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Patient Pan: During the period when summer heat and dampness were steaming, combined with the accumulation of dampness from food and drink, he suffered from irritability and fullness in the chest and epigastrium, hiccups, vomiting, and dry heaving. He had a sweet taste in the mouth accompanied by dryness, heat in the palms, sweating on the head, a white tongue coating, lack of appetite, loose stools, and scanty urine. This was caused by damp-evil diffusing between the diaphragm, stagnating and steaming into heat. The decoctions and drinks taken were all transformed into turbid stasis floating upward, resulting in an irregular pulse (pulse irregularity). The treatment should employ acrid substances to unblock congestion and bitter substances to direct rebellious Qi downward. The prescription used Peilan (Eupatorium fortunei), Xiangru (Elsholtzia splendens), Baidoukou (Amomi Fructus Rotundus), Gongdingxiang (Caryophylli Flos), Shidi (Kaki Calyx), Yujin (Curcumae Radix), Banxiaqu (Pinelliae Fermentum), Zhike (Aurantii Fructus), and Xingren (Armeniacae Semen Amarum) (all stir-fried). Note: A sweet taste in the mouth is named "Pi Dan" (Spleen Heat/Dampness) in classics; one should use Lancao (Herba Eupatorii) to remove stale accumulation, following the classics for treatment. After one dose, Pi Dan was eliminated, and other symptoms decreased. The formula was changed to light, clear, and bland-leaching herbs: Danzhuru (Bambusae Caulis in Taeniam), Tongcao (Tetrapanacis Medulla), Huashi (Talcum), Shihu (Dendrobii Caulis), Lou Shuang (Trichosanthis Pericarpium), Xiangbei (Fritillariae Thunbergii Bulbus), Chifuling (Poria cum Ligno Rubra), Huogeng (Agastachis Rhizoma), and Dengxincao (Junci Medulla). After two doses, vomiting stopped and hiccups became infrequent, indicating stomach deficiency with rebellious Qi ascending. A single-herb decoction of Damairen (Hordei Fructus Germinatus) was used; the epigastrium felt comfortable, hiccups ceased, profuse sweating occurred, and hunger and desire for food returned. Treatment shifted to regulating and tonifying Stomach Yin. The prescription included Taizishen (Codonopsis Radix), Maidong (Ophiopogonis Radix), Shashen (Glehniae Radix), Bidou (Dolichoris Semen) (stir-fried), Fushen (Poria cum Pinio), Zaoren (Ziziphi Spinosae Semen), Yiren (Coicis Semen), Xiaomai (Tritici Fructus), and Nanzao (Jujubae Fructus). After several doses, eating returned to normal.

Patient Pan: Over sixty years old, he contracted Spring Warmth (Chun Wen). The treating physician used methods for Cold Damage (Shang Han), mixing Guizhi (Cinnamomi Ramulus), Chaihu (Bupleuri Radix), and Gegen (Puerariae Radix). After more than ten days (two decades of days), the condition did not resolve, progressing to damp-heat brewing phlegm, with a greasy tongue coating, sweet taste in the mouth, and scanty, red, painful urination. The physician failed to recognize that Cold Damage transmits sequentially through the Foot meridians, whereas Warm pathogens specifically injure the Hand meridians. Guizhi and Chaihu are warm and ascending, constituting erroneous treatment. Another physician, seeing internal urgency suggesting purgation, used Rouguixin (Cinnamomi Cortex) and Jiaozhuzhu (Atractylodis Macrocephalae Rhizoma carbonized), which was even more alarming, explaining the dry lips and grey tongue coating. The patient stated he had no aversion to cold but only fever, and his body was heavy and difficult to move; thus, Spring Warmth transforming into dampness was evident. Furthermore, the pulse at the Qi Kou (Radial Artery) was Ru (Soft) and Da (Large); excessive dampness generating heat, palpable pulse conditions, along with a sweet taste (Pi Dan), sticky and thick phlegm, and qi obstruction, were all manifestations of damp-heat mixed in the Upper and Middle Jiao. The desire to purge was due to dampness sinking downward; mild diuresis would prevent this urgency. The treatment method was to vent heat and leach out dampness; several doses could bring peace. The prescription used Xiangu (Sojaes Semen Praeparatum), Xingren (Armeniacae Semen Amarum), Beimu (Fritillariae Bulbus) (each 2 qian), Peilan (Eupatorium fortunei), Qianhu (Peucedani Radix), Zhipi (Gardeniae Pericarpium), Zhuru (Bambusae Caulis in Taeniam) (each 1.5 qian), Chifuling (Poria cum Ligno Rubra) (3 qian), Huashi (Talcum) (0.5 qian), Zhezhijue (Saccharum Juice) (half cup), and Dengxincao (Junci Medulla) (1 qian). After one dose, slight sweating occurred, irritability and heat receded, and the sense of urgency disappeared. Xiangu and Peilan were removed, and Tongcao (Tetrapanacis Medulla), Gualou (Trichosanthis Fructus), and Shashen (Glehniae Radix) (each 1 qian) were added. Taken twice daily, phlegm became smoother, and the grey tongue coating gradually shed. This indicated that the Warm pathogen was originally internal conflict of damp-heat. Using Acrid-Cool to vent heat and Sweet-Bland to drive out dampness eliminated the sweet taste and heaviness. Only cloudy urine remained, indicating dampness was not fully cleared. This light-clearing heat and leaching-dampness method is fixed. The prescription used Huafen (Trichosanthis Radix), Xianshengdi (Rehmanniae Radix Fresh), Maidong (Ophiopogonis Radix) (each 2 qian), Chifuling (Poria cum Ligno Rubra), Yiren (Coicis Semen) (each 3 qian), Zhipi (Gardeniae Pericarpium), Chuanbei (Fritillariae Cirrhosae Bulbus), Mutong (Akebiae Caulis) (each 0.8 fen), Dengxincao (Junci Medulla) (0.5 fen), plus Xianlugen (Phragmitis Rhizoma Fresh). Taken twice daily, urine cleared, porridge and drinks increased, and movement returned to normal. Subsequently, the method of tonifying Stomach Yin was advanced: Yuzhu (Polygonati Rhizoma), Chihuhu (Dendrobii Caulis), Lushen (Codonopsis Radix) (each 2 qian), Maidong (Ophiopogonis Radix) (1 qian), Yiren (Coicis Semen) (raw 2 qian, cooked 2 qian), Xiaomai (Tritici Fructus), Xianglian (Nelumbinis Semen) (each 3 qian), Tianxingren (Armeniacae Semen Amarum) (1.5 qian), taken with Zhezhijue (Saccharum Juice). This uses Sweet-Moistening to nourish Stomach Yin, supplemented by drinking beef broth skimmed of oil. Once the intestines and bowels were filled and stool passed, the epigastric organs would feel refreshed.

Nephew: According to the account, last autumn near the sea, tidal surges flooded residences. Those exposed to water dampness suffered swollen and ulcerated feet. Now, while trading there, he was exposed to seasonal pathogens, suffering body pain, dizziness, vomiting, and dry heaving. This is dampness obstructing the Qi level. The physician erroneously used sweating to deplete fluids, followed by digestion-promoting methods, leading to heat-thirst, epigastric fullness, hiccups, and spontaneous diarrhea. One must not forget that patients with dampness contraindicate sweating; digestion-promoters further deplete Stomach fluids. Using Dingxiang (Caryophylli Flos), Renshen (Ginseng Radix), and Gancao (Glycyrrhizae Radix) to stop hiccups cannot promote dampness removal via warming-tonification. Seasonal pathogens arise from damp-earth stagnation and steaming; depending on the timing of contraction, heat rises and dampness stagnates. First, release and resolve; then leach and drain, restoring normal Qi mechanism ascent and descent. The prescription used Douchi (Sojaes Semen Praeparatum), Zhike (Aurantii Fructus), Zhipi (Gardeniae Pericarpium), Loupi (Trichosanthis Pericarpium), Banxia (Pinelliae Rhizoma processed), Huogeng (Agastachis Rhizoma), Tongcao (Tetrapanacis Medulla), Fuling (Poria), Zhuling (Polyporus), decocted with Heye (Nelumbinis Folium). After one dose, all symptoms decreased. Occasional vomiting and thirst indicated failure of Middle Jiao water-grain Qi transformation. Banxia (Pinelliae Rhizoma), Ju Bai (Citri Reticulatae Pericarpium), Fuling (Poria), Xingren (Armeniacae Semen Amarum), Yimi (Coicis Semen), Huafen (Trichosanthis Radix), Sharen (Amomi Fructus) were used; after another dose, he was at peace.

Clansman: Contracted pathogen on the road, Wind-Heat congested upwards, causing vomiting, thirst, heavy head pain, and a Fu-Ru (Floating-Soft) pulse. This is Heat steaming with Dampness lurking. Treatment first ventilated and resolved the Exterior, so Wind-Heat would not contend with Dampness. The prescription used Bohe (Menthae Haplocalycis Herba), Niubangzi (Arctii Fructus), Jiegeng (Platycodonis Radix), Shanzhi (Gardeniae Fructus), Ganju (Chrysanthemi Flos), Sangye (Mori Folium), Chifuling (Poria cum Ligno Rubra), Jiangpi (Zingiberis Cortex), resulting in sweating, resolution, and cool body. Due to eating water chestnuts (Biqie), fever, diarrhea, and irritability recurred. This was incomplete Warm pathogen triggered by raw/cold food moving damp-turbidity. Weiling Tang (Stomach Regulating Decoction) without Baizhu and Cangzhu, plus Zhike (Aurantii Fructus), Dengxincao (Junci Medulla), Lugen (Phragmitis Rhizoma) was decocted and taken to cure.

Nephew: Head felt wrapped, chest full, difficult bowel movements, Bowel Qi failed to descend. Treated as Dampness Stagnation. Tongcao (Tetrapanacis Medulla), Baikouqiao (Amomi Fructus Rotundus Shell), Zhike (Aurantii Fructus), Lou Shuang (Trichosanthis Pericarpium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shanzhi (Gardeniae Fructus), Xingren (Armeniacae Semen Amarum), Banxia (Pinelliae Rhizoma), Danyezhu Ye (Lophatheri Folium), Dong Sang Ye (Mori Folium). Three doses cured.

Nephew: Collateral Heat steamed Phlegm, tight cheeks, sweet taste in mouth, Chen-Ru (Deep-Soft) pulse, Left Cun slightly larger. This is Wind-Heat stagnant in Gallbladder Collaterals, combined with Spleen having Damp-Phlegm congestion and Heat, becoming Pi Dan (Spleen Heat/Dampness). Gouteng (Uncariae Ramulus cum Uncis), Sigualuo (Luffae Fructus Retinervus), Jiegeng (Platycodonis Radix), Lianqiao (Forsythiae Fructus), Xiangbei (Fritillariae Thunbergii Bulbus), Bohe (Menthae Haplocalycis Herba), Peilan (Eupatorium fortunei), Juhong (Citri Reticulatae Pericarpium Rubrum), Yujin (Curcumae Radix). Three doses cured.

Younger Clansman Brother: Habit of drinking wine accumulated dampness; additionally, drinking cold liquids when thirsty after intoxication. Cold and Heat mixed for ten days, dry mouth, greasy tongue, vomiting, nausea, chest fullness, cold feet, diarrhea, Ru-Shu (Soft-Rapid) pulse. Dampness exceeded Heat. Physicians confusedly called it Wen Nue (Warm Malaria). Repeated use of Huangqin (Scutellariae Radix), Shigao (Gypsum Fibrosum), Shengdi (Rehmanniae Radix) made dampness more congealed. Lightly vent dampness outside heat, do not let them fan each other's intensity; the disease can be immediately removed. Tongcao (Tetrapanacis Medulla), Zhike (Aurantii Fructus), Banxia (Pinelliae Rhizoma), Chifuling (Poria cum Ligno Rubra), Cheqian (Plantaginis Semen), Shihu (Dendrobii Caulis), Yiren (Coicis Semen), Maidong (Ophiopogonis Radix), Dengxincao (Junci Medulla), Huafen (Trichosanthis Radix), Lugen (Phragmitis Rhizoma). Taken twice daily, profuse sweating, heat receded, diarrhea stopped, feet normalized. But slight cough remained. Removed Zhike, Cheqian, Lugen; added Xingren (Armeniacae Semen Amarum), Xiangbei (Fritillariae Thunbergii Bulbus), which was more suitable. After porridge and drinks entered, Spleen Yang had not awakened, occasional abdominal pain. Guangpi (Citri Reticulatae Pericarpium), Sharen (Amomi Fructus), Fuling (Poria), Yiren (Coicis Semen), Banxiaqu (Pinelliae Fermentum), Sheng Baizhu (Atractylodis Macrocephalae Rhizoma), Zhizi (Immature Ziziphus fruit or similar, likely Zhishi/Aurantii Fructus based on context of moving Qi, text says 'Zi', possibly Zhizi or Zhishi typo, interpreted as Qi-moving agent here). Several more doses completely cured.