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Shen Yukun's wife suddenly developed epigastric pain. Fan prescribed Xiaoyao San (Free and Easy Wanderer Powder), which temporarily stopped the pain, but was followed by fever and sore throat. Gu Tingquan was invited to diagnose and determined it was caused by pathogenic warm pathogens (Wen Xie). He prescribed a clearing and dispersing method. Although the pain ceased, the fever persisted. Seven days later, the patient presented with closed eyes, nasal congestion, deafness, limb convulsions, mutism, and anorexia. Gu suspected a critical condition and wished to consult Meng Ying. Shen's two sons had studied under Wang Shoushi, so they asked their master for advice. Shoushi agreed that Meng Ying's insight was superior and arranged for his invitation. It was already dusk, so a messenger was sent urgently. Upon personal examination, Meng Ying observed the severe external symptoms but noted that after finishing the pulse diagnosis on the left hand, the patient immediately withdrew it and then extended the right hand. Meng Ying abruptly stated: "This is not coma." He then pried open the teeth to inspect the tongue coating, which was white and slippery. Inquiry revealed that defecation had not occurred. Meng Ying said: "The disease is Wind-Warmth, but it has not transmitted reversely to the Pericardium (Tan Zhong); instead, it has transmitted sequentially to the Stomach Fu-organ. There is nothing to fear in this presentation. Tingquan's scholarship surpasses mine; his willingness to ask questions humbly despite having doubts shows his broad-mindedness! However, while warm pathogens transmitting to the Stomach is common, this case appears so alarming because the patient has pre-existing Phlegm-Fluids (Tan Yin) stagnating in the Stomach. The external pathogens have taken advantage of this, which explains why the tongue coating did not turn yellow and dry. One must not mistakenly equate Warmth solely with Heat pathogens. Since the pulse is wiry, slippery, and rapid, once the Phlegm-Fluids descend, the coating will surely turn yellow. This is like the time when 'clouds obscure and fog hides'; one needs the insight of Wen Taizhen (Wen Qiao) lighting the rhinoceros horn to see clearly, lest one be deceived by the disease. Ancients only spoke of reverse transmission in warm diseases, not sequential transmission, leading later generations to erroneously hold that Cold Damage affects the Foot meridians while Warmth affects the Hand meridians. They fail to realize that meridians are interconnected and cannot be rigidly separated. Yu Jia Yan (Yu Chang) stated that Cold Damage also transmits to the Hand meridians, but the Foot meridians are affected first. I say that Warmth also transmits to the Foot meridians, but the Hand meridians are affected first. By analogy, if there is reverse transmission, there must be sequential transmission. When the pathology moves from the Lung to the Pericardium, it gradually sinks inward, hence called 'reverse.' When it moves from the Lung to the Stomach Fu-organ, the pathology seeks to exit and move downward, hence called 'sequential.' Although the pathogen here is sequentially transmitting, it desires to exit but cannot. As the saying goes, 'Stomach disease leads to disharmony of the nine orifices,' which is vastly different from the syndrome of reverse transmission causing coma treated with Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction). Guo Yuntai said: 'For Stomach excess and disharmony, employing Meng Tan Wan (Rolling Phlegm Pill) is not overly harsh.' This can be considered the true essence of treating this disease." He then prescribed Xiao Xian Xiong Tang (Minor Intra-thoracic Granularity Decoction) combined with Juan Yin Liu Shen Tang (Six-God Phlegm-Fluid Eliminating Decoction), adding Zhi Shi (Immature Bitter Orange) and Hou Po (Magnolia Bark), decocted with water boiled from Lu Fu (Radish), mixed with one cup of Zhu Li (Bamboo Sap), and administered with Si Qian Meng Tan Wan (Meng Tan Pill) four qian. The Shen family felt the prescription was too harsh and showed hesitation. Meng Ying said: "Since you suffer from an alarming disease, you must take alarming medicine. If the medicine does not cause a Mingxuan reaction (severe adverse reaction indicating efficacy), the chronic illness will not heal. Why not consult Shoushi and Tingquan again?" The Shen family nodded. Wang and Gu reviewed the prescription and agreed, adding: "If you fear the heavy dosage, it can be administered gradually over time."

The next day, Meng Ying and Gu consulted together; the pulse and symptoms had not significantly improved. Upon inquiry, they learned the previous medicine had been taken in divided doses. Meng Ying said: "This is due to the dispersion of force and slow action. Now doubts can be dispelled, and aggressive treatment should proceed; the condition will surely turn." Gu deeply agreed. At dawn, several sheng of tough, turbid phlegm were excreted, and all symptoms decreased slightly. The patient could speak briefly and sip thin porridge. The tongue coating turned yellow and dry. The medication was changed to lighter, clearer formulas, and the patient gradually stabilized. Subsequently, nourishing Yin and softening the Liver treatments led to recovery.

Cheng Xieting's son, Zhixiang, contracted warmth this spring and suffered from insecure essence gates (seminal emission). Ten days later, he suddenly experienced penile retraction and chills, feeling unable to withstand it. People diagnosed it as deficiency malaria and wanted to administer Ginseng and Aconite. Meng Ying said: "It is not malaria. Usually, his body is full and damp, and rich flavors have generated phlegm-dampness, resulting in a greasy tongue coating and lack of thirst. He belches easily and vomits. Having inhaled wind-warmth, the phlegm-dampness acts as a mountain pass obstacle. Taking advantage of yin deficiency and yang disturbance, the pathogen easily flows into the Jueyin channel. How can we allow further administration of warming tonics to deplete fluids and imprison pathogens, thereby accelerating spasms and convulsions?" His family, being the sole heir for six generations, was deeply worried by his parents and insisted on good treatment. Meng Ying said: "Although I thoroughly understand the syndrome, the condition is complex. Even with excellent prescriptions, rapid cure cannot be guaranteed. Slight deviation in treatment may cause delay. Although the host trusts me completely, I have my principles. If the illness does not improve quickly, it will inevitably attract criticism. Confusion midway—who will bear the blame? If you trust my words, invite Gu Tingquan to consult together to supplement my shortcomings and silence others' baseless议论." Cheng deeply agreed. Wang and Gu deliberated carefully. In the afternoon, a formula to regulate the Lung and Stomach was given to resolve external pathogens, eliminate phlegm-dampness, and pivot the mechanism. In the morning, a cooling Kidney and soothing Liver method was used to calm floating yang, search the collaterals, and guard the key points. The disease indeed descended in order. However, the patient was prone to anger, easily caught colds, and refused bland diets, leading to repeated relapses. Each relapse brought penile retraction and chills, even purple blood clots at the gum margins, slight redness in fingernails, short dark foul-smelling urine. Meng Ying said: "Fortunately, the Upper Jiao is cleared, and the Central Jiao is functioning. It is urgent to tonify Kidney Yin and clear Liver heat." Formulas alternating among Xi Yang Shen (American Ginseng), Dong Qin (Tian Dong and Mai Dong), Er Di (Shu Di and Sheng Di), Rong Rong (Cistanche), Fen Hua (Trichosanthes Root), Zhi Mu (Anemarrhena), Huang Bai (Phellodendron), Huang Lian (Coptis), Shi Hu (Dendrobium), Bai Shao (White Peony), Shi Ying (Quartz), Mu Li (Oyster Shell), Gui Ban (Turtle Shell), Bie Jia (Softshell Turtle Shell), E Jiao (Donkey-hide Gelatin), and Ji Zi Huang (Egg Yolk) were used in large doses for over twenty prescriptions. Symptoms gradually receded. Later, these medicines were made into a paste for morning consumption, and Miao's Zisheng Wan (Zisheng Pills) was taken at noon. All ingredients were raw, sun-dried, and powdered, formed into pills with Bamboo Sap, and taken with Loquat Leaf Decoction. Health was restored by autumn. Meng Ying remarked: "Ancients used honey for pills, which is meaningless. One should adapt according to the syndrome; this is one method."

Han Zulin, nearly seventy years old, suffered from limb coldness, head swelling, delirium, and urinary incontinence in early winter. Bao treated it as deficiency wind resembling stroke and administered warming tonics, worsening the condition. Meng Ying's pulse diagnosis showed wiry and rapid on the left, slippery and overflowing on the right. He diagnosed internal obstruction by Phlegm-Heat and external invasion by Wind-Warmth. He prescribed Ling Yang Jiao (Antelope Horn), Bei Mu (Fritillaria), Zhu Ru (Bamboo Shavings), Zhi Zi (Gardenia), Lian Qiao (Forsythia), Bai Wei (Cynanchum), Sang Ye (Mulberry Leaf), Ju Hua (Chrysanthemum), Fen Hua, Dan Pi (Moutan), and Xuan Fu Hua (Inula Flower), decocted with Radish soup, leading to recovery.

Qian Wenyuan's second son contracted an exterior condition. Tang prescribed Gui Zhi (Cinnamon Twig), Hou Po, Jiang (Ginger), and Chai Hu (Bupleurum), resulting in frequent hemoptysis of phlegm-blood, mental confusion, deafness, delirium, loose stools, anorexia, extreme thirst, black tongue coating, scanty urine, and insomnia. Fan Yingshu and Gu Tingquan repeatedly used light, clearing formulas. The black coating faded, leaving a crimson tongue without fluid, while external symptoms remained, leaving them helpless. Meng Ying diagnosed fine and rapid pulses, identifying constitutional deficiency of True Yin and scorching of Ying fluids. He advised against fearing cloying herbs due to loose stools and anorexia. He prescribed Xi Yang Shen, Sheng Di (Rehmannia), Er Zhi Wan (Two Solstice Pills), Dong Qin, Gui Ban, Yan Wo (Swallow's Nest), Zhu Ru, Bei Mu, Yin Hua (Honeysuckle), Ou Zhi (Lotus Root Juice), Li Zhi (Pear Juice), Wei Rui (Polygonatum), and Bai He (Lily Bulb). After two doses, hemoptysis increased, much phlegm was expectorated, and thin gruel could be tolerated. Night sleep improved. After five doses, fever subsided, diarrhea stopped, thirst decreased, and pulse harmonized. Ten days later, dry feces were passed, and he recovered.

Wang Binghua's son contracted an exterior condition. Ye used warming dispersants, causing rebellious Qi preventing sleep. Wang Bingheng, an old physician from Siming, treated it as Kidney deficiency failing to grasp Qi, administering large doses of warming tonics, worsening wheezing and coughing, facial and ankle edema, shoulder-lifting breathing, spontaneous sweating, extreme thirst, and hypochondriac pain. Seeking Meng Ying's help, the patient had not slept for half a month. Pulse was wiry, large, and strong on the right; two black coal-like coatings were seen at the tongue root. Face was sallow, body emaciated. Fortunately, loose stools allowed tolerance of many mistaken medicines. Meng Ying directly prescribed Xuan Fu Hua, Dai Zhe Shi (Magnetite), Huang Lian, Zhi Shi, Gua Lou (Trichosanthes Fruit), Su Zi (Perilla Seed), Xing Ren (Apricot Seed), Lai Fu Zhi (Radish Seed), Zi Wan (Aster), and Sheng Shi Gao (Gypsum), six doses. Sleep became possible, but extreme thirst persisted, and epigastric/abdominal distension with hardness and pain appeared. Xuan Fu Hua and Dai Zhe Shi were removed, and small amounts of Bai Jie Zi (White Mustard Seed), Ban Xia (Pinellia), and Xie Bai (Macrostemon) were added, along with eating dozens of Northern pears daily.

After ten days, chest and abdomen relaxed, coatings disappeared, but cough remained. Formula changed to Xi Yang Shen, Xing Ren, Bei Mu, Lu Gen (Lily Rhizome), Zhi Mu, Dong Gua Zi (Winter Melon Seed), Pi Pa Ye (Loquat Leaf), Fen Hua, Shi Shuang (Persimmon Frost), and Zhu Li, ten-plus doses. Cough stopped, and edema, thirst, and diarrhea resolved miraculously. Over 300 jin of pears were consumed, astonishing everyone.

Yu Boquan's son contracted an exterior condition accompanied by abdominal pain and distension. Hu used warming dispersants, causing cessation of urination and defecation, coma, delirium, extreme thirst, and black prickly tongue coating. Meng Ying used Xi Jiao (Rhinoceros Horn - now substituted with Buffalo Horn), Lian Qiao, Zhi Shi, Bo He (Mint), Huang Lian, Fen Hua, Yuan Shen (Scrophularia), and Da Huang (Rhubarb). Bowels opened, spirit cleared. Xi Jiao was removed, Dan Pi added. Two doses later, coating dissolved, heat subsided. Only lower abdominal stiffness and lack of appetite remained. Formula changed to Zhi Zi, Huang Lian, Zhi Shi, Ji Li (Tribulus), Yan Hu Suo (Corydalis), Ju He (Tangerine Seed), Rong Rong, Fen Hua, and Zhi Jun (Prepared Rhubarb). Continuous passage of black stool led to gradual improvement. Just as nourishing Yin was planned, influenced by others, Jin was hired to administer large doses of warming tonics to rapidly restore Yuan Qi. Unaware that residual heat burned internally, scorching Ying blood causing hemorrhage and consuming fluids causing emaciation, they still believed vomiting blood required tonification and emaciation indicated deficiency. Ultimately, excessive tonification led to death.

Zhou Guangyuan's mother contracted warm pathogens, presenting with phlegm-cough, epigastric stuffiness, and profuse sweating. Meng Ying prescribed Shi Gao, Zhu Ru, Zhi Mu, Fen Hua, Xuan Fu Hua, Bei Mu, Lou Ren (Trichosanthes Seed), and Zi Wan, thirty doses, leading to recovery.

Chen Chitang's wife contracted an exterior condition, presenting with red face, insomnia, irritability, delirium, sweet taste in mouth, thirst with greasiness, dysuria, and painful urination. Gu Tingquan's multiple clearing and resolving prescriptions failed. Meng Ying's pulse diagnosis showed wiry, surging, and rapid on the left; slippery and overflowing on the right. Chest oppression, unpassed stool, floating Liver Yang, non-descending Lung Qi, Phlegm-Heat obstruction, and lingering pathogens were identified. Xiao Xian Xiong Tang was combined with Wen Dan Tang and Xue Geng Decoction, plus Xuan Fu Hua and Xie Bai. Chest oppression gradually opened. Ban Xia and Xie Bai were removed, and Dang Gui Long Hui Wan (Angelica and Gentian Pill) was administered. Delirium ceased, sleep returned. Tong You Tang was used to pass black stool. After three times, nourishing Yin and harmonizing Stomach treatments led to recovery.