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Managing household affairs and business operations, excessive mental labor led to the onset of hemoptysis (coughing up blood), which later worsened into coughing. During the early autumn period, upon diagnosis, it was informed that the condition resulted from prolonged coughing due to deficiency of Lung and Kidney Yin (deficiency of the yin substances of the lung and kidney meridians). The deficient fire flared upward, causing body fluids to condense into phlegm rather than generating blood; treatment should focus on nourishing water (Kidney Yin) to control fire, thereby eliminating phlegm naturally. However, these sweet, mellow, and tranquil herbs inherently lack rapid efficacy. Subsequently, other physicians prescribed Ren Shen (Ginseng Root) and Fu Zi (Aconite Lateralis Radix Preparata) to nourish Yang (the active, warming aspect of Qi). After half a month of consumption, all symptoms doubled in severity. The Classic states: "When rigid [yang-drugs] meet rigid [conditions], Yang Qi is scattered, and Yin Qi perishes." Thus, we know that conditions have Yin and Yang distinctions, and medicines have dynamic and static properties. Yang governs movement; using dynamic drugs to treat a dynamic condition is like adding oil to a fire—will it not lead to scorching and decay? Moreover, a single spark can burn a mountain thousands of feet high, yet a cup of water cannot extinguish the fire of a cartload of firewood. This illness originally featured excess fire and insufficient water; rescuing Yin might still be insufficient, let alone enduring desiccating and hot drugs that further scorch Yin. In the three winter months, Kidney Water (Kidney Yin) withers and dries up, leaving little to sustain life in the coming spring. As the saying goes: Chang Pu (Rhizoma Acori Tatarinowii) extends life; wishing to administer Fu Ling (Poria) likely refers to this principle.

The patient approached fifty years of age, suffering from internal injury due to emotional distress, complicated by external pathogens. Mismedication led to procrastination. Pathogens remained unresolved; the pulse was soggy (soft and fine, indicating dampness or deficiency) and lacked spirit (vitality). There was profuse sweating, dizziness, and alternating chills and fever around noon. This indicates exhaustion of both Yin and Yang, with pathogens and healthy Qi contending. How can this be equated with the alternating chills and fever of Shaoyang disease (disease of the Gallbladder and Sanjiao channels characterized by alternating chills and fever)? Zhang Jiebin stated: "Pathogens are like thieves, coming from outside; Yuan Qi (Original Qi) is like the people, guarding within. Enriching the people strengthens the center; strengthening the center enables defense against the exterior." For this syndrome at this time, I do not believe that merely expelling pathogens can cure the disease, nor do I believe that abandoning support for healthy Qi can save the patient. Zhong Jing said: "If Taiyang cold damage is treated with vomiting, sweating, purging, warming, or acupuncture without resolution, it is called a 'ruined disease' (bad outcome due to misdiagnosis/treatment). One must ascertain what error was made and treat according to the current syndrome." Although the theory holds true, the condition is already critical. When a large building is about to collapse, one wooden beam may hardly support it. After a decade of labor and pathogenic invasion, compounded by procrastination and mis-treatment, pathogens have sunk inward while healthy Qi is depleted. As Yu Jia Yan described: "In mild cases, pathogens remain half-out and half-in; in severe cases, they retreat inward along with the Original Qi." Observing his dizziness and sweating occurring during episodes of chills and fever reveals that Yin and Yang are contending, Healthy Qi fails to overcome Pathogens, and signs of separation are emerging. It is like robbers entering a home where doors are wide open and fences are insecure; if the master is so exhausted, how can he contend with robbers for victory? First, save the person; then treat the disease.

An Bo's commentary: At this stage of illness, even if Lu Yi (Bian Que) were reborn, what could be done for life?