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The youngest son of Mr. Mei suffered from an exogenous pathogenic condition (Gan Zheng) in the summer. He presented with fever and dry mouth, and a white, greasy tongue coating, indicating the presence of latent pathogens (Fu Xie). Considering he was a delicate child accustomed to refined food and being carried by adults, one might wonder how the pathogen invaded. Upon questioning the wet nurse, she stated that they previously lived on an upper floor but had recently moved to a basement room due to the hot weather, where the moldy and damp qi was heavy; it is possible the illness resulted from this exposure. I said, "That is correct."

This is because the moldy-damp qi enters through the nose and mouth, lies latent in the Mo Yuan (Membrane Source), and brews into heat, emerging from the interior to the exterior. This differs from wind-cold pathogens attacking the skin and hair, which can be treated with acrid-warm diaphoretic methods. Initially, I used herbs such as Dan Chi (Light Fermented Soybean), Su Geng (Perilla Stem), Xian Huo Xiang (Fresh Patchouli), Qin Jiao (Gentiana Macrophylla), Guang Pi (Broad-leaved Tangerine Peel), Jie Geng (Platycodon Root), Lian Qiao (Forsythia Fruit), Gan Cao (Licorice Root), and Tong Cao (Akebia Stem). The aim was to use aromatic herbs to resolve turbidity and foulness, and acrid-cool herbs to vent the pathogen.

After taking the medicine, the fever intensified, accompanied by irritability and thirst, and the tongue coating turned yellow. Therefore, Su Geng and Guang Pi were removed from the formula, and Huang Qin (Scutellaria Root), Hei Zhi Zi (Black Gardenia Fruit), Chi Ling (Red Poria), and Ze Xie (Alisma Rhizome) were added. However, the fever and thirst persisted, and the tongue color appeared as if it were about to scorch. Due to my habitual hand tremor, I visited his home to examine the patient, while Mr. Xinshu wrote the prescriptions. I told him, "The heat intensity of this condition is extremely severe; only Baihu Tang (White Tiger Decoction) can eliminate the disease." Mr. Xinshu replied, "According to the syndrome, this formula should indeed be applied. However, the name 'Baihu' causes fear and dread among common people. Perhaps we wait until tomorrow; if the illness does not subside, then we administer it, how is that?" I said, "Saving someone from drowning or fire rescue allows no time for delay. Now the tongue is nearly scorched, indicating blazing pathogenic heat and injury to Stomach fluids. If we wait until tomorrow and the tongue turns black, forming a Stomach excess pattern, then using Chengqi Tang would be even more shocking. Therefore, I will explain the etiology and treatment principles in detail to your family to assist in preparation."

One tael of Shi Gao (Gypsum Fibrosum), one qian of Zhi Mu (Anemarrhenae Rhizoma), along with Hua Shi (Talcum) and Lu Gen (Reed Rhizome), should be used. The dosages of other herbs like Zhi Zi and Huang Qin should be increased according to the previous prescription. On the next day's follow-up visit, the body heat was lighter, and the scorched tongue became moist. However, since the disease onset was sudden and violent, abruptly stopping treatment might cause residual heat to reignite. Thus, the original formula was maintained for another dose. Subsequently, Sha Shen (Glehniae Radix), Yu Zhu (Polygonati Odorati Rhizoma), Mai Dong (Ophiopogonis Tuber), Dan Pi (Moutan Cortex), Shi Hu (Dendrobii Caulis), Dou Chi (Prepared Soybean), Li Zhi (Pear Juice), and Zhi Ma (Sesame Seed) were used to nourish Yin and generate fluids, leading to recovery.

An Bo noted: Having not finished reading this case record, I could not help but sigh deeply three times. In ancient times, famous decoctions were tested and refined repeatedly to treat diseases. In current times, given the low-lying geography and thin qi, patients often change doctors several times before finishing a course of medication. Thus, outstanding physicians often find themselves standing behind their patients (implying lack of trust or support), which is perhaps what is meant by fate.