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Wang Kentang: If a Taiyang disease (Taiyang syndrome) has persisted for three days and sweating therapy has been applied, but subsequent emesis, purgation, or warm needle therapy fails to resolve the condition, this is termed a "ruined disease" (Huai Bing). At this stage, Guizhi Tang (Cinnamon Twig Decoction) cannot be fixedly prescribed. One must observe the pulse and symptoms to determine which therapeutic error caused the deviation, and then treat according to the current presentation. The term "deviation" (Ni) refers to inappropriate sweating when it was not indicated, inappropriate purgation when it was not indicated, or excessive application of sweating and purgation methods, all of which violate standard principles; hence they are called deviations. "Treating according to the presentation" means, as stated later in the text: if the disease persists after sweating, or remains unresolved after sweating or purgation, specific decoctions are indicated accordingly. This phrase implies flexible application and broad meaning. Wang Bing, Han Zhihe, and other scholars incorrectly categorized ruined diseases as a distinct syndrome and treated them with Roushou Tang (Mutton Soup).

If a Taiyang disease that has not resolved transitions into Shaoyang (Shaoyang channel), presenting with hardness and fullness in the hypochondrium, dry retching, inability to eat, alternating chills and fever, and where no emesis or purgation has yet been performed, and the pulse is deep and tight, Xiao Chaihu Tang (Minor Bupleurum Decoction) should be administered. However, if delirium occurs due to prior emesis, purgation, sweating, or warm needle therapy, the Chaihu syndrome has ceased, constituting a ruined disease. One must identify the nature of the therapeutic error and treat according to the appropriate method.

Zhao Xianke: In Zhang Zhongjing's discussions, "ruined disease" refers to conditions such as deficiency-heat irritability, chest binding, epigastric fullness, internal irritability after vomiting, and abdominal distension following erroneous sweating, emesis, or purgation in Taiyang disease. This precisely indicates that Guizhi Tang is no longer applicable and Xiao Chaihu Tang syndrome has ceased. It does not refer to diseases caused by "abnormal qi" (heterogeneous pathogens) as suggested in *Qin Ren Shu*. Zhang Zhongjing also stated, "Contracting abnormal qi transforms into another disease," referring to the mixing of two or three types of pathogens. Since these conditions lack definitive names, unlike the four types of Warm Diseases (Wen Bing), they are termed "transformed diseases." Furthermore, Zhang Zhongjing considered Warm Diseases arising from winter cold striking spring heat, or transforming into Warm Malaria, Wind-Warmth, Warm Toxin, or Warm Epidemic, as cases where the disease did not become "ruined," thus calling them transformed syndromes. "Ruined disease" and "transformed disease" have distinct nomenclature. Thus, abnormal qi does not cause ruined disease, a fact that is clear. If Warm Malaria were truly a ruined disease, Zhang Zhongjing would not have mentioned the cessation of the Xiao Chaihu Tang syndrome. Please reflect on this.

Shi Zhai Formula: When Yin and Yang patterns in Cold Damage are indistinguishable, or medication errors lead to severe debility and impending death, this formula may be used after seven days of illness. It is said to be infallible. Use one liang of high-quality Ginseng Radix et Rhizoma (Renshen), remove the rhizome, slice thinly, and decoct in one sheng of water in a silver or ceramic vessel until reduced to one zhan. Cool with fresh water and consume in one dose. The sweat will not emerge from the whole body but will trickle only from the tip of the nose, indicating the therapeutic response. This is miraculous. Su Taoguang reported that Vice Minister Fang Zhang used this formula to save dozens of people. When Envoy Wang served in Qingliu, the son of Che Shentu Xingfu suffered from an epidemic postpartum for over ten days, becoming a ruined case. Upon inquiry, he was found to have recovered simply by taking Ginseng alone. At the time, this specific formula was unknown; it was merely a coincidental alignment.

Haizang (Zhang Yuansu): After excessive sweating and purgation in Yang-pattern diseases, Yang Qi is lost externally, and Blood is depleted internally. Upper Jiao fluids and Lower Jiao essence are exhausted, leading to dual depletion of Jin-Ye (body fluids). Roushou Tang (Mutton Soup) should be used to tonify. How much more so for Yin-pattern diseases, which require warming and tonification? This parallels the use of Zhenwu Tang (True Warrior Decoction) for Taiyang syndrome presenting with tremors. Even when Yang pathology reaches this state, the body remains warm; how much more necessary is tonification for internal Yin-cold patterns?

Han Zhihe: Patients with blood deficiency due to postpartum hemorrhage should use Roushou Tang (Mutton Soup). For Cold Damage patients suffering from Yang collapse and blood loss due to excessive sweating and purgation, relying solely on emergency rescue methods yields slow results. Roushou Tang acts rapidly. Although the patient's complexion may show signs of apparent Yang heat, this is merely floating pathogenic heat; Yin Qi in the Upper, Middle, and Lower Jiao is already abundant. If the Lower Jiao Yang Qi is regulated, the Upper Jiao Yang Qi will descend, and the Dantian Qi will find its residence. Qi has high and low positions; diseases have distant and near origins; syndromes have exterior and interior locations; treatments have light and heavy degrees. Healing occurs when each is appropriately matched. Therefore, if after eight or nine days, excessive sweating and purgation result in deep, thin, and weak pulses, curling up while lying down, aversion to human voices, skin with gooseflesh, and shaking resembling malaria, Roushou Tang (Mutton Soup) is indicated.

Roushou Tang (Mutton Soup) Prescription: Danggui Radix Angelicae Sinensis (Dang Gui), Baishao Radix Paeoniae Alba (Baishao), Mudili (Chishi, Red Ochre) - each 1 liang; Shengjiang Rhizoma Zingiberis Recens (Sheng Jiang) - 2 liang; Guizhi Ramulus Cinnamomi (Guizhi) - 7 qian 5 fen; Longgu Os Draconis (Longgu) - half liang (red variety); Heifuzi Radix Aconiti Lateralis Preparata (Pao Fu Zi) - 4 qian (prepared, peel and umbilicus removed). Grind the herbs into coarse powder. For each dose, take 1 liang of herbs, combined with 4 liang of mutton, 5 cun of Congbai Bulbus Allii Fistulosi, and the heart of Sheng Jiang. Chop finely. Decoct in 5 sheng of water until reduced by half. Strain and remove dregs. Divide into three doses. Note: This formula is suitable for Yin patterns.

Biejia San (Softshell Turtle Powder): Treats Cold Damage persisting for eight or nine days without improvement, unresponsive to various medications, termed "Ruined Cold Damage." Biejia Carapax et Plastrum Testudinis (vinegar-processed and powdered), Shengma Rhizoma Cimicifugae, Qianhu Radium Peucedani, Wumei Fructus Mumee, Zhishi Fructus Aurantii Immaturus, Xijiao Cornu Rhinocerotis (shaved), Huangqin Radix Scutellariae, Gancao Radix Glycyrrhizae, Shengdihuang Radix Rehmanniae. Each dose uses 5 qian of the powder, decocted in 1.5 zhan of water until reduced to 0.8 zhan. Strain and take. Note: This formula is suitable for Yang patterns.