(chapter59)Hyperactive Deficiency Fire Unresponsive to Heat-Clearing Purgation

Unusual diseases can defy conventional understanding. When relying solely on standard treatments, results may fail. Here is a documented case:

In mid-spring, the mother of Wang Danwen (a member of my clan) suddenly developed severe symptoms: extreme thirst, mental confusion, sudden dizziness, profuse sweating, a body burning “like fire,” and near-delirium.

First Treatment Attempt:

• ​Diagnosis by the patient’s brother (a scholar-physician): “Yangming Fever Syndrome” (a heat-related condition in Traditional Chinese Medicine).
• ​Prescription: Baihu Decoction ( “White Tiger Decoction”) with Shigao (gypsum, 37g by ancient measurement).
• ​Result: Fever persisted.

Second Treatment Attempt:

• ​Neighbor Li (another scholar-physician) prescribed Chengqi Decoction (“Qi-Regulating Decoction,” a purgative formula).
• ​Effect: Slight improvement in bowel movements, but fever remained.

  

Third Evaluation:

• Wang Danwen requested my assessment.
• ​Pulse diagnosis: Deep and rapid pulse (Chen-Shu pulse), indicating Yin deficiency with excessive fire (internal heat due to bodily fluid depletion) and severe intestinal dryness.
• ​Conclusion: “No physical blockage exists—this is virtual fire disturbing the mind. Purgatives are ineffective; cooling methods are required.”
• ​Prescription: Dihuang Decoction (“Rehmannia Decoction”) combined with Shanzhi ( gardenia fruit) and Sanhuang ( Huangqin /baical skullcap, Huanglian /coptis root, Huangbai /cork tree bark).
• ​Result: Mental clarity improved slightly, but fever persisted.

Turning Point:

• A heavy snow fell overnight.
• At dawn, the patient demanded to eat snow. Her family initially refused, fearing harm to her elderly body.
• While her son was away, she crawled outside and consumed approximately three bowls of unheated snow.
• ​Immediate effect: “My mind cleared instantly.” She ate more snow, returned to bed, and by evening, her fever broke. She rose the next day and fully recovered within three days.

Physician’s Reflection:

• Medications failed, yet natural snow cured the condition.
• ​Explanation: Snow’s innate Yin-cold properties (unprocessed by fire) provided cooling power surpassing medicinal formulas by “ten thousandfold.”
• ​Note: This method appears in no medical text, and physicians would never dare prescribe it.

Key Terms Clarification:

• Baihu Decoction/Chengqi Decoction/Dihuang Decoction: Classic formulas from Shanghan Lun (Treatise on Cold Damage Disorders, a foundational TCM text).
• Sanhuang (“Three Yellows”): A combination of three bitter herbs used to clear heat.
• Scholar-physicians: Educated individuals (often trained in classical texts) who practiced medicine in historical China.

This case illustrates how nature occasionally offers solutions beyond medical orthodoxy—but such miracles depend on rare circumstances.