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Lei Gong Zhen Jun said: In Re Bing (Disease of Heat), if mania occurs with symptoms resembling seeing ghosts, it is a fatal syndrome. This appears identical to Re Bing causing loss of consciousness; however, while the nature of the heat syndrome is the same, the reasons for fatality differ. Mania resembling seeing ghosts indicates Shi Re (Excess Heat); loss of consciousness in Re Bing indicates Xu Re (Deficiency Heat). Shi Re should be treated by purging fire, while Xu Re should be treated by clearing fire. When heat reaches its extreme and causes mania, it is mostly due to Fire of the Yangming channel. The scorching fire burns within, even incinerating one's own heart. When the heart is internally incinerated, the Shen (Spirit) of the heart floats outward, resulting in hallucinations of seeing ghosts. It is not that ghosts are truly seen, but rather that the symptom of seeing ghosts is genuinely present. When a person reaches the state of seeing ghosts, they are on the verge of death. What medicine should be used to save them? The formula Huo Qi Tang is prescribed: Shigao (Gypsum Fibrosum) 1 liang, Yuanshen (Scrophulariae Radix) 3 liang, Renshen (Ginseng Radix et Rhizoma) 2 liang, Zhimu (Anemarrhenae Rhizoma) 1 qian, Huanglian (Coptidis Rhizoma) 3 qian, Fushen (Poria with Hostwood) 1 liang, Baijiezi (Sinapis Semen) 3 qian. Decoct in water and take orally. In this formula, Shigao descends Stomach Fire, Yuanshen descends floating fire, Zhimu descends Kidney Fire, Huanglian descends Heart Fire, Fushen clears the Heart and guides the various fires out through urination, and Baijiezi eliminates phlegm. Thus, the Shen becomes clear and the Heart settles. However, without adding sufficient Renshen, the Wei Qi (Stomach Qi) would perish, and how could the other herbs then descend the fire? This is the subtlety and efficacy of this formula. After one dose, the mania stops; after two doses, the hallucinations cease; after three doses, the fire is completely extinguished.

Regarding Re Bing causing loss of consciousness, although it also involves Yangming Fire, it is not entirely Yangming Fire. It arises from Liver Qi stagnation, where the Fire within the Wood cannot vent. Consequently, Wood overacts on Earth (Liver overacting on Spleen/Stomach), causing Stomach Fire to flourish. The steaming heat causes mental restlessness, leading to loss of consciousness. However, the Shen remains anchored in the Heart and does not float outward. The formula Kai Zhi Tang is prescribed: Baishao (Paeoniae Radix Alba) 1 liang, Danggui (Angelicae Sinensis Radix) 1 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 3 qian, Shigao (Gypsum Fibrosum) 1 liang, Chaihu (Bupleuri Radix) 1 qian, Chao Zhizi (Gardeniae Fructus Praeparatus) 5 qian, Baijiezi (Sinapis Semen) 3 qian, Changpu (Acori Tatarinowii Rhizoma) 3 qian, Maidong (Ophiopogonis Radix) 1 liang. Decoct in water and take orally. This formula uses Danggui and Baishao to nourish the Liver, Chaihu to resolve stagnation, Shigao and Zhizi to calm the Fire of the Stomach and Liver, Baijiezi and Maidong to eliminate phlegm and clear Lung heat, and Changpu to open the confusion in the Heart. Naturally, the heat dissipates and the Heart calms, preventing restlessness and loss of consciousness. Thus, one dose brings immediate relief, and two doses result in complete recovery.

There are cases where Fire is extremely excessive, causing the tongue to feel like thorns, lips and mouth to crack, and intense thirst with calls for drinking. Although this is not a symptom of Shang Han (Cold Damage Disease), contracting this illness means that even without fever, death is imminent. Baihu Tang can also be used for rescue, but it is too cold and may damage Wei Qi (Stomach Qi). Often, after the heat subsides, complications arise, ultimately leading to death; therefore, Baihu Tang should not be administered lightly. I have a formula named Qing Liang San: Yuanshen (Scrophulariae Radix) 2 liang, Maidong (Ophiopogonis Radix) 1 liang, Ganjuhua (Chrysanthemi Flos) 5 qian, Qinghao (Artemisiae Annuae Herba) 5 qian, Baijiezi (Sinapis Semen) 3 qian, Shengdi (Rehmanniae Radix) 3 qian, Cheqianzi (Plantaginis Semen) 3 qian. Decoct in water and take orally. The brilliance of this formula lies in using Yuanshen as the Sovereign herb to quell the flames of the Upper Jiao; Maidong as the Minister herb to clear heat in the Lungs; Ganjuhua and Qinghao as the Assistant herbs to eliminate Fire in the Stomach; and especially Cheqianzi, Baijiezi, and Shengdi as the Envoy herbs, which either transform phlegm or cool the blood, allowing the excessive heat to drain downward from the Bladder. Thus, the entire body is cooled, the fire naturally disperses, the Stomach is not damaged, and it can support critical conditions without causing complications.

A postpartum woman, half a month after delivery, suddenly experiences profuse sweating like rain, dry mouth and tongue, fever, and irritability, resembling Shang Han symptoms. This is a fatal syndrome. If treated as Shang Han, death is inevitable. This is due to the exhaustion of internal Yin fluids, leaving no Blood to nourish Heart Yang. Qi cannot transform without Yin. This is sweating leading to Yang collapse and subsequent body heat. Therefore, although there is thirst, there is no desire to drink; although the tongue is dry, the coating is slippery. There is mental irritability but not mania. These are the differences from the external symptoms of Shang Han. At this time, urgently prescribe Renshen (Ginseng Radix et Rhizoma) 2 liang, Danggui (Angelicae Sinensis Radix) 2 liang, Huangqi (Astragali Radix) 2 liang, Sangye (Mori Folium) 30 leaves, Bei Wuweizi (Schisandrae Chinensis Fructus) 1 qian, Maidong (Ophiopogonis Radix) 5 qian. Decoct in water and take orally. The formula is named Shou Han Dan. Renshen, Danggui, and Huangqi greatly tonify Qi and Blood; Maidong and Wuweizi have astringent properties amidst their cooling nature, assisting Sangye to stop sweating, achieving miraculous results. Generally, such deficiency sweating cannot stop without tonification, nor can it consolidate without astringents. Thus, one dose stops the sweating, two doses consolidate it, bringing the dying back to life. This refers precisely to this formula.