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First Visit: The patient has suffered from insomnia for a long time, requiring sleeping pills every day during afternoon naps and at night to barely fall asleep. However, the sleep is shallow, with many dreams and easy awakening, or even staying awake all night. Before falling asleep, the patient must cough up a large amount of yellow-white thick phlegm; only after the chest and diaphragm feel comfortable can they fall asleep. Daily symptoms include fatigue, shortness of breath, spontaneous sweating, dizziness, irritability, bitter or bland taste in the mouth, heat sensation in the palms and soles, and frequent urination. While on vacation in Kunming, the patient invited me for consultation. The pulse was fine and wiry (Xian Mai), the tongue was red, and the coating was white and greasy. This indicates Spleen deficiency leading to failure of dampness transformation, with phlegm-heat accumulating internally and disturbing the Heart and Gallbladder. As stated in the *Neijing* (Classic of Internal Medicine): "When Yang qi cannot enter Yin, the eyes remain open (insomnia)." The treatment principle should be to dispel phlegm and remove dampness, clear Gallbladder heat, and nourish the Heart to calm the Spirit. It is appropriate to administer a Wendan Tang (Warm the Gallbladder Decoction) variant at noon to wash away phlegm turbidity, and a Heart-nourishing and Spirit-calming formula at night, treating both root and branch, so that Yin and Yang intersect, allowing for peaceful sleep. Prescription:
Formula 1: Fa Banxia (Prepared Pinellia Rhizome) 9g, Fuling (Poria) 15g, Chao Zhishi (Stir-fried Immature Bitter Orange) 3g (taken with water), Guang Chenpi (Aged Tangerine Peel) 6g, Sheng Gancao (Raw Licorice Root) 3g, Zhuru (Bamboo Shavings) 6g, Chuan Beimu (Fritillaria Cirrhosa Bulb) 6g (taken with water), Guang Xingren (Apricot Seed) 9g, Gualou Qiao (Trichosanthes Fruit Shell) 1 piece (crushed).
Formula 2: Zaoren (Sour Jujube Seed) 15g, Fushen (Poria with Hostwood) 15g, Chuanxiong (Szechwan Lovage Rhizome) 6g, Chao Zhimu (Stir-fried Anemarrhena Rhizome) 4.5g, Baiziren (Biota Seed) 9g, Zhi Yuanzhi (Prepared Polygala Root) 6g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Guang Jieluo (Citrus Reticulata Stem) 9g, Xiaomai (Floating Wheat) 16g, Hong Zao (Red Date) 11 pieces, Jing Pipaye (Clean Loquat Leaf) 3 pieces, Yejiaoteng (Polygonum Multiflorum Vine) 15g, Sheng Gancao (Raw Licorice Root) 3g.
After taking these two formulas day and night for one week, the patient coughed up a large amount of phlegm turbidity, gradually feeling refreshed and comfortable in the chest and diaphragm, without needing to spit phlegm before sleep. Sleeping pills were reduced or stopped, yet sleep was achieved, dreams decreased, and symptoms like spontaneous sweating and dizziness gradually disappeared. The pulse became harmonious, the tongue remained red, and the coating became thin and white. With the phlegm-heat and dampness cleared, the Heart and Gallbladder are tranquil. Continue adjusting Formula 2 for treatment, resulting in the cure of all symptoms. Prescription:
Zaoren (Sour Jujube Seed) 15g (taken with water), Fushen (Poria with Hostwood) 15g, Chuanxiong (Szechwan Lovage Rhizome) 6g, Chao Zhimu (Stir-fried Anemarrhena Rhizome) 6g, Yejiaoteng (Polygonum Multiflorum Vine) 15g, Guang Jieluo (Citrus Reticulata Stem) 9g, Hetie Ding (Lotus Leaf Tip) 3 pieces, Zhi Yuanzhi (Prepared Polygala Root) 6g, Xiaomai (Floating Wheat) 15g, Zhi Gancao (Honey-fried Licorice Root) 3g, Xiao Zao (Small Date) 11 pieces.
[Commentary]: Administering modified Wendan Tang at noon clears phlegm and transforms turbidity, thereby raising Clear Yang. Administering modified Suanzaoren Tang at night calms the Spirit and nourishes the Heart, thereby nourishing True Yin. When Qi mechanism is smooth and Yin and Yang intersect, peaceful sleep is achieved.

Guan Ge (Obstruction and Rejection Syndrome)
Guo XX, Female, 35 years old, Cadre.
Consultation at a certain hospital in July 1971: The patient reported suffering from stomach disease for over ten years, occurring two or three times a year, with no history of bleeding. This episode began half a month ago, initially presenting with distension and fullness in the chest, diaphragm, and epigastrium, loss of appetite, followed by hiccups, acid regurgitation, belching, and difficulty swallowing, with a sensation of obstruction and pain in the esophagus. No bowel movement for over ten days, scanty urine, restless sleep, sallow complexion, and progressive emaciation. A certain hospital's examination and diagnosis suspected a foreign body in the esophagus.
The pulse was fine and wiry at both Guan positions and slightly floating at Cun position; the tongue coating was thin and greasy. Ancient physicians stated: "Inability to pass stool and urine is called Guan; inability to take food and drink is called Ge." The patient exhibits both symptoms, belonging to the "Guan Ge" syndrome. The treatment principle is to broaden the middle and regulate Qi, descend rebellious Qi, promote free flow, and moisten and unblock. Prescription:
Gong Dingxiang (Clove) 4.5g (taken with water), Shidi (Persimmon Calyx) 4.5g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Guang Chenpi (Aged Tangerine Peel) 6g, Bo Kou (Cardamom) 6g, Huoxiang Geng (Agastache Stem) 4.5g, Peilan Ye (Eupatorium Leaf) 4.5g, Chao Zhiqiao (Stir-fried Aurantium Fruit) 6g, Fuling (Poria) 15g, Daizheshi (Magnetite) 9g, Fulonggan (Kitchen Hearth Soil) 30g (heated red until smoking, quenched with water for decoction).
Each dose is taken with two spoons of raw honey and one spoon of milk as a guide.
Second Visit: After taking three doses of the above prescription, the patient felt gradual relief in the chest and diaphragm, with significant reduction in distension, hiccups, acid regurgitation, and belching. One bowel movement occurred, small in quantity, resembling sheep dung; urinary frequency increased slightly, but volume remained low. Able to consume a small amount of thin porridge, throat obstruction and pain slightly reduced, but swallowing remains difficult. Mental fatigue and limb weakness persist; pulse and tongue remain unchanged. The treatment principle adheres to the original intent. Prescription:
Gong Dingxiang (Clove) 4.5g, Shidi (Persimmon Calyx) 4.5g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Guang Chenpi (Aged Tangerine Peel) 6g, Lao Sugeng (Old Perilla Stem) 9g, Huoxiang Geng (Agastache Stem) 6g, Guang Taiwu (Cyathula Root) 9g, Daizheshi (Magnetite) 9g, Chao Zhiqiao (Stir-fried Aurantium Fruit) 9g, Hong Zao (Red Date) 11 pieces.
Each dose is taken with two spoons of raw honey and one spoon of milk as a guide.
Third Visit: After taking three consecutive doses, the patient's chest and diaphragm feel comfortable, swallowing is smooth, throat obstruction and pain have disappeared, and foods like noodles and steamed buns can be eaten. Bowel movements are smooth, urine volume increases. Sleep is peaceful, and other symptoms are eliminated. The pulse is fine, weak, and moderate; the tongue is red with a moist coating. The illness is gradually resolving. Continue with soothing Liver, regulating Stomach, regulating Qi, broadening chest, and strengthening Spleen. Prescription:
Taizishen (Pseudostellaria Root) 9g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Guang Chenpi (Aged Tangerine Peel) 6g, Guang Muxiang (Vladimiria Root) 3g, Xi Sharen (Amomum Fruit) 6g, Chao Hangshao (Stir-fried White Peony Root) 9g, Fuling (Poria) 15g, Shengjiang (Fresh Ginger) 2 slices, Gancao (Licorice Root) 3g, Xiao Zao (Small Date) 11 pieces, Sumi (Glutinous Rice) 15g.
After taking two doses of the above prescription, the patient recovered and was discharged. Advised to continue taking Xiangsha Liujun Wan (Atractylodes Macrocephala and Amomum Six Gentlemen Pills) for consolidation.
[Commentary]: The Classics state: "When Yin and Yang do not correspond, the disease is named Guan Ge." The etiology and pathogenesis involve unclear cold and heat, failure of damp-phlegm transformation, rebellious Qi of Liver and Stomach knotting at the pharynx and diaphragm Renying area; thus, intake and output, ascending and descending functions fail, transportation and conduction lose their duty, Qi and Blood lose nourishment, and Body Fluids are difficult to moisten.
This case was treated with aromatic unblocking and promoting free flow, broadening the middle and descending rebellious Qi, assisted by moistening agents, guiding according to the situation, achieving rapid effect.

Cold Huoluan (Acute Vomiting and Diarrhea)
Su XX, Female, 52 years old, Suburbs of Kunming City. Summer 1941.
First Visit: Due to field labor until noon, suffering from intense summer heat, thirst led to drinking several handfuls of ditch water. Soon, rumbling and colicky pain in the abdomen occurred, with simultaneous vomiting and diarrhea. I was then evacuated to the countryside due to the Anti-Japanese War, and the patient's family invited me for treatment. Symptoms included confused consciousness, cyanotic face and lips, cold limbs, incessant cold sweat. Pulse was soggy, minute, deep, and fine; tongue was pale white. I diagnosed this as Cold Huoluan, struck by severe Yin-Cold, causing major damage to Spleen-Yang, with a critical trend towards collapse! Urgently prescribed the following formula to rescue:
Dangshen (Codonopsis Root) 15g, Fupian (Prepared Aconite Lateral Root) 30g (simmered thoroughly in boiling water first), Chao Cangzhu (Stir-fried Atractylodes Lancea Rhizome) 12g, Fuling (Poria) 15g, Hexiang (Agarwood) 4.5g, Xi Sharen (Amomum Fruit) 9g (taken with water), Gong Dingxiang (Clove) 3g (taken with water), Shang Rougui (Cinnamon Bark) 6g (taken with water, mixed and drunk), Duan Longgu (Calcined Dragon Bone) 12g, Zhi Wuyu (Prepared Evodia Fruit) 4.5g, Zaoxin Tu (Kitchen Hearth Soil) 1 piece (heated red until smoking, quenched with water for decoction).
Second Visit: The above prescription was rapidly decocted and frequently administered, completing the dosage day and night. The next day, consciousness gradually returned. Limbs warmed, sweat stopped, vomiting and diarrhea reduced. Face remained pale, still hiccupping, abdominal rumbling. Pulse gradually strengthened, tongue turned pale red. This indicates return of Yang with Middle Deficiency, Stomach stagnation and rebellious Qi. Prescribed formula to continue warming and transporting:
Dangshen (Codonopsis Root) 15g, Fupian (Prepared Aconite Lateral Root) 30g (simmered thoroughly in boiling water first), Chao Cangzhu (Stir-fried Atractylodes Lancea Rhizome) 9g, Fuling (Poria) 15g, Xi Sharen (Amomum Fruit) 6g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Shang Rougui (Cinnamon Bark) 6g (taken with water, mixed and drunk), Gong Dingxiang (Clove) 3g (taken with water), Ganjiang (Dried Ginger) 9g, Sumi (Glutinous Rice) 15g, Chenmi (Aged Rice) 15g, Xiao Zao (Small Date) 10 pieces.
Third Visit: After taking the above prescription, Stomach Qi gradually recovered, desire for food appeared, able to sit up. Pulse was weak and slow, tongue pink and moist. Signs of collapse resolved, now presenting with Righteous Qi deficiency and physical weakness. Treatment should warm, regulate, and tonify; a few doses will bring peace. Prescription:
Dangshen (Codonopsis Root) 15g, Baizhu (Atractylodes Macrocephala Rhizome) 12g, Ganjiang (Dried Ginger) 9g, Xi Sharen (Amomum Fruit) 9g, Shang Rougui (Cinnamon Bark) 6g (taken with water, mixed and drunk), Fupian (Prepared Aconite Lateral Root) 30g (simmered thoroughly in boiling water first), Gancao (Licorice Root) 3g, Dazao (Jujube) 3 pieces, Chao Yumi (Stir-fried Corn) and Laomi (Old Rice) 12g each.
Commentary see next case "Hot Huoluan".

Hot Huoluan (Acute Vomiting and Diarrhea)
Zhang XX, Male, 34 years old, Suburbs of Kunming City. Summer 1941.
First Visit: Exhaustion from summer heat, sitting and lying on wet ground, indulging in cold foods. Soon followed by irritability, dizziness, sudden violent vomiting and diarrhea, dozens of times day and night. Lips and mouth dry, feverish sensation, scanty urine, incessant spontaneous sweating, chaotic sensation in the chest. Patient presented with red face and irritability, pulse floating, slippery, and rapid; tongue red with yellow coating. Urgently sought cold drinks, vomiting and diarrhea still frequent. This is Hot Huoluan, caused by injury from Summer-Heat and Dampness, with Fire scorching Heart and Gallbladder, thus Clear and Turbid interfere with each other, Qi mechanism rebels and becomes chaotic. Same disease as previous case but different symptoms. Treatment should clear Summer-Heat and promote dampness drainage, using aromatic methods to transform turbidity. Prescription:
Xiangru (Mosla Herb) 6g, Huoxiang (Patchouli) 6g, Sheng BianDou (Raw Lablab Bean) 12g (taken with water), Fuling (Poria) 12g, YiYuan San (Benefit Origin Powder) 12g, Bo Kou (Cardamom) 9g (taken with water), Chao Gu Ya and Mai Ya (Stir-fried Barley Sprout and Malt) 9g each, Sumi (Glutinous Rice) 30g, Dan Zhuye (Lophatherum Leaf) 9g, Shao Jijin (Roasted Chicken Gizzard Membrane) 2 pieces.
Second Visit: After taking the above prescription, facial redness, irritability/thirst, and sweating decreased. Fever subsided somewhat, vomiting and diarrhea reduced by half. Poor appetite, chest fullness, abdominal rumbling, urine slightly clearer. Pulse slippery and rapid, tongue coating yellow and greasy. Summer-heat is largely resolved, Qi mechanism is regulated. Continue with aromatic clearing and transforming:
Huoxiang (Patchouli) 6g, Fen Ge (Kudzu Root) 9g, Cu Fa Banxia (Vinegar-treated Prepared Pinellia Rhizome) 9g, YiYuan San (Benefit Origin Powder) 12g, Fushen (Poria with Hostwood) 15g, Zhuling (Polyporus) 9g, Bo Kou (Cardamom) 9g (taken with water), Peilan Ye (Eupatorium Leaf) 9g, Sumi (Glutinous Rice) 30g, Shao Jijin (Roasted Chicken Gizzard Membrane) 2 pieces, Cheqian Ren (Plantago Seed) 6g, Jing Zhuru (Clean Bamboo Shavings) 9g.
Third Visit: Sweating, thirst, irritability, fever, vomiting, and diarrhea symptoms all reduced. Pulse slippery, tongue coating greasy and slightly yellow. Symptoms responded well to medication, continue with clearing and transforming. Prescription:
Huoxiang (Patchouli) 6g, Cu Fa Banxia (Vinegar-treated Prepared Pinellia Rhizome) 9g, Fuling (Poria) 15g, Zhuling (Polyporus) 9g, Bo Kou (Cardamom) 6g (taken with water), Chao BianDou (Stir-fried Lablab Bean) 15g (taken with water), Guang Chenpi (Aged Tangerine Peel) 6g, Cheqian Zi (Plantago Seed) 6g, Sumi (Glutinous Rice) 15g, Zhuru (Bamboo Shavings) 6g, Shao Jijin (Roasted Chicken Gizzard Membrane) 2 pieces, Chao Zhiqiao (Stir-fried Aurantium Fruit) 6g.
Fourth Visit: After taking two doses of the above prescription, various symptoms gradually subsided, desire for food appeared, mental fatigue and weakness persisted. Pulse slippery and slow, tongue slightly yellow. Due to excessive vomiting and diarrhea, Middle Qi has not recovered. Prescribed a formula for strengthening transportation, regulating, and nourishing to achieve recovery. Prescription:
Baizhu (Atractylodes Macrocephala Rhizome) 12g, Fuling (Poria) 15g, Zhuling (Polyporus) 9g, Zexie (Alisma Rhizome) 6g, Chao BianDou (Stir-fried Lablab Bean) 15g, Sutiaoshen (Codonopsis Root) 15g, Cundong (Ophiopogon Tuber) 9g, Bo Kou (Cardamom) 6g (taken with water), Guang Chenpi (Aged Tangerine Peel) 6g, Gancao (Licorice Root) 3g, Chao Yumi (Stir-fried Corn) and Laomi (Old Rice) 12g each.
[Commentary]: Huoluan has posed a threat to the Chinese people since ancient times. Physicians through the ages have extensively recorded treatment experiences. Until the founding of New China, with improved medical and health conditions, this disease rarely epidemics.
The two cases in this book occurred in 1941, when there was a major epidemic of Huoluan in Kunming, with many deaths.
Both cases belong to Huoluan, but exhibit same disease with different symptoms, one Cold and one Hot. The former is Cold Huoluan due to major damage to Spleen-Yang and impending depletion of Primordial Qi, so Rescuing Yang and Reviving from Collapse method was used; the latter is Hot Huoluan due to Liver-Gallbladder Fire scorching and chaotic Qi mechanism, so Aromatic Transforming Turbidity method was used. Both cases achieved efficacy.

Chang Yong (Intestinal Abscess) with Hematochezia
Shi XX, Male, 63 years old, Resident of Kunming City. August 1962.
First Visit: Reported long-term preference for tobacco, alcohol, spicy, and rich foods. Hematochezia for over twenty years, intermittent. Recently, due to excessive drinking, hematochezia became severe, seven to eight times daily, either bleeding before defecation or entirely fresh blood without defecation, with dull pain in the lower abdomen. Dizziness, palpitations, sallow and slightly puffy complexion, spontaneous sweating, decreasing appetite. Restless sleep, many dreams, mental fatigue. Illness lasted over a month, various hemostatic agents used with no effect.
Pulse was fine, rapid, and Choppy (Kou); tongue body red, coating light yellow and greasy. *Jin Gui Yao Lue* states: "Blood passing below, blood first then stool, this is Near Blood, treated primarily with Chixiaodou Danggui San." This is due to long-term preference for tobacco, alcohol, and spicy foods, causing severe accumulation of Damp-Heat in the Intestines. Treatment should prioritize clearing and transforming Damp-Heat, invigorating Blood and stopping bleeding. Prescription:
Chixiaodou (Adzuki Bean) 18g (taken with water), Tu Chao Quanchuan Danggui (Earth-stir-fried Whole Sichuan Angelica Sinensis Root) 15g, Chao Chi Bai Shao (Stir-fried Red and White Peony Roots) 9g each, Zhe Beimu (Fritillaria Thunbergii Bulb) 9g (taken with water), Wu Baizhi (Angelica Dahurica) 9g, Gan Dihuang (Rehmannia Root) 15g, Jinyinhua Tan (Charred Honeysuckle Flower) 9g, Ou Jie Chao Tan (Charred Lotus Node) 9g, Fen Danpi (Moutan Cortex) 6g, Chao Diyutan (Charred Sanguisorba Root) 9g, Chao Huangqin Tan (Charred Scutellaria Root) 6g.
Second Visit: After taking three doses of the above prescription, hematochezia gradually decreased, dizziness, palpitations, and spontaneous sweating reduced.
However, five to six episodes of blood-first-then-stool still occur daily, occasional lower abdominal pain. Sleep relatively peaceful, appetite slightly increased, complexion still sallow. Yellow tongue coating thinned, pulse Choppy sign reduced but still deep and rapid. This is due to incomplete clearance of Damp-Heat, Blood not returning to its vessels. Continue with hemostasis, nourishing Yin, clearing and transforming Damp-Heat. Prescribed:
Dong Ejiao (Donkey-hide Gelatin) 15g (melted and taken in divided doses), Chao Yunlian (Stir-fried Coptis Rhizome) 3g, Chong Fan Dou (Rice-soaked Adzuki Bean) 15g, Danggui (Angelica Sinensis Root) 15g, Chao Chi Bai Shao (Stir-fried Red and White Peony Roots) 9g each, Huaihua (Sophora Flower) 6g, Chao Diyetan (Charred Sanguisorba Root) 9g, Chao Ku Qin (Charred Scutellaria Root) 6g, Fushen (Poria with Hostwood) 12g, Jinyinhua Tan (Charred Honeysuckle Flower) 15g, Gan Dihuang (Rehmannia Root) 15g.
Third Visit: After taking five consecutive doses of the above prescription, bowel movements two to three times daily, only occasional small amounts of fresh blood, lower abdominal pain gradually disappeared. Face sallow and thin, no longer puffy. Appetite increasing daily, able to sleep peacefully at night. Pulse deep and wiry, tongue pale with thin coating. Symptoms belong to excessive blood loss, Yin deficiency and Qi weakness, Liver-Spleen disharmony. Should nourish Yin, consolidate Qi, nourish Blood, and continue treatment. Prescription:
Dong Ejiao (Donkey-hide Gelatin) 15g (melted and taken in divided doses), Gan Dihuang (Rehmannia Root) 12g, Danggui (Angelica Sinensis Root) 15g, Chao Baishao (Stir-fried White Peony Root) 12g, Fushen (Poria with Hostwood) 15g, Sutiaoshen (Codonopsis Root) 9g, Chixiaodou (Adzuki Bean) 12g (taken with water), Chao Huaihua (Charred Sophora Flower) 6g, Chao Ku Qin (Charred Scutellaria Root) 4.5g, Sheng Gancao (Raw Licorice Root) 3g, Chao Yiren (Stir-fried Coix Seed) 12g, Guang Muxiang (Vladimiria Root) 1.5g.
Advised to quit tobacco, alcohol, and spicy foods.
[Commentary]: *Jin Gui Yao Lue* points out: "Stool first then blood is Far Blood," similar to gastric and duodenal ulcer bleeding. "Blood first then stool is Near Blood," referring to rectal and anal abscess ulceration bleeding. This patient developed "Near Blood" due to Damp-Heat stagnation. Treatment followed *Jin Gui*: flexibly modified Chixiaodou San to stop bleeding, invigorate Blood, and clear/transform Damp-Heat.
Later, nourished Yin, strengthened Spleen, regulated Liver, and replenished Qi and Blood. Li Shizhen stated: "Chixiaodou eliminates cold-heat abscesses, discharges pus and disperses Blood, resolves alcohol toxicity, treats swelling and distension, and benefits intestinal dysentery..." Indeed possesses certain efficacy. Additionally noteworthy is that the patient strictly followed medical advice, forcefully quitting tobacco, alcohol, and spicy/rich foods, eliminating the cause of disease, thus achieving complete cure.

Stomach Pain with Hematemesis
Zhong XX, Male, 43 years old, Cadre.
Late night of June 10, 1965, invited by a certain hospital for consultation. Patient suffered from stomach disease for over twenty years. Recently, due to strenuous labor, experienced stabbing pain in chest and stomach, massive hematemesis with dark red blood and black clots. Self-administered half a small bottle of "Yunnan Baiyao" before entering hospital for emergency care. Diagnosed with upper gastrointestinal bleeding. Various hemostatic measures failed, surgery planned, but patient requested TCM consultation. Symptoms included low voice and weak breathing, bright white complexion, spontaneous sweating, pulse deep, fine, and rough (Se); tongue pale, coating thin and white. Diagnosis: Excessive blood loss, major Qi and Yin deficiency, insufficient Spleen-Yang. If delayed further, fear Qi will follow Blood into collapse, making rescue difficult. First priority: Stop bleeding and consolidate/astringe. Prescribed:
Yunnan Sanqi Powder (Notoginseng Root Powder) 9g (mixed in divided doses), Ce Baiye Tan (Charred Biota Twig) 9g, Chen Zong Tan (Charred Palm Fiber) 9g, Chao Ai Tan (Charred Mugwort Leaf) 9g, Pao Jiang Tan (Charred Processed Ginger) 9g, Ou Jie Tan (Charred Lotus Node) 6g, Ejiao Zhu (Gelatin Pellet) 15g.
Each dose guided by a small wine glass of Tongbian (Child Urine).
Second Visit: After slowly taking the above prescription, massive hematemesis basically stopped by noon the next day, only small amounts of blood clots mixed with phlegm foam spat out, purple-black color. Patient mentally depressed, short of breath, reluctant to speak, no desire for food, pale face. Pulse at Guan position still deep, fine, and rough; Cun positions floating and Choppy; Chi position deep and minute; tongue still thin and white. Syndrome belongs to dual deficiency of Qi and Blood, Liver-Spleen disharmony, Heart-Spirit insufficiency. Treatment should tonify Qi and enrich Blood, nourish Liver and warm Spleen, assisted by resolving phlegm. Prescribed:
Jilin Hongshen (Jilin Red Ginseng) 9g (decocted separately and mixed), Tu Chao Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome) 12g, Fushen (Poria with Hostwood) 18g, Dong Ejiao (Donkey-hide Gelatin) 18g (melted and taken in divided doses), Pao Jiang Tan (Charred Processed Ginger) 6g, Danggui (Angelica Sinensis Root) 12g, Chao Hangshao (Stir-fried White Peony Root) 9g, Ce Baiye Tan (Charred Biota Twig) 6g, Sanqi Powder (Notoginseng Root Powder) 4.5g (mixed in divided doses), Sheng Gancao (Raw Licorice Root) 3g (guided by Tongbian/Child Urine).
Third Visit: After taking two consecutive doses of the above prescription, hematemesis stopped, able to consume small amounts of liquid diet, spontaneous sweating ceased, able to sleep peacefully, stabbing pain in chest/stomach reduced. Complained of dizziness, mental fatigue, and weakness. Pulse became moderate and slower, stronger than before; tongue body pale red, coating gradually moist. Continue with original formula modifications:
Jilin Hongshen (Jilin Red Ginseng) 9g (change to Sutiaoshen/Codonopsis Root 15g after five doses), Chao Baizhu (Stir-fried Atractylodes Macrocephala Rhizome) 12g, Fushen (Poria with Hostwood) 15g, Sharen (Amomum Fruit) 6g (taken with water), Danggui (Angelica Sinensis Root) 15g, Chao Hangshao (Stir-fried White Peony Root) 9g, Guang Chenpi (Aged Tangerine Peel) 6g, Zhi Gancao (Honey-fried Licorice Root) 3g, Lianzi (Lotus Seed) 12g (heart removed), Longyanrou (Longan Aril) 9g, Pao Jiang (Processed Ginger) 4.5g, Dazao (Jujube) 3 pieces.
After taking more than ten doses of the above prescription, all symptoms disappeared, appetite increased, patient recovered and was discharged.
[Commentary]: This patient had chronic stomach disease, and due to strain injury, suffered continuous massive hematemesis, severely damaging Spleen and Stomach, with danger of Qi following Blood into collapse! Urgently needed to stop bleeding and consolidate. In hemostasis, Blood should be moved, not coagulated; thus, Sanqi (Notoginseng) is the main herb. Should regulate Qi mechanism, using a little Tongbian (Child Urine) as guide. As bleeding gradually stops, increase herbs for tonifying Qi, enriching Blood, nourishing Liver, and warming Spleen. Subsequently, calm Heart and Spirit, tonify Qi and Blood, strengthen Spleen and Stomach to conclude treatment.

Stomach Pain with Melena/Hematochezia
Chen XX, Male, 60 years old, Worker. May 1970.
First Visit: Patient suffered from stomach pain for thirty years, symptoms worsening over the past ten years. Often feels pain, distension, and fullness in chest/diaphragm and epigastrium, hiccups, acid regurgitation. Bowel movements once every two to three days, sometimes black-brown, or fresh blood after defecation. Gradually became extremely emaciated, face pale, sparse appetite, spontaneous sweating, aversion to cold, cold limbs, mental depression. Barium meal examination confirmed gastric and duodenal ulcer. Fecal occult blood test varied from (+) to (++++). Due to ineffective multiple treatments, specially admitted for hospitalization. Pulse deep, fine, and tight; tongue pale, coating thin and white, yellow and greasy in center. This long-standing illness involves Yang deficiency and Spleen weakness, internal stagnation of Cold-Damp, disharmony of Qi and Blood, damage to Stomach collaterals. Treatment principle: Warm and transport. Prescription:
Dangshen (Codonopsis Root) 15g, Tu Chao Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome) 12g, Fuling (Poria) 12g, Fa Banxia (Prepared Pinellia Rhizome) 9g, Xi Sharen (Amomum Fruit) 9g, Shang Rougui (Cinnamon Bark) 6g (mixed and drunk), Bi Cheng Qie (Schisandra Fruit) 6g, Gong Dingxiang (Clove) 4.5g (taken with water), Gancao (Licorice Root) 3g, Ce Baiye Tan (Charred Biota Twig) 9g, Shao Jijin (Roasted Chicken Gizzard Membrane) 6g, Pao Jiang Tan (Charred Processed Ginger) 9g.
Second Visit: After taking three doses of the above prescription, distension and pain slightly reduced, but now presents with dry mouth and lips, dizziness, palpitations, shortness of breath, spontaneous sweating, restless sleep, constipation, stool color especially dark brown. Pulse deep, fine, tight, and rapid; tongue coating yellow, dry, and lacking fluids. This indicates slight resolution of Middle Jiao Cold-Damp, but the above prescription is too drying, showing signs of Yin deficiency with floating Heat. Changed to the following prescription:
Hong Renshen (Red Ginseng) 9g (mixed and drunk), Danggui (Angelica Sinensis Root) 15g, Chao Hangshao (Stir-fried White Peony Root) 9g, Tu Chao Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome) 9g, Fushen (Poria with Hostwood) 15g, Haipiaoxiao (Cuttlefish Bone) 12g (calcined), Zhe Beimu (Fritillaria Thunbergii Bulb) 9g (taken with water), Xi Sharen (Amomum Fruit) 9g.