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Mr. Wu Dongxing, a Shangshe (an honorific title for students in the Imperial Academy), was the eldest son of the Prefect of Chenzhou. He traveled to Nanjing during the summer heat to take the imperial examinations. After failing, he returned home feeling depressed and frustrated, which led to malaria. From mid-August until October, although the malaria subsided, he suffered from lower back pain, white turbidity (white discharge from the urethra), day-and-night coughing, and severe emaciation. Medications were administered indiscriminately: when considered as wind-pathogen, Qianghuo, Fangfeng, and Xuduan were used for dispersal; when considered as deficiency, Liuwei Dihuang Wan was used for tonification; when considered as fire, Huangqin, Huanglian, Zhizi, Huangbai, Zhimu, Tianhuafen, and Shengdihuang were used to purge fire; when considered as half-deficiency and half-excess, Duhuo Jisheng Tang was administered; and when considered as cold, Da Fuzi, Rougui, Lujiaojiao, Renshen, and Baizhu were used for warming and tonifying. The pain was so severe that he wished to die, his cries shaking the neighbors. Upon palpating his pulse, I found it wiry and fine on the left, slippery and large on the right, both reaching six beats per breath (extremely rapid). He had thirst and red eyes. I knew he had previously suffered from Yangmeichuang (syphilis), with residual toxins lying dormant in the meridians. Coinciding with the post-malaria deficiency of qi and blood, the old toxins were stirred up, causing sudden and violent pain. I prescribed Danggui, Shaoyao, Gancao, Niuxi, Gouteng, Yiyiren, Mutong, and Baixianpi, decocting four liang of Tufuling in water to replace water for decocting the aforementioned herbs. After taking this, the pain ceased, and the cough also disappeared. The pulse slowed by half. After several doses, there was significant effect, and his spirit gradually recovered. He then resumed supervising projects and handling official duties. On the Winter Solstice, emboldened by wine and dancing, he indulged in sexual activity without restraint. The next day, his waist felt bound, the dorsum of his feet hurt, his left eye was red, urination was scanty, and a sensation of fire rose from his soles straight up through his hips, causing unbearable pain. I prescribed Danggui, Gouteng, Gancao, Baishaoyao, Niuxi, Yiyiren, Shihu, Honghua, Shengdi, and Huangbai. After three days of regulation, the symptoms stabilized with no progression or regression. Suddenly, heavy snow fell, and the cold was extreme. A female physician trusted by his household, noting his dry and hard stool, administered one liang and five qian of Xuanmingfen within a day and night. His stool remained unpassed, but his lower back pain intensified, his legs became spasmodic and contracted, his breathing was faint, changing three times per sentence, and his face turned cyanotic and pale. Feeling critical, he summoned his wife and younger brothers to settle his affairs. At dawn, I arrived to diagnose him. All six pulses were deep and hidden due to the pain. Inquiring into the cause, I learned it resulted from the ingestion of Xuanmingfen. I said: "Although the syndrome is heat and the stool is dry, your disease lies not in the intestines and stomach, but in the meridians, sinews, bones, and joints. Purging the intestines and stomach alone is of no benefit. Moreover, in winter, yang qi is stored and concealed. Misusing purgatives will deplete yang qi, leaving no root for growth in the coming spring. Now, the contraction of the four limbs and severe pain in the waist and hips are due to the extreme cold weather recently, causing stagnation and obstruction in the meridians. Cold governs contraction. The treatment method should first warm and disperse the cold pathogen to alleviate the branch symptoms and stabilize the pain, before treating the root, so that life can be preserved." Thus, I used Guixin, Duzhong, Zhigancao, Cangzhu, Poguozhi (Buguzhi), and Wujia Pi. After two doses, the pain settled, the limbs became flexible, and food intake resumed. Knowing his household preferred quick results, and since I was about to travel to Jingxi, I declared: "Your illness resides in the meridians. Given the severe cold today, I advise you to endure patiently until the warmth of spring arrives to eradicate the root of the disease." His household did not accept my words and instead consulted Zhang Yunxi for regulation. I agreed that Zhang's approach could be maintained, as Zhang's medications nourished blood and cleared heat; although they would not remove the disease root, they would not cause harm. By February, the Prefect returned, and Shen Chunyu was consulted. Shen surmised that the condition must be yin deficiency caused by alcohol and sexual indulgence, so he exclusively used yin-nourishing and fire-purging formulas, expecting results within ten days. However, after more than a month of treatment, there was no improvement. I returned from Jingxi and visited him in early March. Hearing of my arrival, he presented Shen's prescriptions to me and said: "You promised that the root could be removed when spring arrives; this is the time." Knowing the Prefect deeply trusted Shen, I comforted him gently: "Dr. Shen is a renowned scholar; let him fully demonstrate his expertise." Shen treated him for another half-month but left without success. After Shen departed, I again administered Weishen San (Roasted Kidney Powder). He had severe diarrhea five or six times, his limbs became ice-cold, and the whole family was terrified, believing my purging method was wrong. I said: "The patient has improved day by day; why worry?" Subsequently, spleen-regulating medicines were given. After a few doses, his spirit recovered, his waist and hips became flexible, and he could get out of bed and walk a few steps. Only then did he believe and ask me: "Everyone uses tonification for treatment. How did you truly grasp the source of the disease? Your predictions before March have come true step by step." I replied: "This is residual toxin from Yangmeichuang lying dormant in the meridians. How could tonifying agents remove it! Therefore, I first promoted the unblocking of damp-heat, and then used tonifying agents to conclude the treatment, avoiding recurrence." Later, I prescribed two qian of Weilingshan powder inserted into a pig kidney, roasted and eaten. He had one or two more bowel movements, and the disease root was completely eradicated. Finally, Yiyiren, Danggui, Shengdihuang, Shoudihuang, Baishaoyao, Niuxi, Huangbai, Danshen, and Gui Ban were used for regulation, leading to full recovery.