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Wei Syndrome of the Lower Jiao. Previously, there was a history of seminal emission and wet sores. Frequent use of diaphoretic and draining agents injured both Yin and Yang. Although Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu) were used to nourish the Spleen and Lung to benefit Qi, they failed to rescue the Lower Jiao. For instance, aversion to cold and weak Yang manifested; several days later, vomiting occurred after meals. This indicates a sudden decline of Stomach Yang, corresponding to the failure of exterior Yang functions. However, diseases of the Lower Jiao mostly belong to injury of Essence and Blood. Two courses of soft and warming unblocking tonics were administered. Since the Kidney dislikes dryness, chronic illness requires unblocking the Ren and Du vessels (referring to key meridians of the Eight Extraordinary Vessels, implying both unblocking and securing). Unblocking and securing are applied simultaneously. This also references methods used by ancient sages such as Si Jin Wan (Four-Jin Pill) and Jin Gang Jian Bu Wan (Golden Cudgel Walking-Strong Pill). As for medicines for the Stomach, they must be prescribed separately. The Stomach organ primarily governs Qi; Qi should descend smoothly. Li Dongyuan's theory of raising Yang to benefit the Stomast seems contradictory. However, are Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian) not bitter and descending in nature? For one or two days after vomiting, blood-nourishing medicines for the Lower Jiao should be suspended, and Yang-supporting and Stomach-regulating medicines should be used for two days, ensuring both the Middle and Lower Jiao are secured. The *Neijing* states that the Maiyang Meridian binds sinews and bones to facilitate joint movement; presumably, this disease aligns with this principle.

Lu Rong (Cervus Nippon Antler Gelatin), Dan Congrong (Cistanche Deserticola), Dang Gui (Angelica Sinensis), Gouqi Zi (Lycium Barbarum Fruit), Buguzhi (Psoralea Corylifolia), Bajiji Jian (Bacopa Monnieri Tip), Niuxi (Achyranthes Bidentata), Baizi Ren (Biota Seed), Fuling (Poria), Chuan Hu (Dendrobium Officinale).

During the late summer, damp-heat prevails, causing stagnation in the flow of Qi through the meridians. Coupled with deficiency in the Yuan source collaterals of the Kidney, the limbs become weak and unable to bear walking. There is often a sensation of soreness and pain. Stool may be either constipated or loose, all belonging to Liver and Kidney pathology. However, tonifying the Lower Jiao must be assisted by promoting the circulation of collaterals; this is the correct treatment method. If merely static tonification is used, it is feared that damp-heat will disturb the body again after the late summer, so preventive regulation is necessary.

Lujiaoshuang (Deer Horn Frost), Dang Gui (Angelica Sinensis), Sheng Maoyu (Raw Atractylodes Chinensis), Shudi (Prepared Rehmannia Root), Fuling (Poria), Sangshenzi (Mulberry Fruit), Congrong (Cistanche Deserticola), Bajitian (Morinda Officinalis), Yuanzhi (Polygala Root), Xiaohui (Fennel), Jinmao Gouji (Dryopteris Crassirhizoma Rhizome).
Steeped in wine, decocted in water to make a paste, mixed with powder to form pills, taken with light salt water.

Wei Syndrome located in the lower part is mostly caused by Liver and Kidney diseases. However, due to habitual alcohol consumption, there is inevitably damp-heat in the body. Heat stasis and damp obstruction lead to non-circulation of Qi and Blood. Sinews contract, muscles become insensible. Those with heavy constitutions find it difficult to move; this is nothing but deep-seated pathogenic dampness. If discussing Yang deficiency, widespread sores and ulcers should not occur. But chronic illness cannot be attacked rapidly; do not worry about slow efficacy, only then can the disease be cured.

Xi Shengdi (Fresh Rehmannia Root), Xian Congrong (Fresh Cistanche), Dangguixu (Angelica Sinensis Tail), Niuxi (Achyranthes Bidentata), Huangbai (Phellodendron Bark), Sheng Cilii (Tribulus Terrestris), Chuan Hu (Dendrobium Officinale), Biexie (Dioscorea Hypoglauca Rhizome).

The complexion is dark, pulse is excess, and the constitution is robust. Although over forty years old, the primal Qi is abundant. It is learned that he usually enjoys drinking sweet wines and eating rich, fatty foods. This has brewed damp-fire, accumulating in the Lower Jiao. Currently, the lower abdomen is slightly swollen and hard, urination and defecation are obstructed. He feels distension in the lower abdomen with Qi rushing downward, heaviness in both legs, and difficulty walking. The skin of the thighs and calves feels very hot. This is what the *Neijing* says: "When damp-heat is not removed, the large sinews shorten, and the small sinews relax. Shortening leads to spasm; relaxation leads to Wei." He further recounted that while preparing herbal plasters containing scorpions and centipedes, he inhaled foul toxic vapors, which likely combined with damp-heat, sinking and storing in the Lower Jiao. The previous discussion proposed bitter, acrid, cold, and drying methods; now, assisting with herbs that search out and expel pathogens from the collaterals is added. However, since this disease entered via the mouth, one must adhere to a vegetarian diet and abstain from alcohol for one to two years.

Mian Yinyang (Artemisia Capillaris), Huangbai (Phellodendron Bark), Chuan Biexie (Dioscorea Hypoglauca Rhizome), Fulingpi (Poria Peel), Jinlingzi (Melia Toosendan Fruit), Chuanshanjia (Pangolin Scale), Da Binglang Zhi (Areca Seed Juice).

Traumatic bleeding injures the meridians and Ying collaterals. If organs and viscera are damaged, it is suddenly incurable. Later, anger moves the Liver, belonging to the upward reversal of Yang Qi among the Five Emotions, bursting forth and transforming into fire along with external pathogens. Bitter and acrid Qi-draining medicines, taken frequently and in excess, cause Yang to dissipate. Although the physique appears full, the storage and securing functions fail. The lower abdomen lacks constraint, the Yang pathway does not erect, the back prefers leaning, and walking is powerless; these are all signs of Wei weakness, gradually progressing to paralysis. It is proposed to use the method of unblocking and receiving, specifically nurturing and generating True Qi, hoping that the Yang of the Lower Yuan and the Qi of the Eight Extraordinary Vessels will be properly stored and circulated, thus approaching reason.

Lujiaoshuang (Deer Horn Frost), Dan Congrong Gan (Dried Cistanche), Sheng Tusifen (Raw Cuscuta Seed Powder), Sheng Duzhong Fen (Raw Eucommia Bark Powder), Guishen (Angelica Sinensis Body), Wuweizi (Schisandra Berry), Dahui (Star Anise), Yuanzhi (Polygala Root), Jiajiuzi (Allium Tuberosum Seed), Fupenzi (Rubus Chingii Fruit), Yun Fuling (Poria). Formed into pills using garlic juice.

At fifty-four, Yang Qi is daily declining. The Maiyang meridians are empty and deficient, unable to bind sinews and bones to facilitate joint movement. Shoulder pain and numbness, head and eyes feel covered, movement is weak and powerless. This is deficiency below and excess above, with heat in the collaterals and internal wind boiling up. It becomes severe when entering summer and Yang rises. Methods of drying dampness and draining phlegm will certainly not match the disease. It is proposed to clear Ying-level heat to extinguish internal wind.

Xijiao (Rhinoceros Horn - note: substitute with Buffalo Horn in modern practice), Xian Shengdi (Fresh Rehmannia Root), Yuanshenxin (Scrophulariae Radix Heart), Linqiaoxin (Lonicerae Japonicae Flos Heart), Dong Sangye (Mulberry Leaf), Danpi (Moutan Cortex), Gouteng (Uncaria Rhynchophylla), Ming Tianma (Gastrodia Elata).

Forcing semen emission causes penile retraction and scrotal laxity. Not only does the body become hunched, but the anus and umbilicus also contract. The throat feels tied. Food intake gradually decreases. Because Jing and Blood are tangible substances that are hardest to regenerate spontaneously. The Foot Shaoyin and Foot Jueyin meridians follow the throat and open into the two yin orifices. Having suffered damage, their Qi is insufficient to fill the Eight Extraordinary Vessels. All observed symptoms are those of constraint. Last year, soft Yang-tonifying medicines were administered; afterwards, the meridians at the vertex swelled, and tinnitus worsened. It is thought that Zang Yin prefers stillness. Trying riding in a carriage and experiencing bodily fright adds to restlessness and unease. Therefore, ascending and moving Yang medicines are ineffective. The Shaoyin internally stores, originally having warming and steaming methods; the Jueyin houses Ministerial Fire internally, disliking cold and preferring coolness. Imitating Zhu Danxi's method of subduing Yang, awaiting determination by higher authorities.

Wuanban (Testudo Plastron), Zhimu (Anemarrhena Rhizome), Fuling (Poria), Qiushi (Urea Stone), Shengdi (Rehmannia Glutinosa Root), Ejiao (Donkey-Hide Gelatin), Yuanzhitan (Charred Polygala Root), Baizi Ren (Biota Seed).

Another consultation: During the transition of the four seasons, heat exceeds and primal Qi is deficient, making one unable to sit for long periods. The center of the tongue is ulcerated, inhalation is short, Qi seems discontinuous. The Middle Jiao likes pressure, bringing relief. Eyelids droop and are hard to open, limbs are slightly cold and disharmonious. Previous regulation showed improvement, often using warming and nourishing of the Three Yin Meridians of the Foot, combined with products filling the form with Qi and Blood, reducing the disease. Now, during the late summer when the Spleen and Stomach dominate the Qi, Qi leaks and the Middle becomes deficient, most fearing invasion by external pathogens. Therefore, heavy tonics should be slowed down, while nourishing the Stomach, generating fluids, calming the Spirit, and astringing fluids remain indispensable. When late autumn arrives and Heaven's Qi descends, using the previous method is stable. Proposed daily regulation method:

Renshen (Ginseng Radix et Rhizoma), Maidong (Ophiopogon Japonicus Tuber), Zhimu (Anemarrhena Rhizome), Tiandong (Asparagus Cochinchinensis Tuber), Fushen (Poria with Hostwood), Gancao (Licorice Root), Chuan Hu (Dendrobium Officinale), Jianlian (Nelumbinis Semen).

When summer fluctuates repeatedly, due to the great leakage of Heaven and Earth's Qi mechanism, the body's Qi has been deficient for a long time, lacking the ability to govern. Thus, treating the disease upon seeing it yields no merit, whereas calming the Middle and receiving downwards often achieves effect. Taking Autumn, taking Fuzi Qiwei Wan (Aconite Seven-Ingredient Pill) regularly brings peace. At the Autumn Equinox, Heaven's Qi descends, Earth's Qi gathers. Due to injury by fire-heat Qi, the deficient body fails to gather and肃ify. Hence, joints are sometimes cold, the vertex feels cold. This is nothing but various Qi becoming depleted due to long-standing illness, leading to less protection by exterior-warding Yang, dark withering of fluids and marrow, non-nourishment of blood vessels, and lack of internal guarding by Yin. All these indicate the gradual fading of Sheng Qi (Vital Qi). Urgently need to warm, nourish, benefit Qi, and fill the primal form, allowing the Autumn command to assist in storage and gathering, preparing for the sprouting and generation of next Spring. According to the *Neijing*, there is the method of adjusting the spirit according to the four seasons; even the current medication should follow this principle.

Lutai (Deer Fetus), Shudi (Prepared Rehmannia Root), Wuweizi (Schisandra Berry), Maidong (Ophiopogon Japonicus Tuber), Renru Fen (Human Milk Powder), Congrong (Cistanche Deserticola), Huang Goushen (Yellow Dog Kidney), Baizi Ren (Biota Seed), Qingyan (Green Salt).

Entering Winter, storage is appropriate. In the elderly, Lower deficiency causes the two Qi to barely continue. Suddenly, right-sided hemiplegia and aphasia occur, face shines with floating Yang (Daiyang), yawning and short inhalation, desire to choke. This is not an external pathogen, but rather the root being initially weak. Historically dizzy, Liver storing deficient wind is obvious. Water failing to generate Wood, True Yang within Kan (Kidney) is hidden; the Lower must be warmed and regulated. Generally, Yang governs unblocking, Yin governs securing. After supporting for seven days, Shaoyang governing Qi revives again, hoping the paralysis extends indefinitely. If attacking wind and劫ting phlegm treatments are used, it is not the law for self-disease of the original Qi.

Renshen (Ginseng Radix et Rhizoma), Shu Fu (Prepared Aconite Caralis Lateralis Radix), Yuanzhi (Polygala Root), Fushen (Poria with Hostwood), Xian Changpu (Acorus Tatarinowii Rhizome) crushed and juice squeezed for flushing.

In advanced age, fluids are depleted and wind moves; alcohol and dampness steam. The toes once had ulceration. Over the years, there has been numbness or pulling, inability to turn or side, already becoming Wei of sinews and bones. Combined with fire rising causing dizziness, the clear orifices of the head and face often feel unsatisfactory. Defecation is difficult, only once every four or five days. Yang Qi cannot hide, Yin fluids daily wither. For Wei syndrome in old age, there is originally no method of complete recovery. The pulse is rapid, moving, and swift. Warming and drying tonics are useless and harmful. Imitating Danxi's Tiger Hidden prescription, slightly modified, hoping to retain some fluids, also calculating for peaceful longevity. This is not attacking the disease.

Da Shengdi (Large Fresh Rehmannia Root), Dan Tiandong (Light Asparagus Cochinchinensis Tuber), Rou Congrong (Meat Cistanche), Huai Niuxi (Huai Achyranthes Bidentata), Sheng Baishao (Raw White Peony Root), Hugu Jiao (Tiger Bone Gelatin - note: substitute in modern practice), Baizi Ren (Biota Seed), Fei Zhimu (Fat Anemarrhena Rhizome), Chuan Huangbai (Sichuan Phellodendron Bark).