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In the Dingwei year, a woman suffered from Shanghan (Cold Damage). She presented with alternating chills and fever, delirium at night, visual hallucinations of ghosts, and restlessness with mania. Her husband visited me to inquire about treatment methods. I said:
If her menstruation had just started or recently ceased, it is likely that heat has entered the Blood Chamber (a concept referring to the uterus and related liver meridian pathways). The next day, her husband urgently reported that symptoms of Jie Xiong (Chest Binding, where pathogenic factors bind with phlegm and fluid in the chest) had developed. Upon palpating her pulse, I said: If you trust me, administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) and similar formulas immediately, and she will surely recover. The previous physicians failed to nurture the healthy Qi, leading to this state, resulting in a Jie Xiong syndrome for which medicinal herbs are no longer effective. If there is no other way, there is one method: puncture the Qimen acupoint, which might lead to recovery. Following my advice, she recovered.

The commentary states: Someone asked why Heat entering the Blood Chamber results in Jie Xiong. I said: Pathogenic factors enter the meridians and contend with Healthy Qi, circulating up and down. If this occurs when menstruation is just starting or has ceased, pathogenic factors enter the Blood Chamber due to deficiency. Blood and pathogenic factors press against each other and ascend into the Liver Meridian. Once the Liver is affected by pathogens, delirium resembling seeing ghosts occurs. Liver pathology causes seeing ghosts; blurred vision also causes seeing ghosts. If the pathogen enters further into the Danzhong (Conception Vessel area between the nipples), blood binds in the chest. Why is this so? Because in women, menstruation normally nourishes the eyes, and blood nourishes the Liver. Before pregnancy, it descends to become menstrual blood; during pregnancy, it is retained centrally to nourish the fetus; after childbirth, it ascends and transforms via Metal energy into milk. Now, pathogens chase these fluids and converge into the Liver Meridian, gathering at Danzhong and obstructing below the breasts. Without puncturing Qimen to drain the pathogen, it cannot be resolved. Qimen is the membrane origin of the Liver. If the pathogen has not yet gathered at the breast, Xiao Chai Hu Tang can still be used. Since it has gathered at the breast, Xiao Chai Hu Tang is contraindicated. This is like vicious bandits roaming the streets, forced by patrols, while widows or unmarried women happen to open their doors, allowing the bandits to burst into the room. The women, pressured by the bandits, retreat into hidden places to hide. The bandits follow their tracks and refuse to leave. Thus, an opening is created to lure them out, perhaps allowing their removal. Puncturing Qimen for blood binding in the chest is no different from this scenario.

An official was returning by boat. In April, amidst wind and rain, with irregular diet, he fell ill with symptoms resembling Shanghan. He experienced heavy head, spontaneous sweating, and generalized body pain. Physicians treated him as Wind-Dampness striking the middle, administering decoctions containing Atractylodis Rhizoma (Baizhu), Aconiti Lateralis Radix Praeparata (Fuzi), Zingiberis Rhizoma (Jiang), etc. Sweating did not cease. He took Fuzi alone and received moxibustion below the navel, but sweating continued. I examined him and said: All Six Yangs are exhausted (failure of all six Yang qi systems); it is untreatable. (His sweat would indeed be like pearls, which proved true; he died half an hour later.)

The commentary states: The Nan Jing states that when the Six Yang qi are simultaneously exhausted, Yin and Yang separate. When Yin and Yang separate, the Cou Li (pores and interstitial spaces) open, and Jue Han (terminal sweat) emerges. The sweat appears like pearls, rolling but not flowing. Death is predicted for morning if observed in the evening, and for evening if observed in the morning. This is what is meant. Patient's sweat varies: there is Excess Yang with Deficient Yin, and Excess Yin with Deficient Yang. In Excess Yang cases, such as bone-steaming fever, sweat flows freely and moistens. In Deficient Yang cases like this syndrome, sweat coagulates and stops. Imagine steaming food in a steamer; sweat evaporates and disperses, representing Excess Yang. Imagine placing ice in gold, silver, or earthenware vessels; sweat condenses and does not flow, representing Deficient Yang.