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Mr. Pan Jiansuo had a servant named Xiaosheng, aged about sixteen or seventeen, who suffered from afternoon fever. A friend in the city named Zhou diagnosed it as Yin deficiency and prescribed treatments to nourish Yin and descend fire. After taking more than thirty doses, the fever worsened, and his abdomen gradually distended, with a pale and cold complexion. They continued with Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) supplemented with Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Radix), and Wuweizi (Schisandrae Fructus). After another thirty doses, his abdomen became as large as a bucket and hard as stone, food intake decreased significantly, hair turned yellow and brittle like tufts, forehead and skull shone, thirst was unbearable, muscles of both legs were completely wasted, eyes protruded, facial muscles emaciated, skin dry and rough like pine bark, appearing as if a living skeleton. I observed that his eyes still retained five-tenths of spirit. I intended to prescribe medicine for him, but those in Mr. Pan's household said to me, "With such physical and symptomatic conditions, death is imminent; can he still take medicine?" I said, "This is not a terminal condition; it is due to medical error. It is like a tree: if the roots are destroyed and branches withered, no effort can revive it; now the withering is due to axes damaging the branches, while the roots remain intact. If irrigated properly, there is still hope for survival, how can one give up? I administered Shenshou Dan (Divine Grant Pill), one pill daily, fed to him with four taels of boiled pork. After ten days, his abdomen softened by half, and the fever subsided by half, with gradual improvement in spirit and color. Mr. Pan asked me, 'What disease is this? You have restored spirit to someone whose flesh has wasted away.' I said, 'This is Ganji syndrome (infantile malnutrition and digestive dysfunction). They mistakenly identified it as Kidney deficiency and used Yin-nourishing medicines, thereby exacerbating stagnation; how could the abdomen not become large and hard?' Mr. Pan said, 'They used purely cold medicines, yet the heat intensified; you used non-cold medicines, yet the heat receded. What is the explanation?' I said, 'This heat is damp-heat caused by Spleen deficiency. Yin-nourishing agents are all damp in nature. The Spleen belongs to Earth, dislikes dampness, and prefers dryness. Now, using Dalulinwan (Large Aloe Pill) and Fei'er Wan (Child-Nourishing Pill) for conditioning over one month will lead to full recovery.' Mr. Pan said, 'Good. Without you, I would already be a ghost under the springs.'

Vice Minister Ling Yi quan, an elderly gentleman past seventy, originally suffered from Phlegm-Fire disorder. In early January, due to overexertion during his grandson's wedding, he accidentally contracted Wind-Cold, resulting in internal heat, coughing, blood in sputum, with more blood than phlegm, thick phlegm difficult to expectorate, clear nasal discharge, prickles on the tongue, scorched yellow tongue coating, stiff and unclear speech, difficulty in urination and defecation, rapid panting preventing sleep, inability to lie flat or supine, only able to sit on a high chair with a table in front, pillow on the table, resting his forehead on the pillow daily. City physicians treated him for half a month without relief, so they earnestly requested my diagnosis. Both wrists' pulses were floating and surging, with the Guan positions slippery, large, and forceful. I knew he had accumulated internal heat and Phlegm-Fire, invaded by Wind pathogen, and aggravated by anger, causing blood to rebel upwards. Critics feared that an elderly person presenting with hemoptysis, large pulse, and fever was a bad sign. I said, "This is an Excess syndrome. The gentlemen identified it as Yin deficiency and applied Yin-nourishing and fire-descending methods, hence the lack of improvement. The method should first clear the middle Jiao of Phlegm-Fire and accumulated heat, then use Rehmannia blood-nourishing formulas to conclude treatment, thus maintaining the correct sequence." The old gentleman agreed. I prescribed Gualou (Trichosanthis Fructus) and Shigao (Gypsum Fibrosum), each three qian, along with Juhong (Citri Reticulatae Pericarpium Rubrum), Banxiaqu (Pinelliae Fermentatum), Sangbaipi (Mori Cortex), Qianhu (Peucedani Radix), Xingren (Armeniacae Semen Amarum), Jiuhuangqin (Scutellariae Radix prepared with wine), and Zisuzi (Perillae Fructus), decocted in water. Just before administration, add a small wine cup of Luobozhi (Raphani Juice). After one dose, bleeding stopped. On the next day, the pulse remained floating, surging, and large, with aversion to cold. I said, "Ancient texts state that Wind injury causes aversion to wind, and Cold injury causes aversion to cold; this is the norm. Because earlier treatment failed to clear and disperse, the exterior heat was not thoroughly resolved, and instead, Yin-nourishing agents were used, plus Tongbian (Boy's Urine) for astringency, descending too rapidly, causing Wind-Cold to stagnate and fail to dissipate, thus intensifying the heat." I changed the prescription to Dingchuan Tang (Panting-Calming Decoction). After one dose, panting halved; after two doses, heat receded and aversion to cold disappeared. Upon re-examination, the floating quality of the pulses in both hands was gone, only the Guan positions were drum-like and forceful against the fingers, indicating long-standing stubborn accumulation of Phlegm in the middle Jiao, which must be guided out at this time. I administered Qingzhong Wan (Middle-Clearing Pill) combined with Danggui Longhui Wan (Angelica Dahurica and Gardenia Pill), totaling two qian. That night, the stool passed contained a large amount of sticky, foul accumulation. I recalled Zhu Danxi saying, "For asthma with excessive Fire, Baihu Tang (White Tiger Decoction) added with Huanglian (Coptidis Rhizoma) and Zhishi (Aurantii Fructus Immaturus) is effective." This method precisely matched Old Man Ling's condition. Ten doses were given, followed by Qingzhong Wan combined with Shuangyu Wan (Double Jade Pill) taken at night for conditioning, leading to recovery.