江东江西诸源涧有虫。名曰短狐溪毒。又名射公。其虫有翅能飞。有一长角横在口前。
如弩
檐。临其角端如上弓。以气为矢。无目。有耳能听。在山源水中。闻人声使以气毒射人。故
谓之射公。此虫畏鹅。鹅能食之。此症似乎伤寒。寒热往来。身不喜冷。筋急体强。目疼头
痛
。张口呻吟。咳嗽。呼吸闷乱。始终更不能言朝轻暮重。非其土人中之。便谓之伤寒。今说
其状。以明其症。与伤寒别矣。
螺蛳疔
恶寒发热。胸膈作闷。身发红点。如蚊迹者。类乎伤寒。此点起之于手。沿至于心前其
人发狂闷乱而毙。不知者。但以伤寒发斑治之。百无一生也。
以三角针刺其红点之首尾处出血。外用锈铁钉。磨水敷之。内服犀角地黄汤立愈。（方
（阳毒渐深六脉洪大内外结热舌卷焦黑鼻如烟煤。）
叠布数重。新水渍之。稍捩去水。搭于患人胸上。须臾蒸热。又以别浸冷布易之。频
换热稍退。再进阳毒药。
验舌形症。三十六种。
\r里黑舌\ps48a23.bmp\r
舌见红色。内有干硬黑色。形如小长舌。有刺者。此热毒炽盛。坚结大肠。金受火制。
不能平木故也。急用调胃承气汤下之。
调胃承气汤（方见前）
\r白胎舌\ps48a24.bmp\r
舌见白苔滑者。邪初入里也。丹田有热。胸中有寒。乃少阳半表半里之症。宜小柴胡汤
。栀子豆豉汤治之。
小柴胡汤（方见前）
栀子豆豉汤（方见后）
\r将瘟舌\ps48a25.bmp\r
舌见红色。热蓄于内也。宜用透顶清神散。
透顶清神散
当归 白芷 北细辛 猪牙皂角
上为末。等分和匀。令病患先噙水一口。以药少许吹入鼻内。吐去水。取嚏为度。如未
嚏。仍用药再吹。
\r中焙舌\ps48a26.bmp\r
舌见纯红。内有黑形如小舌者。乃邪热结于里也君火炽盛。反兼水化。宜服凉隔散。大
大柴胡汤（方见前）
凉隔散（方见后）
\r生 舌\ps48a27.bmp\r
舌见红色。而有小黑色者。热毒乘虚入胃。蓄热则发 矣。宜用升麻葛根汤。加玄参化
汤解之升麻葛根汤（方见前）
化 汤（方见前）
\r红星舌\ps48a28.bmp\r
舌见淡红中有大红星者。乃少阴君火热之盛也。所不胜者。假火热以侮脾土。将欲发黄
之候。宜茵陈五苓散治之。
茵陈五苓散（方见后）
\r黑尖舌\ps48a29.bmp\r
舌见红色。尖见青黑者。水虚火实。肾热所致。宜竹叶石膏汤治之。
竹叶石膏汤（方见前）
\r里圈舌\ps48a30.bmp\r
舌见淡红色。而中有一红晕。沿皆纯黑。乃余毒遗于心胞络之间。与邪火郁结。二火亢
极。故有是症。以承气汤下之。
承气汤（方见前）
\r人裂舌\ps48a31.bmp\r
舌见红色。更有裂纹如人字形者。乃君火燔灼。热毒炎上。故发裂也。宜服凉隔散。
凉隔散（方见后）
\r虫碎舌\ps48a32.bmp\r
舌见红色。更有深红色 点。如虫蚀之状者。乃热毒炽盛。火在上水在下。不能相济故
也。宜小承气汤（下之）。
小承气汤（方见前）
\r厥阴舌\ps48a33.bmp\r
舌见红色。内有黑纹者。乃阴毒厥于肝经。肝主筋。故舌见如丝形。宜理中汤。四逆汤
理中汤
四逆汤（方俱见前）
\r死现舌\ps48a34.bmp\r
舌见黑色。水克火明矣。患此者。百无一生。治者审之。
\r黄胎舌\ps48a35.bmp\r
舌见尖白根黄。其表症未罢也。宜解表。然后方可攻之。如大便秘。用凉隔散。加硝黄
泡服。小便涩者。用五苓散。加木通。合益元散。加姜汁少许白滚汤调服。
凉隔散
五苓散（方俱见前）
\r黑心舌\ps48a36.bmp\r
舌见弦白心黑。而脉沉微者难治。脉浮滑者可汗。沉实者可下。始病即发此色。乃危殆
之芒也。速进调胃承气汤。
调胃承气汤（方见前）
\r十五舌\ps48a37.bmp\r
舌尖白苔二分。根黑一分。必有身痛恶寒。如饮水不至甚者。五苓散。自汗渴者。白虎
汤下痢者。解毒汤。此亦危症也。
白虎汤（方见前）
解毒汤（方见后）
\r十六舌\ps48a38.bmp\r
舌见白苔。中有黑小点乱生者。尚有表症。其病来之虽恶。宜凉隔散。微表之即退。速
当下之。下用调胃承气汤。
调胃承气汤（方见前）
\r十七舌\ps48a39.bmp\r
舌见如灰色。中间更有黑晕两条。此热乘肾与命门也。宜急下之。服解毒汤。下三五次
。迟则难治。如初服量加大黄。
解毒汤（方见后）
\r十八舌\ps48a40.bmp\r
舌见微黄色者。初病即得之发谵语者。由于失汗。表邪入里也。必用汗下兼行之。以双
解散。加解毒汤。两停主之。
双解散
解毒汤（方俱见后）
\r十九舌\ps48a41.bmp\r
舌中见白苔。外则微黄者。必作泻。宜服解毒汤。恶寒者五苓散。
解毒汤
五苓散（方俱见后）
\r二十舌\ps48a42.bmp\r
舌见微黄色者。乃表症未罢宜用小柴胡汤。合天水散主之。可下者。大柴胡汤下之。表
里双除。临证时当审用之。
大柴胡汤（方俱见前）
\r二十一舌\ps48a43.bmp\r
舌见黄色者。必初白苔而变黄色也。皆表而传里。热已入胃。宜急下之。若下迟必变黑
色。为恶症为亢害。鬼邪气深也。宜调胃承气汤。
调胃承气汤（方见前）
\r二十二舌\ps48a44.bmp\r
舌左白苔而自汗者。不可下。宜白虎汤。加人参三钱服之。
白虎汤（方见前）
\r二十三舌\ps48a45.bmp\r
舌右白苔滑者。病在肌肉。为邪在半表半里。必往来寒热宜小柴胡汤和解之。
小柴胡汤（方见前）
\r二十四舌\ps48a46.bmp\r
舌左见白苔滑。此脏结之症。邪并入脏难治。
\r二十五舌\ps48a47.bmp\r
舌见四围白而中黄者。必作烦渴呕吐之症。兼有表者。五苓散。益元散兼服须待黄尽方
益元散（方见前）
五苓散（方见后）
\r二十六舌\ps48a48.bmp\r
舌见黄色。而有小黑点者。邪遍六腑。将入五脏。急服调胃承气汤下之。次进和解散
调胃承气汤（方见前）
和解散
本 桔梗 甘草（炙各五钱） 苍术（三钱） 陈皮 浓朴（姜制各一钱）
上水二钟。姜三片。枣二枚。煎七分。去渣不拘时服解毒汤。
黄连（一两） 黄柏（五钱） 黄芩（五钱） 山栀（六钱）
上每服五钱。水一钟半。煎至一钟。热服。
五苓散（加茵陈即茵陈五苓散）
泽泻（二钱五分） 茯苓 猪苓 白术（各一两） 肉桂（五钱）
上每服六钱。水二钟。煎至一钟。温服。
凉隔散
生甘草（二钱） 连翘（四钱） 山栀仁（八钱） 大黄（二钱） 黄芩 薄荷 朴硝（各一钱
上作一剂。水二钟。加淡竹叶二十片。煎一钟。不拘时服。以利为度。
栀子豆豉汤
栀子（二钱） 淡豆豉（五钱）
上水二钟。煎七分。去渣服。
双解散（加解毒汤）
防风 川芎 当归 白芍药 大黄 麻黄 连翘 芒硝（各五钱） 石膏 黄芩 桔梗（
各一两） 滑石（三两） 甘草（二两） 荆芥 白术 山栀（各五钱）
上每服一两。水一钟半。姜三片。煎八分。去渣服。
茵陈汤
茵陈（五钱） 大黄（三钱） 山栀仁（二钱）
上水一钟半。煎至一钟。去渣服。
抵当汤
大黄（三钱） 水蛭（糯米炒七枚） 虻虫（炒去翅。足七枚）
上作一服。水一钟半煎一钟。去渣服。
十枣汤
莞花（醋浸炒） 大戟 甘遂（煨各等分）
上每服二钱。弱人减半。水二钟。枣十枚。煎八分去渣服。
\r二十七舌\ps48a49.bmp\r
舌见黄而尖白者。表少里多。宜天水散一服。凉隔散二服合进之脉弦者。宜防风通圣散
防风通圣散（方见前）
\r二十八舌\ps48a50.bmp\r
舌见黄。而色有膈瓣者。热已入胃。邪毒深矣。心火烦渴。急宜大承气汤下。若身发黄
者用茵陈汤下。血用抵当汤。水在胁内十枣汤。结胸甚者入陷胸汤。
大承气汤 茵陈汤 抵当汤 十枣汤 大陷胸汤（五方俱见前）
\r二十九舌\ps48a51.bmp\r
舌见四边微红。中央灰黑色者此由失下而致用大承气汤下之。热退可愈。必下三四次方
退。五次下之而不退者。不治。
大承气汤（方见前）
\r三十舌\ps48a52.bmp\r
舌见黄。而黑点乱生者。其症必渴谵语。脉实者生。脉涩者死循衣摸床者不治。若下之
见黑粪亦不治宜大承气汤。
大承气汤（方见前）
\r三十一舌\ps48a53.bmp\r
舌见黄中黑至尖者。热气已深。两感见之十人九死。恶寒甚者亦死。不恶寒而下利者可
治。宜调胃承气汤主之。
调胃承气汤（方见前）
\r三十二舌\ps48a54.bmp\r
舌见外淡红心淡黑者如恶风表未尽。用双解散。加解毒汤。相半微汗之。汗罢急下。如
结胸烦躁目直视者不治。
双解散加解毒汤（方见前）
\r三十三舌\ps48a55.bmp\r
舌见灰色。尖黄而不恶寒者。脉浮可下之。若恶风恶寒者。用双解散加解毒汤主之三四
下之见粪黑不治。
双解散加解毒汤（方见前）
\r三十四舌\ps48a56.bmp\r
舌见灰黑色。而有黑纹者。脉实急以大承气汤下之。脉浮渴饮水者。用凉隔散。
大承气汤
凉隔散（方见前）
\r三十五舌\ps48a57.bmp\r
舌根微黑。尖黄脉。滑者可下之。脉浮者当养阴退阳。若恶风寒者微汗之。用双解散。
若下利用解毒汤。十救七八也。
双解散
解毒汤（方俱见前）
\r三十六舌\ps48a58.bmp\r
舌根灰黑。尖黄。隐见或有一纹者。脉实急用大承气汤下之。脉浮渴饮水者。以凉膈
散解之。十可救二三。大承气汤。
凉隔散（方俱见前）
以上三十六舌。乃伤寒验证之捷要。临症时当细心治之百无一失耳。
灸少阴（少阴吐痢手反不冷反食饮水脉不至者）
少阴即太溪穴也。太溪二穴。在足内踝。后跟骨上。动脉陷中灸七壮。
灸关元穴（脏结死症不可攻宜此）
关元穴。在脐下一寸是也。乃少阴任脉之会。
灸期门穴（妇人热入血室 咳逆 打呃）
妇人屈乳头向下尽处骨间。丈夫及乳小者。以指为率。陷中有动脉是穴。艾炷如小豆大
。灸五七壮妇人热入血室刺之下针。令病患吸五吸。停针良久起针。
江东、江西等地的山涧溪流中有虫，名叫短狐溪毒，又被称为射公。这种虫子有翅膀能飞，有一根长角横在口前，像弩的弓檐一样。它的角端向上弯曲如弓，以气息为箭矢。它没有眼睛，但有耳朵能听声音，生活在山间水源中。听到人的声音，便用气毒射人，所以叫它射公。这种虫子害怕鹅，鹅能吃掉它。这种病症看起来像伤寒，表现为寒热往来，身体不喜欢冷，筋脉拘急，身体僵硬，眼睛疼痛，头痛，张口呻吟，咳嗽，呼吸闷乱，始终不能说话，病情早晨轻晚上重。如果不是本地人被咬伤，就会被误认为是伤寒。现在描述其症状，以明确其病症，从而与伤寒区别开来。
螺蛳疔：恶寒发热，胸膈部感到闷热，身上出现红点，像蚊子叮咬的痕迹，类似伤寒。这些红点从手部开始，蔓延至心前区，患者会发狂、闷乱而死。不知情的人，只按伤寒发斑治疗，百无一活。应用三棱针刺破红点的头部和尾部出血，外用生锈铁钉磨成的水敷贴患处，内服犀角地黄汤可立即痊愈。（方剂见前）
阳毒逐渐深入，六脉洪大，内外结热，舌体卷缩焦黑，鼻孔如烟煤色。将布叠数层，用新汲冷水浸湿，稍拧去水分，搭在患者胸口上。片刻后布变热，再用另外浸过冷水的布替换，频繁更换，热度稍退后，再服用阳毒药。
观察舌形症状，共有三十六种。
里黑舌：舌面见红色，内部有干硬的黑色，形状像小长舌，有刺状突起。这是热毒炽盛，坚结于大肠，金（肺）受火（心）克制，不能平抑木（肝）的缘故。急需使用调胃承气汤攻下。
调胃承气汤（方剂见前）
白胎舌：舌面见白苔且滑润，说明邪气初入里。丹田有热，胸中有寒，属于少阳半表半里的病症。适宜用小柴胡汤、栀子豆豉汤治疗。
小柴胡汤（方剂见前）
栀子豆豉汤（方剂见后）
将瘟舌：舌面见红色，说明热蓄积于体内。适宜使用透顶清神散。
透顶清神散：当归、白芷、北细辛、猪牙皂角。以上药物研为细末，等分混合均匀。让患者先含一口水，取少许药粉吹入鼻内，吐出清水，以打喷嚏为度。如果未打喷嚏，仍用药粉再次吹入。
中焙舌：舌面见纯红色，内部有黑色形状如小舌者，这是邪热结聚于里，君火炽盛，反而兼有水化之象。适宜服用凉隔散、大大柴胡汤。
大大柴胡汤（方剂见前）
凉隔散（方剂见后）
生[黑]舌：舌面见红色，而有小黑色斑点者，这是热毒乘虚侵入胃腑，蓄积热量则发病。适宜使用升麻葛根汤，加玄参化[斑]汤解之。
升麻葛根汤（方剂见前）
化[斑]汤（方剂见前）
红星舌：舌面见淡红中有大红星者，这是少阴君火热势旺盛的表现。所不胜者（肾水），假借火热来侮脾土，是将要发黄的症状。适宜用茵陈五苓散治疗。
茵陈五苓散（方剂见后）
黑尖舌：舌面见红色，舌尖见青黑色者，这是水虚火实，由肾热所致。适宜用竹叶石膏汤治疗。
竹叶石膏汤（方剂见前）
里圈舌：舌面见淡红色，而中间有一圈红晕，周围皆纯黑，这是余毒遗留在心包络之间，与邪火郁结，二火亢极，所以有此症状。用承气汤攻下。
承气汤（方剂见前）
人裂舌：舌面见红色，更有裂纹如人字形者，这是君火燔灼，热毒炎上，所以发生裂纹。适宜服用凉隔散。
凉隔散（方剂见后）
虫碎舌：舌面见红色，更有深红色斑点，如虫蚀之状者，这是热毒炽盛，火在上水在下，不能相互济助的缘故。适宜用小承气汤攻下。
小承气汤（方剂见前）
厥阴舌：舌面见红色，内有黑纹者，这是阴毒厥逆于肝经。肝主筋，所以舌面呈现如丝形的纹路。适宜用理中汤、四逆汤。
理中汤
四逆汤（两方均见前）
死现舌：舌面见黑色，水克火之象明显。患此症者，百无一活。医者需谨慎审察。
黄胎舌：舌面见舌尖白、舌根黄，说明表证尚未解除。应先解表，然后才可攻里。如大便秘结，用凉隔散，加芒硝、大黄泡服。小便涩滞者，用五苓散，加木通，合益元散，加少许姜汁，用白开水调服。
凉隔散
五苓散（两方均见前）
黑心舌：舌面见边缘白、中心黑，且脉象沉微者难治。脉浮滑者可发汗，脉沉实者可攻下。初病即出现此颜色，是危殆的征兆。速进调胃承气汤。
调胃承气汤（方剂见前）
十五舌：舌尖白苔占二分，舌根黑苔占一分，必定伴有身痛、恶寒。如饮水不多者，用五苓散；自汗口渴者，用白虎汤；下痢者，用解毒汤。这也是危重症。
白虎汤（方剂见前）
解毒汤（方剂见后）
十六舌：舌面见白苔，中间有黑色小点杂乱生长者，尚有表证。虽然病情凶险，适宜用凉隔散轻微解表即可消退，速当攻下。攻下用调胃承气汤。
调胃承气汤（方剂见前）
十七舌：舌面见如灰色，中间更有两条黑晕，这是热邪侵犯肾与命门。宜急下，服用解毒汤，攻下三到五次。拖延则难治。如果初次服药，剂量加大大黄。
解毒汤（方剂见后）
十八舌：舌面见微黄色者，初病即得此象并发谵语者，是由于失于发汗，表邪入里。必须用汗下兼行的方法，以双解散加解毒汤，两者各半为主治。
双解散
解毒汤（两方均见后）
十九舌：舌中见白苔，外部则微黄者，必定作泻。适宜服用解毒汤。恶寒者用五苓散。
解毒汤
五苓散（两方均见后）
二十舌：舌面见微黄色者，乃表证未罢，适宜用小柴胡汤合天水散主治。可以攻下的，用大柴胡汤攻下。表里双除，临证时应当审慎使用。
大柴胡汤（两方均见前）
二十一舌：舌面见黄色者，必定是先有白苔而后变为黄色。都是表证传里，热已入胃，宜急下。若攻下迟缓必变黑色，成为恶症，为亢害，鬼邪气深重。适宜用调胃承气汤。
调胃承气汤（方剂见前）
二十二舌：舌左面见白苔且自汗者，不可攻下。适宜用白虎汤，加人参三钱服用。
白虎汤（方剂见前）
二十三舌：舌右面见白苔滑者，病在肌肉，为邪在半表半里，必定往来寒热，宜用小柴胡汤和解。
小柴胡汤（方剂见前）
二十四舌：舌左面见白苔滑，这是脏结的病症，邪气并入脏，难治。
二十五舌：舌面见四周白而中间黄者，必定出现烦渴呕吐的症状。兼有表证的，五苓散、益元散兼服，须待黄色尽去方可。
益元散（方剂见前）
五苓散（方剂见后）
二十六舌：舌面见黄色，而有小黑点者，邪气遍走六腑，将入五脏。急服调胃承气汤攻下。其次进服和解散。
调胃承气汤（方剂见前）
和解散：本[草?]、桔梗、甘草（炙各五钱）、苍术（三钱）、陈皮、浓朴（姜制各一钱）。以上用水二钟，姜三片，枣二枚，煎至七分，去渣，不拘时候服用。解毒汤：黄连（一两）、黄柏（五钱）、黄芩（五钱）、山栀（六钱）。以上每服五钱，水一钟半，煎至一钟，热服。五苓散（加茵陈即茵陈五苓散）：泽泻（二钱五分）、茯苓、猪苓、白术（各一两）、肉桂（五钱）。以上每服六钱，水二钟，煎至一钟，温服。凉隔散：生甘草（二钱）、连翘（四钱）、山栀仁（八钱）、大黄（二钱）、黄芩、薄荷、朴硝（各一钱）。以上作一剂，水二钟，加淡竹叶二十片，煎一钟，不拘时候服用，以利为度。栀子豆豉汤：栀子（二钱）、淡豆豉（五钱）。以上水二钟，煎七分，去渣服。双解散（加解毒汤）：防风、川芎、当归、白芍药、大黄、麻黄、连翘、芒硝（各五钱）、石膏、黄芩、桔梗（各一两）、滑石（三两）、甘草（二两）、荆芥、白术、山栀（各五钱）。以上每服一两，水一钟半，姜三片，煎八分，去渣服。茵陈汤：茵陈（五钱）、大黄（三钱）、山栀仁（二钱）。以上水一钟半，煎至一钟，去渣服。抵当汤：大黄（三钱）、水蛭（糯米炒七枚）、虻虫（炒去翅足七枚）。以上作一服，水一钟半煎一钟，去渣服。十枣汤：莞花（醋浸炒）、大戟、甘遂（煨各等分）。以上每服二钱，体弱者减半，水二钟，枣十枚，煎八分去渣服。
二十七舌：舌面见黄而舌尖白者，表少里多，适宜天水散一服，凉隔散二服合进。脉弦者，宜防风通圣散。
防风通圣散（方剂见前）
二十八舌：舌面见黄，而色泽有隔膜瓣者，热已入胃，邪毒深重。心火烦渴，急宜大承气汤攻下。若身体发黄者用茵陈汤攻下。血瘀用抵当汤。水饮在胁内用十枣汤。结胸严重者加入陷胸汤。
大承气汤、茵陈汤、抵当汤、十枣汤、大陷胸汤（五方均见前）
二十九舌：舌面见四边微红，中央灰黑色者，这是由于失于攻下所致。用大承气汤攻下。热退可愈，必须攻下三四次才能退热。攻下五次而不退者，不治。
大承气汤（方剂见前）
三十舌：舌面见黄，而黑点杂乱生长者，其症状必定口渴、谵语。脉实者生，脉涩者死。循衣摸床者不治。若攻下后见黑粪亦不治。宜大承气汤。
大承气汤（方剂见前）
三十一舌：舌面见黄中黑直至舌尖者，热气已深，两感证见到此象十人九死。恶寒严重者也死。不恶寒而下利者可治，适宜用调胃承气汤主治。
调胃承气汤（方剂见前）
三十二舌：舌面见外淡红心淡黑者，如恶风表证未尽，用双解散加解毒汤，各半量轻微发汗。汗止后急下。如出现结胸、烦躁、目直视者不治。
双解散加解毒汤（方剂见前）
三十三舌：舌面见灰色，尖黄而不恶寒者，脉浮可攻下。若恶风恶寒者，用双解散加解毒汤主治。三四次攻下后见黑粪不治。
双解散加解毒汤（方剂见前）
三十四舌：舌面见灰黑色，而有黑纹者，脉实急以大承气汤攻下。脉浮渴饮水者，用凉隔散。
大承气汤
凉隔散（方剂见前）
三十五舌：舌根微黑，尖黄脉滑者可攻下。脉浮者当养阴退阳。若恶风寒者微汗之，用双解散。若下利用解毒汤，十救七八。
双解散
解毒汤（两方均见前）
三十六舌：舌根灰黑，尖黄，隐见或有一纹者，脉实急用大承气汤攻下。脉浮渴饮水者，以凉膈散解之。十可救二三。大承气汤。
凉隔散（两方均见前）
以上三十六种舌象，是验证伤寒的简要关键。临证时应当细心诊治，百无一失。
灸少阴穴（适用于少阴病吐痢，手足反不冷，反能食饮水，脉不至者）
少阴即太溪穴。太溪二穴，位于足内踝后方跟骨上方的动脉凹陷处，灸七壮。
灸关元穴（适用于脏结死症，不可攻下，宜用此法）
关元穴，位于脐下一寸处，是少阴任脉的交会穴。
灸期门穴（适用于妇人热入血室，咳逆，打呃）
妇人屈乳头向下尽处的骨间，男子及乳房较小者，以手指为界限，凹陷中有动脉即是该穴。艾炷如小豆大，灸五到七壮。妇人热入血室刺之下针，令患者吸气五次，停针良久起针。
In the mountain streams and creeks of Jiangdong and Jiangxi, there are insects known as "Duanhu Xidu" (Short Fox Stream Poison), also called "Shegong" (Shooting Duke). These insects have wings and can fly; they possess a long horn protruding horizontally in front of their mouths, resembling the bow brace of a crossbow. The tip of this horn curves upward like a bowstring, using breath as an arrow. They lack eyes but have ears capable of hearing. Living in mountain springs and waters, upon hearing human voices, they shoot toxic breath at people, hence the name "Shegong." These insects fear geese, which can eat them. This condition resembles Taiyang disease (diseases affecting the Taiyang channel), presenting with alternating chills and fever, aversion to cold by the body, tendon stiffness, rigid physique, eye pain, headache, open-mouthed groaning, coughing, stifled and chaotic breathing, inability to speak throughout the illness, with symptoms lighter in the morning and heavier in the evening. If not bitten by locals, it is often misdiagnosed as Taiyang disease. The following description clarifies its symptoms to distinguish it from Taiyang disease.
*Luosi Ding* (Snail Carbuncle): Aversion to cold, fever, stuffiness in the chest and diaphragm, red spots appearing on the body resembling mosquito bites, similar to Taiyang disease. These spots originate from the hands and spread to the precordial region, leading to madness, confusion, and death. Unaware practitioners treating it merely as Taiyang disease with macules will find no survivors. Treatment involves pricking the head and tail of the red spots with a three-edged needle to induce bleeding, applying water ground from rusty iron nails externally, and internally administering *Xijiao Dihuang Tang* (Rhinoceros Horn and Rehmannia Decoction) for immediate recovery. (Formula see previous section)
When Yang Poison deepens, the six pulses become surging and large, with internal and external heat accumulation, tongue rolling and scorching black, and nostrils resembling soot. Fold several layers of cloth, soak them in fresh cold water, wring out slightly, and place on the patient's chest. After a moment when the cloth becomes hot, replace it with another soaked in cold water. Repeat frequently until heat subsides slightly, then administer Yang Poison medicine.
Observation of tongue forms reveals thirty-six types:
**Lihei She** (Inner Black Tongue): The tongue surface appears red, with dry, hard blackness inside, shaped like a small elongated tongue with prickles. This indicates excessive heat toxin firmly binding in the Large Intestine; Metal (Lung) is controlled by Fire (Heart) and cannot balance Wood (Liver). Urgently use *Tiaowei Chengqi Tang* (Stomach-Regulating Daoshi Decoction) to purge.
*Tiaowei Chengqi Tang* (Formula see previous section)
**Baitai She** (White-Coated Tongue): The tongue shows a slippery white coating, indicating pathogenic factors have just entered the interior. Heat exists in the Dantian, while cold resides in the chest; this is a Shaoyang half-exterior half-interior syndrome. Suitable treatments include *Xiaochaihu Tang* (Minor Bupleurum Decoction) and *Zhizi Chidui Tang* (Gardenia and Fermented Soybean Decoction).
*Xiaochaihu Tang* (Formula see previous section)
*Zhizi Chidui Tang* (Formula see following section)
**Jiangwen She** (Impending Plague Tongue): The tongue is red, indicating heat accumulating internally. Use *Touding Qingshen San* (Top-Penetrating Spirit-Clearing Powder).
*Touding Qingshen San*: *Danggui* (Angelica Sinensis Root), *Baizhi* (Angelica Dahurica Root), *Beixixin* (Asarum Sieboldii Root), *Zhuyazaojiao* (Zanthoxylum Bungeanum Fruit). Grind into powder, mix equally. Have the patient hold a mouthful of water, blow a small amount of powder into the nose, spit out the water, stopping when sneezing occurs. If no sneeze, repeat.
**Zhongbei She** (Middle-Baked Tongue): The tongue is purely red with black shapes inside resembling a small tongue. This signifies evil heat binding in the interior, with Sovereign Fire blazing excessively, counteracting with Water transformation. Take *Liangge San* (Cooling the Diaphragm Powder) and *Dada Chaihu Tang* (Great Bupleurum Decoction).
*Dada Chaihu Tang* (Formula see previous section)
*Liangge San* (Formula see following section)
**Sheng [Hei] She** (Raw [Black] Tongue): The tongue is red with small black spots. Heat toxin enters the Stomach through deficiency, accumulating heat causes disease. Use *Shengma Gegen Tang* (Kudzu and Rhizoma Cimicifugae Decoction) plus *Xuanshen Hua [Ban] Tang* (Scrophularia Spot-Resolving Decoction) to resolve.
*Shengma Gegen Tang* (Formula see previous section)
*Hua [Ban] Tang* (Formula see previous section)
**Hongxing She** (Red Star Tongue): Pale red tongue with large red stars indicates excessive heat of Shaoyin Sovereign Fire. The non-conquering element (Kidney Water) borrows fire to insult Spleen Earth, a precursor to jaundice. Treat with *Yinchen Wuling San* (Artemisia Capillaris and Five-Ingredient Poria Powder).
*Yinchen Wuling San* (Formula see following section)
**Heijian She** (Black-Tipped Tongue): Red tongue with cyan-black tip indicates Kidney heat due to Yin deficiency and Fire excess. Treat with *Zhuye Shigao Tang* (Bamboo Leaf and Gypsum Decoction).
*Zhuye Shigao Tang* (Formula see previous section)
**Liquan She** (Inner-Ring Tongue): Pale red tongue with a central red ring surrounded by pure black. Residual toxins remain in the Pericardium collaterals,郁结 with evil fire, causing extreme亢 of two fires. Purge with *Chengqi Tang* (Daoshi Decoction).
*Chengqi Tang* (Formula see previous section)
**Renlie She** (Human-Crack Tongue): Red tongue with cracks resembling the character "human." Sovereign Fire blazes, heat toxin flares upward, causing cracks. Take *Liangge San*.
*Liangge San* (Formula see following section)
**Chongsui She** (Bug-Eaten Tongue): Red tongue with deep red spots resembling bug-eaten patterns. Heat toxin is excessive, Fire above and Water below fail to assist each other. Purge with *Xiao Chengqi Tang* (Minor Daoshi Decoction).
*Xiao Chengqi Tang* (Formula see previous section)
**Jueyin She** (Jueyin Tongue): Red tongue with black striations. Yin poison reverses into the Liver channel. The Liver governs tendons, hence the silk-like appearance. Treat with *Lizhong Tang* (Regulate the Middle Decoction) and *Sini Tang* (Reverse the Collapse Decoction).
*Lizhong Tang*
*Sini Tang* (Both formulas see previous section)
**Sixian She** (Death-Appearance Tongue): Black tongue clearly showing Water conquering Fire. No survivors. Practitioners must exercise caution.
**Huangtai She** (Yellow-Coated Tongue): White tip, yellow root indicates exterior syndrome remains. Resolve the exterior first, then attack the interior. For constipation, use *Liangge San* with *Mangxiao* (Mirabilite) and *Dahuang* (Rhubarb Root) soaked. For scanty urine, use *Wuling San* (Five-Ingredient Poria Powder) with *Mutong* (Akebia Stem) combined with *Yiyuan San* (Benefit Origin Powder) and a little ginger juice mixed in boiled water.
*Liangge San*
*Wuling San* (Both formulas see previous section)
**Heixin She** (Black-Heart Tongue): White edges, black center with sinking-micro pulse is difficult to treat. Floating-slippery pulse allows sweating; sinking-solid pulse allows purging. Appearance at onset indicates critical danger. Quickly administer *Tiaowei Chengqi Tang*.
*Tiaowei Chengqi Tang* (Formula see previous section)
**Fushi She** (Fifteenth Tongue): White coating on tip (2 parts), black on root (1 part). Accompanied by body ache and aversion to cold. If drinking is not excessive, use *Wuling San*. For spontaneous sweating and thirst, use *Baihu Tang* (White Tiger Decoction). For dysentery, use *Jiedu Tang* (Detoxification Decoction). This is also critical.
*Baihu Tang* (Formula see previous section)
*Jiedu Tang* (Formula see following section)
**Shiliu She** (Sixteenth Tongue): White coating with chaotic small black dots in the middle. Exterior syndrome remains. Though severe, use *Liangge San* to mildly release the exterior, which will recede. Quickly purge with *Tiaowei Chengqi Tang*.
*Tiaowei Chengqi Tang* (Formula see previous section)
**Shiqi She** (Seventeenth Tongue): Grayish tongue with two black halos in the middle. Heat invades the Kidney and Mingmen. Purge urgently. Take *Jiedu Tang*, purging 3-5 times. Delay makes treatment difficult. Increase dosage of *Dahuang* initially.
*Jiedu Tang* (Formula see following section)
**Shiba She** (Eighteenth Tongue): Slightly yellow tongue. Onset with delirium due to missed sweating, exterior pathogen entering interior. Must use simultaneous sweating and purging. Use *Shuangjie San* (Double Release Powder) plus *Jiedu Tang*, equal parts.
*Shuangjie San*
*Jiedu Tang* (Both formulas see following section)
**Shijiu She** (Nineteenth Tongue): White coating in center, slightly yellow outside. Will cause diarrhea. Take *Jiedu Tang*. For aversion to cold, use *Wuling San*.
*Jiedu Tang*
*Wuling San* (Both formulas see following section)
**Shier She** (Twentieth Tongue): Slightly yellow tongue, exterior syndrome not resolved. Use *Xiaochaihu Tang* combined with *Tianshui San* (Heaven-Water Powder). If purgable, use *Daxiehu Tang* (Major Bupleurum Decoction) to purge. Resolve both exterior and interior; apply cautiously clinically.
*Daxiehu Tang* (Formula see previous section)
**Shiyi She** (Twenty-first Tongue): Yellow tongue, likely changed from white. Exterior transmitting to interior, heat entered Stomach. Purge urgently. Delay leads to black color, malignant syndrome, excessive harm, deep ghost-pathogen qi. Use *Tiaowei Chengqi Tang*.
*Tiaowei Chengqi Tang* (Formula see previous section)
**Shier She** (Twenty-second Tongue): Left side white coating with spontaneous sweating. Do not purge. Use *Baihu Tang* with 3 qian of *Renshen* (Ginseng Root).
*Baihu Tang* (Formula see previous section)
**Shisan She** (Twenty-third Tongue): Right side white slippery coating. Disease in muscles, pathogen in half-exterior half-interior. Alternating chills and fever. Use *Xiaochaihu Tang* to harmonize.
*Xiaochaihu Tang* (Formula see previous section)
**Shisi She** (Twenty-fourth Tongue): Left side white slippery coating. Zang-Jie syndrome (Zang binding). Pathogen merges into Zang, difficult to treat.
**Shiwu She** (Twenty-fifth Tongue): White perimeter, yellow center. Causes irritability, thirst, vomiting. With exterior signs, take *Wuling San* and *Yiyuan San* together until yellow disappears.
*Yiyuan San* (Formula see previous section)
*Wuling San* (Formula see following section)
**Shiliu She** (Twenty-sixth Tongue): Yellow tongue with small black dots. Pathogen pervades Six Fu organs, about to enter Five Zang organs. Urgently purge with *Tiaowei Chengqi Tang*. Then administer *Hejie San* (Harmonizing Powder).
*Tiaowei Chengqi Tang* (Formula see previous section)
*Hejie San*: *Bencao*?, *Jiegeng* (Platycodon Root), *Gancao* (Licorice Root, honey-fried, 5 qian each), *Cangzhu* (Atractylodes Rhizome, 3 qian), *Chenpi* (Tangerine Peel), *Nanpu* (Magnolia Bark, ginger-processed, 1 qian each). Boil 2 zhong water with 3 slices ginger and 2 dates to 0.7 portion, strain, drink anytime. *Jiedu Tang*: *Huanglian* (Coptis Rhizome, 1 liang), *Huangbai* (Phellodendron Bark, 5 qian), *Huangqin* (Scutellaria Root, 5 qian), *Shanzhi* (Gardenia Fruit, 6 qian). Take 5 qian per dose, boil 1.5 zhong water to 1 zhong, drink hot. *Wuling San* (add *Yinchen* to make *Yinchen Wuling San*): *Zexie* (Alisma Rhizome, 2.5 qian), *Fuling* (Poria), *Zhuling* (Polyporus, *Baizhu* (Atractylodes Macrocephala Rhizome, 1 liang each), *Rougui* (Cinnamon Bark, 5 qian). Take 6 qian per dose, boil 2 zhong water to 1 zhong, drink warm. *Liangge San*: *Sheng Gancao* (Raw Licorice Root, 2 qian), *Lianqiao* (Forsythia Fruit, 4 qian), *Shanzhiren* (Gardenia Seed, 8 qian), *Dahuang* (Rhubarb Root, 2 qian), *Huangqin* (Scutellaria Root), *Bohe* (Mint), *Pu Xiao* (Mirabilite, 1 qian each). One dose, boil 2 zhong water with 20 leaves of *Dan Zhuye* (Bamboo Leaf) to 1 zhong, drink anytime, stop when purged. *Zhizi Chidui Tang*: *Zhizi* (Gardenia Fruit, 2 qian), *Dan Douchi* (Fermented Soybean, 5 qian). Boil 2 zhong water to 0.7 portion, strain, drink. *Shuangjie San* (plus *Jiedu Tang*): *Fangfeng* (Saposhnikovia Root), *Chuanxiong* (Ligusticum Rhizome), *Danggui* (Angelica Sinensis Root), *Baishao* (White Peony Root), *Dahuang* (Rhubarb Root), *Mahuang* (Ephedra Herb), *Lianqiao* (Forsythia Fruit), *Mangxiao* (Mirabilite, 5 qian each), *Shigao* (Gypsum Fibrosum), *Huangqin* (Scutellaria Root), *Jiegeng* (Platycodon Root, 1 liang each), *Huashi* (Talcum, 3 liang), *Gancao* (Licorice Root, 2 liang), *Jingjie* (Schizonepeta Spike), *Baizhu* (Atractylodes Macrocephala Rhizome), *Shanzhi* (Gardenia Fruit, 5 qian each). Take 1 liang per dose, boil 1.5 zhong water with 3 slices ginger to 0.8 portion, strain, drink. *Yinchen Tang*: *Yinchen* (Artemisia Capillaris Herba, 5 qian), *Dahuang* (Rhubarb Root, 3 qian), *Shanzhiren* (Gardenia Seed, 2 qian). Boil 1.5 zhong water to 1 zhong, strain, drink. *Didang Tang*: *Dahuang* (Rhubarb Root, 3 qian), *Shuizhi* (Leech, stir-fried with glutinous rice, 7 pieces), *Mengchong* (Blue Bottle Fly Larva, stir-fried removing wings/legs, 7 pieces). One dose, boil 1.5 zhong water to 1 zhong, strain, drink. *Shizao Tang*: *Wanhua* (Genkwa Flower, vinegar-soaked stir-fried), *Daji* (Euphorbia Lathyris Root), *Gansui* (Kansui Root, baked, equal parts). Take 2 qian per dose, half for weak persons. Boil 2 zhong water with 10 Jujubes to 0.8 portion, strain, drink.
**Ershiqi She** (Twenty-seventh Tongue): Yellow tongue with white tip. Less exterior, more interior. Take one dose of *Tianshui San* and two doses of *Liangge San* together. If pulse is wiry, use *Fangfeng Tongsheng San* (Saposhnikovia Universal Life Powder).
*Fangfeng Tongsheng San* (Formula see previous section)
**Ershiba She** (Twenty-eighth Tongue): Yellow tongue with partitioned color. Heat entered Stomach, pathogen toxin deep. Heart fire causes irritability and thirst. Urgently purge with *Dachengqi Tang* (Major Daoshi Decoction). For jaundice, use *Yinchen Tang*. For blood stasis, use *Didang Tang*. For fluid retention in hypochondrium, use *Shizao Tang*. For severe Jie Xiong (Chest Binding), add *Xianxiong Tang* (Trap-in-the-Chest Decoction).
*Dachengqi Tang*, *Yinchen Tang*, *Didang Tang*, *Shizao Tang*, *Daxianxiong Tang* (All five formulas see previous section)
**Ershijiu She** (Twenty-ninth Tongue): Slightly red edges, gray-black center. Caused by missed purging. Purge with *Dachengqi Tang*. Heat recedes and recovers after 3-4 purges. If not receding after 5 purges, untreatable.
*Dachengqi Tang* (Formula see previous section)
**San Shi She** (Thirtieth Tongue): Yellow tongue with chaotic black dots. Symptoms: thirst, delirium. Solid pulse indicates survival; choppy pulse indicates death. Clutching clothes and bed indicates untreatable. Black stool after purging also indicates untreatable. Use *Dachengqi Tang*.
*Dachengqi Tang* (Formula see previous section)
**San Shi Yi She** (Thirty-first Tongue): Yellow with black extending to tip. Heat is deep. Seen in Lianggan (Dual Infection), 9 out of 10 die. Severe aversion to cold also dies. Non-aversion to cold with diarrhea is treatable. Use *Tiaowei Chengqi Tang*.
*Tiaowei Chengqi Tang* (Formula see previous section)
**San Shi Er She** (Thirty-second Tongue): Outer pale red, inner pale black. If aversion to wind, exterior not fully resolved. Use *Shuangjie San* plus *Jiedu Tang*, equal parts, mild sweating. After sweating, purge urgently. Chest binding, irritability, fixed gaze indicate untreatable.
*Shuangjie San* plus *Jiedu Tang* (Formula see previous section)
**San Shi San She** (Thirty-third Tongue): Gray tongue, yellow tip, no aversion to cold. Floating pulse allows purging. If aversion to wind/cold, use *Shuangjie San* plus *Jiedu Tang*. Black stool after 3-4 purges indicates untreatable.
*Shuangjie San* plus *Jiedu Tang* (Formula see previous section)
**San Shi Si She** (Thirty-fourth Tongue): Gray-black tongue with black striations. Solid pulse: urgently purge with *Dachengqi Tang*. Floating pulse with thirst/drinking: use *Liangge San*.
*Dachengqi Tang*
*Liangge San* (Formula see previous section)
**San Shi Wu She** (Thirty-fifth Tongue): Slightly black root, yellow tip, slippery pulse allows purging. Floating pulse: nourish Yin, retreat Yang. If aversion to wind/cold, mild sweating with *Shuangjie San*. If diarrhea, use *Jiedu Tang*, saving 7-8 out of 10.
*Shuangjie San*
*Jiedu Tang* (Both formulas see previous section)
**San Shi Liu She** (Thirty-sixth Tongue): Gray-black root, yellow tip, hidden or single striation. Solid pulse: urgently purge with *Dachengqi Tang*. Floating pulse with thirst/drinking: resolve with *Liangge San*. Save 2-3 out of 10. *Dachengqi Tang*.
*Liangge San* (Both formulas see previous section)
The above thirty-six tongue images are key verification methods for Taiyang disease. Clinicians must examine carefully to ensure success.
**Moxibustion on Shaoyin** (For Shaoyin vomiting/dysentery, hands/feet not cold, able to eat/drink, pulse absent):
Shaoyin refers to Taixi acupoint. Taixi points are located behind the medial malleolus in the depression of the posterior heel bone artery. Moxa 7 cones.
**Moxibustion on Guanyuan Acupoint** (For Zang-Jie death syndrome, not suitable for purging, use this):
Guanyuan point is 1 cun below the umbilicus, intersection of Shaoyin and Ren Mai.
**Moxibustion on Qimen Acupoint** (For women with Heat Entering Blood Chamber, cough/counterflow qi, hiccups):
For women, at the end of the nipple downwards to the bone gap. For men or those with small breasts, use finger measurement. Depression with arterial pulse is the point. Moxa cone size of a small bean, moxa 5-7 cones. For women with Heat Entering Blood Chamber, acupuncture: insert needle, ask patient to inhale 5 times, retain needle for a long time, then remove.