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Luo's discussion on the syndrome of deficiency consumptive disease (Xu Lao) posits that it arises primarily from latent pathogenic factors and blood stasis, rather than solely from Yin deficiency. The occurrence of alternating chills and fever in the evening, varying in intensity, indicates that Yang Qi has sunk into the Yin aspect. Nourishing Kidney Water to generate Liver Wood is the most appropriate method; slight adjustments may be made without fundamentally altering the prescription.

Shu Di Huang (Prepared Rehmannia Root), Bai Shao (White Peony Root), Dan Pi (Moutan Cortex), Fu Ling (Poria), Huai Yao (Chinese Yam), Chai Hu (Bupleurum Root), Bie Jia (Turtle Shell), Zhi Cao (Honey-fried Licorice Root).

When True Yang Qi is weak, it fails to nourish the sinews, leading to retraction of the genitalia; it fails to secure the interior, leading to seminal emission; and it fails to defend the exterior, leading to spontaneous sweating. These three manifestations often occur together. This pathology lies at the pivot of the Three Yin meridians and cannot be treated with the methods of later generations. Taking the ancient formula Ba Wei Wan (Eight-Ingredient Pill / Jin Gui Shen Qi Wan) exclusively and for a prolonged period should yield results.

Vertigo, nausea and vomiting, chest fullness, short and frequent urination, dry mouth. This presents as Kidney Water deficiency below, internal Wind stirring above, and Phlegm-fluid accumulation in the middle. The pathology is multifactorial.

Ling Yang Jiao (Antelope Horn), Gou Teng (Uncaria Ramulus cum Uncis), Ban Xia (Pinellia Rhizoma), Xiao Sheng Di (Young Rehmannia Root), Tian Ma (Gastrodia Rhizome), Zhu Ru (Bamboo Shavings), Guang Pi (Aurantii Pericarpium), Fu Ling (Poria).

Liver Yang transforming into internal Wind reverses and invades the domains of the Spleen and Stomach. Body fluids condense into Phlegm, which flows through the collaterals of the Liver and Gallbladder. This explains the left-sided body numbness and stifling oppression in the heart and diaphragm. Since both Wind and Fire have an upward nature, symptoms such as rising fire, rebellious Qi, and epistaxis appear in the upper body. These conditions result from long-term irregular diet, overwork, and emotional depression, not occurring overnight. The treatment requires clearing Liver Fire and strengthening Spleen Qi, which cannot be achieved quickly.

Ling Yang Jiao (Antelope Horn), Ju Hong (Tangerine Red Peel), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Zhi Shi (Immature Bitter Orange), Tian Ma (Gastrodia Rhizome), Ban Xia (Pinellia Rhizoma), Fu Ling (Poria), Gan Cao (Licorice Root), Mai Dong (Ophiopogon Tuber).

Insufficiency of Lung Yin and excess of Lung Heat cause cough with nasal discharge. The body fears wind because heat escapes through orifices while Lung Qi fails to protect the exterior. Although other organs may be diseased, priority should be given to treating the Lungs.

E Jiao (Donkey-hide Gelatin), Xing Ren (Apricot Seed), Bei Mu (Fritillaria Bulbus), Bei Shen (North Codonopsis Root), Dou Ling (Stemona Root), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice Root), Nuomi (Glutinous Rice).

Dry cough without phlegm indicates Liver Qi rebelling against the Lung, not a primary Lung disease. Treatment should focus on the Liver, combined with nourishing Liver Qi.

Chuan Lian (Coptis Rhizoma), Bai Shao (White Peony Root), Wu Mei (Mume Fruit), Gan Cao (Licorice Root), Dang Gui (Angelica Sinensis Radix), Mu Li (Ostrea Concha), Fu Ling (Poria).

When there are gaps in the collaterals, Qi must circulate freely, causing pain. One must fear that during late spring and early summer, when Yang Qi rises from the earth, Blood will overflow following Qi. Seizing this opportunity to prepare, one should tonify Essence and marrow. Generally, Yin-deficiency cough involves other organs affecting the Lungs. If treated with cooling agents, not only will the disease persist, but the Stomach will be damaged, appetite will decrease, and deficiency consumptive disease will develop rapidly, becoming difficult to treat.

Hai Shen (Sea Cucumber), Shu Di (Prepared Rehmannia Root), Jin Ying Gao (Golden Berry Paste), Lu Jiao Jiao (Deer Antler Glue), Xiang Lian Rou (Lotus Seed Meat), Bei Wei (Schisandra Berry), Yu Rou (Cornus Fruit), Huai Yao (Chinese Yam), Fu Shen (Poria with Hostwood), Qian Shi (Euryale Seed).

These two pastes should be processed into pills.

Yin insufficiency with Yang excess; Liver tends to rebellion, Lung tends to stagnation. Pulse is rapid, with panting, rebellious cough with hemoptysis, and hypochondriac pain. Treatment should favor nourishing and descending, along with quiet rest. Otherwise, continuous bleeding may ensue.

Xiao Sheng Di (Young Rehmannia Root), Jing Tan (Charred Schizonepeta Spike), Bai Shao (White Peony Root), Tong Bian (Human Urine), Yu Jin (Curcuma Tuber), Xiao Ji (Cirsii Herba), Ou Zhi (Lotus Rhizome Juice).

Unresolved blood outside the vessels stagnates internally, while cold-heat pathogens interact chaotically, disrupting Qi. Thus, abdominal fullness, vomiting and diarrhea, alternating chills and fever, and dry mouth occur. Treatment should calm chaotic Qi and guide out accumulated blood. Although Yuan Qi is deficient, sudden tonification is inappropriate.

Dan Pi (Moutan Cortex), Zha Tan (Charred Hawthorn Fruit), Ze Lan (Lygodii Herba), Chi Shao (Red Peony Root), Yu Jin (Curcuma Tuber), Dan Shen (Salvia Miltiorrhiza Radix), Niu Xi (Achyranthes Root), Xiao Ji (Cirsii Herba).

In cases of blood stasis, Yin is already injured, and Qi inevitably rebels. Here, the blood is dark purple and scanty, yet there is chest fullness, indicating residual stasis; the tongue is crimson without coating, indicating Yin deficiency; persistent vomiting indicates Qi rebellion. Additionally, heavy head and cold feet suggest lower deficiency with upper collapse; aversion to cold and delirium indicate weak Yang and depleted Qi. This condition is stubborn: tonification is unsuitable, and purgation is contraindicated.

Ren Shen (Ginseng Radix), Fu Ling (Poria), Shan Qi (Eucommia Bark - *Note: Text says "Shan Qi", likely referring to a specific herb or typo for Shan Yao/Zhu, kept as literal*), Wu Zhu Yu (Evodia Fruit), Wu Mei (Mume Fruit), Mu Li (Ostrea Concha), Chuan Lian (Coptis Rhizoma), Yu Jin (Curcuma Tuber).

Shaoyin is the pivot of Yin, governing opening and closing internally. Deficiency leads to loss of normal function. One should strengthen the pivot using appropriate methods; neither pure unblocking nor pure securing is correct.

Shu Di (Prepared Rehmannia Root), Qi Zi (Goji Berry), Tu Si (Dodder Seed), Fu Ling (Poria), Dan Pi (Moutan Cortex), Yu Rou (Cornus Fruit), Huai Yao (Chinese Yam), Sha Yuan (Astragali Complanati Semen).

Middle Qi deficiency and cold lead to diarrhea upon exposure to cold, accompanied by rising fire and gingival bleeding. This corresponds to the ancients' description of residual fire gathered in the chest and deep cold accumulated in the abdomen. Treatment should warm and tonify Middle Qi so that when Earth is thick, Fire naturally收敛 (converges/retains).

Ren Shen (Ginseng Radix), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Zhi Cao (Honey-fried Licorice Root), Gan Jiang (Dried Ginger), Yi Zhi Ren (Alpinia Oxyphylla Fruit).

This is a presentation of Lung Excess above, Kidney Deficiency below, and Spleen distress in the middle. However, excess should not be attacked; instead, address the deficiency temporarily. The middle should not be dried; instead, warm the lower temporarily. Since the Kidney is the gate of the Stomach, and Fire is the mother of Earth, slight improvement may be possible.

Jin Gui Shen Qi Wan (Kidney Qi Pill from the Golden Cabinet).

Sweating occurs asymmetrically (pian ju); the pulse is not supple and occasionally skips beats. This indicates Liver Yang excess and Stomach Yin insufficiency, leading to thick phlegm and turbid fire disturbing the interior and obstructing the exterior. Although currently stable, the ancients advocated treating disease before it arises. Wise individuals perceive the significant from the subtle and should prioritize regulation and preservation.

Ren Shen (Ginseng Radix), Chuan Hu (Dendrobium Stem), Nan Zao (Southern Jujube), Ban Xia (Pinellia Rhizoma), Fu Ling (Poria), Zhi Cao (Honey-fried Licorice Root), Mai Dong (Ophiopogon Tuber), Dan Pi (Moutan Cortex), Xiao Mai (Wheat Grain).

Exterior deficiency makes one susceptible to Wind pathogens; interior deficiency leads to diarrhea; upper deficiency causes vertigo; lower deficiency leads to nocturnal emissions. Yu Ping Feng San (Jade Windscreen Powder) is suitable.

Huang Qi (Astragalus Root), Fang Feng (Saposhnikovia Root), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Mu Li (Ostrea Concha), Zhi Cao (Honey-fried Licorice Root).

Moist fluid with a fishy odor at the umbilicus, with a generally large pulse, indicates Damp-Heat in the Shaoyin meridian. Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) can clear Damp-Heat from the Kidney region; it should be modified for treatment.

Modify Liu Wei Di Huang Wan: Remove Shan Yao (Chinese Yam), add Chuan Bai (Phellodendron Bark), Bi Xie (Dioscorea Hypoglauca Rhizome), Che Qian (Plantago Seed), Nu Zhen (Ligustrum Lucidum Fruit).

Following lower body hemorrhage, Yin Qi is necessarily injured. Pathogens enter the Yin directly due to deficiency, carrying deficient Yang upward. Symptoms include head heat, limb cold, coughing, and Qi rushing, worsening at night. This case features less pathogen and more deficiency, lower deficiency with upper excess, differing from common seasonal diseases. This is my biased view; I ask if experts agree.

Sheng Di (Rehmannia Root), Bai Shao (White Peony Root), Fu Ling (Poria), Mai Dong (Ophiopogon Tuber), Zhi Cao (Honey-fried Licorice Root), Yuan Shen (Scrophularia Root).

Malaria with upper and lower bleeding results from Middle deficiency and pathogenic disturbance. After significant blood loss, malaria pathogens remain strong, and central disturbance continues. Who can guarantee blood will not return? Following ancient principles, for Middle deficiency with blood loss, relying solely on blood-astringing herbs is incorrect. For chronic malaria, securing Middle Qi is essential. I propose Li Zhong Tang (Regulate the Middle Decoction); it stops bleeding and malaria alike. Please advise.

Ren Shen (Ginseng Radix), Yu Zhu (Atractylodis Rhizoma), Pao Jiang (Roasted Ginger), Zhi Cao (Honey-fried Licorice Root).

The Heart houses the Spirit. Overlabor scatters Spirit and weakens the Heart; Heart weakness allows Kidney Qi to invade, causing fear. As the Classics state, "Rebellious Qi ascending causes fear." This disease began with the Heart affecting the Kidney, then the Kidney further troubling the Heart. The Classics say: "The Heart desires softness, the Kidney desires firmness." Softening the Heart requires salty flavors to facilitate descent; firming the Kidney requires bitter flavors to prevent floating. Also, "High things are suppressed, scattered things are collected." Treating unrestrained Heart-Kidney Spirit requires adhering to these principles. Since the Heart governs Blood and the Kidney governs Essence, preserving Spirit requires nourishing Blood, and stabilizing Will requires benefiting Essence. Therefore, sweet, moist, substantial, and rich-tasting substances serve as the foundation for collecting Spirit and Will.

Ren Shen (Ginseng Radix), Chuan Lian (Coptis Rhizoma), Huai Yao (Chinese Yam), Tian Dong (Asparagus Tuber), Shu Di (Prepared Rehmannia Root), Fu Shen (Poria with Hostwood), Wu Wei (Schisandra Berry), Mu Li (Ostrea Concha), Yu Rou (Cornus Fruit), Bai Ren (Biota Seed), Gui Xin (Cinnamon Twig Center).

Sudden fright and terror cause cold extremities, Qi rushing from the lower abdomen leading to syncope, retraction of the genitals, and sweating. Lower Yuan deficiency leads to loss of retention control, requiring Yang-tonifying and grasping methods. However, symptoms of thirst, palpitations, and sudden hollow feeling in the abdomen indicate Wind-Consumption and Liver Syncope, making harsh Yang-tonics like Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) inappropriate.

Chao Hei Qi Zi (Blackened Goji Berry), Bo Hui Xiang (Fennel Seed), Dang Gui (Angelica Sinensis Radix), Gui Mu (Cinnamon Wood), Zi Shi Ying (Purple Quartz), Bai Long Gu (Fossilized Bone), Xi Xin (Asarum Root).

Constitutional Liver Yin deficiency disturbed by Wind-Warmth leads to Spasm Disease, coma, teeth grinding, and intermittent convulsions. Treatment should nourish Liver Yin to benefit sinews and clear Phlegm-Heat to calm Spirit. If effective, worry is unnecessary.

Ling Yang Jiao (Antelope Horn), Fu Shen (Poria with Hostwood), Gou Teng (Uncaria Ramulus cum Uncis), Chuan Bei (Fritillaria Thunbergii Bulb), Zhen E Jiao (Authentic Donkey-hide Gelatin), Xian Chang Pu (Fresh Acorus Rhizome), Xian Zhu Li (Fresh Bamboo Sap).

Wind-Heat attacking severely causes persistent headache, like a nest high atop. It should be shot away (cleared).

Zhi Jun (Prepared Rhubarb), Xi Jiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Chuan Xiong (Ligusticum Rhizome), Xi Cha (Fine Tea).

This is Kidney-Jue Heart Pain, with back distension radiating to the waist. Prescribe Xu Xue Shi's Xiang Rong Wan (Musk and Velvet Deer Horn Pill).

Lu Rong (Velvet Deer Horn), Qi Zi (Goji Berry), Sha Yuan (Astragali Complanati Semen), Da Hui Xiang (Star Anise), She Xiang (Musk).

Yawning, coughing, and hypochondriac pain preventing lying on the left side. The disease is in the Liver, rebellion in the Lung, caused by emotional factors, difficult to dispel quickly. Treatment should target the Liver, not the Lung.

E Jiao (Donkey-hide Gelatin), Bai Shao (White Peony Root), Fu Ling (Poria), Dan Pi (Moutan Cortex), Qian Cao (Madder Root), Zhi Cao (Honey-fried Licorice Root), Bo Yu Tang (Soup of Sea Bass) as water base.

Liver dysfunction invading the Spleen causes pain; insulting the Lung causes dry cough. Internal origin differs from external pathogens. Harmonize internal organ Qi rather than depleting defensive Qi externally. However, with weak and rapid pulse, emaciated form, sallow complexion, upper heat and lower cold, and depleted root, complete recovery is doubtful.

Dang Gui Jian Zhong Tang (Angelica Build the Middle Decoction).

Wind-Qi invading Kidney collaterals due to deficiency causes lower back pain radiating to the back and flanks. Use Ji Sheng Tang (Parasite Decoction) to tonify deficiency, unblock collaterals, and expel Wind.

Sheng Di (Rehmannia Root), Dang Gui (Angelica Sinensis Radix), Hei Dou (Black Soybean), Du Huo (Angelica Pubescens Root), Huai Yao (Chinese Yam), Du Zhong (Eucommia Bark), Bai Ji Li (Tribulus Fruit), Zhi Cao (Honey-fried Licorice Root), Sang Ji Sheng (Taxillus Branch).

Lung collaterals connect to the ears. Wind-Fire invading the Lung, lingering unresolved, closes orifices and collaterals, causing nasal congestion, loss of smell, deafness, and tinnitus. Clear and unblock Lung Qi now.

Cang Er (Xanthium Fruit), Bo He (Mentha Herb), Jie Geng (Platycodon Root), Lian Qiao (Forsythia Fruit), Xin Yi (Magnolia Flower), Huang Qin (Scutellaria Root), Shan Zhi (Gardenia Fruit), Xing Ren (Apricot Seed), Gan Cao (Licorice Root), Mu Tong (Akebia Stem).

Wind-Heat accumulating in the brain marrow for years causes Bi Yuan (Nasal Sinusitis). This is a stagnant disease requiring unblocking; without unblocking, it cannot be cured.

Xi Jiao (Rhinoceros Horn - *Substitute*), Cang Er (Xanthium Fruit), Huang Qin (Scutellaria Root), Xing Ren (Apricot Seed), Chuan Xiong (Ligusticum Rhizome), Yu Jin (Curcuma Tuber).

After chills and fever, pathogens travel along the Hand-Shaoyin meridian, causing sudden aphasia and pulling discomfort in shoulders and arms. Use pungent agents to unblock.

Chang Pu (Acorus Rhizome), Yuan Zhi (Polygala Root), Gan Cao (Licorice Root), Mu Tong (Akebia Stem), Dang Gui (Angelica Sinensis Radix), Dan Pi (Moutan Cortex), Dan Shen (Salvia Miltiorrhiza Radix), Shen Jin (Lycopodium Club).

Spleen deficiency generates Dampness, stagnating Qi and failing to secure Blood. This differs from excessive menstruation due to Blood-Heat.

Jiao Zhu (Charred Atractylodes), Ze Xie (Alisma Rhizome), Bai Shao (White Peony Root), Chen Pi (Tangerine Peel), Zhi Cao (Honey-fried Licorice Root), Fu Ling (Poria), Chuan Xiong (Ligusticum Rhizome), Niu Jiao Hui (Buffalo Horn Ash).

During pregnancy, edema (Zi Zhong) occurred. Four days postpartum, severe diarrhea ensued, followed by laughter-induced syncope and unconsciousness. Upon recovery, right hypochondriac pain persisted for over three months. Emaciation, weak pulse, poor appetite, abdominal fullness, foot swelling, and dysuria indicate Spleen disease transmitting to Heart, then to Liver, and back to Spleen. This is mutual conquest among Five Zang organs, distinct from Six Fu organ distension caused by food, Qi, water, and blood. Sequential tonification and purgation have failed. Tentatively prescribe draining Liver and harmonizing Spleen methods.

Tai Zhu (Atractylodes Macrocephala), Mu Gua (Chaenomeles Fruit), Guang Pi (Tangerine Peel), Jiao Mu (Pepper Seeds), Fu Ling (Poria), Bai Shao (White Peony Root).