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Hematitum (Zhe Shi): Red in color, slightly cool in nature. It can generate blood and also cool blood. Due to its heavy and descending quality, it is excellent at suppressing rebellious Qi, descending phlegm-fluids, stopping vomiting, and unblocking dry impactions. When used appropriately, it can achieve remarkable effects. Its original substance is formed by the combination of iron oxide. Although its structure is hard, it is layered like rust (rust is also a compound of iron oxide). When raw and ground for consumption, it does not damage the stomach and intestines; even consuming slightly coarse powder causes no harm to the gastrointestinal tract. Moreover, when taken raw, the iron oxide component remains pure and complete, greatly nourishing blood. Therefore, *Shennong Bencao Jing* states it treats "chi wo" (blood discharge) and metrorrhagia; *Rihua Zhujia Bencao* states it treats menorrhagia. If calcined, it loses this efficacy. Quenching it in vinegar after calcination is particularly inappropriate. Furthermore, its nature is very mild; although it descends rebellious Qi, it does not damage healthy Qi, and unblocks dry impactions without any destructive properties. Thus, calcination is originally unnecessary. The form suitable for medicine consists of thin sheets, layered upon each other, with one side dotted with convex bumps and the other side with concave depressions.

Hematitum is a compound of iron oxide, with a nature similar to rust, and is originally unsuitable for calcination. Xu Lingtai stated that if calcined and then quenched in vinegar, it can damage the lungs. In all prescriptions in this book containing Hematitum, raw Hematitum should be crushed into fine powder for use.

[Attached Case 1] Chi from the neighboring village, approximately forty years old, developed a sore on the upper epigastrium, the size of a walnut. After rupture, treatment failed to heal it for three years. The sore opening was the size of a coin, ulcerating internally and spreading along the hypochondrium to the back. Daily, pus drained from the back towards the sore opening. He sought my treatment, stating that since contracting this sore three years ago, he had never slept peacefully. Lying down briefly caused him to feel Qi rising from the lower Jiao, rebelling upwards and rushing to the heart. I said, "This is the root cause of your condition." I instructed him to use one liang of raw Euryale Seed (Qianshi), boiled into a thick decoction, to deliver five qian of raw Hematitum fine powder. He was then able to sleep. After several more doses, he slept steadily through the night. The upward rebellion of Qi was actually the rebellion of Chong Qi. Using Hematitum to suppress it and Euryale Seed to astringe it allowed the Chong Qi to settle in its residence. Subsequently, using Huoluo Xiaoling Dan (Active Collaterals Efficacious Spirit Pill) with added three qian of raw Astragali Radix (Huangqi) and three qian of raw Hematitum, taken as one dose daily, resulted in complete recovery within half a month.

A young man surnamed Mao from the neighboring village, after recovering from a cold damage disease, suddenly experienced phlegm-fluids obstructing upwards, blocking the throat, making breathing nearly impossible. His father, who knew medicine, pressed the Tiantu (CV22) acupoint with his thumb (nail against the throat, fingertip on the point, pressing downwards, not inwards). Breathing became slightly clear, and he urgently invited me for treatment. I used two liang of sesame oil, heated and mixed with one fen of Moschus (Shexiang), and administered it orally. Immediately, some phlegm-fluids flowed out. Then, I used one liang of raw Hematitum, six qian of Ginseng Radix et Rhizoma (Renshen), and four qian of Perillae Fructus (Suzi), decocted in water, and administered slowly. The phlegm obstruction cleared instantly.

A woman surnamed Zhou, approximately thirty years old, suffered from continuous vomiting. For five or six days, she could not retain even a spoonful of water, and her bowels did not move. She felt pain and stagnation in the lower epigastrium. Any medicine with flavor was vomited immediately upon entering the mouth, and even flavorless medicine was vomited shortly after. Doctors refused to treat her. Later, I examined her pulse, which showed a slippery aspect, with excess above and deficiency below. Suspecting pregnancy, I asked if her menstruation had ceased for fifty days. Indeed, the stagnation was severe, and danger was imminent. *Neijing* states: "If there is a cause, there is no injury." I used only two liang of Hematitum, decocted in water and drunk. She felt the medicine reaching the site of stagnation but unable to descend, so it was vomited back up. I then used four liang of Hematitum, sifted to obtain about one liang of fine powder, decocted the remaining three liang in water, and mixed the fine powder into the decoction for administration. The stagnation cleared, bowels moved, and she remained safe until delivery.

Someone asked: *Mingyi Bielu* states Hematitum causes miscarriage. Yet now you treat pregnant women with such large amounts of Hematitum. Even if effective, is this not taking undue risks? I replied: In my life treating patients, I always deliberate thoroughly before prescribing; I never gamble blindly. Hematitum is heavy, and its descending power can push down有形 (tangible) stagnation. If the fetus is at six or seven months, its use might be problematic. However, in early pregnancy, where morning sickness leads to stagnation, the uterine cavity contains only coagulated blood. Hematitum has no blood-breaking弊端 (drawbacks) and effectively treats blood discharge and metrorrhagia. What harm is there in heavy use? Moreover, in this case, for five or six days, no fluid could pass downward. The rebellion of Qi and stagnation of Qi transformation reached their peak. Using Hematitum to descend rebellion and open stagnation merely harmonizes the Qi transformation of the Zang-Fu organs to reach balance. How could it cause other harms?

The wife of Lv XX in Guangping County, over twenty years old, suffered severe vomiting due to morning sickness. Within nine days, she retained little water and vomited all food. I examined her pulse, which was forceful, and her tongue had a yellow coating. Asking about her symptoms, she reported heat in the heart. Knowing this involved an external pathogen, I first used one and a half liang of raw Gypsum Fibrosum (Shigao), decocted in a cup of water, to prevent vomiting, administering it slowly while warm. The heat subsided slightly. Then, I used two liang of raw Hematitum, decocted in a large cup of water, divided into two warm doses. She felt pain in the lower epigastrium as the medicine reached it, and it reverted upwards and was vomited. Knowing the stagnation in the lower epigastrium was very firm and light agents could not penetrate it, I used four liang of raw Hematitum fine powder, sifted to obtain one liang of extremely fine powder, decocted the remaining three liang in water, and delivered the extremely fine powder with the decoction. The stagnation cleared, diet proceeded smoothly, and she delivered at term.

An unmarried girl, after the Mid-Autumn Festival, contracted wind-cold. For three or four days, she experienced fullness and oppression in the chest and diaphragm, unable to eat or drink. Even one sip of water caused vomiting. At times, she scratched her chest with her hands. Her pulse was slippery and solid, especially on the right side. I used only one and a half liang of raw Hematitum fine powder, decocted in water for warm drinking. After a meal's time, she still vomited. This was because her stomach was blocked by phlegm-fluids; the medicine could not overcome the disease, failed to descend, and reverted upwards. I then changed to four liang of Hematitum, decocted in a large bowl of water, administered in three warm doses successively. The chest cleared, and she could drink water without vomiting. The next day, her pulse was surging and long, and her tongue coating changed from slightly yellow to black. I heavily used Baihu Tang (White Tiger Decoction) for two major doses, each with four liang of raw Gypsum Fibrosum, administered in divided warm doses. Bowels moved, and she recovered.

Qu XX, over thirty years old, contracted a pestilential disease. For two to three days, he experienced nausea and vomiting. For five days, he could not swallow food and came to the clinic seeking medical help. His pulse was floating and wiry, rapid with nearly six beats per breath, and weak upon heavy pressure. He had bitter taste, heat in the heart, and a slightly yellow tongue coating. I reasoned that the floating and wiry pulse indicated a combined disease of Yangming and Shaoyang. The pathogenic mechanisms of these two meridians rushed upwards together, causing vomiting. Heat in the heart and bitter taste indicated substantial internal heat. The weak and rapid pulse indicated lack of grain Qi support and pressure from internal heat. I thought that boiling raw Hematitum in water would have no odor and possess cooling and settling power, possibly stopping vomiting. I used two liang of raw Hematitum, boiled in two cups of water, administered in two warm doses. After finishing, he vomited again. The patient was terrified, and due to prolonged fasting, he looked weak. I said, "Do not fear. Take a few qian of the powder, and vomiting will stop immediately." I used only five qian of raw Hematitum fine powder, delivered with boiling water. Nausea stopped instantly, and the chest cleared. He drank a cup of thin porridge, which descended smoothly. Diet resumed without vomiting, but he still had heat in the heart, swelling of the tongue root, and difficulty speaking. I used one liang of raw Gypsum Fibrosum, and three qian each of Salvia Miltiorrhiza Radix et Rhizoma (Danshen), Boswellia Resina (Ruxiang), Myrrha Resina (Moyao), and Forsythiae Fructus (Lianqiao). Two doses resulted in complete recovery.

In autumn of the Guihai year, the clan sister of Li XX had burning heat throughout the body, a surging and solid pulse, restlessness, palpitations, and vomiting immediately after swallowing food or medicine. Her tongue coating was thick and yellow, and she had not had a bowel movement for several days. I knew the external heat had entered the Yangming Fu organ, accompanied by rebellious Stomach Qi and rushing Chong Qi. I prescribed eight qian of raw Hematitum fine powder, one and a half liang of raw Gypsum Fibrosum fine powder, one liang of Trichosanthis Semen (Gualouren), six qian each of Scrophulariae Radix (Xuanshen) and Asparagi Radix (Tian dong), and two qian of Glycyrrhizae Radix et Rhizoma (Gancao). The latter five herbs were decocted in a large cup of water. First, the Hematitum powder was delivered with boiling water, followed by the decoction. She retained the medicine without vomiting, and one more dose cured her.

A woman near fifty years old contracted a warm disease. For seven or eight days, both exterior and interior were hot. Her tongue coating was very thin and black, resembling spots. This was a condition of external contraction combined with internal deficiency. The doctor used purgative herbs twice, leading to wheezing and rebellion. Having her son press her heart area with both hands stopped the wheezing temporarily. Soon it returned, and pressing tightly stopped it again. Her pulse had no root in the chi position and was shaky in the cun position, indicating impending collapse. It was mid-summer. I instructed her to take four raw egg yolks mixed with fresh well water. Wheezing subsided slightly, allowing time to prepare medicine. I used two qian of Hematitum fine powder mixed with two raw egg yolks in warm water. Wheezing ceased, and pulse stabilized. Subsequently, Shen Zhen Zhen Qi Tang (Ginseng and Hematitum to Suppress Qi Decoction) was used to consolidate recovery.

My friend Mao XX treated a woman with chest oppression, inability of food to descend to the stomach, and occasional vomiting. Mao XX used six qian of Hematitum fine powder, delivered with strong Ginseng Radix et Rhizoma decoction. Shortly, sounds like firecrackers were heard in the abdomen, and the chest and stomach felt open. Diet returned to normal.

My friend Gao XX treated a man with fullness in the upper Jiao, difficulty eating, and a sensation of obstruction in the chest. The doctor used ten doses of Da Huang (Rhubarb Radix et Rhizoma) and Gualou (Trichosanthis Fructus) formulas for Tanxiong (Chest Binding). The patient felt increased fullness in the chest, extending to the throat, overflowing water immediately upon drinking. Gao XX used two liang of Hematitum and six qian of Ginseng Radix et Rhizoma, decocted and administered. The obstruction sensation dropped to the lower Jiao. Adding Angelicae Sinensis Radix (Danggui) and Cistanches Herba (Roucongrong), one more dose expelled stagnant material, and the illness vanished.

My friend Li XX treated a man with cold-phlegm stagnation in the stomach, vomiting refusing food, and no bowel movement for ten days. Eight qian of Ginseng Radix et Rhizoma, six qian of dried Ginger (Ganjiang), and one liang of Hematitum were used. One dose stopped vomiting. Adding five qian of Angelicae Sinensis Radix allowed bowel movement and recovery.

My disciple Gao XX treated an elderly man over seventy years old with hiccups and urinary retention. At severe times, he felt throat blockage, inability to breathe, eyes rolling up, and body arching backwards. Several doctors failed to treat him. Gao XX found a floating and weak pulse. He prescribed Hematitum, Taishen (Codonopsis Radix), raw Dioscoreae Rhizoma (Shanyao), raw Euryale Seed, and Fraxinidis Cortex (Niuxizi). Hiccups ceased instantly. Adding Bamboo Shavings (Zhuru) for one dose allowed urination to become smooth.

Observing the above cases, Hematitum is indeed a great medicine for saving critical conditions. Yet modern people rarely use it. Those who do use only two or three qian, insufficient to overcome the disease, making its use equivalent to non-use. When I boldly use amounts up to several liang, it is not rash. Having practiced clinically for a long time, I have studied the nature, capacity, and appropriate dosage of medicines for decades, forming firm convictions in my mind before daring to use them boldly. Hundred uses result in no errors. Hematitum can suppress rebellious Qi and push down tangible stasis because of its heavy descending power, without damaging Qi or Blood. Moreover, supplementing with Ginseng Radix et Rhizoma for Qi deficiency makes it a perfect strategy.

Using Ginseng Radix et Rhizoma and Hematitum together not only guides Qi back to its origin but also treats conditions where rebellious Qi invades upwards, filling the chest, or accompanied by vomiting, characterized by excess above and deficiency below.

*Neijing* states: Yangming reversal leads to wheezing, cough, body heat, fright, epistaxis, and hematemesis. Huang Kunzai elaborated on *Neijing*, stating: "Blood loss via urine/feces is due to Taiyin failing to ascend; blood loss via vomiting/epistaxis is due to Yangming failing to descend." This statement deeply understands *Neijing*. Yangming Stomach Qi naturally descends. If it fails to descend, it stagnates and rebels upwards. Extreme rebellion causes blood to rise with it, leading to hematemesis and epistaxis. Treating these conditions requires descending Stomach Qi as the primary method, and Hematitum is the most effective herb for this. However, reasons for Stomach Qi failing to descend vary. If due to heat, descend with Hematitum assisted by Trichosanthis Semen and Paeoniae Radix Alba (Baishao); if heat combined with deficiency, add Ginseng Radix et Rhizoma. If due to cold, descend with Hematitum assisted by dried Ginger and Baishao (using Baishao prevents dried Ginger's heat from invading Liver/Gallbladder, though cold-induced non-descending Stomach Qi causing bleeding is rare); if cold combined with deficiency, add Atractylodis Macrocephalae Rhizoma (Baizhu). If due to lower Jiao deficiency and Chong Qi failing to control upward rushing of Stomach Qi, descend with Hematitum assisted by raw Dioscoreae Rhizoma and raw Euryale Seed. If due to Stomach Qi failure causing rupture of gastric vessels with chronic non-healing, descend with Hematitum assisted by Dragon Bone (Longgu), Oyster Shell (Muli), and Notoginseng Radix et Rhizoma (Sanqi). Regardless of the cause, Hematitum is the main herb, adjusted with appropriate assistants based on syndrome. Hematemesis and epistaxis will invariably heal.

Zhang XX from Fengtian, near forty years old, suddenly suffered severe epistaxis. Pulse was surging and slippery in the guan position, weak in the chi position upon heavy pressure, indicating excess above and deficiency below. He complained of unclear head and eyes, dry tongue upon waking, and dry stool occurring every few days. I prescribed: one liang each of Hematitum, raw Rehmanniae Radix (Shengdihuang), and raw Dioscoreae Rhizoma; five qian each of Angelicae Sinensis Radix, Baishao, raw Longgu, raw Muli, and Achyranthes Bidentatae Radix (Huainiuxi). Decocted in water, delivered with two qian of Notoginseng Radix et Rhizoma fine powder. (When using Shengdi for bleeding, Sanqi should be added to prevent blood stasis in collaterals after bleeding stops). One dose stopped bleeding. Later, reduced Shengdi by four qian, added four qian each of prepared Rehmanniae Radix (Shudi) and Lycii Fructus (Gouqi). Several doses normalized the pulse.

Early purgation in cold damage can lead to Tanxiong (Chest Binding); untreated plague can also cause it. Tanxiong is the binding of external pathogens with chest phlegm-fluids, blocking airways and making breathing difficult. Zhang Zhongjing's Daxiexiong Tang (Major Chest Binding Decoction) and Wan are good formulas for this. However, since both contain Kansui Radix (Gansui), doctors dare not use them lightly, nor do patients. All Qi-promoting and phlegm-resolving drugs are ineffective, leaving doctors helpless. Previously, I treated such cases by having patients consume four liang of newly stir-fried Trichosanthis Semen, crushed and decocted, which often worked. Later, I devised a formula: two liang each of Hematitum and Trichosanthis Semen, six qian of Perillae Fructus (named Dangxiong Tang). Used as a substitute for Daxiexiong Tang/Wan, it proved effective repeatedly. If the binding is at the stomach entrance, with epigastric fullness and tenderness on pressure (Xiaoxiexiong Tang syndrome), halving the dosage substitutes for Xiaoxiexiong Tang, with even faster efficacy. Since devising this formula, I have saved many people. For cold/warm diseases transmitted to Yangming Fu without high fever, but with upper Jiao phlegm stagnation and lower Jiao constipation, this formula can also be used (dosage should be reduced). It clears phlegm above and unblocks bowels below, achieving two goals with one action.

For cold/warm diseases not leading to Tanxiong or epigastric fullness, but where rebellious Qi carries Stomach heat upwards, preventing eating and medication tolerance, Hematitum should be used with heat-clearing herbs. I treated the wife of An XX from Fengtian, over forty years old, delivering twins, exhausted, with nausea, vomiting, inability to eat for days, and vomiting all medicine. Mental confusion and critical condition led doctors to refuse treatment. I found a surging and solid pulse, fiery face, and thick yellow tongue coating. Diagnosing postpartum warm disease with substantial Yangming Fu heat causing Stomach Qi rebellion due to heat, I instructed her to take one and a half liang of Scrophulariae Radix and one liang of Hematitum, decocted together. One dose cleared heat and stopped vomiting, allowing food intake. Subsequent use of Scrophulariae Radix, Baishao, and Forsythiae Fructus cleared residual heat, resulting in full recovery. I dared to use Scrophulariae Radix boldly because *Shennong Bencao Jing* explicitly states it is suitable for childbirth/lactation.

In conditions with substantial cold below and floating heat above, warming herbs may be rejected by the upper Jiao. Supplementing with Hematitum helps them descend quickly to the disease site, causing the upper Jiao floating heat to descend. I treated Liu XX from the neighboring village. After intercourse and excessive consumption of raw/cold foods, he suddenly had cramping pain in the lower abdomen, retracted testicles, constipation, and irritability/heat in the upper Jiao. The doctor prescribed Da Huang Fuzi Xixin Tang (Rhubarb, Aconite, and Asarum Decoction), worsening upper Jiao heat, hypochondriac pain/swelling, constipation, retracted testicles, and abdominal pain. The family was terrified. His pulse was wiry and deep, deeper in the chi position. I first applied vinegar-fried scallion white to the umbilicus and below, producing rumbling sounds, indicating opening. Testicle retraction and abdominal pain improved, but bowels remained blocked. I used two liang of Hematitum, five qian of processed Aconite Root (Wufuzi), and one liang each of Angelicae Sinensis Radix and Perillae Fructus, decocted and drunk. The medicine's power descended. After two hours, the dregs were decocted and drunk. Soon, hard stool was expelled, and all illnesses healed.

Dysphagia (Ge Shi) is a difficult-to-treat condition since ancient times. *Shanghan Lun* has Xuanfu Daizhe Shi Tang, originally for post-sweating/vomiting/purgation syndromes with epigastric hardness and persistent belching. Zhou Yangjun and Yu Jiayan considered it very effective for Ge Shi. However, *Shennong Bencao Jing* states Xuanfu Hua (Inula Flower) tastes salty. True Xuanfu Hua is salty and pungent (produced in Wudutai, my hometown). Modern pharmacy Xuanfu Hua is very bitter and unusable. Thus, I treat Ge Shi by removing Xuanfu Hua from the formula and increasing Hematitum. If Chong Qi rebellion is severe with dry constipation, I use Hematitum up to one liang, adding Angelicae Sinensis Radix, Diospyros Fruit Frost (Shishuang), and Asparagi Radix to moisten dryness and generate fluids. Adjusting according to the syndrome, many have been cured. This condition arises from weak Stomach Qi failing to support the cardia, and lower Jiao Chong Qi carrying phlegm upwards to block it, preventing food intake. Ginseng strengthens Stomach Qi, supporting the cardia to expand. Hematitum descends Chong Qi, carrying phlegm downwards, preventing blockage. This explains the formula's efficacy. If salty and pungent Xuanfu Hua is available, it can be added, but Hematitum dosage must be reduced. If the cardia is swollen with blood stasis causing narrowing, add Sappan Wood (Sumu) and Ground Beetle (Dubiechong), two qian each.

Headache, known in Western medicine as cerebrospinal nerve disease, can often be cured with heavy Hematitum. Recently in Fengtian, I treated a woman surnamed He, over twenty years old. Every day at Si hour, she had severe headache, worse on the left, resolving after noon. Japanese doctors tried anesthetics without effect. Her left pulse was floating, wiry, and forceful, indicating Shaoyang fire carrying Heart heat rising during Yang prosperity to conflict with the brain. I prescribed: six qian each of Hematitum, Longgu, Muli, Tortoise Carapace and Plastron (Guiban), Cornus Officinalis Fructus (Yurou), and Baishao; two qian of Gentiana Scabra Radix (Longdancao). All herbs were used raw.