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Wang Shishan treated Scholar Xiao. He was over fifty years old, with a fat body and purplish complexion. Qi rushed upward from below the navel, causing restlessness in sleep and lying down, reduced appetite, and mental fatigue. Wang examined his pulse, finding it floating, soggy (Ru), and slow throughout. He stated, "This is Qi deficiency." The questioner asked, "Danxi said that Qi rising from below the navel is due to Yin Fire. Why do you call it Qi deficiency?" Wang replied, "One cannot adhere rigidly to fixed theories. Danxi also said that fat people often have Qi deficiency, and a slow pulse also indicates Qi deficiency. Now, based on the patient's physique and pulse, we should treat this as Qi deficiency." Thus, he used [missing herb] and Ginseng Radix (Renshen) as the sovereign drug, Atractylodis Macrocephalae Rhizoma (Baizhu) and White Peony Root (Baishao) as the minister drugs, Angelicae Sinensis Radix (Guishen) and Prepared Rehmanniae Radix (Shudi) as the assistant drugs, Phellodendri Cortex (Huangbai), Licorice Root (Gancao), and Tangerine Peel (Chenpi) as the envoy drugs. After taking more than ten doses of the decoction, the condition slightly improved. Because the patient experienced discomfort in the chest and diaphragm, Chenpi was increased to 7 fen. However, the upward rushing of Qi recurred. Wang adhered to the original prescription. The patient recovered after more than a month.

Zhen commented: This case still combines both of Danxi's theories simultaneously; it does not exclusively focus on Qi deficiency. It seems that for soggy and slow pulses, Master Wang frequently combined Ginseng Radix (Renshen), [missing herb], Ophiopogonis Radix (Maidong), and Phellodendri Cortex (Huangbai), without adding Aconiti Lateralis Radix Praeparata (Fuzi). This must be an experience where he excelled throughout his life. Regarding the fact that increasing Chenpi to 7 fen caused the Qi to rush upward, this is a clear manifestation of Qi deficiency. The previous formula could surely achieve efficacy. I privately recall treating numerous cases of Qi rushing syndrome in my life using Prepared Rehmanniae Radix (Shudi), Angelicae Sinensis Radix (Danggui), Lycii Fructus (Gouqi), Achyranthis Bidentatae Radix (Niuxi), Hematitum (Zishiying), Juglandis Semen (Hetaoren), Penis Bovis (Kanzi), and Lead (Qingqian), resulting in cures, which are too many to count. There were also cases cured by Shenqi Wan (Kidney Qi Pill), Dabu Yin Wan (Great Yin Tonifying Pill), and Sancai Wan (Three Talents Pill). All these methods did not deviate from Danxi's teachings. However, there was one scholar surnamed Lu, who was thin, had normal appetite, and no other illnesses, yet Qi rushed upward from below the navel. Initially, it only reached the chest, then gradually ascended to the throat, then to the vertex, then descended from the back of the head along the Du Meridian and the sides of the spine, then to the ankles and soles of the feet, re-entering the lower abdomen, and then rushing upward again. The rushing was very slow, taking about one year to complete a full cycle up and down. Food digestion proceeded normally, but muscles wasted away. After two and a half years, the patient died. He tried every kind of warming, cooling, tonifying, and draining medicine, and tested all acupuncture and exorcism methods. Zhen could not cure him, nor could the two masters Ye and Xue in Wu men (Suzhou) achieve any effect. For such a disease, I regret not meeting Zhang Dairen, Yu Xichang, or Zhou Shenzhai to listen to their discussions and open my mind. Furthermore, according to the Biography of Hua Tuo in the Records of Wei (Wei Shu), a gentleman suffered from discomfort. Hua Tuo said, "Your illness is deep; the abdomen must be opened to remove the pathology. However, your lifespan will not exceed ten years. The disease will not kill you; endure the pain for ten years, and your lifespan will end naturally. It is not worth mutilating yourself." The gentleman could not tolerate the pain and itching and insisted on removing the disease. Hua Tuo performed surgery, and the illness quickly healed. Ten years later, he indeed died. Reading this, Zhen further lamented the limitations of medical art. If Master Hua had encountered this scholar Lu, even if he knew early on that the scholar would die of Qi rushing syndrome in ten years, what medicine could be done?

Ma Yuanyi treated Yuan Yuxing. There was rebellious Qi rushing upward from the lower abdomen, accompanied by vomiting. Drinking water exacerbated the vomiting. Various medicines were ineffective. Ma examined his pulse, finding both wrists deficient and choppy (Se), while the right Chi position alone showed a wiry and rapid (Xian Ji) quality. This indicated turbid Qi in the lower jiao overpowering upwards, preventing the Yang Qi in the chest from distributing. Thus, when water entered the stomach, it obstructed upward and failed to descend. The method should be to unblock the "earthly pathway" (intestines). He used Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction). A large amount of retained feces was discharged. Subsequently, the middle Qi was gradually fortified, and the patient recovered.

Zhen commented: All diseases have deficiency and excess aspects. One should not assume that Qi rushing syndrome is always due to Yin or Qi deficiency. Therefore, this case was selected to present a different example. However, it must be an acute illness or constipation for the right Chi pulse to confirm the mechanism. In the past, I once treated a patient with Kidney Deficiency in the lower jiao and Qi rushing in the upper jiao together with Mr. Du Liangyi. Mr. Du used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with Wumo Yinzi (Five-Monk Drink) with Xiangru removed, taken as a liquid mixture, which was effective. This represents another new approach.