Library

Qi pain (pain caused by qi stagnation) is all due to the invasion of wind pathogen. Internal residual heat combats with wind. When encountering this syndrome, do not treat it recklessly; the method should be divided into two categories based on cold and heat syndromes.

Qi pain complicating measles is all because internal heat has not been vented, and externally the body is attacked by wind-cold. Food stagnation combats with heat, attacking from both inside and outside, leading to this condition. However, there is a distinction between cold and heat syndromes.

Cold syndromes are easy to treat; heat syndromes are difficult to manage. The practitioner must first probe whether it is a cold or heat syndrome before applying treatment, so as to avoid errors. Whenever this condition occurs, first stir-fry cold rice until hot, wrap it in silk cloth, and rub the patient's chest while it is still hot. If the patient enjoys the rubbing and the pain slightly subsides, this indicates more cold than heat. Administer Xiangzhu Tang (Cinnamon Twig and Evodia Decoction) for immediate ingestion. If vomiting occurs, the cold pathogen will be expelled outward, and the pain will stop immediately; even if no vomiting occurs, recovery will follow. If the pain intensifies after rubbing, this indicates that internal heat toxicity is extremely severe and external wind-cold penetration is deepest. Heat toxicity and wind-cold are knotted in the chest. Vomiting is difficult to reduce it, purgatives are ineffective, warming aggravates it, and cooling fails to subside it. After one or two days, the lungs and stomach rot, leading to death. Even with agents that clear heat, protect the lungs, and clear the stomach, only one or two out of ten may survive.

Zhu stated: The method for testing the cold or heat nature of Qi pain is very refined. However, using stir-fried hot salt for testing is also acceptable. Abdominal pain is not limited to just cold and heat syndromes; it can be caused by qi, blood, phlegm, and food, and includes deficiency pain and excess pain, with various causes.

Xiangzhu Tang: Treats cold pain, intestinal colic (Jiaochang Sha), etc.
Ingredients: Xiangfu Mi (Cyperi Rhizoma), Wuzhuyu (Evodiae Fructus), Wulingzhi (Trogopteri Dung), Taiwuyao (Linderae Radix) (each 3 qian, all stir-fried with vinegar). Decoct in water to make a concentrated juice. Take once. Stop when the disease is cured.

Measles belongs to Yang syndromes, and the body should be warm. If the body is not warm, disaster ensues. If neither the head nor the feet are warm, it is an unfavorable sign; once complications appear, death is imminent.

Head warmth with foot coldness is a reverse syndrome. Do not panic if seen when measles first erupts. If the feet remain cold during the full eruption or resolution phase, even divine prescriptions are useless.

Generalized fever is common in measles; without fever, suffering is unbearable. If the lower body becomes cold below the knees after resolution, this indicates kidney failure, which is untreatable.

Limbs and body cold as snow/ice: if seen during initial fever, toxin cannot emerge. If encountered during full eruption or resolution, spleen and stomach failure and necrosis are certain, leading to death.

In smallpox, head warmth with foot coldness is a favorable (shun) syndrome. In measles, however, head warmth with foot coldness is a reverse (ni) syndrome. Yet, measles cases with cold lower bodies can be either favorable or reverse, distinguished by timing. Why? Measles pathology is primarily located in the upper jiao (diaphragm area). Heat must spread from the head down to the feet. During initial fever, the upper body is intensely hot while the lower body and feet are cool. It is necessary for intense heat to reach the feet for measles to erupt. Therefore, cool lower body and feet during initial fever are a favorable sign. However, after eruption and during resolution, it is best for both upper and lower bodies to be non-cold. Coldness in the lower body at this stage is a reverse sign. After measles resolution, the whole body should be lukewarm as normal. If, after resolution, the whole body is lukewarm but the lower body is cold above the knees, this is kidney failure, an untreatable condition. If during initial eruption, the waist and below are not hot, preventing toxin transparency, and instead gradually resolving, this is also a reverse sign. Urgently warm and nourish the spleen and kidney; survival is possible. To warm the spleen, use Baishao Yao (Paeoniae Radix Alba), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata); Guoren (Pruni Semen) and Baizhu (Atractylodis Macrocephalae Rhizoma) are contraindicated. To nourish the kidney, use Shudihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix); Duzhong (Eucommiae Cortex) and Gouqi (Lycii Fructus) are strictly contraindicated. Only Yangyin Tang (Nourishing Yin Decoction) [see Article 32] should be used, removing Maidong (Ophiopogonis Radix), Yuanshen (Scrophulariae Radix), Bohe (Menthae Haplocalycis Herba), Jingjie (Schizonepetae Spica), and Chuanxiong (Ligustici Chuanxiong Rhizoma), adding Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) to tonify the spleen and nourish the kidney. Measles originates from evil heat in the lungs and stomach, belonging inherently to Yang. Thus, limbs and body should generally remain warm. If limbs and body become cold as ice, it is a major reverse syndrome. If limbs and body are cold as ice during initial or full eruption, toxin cannot penetrate, and measles will gradually resolve prematurely. If limbs and body are cold as ice during resolution or after resolution, this indicates spleen and stomach failure, extreme deficiency of qi and blood, and incomplete expulsion of toxin; it is definitely untreatable.