Library

In the early summer of the Jiashen year, Mr. Zhaojia, an old friend from the Fujian Academy, suffered from the aforementioned condition, presenting with fever (Fe), dry throat (Yan Gan), dizziness and vertigo (Hun Xuan), and insomnia (Bu Mei). His urination and defecation were normal. After several doses of miscellaneous treatments, his condition did not improve. Upon examining the prescription, it was found to include exterior-releasing herbs combined with diuretics such as Alisma Rhizoma (Zexie) and Poria Cocos with Red Core (Chiling). I said: To release the exterior, one must use acrid and dispersing herbs that ascend; if diuretics are used, they guide the pathogenic factor downward, thus preventing the external heat from being vented, which leads to lingering illness. Therefore, I prescribed Qianghuo Gegen Tang (Notopterygium and Pueraria Decoction) with modifications. After two doses, he recovered. Treating such a condition should not be difficult; yet, using Wuling San (Five-Ingredient Powder with Poria) — intended for Taiyang disease transmitting to its interior with heat binding in the Bladder — to treat residual heat in both Taiyang and Yangming stages is fundamentally contradictory.

In the autumn of the Guiwei year, Lin Huayuan from Shangjie suffered from the aforementioned condition. His pulse was surging and rapid (Hong Shu). I administered acrid-cool agents, and he recovered after one dose. Shortly thereafter, relapse occurred due to exertion after eating. He was treated according to the same method and subsequently recovered.

In the summer of the Jiashen year, Tang Ying, my neighbor, suffered from the aforementioned condition. Symptoms included fever, spontaneous sweating, vomiting and regurgitation, abdominal distension and oppression, and delirious speech at night. He had constipation and dysuria. All six pulses were surging, rapid, and forceful. I administered a large dose of Sanhuang Tang (Three-Yellow Decoction) supplemented with Anemarrhenae Rhizoma (Zhimu), Bambusae Folium (Danzhu), Akebia Caulis (Mutong), Rheum Palmatum (Dahuang), and Gypsum Fibrosum (Shigao). I instructed him to drink water day and night. After several doses, the fever subsided, sweating ceased, and urination and defecation became clear and smooth. I predicted that he would recover through shaking sweat (Zhan Han) on the seventh day, which indeed happened. When pulse and symptoms correspond, indicating a true excess pattern, the disease is inherently not difficult to treat. If bitter-cold agents are not used, heat may linger in the zang-fu organs, causing lingering distress and complications. Often, physicians at this juncture, although knowing it is a heat pattern, hesitate to use strong purgatives due to symptoms like vomiting, regurgitation, wheezing, and distension, thereby failing due to timidity.

In the summer of the Guiwei year, a male surnamed Ruan from outside West Gate suffered from the aforementioned condition. The exterior symptoms had resolved, leaving only a dry throat and abdominal pain, followed by diarrhea with red-yellow stool. His pulse was slightly floating. I administered Guizhi Dahuang Tang (Cinnamon Twig and Rhubarb Decoction) with modifications. He recovered after one dose.

In the twelfth lunar month of the Jiashen year, Mr. Luo Chong, a friend from the Minqing Academy, suffered from the aforementioned condition. He experienced irritability, thirst, abdominal distension, and loose stools. His hands and feet were warm. His pulse was deep, fine, yet forceful. He also presented with alternating chills and fever. I administered acrid-cold agents including Scutellariae Radix (Huangqin), Paeoniae Radix Alba (Baishao), Anemarrhenae Rhizoma (Zhimu), Magnoliae Officinalis Cortex (Noupu), Bupleuri Radix (Chaihu), and Rheum Palmatum (Dahuang). He recovered after two doses.

In the late autumn of the Guiwei year, Wu Yinyu, a Jingyi from Jingxian County, contracted the aforementioned condition while in Fujian. Six days later, his body had no significant fever, his throat was slightly dry, and although he was lethargic and lacked spirit, his pulse was balanced, even, and gentle. I informed him that he would recover through shaking sweat the next day and required no medication. He indeed recovered as predicted. In the autumn of the Jiashen year, a male surnamed Wei from Xihe contracted the aforementioned condition. He presented with tongue retraction, cold limbs (Ni), vomiting, and lethargy. His six pulses were deep and scattered. Upon examining previous prescriptions, it was found that excessive use of Chengqi Tangs caused the error, leading to stomach qi exhaustion and untreatable condition. He died shortly thereafter. It must be noted that the three Chengqi Decoctions are harsh and potent acrid-cold agents. They should not be lightly administered unless the patient has a robust constitution and presents with both pulse and symptoms of excess. Misuse can result in wrongful death.