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(When eating, the patient requires others to feed them; mouth and eyes open wide, lips and oral cavity are chewed raw; the body trembles as if pulled by strings like a marionette. Every time an episode occurs, townspeople gather to watch. At night, while lying in bed, there is fever, tightness of clothing and bedding, dryness and itching all over the body. There is internal heat but external cold sensation, desire for suicide, inability to hold a rope. They exhausted their wealth seeking medical help, even going bankrupt, yet the disease became more stubborn. The old man's son was an old minor clerk in the county, who consulted Dai Yuanli (Dai Ren) with his parents. Dai said: "This disease is very easy to treat. If it were the height of summer, one induction of vomiting would suffice; repeating the vomiting to drain the pathogen would cure it. Now that it is autumn cold, three inductions of vomiting can be used. If not cured, needling acupoints will surely cure it." First, administer Tongsheng San (Universal Salvation Powder) to induce sweating, then take the emetic agent. This resulted in vomiting one or two sheng of phlegm, and by evening, five or six bowel movements occurred. The illness improved slightly. After waiting five days, another induction of vomiting expelled three or four sheng of phlegm, clumped like chicken yolk, hot like boiling water. Due to hand tremors, the old man could not probe himself; his wife and others assisted, causing swelling and injury to the throat. He fell into a coma resembling drunkenness. After about one or two hours, he gradually regained consciousness, had several more bowel movements, and immediately felt reduced trembling in the legs, cessation of fever, ability to walk, comb hair, hold chopsticks and spoons. Before three inductions of vomiting, the disease vanished like a leap. Post-illness, only extreme cold was felt. Dai said: "Nourishment through food should be used; it will recede naturally over time. Because after a major illness, Wei Qi (Defensive Qi) has not recovered, it is appropriate to use herbs that move and guide Qi. Do not use hot tonics, lest they cause other diseases."

[Shen Yuan notes] Tremor and convulsion (Chan Zhen), according to ancients, is caused by flourishing Wood Fire and insufficient Kidney Yin, constituting a syndrome of deficiency below and excess above. Excess involves Phlegm-Fire; deficiency involves Kidney depletion. The method should clear the upper and tonify the lower. In Dai's treatment, if this old man had adhered rigidly to ancient methods, how would the Phlegm have been expelled? Thus, physicians must be flexible. If it is indeed excess at the branch (biao) and deficiency at the root (ben), treatment should follow ancient principles.

He also treated Li Zhengzhi from Xihua suffering from Cold Jue (Cold Reversal), while his wife suffered from Heat Jue. For over ten years, they took Xiaoyao San (Free and Easy Wanderer Powder) more than ten doses without effect. Both had floating, large, and forceless pulses. Li said: "My hands and feet are cold; soaking them in hot water does not stop the cold. My wife's hands and feet are hot; pouring cold water on them does not relieve the heat. Why?" Zihe (Dai) said: "These are Cold and Heat Jue syndromes. Both result from gluttony and indulgence in desires." He then cited the *Neijing* (Classic of Internal Medicine) discussion on Jue to explain. Li rejoiced: "The *Neijing* is truly a sacred text! My doubts of many years are now resolved. I will take no medicine, and the illness will heal by half." Heat Jue is due to Cold in the Upper Jiao; Cold in the Upper Jiao is treated by warming agents to tonify the Lung. Cold Jue is due to Heat in the Upper Jiao; Heat in the Upper Jiao is treated by cooling agents to clear the Heart. Two prescriptions were given separately, and both were cured within ten days.

Dongyuan stated: Someone suffered pain in the ten fingers of both hands. One finger hurt, then another; swelling followed pain. Bone pain and knee pain occurred; left knee pain preceded right knee pain. Episodes lasted five days at most, three days at least. Symptoms were lighter by day and heavier by night. During pain, heat sensation moved; walking relieved pain but worsened swelling. Annotation: Blood disturbance preceding Qi disturbance means pain precedes swelling; this is form injury affecting Qi. The main formula is Hexue Santong Tang (Blood Harmonizing and Pain Dispelling Decoction).

Luo Qianfu treated Temuer, Marshal of the Southern Expedition, nearly seventy years old. In autumn, while passing Yangzhou during the Southern Expedition, in mid-winter he suffered diarrhea with undigested food, cold pain in the umbilical and abdominal region, cold calves, and loss of pain/itch sensation upon scratching. He burned stones to warm himself, but could not get warm. Pulse was deep, fine, and faint. Likely due to advanced age and weak Qi entering enemy territory, complex military affairs, morning/evening exposure to cold, irregular diet, excessive consumption of milk and cheese, wet shoes in the morning failing to secure Yang Qi externally. Thus, cold-damp invaded deficiency, disease arising from below, resulting in cold and reversal coldness. *Neijing* says: "Attacked by cold, disease is contracted; mild cases become coughs, severe cases become diarrhea and pain." This is a disease of combined Cold-Damp. Method: Immediately expel Cold-Damp pathogens, vigorously tonify Yang. Moxibustion is essential. First, moxa cones on Qihai (CV6) for one hundred burns to tonify Lower Jiao Yang deficiency. Next, moxibustion on Zusanli (ST36), thirty-seven burns each side, to treat cold reversal and guide Yang Qi downward. Also moxa Sanyinjiao (SP6) to disperse Cold-Damp in the feet. Prescription: When Cold dominates, treat with Pungent-Hot. When Damp is external, level with Bitter-Hot, using Bitter to disperse. Fuzi (Prepared Aconite Root) is Great Pungent-Hot, assisting Yang, retreating Yin, warming meridians, dispelling cold; thus it is the Sovereign herb. Rougui (Cinnamon Bark) is Great Hot, Pungent-Sweet, also dispelling Cold-Damp. Baizhu (Atractylodes Rhizome) and Banxia (Pinellia Tuber) are Bitter-Pungent-Warm, drying Spleen Damp; thus they are Ministers. Renshen (Ginseng Root), Caodoukou (Cardamom Seed), and Gancao (Licorice Root) are Great Warm, benefiting Middle Jiao and Qi. Ganjiang (Dried Ginger) is Great Pungent-Warm, dispersing Cold-Damp. Congbai (Scallion White) is Warm, unblocking Upper Jiao Yang Qi; thus they are Assistants. Furthermore: Tonifying the Lower Jiao requires urgency; urgency demands strong flavor and aroma, hence a large dose. Within a few doses, diarrhea stopped, pain decreased, feet warmed. Diet regulated, recovered in ten days. Next autumn, passing Xiangyang during continuous rain for ten days, previous symptoms recurred. Moxa again as before, adding Yangfu (GB38), thirty-seven burns each. Administer previous prescription for a few doses until cured.

Xu Keyu treated the wife of Shen Zhonggang from Wuxing. Knee swelling and pain, worse on the right first. Hot compress shifted pain to the left; compressing left shifted to right. Compressing both caused borborygmus rising to the chest, followed by back pain like being beaten by ten thousand hammers, sparing only the head. Upon onset, face turned dark blue, pulse indistinguishable, coma until dawn, daily weakness deemed incurable. Xu examined the pulse: "Struck by Damp, subsequently injured by Shock. Gallbladder disease is severe but treatable." Ordered cotton wrapped around the chest, then induced vomiting of green-white saliva, nearly one dou. After vomiting settled, Xu said: "Now when the disease rises to the abdomen it stops, face won't turn cyanotic. Coma and knee pain remain like before, but certainly won't reach the chest. By third watch, it will settle." All happened as Xu predicted. After three episodes of coma, it did not recur, and she recovered.

Liu Dayong treated Chen Shi, a wealthy woman in Gutian, 70 li south of Shaozhou. She had a strange illness: normally no discomfort, but upon slight breeze, a point of intense itch between thighs, uncontrollable scratching, spreading to whole body, leading to fainting. Awake every three days. Sitting produced cough-like sounds. Body swayed forward and backward, unstable, hundreds of times before settling. Then slept confused for days, unaware of surroundings, afraid to go out. Multiple doctors failed. Liu observed: "I know her syndrome. First, give one dose of medicine. Take a string of prayer beads. Family didn't understand its use. Count the swaying episodes. As count decreases, then say it is Gui Zhu (Ghost Impregnation), possessed by ghosts in temples, causing essence and Qi to scatter. Method: Use pillow of a dead person, decoct and drink. After drinking, massive diarrhea several times, cured. Return pillow to original place."

Han Feixia treated a Du Si (Commandant). Heavy head, dim eyes, deafness, toothache. Said feet felt like not touching ground. Doctors didn't know the disease. One day after washing/combing, abdominal pain subsided slightly, but hands and feet couldn't lift. Han said: "This is a Fire syndrome, likely due to chronic mental and physical labor." Showed him *Yuji Weiyi*. Used Pungent-Dispersing agents for ten doses, fearing complications like Xiao Ke (Wasting-Thirst), Wei Bi (Flaccidity), Chuang Yang (Sores). Advised quiet rest away from noise. Indeed, after ten doses, heard voices, body developed wind-rash/itching nodules, then head and feet felt grounded. Urgently entered mountains for quietude. Angered by an incident, Fire flared, thirst like madness. Ate melons, pears, drank spring water endlessly. Han said: "Herbal medicines cannot support this." Sought human milk, ten cups daily. Thirst reduced after ten days. Angered again, limbs paralyzed, soft as cloth. Lying for four days, consumed countless milk until recovery. Pulse Heart-Choppy: "Sores will arise. Fortunately no severe toxicity. Developed horse-eye pus sores, ceased after eight months."

Xue Ji treated a young woman. Small tumor on front of leg, itchy. Scratched open, released insects like mosquitoes flying away. Alternating chills and fever like malaria. Liver Meridian syndrome, hence lice-tumor affliction. Cured with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Another type of hair-tumor, opening reveals hair, belongs to Kidney Meridian syndrome.

A scholar liked burning fire even in peak summer, wanted limbs soaked in boiling water. Red face, spitting phlegm, resembling Excess Fire. Vomiting expelled old food too. Only comfortable eating pepper/ginger. Xue said: "Food intake followed by regurgitation indicates Kidney-Stomach Deficiency-Cold." Used Bawei Wan (Eight-Ingredient Pill), Shiquan Dabu Jia Pa Jiang (Ten Complete Tonifying with Roasted Ginger). Gradually recovered, healed within a month.

Sun Dongsu treated a scholar. Feet neither sore nor painful, but movement completely disobedient. Twisting left then falling right, twisting right then falling left. Unable to walk straight. Rare sight, unknown disease. I surmise: Soft sinews unable to bind bones, causing deviation/twisting/falling. Sinews are governed by Liver. Liver belongs to Wood. Unrestrained Wood needs Metal to control. Use Renshen (Ginseng), Huangqi (Astragalus), Baishao (White Peony Root) to tonify Lung Metal. Yiren (Coix Seed), Hugu (Tiger Bone - *note: modern substitutes used*), Guiban (Turtle Shell), Duzhong (Eucommia) to strengthen sinews/bones. Tiehua Fen (Iron Flower Powder) specifically controls Liver Wood. Honey pills, taken morning/evening, cured.

A man suffered heel bone displacement. Pain on movement, difficult walking. Formula: Wu Men Quhu Dan (Wu Gate Fire-Removing Pill).
Shudihuang (Rehmannia Root) 3 liang, Beiwuwei (Schisandra Fruit) 5 qian, Maidong (Ophiopogon Tuber) 1 liang, Shanzhuyu (Cornus Fruit) 5 qian, Danpi (Moutan Bark) 3 qian, Ganju (Chrysanthemum) 5 qian, Bai Fuling (Poria) 2 qian, Zexie (Alisma) 3 qian, Cheqianzi (Plantago Seed) 2 qian. Decoct in water.

Xiaoshi Huaguai Tang (Dampness Eliminating and Anomaly Resolving Decoction).
Baizhu (Atractylodes Macrocephala Rhizome), Qianshi (Euryale Seed) 1 liang, Zexie (Alisma) 5 qian, Yiren (Coix Seed) 1 liang, Rougui (Cinnamon Bark) 5 fen, Renshen (Ginseng), Fuling (Poria), Cheqian (Plantago), Bibo (Dioscorea Hypoglauca Rhizome), Baijiezi (White Mustard Seed), Baifan (Alum) 3 qian, Niuxi (Achyranthes Root), Chenpi (Citrus Peel), Banxia (Pinellia Tuber) 2 qian. Decoct in water.

Xiaokuai Shendan (Mass Eliminating Divine Elixir).
Qiuyinfen (Earthworm Excrement) 1 liang, Shuiyin (Mercury) 1 qian, Pengsha (Borax) 1 fen, Huangbo (Phellodendron Bark) 5 qian, Ercha (Catechu) 3 qian, Bingpian (Borneol), Shexiang (Musk) 5 fen. Grind to fine powder, grind until Mercury disappears. Mix with vinegar to paste, apply to affected area. Completely resolves in one day.

Xiaozhi San (Finger Eliminating Powder).
Pengsha (Borax) 1 fen, Wachong (Tile Onion) 1 liang, Bingpian (Borneol) 3 fen, Renshen (Ginseng) 1 qian. Grind to powder, apply.

Huashui Tang (Water Transforming Decoction).
Baizhu (Atractylodes Macrocephala Rhizome) 5 qian, Banxia (Pinellia Tuber) 1 qian, Gancao (Licorice Root) 2 qian, Yiren (Coix Seed) 1 liang, Bibo (Dioscorea Hypoglauca Rhizome), Baijiezi (White Mustard Seed), Niuxi (Achyranthes Root), Renshen (Ginseng) 3 qian. Decoct in water.

Tiaowei Chengqi Tang (Regulating Stomach and Descending Qi Decoction).
Dahuang (Rhubarb Root), Mangxiao (Mirabilite), Gancao (Licorice Root). Decoct in water.

Sanhua Tang (Three Transformations Decoction).
Dahuang (Rhubarb Root), Nongpo (Magnolia Bark), Zhishi (Immature Bitter Orange), Qianghuo (Notopterygium Rhizome). Decoct in water.

Hexue Santong Tang (Blood Harmonizing and Pain Dispelling Decoction).
Qianghuo (Notopterygium Rhizome), Shengma (Cimicifuga Rhizome), Mahuang (Ephedra Stem) 1.5 qian, Taoren (Peach Seed) 10, Chaihu (Bupleurum Root), Fangfeng (Saposhnikovia Root), Huangbo (Phellodendron Bark), Zhimu (Anemarrhena Rhizome) 1 qian, Huanglian (Coptis Rhizome), Fangji (Stephania Root) 6 fen, Zhuling (Polyporus), Duhuo (Angelica Pubescens Root), Danggui (Angelica Sinensis Root) 1 fen, Gancao (Licorice Root) 2 fen, Honghua (Carthamus Flower) 1 fen. Divide into two doses, decoct in water, take hot before meals.

Guifu Bawei Wan (Cinnamon and Aconite Eight-Ingredient Pill).
Shudihuang (Rehmannia Root) 8 liang, Shanzhuyu (Cornus Fruit), Shanyao (Dioscorea Rhizome) 4 liang, Danpi (Moutan Bark), Fuling (Poria), Zexie (Alisma), Rougui (Cinnamon Bark), Fuzi (Prepared Aconite Root) 1 liang. Honey pills, taken on empty stomach with salt water, or winter wine.

Shiquan Dabu Tang (Ten Complete Tonifying Decoction / Ten Complete Powder).
Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Danggui (Angelica Sinensis Root), Fuxiong (Ligusticum Chuanxiong Rhizome), Baishao (White Peony Root), Shengdi (Rehmannia Root), Gancao (Licorice Root), Huangqi (Astragalus Root), Rougui (Cinnamon Bark). Decoct with Ginger and Jujube.

Shengling Dan (Divine Spirit Elixir).
Kutingli (Descurainia Seed, stir-fried) 4 liang, Hanfangji (Stephania Tetrandra Root), Muxiang (Vladimiria Root), Fuling (Poria), Mutong (Akebia Stem), Renshen (Ginseng) 2.5 qian. Grind to powder, make pills with jujube flesh size of wutong seeds. Take 30 pills per dose, wash down with Mulberry Bark Decoction.

Shengji San (See Head Section).
Liushi Wan (See Ear Section).
Tongsheng San (See Head Section).
Jiawei Xiaoyao San (See Eye Section).