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Mr. Qian Shuweng, an elder gentleman, had a slender physique. He typically suffered from excessive internal heat with scant phlegm. In recent years, the latent heat within his body steamed and transformed dampness into phlegm. During the summer and autumn of the Xinsi year, when damp-heat was alternating in dominance, he suddenly developed numbness in his right foot, feeling as cold as ice or stone. This is actually a manifestation of extreme heat resembling cold, similar to hail falling during the height of summer. The physician, observing only the coldness of his dorsal foot, failed to carefully distinguish this condition of "extreme heat resembling cold." He erroneously treated him with warming herbs such as Achyranthis Radix (Niuxi), Chaenomelis Fructus (Mugua), Stephaniae Radix (Fangji), Phellodendri Cortex (Jiapí), Notopterygii Rhizoma et Radix (Qianghuo), and Saposhnikoviae Radix (Duhuo). Furthermore, some believed it was a deficiency and exhaustion of the Lower Yuan (Kidney and Mingmen) and erroneously used warming tonics like Aconiti Lateralis Radix Praeparata (Fuzi), Cinnamomi Ramulus (Guizhi), and Placentae Hominis (Heche). This approach was akin to adding fire to fire and heat to heat. Consequently, the area swelled and ulcerated, discharging pus for several months. The area below the ankle, the dorsum of the foot, toes, and heels became disabled and unusable. All this resulted from misdiagnosis and mistreatment reaching its extreme. The principle is clear and not difficult to discern. If it were truly lower-sinking cold-phlegm, it would merely be hard and congealed without dispersing; at worst, it might cause flaccidity, bi-syndrome, and loss of sensation. How could it progress to swelling, ulceration, profuse yellow discharge, rotting flesh, and penetrating sinews? Mr. Qian did not realize he was harmed by medical error but instead blamed the malefic influences of directional spirits. Is this really the case? This condition is no different from the "ruined syndrome" (Huai Zheng) in Cold Damage diseases, where pathogenic heat penetrates deeply into the meridians causing migratory abscesses (Liuzhu). The Ginseng Paste used at that time could only specifically regulate primordial Qi, lacking herbs to clear and resolve damp-heat as assistants, hence showing little effect. It is like assigning a senior statesman to handle trivial and complex affairs; it is inappropriate. If Bamboo Sap (Zhuli) had been used concurrently, Ginseng would have secured the channels while Bamboo Sap unblocked the collaterals; their sweet-cold properties would have complemented each other perfectly. Mr. Xu Taiye took Ginseng Paste to treat deficient wind but erroneously combined it with the heat of Aconite, resulting in shortened sinews and tendons and difficulty walking to this day. This too stems from a failure to understand that sweet-cold substances can unblock meridians. Moreover, after Mr. Qian used the Ginseng Paste, his Spleen Qi became robust, and transportive functions increased significantly. At this juncture, if he had regulated his diet, allowing the Yang Qi generated by the Spleen to focus on expelling phlegm and heat, the phlegm-heat would not have lingered, and the foot ailment could have resolved. However, he added night snacks to his daily meals. Although the robust Spleen Qi was not damaged by food, the Spleen Qi generated by the Ginseng's power was not utilized to transform phlegm and heat but solely to digest food, which is truly regrettable. Now, even ingested food is difficult to transport; what was intended to strengthen vitality has led to decline. Phlegm-fluids have become sticky and knotted in the chest, causing fullness, oppression, frequent coughing with ineffective expectoration. This is all due to the Spleen losing its healthful function of transporting fluids for the Stomach, causing food to generate phlegm instead. This phlegm gradually infiltrates and fills the lung orifices, making coughs difficult to expel. Although treating phlegm is urgent, most phlegm-resolving drugs consume Qi and damage deficiency. There is a fear that before the phlegm is expelled, wind pathogens may enter first. Therefore, the correct method is to firmly use sweet-cold herbs to block wind, eliminate heat, moisten dryness, tonify deficiency, and resolve phlegm. Pungent-warm herbs must absolutely not be used again. The physicians clearly saw these signs yet repeatedly used Cinnamon Twig and Prepared Aconite. They likely assumed that because the pus dried easily, it was due to the efficacy of pungent-warm herbs, and thus vigorously promoted this outcome to conclude the treatment. Such errors are unpardonable.

Mr. Hu Youchen stated: Damp-heat injuring the feet transmits from top to bottom; foot cold harming the Heart transmits from bottom to top. For transmissions from top to bottom, one should first clear the upper part; for transmissions from bottom to top, one should first warm the lower part. Observing this case reveals that just as people's illness harms the state, governance must prioritize the people.