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Luo Qianfu treated the wife of Physician Yang. She was over fifty years old, with a robust and obese physique. In spring, she suffered from dizziness and stuffiness in the head and eyes, along with facial redness and heat. She had taken numerous herbs to clear heat from the upper jiao, but to no avail.

Dr. Luo examined her pulse, which was surging (Hong) and forceful. The *Neijing* states: "Facial heat indicates disease of the Foot-Yangming meridian." The *Maijing* states: "When Qi of the Yangming meridian is excessive, the anterior aspect of the body will be hot." Moreover, this person habitually consumed rich and greasy foods, leading to accumulated heat in the Stomach. The Yangming meridian is abundant in blood and Qi; originally presenting as excess syndrome, wind-heat ascended. All Yang meridians converge at the head, thus giving rise to the condition of facial heat. Initially, Tiaowei Chengqi Tang (Regulate the Stomach Purge Decoction) 7 qian, Huanglian (Coptidis Rhizoma) 2 qian, and Xijiao (Rhinocerotis Cornu) 1 qian were administered to promote bowel movements three to four times, thereby withdrawing the root heat. Subsequently, Shengma Jia Huanglian Tang (Cimicifugae Decoction with Added Coptis) was used to dispel wind-heat ascending through the collaterals, resolving both the branch and root conditions. The prescription consisted of Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Lobatae Radix) each 1 qian, Baizhi (Angelicae Dahuricae Radix) 7 fen, Gancao (Glycyrrhizae Radix et Rhizoma) and Zhi Baishao (Prepared White Peony Root) each 5 fen, Huanglian and Huangqin (Scutellariae Radix) prepared with wine each 4 fen, Chuanxiong (Chuanxiong Rhizoma) and raw Xijiao powder each 3 fen, Jingjiesui (Schizonepetae Spica) and Boheye (Menthae Haplocalycis Folium) each 2 fen. Half zhan of water was used to soak Chuanxiong, Jingjiesui, and Bohe initially. Separately, two and a half zhan of water were boiled down to one and a half zhan, then the pre-soaked three ingredients were added and decocted together until one zhan remained. It was taken warm after meals, three times daily. Wet noodles and pungent spices (Wuxin) were prohibited.

A monk from Weimo Temple in Zhending Prefecture, over sixty years old, was emaciated and weak. In early winter, his head and face could not tolerate cold, and his Qi was too weak to withstand the wind. Various treatments failed.

Dr. Luo examined his pulse, which was wiry (Xian), fine (Xi), and faint (Wei). Furthermore, being elderly and subsisting on vegetarian food, tea, and fruits, indicated deficiency of the Yangming meridian. The *Maijing* states: "When Qi is insufficient, the anterior aspect of the body will feel cold and shiver." Additionally, chanting scriptures depleted his Qi, resulting in deficiency of Stomach Qi and collateral Qi, which could not ascend to the head and face, causing severe aversion to wind and cold. Initially, Fuzi Lizhong Wan (Aconite Pill to Regulate the Middle) was administered several times to warm the middle Qi. Subsequently, Shengma Tang (Cimicifuga Decoction) with added Fuzi (Prepared Aconiti Lateralis Radix) was used to circulate Qi in the collaterals. The prescription consisted of Shengma and Gegen each 1 qian, Baizhi and Huangqin each 7 fen, Zhi Gancao, Caodoukou Ren (Cardamomi Fructus), and Renshen (Ginseng Radix) each 5 fen, Pao Hei Fuzi 7 fen, Yizhi Ren (Alpiniae Oxyphyllae Fructus) 3 fen, and Lianxu Congbai (Scallion White with Roots) decocted together. After several doses, he recovered. Someone asked: "Shengma Tang with Huanglian treats facial heat, while with Fuzi it treats facial cold. What is the basis?" The answer was: "It originates from Zhang Zhongjing. In diagnosing Patient Yang, both the root and branch of Yangming were excess, so it was appropriate to first purge the interior, then drain wind-heat from the collaterals; hence Shengma Tang with Huanglian was used to treat heat with cold. For the nun, both root and branch of Yangming were deficient and cold, so it was appropriate to first tonify the interior, then move the collaterals; hence Shengma Tang with Fuzi was used to treat cold with heat. Zhang Zhongjing is the ancestor of all prescriptions; this is indeed true."

Yu Zhen commented: These two cases are clearly annotated by Dr. Luo himself. Because he was well-versed in the *Neijing*, he could expound upon them effectively. The following two cases discuss the principles of dark complexion, which are also highly profound.

He also treated a woman in her thirties who suffered from incessant worry and thought, irregular diet, and damage to the Spleen and Stomach. Her complexion was dark and lusterless, especially around the lips. She felt a hollow sensation in the heart as if hungry, but did not desire food when hungry. Her breath was short and rapid. Dr. Luo said: "The Heart and Lung are located above, circulating Ying and Wei Qi to manifest luster externally; the complexion should be apparent and not hidden. The Liver and Kidney are located below, nourishing sinews and bones to strengthen internally; the complexion should be concealed and not visible. They must rely on the Spleen and Stomach in the middle to transform and transport essence, irrigating the four peripheries, harmonious and ceaseless. If their Qi is injured, the four Zang organs lose their support. Now, incessant worry causes Spleen-Stomach Qi to knot and stagnate; irregular diet depletes Spleen-Stomach Qi, causing insufficiency. Thus, Yin Qi overflows into Yang, and black color appears on the face. Also, the classics state: 'Spleen Qi connects to the mouth, its brilliance manifests in the lips.' Now Water insults Earth, so black color appears on the lips. This is Yin opposing Yang, an adverse condition. The *Shanggu Tianzhen Lun* states: 'Yangming pulse declines upwards, and the face begins to wither.' This indicates insufficiency of Yangming Qi. Therefore, Chonghe Shunqi Tang (Harmonizing and Regulating Qi Decoction) was used: Gegen 1.5 qian, Shengma and Fangfeng (Saposhnikoviae Radix) each 1 qian, Baizhi and Huangqin each 8 fen, Renshen 7 fen, Gancao 4 fen, Baishao and Cangzhu (Atractylodis Macrocephalae Rhizoma) each 3 fen, decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus). It was taken before noon, taking advantage of the time when heavenly Qi ascends, facilitating the ascent of the patient's Yin Qi. After several doses, she recovered. This is the method of treating Yin emerging to overwhelm Yang."

Someone developed a dark aura over the entire face after moxibustion on Zusanli (ST36). Physicians considered it floating Kidney Qi on the face, a critical sign. Someone said: "Dampness in the Kidney meridian steams upward to the Heart; Heart Fire combined with dampness becomes smoke vapor, manifesting on the face. The face belongs to the Heart, and Heart and Kidney Qi are constantly connected. The outer form of Kan (Water) is Li (Fire); the outer form of Li is Kan. Heart and Kidney never separate. The ear belongs to Water, and its hollowness presents the image of Li; the eye belongs to Fire, and its fullness presents the image of Kan. This can be seen." Treatment with damp-draining herbs, such as Wuling San (Five-Ingredient Powder with Poria) or Huangqin and Fangji (Stephaniae Tetrandrae Radix), was applicable.

[Appendix] Early in the Xingguo era, there was a woman named Ren, who was very beautiful. She was betrothed to Jinshi Wang Gongfu. Believing that Wang had failed to obtain any official rank, she became depressed and unhappy, and her complexion gradually turned black. Ashamed, she returned to her natal home for treatment. A Daoist priest said: "This can be cured." He prescribed Nüzhen San (Nüzhen Powder) taken with wine, 2 qian per dose, twice daily. Within a few days, her face turned slightly white, and within a month, it returned to normal. Through bribery, the formula was obtained: it was simply Huangdan (Minii Oxidum) and Ziwan (Asturi Radix) ground into equal parts of powder.

Yu Zhen commented: This case resulted in dark complexion due to depression. This formula is unlikely to be effective. There are also cases where sudden exposure to foul odors causes immediate darkening of the face; burning Chenxiang (Aquilariae Lignum Resinatum) and Tanxiang (Santalum Album Lignum) can be effective.

Ren He from Yuhang was about to take up an official post. While steaming Jiangzhen wood and Muxi incense, he accidentally fell forward onto the steamer lid, scalded by the rising steam. His face immediately swelled, and his mouth and eyes closed. Several physicians failed to treat him. One physician said: "There is no such case in ancient texts; I will treat it based on my understanding." He took cloth used for cooking in temples for a long time, burned it to ash retaining its nature, and applied it topically, causing the swelling to subside. He healed within half a month. Presumably, because the cooking cloth absorbed much steam vapor, using it inversely helped expel the steam toxin, similar to using salt water to extract salt flavor. This demonstrates the ingenuity of clinical intuition.

Yu Zhen commented: Using the condensation water from the pot lid to treat burn alcohol toxicity follows the same principle.