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Patient Gao, during the scorching summer, washed his entire body with cold water and rested under the shade of a tree for a long time, subsequently catching a common cold. In the evening, he took Fresh Ginger Rhizome soup without effect, and then consumed releasing exterior formulas such as Jing Fang and cultivated purple perilla leaf. Unexpectedly, his condition worsened after taking the medicine. He developed a fever with sweating, lay stiffly on his back, became delirious with incoherent speech, experienced enuresis unknowingly, and had difficulty speaking, only able to utter the word "de," repeating "de de de" incessantly day and night. Two experienced Chinese medicine practitioners were consulted, both treating it as phlegm Re Lun syndrome. They prescribed multiple doses of Er Chen Tang, Bamboo Juice, Inula Flower, red tangerine exocarp, Arisaema with Bile, Trichosanthis Fruit, Tabasheer, and other medicines, but the condition remained unchanged. A relative who knew me described the symptoms in detail, and I believed the condition closely matched the triple-yang combination of diseases, making it suitable for White Tiger Decoction. Indeed, his brother invited me for a consultation, and I felt confident in my diagnosis.

Upon examination, the tongue was without coating, and the pulse was rapid and agitated. Other symptoms were as previously described. Although the face was slightly moist, the body was without sweating, and the skin was not very hot to the touch, which was contrary to my earlier assumptions. It seemed the opportune moment had been missed, and the condition no longer matched the White Tiger Decoction syndrome of fever with sweating. However, the tongue was without coating, and the pulse was not deep or solid, indicating no internal dryness accumulation, making purgation inappropriate. The tongue was not crimson and dry, and the pulse was not weak and rapid, so clearing and nourishing methods were also unsuitable. Although the pulse was rapid and agitated, its rhythm was not disordered, suggesting that while pathogenic qi was strong, essential qi had not been depleted. Apart from continuing with White Tiger Decoction, there was no other suitable method. Thus, I prescribed six qian of Gypsum and three qian of Anemarrhena, with other medicines in proportion. After two doses without any changes, the pulse showed no signs of weakening, indicating the medicine's strength was insufficient. I then increased Gypsum to eight qian and Anemarrhena to four qian, and administered two more doses. The next day, the condition had significantly changed. The patient's cries were as intense as before. His relatives reported that after the third dose, he had one episode of loose stools, and after the fourth dose, he had three to four episodes. The pulse remained rapid and agitated but no longer strong and forceful. Noticing the patient holding his lower abdomen, I realized he had abdominal pain. At this point, I felt quite perplexed.

After much deliberation, I concluded that the multiple episodes of diarrhea had eliminated the heat in the lower body. However, due to the prolonged duration, the heat in the upper body had become deeply entrenched and could not descend. The only solution was to use warm medicines to guide the heat downward. Although the diarrhea had removed the heat from the lower body, the pathogenic heat remained in the upper body, stubbornly unmoving, which was unexpected. However, the diarrhea had cleared the lower body's heat, creating a local cold transformation, which provided an opportunity to use warm medicines and create conditions for guiding the heat downward. With this plan in mind, I wrote the prescription:
three fen of cooked Aconite Lateral Root, five fen of blast-fried ginger, and one qian of prepared liquorice root.
After boiling the medicine, the cup was placed in well water to cool it thoroughly, then an egg yolk was added, stirred, and consumed. The egg yolk was added for its lubricating properties, aiding the rapid descent of the guiding medicinal and its moistening effect to protect yin.

The next morning, during the follow-up consultation, the patient appeared calm and normal, even smiling at me. Upon examining his tongue, I noticed a thin, tender yellow coating, which surprised me. The amount of ginger and aconite used had shown such significant effect. The formation of a yellow coating overnight indicated how deeply the pathogenic heat had been entrenched. If the dosage of ginger and aconite had been slightly increased, it could have exacerbated the condition, highlighting the difficulty of medication use.

The pulse was now four beats per breath, very gentle, indicating the recovery of yin qi. However, the patient still could not speak. I prescribed mild yin-tonifying medicines such as Ophiopogon Tuber, raw Millet Sprout, and Polyghace Seche, instructing him to take several doses and then stop, with a recommendation for a light diet and rest. After more than ten days, the illness was completely cured.

Through this experience, I realized that the triple-yang combination of diseases is characterized by excess above and deficiency below, excess externally and deficiency internally, and yang exuberance with yin deficiency. Therefore, the "Cold Damage Disease Treatise" highlights two major cautions: first, "sweating leads to delirious speech," indicating intense internal heat with external fluid loss, warning against sweating before delirious speech to avoid mistaking it for external cold. Second, "purgation leads to sweating on the forehead and reversal cold of hands and feet," indicating yin deficiency below and yang collapse above, warning against purgation after delirious speech to avoid mistaking it for internal dryness. Only when the heat is at its peak, the exterior is open, and body fluids are not depleted is the right time to use White Tiger Decoction. Zhang Zhongjing established this formula as a standard. Although the condition may vary before and after, careful observation reveals a guiding principle, showing that studying Chinese medicine requires both "understanding pathology through the classics" and "grasping the meaning of the classics through clinical experience."