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The therapeutic effect may be slightly delayed. If I were to treat it, the result would certainly exceed this. I record this for now, awaiting the insights of superior practitioners.

In treating accumulations and masses (Ji Ju), regulating Qi is the priority. Once Qi ascends and descends in order, body fluids flow smoothly, and how could accumulations arise? Zhu Danxi argued that Qi is formless and cannot form lumps or masses, advocating primarily phlegm-resolving and blood-breaking methods; this is erroneous! In the world, tangible objects often emerge from the intangible, and accumulations are no exception. Dai Fu'an used a single formula, Da Qi Qi Tang (Great Seven-Qi Decoction), to treat all types of accumulations; he truly understood this principle. For Liver accumulation named Fei Qi (Fatty Qi), use the aforementioned Da Qi Qi Tang, boil it, let it cool, then pour it over red-hot iron, and drink it while hot. For Lung accumulation named Xi Ben (Panting Accumulation), add Sang Bai Pi (Morus Alba Root Bark), Ban Xia (Pinellia Rhizome), and Xing Ren (Apricot Seed) half qian each to the aforementioned decoction. For Heart accumulation named Fu Liang (Hidden Beam), add Shi Chang Pu (Acorus Rhizome) and Ban Xia half qian each. For Spleen accumulation named Pi Qi (Stagnation Qi), administer Hong Wan Zi (Red Pill) with the aforementioned decoction. For Kidney accumulation named Ben Tun (Rushing Pig), double the Gui Zhi (Cinnamon Twig) in the aforementioned decoction, add Hui Xiang (Fennel Fruit) and Chao Lian Zi Rou (Fried Ligustrum Lucidum Flesh) half qian each.

The brain is the Sea of Marrow. When Marrow is insufficient, the brain suffers pain; treatments like Rong Zhu Dan (Deer Antler Pearl Pill) are suitable. Using Wind-dispelling herbs will inevitably lead to death over time.

Abdominal distension is mostly due to Qi deficiency failing to consolidate. Using acrid-dispersing herbs exacerbates it; sour-astringent herbs such as Bai Shao Yao (White Peony Root) and Wu Wei Zi (Schisandra Berry) are appropriate. Add Yi Zhi Ren (Alpinia Oxyphylla Fruit) in small amounts, as it can gather and secure the Yuan Qi of the San Jiao (Triple Burner). If symptoms are mild in the morning and severe in the evening, Dang Gui (Angelica Sinensis Root) is the primary herb. If mild in the evening and severe in the morning, Ren Shen (Ginseng Root) is primary. If severe both morning and evening, use both. Tenderness upon palpation indicates Blood stasis; add Blood-moving herbs. The Classic states: "Turbid Qi residing above causes distension." It also states: "Purgation resolves distension," meaning one should use sinking-descending herbs to guide the Turbid Qi from above downwards, not merely referring to purging the Large Intestine. For initial swelling accompanied by profuse phlegm, wheezing, and difficult urination, Ji Sheng Shen Qi Wan (Kidney Qi Pill from the Bureau for the Care of the Sick) is invariably effective.

Xu Shaowei suffered from oral ulcers. I stated that only Gan Jiang (Dried Ginger) could cure him. He remained skeptical but eventually followed my advice and recovered. My nephew Maoa also suffered from this condition, presenting with critical urgency and intense heat, craving cold drinks. I prescribed Ren Shen, Bai Zhu (Atractylodes Macrocephala Rhizome), and Gan Jiang each 2 qian, plus Fu Ling (Poria) and Gan Cao (Licorice Root) 1 qian. The decoction was administered cold, several times daily until resolved. Alas! Such principles cannot be explained to physicians who rigidly adhere to fixed formulas. (Wang Yutai, *Bilu*)

Question: What is the rationale behind the Five Flavors' tonification and purgation of the Five Zang organs in Materia Medica? Answer: When Heaven and Earth Qi do not interact, creation nearly ceases. Therefore, Acrid flavor disperses. Eastern Qi disperses; if Sour (astringent) is used instead of Acrid, it represents Metal within Wood (Zhen trigram containing Dui trigram). Sour flavor consolidates. Western Qi consolidates; if Acrid is used instead of Sour, it represents Wood within Metal. Thus, Sour enters the Liver to tonify the Lung, and Acrid enters the Lung to tonify the Liver; this is the mutual root of Zhen and Dui. Salty enters the Kidney to tonify the Heart; Bitter enters the Heart to tonify the Kidney; this is the mutual root of Kan and Li. The Spleen does not rule a specific season but thrives during the four seasons, maintaining its native flavor (Sweet). Regarding purgation, the situation differs. It is easy to understand that Kidney, Lung, and Liver are purged by their native flavors, but why are Heart and Spleen unique? The answer is: The Heart is the Sovereign Officer; the Spleen is the source from which Zang-Fu and meridians receive Qi; hence they are unique. The Sovereign Officer uses the Sweet flavor (which it generates) for purgation, avoiding the leakage of Qi. The Spleen receives water and grain, distributing essence to the Zang-Fu, with continuous renewal; thus, it uses the Bitter flavor (which generates it) for purgation, avoiding stagnation. My King (Spleen Earth) generates because the generating Fire rests.

Discussion: Chest masses originating after noon meals can be treated with Qin Hua Wan (Held-in-Mouth Dissolving Pill) during sleep. This ensures medicinal vapor continuously soothes the Lung and Stomach between them. As masses attempt to form, the medicine disperses them; new masses do not increase, old ones gradually dissolve. Illness arising during rest is treated during rest. Since the pathology is above the diaphragm, harsh decoctions or heavy pills are avoided. Instead, slow absorption via holding the pill in the mouth allows gradual penetration. Daily gains seem small, but monthly results accumulate. After taking 60-70 pills, the chest feels progressively looser.

The Sage forgets food in his diligence and eats carefully when dining. Observing the chapter "He did not dislike finely cut food," one sees great meticulousness. This is because the Sage's mind does not linger in one place, remaining present everywhere. Wang Anshi studied intensely, eating whatever was nearby without distinguishing taste. While studying, he already fell into the major flaw of "mind elsewhere, eating without tasting." Common people, having nothing else to focus on, critique food and wine; they are merely eaters, offending the Way even more than Anshi. Those skilled in learning the Dao and nurturing life seek no luxury in taste, eat without negligence, and allow the transformational Yuan Qi to function without fixed patterns. The isolated Zang (Spleen) irrigates the four directions; thus, the Spleen is the transformational Yuan Qi of the whole body. Qi generates substance; Yang generates Yin; thus, the Dantian is the transformational Yuan Qi of essence, fluid, and tissue. Taste belongs to Postnatal Essence; infant nursing belongs to Prenatal Essence. Extending this, maternal pregnancy is Prenatal; parental health during pregnancy is Prenatal; parental innate constitution is Prenatal. All Prenatal aspects belong to Ming (Destiny/Nature), while lifelong regulation belongs to Xing (Character/Disposition). Thus, health or illness is Destiny, but has elements of Disposition; the Junzi does not attribute it solely to Destiny. Fu organs are exterior, Zang organs interior. Fu disease may not affect Zang, but Zang disease always affects Fu. Fu diseases are easier to treat; Zang diseases are harder. Damage to Zang often stems from Seven Emotions; damage to Fu often stems from diet. The Sage warns in the Hexagram Sun (Decrease): "Check anger, curb desires." In Yi (Nourishment): "Be cautious with speech, moderate diet." Checking anger harmonizes Wood; curbing desires nourishes Water; cautioning speech calms Metal; moderating diet prevents Earth from overworking. With these four complete, Spirit and Mind are harmonized. The path of cultivating virtue includes nurturing life; speaking of life nurturing apart from virtue makes life cultivation impossible.

When awake, the Spleen grinds food; when sleeping, food tends to stagnate; this is the normal state of digestion. After extreme fatigue damages the Spleen, a short nap after meals may make one feel hungry due to accelerated digestion; this is a variant state, but one must eat little.

For nourishing foods, meat and bone are paramount; for dispersing and promoting movement, herbs and grasses come first.

Consuming the Qi of food requires shallow cooking (short duration). Consuming the Flavor requires medium cooking. Consuming the Substance requires deep cooking (long duration).

Gan Cao (Licorice Root) harmonizes other herbs because they originally lack harmony. If all herbs used are inherently pure and harmonious, what need is there for harmonization? It is like good friends gathering and inviting a neighborhood head to mediate; whom does he persuade, and what does he resolve? He merely hinders their joy. However, Acrid and Sweet disperse and are Yang; Gan Cao tonifies the Middle and aids dispersion, so it is indeed useful. Recent physicians use Gan Cao to harmonize all prescriptions, forgetting the herb's intrinsic power and mistakenly relying on its auxiliary role. One must examine this carefully.

Materia Medica states that sudden use of Cong Rong (Cistanche Deserticola) may provoke bowel movements. Miao Zhongchun used it with remarkable efficacy. However, his explanation remains unclear. Cong Rong is Salty, Warm, and moistening, descending naturally, entering the Kidney Meridian. Because the Bladder orifice is narrow and the Large Intestine orifice is wide, strong doses cause its moistening and descending force to bypass the Bladder, which cannot accept it immediately, and instead enter the Large Intestine. Thus, the medicinal force fails to reach the Bladder and diverts to the Large Intestine. It is not inherently a laxative. It is suitable for dry blood conditions. However, in cases of Kidney slipping/slippage, using it directs the medicine to the Kidney, which is a familiar pathway, directly increasing slippage/diarrhea, leaving constipation unchanged. This must be carefully observed.

Question: Why is Gu Wu Chong (Grain Worm) the only remedy for childhood pi accumulation? Answer: Bird and beast feces do not produce this worm. It arises from the decomposition of grains. Taking the qi generated from decomposition, cleansing it with water, and roasting it with fire allows it to eliminate what the Zang-Fu cannot digest. Grains are the five flavors of the Spleen; their original nature nourishes the Spleen, and after transformation, they assist the Spleen in resolving accumulations.

Chinese cabbage is dispersing and promoting, but its heart is toxic. Bamboo leaf, bamboo shavings, and bamboo sap all clear heat and resolve phlegm, yet bamboo shoots are toxic. Why the contradiction? Things possess unextended Qi; if harvested out of season, even after undergoing fire and water processing, borrowing human breath, they can still vent their energy. Thus, those with sores and swellings experience increased pain and itching upon eating them. If the body is balanced, Zang-Fu Qi can transform food Qi without harm. Materia Medica states: "Unripe fruits and melons are toxic," implying this meaning. It is not true toxicity, but depression/stagnation. Like a passionate person whose incoming momentum is blocked, feeling displeased; this is Heavenly depression. Wine's toxicity is Human-made depression. Human-caused depressions differ, but depression becoming poison is the same. People commonly say mutton is toxic. Mutton greatly tonifies, similar to Ginseng; where is the toxicity? Yet it aggravates sores and swellings dramatically. This is due to its great warmth and tonification, not toxicity. For example, early use of Bai Zhu (Atractylodes Macrocephala Rhizome) in carbuncles worsens swelling and pain similarly. Is Bai Zhu toxic?

Danxi said: "Excess Qi is Fire." This misleads people. How can Qi have excess? If there is excess, shouldn't all Fire syndromes be treated with Qi-suppressing and Qi-draining herbs? Relative to Blood, Qi excess implies Blood deficiency, not Qi excess. Thus, "Nourish Yin, and Fire extinguishes itself." Only benefit the deficient side, do not harm the sufficient side; the intent is clear. There are two types of Fire: Within Zang-Fu, free ascending and descending is Qi; rushing upward attacking is Fire. Within meridians and muscles, free flowing is Qi; stagnating in one place is Fire. Light cases cause pain and itching; heavy cases cause abscesses and swellings. Summarizing in two words: Qi reversal is Fire; Qi stagnation is Fire. One absolutely cannot equate "excess" with Fire. Reversal requires smoothing; stagnation requires unblocking.

Night sleep causes Qi to descend; day sleep causes Qi to ascend. At dusk, after extreme fatigue, eyes appear cloudy with redness. A night of quiet sleep restores clarity by morning; this verifies Qi descending. During the day, when tired, sit quietly for a moment or walk/play to resolve sleepiness. If one falls into deep sleep, upon waking, the whites of the eyes will be red; this verifies Qi ascending due to daytime sleep. Daytime should open with Yang; closing against this timing harms longevity, just as nighttime should close with Yin, but shouting and drinking excessively harm the source of life. Ancients said: "Rise early, sleep late, work by day, rest by night" is Heaven's mandate and Human discipline. I advise rising early throughout my life, not staying up late at night.

After drinking, lie on the left side; after eating, lie on the right side, allowing the Large Intestine and Bladder to follow their natural convenience.

Ascending (Sheng) and Reversing (Ni) are different. Liver and Kidney, being lower, should Ascend; Heart and Lung, being upper, should Descend. When Water and Fire intersect, there is no disease. Liver is Wind-Wood; Wood grows by ascending, wind rises by ascending; how can this be disease? Excessive ascent causes bitter taste and dizziness; this is Reversal. Kidney Qi reversing causes salty taste in the mouth; this is also Reversal. This is not Water ascending. Therefore, what is below should Ascend, not Reverse; what is above should Descend, not Sink.