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Huang Tingyong, a civil official of the Ministry of Revenue, suffered from fever in both feet, dry mouth, and expectoration due to irregular diet and lifestyle. After self-administering Erchen Tang (Two-Chen Decoction) and Siwu Tang (Four-Substance Decoction), his symptoms worsened; his radial pulses at both chi positions were rapid but forceless. I stated, "This is a syndrome of Kidney deficiency." He did not believe me and continued taking the previous medicines. Consequently, he developed heat and itching in the heels, mistaking it for toxic sores, and further ingested damp-draining agents. This resulted in severe redness, swelling, and heat in the affected area. Topical applications caused the skin to ulcerate and weep fluid, failing to heal over time. Later, after using Zhuidu Dan (Toxin-Pursuing Pill), the sore protruded like a peach, at which point he finally accepted my diagnosis. I treated him by nourishing the source of transformation (nourishing Kidney Yin), and he recovered after half a year.

Zhang Lizhi, a scholar, experienced pain in his left thigh. After using heat-clearing and damp-draining herbs, his complexion became red and swollen, with pain radiating to the waist and hypochondrium, accompanied by weakness in the legs and feet. I diagnosed this as deficiency of the three Yin meridians of the foot and prescribed Buzhong Yiqi Tang (Decoction to Boost the Middle and Augment Qi) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). After more than two months, his vital energy gradually recovered, and various symptoms subsided. Fortunately, he was cautious about his illness, and he fully recovered within a year.

Zhong Zhiying, an assistant prefect, developed sores on both legs. The lesions were dark, coin-sized, resembling tinea, with alternating itching and pain, and profuse purulent discharge. He also exhibited afternoon tidal fever, internal heat, dry mouth, and a sallow complexion. This was diagnosed as Kidney deficiency. Treatment with Jiawei Liuwei Wan (Modified Six-Ingredient Pill with Rehmannia) led to recovery within a few days. Many such cases have been mismanaged due to the inappropriate use of wind-dispelling and detoxifying agents.

A male patient with a history of seminal emissions suffered from heel pain, dry mouth with thirst, dry stool, and severe afternoon fever. He was cured using Buzhong Yiqi Tang modified with Shaoyao (Paeoniae Radix Alba) and Xuanshen (Scrophulariae Radix), along with Liuwei Dihuang Wan.

For other symptoms, please refer to *Waike Shuyao* (Essentials of External Medicine).

A scholar had a chronic tendency toward constipation. After taking Sunfeng Shunqi Wan (Pill to Smooth Wind and Regulate Qi), he experienced chest and diaphragm discomfort, though his appetite remained good and digestion efficient. His face showed signs of Yang heat, and his left Guan and Chi pulses were surging yet empty. I diagnosed this as deficiency of the three Yin meridians of the foot. Relying on his own medical knowledge, he disbelieved me and took Runchang Wan (Intestine-Moistening Pill), which resulted in loose stools and limb fatigue. I then administered Buzhong Yiqi Tang and Liuwei Dihuang Tang. After more than a month, there was a visible effect, and he stabilized within a year. For cases of Spleen and Lung Qi deficiency, Buzhong Yiqi Tang is used. For Spleen meridian stagnation, Jiawei Guipi Tang (Modified Restore the Spleen Decoction) is indicated. For Qi and Blood deficiency, Bazhen Tang (Eight-Treasure Decoction) plus Roushouyu (Cistanche Stem) is prescribed. For depletion of fluids in the Spleen meridian, Liuwei Dihuang Wan is used. For fever with thirst and preference for cold drinks, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) is applied. For dryness in the large intestine, pig bile can be used as a suppository. If Liver and Gallbladder pathogenic factors invade the Spleen, Xiaochaihu Tang (Minor Bupleurum Decoction) added with Zhizi (Gardenia Fruit), Yuliren (Prunus Seed), and Zhike (Aurantii Fructus Immaturus) is used. For accumulated heat from rich foods, Jiawei Qingwei San (Modified Stomach-Clearing Powder) is indicated. There are also cases of heat-dryness, wind-dryness, Yang binding, and Yin binding, which require treatment based on etiological differentiation. Further damage to Stomach Qi often leads to intractable conditions.

An elderly scholar, who had long suffered from wind-heat, maintained normal appetite but experienced constipation for seventeen days without abdominal distension. His pulse was surging and large yet empty upon pressure. This indicated that Yin fire was scorching body fluids. He was treated with twenty-plus doses of Liuwei Dihuang Wan. By the thirty-second day, he felt the urge to defecate, and after using pig bile for lubrication, his bowel movements returned to normal.

A seventy-three-year-old woman presented with phlegm-wheezing, internal heat, constipation, and insomnia for two months. Her pulse was surging and large but fine and weak upon deep pressure. This belonged to Liver, Lung, and Kidney deficiency. She took Liuwei Dihuang Wan in the morning and Xiaoyao San (Free and Easy Wanderer Powder) in the evening, each for over thirty doses. After consuming more than one hundred bowls of food, her abdomen became distended. Pig bile was then used to induce defecation, followed by Shiquan Dabu Tang (Complete Great Tonifying Decoction) for regulation, leading to stability. If the previous medications were interrupted, food intake would decrease, and symptoms would recur.

A man in his fifties suffered from difficulty in defecation due to anger and reduced food intake. After taking Runchang Wan, he developed severe constipation and chest-hypochondriac pain. He also took Piyue Wan (Spleen-Restriction Pill). His Liver, Spleen, and Kidney pulses were floating and choppy. I stated, "This is a syndrome of Essence and Blood deficiency in the three Yin meridians of the foot." Mr. Dongyuan said: If a person has strong Stomach Qi but weak Spleen Qi, constraining fluids so they do not distribute widely but instead flow only to the Bladder, resulting in frequent urination and difficult defecation, Piyue Wan should be used. If a person suffers from withered Yin Blood, blazing internal fire, pathogenic invasion of Lung Metal, and injury to Spleen Earth by Liver Wood, causing dysfunction between Spleen and Lung, leading to constipation with frequent urination, Runchang Wan should be used. Now, by nourishing the source of transformation, bowel movements will naturally regulate. Following this method proved effective.

A scholar suffering from emotional stagnation, compounded by failure in imperial examinations, developed fever, thirst, chest discomfort, and poor appetite. After taking heat-clearing, phlegm-resolving, and Qi-moving agents, his symptoms worsened, accompanied by limb fatigue. His Heart and Spleen pulses were choppy. This was a complication of Spleen injury due to stagnation. I treated him with Jiawei Guipi Tang. His diet gradually improved, and symptoms subsided. However, his stool remained dry, and his malar regions were red, indicating deficient fire of the Liver and Kidney damaging Yin Blood internally. He was given Bazhen Tang plus Roushouyu, Maidong (Ophiopogon Tuber), and Wuweizi (Schisandra Fruit). After over thirty doses, his stool naturally moistened.

A male patient with identical symptoms disbelieved my advice and took Dahuang (Rhubarb Root and Rhizome) and other drugs, resulting in diarrhea, bloody stools, and generalized dark discoloration. He sought treatment again. Upon examination, I said, "Both the Yang and Yin collaterals are injured." The Classics state: Injury to Yang collaterals causes external bleeding; injury to Yin collaterals causes internal bleeding. I declined to treat him, and the outcome proved correct.

Chen Ezhai, a resident of Zhifang, was over sixty years old. Initially, due to constipation, he took internal-purgative agents. Subsequently, his appetite decreased, and he experienced chest-abdominal distension, hypochondriac pain, and physical fatigue. His Chi pulses were floating and large, his left Guan pulse was short and choppy, and his right Guan pulse was wiry and choppy. Seeking treatment in May, I suspected that Mingmen Fire (Gate of Life Fire) was declining, failing to generate Spleen Earth, while Lung Metal was suppressing Liver Wood. I feared he would not survive the peak of Metal season. Indeed, he passed away.