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A woman, aged 52, first diagnosed in the autumn of 1965. She suffered from severe myasthenia gravis and was hospitalized for half a year. She was treated with warming and tonifying nourishing medicines such as Bazhen, Shiquan Dabu, Guipi, Zuogui, and Yougui, but the effects were not significant. Four days ago, due to a sudden fever (38.5°C), her condition worsened sharply. Without an injection of neostigmine before meals, she had no strength to eat, and her body temperature gradually increased, so I was invited for a consultation. The patient had a shallow yellow complexion, was thin and emaciated, with a listless spirit, difficulty opening her eyes, a swollen tongue with white, rough, and dry coating, and a weak, slippery pulse that was slightly wiry and rapid upon deep palpation. She exhibited signs of extreme weakness, but was also troubled by irritability, excessive dreams, yellow urine, and bowel movements every two days, with a high fever (39.4°C).
All the doctors believed that her long-standing deficiency of qi and blood required relieving fever with sweet and warm methods, and there was no other good remedy. After much thought, I said, "Yang deficiency and weak qi should be treated with sweet and warm methods. Although the dosage of medicine is small, the tendency of the disease should slightly improve. How could the fever increase after the treatment? New illnesses are often excess syndromes but can also be deficient, and chronic illnesses are often deficient but can also be excess syndromes. Moreover, deficiency syndromes may be accompanied by excess pathogens, and excess syndromes may also have underlying deficiencies. The true and false deficiencies and excesses are complex and unpredictable, with no fixed pattern of illness, but there are fixed principles of treatment. This patient's high fever, which increased after taking sweet and warm medicines, and the pulse manifestation that is weak and slippery with a slightly wiry and rapid deep palpation, indicate a root deficiency with a superficial excess, a true deficiency with a new contraction of excess pathogens, resembling the White Tiger syndrome. It might be appropriate to try the White Tiger method to observe the response."

I asked the attending doctor to give the patient 200ml of boiled water little by little. After drinking it, the patient still asked for cold water, indicating a desire for cold drinks. Another 200ml was given, and after drinking it, she fell asleep peacefully, with a slight sweat on her forehead. Considering her pulse, tongue color, and symptoms, it was not primarily a root deficiency but a sign of superficial heat. If it were a deficiency heat, how could she crave cold drinks and fall asleep after drinking with a slight sweat? Moreover, her tongue was white, rough, and dry, with a pulse manifestation of thin, wiry, and rapid, along with irritability, excessive dreams, yellow urine, and dry stools, it was diagnosed as Yangming qi aspect heat. Although the patient's constitution was deficient in qi and blood, the current condition was an excess syndrome of superficial heat due to the pathogen transforming into heat. Therefore, the treatment was changed to the White Tiger method's pungent and cool nature, aiming for the effect of the tiger's roar bringing wind and the golden breeze dispelling heat. The prescription was:
Raw Gypsum 25g, Raw Liquorice Root 10g, Anemarrhena 10g, Rice 60g
One dose, decocted to 100ml, taken in two doses. After taking the medicine, she sweated at night, and the fever subsided, with her body temperature returning to normal. Her pulse was weak and soft but slippery, with a thin and weak quality upon palpation, and no longer wiry and rapid. The patient's spirit returned to normal, and her appetite improved. The treatment was then changed to engendering liquid with sweet-cold tonifying qi method to consolidate the recovery.