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Prescription:
Zhi Fupian (Prepared Aconite Lateralis Radix) 120g (decocted for a long time), Ganjiang (Dried Ginger Rhizome) 60g, Zhigancao (Honey-fried Licorice Root) 60g, Baizhu (Atractylodis Macrocephalae Rhizoma) 30g, Fuling (Poria) 30g, Paojiang (Charred Ginger Rhizome) 60g, Shang Rougui (Cinnamon Bark) 15g (dissolved in the decoction).

[Second Visit] After taking one dose of the above prescription, the whole body itched, feeling as if insects were crawling. After continuously taking four doses, the body began to feel relaxed, and the sensation of head numbness gradually disappeared. The prescription was modified according to symptoms: if external wind-cold invasion or joint pain occurred, Mahuang (Ephedrae Herba), Guizhi (Cinnamomi Ramulus), and Xixin (Asari Radix et Rhizoma) were added; as Yang Qi gradually recovered, the dosages of Jiang (Ginger) and Fu (Aconite) were酌情 reduced. Subsequently, Renshen (Ginseng Radix), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), and Tusizi (Cuscutae Semen) were added to enhance the effects of assisting Yang, benefiting Qi, invigorating blood, and nourishing blood. Persisting with this medication for half a year, the complexion gradually returned to normal, edema subsided, appetite increased significantly, limbs became warm, and mental state improved. By April 1972, the patient could get out of bed and take slow steps with the aid of a cane or someone supporting them; by July of the same year, they could walk without a cane.

Follow-up on November 23, 1979: The patient was 73 years old and excitedly introduced to visitors that since late 1972, they had continued taking some Yang-warming and Kidney-nourishing medicines during winter, and had not been bedridden for seven years. They have been able to manage household chores during these years.

[Commentary] The occurrence of stroke is generally due to disharmony of Yin and Yang and reversal of Qi and Blood. At the first visit, the patient already suffered from sequelae of stroke, with hemiplegia lasting for eight years. The condition was severe, and obviously, it could not be treated according to the routine methods for general stroke. Observing the various symptoms, it belonged to Shaoyin Cold Transformation Syndrome, where Yin Excess and Yang Deficiency had reached an extreme. Therefore, a large dose of Sini Tang (Frigid Extremities Decoction) was administered, modified according to symptoms, and always treated according to Shaoyin Cold Transformation Syndrome.

Shaoyin Syndrome: Qi Jue (Syncope due to Qi Reversal)
Huang XX, Female, 48 years old. Resident of Chengdu streets.
[Medical History] Frequent dizziness, cough with shortness of breath, palpitations, fatigue in limbs, edema of the face and legs below both knees, persisting for five years. In severe cases, a sensation of heart sinking, even brief coma. In March 1964, after overwork, palpitations suddenly worsened, followed immediately by coma and loss of consciousness. Neighbors wanted to send her to the hospital urgently; but family members feared that bumps during transport might cause death, so they invited the doctor to the home for emergency treatment.

[First Visit] Unconscious, limbs cold, pale complexion, weak breathing. Pulse deep and faint, tongue pale with black moist coating. This is Shaoyin Syndrome Qi Jue. Immediately administered five pills of self-made Kanli Dan, given with warm water, while simultaneously rapidly decocting a warming middle-jiao and supporting Yang agent for emergency rescue.

Prescription 1:
Chuan Fupian (Sichuan Prepared Aconite Lateralis Radix) 3.5 parts, Shang Rougui (Cinnamon Bark) 1 part, Zhen Hupo (True Amber) 2 parts, Baiziren (Biota Seed) 2 parts, Fei Zhusha (Prepared Cinnabar) 1 part, Shexiang (Musk) 0.5 part.
Grind into fine powder, make pills with water.

Prescription 2: Paojiang (Charred Ginger Rhizome) 15g, Zhigancao (Honey-fried Licorice Root) 10g. One dose, decocted and taken.

[Second Visit] About one hour after administering Kanli Dan, the patient slowly regained consciousness. Then, the decoction was administered urgently, once every two hours. The next day, she came to the clinic by car herself. Palpitations slightly decreased, limbs felt slightly stronger, and spirit improved. Black coating reduced, pulse deep and weak. The method should be warming spleen and tonifying kidney, using Ganjiang Fuzi Tang (Dried Ginger and Aconite Decoction) as the main formula.

Prescription: Ganjiang (Dried Ginger Rhizome) 60g, Zhi Fupian (Prepared Aconite Lateralis Radix) 60g (decocted for a long time).
Three doses.

[Third Visit] After taking three doses of the above prescription, although symptoms improved, the long-term illness caused great decline, Heart Qi consumption, and deficiency of Lung, Spleen, and Kidney. The treatment should focus on warming Yang, benefiting Qi, strengthening spleen, and tonifying middle jiao, starting from the spleen and stomach to nourish the source of Qi and Blood, using Lizhong Tang (Regulate the Middle Decoction) with modifications as the main formula.

Prescription:
Ludangshen (Codonopsis Radix) 12g, Ganjiang Pian (Sliced Dried Ginger) 15g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 15g, Zhigancao (Honey-fried Licorice Root) 6g, Fuling (Poria) 25g, Fa Banxia (Processed Pinellia Tuber) 15g.
Continuously taken for more than ten doses, symptoms significantly improved, and household chores were managed normally. Follow-up in July 1979: The patient was over sixty years old, had only relapsed once in more than ten years, but the condition was mild, and after returning to normal, remained relatively stable.

[Differentiation] The patient's primordial Qi was originally deficient, and long-term illness further weakened them, triggered by overwork leading to severe condition. Weak respiration and deep/faint pulse indicate Heart Qi consumption; pale tongue with black coating, edema, and cold limbs belong to Yang Qi failing to rise and Kidney Water flooding upward; sudden coma is due to temporary reversal of Qi mechanism, sinking of Middle Qi, rising of Yin Qi, and failure of communication between Heart and Kidney. Fortunately, critical signs such as diarrhea, sweating, red face, cold extremities, and pulse nearly imperceptible were not yet present, so Sini Tang did not need to be administered immediately. Instead, agents warming Kidney, tonifying Heart, calming spirit, and opening orifices should be used to harmonize Kan and Li, followed by warming middle-jiao and supporting Yang agents to raise clear Yang and descend turbid Yin, making respiration smooth and consciousness clear. Then, continue with agents expelling Yin, assisting Yang, and warming/tonifying Spleen and Kidney to cultivate the root, finally treating with warming Yang, benefiting Qi, and nourishing Qi and Blood to gradually recover.

[Commentary] "Suwen: Fang Sheng Shuai Lun" states: "Therefore, syncope due to insufficient Qi causes forgetfulness and dreams, and its extreme leads to confusion." Regarding treatment, since deficiency of Qi in the five zang organs and insufficiency of Yang Qi can all cause disease, it is advocated to combine observations of the five zang manifestations, harmonize Yin and Yang Qi, and regulate based on the excess or deficiency of meridians. This patient belongs to the category of insufficient Qi involving the five zang organs, primarily Heart and Kidney Qi deficiency. Throughout, the method of warming and unblocking was used to support Heart and Kidney Yang, keeping in mind the warning against "abandoning Yin to attach to Yang without combining them." Grasping the key points allowed the chronic disease to reverse quickly and remain stable for over ten years.

Shaoyin Syndrome: Cold Jue (Cold Syncope)
Wang XX, Male, 28 years old. Worker at a factory in Chengdu.
[Medical History] The patient had a somewhat isolated personality, prone to sorrow and depression, which led to illness over time without treatment. In early 1947, a lump the size of a fist was found in the epigastrium; pressing it caused movement and sound, but no pain. Urgently sought TCM treatment elsewhere. The medicines taken were mostly blood-invigorating and stasis-resolving herbs like Taoren (Prunus Persica Seed), Honghua (Carthami Flos), Sanleng (Sparganii Rhizoma), and Ezhu (Curcumae Rhizoma). After about half a year of treatment, efficacy was poor, appetite decreased daily, physique wasted, and spirit declined. Even in the heat of July, wearing velvet clothes and covering with quilts at night, still felt cold. Later changed doctors locally, and by April of the following year, the condition worsened. One day, sudden syncope occurred; family mistook it for sudden death, placed him on a wooden board outside the house, preparing for burial. At this time, Master Fan happened to be treating patients in the neighborhood. Someone knocked urgently and said: "Knowing you are here, my neighbor is critically ill, seemingly dead, hoping you will come personally to see if there is any remedy?" So he went to examine.

[First Visit] Patient's complexion was pale, lips dark, extremities cold. Immediately tested nasal breath with a fine lamp wick, slight movement detected. Touched chest pit, slight warmth remained. Checked pulse, seemed present and absent. Said: There is still a trace of vitality; can try giving medicine to see if it can save him. Left him at home, personally guided medication use to observe efficacy.

Prescription 1: Zhigancao (Honey-fried Licorice Root) 30g, Paojiang (Charred Ginger Rhizome) 15g.
Prescription 2: Zhigancao (Honey-fried Licorice Root) 60g, Ganjiang (Dried Ginger Rhizome) 120g, Zhi Fupian (Prepared Aconite Lateralis Radix) 120g (decocted for a long time), Dangshen (Codonopsis Radix) 45g, Tongbian (Child's Urine) as guide.
Instructed family to decoct the above two prescriptions simultaneously in separate pots over high fire. First took half a cup of the decocted liquid from the first prescription, frequently administering it. About fifteen minutes after administration, the patient gradually emitted slight nasal breathing sounds, hands and feet twitched slightly. When the second prescription was ready, it was immediately administered. About two hours after medication, the patient slowly regained consciousness, mind gradually cleared, only then realizing he had been carried outside and family was preparing funeral affairs.

[Differentiation] At first visit, the patient was waiting for burial. Testing nasal breath, touching chest pit, checking pulse, observing color, asking medical history, this belongs to Shaoyin Disease with extreme Yang Decline and Yin Excess, retaining only a trace of faint Yang, with danger of instantaneous collapse. Emergency administration of Sini Tang (Frigid Extremities Decoction) to expel Yin and restore Yang is needed. But Aconite requires long decoction, fearing loss of the opportunity for rescue, so first administer Gancao Ganjiang Tang (Licorice and Ginger Decoction), combining pungent and sweet flavors to specifically restore Yang in the chest; Lung Qi warmed, respiration unobstructed, and dying Yang not instantly severed. Then, use a large dose of Sini Tang plus Ginseng to restore Yang, benefit Yin, save primordial Qi from the brink of death; add child's urine to guide Yang into Yin, making Yang prosperous and Yin harmonious to regain life.

[Second Visit] Voice low, breath discontinuous; although Yang has returned, Qi and Blood deficiency is severe. Again prescribe Lizhong Tang (Regulate the Middle Decoction) with modifications to tonify spleen and strengthen kidney; also, because there is still cold coagulation and accumulation in the epigastrium, add a small amount of cold-expelling and knot-resolving agents.

Prescription:
Dangshen (Codonopsis Radix) 18g, Ganjiang (Dried Ginger Rhizome) 120g, Zhigancao (Honey-fried Licorice Root) 120g, Baizhu (Atractylodis Macrocephalae Rhizoma) 18g, Zhi Fupian (Prepared Aconite Lateralis Radix) 250g (decocted for a long time), Fuling (Poria) 15g, Buguzhi (Psoraleae Fructus) 12g, Gouqi (Lycii Fructus) 60g, Wuzhuyu (Evodiae Fructus) 10g, Shanzhuyu (Corni Fructus) 30g, Baihujiao (White Pepper Fruit) 10g.
After taking one dose of the above prescription, slight hunger and desire to eat appeared, able to take a little liquid food. Continue original prescription for four more doses, condition greatly improved, able to eat a small bowl of thin porridge per meal.

[Third Visit] Complexion slightly lustrous, spirit better, but sallow yellow remains, poor appetite. Still use Lizhong Tang (Regulate the Middle Decoction) with modifications, so Earth Qi prospers to assist vital energy.

Prescription 1:
Dangshen (Codonopsis Radix) 15g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 30g, Zhigancao (Honey-fried Licorice Root) 60g, Ganjiang (Dried Ginger Rhizome) 120g, Zhi Fupian (Prepared Aconite Lateralis Radix) 250g (decocted for a long time), Shang Rougui (Cinnamon Bark) 20g (dissolved in the decoction), Gouqi (Lycii Fructus) 30g, Guizhi (Cinnamomi Ramulus) 15g, Fuling (Poria) 25g.
Prescription 2: Sharen (Amomi Fructus Rotundus) 30g, Baiko (Cardamomi Fructus) 30g. Grind into fine powder, take a little dissolved in water after meals.
Based on condition, the above prescription modified was taken for over two months, all symptoms eliminated, body restored. Follow-up in 1979: Patient was 59 years old, for over thirty years, able to work night shifts regularly, body generally good.

[Commentary] The pathology of "Jue" syndrome is the lack of connection between Yin and Yang Qi. Mild cases involve cold extremities and sudden fainting; severe cases result in death as Jue does not reverse. Thus, "Neijing" discusses Jue Ni extensively, and "Shanghan Lun" contains many methods for rescuing emergencies. However, regarding the nature of Jue, it is either cold or hot. Thus, "Suwen: Jue Lun" states: "If Yang Qi declines below, it becomes Cold Jue; if Yin Qi declines below, it becomes Hot Jue." In clinical emergency rescue, careful differentiation is essential.
For this case of Cold Jue, examining internal and external factors and differentiating to find the cause, it is known that the cold does not come from outside but from within. The method should be regulating Yin and Yang, treating the disease of the primary meridian. This is a case of Shaoyin Disease with extreme Yang Decline and Yin Excess, urgently requiring pungent-sweet agents to restore Yang and rescue from emergency, allowing Yin and Yang Qi to connect smoothly. Thus, the patient waiting for burial instantly revived.

Shaoyin Syndrome: True Cold False Heat
(High Fever)
Che XX, Male, 74 years old. Resident of Chengdu.
[Medical History] In early April 1975, contracted wind-cold, feeling generally unwell. Believing himself elderly and frail, with insecure Ying and Wei defenses, plus economic difficulties and knowing some formulas, he self-prescribed a warming and tonifying decoction. After delaying for more than ten days, the illness did not improve. Reluctantly went out for a walk, caught wind, and condition worsened. Dizziness, body pain, red face, high fever, confused mental state. Neighbors sent him to XX Hospital urgently. Temperature checked at 39°C, diagnosed as cold with high fever, injected Gentamicin, and took Western medicine, but high fever persisted, condition critical, invited Master Fan for home emergency treatment.

[First Visit] Patient intermittently unconscious, pulse faint and nearly imperceptible. High fever for three days, although body extremely hot, still feels cold inside despite heavy blankets. No food intake, urination and defecation blocked. Malar flush, tongue pale and slippery, thick greasy black coating. Patient over seventy, Yin Cold excessive, fearing imminent death. Although accompanied by Taiyang exterior syndrome, should first rescue the interior, urgently administer Tongmai Sini Tang (Pulse-Returning Sini Decoction) for rescue.

Prescription:
Sheng Gancao (Raw Licorice Root) 30g, Ganjiang (Dried Ginger Rhizome) 60g, Zhi Fupian (Prepared Aconite Lateralis Radix) 60g (decocted for a long time), Congbai (Scallion White) 60g.

[Differentiation] Patient has high fever, coma, red face, black coating, blocked urination and defecation, resembling Yang Heat signs. Although high fever, desires heavy blankets; body hot and face red, but extremities cold. Blocked urination and defecation, yet abdomen suffers no discomfort. Thick greasy black coating, but tongue moist with fluid. High fever and coma, no delirium or mania, but pulse deep and faint. Considering age over seventy, weak constitution and declining Qi, this is actually a presentation of Shaoyin solitary Yang flying away, vital Qi about to depart, death imminent. Therefore, urgently administer Tongmai Sini Tang plus Scallion to directly pursue the scattered and nearly extinct Yang.

[Second Visit] After taking two doses of the above prescription, fever subsided, black coating significantly reduced. Yang returned, initial dissipation of Yin turbidity, image of Yin-Yang rejection resolved. But headache and body pain, exterior syndrome remains; Kidney Yang deficiency fails to transform Qi, thus urination and defecation still difficult. Use Mahuang Fuzi Gancao Tang (Ephedra, Aconite, and Licorice Decoction) to drive out cold and secure Yang, add Scallion to generate Shaoyang generating Qi.

Prescription:
Mahuang (Ephedrae Herba) 10g, Zhi Fupian (Prepared Aconite Lateralis Radix) 60g (decocted for a long time),
Sheng Gancao (Raw Licorice Root) 20g, Congbai (Scallion White) 120g. Four doses.

[Third Visit] After taking four doses of the above prescription, head no longer dizzy, urination and defecation unobstructed, black coating completely faded. Only body pain remains. Although Yang returned and exterior resolved, tongue still pale, limbs cold, Yin Cold internally excessive, presenting as Yang deficiency body pain. Should warm and ascend Yuan Yang to dispel cold pathogens, using Sini Tang plus Liaoxixin (Asari Radix et Rhizoma) as the main formula.

Prescription:
Zhigancao (Honey-fried Licorice Root) 20g, Ganjiang (Dried Ginger Rhizome) 30g, Zhi Fupian (Prepared Aconite Lateralis Radix) 60g (decocted for a long time), Liaoxixin (Asari Radix et Rhizoma) 6g. Two doses.

[Fourth Visit] After taking two doses, remaining symptoms eliminated. After recovery from major illness, true Yang deficiency, regulate with Lizhong Tang (Regulate the Middle Decoction) with modifications.

Prescription:
Ludangshen (Codonopsis Radix) 15g, Chao Baizhu (Stir-fried Atractylodis Macrocephalae Rhizoma) 10g, Zhigancao (Honey-fried Licorice Root) 10g, Ganjiang Pian (Sliced Dried Ginger) 15g, Zhi Fupian (Prepared Aconite Lateralis Radix) 30g, Fuling (Poria) 12g.
Follow-up on July 18, 1979: Patient was 79 years old, since recovery, body has been generally good for several years.

[Commentary] Differentiating cold and heat in clinical practice is not too difficult. But things turn into their opposites when extreme, "Extreme cold generates heat, extreme heat generates cold." Differentiating true and false cold and heat, if mistaken once, the danger is unpredictable. Predecessors have elaborated much on this.
This case resembles Yang Heat, but pulse is faint and nearly imperceptible, pulse and symptoms do not match. When Master Fan encountered this difficulty in distinguishing true and false cold and heat, he comprehensively assessed, highlighting tongue diagnosis: tongue body pale indicates Yin Cold excess; coating black, slippery, and moist indicates Kidney Water flooding upward. Absolutely cannot mistake it for Yang Heat; it is actually extreme Yin Cold internally, a false appearance of deficiency cold exposed externally. Therefore, encountering such critical conditions, following Master Zhongjing's methods, daring to break through, often achieves significant effects.

Shaoyin Syndrome: Diarrhea with Void Collapse
(Proper Typhoid)
Huang XX, Male, 11 years old. Former student from Chengdu, Sichuan.
[Medical History] In autumn 1948, initially felt generally unwell, condition gradually worsened, coma, high fever above 40°C, diarrhea. At that time, it was the epidemic season for intestinal typhoid, confirmed by Sichuan Provincial Hospital as "Proper Typhoid". Some experts believed the disease had developed to the peak stage, systemic toxicity too severe, considered incurable. Later consulted by TCM, rescued with large amounts of Xijiao (Rhinocerotis Cornu), Lingyangjiao (Capricornis Cornu), and Zixue Dan (Purple Snow Pill). Although high fever subsided and diarrhea stopped, condition became heavier, limbs ice cold, pulse nearly absent, ultimately critical. Finally came for consultation, treated according to Shaoyin Syndrome Diarrhea with Void Collapse, initial visit showed turning point, cured after several visits.

[First Visit] Child comatose and curled up for days, gray-white-dark complexion, emaciated. Pulse hidden, faint, thin, nearly absent, only testing both nostrils with fine lamp grass revealed slight breath. Limbs cold reversal, hands cold past elbows, feet cold past knees, even entire body skin cold. This is pathogen moving from Yang to Yin, developing into Shaoyin extreme Yin Cold, Yang Qi about to collapse in an instant, a dangerous stage. Urgently use method of expelling Yin, restoring Yang, harmonizing middle, securing collapse, administer one dose of large-dose Tongmai Sini Tang (Pulse-Returning Sini Decoction) for emergency rescue.

Prescription:
Chuan Fupian (Sichuan Prepared Aconite Lateralis Radix) 120g (decocted for a long time), Ganjiang (Dried Ginger Rhizome) 120g, Zhigancao (Honey-fried Licorice Root) 60g.

[Second Visit] Above prescription, frequently administered overnight, until early morning next day, child's parents rushed in saying repeatedly: "Bad, bad, nose bleeding after taking medicine!" Master Fan immediately replied: "Good, good, child is saved!" Then examined again. Child's appearance and symptoms similar to yesterday, but breathing slightly connected and regular, showing initial signs of revival. Should continue original method, administer Tongmai Sini Tang with doubled dosage again.

Prescription:
Chuan Fupian (Sichuan Prepared Aconite Lateralis Radix) 500g, Ganjiang (Dried Ginger Rhizome) 500g, Zhigancao (Honey-fried Licorice Root) 250g.
First decoct one fat hen in soup, separately decoct Fupian in chicken soup for one and a half hours, then add Jiang and Cao. About two hours after taking medicine, child suddenly expelled two purple-black clots of blood from nose, about three inches long, and vomited some blood clots from mouth. At this time, slowly opened eyes, mind began to clear, and spoke: "I want to eat white cake!" Family instantly turned tears to laughter, very happy. Then followed original prescription, took four more doses.

[Third Visit] Child's mind completely clear, language fluent, able to take small amounts of liquid food like chicken soup daily. Complexion blue-dark. Tongue body pale white, dark, no coating. Upper limbs movable, started holding bowl to eat, lower limbs stiff, unable to bend and stretch, limbs still cold. Condition beginning to improve, Yang Qi gradually recovering; but Yin Cold coagulation deep, especially in lower limbs. Original prescription slightly increased Qujiu (Qu Distilled Liquor) as guide, take again.
After taking one more dose of the above prescription, next day lower limbs could slowly bend and stretch. Took two more doses, able to get out of bed and walk slowly. Took thirteen doses, gradually recovered.
Patient wrote letter on December 26, 1978: "Thirty years ago, after Master Fan cured my illness, I joined the army in 1953, received two third-class merits in the military, now working as a fitter at a mechanical parts factory, body has always been good."

[Commentary] This case, due to missed treatment, pathogen moved from Yang to Yin, Yang Qi declined, Yin Cold stagnated, meaning Yin-Yang Qi and Blood could no longer fill the limbs and skin, hence gray-white-dark complexion, hidden/faint/nearly absent pulse, entire body cold reversal, even coma and unconsciousness. Obviously, condition developed to the critical stage of Shaoyin Cold Transformation, belonging to typical Sini Syndrome. At this moment of pure Yin and faint Yang, critical juncture, everything depends on the survival of Yang Qi. If Yang survives, life continues; if Yang perishes, death follows instantly. Non-emergency administration of large-dose Tongmai Sini Tang to restore Yang and rescue from emergency is impossible.