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Chen XX from Tianjin, aged forty-six, suffered from Wind-Warmth complicated by latent Qi transforming into heat.

Etiology: While traveling north by the Beijing-Fengtian railway during midsummer for business, he was exposed to wind on his return journey, which resulted in a warm-heat disease.

Symptoms and Signs: On the day following the onset of the illness, I examined him. His daily activities were normal; however, he felt heat rushing up in the throat, coughing with sputum, slightly hoarse voice, and a sensation of stiffness, soreness, and weakness throughout the body. The pulse was floating and slightly slippery (Fu Er Wei Hua), and the right Guan position (Right Cun-Guan-Chi) was very firm upon heavy pressure. From this, it was known that although the condition arose from wind-induced warmth, the heat rushing up to the throat was actually due to latent Qi transforming into heat and stirring internally. If my prescribed Hanjie Tang (Cold Resolving Decoction) had been used, one sweat would have sufficed for recovery. However, administering a heavy dose of Shigao (Gypsum Fibrosum) immediately at the onset of the disease would likely cause suspicion and refusal by the patient. Therefore, I accommodated his psychology in prescribing. Indeed, since the physician's goal is to save lives, it is acceptable to adopt a tactful approach to practice medicine.

Prescription: Bohe Ye (Menthae Haplocalycis Herba, 3 qian), Qing Lianqiao (Forsythiae Fructus, 3 qian), Chantui (Cicadae Periostracum, 2 qian), Zhi Mu (Anemarrhenae Rhizoma, 6 qian), Xuanshen (Scrophulariae Radix, 6 qian), Tianhuafen (Trichosanthis Radix, 6 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 2 qian).
Decoct together in a large cup, take warm.

Second Visit: On the next day, he invited me again, stating that after taking the medicine, he sweated slightly all over, but the heat in both exterior and interior increased significantly, and the cough and hoarseness worsened. He asked why the heat increased despite taking such cooling medicines and expressed fear that the disease might be difficult to treat. His pulse was surging and full (Hong Da Er Shi) on both hands. It was determined that a heavy dose of Shigao (Gypsum Fibrosum) was indispensable. I told him, "This disease involves latent Qi transforming into heat, combined with new external heat. Even at the initial stage, Shigao must be used to clear the heat for a cure. If you can use four liang of raw Shigao (Sheng Shigao), you will surely recover today; I guarantee it." He asked, "Will all four liang of Shigao be taken at once?" I replied, "No. It can be divided into several doses; stop taking it when the illness resolves." This prescription was issued considering his fear, so that he would believe it.

Prescription: Sheng Shigao (Raw Gypsum Fibrosum, four liang, crushed fine), Jingmi (Oryza Sativa, six qian).
Decoct until the rice is cooked, extract four cups of decoction, and drink slowly and warm in four divided doses. There is no need to finish the entire dose if the illness resolves; stop drinking when the heat subsides. If loose stools occur, especially stop the medication immediately.

Third Visit: On the following day, he invited me again, greeting me with a smile, saying, "My heat has indeed completely disappeared, but my throat feels slightly painful now. Could you please treat it further?" I asked, "Did you finish all four cups?" He answered, "Yes. After drinking three cups, I still felt slightly hot inside, so I finished them. Moreover, there were no loose stools after taking the medicine; Shigao is truly a good medicine." Upon re-examination, his pulse had returned to a normal, peaceful state, and no further medication was necessary. I asked about his bowel movements, noting they had not occurred for three days. Therefore, I prescribed a formula to nourish Yin and moisten the bowels, stating that once the bowels moved freely, the throat pain would also heal itself, and the medication could then be stopped.