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Malaria stops but recurs, with excessive sweating and vomiting; this is deficiency of the Middle Qi leading to rebellious Qi. It is appropriate to benefit the Yangming channel.

Pinellia Rhizoma (Banxia), Poria (Fuling), Exocarpium Citri Reticulatae (Guangpi), Ginseng Radix et Rhizoma (Renshen), Dendrobii Caulis (Shihu), Phragmitis Rhizoma (Lugen), Ginger Juice (Jiangzhi)

Comment by Deng: Observing the intention of this formula, there must be much phlegm-heat in the stomach.

Second visit: The chills and fever have stopped, and both sweating and vomiting have decreased. It is appropriate to harmonize and nourish Ying and Wei.

Ginseng Radix et Rhizoma (Renshen), Cinnamon Twig (Guizhi), Dendrobii Caulis (Shihu), Exocarpium Citri Reticulatae (Guangpi), Angelicae Sinensis Radix (Guishen), Prepared Licorice Root (Zhigancao), Ophiopogonis Radix (Maidong), White Peony Root (Baishao)

Note by Yi: This is the treatment method for a deficient constitution caused by rich and greasy food. Both formulas are clear, steady, and appropriate.

Comment by Deng: Since the phlegm-heat has subsided, Ying and Wei appear even more deficient; hence, the formula is changed to specifically nourish Ying and Wei.

Jaundice Section

The face is dark and eyes yellow, pulse is rapid yet faint, feet are cold up to the knees, and skin and nails feel numb. The disease has penetrated into the Shaoyin channel, but the pathogenic factor originates from dampness due to white wine consumption and sexual exertion.

Kidney Qi Pill (Shenqi Wan)

Note by Yi: This case is recorded in *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet). In recent times, it appeared in *Ailu Yian*, where one prescription was very good. This condition involves blood stasis in addition to dampness. Whether Shenqi Wan will be effective remains uncertain.

Comment by Deng: In this disease, Kidney Yang is indeed deficient, and Ying and Wei are naturally lacking, while damp-heat and blood stasis must also coexist. This formula seems to focus only on deficiency and fails to eliminate pathogens.

Comment by Sun: Jaundice accompanied by black discoloration due to blood stasis shares similar principles, providing another explanation.

Face, eyes, and body are all yellow, but there is no epigastric fullness or stuffiness, and urination is normal. This is what Zhang Zhongjing called "Deficiency Jaundice" (Xu Huang). Treat it using Zhang Zhongjing's method.

Cinnamon Twig (Guizhi), Astragalus Root (Huangqi), White Peony Root (Baishao), Poria (Fuling), Fresh Ginger (Shengjiang), Prepared Licorice Root (Zhigancao), Jujube (Dazao)

Note by Yi: The case clearly indicates appropriate medication.

Comment by Deng: With such accurate differentiation, there is no doubt. Quoting ancient formulas is precise and not superficial.

Comment by Sun: Zhang Zhongjing's method refers to Huangqi Jianzhong Tang.

Dampness stagnates and heat gathers; reversing upward causes throat discomfort; manifesting outwardly causes body and eye jaundice; sinking downward causes red and painful urination.

Artemisiae Scopariae Herba (Yinchen), Magnolia Bark (Houpo), Fermented Soybean (Douchi), Akebia Caulis (Mutong), Polyporus (Zhuling), Exocarpium Citri Reticulatae (Juhong), Poria (Fuling), Gardenia Fruit (Heizhi)

Note by Yi: The discussion of pathology is coherent throughout, so the medication is meticulously matched.

Additional Note: For throat discomfort, add Platycodon Root (Jiegeng) and Peucedani Radix (Qianhu).

Comment by Deng: This is steaming and flooding of damp-heat, classified as Yang Jaundice. The formula is light and elegant without flaws.

Bi-Qi Section

The chest and back belong to the Yang aspect. When Bi obstruction occurs and blocks flow, one should unblock Yang. Generally, if Yang cannot circulate outward and becomes stagnant internally, it leads to internal heat and external cold. Unblocking Yang requires acrid-warm herbs, but acrid-warm herbs may hinder Zang Qi. Therefore, it is proposed to use acrid-moist herbs to unblock the Lung instead.

Asterae Flos (Ziwan) 3 liang, decocted in water for oral administration. Note by Yi: This is a clever method. However, the efficacy is unknown.

Comment by Deng: This resembles the Chest Bi discussed in *Jin Gui Yao Lue*. Herbs like Trichosanthis Fructus (Gualou), Allii Macrostem (Xiebai), and Pinellia Rhizoma (Banxia) can unblock Yang without hindering Zang Qi. Why were they excluded? Perhaps single herb therapy was tested previously.

Damp evil stagnates and obstructs, Yang Qi does not diffuse, presenting with external cold and internal heat, chest fullness, and red urine. It is appropriate to open and reach the Upper Jiao.

Asterae Flos (Ziwan), Platycodon Root (Jiegeng), Curcuma Aromatica Rhizome (Yujin), Amomi Fructus Rotundus (Baiko), Aurantii Fructus Immaturus (Zhike), Apricot Seed (Xingren), Fritillaria Bulb (Beimu), Licorice Root (Gancao)

Note by Yi: This is the standard method for treating Lung Bi.

Comment by Deng: Heat is stagnant internally, and Lung Qi is not diffusing. Thus, lightly opening the Upper Jiao is suitable; it is inappropriate to use warming herbs like Ginger (Jiang) and Cinnamon Twig (Guizhi) merely because of external cold.

Qi stagnation does not dissipate, bowel movement is closed, asthma is urgent, and lying flat is impossible; sudden dispersion is difficult.

Asterae Flos (Ziwan), Lepidii Semen (Tingli), Magnolia Bark (Houpo), Apricot Seed (Xingren), Exocarpium Citri Reticulatae (Juhong), Curcuma Aromatica Rhizome (Yujin), Aurantii Fructus Immaturus (Zhike)

Note by Yi: This condition is more urgent than the previous one, accompanied by constipation, so medication acts by draining and descending from the Middle Jiao.

Comment by Deng: This must be a patient with robust constitution and excess pulse, allowing for vigorous opening and guiding. One with insight naturally has courage.

Second visit: Rhubarb (Dahuang), Magnolia Bark (Houpo), Areca Seed (Binglang), Aurantii Fructus Immaturus (Zhike), Apricot Seed (Xingren)

Note by Yi: Light agents were ineffective, so now we promote bowel movement to drain the Lung.

Comment by Deng: Since the pathogen has transformed into heat, the formula is changed to use cold purgation.

The chest is the seat of Yang. If Yang Qi does not distribute, obstruction and blockage occur. Warming and unblocking is appropriate; clearing heat is not. The more one clears, the more obstructed it becomes.

Cinnamon Twig (Guizhi), Poria (Fuling), Dried Ginger (Ganjiang), Prepared Licorice Root (Zhigancao), Alpinia Oxyphylla Fruit (Yizhiren)

Note by Yi: Adding opening-Bi herbs like Apricot Seed (Xingren), Asterae Flos (Ziwan), Exocarpium Citri Reticulatae (Ju), and Platycodon Root (Jie) would seem more dynamic.

Comment by Deng: Where Clear Yang resides, if purely blocked by cold-fluid retention, only warming and unblocking can open the Bi.

Comment by Sun: Xingren, Ziwan, Ju, and Jie represent the situation where "the more one opens, the more obstructed it becomes."

After eating, chest and back feel stuffy and distended, with belching and discomfort. This is unblocked Yang Qi. Acrid-unblocking methods are appropriate.

Amomi Fructus (Caokouren), Pinellia Rhizoma (Banxia), Cinnamon Twig (Guizhi), Poria (Fuling), Dried Ginger (Ganjiang), Prepared Licorice Root (Zhigancao)

Note by Yi: This condition is similar to Chest Bi.

Comment by Deng: Fluid retention obstructs Qi stagnation, and Yang collaterals easily become blocked. Acrid-unblocking is essential. Herbs like Costus Root (Muxiang) and Amomum Fruit (Sharen) that smooth Middle Qi should also be included.

Epigastric and Abdominal Pain Section

Roundworm Jue causing heart pain, vomiting sour water during pain, and cold extremities. Bitter, acrid, and sour treatments are appropriate.

Coptis Rhizoma (Chuanlian), Cinnamon Twig (Guizhi), Angelicae Sinensis Radix (Guishen), Cyperi Rhizoma (Yanhu), Mume Fructus (Wumei), Zanthoxyli Fructus (Chuanjiao), Poria (Fuling), Toosendan Fructus (Chuandongzi), Prepared Ginger (Paojiang)

Note by Yi: This follows the method of Wumei Wan.

Comment by Deng: The formula matches the syndrome. However, definitive evidence of Roundworm Jue includes bitter heat in the epigastrium, pain attacking tangible structures, or fluctuating lip/tongue/face color, depending on the movement of roundworms.

This is Kidney Jue. Heart pain with back distension radiating to the waist. Propose using Xu Xueshi's Xiangrong Wan.

Deer Antler Glue (Lurong), Lycium Fruit (Qizi), Astragali Complanati Semen (Shayuan), Star Anise (Dahuixiang), Musk (Shexiang)

Note by Yi: Cold invades the Kidney, causing rebellious Qi, hence warm tonification is used. Distension involving waist and back indicates failure of Du Mai Yang. Deer Antler warms and unblocks Du Mai; Musk opens and drains turbid Yin, serving as chief herbs.

Comment by Deng: Consider adding Xuanfuhua Tang to unblock Ying collaterals.

Comment by Sun: Qi rebels upward from below the umbilicus causing Jue, thus named Kidney Jue; limbs are cold, hence warm tonification is used; back pain exceeds chest pain, hence Deer Antler and Musk are used.

String-like pulse, lower abdominal pain, epigastric pain after eating radiating to the throat. Liver Fire invading Stomach. Draining Jueyin and harmonizing Yangming is appropriate.

Toosendan Fructus (Chuandongzi), Akebia Caulis (Mutong), Poria (Fuling), Licorice Root (Gancao), Dendrobii Caulis (Shihu), Chaenomelis Fructus (Mu Gua)

Note by Yi: Suggest adding Cyperi Rhizoma (Yanhu) and Gardenia Fruit (Shanzhiren).

Comment by Deng: The cause is postprandial onset, indicating Stomach Qi is suppressed and not flowing smoothly, differing from cases relieved by eating (deficiency vs. excess). This formula aims at draining.

Comment by Sun: Liver Fire invading Stomach is evidenced by pain radiating to the throat; thus, Black Gardenia (Heizhi) should be added to clear Liver Fire.

Heart and abdominal pain, string-like pulse, blue complexion indicate Liver disease.

Toosendan Fructus (Chuandongzi), Angelicae Sinensis Radix (Guishen), Poria (Fuling), Dendrobii Caulis (Shihu), Cyperi Rhizoma (Yanhu), Chaenomelis Fructus (Mu Gua)

Note by Yi: The formula is stable and appropriate.

Comment by Deng: Differentiation is solid and unbiased, but acrid-unblocking herbs should be assisted in the formula.

Masses and Growths Section

Accumulation below the navel, hot to touch, patient feels heat and pain in uterus and both yin openings. Heat knot is evident. Moreover, past diseases often originate from the Liver. My view is that without draining Jueyin, efficacy cannot be achieved.

Longhui Wan 50 pills taken with wine.

Comment by Deng: Bitter-cold draining of Jueyin fits the pathology well. Additionally, Musk in the formula can search collaterals and disperse masses.

Comment by Sun: The pathology belongs to heat; the key lies in the sentence regarding heat and pain in the anterior and posterior yin openings.

Collateral disease with blood stasis and Bi, left hypochondrium is hard and solid. Last year, insect and ant herbs were used to regulate blood ascent and descent, showing some effect, but epigastrium feels somewhat tangible and slightly painful upon pressure. Previous herbs were too harsh. Now, balance Qi and Blood, using a slow approach.

Vine-processed Cyperi Rhizoma (Yanhu), Turmeric Rhizome (Jianghuang), Asafoetida (awei), Peach Kernel (Taoren), Raw Cyperi Tuber (Xiangfu), Musk (Shexiang), Angelicae Sinensis Radix Tip (Guixu), powder with honey pills, 2 qian per dose.

Note by Yi: Following the previous formula, although stated as balancing Qi and Blood, the main focus remains on dispersing stasis.

Comment by Deng: This adopts the strategy from the previous formula. For blood stasis masses, efficacy should be utilized.

Comment by Sun: Due to hardness and tangibility, insect herbs are used to search blood. Stepping back slightly from the previous formula explains the term "slow method."

Pulse is deficient and rapid, complexion is pale and lusterless. Left hypochondrium has a cup-sized mass, bowel and bladder movements are normal. Disease is in the Liver, Ying and Blood are disharmonious. This is deficiency with excess; tonification must include unblocking.

Atractylodes Macrocephala Rhizome (Baizhu), Angelicae Sinensis Radix (Guishen), Prepared Licorice Root (Zhigancao), White Peony Root (Baishao), Rehmanniae Radix (Shengdi), Poria (Fuling), Amber (Hupo), Exocarpium Citri Reticulatae (Guangpi), Peach Kernel (Taoren), Safflower (Honghua), Agarwood (Chenxiang), Curcuma Aromatica Rhizome (Yujin)

Note by Yi: The treatment is intimate and not superficial.

Comment by Deng: Ancients discussed three stages for treating masses: early, middle, and late. This is the middle stage treatment, but Ginseng (Renshen) could potentially be added.

Seasonal illness relapsed due to diet, unaware of hunger or satiety, bowel movement is unsatisfactory, right hypochondrium, Xuli and Tianshu points show vague tangibility. This is the pathway of Yangming Stomach Collaterals. Frequent belching without transformation, no thirst or irritability. Is this a case requiring aggressive elimination of excess heat? Propose Danxi's method of draining Wood and calming Upper Jiao.

Xiaowenzhong Wan. If effective after half a month, continue with previous method.

Note by Yi: This is a case of Middle Jiao damp accumulation and obstruction.

Comment by Deng: Suspect phlegm-fluid obstructing Stomach collaterals; Chest Bi treatment methods might be borrowed.

Left hypochondrium mass increases daily, painful on pressure, uneasy after eating. Wherever痞结 (stuffiness and knotting) exists, Yang fire must be stagnant within, causing irritability, dry mouth, and heart heat. Bitter-acrid-cold herbs are needed to clear and open. However, this is not easy.

Coptis Rhizoma (Chuanlian), Immature Bitter Orange (Zhishi), Cyperi Tuber (Xiangfu), Ligusticum Rhizome (Chuanxiong), Medicated Leaven (Shenqu), Poria (Fuling), Green Tangerina Peel (Qingpi), Red Peony Root (Chishao)

Note by Yi: As the hypochondriac mass grows larger and tangible, Ying collaterals must be blocked; Ying-nourishing and unblocking seems necessary for efficacy.

Comment by Deng: Masses resulting from long-standing deficiency are extremely difficult to treat effectively.

Formula is stable and fitting; adding Jinlingzi San is advisable.

Comment by Sun: Possibly add Angelicae Sinensis Radix Tip (Guixu) and Jinlingzi San.

Right abdomen shows tangible accumulation, pulse is large, bloating immediately after eating. Treatment focuses on Six Fu organs.

Atractylodes Macrocephala Rhizome (Baizhu), Poria (Fuling), Exocarpium Citri Reticulatae (Guangpi), Raw Cyperi Tuber Juice (Xiangfuzhi), Sparganium Rhizome (Sanleng), Magnolia Bark (Houpo), Tsaoko Cardamom Fruit (Caoguo), Hawthorn Fruit (Shanzha)

Note by Yi: The formula mainly focuses on smoothing Qi mechanism.

Comment by Deng: Since pulse is large, why not add Coptis Rhizoma (Chuanlian) and Immature Bitter Orange (Zhishi)?

Epigastric region protrudes high, extending to left hypochondrium with tangibility, gradually worsening abdominal distension. Considering violent cold in January, cold air inhaled through mouth and nose entered Stomach collaterals and Mo Yuan. Clear Yang fails to function, turbid Yin condenses and obstructs, Stomach Qi is severely injured, leading to isolated abdominal distension. This is no minor ailment.

Magnolia Bark (Houpo), Tsaoko Cardamom Fruit (Caoguo), Pinellia Rhizoma (Banxia), Dried Ginger (Ganjiang), Poria (Fuling), Long Pepper Fruit (Bibo).

Separately, one Suhexiang Wan pill dissolved for administration.

Note by Yi: Cold evil closes Ying collaterals, hence warming and unblocking is used; Cinnamon Twig Tip (Guizhijian) could be added to the formula.

Comment by Deng: High protrusion with tangibility suggests combining Ying collateral unblocking.

Swelling and Distension Section

Pulse is slow, Stomach is cold, abdominal distension, Qi attacks chest and hypochondrium, nausea, poor appetite, diarrhea. Invigorating Spleen and Stomach Yang is appropriate.

Dried Ginger (Ganjiang), Alpinia Oxyphylla Fruit (Yizhiren), Pinellia Rhizoma (Banxia), Magnolia Bark (Houpo), Medicated Leaven (Shenqu), Areca Seed (Binglang), Zanthoxyli Fructus (Chuanjiao), Poria (Fuling)

Note by Yi: This is warming the Middle and regulating Qi method.

Comment by Deng: This arises from Middle Cold and Liver depression. Within the warming formula, add White Peony Root (Baishao), Jinlingzi, and Chaenomelis Fructus (Mu Gua) to peacefully regulate Liver Wood. Also, what is the purpose of Areca Seed (Binglang)?

Comment by Sun: Due to nausea and diarrhea, attention is focused on the Central Palace (Spleen/Stomach).

Mingmen Yang declines, Spleen loses warmth and nourishment, failing to transport and transform. Eating causes immediate distension. Method dictates warming and tonifying Lower Jiao.

Shenqi Wan minus Cinnamon Twig, add Agarwood (Chenxiang) and Sesamum Seed (Jiaomu).

Note by Yi: This is the method of tonifying Fire to generate Earth.

Comment by Deng: This is the gradual onset of isolated abdominal distension. The pill formula adjustments are worthy of study.

Damp-heat sinks into Taiyin causing distension.

Atractylodis Rhizoma (Maotou), Phellodendri Cortex (Chuanbai), Magnolia Bark (Houpo), Chenpi, Mulberry Bark (Sangpi), Akebia Caulis (Mutong), Alisma Rhizome (Zexie), Betel Nut (Dafupi), Tsaoko Cardamom Fruit (Caoguoren).

Note by Yi: This specifically treats Spleen Earth damp-heat. Ancient formula Xiaowenzhong Wan can also be taken.

Comment by Deng: This condition must present with greasy-turbid tongue coating and scanty urine, indicating damp-heat excess syndrome, hence this method is used.

Comment by Sun: Heat generated from dampness, hence Atractylodes and Phellodendrum are used together.

Pulse is faint and slow, old痞 (mass/stuffiness) in left hypochondrium, abdomen gradually enlarges, loose stools, scanty urine. This is turbid Yin attacking upward; unblocking Yang is indicated.

Prepared Aconite Root (Shufuzi), Polygalae Radix (Yuanzhi), Sesamum Seed (Jiaomu), Small Fennel (Xiaohuixiang), Alisma Rhizome (Zexie), Poria (Fuling).

Note by Yi: This is the standard method for warming and unblocking to treat distension.

Comment by Deng: This is Middle deficiency with damp-heat, combined with Liver Qi invading internally. Replacing Aconite with Dried Ginger in the formula is steadier; the purpose of Polygalae Radix is unclear. Suggest adding Atractylodes Macrocephala Rhizome (Baizhu), Jinlingzi, and Green Tangerina Peel (Qingpi).

Spleen Qi is inherently weak, further suppressed by Wood. Suppression makes it weaker. Consequently, Spleen fails in its duty, food is not digested, leading to distension. The weaker the Spleen, the stronger the Liver, constantly attacking and rebelling, producing sounds above and below. Half-year illness, over sixty years old, cannot be resolved overnight.

Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Toosendan Fructus (Chuandongzi), Hawthorn Seed (Zhahe), Licorice Root (Gancao), Chaenomelis Fructus (Mu Gua), White Peony Root (Baishao), Evodia Fruit (Wuyu), Tangerine Seed (Juhe).

Note by Yi: This treats both Liver and Spleen, leaning towards Liver, because besides distension, there are attacking and rebellious symptoms.

Comment by Deng: Case notes clarify reasoning; formula addresses both deficiency and excess.

Comment by Sun: Mildly add Qi-regulating herbs like Magnolia Bark (Houpo) and Exocarpium Citri Reticulatae (Guangpi).

String-like pulse, central fullness, disease in Liver and Spleen.

Ginseng Radix et Rhizoma (Renshen), Evodia Fruit (Wuyu), Chaenomelis Fructus (Mu Gua), Magnolia Bark (Houpo), Exocarpium Citri Reticulatae (Guangpi), Pinellia Rhizoma (Banxia).

Note by Yi: This is the standard method for treating both Liver and Spleen. Formula is concise and worthy of study.

Comment by Deng: For string-like pulse, Baizhu is more appropriate than Renshen.

Right Guan pulse alone is large and beats against finger, indicating disease in Middle Jiao. Food not digested, stuffiness and intermittent pain, chronic for years, sensation of hot Qi rushing up throat, dry mouth with bitter taste, white dry tongue coating. This is Spleen accumulating heat and stagnating dampness. Xiehuang method should be used.

Atractylodis Rhizoma (Maotou), Puerariae Radix (Gegen), Poria (Fuling), Gypsum Fibrosum (Shigao), Pogostemonis Herba (Huoxiang), Costus Root (Muxiang).

Note by Yi: This is an uncommon case in the Stuffiness and Fullness section, preserved for reference.

Comment by Deng: Right Guan being large alone also indicates Liver Wood fire invading Middle and Upper, not just accumulated heat. The method deviates; however, Gypsum is still less suitable than Coptis Rhizoma (Chuanlian).

Comment by Sun: White dry tongue coating warrants Xiehuang method; if thick-dry coating and constipation exist, Chengqi formula can be used.

Pulse and symptoms combined indicate Qi knotting in Upper Jiao, fluids not circulating, steaming into turbid phlegm, changing from intangible to tangible. Xu Zhicai said "light can remove excess," not suitable for sticky Yin-tonifying herbs.

Amomi Fructus (Baokouren), Coicis Semen (Yiren), Apricot Seed (Xingren), Magnolia Bark (Houpo), Loquat Leaf Juice (Pipayezhi), Jiangxiang Juice.

Note by Yi: This formula embodies the subtlety of "Light, Clear, and Agile."

Comment by Deng: This patient likely took Yin-tonifying herbs mistakenly for a long time, hence this argument.

Labor and Depression jointly injure, Ying and Wei disharmony, chest fullness and pain, occasional chills and fever. Different from Six Evils external contraction. Treatment should harmonize and nourish Qi and Blood.

Xiaoyao San.

Note by Yi: Adding Aurantii Fructus Immaturus (Zhi) and Magnolia Bark (Po) for widening Middle would be more comprehensive.

Comment by Deng: Although not external contraction, Liver channel has latent evil and stagnant fire. Method is quite fitting; adding Zhi and Po to regulate Qi would be better.

Comment by Sun: Chills and fever warrant use of Bupleuri Radix (Chaihu).

Spleen's function is transportation and transformation. Epigastric stuffiness prevents eating; eating causes fullness. Spleen has lost its function. But simple transporting herbs are slow and ineffective. Use tonifying-draining and ascending-descending methods.

Ginseng Radix et Rhizoma (Renshen), Dried Ginger (Ganjiang), Pinellia Rhizoma (Banxia), Poria (Fuling), Coptis Rhizoma (Chuanlian), Immature Bitter Orange (Zhishi), Chenpi, Fresh Ginger (Shengjiang).

Note by Yi: This formula imitates Xiexin method with additions.

Comment by Deng: This uses simultaneous tonifying and draining, bitter-draining and acrid-opening. "Ascending and Descending" terms seem forced.

Comment by Sun: Tonifying-draining and ascending-descending can assist transportation function; this is profound truth and innovative style.

Under hypochondrium, there is chronic痞气 (Qi stagnation/mass), occasionally rebelling; now central fullness, Qi attacks causing pain, acid regurgitation, vomiting, can bend forward but not lie back. This is Jueyin stagnant Qi invading Taiyin sector, caused by anger and depression. Long illness weakens Qi, unable to withstand strong attacking/draining; long-stagnated pathogenic Qi is also hard to tonify. Temporarily use harmonizing formula to balance Liver and Stomach. Only when pain settles and appetite improves can safety be guaranteed.

Pinellia Rhizoma (Banxia), Exocarpium Citri Reticulatae (Guangpi), Toosendan Fructus (Chuandongzi), Tangerine Seed (Juhe), Poria (Fuling), Green Tangerina Peel (Qingpi), Prepared Licorice Root (Zhigancao), Chaenomelis Fructus (Mu Gua).

Note by Yi: Pathogenesis analysis is extremely detailed; formula construction is thorough and appropriate.

Comment by Deng: With acid regurgitation evidence, although deficient, tonification is contraindicated.

Forced to create a formula for peacefully regulating stagnant Qi, limited by current situation.

Comment by Sun: Discussion is thorough.

Stomach Yang declines and exhausts, Qi obstructs, phlegm condenses, epigastrium uncomfortable, bloating after eating. Acrid-warm herbs are appropriate.

Tsaoko Cardamom Fruit (Caoguoren), Magnolia Bark (Houpo), Poria (Fuling), Pinellia Rhizoma (Banxia), Licorice Root (Gancao), Areca Seed (Binglang).

Note by Yi: This is damp-phlegm obstructing Middle Palace.

Comment by Deng: Based on herbs, Stomach Yang decline might still be manageable.

Heat knot and Qi closure, abdominal distension, difficult defecation.

Magnolia Bark (Houpo), Apricot Seed (Xingren), Talcum (Huashi), Scutellaria Root (Huangqin), Betel Nut (Dafupi), Pepo Skin (Fulingpi), Akebia Caulis (Mutong).

Note by Yi: This is regulating Middle while draining heat.

Comment by Deng: Add Aurantii Fructus Immaturus (Zhike) and Benincasae Exocarpium (Loupi) to unblock bowels.

Comment by Sun: Two symptoms seem similar, one requires warming for Yang decline, one requires clearing for heat transformation. However, warming without Guizhi/Fuzi means not Lower Jiao Yang decline; clearing without Lianjun/Jun means not severe knot/closure. Similarities contain differences; careful consideration is needed.

Abdominal distension, facial edema, foot swelling, inability to eat, desire to vomit. Spleen deficiency receiving dampness, transportation失常 (abnormal). Not a mild case.

Atractylodis Rhizoma (Maotou), Poria (Fuling), Exocarpium Citri Reticulatae (Guangpi), Mulberry Bark (Sangpi), Akebia Caulis (Mutong), Magnolia Bark (Houpo), Alisma Rhizome (Zexie), Pinellia Rhizoma (Banxia), Polyporus (Zhuling).

Note by Yi: This is regulating Middle and promoting dampness drainage.

Comment by Deng: Foot swelling mostly relates to Yang deficiency. Formula seems lacking Yang-unblocking herbs.

Dark face, yellow eyes, abdominal fullness, leg swelling, scrotal swelling. Damp-heat congestion, spreading from Spleen to Kidney, deep disease, difficult to treat.

Atractylodis Rhizoma (Cangzhu), Prepared Rhubarb (Zhi Jun), Magnolia Bark (Houpo), Chenpi, Akebia Caulis (Mutong), Artemisiae Scopariae Herba (Yinchen), Polyporus (Zhuling), Sesamum Seed (Jiaomu), Alisma Rhizome (Zexie).

Note by Yi: Pathogenic mechanism congested, healthy Qi already injured, hence difficult to treat.

Comment by Deng: Knowing healthy Qi is injured in such diseases, only driving and guiding methods remain, a last-resort plan.

Comment by Sun: Urgently drain congestion to preserve healthy Qi, possibly reversible. This is a method for cases where healthy Qi is not severely damaged, a different category.

Wheezing with sound when lying down, this swelling is Qi congestion in Upper Jiao. Ancient method "Open Ghost Gate" (sweating) should be used to treat Lung and unblock exterior.

Ephedrae Herba (Mahuang), Apricot Seed (Xingren), Coicis Semen (Yiren), Licorice Root (Gancao).

Note by Yi: Accompanied by wheezing/reversal, hence specifically treating Lung.

Comment by Deng: This is Zhang Zhongjing's established method, a targeted formula. Even if healthy Qi is slightly injured, replacing Mahuang with Perillae Fructus (Suzi) suffices.

Wind-Dampness combats, facial edema, abdominal fullness and swelling, difficulty in urination and defecation.

Apricot Seed (Xingren), Perillae Fructus (Suzi), Magnolia Bark (Houpo), Chenpi, Polyporus (Zhuling), Betel Nut (Dafupi), Ginger Skin (Jiangpi), Akebia Caulis (Mutong).

Note by Yi: This is simultaneous interior-exterior unblocking.

Comment by Deng: Disease resembles Fengshui, formula does not strictly follow Zhang Zhongjing's methods, likely due to milder progression or injured healthy Qi, emphasizing adaptability.

Swelling disease, but urination and defecation normal, cold limbs, asthma. Methods of moving Qi and purging water cannot cure this. Shenqi Wan should be used to move Yang and transform water. However, this is also a severe disease.

Shenqi Wan.

Note by Yi: This disease features Yang decline and Qi obstruction, considered incurable.

Comment by Deng: Disease is undoubtedly Kidney deficiency and Yang decline. Large dose decoction might save critical illness.

Headache Section

Fire rises, headache, tinnitus, epigastric stuffiness, occurring immediately after meals. This is Phlegm-Fire intertwining in Yangming and Shaoyang channels, exacerbated by food Qi, different from Yin-deficiency Fire flaming. First clear and regulate, then tonify and descend.

Bambusa Textilis Spathe (Zhuru), Poria (Fuling), Exocarpium Citri Reticulatae (Juhong), Prepared Licorice Root (Zhigancao), Pinellia Rhizoma (Banxia), Antelope Cornu (Lingyangjiao), Dendrobii Caulis (Shihu), Uncaria Rhynchophylla (Goutenggou)