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The second daughter of the Vice Commissioner of Surveillance (Wen Fantai) in Sichuan developed macules (rash spots) immediately upon falling ill in the winter month of the Gui-Chou year. The color was deep red and loose-floating; the symptoms were originally not severe, but the pulse was fine, rapid, and forceful, indicating latent heat within.

An intermediate dosage prescription was used initially, with *Da Qing Ye* (Isatidis Folium) added. After five consecutive doses, the macules receded and the spirit calmed; two more doses would have sufficed for recovery. However, due to her youth and fear of medication, she refused to take more, and failed to observe dietary restrictions. Seven days later, she suddenly suffered from high fever, extreme thirst, swollen lips, bleeding from the gum spaces, and foul breath. I prescribed a large-dose formula, adding one liang of *Sheng Di Huang* (Rehmanniae Radix). The next day, the fever and thirst subsided slightly, but swelling and redness appeared on the neck. Therefore, I added three qian each of *Niu Bang Zi* (Arctii Fructus), *Xia Ku Cao* (Prunellae Spica), and *Yin Hua* (Flos Lonicerae Japonicae) to the original formula. After three consecutive doses, the neck swelling subsided, but the right cheek swelled again. I then removed *Niu Bang Zi* and *Xia Ku Cao* from the formula and added *Ban Lan Gen* (Radix Isatidis) and *Ma Bo* (Pilulae Fomes). After another three doses, the cheek swelling completely disappeared, and the lip swelling partially resolved. Sand-like eruptions appeared all over the body, alternating between red and white. I then removed *Ban Lan Gen* and *Ma Bo* and increased the amount of *Da Qing Ye*. After three more doses, the lip swelling completely subsided, and the entire body shed skin in sheets. She continued to regulate her condition using this formula for over ten days before fully recovering. In total, this case required more than eight jin of *Shi Gao* (Gypsum Fibrosum), eight liang of *Xi Jiao* (Rhino-Cornu, now substituted with Buffalo Horn), and seven liang of *Huang Lian* (Coptidis Rhizoma). When this gentleman served as a Ministry Official, he had a close friendship with me, and his wife trusted me implicitly, which contributed to his daughter's recovery.

Huolongwu, a Guard of the Plain Red Banner, was the nephew of Huagong, Vice Director of the Court of Imperial Entertainments, and also a family friend of long standing. In the summer of the Bing-Wu year, he contracted measles (exanthematous disease), which was initially mild. His father, fearing my prescriptions were too harsh, hesitated to invite me. It was only when he developed tongue retraction (she juan) and scrotal retraction (nang suo) that he sought my treatment. Upon examination, his pulse was fine, rapid, and forceful; his complexion showed robust qi and spirited demeanor, indicating it was not a terminal sign. Upon inspecting his tongue, the coating was black as coal and hard as iron, producing a clattering sound when tapped. I asked, "Why did previous physicians withhold medication?" His father replied, "They said the entire tongue was black, which earlier authorities listed as untreatable." I said, "Water overcoming Fire—how could there be a coating thick like armor? Recalling the onset, the tongue coating must have been white and thick; this is the phenomenon of extreme Fire transforming into Water [false cold signs]. Misdiagnosed as Cold-encumbrance, warm-releasing exterior-dispersing methods were recklessly applied, causing blazing fire to scorch, leading to heat-toxin obstruction in the Middle Jiao. Heart Fire could not descend, and Kidney Water could not ascend, resulting in steaming heat. Thus, it changed from white to yellow, and from yellow to black." The treatment should focus heavily on clearing Stomach Heat while cooling the Heart and Kidneys; only great bitter-cold herbs can reverse this situation. I immediately prescribed a large-dose formula, heavily utilizing *Xi Jiao* and *Huang Lian*, plus *Sheng Di Huang*, *Zhi Mu* (Anemarrhenae Rhizoma), and *Mu Dan Pi* (Moutan Cortex - note: text says Zhi, Bai, likely Zhi Mu and Huang Bai), to suppress Yang and support Yin. After four consecutive doses, the tongue coating shed entirely, revealing a smooth surface resembling an enlarged tongue. Three subsequent small-dose prescriptions completed the cure.