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The hot qi of heaven descends, and the damp qi of earth ascends. Humans exist within the intersection of these two qis, with no place to avoid them. When the body is deficient and susceptible to pathogenic factors, it is named "Shu" (Summerheat). The term "Shu" implies the presence of both dampness and heat, which goes without saying. Shu pathogen first enters the Heart and inevitably injures Qi. If the dampness in the Qi level is not removed first, the accumulated heat cannot be expelled outward. Therefore, at the initial stage where Shu, Dampness, and Heat interact and steam together, it is imperative to eliminate the dampness, which aligns with the ancient principle that "to dispel summerheat, one must first dispel dampness." However, once the damp pathogen is eliminated, the hot qi reaches outward from the exterior; this condition is then named "Shu-Re" (Summerheat-Heat) rather than "Shu-Shi" (Summerheat-Dampness). Although originating from a single pathogenic factor, the preceding and subsequent conditions have different names because the medication strategies differ. This is because heat injures Yin, and Qi becomes even weaker. No wonder the old ailment of epistaxis (nosebleed) recurs, bleeding out from the upper clear orifices; the body feels heavy and exhausted; food intake gradually decreases; the pulse turns wiry and rapid; the Yang level becomes hotter; the mouth feels dry; all these manifestations present an image of deficiency mixed with excess. Regarding the syndrome of Shu pathogen, Hejian (Liu Wansu) often discusses it via the Sanjiao (Triple Burner). Currently, the patient's head and forehead feel heavy and confused, indicating that the evil heat is biased toward the Middle and Upper Jiao. Only due to excessive blood loss from epistaxis is there a deficiency of Yin fluids in the Lower Jiao. With such detailed diagnosis, the judgment lies in "Insufficiency of Shaoyin and Excess of Yangming," leaving no room for doubt. I propose adopting Zhang Jingyue's Yungnü Decoction method, so that the hot qi steaming upward from the Middle and Lower Jiao to the Lung can be resolved covertly, and the Yin qi of the Lower Jiao will no longer be injured. This still falls within the framework of Liu's Sanjiao treatment examples. I wonder if this is correct? I await Mr. Xigeng's correction.

Raw Rehmanniae Radix (prepared), Calcined Gypsum Fibrosum, Huai Achyranthis Bidentatae Radix, Ophiopogonis Radix, Anemarrhenae Rhizoma.

Jiuniu Erhu Wan (Nine Oxen and Two Tigers Pill): Zuo Huzhang (12 liang, roasted with butter), Poria (5 liang, steamed with human milk and sun-dried), Cow Rib Bone (9 pieces, preferably the third rib, roasted with butter), Achyranthis Bidentatae Radix (5 liang, stir-fried with salt water), Arctii Fructus (20 liang, sun-dried raw), Tribuli Fructus (20 liang, thorns removed), Chuanxiong Rhizoma (1 liang, sun-dried raw), Angelicae Sinensis Radix (5 liang, stir-fried with wine), Astragali Membranacei Radix (5 liang, honey-roasted), Glehniae Radix (5 liang, stir-fried with salt water), Male Black-bone Chicken (1 whole chicken, feathers and impurities cleaned, boiled until tender, pounded into paste with bones, roasted with butter).

Grind all ingredients into fine powder. Mix with refined honey to form pills, sized like paulownia seeds. Take 4 qian per dose, swallowed with warm water in the morning.