Library

Xue Lizhai treated Jin Jie'an, a Grand Secretary. The spaces between the toes were itchy and exuding fluid, with swelling on the dorsum of the foot. Topical application of anti-itch medicines was ineffective, and internal administration of dampness-resolving medicines exacerbated the condition.

Xue diagnosed: "This is Yin deficiency with damp-heat pouring downward." He prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish Kidney Yin and Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) to tonify Spleen and Stomach Qi, resulting in recovery.

A scholar suffered from heat and itching in the soles of his feet. Scratching followed by immersion in boiling water caused skin ulceration and exudation. His body became emaciated ("bone-thin"), accompanied by hiccuping and expectoration. After taking Buzhong Yiqi Tang and Liuwei Dihuang Wan for over a year, his Yuan Qi (Original Qi) recovered, and all symptoms resolved.

Another scholar presented with swollen, hard ankles with white discoloration, persisting for over two months. Da Fangfeng Tang (Great Wind-Expelling Decoction) was used, combined with Shiquan Dabu Tang (Ten Complete Tonification Decoction), leading to resolution. Later, due to failure in the imperial examinations, irregular diet, and fatigue, the condition recurred with night sweats, internal heat, indigestion, loose stools, muscle wasting, dizziness, and occasionally headache with profuse phlegm. This indicated Kidney failing to grasp Qi (Kidney not receiving Lung Qi). Bayi Wan (Eight-Ingredient Pill, i.e., Jin Gui Shenqi Wan) and Buzhong Yiqi Tang were administered for over a hundred doses, bringing stability.

Sun Dongsu stated: A patient developed a dislocation of the Huantiao (GB30) joint after a fall while recovering from Yangmeichuang (Syphilis/Kapok Disease). The joint could not be reduced, causing severe pain, resulting in leg length discrepancy. I reasoned that the inability to reduce was due to blood stasis filling the joint cavity, preventing bone re-engagement. Therefore, eliminating blood stasis was key, primarily using Qi-moving and Blood-invigorating agents, assisted by descending guide herbs. We used bricks/tiles from old cellars, washed thoroughly (4 liang), Shengdi Huang (Radix Rehmanniae Preparata) (1.5 liang), Duniu Xi (Radix Achyranthis Bidentatae) (1.5 liang), Gusuibu (Os Dinosauri) (1.5 liang), Danshen (Radix Salviae Miltiorrhizae) (1.5 liang), Chishao (Radix Paeoniae Rubra) (1.5 liang), Ziran Tong (Pyritum) (3 liang), Puhuang (Pollen Typhae) (1 liang), Cheqianzi (Semen Plantaginis) (1 liang), Sumu (Lignum Sappan) (1 liang), Lu Jiao (Cornu Cervi Pantotrichum) (2 liang), and Yuanming Fen (Natrii Sulfas) (0.5 liang). Each was powdered. A paste was made from Maocaogen (Rhizoma Imperatae) (1 jin) and Honghua (Flos Carthami) (4 liang). The powders were mixed with the paste, dried, and formed into pills with honey. Efficacy was achieved.

Yu Zhen's commentary: Xue's prescriptions are balanced and upright; Sun's medication is skillful and agile. Both are worthy of emulation. However, for the bricks/tiles, those from urine pits should be used, not those from manure pits.

Shi Lize treated Zhang Tongchu, Vice Director of the Directorate of Education. He had suffered from lower leg pain for three years. Pulse diagnosis revealed a deep, fine, and choppy pulse. Shi said: "This is insufficiency of Yuan Qi in the Lower Jiao, failing to nourish sinews and bones." Tonifying and sinew-relaxing medicines were prescribed, yielding slight effect initially. However, relapses occurred due to exertion. Re-examination showed a floating and rapid pulse, indicating further depletion of Yuan Qi. Ren Shen Gao (Ginseng Paste) and Heche Tianyi Wan (Placenta Tianyi Pill) were prepared and taken alternately, gradually strengthening Yuan Qi. Yet, pain in both calves remained unbearable. Wanling Gao (Myriad Miracles Plaster) was formulated, excluding Zhagnnao (Borneolum Syntheticum), adding Shaofen (likely a specific mineral or processed herb, contextually unclear but kept as name), Suhexiang (Styrax), and Shexiang (Moschus). The plaster was tightly bound to the calves with soft cloth, and the patient drank Gancao Tang (Licorice Decoction). Within moments, the pain vanished. This plaster is highly effective; its formula is recorded in Bencao Gangmu (Compendium of Materia Medica). Subsequently, Huangqi Jianzhong Tang (Astragalus Decoction to Build the Middle) supplemented with Renshen (Radix Ginseng) and Danggui (Radix Angelicae Sinensis) was used for regulation, leading to complete recovery.

Yu Zhen's commentary: This case and the previous one are selected here because they demonstrate different formulas addressing similar or related presentations.