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During the eleventh month, Elder Qi contracted a cold pathogen, resulting in stiffness of the head and neck and body pain. He self-administered four or five pills of Lingsha Dan (Cinnabar Pill), taken with wine as a vehicle, which led to profuse sweating.

After sweating, he felt physically light; however, by nightfall, his previous symptoms recurred. He took the same medication again to induce sweating, but the illness did not resolve. Subsequently, he took Tongsheng San (Tongsheng Powder) to induce sweating, which worsened his condition, adding symptoms of heavy body, cold feet, and aversion to cold.

It was only on that day that the family summoned a physician. The physician failed to investigate the prior treatments and administered Wuji San (Wuji Powder) to induce sweating. By the next day, his body was as heavy as stone, unable to turn over or change position. His feet were like ice, with coldness extending up to the waist and back. Sweat on the head flowed like beads strung together, emerging but not flowing freely. He experienced restlessness and heat in the chest and heart, mental agitation, and discomfort, desiring cold drinks. Foods such as watermelon, pear, persimmon, and iced water were kept constantly by his side.

When the condition reached this stage, he requested my treatment. I palpated the six pulses, finding them thin as spider silk, faint and nearly imperceptible. I pronounced it a fatal case. The head of the household said, "He has sweated profusely; how can this be harmful?" I replied, "The invasion of cold pathogens is caused by insufficiency of Yang Qi. The severity of contraction varies; how can sweating therapy be applied without proper appropriateness? Zhang Zhongjing stated: 'In cases of Yin excess and Yang deficiency, sweating may cure' [Note: Interpreting original text literally]. Sweating is intended to assist Yang and retreat Yin. Moreover, cold pathogens cannot exit spontaneously; they must wait for the venting of Yang Qi to be expelled through sweat.

Considering the season, the general principle is that sweating is suitable in summer; this is a general rule. However, one must beware of excess. Furthermore, the three months of winter are a time of storage and concealment; one should not disturb Yang, nor allow the skin pores to open, causing frequent depletion of Qi. This is the way of nourishing storage. Violating this leads to the failure of Shaoyin (Kidney) to store, contradicting the correspondence of Winter Qi. In cases of external invasion, slight sweating should be induced, aiming for balance, stopping when the pathogen recedes. One should urgently wear warm clothes, reside in a sealed room, and take formulas that consolidate the exterior and tonify Wei Qi (Defensive Qi). Even if cold pathogens are present, they will cause no harm; this is a flexible treatment approach. Now, inducing massive sweating out of season is called 'counter-flow' (Ni). Thus, Zhang Zhongjing said: 'One error may prolong life for a day; two errors accelerate the end of life.' Here, originally suffering from injury (cold), he was made to sweat; after sweating, he was injured again; after being injured, he was made to sweat again. Multiple episodes of sweating caused frequent depletion of Qi, loss of defensive function of Wei Qi, leakage of Yang on the exterior, and invasion of Yin on the interior. Hence, the Classics state: 'Solitary Yang does not generate; solitary Yin does not grow.' Why would he not die? Even if Lu Yuan (Bian Que) were alive, he could not save him.

That night, near midnight, he developed stiffness of the neck, insensibility of the body, spasms and cramping of the hands and feet, and cyanosis of the nail beds, after which he died. The *Jin Gui Yao Lue* states: 'Sweating improperly when not indicated causes depletion of fluids and death by withering.' Even when sweating is indicated, going too far can sever life; how much more so when sweating is forced inappropriately?"