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The lady of Mr. Tao Junsheng in the town of Zhenhai suffered from edema and vomiting, which persisted for over a month. Initially, there was swelling of the feet during pregnancy, which worsened significantly postpartum, accompanied by coughing and vomiting. Several renowned physicians in the area treated her, administering sequentially Zhouche Wan (Boat and Cart Pill), Wupi Yin (Five-Peel Decoction), Gualou Xiebai Baijiu Tang (Trichosanthes Rhizome, Macrostemon Tuber, and White Wine Decoction), and Bazhen Tang (Eight-Treasure Decoction), but to no avail. Her face, eyes, and limbs were all swollen, and her abdomen was distended like a drum. Although she could eat after vomiting, her pulse was wiry and slippery yet retained Stomach Qi (an indication of preserved Spleen-Stomach function). Her speech was clear. I initially prescribed Xiaobanxia Tang (Minor Pinellia Decoction) with added Ganjiang (Dried Ginger) and Wuweizi (Schisandra Berry), as well Houpo Banxia Gancao Renshen Tang (Magnolia Bark, Pinellia, Licorice, and Ginseng Decoction) and Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction), but without significant effect; her vomiting even intensified. Another physician was recommended, but his treatment also resulted in chest oppression, indicating an impending relapse where she would vomit several bowls of phlegm-fluids before feeling relief. Recently, she felt extreme oppression, almost unable to breathe. Even after vomiting, she still felt oppressed, with coughing preventing her from lying down. After deep contemplation, I realized: "This is due to the airways in the lungs being blocked by phlegm-fluids." The blockage occurs because abdominal distension and oliguria indicate that the stomach and diaphragm are filled with phlegm-fluids. When these fluids fill the diaphragm, they overflow into the lung airways; when the airways are filled, they stir upward, causing vomiting. Hence, the vomitus consists of basins and bowls full of saliva and foam. Once expelled, the diaphragm, lungs, and stomach relax, allowing hunger and eating. However, after a few days, accumulation recurs. This is the essence of the disease. The treatment must focus on expelling phlegm-fluids, especially those in the lung airways. After much thought, I prescribed Sanzi Yangqin Tang (Three-Seed Decoction to Nourish the Elderly) combined with Erchen Tang (Two-Aged Decoction), plus 5 li of Shexiang (Musk) taken with the decoction. Baixiaoziren (White Mustard Seed) can horizontally open lung phlegm; Shexiang's pungent penetration unblocks airways and diaphragm obstruction and stops vomiting.

On the next day's follow-up, the patient reported that after taking the medicine, she felt its penetrating nature moving incessantly, up to the throat and down to the lower abdomen, especially in the chest. With this movement came vomiting of copious phlegm-saliva, preventing sleep until midnight. However, chest oppression eased, breathing became smooth, and vomiting stopped, indicating the airway blockage had cleared. I removed Shexiang from the original formula and administered three more doses. Chest comfort improved significantly, and cough decreased. I then added Dongchongxiacao (Cordyceps), Beishashen (Glehnia Root), Shengjiang (Fresh Ginger), and Dazao (Jujube) to the original formula for another three doses. Edema resolved, and cough largely ceased. However, abdominal distension remained hard and uncomfortable. I suspended the decoction and prescribed Yuyuliang Wan (Hematite Pill) twice daily, 3 qian per dose, avoiding salt and soy sauce. After five days, distension subsided; after ten days, it halved. She felt mentally exhausted and empty inside her heart and organs, indicating Qi and Blood deficiency following the resolution of fluid retention. I instructed her to take half the dose of the pill and alternate with a decoction of Renshen (Ginseng), Baizhu (Atractylodes), Danggui (Angelica Sinensis), Shaoyao (Peony), Shanyao (Dioscorea), and Fuling (Poria). Within ten days, distension fully resolved, and the disease was cured. Everyone marveled at this. Six years later, the disease had not recurred, and she had successfully given birth.

In the fourth month of Gengxu year, Mr. Yuan Yaokuan of Guang'anxiang Sugar Warehouse suffered from Warm Disease (Wen Bing). Initially treated by Dr. Zhang Shouqing, several doses failed to reduce the illness. Later, Dr. Zhang went to Jiangbei to distribute relief grain and referred me. Symptoms included high fever, delirium, smiling upon seeing people, thirst, red urine, and ability to consume only small amounts of thin porridge soup. Tongue coating was yellow, thin, dry, and devoid of fluids. The body was obese, and the pulse was slippery and rapid, especially on the right side. This is Warm Disease, where heat pathogens have been concealed for a long time and erupted violently, making the condition critical. Treatment should prioritize clearing heat, assisted by resolving phlegm and moistening dryness. I prescribed Sanhuang Shigao Tang (Three-Yellow and Gypsum Decoction) combined with Xiao Xiexiong Tang (Minor Trap-the-Chest Decoction), removing Mahuang (Ephedra), Douchi (Fermented Soybean), and Banxia (Pinellia), adding Bei Mu (Fritillaria), Lianqiao (Forsythia), Qinghao (Artemisia Annua), and Lizhi (Pear Juice). After two days, heat did not subside significantly. On the third dose, Battle Sweat (Zhan Han) occurred, leading to resolution. Residual heat remained, so I modified the formula by removing Shigao (Gypsum), Huangqin (Scutellaria), Huanglian (Coptis), and Gualou (Trichosanthes), adding Yiyiren (Coix Seed), Huashi (Talc), Lugeng (Reed Rhizome), Huafen (Trichosanthes Root), and Shashen (Glehnia) to clear residual pathogens. After several doses, recovery was achieved. It is said that Warm Diseases often resolve through Battle Sweat, a theory pioneered by Liu Hejian and Wu Youke, and expanded by Ye Tianshi and Wang Jiufeng. Based on my experience, this is indeed an accurate and unchangeable doctrine. Previous physicians derived this from experience; efficacy requires multiple doses, and sweating is preceded by shivering, which can be frightening. Physicians must possess firm conviction and stability in such situations.

Mrs. Jin Zhisheng, nearly fifty years old, presented with fever, body pain, white greasy tongue coating, hot urine, chest oppression, and slippery pulse. I initially used Sanren Tang (Three-Seed Decoction) with Lianqiao and Shanzhi (Gardenia). After two doses, heat intensified, with thirst, irritability, dry tongue coating, and rapid pulse. This indicated severe hidden pathogenic heat. I changed the prescription to Huangqin, Gualou, Digupi (Groundcherry Root Bark), and Qinghao each 3 qian; Lianqiao and Zhimu (Anemarrhena) each 4 qian; Mutong (Akebia) 1 qian; Yin Chaihu (Stellaria Root) 2 qian; Lugeng, Maogen (Imperata Rhizome), and Xianshengdi (Fresh Rehmannia) each 1 liang; mixed with one cup of Lizhi. After one dose, heat slightly stabilized. After two doses, the patient suddenly experienced chills and shaking, shaking the bed curtains, indicating impending Battle Sweat. The family misunderstood this as a medication error and planned to call another doctor. Fortunately, her brother Tao Junsheng informed me, and I rushed to treat her. I explained this was Battle Sweat, a sign of disease retreat, and advised against interference. Upon arrival, the shaking had stopped, profuse sweating occurred, pulse was calm, body temperature normalized, and spirit was quiet, though fatigue remained. I gave thin porridge soup to support Stomach Qi and prescribed Shashen, Maidong (Ophiopogon), Baihe (Lily Bulb), Yiyiren, Shihu (Dendrobium), Huafen, Gancao (Licorice), and Fuling for two days of recuperation, resulting in full recovery.

In April of Gengxu year, Mr. Shi Hanquan suffered from Warm Disease, presenting with lethargy, muteness, dirty complexion, red eyes, black nostrils resembling soot, high fever burning to the touch, continuous sweating, black dry tongue coating, arm spasms, rapid and frantic pulses, and red urine. He had been mute since yesterday, previously delirious. Loud calls elicited eye contact. Bowel movements: diarrhea at onset, now constipated for three days. Previous prescriptions were within the scope of Yinqiao San (Honeysuckle and Forsythia Powder), Sanren Tang, and Zengye Tang (Fluid-Increasing Decoction). I diagnosed this as Yangming Extreme Heat and Stomach Excess, requiring purgation. I prescribed Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) combined with Sanhuang Shigao Tang, removing Mahuang and Douchi, adding Xijiao (Rhinoceros Horn - *note: substitute with Niuxi or other suitable herb in modern practice*) and Gualou Ren (Trichosanthes Seed). After two doses, no stool passed, only foul flatus, blood-colored urine, clearer consciousness, but persistent fever and black tongue. I removed Yuanmingfen (Mirabilite) and Dahuang (Rhubarb), added fresh Shengdi (Rehmannia), and advised liberal consumption of Lizhi and Laifu (Radish) juice. Heat reduced, consciousness cleared, black tongue faded, pulse stabilized. Sticky phlegm was expectorated, eyes turned yellow. I switched to Xiao Xiexiong Tang with Lugeng, Maogen, Qinghao, Shichangpu (Acorus), Zhuru (Bamboo Shavings), Beimu, Dongguaren (Winter Melon Seed), and Mutong to resolve phlegm-heat in the diaphragm. After four doses, white miliary rash (Bai Ping) appeared on the chest, head, neck, abdomen, and legs, resembling crystal beads. Fever cleared completely, appetite returned, though spirit remained weak. I then used Xiyangshen (American Ginseng), Maidong, Shihu, Yiyiren, Beimu, Zhuru, and Pipaye (Loquat Leaf) for several days of nourishment. Only then did he pass several stools of black, dry feces. The previous failure of Dahuang was due to relatives secretly reducing the dose by one qian per prescription (using only 2 qian instead of 3), providing detoxification but lacking purgative force, thus slowing efficacy. Nevertheless, this was superior to reckless use of Mirabilite and Rhubarb by incompetent physicians.

Yao's son, fifteen years old, returned from school in March complaining of aversion to cold and drowsiness, followed by fever, headache, body pain, delirium, and inability to recognize people. Pulse was slippery and rapid; urine was red. I initially considered Zhi Chi Tang (Gardenia and Fermented Soybean Decoction) and Yinqiao San. At the afternoon follow-up, symptoms persisted: coma, delirium, continuous sweating, red face, thirst for water, slippery but not rapid pulse, thin greasy tongue coating (not yellow or dry). Recalling the Shanghan Lun: "Yangming disease with fever and profuse sweating requires urgent purgation." Red face and coma also indicate need for purgation. I switched to Xiao Chengqi Tang: Dahuang 3 qian, Houpo 5 fen, Zhike (Immature Bitter Orange) 2 qian, plus Huangqin, Lianqiao, and Zhimu each 2 qian. After administration, two bowel movements occurred, consciousness cleared, sleep was peaceful, sweating and fever stopped, and he sat up independently, expressing hunger. The family believed he was cured and discontinued medical care. Three days later, fever, sweating, and thirst recurred with a slippery-rapid pulse. I prescribed Baihu Tang (White Tiger Decoction) combined with Xiao Xiexiong Tang, using 3 qian of Shigao. Heat and delirium resolved, leaving only cough with blood-streaked sputum. Two doses of Xiebai San (Lung-Clearing Powder) with Huangqin, Zhimu, and Maogen cured him.

Mrs. Zhang Zhaokui, about thirty years old, slender, presented with fever, delirium, thirst, irritability, craving for cold food, chest oppression, hot urine, yellow greasy non-dry tongue coating, and bilateral rapid pulses. Xiao Xiexiong Tang with Chaihu (Bupleurum) and Huangqin was ineffective; heat increased. I switched to Liangge San (Cool the Diaphragm Powder) with Dahuang and Yuanmingfen each 3 qian. Two bowel movements and Battle Sweat ensued, resolving the fever. Spirit was weak and lethargic. I prescribed Dangshen (Codonopsis), Maidong, Gouqizi (Goji Berry), Dihuang (Rehmannia), Huangqi (Astragalus), and Zhi Gancao (Honey-fried Licorice) to tonify Qi and Blood. Two doses restored normal activity and diet.

Chen Zhushan of Hongtai Sugar Warehouse, about thirty years old, suffered from latent Summerheat in July. After four to five days of ineffective treatment by another doctor, he presented with high fever, headache, chest oppression, dry throat, thirst, crimson tongue with thin scorched dry coating, constipation for seven to eight days, red urine, and rapid pulse. This was latent Summerheat with intestinal heat binding. Treatment required opening the bowels to relieve intestinal burning. I prescribed raw Dahuang 2 qian, Yuanmingfen 3 qian, Zhike, Huangqin, Maidong, and Huafen each 2 qian, Gancao 5 fen. Two bowel movements occurred, heat resolved, headache lightened, tongue coating turned white greasy, pulse slowed, urine remained red, and appetite returned. I switched to Lianqiao, Yiyiren, Peilan (Plagiorheuma), Huafen, Shashen, and Beimu to clear residual pathogens. Two days later, fever, thirst, and chest oppression recurred, indicating residual pathogens attempting to exit. I used Xiao Xiexiong Tang combined with Xiao Chaihu Tang (Minor Bupleurum Decoction), removing Renshen, Shengjiang, and Dazao, adding Lianqiao and Qinghao. Two doses induced sweating and peace. For diseases requiring Mirabilite and Rhubarb, no other herbs can substitute. Fear of their use leads to prolonged illness. Accurate differentiation and proper application are essential; one must not be reckless.

In summer of Dingwei year, while visiting Suzhou, Cholera (Huoluan) was epidemic. A widow near Shenxian Temple contracted it, suffering from simultaneous vomiting and diarrhea. Treatments with Wuling San (Five-Ling Powder), Yushu Dan (Jade Pivot Pill), Fuzi Lizhong Tang (Aconite and Poria Decoction), and Zuojin Wan (Left Metal Pill) caused immediate vomiting upon ingestion. After three days, she exhibited sunken eyes, emaciation, cold limbs, irritability, inability to lie comfortably, bitter taste, craving for cold drinks, red tongue with greasy root coating, slight head sweat, and rapid pulses lacking spirit upon heavy pressure. This was Summerheat disease. I prescribed Huanglian Xiangru Yin (Coptis and Elsholtzia Decoction), removing Houpo, adding Yiyiren, Can Sha (Silkworm Sand), Banxia, Shihu, Shashen, Huangbo (Phellodendron), and Pipaye. Vomiting and irritability stopped, limbs warmed, diarrhea decreased after two doses, and she could eat porridge. I then removed Huangbo and Can Sha, reduced Huanglian (Coptis), stopping diarrhea. Remaining symptoms: palpitations, sore back, dizziness, fatigue, inability to sit, fine-small pulses. This indicated Qi and Blood deficiency post-illness. I prescribed Xiyangshen, Baizhu, Shihu, Shanyao, Duzhong (Eucommia), Zaoren (Sour Jujube Seed), Fushen (Poria with Hostwood), Danggui, Gancao, and Dazao for three days of tonification, resulting in recovery.

A young man surnamed Cheng from Yingpangchang outside Changmen Gate, Suzhou, also had Cholera with continuous vomiting and diarrhea, irritability, aversion to heat, nakedness despite extreme heat sensitivity, desire to lie on cold ground, cold limbs, cool chest/abdomen, thirst for watermelon, short red urine, slight head/neck sweat, calf cramps, rapid cun-guan pulses, and yellow dry tongue coating. This was latent Summerheat with deep heat causing cold extremities (True Heat, False Cold). I prescribed Baihu Tang combined with Huanglian Xiangru Yin, removing Houpo and Jingmi (Glutinous Rice), adding Maidong, Yiyiren, and Shihu, brewed with Yin-Yang Water. One dose stopped vomiting, two doses stopped diarrhea and calmed thirst. Limbs remained cold; I advised thin porridge and sleep. Body temperature normalized overnight. Dietary management alone led to recovery.

Mr. Xu, about thirty years old, suddenly developed abdominal pain, vomiting, diarrhea, fever, thirst, irritability, yellow greasy tongue coating, and slippery-rapid pulse in autumn. This was Summer-dampness stagnating in the Middle Jiao with food retention. I prescribed Huanglian Xiangru Yin combined with Pingwei San (Calm the Stomach Powder). One dose stopped vomiting/diarrhea and reduced fever; a second dose restored appetite. For diseases suitable for Huanglian and Shigao, the tongue coating must be yellow greasy or dry, and urine red. If urine is clear/profuse and tongue is bare/smooth, these herbs are contraindicated, as tongue texture indicates Stomach deficiency/excess.

Zhu's eight-year-old son had Cholera in autumn with cold limbs, thirst, sunken eyes, emaciation, anorexia, yellow greasy tongue coating, and small-rapid pulse. I used Jiangzhi Chao Chuanlian (Ginger-fried Coptis) 3 fen, Faxia Banxia (Processed Pinellia) 1 qian, Biandou (Lablab Bean) 3 qian, Yiyiren 3 qian, Muxiang (Aucklandia) 5 fen, and Beishashen 2 qian. Vomiting/diarrhea stopped, limbs warmed, tongue coating cleared, and he ate porridge. Severe thirst remained, so I switched to Maidong and Huafen each 1.5 qian, Beishashen 2 qian, Baizhu 1 qian, Yiyiren and Biandou each 3 qian. Two doses cured him.

Mrs. Zhang, over forty, had palpitations, vertigo, and fever in April, cured by Tianwang Buxin Dan (Heavenly Emperor Heart-Nourishing Pill) with Qinghao and Digupi. In summer, she suddenly developed abdominal pain radiating to the heart, vomiting clear fluid, dysentery (red and white discharge), cold limbs, sweating, and fatigue during severe pain. Pulse was deep, slow, and small; complexion pale with light lips. This was Yang deficiency and Middle Cold, likely from sleeping on bamboo beds and eating watermelon. I prescribed Fuzi Lizhong Tang with Wuzhuyu (Evodia), Guizhi (Cinnamon Twig), Shaoyao, and Sharen (Amomum). Pain eased after one dose, resolved after two, limbs warmed. I removed Fuzi, reduced Ginger and Evodia. Diarrhea stopped, appetite returned. Guishao Liujunzi Tang (Angelica and Peony Six-Gentlemen Decoction) for several days completed the cure.

Mr. Zhan Yunxi's infant son, a few months old, consumed too much Helu Lu (Lotus Leaf Dew) and Yinhua Lu (Honeysuckle Dew) in summer, resulting in diarrhea, cold hands, pale face, and salivation. Family despaired. I used Lizhong Tang (Middle-Regulating Decoction) with Dingxiang (Clove), in a smaller dose. One dose stopped diarrhea and salivation; two doses restored spirit and warmth. Wuyi Yigong San (Five-Agent Success Formula) cultivated Stomach Qi. Now ten years old, he is a primary school student.

Mr. Zhang Xingda (Shoutang, from Tongcheng), Magistrate of Kunshan, had a wife in her forties who recovered from Metrorrhagia (Blood Flooding) but subsequently suffered insomnia, fatigue, and poor appetite. Left pulse was fine-small, Heart pulse particularly weak. Pulsatile movement below the left umbilicus, sometimes rising upward, with palpitations, sweating, and tendon twitching in the chest. This indicated Blood deficiency failing to nourish tendons and floating deficient Yang. I prescribed Ejiao Jizihuang Tang (Donkey-Hide Gelatin and Chicken Egg Yolk Decoction). Sleep improved slightly; fifteen doses greatly reduced symptoms and improved appetite. I then added Shengdi and Shudi (Prepared Rehmannia) to make a paste for regular use, achieving full recovery.

In March of Gengxu year, Mrs. Ye was critically ill. Her son invited me urgently, stating previous doctors deemed it incurable. She showed severe decline, cold sweats, cold hands/forehead, sallow complexion, palpitations, dizziness, exhaustion, and weak-small pulse. This was severe Yang deficiency, imminent Yang collapse. I prescribed Sini Jia Renshen Tang (Cold Extremity Plus Ginseng Decoction) with Huangqi, Baizhu, Zaoren, Shaoyao, and Dazao. Jiang (Ginger) and Fuzi (Aconite) each 1.5 qian; Renshen, Huangqi, Baizhu each 3 qian. Decocted urgently. Sweating and coldness stopped, limbs warmed, spirit recovered, and she ate rice porridge. I removed Fuzi, reduced dosage, and continued for three days until stable.

Mrs. Zhu, after a miscarriage, developed cold limbs, aversion to cold, continuous spontaneous sweating, chest oppression, anorexia, soft-slippery-small pulse, and thin-white tongue coating. This was postpartum Yang deficiency with Phlegm-Damp obstruction. I prescribed Huangqi Jianzhong Tang (Astragalus and Middle-Regulating Decoction) without Yitang (Maltose), adding Chenpi (Tangerine Peel) and Banxia. One dose stopped sweating and warmed limbs; two doses cured her.

In December of Renyin year, my mother, exhausted by caring for my grandmother and funeral arrangements, exposed herself to wind and snow, developing joint pain unable to leave bed. Qianjin Du Huo Jisheng Tang (Thousand Gold Notopterygium and Taxillus Decoction) relieved pain, allowing sitting up. Two days later, sudden profuse sweating, staring eyes, and cold hands occurred. Family panicked. My father took 0.5 branch of Jilin Renshen (Ginseng) and ten jujubes, decocted quickly. Consciousness calmed, sweating stopped. Lizhong Tang with Huangqi continued for two days. Stable for thirteen years since, never ill. This demonstrates the benefit of medical knowledge in our family.

Mrs. Fang Zhaozhen, twenty-something, had been ill for ten days with multiple ineffective prescriptions, presenting with restlessness, delirium, cursing, craving cold food, cold hands, deep-weak pulse, thirst but inability to drink, dry lips but moist tongue (non-red), sallow complexion, and no fever. I diagnosed deficiency-cold, likely from excessive cold/purgative herbs. Previous prescriptions contained Huangqin, Huanglian, Qianghuo (Notopterygium), Gualou, and Haishi (Floating Quartz). Family asked why a cold disease presents with heat signs like restlessness and craving cold. I explained: Cold diseases have standard and variant presentations. Standard: aversion to cold, cold limbs, clear watery diarrhea, neutral mouth, no thirst. Variant: restlessness, desire for cold floor/food. This variant arises from deficient-cold Yang causing "Dragon-Leopard Fire" to float outward, known as Yin excess repelling Yang or True Cold-False Heat. Treatment requires guiding fire back to its source; otherwise, cold herbs will cause death. I prescribed Sini Tang with Ganjiang and Fuzi each 2 qian, Rougui (Cinnamon Bark) 8 fen, Dangshen, Baizhu, Shudi, Zaoren, and Fushen each 3 qian, taken cold. Restlessness subsided, sleep returned after one dose. Spirit calmed, appetite returned...