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Wang, aged 73, suffered from Wind-Warmth injuring the Lung. Symptoms included dizziness and blurred vision, a retracted tongue with no saliva, body pain and cold limbs, dry mouth without desire to drink, mental confusion with snoring respiration, difficulty in speech, and a large pulse at the Cun position.

The syndrome belongs to Phlegm-Heat obstructing orifices. Initially, clear Heat from the Qi level was prioritized. Herbs used: Xingren (Apricot Seed), Xiangbei (Fritillariae Thunbergii Bulbus), Huafen (Trichosanthis Radix), Lingyangjiao (Saigae Tataricae Cornu), Shashen (Glehniae Radix), Nensangye (Mori Folium), Zhuru (Bambusae Caulis in Taeniam), Shanzhi (Gardeniae Fructus). After one dose, symptoms decreased and limbs became warm, but the center of the tongue turned black while the tip was crimson, indicating blazing Fire of the Heart and Stomach, raising concern that pathogens might enter the Ying (Nutritive) level and consume fluids. Fresh Shengdi (Rehmanniae Radix), Xijiao Zhi (Rhinocerotis Cornu Juice), Xuanshen (Scrophulariae Radix), Danpi (Moutan Cortex), Maidong (Ophiopogonis Radix), Ejiao (Asini Corii Colla, melted), and Zhezhizhi (Saccharum Sinense Juice) were used. After three doses, the tongue became moist, spirit recovered, body temperature normalized, and pulse calmed. However, stool remained unpassed, and there was no appetite for porridge or drinks, indicating Yin injury by burning heat and incomplete recovery of fluids. Subsequently, nourishment of Stomach Yin was continued, assisted by methods to awaken the Spleen. Within ten days, full recovery occurred.

Tang, an elderly patient suffering from Winter-Warmth invading the Lung, had been treated with exterior-releasing methods for Cold Damage, leading to dryness, thirst, and irritability. Subsequently, Chaige Jieji Tang was administered, resulting in choking cough with profuse phlegm and insomnia throughout the night. It must be noted that Cold Damage transmits through the Foot meridians, whereas Warm pathogens invade the Hand meridians; their treatments are originally different. Moreover, Warm pathogens contraindicate sweating; exterior dispersion consumes fluids. The pulse was deficient and rapid, eyes red, tongue crimson. Warmth had transformed into Heat; further fluid depletion would inevitably lead to coma and convulsions. Sweet-moistening to generate fluids and bitter-pungent to descend Qi were indicated. Herbs used: Maidong (Ophiopogonis Radix), Xingren (Apricot Seed), Gualou (Trichosanthis Fructus), Shanzhi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), Beimu (Fritillariae Cirrhosae Bulbus), Sangpiao (Mori Cortex Radicis), Juhong (Citri Reticulatae Pericarpium Rubrum). After two doses, heat decreased and cough stopped. Due to dark and difficult urination, Sangpiao was removed, and Shashen (Glehniae Radix), Chifuling (Poria cum Ramo et Ligno Cum Polyporo), Mutong (Akebiae Caulis), and Baihe (Lilii Bulbus) were added to the decoction. Recovery followed after further regulation.

Li, with Winter-Warmth exterior heat transmitting inward, presented with dry lips and tongue, thirst with drinking accompanied by vomiting of frothy saliva, urgent diarrhea of watery stools without limit, and a soggy-slow pulse. This was due to excessive Dampness generating Heat. Fresh Lugen (Phragmitis Rhizoma) soup was drunk, followed by Huangqin (Scutellariae Radix), Gualou (Trichosanthis Fructus), Tongcao (Tetrapanacis Medulla), Chifuling (Poria cum Ramo et Ligno Cum Polyporo), Cheqianzi (Plantaginis Semen), Zhuling (Polyporus), and Banxiaqu (Pinelliae Fermentatum). After several doses, vomiting, thirst, and spontaneous diarrhea ceased. Zhuling and Banxiaqu were removed, and Huashi (Talcum), Dengxincao (Junci Medulla) were added to percolate and drain Damp-Heat, leading to cure.

Jing, suffering from Winter-Warmth complicated by deficiency, presented with burning heat and cough. Due to mismanagement, pathogens sank into the Ying (Nutritive) level, causing severe hematochezia, internal exhaustion of Yin fluids, black tongue, scorched teeth, immobility of Shen mechanism, deficient-rapid pulse on the left, floating-rapid pulse on the right, deafness, blurred vision, red cheeks, enuresis, and incontinence. This indicated impending exhaustion of Yin with floating of solitary Yang. Emergency measures to preserve Yin by replenishing fluids were taken. Herbs used: Shengdi (Rehmanniae Radix), Xijiao Zhi (Rhinocerotis Cornu Juice), Wuweizi (Schisandrae Chinensis Fructus), Ejiao (Asini Corii Colla), Shashen (Glehniae Radix), Maidong (Ophiopogonis Radix), Shihu (Dendrobii Caulis), JiZihuang (Galli Ovum). After three doses, groaning and turning over were possible, but the pulse was so deficient it could not withstand pressure. Xijiao was removed, and Yangshen (Panacis Quinquefolii Radix), Fushen (Poria cum Radice), Zaoren (Ziziphi Spinosae Semen), and Baishao (Paeoniae Radix Alba) were added. After another dose, the tongue became moist, spirit cleared, though there was no hunger or appetite, indicating Heat-Phlegm knotting in the upper epigastrium. Chuanbeimu (Fritillariae Thunbergii Bulbus) and Lou Shuang (Trichosanthis Fructus Pulvis) were added. Later, due to Lung deficiency failing to transform fluids, Fumai Tang (Restore the Pulse Decoction) minus Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Cortex), and Maren (Cannabis Semen), plus Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) were used. Turbid phlegm descended, stool passed, pulse became even and spirited, but food intake remained low, indicating Spleen Yang was trapped and not yet revived. Luoshen (Codonopsis Radix) was substituted. Combined with Fushen (Poria cum Radice), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), Baizhu (Atractylodis Macrocephalae Rhizoma), Guya (Oryzae Fructus Germinatus), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Lianzi (Nelumbinis Semen), and Dazao (Ziziphi Jujubae Fructus), appetite improved.

Geng, suffering from Yin Malaria in late autumn, contracted a strange pathogen in early winter, presenting with chills, fever, vomiting, and oppression. Physicians diagnosed Cold Damage; exterior release failed. Chengqi Tang was then used, plus Cangzhu (Atractylodis Rhizoma) and Houpo (Magnoliae Officinalis Cortex), leading to dizziness, high fever, irritability, thirst, and diarrhea. Another physician also diagnosed Cold Damage with leakage bottom syndrome, deeming it untreatable. Progression led to closed eyes, delirious speech, blistered lips, blackened teeth, dry scorched retracted tongue. His grandfather, an eighty-year-old relative, pleaded for help. Pulse was deficient-rapid on the right, wiry-rapid on the left. I stated this was Warm Pathogen, disease in the Upper Jiao, requiring light agents to disperse Qi level. Xiaoshi (Sodi Sulphas) and Huanglian (Coptidis Rhizoma) are bitter-cold descending, irrelevant to formless diffuse Heat. Cangzhu and Houpo are warm-dry, consuming fluids and aiding burning heat. Now fluids are exhausted, spirit is confused, pathogens entered the Pericardium. Rapid generation of fluids and clearing of heat, sweeping away Pericardium Phlegm obstruction, offers hope. Herbs used: Xijiao (Rhinocerotis Cornui, 5 fen ground to juice), Xian Changpu (Acori Tatarinowii Rhizoma fresh, 3 qian crushed for juice), Shanzhi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus, each 8 fen), Xian Shengdi (Rehmanniae Radix fresh, 5 qian), Xian Shihu (Dendrobii Caulis fresh, 5 qian), Shashen (Glehniae Radix), Lou Shuang (Trichosanthis Fructus Pulvis), Maidong (Ophiopogonis Radix), Beimu (Fritillariae Cirrhosae Bulbus, each 2 qian), Zhuru (Bambusae Caulis in Taeniam, 3 qian). After one dose, tongue moist, spirit recovered, heat reduced. Due to short dark urine, Yuan Shen (Scrophulariae Radix, 2 qian), Dengxincao (Junci Medulla), Cheqian (Plantaginis Semen, each 5 fen) were added to the original formula. After another dose, heat receded, appetite returned, swelling and pain under the chin appeared, named residual toxin. Due to initial failure to disperse, clearing and resolving remained primary. Herbs used: Douchi (Sojae Semen Preparatum), Jiegeng (Platycodonis Radix), Huafen (Trichosanthis Radix), Zhuye (Bambusae Folium), Niuxib (Arctii Fructus), Beimu (Fritillariae Cirrhosae Bulbus), Qiao (Forsythiae Fructus), Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma). After several doses, resolved.

Yuan, suffering from Yin Malaria for years, injured by raw/cold foods, further infected by strange pathogens; initially chills, fever, cough, wheezing; subsequently delirium, irritability, insomnia; upper part dry lips, gray tongue, coal-colored nose; middle part cough, vomiting, chest/hypochondriac pulling pain; lower part enuresis, spontaneous diarrhea of foul loose stools; pulse wiry-large-rapid. Physicians did not recognize the syndrome, casually stating Yin deficiency nearing extinction, family begged for help. Reluctantly prescribed Ge Fen (Mercurii Carbonas) and Shudi (Rehmanniae Radix Preparata) tonics. I stated this was Warm Pathogen transforming into dryness, affecting all three Jiaos, how could astringent-greasy herbs block pathogens? Treatment should be dispersing and draining for cure; why die from this pulse! Considering pathogens enter from above, treat the upper. Herbs used: Bohe (Menthae Haplocalycis Herba), Shanzhi (Gardeniae Fructus), Sangpiao (Mori Cortex Radicis), Xingren (Apricot Seed), Gualou Ren (Trichosanthis Fructus Semen), Beimu (Fritillariae Cirrhosae Bulbus), Juhong (Citri Reticulatae Pericarpium Rubrum), Shihu (Dendrobii Caulis), Lipi (Pyrus Communis Pericarpium), Chifuling (Poria cum Ramo et Ligno Cum Polyporo), Dengxincao (Junci Medulla). Next morning, cough and irritability ceased, chest/hypochondriac pain flattened, tongue coating floated and moist. Three days later, due to emotional agitation, chills at noon, fever at dusk, coarse breathing, delirium, pulse wiry-large-floating, dry tongue center, dry lips/teeth. I stated pulse indicates easy sweating, but must save fluids to clear Heart/Stomach blazing heat. First used Shengdi (Rehmanniae Radix), Tiandong (Asparagi Radix), Maidong (Ophiopogonis Radix), Xijiao (Rhinocerotis Cornu), Huafen (Trichosanthis Radix), Shihu (Dendrobii Caulis), Lianzixin (Nelumbinis Plumula). Re-examination showed large Stomach pulse, dry tongue center, used Shigao (Gypsum Fibrosum), Zhimu (Anemarrhenae Rhizoma), Zhuye (Bambusae Folium), Sheng Baishao (Paeoniae Radix Alba), Er Dong (Tiandong and Maidong), pulse normalized, sweat issued, heat retreated by 70-80%. Next day, tongue tip again dry-crimson, erythema appeared on Yintang, still indicating blazing Heart Yang. Immediately used Shengdi (Rehmanniae Radix), Xian Ou (Nelumbinis Rhizoma fresh), Ejiao (Asini Corii Colla, separately melted), Changpu (Acori Tatarinowii Rhizoma), Xuanshen (Scrophulariae Radix), Danshen (Salviae Miltiorrhizae Radix), Tiandong (Asparagi Radix), preventing heat sinking into Heart Ying. After two doses, tongue tip moist, eryma faded. Later used Shengdi (Rehmanniae Radix), Ejiao (Asini Corii Colla), Sheng Biejia (Testudinis Carapax et Plastrum), Danpi (Moutan Cortex), Baishao (Paeoniae Radix Alba), Qinghao (Artemisiae Annuae Herba), sweat thorough, body cool, regulated and stabilized.