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I once treated a pregnant woman suffering from Shanghan (Cold Damage). After sweating to release the exterior, she suddenly called for her maid, making sounds of crying injustice. I realized this indicated disturbance of Yang Qi (the body's defensive and warming energy), with the patient feeling urgent distress. I ordered Ginseng Decoction to be administered, but it could not be obtained immediately.

Consequently, I used three taels of Atractylodis Rhizoma (Baizhu, 白术), boiled it into a thick decoction of one bowl, and gave it to her to drink. She was instantly pacified. How much more potent is Ren Shen (Ginseng) compared to Baizhu!

Case 23: A man had contracted an external pathogen in his youth. Due to improper treatment, all his body fluids were scorched by the evil heat. For ten years thereafter, residual heat remained uneliminated, causing his right ear orifice to frequently become blocked. This summer, he contracted another external pathogen. The illness lingered for over fifty days, accompanied by edema of the face and feet, restless sleep, and a sensation of qi rushing out from the ears. This occurred because the new heat combined with the old heat, creating a compounded pathology that was difficult to expel. The physician failed to observe this tangled and knotted condition, treating blindly without hitting the key point. It was not until late autumn, when Metal Qi (associated with Autumn/Lungs) became cold and Water Qi (Kidneys) turned chilly, that the disease naturally receded. However, superficial pathogens can recede easily, while deep-seated ones cannot disappear abruptly.

The edema of the face and feet results from Lung Metal Qi being forced by heat, losing its function of clearing, purifying, and descending. Restless sleep occurs because stomach fluids are dried up, failing to internally nourish the Hun and Po (spiritual aspects). The sensation of large amounts of qi rushing out from the ears happens because the long-blocked orifice usually does not perceive normal qi movement; now, due to the debilitated state of the body and lack of internal obstruction, rebellious qi rushes upward, making the sensation noticeable. Although the external illness has healed, internal regulation through diet and medicine still accounts for half the recovery. I highlight these two main points to clarify post-illness care methods for those who have suffered from external pathogens. Generally, after contracting a pathogen, the body's Yuan Qi (Original Qi) is deficient, and residual evil heat is not yet cleared. If one tonifies deficiency at this stage, the heat cannot be eliminated; if one clears heat, the deficient body cannot tolerate it. Even combining half tonification and half clearing remains vague and misses the essence. Yet, apart from tonifying deficiency and clearing heat, there is no other method; careful differentiation is required.

Tonifying deficiency has two methods: one is tonifying the Spleen, the other is tonifying the Stomach. For example, after malaria or dysentery, if Spleen Qi is weak and digestion fails, tonifying the Spleen is appropriate. After Shanghan, if stomach fluids have been depleted for a long time and new fluids have not yet generated, tonifying the Stomach is appropriate. These two differ vastly.

Clearing heat also has two methods: Heat present at the onset of illness is Excess Heat, suitable for clearing with Bitter-Cold herbs. Heat remaining after a severe illness is Deficiency Heat, suitable for clearing with Sweet-Cold herbs. These two also differ vastly.

The innate Qi of the human body resides entirely in the Stomach Qi (appetite/digestive function). Insufficient body fluids constitute deficiency; generating body fluids constitutes tonifying deficiency. Therefore, using fluid-generating herbs combined with Sweet-Cold heat-clearing herbs to treat post-infection deficiency heat is correct. Examples include Sheng Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Tuber), Gu Pi (Cortex Lycii), Ren Shen (Ginseng), Li Zhi (Pear Juice), and Zhu Li (Bamboo Sap). Zhang Zhongjing often used Tian Shui San (Heavenly Water Powder, i.e., Liu Yi San) to clear deficiency heat, precisely utilizing Hua Shi (Talcum) and Gan Cao (Licorice Root)—one sweet and one cold—to form a Sweet-Cold formula. If one mistakenly uses Ren Shen, Fu Ling (Poria), and Bai Zhu as tonics for the Spleen, would one not be tonifying the evil heat along with it?

Regarding dietary tonification, one should seek their Qi (energetic quality) rather than their Flavor (taste/substance). Nourish with the Qi of the five grains, fill with the Qi of the five vegetables. During each meal, one will feel a gentle sweat permeating the skin, gradually transporting accumulated evil heat out through the pores. How refreshing! People do not understand this principle; they urgently use rich, sweet, and fatty foods to tonify. While this may temporarily boost vitality and spirit, greasy foods obstruct the meridians, preventing evil heat from exiting. Over time, this accumulates firmly within the body, leaving no way out. Forefathers, aware of this, preferred light diets and vegetables, accepting temporary bodily weakness to facilitate the expulsion of pathogens, which is truly valuable.

In the previous prescription, edema was attributed to the Spleen, treated with Fu Ling and Bai Zhu; insomnia was attributed to the Heart, treated with Fu Shen (Poria with Hostwood) and Suan Zao Ren (Ziziphus Seed). This was done because the principles of tonifying deficiency and clearing heat were not clearly understood, hence this detailed explanation.