomen, causing severe closure and heat generation. Heat closure forms toxicity, a process that develops over time. Therefore, the treatment method should ideally involve vigorously purging fire toxicity to rapidly relieve the stagnant Qi. However, herbs that purge fire are inherently cold in nature. If one does not first use exterior-releasing agents but instead abruptly applies cold-cooling herbs, the fire pathogen becomes further blocked and unable to reach the exterior, which ultimately harms the patient. Thus, one must combine dispersing methods with purging methods so that the epidemic can be swept away. The formula used is Sanwen Tang (Scatter Plague Decoction): Jingjie (Sanqian, Schizonepetae Spica), Shigao (Wuqian, Gypsum Fibrosum), Xuanshen (Yiliang, Scrophulariae Radix), Tianhuafen (Sanqian, Trichosanthis Radix), Sheng Gancao (Yiqian, Glycyrrhizae Radix et Rhizoma), Huangqin (Erqian, Scutellariae Radix), Chenpi (Yiqian, Citri Reticulatae Pericarpium), Maiya (Erqian, Hordei Fructus Germinatus), Shenqu (Sanqian, Massas Medicatae Fermentatae), Fuling (Wuqian, Poria). Decoct in water and take orally. After one dose, the illness lightens; after two doses, it lightens further; after three doses, full recovery occurs. This formula primarily purges fire from the Lung and Stomach meridians, as the heat of plague often stems from fire in these two meridians. Jingjie assists Shigao and Huangqin to both purge and disperse fire; when fire disperses, heat emerges outward; when fire is purged, toxicity resolves inward. With fire cleared and toxicity eliminated, how can plague spirits cause harm?

I have also heard the teachings of Zhang Zhenren from Nanyang, who stated that plague has traditionally lacked fixed formulas, yet formulas can be predetermined because plague diseases are always heat syndromes. To eliminate fire, reduce heat, resolve pathogens, and expel filth, it is indeed possible to determine a life-saving agent amidst uncertainty. The formula uses: Dahuang (Yiqian, Rheumii Radix et Rhizoma), Jingjie (Yiqian, Schizonepetae Spica), Sheng Gancao (Yiqian, Glycyrrhizae Radix et Rhizoma), Chaihu, Cangzhu, Chuanxiong (each Yiqian), Baizhi (Wufen, Angelicae Dahuricae Radix). Use two bowls of water, decoct until eight-tenths remain. One dose brings back vitality.

This formula differs slightly from Sanwen Tang, but its primary focus on dispersing fire shares the same intent. Treatment methods for plague must not be rigidly adhered to; thus, this formula is recorded below for practitioners to select from.

Master Bogao, courtesy name Huaizhenzi, passed down Yuantian Kujiu Tang (Heavenly Bitter Salvation Decoction) to me, which is also very effective for treating the aforementioned plague, and is attached here: Kushen (Wuqian, Sophorae Flavescentis Radix), Yuanshen (Yiliang, Scrophulariae Radix), Tianhuafen (Wuqian, Trichosanthis Radix). Decoct these three herbs in water and take orally. One dose ensures no threat to life.

It is also said: In occasional cases of plague infection, the corners of the eyes suddenly swell significantly, the body suddenly experiences alternating chills and fever, and the throat swells greatly and hurts. Several days later, bleeding occurs from the nose, delirious speech ensues, cursing and scolding occur upon seeing people, thirst arises, and drinking water leads to incessant diarrhea and dysentery. Within half a month, the person dies. Upon seeing swollen eye corners, immediately treat with Qixing Tang (Seven Stars Decoction); two doses result in cure. If it progresses to diarrhea and dysentery, this formula cannot save the patient. Instead, use Jiawei Shuling Tang (Modified Atractylodes and Poria Decoction) for rescue; if dysentery stops, the patient lives, otherwise, they do not survive. It is better to disseminate formulas for plague prevention than to have plague without remedies; therefore, I describe them fully, hiding nothing. The two formulas are recorded below.

Qixing Tang treats contagious plague characterized by sudden significant swelling of the eye corners, sudden onset of chills and fever, severe throat swelling and pain, cursing, and thirst. Xuanshen, Maidong (each Yiliang, Ophiopogonis Radix), Tianhuafen (Sanqian, Trichosanthis Radix), Gancao (Yiqian, Glycyrrhizae Radix et Rhizoma), Jingjie (Erqian, Schizonepetae Spica), Shenqu (Yiqian, Massas Medicatae Fermentatae), Jiegeng (Erqian, Platycodonis Radix). Decoct in water and take orally. If nasal bleeding occurs, add Xijiao (Yiqian, Rhinocerotis Cornu); do not substitute with Shengma under any circumstances; preferably use Huangqin (one or two qian, Scutellariae Radix).

Jiawei Shuling Tang treats the aforementioned plague symptoms where nasal bleeding is followed by diarrhea and dysentery induced by drinking water. Baizhu (Wuqian, Atractylodis Macrocephalae Rhizoma), Fuling (Yiliang, Poria), Guanzhong (Yiliang, Cibotii Rhizoma), Gancao (Erqian, Glycyrrhizae Radix et Rhizoma), Cheqianzi (Wuqian, Plantaginis Semen). Decoct in water and take orally. If dysentery stops, the patient lives; otherwise, they do not survive.