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Mr. Xiang Xin of Dongjia stated that severe and hard pain belongs to heat, which specifically refers to sores and ulcers. The *Classic* says: "All kinds of pain, swelling, itching, sores, and ulcers belong to Heart Fire." Since the Heart governs heat transformation, pain belongs to heat, thus there is no need to explain it in terms of cold. As for acute pain caused by cold, the *Treatise on Pain* (Jutong Lun) proposed the theory that various pains are due to cold. The *Classic* also states: "When cold invades the interior, disperse it with acrid-hot herbs, assisted by bitter-cold herbs." Zhang Zhongjing (of Changsha) used acrid-hot formulas to disperse the chaotic wind-cold qi, precisely based on this principle. In clinical practice, one must certainly observe the yin and yang of the pulse and verify the deficiency and excess of the patient. One should not exclusively assume there is only heat without cold, nor exclusively assume there is only cold without heat; only then can one achieve a balanced approach.

At the end of the Hongzhi reign, Emperor Xiaozong fell ill with fever before his death. Liu Wentai, the President of the Imperial Medical Academy, mistakenly administered hot-natured medicines. After taking them, the Emperor became extremely thirsty and demanded water, but Liu Wentai firmly refused. A eunuch offered watermelon, which the Emperor ate, allowing him to barely speak and summon ministers such as Liu Jian to receive his临终嘱托 (last will and testament). Consequently, Liu Wentai was imprisoned, though he was merely exiled to guard Guangxi and died there. Previously, Yao Sengtan of the Later Zhou dynasty was a renowned physician. When the Emperor had a fever and wished to take Dahuang (Rhei Radix et Rhizoma), Yao Sengtan said, "Dahuang is a drastic medicine. Your Majesty is advanced in age and should not use it lightly." The Emperor did not listen, took it, and his condition deteriorated until he passed away. Later, when Emperor Ming was ill, other physicians argued that His Majesty's noble status precluded drastic purgation and suggested mild medicines. Yao Sengtan said, "The pulse is flooding and full, indicating retained food stagnation. Without using Dahuang, recovery is impossible." The Emperor followed his advice, expelled the retained food, and recovered. Physicians must first distinguish the strength and weakness, deficiency and excess of the constitution, and observe the floating and sunken nature of the pulse. This error lies not with Dahuang, but with the physician's misdiagnosis.

Liu Guan, President of the Imperial Medical Academy, often attended upon Emperor Taizong. During intense summer heat, the Emperor wore a belt made of Pian Nao (Borneolum Syntheticum). He asked Liu Guan, "What do you think of this belt?" Liu Guan replied, "Pian Nao is cold in nature and damages the Kidney; only fragrance is beneficial." The Emperor immediately ordered it removed. According to the *Materia Medica*, Pian Nao is acrid-hot and moves freely, thus able to dissipate heat. Why does Liu Guan claim it is cold? Zhu Danxi stated, "Long Nao (Borneol) belongs to Fire, and all aromatics belong to Yang. How can something extremely aromatic be cold?" Alas, Liu Guan spoke carelessly, likely due to ignorance and lack of skill.

Chen Ruzhong once suffered from symptoms of stagnant fire in the Spleen and Stomach and sought treatment from Sheng Yongmei. Sheng Yongmei palpated his pulse and said, "If treated this way, he will live; if treated that way, he will die. If treated this way, he may slightly recover; if treated that way, he will die quickly." Subsequently, during treatment, Chen Ruzhong felt the effect was slow. A monk known for medical skills recommended himself, and Chen Ruzhong, confused by this suggestion, sought treatment from him. After drinking the monk's medicine, he vomited a sheng (approx. 500ml) of blood and died. Alas, physicians use medicine to attack disease; if the disease is not removed but death results, what is the purpose of medicine? That monk was a quack who knew neither medical classics nor herb properties, could not palpate pulses or assess constitution and disease duration, ignoring all these factors to simply attack the body with drugs. He likely killed many people. I blame Chen Ruzhong for failing to choose a physician wisely, leading to his rapid death. I record this as a warning to those who take medicine lightly.