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The trend of obtaining prescriptions through spirit writing (Ji Fang, a divination method for medical advice) is particularly prevalent nowadays. Do immortals really treat human diseases? Mostly, they are just cunning spirits; therefore, some prescriptions work while others do not. Cases I have witnessed personally include: Zhang Ziya from the capital suffered from alternating chills and fever. The spirit-written prescription used Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix), resulting in death due to phlegm obstruction. Li Yixuan from Xiaoshan, an elderly man with flaccidity of the lower limbs, was prescribed Fu Zi (Aconiti Lateralis Radix Preparata), Shu Di Huang (Rehmanniae Radix Preparata), Qiang Huo (Notopterygii Rhizoma et Radix), and Xi Xin (Asari Radix et Rhizoma) via spirit writing, leading to fatal hemorrhage. Those bewitched by this practice attribute efficacy to the immortals' power and failure to the patient's destined death, effectively using immortals as tools to kill. Alas! Can one reason with such people?

Medicines can nourish life but also harm it; those who take them must be extremely cautious. Wang Tao (courtesy name Huang Xiaolian) from Xiushui was skilled in poetry, calligraphy, and medicine. In the Yiwei year of the Daoguang era, he and I resided together in Kudui Hutong, Beijing. Patients seeking his treatment were constantly arriving. In the first month of the Bing Shen year, Wang suddenly developed fever and sweating. Believing it to be Yangming heat pathogen suitable for treatment with Shi Gao (Gypsum Fibrosum), he took one dose. However, the heat sank inward, leading to cold skin, diarrhea, and coma, causing his death within three days. Physicians stated that this originally belonged to a Guizhi Tang (Cinnamon Twig Decoction) pattern and should not have been treated with Shi Gao to suppress the exterior pathogen. Wu Pengfei (courtesy name Fuxuan), a Mingjing scholar from Shengxian, served in Taiping County. During the Ke examination in June of the Renyin year, the weather was extremely hot. His constitution was weak, and he was overworked, leading to deep pathogenic invasion. By mid-autumn, the illness manifested with initial aversion to cold and fever, with mild severity. Local custom in Shaoxing and Taizhou dictated drinking ginger soup for patients. Unaware that while suitable for cold invasion, it is contraindicated for summerheat, he drank two cups, exacerbating the summerheat pathogen, leading to untreatable condition. Another case involved misidentification of herbs: Chen Longguang from Gui'an, a surgeon, suffered from toothache and ordered his daughter-in-law to decoct Shi Gao (Gypsum Fibrosum). Mistakenly, Bai Pi (Realgar or Arsenic Sulfide, context implies arsenic compound here given toxicity) was used. Upon ingestion, severe abdominal pain ensued, worsening rapidly. Realizing the error, he induced vomiting with fecal liquor. He remained prostrate for several days before stabilizing, fortunate that only half a cup was consumed and rejected due to taste difference; otherwise, it would have been fatal. The son of Mr. Li from Chenzhuang in my county contracted cholera in summer. A physician prescribed Ban Xia (Pinelliae Rhizoma Preparata) 2 qian. Due to pharmacy shortage and high demand, a new assistant mistakenly provided Fu Zi (Aconiti Lateralis Radix Preparata). After ingestion, severe abdominal pain, madness, and hematemesis occurred, leading to death. Mr. Li blamed the physician, who claimed the medicine was correct and demanded to see the dregs, finding Fu Zi there. He sued the pharmacy, settling with a bribe.

Secular society favors warm-tonic medicines like Rou Gui (Cinnamomi Cortex), Fu Zi (Aconiti Lateralis Radix Preparata), and Lu Jiao Jiao (Colla Cornus Cervi). This is especially true for the elderly, who believe these boost yang. However, most elderly individuals suffer from yin deficiency. Taking these drugs depletes fluids and exhausts kidney water, shortening lifespan. I have seen many harmed by this.

Animals possess intelligence. Tigers eating green mud after being arrow-poisoned, wild boars eating shepherd's purse, pheons applying Rehmannia leaves to eagle wounds, rats drinking muddy water after aluminum sulfate poisoning, spiders covering bee sting wounds with earthworm excrement, mice rubbing taro roots on injuries, and storks wrapping broken eggs with medicinal residue—these examples in medical texts are numerous. Today, people fail to distinguish herb properties. Upon illness, they entrust their lives to incompetent physicians, turning mild cases severe and severe cases fatal. It is truly lamentable.

When taking tonics, one must assess constitutional suitability. Bias leads to disaster. Ye Tianshi's *Commentary on Jingyue Quanshu* records: Shen Chiwen, a brilliant youth, took Quan Lu Wan (Whole Deer Pill) distributed among four youths before marriage. Consuming it from winter to early spring, he developed whole-body pain, abdominal masses, emaciation, anorexia, and craving for cold drinks. Later, Jiuzheng Dahuang Wan (Wine-Steamed Rhubarb Pill) expelled black clumps swelling to the size of black soybeans in water, revealing the transformation of the deer pill. He died of extreme heat days later. The other three youths died of throat bi, anal abscess, and hemoptysis/cough respectively. This illustrates the harm of hot medicines. *Ye Tianshi's Medical Records* states: Huang Langling feared cold in June, wearing heavy cotton-pelt robes and sheepskin hats, keeping a stove by the bed, yet still complaining of cold despite scalding food. His pulse was floating, large, slow, and soft, fine as silk upon pressure. This indicates extinguished true fire and total absence of yang. Investigating his history, his father believed Tian Dong (Asparagi Radix) and Mai Dong (Ophiopogonis Radix) paste was excellent for youth. Administered morning and night for three years, the cold nature of these herbs infiltrated the zang organs, diminishing yang. Spring brought tidal fever. Dispersing herbs failed; sweating continued. Subsequent use of Huang Lian (Coptidis Rhizoma), Fen Hua (Bambusae Caulis in Taeniam), Mu Dan Pi (Moutan Cortex), Di Gu Pi (Lycii Cortex), Bai He (Lilii Bulbus), Bian Dou (Dolichos Lablab Semen), Bei Mu (Fritillariae Cirrhosae Bulbus), Bie Jia (Testudinis Carapax et Plastrum), and Wei Yu (Polygonati Odorati Rhizoma) worsened the condition. The corrected prescription used Ren Shen (Ginseng Radix) 8 qian, Fu Zi (Aconiti Lateralis Radix Preparata) 3 qian, Rou Gui (Cinnamomi Cortex) and Pao Jiang (Zingiberis Rhizoma Preparatum) 2 qian each, Chuan Jiao (Sichuan Pepper) 5 fen, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Huang Qi (Astragali Radix) 3 qian, Fu Ling (Poria) 1 qian, Dang Gui (Angelicae Sinensis Radix) 1.5 qian, and Chuan Xiong (Ligustici Chuanxiong Rhizoma) 0.7 qian. After eight doses, outer garments were removed, though food intake remained cold-sensitive. Bajun Wan (Eight-Ingredient Pill) modifications and Liu Jin Dan (Golden Liquid Pill) made from Liu Huang (Sulfur) were taken for 100 days until recovery. This demonstrates the harm of cooling medicines. Parents should heed this caution regarding tonics.

Cheng Yanxuan treated carpenter Wang's summer chills/fever, vomiting/diarrhea, spontaneous sweating, and headache. Other doctors used harmonizing exterior-interior formulas. Vomiting/diarrhea stopped, but fever persisted without thirst. The patient was fatigued, spoke little, had a slightly yellow moist tongue coating, and a deficient-thin pulse. Citing *Neijing*: "Deficient pulse with body heat results from summerheat injury," Cheng used Qingshu Yiqi Tang (Clear Summerheat and Boost Qi Decoction) modified. One dose worsened night fever, causing delirium and restlessness. Next morning, pulse was thinner, tongue purple with cracked flesh and blood traces, thirsty for cold drinks. Heat pathogen was trapped internally. Discarding pulse diagnosis for symptoms, Cheng switched to Baihu Tang (White Tiger Decoction) plus Sheng Di Huang (Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Shan Zhi (Gardeniae Fructus), Huang Qin (Scutellariae Radix), Zhu Ye (Bambusae Folium), and Deng Xin Cao (Junci Medulla). Sweating followed, calming delirium, but consciousness was lost, limbs cold, pulse imperceptible at bone depth (compare with Huxianweng's wind-heat case). Eyes closed, unconscious. Diagnosed as heat jue (reversal). Tongue coating short/thick, covered in purple blisters grape-sized, mixed with green/yellow/black colors. Prognosis: terminal. Mother begged for help. Cheng applied Zixue San (Purple Snow Powder) with honey to the tongue, added Xijiao (Rhinocerotis Cornu - now prohibited, substitute Niujiao or similar in modern practice, but text says Xijiao), Huang Lian (Coptidis Rhizoma), Xuanshen (Scrophulariae Radix) to clear heat; Jinzhi (Human Excrement Distillate), Renzhonghuang (Refined Human Excrement), Yin Hua (Lonicerae Japonicae Flos), Lv Dou (Phaseoli Semen) to detoxify. Decocted with snow water. Reversal reversed, pulse returned, blisters subsided, coating receded, leaving dry purple tongue. Two more doses cleared heat and restored clarity. Cheng admitted failing to detect excess syndrome resembling deficiency initially, blaming the initial Qingshu Yiqi Tang. He warned against lightly using this formula, especially with deficient pulse and sweating/thirst signs.

Physicians' pills and powders should not be trusted blindly. A villager treated for pi mass (abdominal lump) by a Huzhou doctor took pills. The mass resolved, but he died of distension. An infant with convulsions was given excessive powder medicine by a doctor. Convulsions stopped, but the child became permanently痴呆 (dull/stupid) due to excessive Zhusha (Cinnabar).

People love Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma). Deficiency benefits; excess harms. A Suzhou official's mother had food stagnation and wind-cold invasion: fever, anorexia. Doctor, citing age and weakness, added Ren Shen and Bai Zhu to dispersing herbs. Condition worsened dangerously. Her nephew, a physician, examined her: right pulse deep, rapid, forceful. Though exhausted, spirit was clear. Diagnosis: food stagnation mistreated by tonics. Required harsh purgation. Used Da Huang (Rhei Radix et Rhizoma), Bing Lang (Arecae Semen), Hou Po (Magnoliae Officinalis Cortex), Laifu Zi (Radish Seed). First dose ineffective. Nephew insisted on potency, added two more doses. Massive stool discharge cured the illness. Lesson: beware of indiscriminate tonic use.

Secular belief holds external single-formula treatments are safer than internal ones. Yet, harm occurs. *Continued Famous Medical Cases* records a monk with sores using Xionghuang (Realgar) and Ai Ye (Artemisiae Argyi Folium) fumigation. Next day, whole body swollen, skin ruptured, fluid oozing, unable to eat. Detoxification failed; he died. Poison entered interior, scattering true qi. Another case: author's family used fumigation for sores; sores didn't heal. Child later died of smallpox with severe symptoms, unable to swallow medicine, likely due to toxic accumulation. The sores were likely heat-toxin; attacking heat with heat intensified it. Always differentiate yin/yang and deficiency/excess before external treatment.

Body fatness/thinness doesn't dictate health risks. Wang Zilong from Suichun was fat but took Luqie Wan (Reed Eggplant Pill) to slim down. Status rise/fall doesn't define honor/disgrace. Kou Zhun (Lord Lai) became chancellor but took Dihuang (Rehmanniae Radix) and ate radishes. Seeking immortality via Golden Elixir shortened life; seeking offspring via aphrodisiacs harmed life. These pursue trivialities while neglecting fundamentals.

Zhou Shun, a famous doctor from Poyang, warned against blind ancient prescription use. While texts like *Shenghui Fang*, *Qianjin Fang*, and *Waitai Miyao* contain valuable pathology/pulse/acupuncture info, dosage differs significantly from modern standards. Without deep study, do not use them arbitrarily. One eye disease patient using ancient formula suffered protruding eyes. A postpartum woman using *Waitai Miyao* suppository formula suffered lochia retention lifelong. Ancient and single formulas can be effective if matched correctly, but avoid harsh drugs.

Scholars lacking medical knowledge are often misled by quacks. Others discuss medicine superficially and harm themselves with rash medication. Example: Su Shi (Su Dongpo). In Jianzhong Jinguo Year 1, aged 66, returning from overseas, he stopped at Yizhen. Climbing Jinshan Miaogao Terrace, deciding to return to Wuling, he toured West Mountain with Mi Yuanzhang. Escaping summer heat under pines/bamboos, he found boat heat unbearable, slept outdoors, drank excessive cold liquids. Midnight sudden diarrhea left him exhausted. Huangqi (Astragali Radix) porridge helped slightly. Mi invited dinner next day. Suddenly, miasma toxin flared, diarrhea continued. Chest fullness, anorexia, insomnia. Departed Yizhen 11th, worsened 14th, severe heat toxin 15th. Refused all meds except Renshen-Fuling soup which calmed breath slightly. Wrote to Qian Jiming: "Night fever unbearable, gums bleeding like earthworms until dawn. Exhausted. Heat toxin root is deep. Should use cooling meds. Ordered Ren Shen, Fu Ling, Maidong (Ophiopogonis Radix) boiled thick, sipped when thirsty. Stopped others. Zhuangzi said 'Hear of governing by non-interference, not treating the world.' These three herbs represent non-interference. If not cured, it is heaven's will." 21st: slight improvement. 25th: critical. 27th: upper dryness, lower cold, breath failing. 28th: died.

My comment: Diarrhea from cold drinks contraindicates Huang Qi. Chest fullness/heat/tooth bleeding contraindicates Ren Shen/Maidong. Wasn't this harm from tonics? (*Changyi Sheying Shihua* by Lin Xiaolian argues: At diarrhea stage, yang suppressed by yin, should use Dashun San or Qingshu Yiqi Tang/Wuling San/Lengxiang Yinzi/Erxun Tang/Zhongman Tang. Huangqi porridge caused pathogen sinking. Chest fullness mistaken for miasma. Gum bleeding due to prior mishandling, summerheat invading stomach. Should use Ganlu Yin or Xijiao Dihuang Tang. Instead, Maidong Yinzi/Ren Shen/Fu Ling/Maidong were used, mismatching disease, causing death. I agree Ganlu Yin/Xijiao Dihuang Tang fits. But Gui/Fu are definitely wrong for such severe heat toxin.)

Medication忌讳 (taboo) mixing incompatible herbs. Even one or two mismatches hinder efficacy. Wuwu year, late spring, returning from Hangzhou, boatman Chen had warm disease: high fever, no sweat, 7 days no food, thirst, chest stuffiness, cough, headache, rapid pulse (right > left). Hangzhou doctor prescribed Lianqiao (Forsythiae Fructus), Gualou Pi (Trichosanthis Pericarpium), Niubang Zi (Arctii Fructus), Dong Sangye (Mori Folium), Ku Xingren (Armeniacae Semen Amarum), Hei Shanzhi (Gardeniae Fructus Charred), Xiangbei (Fritillariae Thunbergii Bulbus), Zhuye (Bambusae Folium), Lugeng (Phragmitis Rhizoma). Herbs matched disease, but included Lingyangjiao (Tauri Cornu) and Zhike (Aurantii Fructus). One dose: no improvement, chest oppression, worse heat. Asked me to consult. I removed Lingyangjiao/Zhike, added Danshichi (Fermented Soybean) and Bohe (Menthae Haplocalycis Herba). One dose: whole body sweating, cool body, appetite returned. Removed Danshichi/Niubang Zi, added Tianhuafen (Trichosanthis Radix). Two doses: cured. Reflection: Common warm-disease treatment uses Lingyangjiao/Xijiao immediately. Pathogen is in Lung/Stomach; these herbs divert pathogen to Liver/Heart, worsening mild cases.

*Tao Gu Qingyi Lu* states: Han Yu (Han Changli) favored cosmetics in old age, frequently ingested sulfur mixed with porridge/rice, ate roosters, processed over 1000 days into "Fire Spirit Warehouse," consuming one every other day. Initially effective, ultimately fatal. HT notes: Bai Juyi's poem "Tuizhi takes sulfur" was previously debunked as not referring to Han Yu. Tao's account may be unreliable, but suffices to warn against reckless ingestion practices.