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The son of Mr. Chen, aged sixteen, suffered from an exogenous febrile disease in summer. He presented with high fever and coma, flushed face, irritability, thirst, dry lips, scorched tongue, and bleeding from the mouth, nose, and gum roots, all indicating heat syndromes. However, his pulse was deep and fine, and his four extremities were cold; treatments by other physicians were ineffective. By the ninth day, he invited me to consult. I said: This is not a Yin syndrome, but a Yang syndrome. Today, cool-natured medicines should be heavily used, but fearing your family's reluctance due to apprehension, I will tentatively prescribe Xiao Chai Hu Tang (Minor Bupleurum Decoction) without Banxia (Pinelliae Rhizoma) and Renshen (Ginseng Radix et Rhizoma), adding Shengdi Huang (Rehmanniae Radix), Huafen (Trichosanthis Radix), Zhizi (Gardeniae Fructus), and Danpi (Moutan Cortex) for trial. Unfortunately, the local custom in Xi County holds that overdosing on hot medicines can be remedied, whereas cool medicines cannot. Seeing cool medicines in the prescription, they indeed refused to take them. Three days later, the condition worsened, and they came again to fetch me. I declined, so they entreated my friend, Mr. Hu Jing San, to invite me again. I said: Saving a life is like putting out a fire; the patient is already critically ill, and further delay makes it difficult to treat. Mr. Hu said: Let us go and decide; if treatable, we shall treat. Upon examining the pulse, the previous deep and fine pulse had vanished. Palpating the limbs, they were colder than the elbows and knees. Additionally, there was abdominal pain with refusal to press, desire to defecate but inability to do so, and restlessness with惊狂 (fright and mania). I said: The disease is urgent; only Cheng Qi Tang (Major Order the Qi Decoction) for purgation will suffice. After prescribing, Mr. Hu privately asked: In treating Taiyang and Shaoyin syndromes of Cold Damage, medication is based on the pulse, regardless of floating or deep, large or small, distinguished primarily by forcefulness. Forceful indicates Yang, weak indicates Yin. Now, the pulse is imperceptible, and the limbs are extremely cold; this seems to be a Yin syndrome. What should we do? I said: This is extreme Yang mimicking Yin, as recorded in Wu Youke's "Wen Bing Lun" (Treatise on Pestilential Diseases), known as "Jue of Body and Pulse." Go check the book and read it. Mr. Hu agreed and administered the purgative. That night, two bowel movements occurred. By morning, the cold extremities warmed, and the pulse reappeared. We then switched to Gan Lu Yin (Sweet Dew Drink) and later to Sheng Mai Di Huang Tang (Generate the Pulse and Rehmannia Decoction), resulting in recovery within a month.

After Mr. Chen's son recovered, his wife contracted the illness due to worry and overwork. Initially, she had headache, aversion to cold, and fever. I prescribed Xiang Su Yin (Aromatic Perilla Infusion), which resolved the condition through sweating. Subsequently, relapse occurred due to overexertion with fever, bitter taste in the mouth, and deafness. Coinciding with her menstrual period, I feared heat entering the Blood Chamber (Xue Shi). I酌情 (discretionarily) prescribed Chai Qin Jian (Bupleurum and Scutellaria Decoction) with added Shengdi Huang (Rehmanniae Radix), Chi Shao (Red Peony Root), and Danpi (Moutan Cortex). The fever persisted, accompanied by a flushed face, yellow tongue coating, delirium, and rapid pulse. I said: The pathogen has invaded the Shaoyang and Yangming channels. I imitated Sheng Sheng Zi's Bai Hu Tang (White Tiger Decoction), substituting stir-fried Huang Qin (Scutellariae Radix) with raw Huang Qin, and added Zhu Ye (Bamboo Leaf) and Deng Xin Cao (Juncus Effusus) as guides. I told the husband: I was away earlier. If I arrive late tomorrow, you may consult Mr. Hu, or simply administer the dregs of the original prescription. When I returned at noon the next day, he had sent people to urge me several times. Rushing to his house, he cried: The condition has changed drastically. I asked for details. He said: After taking your medicine last night, she suffered from irritability, heat, and insomnia. This morning, she suddenly clenched her teeth, closed her eyes, fainted, and lost urine control. Mr. Hu has consulted and administered the dregs of the original prescription, but there is no improvement. What should we do? I said: Although yesterday's condition was severe, additional herbs were included. Even if ineffective, it shouldn't have led to this state. Did you administer other medicines? He replied: Your treatment saved my son's life; we deeply admire you. We rely solely on you now and dare not change doctors. Mr. Hu suddenly realized: Usually, I do not inspect the purchased medicines. This morning, checking the prescription for raw Huang Qin, the pharmacy mistakenly dispensed raw Da Huang (Rhei Radix et Rhizoma). I ordered them to replace it. Could the previous prescription have inadvertently contained Da Huang? Inspecting the discarded dregs from yesterday confirmed this. I said: The pathogenic factor was originally heavy. The previous medicines exerted full effort to expel it but failed. The accidental ingestion of Da Huang likely trapped the pathogenic heat, causing it to attack the Pericardium internally, obstructing the orifices and collaterals, thus leading to such drastic changes. We must urgently clear the heat from the Pericardium, open the orifices, and repel the pathogen to preserve life. I formulated Dao Chi Ge Ban Tang (Half-and-Half Decoction of Dao Chi), removing Renshen (Ginseng Radix et Rhizoma), adding Jin Yin Hua (Lonicerae Japonicae Flos) and Jin Zhi (Gold Juice), and externally applied Zi Xue (Purple Snow) to the tongue. By evening, after drinking the medicine, her spirit slightly recovered. Four doses consecutively administered showed gradual improvement. However, she remained dull, deaf, and prone to delirious speech. I switched to Man Jian (Barbarian Decoction), two doses of which slightly clarified her mind. Later, yin-nourishing and spirit-stabilizing agents were used, and she stabilized after more than a month. In this case, if Mr. Hu had not verified the medicinal error, the family would have blamed the physician, and the physician would not have known the cause. I record this to remind that when treating serious illnesses, physicians must personally verify the purchased medicines and not neglect this step.