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Those infected with this poison often die within thirty days. In the region, it is common to experience vomiting or diarrhea, followed by abdominal distension, loss of appetite, and a very fishy odor in the mouth.
In severe cases, the forehead becomes hot and the face red, with veins bulging on the head and face, feeling as if insects are crawling or earthworms moving. Sometimes, one may feel like there are one or two insects inside the nose or ears; this is due to the medicinal qi rushing upward, not actual insects. Alternatively, there may be sounds in the abdomen resembling a snake turning over, accompanied by constipation. If poisoned while drunk in alcohol, not only will the intestines and viscera turn blue-black, but the lungs, liver, heart, and spleen will also be tainted with black qi. One must take medicines that defeat poison, promote toxin expulsion, and detoxify. Severe poisoning results in black stool, while mild poisoning results in blue stool. If the antidote is unknown, the black qi will transform into black spots. With one spot, the abdomen feels like being pricked by needles; with more than ten spots, they open like snake mouths, biting towards the heart like a snake bite, leading to bloody stools, which are mostly incurable. If further administered with mad drugs, the person becomes confused and unconscious; if administered with swelling-inducing drugs, one ear becomes constantly blocked, while the other becomes less red and purulent, feeling like insects crawling. After taking the antidote, the black qi exits with the feces. If any black qi remains impure, strict dietary restrictions are required. Otherwise, upon recurrence, dozens of black spots may appear in the intestines, like two or three snake mouths biting inside the abdomen, and external snake toxins may arrive via wind, causing the patient to be unable to sleep at night.
Also, use realgar powder, garlic cloves, and Acorus tatarinowii (Changpu) mashed and placed in hot water for bathing to ward off "external snakes." If poisoned through alcohol, absolutely do not decoct medicine in an alcohol jar; violating this will cause relapse, making the toxin penetrate deeper. If poisoned through tea, abstain from tea until recovery. When severely ill, avoid overeating, raw/cold/fried foods, all tonics, rain wetting the body and feet, long journeys, and anger. Treat according to the subsequent Zhonggan prescription. Abstain from meat and salt; cook vegetables with one teacup of bamboo shoot water per meal. Those with weak constitutions should frequently decoct Perilla frutescens (Zisu) and Mentha haplocalyx (Bohe) as tea, which are essential herbs, preferably adding wild arrowhead (Cizhu) from fields. Those with strong constitutions should adjust and take the four formulas of Suhe Tang subsequently. Other foods consumed are the same as in the subsequent Zhonggan section. As long as food passes unchanged, such as excreting undigested vegetables or even rice grains after eating rice, the toxin is cleared. Thereafter, after three or four days, when food digestion resumes normally and stools turn yellow, consuming meat, salt, raw/cold items, wine/vinegar, and fried foods is permissible. However, chicken and duck should be avoided for two years, sheep and goose for three years, and fish, shrimp, snails, clams, and other seafood for three to four years. Snakes and frogs must never be eaten for life. The subsequent Zhonggan section has similar dietary restrictions. Among aquatic foods, only soft-shell turtle is safe to eat. Note: In the region, some recovered within one or two days after eating horse meat. Furthermore, those poisoned by Gu who refuse to abstain from meat and salt should reduce salt intake and consume less meat, but must still avoid chicken, duck, fish, and shrimp.