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Safflower (Sha Ren) and Motherwort (Yi Mu Cao), as well as acrid-warm formulas, should be strictly contraindicated. This applies to all diseases, not just those during pregnancy! Drugs that are extremely cold, extremely hot, strongly tonifying, or aggressively purgative can save lives if used correctly, but can kill if misused. However, in cases of false heat and false excess, the mistaken use of cold and purgative drugs will lead to immediate death, which cannot be reversed. In cases of false cold and false deficiency, the mistaken use of acrid-warm and tonifying drugs will only increase dryness, heat, irritability, and oppression. If death is avoided, using cooling methods will show efficacy. Therefore, ancient sages held that treating deficiency with methods for excess, or treating excess with methods for deficiency, is inadvisable; this is indeed well-founded.

Mr. Zhang from Daxing County had a relative suffering from severe dysentery for a long time, fainting several times a day. I was summoned to examine him. His six pulses were all thready and weak. I prescribed a formula containing Ginseng Radix et Rhizoma (Renshen), Scutellariae Radix (Qin), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Atractylodis Macrocephalae Rhizoma (Baizhu), Cinnamomi Cortex (Rougui), and Schisandrae Fructus (Wuweizi). The attending physician argued against adding tonics, fearing that the residual stagnation would be "locked in" by tonification. I said, "I have heard that robust individuals rarely retain stagnation, never that robustness leads to qi stagnation. If we wait too long to tonify, given his daily fainting, there may soon be no body capable of receiving tonification." Mr. Zhang agreed. After two or three doses, his spirit recovered, and the dysentery healed.

Old Man Tan, an official in the Ministry of Personnel, fell ill while staying at the residence of Censor Xu. He had fevered for several days, appeared lethargic, and his pulse was thready and weak, indicating fever due to labor injury. One physician diagnosed it as Cold Damage (Shanghan) and administered diaphoretic herbs, forbidding food intake, which worsened his condition critically. Upon my examination, his pulse was wiry and empty, ruling out Cold Damage. I first gave him half a bowl of thick rice soup. He remarked, "It is very fragrant and sweet; after drinking, my eyes felt clear, but please do not let Old Man Xu know." I returned home and privately administered Guipi Tang (Restore the Spleen Decoction), followed by thin rice gruel. After three to four days, his spirit fully recovered. Alas! Many people mistake headache and fever for Cold Damage and die from excessive purging and starvation.

Madam Han, wife of a Vice Commander, suffered from severe malaria with high fever and no sweat. Her six pulses were surging yet empty. I stated, "Sweat originates from Yin fluids, and the Kidney governs the five fluids. With only Yang signs and no Yin signs in the pulse, how can we induce sweating again, accelerating the collapse of isolated Yang?" I prescribed Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) plus Achyranthis Bidentatae Radix (Niuxi) and Schisandrae Fructus (Wuweizi), adding two liang of Shu Dihuang (Prepared Rehmanniae Radix) per dose, decocted into over a bowl, which she drank in large gulps. Nourishing water induces sweating. She sweated profusely and recovered. Later, I used Shiquan Dabu Tang (Ten-Agent Great Tonifying Decoction), removing Chuanxiong Rhizoma (Chuanxiong) and Glycyrrhizae Radix et Rhizoma (Gancao), adding Ziziphi Spinosae Semen (Zaoren) and Wuweizi, replacing raw Sheng Dihuang with prepared Shu Dihuang. After several doses, her spirit greatly improved.

**Formula for Nourishing Heart, Educating Spleen, Harmonizing Liver, Clearing Lungs, Nourishing Kidneys, Enriching Ying, and Benefiting Wei (Paste and Pill Formula):**

The essence of the Five Zang organs flows into the Kidneys. Thus, the *Classic* states: "When the Five Zang are abundant, they can discharge." Each Zang has its essence, which pours into the Kidneys as needed. The Kidney serves merely as a gathering and management center. During intercourse, the fire of the San Jiao (Triple Burner) descends, opening the pores (Xuanfu) throughout the body, releasing essence that gathers in Yin and emerges. Is it merely stored in the Kidney? Essence is born from Blood; if Blood is scant, how can Essence be generated? The Heart governs Blood, hence: "For infertility, look to the Heart; for premature graying, look to the Kidney." Therefore, those valuing fertility must not only tonify the Kidney but also nourish the Heart, and further harmonize the Five Zang so their essence remains abundant, ensuring the Kidney is full. If the other four Zang are dry and barren, what substance returns to the Kidney?

The Heart belongs to Fire and corresponds to the Li trigram (Yang outside, Yin inside); the Water in the Heart is True Water. The Kidney belongs to Water and corresponds to the Kan trigram (Yin outside, Yang inside); the Fire in the Kidney is True Fire. Heart and Kidney are roots of each other; Yin and Yang function mutually. Once the Dao of Ji Ji (Intersection) is mastered, the misty Qi condenses, and the embryo forms.

Currently, the Right Chi pulse is weak upon heavy pressure, indicating insufficiency of Mingmen (Gate of Life) True Yang. The Left Chi pulse is neither deep nor solid, indicating emptiness of Tianyi (Heavenly One) True Water. Bawei Dihuang Wan tonifies both Water and Fire, essential for this pattern. However, since Yin deficiency is extreme, prepare a paste from over one jin of Shu Dihuang (yielding eight liang of paste), replacing honey for pills, taken on an empty stomach. It is said: "Long-term use makes one fat, strong, and fertile," which is true. But Heart Yin is also insufficient, and Liver Ying and Middle Qi are not surplus; how can the Kidney receive and utilize them? At night, after meals, take formulas that nourish Ying, benefit Wei, and tonify all Five Zang. One tonifies先天 (Xiantian/Pre-heaven) insufficiency; the other assists 后天 (Houtian/Post-heaven) generation. Qi and Blood will grow daily, ensuring abundant offspring. The formula follows:

* **Huangqi (Astragali Radix)** and **Renshen (Ginseng Radix et Rhizoma)** tonify Qi as Sovereign (Jun), allowing Yin to grow with Yang, transforming the formless into the formed. (4 liang, stir-fried with honey water).
* **Danggui (Angelicae Sinensis Radix)** nourishes and invigorates Blood as Minister (Chen), harmonizing Ying, generating from Qi. (3 liang, stir-fried with wine).
* **Suanzaoren (Ziziphi Spinosae Semen)**, red like Li, enters Spleen via aroma, Liver via sourness. It calms the Heart, benefits the Liver, and nourishes Spleen Earth. Together with Danggui, it nourishes Blood of three Zang and Qi of three Zang. (5 liang, stir-fried until ripe, crushed before decoction).
* **Shudihuang (Rehmanniae Radix Praeparata)**, heavy and turbid like Earth, sweet and warm, nourishes Yin, tonifies Tianyi True Water, and moistens dry meridians. With Baizhu, it balances Spleen Earth's dryness (Baizhu) and moisture (Shudihuang), making Earth the mother of all things. (6 liang, sliced with copper knife).
* **Jitui Baizhu (Atractylodis Macrocephalae Rhizoma)**, fragrant and mild, possesses righteous Qi. It tonifies Middle Qi. As praised: "Tastes better than gold, fragrant more than jade, repels hundred evils, fills six Fu organs." To enhance moistening, stir-fry with cow's milk until dry and yellow. Combined with Shudihuang and Baishaoyao, it strengthens Water and nourishes Spleen. Baizhu tonifies Spleen Yang; Baishaoyao tonifies Spleen Yin, preventing dryness. (4 liang, soaked in cow's milk, dried, stir-fried yellow).
* **Yuanzhi (Polygalae Radix)**, embracing the Heart, yellow in color, calms Spirit, generates Spleen Earth. Pungent and bland, expels turbid Yin, preserving True Essence. It aids Heart-Kidney-Spleen interaction. Pre-soaked in Licorice juice to remove pungency. (2 liang).
* **Zhi Maidong (Ophiopogonis Radix Praeparata)**, Kidney is Pre-heaven, Spleen is Post-heaven. Deficiency requires tonifying the Mother (Metal/Lung) or Child (Water/Kidney). Since Water deficiency dries Metal, and Metal dryness depletes Water, mutual support is lost. Maidong, combined with Shudihuang and Baizhu, supports Mother without stealing and generates Child with surplus. Stir-fried with old rice to mitigate coldness. (3 liang).
* **Baishaoyao (Paeoniae Radix Alba)**, sweet-cold enters Spleen, sour-astringent enters Liver. Harmonizes Liver Ying with Danggui, nourishes Spleen Yin with Baizhu. (2 liang 4 qian, stir-fried with honey and wine).
* **Duzhong (Eucommiae Cortex)**, promotes circulation of tonified Qi/Blood in meridians, strengthens sinews and bones, guides herbs to Deep Yin. Works with Xuduan to harmonize joints. (3 liang, stir-fried with wine).
* **Xuduan (Dipsaci Radix)**, complements Shudihuang (tonifies Jing) and Duzhong (tonifies Qi), regulating joints. (3 liang, stir-fried with wine).
* **Ming Niuxi (Achyranthis Bidentatae Radix)**, guides herbs to strengthen Lower Yuan, directs turbid Yin down so Clear Yang rises. Steamed with wine to slow descent. (3 liang, steamed, dried, baked).
* **Lianzi (Nelumbinis Semen)**, clears/nourishes Heart, strengthens Spleen/firms Kidney. Decocted to mix with other herbs.

**Preparation:**
Decoct 2 jin of Lianzi (removed heart and skin) in clear water to yield 30+ bowls. Remove lotus meat, add previous herbs, decoct twice, filter residue, boil to thick paste. Add final three ingredients (likely referring to specific processing steps or remaining powders mentioned in context, though text implies mixing powders later), form fine pills.

* **Renshen (Ginseng Radix et Rhizoma)**, Sovereign, tonifies Yuan Shen, neutral nature. Harmonizes Huangqi, Danggui, Baizhu, Suanzaoren, Shudihuang. (5 liang, powdered finely).
* **Baifuling (Poria) & Fushen (Poria with Hostwood)**, Ministers. Fuling drains dampness to aid Baizhu; Fushen secures Spirit to aid Suanzaoren. (Each 3 liang, powdered finely).

Mix powders with paste. Take 4 qian with warm water before sleep, or chew large pill with saliva, or dissolve in warm water.

**Case 1:**
Old Man Hu, near sixty, ill for months, treated with mixed cold/hot and tonifying/purgative methods, leading to confusing symptoms. Pulse was surging and forceful, suggesting not Yang deficiency. In summer, he sweated and feared wind, ate normally, but grew weary, had phlegm and nasal congestion. I diagnosed Yin deficiency failing to anchor Yang, causing Yang floating and Yin scattering, mixing Clear/Turbid, with pathogenic fire consuming Grain and generating Phlegm instead of Blood. Treatment: Nourish Yin to anchor Yang. Prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) with Salt-water processed Chenpi (Citri Reticulatae Pericarpium), Maidong, and Wuweizi. Within three doses, spirit cleared. He asked for fertility pills. I advised Liuwei Dihuang Wan plus Maidong and Wuweizi. He ignored this. Half a month later, spirit declined again. He resumed the formula, spirit revived, sexual potency returned. Three months later, his concubine became pregnant.
Later, the concubine complained of extreme bland taste in mouth and chest agitation. Other doctors suspected blood stasis or masses and suggested purging. I strongly opposed this. By 5-9 months, abdomen enlarged but soft, shifting sides, waist moving, no fetal movement at navel. Doctors called it a "Ghost Fetus" and demanded removal. I resisted. Suddenly, she went into labor without pain. The husband blamed me. I explained: "Fruit falls when ripe. No pain delivery is normal for obese women with excess amniotic fluid. The bland taste is due to Stomach lacking True Fluids." Servants announced the birth of a healthy boy. The husband knelt in gratitude.

**Case 2:**
Grandson of Chancellor Jiang, five months old, developed smallpox. Not dense, but congenital True Yin/Yang deficiency, pale flesh. Summer heat caused Yang to float to surface, high fever, profuse sweating. Smallpox receded and flattened after 4-5 days, with lethargy and fright. I diagnosed: High fever = Yang outside; Sweating = Yin leaking, Yang exhausting. Must gather True Yin/Yang. Without tonifying Yin, floating Yang cannot be anchored; without tonifying Yang, Yin cannot return to source. Middle Qi is also deficient. Floating Yang needs astringent power to gather. Prescribed: Shudihuang 8 qian, Jitui Baizhu (milk-fried) 3 qian, Niuxi 2 qian, Maidong (heart removed, fried) 2 qian, Wuweizi 4 fen, Rougui (Cinnamon Bark, bark removed) 6 fen. Decoct, drink warm before meal. Rougui + Wuweizi enhances blood circulation and surface penetration, helping the rash erupt. Patient slept, cooled, sweat stopped, spirit refreshed, rash rose, appetite returned, and he healed.

**Case 3:**
Mr. Zhao Taibao, 72 years old, ill for 2+ months, undiagnosed by others. Right cheek swollen and hard, extending to jaw/neck/behind ear, firm, non-hot, non-painful. Treated for 70+ days with detox/purging/topicals with no effect. Pus appeared in mouth, jaw locked, poor intake, declining spirit. Pulse surging and empty. Diagnosed as Shiju (Stone Abscess) due to Qi/Blood exhaustion and Yin-Cold accumulation. Without Yang warmth, it cannot resolve externally or internally. Recommended: Pig fat mashed with Rougui powder, scallion heads, salt, applied thickly. Fat treats flesh/blood (same energy), scallion opens orifices, salt softens hardness, Rougui moves blood, oil moisturizes skin. Internally: Kongxin Shengmai Yin (Heart-Empty Generating Pulse Drink) with Bawei Wan. After meals: Renshen, Danggui, Baishao, Fuling, Baizhu, Hougui (Thin Cinnamon), Jinyinhua (Lonicerae Japonicae Flos), Jiaocishi (Cirsii Japonici Herba). True Yang restored, Yin-Cold resolves, Qi/Blood harmonizes, driving out toxin. In 3-5 days, hardness softened, swelling raised, numbness turned painful, purple turned red. Appetite increased, Qi/Blood grew, toxin expelled. Necrotic tissue resolved. Healed in less than 10 days. Confirms: All diseases root in Water/Fire, function through Qi/Blood. Abscesses require Water/Fire/Qi/Blood to generate pus and heal.

**Case 4:**
Young Master Du, 19, critically ill in summer. Pulse sometimes surging/wiry with weak Chi, sometimes wiry/thin with tight Chi. Alternating chills/fever, swelling/pain below ears, slight foot swelling, weak voice, vomiting immediately after eating. Vomiting reduced when lying still, worsened with movement. History: Exposed to hail/cold in summer, dispersed unsuccessfully, harmonized unsuccessfully, then cooled with Huangqin/Gardenia, triggering vomiting. I diagnosed medication error. Summer cold indicates unstable Middle/Exterior Qi. Born late in father's life (weak constitution), pampered (fragile sinews/bones). Should have been warmed internally. Wind disperses, Cold warms. Wind injures Wei (Surface), Cold injures Ying (Interior). Using dispersants for Cold injury harms Middle Qi, causing Cold stagnation and Fire rising to empty areas (ears/cheeks). Misdiagnosed as Excess Fire, treated with Cold herbs, floating Fire and damaged Middle Yang. Cannot tolerate food. Classic says: Cold from Yin meridians is True Yin syndrome, requires warming. Internal injury > External injury, requires warming/tonifying, not dispersing. Righteous Qi expels Cold. Current case: New disease awakens old evil, branch disease triggers root disease. Must treat upper/lower. Warming to scatter Cold finds no Cold; warming Middle is blocked by ear swelling; nourishing Yin is blocked by Middle Jiao obstruction. Solution: Strongly tonify True Yang to reach lower, heavily nourish True Yin to sustain middle. Large dose of Bawei plus Niuxi, Maidong, Wuweizi, mixed with concentrated Renshen juice to open obstruction. Two doses, vomited shortly after. Even rice water rejected. Cold herbs severely injured Middle. Condition critical, could not wait. Prepared powder of Renshen, Paoshengjiang (Blast-fried Ginger), Fuzi (Aconiti Lateralis Radix Praeparata)...