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The *Classic of Internal Medicine* states: If there is fever, headache, body pain, aversion to cold, accompanied by vomiting and diarrhea, what disease does this belong to? The answer is: This is named Huoluan (Cholera-like syndrome). However, there are differences between Gan Huoluan (Dry Cholera) and Shi Huoluan (Wet Cholera). In Shi Huoluan, there is upper vomiting and lower diarrhea; the pathogenic matter can be completely expelled, leading to spontaneous recovery. In Gan Huoluan, one cannot vomit upwards nor defecate downwards; the pathogenic matter cannot be discharged, causing an accumulation and closure of pathogenic factors, blocking the interaction between Yin and Yang. The patient experiences irritability, stifling sensation, and chaotic distress, ultimately dying from colic and abdominal pain. Generally speaking, vomiting and diarrhea caused by Shanghan (Cold Damage) result from pathogenic invasion; those caused by miscellaneous diseases result from dietary injury. Alas, if diet were regulated and daily routines regular, how could one contract Huoluan? "If food intake doubles, the stomach and intestines are injured." The cause of death is truly self-inflicted.

Zhengsheng (abnormal speech resembling music of Zheng and Wei) refers to a voice that resembles the licentious music of Zheng and Wei, lacking uprightness. Confucius said, "I detest the music of Zheng for disrupting the elegant music." The *Classic* states, "Deficiency manifests as Zhengsheng." This occurs due to excessive sweating or purging, leading to extreme deficiency in both exterior and interior, resulting in the collapse of Yang and excess of Yin. The person's righteous Qi declines, losing their normal voice; their spirit is depleted, causing repetitive speech. They present with cold hands and feet, coma, a short tongue, and muffled voice. This differs significantly from Zhanyu (delirious speech). This condition is rarely curable (one in ten cases); out of desperation, one may tentatively use Dushen Tang (Single Ginseng Decoction) or Baitong Tang.

Yanyan Yu (often synonymous with Zhanyu/Delirium) refers to muttering speech, also called Zhanyu, which involves speaking based on hallucinations. Both are caused by the confusion of True Qi and unclear consciousness. Furthermore, if exterior pathogens do not dissipate but sink into the Stomach, where heat becomes excessive, it ascends to harass the Heart. When the Heart is covered by heat, the spirit and Qi become confused, leading to hallucinations and speech. Mild cases involve muttering during sleep; severe cases involve delirious speech even when awake. Variations include Cuoyu (incorrect speech), Duyu (soliloquy), Kuangyu (manic speech), continuous speech, and chaotic speech, each reflecting different degrees of heat. Generally, when heat enters the Stomach, fluids dry up and feces become hard, inevitably triggering Zhanyu. The *Classic* states, "When pathogenic factors are excessive, it is Excess; in Excess conditions, Zhanyu occurs."

Dongqi (pulsating sensation) refers to a throbbing or palpitation feeling. This is generally because the person has pre-existing stagnant Qi, and upon contracting Shanghan, the physician erroneously applies sweating, vomiting, or purging methods. This disturbs the Qi, causing it to manifest as pulsations around the umbilicus (left, right, above, below) according to the associated Zang organs. These are all signs of insufficient True Qi. When Dongqi occurs at the umbilicus, it is because the Spleen resides in the Central Region (Middle Jiao); sweating, vomiting, and purging first disturb Spleen Qi, which is self-evident. Therefore, when True Qi is internally deficient and Zang Qi is unregulated, one must strictly avoid sweating and purging. Additionally, if Kidney Qi is internally deficient, water retention fails to dissipate. Qi and Water contend with each other, triggering Ben Tun (Rushing Pig syndrome, characterized by gas rushing upward from the hypochondrium/abdomen). The appropriate treatment is Lizhong Tang (Regulate the Middle Decoction) with Baizhu (Atractodis Rhizoma) removed and Guizhi (Cinnamon Twig) added. This is because Baizhu dries Kidney water but may obstruct Qi flow, whereas Guizhi treats Ben Tun.