Library

Treating Shanghan (Cold Damage) and Shiqi (Epidemic Qi), if Yin Du (Yin Toxin) forms within one or two days of contracting the disease, or if it transforms into Yin Du six to seven days after taking medication, up to ten days later, presenting with heavy body and stiff back, colicky abdominal pain, difficult throat, toxin attacking the heart, hardness below the heart, shortness of breath and inability to breathe fully, vomiting and regurgitation, cyanotic lips and black complexion, cold limbs, and a pulse that is deep, fine, and rapid. Zhang Zhongjing stated: Regarding the three stages of Yin Du, the body feels as if beaten by a stick, with sore throat; it is treatable at five to six days, but untreatable at seven days.

Gancao (Zhi) [Prepared Licorice Root], Shengma [Cimicifugae Rhizoma], Danggui [Angelicae Sinensis Radix] (each 2 fen), Xionghuang [Realgar], Shujiao [Sichuan Pepper] (1 fen, remove seeds), Guijia [Testudinis Carapax et Plastrum] (1 liang, vinegar-fried), Guizhi [Cinnamomi Ramulus] (2 fen).

Crush the herbs. Take 5 qian per dose, add 1.5 zhan of water, decoct until 0.8 zhan remains, strain. Administer one dose within the time it takes a person to walk five li. Cover warmly to induce sweating; the toxin should exit via sweat, and recovery follows upon sweating. If not cured, administer another dose.

The above citation references Zhang Zhongjing’s statement that it is untreatable at seven days, implying there are other interpretations.

Question: Huoren Shu's Yin Du Gancao Tang cites Zhang Zhongjing saying Yin Du is treatable at five to six days but untreatable at seven days. Why?

Answer: For instance, if internal injury from cold food causes disharmony in the Middle Jiao, manifesting as Shaoyin disease or Jueyin disease, with no fixed pattern in the pulses, extreme internal Yin causes Yang Qi to reverse and ascend. Upon reaching the Yangming channel, there is often delirious speech; upon reaching the Taiyang channel, there is slight headache; upon reaching the Shaoyang channel, alternating chills and fever occur. This is not the standard external contraction disease of Shaoyang. Although this channel exhibits chills and fever, the Spleen is actually affected first. Between Mao and You hours, Earth resides in the middle, connecting to the Gallbladder and Lungs, hence such manifestations. The internal Yang is exhausted here, thus becoming untreatable at seven days. In Yin Zheng (Yin Syndromes), tongue retraction indicates the extinction of Heart Fire, meaning Shen (Spirit) has departed. It is also said: Loss of Shen leads to death. In Yang Zheng (Yang Syndromes), tongue retraction indicates the lack of Water in Shaoyin. External contractions transmitting through the Six Channels should be treated by releasing the exterior first, then purging internally. Internal injuries transmitting through the Three Yang channels should only treat the Three Yin channels; medications are adjusted by addition and subtraction, and cooling medicines are no longer used. With the departure of internal Yang, transmission does not need to proceed sequentially through all Three Yang channels; once it reaches one channel, it ascends to the highest point, hence untreatable at seven days. This summarizes the exhaustion of all Six Channels, so sequential transmission through all Three Yang channels is unnecessary.

Haizang stated: Only Fuzi San explicitly notes Yin Du with cyanotic lips and black complexion; Zhengyang San explicitly notes Yin Du with blue face and black tongue. These two conditions have no hidden Yang, therefore the medicinal ingredients are all warm, hot, acrid, sweet, and devoid of bitter-cold properties.