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The medical skills of Fengting were naturally at a high level. People in the capital reported that he could cure stubborn diseases and support the frail, even predicting the exact time of death with many miraculous verifications. Now, based on the medical cases recorded by his disciples, I extract the key points as follows. (Zhuoxuan commented: Old Master Fengting liked to read *Qianjin Fang* and *Waitai Mi Yao*, so his discussions on diseases and prescriptions were mostly based on these two books. After the predecessors, wanting to open up a new path, he had to rely on the works of Sun Simiao and Wang Tao. Doctors of the Qing Dynasty did not have this insight.)

In the world, there is a condition characterized by a sallow complexion, dry and withered skin like that of an elderly person, excessive eye discharge and tears, runny nose, rebellious Qi causing irritability, and chest oppression. Pressing the Ren Mai (Conception Vessel) from Jiutui (CV15) to the umbilical and abdominal area feels tight and tense like two drawn bowstrings; pressing causes pain, palpitations are severe, the pulse is often slippery, and the patient desires tea or mixed foods. During sleep, the Heart Qi is lazy, indecisive about matters, or angry and unhappy, gradually leading to slight swelling under the eyes and on the shins. Some die prematurely in middle age, while others become foolish. Physicians mistakenly diagnose it as Huangpang disease (malnutrition edema) or epilepsy, but treatment fails. They do not know that the root cause of this disease is unfulfilled desires, improper diet, and overexertion, leading to the accumulation of damp-heat. The heat steaming upward causes sallow complexion; severely, stagnant heat consumes the Liver and Gallbladder, causing worry and fear, indecision, and insomnia day and night, resulting in this disease.

This syndrome has deficiency and excess aspects: thick muscles indicate excess, while emaciation indicates deficiency. Facial or shin edema in deficiency syndromes is harmless. However, if after a long duration, slight swelling appears on the shins and under the eyes in an excess syndrome, it is a collapse pattern (critical sign), which is feared. I name it "Pi Lao" (Spleen Labor). The Pi Lao mentioned in *Qianjin Fang* is very different from this syndrome; the Pi Huang disease mentioned in *Bencao Bai Bing Zhu Zhi* under the Iron Sand entry is slightly closer. Whenever Pi Lao damp-heat overflows outside the membranes causing edema, Shengji Zisu Zhusan (Holy Relief Perilla Decoction) is suitable. If stagnant heat flows into the intestines causing rectal prolapse or hemorrhoids, a lubricating purgative is suitable. But for those with difficult defecation, Piyue Wan (Spleen Restriction Pill) is suitable. For those with diarrhea and inability to eat, it belongs to deficiency. If stagnant heat invades the Gallbladder Fu organ, epistaxis occurs easily. Heat transferring to the Liver causes easy fright. Heat stagnating in the chest and back causes neck stiffness. Spasm of the left hypochondrium, or throat discomfort like Plum Pit Qi, or water-fluid retention in the Chong Mai (Penetrating Vessel) causing cough, or a plate-like hardness below the heart with food intolerance and frequent vomiting, are treated with Banxia Tang (Banxia Decoction, from *Waitai*). For belching, acid regurgitation, and subcardiac pain, Siwei Zhike San (Four-Ingredient Aurantium Powder) is suitable. Because in this syndrome, stagnant heat obstructs the Chong Mai, preventing fluid circulation, causing subcardiac palpitations. If treated as retained fluid, it causes harm. Only by resolving the heat will the fluid disappear naturally.

If the person is emaciated with insufficient body fluids, severe subcardiac palpitations, slight swelling under the eyes, tinnitus, dizziness, and vertigo, it belongs to a deficiency pattern, and Chenxiang Jiangqi Tang (Agarwood Descending Qi Decoction) is suitable. If heat transmits to the Large Intestine causing hematochezia along with the above symptoms, Tieshua Tang (Iron Brush Decoction) is suitable. If appetite is preserved but bleeding continues, Xiaodou Danggui San (Adzuki Bean and Angelica Powder) is suitable. For diarrhea with abdominal pain resembling dawn diarrhea, Zhenwu Tang (True Warrior Decoction) is suitable. For borborygmus and diarrhea, Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is suitable. For no diarrhea but pain in the right side of the subcardiac region corresponding to the Stomach Fu, Xiangsha Pingwei San (Aucklandia and Amomum Powder to Calm the Stomach) is used. For spasm and cold pain from the left hypochondrium to the lower abdomen, Chaihu Biejia Tang (Bupleurum and Turtle Shell Decoction) is used. If heat steams the chest and back, producing phlegm, cough, wheezing with shoulder breathing similar to Zhi Yin (Branch Fluid), Jiawei Banxia Tang (Nine-Ingredient Modified Pinellia Decoction) is suitable. For bilateral hypochondriac distension and urgency, abdominal fullness, inability to eat, headache, high fever, and body pain, Yannian Zhishi Tang (Longevity Aurantium Decoction, from *Waitai*) is suitable. For old-year Pi Lao where cold and heat are imbalanced forming a mass, undigested food, and false fullness like water, Qianhu Zhishi Tang (Peucedanum and Aurantium Decoction) is suitable. For those with weak constitution, unfulfilled worries and thoughts, long-standing stagnation, dry blood, alternating chills and fever, night sweats, and cough, this is what *Shengji Zonglu* calls Pi Cheng Gu Zheng (Mass Transforming into Bone Steaming), and Qinjiao Biejia San (Gentian and Turtle Shell Powder) is suitable. If heat steams the Spleen and Stomach, and Liver/Gallbladder indecision persists, subcardiac hardness like a plate,沉香-colored tongue, and manic behavior occur, Banxia Tang plus Shigao (Gypsum) is suitable. For subcardiac stuffiness and pain radiating to the breasts, or Chong Mai obstruction causing chest pulling pain, Chaihu Baizhu San (Bupleurum and Atractylodes Macrocephala Powder) is suitable. Recently, many suffer from this disease. Generally, current symptoms may completely resemble other diseases but belong to variations of Pi Lao, or other diseases may be primary with Pi Lao secondary. Careful differentiation allows for appropriate prescription, achieving half the success. (Regarding this internal injury disease, naming it Pi Lao may not be entirely accurate. However, its repeated symptom differentiation traces the source, and its step-by-step medication application is effective. Since many recently suffer from it, its treatment deserves study.)

The origin of Wind Stroke (*Zhong Feng*) varies: *Suwen* attributes it solely to Wind, Liu Hejian to Fire, and Li Dongyuan to Internal Injury, making it hard to follow. However, Xu Renze's discussion in *Waitai* seems reasonable. This syndrome should first be treated with Zhuli Tang (Bamboo Juice Decoction from *Qianjin*). If decoction cannot be taken, Wuxi Wan (Black Rhinoceros Horn Pill) can open the throat. If stomach Qi rebels causing vomiting, one in a hundred survives.

A man in his forties suffered from warm epidemic with hematochezia, followed by heavy body, difficulty turning, flaccid limbs, deviated mouth and eyes, aphasia, resembling a statue. His pulse was slippery, tongue had prickles, and he desired cold drinks. I judged all downward indications present and administered Dachengqi Tang (Major Order the Qi Decoction). After one dose, eyes moved, speech returned slightly; continuing the formula led to full recovery. Another patient had the same disease but slightly clearer spirit, relaxed pupils, sticky/dry mouth, aphagia, fasting for days, considered a death case. The patient moved fingers, seeming to want water. Giving water allowed slight speech, repeated several times. I tried giving Baihu Tang (White Tiger Decoction) and cured him. Dachengqi Tang governs mental confusion and aphasia; Baihu Tang governs clear spirit, sticky/dry fluids, and aphasia. Both are Interior Excess, but their indications are distinct. (*Zhongxi Shenzhai Mingshu Jie* distinguishes Baihu and Chengqi clearly. Fengting gained this from practice; both should be cross-referenced without error.)

Fei Wei (Lung Flaccidity) has cold and heat types. *Jinkui Yaolue* only records formulas for Lung Cold, omitting Lung Heat. *Qianjin Fang* and *Waitai Mi Yao* also lack clarification. Only *Shengji Zonglu* discusses Ren Shen Yang Rong Tang for Lung Heat treatment, which I found effective. For severe heat, Qinjiao Fulie Tang (Gentian Supporting Emaciation Decoction) or Zhimu Fuling Tang (Anemarrhena and Poria Decoction) are suitable. For abdominal fullness, Qinjiao Biejia San plus Binglang (Areca Seed) is suitable. Lung Heat is generally untreatable, while Lung Cold is easier to treat; this must be known.

There is a condition with throat discomfort, neither true Ge (Diaphragm) disease, voice like a child playing a grass flute, inability to lie down, rapid and urgent pulse, suddenly vomiting over a liter of pus and blood before death. This Fei Yong (Lung Abscess) is extremely difficult to treat.

Ben Tun (Running Piglet) Syndrome: Guizhi Jia Gui Tang (Cinnamon Twig Decoction Plus Cinnamon) governs escaping Qi; Bentun Tang (Running Piglet Decoction) harmonizes pain. If this syndrome prefers bitter taste, use Bentun Tang. If preferring sweet taste, use the former formula.

Among the Four Fluid Retentions, Zhi Yin (Branch Fluid) is most feared. This is water-fluid stagnating in the chest and diaphragm, branching onto the Heart. Initially, chest/diaphragm fullness strongly presses the Heart, subcardiac area feels moist, throat wheezing/rebellious Qi,急促 breathing, inability to lie down. *Shengji Zonglu* Xuanfuhua Tang (Inula Flower Decoction) is particularly effective. If subcardiac hardness is severe, fluid retention is tightly knotted, or recurs after this decoction, Mufangji Tang (Stephania Decoction) or Qu Shi Jia Fu Xiao Tang (Remove Gypsum Add Poria and Saltpeter Decoction) are suitable. Outside these two formulas, I have seen no efficacy. (Zhuoxuan commented: Ancient theories on Zhi Yin vary: some say Heart obstruction, some Spleen/Stomach deficiency, some Kidney Qi insufficiency. I disagree. Below the Heart and Lungs lies the Diaphragm membrane. When water-fluid stasis reaches here, it causes upper Lung Qi obstruction and lower Stomach Qi rebellion, leading to subcardiac hardness—this is Zhi Yin. *Zhubing Yuanhou Lun* says: Excessive water-fluid stagnates in chest/diaphragm, branches on Heart, hence called Zhi Yin. Recording formulas clarifies this note.)

Edema with diarrhea is a bad omen. Edema appearing before diarrhea suggests water-Qi; Mufangji Tang is suitable, confirmed by *Waitai*. Diarrhea appearing before edema indicates Deficiency Consumption, a critical omen. Hongjiao (Beriberi) swelling with diarrhea leads to sudden Heart attack and death. Therefore, edema generally promotes diuresis and forbids purgatives. If diuretics cause diarrhea, it is also an ominous sign.

Xiong Bi (Chest Bi) and Heart Pain: Severe pain in the center of the chest and subcardiac region leading to hematemesis and death is common in my observation.

A man suddenly developed Heart Pain, cold extremities, absent pulse, near death. I administered Chishizhi Wan (Halloysitum Pill), and he recovered quickly.

Women with irregular menstruation, cold Qi in lower abdomen due to Blood Stasis: Wenjing Tang (Warming the Menses Decoction) is miraculous. Post-menstrual abdominal pain also due to Blood Stasis: Huashi San (Talc Powder) is suitable. Abdominal pain during menstruation indicates Qi Stagnation: Siwu Tang (Four Substances Decoction) is suitable. Irregular menstruation with Qi stagnation, obesity, and Blood Stasis: Xiaoyao San (Free and Easy Wanderer Powder) or Zhengqi Tianxiang Tang (Righteous Qi Heavenly Fragrance Decoction). Postpartum Blood Stasis rebelling upward: Chen Sha (Cinnabar) is most effective. Headache before menstruation indicates Fluid Retention: Guizhi (Cinnamon Twig), Jupi (Tangerine Peel), Ganjiang (Dried Ginger) etc. are suitable. (*YiTong*)

Miscarriage after the fifth month of pregnancy is generally caused by masses. Controlling the mass early preserves the fetus. Predecessors ignorant of this add tonifying medicines, which are ineffective. (This theory originates from Zhang Zhongjing and is most logical. Female medicine specialists often inherit from fathers/grandfathers without studying ancient texts, failing to grasp flexible application. Clinging to warming/tonifying as essential for calming the fetus has harmed many. Alas.)

Slight water-Qi before childbirth is not feared. Water-Qi in the upper body with急促 breathing/wheezing leads to sudden Heart attack postpartum. Dry Lung Blood in the lying-in period causing hemoptysis is also feared. Postpartum bathing exposing to dampness causing Hongjiao swelling requires early treatment to avoid unpredictable changes.

Jaundice with irritability, thirst, vomiting, and abdominal distension is a bad syndrome. Inability to sleep at night, irritability, heat, and thirst lead to death within two to three days.

Abdominal mass with whole-body yellowing is named Pi Huang Dan (Mass Jaundice), also difficult to treat.

Patient initially has deep, rapid pulse, suddenly becoming slow, seeming like recovery, but with depressed Qi, silence, desire to lie down, heavy body, poor appetite, and urine like juice—this is the onset of Yin Huang (Yellow Jaundice).

Deficient persons' Malaria Heat and Labor Heat are easily confused. Malaria pulse is wiry and large but not rapid; Labor pulse is rapid but not wiry/large. This is the distinction.

For deficient persons stopping malaria, moxibustion on Dazhui (GV14) is best: three moxa cones at dawn, three at noon, three before onset.

Malaria with intense internal heat, frequent thirst, exposure to wind for cooling, preventing pathogen release, transforms into edema. Yuebi Jia Zhu Tang (Ma Huang Decoction Plus Atractylodes Macrocephala) is suitable. I once treated this; water-Qi removed then malaria recurred, confirming this.

Huo Luan (Cholera-like disorder) with chills indicates Yang Qi returning, a good omen. For deficient persons unable to tolerate trembling, Sini Tang (Reverse the Collapse Decoction) is suitable.

Sudden vomiting can be Huo Luan or acute Wind Stroke, with similar symptoms. Differentiation: post-vomit pulse in Wind Stroke is slow, not tight; extremities are not cold; hands/feet shake during vomiting; after vomiting, hemiplegia and somnolence occur.

Physicians mistakenly identify foot swelling as Hongjiao. Hongjiao is characterized by pain, spasm, flaccidity, or numbness, not merely water-Qi. Dampness dominance causes swelling/fullness; Wind dominance causes insensibility. Disease may start in abdomen spreading to feet, or feet spreading to abdomen. Pulse fears surging/tight/wiry but not rapid. Hyperactive pulses at Xin Xia (Subcardiac) and Yingchong (Renying, ST9) are strictly contraindicated.

I treat Hongjiao by distinguishing Exterior/Interior as the standard. Exterior signs: swelling, numbness, lumbar/foot weakness; treated primarily with sweating and detoxification. Interior signs: intense wind-heat, vigorous Qi movement,急促 breathing, abdominal fullness, vomiting; treated primarily with descending Qi and promoting urination. Physicians wrongly consider exterior signs critical and interior signs mild, leading to erroneous prescriptions and unpredictable deaths.

Roundworms have cold and heat types. Nagata Tokuhon used Taiyi Wan for heat-type worm accumulation and Muxiang Wan for cold-type, which is correct. Stagnant heat in the diaphragm causes roundworm movement; physicians generally treat as Hui Jue (Roundworm Reversal), which is mistaken. (Wu Keyi discussed stomach heat vomiting roundworms but lacked specific treatment. Chen Zhi said: Warm-heat disease vomiting roundworms is stomach heat. Stomach deficiency with heat, worms ascend with heat vapor, vomited out; Xijiao Huanglian Tang (Rhinoceros Horn and Coptis Decoction) is suitable. *Shanghan Bianzhu* Qingzhong Anhe Tang treats stomach excess heat vomiting long worms, also applicable. Akki Shitsu said: Vomiting dead roundworms indicates heat; living ones indicate stomach cold. Dead worms are white, living are reddish; this reasoning seems logical but is not absolute.)

Dysentery treatment depends on heat severity regardless of stool volume. First use Tiaozhong Tang (*Waitai*), then after sweating, combine with Da Chaihu Tang or Shaoyao Tang to harmonize. For delirium, dry/black tongue, severe tenesmus with red/white pus/blood, use Dachengqi Tang or Bingshao Shunqi Tang to purge; resolving heat stops diarrhea.

Jinkou Li (Closed-Mouth Dysentery) with empty irritability: Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is suitable. *Baiyi Xuanfang* Ginseng, Huanglian, Chenpi, Lotus Seed (four ingredients) is also good. This syndrome with hiccups is untreatable.

Xixi Li (Intermittent Dysentery) with only white mucus: Zhenwu Tang plus Chishizhi (Halloysitum) is suitable.

Zhang Zihe said: Wherever head sores/swellings occur, water-Qi gathers, so purgatives are suitable. I added Cangzhu (Atractylodes Lancea) to head sores to remove water-Qi. For excess patterns, Qianniuzi (Pharbitis Seed) is effective. Same principle.

*Jinkui Yaolue* Xiexin Tang says: Insufficient Heart Qi causing hematemesis/epistaxis, but its indication is vague. According to *Bencao Bai Bing Zhu Zhi* under Dahuang (Rhubarb): Drains blood stasis/chest oppression, insufficient Heart Qi, hematemesis/epistaxis, chest/hypochondriac stabbing pain/distension, decocted with Huanglian (Coptis) and Huangqin (Scutellaria). Using this to treat hematemesis/epistaxis with chest/hypochondriac stabbing pain, I rarely fail.

For lower toothache, moxibustion on Jianjing (GB21) is effective. Jianjing is on the Yangming Meridian. For swollen lower gums, pricking releases blood and cures. Blood/Qi wandering and gathering at gums causes this.

Gu Cao Feng (Bone Tunnel Wind) is detailed in *Waike Zhengzong*. This sore arises behind the ear/jawbone, ulcerates/perforates, spraying pus from mouth. Initially, facial deviation may occur; later upper gum ulceration prevents eating, leading to death. If caused by syphilis toxin, removing toxin cures it. Early Gu Cao Feng: Yitong Yincheng San (Artemisia Capillaris Powder). (Ingredients: Yincheng, Jingjie, Bohe, Lianqiao, Mahuang, Shengma, Qianghuo, Jiangcan, Xixin, Dahuang, Heiqiu - 11 herbs.)

No cough but voice loss: Waitai Fuling Anshen Tang (Poria Calming Spirit Decoction) is suitable. Tea drinkers often get this. Distinction between treatable and untreatable: Upper Jiao deficiency-cold is mostly untreatable. Upper Jiao deficiency-cold with voice loss: Waitai Huang [missing character] Lizhong Tang. Swollen/itchy throat with cough and voice loss: Shengji Huang [missing character] Tang.

Later generations erroneously separated Zhong Shu (Heatstroke) and Zhong Re (Heat Illness) into different names. They are one disease, not different causes. Dongyuan failed to distinguish dynamic acquisition as Zhong Shu and static acquisition as Zhong Re, creating Qingshu Yiqi Tang, which is incorrect. Those arguing ancient formulas exclude Zhong Shu from Shanghan are also wrong. *Book of Han: Emperor Wu Annals* mentions summer drought and many deaths, predating Zhongjing. Summer heat/sweat/cold aversion/thirst/heaviness/pain responds like water on charcoal to Zhongjing's Baihu Tang. Summer sleeping in cold air causing cold/fever/pain responds to Guizhi/Mahuang per Shanghan methods. These two cannot be mixed.

It is wrong to limit Huo Luan to summer. Vomiting/diarrhea with chaos occurs in all seasons, confirmed by *Waitai* and *Rumen Shiqin*. More common in summer because winter Yang is inside (warm), summer Yang moves outside (cold inside), plus craving cold drinks/food. Resembles Food Stagnation, but Food Stagnation causes abdominal fullness/pain with profuse vomiting/diarrhea, resolving next day. Huo Luan continues pain after vomiting/diarrhea, adds fever/body pain, severe cases have cold extremities, irritability/thirst. Occurs in all seasons, heavier in summer, hence mistakenly called Heatstroke.

Huo Luan with subcardiac pain必然 vomits; umbilical pain必然 diarrhea.

Li means treat/control. Zhong refers to Middle Jiao Stomach Qi. Stomach deficiency-cold, undigested food, chaotic vomiting/diarrhea, like tangled thread, gradually untangled to treat, hence Lizhong Wan (Regulate Middle Pill). Jian means strengthen, strengthening Middle Jiao, hence Jianzhong Tang (Strengthen Middle Decoction). Meanings differ; physicians combining them into Jianli Tang is not ancient intent.

Banxia Xiexin Tang drains subcardiac fullness; later physicians thought it drained Heart Fire and treated epilepsy, a major error.

*Gukong Lun* says: Chong Mai disease involves rebellious Qi and interior tension. Chong Mai deficiency and dry blood cause Jiutui subcardiac fullness, Qi rebelling to chest, abdominal skin sticking to back, hanging Heart pain, called Xiong Bi. Guizhi Zhishi Shengjiang Tang and Zhishi Xiebai Guizhi Tang treat pathogens invading Chong Mai.

Subcardiac palpitations have three paths: 1. Cold Qi invading Chong Mai, branching Ren/Chong causing palpitation: Zhigancao Tang, Da Jianzhong Tang treat this. 2. Palpitation due to water-fluid: Guizhi Fuling Baizhu Gancao Tang, Zhenwu Tang treat this. 3. Toxic palpitation: Hongjiao rebelling upward.

Manic/Epileptic syndromes: Manic running/restlessness is easy to treat. Delirious laughter/speech is Dian (Depression), also called Lost Heart Wind, difficult to treat. *Suwen*'s Yang Dian/Yin Dian classification is reliable. *Benshi Fang* Fuling San, Ningzhi Gao, Kuangqi Wan treat both Yin/Yang. Insomnia: Zhunsun Lingyuan Chen Sha San. Continuous salivation: Jufang Yangzheng Dan. Yang Dian: Irrigation therapy. Severe cases: Fill large barrel with water, surprise patient, irrigate. Or bathe in waterfall. All descend rising Yang Qi.

Liuzhu (Flowing Nodule) described by世人: Flowing from chest to lower abdomen/waist/extremities, sometimes forming lumps, flat/swollen, soft but hard underneath. Ulceration discharges pus; one heals, another appears. Severe cases form 3-4 lumps, ultimately untreatable. Chest-up onset is Wet-Phlegm Liuzhu; Chest-down onset is Blood Stasis Liuzhu. Chest-up/extremities easy to treat; Lower abdomen/waist difficult. Blood Stasis Liuzhu: Before lump formation, lumbar/foot stiffness, slight fever. Acute onset dies within a month; chronic lasts half a year.