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Past obesity and current emaciation indicate fluid retention (Yin, 饮). Zhang Zhongjing stated: "A pulse that is deep and wiry indicates a patient with fluid retention." In old age, men first suffer from deficiency in the lower yuan (lower primordial qi). When qi fails to secure and hold, phlegm-fluids float upward. Fluids surging with qi result in coughing. Modern physicians, upon seeing cough, immediately use herbs to clear the lungs, direct qi downward, and resolve phlegm. After prolonged ineffectiveness, they switch to yin-nourishing methods, failing to understand that phlegm-fluids are transformations of turbid yin. Yin-nourishing herbs accumulate and obstruct, aiding turbidity and stagnating qi. Consider the symptom of coughing and choking when lying down: knowing that when the body lies flat, upper qi becomes uneven, it must rush downward and rebel upward. This indicates that phlegm-fluids are latent at the boundary of extreme yin (the Kidneys), undoubtedly involving disease of the Kidney collaterals. Physical coldness and aversion to wind indicate weak yang qi and loose defensive barriers. Zhang Zhongjing succinctly stated: "Fluid pathogens must be treated with warm herbs to harmonize them." Furthermore, external fluids are treated via the Spleen, internal fluids via the Kidneys. Without reading the classics, how can one know this principle?

Guiling Gan Zhu Tang (Cinnamon Twig, Poria, Atractylodes Macrocephala, and Licorice Decoction)

The pulse is wiry, with the right position being soggy and weak. Yang qi is weak, there is aversion to cold, turbid fluids invade upward causing coughing and expectoration of saliva foam. Appetite is reduced and stomach qi is declining; cold hernia lurks within. The manifestations of yin turbidity are not limited to one aspect. Yu Jiayan said that when turbid yin rises to the heavens (upper body), unless the bright sun shines overhead, how can the mist retreat? Instead, using yin-nourishing herbs like Rehmanniae Radix Preparata (Shu Dihuang) and Schisandrae Fructus (Wuweizi) to support yin causes yin-mist to surge and rebel tyrannically, making fluid pathogens uncontrollable. It is proposed to adopt Zhang Zhongjing's method of pairing Prepared Aconite Root (Shu Fuzi) with Fresh Ginger Juice (Shengjiang Zhi) to sweep away yin pathogens and expel fluid retention, thereby preserving yang qi as the foundation. Especially for the elderly, urgent protection of true yang is paramount.

Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Shu Fu Zi (Prepared Aconite Lateral Root), Sheng Jiang Zhi (Fresh Ginger Juice), Nan Zao (Chinese Jujube Fruit)

In December, the pulse indicated weak yang and turbid fluids invading upward causing cough, preventing supine rest. Xiao Qing Long Tang (Minor Blue Dragon Decoction) was used previously, with Ephedrae Herba (Mahuang) and Asari Radix (Xixin) removed. After taking it, the patient could lie on a pillow to sleep. Presumably, subsequent physicians did not understand the method for treating fluid retention. Upon reaching Jingzhe (Awakening of Insects solar term), yang qi erupts, and the disease condition intensifies. Current pulse is soggy, weak, and spiritless; phlegm-fluid cough and rebellion persist. It is estimated that the previous method will not be effective. Following Zhang Zhongjing's Zhen Wu Tang (True Warrior Decoction) method, pairing Prepared Aconite Root with Fresh Ginger to unblock yang and expel fluids is established as the principle.

Zhen Wu Tang (True Warrior Decoction) minus Bai Zhu (Atractylodis Macrocephalae Rhizoma), plus Ren Shen (Ginseng Radix et Rhizoma)

The pulse is wiry, with the right position being choppy. The face appears lustrous, tongue coating is white, mouth is dry but without desire to drink. Head feels heavy and oppressive. Chest and epigastrium feel blocked and painful, slightly relieved by belching. Wine drinkers often have scant grain intake and middle jiao deficiency, leading to phlegm-fluid accumulation. During summer, earth qi rises; fluid pathogens carry qi upward, blocking the clear spaces (head/chest). Thus, previous symptoms recur. *Jin Gui Yao Lue* states: "Wiry pulse indicates fluid retention; bright complexion indicates retained fluid; dry mouth without desire to drink indicates fluid pathogen has not departed." Moreover, sweating—could this be wind-cold? In spring and summer, warm pathogens make acrid-warm dispersing methods strictly forbidden. The patient reports a sensation of bodily emptiness and floating; aged sixty-four, using acrid-dispersing herbs to leak yang qi is indeed erroneous.

Ban Xia (Pinelliae Tuber), Jiang Zhi (Ginger Juice), Chuan Lian (Coptidis Rhizoma), Wu Zhu Yu (Evodiae Fructus), Fu Ling (Poria), Zhi Shi (Aurantii Fructus Immaturus), Zhu Li (Bamboo Sap)

Traveling far, wind-cold is received externally while heat steams internally. Phlegm-fluids accumulate daily outside the zang-fu organs and within the collaterals. Whenever encountering wind-cold, exposure to scorching sun, physical labor, or mental agitation, the dormant fluids in the collaterals are disturbed. Fluids flood and qi rebels, causing cough; qi blocks the throat base; chest and diaphragm lose appetite for food; lying down causes choking and expectoration of thick sputum. Health returns when qi descends. The disease name is asthma with latent fluid retention. If treatment is appropriate, roots may not be quickly eliminated, burdening the patient in old age.

Xiao Qing Long Tang (Minor Blue Dragon Decoction) minus Xi Xin (Asari Radix)

Winter-warmth disease: yang qi does not hide; latent fluids float upward. Zhang Zhongjing said: "Deep pulse belongs to fluid retention; bright facial color indicates fluid retention. For patients with fluid retention, severe cough should be treated by addressing the fluid, not just the cough." Because the elderly have deficient root qi in the lower jiao, due to warmth causing qi leakage and failure to store, fluid pathogens disturb the lung upward. Lung qi fails to descend, causing obstruction of whole-body qi, continuous burning, and bleeding from collaterals rising. Classics state: inability to lie down, worsening wheezing and blockage when lying down, indicates rebellious disorder of lung qi. If one treats the disease blindly without understanding complexion diagnosis and qi assessment, cough will transform into abdominal swelling and fullness, becoming increasingly incurable. Astute physicians must not neglect this as a trivial matter. Based on my humble opinion, I briefly outline the main idea. It is proposed to open the Taiyang channel to guide turbid fluids downward, without hindering the winter-warmth condition, combining Zhang Zhongjing's Xiao Qing Long Tang with Spleen-regulating harmony methods.

Xing Ren (Armeniacae Semen Amarum), Fu Ling (Poria), Yi Yi Ren (Coicis Semen), Chao Ban Xia (Stir-baked Pinelliae Tuber), Guizhi Mu (Cinnamomi Ramulus), Shi Gao (Gypsum Fibrosum), Bai Shao (Paeoniae Radix Alba), Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma)

Latent fluid yin-turbidity invades upward, triggered by spring earth qi rising. Vomiting and lack of hunger naturally injure the Spleen and Stomach. Liu Jun Zi Tang (Six Gentlemen Decoction) for tonification and supplementation is not an bad method. However, current pulse shows very faint inspiration, morning urination is smooth but evening urination is difficult (retention), and dorsal foot edema exists. The opening and closing functions of fu organ qi are dysfunctional; middle-fullness is most feared. Taiyang governs opening, Yangming governs closing. Yin-turbidity pervades; unblocking fu organs is equivalent to unblocking yang. Mimicking Zhang Zhongjing's method of opening Taiyang.

Mu Li (Ostreae Concha), Ze Xie (Alismatis Rhizoma), Fang Ji (Stephaniae Tetrandrae Radix), Fu Ling (Poria), Wu Wei Zi (Schisandrae Fructus), Gan Jiang (Zingiberis Rhizoma)

At the Summer Solstice, pulses at both Guan positions are wiry and long. The five fires blaze, especially Liver Yang and Stomach Yang. Anger-induced twitching indicates Liver disease; illness triggered by consuming pungent, aromatic, and rich flavors indicates Stomach disease. Phlegm-fire has deep roots and cannot be removed instantly. Only through quiet cultivation, avoiding anger, and light diet to clear interior heat can this be managed. The progression of this disease will be slow; gradual medicinal intervention is a rational therapeutic method.

Ling Yang Jiao (Capricornis Cornu), Xi Jiao (Rhinocerotis Cornu), Chuan Lian (Coptidis Rhizoma), Yu Jin (Curcumae Radix), Shan Zhi (Gardeniae Fructus), Bei Qin Pi (Fraxini Cortex), Niu Huang (Bovis Calculus), Dan Xing (Arisarum Bulbus cum Bile), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Sheng Shi Gao (Raw Gypsum Fibrosum)
Han Shui Shi (Halloysitum Rubrum), Jin Bo (Folium Aurum), Fang Zhu Shui Fa Wan (Pills made with Fang Zhu Water), sent down with Zhu Ye (Phyllostachys Viridis Folium) and Deng Xin (Junci Medulla) decoction.

The illness began with phlegm-fluids, gradually developing into cough and exterior cold. It recurs with fatigue. Attacks cause chest and diaphragmatic distension, expectorating thin saliva and turbid foam. As the disease recedes, sputum becomes thick, and health returns only when qi descends. All fluid pathogens are condensed yin-turbidity. Over two years, abdominal blooming and food intolerance gradually developed. The anus and sacrum area are fine when sitting, but standing or walking causes frequent sensation of qi sinking. Defecation requires effort, clearly indicating Kidney deficiency failing to secure. Confused by previous views of treating cough by resolving phlegm, if not using acrid-resolving methods, then cold-descending methods were used, thereby fostering entrenched disease.

Shen Qi Wan (Kidney Qi Pill) plus Zi Yi Hu Tao (Walnut Kernel with Membrane) and Chen Xiang Zhi (Aquilariae Resina Juice)