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Diseases vary in depth, and treatments differ in urgency. (Recognizing the condition of the disease and selecting the appropriate pace of medication is the primary concern for physicians.) If urgent conditions are treated with slow-acting remedies, it nurtures the pathogen and kills; if chronic conditions are treated with aggressive remedies, it forces the pathology and kills. Mediocre doctors, upon encountering a disease, cannot determine its name nor the appropriate medication, generally testing with mild and neutral drugs. For chronic conditions, this may suffice, but for major diseases, it causes significant mismanagement, hence termed "nurturing death" (death due to delay). If aggressive drugs are used for chronic conditions, it seeks rapid efficacy, not realizing that excessive attack generates complications, which is termed "forcing death" (death due to over-treatment). (These two errors are common among modern physicians; those who are timid fall into the trap of "nurturing death," while those who are careless cause "forcing death." Medicine is meant to save lives, yet becomes a reservoir of killing—how tragic!)

I observed Lü Shi, a renowned physician in the capital, who was familiar with this method but applied it too late. He initially used mild and neutral drugs for regulation, and only when the condition became critical did he consider moxibustion, pills, and Aconite preparations, mostly without effect. He then claimed, "It is destiny." Little did he know that rescue was already too late; the Zang-Fu Qi had collapsed, rendering even miraculous medicines ineffective. I witnessed him treat a case of Shanghan (Cold Damage) on the fifth day, where the patient was comatose and delirious, with six pulses appearing surging (Hong). He diagnosed heat in the Stomach and administered Chengqi Tang (Gut-Clearing Decoction) to purge. The patient died at the third watch (4–6 AM). The magnitude of the six pulses was not truly surging but indicated impending collapse of Yang Qi. Using purgatives further depleted Yin, leaving Yang without attachment, thus accelerating death. Had he first applied three hundred moxa cones below the navel to secure Spleen and Kidney Qi, and internally administered Baoyuan Dan (Protect the Origin Pill), Lianyang Dan (Astringe Yang Pill), and Jiangfu Tang (Ginger and Aconite Decoction), after three days, natural sweating would have occurred, leading to recovery.

I treated another Shanghan case presenting with coma and delirium, with string-taut and large pulses. I stated: Large pulses with coma indicate not excess heat, but Qi scattering with the pulse; I treated it reluctantly. (The Master is truly benevolent; I share this heart for forced treatment, but due to lack of trust from others and my own speech impediment, I often refrain, feeling ashamed that I am not truly practicing benevolent medicine.) I applied intense fire moxibustion to Guanyuan (CV 4). Initially, the patient felt pain, but by seventy cones, fell into a painless sleep. By the third watch, the patient opened his eyes, desired food, and was given Jiangfu Tang. After three days, Yuan Qi (Primal Qi) recovered, and the disease resolved through profuse sweating. (Today, indulgence has become the norm, and moxibustion is difficult to practice. I sigh: although Ginseng saves lives, Ginger and Aconite restore Yang power. Yet people do not understand, and vulgar physicians vehemently reject them, which is lamentable.)

Reflecting on the previous cases, they were Shaoyin diseases. Coma and delirium resemble Yang syndromes; had Chengqi Tang been administered immediately, death would have been inevitable. Therefore, deafness without groaning, red-black spots on the body, cold fingers extending to the feet, heaviness like a mountain, excessive phlegm and saliva, and intermittent restlessness/heat are all Shaoyin signs. Zhang Zhongjing attributed deafness to Shaoyang and delirium to Yangming, using Chaihu (Bupleurum) and Chengqi formulas, misleading many. Knowing only that the Shaoyang meridian runs along the flanks and connects to the ears, he failed to consider that the ear orifices belong to the Kidney. Attributing deafness to Shaoyang is an area Zhang Zhongjing did not fully explore. (Zhang Zhongjing discussed deafness as deficiency of Zong Qi (Gathering Qi), not attributing it to Shaoyang. Regarding delirium, the text mentions deficiency of Shen Qi (Spirit Qi) frequently, with only a few lines regarding Yangming. The Master’s criticism seems somewhat nitpicking.)