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The patient has previously been injured by wind pathogen, and is subsequently injured by heat pathogen. Wind and heat contend with each other, resulting in the onset of Fengwen (Wind-Warmth). The manifestations include flaccidity and weakness of the four limbs, headache, feverish sensation in the body, frequent spontaneous sweating without resolution of the disease. Treatment should focus on Shaoyin (Lesser Yin) and Jueyin (Terminal Yin) meridians. (Shaoyin corresponds to Fire, Jueyin corresponds to Wood.) Sweating-inducing methods must not be used. If sweating is induced erroneously, it will lead to delirious speech, internal restlessness preventing sleep, susceptibility to fright, and a gaze lacking spirit. If the physician again errs by inducing sweating in such cases, the physician is effectively killing the patient.

In Fengwen disease, the pulse is floating at all three positions (Cun, Guan, Chi). There is sweating, heaviness of the body,必然 (necessarily) panting, a silent demeanor with a desire to sleep. Erroneous purgation leads to difficulty in urination; erroneous sweating leads to delirium; adding moxibustion or warming needle therapy leads to deafness and difficulty in speaking; using only emetics or purgatives leads to urinary incontinence. The appropriate formula is Zhenyu Tang (Jade Ribbon Decoction). (This formula is recorded in *Wenbing Yue Fang Lun* [Treatise on Formulas for Hiccups in Warm Diseases].) If, after sweating induction, the body no longer fears cold but instead fears heat, and there are no signs of interior excess, this is named Fengwen, and Zhimu Shigao Tang (Anemarrhena and Gypsum Decoction) is indicated.

Zhimu (Anemarrhenae Rhizoma) (1 liang), Shigao (Gypsum Fibrosum) (1.5 liang), Gegen (Puerariae Lobatae Radix), Zhenyu (Polygonati Odorati Rhizoma) (each 3 fen), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), Shengma (Cimicifugae Rhizoma), Renshen (Ginseng Radix), Xingren (Armeniacae Semen Amarum), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix) (each 0.5 liang).

Decoct the coarsely powdered herbs in 3 sheng of water until 1.5 sheng remains. Strain and administer warm, one zhan (cup) at a time, continuously to induce sweating.

If the patient was previously injured by cold pathogen and is subsequently re-injured by cold, it transforms into Wenmai (Warm Malaria). For cases where cold symptoms predominate over heat, Huatuo Chisan (Huatuo's Red Powder) is the primary treatment. (Recorded in *Han Yi Zhi Fa*). For cases where cold and heat symptoms are equal, Dansha Wan (Cinnabar Pill) is used. (Also treats intermittent malaria.)

Dansha (Cinnabaris), Renshen (Ginseng Radix) (each 1 qian), Fuzi (Aconiti Lateralis Radix Praeparata) (one piece, weighing 0.5 liang).

Grind into fine powder, form pills the size of paulownia seeds using honey decoction. Swallow 20-30 pills with Zhu Ye (Bambusae Folium) decoction before the onset of fever. If the medicine reaches the disease site, vomiting may occur, or the body may feel slightly numb. If the medicine has not yet reached the site, increase the dose to 40 pills. For intermittent malaria, take as directed before the onset of fever; stop once the medicine reaches the disease site.

For Wenmai with intense internal heat and a dazed, silent demeanor, Main Wan (Moin Pill) is the primary treatment. (Recorded in *Ke Han Men*).

For Wenmai where the pulse appears normal, the body feels no cold but only heat, joints are painful and vexed, and there is occasional vomiting, Baihu Jia Guizhi Tang (White Tiger plus Cinnamon Twig Decoction) is indicated.

Shigao (Gypsum Fibrosum) (4 liang), Zhimu (Anemarrhenae Rhizoma) (1.5 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 liang), Jingsmi (Oryza Sativa), Guizhi (Cinnamomi Ramulus) (3 fen).

Decoct the coarsely powdered herbs in 3.5 sheng of water until the rice is cooked. Remove the rice, add the remaining herbs, and decoct until 1.5 sheng remains. Administer warm, one zhan at a time.

The characteristic of Wenmai disease is fever followed by chills.

If the patient was previously injured by dampness pathogen, leading to stagnation in the middle jiao, dampness and heat contend with each other, resulting in Shiwen (Damp-Warmth). The patient suffers from reverse coldness in both calves, abdominal fullness, pain in the chest, head, and eyes, and delirious speech. Treatment should focus on Shaoyin meridian; sweating-inducing methods are contraindicated. If sweating is induced erroneously, it leads to inability to speak, deafness, loss of localization of pain, cyanosis of the body, and change in complexion. This condition is called "Chong Re" (Severe Heat/Damp-Heat), and such patients are killed by the physician.

For Shiwen presenting with the aforementioned symptoms, Baihu Tang (White Tiger Decoction) is the primary treatment. (Recorded in *Shanghan Jueyin Men*).

For Shiwen with profuse sweating, delirious speech, irritability, and thirst, Shigao Gancao San (Gypsum and Licorice Powder) is indicated.

Shigao (Gypsum Fibrosum), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).

Grind into fine powder, mix with Jiangshui (fermented grain water), and take 2 qian bi per dose, three times daily.

Pang Anshi states: Ignorant physicians fail to distinguish between cold and hot pulses. Upon observing cold calves, they often administer Sini Tang (Frigid Extremities Decoction) and similar formulas. The number of patients killed by such medical errors is incalculable. The pulse in Shiwen is small and tight, resembling the pulse of Shanghan (Cold Damage), but the clinical manifestations differ. Frequent administration of Baihu Tang will naturally warm the calves and lead to recovery.

If the patient was previously injured by heat pathogen and is subsequently re-injured by heat, it transforms into Wendu (Warm-Toxin). Wendu is the most severe among these diseases.

If an initial Taiyang disease does not resolve and transfers to Shaoyang, and the Xiao Chaihu Tang syndrome resolves, this becomes a Huai Bing (Ruined Disease/Malpractice-induced complication). One must determine what error was made and treat accordingly.

The Cun Kou (radial artery) pulse is surging, large, rapid, and slippery. Surging and large indicate abundant Ying (Nutrient) Qi; rapid and slippery indicate excess Wei (Defensive/Stomach) Qi. Abundant Ying Qi means Yang is excessive; stagnation prevents its release. Excess Stomach Qi means interior firmness and difficulty; bitter dryness in the stool indicates closure of the Three Jiao and obstruction of Jin-Ye (Body Fluids). If the physician again errs by inducing sweating, Yang Qi becomes excessive and fails to circulate throughout the body; if purgatives are then heavily applied, constipation ensues, and urination becomes difficult. Ying and Wei Qi contend with each other, causing five-palm heat, eyes burning like fire, dry nose, red face, dry tongue, yellow teeth, and extreme thirst. After passing through the meridians, it becomes a Huai Bing. (Chao Yuanfang also recorded this manifestation; it is now included in the syndromes, accompanied by effective formulas verified by hand.) Treatment follows the previous descriptions.

Sanhuang Shigao Tang (Three Yellows and Gypsum Decoction)

Shigao (Gypsum Fibrosum) (1 liang, ground), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix) (each 0.5 liang), Xiangchi (Fermented Soybean), Zhizi (Gardeniae Fructus) (5 pieces), Mahuang (Ephedrae Herba) (3 fen).

Decoct the coarsely powdered herbs in 3 sheng of water until 1 sheng remains. Divide into three doses. If the disease is not cured, administer another dose; the effect is miraculous.

*Shen Shi Fang* states: After Shanghan has persisted for eight or nine days, heat generates in the Three Jiao. The pulse is slippery and rapid, consciousness is clouded, the body is feverish, heavy, stiff, and restricted, with occasional groaning. Attempting to purge the interior is hindered by heaviness and stiffness because the exterior is unresolved; directly using diaphoretics exacerbates the toxin. Ancient formulas lack those treating both exterior and interior simultaneously. I intend to use Sanhuang Tang to resolve internal heat, adding ingredients to resolve the exterior, thus creating Sanhuang Shigao Tang.

The treatise states: After Shanghan is treated with sweating, or erroneously with purgation or other methods, heat later generates in the Three Jiao. The pulse is surging and rapid, delirious speech persists, breathing is labored day and night, epistaxis occurs repeatedly, and the disease momentum does not subside. The body and eyes appear jaundiced, and the patient is manic, restless, and desires to run. Sanhuang Shigao Tang is indicated.

The above four types of Warm Diseases are what Wang Shuhe referred to as "same disease, different names; same pulse, different meridians." The pulse of Fengwen is the same as Zhongfeng (Wind Strike); the pulse of Wenmai is the same as Shanghan; the pulse of Shiwen is the same as Zhongshi (Damp Strike); the pulse of Wendu is the same as Rebing (Heat Disease). Only the clinical manifestations differ, leading to different medication choices. Mistakenly treating them as Shanghan and inducing sweating results in death in nine out of ten cases, with none surviving.