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One person suffered from Yin deficiency with internal heat. Zhongchun said: "Gan-han (sweet and cold) herbs should be used, not Ku-han (bitter and cold) herbs. It will not take effect without more than a hundred doses." Tian Dong (Asparagi Radix) and Mai Dong (Ophiopogonis Radix) were used to nourish Yin and clear Lung heat...

A woman suffered from insomnia all night long, had no food or drink for two months, and her body wasted away daily. Everyone believed she was incurable. I invited a doctor to treat her, promising that she could be saved. Since this syndrome belongs to deficiency... naturally, Water will ascend and Fire will descend, leading to recovery. Shengmai San (Generate the Pulse Powder) was used, added with Fu Ling (Poria), Zao Ren (Ziziphus Seed), Yuan Zhi (Polygalae Radix), Dang Gui (Angelicae Sinensis Radix), and Di Huang (Rehmanniae Radix), administered in large doses. Because the deficiency was severe and Qi was timid, Hu Po (Amber), Chen Sha (Cinnabar), and silver/gold vessels were added as auxiliaries. After approximately a hundred doses, she recovered.

One person suffered from eye pain as if the eyeballs would fall out, chest, hypochondrium, and back feeling as if beaten to pieces, coughing day and night, with sleep and diet abandoned. He judged himself unable to survive. Zhongchun ordered him to consume Tong Bian (Child's Urine) and Pi Pa Ye (Loquat Leaf) daily, along with Bei Mu (Fritillariae Bulbus) and Zhu Li (Bamboo Sap) to descend Phlegm-Qi, Qing Hao (Artemisiae Annuae Herba), Bai Shao (Paeoniae Radix Alba), and Bie Jia (Testudinis Carapax et Plastrum) to treat Liver Fire. After a long time, there was no cure. The family suspected deficiency and urged the use of Ren Shen (Ginseng Radix)... Zhongchun refused. The patient secretly added Huang Bo (Phellodendri Cortex, 2 qian) to the medicine and tried it. The result was whole-night stifling heat and inability to close eyes. Only then did he firmly adhere to the original prescription, taking Qinhua Wan (Swallow-and-Melt Pill) concurrently. Without stopping for over a month, the condition stabilized. This disease originated from excessive grief over a relative's death, compounded by anger, causing intense Heat in the Lung Meridian and upward rushing of Liver Blood. Therefore, Ren Shen... was unsuitable!

A fifteen-year-old boy suffered from alternating chills and fever with cough, red face, nasal congestion, worsening at night. His family thought it was Wind-Cold invasion. Zhongchun diagnosed it as Yin deficiency. Because [Wind-Cold presents differently], it is due to his Yin deficiency. Bie Jia (Testudinis Carapax et Plastrum) was given to remove chills and fever, Sheng Di Huang (Rehmanniae Radix Preparata) to tonify Kidney Yin, Mai Dong (Ophiopogonis Radix), Sang Bai Pi (Mori Cortex), Bei Mu (Fritillariae Bulbus), Sha Shen (Glehniae Radix), and Bai Bu (Stemonae Radix) to clear Lung heat and descend fire, Wu Wei Zi (Schisandrae Fructus) to astringe Lung fire. Within four doses, he was calm.

One person suffered from asthma, spontaneous sweating, insomnia, and anorexia day and night. Doctors treated it as an External Contraction, making it worse. Zhongchun said: "This is Kidney deficiency with Qi failing to return to its source, causing Fire to float upward..." [Missing text regarding symptoms/mechanism], Fu Ling (Poria), Bai Shao (Paeoniae Radix Alba), and Zao Ren (Ziziphus Seed) were used to tonify Spleen and astringe Lung. In a few doses, he recovered.

A man indulged in brothels while staying at an inn and experienced many frustrations. By the end of winter, he had fever and cough. Doctors used releasing-surface and harmonizing methods, treating it as an External Contraction. [Missing description of spirit/color], there was internal Blood stasis, hence the pulse occasionally knotted. Lung and Liver lobes were damaged, so he could not lie flat. The syndrome was incurable. Moreover, mistaking it for an External Contraction and taking many dispersing herbs violated the prohibition against weakening the deficient. He died within a few days.

One person was physically frail, with depleted Spirit and Qi, and had a history of alcohol and sexual indulgence, often suffering from gingival bleeding. In spring, he suddenly had abnormal pain in the right breast area, shoulder, and back... [Missing text]. I was invited to consult. The six pulses were deficient and rapid, especially in the Liver and Kidney. I diagnosed it as Yin deficiency with Fire hyperactivity. Treatment should nourish Yin and tonify Blood, support the Spleen and Stomach, allowing Yin-Blood to gradually generate and Deficient Fire to descend. Then the pain would stop without needing specific pain relief. If one urgently tries to harmonize injury to relieve pain, it merely damages Stomach Qi and depletes True Yuan, which is inappropriate. I prescribed a formula using Di Huang (Rehmanniae Radix), Bai Shao (Paeoniae Radix Alba), Gou Qi Zi (Lycii Fructus), Niu Xi (Achyranthis Bidentatae Radix), and Mai Dong (Ophiopogonis Radix) to nourish Yin and Blood; Shi Hu (Dendrobii Caulis) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to support Spleen and Stomach; Sang Bai Pi (Mori Cortex), Xu Duan (Dipsaci Radix), and Dan Pi (Moutan Cortex) to harmonize blood vessels. I instructed that effects would appear after ten doses, as Yin cannot be replenished abruptly. After eight doses, the pulse became harmonious, and spirit improved. He could walk out to the central hall, though pain remained, but vitality was evident. Regrettably, he was too impatient, misled by petty people, discarded my prescription, and took previous medicines indiscriminately. After a month, Stomach Qi failed, vomiting occurred, Yin-Blood was further depleted, tidal fever appeared, Spleen Qi was exhausted, abdominal distension developed, and he died half a month later.

One person suffered from spermatorrhea, ejaculating upon hearing a woman's voice, becoming emaciated to the point of death. Doctors felt their techniques were exhausted. A disciple of Zhongchun used Yuan Zhi (Polygalae Radix) as the sovereign herb, Lian Xu (Nelumbinis Stamen), and Shi Lian Zi (Nelumbinis Semen) [missing text], completing the course cured him.

One person suffered from nocturnal emission due to excessive mental labor from studies for three or four years. It occurred every few days. After each episode, Deficient Fire flared up, causing hot flashes on the head and face... [Missing text], Gou Qi Zi (Lycii Fructus), Yu Rou (Corni Fructus), and Tian Dong (Asparagi Radix) tonified the Kidney; Mai Dong (Ophiopogonis Radix) cleared the Heart; Lian Xu (Nelumbinis Stamen) and Wu Wei Zi (Schisandrae Fructus) astringed Essence; Biao Jiao (Colla Corii Asini) filled Essence; Che Qian Zi (Plantaginis Semen) drained damp-heat water, calming Ministerial Fire. Cured in less than one dose. Initially, the patient feared Huang Bo (Phellodendri Cortex) was too cold and refused it. I said: "The reason your illness persisted is precisely because you did not use this herb!" The Classic says: "The Kidney desires firmness; hasten to eat bitter to firm it." Huang Bo is such an herb. When the Kidney is firm, even if there is Fire in the Heart Meridian, Essence remains secure. Why would nocturnal emission occur? Previously, only tonifying and astringing herbs were used, missing this key aspect, hence little effect.

One person suffered from hemoptysis/hematemesis, occurring two or three times a year. Later, bleeding increased, accompanied by cough, fever, reduced appetite, and emaciation. He visited Pingkang [hospital/clinic] repeatedly without concern. In summer and autumn... [Missing text], Zhu [Cang Zhu/Bai Zhu]... caused chest and diaphragm stuffiness and hoarseness. He took Fu Ling (Poria) and Shan Yao (Dioscoreae Rhizoma), and previously collected Hong Qian Mo (Red Lead Powder). He passed several sheng of black blood, and his chest and throat instantly relieved, complexion improved. He thought he had found the method of "bamboo broken, bamboo patched" (treating damage with similar nature). Adding Gui Zhi (Cinnamomi Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) for two doses led to diarrhea, ten-plus times day and night, difficulty eating, unclear consciousness, and worsening condition. Jiayan diagnosed: Spleen pulse large and empty, Kidney pulse small and chaotic, Lung pulse deep and hidden. The patient asked what syndrome this was. Jiayan said: "This syndrome involves loss of Yin. Moreover, the harsh hot medicines used are like powerful ministers and fierce generals; they will not attack upwards until they have destroyed everything." The predicted date of death was three days after Start of Winter. Calculated from today, it would be no more than two nights. No prescription can help. Why? The Classic says: "Sudden illness is not purely Yang; chronic illness is not purely Yin." Years of blood loss undoubtedly indicate Excess Yang and Deficient Yin. Reduced intake leads to no blood generation, gradual emaciation, and daily drying of blood. The deficient becomes more deficient, the excess becomes more excessive. Yin Fire will blaze upward, damaging Lung Metal, causing cough and phlegm. The descending and clearing function is blocked. Consequently, Kidney Water lacks Mother Qi to generate it and cannot nourish the bones. Extremely emaciated, he felt chilly aversion to wind during Shen and You hours (3-7 PM), turning into fever, with slight sweat subsiding at dawn. Like summer heat requiring rain to resolve. His internal state clearly had Spring/Summer but no Autumn/Winter. Medication must urgently cool Metal and Water to suppress the momentum, otherwise it will go unrestrained. Mistakenly using Ren Shen (Ginseng Radix) and Zhu (Atractylodes Rhizoma) tonics for diarrhea ignored the long-standing Lung Heat. There was only one path for release: through the skin/hair. Now, tonifying without venting forces Heat into the Large Intestine, known as "Lung Heat internally transmitting to the Intestines." Using Hong Qian Mo (Red Lead Powder) to pass black blood worked because Yangming Blood following Clear Qi had been vomited out. Yin Branch Blood following Turbid Qi reached the chest, closed by Mouyuan (Diaphragmatic Origin), stagnating in the膈 (diaphragm) for a long time. Getting blood from menstruation (Yin branch flowing downward) guided it to exit via lower orifices, a miracle of resonance between sound and Qi. Long accumulation suddenly relieved, color slightly turned, speech and laughter slightly comfortable—this was due to attacking power, not tonifying power. However, pre-stocked medicines were likely confused by alchemists. Seeing apparent severe Yang deficiency, they boldly added Gui Zhi (Cinnamoni Ramulus) and Fu Zi (Aconiti Lateralis Radix Preparata) dry-heat herbs to exhaust Yin. Pity that it wasn't stopped then. Now, both Chi (Cun-Chi) pulses are chaotic, Fire blazing and springs dried. Spleen/Stomach pulses floating, excessive diarrhea causing Yin loss, Yang has no attachment. Lung branch deep and hidden, Metal Qi contracting and not moving. Consciousness unclear, Soul already lost. Ancient doctors said: "In chaotic times, turbidity is like fire transformation." Using fire to aid fire... [Historical analogy regarding Han Dynasty].

One person suffered excessive mental labor, then vomited blood with phlegm after eating seafood, felt a lump in the throat, afternoon irritability and heat. Shicai diagnosed: Six pulses not rapid, only Left Cun [missing text]... dose, symptoms reduced by 60-70%. Taking Liuwei Wan (Six-Ingredient Pill with Rehmannia) for three months, it did not recur.

One person had fever, cough, breathing急促 (rapid), and wheezing. Suzi Jiangqi Tang (Perilla Fruit Decoction to Descend Qi) was ineffective. Then Ba Wei Wan (Eight-Ingredient Pill) was taken, and wheezing worsened. Shicai said: Both cheeks were red [missing text], wheezing stopped instantly. Then Dihuang Wan material was used, with Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Fructus) decocted into paste, and Gui Jiao (Colla Cornu Cervi) made into pills. Taking ten jin (5kg) brought peace.

A seventeen-year-old maiden suffered from scrofula (Luoli) for a long time without healing. Tian Gui (Menstruation) had not started. She had fever, cough, and poor appetite. Doctors wanted to use Ba Dou (Crotonis Fructus) and Rou Gui (Cinnamomi Cortex). [Missing text], stating that Qi禀 (constitution) is insufficient, Yin-Blood not filled. Must nourish Qi and Blood, benefit Jin-Ye (Body Fluids), and menstruation will come naturally. Misled by quick results, she still took previous medicines. Lizhai said: "This is not the correct treatment." Such fierce agents greatly assist Yang Fire. Yin-Blood will flow recklessly when exposed to them; Spleen/Stomach will become more deficient. The Classic says: "Girls reach Tian Gui at age fourteen." If overdue, it is abnormal and must have a cause. Kou Zongshi said: "Human life is based on Qi and Blood. Illness always injures Qi and Blood." Chaste men and women, harboring thoughts in heart, overthinking, often lead to consumptive damage. In men, Spirit and Color fail first; in women, menstruation closes first. Why? Worry and thought injure the Heart. Heart injury leads to reversal and exhaustion, so Spirit/Color fails and menstruation stops. Fire being diseased cannot nourish its child (Earth/Spleen), hence poor appetite. Spleen deficiency leads to Metal Qi deficit, causing cough. Once cough starts, Water Qi cuts off, limbs dry, Wood Qi insufficient, leading to anger, scorched hair/nails, and weak sinews/bones. Waiting for transmission among five Zang organs, although sudden death may not occur, death is inevitable. This type of Xu Lao (Consumptive Disease) is hardest to treat. If mindset changes and medicine supports, one chance in nine may exist. Zhang's clan said: For maidens with prolonged amenorrhea, never use Ku-Han (Bitter-Cold) herbs, as Blood congeals when cold. If menstruation is scant and gradually stops, with internal bone pain, wasting, tidal fever, and fine-rapid pulse, this is Yin deficiency, Blood weakness, Fire excess, Water deficit. Do not use toxic herbs to induce menstruation. Regularly take Baizi Ren Wan (Biota Seed Pill) and Zelan Tang (Eclipta Decoction).

A released palace maid, aged thirty, had pain in both hips, unchanged skin color, pain in urination/defecation resembling strangury, worse on toilet. Lizhai said: This is [Blood Stasis/Dampness]... Visible that long depression in the palace, followed by unsuccessful marriage, caused this syndrome. Further seeing Liu Zhu (Contagious Disease) and Luoli (Scrofula), Seven Emotions and Qi/Blood were injured. Attack is contraindicated. Note: Jingxue Pian says: "If sex occurs before Jing (essence) is connected, forcing ejaculation, the Five Zang have unmet needs, leading to difficult diseases later. If Yin is impotent but desiring color to release essence, essence does not exit but rots internally, causing urethral obstruction and strangury. If essence is consumed and exhausted again, urination/defecation pull and hurt. More pain leads to desire to defecate/urinate, more defecation/urination leads to more pain. Women, once Tian Gui arrives, if no intercourse for over ten years, menstruation becomes irregular. Irregular means old blood stays, new blood flows wrongly, soaking into bones or swelling. Even with intercourse, conception is difficult. Many partners lead to essence depletion and weakness; many births lead to blood depletion and death. Observing Jing and Blood, one understands half the truth."

A widow, aged thirty-seven, suffered from leg bone pain, evening fatigue, irregular menstruation, alternating chills and fever for years. [Missing doctor/method]... medicines, over thirty doses, symptoms gradually eased. Using Jiawei Guipi Tang (Modified Return the Spleen Decoction) for over a year, she recovered.

A released palace maid, aged forty+, had pain in buttocks/thighs, evening fever, dry mouth, irregular menstruation. Lizhai said: This is Liver Meridian Blood deficiency... [missing text] doses, she recovered.

A released palace maid, had buttock/thigh swelling/pain, internal heat, evening fever, aversion to cold, fatigue, cough, chest fullness, delayed and scant menstruation. She thought it was Qi toxicity and Liu Zhu (Contagious Disease). [Missing text]. Spleen should be tonified, Liver restrained. She didn't believe it, took previous medicines, and died.

A widow had internal/evening fever, abdominal distension, hypochondriac pain, limb soreness/numbness, occasional phlegm expectoration, irregular menstruation, green/yellow leukorrhea. Lizhai said: This is [Liver Depression/Fire]... [missing text] doses, she recovered.

A woman, husband away trading, had alternating chills/fever, menstruation lasting ten days. Took cooling/fire-descending herbs, internal heat worsened, spontaneous/diaphoresis, menstruation [missing text].

A woman had fever, dry mouth, limb fatigue, leg pain/knee swelling, irregular menstruation. Lizhai said: This is Foot Three Yin Blood deficiency. Used Liuwei Wan (Six-Ingredient Pill) and Xiaoyao San (Free and Easy Wanderer Powder) concurrently for two months. Diet gradually improved, physique strengthened, knee swelling subsided, and she recovered.

One person had Yin deficiency with internal heat and cough with phlegm. I used Huisheng Wan (Return Life Pill) in the morning to tonify Kidney and root the foundation; at noon/bedtime, used Jiawei Qingfei [Tang] (Modified Clear Lung Decoction) to clear Lung and manage phlegm/cough. Sometimes Spleen Qi was poor, taking Zisheng Wan intermittently; sometimes internal heat was severe, taking Baoyin Jian (Preserve Yin Decoction) modified. Glad that he observed dietary taboos and health preservation methods, after over a year, deficiency receded and heat removed. For three years, pastes, pills, and liquids were taken daily without interruption, achieving full recovery. Others with previous symptoms treated with these methods also recovered fully. Many who lingered for years without dying also benefited. For hemoptysis, Zhongchun's formulas were used; for chills/fever like malaria, Xiaoyao San was used.

Generally, for this syndrome, if damage is not severe and internal heat not intense, initial caution, consistent treatment, avoiding gaps, and avoiding impatience for quick results will naturally lead to long-term benefit... [missing text] benefiting Qi. I believe Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) are indeed correct Qi-tonifying herbs. However, if Lung Fire is blazing for a long time, Lung Qi will become exhausted. One must then use moistening-drying and clearing-Metal herbs. Clearing Lung Heat saves Lung Qi and is the root of benefiting Qi. Medication must be flexible like pearls rolling on a plate. Yue Ren's reason for not prescribing fixed formulas lies here. Damaging the Heart requires regulating Ying and Wei. Heart is the origin of Blood, the start of Ying/Wei movement. Ancient formula Guipi Tang is a method to regulate Ying/Wei. Damaging the Spleen requires adjusting diet and adapting to cold/warmth. Eating cool/cold in Spring/Summer, warm/hot in Autumn/Winter, and clothing/living according to seasons, but do not be rigid. Damaging the Liver requires soothing its center. The Classic says: "Liver suffers from urgency; hasten to eat sweet to soothe it." Using Gan Cao (Licorice Root) in Xiaoyao San refers to soothing the center. Damaging the Kidney requires benefiting Essence. Any sticky/moist substances are Essence-benefiting. The Classic says: "For Essence insufficiency, supplement with flavor." This is the wonderful method for treating Sun (Damage), nothing surpasses it.