瘟疫本即伤寒，然亦有稍异。以其多发于春夏，且因时气遍行，大小相似，必待日数足
，然后得汗而解者，是为瘟疫之证。虽古法云∶瘟病在三阳者多，三阴者少，然亦不可拘泥
。若见阴证阴脉，是即三阴病也，大宜辨而治之。
一、瘟疫之在三阳者，当辨其经。如脉浮头疼，发热身痛者，太阳证也，宜九味羌活汤
加减治之。若脉长，鼻干，不眠而躁者，阳明病也，宜葛根解肌汤，或十味参苏饮加减治之
。若脉弦而数，胸胁痛而耳聋，少阳证也，宜小柴胡汤加减治之。按此三阳之治，乃古方治瘟
之大略。然此证寒热虚实，无所不有，仍当察治如前，不可拘也。
一、瘟疫初起，而头疼身痛，憎寒发热，脉紧数洪滑，而别无他证，先宜正柴胡饮，或
败毒散，或十神汤。若温疫初起，多阴少阳，脉证无虚者，宜神术散。若瘟疫胸膈满闷，小
柴胡加枳实、橘红。热在内者，仍加黄连。若暑月时行瘟疫，表里俱热甚，宜清火解毒者，
羌活升麻汤。若瘟疫火盛，脉洪大而热躁甚者，三黄石膏汤。若瘟疫热毒上浮，头面俱肿，
目不能开，口干舌燥，咽喉不利者，普济消毒饮。若瘟疫脉洪大，烦躁热渴者，白虎汤。或
兼呕吐者，仲景竹叶石膏汤。若瘟疫发狂谵语，脉洪大滑实，而大便秘结不通者，大承气汤
，或鸡子清饮。若瘟疫内外俱有实邪，大便不通，当表里双解者，防风通圣散。若瘟疫病八
九日不退，而发斑发黄。但脉不虚不浮紧，而腹见痞满者，率可以承气、五苓合服而下之。
若瘟疫头身红赤，肢体热甚，烦躁不能当者。宜用解瘟疫热毒法，及内饮悉尼浆，或用井花
水调玉泉散，俱妙。按以上诸法，乃因时因证，皆阳证实邪之所宜。若瘟疫脉弱无力，或外虽
实而内则虚，或口不喜冷，大便不结之类，即非阳证，不得以身热脉数，俱认为火，虽在暑
月，如理中汤、理阴煎、大温中饮、大补元煎，及前温补诸法，皆当随证必用，此舍时从证
之妙法也。矧夏月尤多伏阴，故凡临此证者，必先察阴阳，次辨虚实，则其要也。宜切识之
。
徐东皋曰∶瘟疫六七日不解，以致热入血室，发黄身如烟熏，目如金色，口燥而热结。
以砭针刺曲池出恶血，仍以通圣散兼散兼下。得汗如黄水，粪如黑膏而即愈。按此即此方之
所谓打寒也。其法用手捋上膊，使血聚于臂，以帛缚定，乃用筋夹瓷锋，击刺肘中曲泽傍之
大络，使邪毒随恶血而出，亦最捷之法，穷人用之极效，然非曲池穴也。
瘟疫本质上属于伤寒范畴，但也存在一些细微差异。因为瘟疫多发生在春夏季节，且由于时行疫气广泛传播，病情表现大小相似，必须等到病程天数充足，然后才能通过出汗而解除的，这就是瘟疫的证候。虽然古法说：瘟病在三阳经的多，在三阴经的少，但也不可拘泥不变。如果见到阴证的脉象和症状，那就是三阴病，非常需要仔细辨别并治疗。
一、瘟疫发生在于三阳经的，应当辨别其所属经络。如脉浮、头痛、发热、身体疼痛的，是太阳病（太阳经受邪所致的病证），适宜用九味羌活汤加减治疗。如果脉长、鼻干、不眠且烦躁的，是阳明病（阳明经受邪所致的病证），适宜用葛根解肌汤，或十味参苏饮加减治疗。如果脉弦而数、胸胁痛且耳聋的，是少阳病（少阳经受邪所致的病证），适宜用小柴胡汤加减治疗。按此三种阳经的治疗，是古代方剂治疗瘟疫的大致原则。然而这种病症寒热虚实无所不有，仍然应当像前面所说那样观察治疗，不可拘泥。
一、瘟疫初起，出现头痛身痛、怕冷发热、脉紧数洪滑，而没有其他症状的，先适宜用正柴胡饮，或败毒散，或十神汤。如果温疫初起，阴证多而阳证少，脉证没有虚象的，适宜用神术散。如果瘟疫导致胸膈满闷，用小柴胡汤加枳实、橘红。热在体内的，再加黄连。如果在暑月发生的时行瘟疫，表里都热得很厉害，适宜用清火解毒法的，用羌活升麻汤。如果瘟疫火气旺盛，脉洪大且热躁严重的，用三黄石膏汤。如果瘟疫热毒上浮，头面部都肿胀，眼睛不能睁开，口干舌燥，咽喉不利的，用普济消毒饮。如果瘟疫脉洪大，烦躁热渴的，用白虎汤。或者兼有呕吐的，用张仲景的竹叶石膏汤。如果瘟疫发狂谵语，脉洪大滑实，且大便秘结不通的，用大承气汤，或鸡子清饮。如果瘟疫内外都有实邪，大便不通，应当表里双解的，用防风通圣散。如果瘟疫病八九日不退，出现发斑发黄。只要脉不虚不浮紧，且腹部见痞满的，通常可以用承气汤、五苓散合服来攻下。如果瘟疫头身红赤，肢体热得很厉害，烦躁得无法忍受的。适宜用解瘟疫热毒的方法，以及内服悉尼浆，或用井花水调玉泉散，都非常好。按以上各种方法，都是因时因证，适用于阳证实邪的。如果瘟疫脉弱无力，或者外边虽实而内部则虚，或者口不喜欢冷的，大便利结之类的，就不是阳证，不能因为身热脉数，就都认为是火证，即使在暑月，如理中汤、理阴煎、大温中饮、大补元煎，以及前面的温补各种方法，都应当随证必用，这是舍弃时令而从证候论治的妙法。况且夏季尤其多有伏阴，所以凡是遇到这种病症的人，必须先察阴阳，再辨虚实，这才是关键。应该深切记住。
徐东皋说：瘟疫六七日不解，导致热入血室（热邪侵入胞宫或血分），发黄身体如烟熏，眼睛如金色，口燥且热结。用砭针刺曲池穴放出恶血，仍用防风通圣散兼用散法和下法。出汗像黄水一样，粪便像黑膏一样随即痊愈。按此就是此方所说的“打寒”疗法。其方法是用手捋上臂，使血液聚集于手臂，用布帛绑紧，然后用筋夹持瓷锋，击刺肘中曲泽旁的大络，使邪毒随着恶血排出，也是最快捷的方法，穷人使用极有效，但这并非曲池穴。
Plague (Yi Wen) is essentially in the category of Cold Damage (Shang Han), yet there are slight differences. Because plague tends to occur in spring and summer, and due to the widespread circulation of seasonal epidemic qi, the manifestations are similar in severity; it is only after a sufficient number of days have passed that sweating occurs leading to resolution, which constitutes the syndrome of plague. Although ancient texts state that plague diseases affecting the Three Yang meridians are more common than those affecting the Three Yin meridians, one must not adhere rigidly to this. If yin syndromes and yin pulses are observed, it is a disease of the Three Yin meridians, requiring careful differentiation and treatment.
One: For plague affecting the Three Yang meridians, one must differentiate by meridian. If the pulse is floating, accompanied by headache, fever, and body pain, it is a Taiyang syndrome (syndrome caused by pathogenic invasion of the Taiyang channel); Jiwei Qianghuo Decoction (Nine-Ingredient Notopterygium Decoction) with modifications is appropriate. If the pulse is long, with dry nose, insomnia, and restlessness, it is a Yangming syndrome (syndrome caused by pathogenic invasion of the Yangming channel); Gegen Jieji Decoction (Pueraria Muscle-Releasing Decoction) or Shiwei Shenru Yin (Ten-Ingredient Ginseng and Perilla Drink) with modifications are appropriate. If the pulse is wiry and rapid, with chest and hypochondriac pain and deafness, it is a Shaoyang syndrome (syndrome caused by pathogenic invasion of the Shaoyang channel); Xiao Chaihu Tang (Minor Bupleurum Decoction) with modifications is appropriate. These treatments for the three yang meridians represent the general principles of ancient formulas for treating plague. However, such conditions encompass all types of cold, heat, deficiency, and excess; therefore, observation and treatment should follow previous guidelines without rigidity.
One: In the initial stage of plague, presenting with headache, body pain, aversion to cold and fever, and a tight, rapid, full, or slippery pulse, without other symptoms, Zheng Chaihu Yin (Correct Bupleurum Drink) initially is appropriate, or Baidu San (Defend Against Toxins Powder), or Shishen Tang (Ten-God Decoction). If warm plague begins with predominantly yin and little yang, and the pulse and signs show no deficiency, Shenzhu San (Divine Operation Powder) is appropriate. If plague causes fullness and oppression in the chest and diaphragm, Xiao Chaihu Tang (Minor Bupleurum Decoction) combined with Zhishi (Immature Bitter Orange) and Juhong (Aged Tangerine Peel) is used. If heat is internal, add Huanglian (Coptis Rhizome). If seasonal plague occurs during summer months with severe heat in both exterior and interior, Qinghuo Jiedu (Clearing Fire and Resolving Toxin) methods are suitable; Qianghuo Shengma Tang (Notopterygium and Ligusticum Decoction) is used. If plague fire is excessive, with a full, large pulse and severe heat and restlessness, Sanhuang Shigao Tang (Three-Yellow Gypsum Decoction) is used. If plague heat-toxin floats upward, causing swelling of the head and face, inability to open the eyes, dry mouth and tongue, and throat obstruction, Puji Xiaodu Yin (Universal Benefit Detoxification Drink) is used. If plague presents with a full, large pulse, restlessness, heat, and thirst, Baihu Tang (White Tiger Decoction) is used. If accompanied by vomiting, Zhang Zhongjing's Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is used. If plague leads to mania and delirium, with a full, large, slippery, and solid pulse, and constipation, Dachengqi Tang (Major Order the Qi Decoction) or Jizi Qing Yin (Egg White Drink) is used. If plague involves excess pathogens both internally and externally, with constipation, requiring simultaneous release of exterior and interior, Fangfeng Tongsheng San (Saposhnikovia Unblocking Heroic Powder) is used. If plague persists for eight or nine days without subsiding, presenting with macules and jaundice, provided the pulse is not deficient or tight-floating, and abdominal distension is present, Chengqi Tang (Order the Qi Decoction) and Wuling San (Five-Ling Powder) can be taken together to purge. If plague causes redness of the head and body, extreme limb heat, and unbearable restlessness, methods to resolve plague heat-toxin are appropriate, along with drinking Xini Jiang (Sydney Slurry - *Note: likely a transcription error in original text for a local remedy*) or mixing Yuquan San (Jade Spring Powder) well water; both are excellent. The aforementioned methods are all suitable for yang syndromes and excess pathogens based on time and condition. If the plague pulse is weak and powerless, or if the exterior appears excess while the interior is deficient, or if the patient dislikes cold drinks and has loose stools, it is not a yang syndrome. One must not assume it is fire merely because of fever and rapid pulse; even in summer, Lizhong Tang (Regulate the Middle Decoction), Liyin Jian (Nourish Yin Decoction), Dawenzhong Yin (Great Warm the Middle Drink), Dabuyuan Jian (Great Tonify Origin Decoction), and other warming and tonifying methods mentioned previously should be used according to the syndrome. This is the subtle method of abandoning temporal considerations in favor of syndrome differentiation. Moreover, summer often harbors latent yin; thus, when encountering such cases, one must first observe yin and yang, then differentiate deficiency and excess—this is the key. It must be deeply remembered.
Xu Donggao stated: If plague remains unresolved after six or seven days, leading to heat entering the Blood Chamber (Xue Shi), resulting in jaundice where the body looks like smoke, eyes appear golden, dry mouth, and heat accumulation, bi-sticking acupuncture at Quchi (LI11) to release bad blood, combined with Fangfeng Tongsheng San (Saposhnikovia Unblocking Heroic Powder) using both dispersing and purging methods, results in recovery. Sweating resembles yellow water, and stool resembles black paste. This refers to the "Da Han" (Beating Cold) method described in this formula. The technique involves stroking the upper arm to gather blood there, binding it tightly with cloth, then using a tendon clamp holding a porcelain edge to strike the large collateral near Quze (PC3) in the elbow, allowing evil toxins to exit with the bad blood. This is also a very swift method, extremely effective for the poor, though it is not actually the Quchi acupoint.