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White urine indicates the absence of Fire; therefore, yellow or reddish urine is caused by the presence of Fire, and should be treated primarily with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma). However, there is a distinction between Excess Fire and Deficiency Fire. For instance, when the weather is hot and sweating is profuse, or when the Yin aspect is dry and depleted, urine volume becomes scanty; scanty urine must appear yellow. This constitutes Deficiency Fire, and one must not exclusively use cold-natured herbs to clear heat.

The interchange of position for feces and urine (feces exiting from the anterior orifice, urine from the posterior orifice) is caused by the disorder of Zang-Fu Qi. It may result from drunkenness and overeating, or from extreme anger, causing Qi chaos in the middle Jiao. The intestines and stomach lose their proper functions and fail to follow the normal pathways of transportation and transformation. The treatment method should employ emesis to raise and lift the Qi (similar to guiding someone who has taken a wrong path back to the original route so they do not err again), thereby clearing and benefiting the Lanmen (the partition between small and large intestines), allowing it to resume its function of separating the clear from the turbid, leading to recovery. After vomiting, it is appropriate to take Wuling San (see Shangshi chapter) and Muxiang Tiaoqi San (see Zhongqi chapter), each one qian, mixed with one qian of Ejiao powder, and taken with decoction. Alternatively, grind Huanglian Ejiao Wan into powder, add a small amount of Muxiang, and swallow with decoction. These are all formulas that remove damp-heat. Qi disorder stems from stagnation (if there were no stagnation, Qi would flow along the correct path; how could it be chaotic? Only when stagnation reaches its peak and suddenly extends does it inevitably act recklessly and break through boundaries, failing to follow the regular path). Qi stagnation generates damp-heat. Those who consume alcohol inevitably have blood stasis, which is damage caused by damp-heat. One may use Siwu Tang (see Xuezheng chapter) plus Haijinsha (Lygodii Spora), Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Mutong (Akebiae Caulis), and Taoren (Persicae Semen). Jiang Yiren’s case involved both feces and urine exiting from the anterior orifice, which was mistaken for Jiaochang disease, and Wuling San was used. Yu Jiayan stated: Incorrect. Jiaochang is an acute disease where Qi suddenly becomes chaotic in the middle. This condition, however, is a chronic illness where blood gradually depletes internally. Initially, the Spleen fails to control the blood, leading to downward bleeding resembling metrorrhagia. Blood from the Baomen Zihu (uterus) gradually escapes, then blood from the Large Intestine is absorbed until exhausted, followed by blood from the Stomach until exhausted. The downward loss of blood eventually stops due to lack of source. When blood is exhausted, Qi stands alone without a companion, forming fist-like or lump-like masses, rushing and scattering chaotically. Water and grain abandon the old path and seek the new; the water pathway opens as the grain pathway, merging two channels like the Yangtze and Han rivers into one. This differs from Jiaochang where feces and urine exit via swapped positions. How can Wuling San be used again to further rob the Yin? His argument is very detailed and is recorded here. Xia Zi Yi’s *Qiji Fang* treats women suffering from Jiaochang due to postpartum conditions using the skull of a deceased person, burned to ash and taken with wine, while intermittently administering Wuling San to separate and drain dampness. If a skull is unavailable, an old gauze cap can serve as a substitute, as it has been influenced by head Qi for a long time, invoking the meaning of Yang Qi ascending (utilizing the lifting intent of emesis, thus also treating metrorrhagia), and utilizing the property of lacquer to move stagnant blood.