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Zhang Zhenxi from Pinghu, startled by a fire in the neighboring house, fell ill after several days. He had no significant chills or fever, but suffered from mental restlessness, chest oppression, anorexia, lethargy, and insomnia. Upon examination, he spoke as if engaging in casual conversation, yet his spirit was disconnected. I said: This is a syndrome of lost soul (Shi Hun). Not only has the pathogenic wind-cold penetrated deeply, but the Shen (Spirit) and Zhi (Intellect) are also injured. It cannot be cured quickly, nor should heavy decoctions be used. Decoctions should be used to expel pathogens, and pills/powders to calm the Shen; only then can gradual recovery occur. At that time, it was New Year's Eve. I prescribed medication for half a month, and he returned home. By the Lantern Festival, it was learned that he remained in his bedroom, and when asked about previous events, he knew nothing. By February, his health had recovered. He came with his younger brother, Yuanruo, to thank me in the mountains. He added: Last night, a scrofula (Luo Li) appeared at the back of my head, slightly painful. Upon inspection, I exclaimed: This is Yuzhen Ju (Yuzhen Carbuncle/Ulcus). This is a very dangerous condition. Medicines are scarce here. I urgently took him back, employing external extraction and internal support methods, combining various therapies. His brother could not stay long and returned first. The next morning, my son shouted in alarm: Master Zhang is in critical condition! I rose to examine him. His head was large as a basin, lips thickened by more than an inch, eyes reduced to narrow slits. From crown to shoulders, there were thousands of pustules. Fortunately, his Shen was not confused, and the toxin had not attacked the Heart; rescue was still possible. I urgently sent a boat to fetch his brother. First, I administered heart-protective medicine to prevent the toxin from attacking the interior. Then, I used a decoction to push the toxin out from within, and applied external medicines to soften hardness, reduce swelling, detoxify, and promote pus discharge. Over one day, more than a dou (approx. 10 liters) of toxic fluid was discharged. By evening, the swelling subsided, and the skin wrinkled. The next day, his mouth and tongue moved freely, and he could eat. Ultimately, it did not develop into a severe carbuncle; the wound was only coin-sized and scabbed over in a few days. When his brother arrived, he was already 80-90% recovered. Whenever pathogens remain without an exit, they must manifest as swellings or sores. Many patients suffer this, but few doctors can treat it.

Madam Wu Yuntai from Yangzhou suffered from Xiao Ke (Wasting and Thirsting Syndrome). She drank dozens of bowls of porridge day and night, experienced rebellious Qi and flaming Fire, and could not sleep all night. My pulse diagnosis revealed six pulses that were fine, rapid, and disordered; her Shen was unclear. I said: This resembles a pulse of possession (Chong Mai), indicating another cause. Her family did not believe. Suddenly, one morning, a maid entered to greet her, saw a beautifully dressed woman sitting upright on the bed, thought it was Madam Wu, but upon closer inspection, saw no one. She reported this. Madam Wu said: This girl often lies in my bed, preventing me from sleeping and causing irritability and thirst. My medicine had little effect. One night around midnight, the patient suddenly shouted: Quickly invite Third Uncle! Do not open the door, or my soul will leave. Third Uncle is her brother, Tang Jun Huisheng. The bedroom was far apart, so she could not hear the call. A female servant secretly opened the door to invite him. The soul followed out, touring the halls and corridors, even places never visited before. Meeting Tang Jun approaching, the soul firmly held his braid and returned to the room. Seeing her own body lying on the bed, Tang Jun stroked her, and the soul attached itself to the body. Asked about what she saw, everything was clear. Careful investigation revealed the woman was Yun Tai's betrothed wife, who died before marriage. Before dying, she instructed her parents that Wu Lang would become noble, and begged to be sacrificed to and buried in the ancestral tomb. After Yun Tai became an official, he had no time to arrange this, hence the possession. Yun Tai told me: You said there was possession; verification proved true. You are truly divine. How shall we appease her? I said: When ghosts have a place to return to, they do not become malevolent. You should welcome the coffin to the tomb, set up a tablet, and sacrifice to her. Yun Tai followed my advice. Then the medicine worked, and the root of the disease was permanently removed.

Possession Disease (Chong Bing)

Zhu Weng Yuanliang, a fellow townsman, lived temporarily in the commandery city. At the beginning of the year, his daughter-in-law went to the city to congratulate her uncle. Passing Lou Gate, she saw the Snake King Temple on the city wall. Folk custom says burning incense prevents sores and swellings, so she went to worship. Upon returning, she spoke madly and fainted, her tongue moving like a snake, claiming the Snake King sent two female servants and one male servant to welcome her. I was invited to diagnose. I gave one pill of Zhibao Dan (Treasure Protecting Pill) to an old woman to administer. The patient said this is poison and must not be taken. She spat the medicine at the old woman, who also collapsed, unconscious, tongue extended, neck turning, mimicking a snake shape. Another person administered the medicine. The patient said a female servant was burned to death. All ghosts fear Cinnabar (Zhusha) as fire. The next day, decocting medicine containing Arisaematis Cum Bile (Gu Jian Yu), the patient said a male servant was shot dead; ghosts use Gu Jian as arrows. Gradually, she calmed down. Regulated with phlegm-resolving and Shen-calming herbs, she recovered in over a month. This is also a case of possession (Ke Xu). Without mineral or spiritually penetrating medicines, efficacy cannot be achieved.

The wife of the gatekeeper at the Zhou residence in Linjia Alley hanged herself. Saved and revived, I happened to be staying at the Zhou house. Following others to inspect, I urgently crushed Zijin Ding (Purple Gold Pill) and administered it with water to wake her. The next day, she hanged herself again, was saved again, and I administered the same medicine. Asking the reason for seeking death, she said: My heart pain was severe. An old woman advised me to tie a rope around my neck to remove the pain, so I complied. I did not seek death. I asked: Where is this old woman now? She said: On the inner bed. Looking, there was none. She said: The Xianggong (Scholar) has come, and she has left. I said: This is a ghost of a hanged woman. Your pain is caused by her possession. If she comes again, chew my medicine and spit at her. The woman followed my advice. When the old woman arrived, she said: What is in your mouth? Do you want to harm me? She cursed and left. As she narrated, the spiritual efficacy of Zijin Ding in dispelling evil is thus.

My classmate Li Minggu was honest, sincere, and literate. His Ba Fen calligraphy was the best of the time. Poor and frustrated, he developed a strange illness. People cursed him day and night; he heard voices but saw no form. The curses were vicious. He was angry and resentful all day, neither sleeping nor eating. Despite many attempts to enlighten him, he did not understand. His great-uncle, Mr. He Xiaoshan, pitied him greatly and went with me to diagnose. Li said: I am not sick; people just curse me. I said: This is the illness. He did not believe. Xiaoshan persuaded him: Your learning and character are admired by all. Who would curse you? Li changed color and cried: Others persuading me is acceptable, but if my great-uncle also persuades me, it is too unreasonable. Yesterday, someone cursed me all day in the next door; it was you, Great-Uncle. Why are you flattering me face-to-face today? Xiaoshan said: I was somewhere else all day yesterday. How could I come here? And who lives next door? How could I enter? The more he argued, the more suspicious Li became. He only bowed his head and sighed heavily. Ultimately, he died of sorrow.

Plague (Wen Yi)

In the 10th year of Yongzheng, a plague raged in Kunshan. Due to a tsunami the previous year, tens of thousands of refugees from coastal areas died in Kunshan and were buried under the city walls. In summer, heat steamed the corpse gas. Contact with it caused illness, killing thousands. Wang Weng Tiancheng also contracted this. He had fever, coma, oppression, confusion, irritability, and irregular rapid pulse. I used cooling, aromatic, and potent herbs such as fresh Rhizoma Acori Tatarinowii (Xian Changpu), Folium Eupatorii (Zelan Ye), Folium Menthae Haplocalycis (Bohe), Herba Artemisiae Annuae (Qinghao), Radix Imperatae (Lugen), and Radix Imperatae Alterniflorae (Maogen), combined with anti-possession and detoxifying pills/powders. He gradually regained consciousness. He described his experiences during fainting; although vivid, they were ultimately illusory and not worth recording. When I first arrived in Kunshan, fearing social engagements would reveal my presence, I found Wang had recovered and I was preparing to leave. However, charity was offered. Words spoken attracted 27 families seeking treatment. Checking their previous medications, all were aromatic, drying, and ascending drugs, contrary to the syndrome. I continued using the previous method. Upon return, Ye Sheng recorded names. 24 recovered, only 3 died, all due to misdiagnosis by other doctors. Thus, I knew the deaths were unjust. In treating diseases, one must know the shift of Qi and Yun (Luck/Climate). Last year, illness was due to water-dampness. Extreme dampness must transform into dryness. The *Neijing* states this clearly. Moreover, medication must change according to symptoms. How can one rigidly stick to last year's wind-dispelling and damp-expelling formulas to treat plague pathogens and dry-fire syndromes?

Xiong's Note: Wind-damp pathogens, once transforming into heat, should be cleared and resolved. Warming and ascending drugs are strictly prohibited. Yu Shi discussed plague, advocating detoxification, which is correct. But exclusively praising Bai Du San (Defeat Toxin Powder) is wrong. Although named "Defeat Toxin," it gathers many ascending and dispersing agents. For warm-pathogen and dry-fire syndromes, using it causes death. Users must be cautious.

Summerheat (Shu)

Classmate Zhao Ziyun, living by Lake Tai, suffered critically from Summerheat Dysentery. I treated him for three days until he recovered. It was extremely dry, people were busy, and boats were rare. I wanted to return but couldn't. Only one neighbor's boat was available, borrowed because a man had just died and needed to go to Zhenze to buy a coffin. Borrowing for one day was refused. An old woman pointed at me and said: This is the one who cured Zhao's illness. This young woman clings to life strongly, so her Qi hasn't completely cut off. Why not request a diagnosis? I agreed. Pulse was absent, but heart was still warm, skin color unchanged. This is Summerheat pathogen blocking the orifices; death is not immediate. I prescribed Qing Shu Tong Qi Fang (Clear Summerheat Unblock Orifices Formula). The family, unable to refuse out of courtesy, lent the boat. Days later, Ziyun's son came. One dose produced sound; two doses allowed turning over; three doses enabled getting up.

I was staying in Linjia Alley, commandery city, during peak summer. A certain actor's mother suddenly vomited, fainted, and stiffened, resembling a corpse, with teeth clenched shut. Funeral arrangements were made. The landlord's servant urged the actor to seek my help. Going nearby to diagnose, I used chopsticks to pry open his teeth, but he bit down hard. I said: This is Summerheat pathogen blocking the orifices. I ground two Zijin Dings in water and administered them. They went down. Then administered Qing Shu Tong Qi Fang. The next day, boating to Tiger Hill, I saw a room by the river. An old woman sat on a window couch, resembling the patient. Returning to visit, that evening at dusk, she could speak. Taking decoction, she fully recovered. Such treatments are very simple and easy, but known by few. When pathogen rebels upward, all orifices close. Only aromatic and spiritually penetrating medicines can immediately open them. Merely pouring decoctions, even if accurate, cannot enter the meridians and orifices. Especially when wrongly using contrary drugs, how can one revive the dead?

Zhe Gengshi from Luxu, suffering from ruined Summerheat syndrome, had a faint, nearly imperceptible pulse, urinary incontinence, delirium, and picking at clothes/bed sheets. This is Yang floating away syndrome, about to sweat profusely and collapse. Urgently administered Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Praeparata) with child's urine. Slightly revived but unrecognized. I went to the city for business, instructing his family: If he wakes and speaks, send a boat to fetch me. Three days later, they summoned me. He was alive. Doctors said previous medicine worked and continued the same decoction. I arrived and said: Yang has returned, Fire is blazing, Yin is exhausted. Fuzi entering the throat is dangerous. Ordered him to eat watermelon. Patient was delighted, ate several daily. Further treated with Qing Shu Yang Wei (Clear Summerheat Nourish Stomach) formula, and recovered. Later, thanking me, he recounted his coma vision: A black man stood before him wanting to eat him, causing bone-chilling cold. A child drove him away with a fan, saying: Aren't you afraid of thunderbolts? Black man said: Endure three thunderbolts from you, what can you do? Child said: How about ten more watermelons? Black man retreated in fear. I said: Fuzi's ancient name is Pi Li San (Thunderbolt Powder). Indeed, taking three doses, without watermelon, how would latent Summerheat retreat? His words have evidence; it is a marvel.

Xiong's Note: Yuan Jianzhai's *Biography of Mr. Lingtai* records this case: First dose given, soon eyes closed but could speak. Second dose of soup, jumped up. So Mr. Zhang Liuyin believed the second soup should be Baihu Tang (White Tiger Decoction). The original case says watermelon was eaten, because watermelon is called "Natural White Tiger Soup." Yuan used the word "soup," causing later doubt. Narration must be careful; this is an example.

Mao Lühe's son Jietang, suffering from extreme Summerheat heat, had continuous profuse sweating, faint pulse, cold limbs, red face, and shortness of breath. Doctors still treated it as Heat syndrome. I said: This is immediate Yang collapse. Urgently advance Renshen and Fuzi to restore Yang. His grandfather showed hesitation. I said: Out of friendship, I cannot sit idly by. Is there any reason to lack self-confidence and try? If he dies, I am willing to pay with my life. Reluctantly, he drank it. One dose stopped sweating, body warmed, slept. Formula changed. Recovered in less than ten days. Meanwhile, Xu Xin yi's grandson Lunwu from Dongshan had identical symptoms. I also used Renshen and Fuzi. The whole family was shocked and suspicious. His maternal uncle, Xi Jifei, trusted me firmly and insisted on usage. Also recovered in one dose. But this syndrome is transformed from Heat disease. Due to extreme heat and sweating, Yang collapses. Unless pulse is faint, feet cold, sweating, and tongue moist, it remains Heat syndrome. Wrong usage causes death. Many die, heartbreaking. Such formulas should not be tried without solid insight. Xiong's Note: "Tongue moist" must be remembered carefully.

A certain surname running a spice shop inside Lumen Gate suffered Summerheat syndrome. Medication was mistaken. The room was small and west-facing; downstairs was spicy/dry aroma, scorching fluids. Fainted, unconscious, tongue scorched, eyes cracked. Family lived 3 li from the shop, wanted to carry him in the scorching sun to wait for death. I said: This syndrome is critical, but if medication is correct, there may be hope. Exposing to scorching sun guarantees death on the road. First administer Zhibao Dan, then Huanglian Xiangru Yin (Coptis and Mosla Drink), combined with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) plus Lugen. Slowly administer various cooling and moistening medicines. Overnight, eye redness subsided, sound returned, Shen recovered, able to turn. Two days later, body harmonized, could eat thin porridge. Returned home to recuperate and healed. Xiong's Note: Fluids are scorched, tongue scorched, eyes cracked. Using Zhibao Dan is inferior to using Zixue (Purple Snow). Xiangru is also debatable.

Xi Xiangbei from Changshu, suffered Summerheat syndrome for over ten days. Body like hot charcoal, hands could not touch, irritability, drowsiness. Gathered various sweating drugs, but no sweat. I said: Extreme heat, fluid exhaustion. How can sweat generate? Prescribed moistening and clearing aromatic herbs. Three doses. Sweat started on head, spread to arms, then whole body, heat resolved. Sweating has two methods: For damp pathogen, use aromatic-drying herbs; sweating removes dampness. For dry disease, use moistening herbs; nourishing water generates sweat. Principle is easy to know, but doctors are ignorant. Tragic.

A Xi surnamed person from back mountain of Dongting Island, Summerheat pathogen knotted internally. Cold limbs like a corpse, body not cold, pulse barely present. This is Shi Jue (Corpse Syncope). I told his father: Pathogen fills and blocks, forcing Hun (Ethereal Soul) outside. Open the orifices, and Hun returns naturally. First grind and take Zijin Ding. Then use juice from watermelon, Lugen, radish, sugarcane, administered frequently. One day and night, consumed two large bowls, gradually revived. Asked, he said: I sat on a big stone in front of the new temple for three days. Saw an old woman and a boy from certain families. Suddenly smelled fragrant aroma. Gradually realized I was in a room. Someone lying on bed, I lay beside him, then could open eyes and see. New temple is the必经 route from front to back mountain. Indeed, there is a big stone. Inquiry confirmed the old woman and boy existed. Many such cases, cannot list all. Principle is natural, not liking to speak of miracles.

Gong Xiaowei from Lumen Gate, suffered Heat disease. Suddenly limbs convulsed, groaning continuously, confused and comatose. Invited me to diagnose. Pulse faint and restless, cool skin, sweating. Yang about to collapse. Urgently prescribed Shen Fu Tang (Ginseng and Aconite Decoction). Relatives filled the room, saying in peak summer, Heat disease is intense, strongly opposed using it. His brother, trusting me, defied crowd and took it. Body slightly stabilized. Next day, another dose. Gradually revived and spoke. Then prescribed Xiaoshu Yang Yin (Cool Summerheat Nourish Yin) formula, and healed.

Friend Jiang Yilan in the commandery, robust constitution. Celebrated birthday at relative's house in summer, ate too much noodle soup. Returning to Lumen Gate, exposed to foul smell. Sha (Sand) Summerheat mixed with food stagnation. Fever, oppression, confusion. Doctor treated, told the cause, reluctantly used light medicine one dose, failed to hit the mark. Food undigested, Summerheat unremoved, how can one dose cure? Next day re-diagnosed: Clearing didn't work, must be deficiency. Immediately used Renshen and Fuzi. That night, irritability, coma, cold limbs. Famous doctor treated again: Extreme deficiency. Increased Renshen and Fuzi dosage. Next day, heat, coma, and death. I mourned, heartbreaking. Thinking such deaths are everywhere, when will this trend stop? Relatives and friends suffered this fate. Returned and wrote *Shen Ji Chu Yan* (Admonitions on Cautious Illness), printed 10,000 copies, distributed widely, hoping people might awaken.

Xiong's Note: *Shen Ji Chu Yan* is rarely circulated now. Mr. Zhang Liuyin of Haifeng added notes, retitled *Yi Bian* (Medical Critique), aiming to critique the ignorance of mediocre doctors. I have included it in the series.

Summerheat Heat Hiccups (Shu Re E)

Xi Shihou from Dongshan, caught cold in summer. Pathogen remained in Upper Jiao. Coma and hiccups. Doctors considered it a ruined syndrome, untreatable. Advanced Renshen and Fuzi. Hiccups worsened. I said: This is Heat Hiccup. Hiccup is in Upper Jiao. Ordered eating watermelon. Doctors uproar. Patient, hearing me, wanted to eat. Ate, hiccups gradually stopped. Advanced descending/clearing herbs. Two doses, all illnesses gradually improved.

Another relative, Shen Junlun, age 70. Seasonal pathogen sank internally causing hiccups. I was going to Yangzhou, entrusted friend You Jun in Jing: This is Heat Hiccup. Use Bi Pa Ye (Loquat Leaf), fresh Lugen, etc., descending/clearing herbs. Must recover. You Jun followed, healed. Hiccups have two causes: Deficiency-Cold, rising from below navel, root in Kidney, difficult to treat. Heat, stopping in chest/diaphragm, root in Stomach, easy to treat. Severity differs vastly. People call it Cold Hiccup, generally treat as Cold. All die. After death, say all hiccups are terminal signs. Don't know healthy people, eating cold then hot things, cold-hot conflict, can also hiccup. Self-heals without treatment, commonly seen. Why not think?

Malaria (Nüe)

Jiang Xichang's eldest son Peifang from Dongting Island, constitution weak, suffered chronic Malaria. I was invited by Ye family in Shanqian, passed by to meet. Peifang came out. Complexion dull, pulse faint, movement induced sweating. I was alarmed: Tonight you will sweat profusely and lose Yang. Urgently advance Renshen and Fuzi, perhaps salvage. Father and son didn't fully believe. Tentatively gave 3 qian of American Ginseng (Xi Yang Shen) with Fuzi. Returned to Ye house. Midnight, urgent knocking. Opened door, Xichang arrived in sedan chair. Arrived, sweating like paste, eyes staring straight, breathing out but not in. Still relied on having taken Renshen/Fuzi, Yang not yet collapsed. Happily, I carried a small amount of Renshen. Mixed with Fuzi and child's urine, administered. Dawn, sweat stopped, Yang returned, conscious. Yet still fainted at sound, too weak to rise for two months, then sat up. Superior doctors treat before disease arises; this is it. Such critical conditions, not only wrong treatment causes death, but delayed treatment also fails to save. Those who value life must know medical principles.

Dysentery (Li)

Shi family from Chongming, moved to Panmen Gate, commandery. Son suffered Summerheat-Toxin Bloody Dysentery. Over 100 times day and night, extreme pain. Zhang Yuting from Jiading, relative by marriage, earnestly requested diagnosis. I said: Heat-toxin accumulation. Treat with Huanglian (Coptidis Rhizoma) and Ejiao (Asini Corii Colla). One dose, 70-80% gone. Next day, spirit clear, face happy. Had business, returned home, planned to revisit in two days. Weather prevented travel for three days. Went to diagnose. Patient glared, asked if well, replied harshly: Used good medicine, illness worsened. I suspected. Asked father: Took other medicine? Father hid it. Very suspicious, left. Two doctors entered. Entrusted Yuting to investigate. Father, because I didn't come, invited famous city doctor, advanced Renshen and Ganjiang (Zingiberis Rhizoma). Lied to patient: City famous doctor diagnosed, but medicine uses Mr. Xu's formula. Took it, pain intensified, dysentery increased. Hated me to the bone. Unjust! Heard after medicine, mouth dry like fire, wanted watermelon. Doctor said: Dysentery eating watermelon means death. Wanted cool water, forbidden. Deceived child to get well water to rinse mouth, stole half bowl to drink. Screamed for two days, died. Recently treating Summerheat Dysentery, all use *Shanghan Lun* methods for Cold Dysentery (Yin-Cold invading viscera). Modify Lizhong Tang. All rot viscera and die miserably, some bleeding from seven orifices. Doctors and families view as fixed method. Deaths follow each other, no repentance. Most lamentable.