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Warm-heat diseases refer to illnesses caused by pathogenic factors of spring warmth and summer heat, occurring mainly in the third, fourth, and fifth months (lunar calendar). The common people often mistakenly call them "Shanghan" (Cold Damage). According to Zhongchun:
Among various diseases such as Shanghan and epidemic febrile diseases, those presenting with Yangming syndrome are particularly numerous. Therefore, once tidal fever (fever that occurs at regular intervals), spontaneous sweating, preference for coolness and aversion to heat, irritability, desire to drink cold water, abnormal tongue coating, delirium, cold extremities, appearance of macules or mania, and a flooding pulse are observed, Baihu Tang (White Tiger Decoction) should be administered urgently, added with Zhu Ye (Bamboo Leaf) and Maidong (Ophiopogon Tuber), to clear heat, generate fluids, and relieve thirst. If the condition is severe, large doses can be administered continuously, and all symptoms will naturally subside. In cases of heatstroke during summer, characterized by sweating, aversion to cold, body heat, thirst, and a deficient pulse, treatment should consist solely of Baihu Tang added with Renshen (Ginseng). Materia Medica records that Shigao (Gypsum Fibrosum) has the power to revive the dying, functioning similarly to "Golden Liquid"; if the dosage is too low, it is difficult to achieve efficacy. Physicians of the world do not understand this, so I specifically point it out. Zhang Zhongjing, in his treatise on Shanghan, mentioned that after Shanghan, when patients present with emaciation, shortness of breath, and rebellious qi causing nausea, Shigao is still used because its sweet and cold nature differs from bitter-cold herbs that damage stomach qi. It is laughable that nowadays people do not fear the bitterness and cold of Huangqin (Scutellaria Root) and Lianzi (Lotus Seed) or Lianhua (Lotus Flower), but only fear Shigao. Does this align with the name "Baihu" (White Tiger)? Alas! How ignorant! Baihu represents the Metal Spirit of the West; when the command of Autumn Metal prevails, the inflammation of Summer Fire is extinguished. The formula is named "Baihu" to signify its function of executing a clearing and肃ifying (purifying/descending) command to remove heat, not implying that it is fierce like a tiger and harmful to humans. Consider the theories of Yu Jiayan and Li Zhongzi, who most valued warm-tonic therapies, and Zhongchun, who was extremely cautious in prescribing. For all the aforementioned conditions, they all used this formula. Because my late father died of a heat disease due to being prescribed Renshen and Fuzi (Aconite Root) by quacks, and influenced by the words of Wang Xuan'yan (Wang Shuhe), I have meticulously studied this field for thirty years. Later, while serving in a hospital, I saw that famous physicians using this formula often achieved results. I also treated many patients; for those suffering from Yangming syndrome, the efficacy of this prescription is too numerous to list. For example, Mr. Zanguan Wang contracted an epidemic disease and summoned me for diagnosis. Observing that he exhibited all signs of Yangming syndrome, I prescribed Baihu Tang, using three liang of Shigao per dose. After two doses, the heat symptoms decreased drastically. Famous hereditary physicians in our hometown were horrified, stating, "With cold sweat all over the body, cold limbs, and hiccups, only Renshen and Fuzi can restore yang." Many doctors concurred, arguing that administering Baihu Tang again would certainly lead to death. I cited Zhang Zhongjing's text "the deeper the heat, the deeper the cold extremities," Jiayan's statement that "yang syndromes suddenly transforming into yin cold extremities occur in one in ten thousand," and Wu Keyi's argument that "yin syndromes are rare diseases in the world." Hiccups are also caused by stomach heat. If one adheres to the name "cold hiccups" and administers hot-natured agents, the error is profound. I earnestly argued and strongly refuted their views, but they remained obstinate. When they finally administered agents containing Renshen and Fuzi to restore yang and stop sweating, the sweating increased, and the body became colder. They then blamed the harm of Baihu Tang. At this point, the faint yang qi was on the verge of collapse, and the situation was critical. The whole family was panicked and came to seek treatment again. I disregarded their objections entirely and continued to use Baihu Tang. I instructed their messenger to secretly administer three liang of Shigao, giving two large doses. The sweating stopped, and the body warmed up. Subsequently, I used the previous decoction with modifications. After several doses, he recovered. From this, it is evident that it was entirely due to Baihu Tang reviving him. Previously, Jiayan analyzed Shanghan in deficient individuals, stating that in sweating, purging, and harmonizing prescriptions, Renshen should not be used. He said those who err in this way deserve to plow hell upon death. I believe that henceforth, in warm-heat diseases, if patients present with thirst and a desire to drink cold water, anyone who claims Shigao should not be used deserves to plow hell. Jiayan stated that those who kill by using Renshen for Shanghan when inappropriate did so because they combined it with Cangzhu (Atractylodes Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Root), Ganjiang (Dried Ginger), Fuzi, and Guizhi (Cinnamon Twig) for warm-tonic purposes. I argue that those who kill by using Baihu Tang when inappropriate are dealing with conditions that merely resemble Baihu Tang patterns, which occur only in patients with blood loss. Hence, Li Dongyuan issued warnings. People fail to examine carefully, fear using Shigao, and claim they follow Li Dongyuan's "Kingly Way," stubbornly believing that nine out of ten patients are deficient. In clinical practice, they only employ warm-tonic methods, regardless of exterior or interior, excess or deficiency, cold or heat, indiscriminately administering Renshen, Cangzhu, Baizhu, Danggui, and Fuzi, even adding Ganjiang, Fuzi, and Guizhi. This causes mild conditions to become severe and severe ones to result in death. I frequently see patients taking hot medicines develop dry mouth and tongue, sore throat, toothache, restlessness, red eyes, ruddy complexion, stiff tongue, cracked lips, twitching tendons, moving muscles, and bleeding from orifices. Yet, they attribute this to floating deficient yang and increase the dosage, which is truly pitiable. Furthermore, there is a condition caused by sexual exhaustion. Jiayan noted that the world is often confused by the name "yin syndrome," often administering hot medicines that hasten sudden death, yet blaming it on "extreme yin being incurable," causing ghosts to wail at night without repentance, unaware of where the killing will end. Similarly, internal heat from deficiency labor, bone-steaming night sweats, coughing with phlegm, and blood loss are all caused by insufficiency of Kidney Water. Thus, Wang Jiezhai said: "Nine or ten out of ten illnesses are caused by water deficiency; one or two out of a hundred are caused by fire deficiency leading to consumption." Zhongchun believed that among modern patients, yin deficiency is very common, whereas true yang insufficiency accounts for only one or two in a thousand. However, blind physicians fail to observe and indiscriminately administer warm tonics, further assisting yang and robbing yin, leading to sore throat, rotting gums, hoarseness, and death. No wonder Jiayan sighed, "Nature creates quack doctors who slaughter door-to-door without wielding a knife." I witnessed this with heartbreak. In my old age, gaining some clarity, I compiled the *Yi Jing* (Mirror of Medicine) hoping to reverse the trend. Now, since many physicians reject Baihu Tang and revere Guizhi and Fuzi, I have no choice but to publish this first. I reflect that Sanwu is a hub of culture and literature; surely there are high sages there, making my additions unnecessary. For those with biased views, if they read this and pay attention, it may not fail to benefit the world. Someone asked, "Since you do not propagate your Dao and are not competing for fame or profit, why do you criticize others and praise yourself so deeply? Will you not anger the masses?" You imply that I prefer Baihu Tang and dislike Fuzi and Guizhi. Fuzi and Guizhi also have the power to revive the dying, and Baihu Tang is not necessarily a killing agent. Why do you criticize so severely? I replied, "Indeed. I once heard Zhang Jingyue say: 'I know only of Huangdi and Qibo, not of other masters; I know only of loving life, not of avoiding taboos.' This is why I made this distinction. Whether they understand or blame me, I do not care." To say that I like Baihu Tang and dislike Fuzi and Guizhi is incorrect. As the ancients said, "Medicines are not bound by formulas; use what is appropriate." Therefore, use medicine according to the disease. Diseases change in thousands of ways, and so do medicines. Could there be a deficiency-cold pattern where one abandons Fuzi and Guizhi to use Baihu Tang? Thus, Fuzi and Guizhi are originally not killing drugs; it depends on how they are used. Previously, my clan uncle Xiao Xie Gong's elderly aunt suffered from a surgical condition and consumed more than ten jin of Renshen in a hundred days. This would again be cited as proof that I favor Renshen. Alas! The difficulty of discussing medical principles is thus. Grand Historian Zhu Shenzhai said: "Possessing talent in classics and history, elucidating the learning of Qi and Huang, one ought to have unique insights and bring spring back under the hands [heal]. The Bian Que of the Central Plains is indeed worthy of gift." Grand Historian Feng Fangyin said: "Physicians should not stick to fixed formulas but must follow symptoms to save critical patients. Today's physicians do not distinguish yin and yang, excess and deficiency, cold and heat, acting arbitrarily, often using Renshen and Fuzi as vanguard, frequently endangering patients without remorse. Is this the intent of Lu and Bian? Song Yuan alone could refute public opinion, turn danger into safety, and directly expose the crimes of reckless use of Renshen and Fuzi. I also suffered from dysentery and nearly fell victim to such treatments, so I wrote this book to present to him." Vice Minister of Personnel Song Yiangong said: "When I was in the capital, I already heard of Brother Song's great reputation. Later, when my son-in-law Sun Si suffered from a weak condition, all physicians considered it a terminal, untreatable case, but Brother Song alone said it was a false image easy to treat. The following spring, my son-in-law Xun Zhao also suffered from this disease. All physicians believed yang deficiency could be cured, but Brother Song alone said true yin was exhausted and incurable. Both predictions proved correct. If differentiation of symptoms were not extremely clear, how could this be achieved? Every time I observe Brother Song treating diseases with medicine, it seems contrary to the symptoms but turns out to be appropriate. There are many such cases, hence his reputation is well-deserved." National Physician He Youlian said: "Physicians do not select fixed formulas; they use what is appropriate. I deeply hate vulgar quacks who stick to pungent-warm drastic tonics. When seeing cold-clearing medicines used, they add private criticisms, making patients afraid to use them, thus resorting to bland agents day after day until the patient is critical, beyond even the saving power of the wise. Such negligence kills five out of ten, yet they feel no shame or sorrow! Brother Song's scholarship is profound, and his insight surpasses others. This discussion is truly a pillar in midstream." Mingjing Hanlin Academician Wang Xuetao said: "In his youth, Song Weng gained fame in examinations as a student member. Later, serving as Ershou in the Imperial Hospital, he requested leave to write books. Relatives and friends sought his prescriptions knowing his miraculous skills, but many disagreed with him, slandered him when they didn't understand, yet his prescriptions were effective. There are many such cases. Reading this discussion on using Baihu Tang and warning against indiscriminate hot agents, the analysis is detailed and clear, awakening even the deaf and confused. It is truly a ferry crossing for saving the world." Xiaolian Son-in-law Cheng Yike said: "This work concerns life and death; it should be placed beside the bed to avoid toxic hands."