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Xia Ziyi recorded in *Qi Ji Fang* (Strange Disease Formulas): There was a person whose ten fingers on hands and feet had broken joints, with only tendons connecting them, lacking the flesh at the joints. Worms emerged like rush pith, several inches long, and the whole body grew green curly hair. This disease is named "Xue Yu" (Blood Remnant).
Decocting Poria (Fuling) and Coptis Chinensis Rhizome (Huhuanglian) to drink will lead to self-healing.

[Shen Yuan's Note] The *Classic of Internal Medicine* (*Neijing*) states: Spleen heat generates muscle flaccidity (Rou Wei), and the symptom of muscle flaccidity is yellowish skin color with muscle twitching. It also states: Dampness from the earth, when it affects the human body, harms the skin, flesh, and joints. The annotation says: Dampness enters from the lower part, first entering the skin and flesh; if dampness flows into the joints, it damages the tendons and vessels; once the tendons and vessels are damaged, the Liver also suffers disease. This condition arises from flesh transforming into worms, causing the ten fingers to break and lack joint flesh, and further being affected by the Qi of Liver Wood, generating green-haired curly worms. This corresponds to the scripture saying that the East generates Wood, Wood generates Wind, and in the Zang organs, it belongs to the Liver, and its worm is the hairy worm. The so-called hairy worm presents a dense appearance, hence this form, thus the disease name "Xue Yu". Because the Liver stores Blood, obtaining the residual Qi of the Liver generates the hairy worm. However, why does it not generate other colors but exclusively green? Presumably, the Spleen belongs to Earth, its color is yellow; the Liver belongs to Wood, its color is blue-green. When the blue-green and yellow Qi interact, this color is generated. Poria tonifies the Spleen and promotes dampness drainage; Coptis Chinensis Rhizome clears the heat of Liver Wood, making the Wood Qi peaceful and the Spleen strong, thus the condition heals itself.

It is also recorded: A person suffered from dislocation of the joints of the four limbs, connected only by skin, unable to move. This is named "Jin Jie" (Tendon Dissolution). Soaking three taels of Phellodendron Bark (Huanglu) in wine for one night, taking it out, drying it over fire, grinding it into powder, taking two qian each time, mixed with wine and swallowed, brings peace upon completion.

[Shen Yuan's Note] In this condition, the joints of the four limbs are dislocated, connected only by skin, because the tendons and vessels of the four limbs are flaccid and unusable, hence called "Jin Jie". "Jie" means the tendons and vessels have dissolved and cannot be used. However, flaccidity has deficiency flaccidity and excess flaccidity. Liu Hejian said: Four limbs unable to move is commonly known as paralysis and laxity. Thus, the scripture says: If the Spleen is excessive, it causes people's four limbs to be unable to move. It also says: If Earth is excessive, it becomes Dun Fu (high and thick). Fu means high, Dun means thick. Since it is both thick and high, it must be removed. This is truly what is called the disease of rich food and fine drinks (Gao Liang Zhi Ji), and the treatment should be purging, making the Qi weak and Yang decline, until Earth Qi is peaceful and recovery occurs. One may select San Hua Tang or Tiao Wei Cheng Qi Tang for use; if the Spleen is deficient, do not use them. The scripture says: If Earth is insufficient, the Spleen sinks low, meaning a pit. Thus, Spleen disease causes four limbs to be unable to move. The four limbs all receive Qi from the Stomach, but cannot reach the meridians directly; they must rely on the Spleen to receive it. Now, due to Spleen disease, it cannot transport fluids together with the Stomach; the four limbs do not receive water and grain Qi, Qi declines daily, vessel pathways become unfavorable, sinews, bones, muscles, and flesh have no Qi to grow, hence they are unusable. Treatment can use Shi Quan San, or modified Si Wu Tang, eliminating evil while preserving righteousness. I examined the *Neijing*, which states that the five Zang organs can cause flaccidity, yet Hejian alone emphasizes treating the Spleen. The *Neijing* also says: Discussions on treating flaccidity emphasize solely selecting the Yangming. Yangming is the sea of the five Zang and six Fu organs, primarily moistening the Zong Jin (major tendons); Zong Jin primarily binds bones and facilitates joint movement. The Chong Mai (Penetrating Vessel) is the sea of the meridians, primarily seeping and irrigating the valleys, combining with Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichong point, with Yangming as their leader, all belonging to the Dai Mai (Belt Vessel), and connecting to the Du Mai (Governing Vessel). Thus, Yangming deficiency leads to Zong Jin laxity, and the Dai Mai fails to draw, resulting in foot flaccidity and inability to use. Question: How to treat? Answer: Tonify each Ying (Nutrient) point and unblock each Shu (Transport) point, regulate their deficiency and excess, harmonize their reversal and smooth flow. For sinews, vessels, bones, and flesh, treat according to their respective months of receiving Qi (e.g., Liver prospers on Jia/Yi days, Heart on Bing/Ding days), then the disease will end.

It is also recorded: A person had convex swelling on both soles of the feet, with black bean-like sores growing on top, hard as nails, fragmented holes in the tibia bone with marrow flowing out, shivering chills in the body, and only desiring to drink alcohol. This is the swallowing of cold and heat between the Liver and Kidney. Applying processed Sichuan Aconite Root (Chuan Wutou) externally and drinking Leek Seed Decoction internally is effective.

It is also recorded: A person suddenly developed alternating chills and fever that did not stop for several days, limbs hard as stone, producing bell and chime sounds when struck, gradually becoming emaciated and ugly. Equal parts of Evodia Fruit (Wuzhuyu) and Costus Root (Muxiang) decocted and drunk leads to self-healing.

[Shen Yuan's Note] This condition is caused by Cold Evil lodging in Shaoyang. Shaoyang and Jueyin are exterior-interior pairs. At the end of the Three Yang meridians, Yang ends and Yin begins, hence the alternating chills and fever. At the end of the Three Yin meridians, Yin ends and Yang connects, hence the victory and recurrence of chills and fever. This condition arises from Yin excess failing to return outward to Yang, leading to evil invading the Spleen horizontally. Jueyin loses its function of healthy transportation, so all four limbs become hard as stone, which is what the scripture calls "Cold solidifies." The sound of striking resembling bells and chimes is the Earth tone. Presumably, the Spleen belongs to Earth, its tone is Gong (Palace), which is heavy and grand, hence the sound. Any Spleen Earth tone requires Fire to emit, and requires stagnation to emit, just like the primal Yang Qi of heaven and earth, which is stagnant below and then reaches outward; when it reaches, thunder sounds from within. Presumably, Spleen Earth is depressed by Cold; striking causes the tendons and vessels to respond and make sound. As for the gradual emaciation of the four limbs, it is because Spleen disease fails to nourish the skin and flesh. However, treating disease requires seeking the root. Using Evodia Fruit to enter the Liver directly drives out deep Cold; using Costus Root to unblock stagnant Qi allows Qi to flow and Cold to scatter, making Wood peaceful and Earth secure, thus healing.

Someone asked: Evil enters Jueyin, due to Yin excess and Yang failing to return downward, evil invades Spleen Earth horizontally; there should surely be vomiting and diarrhea, why is there none? I say: Although Spleen Earth is troubled, its Qi mechanism can still move internally, so striking produces corresponding sound, as stated in the *I Ching*: Kun is extremely soft yet moves with strength, hence no such disaster. However, this sound exists because Cold depression prevents self-reach, so striking produces sound, similar to Earth vessels having Qi. An instrument with Qi, when struck with iron, fire emerges from within; this is Qi. Presumably, Qi is closed and depressed within the Cold body; striking activates the internal Qi mechanism, emitting sound externally. Without Fire, there is no Qi; without Qi, there is no ringing. To understand this disease, one should observe it through the analogy of Qi striking and producing sound.

Another question: Earth vessels with sound produce it immediately upon striking where hit. If Spleen Earth resides deeply inside, although tendons and vessels correspond, perhaps it cannot produce sound following the strike. I say: The sound of Spleen Earth upon striking is like the resonance of a lute. If a lute has no body, strings do not ring; plucking the string causes immediate response. Understanding instruments this way reveals the sound produced by striking this disease.

Another question: Earth vessels with Qi ring; thus, wood contains Fire, which is not Qi? Why does it only make sound without ringing? I say: You do not understand the instrument as substance, distinguishing the five tones, which are not based on Qi. For example, wood as an instrument has the tone Jue (Ang), which is melodious and straight, hence the sound. What I mean by Earth vessels having sound is that knocking produces ringing. If analyzed by five tones, it is the sound of Gong (Palace). Without Qi, there is no such tone; how can it generally be discussed as Qi? If discussed as Qi, then bells and drums are also Gong tones; do they have Qi?

Another question: Bells and drums naturally have no sound; why do Qi-less vessels ring loudly and far? I say: Although bells have no Qi, they have internal pulse pathways; sound travels along these pathways, hence ringing far. Thus, cutting metals makes them shiny; breaking them results in uneven edges, divided by pulse paths, hence uneven. Among the five metals, only Tin and Lead have no sound because they are soft and not rigid. Regarding drums, sound arises from urgency, not from Qi or pulse pathways. Drum sound travels inward; if covered with skin below, striking responds below, hence ringing far; otherwise, sound is shallow and not far.

*Qi Bing Fang* records: A person's finger webs bled incessantly, with small worms like mayflies drilling out, able to fly away shortly after. This condition is caused by Damp-Heat generating worms. But why can they fly? Presumably, Damp-Heat combined with Wind Evil. All worms sensing Wind gain wings and can fly. Worms in the human body obtain the Qi of Wind, hence they can also fly. The formula uses Astragalus Root (Huangqi), Prepared Rehmannia Root (Shudi), and Coix Seed (Yiren) each 5 qian; Angelica Sinensis Root (Danggui), White Peony Root (Baishao), Poria (Fuling), and Atractylodes Macrocephala Rhizome (Baizhu) each 3 qian; Ginseng (Renshen), Bupleurum Root (Chaihu), Schizonepeta Spike (Jingjie), and Ligusticum Chuanxiong Rhizome (Chuanxiong) each 1 qian. Decoct in water and take orally. Four doses cure it. This formula does not focus on killing worms but merely tonifying Qi and Blood, assisting with draining Dampness and expelling Wind. When human Qi and Blood are harmonious, worms extinguish themselves.

It is also recorded: A person suffered from falling off of hands and feet but remained alive. This occurred during a Typhoid Fever (Shanghan) episode; thirst led to excessive drinking of cold water to relieve temporary thirst. Who knew that water would stagnate in the abdomen, unable to dissipate quickly, causing disease in the four limbs, blocking Qi and Blood circulation. Over time, hands and feet rotted first, fingers and toes fell off. Or after toes fell off, the soles rotted. Eventually, even the feet fell off. If one has Typhoid Fever with thirst and drinks excessive cold water, and after recovery, fluid oozes from fingers and toes, urgently use this formula to save the finger joints and soles. The formula uses Coix Seed 3 liang, Poria 2 liang, Cinnamon Twig (Rougui) 1 qian, Atractylodes Macrocephala Rhizome 1 liang, Plantago Seed (Cheqianzi) 5 qian. Decoct in water and take orally for ten consecutive doses. With profuse urination, the oozing from hands and feet stops.

It is also recorded: A person suffered from red-hot soles of feet, unable to touch the ground, not phlegm-toxin, lasting years without healing. This condition resulted from using hot medicines and immediately engaging in sexual intercourse, causing Fire to gather in the soles and not dissipate, hence chronic non-healing. The method should use internal medicine to resolve it. If external treatment is used, the sole must rot away first. Decocting and drinking Qu Huo Dan (Fire-Quenching Pill) for ten doses resolves it spontaneously; twenty doses bring full recovery. However, sexual abstinence for three months is required; otherwise, it will recur, and recurrence leads to death. Be cautious.

It is also recorded: A person's fingernails all fell off, without pain or itching. This is due to deficient Fire in the Kidney Meridian, followed by washing hands with cold water after sexual intercourse, resulting in this disease. The formula uses Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), adding Bupleurum Root, White Peony Root, and Drynaria Rhizome (Gusuibu). Treatment leads to recovery.

It is also recorded: A person's palm suddenly rose one cun high, without pain or itching. This is Fire of the Yangming Meridian not dispersing, but stagnating in the hand. Addressing pain/itchlessness indicates not only Fire stagnating in the couli (interstices) but also Water obstructing the skin and hair. The method should use external medicine to resolve it. Presumably, Yangming Fire excess causes constant thirst and drinking; if not thirsty, it means Stomach Fire has dispersed, flowing poison into the palm. Likely, the person had Yangming Fire excess, pressed hands on the bed/mat, intentionally engaged in intercourse with excessive effort, causing Qi and Blood in the palm to stagnate. Over time, it bulged up, painless and itchless, becoming dead flesh. The formula uses one Aconite Lateralis Preparata Radix (Fuzi), decocted in water to soak the hand until cool, stopping. Doing this for ten days inevitably causes pain; soaking again causes itching; further soaking flattens the elevation. Presumably, Aconite is a great heat substance, entering no meridian it does not penetrate; even used externally, it enters internally. If taken as a decoction, the whole body heats up, stirring Stomach Fire, palm flesh does not resolve, and internal symptoms arise蜂起 (swarm up). Hence, external treatment achieves cure. Alternatively, adding one fen of Calomelas (Qingfen) to the Aconite decoction introduces it to the bone marrow, yielding miraculous effects.

It is also recorded: A large fleshy lump suddenly grew above the calf, looking like a tumor but not, like flesh but not, painful to touch. This is Spleen Meridian Dampness condensing into this lump, carrying Fire that does not dissipate, hence painful to touch. The method should strongly tonify, specifically tonifying Spleen Qi and dispersing Dampness. However, external strange flesh, if resolved internally instantly, may not heal. An internal-external attack method is needed. Internally take Xiao Shi Hua Guai Tang (Dampness-Dispersing Strange-Lump Resolving Decoction) for two doses, then apply Xiao Kuai Shen Dan (Lump-Resolving Divine Pill) to the lesion. It resolves in one day, extremely miraculous.

It is also recorded: Suddenly, blood spurts from pores on the foot like a thread, flowing incessantly leads to death. Urgently boil three sheng of rice vinegar until hot, soak both feet, stopping bleeding immediately. Then decoct one liang of Ginseng and three liang of Angelica Sinensis Root with one slice of Pangolin Scale (Shanjiapia), roasted and powdered, mixed with liquid and drunk. The condition never recurs. This is caused by unrestrained alcohol and sexual desire; treat urgently.

It is also recorded: A sudden finger-like growth appeared on the sole, unbearable pain, formed by Damp-Heat Qi condensation. Use Xiao Zhi San (Finger-Resolving Powder), lightly prick with a knife to bleed, pricking the grown finger. Fluids emerge immediately; apply to the bleeding area, sprinkling powder as fluid comes out, continuing until blood stops. After three days, fluid secretion ceases, and pain lessens. Then decoct and drink Hua Shui Tang (Water-Transforming Decoction) for four doses for full recovery, the finger transforms entirely into water. Externally apply Sheng Ji San (Flesh-Generating Powder) and cover with plaster for healing.

Cheng Shanru Wen saw a person suddenly grow a branch-like growth on the hand, unbearable pain. A doctor used Akebia Caulis (Tongcao) powder mixed with egg white applied, resolving it immediately.

*Qi Xiao Fang* records: A person suffered from toxic inflammation of hands and feet, unbearable pain. Use hornet nests from walls, powdered, add a little Frankincense (Ruxiang), grind evenly, mix with vinegar to apply. When dry, moisten with vinegar.

*Hua Tuo Bie Zhuan* records: A snake-shaped mark appeared on the skin of a hand, unbearable pain. This snake took advantage of sleep to interact with the body, causing this strange disease. Herbal decoctions were ineffective. Prick with a knife, bleeding like ink. Externally apply Angelica Dahurica Root (Baizhi) powder, slightly improving. Next day, prick again, blood as before, apply Baizhi powder again. Two or three times dissolve the shape. Prick head first, then tail, do not confuse.

Zhang Gao's *Yi Shuo* cites *Zhi Qing Za Ji*: A person suffered from foot sores, silent in winter, foul and rotten in summer, unbearable pain. Met a Daoist who said: You walked on grass, attracting snake mating residue; there are snake babies in the sore. They hide in winter, hence safe; they emerge in summer, hence rotten. Urgently crush fresh toad and apply, changing three times a day. Within three days, a small snake emerges from the sore; clamp it with iron tongs, the sore heals.

It is also recorded: Anyone warming by fire in winter, fire Qi enters internally, causing sores on both thighs, dripping fluid incessantly, unrecognized by the world. Apply Phellodendron Bark (Huangbai) powder, curing immediately. A woman suffered this, unrecognized by others, also cured by this.

Li Lou's *Guai Zheng Fang* records: A fourteen-year-old girl had a growth at the soft wrist, soybean-sized, half in flesh, red-purple, unbearable pain, all medicines ineffective. A practitioner used four liang of Mercury, rubbed with two sheets of white cotton paper, dipped in mercury and rubbed on it. It fell off naturally in three days, curing her.

*Benshi Fang* records: During the Tang Dynasty, a merchant had a sore on his left upper arm, growing like a human face, with no other suffering. The merchant jokingly dripped wine into its mouth; its face turned red. Feeding it objects, it could eat; too much caused arm swelling; not eating caused arm numbness. A famous doctor taught him to test various medicines; none caused harm. When administered Fritillaria Bulb (Beimu), the sore knit eyebrows and closed eyes. The merchant joyfully destroyed its mouth with a small reed tube and poured it in. Scabs formed in a few days, curing it. Unknown what disease it was; *Ben Jing* says it is a metal wound; is this a type of metal wound?

*Zhou Hou Bei Ji Fang* records: A person's fingers were red, rising and falling with the moon. Boil a handful of raw Scallion Bulb (Xie) in sour wine, mash and apply, the disease stops.

[Shen Yuan's Note] This condition is caused by Cold Evil reversing into the meat texture, Ying Qi not following, blood coagulating and not moving, remaining in the vessel pathways, appearing and disappearing with the rise and fall of human Qi and Blood, showing the color of blood. The *Neijing* says: When weather is warm and sunny, human blood overflows, and Wei Qi floats, so blood is easily discharged, Qi moves easily. When cold and cloudy, blood coagulates, Wei Qi sinks. When the moon begins to wax, blood becomes refined, Wei Qi begins to move. When the moon is full, Qi and Blood are substantial, muscles firm. When the moon wanes, muscles reduce. Meridians are empty, Wei Qi departs, form stands alone. Thus, adjust Qi and Blood according to heavenly timing. Inferring from this, when the moon begins to wax, Qi and Blood initially prosper, red color floats outward with Qi, gradually arising. When full, Qi and Blood are substantial, so color appears externally. When waning, Qi and Blood decline, meridians empty, Wei Qi departs, form stands alone (like Sun Soul departing and Moon Soul standing alone), so it gradually hides internally. Thus, knowing the afflicted red color rises and falls with the moon. Scallion Bulb is pungent and warm, dispersing blood and Qi; sour wine acts as a guide, allowing Qi to scatter and Blood to move, Cold extinguishes itself, hence mashing and applying cures.

*Taiyuan Gushi* records: Xu Zhicai treated a person with swollen and painful heels, unrecognized by other doctors. Xu said: This is a clam spirit disease, caused by dipping feet in seawater while boating. The patient said: Indeed, it happened so. Zhicai dissected and found two clams, size of elm seeds.

Deng's *Bifeng Fang* records: A person had wooden hardness on the soles. Melt cowhide with ginger juice, mix with Arisaema Rhizome (Nanxing) powder, apply, and iron with heated object.

[Shen Yuan's Note] This condition is Kidney Cold, Ying Qi coagulating and not moving, forming this disease, which is what the *Neijing* calls "skin not nourished leads to insensitivity," and also "North generates Cold, in Qi it is hardness."

Daoist Wang Yu said: Suddenly suffering from soles feeling like arrow strikes, unbearable pain, irregular onset, this is Kidney Wind-Toxin, draining the Kidney cures it.

*Nangong Cong Julou Shenshu* records: The South is low and damp; many suffer from foot sores, years later generating worms like leeches emerging, caused by Wind-Toxin attacking. Use beef tripe, sheep tripe, or pig tripe (without washing off feces), grind to mud. Depending on sore size, add half liang of Alum (Fan), apply on cloth and paste. Soon, sore itching enters the heart; slowly remove cloth with it, roast over fire. Thousands of silk-hair-like tails emerge, green, white, red, or black. Wash with water. Do this every three days, not exceeding several times; worms exhaust, sore heals.

*Hanlin Congji* records: Li Ding spoke of Shi Zangyong, a good doctor. Someone washed hands under eaves drip, felt something enter nail beds, initially like silk/hair, days later like a thread, unable to extend/retract, realized a dragon hid there. Knocked on Zangyong for treatment. Zangyong said: Medical books have no record, seek by intuition. Grind mantis into powder, apply to finger, hopefully avoiding lightning disaster. The person followed advice. Later, lightning fire surrounded body; urgently needle-picked, indeed saw an object jump out, no disaster ensued.

*Feixue Lu* records: A folk woman in Shandong had a hidden lump on one arm, curved like a dragon. She liked immersing her arm in water. One day, lightning came from window; indeed, a dragon split clouds and left from the arm.

Cai Yuanchang, Prefect of Kaifeng, was working at his desk when suddenly a bug crawled from sole to waist, dropping pen and fainting. Recovered after a long time. Clerk said: Only Scholar Yu can treat this. Summoned Yu. Yu said: This is true Hong Kong Foot (Gout/Cramp). Method: Moxibustion on Fengshi (GB31). One moxa cone applied, Cai returned to normal calmly. Next day, relapse. Summoned again. Yu said: Removing root requires thousand moxa cones. Followed advice, applied five hundred cones, healed since.

*Ming Yi Lu* records: Scholar Ren Dao suffered from black swollen sore between legs, narrow and long. Northern Doctor Wang Tong said: This is Fish Umbilicus Sore, caused by Wind-Toxin accumulation and accidental ingestion of human sweat. Applied Yi Yi San (Unique Powder), cured in days. Begged for formula. Said: Only Xue Xuan (Snow Black? likely referring to a specific ingredient or alias, context implies a single herb). Ren visited widely, none knew. Famous Doctor Hao Yun said: *Sheng Hui Fang* treats this with ash of cured pig head mixed with chicken egg white applied, which is it.

Zhang Zihe treated Old Ma of Xinzhai, age 59. Due to autumn tax arrears, beaten sixty times by officials, obtained shock Qi becoming wind convulsion, already three years. Severe attacks caused hand and foot trembling, unable to hold objects,