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Yin Ting (Prolapse of the Uterus or Vaginal Wall), as discussed in detail in the commercially printed *Waike* (External Medicine) texts, is generally attributed to Damp-Heat pouring downward. Xue Lizhai used Buzhong Yiqi Tang (Spleen-Strengthening Qi-Supplementing Decoction), Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), and Zhibai Bawei Wan (Anemarrhena and Phellodendron Eight-Ingredient Pill) as primary formulas, with Danggui Lvhua Wan (Angelica and Gardenia Pill) and Longdan Xiegan Tang (Gentian Liver-Draining Decoction) as auxiliary formulas. This approach could be considered superior, yet no treatment yielded any effect. Why? Because it was misled by the predecessors' concept of "Damp-Heat."

When I was in my hometown, my medical skills were quite well-regarded. Having practiced for thirty-seven years, my experience was not insignificant, yet I had rarely seen a case of Yin Ting for a long time. I suspect that ancient physicians were thorough in their attention to detail, merely recording disease names based on hearsay. It was not until the Xin You year, when I was dispatched to Zhili as a county magistrate awaiting appointment, that I had the opportunity to practice this specialty during spare time. I then learned that among women in Zhili, about three or four out of ten suffered from this disease. In severe cases, the prolapse protruded one to two cun or even three to four cun, thick as a finger or large as a fist, taking shapes resembling snakes, melons, mushrooms, or toads. Some presented with continuous bleeding and discharge, some with dryness and lack of moisture, some with pain and itching, and some with numbness. This led to gradual amenorrhea, sallow complexion, poor appetite, emaciation, cough, hemoptysis, alternating chills and fever, spontaneous sweating, and night sweats, ultimately resulting in death due to consumption and injury. In mild cases, there was only a sensation of obstruction in the vagina without visible protrusion, or the protrusion was slight and caused little pain or harm. If menstruation was regular and adequate, fertility could still be maintained. Contemporary physicians named this condition "Yin Zhi" (Yin Hemorrhoids), also known as "Chi Xue Lao" (Blood-Eating Consumption). None of the prescribed medications were effective; surgical excision provided temporary relief but the condition soon worsened. I often treated according to previous methods but saw no results. I wondered why. After studying the *Neijing* (Classic of Internal Medicine), *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), *Qianjin Fang* (Prescriptions Worth a Thousand Gold), and various secret manuscripts, seeking their underlying meanings and combining them with my observations, I gained considerable insight. I realized that people in the South do not suffer from this disease, or if they do, it is easily cured; whereas people in the North frequently suffer from it, and treatments are invariably ineffective. There is a specific reason for this. Southern cases of Yin Ting arise from pathological changes, for which books provide formulas that are mostly effective when applied correctly; Northern cases arise from "Qi Xi" (habitual environmental exposure). Although the clinical manifestations are similar, the etiology differs, hence the ineffectiveness. What is meant by "Qi Xi"? The local custom involves sitting on damp ground daily and sleeping on earthen kang beds at night, leading to the gradual accumulation of Cold-Dampness, which goes without saying. Men engage in labor and disperse their essence, while women remain sedentary and often idle. During spring, summer, and late summer, dampness is steamed upward by heat, akin to steaming rice. When a woman's menstruation arrives, her Blood Sea is empty; emptiness makes one susceptible to pathogens. Furthermore, sitting on damp ground all day while engaging in needlework causes the earth's qi to dry the soil slightly, allowing dampness to enter internally along with the human qi. This aligns with the concept of "Baomen Shanghan" (Cold Damage to the Womb Gate) in the *Jingui Yaolue*. Even more severely, in late summer, after rain, worms in the dry earth become active. Upon smelling blood, they raise their heads and inhale the scent. Worms belong to the Yin category, and blood is Yin fluid. Yin follows Yin, and toxic vapors combine, forming the root cause of Yin Ting. Extending this logic, even without sitting on damp ground, if a woman squats in a toilet to defecate or urinate instead of using a chamber pot, she exposes herself to hidden dampness and worms in this filthy, secluded place. Their toxic vapors can ascend and invade along with the bloody scent. In my mountain home, I often see children sitting on damp ground suffering from penile swelling or painful itching, commonly called "Earthworm Blowing." Treatment involves placing a duck's mouth over the area, as ducks eat earthworms, or washing with a decoction of Sichuan pepper (*Zhuojiao*) and alum (*Binfan*), because pepper dispels cold and alum dries dampness. Understanding this makes the root cause of Yin Ting clear as day. Physicians who fail to investigate the cause and merely apply standard formulas cannot be blamed for the worsening condition. Moreover, some profit-driven practitioners administer harsh purgative and detoxifying pills internally, and apply external pastes containing toad venom (*Chansu*), borax (*Pengsha*), mirabilite (*Mangxiao*), musk (*Shexiang*), realgar (*Xionghuang*), borneol (*Bingpian*), olibanum alternative (*awei*), and white arsenic (*Baipi*), causing even greater harm. I could not bear to sit idly by.

For initial cases, I treated patients with a pill made from Wuling San (Five-Ingredient Powder for Promoting Urination) ingredients, added with Sichuan pepper (*Shujiao*), Phellodendron bark (*Huangbai*), small fennel (*Xiaohui*), Aconite (*Fuzi*), Codonopsis (*Shashen*), Ligusticum (*Chuanxiong*), and Safflower (*Honghua*), bound with honey. Each dose was 4 qian, taken twice daily. Externally, I used a decoction of Sichuan pepper, Sophora root (*Kushen*), Atractylodes (*Cangzhu*), and Sophora flower (*Huaihua*) with added mirabilite for fumigation and washing. Additionally, I prepared a suppository using calcined alum (6 liang), verdigris (4 qian), Schisandra fruit (*Wuweizi*), and realgar (5 qian each), and peach kernels (1 liang), ground into fine powder and bound with honey into 4-qian pills coated with realgar, inserted into the vagina, yielding miraculous effects. For chronic cases complicated by consumption and irregular menstruation, I primarily used Wenjing Tang (Warming the Menses Decoction) and Shenqi Wan (Kidney Qi Pill), adjusting with turtle shell (*Guiban*), softshell turtle shell (*Biejia*), and Tribulus (*Jili*) as needed. Many recovered, though details are too numerous to record here. Had I found even a single word or phrase in the *Jingui Yaolue: Women's Miscellaneous Diseases* chapter or elsewhere in the complete text to enlighten me regarding this matter, I would have been certain that no case was incurable.