臭毒。俗名发痧。皆由中气素亏之故。盖脾胃之所喜者香燥。所恶者臭湿。今脾胃真气有亏。
或素多湿郁。所以不能主持。故臭恶之气。得以直犯无禁。发则腹痛。不能饮食。或上连头额俱
痛。或下连腿及委中俱痛。甚至有欲吐不吐。欲泻不泻。或四肢厥逆。面青脉伏。或遍体壮热。
面紫脉坚。此平昔火衰火盛之别也。有痛死不知人。少间复苏者。有腹痛不时上攻。水浆不入。
数日不已者。欲试真否。但与生黄豆嚼之。觉香甜者。即是臭毒。觉腥者非也。举世有用水搭肩
背及臂者。有以苎麻水湿刮之者。有以瓷碗油润刮之者。有以瓷锋针刺委中出血者。有以油纸点
照。视背上有红点处皆烙之者。总欲使腠理开通之意。又有以冷水咽椒数十粒者。有以白矾生研
冷水。调服二三钱者。然椒性辛散。误饵无妨。矾性酸涩。苟非臭毒。为祸不浅。多有误认食积。
屡攻不愈。绵延十日半月而死者。常见有大饮冷水。而变下痢者。亦有饮水停于肺中。而变水肿
者。有误服矾水。呃逆呕哕不止者。有刺委中去血过多。移时而死者。亦有伤寒阴证腹痛。误刺
委中。及饮冷水。而致不救者。又有内伤冷食腹痛。误刺委中。而致转剧者。诚可悯也。按此腹
痛。乃阴邪秽气。郁遏脾胃中伏火。两邪相击而致。每苦时常举发。药之不应。古法。有初得病
时。饮以艾汤试吐。即是此证。有以蚕蜕纸泡汤饮之。温覆取汗。盖蚕性豁痰祛风利窍。其纸已
经盐过而顺下最速也。余尝谓此证既属中土气衰。秽气内贼。盒饭用利气药以散秽浊之气。合用
一味香附。童便浸晒为末。停汤顿服四五钱立效。或越鞠丸、沉香降气散亦佳。又脾虚挟火。兼
犯秽气。则心腹扰痛。上下不通。俗谓之干霍乱。近世谓之绞肠痧。以秽气在外。固结不散。火
邪在内。攻击不开。故为证最急。急以盐置刀头烧红。淬水中。搅匀灌吐。以升提郁闭之气。然
后以藿香正气散。放温与之。曾见有热服汤药而毙者。有服玉枢丹、苏合香丸而愈者。然不若盐
汤和童便为最。点眼砂亦佳。
但凡臭恶腹痛。脉或伏。或细小紧涩。或坚劲搏指中而带促结。皆是阴逆阳伏之象。不可误认阴
寒而投热药。致动其火。为害不可胜言。非但热药当禁。即砂仁辛温香窜。生姜辛辣上升气。酒
辛烈助火。皆当忌之。热汤亦切勿与。热浴尤为大忌。热则上冲莫制也。若见面青唇黑。脉劲搏
指。厥逆喘促者。多不可救也。
臭毒。俗称发痧。都是由于中气素来亏虚的缘故。大概脾胃所喜欢的是香燥之气，所厌恶的是臭湿之气。如今脾胃真气有亏损，或者原本湿气郁滞较多，所以不能主持运化。因此臭恶之气得以直接侵犯而无人阻挡。发作时出现腹痛，不能进食。有的疼痛向上牵连到头额都痛，有的向下牵连到腿部和委中都痛。甚至有想吐吐不出来，想拉拉不出来的情况。或者四肢厥冷，面色青紫，脉象伏匿；或者全身壮热，面色紫红，脉象坚劲。这是平时火衰或火盛的区别。有的痛得死去活来不知人事，过一会儿又苏醒过来。有的腹痛不时向上攻冲，水浆无法入口，数日不愈。想要试探是否真的是臭毒，只需给患者嚼生黄豆，觉得香甜的，就是臭毒；觉得腥味的就不是。
世上有人用水搭在肩背及手臂上（试图引邪外出），有用苎麻水湿润后刮拭的，有用瓷碗涂油润后刮拭的，有用瓷锋针刺委中穴放血的，有用油纸点照，看到背上有红点的地方就用火烙的。这些方法总归是想让腠理开通的意思。又有用冷水吞服花椒几十粒的，有用白矾生研后用冷水调服二三钱的。然而花椒性味辛散，误服无妨；白矾性味酸涩，如果不是臭毒，造成的祸害就不浅了。多有误认为是食积，屡次使用攻下法治疗不愈，拖延十天半月而死的人。常见有大饮冷水，反而变成下痢的；也有饮水停滞在肺中，变成水肿的；有误服矾水，导致呃逆、呕吐不止的；有刺委中放血过多，过了一会儿就死亡的；也有患伤寒阴证腹痛，误刺委中，以及饮用冷水，导致无法救治的；又有内伤冷食腹痛，误刺委中，导致病情加重的。实在令人怜悯。
按此腹痛，乃是阴邪秽气，郁遏脾胃中潜伏之火，两邪相击而致。常常苦于时常发作，用药不应。古法中，有刚得病时，饮用艾叶汤试吐，如果是此证就会吐出。有用蚕蜕纸泡汤饮用，温覆取汗的方法。盖因蚕性豁痰祛风利窍，其纸已经盐渍过而顺下最快。我曾说此证既然属于中土气衰，秽气内贼，应当用利气药以散秽浊之气，合用一味香附，用童便浸晒为末，停汤顿服四五钱，立刻见效。或者越鞠丸、沉香降气散也很好。又有脾虚挟火，兼犯秽气，则心腹扰痛，上下不通，俗称为干霍乱，近世称为绞肠痧。因为秽气在外，固结不散，火邪在内，攻击不开，所以病症最为急迫。紧急时用盐放在刀头上烧红，淬入水中，搅匀灌服催吐，以升提郁闭之气。然后用藿香正气散，放温后给予服用。曾见有热服汤药而毙命的，有服玉枢丹、苏合香丸而痊愈的。然而不如盐汤和童便最好。点眼砂也很好。
凡是臭恶腹痛，脉象或伏匿，或细小紧涩，或坚劲搏指中带促结，都是阴逆阳伏的现象。不可误认为阴寒而投用热药，致使动其火，危害不可胜言。不仅热药当禁，即如砂仁辛温香窜，生姜辛辣上升之气，酒辛烈助火，都应当忌之。热汤也切勿给予，热浴更是大忌。热则上冲无法控制。如果见面色青黑，脉劲搏指，四肢厥冷，气喘急促的，大多不可救也。
Chou Du (Stench Poison), commonly known as Fa Sha (Epidemic Heat Toxin). It is all caused by the inherent deficiency of Middle Qi (Vital Energy of the Middle Jiao). Generally, the Spleen and Stomach favor aromatic and dry substances, but detest foul and dampness. Now, if the True Qi of the Spleen and Stomach is deficient, or if there is originally excessive dampness stagnation, it cannot govern and transform properly. Therefore, foul and evil Qi can invade directly without restraint. Upon onset, abdominal pain occurs, and the patient cannot eat. The pain may radiate upward to involve the entire head and forehead, or downward to involve the legs and Weizhong (BL40). In severe cases, there is a desire to vomit but unable to do so, or a desire to defecate but unable to do so. Alternatively, there may be cold limbs, cyanotic complexion, and a deep-hidden pulse; or high fever throughout the body, purplish-red complexion, and a firm pulse. These distinctions reflect whether one's constitution tends toward Fire Deficiency or Fire Excess. Some patients collapse in pain and lose consciousness, only to recover after a short while. Others experience intermittent upward attacking abdominal pain, inability to take in fluids, persisting for several days. To test if it is truly Chou Du, have the patient chew raw soybeans. If they taste sweet, it is Chou Du; if they taste fishy, it is not.
In the world, some methods include pouring water over the shoulders, back, arms, and hands (to draw out pathogens); scraping with Ramie fiber soaked in water; scraping with a porcelain bowl lubricated with oil; pricking Weizhong (BL40) with a porcelain shard to bleed; or using an oiled paper lamp to illuminate the back, identifying red spots, and cauterizing them. All these methods aim to open the Cou Li (interstices and skin pores). Other methods include swallowing dozens of Sichuan peppercorns with cold water, or taking 2-3 qian of raw-studied Alum dissolved in cold water. However, since Peppercorn has a pungent and dispersing nature, accidental ingestion does no harm. Alum has a sour and astringent nature; if it is not Chou Du, the harm caused will be profound. Many are misdiagnosed as Food Stagnation, treated repeatedly with purgatives without success, dragging on for ten days or half a month until death. It is common to see those who drink large amounts of cold water and subsequently develop Dysentery; or those whose water retention in the Lung leads to Edema; or those who accidentally ingest Alum water, resulting in persistent hiccups and vomiting; or those who bleed too much from Weizhong pricking and die shortly after; or those with Cold Damage Yin Syndrome abdominal pain who are mistakenly pricked at Weizhong and drink cold water, leading to untreatable conditions; or those with Internal Injury from Cold Food abdominal pain who are mistakenly pricked at Weizhong, causing the condition to worsen. This is truly pitiable.
According to this analysis, the abdominal pain is caused by Yin Evil and Filthy Qi suppressing the latent Fire within the Spleen and Stomach, with the two evils striking each other. It often recurs frequently, and medications are ineffective. Ancient methods suggest that upon initial onset, drinking Mugwort Decoction to induce vomiting can confirm the diagnosis. Another method involves drinking tea made from Silkworm Molt Paper and covering warmly to induce sweating. This is because Silkworms have properties to resolve Phlegm, dispel Wind, and open orifices, and the paper, having been salted, descends rapidly. I once stated that since this syndrome belongs to the decline of Earth Qi and internal invasion by Filthy Qi, one should use Qi-moving herbs to dissipate turbid filth, combined with a single herb: Cyperi Rhizoma (Xiangfu), soaked in Child's Urine, dried, powdered, and taken in one dose of 4-5 qian with warm water for immediate effect. Yueju Pill or Chenxiang Jiangqi San are also good options. Furthermore, if Spleen Deficiency with accompanying Fire combines with Filthy Qi invasion, it causes chaotic pain in the heart and abdomen, with blockage above and below. This is colloquially called Gan Huoluan (Dry Cholera), and in recent times, Jiaochang Sha (Intestinal Twisting Miasma). Because Filthy Qi is external, solidified and unscattered, and Fire Evil is internal, attacking but unable to break through, the syndrome is extremely urgent. Emergency treatment involves placing Salt on the head of a knife, heating it until red, quenching it in water, stirring well, and administering to induce vomiting, thereby lifting the trapped and closed Qi. Subsequently, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) should be given lukewarm. I have seen cases where hot herbal decoctions led to death, while others recovered with Yushu Dan or Suhe Xiang Wan. However, Salt Water mixed with Child's Urine is superior. Dian Yan Sha (Eye-Dotting Sand) is also effective.
Whenever there is foul-smelling abdominal pain, with pulses that are hidden, fine, small, tight, and choppy, or firm and beating against the finger with rapid and intermittent rhythms, these are signs of Yin Rebellion and Yang Trapping. One must not mistake this for Yin-Cold and administer Hot Herbs, which would agitate the Fire and cause immeasurable harm. Not only Hot Herbs are contraindicated, but also Amomi Fructus (Sharen) due to its pungent-warm and aromatic penetrating nature, Ginger Root (Shengjiang) due to its pungent-spicy and ascending nature, and Alcohol due to its pungent-hot and fire-assisting nature. All should be avoided. Hot soups should definitely not be given, and hot baths are particularly taboo. Heat causes upward rushing that cannot be controlled. If the patient presents with cyanotic face and black lips, a firm pulse beating against the finger, cold limbs, and panting, recovery is unlikely.