肘后中溪毒论，葛氏云，水毒中人，一名中水，一名中溪，一名中洒，一名水病，似射
工而无物，其诊法，初得之，恶寒头微痛，目眶疼，心中烦懊，四肢振 ，腰背骨节皆强，
筋急两膝疼，或 而热但欲睡，旦醒暮剧，手足逆冷至肘膝，二三日则腹中生虫，食人下
部，肛中有疮，不痛不痒，不令人觉。视之乃知耳，不即疗，过六七日下部脓溃，虫上食
五脏，热盛烦毒，汪下不禁，八九日良医所不能疗之，觉得之，急当早视下部，若有疮正赤
如截肉者为阳毒，最急，若疮如蠡鱼齿者，为阴毒，犹小缓，要皆杀人，不过二十日也，
欲知是中水，当作数斗汤。以小蒜五升 咀，投汤中，莫令太热，热即无力。去滓，消息适
寒温以
又疗中水毒方。
取梅若桃叶捣，绞取汁三升许，为二服，或干，以水绞取汁极佳。（集验文仲备急千金
同姚云小儿不能饮以汁敷乳头与之）
又方
取常思草捣，绞汁三升饮之妙，并以绵裹导下部中，日三瘥。（文仲备急同）
又方
捣蓝青汁，以少水和，涂头面遍身令匝。（文仲千金翼备急同）
又方
取蓼一把捣，以酒一升和，绞服之不过三服。（文仲千金翼备急云肘后用梨叶）
又方
取大莓连根
上一味捣作屑服之，亦可投水捣，绞汁饮一二升，并导下部生虫者，夏月常行，多 此
屑，欲入水浴，先以少屑投水上流，便无所畏，又辟射工，家中虽以器盛水浴，亦常以此屑
投水
又今东间诸山州县人，无不病溪毒，每春月多得，亦如京都伤寒之状，呼为溪温，未必
皆是射工辈尔，亦尽患疮痢，但寒热烦疼，不解便死耳，方家疗此，用药与伤寒温疾颇相似，
今复疏其
东向三两步，即以手左一搅取水，将蒜一把熟捣，以酒渍之，去滓，可饮两杯当吐，得
吐便瘥，此方甚效。
备急疗溪毒方。
取五加根烧末，以酒若浆服方寸匕。（肘后文仲备急同）
又方
烧鲛鱼皮，以饮服方寸匕，立瘥。
又方
荆叶捣汁饮之佳。（肘后同）
又方
捣柒姑以涂之腰背诸处，柒姑生东间，细叶如蒜状。
又方
乌蒜一枚捣，以酒和服半升，得吐即瘥，又名乌韭，山中甚多。
又若下部生疮已决洞者方。
取秫米一升，盐五升，水一石，煮作麋，坐中即愈。（文仲备急同肘后并同）
又方
取桃叶艾叶捣熟，以水渍之，纵取浓汁，去滓，着盘中坐，有白虫出瘥。（文仲备急同
肘后云取桃皮叶无艾叶）
又方
烧皂荚捣末，以绵裹导之。
又方
以盐和皂荚末，捣之，绵裹导之。
又方
末牡丹屑，以饮服方寸匕，日三。
又其土俗有疗之术方。
初觉，便取溪蒜 桃叶锉一斤，蒸使遍热，出布席上，解衣卧上，浓覆衣被，大汗良
久。出拭之，勿见风则瘥，已五六日恐毒入腹，不可救尔。应先服药，东间诸山有大木名埋
檀，
预取干之，亦单用茜根白 荷根蓝青汁并佳若卒无根皮，亦可单用蓝汁。可服之，亦可都合
煮取汁渍之，若患腹中痛，恐转成蛊啖人腹藏者，取猪脂二升熬令燥，水一斗，绞取汁，稍
稍服之。（并出第八卷中）
千金疗溪毒方。
取大蒜十枚，合皮安热灰中炮令热，刀切断头，以柱所着毒处。（文仲备急崔氏同）
又方
雄黄 朱砂 常山（各等分）
上三味，五月五日午时使童子捣合之。（出第二十六卷中）
张文仲疗溪毒方。
取蓼捣取汁，服一二升，又以涂同匝瘥。
又方
取雄牛膝根一把捣，水酒共一升渍，绞取汁饮之，日三，雄牛膝茎白紫色者是。（出第
十卷中）
《肘后备急方》中关于溪毒的论述，葛洪说：水毒侵入人体，一名“中水”，一名“中溪”，一名“中洒”，一名“水病”。症状类似射工虫（一种水生毒虫）叮咬，但看不到实物。其诊断方法为：初起时，恶寒、头部微痛、眼眶疼痛、心中烦闷懊恼、四肢震颤、腰背及骨节僵硬、筋脉拘急且两膝疼痛；或者身体发热却只想睡觉，早晨清醒而傍晚加重，手足逆冷直至肘部和膝盖。二三天后，腹中生虫，侵蚀人体下部，肛门周围生疮，不痛不痒，患者自己察觉不到，只有查看才能发现。如果不立即治疗，过了六七天，下部化脓溃烂，虫子向上侵蚀五脏，热盛烦躁毒烈，大便失禁无法控制。到了八九天，即使是良医也无法救治了。如果刚觉得不适，应当尽早检查下部。如果有疮口颜色正红如截断的肉块，这是阳毒，最为紧急；如果疮口像蠡鱼牙齿形状，这是阴毒，稍微缓和些，但总之都是致人死亡的，不超过二十天。想要知道是否是中水毒，可以煮几斗热水。用小蒜五升切碎，投入汤中，不要让水太热，太热则药效减弱。滤去药渣，调节水温至适宜温度，用来洗浴。
又治疗中水毒的方子。
取梅叶或桃叶捣碎，绞取汁液约三升，分两次服用。如果是干叶，用水绞取汁液效果也很好。（《集验方》《文仲方》《备急千金要方》相同。姚和众说：小儿不能饮用的，可以将汁液涂在乳头上让他吸吮。）
又一个方子。
取常思草捣碎，绞取汁液三升饮用，效果很好。并将药渣用棉布包裹，塞入下部（肛门），每天三次，痊愈。（《文仲方》《备急方》相同）
又一个方子。
捣取蓝青（蓼蓝等植物制成的染料原料）的汁液，加少量水调和，涂抹于头面及全身，使其覆盖均匀。（《文仲方》《千金翼方》《备急方》相同）
又一个方子。
取蓼一把捣碎，用酒一升调和，绞汁服用，不超过三次即可。（《文仲方》《千金翼方》《备急方》说《肘后方》后用梨叶）
又一个方子。
取大莓连根茎，以上一味药捣成屑服用。也可以加水捣碎，绞取汁液饮用一二升。对于下部生虫者，夏季经常行走时，多携带这种药屑。如果要入水洗澡，先取少许药屑投在水流上游，便无所畏惧。又可以辟除射工虫的危害。家中即使是用器皿盛水洗澡，也常常将这种药屑投入水中。
如今江东各山州县的人，没有不得溪毒病的，每年春季多得此病，也像京都伤寒的症状一样，称为“溪温”，未必全都是射工虫所致，也都患疮痢，只是寒热烦躁疼痛，不解脱就会死亡。医生治疗此病，用药与伤寒温病颇为相似，现在再列出其方剂。
面向东方走两三步，随即用手向左搅动取水，取一把大蒜煮熟捣烂，用酒浸泡它，滤去药渣，可喝两杯，应当能引起呕吐，得到呕吐后即可痊愈，此方非常有效。
《备急方》治疗溪毒的方子。
取五加根烧成末，用酒或浆水送服一方寸匕。（《肘后方》《文仲方》《备急方》相同）
又一个方子。
烧鲛鱼皮，用饮品送服一方寸匕，立刻痊愈。
又一个方子。
捣荆叶取汁饮用效果好。（《肘后方》相同）
又一个方子。
捣柒姑（一种植物）涂抹在腰背各处。柒姑生长在江东地区，叶子细小像蒜叶状。
又一个方子。
取乌蒜一枚捣碎，用酒调和服用半升，引起呕吐即痊愈。乌蒜又名乌韭，山中很多。
如果下部生疮已经溃破洞开的方子。
取秫米一升，盐五升，水一石，煮成稠粥，坐在上面即刻痊愈。（《文仲方》《备急方》相同，《肘后方》也相同）
又一个方子。
取桃叶、艾叶捣熟，用水浸泡，尽量取出浓汁，滤去药渣，倒入盘中坐着，有白虫出来即痊愈。（《文仲方》《备急方》相同。《肘后方》说取桃树皮叶，无艾叶）
又一个方子。
烧皂荚捣成末，用棉布包裹塞入下部。
又一个方子。
用盐和皂荚末，捣匀，用棉布包裹塞入下部。
又一个方子。
牡丹屑研末，用饮品送服一方寸匕，每天三次。
还有当地风俗治疗的方法方子。
刚觉得不适，就取溪蒜和桃叶锉碎一斤，蒸得遍体发热，铺在布席上，解开衣服躺上去，盖上厚衣被，大汗出很久。出来后擦拭干净，不要见风就能痊愈。如果已经五六天，恐怕毒气进入腹部，就无法挽救了。应该先服药。江东诸山有大树名叫埋檀，预先采集晒干。也可以单用茜草根、白荷根、蓝青汁，都很好。如果突然没有根皮，也可以单用蓝汁。可以服用，也可以将所有药物一起煮取汁液浸渍身体。如果患有腹痛，恐怕转变成蛊毒啃食人内脏的，取猪脂二升熬至干燥，加水一斗，绞取汁液，慢慢服用。（均出自第八卷）
《千金要方》治疗溪毒的方子。
取大蒜十枚，带皮放在热灰中炮烤至热，用刀切断头部，以切面柱按在中毒部位。（《文仲方》《备急方》《崔氏方》相同）
又一个方子。
雄黄、朱砂、常山（各等分）。
以上三味药，在五月五日午时让童子捣合在一起。（出自第二十六卷）
The discussion on "Stream Poison" (Xidu) in *Zhouhou Beiji Fang* states that Ge Hong said: Water toxin invading the human body is also known as "Zhong Shui" (Water Strike), "Zhong Xi" (Stream Strike), "Zhong Sa", or "Shui Bing" (Water Disease). Its symptoms resemble those of a bite from a Shegong insect (a type of aquatic venomous insect), but no physical object is visible. The diagnostic method is as follows: Initially, there is aversion to cold, slight headache, pain in the eye sockets, mental restlessness and distress, trembling of the four limbs, stiffness of the waist, back, and joints, tendon tension with pain in both knees; or alternatively, fever accompanied by drowsiness, clarity in the morning worsening in the evening, and cold extremities extending up to the elbows and knees. After two or three days, worms may develop in the abdomen, eroding the lower part of the body, causing sores around the anus that are neither painful nor itchy, and imperceptible to the patient unless examined. If not treated immediately, after six or seven days, the lower part will suppurate and ulcerate, the worms will ascend to erode the five zang organs, leading to intense heat, irritability, and toxicity, with uncontrollable diarrhea. By the eighth or ninth day, even a skilled physician cannot cure it. Upon feeling unwell, one should promptly examine the lower region. If the sore is bright red like cut meat, it is classified as Yang Du (Yang Toxicity), which is most urgent. If the sore resembles the teeth of a conch fish, it is classified as Yin Du (Yin Toxicity), which is slightly less acute. However, all such conditions are fatal within twenty days. To determine if it is Zhong Shui poison, boil several dou of water. Add five sheng of chopped small garlic (Allium sativum var. cernuum) to the water. Do not let the water be too hot, as excessive heat reduces efficacy. Strain the residue, adjust the temperature to a comfortable warmth, and use for bathing.
Another prescription for treating Zhong Shui poison:
Crush plum leaves or peach leaves, and squeeze out approximately three sheng of juice. Divide into two doses. If using dried leaves, squeezing juice with water is also excellent. (*Jiyan Fang*, *Wenzhong Fang*, *Beiji Qianjin Yaofang* are identical. Yao Hezhong stated: For children who cannot drink it, apply the juice to the nipple for them to suck.)
Another prescription:
Crush Changsi Cao (Changsi Grass), squeeze out three sheng of juice and drink it. This is effective. Also, wrap the residue in cotton and insert it into the lower orifice (anus) three times daily until recovery. (*Wenzhong Fang*, *Beiji Fang* are identical)
Another prescription:
Crush Lanqing (Indigo plant dye material), mix with a small amount of water, and apply evenly over the head, face, and entire body. (*Wenzhong Fang*, *Qianjin Yifang*, *Beiji Fang* are identical)
Another prescription:
Take a handful of Polygonum (Liao), crush it, mix with one sheng of wine, squeeze out the juice, and take it. No more than three doses are needed. (*Wenzhong Fang*, *Qianjin Yifang*, *Beiji Fang* note that *Zhouhou Fang* later used pear leaves)
Another prescription:
Take Da Mei (Large Berry) including roots. Grind this single herb into powder and take it. Alternatively, add water, crush, squeeze out the juice, and drink one to two sheng. For cases with worms in the lower body, carry this powder frequently when walking outdoors in summer. Before entering water to bathe, throw a small amount of powder upstream to ensure safety. It also repels Shegong insects. Even when bathing in vessels at home, it is common practice to throw this powder into the water.
Currently, people in various mountain prefectures east of the river suffer from Stream Poison every spring. The symptoms resemble Typhoid Fever (Shanghan) in the capital, hence called "Xi Wen" (Stream Warmth). It is not necessarily caused solely by Shegong insects; patients also suffer from sores and dysentery, characterized by chills, fever, irritability, and pain. Without resolution, death ensues. Physicians treat this condition using medications similar to those for Shanghan and Warm Diseases. The following prescriptions are listed:
Stand facing east, take two or three steps, then stir the water to the left with your hand. Take a handful of garlic, cook and crush it thoroughly, soak it in wine, strain the residue, and drink two cups. Vomiting should occur, and recovery follows. This prescription is very effective.
*Beiji Fang* prescription for Stream Poison:
Burn Wujiagen (Acanthopanacis Cortex/Radix) into ash/powder, and administer one fangcun bi (a square inch measure) with wine or grain wash. (*Zhouhou Fang*, *Wenzhong Fang*, *Beiji Fang* are identical)
Another prescription:
Burn Jiaoyu Pi (Shark Skin), and administer one fangcun bi with drinks. Recovery is immediate.
Another prescription:
Crush Jing Ye (Evodiae Folium/Herba Evodiae) and drink the juice. (*Zhouhou Fang* is identical)
Another prescription:
Crush Qigu (a local plant) and apply it to the waist and back. Qigu grows in the eastern regions, with fine leaves resembling garlic leaves.
Another prescription:
Take one Wusuan (Black Garlic/Allium), crush it, mix with wine, and take half a sheng. Vomiting indicates recovery. Wusuan is also known as Wujiu (Black Leek) and is abundant in mountains.
For cases where sores in the lower body have already ulcerated and opened:
Take one sheng of Shumi (Millet/Sorghum), five sheng of salt, and one dan of water. Boil into a thick porridge. Sit in it for immediate healing. (*Wenzhong Fang*, *Beiji Fang* are identical; *Zhouhou Fang* is also identical)
Another prescription:
Crush Tao Ye (Peach Leaf) and Ai Ye (Artemisiae Argyi Folium) until cooked/soft. Soak in water, extract concentrated juice, strain, pour into a basin, and sit in it. White worms will emerge, indicating recovery. (*Wenzhong Fang*, *Beiji Fang* are identical. *Zhouhou Fang* specifies using peach bark/leaves without mugwort)
Another prescription:
Burn Zaojiao (Gleditsiae Fructus), grind into powder, wrap in cotton, and insert into the lower orifice.
Another prescription:
Mix salt with Zaojiao powder, crush together, wrap in cotton, and insert into the lower orifice.
Another prescription:
Grind Mudanpi (Moutan Cortex) into powder, take one fangcun bi with drinks, three times daily.
Local folk treatment methods:
Upon first feeling unwell, take Xisuan (Stream Garlic) and crushed Taoye (Peach Leaf), one jin. Steam until thoroughly hot, spread on a cloth mat, undress, lie on it, cover with thick quilts, and induce profuse sweating for a long time. Afterward, wipe dry and avoid wind exposure for recovery. If five or six days have passed, the toxin may have entered the abdomen, making it incurable. Medication should be taken first. Large trees named Litán grow in the eastern mountains; harvest and dry them in advance. Alternatively, use Qigen (Qiancao Radix), Baihegen (Lili Bulbus), or Lanqing juice alone, all of which are good. If roots/bark are unavailable, pure Lanqing juice can be used. It can be ingested or boiled with other herbs for topical application. If abdominal pain occurs, fearing transformation into Gu (Gu Poison) eating internal organs, take two sheng of Zhizhi (Porcine Fat), render until dry, add one dou of water, squeeze out juice, and take slowly. (All from Volume 8)
*Qianjin Yaofang* prescription for Stream Poison:
Take ten cloves of Datasuan (Garlic), keep the skin on, roast in hot ashes until hot. Cut off the root end with a knife, and press the cut surface onto the poisoned area. (*Wenzhong Fang*, *Beiji Fang*, *Cui Shi Fang* are identical)
Another prescription:
Xionghuang (Realgar), Zhusha (Cinnabar), Changshan (Radix Dichroae) (equal parts).
On the noon hour of the fifth day of the fifth lunar month, have a young boy crush and mix these three ingredients. (From Volume 26)
Zhang Wenzhong's prescription for Stream Poison:
Crush Liao (Polygonum) to extract juice, drink one to two sheng. Apply externally to the whole body for recovery.
Another prescription:
Take a handful of Xiong Niuxi (Achyranthis Bidentatae Radix - male variety) roots, crush them. Soak in one sheng of mixed water and wine, squeeze out juice, and drink three times daily. The stem of the male Niuxi is white and purple. (From Volume 10)