Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)

Category: Formulas that Clear Heat

Pattern: Yin Yang Exchange (陰陽易) syndrome: Transmission of from Toxins through the genitals during sexual intercourse with someone who is infected with Cold Damage.

Key Symptoms: A heavy sensation in the body, shortness of breath, twitching and spasms in the lower abdomen that radiates to the outer genitals, a sensation of heat that surges to the chest, a heavy sensation in the head that makes the patient not want to lift their head, floaters in front of the eyes and spasms in the knees and lower legs.
Secondary Symptoms: Chao Yuanfang (610 C.E.) added: A gummy substance in the eyes, hypertonicity of the four limbs and the hands and feet curl into fists. They gradually become weaker until the joints separate, Qi and Blood become empty, the bones and Marrow are exhausted, strength decreases and they cling to the bed unable to move. They rely on people for their daily life for months or even years, and eventually die. Xu Shuwei (12^th century) also agreed this could be fatal, warning a patient that "he would spit out his tongue several inches and then die" if not treated.

Abdomen: Twitching and spasms in the lower abdomen

Ingredients

Subsitutions:
This is an example of a formula based upon magical principles that remains within the Shang Han Lun. Xu Shuwei prescribed this formula accomanied with mouse dropping decoction (豭鼠粪湯 Jia Shu Fen Tang) but this is also not commonly used today. Modern commentaries usually suggest replacing with Zhu Ru, Tian Hua Fen and Bai Wei (Hot type), or Si Ni Tang or Dang Gui Si Ni Tang (Cold Type).

Preparation: Char the crotch of a woman's underwear to ashes. Take 6-9g of the ashes with water and take three times per day. Urination should return to normal and there should be a slight swelling of the glans penis which will indicate recovery from the disease. Should a woman suffer from this disorder the ashes should be prepared from a man's underwear.

Actions: Clears stagnation, expels Turbidity and resolves Toxicity, fortifies the Jing and Qi.

Notes:
This syndrome is often described as a kind of sexual obsession which is being cured through magical principles in modern texts that focus on the symbolism of the formula but historically it was considered the contraction of a External Pathogen from a sexual partners of the opposite sex when one party has not fully recovered from Cold Damage. See Wilcox (2025) for a complete discussion of its mention throughout history.