典藏书目

When taking medicine for Shanghan (Cold Damage disease), stop medication as soon as the condition improves; there is no need to finish the entire dose. *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) states: After a recent recovery from Shanghan, consuming pork, mutton blood, raw fish, and other rich or greasy foods will inevitably cause severe diarrhea. Consuming wheat cakes, fried foods, or fruits may also lead to recurrent fever because the Stomach Qi is still deficient and unable to digest them; these conditions are difficult to treat. It further states: After a recent recovery, one should only consume small amounts of rice gruel, maintaining a slight sense of hunger, avoiding overeating, indulgence, or arbitrary eating; even if cravings arise, such foods should not be provided. One must also avoid heavy meats and various bone broths. *Bencao* (Materia Medica) notes: Mutton is hot in nature; consuming it after recovery can cause fever leading to death. Furthermore, after a recent recovery, one should rest quietly in bed; one must not get up early to comb hair or bathe, nor engage in excessive physical labor, talking, or mental exertion, as these will cause Laofu (recurrence due to overexertion). Additionally, engaging in sexual activity within 100 days of recovery, before strength has fully returned, will invariably cause recurrent fever and death, which is untreatable. These are the major taboos after recent recovery.

1. In cases of Shanghan where the patient runs wildly and becomes uncontrollable, first place a basin of fire in the patient's room and pour a bowl of vinegar onto the fire. The inhalation of vinegar vapor will calm the patient, allowing for an accurate assessment of the excess heat and mania (Yang Kuang) to ensure correct medication. If, after the initial symptoms of headache, fever, and aversion to cold have subsided, the patient climbs high, sings, discards clothes, runs around, climbs walls or roofs, shouts curses, feels extreme thirst desiring death, and presents with a forceful pulse, this indicates that pathogenic factors have entered the interior, causing Yang excess and mania. Cold-purgative herbs should be used. Cases presenting with curled tongue and retracted testicles are untreatable. Conversely, if at the onset there is no headache, only slight body heat, a red face resembling "floating Yang" (Dai Yang), irritability, and a deep, faint, and weak pulse, with a desire to sit or lie on cool water, this is caused by extreme cold triggering agitation, known as Yin syndrome resembling Yang (Yin Zuo Si Yang). Hot-warming herbs should be used; this is called Yin Restlessness (Yin Zao). Cases presenting with cold extremities, diarrhea, and delirious speech are untreatable. If physicians fail to examine the pulse and mistake restlessness caused by floating deficiency Yang for excess heat, administering cooling medicines will exacerbate thirst and agitation, depleting Qi and causing great harm. One must distinguish between forceful and weak pulses; this is a sound method.

1. For severe abdominal pain in Shanghan, give the patient a bowl of cool water. If the pain alleviates slightly, it is classified as Heat Pain, treated with cooling herbs. If cooling fails and the patient develops hard, painful tenderness around the umbilicus, dry stool, irritability, and thirst, it is Dry Feces Pain, requiring urgent purgation with cold herbs. Food stagnation pain is treated similarly. If there is hardness and pain in the lower abdomen, free urination, black stool, and yellowing of the body and eyes, it is Blood Stasis Pain, treated with cold agents combined with blood-invigorating herbs until black material is discharged, indicating cure. These three scenarios follow the principle that pain diminishes with unblocking.
If drinking water exacerbates the pain, it is Cold Pain, treated with warming harmonizing herbs. If this fails and progresses to cold extremities, abdominal pain, vomiting, and diarrhea, urgent administration of warming herbs is required. Distinguishing between forceful and weak pulses is essential.

1. For true cold syndromes directly attacking the Yin meridians in Shanghan, characterized by severe illness and absence of pulse, or loss of Yuan Qi due to vomiting and diarrhea resulting in absent pulse, administer half a cup of good wine mixed with half a cup of ginger juice. Recovery of the pulse indicates treatability. Medication should be based on Yin syndrome characteristics, regardless of whether the pulse is floating, sunken, large, or small; any palpable pulse indicates life. If the pulse remains absent after this intervention, death is certain. Inquire about specific painful areas; intense pain often causes the pulse to become hidden (Fu), which is not necessarily ominous. However, if there is no pain and the pulse remains absent after intervention, it is ominous. Also, check if the patient normally has a pulse in a specific position; when taking the pulse with the hand reversed, presence of pulse indicates safety. If the pulse was previously absent in that position but appears upon reversal, it indicates disorder of Yin and Yang, requiring harmonization. Absence of pulse in both normal and reversed positions indicates death.

1. For coating on the tongue in Shanghan, regardless of whether it is slippery, white, yellow, or black, soak a piece of blue cloth in well water, apply it to the tongue, clean it, and then repeatedly scrape the tongue with slices of fresh ginger dipped in water until the coating recedes. Black coating with prickles on the tongue indicates death, signifying deep penetration of heat toxin where Kidney Water fails to control Heart Fire. (Note: The statement that Kidney Water controls Heart Fire here may be erroneous; given the deep heat toxin, it is more likely that Kidney Water fails to restrain the Fire pathogen.) For jaundice, rub the whole body frequently with fresh ginger until the yellowing subsides. For stubborn fullness, oppression, and hard pain in the chest, heart, and hypochondrium due to pathogenic accumulation, crush one piece of fresh ginger, remove the juice, stir-fry the residue until slightly dry yet moist, wrap it in silk, and apply warm compresses to the affected area. Once relieved, mix the residue with the reserved juice, dry it again, and apply warm compresses for a prolonged period until a sensation of relief is achieved.

1. For persistent epistaxis (nosebleed) in Shanghan, grind roasted black Gardenia (Shanzhi) into fine powder, insufflate it into the nose, and apply wet grass paper to the nostrils externally to stop bleeding. If the bleeding is merely dripping and not flowing, the pathogen remains in the meridians; refer to secret formulas elsewhere, not this method.

1. When heat pathogen transmits to the interior in Shanghan, after taking medicine, take one sheng of bran stir-fried with salt, wrap it in silk, and place it on the patient's abdomen. Apply gentle warm compresses to facilitate the movement of medicinal Qi via heat, aiding bowel movement.

1. For continuous hematemesis (vomiting blood) in Shanghan, swallow small sips of chive juice mixed with ground Jingmo (Beijing Inkstick). The blood will turn black and stop. If chive juice is unavailable, egg white can be used. This relies on the principle that red corresponds to Fire and black to Water, thus achieving mutual restriction.

1. For true cold syndromes directly attacking Yin meridians or Yin Toxic syndromes in Shanghan, presenting with body pain like being beaten, severe abdominal cramping, heavy retching, unconsciousness, limbs cold as ice, cyanosis of nails and lips, inability to ingest medicine, deep and thin six pulses, or absent/nearly absent pulses: Bind a handful of green onions, cut off roots and leaves leaving about three inches of white part, and mash into a cake. Place half a fen of Musk in the umbilicus, cover with the onion cake, and apply warm compresses. Replace the cake when it rots, changing two or three times. Once the patient regains slight consciousness, administer Ginger Juice Decoction along with Hu yang Jiu Ji Tang (Restore Yang Rescue Crisis Decoction). If unconscious, moxa Guanyuan (CV-4) and Qihai (CV-6) acupoints for 20-30 moxa cones to conduct internal heat, expel external pathogen, and restore Yang Qi within the extreme Yin. Warming extremities and sweating indicate survival; lack of warmth, sweating, and continued unconsciousness indicate death.

1. For Shanghan febrile diseases where heat transmits to the interior and reaches extreme hyperactivity without resolution: Decoct Coptis (Huanglian) in water, chill it in well water, soak a blue cloth, and apply to the chest. Replace when slightly warm. Remove once heat subsides slightly; do not leave for long. Use this in summer, not in winter.

1. For Shanghan patients who vomit immediately after taking medicine and cannot retain it: Firmly press Neiguan (PC-6) acupoint using a bamboo tube, then administer half a cup of hot natural ginger juice to stop vomiting. Generally, cold medicines should be taken warm, hot medicines cold, and neutral medicines lukewarm. To induce sweating, even pungent-sweet formulas should be taken hot; to stop sweating, even pungent-sweet-warm formulas should be taken warm.

1. For Stroke (Zhong Feng) with phlegm-jue, sudden collapse, coma, and near-death state: First, burn paper twisted with Soap Pod (Zaojiao) powder and inhale the smoke into the nose. Presence of sneezing indicates treatability. Then use expectorant method: Mix 5 fen of Soap Pod powder, 3 fen each of Pinellia (Banxia) and Alum (Baifan) into fine powder, mix with ginger juice, and induce vomiting. Follow with modified Dao Tan Tang (Guide Out Phlegm Decoction). Absence of sneezing indicates untreatability.

1. For Gan Huoluan (Dry Cholera) unable to vomit: Drink one bowl of boiling water mixed with 3 fen of Soap Pod powder and a pinch of salt to induce vomiting. Do not provide rice soup; doing so is fatal as grain Qi aids the pathogen.

1. For sudden collapse due to Cold invasion, coma, and unconsciousness: Administer half a cup of hot wine mixed with half a cup of ginger juice. Once slightly conscious, administer Jia Wei Li Zhong Yin (Modified Regulate Middle Drink) for efficacy. Non-drinkers should receive only ginger juice, following the same protocol. This condition is common in the twelfth lunar month but rare in other months.

1. For Shanghan persisting beyond ten days with exterior signs suitable for diaphoresis: Use Qianghuo Chonghe Tang (Notopterygium Harmonizing Decoction) for mild sweating. If interior signs suitable for purgation appear after ten days: Use Da Chaihu Tang (Greater Bupleurum Decoction) for purgation. Since Shanghan lasting many days depletes Zheng Qi, strong formulas like Mahuang Tang or Chengqi Tang are too harsh. Misuse of Mahuang leads to loss of Yang; misuse of Chengqi leads to uncontrollable purging. Hence the warning. If exterior signs remain while interior urgency requires purgation, Da Chaihu Tang is used to harmonize exterior and interior gently. For elderly, weak, or Qi-Blood deficient patients with interior excess signs, Da Chaihu Tang is also used to avoid damaging Yuan Qi. Young and robust patients are not bound by this prohibition and should be treated according to individual suitability.