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The wife of Zhu Ziming from Suzhou suffered from a condition where she would cry out loudly for dozens of times, pause briefly, and then resume. People believed she was possessed by malevolent spirits and could not be treated. Dai Yuanli said, "This is a case of Qi Depression (Yu Bing). Phlegm turbidity blocks the Upper Jiao, while Fire pathogen is depressed in the Lower Jiao; thus, crying out allows the Qi mechanism to relax slightly. The *Classic* states: 'When Fire is depressed, it must be dispersed.' This applies here." He subsequently used a heavy emetic agent, causing the patient to vomit an immeasurable amount of phlegm resembling glue, after which she recovered.

Yi Silan treated a woman who presented with general fatigue, yawning, dry mouth, and an inability to eat for a month; when forced, she consumed only a few grains. Some practitioners treated her for Blood Deficiency, others for Qi Weakness, and some recognized the presence of Fire but failed to identify its source. The medications were chaotic, and the more she was treated, the worse her condition became. By winter, symptoms subsided slightly, but in the following summer, all ailments recurred. Her muscles wasted away, bones became prominent, the pulse at the Sanjiao (Triple Burner) position was surging and large moving upward, while the Spleen and Lung positions were faint and deep; other positions were peaceful. This was diagnosed as Lung Fire disease. He used Gardenia seeds (Zhi Zi Ren) soaked in ginger juice overnight, stir-fried until black, and ground into fine powder, administered with a decoction of Ginseng (Ren Shen), Ophiopogon (Mai Dong), and Mume fruit (Wu Mei). After two doses, she felt hunger and desired food; within ten days, her limbs regained their normal fullness. Later, due to infertility caused by prolonged illness, everyone assumed it was Blood Deficiency and prescribed Ginseng and similar tonics. Half a month later, she experienced chest and diaphragmatic fullness and distension, and her appetite suddenly decreased. It took over three months for her menstruation to start, discharging foul, black impurities, intermittently flowing but obstructed, causing immense suffering. She was then treated with Siwu Tang (Four Substances Decoction) [Note: Text says Si Wu Tang, likely referring to Four Substances], substituting Rehmannia root (Sheng Di Huang), and adding Tangerine peel (Chen Pi), Perilla stem (Su Geng), Scutellaria (Huang Qin), Gardenia (Shan Zhi), Bitter orange rind (Qing Pi), and Aurantium fruit (Zhi Qiao). After more than ten doses, she conceived within a month.

Commentary by Zhen: The first case involves Depression syndrome, which is easy to differentiate; the emetic method is indeed superior to oral medication. The second case's pathology is difficult to discern, and that prescription may not have produced rapid effects. Once menstruation had resumed and the illness lightened, the medication should naturally be mild and stable.

Zhou Shenzhai treated a man whose six pulses were choppy and stagnant, accompanied by hypochondriac pain, vomiting of foul-smelling phlegm, nausea, and inability to eat. The hypochondrium is the domain of the Shaoyang (Lesser Yang) channel. When Clear Qi fails to ascend, Turbid Qi stagnates in the Shaoyang collaterals, causing pain. Turbid Qi counterflows upward, causing the vomiting of foul phlegm and nausea. Because it is Turbid Qi, it smells foul. The inability to eat occurs because the Clear Yang Qi of Shaoyang does not ascend, preventing the Liver from distributing essence. He used Bupleurum (Chai Hu) and White Cardamom (Bai Kou) each 2 fen, Black Gardenia (Hei Shan Zhi) and Licorice (Gan Cao) each 5 fen, White Peony Root (Bai Shao) and Moutan Bark (Dan Pi) each 1 qian, Poria (Bai Fu Ling) and Tangerine Peel (Guang Pi) each 1.5 qian, Angelica sinensis root body (Gui Shen) 8 fen, and Ophiopogon (Mai Dong) 2 qian. After ten prescriptions, he was completely cured.

Commentary by Zhen: Hypochondriac pain with vomiting of foul phlegm—vulgar physicians would certainly misdiagnose this as Lung Abscess (Fei Yong) or Lung Withering (Fei Wei). With such analysis, this case can stand immortal alongside Shi Shan's case of treating foul phlegm.

Ji Huashan was arrogant yet unlucky, having no sons. He was often depressed and unhappy, gradually developing abdominal fullness and distension. Over four years, his muscles wasted away completely, and he resigned himself to death. Zhang Lianshui from Suzhou examined him and jokingly said, "Why do you need medicine? You will recover instantly after one box of rice." He prescribed Dang Gui (Angelica sinensis) 6 qian, Leek seeds (Jiu Cai Zi) 1 liang, and Cyperus rhizome (Xiang Fu) stir-fried with child urine 8 qian, instructing him to take it. Ji showed reluctance and, under pressure, halved the dose. Zhang asked, "Should I make two doses?" Upon taking the first dose, Ji had a nocturnal emission, and the whole family wept bitterly. Zhang slapped the table and said, "I intended for him to unblock and discharge." He then administered the remaining half-dose. Ji felt as if a warrior had pushed forcefully within his chest and diaphragm, passing an immeasurable amount of black stool. He then drank two bowls of porridge. The next day, he dressed and received guests. A year later, he fathered a son.

Commentary by Zhen: Abdominal fullness and distension for four years, with complete muscle wasting, yet recovering miraculously after one nocturnal emission and half a dose of medicine. Although described by Zhongchun, I dare not believe it.