《素问·阴阳应象大论》，黄帝曰：燥甚则干。又岐伯曰：西方生燥，燥生金，金生辛，辛生肺。 又藏气法时论，岐伯曰：肾主冬，足少阴太阳主治，其日壬癸，肾苦燥，急食辛以润之。 又宣明五气篇曰：肾恶燥。 又天元纪大论，鬼臾区曰：神在天为燥，在地为金。又曰：阳明之上，燥气主之。 又五运行大论，岐伯曰：燥以干之。又曰：故风寒在下，燥热在上，湿气在中，火游行其间。又曰燥胜则地干。 又气交变大论，岐伯曰：岁金太过，燥气流行。又曰：岁木不及，燥乃大行。又曰：西方生燥，燥生金，其德清洁，其化紧敛，其政劲切，其令燥，其变肃杀，其灾苍陨。 又五常政大论，岐伯曰：阳明司天，燥气下临。 《易》曰：燥万物者，莫熯乎火。又曰：火就燥。 《左传》曰：晦淫惑疾。 刘河间《原病式》曰：涩物湿则滑泽，干则涩滞，燥湿相反故也。如遍身中外涩滞，皆属燥金之化，故秋脉KT，KT，涩也。或麻者，亦由涩也。由水液衰少而燥涩。 又曰：枯，不荣生也。涸，无水液也。干，不滋润也。劲，不柔和也。春秋相反，燥湿不同故也。 又曰：经所不取火化渴者，谓渴非特为热。如病寒吐利，亡液过极，则亦燥而渴也。虽病风热，而液尚未衰，则亦不渴，岂可止言渴为热而不为寒也。夫燥渴之为病也，多兼于热，故《易》曰：燥万物者，莫熯乎火。今言渴为燥，则亦备矣。 又曰：病燥过极则烦渴，反兼火化制之也。 又《宣明方》曰：燥干者，金肺之本，肺藏气，以血液内损，气虚感风，则皴揭。风能胜湿，热能耗液，皆能成燥。故经云：风热火兼为阳，寒湿燥同为阴。又燥湿亦异也。然燥金虽属秋阴，而其性异于寒湿，燥阴盛于风热火也。故风热甚而寒湿同于燥也。然中寒吐泻，亡液而成燥者，亦以此矣。故经云：诸涩枯涸，干劲皴揭，皆属于燥也。 张子和曰：燥于外则皮肤皴揭，燥于中则精血枯涸，燥于上则咽鼻焦干，燥于下则便溺结闭。夫燥之为病，是阳明之化也。 《丹溪心法》：消渴便结，列于燥门。（消渴便结，俱见本书，兹不赘。） 王肯堂曰：燥乃阳明燥金，肺与大肠之气也。燥之为病，皆属燥金之化，然能令金燥者，火也。故曰：燥万物者，莫熯乎火。夫金为阴之主，为水之源，而受燥气，寒水生化之源，竭绝于上，而不能灌溉周身，营养百骸，色干而无润泽皮肤，滋生毫毛者，有自来矣。 喻嘉言曰：春伤于风，夏伤于暑，长夏伤于湿，秋伤于燥，冬伤于寒。觉六气配四时之旨，与五运不相背戾，而千古之大疑始一抉也。然则秋燥可无论乎。夫秋不遽燥也。大热之后，继以凉生，凉生而热解，渐至大凉而燥令乃行焉。又曰：病机之诸气膹郁，皆属于肺。诸痿喘嗽，皆属于上。二条明指燥病言矣。生气通天论，谓秋伤于燥，上逆而咳，发为痿厥。燥病之要，一言而终，与病机二条道相吻合，只以误传伤燥为湿。 蒋宝素曰：燥证者，六淫金燥之证也，与火证之燥不同。火气燥烈，烁阴耗液，百病之中皆有。各详本门论治，不得入六淫燥门。金燥之证，在《内经》本无重病，在五运六气，不过言胜复之气耳。前贤误认火证之燥，错作金燥之证。素问阴阳应象大论曰：西方生燥，燥生金。又天元纪大论曰：神在天为燥，在地为金。又曰：阳明之上，燥气主之。又气交变大论曰：岁金太过，燥气流行。又五常政大论曰：阳明司天，燥气下临。又至真要大论曰：阳明司天，其化以燥。此内经诸篇言金燥也。《易》曰：燥万物者。莫熯乎火。又曰：火就燥。此《易》言火气之燥烈也。燥万物之不燥，就万物之已燥，火也。不待火而自燥，火不能就之燥，金也。（兰亭注曰：以诸物试于灯下，诸物之燥，火皆就。惟金燥，火不就。若以金在上，火在下，是火烁，非火就。）金只自燥，不能燥物，火不止燥，能燥万物。万物皆可湿，金不可湿。此金燥与万物之燥所以不同也。火气能燥，风亦能燥，寒亦能燥，皆非固有良能之金燥可比。试以万物与金同入于水，金独不濡。（香海注曰：玉石入水亦不濡者，金石同类也。故李时珍曰：石之精为金为玉，）同入于火，金独不枯。乃见金燥良能之本体，岂可与火燥混同乎。前贤不知金燥本无重病，但见火之燥烈，百病之中皆有，故误以火证之燥，错入金燥之门。盖未考《内经》大易之旨。夫金在气则天，苍苍悠悠，星汉光明而不变也。在质则金，坚强莹洁，万古而不磨灭也。在位则西，东作而西成也。在时则秋，春华而秋实也。在病不过毛发苍陨等疾，犹秋叶之摇落，而根干精华内蕴也。此金气主成功，燥不为重病，故《内经》诸篇，皆以秋伤于湿为病，不言秋伤于燥者是也。刘河间以渴为燥。（此火燥金，非金自燥。）又以血液内损为燥。（此乃火烁，阴消液耗，非金燥所致。）张子和以咽鼻干焦、便溺结秘为燥病。（此火上炎下炽，非金燥。）朱丹溪列消渴便结于燥门。（香海注曰：此皆火燥，非金燥。或曰饮一溲二，大便阴结，岂非金燥乎。曰：溲多内不燥，阴结是火亏，乃水冰地坼之寒燥。）王肯堂言能令金燥者火也。（余侄安伯曰：万物之燥，皆待火。惟金燥不待火，以火灼金，熔化为水液，反无燥象。）喻嘉言以秋伤于燥，谓生气通天论，秋伤于湿，乃误传伤燥与湿，且漫引诸气膹郁诸痿喘呕等病为燥证。（兰亭注曰：《内经》不言秋伤于燥，而曰秋伤于湿，以五行五方五位言之。东方春肝木，生南方夏心火，南方夏心火，生中央长夏脾土，中央长夏脾土，生西方秋肺金，西方秋肺金，生北方冬肾水，北方冬肾水，复生东方春肝木，五行方位相生，如环无端，脾土虽无成位，寄旺四季，然主中央长夏，由南方心火所生，而生西方肺金，然则脾土由南而中，由中而西，旺于夏末秋初之际，故曰长夏。金燥不为重病，湿亦秋之正邪，故可伏而后发，故曰秋伤于湿，冬生咳嗽。喻嘉言才宏笔肆，好作大言欺人，不知金燥玄微，谬以秋燥伤肺，谓《内经》秋伤于湿，乃误传伤燥为湿，妄改经文，不容不辨。）皆未达《内经》金燥固有良能之本体也。夫秋金之气，虽燥见于外，金能生水，而金水蕴于中，内何枯燥之有。如水旺于冬，而冬水易涸者，蕴蓄于内也。岂可谓水涸于冬乎。此金燥所以不为重病者，外燥而内不枯也，而病之中外枯燥者，火也。自河间以来，诸贤所论燥证，俱是火证之燥，非金燥之证，不得入于六淫燥门。兹立燥门，以正六淫名目。略曰：在天为气，在地成形。在天为燥，在地成金。金止于燥，燥而不枯，故为病轻。火不止燥，燥即枯焚，故为病重。故《内经》有火证之燥，无金燥之证，而后世妄意之言，岂足凭哉。
伏邪第八 《椿田医话》曰：小金丹，主治预解伏邪温疫。夫兵荒之后，人多病疫，固在人事，不在天时。然牛疫而人不疫，鸡瘟而鸭不瘟，岂非天乎。盖天时人事两失其宜，疫厉乃作。 大块朱砂（五钱） 明雄黄（五钱） 黑沉香（五钱） 草果仁（五钱） 川厚朴（一两） 鸡心槟榔（两半） 白檀香（一两） 降真香（一两） 锦纹大黄（两半） 为末，神曲糊丸，桐子大，金箔为衣。凡瘟疫盛行之际，空心开水服一钱，每食后仍服三丸，亦可将此丸投入井中及水缸中，不拘多少皆妙，并治山岚瘴气、痎疟、沙蜮、霍乱、邪祟诸证。
柴胡生地汤，主治伏邪温疫，人虚证实，正不敌邪，攻补两难，或攻补失宜，日久不解，余氛未尽，阴液大亏，邪正相持，奄然待毙。 大生地（四钱至八钱） 柴胡根（一钱） 黄芩（钱半） 炙甘草（五分） 当归身（三钱） 赤芍药（二钱） 云茯苓（三钱） 陈橘皮（一钱） 活水芦根（二两） 虚甚加人参一钱，便结加怀牛膝三钱，中胃不开加谷芽、神曲。
柴胡白虎汤，主治伏邪温疫，身热脉浮，有汗心烦口渴等证，非羌防所宜者。 柴胡根（一钱） 黄芩（钱半） 当归身（二钱） 炙甘草（五分） 生石膏（八钱） 白知母（二钱） 淡竹叶（三十片） 晚米（五钱） 痰多加制半夏钱半，陈橘皮一钱。心下满加枳壳一钱，桔梗一钱，或加秋梨二两，或加荸荠六个。
人参大黄汤，主治伏邪温疫，日久失下，阴液枯涸，神志沉迷，溲赤而浑，大便不解，不思米饮，手足掉摇，形消脉夺，攻之元气不继，补之邪结不开，攻之不可，补之不及，两无生理，与其坐待，莫如一决，故立此方，冀其百一。 生大黄（三钱至五钱，或八钱） 人参（一钱至钱半，或三钱） 上二味，长流水另煎和服。
中承气汤，主治伏邪一切下证，虑其大承气太峻，小承气太轻，调胃承气太缓，三乙承气太浑，执其中治宜之。 生大黄（三钱） 玄明粉（二钱） 枳实（一钱） 蒌贝二陈汤，主治里实宜下，人虚证实，非硝黄所宜。 栝蒌仁（四钱） 大贝母（二钱） 赤茯苓（三钱） 生甘草（五分） 制半夏（钱半） 陈橘皮（一钱） 麸炒枳实（一钱） 活水芦根（二两） 或加淡竹茹（钱半） 或加大荸荠（六个） 或加陈海头（二两） 或加滚痰丸（三钱）
治疫大法，汗、下、养阴而已。然下证十居八九，下之当万举万全，下之不当，危亡立见，运用之妙，存乎一心。兹略举其应下诸证，以俟圆机之士。 舌苔起刺，其苔或黑或灰，或黄或白，其舌或强或硬，或短或裂或卷。 唇齿焦黑。 鼻煤如烟熏。 目赤如火烁。 咽喉干燥思冷饮。 心下至少腹痞满胀痛拒按。 溲赤而浑，或涓滴作痛。 大便自利纯臭水不可近，或如败酱。 大便秘结。 二便俱秘。 热厥，厥深热亦深，甚至身冷脉伏。 神昏如醉。 发狂。 消渴。 谵语烦躁。 发痉，身形强直。 未申时潮热。 呃逆腹满，二便不利。 发黄。 畜血。 通宜犀角地黄汤合调胃承气汤下之。素禀阳虚者加制附子，阴亏已极者用生地露煎药，气虚者加人参，痰多者加陈胆星。凡下不必待七日后，有三五日即死，何可待也。有是证则投是药，大都三五日即死者，皆下证也。然有不可下者，大劳大欲之后，及宿疾先亏，年迈气衰，禀赋羸弱，适逢伏邪内发，如空城遇敌，战守两难，惟有犀角地黄汤合生脉散，冀其或免。
《周礼·天官》疾医职曰：疾医掌养万民之疾病，四时皆有厉疾。
《吕氏春秋·孟春纪》曰：孟春行秋令，则民大疫疾。又季春纪曰：季春行夏令，则民多疾疫，时雨不降，山陵不收。又仲夏纪曰：仲夏行秋令，则草木零落，果实早成，民殃于疫。又仲冬纪曰：发盖藏，起大冢，地气且泄，是谓发天之房，诸蛰则死，民多疾疫。
《礼记·月令》曰：孟夏行秋令，则民多大疫。
《史记·扁鹊仓公列传》曰：齐中御府长信病，臣意入诊其脉，告曰：热病气也。然暑汗脉少衰不死。曰：此病得之当浴流水而寒甚，已则热。信曰：唯然。往冬时为王使于楚，至莒县阳周水，而莒桥梁颇坏，信则揽车辕未欲渡也。马惊即堕，信身入水中几死，吏即来救，信出之水中，衣尽濡，有间而身寒，已热如火，至今不可以见寒。臣意即为之汤液火剂逐热，一饮汗尽，再饮热去，三饮病已。即使服药出入二十日，身无病者。所以知信之病者，切其脉时并阴。《脉法》曰：热病阴阳交者死。切之不交，并阴，并阴者，脉顺清而愈。其热虽未尽，犹活也。肾气有时间浊，在太阴脉口而希，是水气也。肾固主水，故以此知之。失治一时，即转为寒热。
《说文》曰：疫，民皆疾也。
《释名》曰：疫，役也。言有鬼行役也。
《张华博物志》曰：汉武帝时，西域月氏国，度弱水贡返魂香三枚，大如燕卵，黑如桑椹。值长安大疫，西使请烧一枚辟之。宫中病者闻之即起，香闻百里，数日不歇。疫死未三日者，熏之皆活。（理之所无，而事或有。芳香解疫则然也。）
《通鉴·唐纪》：关中比岁饥馑，兵民率皆瘦黑，至是麦始熟，市有醉人，当时以为嘉瑞。人乍饱食，死者五之一。
《太平御览》七百四十二卷，载曹植《说疫气》曰：建安二十二年，厉气流行，家家有僵尸之痛，室室有号泣之哀，或阖门而殪，或覆族而丧，或以为疫者，鬼神所作。夫罹此者，悉被褐茹藿之子，荆室蓬户之人耳。若夫殿处鼎食之家，重貂累蓐之门，若是者鲜焉。此乃阴阳失位，寒暑错时，是故生疫，而愚民悬符厌之，亦可笑也。
《元史·耶律楚材列传》曰：材从太祖下灵武，诸将争取子女金帛，材独取遗书及大黄。既而士卒病疫，惟得大黄辄愈。
《九峰医案》曰：第二日憎寒发热，头身腰背俱痛，苔白溲赤，无汗脉数，邪伏膜原，外越太阳经也。 羌活（一钱） 防风（一钱） 川芎（八分） 海南槟榔（一钱） 川厚朴（八分） 草果仁（五分） 酒炒黄芩（一钱） 炙甘草（五分） 赤芍（钱半） 生姜（一片）
《素问·阴阳应象大论》中，黄帝说：燥气过盛则导致干燥。岐伯又说：西方产生燥气，燥气生成金（五行之一），金生成辛味，辛味滋养肺脏。在《藏气法时论》中，岐伯说：肾脏主管冬季，足少阴肾经和足太阳膀胱经主治此季，对应的日子是壬日和癸日，肾脏厌恶干燥，应当立即食用辛味食物来滋润它。在《宣明五气篇》中说：肾脏厌恶燥邪。在《天元纪大论》中，鬼臾区说：神在天表现为燥，在地表现为金。又说：阳明之上，由燥气主司。在《五运行大论》中，岐伯说：燥使物体干枯。又说：所以风寒在下，燥热在上，湿气在中，火气游行于其间。又说：燥胜则大地干枯。在《气交变大论》中，岐伯说：岁运金气太过，燥气流行。又说：岁运木气不及，燥气便大肆横行。又说：西方产生燥气，燥气生成金，其德性清洁，其化育紧缩收敛，其政令刚劲急切，其命令为燥，其变化为肃杀，其灾害为草木苍老陨落。在《五常政大论》中，岐伯说：阳明司天之年，燥气下临。《易经》说：使万物干燥的，没有比火更猛烈了。又说：火趋向于干燥之物。《左传》说：晦淫（过度沉溺于阴柔之事）会导致迷惑之疾。刘河间在《原病式》中说：湿润的物品变得滑泽，干燥的物品变得涩滞，这是燥与湿相反的缘故。如全身内外涩滞，都属于燥金的化生，所以秋季脉象浮涩，涩就是涩滞。或者感觉麻木，也是由于涩滞。这是由于水液衰少而导致的燥涩。又说：枯，是指不能荣养生机。涸，是指无水液。干，是指不滋润。劲，是指不柔和。春秋季节相反，燥湿不同，所以如此。又说：经典中不取用火化解释口渴，是说口渴不仅仅是因为热。如患寒证呕吐腹泻，津液亡失过多，也会因燥而口渴。虽然患风热病，但津液尚未衰少，也不会口渴，怎么能只说口渴是热证而不是寒证呢？这种燥渴作为疾病，多兼有热邪，所以《易经》说：使万物干燥的，没有比火更猛烈了。现在说口渴属于燥，也就完备了。又说：患燥病过极就会烦渴，这是因为反兼火化来制约它。《宣明方》中说：燥干者，是金肺的本性，肺脏藏气，如果血液内部受损，气虚感受风邪，就会导致皮肤皴裂。风能胜湿，热能耗液，都能造成燥。所以经典说：风、热、火兼属阳，寒、湿、燥同为阴。而且燥与湿也是不同的。然而燥金虽然属于秋天的阴气，但其性质不同于寒湿，燥阴盛于风热火之上。所以风热甚而寒湿同于燥。然而中寒呕吐泄泻，津液亡失而成燥的，也是因为这个原因。所以经典说：各种涩滞、枯涸、干劲、皴揭，都归属于燥。张子和说：燥在外则皮肤皴裂，燥在内则精血枯涸，燥在上则咽喉鼻腔焦干，燥在下则大小便结闭。这种燥作为疾病，是阳明气的化生。《丹溪心法》：消渴和大便干结，列在燥门。（消渴和大便干结，详见本书，此处不再赘述。）王肯堂说：燥是阳明燥金，是肺与大肠的气。燥作为疾病，都归属于燥金的化生，然而能使金燥的是火。所以说：使万物干燥的，没有比火更猛烈了。金是阴的主宰，是水的源头，而受燥气影响，寒水是生化之源，如果在上面枯竭绝灭，就不能灌溉周身，营养百骸，面色干枯而没有润泽的皮肤，滋生毫毛，是有其原因的。喻嘉言说：春伤于风，夏伤于暑，长夏伤于湿，秋伤于燥，冬伤于寒。觉得六气配四时的宗旨，与五运不相违背，千古的大疑这才解开。那么秋燥可以不论吗？秋天不突然就燥。大热之后，接着产生凉意，凉意产生而热解，逐渐到大凉而燥令才施行。又说：病机中的诸气痞满郁结，都归属于肺。诸痿喘咳，都归属于上。这两条明确指的就是燥病。《生气通天论》说：秋伤于燥，气上逆而咳嗽，发为痿厥。燥病的要点，一句话就结束了，与病机的两条道理相吻合，只是误传将伤燥说成伤湿。蒋宝素说：燥证，是六淫中金燥的证候，与火证的燥不同。火气燥烈，灼烧阴液，消耗津液，百病之中都有。各详本门论治，不得入六淫燥门。金燥的证候，在《内经》中本来没有重病，在五运六气中，不过是说胜复之气罢了。前贤误认火证的燥，错作金燥的证候。《素问·阴阳应象大论》说：西方生燥，燥生金。又《天元纪大论》说：神在天为燥，在地为金。又说：阳明之上，燥气主之。又《气交变大论》说：岁金太过，燥气流行。又《五常政大论》说：阳明司天，燥气下临。又《至真要大论》说：阳明司天，其化以燥。这些《内经》各篇说的是金燥。《易经》说：燥万物者。又说：火就燥。这是《易经》说的火气的燥烈。使万物不燥的，趋向于万物已燥的，是火。不等待火而自己燥的，火不能趋向它的燥，是金。（兰亭注说：拿各种物品在灯下试验，各种物品的燥，火都趋向。只有金燥，火不趋向。如果把金放在上面，火放在下面，那是火熔化金，不是火趋向金。）金只自己燥，不能使物燥，火不止于燥，能使万物燥。万物都可以湿，金不可湿。这就是金燥与万物的燥不同的原因。火气能燥，风也能燥，寒也能燥，都不是固有的良能的金燥可比的。试把万物与金一同放入水中，金独不湿。（香海注说：玉石入水也不湿，是因为金石同类。所以李时珍说：石的精华是金是玉。）一同放入火中，金独不枯。这才见到金燥良能的本质，怎么可以与火燥混同呢？前贤不知道金燥本来没有重病，只见火的燥烈，百病之中都有，所以误把火证的燥，错入金燥的门。大概没有考察《内经》和《易经》的宗旨。金在气则是天，苍苍悠悠，星汉光明而不改变。在质则是金，坚强莹洁，万古而不磨灭。在位则是西，东作而西成。在时则是秋，春华而秋实。在病不过毛发苍白陨落等疾，就像秋叶摇落，而根干精华内蕴。这是金气主成功，燥不为重病，所以《内经》各篇，都以秋伤于湿为病，不说秋伤于燥的原因就在这里。刘河间以渴为燥。（这是火燥金，不是金自燥。）又以血液内损为燥。（这是火烁，阴消液耗，不是金燥所致。）张子和以咽鼻干焦、大小便结秘为燥病。（这是火上炎下炽，不是金燥。）朱丹溪列消渴大便干结于燥门。（香海注说：这些都是火燥，不是金燥。有人说饮一溲二，大便阴结，难道不是金燥吗？回答说：尿多内不燥，阴结是火亏，是水冰地坼的寒燥。）王肯堂说能使金燥的是火。（我侄子安伯说：万物的燥，都等待火。只有金燥不等待火，用火灼金，熔化为水液，反而没有燥象。）喻嘉言以秋伤于燥，说《生气通天论》中“秋伤于湿”，是误传伤燥为湿，并且随意引用诸气痞满、诸痿喘呕等疾病作为燥证。（兰亭注说：《内经》不说秋伤于燥，而说秋伤于湿，从五行五方五位来说。东方春肝木，生南方夏心火，南方夏心火，生中央长夏脾土，中央长夏脾土，生西方秋肺金，西方秋肺金，生北方冬肾水，北方冬肾水，复生东方春肝木，五行方位相生，如环无端，脾土虽然没有成位，寄旺四季，然而主中央长夏，由南方心火所生，而生西方肺金，然而脾土由南而中，由中而西，旺于夏末秋初之际，所以叫长夏。金燥不为重病，湿也是秋的邪气，所以可伏而后发，所以说秋伤于湿，冬生咳嗽。喻嘉言才宏笔肆，喜欢说大话欺人，不知道金燥玄微，谬以秋燥伤肺，说《内经》秋伤于湿，是误传伤燥为湿，妄改经文，不容不辨。）都没有通达《内经》金燥固有良能的本质。秋天的金气，虽然燥见于外，金能生水，而金水蕴于中，内部有什么枯燥的呢？如水旺于冬，而冬水容易枯竭的，是因为蕴蓄于内。怎么能说水在冬天枯竭呢？这就是金燥之所以不为重病的原因，外燥而内不枯，而病中的内外枯燥，是火。自从河间以来，各位贤者所论述的燥证，都是火证的燥，不是金燥的证候，不得入于六淫燥门。现在设立燥门，以正六淫名目。大致说：在天为气，在地成形。在天为燥，在地成金。金止于燥，燥而不枯，所以为病轻。火不止于燥，燥即枯焚，所以为病重。所以《内经》有火证的燥，没有金燥的证候，而后世妄意的言论，哪里值得相信呢。
伏邪第八 《椿田医话》说：小金丹，主治预先解除伏邪温疫。战争饥荒之后，人们多患疫病，固然在于人事，不在于天时。然而牛得瘟疫而人不感染，鸡得瘟病而鸭不得，这难道不是天意吗？大概是天时人事两失其宜，疫厉才发作。大块朱砂（五钱） 明雄黄（五钱） 黑沉香（五钱） 草果仁（五钱） 川厚朴（一两） 鸡心槟榔（一两半） 白檀香（一两） 降真香（一两） 锦纹大黄（一两半） 研为细末，神曲糊丸，梧桐子大，金箔为衣。凡是瘟疫盛行之际，空腹开水送服一钱，每顿饭后再服三丸，也可以将此丸投入井中和水缸中，不拘多少都好，并治山岚瘴气、疟疾、沙蜮、霍乱、邪祟等各种证候。
柴胡生地汤，主治伏邪温疫，人体虚而病证实，正气不敌邪气，攻补两难，或者攻补失宜，日久不解，余氛未尽，阴液大亏，邪正相持，奄奄一息等待死亡。大生地（四钱至八钱） 柴胡根（一钱） 黄芩（钱半） 炙甘草（五分） 当归身（三钱） 赤芍药（二钱） 云茯苓（三钱） 陈橘皮（一钱） 活水芦根（二两） 虚甚加人参一钱，大便干结加怀牛膝三钱，中胃不开加谷芽、神曲。
柴胡白虎汤，主治伏邪温疫，身体发热脉浮，有汗心烦口渴等证，不适合用羌活、防风治疗的。柴胡根（一钱） 黄芩（钱半） 当归身（二钱） 炙甘草（五分） 生石膏（八钱） 白知母（二钱） 淡竹叶（三十片） 晚米（五钱） 痰多加制半夏钱半，陈橘皮一钱。心下满加枳壳一钱，桔梗一钱，或加秋梨二两，或加荸荠六个。
人参大黄汤，主治伏邪温疫，日久失于攻下，阴液枯涸，神志沉迷，小便赤而浑浊，大便不解，不思饮食，手足掉摇，形体消瘦脉象微弱，攻之元气不继，补之邪结不开，攻不可，补不及，两无生理，与其坐以待毙，不如决一死战，所以立此方，希望有一线生机。生大黄（三钱至五钱，或八钱） 人参（一钱至钱半，或三钱） 以上两味，长流水另煎和服。
中承气汤，主治伏邪一切下证，担心大承气汤太峻猛，小承气汤太轻微，调胃承气汤太缓慢，三乙承气汤太浑杂，执其中治宜。生大黄（三钱） 玄明粉（二钱） 枳实（一钱） 蒌贝二陈汤，主治里实宜下，人体虚而病证实，不适合用硝黄治疗的。栝蒌仁（四钱） 大贝母（二钱） 赤茯苓（三钱） 生甘草（五分） 制半夏（钱半） 陈橘皮（一钱） 麸炒枳实（一钱） 活水芦根（二两） 或加淡竹茹（钱半） 或加大荸荠（六个） 或加陈海头（二两） 或加滚痰丸（三钱）
治疗疫病的大法，汗、下、养阴而已。然而下证十居八九，下之当万举万全，下之不当，危亡立见，运用之妙，存乎一心。这里略举其应下的诸证，以等待圆机之士。舌苔起刺，其苔或黑或灰，或黄或白，其舌或强或硬，或短或裂或卷。唇齿焦黑。鼻煤如烟熏。目赤如火烁。咽喉干燥思冷饮。心下至少腹痞满胀痛拒按。小便赤而浑浊，或涓滴作痛。大便自利纯臭水不可近，或如败酱。大便秘结。二便俱秘。热厥，厥深热亦深，甚至身冷脉伏。神昏如醉。发狂。消渴。谵语烦躁。发痉，身形强直。未申时潮热。呃逆腹满，二便不利。发黄。畜血。通宜犀角地黄汤合调胃承气汤下之。素禀阳虚者加制附子，阴亏已极者用生地露煎药，气虚者加人参，痰多者加陈胆星。凡下不必待七日后，有三五日即死，何可等待呢。有是证则投是药，大都三五日即死的，都是下证。然而有不可下的，大劳大欲之后，及宿疾先亏，年迈气衰，禀赋羸弱，适逢伏邪内发，如空城遇敌，战守两难，惟有犀角地黄汤合生脉散，希望或许能免。
《周礼·天官》疾医职说：疾医掌管养育万民的疾病，四季都有厉疾。
《吕氏春秋·孟春纪》说：孟春实行秋令，则百姓大患疫疾。又季春纪说：季春实行夏令，则百姓多患疾疫，时雨不降，山陵不收。又仲夏纪说：仲夏实行秋令，则草木零落，果实早成，百姓遭殃于疫。又仲冬纪说：发掘储藏，兴起大墓，地气且泄，这叫开发天的库房，诸蛰虫则死，百姓多患疾疫。
《礼记·月令》说：孟夏实行秋令，则百姓多大疫。
《史记·扁鹊仓公列传》说：齐国中御府长信生病，臣意进去诊脉，告诉他说：这是热病气。然而暑天出汗脉少衰不死。说：这病得之于应当在流水中洗澡而寒气很重，过后就发热。长信说：是的。往年冬天为王出使楚国，到莒县阳周水，而莒桥梁颇坏，长信则揽车辕不想渡河。马惊即堕，长信身入水中几乎死，官吏就来救，长信出水，衣服尽湿，过了一会儿身体寒，过后热如火，至今不可以见寒。臣意就为他做汤液火剂逐热，一饮汗尽，再饮热去，三饮病已。即使服药出入二十日，身无病者。所以知道长信的病，切其脉时并阴。《脉法》说：热病阴阳交者死。切之不交，并阴，并阴者，脉顺清而愈。其热虽未尽，犹活也。肾气有时间浊，在太阴脉口而希，是水气也。肾固主水，所以以此知之。失治一时，即转为寒热。
《说文》说：疫，民皆疾也。
《释名》说：疫，役也。言有鬼行役也。
《张华博物志》说：汉武帝时，西域月氏国，度弱水贡返魂香三枚，大如燕卵，黑如桑椹。正值长安大疫，西使请烧一枚辟之。宫中病者闻之即起，香闻百里，数日不歇。疫死未三日者，熏之皆活。（理之所无，而事或有。芳香解疫则然也。）
《通鉴·唐纪》：关中连年饥馑，兵民率皆瘦黑，至此麦子始熟，市有醉人，当时以为嘉瑞。人乍饱食，死者五之一。
《太平御览》七百四十二卷，载曹植《说疫气》说：建安二十二年，厉气流行，家家有僵尸之痛，室室有号泣之哀，或阖门而殪，或覆族而丧，或以为疫者，鬼神所作。遭受此灾的，都是穿粗布吃野菜的儿子，荆室蓬户之人耳。至于殿处鼎食之家，重貂累蓐之门，像这样的人很少。这是阴阳失位，寒暑错时，所以生疫，而愚民悬符厌之，也可笑啊。
《元史·耶律楚材列传》说：耶律楚材跟随太祖攻下灵武，众将争取子女金帛，楚材唯独取遗书及大黄。不久士卒病疫，唯独得到大黄就痊愈了。
《九峰医案》说：第二日憎寒发热，头身腰背俱痛，苔白溲赤，无汗脉数，邪伏膜原，外越太阳经也。羌活（一钱） 防风（一钱） 川芎（八分） 海南槟榔（一钱） 川厚朴（八分） 草果仁（五分） 酒炒黄芩（一钱） 炙甘草（五分） 赤芍（钱半） 生姜（一片）
In the *Suwen: Yin-Yingyingxiang Dalun* (Basic Questions: The Great Treatise on the Correspondence of Yin and Yang), Huangdi said: When dryness is excessive, it leads to dryness. Qibo further stated: The West generates Dryness; Dryness generates Metal (one of the Five Phases); Metal generates the Pungent flavor; the Pungent flavor nourishes the Lung organ. In the *Zangqi Fashi Lun* (Treatise on the Methods of Organ Qi matching the Seasons), Qibo said: The Kidney governs Winter; the Foot-Shaoyin Kidney Meridian and Foot-Taiyang Bladder Meridian govern this season; the corresponding days are Ren and Gui days. The Kidney dislikes Dryness; one should immediately consume Pungent foods to moisten it. In the *Xuanming Wuqi Pian* (Chapter on the Manifestation of the Five Qi), it is said: The Kidney abhors Dryness. In the *Tianyuanji Dalun* (Great Treatise on the Heavenly Origin), Gui Yuzhou said: The Spirit manifests as Dryness in Heaven, and as Metal on Earth. It also states: Above Yangming, Dryness Qi governs. In the *Wuyunxing Dalun* (Great Treatise on the Movement of the Five Phases), Qibo said: Dryness causes things to wither. It also states: Therefore, Wind-Cold is below, Dryness-Heat is above, Dampness is in the middle, and Fire Qi travels between them. It also says: When Dryness prevails, the earth becomes dry. In the *Jiaobi Da Dalun* (Great Treatise on the Great Changes of Qi Intersection), Qibo said: When the Yearly Metal Phase is excessive, Dryness Qi circulates widely. It also states: When the Yearly Wood Phase is deficient, Dryness Qi acts extensively. It further says: The West generates Dryness; Dryness generates Metal. Its virtue is cleanliness; its transformation is contraction and gathering; its administration is vigorous and cutting; its command is Dryness; its change is solemn killing; its disaster is the withering and falling of vegetation. In the *Wuchangzheng Dalun* (Great Treatise on the Normal Policies of the Five Phases), Qibo said: In years where Yangming rules the Heaven, Dryness Qi descends. The *I Ching* (Book of Changes) says: Among all things that dry up others, none is more blazing than Fire. It also says: Fire tends toward dryness. The *Zuo Zhuan* (Commentary of Zuo) says: Excessive indulgence in Yin [sexual excess] leads to confusion and disease. Liu Hejian, in his *Yuanbing Shi* (Original Causes of Disease), said: Wet objects become slippery when moistened, but become astringent and stagnant when dry; this is because Dryness and Dampness are opposites. For example, if the whole body feels astringent and stagnant inside and out, it belongs to the transformation of Dryness-Metal. Therefore, the autumn pulse is floating and astringent (se). Astringency means stagnation. Or numbness, which is also due to astringency. This is caused by the decline of body fluids leading to dryness and astringency. He also said: "Ku" (withered) means failing to nourish life. "He" (dried up) means having no water/fluids. "Gan" (dry) means lacking moisture. "Jin" (stiff/tough) means lacking softness. Spring and Autumn are opposite, Dryness and Dampness are different, hence the distinction. He further stated: The classics do not attribute thirst solely to Fire transformation, meaning thirst is not exclusively caused by Heat. For instance, in cases of Cold syndrome with vomiting and diarrhea, if fluids are excessively lost, dryness and thirst will also occur. Although suffering from Wind-Heat, if fluids have not yet declined, there will be no thirst. How can one only say thirst is Heat and not Cold? This disease of Dryness-Thirst often accompanies Heat, so the *I Ching* says: Among all things that dry up others, none is more blazing than Fire. Now saying thirst belongs to Dryness makes it complete. He also said: When Dryness disease is extreme, it causes irritability and thirst, counteracting via Fire transformation. The *Xuanming Fang* (Prescriptions of Xuanming) stated: Dryness and dryness belong to the root nature of Metal and Lung. The Lung stores Qi. If internal blood is damaged and Qi is deficient, allowing Wind invasion, the skin will crack and peel. Wind overcomes Dampness, Heat consumes fluids; both can cause Dryness. Thus, the classics say: Wind, Heat, and Fire jointly belong to Yang; Cold, Dampness, and Dryness jointly belong to Yin. Moreover, Dryness and Dampness are distinct. Although Dryness-Metal belongs to Autumn Yin, its nature differs from Cold-Dampness; Dryness Yin is superior to Wind-Heat-Fire. Therefore, when Wind-Heat is severe, Cold-Dampness aligns with Dryness. However, Middle-Jiao Cold with vomiting and diarrhea, leading to fluid loss and Dryness, is also due to this. Thus, the classics say: All astringency, withering, drying up, stiffness, and skin cracking belong to Dryness. Zhang Zihe said: Dryness outside causes skin cracking; Dryness inside causes withering of essence and blood; Dryness above causes scorching dryness of throat and nose; Dryness below causes constipation and urinary retention. This Dryness as a disease is the transformation of Yangming. *Danxi Xinfa*: Xiao Ke (Wasting-Thirst) and stool constipation are listed in the Dryness section. (Xiao Ke and stool constipation are detailed elsewhere in this book, omitted here.) Wang Kentang said: Dryness is Yangming Dryness-Metal, the Qi of the Lung and Large Intestine. Diseases of Dryness all belong to the transformation of Dryness-Metal, yet what makes Metal dry is Fire. Hence it is said: Among all things that dry up others, none is more blazing than Fire. Metal is the master of Yin and the source of Water. Receiving Dryness Qi, if the source of Cold-Water exhausts above and cannot irrigate the body or nourish the bones, resulting in dry complexion and lack of lustrous skin and hair growth, there is a reason. Yu Jiayan said: Injury by Wind in Spring, Summerheat in Summer, Dampness in Late Summer, Dryness in Autumn, and Cold in Winter. I feel the principle of matching the Six Qi to the Four Seasons does not contradict the Five Movements, resolving a millennium-old doubt. Then how can Autumn Dryness be ignored? Autumn does not suddenly become dry. After intense heat, coolness arises; as coolness increases and heat dissipates, gradually reaching great coolness, the Dryness command then operates. He also said: In the Pathogenesis, all Qi stagnation and depression belong to the Lung. All Wei, wheezing, and coughing belong to the Upper Jiao. These two points clearly refer to Dryness diseases. The *Shengqi Tongtian Lun* (Treatise on Life Energy Connecting to Heaven) states: Autumn injury by Dryness causes upward rebellion and cough, developing into Wei Jue (impotence/weakness). The essence of Dryness disease is summarized in one sentence, consistent with the two pathogenesis points, except for the mis-transmission of injuring Dryness as injuring Dampness. Jiang Baosu said: Dryness syndromes are those of the Metal Dryness among the Six Exogenous Pathogens, differing from the Dryness of Fire syndromes. Fire Qi is fierce, scorching Yin and consuming fluids, present in many diseases. Each should be treated according to its own section, not entering the Six Exogenous Dryness section. Dryness-Metal syndromes had no severe diseases in the *Neijing*; in the Five Movements and Six Qi, they merely speak of overcoming and retaliating Qi. Predecessors mistakenly identified Fire Dryness as Metal Dryness. *Suwen: Yin-Yingxiang Dalun* says: The West generates Dryness; Dryness generates Metal. *Tianyuanji Dalun* says: The Spirit is Dryness in Heaven, Metal on Earth. It also says: Above Yangming, Dryness Qi governs. *Jiaobi Da Dalun* says: When Yearly Metal is excessive, Dryness Qi circulates. *Wuchangzheng Dalun* says: When Yangming rules Heaven, Dryness Qi descends. *Zhizhen Yao Dalun* says: When Yangming rules Heaven, its transformation is Dryness. These Neijing chapters discuss Metal Dryness. The *I Ching* says: Drying up all things... and Fire tends toward dryness. This refers to the fierceness of Fire Qi. Fire dries things that are not yet dry and tends toward things already dry; this is Fire. Things that dry themselves without waiting for Fire, which Fire cannot tend toward, are Metal. (Lanting notes: Testing items under a lamp, Fire tends toward the dryness of all items. Only Metal's dryness, Fire does not tend toward. If Metal is above and Fire below, it is Fire melting Metal, not Fire tending toward Metal.) Metal only dries itself, it cannot dry other things; Fire not only dries but can dry all things. All things can be wetted, but Metal cannot be wetted. This is why Metal Dryness differs from the dryness of other things. Fire Qi can dry, Wind can dry, Cold can dry, but none compare to the inherent capability of Metal Dryness. Try putting all things and Metal into water; only Metal does not become wet. (Xianghai notes: Jade and stone also do not become wet, as metal and stone are of the same category. Li Shizhen said: The essence of stone is Metal and Jade.) Put them into fire; only Metal does not wither. This reveals the true nature of Metal Dryness; how can it be confused with Fire Dryness? Predecessors did not know Metal Dryness inherently lacks severe disease; seeing Fire's fierceness in many diseases, they mistakenly placed Fire Dryness into the Metal Dryness category. They failed to examine the principles of the *Neijing* and *I Ching*. Metal in Qi is Heaven, vast and bright, unchanging. In substance, it is Metal, strong and pure, enduring forever. In position, it is West, East produces, West completes. In time, it is Autumn, Spring flowers, Autumn fruits. In disease, it is limited to ailments like pale hair and falling leaves, like autumn leaves dropping while roots and essence remain stored within. This shows Metal Qi achieves success; Dryness is not a severe disease. Thus, the *Neijing* chapters attribute Autumn illness to Dampness, not Dryness, for this reason. Liu Hejian equated thirst with Dryness (This is Fire drying Metal, not Metal self-drying). He also equated internal blood damage with Dryness (This is Fire scorching, Yin declining and fluids depleting, not caused by Metal Dryness). Zhang Zihe equated scorching dryness of throat/nose and constipation with Dryness disease (This is Fire flaming upward and burning downward, not Metal Dryness). Zhu Danxi listed Xiao Ke and constipation in the Dryness section (Xianghai notes: These are all Fire Dryness, not Metal Dryness. Some ask: Drinking much and urinating much, yin constipation, isn't this Metal Dryness? Answer: Frequent urination means interior is not dry; yin constipation is Fire deficiency, representing the cold dryness of frozen water and cracked earth). Wang Kentang said what makes Metal dry is Fire (My nephew Anbo said: The dryness of all things awaits Fire. Only Metal Dryness does not await Fire; burning Metal melts it into liquid, removing the dry appearance). Yu Jiayan cited Autumn injury by Dryness, claiming the *Shengqi Tongtian Lun*'s "Autumn injury by Dampness" was a mis-transmission of injuring Dryness as Dampness, and arbitrarily cited Qi stagnation, Wei, wheezing, and vomiting as Dryness syndromes (Lanting notes: The *Neijing* does not say Autumn injury by Dryness, but by Dampness. Considering Five Phases, Five Directions, and Five Positions: East-Spring-Liver-Wood generates South-Summer-Heart-Fire; South-Summer-Heart-Fire generates Central-Late Summer-Spleen-Earth; Central-Late Summer-Spleen-Earth generates West-Autumn-Lung-Metal; West-Autumn-Lung-Metal generates North-Winter-Kidney-Water; North-Winter-Kidney-Water regenerates East-Spring-Liver-Wood. The cycle is endless. Spleen Earth has no fixed position but thrives in the four seasons, governing Central Late Summer, generated by South Heart Fire, generating West Lung Metal. Thus Spleen Earth moves from South to Center, Center to West, thriving at the end of Summer and beginning of Autumn, hence called Late Summer. Metal Dryness is not a severe disease; Dampness is also an Autumn pathogen, capable of lying dormant and manifesting later, hence "Autumn injury by Dampness, Winter generates cough." Yu Jiayan was eloquent but prone to exaggeration, unaware of the subtleties of Metal Dryness. He erroneously claimed Autumn Dryness injures the Lung, stating the *Neijing*'s "Autumn injury by Dampness" was a mis-transmission of injuring Dryness as Dampness, and absurdly altered the text, requiring refutation.) None understood the inherent nature of Metal Dryness in the *Neijing*. Autumn Metal Qi, though appearing dry externally, generates Water, and Metal-Water is stored internally; how can there be internal dryness? Like Water thriving in Winter, yet Winter water easily drying up because it is stored internally. How can one say Water dries up in Winter? This is why Metal Dryness is not a severe disease: external dryness but internal non-withering. The internal and external dryness in diseases is Fire. Since Hejian, all discussions of Dryness syndromes by sages were Fire Dryness, not Metal Dryness, and should not enter the Six Exogenous Dryness section. Now establishing the Dryness section to correct the names of the Six Exogenous Pathogens. Briefly: In Heaven it is Qi, on Earth it forms shape. In Heaven it is Dryness, on Earth it becomes Metal. Metal stops at dryness; dry but not withered, thus disease is mild. Fire does not stop at dryness; dryness leads to withering and burning, thus disease is severe. Therefore, the *Neijing* has Fire Dryness but no Metal Dryness syndrome. Later baseless remarks are unreliable.
Formulas for Fire Syndromes: Yuhu Dan (25); Xue Lizhai's Modified Bawei Wan (26).
Latent Pathogen Chapter 8: *Chuntian Yihua* states: Xiaojin Dan treats the preemptive resolution of latent pathogenic warm epidemics. After war and famine, people often suffer epidemics, which depends on human affairs rather than heavenly timing. Yet cattle get plague while humans do not; chickens get pestilence while ducks do not. Is this not heaven? It seems when both heavenly timing and human affairs fail, epidemics arise. Cinnabar (5 qian), Realgar (5 qian), Black Agarwood (5 qian), Tsao-ko Kernel (5 qian), Magnolia Bark (1 liang), Betel Nut (1.5 liang), White Sandalwood (1 liang), Dalbergia Odorifera (1 liang), Rhubarb (1.5 liang). Grind into powder, bind with Fermented Rice Pill paste, make pills the size of tung tree seeds, coat with gold foil. During epidemic outbreaks, take 1 qian on an empty stomach with boiled water, and 3 pills after each meal. Pills can also be thrown into wells or water vats, any amount is effective. Also treats mountain miasma, malaria, sand demons, cholera, and evil spirits.
Chaihu Shengdi Tang: Treats latent pathogenic warm epidemics where the patient is weak but the pathogen is strong, righteous Qi cannot overcome evil, making attack and tonification difficult, or improper use leads to prolonged unresolved illness, residual pathogens remain, Yin fluids severely depleted, pathogen and righteous Qi stalemate, nearing death. Raw Rehmannia Root (4-8 qian), Bupleurum Root (1 qian), Scutellaria Root (1.5 qian), Prepared Licorice Root (0.5 qian), Angelica Sinensis Body (3 qian), Red Peony Root (2 qian), Poria (3 qian), Tangerine Peel (1 qian), Fresh Reed Rhizome (2 liang). For severe weakness add Ginseng (1 qian); for constipation add Achyranthes Bidentata (3 qian); for poor digestion add Millet Sprout and Fermented Rice Pill.
Chaihu Baitu Tang: Treats latent pathogenic warm epidemics with fever, floating pulse, sweating, irritability, and thirst, unsuitable for Notopterygium and Saposhnikovia. Bupleurum Root (1 qian), Scutellaria Root (1.5 qian), Angelica Sinensis Body (2 qian), Prepared Licorice Root (0.5 qian), Raw Gypsum (8 qian), Anemarrhena Rhizome (2 qian), Light Bamboo Leaf (30 slices), Rice (5 qian). For excess phlegm add Processed Pinellia Ternata (1.5 qian) and Tangerine Peel (1 qian). For fullness below the heart add Aurantium Fructus (1 qian) and Platycodon Root (1 qian), or add Autumn Pear (2 liang) or Water Chestnut (6 pieces).
Renshen Dahuang Tang: Treats latent pathogenic warm epidemics where purgatives were delayed for too long, Yin fluids are withered, consciousness is dull, urine is red and turbid, stool is retained, appetite is absent, limbs tremble, body emaciated, pulse is faint. Attack fails to sustain Yuan Qi; tonification fails to resolve pathogen binding. Both attack and tonification are futile; better to decide than wait passively. Hence this formula is established for a slim chance. Raw Rhubarb (3-5 qian, or 8 qian), Ginseng (1-1.5 qian, or 3 qian). Decoct these two separately in flowing water and mix before taking.
Zhong Chengqi Tang: Treats all purgative indications for latent pathogens. Worrying that Dachengqi Tang is too harsh, Xiaochengqi Tang too mild, Tiaowei Chengqi Tang too slow, and San Yi Chengqi Tang too complex, it holds the middle ground. Raw Rhubarb (3 qian), Mirabilite (2 qian), Immature Bitter Orange (1 qian).
Loubei Erchen Tang: Treats interior excess requiring purgation, where the patient is weak but the pathogen is strong, unsuitable for Mirabilite and Rhubarb. Trichosanthes Seed (4 qian), large Fritillaria Bulb (2 qian), Red Poria (3 qian), Raw Licorice Root (0.5 qian), Processed Pinellia Ternata (1.5 qian), Tangerine Peel (1 qian), Bran-fried Immature Bitter Orange (1 qian), Fresh Reed Rhizome (2 liang). Optionally add Light Bamboo Shavings (1.5 qian), large Water Chestnut (6 pieces), aged dried tangerine peel (2 liang), or Gaotan Wan (3 qian).
The general method for treating epidemics involves sweating, purging, and nourishing Yin. However, purgative indications account for 80-90%. Purging correctly ensures success; incorrectly, danger and death follow immediately. The subtlety lies in the mind. Here are briefly listed the indications for purging, for skilled practitioners. Tongue coating prickly, black, gray, yellow, or white; tongue stiff, hard, short, cracked, or curled. Lips and teeth scorched black. Nose coal-like as if smoked. Eyes red as if scorched. Throat dry craving cold drinks. Fullness, distension, pain, and refusal to press from chest to lower abdomen. Urine red and turbid, or painful drops. Diarrhea of pure foul-smelling water or like spoiled sauce. Severe constipation. Both stool and urine blocked. Heat Jue (cold extremities), deeper Jue means deeper heat, even cold body and hidden pulse. Coma like drunkenness. Mania. Wasting-thirst. Delirious speech and irritability. Convulsions with rigid body. Tidal fever at Wei/Shen hours (1-5 PM). Hiccups, abdominal fullness, inability to pass stool/urine. Jaundice. Blood stasis. Generally suitable to purge using Xijiao Dihuang Tang combined with Tiaowei Chengqi Tang. For those constitutionally Yang-deficient, add Processed Aconite Root. For extreme Yin deficiency, decoct medicine with Raw Rehmannia Dew. For Qi deficiency, add Ginseng. For excess phlegm, add aged Pinellia with Alum. Do not wait seven days for purging; some die in three to five days. With these signs, administer these medicines. Most dying in three to five days have purgative indications. However, there are contraindications: after severe labor or sexual excess, pre-existing deficiency, advanced age with declining Qi, weak constitution, or sudden latent pathogen emergence, like an empty city facing enemies, where fighting or defending is difficult. Use Xijiao Dihuang Tang combined with Shengmai San, hoping for survival.
*Rites of Zhou - Heavenly Officials*, Physician Department: Physicians manage the diseases of the myriad people; there are epidemic diseases in all four seasons.
*Lüshi Chunqiu - Mengchun Ji*: In early spring, if autumn measures are taken, the people will suffer major epidemics. In late spring, if summer measures are taken, the people will suffer many epidemics, seasonal rains will not fall, and hills will not yield harvest. In midsummer, if autumn measures are taken, grass and trees will wither, fruits will ripen early, and people will suffer epidemics. In midwinter, if storehouses are opened and large tombs dug, earth Qi will leak, called opening heaven's granary; hibernating insects will die, and people will suffer many epidemics.
*Liji - Yueling*: In early summer, if autumn measures are taken, the people will suffer major epidemics.
*Records of the Grand Historian - Biographical Sketches of Bian Que and Cang Gong*: Chang Xin, Director of the Qi Imperial Carriage Office, fell ill. Cang Gong examined his pulse and said: This is Heat Qi disease. However, sweating in summer with a slightly weakened pulse indicates survival. He said: This illness resulted from bathing in running water while very cold, followed by heat. Chang Xin agreed: Yes. Last winter, while serving as an envoy to Chu, he reached Yangzhou River in Juxian County. The bridge was broken. Chang Xin held the carriage shaft, unwilling to cross. The horse panicked and fell; Chang Xin entered the water, nearly drowning. Officials rescued him. His clothes were soaked. Soon he felt cold, then hot as fire, unable to tolerate cold since. Cang Gong prepared a decoction and fire agent to drive out heat. After one drink, sweat ceased; after two, heat gone; after three, disease cured. Even after twenty days of medication, he remained healthy. Knowing Chang Xin's illness, Cang Gong noted the pulse showed concurrent Yin. The *Pulse Classics* state: Death occurs in Heat diseases when Yin and Yang intersect. Here, they did not intersect; concurrent Yin means the pulse is smooth and clear, indicating recovery. Though heat remains, he lives. Kidney Qi occasionally turbid at the Taiyin pulse point indicates Water Qi. The Kidney governs Water, hence known. Delayed treatment for a moment turns it into alternating chills and fever.
*Shuowen*: Yi (Epidemic) means all people are sick.
*Shiming*: Yi means service/campaign. It implies ghosts performing a campaign.
*Zhang Hua's Bowuzhi*: During Emperor Wu of Han's reign, the Yuezhi Kingdom of the Western Regions crossed the Ruo River to tribute three pieces of Resurrection Incense, size of swallow eggs, black like mulberries. At that time, a major epidemic struck Chang'an. The Western envoy requested burning one piece to ward it off. Sick people in the palace heard the scent and recovered; the scent spread a hundred li, lasting several days. Those dead from epidemic for less than three days revived upon fumigation. (Logically impossible, but events may occur. Fragrant aromatics indeed resolve epidemics.)
*Zizhi Tongjian - Tang Annals*: Guanzhong suffered consecutive years of famine. Soldiers and civilians were thin and dark. Wheat finally ripened. Drunkards appeared in the market, considered an auspicious omen. People ate suddenly until full; one-fifth died.
*Taiping Yulan*, Vol. 742, cites Cao Zhi's *Shuo Yi Qi*: In the 22nd year of Jian'an, lethal Qi circulated. Every family mourned corpses; every room wept. Some entire households perished; some clans were wiped out. Some believed epidemics were caused by ghosts and gods. Those afflicted were mostly sons of coarse cloth and wild vegetable eaters, living in thorn-hedged and thatched houses. Those in palatial homes with bronze tripods and fur-lined beds rarely suffered. This results from Yin and Yang losing their positions, Cold and Heat occurring at wrong times, thus generating epidemics. Ignorant people hang talismans to suppress them, which is laughable.
*History of Yuan - Biography of Yelü Chucai*: Chucai followed the Great Khan to capture Lingwu. Generals fought for children, gold, and silk; Chucai alone took books and Rhubarb. Soon soldiers suffered epidemics; those who obtained Rhubarb recovered.
*Jiufeng Medical Cases*: On the second day, aversion to cold and fever, pain in head, body, waist, and back, white coating, red urine, no sweat, rapid pulse. Pathogen latent in Mo Yuan, emerging to the Taiyang Meridian. Notopterygium Root (1 qian), Saposhnikovia Root (1 qian), Ligusticum Chuanxiong (0.8 fen), Betel Nut (1 qian), Magnolia Bark (0.8 fen), Tsao-ko Kernel (0.5 fen), Wine-fried Scutellaria Root (1 qian), Prepared Licorice Root (0.5 fen), Red Peony Root (1.5 qian), Ginger (1 slice).