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Thus, a couplet for mourning was written: "Drifting and homeless, I feel bored; moved by twenty years of spiritual communion. Meeting like duckweed in Shenjiang (Shanghai), just as I was about to examine the remaining manuscripts for your critique, passing away peacefully is originally a blessing, yet you departed suddenly one morning. The autumn night wind is desolate; how can I bear losing a kindred spirit with my graying hair."

My second daughter, Dingyi, was twenty years old, robust and enduring hardship, married to a man from the Dai family in our county. At the beginning of the month, I received a letter from her husband stating that on August 23rd, she suddenly suffered from painful diarrhea, and her condition gradually deteriorated into emaciation. Subsequently, *Fugui Bawei Tang* (Aconite and Cinnamon Eight-Ingredient Decoction) was used, leading to her death on the 29th with a tongue scorched black like charcoal. While dying, she said to her husband: "If my father were here, the illness would not have reached this state." Alas! Based on these symptoms, this was *Fu Shu* (Hidden Summerheat). The Dai family are physicians of accumulated virtue; they possessed all ten volumes of my previously published *Wangshi Yishu Shizhong* (Ten Medical Books of the Wang Family), yet she died due to erroneous medication, which is truly tragic. I sent postal condolences to the You family, expressing unspeakable grief, having tried various erroneous medicines—dry-hot, cold-cooling—and recalling past nurturing, only shedding tears in the autumn wind. Alas! A good friend and a beloved daughter, both perishing on the same day from similar causes, make the task of revising this book even more imperative. I attach mourning verses to record both our friendship and the tragedy of medical error.

Before Frost's Descent, Qiexie, a nephew from the Shuibei branch of my clan, invited me to examine the daughter-in-law of his relative, Mr. Jiang Xun'an, who had suffered from Huoluan with tendon spasms for three days. She presented with cold extremities (*Jue Ni*), protruding eyes, chest diaphragm fullness with anuria, yellow coating, bitter taste, thirst, and a very wiry and fine pulse. After multiple administrations of *Guizhi*, *Fuzi*, *Ganjiang*, and *Baizhu*, her qi rebellion became nearly fatal. I prescribed modified *Changyang Xiexin Tang* (Reed Rhizome Heart-Draining Decoction), to be taken slowly after decoction. Externally, *Wuzhuyu* powder mixed with vinegar was applied to the *Yongquan* acupoint. After two doses, vomiting ceased and feet warmed. Removing *Suzhe* and *Houpo*, and adding *Chuanlianzi*, *Shihu*, and *Pugongying* over several doses, she finally recovered. This case involved *Fu Shu* complicated by naturally hyperactive Liver Yang, where mistaken warm-tonifying herbs prevented the rapid clearance of pathogens.

The daughter of the Fang family in Hezhong migrated for three years, arriving in Shanghai in mid-autumn. She suffered from vomiting and diarrhea, which was cured with a single dose when examined by my relative, Scholar Qian Bosheng. Later, she developed edema but, being a lodger, received no treatment. When Frost's Descent arrived, the edema suddenly subsided. Within a few days, she contracted Huoluan again, followed by mental confusion, pacing around the room, calling for her sister. Her sister forced her to lie down, but her eyes continued to rotate, tears flowed profusely, and her jaw clenched. Before I could attend to her, she passed away. When asked for the cause, I explained: "This resulted from displacement and hardship, deep depression causing Wood (Liver) to overact on Earth (Spleen/Stomach), leading to vomiting, diarrhea, and edema. With Frost's Descent, the肃 (desiccating) qi cleared the edema, but the depression remained unvented, directly attacking the Spleen and Stomach, causing sudden vomiting and diarrhea. Liver Fire surged upward, causing wild running and staring eyes, with Yang floating upwards. This is Huoluan caused by emotional internal injury. Hence, the rapid declaration of critical condition."

Shen Chunquan from Nanxun, aged fifty-seven, suddenly developed Huoluan with tendon spasms five days before Start of Winter after eating crab noodles. His vomit and stool were watery. Initially given *Guizhi* and *Fuzi* preparations, the spasms worsened, accompanied by slight sweating, fatigue, reluctance to speak, cold fingers, sinking pulse, and frequent sighing. A new prescription of *Muli* (Oyster Shell), *Guiban* (Turtle Shell), and *Ejiao* (Donkey-hide Gelatin) made the condition worse. Upon examination, I found a yellow coating, extreme thirst, complete anuria, extremely hot stool, and abdominal tenderness. This was *Fu Shu* combined with food retention. I do not know why dry-hot, tonifying, astringent, and cloying herbs were prescribed. The family trusted the physician because he was excellent in calligraphy and painting, leading to his death—a pitiful and laughable situation. Later, I heard his second son suffered the same condition after Start of Winter. The physician recognized *Fu Shu* and used *Huanglian* etc., stopping vomiting and diarrhea. However, not knowing that the latent heat was not cleared because the pulse hadn't immediately risen, he switched to *Fuzi* and *Guizhi* for three doses, resulting in death. This is especially mournful.

Luo Jiren from Shangyu suffered from Huoluan with tendon spasms before Start of Winter. Ziyun knew his Yin was deficient and the disease stemmed from *Fu Shu*. Medication initially improved the condition, but eructation appeared days later. Upon examination, the pulse was wiry and rapid (stronger on the left), tongue coating scorched with thirst, gingival bleeding, epigastric fullness, loose dark-brown stool, and scanty red urine—all signs of unresolved *Fu Shu* and obstructed Qi mechanism. Despite the loss of clear-descending function, a *Huiyang Gao* (Return-Yang Plaster) was still applied to the navel. I repeatedly urged its removal without success. He subsequently died. This was not a terminal collapse; I deeply regretted it.

Zhang Ermei from Nanxun, over sixty, suffered from Huoluan with tendon spasms in autumn. Physicians, seeing his advanced age, cold extremities, and profuse sweating, proposed warm-tonifying herbs, but Zhang refused. He recovered using mild single-herb prescriptions and external treatments. However, thereafter, his stools were soft, he sweated spontaneously, developed widespread skin sores and scabies, and felt extreme aversion to heat. By Start of Winter, upon examination, his pulse was slippery and rapid, with thirst, yellow coating, hot urination and defecation, yet he wore lined clothing. This indicated a Yang-predominant constitution with abundant internal Damp-Heat. Fortunately, avoiding warm tonification allowed him to live longer. Large doses of clearing and resolving methods gradually healed him. This year, cases of scabies are everywhere, confirming the saying "wounds cover the land" is not false. There are many external treatments, but few effective ones. Some improper treatments cause sores to heal suddenly but lead to complications and rapid death due to toxin entrapment and internal conflict. Ziyun transmitted a good formula: *Mahuang* (Ephedrae Herba) 1 liang, *Chuanjiao* (Sichuan Pepper Fruit) 5 qian, *Shechuangzi* (Cnidii Fructus) 5 qian, *Banmao* (Meloides Insecta) 7 pieces, boiled in boar lard or asphalt until clear, filtered. Added *Mingfan* (Alumen) and *Huangbai* (Phellodendri Cortex) 1 liang each, *Bimazi* (Ricini Semen) and *Dafengzi* (Aleuritidis Fructus) 40 grains each, ground to powder, mixed into the oil, wrapped in silk, and rubbed on affected areas. It extracts hidden toxins and pathogens, curing within ten days without sequelae. This aligns with the principle of using hot wine massage for tendon spasms. Do not criticize it for being potent. Thus appended: Unverified claims are not believed; methods worth learning are collected from books as a guide. Yet, the elusive nature of diseases is like deceptive enemy tactics, appearing correct yet incorrect, with no clear pattern. Presuming upon personal experience, I append this as "Dream Shadows." Times change, events shift, circumstances resemble dreams, and attempts to understand are like groping for a lock in the dark. Perhaps even bamboo scraps and wood chips are needed by master craftsmen. I respectfully submit this to experts, asking not to despise its triviality, hence listed as the third set of medical cases.