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[July] The patient’s constitution is inherently Yin-deficient. Having contracted the pathogenic factor of intense summer-heat, which accumulated in the Yangming channel, and further aggravated by wind and food stagnation, the initial symptoms included headache, aversion to cold, vexation with thirst, vomiting, and nausea. Subsequently, the condition progressed to fever and epigastric stuffiness; as the heat intensified, it led to coma. Red rashes and white miliary blisters (a type of small vesicle caused by damp-heat accumulation) appeared on the skin and interstices, gradually emerging. The disease had persisted for a month, during which the Lung fluids and Stomach fluids were consumed by the heat pathogen. Previous treatments employed aggressive and unrefined methods, causing daily depletion of the Yin aspect, consistent with the saying "excessive sweating leads to blood loss." Current pulse diagnosis reveals a wiry, slippery, deficient, and rapid quality, lacking vitality upon palpation. The lips are scorched and dry, and the mouth is parched. Correlating the pulse with the symptoms, further delay may risk asthma and collapse. Tentatively prescribing a method to support the healthy Qi and transform pathogens, hoping for a turning point. Attached is the prescription for review by distinguished physicians.

Prescription: Taishen Xu (Ginseng Rootlets) with Rose Flowers (three flowers stewed together and taken with the decoction), Trichosanthis Radix (Tianhuafen), Halitum (Shijueming), Zhen Chuanbei (True Fritillaria Bulb), Zhuhuang San (Pearl and Realgar Powder), Dalianxin Maidong (Lonicera Caulis with Heart), Xian Jinhu (Fresh Dendrobium), Zhufushen (Poria with Cinnabar), Zhuli Changpu Zhi (Acorus Rhizome Juice mixed with Bamboo Sap, one teaspoon taken with the decoction), Sheng Dihuang (Fresh Rehmannia Root), Mudanpi (Tree Peony Bark), Lianqiao (Forsythia Fruit), Yi Yuan San (Benefiting Origin Powder), Zhen Xi Po (True Amber, three fen ground and taken with the decoction).

Since previous treatments involved cloying and astringent substances, floral distillates are now prescribed to cleanse the intestines and stomach.
Jinyin Lu (Honeysuckle Distillate), Qinghao Lu (Artemisia Annua Distillate), Foshou Lu (Citrus Medica Distillate), Meigui Lu (Rose Distillate), Xian Gu Zi Lu (Fresh Millet Distillate), Paye Lu (Loquat Leaf Distillate).

Commentary: This approach is based on the method of Ganlu Yin (Sweet Dew Decoction).

[July 13th, by lamplight] Two years ago, the patient experienced hemoptysis. Fire rising and chronic cough have existed for a long time; the mechanism of Yin deficiency with floating Yang is self-evident. Since entering summer, the patient contracted summer-heat-dampness pathogenic factors, which disturbed Liver Yang from the Yangming channel. During tidal fevers, ministerial fire moved recklessly, leading to nocturnal emission and seminal leakage. Symptoms include scanty dark urine, thirst, and fluid distress. Previous physicians treated this as a warm disease, even administering Zijue Dan (Purple Snow Pill) and Zhibao Dan (Treasure of Life Pill) in doses of two jiao and two fen. Consequently, body fluids suffered sudden depletion. The lips are gray, dry, and cracked; the tongue surface has white patches; diarrhea and dysentery persist uncontrollably. There is internal heat but drinking does not quench thirst. The pulse is fine as a silk thread, indicating a risk of asthma and collapse. Reluctantly prescribing the method of "strengthening the master of water to control sunlight" (nourishing Yin to suppress hyperactive Yang), though efficacy may be limited due to the severity. Attached is the prescription for review by distinguished physicians.

Prescription: Taishen Xu (Ginseng Rootlets) with Rose (three flowers stewed together and taken with the decoction), Nvzhenzi (Ligustrum Lucidum Fruit), Biejia (Turtle Shell, processed with child's urine), Chao Shumi (Stir-fried Sorghum), Cheqiancao (Plantago Herb), Maidong (Ophiopogon Tuber, stir-fried with rice), Dong Baishao (White Peony Root from East), Qinghao (Artemisia Annua, processed with child's urine), Xian Lianzi (Fresh Lotus Seed), Huo Shihu (Dendrobium), Zuomuli (Left Oyster Shell), Sheng Shu Guya (Raw and Cooked Barley Sprouts, four qian each), Banbei Wan (Banxia and Beimu Pill).

[14th Day, Second Visit] Stool has formed, internal heat has decreased, and spirit is gradually recovering. However, there is pain in the lower back and loins, epigastric obstruction, poor appetite, dizziness, and fatigue. These indicate Yin deficiency. The pulse remains soggy, small, and rapid; the Guan positions on both sides are near-wiry. The tongue edges are slightly red; the white patches on the middle and posterior parts have receded, turning slightly yellow. Treatment follows the previous method with slight modifications. Attached is the prescription for correction.

Prescription: Taishen Xu (Ginseng Rootlets), Zuomuli (Left Oyster Shell), Digupi (Cortex Lycii), Sheng Guya (Barley Sprout), Cheqiancao (Plantago Herb), Jinjiong Hu (Dendrobium), Dan Biejia (Light Turtle Shell), Zhufushen (Poria with Cinnabar), Sheng Yiren (Coix Seed), Dong Baishao (White Peony Root), Chen Qinghao (Old Artemisia Annua), Zhen Chuanbei (True Fritillaria Bulb), Xian Lianzi (Fresh Lotus Seed).