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Duxiao An was able to transcend worldly dust, possessing a generous sense of righteousness, appearing disdainful of medicine. However, when he encountered diagnostic errors or treatment mistakes, he would record them in detail for future reference. Thus, although he had not yet reached his prime, his therapeutic methods were largely commendable. Herein, I excerpt one or two points from his remaining writings.

In the initial stage of dysentery, heavy sweating should be particularly employed; once the pathogenic factor gathers in the Stomach, administering Da Cheng Qi Tang (Great Order the Yang Decoction) or Xiao Cheng Qi Tang (Minor Order the Yang Decoction) is appropriate. (Note: The timing of sweating and purging in epidemic dysentery is most critical. If sweating thoroughly penetrates at the onset, seven or eight out of ten cases can be cured. If the interior syndrome does not miss the opportunity for purging, various complications following dysentery will not arise; missing this opportunity often leads to collapse syndromes.)

In Shanghan (Cold Damage), on the second or third day, if the pulse is deep and rapid, the Xu Li point (located above the heart apex) beats violently like a galloping horse, or there is fullness and hardness below the heart, these conditions will later develop into major ailments.

For diseases with a slow progression, life and death are easy to determine, such as Lao Zhai (Consumption/Tuberculosis), Ge Ye (Regurgitation/Dysphagia), and Gu Zhang (Drum Distension/Ascites). For diseases with acute progression, life and death are difficult to predict in advance, such as Shanghan (Cold Damage), Ma Zhen (Chickenpox/Measles), and Dou Chuang (Smallpox). Physicians must study diligently and carefully, lest they miss this crucial opportunity.

Epilepsy is indeed a difficult condition to treat. However, for men whose essence has not yet been released, or women whose Tian Gui (Menstruation) has not yet arrived, if moxibustion and medication are properly applied, four or five out of ten cases can be cured. But if the condition is congenital due to prenatal endowment, it is determined to be incurable.

Domestic pig gallbladder can unblock stagnation and direct rebellious Qi downward; its efficacy is not inferior to that of bear gallbladder. Bear gallbladder is often counterfeit, and only those skilled in identification can distinguish it. (Zhuo Xuan said: According to records, the functions of various gallbladders are similar; ox gallbladder and ape gallbladder can also be used as substitutes, far superior to fake bear gallbladder.)

Han Shen (a type of Codonopsis/Panax) moistens dryness, relieves thirst, and directs Qi downward, surpassing other herbs in efficacy. Some people claim that Han Shen loses its nature after processing and roasting, unlike wild-grown varieties, which is truly unjustified. (I heard that Han Shen from Tsushima Island grows fat and long, four or five cun, and when held in the mouth, it alleviates wheezing; even amidst smoke and fire, it is not scorched. I also heard from flower arrangers that chewing Han Shen and inserting its stem into a morning glory stem prevents the latter from wilting quickly. Probably, during summer months, Han Shen soaked in water vessels soon sprays foam resembling boiling turbid vinegar. Thus, using these facts proves the accuracy of this statement.)

Currently, patients suffering from Mei Du (Syphilis) often have concurrent Qi disorders. Therefore, if prescriptions do not include Qi-regulating herbs, the toxic vapors will condense and fail to disperse.

Lin Ji (Strangury) and Zhi Lou (Hemorrhoids/Fistulas) are also caused by Qi disturbances in many cases; attacking the pathogen while regulating Qi is acceptable.

In Wei Bing (Flaccidity Syndrome), at the initial onset, if the patient lacks symptoms of damp-toxin and blood stasis, but presents with fullness, hardness, string-tightness, and urgency below the heart, this is a Qi disorder. It is suitable to induce vomiting first, followed by taking Xie Xin Tang (Drain the Epigastrium Decoction).

Lao Zhai (Consumption) is indeed incurable, but conditions resembling Lao Zhai are treatable. Ge Ye (Regurgitation) is indeed incurable, but conditions resembling Ge Ye are treatable. Physicians of the world often claim they can cure these, but they are actually treating the "resembling" conditions.

Hematemesis (vomiting blood) caused by alcohol is easy to treat; that caused by Qi rebellion is difficult. The first episode may be manageable, but recurrent episodes often lead to death. Hematemesis followed by edema indicates a critical condition.

People who overthink easily stir up Fire; when Fire moves, body fluids dry up. Coupled with excessive desire, this leads to Kidney Lao (Kidney Exhaustion), which is often accompanied by Qi disorders. In cases where Qi disorders cause Wei Bing (Flaccidity), the genitals usually shrink first; as recovery approaches, the genitals become relaxed and comfortable first.

Mei Du (Syphilis) acquired from the embryo is determined to be incurable. Even if one miraculously recovers once, it will inevitably recur later. Parents, can they not be cautious at the beginning?

Jing Bing (Spasm Syndrome) presenting with exterior signs and spasms/paralysis of the hands and feet should be treated with Ge Gen Tang (Kudzu Decoction) to release the exterior. Once the exterior signs are resolved, if spasms and paralysis persist, Da Chai Hu Tang (Major Bupleurum Decoction) will bring about a cure.

Zhong Yu (Food Poisoning/Acute Gastroenteritis) presenting with vomiting, diarrhea, and cold extremities has two pathways: one is suitable for Si Ni Tang (Frigid Extremities Decoction), and the other for Bai Hu Tang (White Tiger Decoction). Physicians should ponder deeply and diagnose carefully. (The distinction between heat-jue and cold-jue in Huo Luan (Cholera-like disease) should also be examined carefully.)

Formulas in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) for treating Xiong Bi (Chest Bi) and Heart Pain mostly use Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root). However, in this shallow and decadent era, the populace is cunning and desirous, leading to internal stagnation transforming into Qi-Fire. Thus, cases suitable for Huang Qin (Scutellaria Root) and Lian Zi (Lotus Plumule) are common, while those suitable for Gui Zhi and Fu Zi are rare. One must examine the syndrome details carefully to avoid error. (Outside the gates of Zhong Jing's school, opening new paths. Who but those who think profoundly about medical arts can achieve this?)

Postpartum Qi and Blood are prone to depletion. Seeking out labor and mental injury leads to dry tongue, diarrhea, and coughing, termed Lao (Exhaustion). Additionally, if lochia is incomplete after childbirth, coagulation rushes upward causing tongue ulcers, diarrhea, and coughing, also termed Lao. (The theory of Lao having two categories is indeed an unshakeable truth. Specialists in obstetrics may not fully comprehend this meaning.)

In Shanghan (Cold Damage), on the second or third day, if there is fullness and hardness below the heart and a deep, rapid pulse, it will later become a major ailment; mild induction of vomiting is permissible. (Inducing vomiting in Shanghan should not exceed two or three times. Stop once a satisfying vomit occurs, using 3-5 fen of Gua Di (Melon Seed). If treatment goes awry, acute cases accelerate death, while chronic cases become complicated syndromes.)

If Shanghan patients take Cheng Qi Tang (Order the Yang Decoction) but cannot pass stool, one should perform vomiting first, then proceed to purging. (This is the meaning of the proverb: "To get the south wind, open the north window." Urinary retention also uses this method. Chen Xiuyuan said: It is like a dripping vessel; blocking the upper orifice blocks the lower orifice. Removing the blockage from the upper orifice allows water to flow freely. Using Bu Zhong Yi Qi Tang or vomiting methods is very clever.)

If Shanghan exterior signs are resolved but there is retained phlegm and old water in the chest, mild induction of vomiting is indicated.

If menstruation has been absent for years and there is fullness/hardness below the heart, or if Lin Ji (Strangury) with turbid urine and fullness/hardness below the heart fails to respond to various medicines, one should first administer a vomiting formula, then take symptom-specific medicine.

At the onset of Wei Bing (Flaccidity Syndrome), or when the disease is about to manifest, if there is fullness in the epigastrium, inducing vomiting first is best. (Di Yuan Kai said: For sudden onset of Wei Bing with inability to move waist, thighs, and legs, and a slippery, forceful pulse, one should first give a vomiting formula, then use Wu Tou (Aconite) and Fu Zi preparations.)

To decide whether a disease is treatable and to determine the time of death, one must examine the emptiness or fullness in the abdomen. All methods of examining the abdomen seem easy but are actually very difficult. Why? Because there are cases that appear empty but are full, appear full but are empty, appear empty due to pathogen but become full after pathogen removal, and appear full due to pathogen but become empty after pathogen removal. This judgment relies on tactile sensation and resonates in the mind; a father cannot teach it to his son.

The flowers and fruits of land, water, trees, and grass vary; some open and fall suddenly, some bloom and wither instantly, some bloom abundantly but bear no fruit, some bear fruit without flowers, some have small flowers that last long, and some have large flowers that fall quickly. Disease transmission to humans is also like this. Physicians must observe the mechanism of opening and falling, and carefully choose the time for pruning (treatment).

If the physician is controlled by the disease, even with harsh drugs and large doses, the disease will not be easily cured. If the physician controls the disease, even with mild drugs and small doses, the disease can be cured. Physicians should plan before illness strikes and verify after illness occurs. (Zhuo Xuan said: "Physician controlled by disease, physician controlling disease" is extremely profound. Such texts are rare in medical books; scholars who do not become physicians who control diseases will find it difficult.)

Reading through various cases, those that heal spontaneously without treatment account for no more than sixty out of a hundred. Of the remaining forty, ten are fatal cases, ten are difficult-to-treat cases, ten are dangerous cases requiring a good physician to save them, and only ten are within the scope of ordinary practitioners. Physicians of the world do not know this distinction, treating casually to gain a reputation for arrogance, and then blaming ancient formulas. How unreasonable! I practiced using ancient sweating, vomiting, and purging formulas to treat epilepsy, consumption, asthma, drum distension, and regurgitation for several years, and only then understood this distinction. My diagnosis became clear, and I found resources everywhere. Only then did I believe that the skill of the ancients lies not in treating after illness, but in preventing before illness.