Library

Hu's daughter-in-law suffered from an exogenous febrile disease in summer. When consulted, she had been ill for seven days. The pulse was wiry and rapid, forceful against the finger; she had high fever, delirium, and mania; her face and eyes were flushed red; the tongue was black with dry coating; stool was constipated; abdominal pain was present with tenderness upon pressure. After examination, I ordered a bowl of cold water to be given to her first. The family member showed hesitation, but I said, "Cold water is a wonderful medicine; drinking it will cause no harm." This was to observe the quantity of water she could drink to assess the severity of the heat pathogen. Her mother-in-law brought the water. Although she heard my words, she remained hesitant and reluctantly gave half a cup. The woman angrily asked, "Why so little?" I ordered the whole bowl to be given to her, which she drank in one gulp. I asked, "How does it feel?" She replied, "It tastes as sweet as syrup, and my mind feels instantly refreshed. I have wanted to drink water these past few days, but everyone strictly forbade it, causing such anxiety and irritability." I said, "Do not worry. Now I allow you to drink, just do not overindulge." Then I told the family member, "Your wife's illness is a severe exogenous febrile disease. The pathogen occupies the Yangming channel, forming excess syndrome in the Stomach (Wei). What medicines did you take previously?" The family member presented the previous prescription, which was Xiaochaihu Tang (Minor Bupleurum Decoction). I said, "Can a cup of water save a cartload of burning firewood? Even using Baihu Tang (White Tiger Decoction) and Xiexin Tang (Drain the Epigastrium Decoction) would only be like stirring boiling water to stop it from boiling." The family member asked, "Then what formula should be used?" I prescribed Dachengqi Tang (Major Order the Qi Decoction). The family member hesitated to take the prescription. A neighbor said, "My wife once had this illness and recovered after taking this formula." Thus, the medicine was prepared and administered. During the night, she defecated twice. By early morning, although the abdominal pain ceased, other symptoms persisted. We modified Baihu Tang (White Tiger Decoction), Xiexin Tang (Drain the Epigastrium Decoction), and Ganlu Yin (Sweet Dew Drink) by adding or subtracting herbs. Shigao (Gypsum Fibrosum) was used up to four liang, Huangqin (Scutellariae Radix) and Huanglian (Coptidis Rhizoma) several qian each, assisted by Jinyinhua (Lonicerae Japonicae Flos) and Jinzhi (Human Excrement Juice) to clear turbidity and detoxify. Within several days, several jin of medicine and more than ten bowls of cold water were consumed before the fever subsided and the illness was cured. Everyone admired my boldness. I said, "It is not boldness; for such severe cases, heavy doses are indispensable."

Madam Wang suffered from a febrile disease with persistent high fever, red eyes, dry lips, a black tongue with prickles, constipation, and dark scanty urine. The pulse was wiry, rapid, and forceful. The use of cooling agents was undoubtedly indicated. I asked, "Are you thirsty?" She replied, "Not very thirsty. I only desire to sip a few mouthfuls of boiling hot water; if it cools slightly, I have no desire for it." In such a heat syndrome, thirst and desire for water are expected. Why does she prefer boiling water? If we treat this as a Yin syndrome based solely on this sign, it seems inappropriate. I recalled a medical principle: "When two offenses are committed simultaneously, judge according to the heavier one." Currently, both pulse and symptoms belong to Yang-Heat. How can the preference for hot water cause doubt? Initially, Xiaobai Tang (Minor White Decoction) was given. The condition remained similar, indicating the medication was insufficient for the disease. Therefore, a large dose of Baihu Tang (White Tiger Decoction) was administered, with Shigao (Gypsum Fibrosum) heavily dosed at four liang. Due to Stomach Heat rushing upward causing vomiting, nausea, and anorexia, Lugen (Phragmitis Rhizoma) and Zhuru (Bambusae Caulis in Taenia) were added as guiding herbs. Additionally, Yuanmingfen (Mirabilite) mixed with honey was applied to the tongue to moisten dryness. Through continuous administration of cold-natured herbs, after fourteen days, the fever subsided, consciousness cleared, bowel movements resumed, and the tongue became moist. If one adhered rigidly to ancient methods, treating as Yin syndrome due to preference for hot drinks and administering warm herbs, it would be akin to carrying firewood to extinguish a fire. Mencius said, "To believe everything in books is better than having no books at all." This statement serves as proof.