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Black. If Wuwei Zi (Schisandrae Fructus), Maidong (Ophiopogonis Radix), and Rougui (Cinnamomi Cortex) are ineffective, Jiajian Bawei Wan (Modified Eight-Ingredient Pill with Rehmannia) should be used urgently. Fever occurs at irregular times or in undefined locations, or originates from the sole of the foot; this is "rootless deficiency fire." Use Jiajian Bawei Wan, as well as Shiquan Dabu Tang (Decoction for Complete Great Tonification) added with Maidong and Wuwei Zi. Wu Zhiwang stated: In phthisis with bone-steaming fever, this is a disease primarily affecting the vessels. The Kidney governs the bones; if the bones exhibit steaming heat, it indicates that True Yin is exhausted, leaving no basis for Yang to attach. Bone-steaming arises from accumulated heat attaching to the bones. Furthermore, diseases such as Chuan Shi (Transmitted Corpse), Fu Lian (Repeating Link), and Wu Gu (Innocent) are all caused by Spleen and Stomach deficiency. The patient appears emaciated, suffers from abdominal distension and dysentery, and has weak limbs. If the disease transmits to the Kidney, there will be incessant night sweats, cold pain in the lower back and knees, dreams of sexual intercourse with ghosts, and dark yellow urine. If it transmits to the Heart, there will be mental palpitations, irregular emotions of anger or joy, red cheeks and lips, and alternating hot and cold sensations. If it transmits to the Lung, there will be lung fullness, shortness of breath, coughing with sputum, and skin rough like fish scales. If it transmits to the Liver [Note: Original text repeats "Kidney", but symptoms describe Liver pathology], there will be dim vision and hypochondriac pain, irritability behind closed doors. Once the Five Viscera are diseased, treatment becomes difficult.

Virgin Phthisis Kou Zongshi stated: Humans rely on Qi and Blood as their foundation; no illness occurs without first damaging Qi and Blood. For virgins or young males and females, persistent thoughts and excessive worry often lead to consumptive damage. Males show dissipation of spirit and complexion, while females experience amenorrhea first. This is because sorrow and worry injure the Heart, causing blood to reverse and exhaust, leading to the prior dissipation of spirit and cessation of menstruation. Moreover, Heart disease fails to nourish the Spleen, resulting in loss of appetite. Spleen deficiency leads to Lung Metal deficiency, causing cough. When Kidney Water is exhausted, fluid energy fails to nourish the limbs, leading to dry and flaccid limbs, irritability, scorched hair, and flaccid sinews and bones. If the disease spreads through all five viscera, death ensues. If the patient can change their mindset and receive medicinal support, drugs that cool blood and move blood, such as Qinghao (Artemisiae Annuae Herba) and Mengchong (Tabani Semen), must strictly be avoided. Xue Ji stated: The Classics say: When five grains enter the stomach, their dregs, essence, fluids, and Zong Qi (Gathering Qi) divide into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, and penetrates the Heart and Lung to facilitate respiration. Ying Qi (Nutrient Qi) secretes its essence and fluids, injects them into the vessels, transforms them into blood, and nourishes the four extremities and the internal five viscera and six bowels. If bitter-cold agents are taken, further injuring Stomach Qi, recovery will be impossible.

Postpartum Rulao Treatment Xue Ji stated: Postpartum Rulao (postpartum consumptive fatigue) should be treated primarily by nurturing righteous Qi, using Liujunzi Tang (Six Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix). If Spleen and Lung Qi deficiency causes cough and dry mouth, use Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting Qi) added with Maidong and Wuwei Zi. If middle Qi deficiency causes dry mouth and dizziness, use Buzhong Yiqi Tang added with Manjingzi (Vitex Fruit). If Liver channel blood deficiency causes limb pain, use Siwu Tang (Four Substance Decoction) added with Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). If Liver and Kidney weakness causes spontaneous sweating, night sweats, and alternating chills and fever, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Wuwei Zi. If Spleen deficiency and blood weakness cause abdominal pain and irregular menstruation, use Bazhen Tang (Eight Treasures Decoction) with doubled Baizhu. If Spleen deficiency and blood dryness cause skin itching, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Generally, this condition arises mostly from Spleen and Stomach weakness and reduced diet, leading to exhaustion of all meridians. One must tonify the Spleen and Stomach; once diet improves, Essence and Qi are generated, and the viscera find reliance, allowing the disease to heal spontaneously. Refer also to the treatise on fevers due to deficiency and consumption.

Accumulation and Mass Treatment Xue Ji stated: Female food stagnation, due to weak form and Qi, requires first regulating and tonifying the Spleen and Stomach, assisted by digestion-promoting methods. If form and Qi are robust, one should first promote circulation, assisted by tonifying the Spleen and Stomach. If Qi stagnation and blood stasis prevent movement, use Wuyao San (Lindera Powder): equal parts of Wuyao (Linderae Radix), Pengzhu (Curcumae Rhizoma), Rougui, Danggui, Taoren (Persicae Semen), Qingpi (Citri Reticulatae Pericarpium Viride), and Muxiang (Aucklandiae Radix), ground into powder. Take two qian per dose, mixed with hot wine, to disperse and move the stagnation. If Spleen Qi deficiency prevents blood movement, use Sijunzi Tang (Four Gentlemen Decoction) added with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui, to tonify and move. If Qi depression prevents blood movement, use Guipi Tang (Restore the Spleen Decoction) to resolve and move. If Liver and Spleen blood dryness prevents movement, use Jiawei Xiaoyao San to clear and move. Generally, food accumulation and痞块 (masses) are tangible; when pathogenic Qi prevails, it is excess; when True Qi is depleted, it is deficiency. One must nurture righteousness and repel evil, and the accumulation will remove itself. Another question: Are blood stasis and qi stagnation the same? How to know it is blood stasis? Blood stasis presents with drowsiness, restlessness, delirium, mania, vomiting of phlegm, excessive sweating, bone heat, and cold limbs. If stasis is in the Lower Jiao, there will be urgency and binding below the umbilicus, external heat with internal pain, and a surging, rapid radial pulse. Zhang Hezi stated: Enuresis and stranguria, impotence and floating numbness, seminal emission and leukorrhea are hernias in men. If blood is fixed, menstruation does not occur; after menstruation, a mass remains in the lower abdomen, sometimes moving, with protrusion of the anterior orifice and hemorrhoids at the posterior orifice; these are hernias in women. However, women do not call them hernias, but rather Shanjia (hernial masses).

Breast Disease Manifestations Chen Shigong stated: In the initial stage, redness, swelling, heat, and pain with slight chills and fever, without dizziness, dry mouth, or mild pain, indicate a favorable prognosis. If abscesses have formed, with swelling, heat, pain, and localized lumping without spreading to other lobes, the condition is mild. If ulcerated, with thick yellow pus, subsiding swelling, gradually stopping pain, and itching at the edges indicating new flesh growth, it is favorable. If after ulceration, pus stops naturally, swelling and pain subside, new flesh grows easily, and the wound closes spontaneously, it is favorable. Conversely, if initially the entire breast is swollen, painful, non-red, accompanied by chills/fever, mental restlessness, vomiting, and anorexia, it is unfavorable. If abscesses have formed but are neither hot nor red, hard as stone, with dry mouth, insomnia, chest stuffiness, and poor appetite, it is unfavorable. If ulcerated without pus, with necrosis of the head, increasing swelling and pain, and bleeding, death results. If after ulceration the flesh is purple-black, pain pierces the heart, toxicity deepens daily, and the body wastes away, death results. Initially, if fever and aversion to cold occur with dizziness, fatigue, and floating-rapid pulses, the pathogen is in the exterior; disperse it. If fever without chills, nausea, vomiting, dry mouth/thirst, and chest discomfort occur, clear it. If depression injures the Liver and worry injures the Spleen, causing hard, slightly painful lumps, soothe the Liver and move Qi. If abscesses have formed with fever and periodic pain, approaching suppuration, use interior-supporting detoxification. If pus has formed with distending pain, incise urgently. If Spleen and Stomach are weak, support with tonification. If ulcerated but not healing, with thin pus, unresolved swelling, and unceasing pain, greatly tonify Qi and Blood. If tubercles are painless, slowly enlarging over time, and discharge watery fluid after rupture, nourish Blood and clear the Liver. Zhang Jiebin stated: Postpartum lactation is due to insecure Yangming Stomach Qi. Differentiate between fire and no-fire. If leakage is incessant due to Qi deficiency, use Shiquan Dabu Tang. If Yangming blood heat causes overflow, use Baoyin Jian (Preservation of Yin Decoction). If Liver fire surges upward causing breast distension and overflow, use Jiajian Yiyin Jian (Modified One-Yin Decoction). If breasts are distended, painful, and overflowing, apply warm cloth compresses to dissipate.