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Hua family and my family have been intermarried for generations. Mr. Hua Xiuyun is proficient in Traditional Chinese Medicine (TCM) and always harbors a heart to benefit and save people, working diligently without fatigue. He has long admired Master Ye Tianshi of Suzhou and has visited his disciples extensively.

Warm-heat pathogenic factors enter the body from the mouth and nose (Note: Pathogens enter via the mouth and nose, hence called "upper reception"). However, Spring-Warmth disease is caused by cold pathogens contracted in winter, lying latent in the Shaoyin channel, and triggered by the warmth energy of spring; Winter-Warmth disease is caused by winter being warmer than it should be, leading to unhidden yang qi and latent heat within. As for Cold damage (Shanghan) pathogens, they linger on the exterior before transforming into heat and entering the interior. Warm-heat pathogens change to heat most rapidly; before transmitting to the Pericardium, the pathogen remains in the Lung. The Lung governs the Qi of the whole body and connects with the skin and hair, so it is said that the pathogen is at the exterior. When the pathogen is at the exterior, initially use light acrid-cool formulas. If accompanied by Wind, add herbs like Bohe (Menthae Haplocalycis Herba) and Niubangzi (Arctii Fructus); if accompanied by Dampness, add Gen (Phragmitis Rhizoma) and Huashi (Talcum). Alternatively, vent the Dampness outside the Heat, or leach the Dampness below the Heat, so that Dampness does not contend with Heat, and the Dampness will inevitably become isolated. Otherwise, Wind carrying warm-heat generates dryness, and the clear orifices will certainly become dry. This is because the essence of Water cannot nourish the upper orifices, and two Yangs (Wind and Warmth) mutually deplete each other. When Dampness combines with Warmth, steaming and stagnation obscure the upper clear orifices, causing obstruction. This is turbid pathogenic factors harming the clear Yang. This disease resembles Cold damage; the method of verification and differentiation is: Cold damage often presents with complex changing symptoms, whereas Warm-heat diseases, even if prolonged, remain fixed in one channel, which serves as the point of differentiation.

Previously mentioned using acrid-cool herbs to disperse Wind and sweet-bland herbs to drive out Dampness. If the disease still does not resolve, it indicates that the pathogen is gradually entering the Ying (Nutrient) level. When the Ying level is heated, blood is depleted, and the Shen (Spirit) becomes unsettled. If the patient usually has Kidney Yin deficiency, Jiajian Fumai Tang (Modified Decoction to Restore the Pulse) can be used; if the patient usually has Middle Jiao Qi deficiency, Yupingfeng San (Jade Windscreen Powder) etc. may help hope for expelling the pathogen through a battle-sweat. The method should benefit the Stomach, allowing fluids to accompany sweat, heat reaches the cou li (pores), and the pathogen exits with sweat. After resolution, Stomach Qi is empty, and skin coldness may last for a day and night. At this time, let the patient rest peacefully to nourish the recovery of Yang Qi. Bystanders must not panic or call frequently, disturbing the Yuan Shen (Original Spirit) and causing irritability. Only diagnose the pulse; if it is deficient, soft, and slow, although the patient is tired, lying down, silent, sweating, and has cold skin, it is not a Collapse syndrome. If the pulse is rapid, the patient is restless and unable to lie down, with cold sweat and cold skin, it is a Qi Collapse syndrome. Furthermore, when pathogenic factors are excess and Zheng Qi (Upright Qi) is deficient, one battle-sweat may not resolve it; stopping for one or two days for another battle-sweat to heal is possible, which must be known. Again discussing Qi-level diseases that do not transmit to the Blood level but remain in the Sanjiao (Triple Burner), similar to Shaoyang disease in Cold damage. That involves harmonizing half-exterior and half-interior; this involves distributing and eliminating the momentum of upper and lower jiao, changing methods according to symptoms, such as using Xingren (Armeniacae Semen Amarum), Houpo (Magnoliae Officinalis Cortex), and Fuling (Poria) etc., or Wendan Tang (Gallbladder-Warming Decoction) for descending and draining. Because the pathogen is still in the Qi level, there is still hope for expelling it via battle-sweat or transforming into a malaria-like attack. Generally speaking, the pattern of progression is: after Wei (Defensive) comes Qi, after Ying comes Blood. For pathogen in Wei, sweating method is applicable. (Note: Acrid-cool opening of Lung Qi acts as a sweating agent, unlike the acrid-warm sweating of Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) in Cold damage). Only when reaching Qi level can one clear Qi heat. Entering Ying, one can still vent heat to transform Qi, using drugs like Shuijiao (Rhinocerotis Cornu - now substituted with Shexiang Niujiao or similar), Xuanshen (Scrophulariae Radix), and Lingyangjiao (Saigae Tataricae Cornu). Entering Blood, fear of damaging and moving blood requires directly cooling Blood and dispersing Blood stasis, using drugs like Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Ejiao (Colla Corii Asini), and Chishao (Paeoniae Radix Rubra). Otherwise, failing to follow the principles of urgency and slowness leads to errors and panic. Moreover, our Wu region suffers widely from Dampness. Those with white complexion must protect their Yang Qi; excessive Dampness leads to weak Yang. The method should use cooling drugs, but when reaching 60-70% efficacy, one must not be overly cold, lest success be abandoned. Why? Once damp-heat is gone, Yang also declines. Those with dark complexion must protect their Jin-Ye (Body Fluids). Cooling drugs to 60-70%, often reducing heat and causing body chill, should not be treated as deficiency-cold with tonics, fearing that although the fire is out, embers remain. One must examine carefully and give tonics sparingly, never acting rashly. Also, wine drinkers have inherent internal Dampness; external pathogens entering the interior combine with internal Dampness. In constitutions with strong Yang, Stomach Dampness is abundant; in constitutions with strong Yin, Spleen Dampness is not lacking. However, their transformation into Heat is the same. Saving Yin in heat diseases is easy; unblocking Yang is hardest. Saving Yin lies not in nourishing Blood, but in preserving Jin-Ye and Sweat; unblocking Yang lies not in warming, but in promoting urination. This differs from miscellaneous diseases.

Again discussing Sanjiao pathogens unable to resolve from the exterior inevitably form interior knotting. Where is the interior knot? In the Yangming Stomach and Intestines. One must also use purgative methods; one cannot refrain due to Blood and Qi deficiency. If tongue coating is yellow-white mixed, or gray-white without thirst, strictly avoid indiscriminate bitter-purgatives. Among them, those with unresolved exterior and pre-existing interior knot, or depressed pathogen not yet extending, or constitutionally middle-jiao cold, although having epigastric fullness and pain, should use opening-draining methods to ventilate Qi stagnation and return it to the Lung, such as common Xingren (Armeniacae Semen Amarum), Doukou (Amomi Fructus Rotundus), Chenpi (Citri Reticulatae Pericarpium), and Jiegeng (Platycodonis Radix), which are light bitter and slightly acrid, possessing flowing properties.

Previously mentioned yellow or turbid tongue coating must have roots. If smooth, it is formless damp-heat with deficient Middle Qi, strictly forbidding previous methods. If yellow coating is thick and dry, Qingpi (Aurantii Fructus Immaturus) etc. must not be used randomly to avoid confusion. If yellow coating is not thick but slippery, Heat has not damaged Jin-Ye, still can clear Heat and vent exterior. If thin but dry, pathogen is gone but Jin-Ye is damaged, heavy bitter drugs must not be used again.

Again discussing heat transmitting to Ying level, tongue color must be crimson (Jiang). Jiang is deep red. Upon initial transmission, crimson color mixed with yellow-white indicates remaining pathogen in Qi level, must drain Qi pathogen. If tongue is crimson with dry center, Heart-Stomach Fire blazing, depleting Jin-Ye, Huanglian (Coptidis Rhizoma) and Shigao (Gypsum Fibrosum) can be added. If irritability, thirst, and heat with dry tongue center and fluid deficiency, add Yin-nourishing and heat-clearing drugs.

Again heat transmitting to Ying-Blood, if the person has old blood stasis in chest-diaphragm, combining with heat, tongue color must be purple and dark, moist to touch, should add blood-invigorating and stasis-resolving drugs. Symptoms seem like blood stasis obstruction, must clear Ying and cool Blood.

If only the tongue center is crimson and dry, this is Stomach Heat scorching Heart Ying, should add Heart-clearing drugs to Stomach-clearing formulas. Otherwise spreading to tip causes fluid dryness and fire excess. Tip crimson and dry alone indicates Heart Fire flaming upward, use Daochi San (Guide Out Redness Powder) to drain the Fu organ.

Again white coating thick and dry indicates Stomach dryness and Qi injury, add Gancao (Glycyrrhizae Radix et Rhizoma) to Kidney-nourishing drugs to mean "sweet retains and fluids return". White coating thin indicates exterior Cold-Wind pathogen, use acrid-warm exterior-releasing drugs. If stagnation transforms to heat, drugs change with symptoms. Xuanfuhua (Inulae Flos) and Daizheshi (Haematitum) must not be used randomly to reverse Qi mechanism.

Again white coating sticky and greasy, spitting turbid thick saliva, mouth tastes sweet, is Pi-Dan (Spleen Prolusion) disease, damp-heat gathering combing with grain Qi, earth-dampness-turbidity stagnating, must urgently open and drain; otherwise closing middle jiao prevents exit from Mu Yuan (Source of Malaria).

If no coating but smoke-black faintly visible, no thirst, cold limbs, indicates accompanying Yin disease. If thirsty and irritable-hot, it is usual Stomach dry tongue, must not purge. If black and slippery tongue, Water overcoming Fire is Yin syndrome, must warm. If short and contracted, Kidney Qi exhaustion, difficult to treat; to save, add Ren Shen (Ginseng Radix) etc. If dry water exhaustion, urgently purge with salty-bitter drugs.

Light red colorless tongue, or dry and dull, indicates Stomach Jin-Ye injury and Qi failing to transform fluid, use Zhi Gancao Tang (Honey-Fried Licorice Decoction), must not use cold-cooling drugs.

If white powder-like slippery tongue with purple-crimson edges, warm epidemic disease just entered Mu Yuan, not yet returned to Stomach Fu, urgently vent and resolve, do not wait for transmission collapse. Large purple spots indicate Stomach Heat. Black spots bright indicate Heat excess toxin abundance, although untreatable, if person has sufficient Blood-Qi, following method may save; if black and dull, death is certain. If black faintly with red surroundings, Fire depression internal伏, large use cooling and venting, occasionally turning red saves. If spots mixed with macules, all pathogen differences, drain according to部位. Spots belong to Blood mostly, macules to Qi not few. Spots and macules are pathogen appearing outward, eruption should bring clear spirit, meaning exterior resolved interior harmonized; if spots/macules erupt with coma, Zheng fails to overcome pathogen, interior collapse, or Stomach fluid depletion.

Another type of Bai Bao (White Papules), small grains like crystal color, damp-heat injuring Lung, pathogen out but Qi-fluid exhausted, must get sweet drugs to tonify. Or not yet Qi-fluid exhaustion, also need protection.

Again warm-heat diseases, after examining tongue, must also inspect teeth. Teeth are remainder of Kidney, gums are network of Stomach. Heat pathogen not drying Stomach Jin-Ye, must consume Kidney fluid. If teeth shiny dry like stone, Stomach Heat excess, if no sweat aversion to cold, Wei excess, acrid-cool draining Stomach and venting sweat is key. If like dried bone color, Kidney Yin exhaustion, difficult to treat. Not Stomach deficiency, but Kidney water exhaustion.

If tooth tartar like gray cake, Stomach Qi powerless, Jin-Ye lost, damp-turbidity dominant, mostly death. Initial illness gum bleeding clear blood, painful, Stomach Fire rushing, use Yunnv Jian (Lady of the Jade Vessel Decoction) modified.

Again women suffering warm diseases same as men; but more often before/after pregnancy, and during menstruation onset/cessation. Generally before pregnancy diseases, ancients used Siwu Tang (Four Substances Decoction) modified to protect, solidifying fetal root, removing pathogen, treating both root and branch. If receiving pathogen, i.e., Tao's saying "before pregnancy clear heat and calm fetus" etc. If accompanying cold add Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus). Stomach excess, abdominal fullness, side-lying discomfort, i.e., Tao's saying "after pregnancy greatly tonify Blood-Qi" etc. This formula