Library

The son of Xu Wenxue, who served as the magistrate of Sanquan, experienced fever every afternoon until dawn, with the fever worsening at night. He suffered from distending pain in the right hypochondrium, coughing that pulled at the pain, and pain regardless of whether he sat or lay down.
Physicians treated him for malaria (Nüe) without effect. After more than twenty days, the fever had not subsided. Subsequent physicians diagnosed it as deficiency heat (Xu Re) and administered formulas primarily consisting of Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu), which only increased the pain. I examined his pulse: the left pulse was wiry and large (Xuan Da), and the right pulse was slippery and large (Hua Da), striking the fingers forcefully. I stated: The *Neijing* says, "Left and right are the pathways of Yin and Yang." Based on the pulse, the fire of the Liver and Gallbladder is congealed by phlegm (Tan). This must be due to forcing oneself to write essays and excessive rumination without resolution, causing the nature of Wood and Fire to fail to circulate freely, becoming stagnant and resulting in pain. The worsening at night indicates excess pathogenic factors in the Liver. Initially, treatment should have focused on regulating Liver Qi, which could have been cured with one dose. Misdiagnosing it as malaria agitated the fire, and tonifying with Renshen and Baizhu blocked the Qi. Medical texts state: "When the body is hot like burning charcoal, sweating will disperse the heat." Now, there is no sweat, and the tongue coating has turned dark brown (chen xiang se), indicating extreme heat. If not treated urgently, critical danger will ensue immediately. Therefore, I used Zhongjing's Xiao Xian Xiong Tang (Minor Intra-thoracic Decoction) as the main formula: 1 liang of Trichosanthis Fructus (Gualou), 3 qian of Coptidis Rhizoma (Huanglian), 2 qian of Pinelliae Fermentata (Banxia Qu), and 1 qian each of Peucedani Radix (Qianhu) and Tangerine Peel (Qingpi), decocted in water for oral administration. At night, he took Danggui Longhui Wan (Angelica Sinensis and Picrorhiza Pill) to induce mild purgation. The other physicians still argued: "The illness has persisted for a long time, food intake is poor, and the spirit is so exhausted; how can we use purgation?" I replied: The classics state that the Liver is often in a state of excess, and the pulse also indicates excess; therefore, what is excess should be drained. Previously, misdiagnosing it as deficiency and using tonification was already an error; how could we err again? After taking the medicine, the pain stopped and the fever receded by midnight. After two doses, he was completely recovered.

Wu Zucuan's wife felt slightly cold after morning meals, with aversion to wind, fever, and pain throughout the body. She sweated profusely and continuously, felt heat in her mouth, had no appetite, short urine, and all six pulses were choppy (Se). I prescribed 5 qian of Paeoniae Radix Alba (Baishao), 2 qian of Atractylodis Macrocephalae Rhizoma (Baizhu), 1 qian each of Cinnamomi Cortex (Guipi) and Scutellariae Radix (Huangqin), and 8 fen of Glycyrrhizae Radix et Rhizoma (Gancao). After two doses, the sweating stopped, and the chills and fever resolved. Baizhu was removed, and Angelicae Sinensis Radix (Danggui) was added, which stopped the whole-body pain.

Fei Shaoyuan's wife was nine months pregnant, suffering from abundant phlegm, wheezing, and coughing, with fetal qi rebelling upward, inability to keep her eyes open, and slight pain in both temporal regions. I stated: This is the Zi Xuan syndrome (Fetal Suspension) complicated by Phlegm-Fire. I used Da Zisu Yin (Major Perilla Decoction) as the main formula. After just one dose, the rebellious fetal qi ceased, and the chest and diaphragm instantly felt relaxed. However, the wheezing and coughing persisted, so I administered Qizhi Huatan Wan (Seven-Processed Phlegm-Resolving Pill), which brought relief.