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Shen (Case): When the warm pathogen initially manifested, menstruation arrived simultaneously. Symptoms included chills and fever, deafness, dry retching, irritability, thirst with desire to drink. These manifestations already belong to Heat Entering the Blood Chamber (Re Ru Xue Shi). The previous physician observed cough, rapid pulse, and white tongue coating, diagnosing Warm Pathogen in the Lung, and used a mild acrid-cool formula (Xin Liang Qing Ji), which exacerbated the irritability and thirst. My opinion is that deep heat has persisted for thirteen days without resolution; not only is the Qi level affected, but the patient also has a constitutionally weak physique, with a dark and sallow complexion. There is fear of pathogen sinking leading to spasms and syncope (Jing Jue). Spasms occurred three days ago. Body fluids are secretly consumed, stirring internal wind (Nei Feng). How can this be regarded as a trivial ailment? It is proposed to use Yujun Decoction (Yujun Jian) to clear both Qi and Blood levels of pathogenic heat, while possessing the ability to rescue Yin. (Heat pathogen sinking internally, fluid injury causing spasms). Yujun Decoction plus Zhu Ye Xin (Bamboo Leaf Heart). Decoct with vigorous fire, take 5 fen of the decoction.

Second visit: Pulse is rapid, complexion is dark, tongue turns red. Chills, fever, and excessive thirst have all alleviated. Previously treating both Qi and Blood clearing showed efficacy against latent pathogens. Generally, for those constitutionally weak, when expelling half the pathogen, one must concurrently protect Yuan Qi (Original Qi), still assisting with clearing pathogens. Now presenting with abdominal pain and loose stools, harmonizing Yin is urgent.
Prescription: Bai Shao (Radix Paeoniae Alba), Zhi Cao (Prepared Licorice Root), Ren Shen (Ginseng Radix), Chao Mai Dong (Fried Ophiopogon Tuber), Chao Sheng Di (Fried Rehmannia Root).

Third visit: Right pulse rapid, left pulse deficient. Slight chills and fever in the late afternoon. Use Fumai Decoction (Fumai Tang) removing Jiang (Ginger) and Gui (Cinnamon Twig).

Wu (Case): After seventeen days of febrile disease. Right pulse long, left pulse sunken. Tongue flaccid, preference for cold drinks. Irritability and heat. Spirit fluctuates between clarity and confusion. Menstruation began three days prior to illness onset. Heat within the Blood Chamber took advantage of the void to sink inward. This should be discussed as Stasis-Heat residing inside. However, the condition is critical; follow the example of Accumulated Blood (Xu Xue) with mania. (Accumulated Blood Syndrome)
Prescription: Xi Sheng Di (Fine Rehmannia Root), Dan Pi (Moutan Cortex), Zhi Da Huang (Prepared Rhubarb Rhizome), Chao Tao Ren (Fried Peach Seed), Ze Lan (Herba Lycopi), Ren Zhong Bai (Calcinatus Human Bone Ash).

Examining Heat Entering the Blood Chamber, *Jin Gui Yao Lue* presents five methods. The first primarily uses Xiao Chai Hu Tang (Minor Bupleurum Decoction) due to alternating chills and fever. Although menstruation has just ceased, urgently extracting Shaoyang pathogen to prevent downward sinking is paramount. The second: Taiyang cold damage with fever, menstruation arriving, already showing daytime lucidity and nighttime exacerbation, delirium and hallucinations. To avoid misdiagnosing as Yangming excess, there are warnings against violating Wei Qi and the Upper Two Jiao. The third: Wind-stroke with chills and fever, menstruation arriving, after seven to eight days, slow pulse, cool body, chest and hypochondriac fullness resembling Jie Xiong syndrome, with delirium. Clearly no exterior syndrome remains, fully revealing Heat Entering the Blood Chamber signs. One should urgently puncture Qi Men (LR14), demonstrating acupuncture's superiority over herbal medicine. The fourth: Yangming disease, bleeding, delirium, only head sweating, also Heat Entering the Blood Chamber, also puncturing Qi Men, resolving with sweating. Zhang Zhongjing merely expanded the meaning, teaching adaptability. The fifth: Clarifying one symptom while addressing other harmful causes, such as phlegm flooding the upper Jiao causing coma, requiring phlegm resolution before heat clearance. This is "treating the urgent first." Yet today's physicians, upon encountering this syndrome, do not distinguish the severity of heat entry or the fullness/emptiness of the Blood Chamber, rashly administering Xiao Chai Hu Tang, inevitably causing harm. In summary, for severe heat with blood stasis, use Tao Ren Cheng Qi Tang (Peach Kernel Major Order the Middle Decoction) and species like Shan Jia (Pangolin Scale) and Gui Wei (Angelica Sinensis Tail); for empty Blood Chamber with heat sinking, use Xi Jiao Di Huang Tang (Rhinoceros Horn Rehmannia Decoction) adding Dan Shen (Salvia Miltiorrhiza Root) and Mu Tong (Akebia Caulis); for incomplete exterior pathogen with remaining exterior symptoms, adhere to Harmonizing methods; for mild heat with overuse of cooling herbs causing sluggish Qi mechanism, borrowing warm-acrid agents as guides is acceptable. For Blood Stasis Chest, Guizhi Hong Hua Tang (Cinnamon Twig and Safflower Decoction) added with Hai Ge (Clam Shell) and Tao Ren; for severe coma and mania, administer Niu Huang Gao (Calculus Bovis Paste) mixed with Qi Qing Hua Jie decoctions. Observing the cases, there is the Yujun method for dual-clearing Qi and Blood blazing heat; for severe heat injuring Yin, the Fumai method for nourishing Yin and supporting Qi; and the gentle purging method for protecting Yin and washing away heat. Ancient sages and later worthies, their treatments are always meticulously analyzed. Students examining symptoms and prescribing must not be confined to the single method of Chai Hu (Bupleurum). (Comment by Shao Xinpu)

Xu's Commentary: In the past, reading this old master's handwritten medical cases, I often found borrowed or fabricated discussions, and the literary flow was sometimes disjointed. The currently published cases not only have coherent prose but also concise and clear writing style, surpassing even recent essayists. I wonder if the original text was thus, or if the editor performed revisions.