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Ji Neijin (Chicken Gizzard Lining): It is the stomach and spleen of the chicken. It originally contains dilute hydrochloric acid, so its taste is sour and its nature is slightly warm. It can digest porcelain, stones, copper, and iron; thus, it is known for its ability to resolve blood stasis and accumulation. The *Neijing* (Classic of Internal Medicine) states that "all dampness-induced swelling and fullness belong to the Spleen." This is because the Spleen contains many venous vessels and is originally a transparent and delicate organ, residing in the Middle Jiao (Middle Burner) to regulate the ascending and descending of Qi transformation. If there is accumulation, Qi transformation cannot ascend or descend, leading easily to distension and fullness. Using Ji Neijin as an organ therapy, when combined with equal parts of Baizhu (Atractylodis Rhizoma), it becomes a key medicine for resolving accumulation and an excellent product for strengthening and tonifying the Spleen and Stomach. A strong Spleen and Stomach can better transport and transform medicinal power to eliminate stagnation. Furthermore, since Ji Neijin contains dilute hydrochloric acid, it not only eliminates accumulation in the Spleen and Stomach but also resolves accumulation anywhere in the Zang-Fu organs. Therefore, *pi* masses in men and *jia* masses in women can be cured with long-term use. Additionally, in cases of deficiency consumption (Xu Lao), meridians often have stasis. Adding Ji Neijin to tonic medicines to resolve meridianal stasis allows the disease to heal. For treating virgins who have never menstruated, it is especially a crucial medicine because it assists Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix) to unblock menstruation and helps tonifying medicines increase dietary intake to generate blood.

The syndrome of Gan Xue Lao (Dry Blood Consumption) in women is one of the most difficult to treat, hence few recover. Only those skilled in using Ji Neijin can achieve good results. In my past practice treating women with poor appetite, I often combined Baizhu with Ji Neijin. However, on two occasions, patients experienced menstruation three times within a month after taking this combination, leading me to realize the drawback of overusing Ji Neijin. Since Ji Neijin excels at dissolving blood stasis, it can accelerate the downward flow of menstruation. Thus, while it may cause excessive flow in those with normal menstruation, it facilitates flow in those with amenorrhea. Moreover, the *Neijing* states that "the Middle Jiao receives Qi, extracts juices, transforms them into red, which is blood." The source of blood lies in the Spleen and Stomach's ability to digest food well. The combination of Ji Neijin and Baizhu strengthens the Spleen and Stomach to aid digestion. The Spleen is the root of postnatal nourishment, residing centrally to irrigate the four directions. Frequent labor coughs in this condition indicate that Spleen deficiency leads to Lung deficiency; frequent sensations of burning heat indicate that Spleen deficiency leads to Kidney deficiency. Adding Shanyao (Dioscoreae Rhizoma), Dihuang (Rehmanniae Radix), and Gouqi (Lycii Fructus) to tonify the Lung and nourish the Kidney, along with Ji Neijin to facilitate transformation, naturally converts thick fluids into essence to irrigate the Lung and Kidney. After long-term medication, when visceral diseases are cured and the body has emaciated but menstruation still does not occur, one may add Chong (Mantis Ootheca) and Shui Zhi (Hirudo). If these are considered too harsh, Taoren (Persicae Semen) and Honghua (Carthami Flos) can substitute. However, sufficient Qi-tonifying medicines must be used to control them to ensure benefit without harm. I previously formulated a prescription based on this idea named Zisheng Tongmai Tang (Nourishing Life and Unblocking Pulse Decoction); several case records of its successful use follow for reference.

The *Neijing* states that "at age fourteen (two sevens), Tian Gui arrives in women." Fourteen years old is the standard, meaning menstruation should begin around fifteen. If menstruation has not started by fifteen, preventive measures should be taken. Use whole raw Huai Shanyao (Dioscorea opposita), finely ground and sifted. Take 1 liang or 8 qian, boil as tea, adjust taste with sucrose, and take with approximately 5 fen of raw Ji Neijin powder as a snack. Twice daily; over time, menstruation will naturally flow. This is because Shanyao nourishes blood, and Ji Neijin unblocks blood. If amenorrhea leads to reduced appetite and gradual burning heat, this formula can also be used. Increase Ji Neijin powder to 1 qian, and after drinking the tea, chew Tian Dong (Asparagi Radix) 2-3 qian.

If the condition worsens with physical weakness and labor cough, use my Zisheng Tongmai Tang. Several cases following this formula show modifications. If symptoms improve with Zisheng Tongmai Tang but menstruation remains absent, refer to the modified formulas in the attached cases.

Beyond the aforementioned prescriptions, I have newly formulated another: for those whose symptoms improve with Zisheng Tongmai Tang but menstruation does not return, use 4 liang of raw Huai Shanyao boiled into a thick decoction to deliver 3 qian of raw Ji Neijin powder. Boil the remaining Shanyao dregs several times and drink as tea. Menstruation will eventually arrive. Raw Ji Neijin is the most important herb for inducing menstruation, but excessive use may slightly damage Qi. Hence, the large dose of Shanyao is used to support Qi.

[Attached Cases]
Gong XX from Shenyang, aged 30, had a hard mass blocking the epigastrium for years, reducing appetite and preventing food descent. His pulse was deep and slightly wiry, more pronounced on the right side. Prescribed: Ji Neijin 1 liang, raw Jiuqu (Medicated Leaven) 5 qian. After several doses, the hard mass completely dissolved.

Shi XX from Fengtian, nearly 40, had abdominal accumulations unresponsive to treatment. The mass was under the left hypochondrium, 3 cun in diameter, very hard upon pressure, with occasional pain, hiccups, shortness of breath, and reduced appetite. Pulse was deep and wiry. This is a type of Liver accumulation called Feiqi. Prescribed: Raw Ji Neijin 3 liang, Chaihu (Bupleuri Radix) 1 liang, powdered together. Take 1.5 qian per dose, three times daily. Completely cured after ten-plus days.

Qin XX from Fengtian, over 30, suffered from gastric fullness and inability to eat, feeling obstruction at the cardia. Previous treatments failed. Pulse was deep and firm. Prescribed: Ji Neijin 6 qian, Baizhu 5 qian, Zheshi (Ostreae Concha) 5 qian, Ruxiang (Boswelliae Resina) 4 qian, Moyao (Myrrhae Resina) 4 qian, Danshen (Salviae Miltiorrhizae Radix et Rhizoma) 4 qian, raw Taoren 2 qian. Cured after eight doses.

Ms. Song from Fengtian, aged 19, had gastric stasis pain since age 17, unresponsive to treatment, progressing to inability to eat. Pulse was deep and weak, more pronounced on the right. Prescribed: Ji Neijin 1 liang, raw Jiuqu 5 qian, Dangshen (Codonopsis Radix) 5 qian, Sanleng (Sparganii Rhizoma) 3 qian, Ezhu (Curcumae Rhizoma) 3 qian, Zhimu (Anemarrhenae Rhizoma) 3 qian, Chuji (Red Ladybug, 15 pieces). After eight doses, blood appeared in stool and urine, the stomach felt clear, and pain ceased.

Mrs. Li from Yanshan, aged 30, had a stationary accumulation in the epigastrium for years, growing to the size of a fist and becoming very hard, preventing eating. Left pulse was wiry and thin; right pulse was deep and soft. Prescribed: Ji Neijin 8 qian, raw Huangqi (Astragali Radix) 6 qian, Sanleng 3 qian, Ezhu 3 qian, Ruxiang 3 qian, Moyao 3 qian, Danggui 4 qian, Zhimu 4 qian. Cured after twenty-plus doses.

Friend Mao XX treated a child whose abdomen swelled from ages 2-3, worsening by ages 5-6, with sallow, thin complexion and reduced appetite, commonly known as "Big Belly Bloat." Seeing my note on Qiyi Bing (Longevity Cake) stating that removing Qianshi (Euryales Semen) treats pediatric malnutrition bloat and adult accumulations, he used that formula (Raw Ji Neijin powder 3 liang, wheat flour 0.5 jin, white sugar as needed, mixed into thin pancakes, baked until crisp, taken as snacks). Cured in over a month.