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My cousin, Zhou Ken'an (courtesy name Shibian), was well-versed in medical principles. In the summer of Bingwu year during the Daoguang reign, the pathogenic factor of Summerheat-Wind (Shu Feng) was severe, and an epidemic broke out widely; most patients suffered from sore throat, with deaths following one after another. Physicians were at a loss, but Zhou Ken'an treated numerous cases within his family personally, achieving full recovery. Pitying the limited knowledge of contemporary physicians, he wrote an essay stating: Summerheat-Wind enters through the mouth and nose, as does the seasonal cold and turbid qi. Initially, it injures the Upper Jiao Hand-Taiyin Lung Meridian. The initial symptoms may include sore throat with or without ulceration, aversion to cold with shivering, internal steaming heat, sweating that does not resolve the condition, a diffuse red flush over the body, and a white, greasy tongue coating. The primary treatment should use a mild acrid-cool formula, selecting from Forsythiae Fructus (Lianqiao), Menthae Haplocalycis Herba (Bohe), Schizonepetae Spica (Jingjie Sui), Lonicerae Japonicae Flos (Yinjinhua), Fermented Soybean (Danshichidou), Armeniacae Semen Amarum (Xingren), Platycodonis Radix (Jiegeng), Bupleuri Radix (Chaihu - *Note: Text says Yuan Shen/Xuanshen*, corrected to Scrophulariae Radix (Xuanshen)), Phallus Impudicus (Zi Mabo), Trichosanthis Pericarpium (Gualou Pi), Imperatae Rhizoma (Baimaogen), and Bambusae Folium (Zhuye), chosen according to specific symptoms, to release the exterior wind and disseminate turbid qi.

In the subsequent stage, there is fever without chills, persistent sore throat, thick and sticky phlegm, red eyes with excessive discharge, a crimson tongue without coating, bloody dysentery mixed with white rashes, irritability, thirst, mental confusion, restlessness, muttering in sleep, but clear consciousness upon waking. These signs resemble those of Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) and Baihu Tang (White Tiger Decoction). However, one must recognize that the Lung Wei (Defensive) level is close to the Heart Ying (Nutritive) level; this is lung heat encroaching on the Pericardium, not yet fully entering the Ying level, which can be distinguished by the absence of deep coma. If Rhinoceros Horn (Xijiao) is used hastily at this stage, it is akin to "opening the door to invite thieves" (inviting pathogens deeper). Alternatively, if the mind is clouded and orifices are blocked, using Rhinoceros Horn combined with Niuhuang Qingxin Wan (Calculus Bovis Heart-Clearing Pill) or Zhibao Dan (Precious Treasure Pill) is not contraindicated. Regarding Baihu Tang syndrome, characterized by a flooding pulse, profuse spontaneous sweating, and extreme thirst, adhering to ancient methods of pulse diagnosis is indeed correct. However, if inappropriate herbs are used, the pathogenic heat in the Lung meridian may lack an exit route, forcing its way down to the Large Intestine and causing dysentery. It is advisable to use Curcumae Radix (Yujin), Gardeniae Fructus (Zhizi), Trichosanthis Pericarpium (Gualou Pi), Phragmitis Rhizoma (Lugen), Bambusae Folium (Zhuye), Mori Folium (Sangye), and Chrysanthemi Flos (Ju Hua) to clear heat and dissipate turbidity. For severe toxicity, Glycyrrhizae Radix et Rhizoma (Gancao), Indospongia (Renzhonghuang), Isatidis Radix (Daqingye), and Isatidis Radix (Banlangen) may be added as needed. If accompanied by body pain and limb weakness—indicating Summerheat-Wind wandering through the limbs—Stephaniae Tetrandrae Radix (Fangji), Gentianae Macrophyllae Radix (Qinjiao), and Mori Ramulus (Sangzhi) may be incorporated. In summary, this pathology mostly lingers in the Hand-Taiyin Lung Meridian; therefore, medications should be light, clear, and dispersing. One should avoid bitter-cold and sinking agents to prevent damaging the Middle and Lower Jiao unnecessarily.