Once, I treated a person suffering from cold-damage disease with heat entering the yangming fu-organ. The pulse manifestation was strong and hard, and the patient occasionally spoke deliriously. According to the principles, such a pulse condition should be treated with White Tiger Decoction Plus Ginseng. However, being young at the time and not yet deeply versed in medical knowledge, I prescribed a large dose of White Tiger Decoction, to be taken warm in several doses. The next day, upon examination, the fever had subsided, but the pulse had become rapid, and the delirious speech had worsened. Realizing my mistake, I promptly switched to White Tiger Decoction Plus Ginseng. A large dose was decocted and taken warm in three gradual doses, and the patient recovered completely after finishing the decoction. The pulse in White Tiger Decoction syndrome should appear slippery; a hard pulse is not slippery, indicating a yin deficiency. Therefore, it should be treated with White Tiger Decoction Plus Ginseng, not just White Tiger Decoction alone. After curing this case, whenever I encountered patients with a rapid or wiry and hard pulse, or those over fifty years old, or those who had been overworking mentally or physically, or those with a generally weak constitution, even if they had not undergone sweating, vomiting, or purging, and were thirsty and irritable, I always added Ginseng when using White Tiger Decoction. This approach ensures a solid foundation and guarantees success in treatment.
In my practice, I have used White Tiger Decoction Plus Ginseng more often than White Tiger Decoction alone for treating cold and warm excess heat, always adapting the prescription according to the symptoms, with only minor modifications to the original formula.