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Zhongshu Zuocheng Zhang Zhongqian, aged fifty-two. In the first month of spring in the year Wuchen of Zhiyuan (1268), he fell ill in Dadu with a wind syndrome (here referring to exogenous wind pathogen or stroke-like symptoms), characterized by numbness on one side of the body. A physician intended to treat him with sweating method but was uncertain whether it was appropriate, so he asked me to decide. I said: "To treat wind syndrome, one should employ 'treating obstruction with unblocking' (i.e., using dredging methods to treat diseases presenting with blockage or abnormal discharge); sweating is permissible. However, in this place and time, although the spring season has begun, cold qi still prevails alone. If sweating is induced, it will weaken the exterior, inevitably leading to aversion to wind and cold." Zhang Zhongqian desired a rapid recovery and thus underwent sweating therapy. Initially, his body felt light and refreshed, but several days later, he invited me again for consultation, saying, "Indeed as you predicted. Due to heavy official duties, I dare not go out. What should I do?" I said: "Zhang Zhongjing stated: 'The general principle is that sweating is suitable in summer because yang qi is on the exterior.' Currently, the seasonal yang qi is still weak, just emerging from the earth. Sweating will cause frequent depletion of qi, loss of defense qi control, and failure to make the couli (pores) dense and substantial. With no yang qi on the exterior, exposure to wind will cause severe aversion." The *Neijing* states: "Yang qi guards the exterior and maintains solidity." It also says: "Human yang qi is like the sun in the sky; if it loses its proper function, lifespan is shortened and brilliance is obscured." Even during times when sweating is indicated, there are warnings against excessive sweating, let alone sweating when it is contraindicated. Therefore, Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle) with added Baizhu (Atractylodis Rhizoma) was prescribed to nourish the spleen and stomach, and generate Ying-Wei (nutritive and defensive) qi. Additionally, warm powder was applied to the skin. Once the spring qi became vigorous and the exterior qi gradually solidified, the illness would resolve. The *Neijing* says: "The Heart must not be excessively attacked; seasonal timing must not be violated." This refers to such cases.

[Huangqi Jianzhong Tang] (See section on Fatigue and Overwork; add Baizhu [Atractylodis Rhizoma] to the formula)

The eldest son of Li Jun, Tixing of Jingjiang Prefecture, was nineteen years old. In April of the year Renwu of Zhiyuan (1282), he suffered from Shanghan (Cold Damage) for nine days. The physician treated it as a Yin syndrome and administered several doses of Fuzi Lizhong Wan (Aconite Pill to Regulate the Middle). His condition worsened. Another physician diagnosed it as a Yang syndrome, leading to conflicting opinions, and the family dared not administer any medicine. Li Jun personally invited me to resolve the doubt. I declined to avoid suspicion. Li Jun knelt and wept, pleading: "If the Imperial Physician does not come, my son will only wait to die." Reluctantly, I went to examine him. There were several people present in the room. Not wishing to state the diagnosis directly, I analyzed the symptoms in detail, allowing them to deduce the nature of the disease themselves. Generally, for Yang syndromes, the body is highly febrile while the hands and feet are not cold; lying down is comfortable, rising shows strength; there is no aversion to cold but rather aversion to heat; no vomiting or diarrhea; thirst with desire to drink water; restlessness and insomnia; ability to eat and talkativeness; pulse floating, large, and rapid—these constitute a Yang syndrome. For Yin syndromes, the body is not hot but hands and feet are cold; aversion to cold with curled-up posture; lying facing the wall; aversion to human voices; pulling clothes to cover oneself; no烦渴 (restless thirst); lack of appetite; free urination; loose stools; pulse deep, fine, and slow—these constitute a Yin syndrome. Upon palpation, his pulse was deep and rapid, beating six to seven times per respiration. His mother reported that he had been shouting incessantly the previous night, unable to sleep at all, and showed a preference for ice water. Hearing these descriptions, I confirmed that all Yang syndrome signs were present. Moreover, he had not passed stool for three days, requiring urgent purgation. I weighed Liuqian (6 qian) of Jiuhuang Dahuang (Wine-baked Radix et Rhizoma Rhei), Erqian (2 qian) of Zhigancao (Prepared Licorice Root), and Erqian (2 qian) of Mangxiao (Natrii Sulfas), decocted them in water, and administered the mixture. By evening, he defecated several times, passing more than twenty pieces of dry feces. That night, he sweated profusely. The next day, upon re-examination, his body temperature was normal and pulse was calm. Reflecting on the *Suwen: Re Lun*, it states: "Treatment requires differentiating and unblocking the zang-fu organs." Thus, Zhang Zhongjing expounded the *Shanghan Lun*, noting that the Six Channels differ and transmission varies. The *Huoren Shu* also states: "In treating Shanghan, one must first clarify the meridians. Without understanding meridians, one wanders blindly. The principles of former and latter sages are identical." Ignorant physicians who neglect learning meridians, fail to inquire into the origin of disease, merely press the cun and chi pulses, and guess at illnesses without knowing the location of pathogens often cause errors and refuse to repent. Han Yugong said: "The fault of a physician lies in insufficient thought." These are words of profound truth, encouraging study and emphasizing the heavy responsibility of saving lives.