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The patient, Sun Zhongdeng, my clan's nephew, had just returned to the city after a lawsuit with his cousin. It was late February. After drinking alcohol heavily, he engaged in sexual intercourse twice. Upon rising to urinate, he immediately experienced pain below the umbilicus, watery diarrhea with hyperactive bowel sounds occurring more than ten times a day, fever, and headache.

The family physician administered Lizhong Tang (Replenish the Middle Decoction). After one dose, he instead developed vomiting and regurgitation, irritability, restlessness, and thirst.

Everyone invited me to examine him. I found his left pulse string-taut and large (Xian Da), and his right pulse flooding and large (Hong Da), both beating seven times per breath (indicating rapid pulse rate). He could not swallow food or drink, could not sleep day or night, his face was red, lips were dry, and the tongue coating was deep yellow and thick.

After the diagnosis, he said to me: "I contracted Yin-pattern Cold Damage (Yin Zheng Shang Han) after sexual activity. My lower abdomen hurts and diarrhea persists; I hope my great-uncle will save me."

I smiled and replied: "Based on what you say, it is determined as a Yin pattern; but based on my palpation, it should be identified as Spring Warmth Yang pattern (Chun Wen Yang Zheng). Moreover, the external symptoms are also Yang. How can we immediately prescribe Lizhong Tang simply because of sexual activity?"

Clansmen who knew the condition told me repeatedly: "His disease indeed belongs to the Yin pattern, hence the vomiting and watery diarrhea. One must not assume it is Yang just because of the red face. However, Floating Yang syndrome (Dai Yang Zheng) is similar to this; please examine carefully. We were planning to add Fuzi (Prepared Aconite Root) and Rougui (Cinnamon Bark) to Lizhong Tang, which might preserve his life."

I strongly objected: "No. Zhang Zhongjing said, 'If Guizhi Tang (Cinnamon Twig Decoction) enters the throat while Yang is abundant, death ensues.' How much more so for Fuzi Lizhong Tang? Between Yin and Yang, Cold and Heat, if the differentiation is not precise, life and death turn over like a palm. Here, we must abandon the symptoms and follow the pulse. Prescribe Wendan Tang (Gallbladder-Warming Decoction) with ginger-juice-fried Huanglian (Coptis Rhizome), Chaihu (Bupleurum Root), and Gegen (Pueraria Root). Give two doses, instructing him to finish them all that night, so that tomorrow there will be no further transmission."

After I left, after taking one dose, his vomiting and regurgitation stopped, but the other symptoms remained. The next morning, upon examining him, I questioned him directly: "Last night, you certainly did not finish the two doses; otherwise, why are both hands' pulses still flooding and forceful against the finger?"

They all said: "Because it contained Zhuru (Bamboo Shavings) and Huanglian, we feared it was not suitable for post-coital deficiency, so we only took one dose."

I said: "Not taking Huanglian caused the heat to intensify. Today, only Shigao (Gypsum Fibrosum) will suffice."

Therefore, I prescribed Baihu Tang (White Tiger Decoction) with added Zhuru, two doses. Before leaving, I instructed him: "The current condition is incomparable to yesterday. Using Shigao is a last resort! If it should be used but is not, and the heat from the meridions transmits to the fu-organs, only Dahuang (Rhubarb Root) can cure it. Do not lose time and cause mishaps."

Unexpectedly, after I left, others confused him again, and he still only took one dose. The diarrhea stopped immediately, but the lower abdominal pain persisted.

The next day, after finishing the examination, I said to him: "Yesterday, before leaving, I urged you repeatedly. Why did you not finish the medicine? Now the pulse is flooding, long, and hard. The pathogenic factor has entered the fu-organs. What shall we do? What shall we do?"

He replied: "The crowd said Shigao is extremely cold, fearing it would worsen the lower abdominal pain. In reality, I only took one dose."

I said: "Fearing the intake of Shigao, now we must use Dahuang. This is the fault of losing time and causing mishaps. As Zhou Jinren's inscription says: 'If the flickering flame is not extinguished, how to handle the blazing fire?' This is exactly what it refers to. I think Tao Ren Chengqi Tang (Peach Kernel Draining the Interior Decoction) is indispensable."

Therefore, I prepared the decoction in front of him for immediate consumption. He drank it continuously for two doses. He passed five or six pellets of extremely black and dry feces. The pain and heat both decreased.

Upon re-examination, all six pulses were slow and weak. Only then was the disease completely eliminated. The prescription was changed to Sijunzi Tang (Four Gentlemen Decoction) with added Baishao (White Peony Root), Huanglian, and Xiangfu (Cyperus Rhizome). After several days of recuperation, he recovered.