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If essence is discharged before it is fully accumulated, there will inevitably be difficult-to-describe illnesses in the future; this was stated by Minister Chu of Southern Qi. Essence and Qi protect the Shen (Spirit). Once damaged, both the Spirit and the physical form become weak and timid, failing to regain fullness and vigor for several years. It is proposed to tonify both the Spleen and Kidney simultaneously, with a slight addition of herbs to unblock collaterals; apart from this method, there is no other alternative.

Hei Di Huang Wan (Black Earth Pill). When pain occurs, use A Wei Wan (Asafoetida Pill).

Chronic pathogenic factors cause distension in the epigastrium, which appears to be Qi stagnation, but actually stems from improper regulation after a miscarriage, with the illness persisting for three years without resolution. The condition worsens day by day into deficiency; there is no desire to eat, and menstruation was previously regular. However, during Lixia (Start of Summer) and Xiaoman (Grain Buds), menstruation ceases. Food is vomited immediately after ingestion; after swallowing liquids, the epigastrium becomes distended and bi-obstructed, the abdomen is full with protrusion of the umbilicus, and bowel movements occur only once every ten-plus days. Initially, there was aversion to cold, but now there is gradually increasing aversion to heat, accompanied by vomiting. First, solid matter is expelled, followed by phlegm-saliva and white foam, which must taste sour and turbid. Consulting various classic texts, this is entirely a disease of the Foot Jueyin Liver Meridian. Yang transforms into internal Wind, which attacks the Yangming Stomach Earth. The Stomach fails to govern smooth descent and transmission to the intestines, resulting in regurgitation (Fan Wei). Treatment should regulate Liver Wood to pacify Earth. However, since Qi rebellion is boiling upward, Yang-tonifying medicines cannot pass through the diaphragm and will inevitably surge out with vomiting. It is proposed to adopt separate treatment methods as follows:

Zuo Jin Wan (Left Metal Pill) is boiled in salt water and formed into pills with steamed wheat cake.

Zuo Jin Wan pacifies the Liver. Its bitter and pungent aroma may worry that its downward action is not fast enough; adding salt flavor accelerates its descent, following the *Neijing* principle that salty and bitter flavors enter Yin meridians. This causes Yang turbidity to retreat. Because the Stomach lacks a central pillar (support), heat and Wind-Yang rebel again. It is proposed to stabilize the Central Palace (Spleen/Stomach) to control Wood and Fire, so they do not attack Earth. After taking Zuo Jin Wan for two shichen (4 hours), follow up with Zhen Tou (Needle Head - likely a specific preparation or typo for another herb, kept as per text), Dai Zhe Shi (Hematite), and Hua Zhou Ju Hong (Exocarpium Citri Reticulatae from Huazhou), formed into pills with rice. Decoct Da Ban Xia Tang (Large Pinellia Decoction) and administer with Ginger Juice.

Second consultation: Ancients said, "In vomiting, there is dispersion," meaning frequent vomiting causes all Qi to ascend and scatter. The *Neijing* states that the Yangming Meridian binds sinews and bones to facilitate joint movement. Now, long-term invasion by Jueyin Wind-Wood has caused middle-jiao deficiency and exhaustion, leading to the collapse of clear Qi and accumulation of turbid pathogens. This results not only in chest and abdominal distension but also lumbar bi-pain and edema of muscles and fascia. Zuo Jin Wan purges the Liver to stop vomiting, addressing the Liver's郁 (depression) and surging Qi. Greatly bitter-cold herbs descend the rebellious Qi, while greatly bitter-hot herbs vent the Qi. Danxi's prescription logic posits that Ministerial Fire resides internally in the Liver and Gallbladder, and ascending Qi all originates from the Liver. Excess Qi becomes Fire. Here, it is not excess, but rather due to days of fasting, the Yangming Stomach Earth is extremely injured and fatigued, lacking a central pillar, allowing Liver Wood to transverse and turbid pathogens to attack. Reviewing sages who treated distension, Hejian separated and eliminated the Sanjiao, and Dairen attacked the Six Fu organs; these are methods for excess conditions. Now it is a deficiency syndrome. If one rigidly tonifies Yang, it will only aid distension. It is proposed to use a method of unblocking and tonifying Yangming while draining Jueyin.

Ren Shen (Ginseng Radix), Chuan Lian Zi (Toosendan Fruit), Yan Hu Suo (Corydalis Rhizome), Ma Ren (Semen Cannabis), Fu Ling (Poria), Chong Wei Zi (Seed of Leonurus japonicus).

Constant seminal emission and lower abdominal distension indicate the Kidney's failure to receive and store. Slight dryness in the throat and rising fire to the face result from Yin failing to ascend and floating Deficient Yang. Last year, pure Yin quieting herbs caused diarrhea; lower damage affected the middle. Now, securing the lower jiao is required.

Shu Di Huang (Prepared Rehmannia Root), Shan Yao (Dioscorea Rhizome), Fu Ling (Poria), Bei Wu Wei Zi (Schisandra Berry), Ren Shen (Ginseng Radix), Qian Shi (Euryale Seed), Xiang Lian (Nelumbo Nucifera Seed).

Form pills using Ren Ru Fen (Human Milk Powder) mixed with He Che (Placenta Hominis) and Jin Ying Zi (Rosa Laevigata Fruit) pastes.

The eyelids are where the Spleen and Kidney meridians circulate. The Taiyin Spleen Meridian runs sluggishly and is dull; sweet and tonifying herbs should be used predominantly.

Zheng Bai Zhu (Steamed Atractylodes Macrocephala Rhizome), Gou Qi Zi (Lycium Fruit), Gui Yuan Rou (Longan Aril), Gui Shen (Angelica Sinensis Root Body), Huang Qi (Astragalus Root), Zhi Cao Cao (Honey-fried Licorice Root).

The pulse is wiry and large on the right. Wiry indicates fluid retention; large indicates Deficient Stomach Yang. Due to overwork and excessive thinking, accumulated labor injured Yang, causing lack of hunger and anorexia. Reluctantly ingesting food leads to irritability. Night sleep is restless, with much waking and little sleeping. There is mental vagueness and inner vexation, sudden abdominal borborygmus and Qi vibration, and flaccid weakness in the limbs and joints. At onset, morning chills and spasms occurred, with slightly cold dorsum pedis. Analyzing these pulses and symptoms over years, Yang deficiency is the root, while Phlegm-Fluid and Qi rebellion accumulate due to deficiency. Deficiency generates Cold, Excess generates Heat. Restless sleep and eating for nearly half a year coincide with the Fourth Qi period (Late Summer damp-earth attacking Spleen/Stomach). Concern arises regarding muscle swelling and abdominal distension, affecting the body's binding of sinews and joint function; the Yangming Stomach Meridian is the site of accumulation. Previous medications confused Qi and Blood, mixing Cold and Heat, without regulating based on Yin-Yang bias, hence no response. It is proposed to primarily unblock and tonify Stomach Yang, with secondary liver-soothing. As Qi spreads and Yang revives, why worry about turbid Phlegm obscuring? Use the method of Fu Ling Yin (Poria Drink) reducing Bai Zhu, combined with Xue's Xing Fu Liu Jun Zi Tang (Star and Aconite Six Gentlemen Decoction).

Ren Shen (Ginseng Radix), Fu Ling (Poria), Xiang Fu (Cyperus Rhizome), Su Geng (Perilla Stem), Bai Fu Zi (Typhonii Rhizoma), Ban Xia (Pinellia Tuber), Jiang Zhi (Ginger Juice), Chen Pi (Citrus Reticulata Peel).

White tongue coating, not very thirsty, alternating chills and fever, restlessness and impending coma, worsening chest/epigastric fullness. Malaria is a guest pathogen, starting from the four extremities reaching the central palace. Cough with phlegm and vomiting/reversal indicate pathogens interfering with Lung and Stomach. Weak constitution allows pathogen aggregation, causing blockage. Thus, coma and vexation occur.郁蒸 (stagnant heat) sweating allows gradual relief, but Ying-Wei pathogens remain uncleared, with chills and fever spreading endlessly. Mild tonification may not hit the mark; treating according to the meridian is appropriate.

Bai Kou Ren (Amomi Fructus Rotundus), Huang Qin (Scutellaria Root), Ban Xia (Pinellia Tuber), Zhu Ye (Bambusa Leaf), Yi Yi Ren (Coix Seed), Jiang Zhi (Ginger Juice).

Treating eye diseases involves only acrid dispersing, cold, and bitter herbs, leading to seminal slip and cloudy urine. Yang deficiency generates external cold; Yin deficiency generates internal heat. Both Essence and Qi are depleted; Shen is isolated, dreams are chaotic, with fright and fear, lacking self-control. The method should secure the Kidney gate, nourish the Heart and calm the Shen, settle fright and treat deficiency. Gradually achieving "night vision and reverse hearing" (internal spiritual focus) with meticulous care is necessary before treatment can proceed.