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Fushu (Lingering Summerheat) presenting with irritability and fever, red tongue, coma, and delirium indicates that the pathogen has entered the Ying (Nutritive) level. It is appropriate to use Yunu Jians (Jade Woman Decoction) added with Lingjiao (Antelope Horn), Xuanshen (Scrophulariae Radix), Shashen (Glehniae Radix), Xian Shihu (Fresh Dendrobii Caulis), Xian Changpu (Fresh Acori Tatarinowii Rhizoma), and Niuhuang Wan (Calculus Bovis Pill) to clear the Ying level and vent the pathogen outward.

The previous clause discussed the pathogen about to transmit to the Ying level; this clause discusses the pathogen having already transmitted to the Ying level. Therefore, heat with irritability, a red tongue, coma, and delirium occur. Without using Shengdi (Rehmanniae Radix), Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix) from Yunu Jians, along with Xuanshen (Scrophulariae Radix), Changpu (Acori Tatarinowii Rhizoma), Yujin (Curcumae Radix), and Niuhuang Wan (Calculus Bovis Pill) to clear the Ying level and vent the pathogen, the heat will inevitably sink into the Xue (Blood) level, leading to the danger of Jingjue (convulsions and coma).

Fushu (Lingering Summerheat) presenting with a dry, scorched tongue tip, crimson tongue tip, coma, delirium, manic laughter, rapid pulse, purple macules, and limb tremors indicates that the pathogen has entered the Xue (Blood) level, where extreme heat generates wind. It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Xuanshenxin (Center of Scrophulariae Radix), Lianqiaoxin (Center of Forsythiae Fructus), Xian Shihu (Fresh Dendrobii Caulis), Xian Changpu (Fresh Acori Tatarinowii Rhizoma), Zicao (Arnebiae Radix), Zhuyeh (Bambusae Folium), and Zhibao Dan (Precious Treasure Pill) to cool the blood and resolve the pathogen.

Whenever Ying-level heat fails to resolve, it inevitably transmits to the Xue (Blood) level. A black tongue with a crimson tip, purple macules, coma, and delirium indicate that blood heat has reached its extreme. Extreme heat damages Yin and causes Yang hyperactivity, generating internal wind that causes vibration; thus, limbs tremble, approaching the state of convulsions. One must use Xijiao (Rhinocerotis Cornu), Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), and Zicao (Arnebiae Radix) to cool the blood and clear heat, combined with Lianqiao (Forsythiae Fructus), Xuanshen (Scrophulariae Radix), Changpu (Acori Tatarinowii Rhizoma), and Shihu (Dendrobii Caulis) to resolve macules and nourish fluids, alongside Zhuye (Bambusae Folium) and Zhibao Dan (Precious Treasure Pill) to clear the heart and calm the spirit. This prevents convulsions and coma, which is a favorable sign.

In women with Fushu (Lingering Summerheat), a crimson tongue, thirst, rapid and choppy pulse, menstruation just starting or stopping, chills and fever alternating like malaria, clarity during the day, and delirium at night indicate Re Ru Xueshi (Heat Entering the Blood Chamber). It is appropriate to use Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shanzha (Crataegi Fructus), Guiwei (Angelicae Sinensis Radix Caudex), Chishao (Paeoniae Radix Rubra), Taoren (Pruni Semen), and Danpi (Moutan Cortex) to break blood stasis and vent the pathogen.

Regarding Heat Entering the Blood Chamber, the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) discusses it most thoroughly. The Blood Chamber is the Sea of Blood. It belongs to the Chong Mai (Penetrating Vessel) and is subordinate to the Yangming channel. As stated in the *Neijing* (Inner Canon): "The Chong Mai is the Sea of Blood, and the Ren Mai (Conception Vessel) governs the uterus." Furthermore, the Chong Mai originates from the bottom of the Zhongji point, runs along the lower abdomen, ascends to the chest, and disperses. The Ren Mai also originates from the bottom of the Zhongji point, runs along the pubic region, surrounds the genitalia, enters the lower abdomen, circles the lips, and nourishes the beard. Thus, women do not grow beards because the blood of the Ren Mai flows downward and cannot ascend to nourish the lips. The Du Mai (Governing Vessel) also arises from the Zhongji point, flanks the waist, follows the spine, and ascends to the vertex. These three vessels—Chong, Du, and Ren—all converge at the Xiaguan (Lower Extremity) and branch out to the back and abdomen. Thus, the Du Mai runs on the dorsal side of the body, the Ren Mai on the ventral side, and the Chong Mai between the back and abdomen. When menstrual blood is abundant, blood from all channels gathers in the Sea of Blood. Its regulated storage and discharge are managed by the Ren Mai as commander, the Du Mai as supervisor, and the Dai Mai (Girdle Vessel) as binder. Additionally, the Yang Wei Mai and Yin Wei Mai maintain Yin and Yang on the anterior body; the Yang Qiao Mai and Yin Qiao Mai regulate mechanisms on the lateral sides. Thus, storage is measured, discharge is timed, following the waxing and waning of the moon, flowing in order without deviation, which is termed menstruation. If the Sea of Blood lacks authority and the Ren and Du vessels lose control, there may be unceasing metrorrhagia or stagnant blood failing to move. Regarding the storage and discharge of blood, whether cold or heat can cause pathology. Therefore, blood stasis in Shanghan (Cold Damage) occurs in all six channels, not only in the Bladder and between the chest and abdomen. Generally, pathogens such as wind, cold, summerheat, and dampness first attack the Yang channels, then transmit elsewhere. Yang channels are located in the exterior, Wei (Defensive) level, and Qi level, gradually transmitting to the blood. Thus, when women fall ill during menstruation (just starting or stopping), heat and blood coagulate, preventing normal flow. For example, initial Taiyang disease presents with headache, fever, aversion to cold, and anhidrosis, or epistaxis and cutaneous bleeding; this is Taiyang channel pathogen interfering with the blood level. Treatment should employ methods to open pores and induce sweating. One must not immediately use cold-natured herbs upon seeing bleeding, lest it form Xuejie Xiong (Blood Stagnation in the Chest) syndrome. If there is hardness and pain in the lower abdomen, free urination, black stool, fever, irritability, and delirium resembling madness, this is a Taiyang Fu (Organ) disease with blood stasis in the Bladder. Master Zhang Zhongjing feared later generations would mistake heat binding in the Bladder for this condition; thus, he distinguished heat binding by difficult urination and blood stasis by free urination. He typically used Tao Ren Chengqi Tang (Persicae Semen and Rheum Decoction) to release the Taiyang exterior and break blood stasis. Similarly, initial Yangming disease presents with eye pain, nasal dryness, insomnia, leading to epistaxis and hematemesis; this is Yangming channel pathogen interfering with the blood level. Treatment should clear both Qi and Blood levels. One must not induce heavy sweating due to scant sweat. If there is hardness and pain in the lower abdomen, free urination, upper Jiao chest binding or hematemesis, lower Jiao abdominal pain or hematochezia, fever, mania resembling possession, this is a Yangming Fu disease with blood stasis in the Chong Mai. It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) to clear Yangming heat and remove blood stasis. Also, Shaoyang disease presents with frontal headache, hypochondriac pain, chills and fever, deafness, bitter taste, vomiting, leading to epistaxis and hemoptysis; this is Shaoyang channel pathogen interfering with the blood level. Treatment should use Xiaochaihu Tang (Minor Bupleurum Decoction) to clear and drain the Gallbladder collaterals. One must not recklessly administer cloying herbs upon seeing bleeding. If there is lower abdominal pain, free urination, black stool, clarity during the day, delirium at night, and chills/fever like malaria, this is a Shaoyang Fu disease with blood stasis in the Liver collaterals. It is appropriate to use Tao Shi Xiaochaihu Tang (Tao's Minor Bupleurum Decoction) added with Shengdi (Rehmanniae Radix), Guiwei (Angelicae Sinensis Radix Caudex), Taoren (Pruni Semen), Shanzha (Crataegi Fructus), and Danpi (Moutan Cortex) to clear Shaoyang and break blood stasis. The above discusses the manifestations of blood stasis in the Jing (Channel) and Fu (Organ) diseases of the Three Yang channels. When heat pathogens transmit to the Three Yin channels, the Shaoyin Heart governs blood, the Taiyin Spleen controls blood, and the Jueyin Liver stores blood. Once the pathogen enters the blood, heat and blood coagulate, making clearance and resolution difficult. This inevitably leads to a crimson tongue, coma, symptoms worsening at night compared to the day, and a state resembling demonic possession. It is appropriate to use Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Yujin (Curcumae Radix) and Changpu (Acori Tatarinowii Rhizoma). In severe cases with abdominal pain and black stool, Zhang Zhongjing used Didang Tang (Should-Enter Decoction) to attack heat and break stasis, achieving dual resolution. However, this condition occurs not only in women but also in men. The treatment principles are roughly similar. If one universally applies Xiaochaihu Tang (Minor Bupleurum Decoction) with blood-breaking herbs for blood stasis and finds no effect, regarding it as untreatable and giving up is the physician's fault. Let this serve as a warning. In the spring of the 19th year of Daoguang, I treated a rudder named Zhang who, after recovering from a warm disease in March, had normal appetite but suffered from lower back pain. Initially suspecting kidney deficiency post-illness, I administered kidney-tonifying herbs, but the pain intensified. An external medicine specialist diagnosed it as Shenshu Fa (abscess at the Shenshu acupoint) and prescribed Yanghe Tang (Yang-Harmonizing Decoction) for several doses, but the condition did not improve, nor was there swelling. The pain worsened in the afternoon, peaked during the Xu-Hai hours (7 PM–11 PM), with continuous crying until dawn when the pain subsided. After a month of various treatments, the pain persisted. At this time, I read Yu Jiayan's *Yimen Falü* (Legal Principles of Medicine Gate) and saw a case in *Yuyi Cao* (Grass of Meaningful Intent) regarding lower back pain progressing to kyphosis. Yu Jiayan stated that lingering heat pathogens in the Taiyang channels coagulate with blood, knotting in the waist; treating with Tao Ren Chengqi Tang (Persicae Semen and Rheum Decoction) for several doses brought relief. Reading this, I had a sudden enlightenment and treated according to this method, resulting in complete pain relief. This was a case of blood stagnation in the Taiyang channel. Later, my nephew surnamed Fan, after a damp-warm disease, also suffered from severe lower back pain. Kidney-tonifying herbs had failed. I instead used Angui (Cinnamomi Ramulus prepared with sugar), Taoren (Pruni Semen), Shan Jia (Manis Squama), Guixu (Angelicae Sinensis Radix Caudex), Xuanfu (Inulae Flos), and Xinyi (Magnoliae Flos). Two doses resulted in immediate cure. This demonstrates that physicians must search widely and collect extensively to broaden their knowledge, lest they be ridiculed for their narrow vision.