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[Appendix 1: Treatment of Hiccups with Purple-Black Eruptions]

In the fourth month of summer in the Bingwu year, Mr. Zhao, my nephew who served as the Administrator of Sai Dao, had suffered from epidemic plague for eleven days. The original attending physician had resigned, preparing for the worst. Master Sai invited another physician who prescribed Lizhong Tang (Cinnamon Twig and Ginger Decoction). Mr. Yi Fanggong, the brother-in-law of Mr. Zhao’s wife and an Assistant Director in the Ministry of Works, who was well-versed in medical arts, refused to let him take the medicine. He stated, "If this condition is to be treated, it must be by me." Due to slander within the family claiming that my prescriptions were too harsh, the relatives were afraid to invite me. Mr. Yi strongly advocated for my invitation and pleaded earnestly. Moved by their trust, I readily went with them. Upon examination, the pulse was deep, fine, and rapid; the symptoms included purple-black macules interspersed on the whole body, accompanied by dizziness, fixed gaze, incoherent speech, ice-cold limbs, incessant hiccups, curled tongue, retracted scrotum, trembling hands and feet, and a tendency to pick at bedclothes. This was indeed a critical condition. Fortunately, the eyes were red and the lips scorched and purple, confirming a heat syndrome. Reviewing the previous prescriptions, they merely emphasized releasing the exterior while neglecting clearing heat and cooling blood. This was like throwing a cup of water into a fire, increasing the flames, leading to a proliferation of complications. I used a large dose of medication, adding Xuan Shen (Radix Scrophulariae) 3 qian and Da Qing Ye (Folium Isatidis) 2 qian, to resolve internally and release externally, administered alongside Simo Yin (Four-Monk Decoction). The family was too fearful to administer it, so Mr. Yi took full responsibility and decocted the medicine himself. After half a day and one night, two doses were given consecutively. The hiccups stopped immediately, and the limbs warmed. The next day, the pulse became surging and rapid, and the body suddenly became very hot, indicating the toxin was being expelled outward. I told Mr. Yi, "Following this method, recovery will occur in twenty-one days. However, this prescription only temporarily suppresses the fire but does not eradicate the root cause. If the medicinal force slackens, the heat will rise again." By the fifth day of taking the prescription, the disease significantly subsided, and the dosage was halved. By the eighth day, the dosage was reduced by two-thirds, and Da Qing Ye was removed. By the tenth day, the dosage was reduced by three-quarters, after which all other symptoms completely receded, and dietary intake gradually improved. In total, Shi Gao (Gypsum Fibrosum) 5 jin 14 liang, Xi Jiao (Cornu Rhinocerotis) 4 liang 6 qian, and Huang Lian (Rhizoma Coptidis) 3 liang 4 qian were consumed. The entire family was overjoyed and regretted listening to the slander.

[Appendix 1: Treatment of Coma and Hiccups]

Mr. Fei Cunxiao, Commander of the Right Camp, was nearly seventy years old. In the fourth month of the Guichou year, he had suffered from epidemic plague for eight days. His pulse was fine, rapid, and intermittent; his complexion appeared dull and dirty, sweat poured from his head like steam, he was comatose and delirious with incoherent speech, his body was not highly febrile, his limbs trembled and were cold, and eruptions were hidden beneath the skin, appearing purple and red, though not tightly constricted. This indicated epidemic toxins lurking internally, a dangerous condition. If the eruptions did not emerge, the toxins would have no outlet, eventually resulting in a stifling syndrome and death by the fourteenth day. The previous prescriptions consisted mainly of Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Sheng Ma (Cimicifugae Rhizoma), and Ge Gen (Puerariae Lobatae Radix). They failed to clear the obstruction caused by toxic fire; without descending internal heat, eruptions could not emerge. Blindly dispersing the exterior only exacerbated the condition, intensifying the burning fire and further suppressing the eruptions. I used a large dose: Shi Gao (Gypsum Fibrosum) 8 liang, Xi Jiao (Cornu Rhinocerotis) 6 qian, Huang Lian (Rhizoma Coptidis) 5 qian, Da Qing Ye (Folium Isatidis) 3 qian, and Sheng Ma (Cimicifugae Rhizoma) 5 fen. This directed the toxic fire downward and guided the eruptions outward, employing the method of resolving internally, releasing externally, descending turbidity, and ascending clarity. The next day, eruptions appeared all over the body, purple-red like brocade. His spirit was fluctuating between lucid and confused, his body became very hot, and his limbs warmed. Occasionally, rebellious qi surged upward. I adhered to the original formula, adding Sheng Di Huang (Radix Rehmanniae Preparata) 1 liang and Zi Cao (Radix Arnebiae) 3 qian, administered with Simo Yin (Four-Monk Decoction). His nephew feared the rebellious qi, but I said, "No harm, it will cease upon ingestion." Upon entering, I saw another notice posted, asking if another doctor had been invited. The nephew replied, "A friend has been invited, but he only diagnosed the pulse and did not prescribe medicine." I said, "My treatment for this condition is unprecedented; yesterday, your uncle survived because he dared to take this prescription. Observers will surely find it strange, so please record this." When the subsequent doctor arrived, he saw my prescription and loudly criticized it, stating, "With eruptions all over the body, one should not follow ancient methods by using such large amounts of cold and watery herbs; how can eruptions emerge? It is urgent to lift and release the exterior, perhaps saving the patient. Immediately use Jing Jie, Fang Feng, Sheng Ma, and Ge Gen, plus Ma Huang (Ephedrae Herba), and decoct twice." By midnight, hiccups sounded continuously, limbs became cold and reversed, and coldness extended past the knees. The family panicked and deeply regretted their actions. The city commander entered the city, knocked on the door to seek an audience, and asked the reason. I said, "The condition has changed." Asked what medicine was taken, he replied, "Medicine from another source." I said, "Since you took medicine from another source, please consult another physician." Seeing that I did not come, the nephew temporarily administered two decoctions of the original Simo Yin (Four-Monk Decoction). The hiccups stopped immediately, and the limbs warmed. They then begged a close associate of mine to visit and plead on their behalf. Pitying that he lived in an official residence and was a stranger in a foreign land, I continued treating him with the original large-dose prescription. He fully recovered in twenty-one days. Total usage: Shi Gao (Gypsum Fibrosum) 5 jin 4 liang, Xi Jiao (Cornu Rhinocerotis) 5 liang 2 qian, and Huang Lian (Rhizoma Coptidis) 4 liang 8 qian. This occurred in April of the Guichou year.