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Thereby establishing the standard for dosage. As mentioned above, misusing purgation leads to Jie Xiong (chest binding syndrome), which is Yang Qi gathering in the Yin aspect; misusing sweating leads to Pi Men (stagnant fullness), which is Yin pathogen invading the Yang aspect. Generally, Yin and Yang each have their fixed positions, and ascending and descending have their regular limits. When one side is full, the other must be deficient; when one side decreases, the other must increase. The art of medicine lies in correcting deviations and remedying defects; the mechanism of change originates from the mind, and the key lies here. Miao Yiting quotes Lu Shi in a medical case: "If it does not spread horizontally, it turns into vertical exhaustion." These two phrases are very profound. "Horizontal spreading" refers to the disease qi moving from inside to outside, emerging from Yin to Yang. "Vertical exhaustion" refers to the disease qi moving straight up and down, with excessive ascending or excessive descending. This is the principle of Yin-Yang ascending/descending, fullness/emptiness, and decrease/increase. Deducting from these two phrases, I extend a few words below for correction by experts. "If the lower part is not unblocked, it will inevitably reverse upward; if it cannot reach upward, it turns into horizontal blockage. If the upper source is blocked, the lower part must be obstructed; if the middle is knotted, it cannot disperse in four directions; excessive purging inevitably leads to deficiency in the middle."

[27] Regarding the theory that Huang Lian (Coptidis Rhizoma) can "thicken the intestines and stomach," I have always doubted it. I believe "thick" is relative to "thin." Only when what was thin becomes not thin can it be called thick. To say that Huang Lian clears damp-heat and thus thickens the intestines and stomach does not ultimately explain the meaning of the character "thick." It was only after personally treating cases of dysentery, often seeing excrement mixed with membrane tissue, named "Chang Gou" (intestinal mucus) or "Gua Chang Li" (scraping-intestine dysentery), that I suddenly realized. In normal people, there is naturally a membrane tissue inside the intestines and stomach, which is soft, tough, sticky, and tightly adheres to the surroundings of the intestinal and gastric walls. Because dysentery causes this tissue to be consumed and forced downward by pathogenic heat, as it is expelled, the membrane tissue on the inner walls gradually becomes thinner. Using Huang Lian to clear damp-heat removes the source of consumption and forcing, allowing the membrane tissue to adhere tightly to the intestinal wall again. This is what is meant by "thickening." Although the intestines and stomach are connected by one Qi, the stomach is the stomach, and the intestines are the intestines; how can they be confused? Dysentery expels intestinal mucus, but no one speaks of expelling gastric mucus; there is scraping-intestine dysentery, but no scraping-stomach dysentery. Moreover, the intestines are coiled with little hollow space; damp-heat disturbance easily affects the surroundings. Either pathogenic energy scrapes the membrane downward, or accumulated filth drags the membrane out. As for the stomach, its body is vast, storing dirt and filth; even with damp-heat, it may not necessarily injure the margins or peel the membrane. Thus, I doubted the theory of Huang Lian "thickening the intestines and stomach" again, suspecting the character "stomach" was inappropriate. Upon consulting *Mingyi Bielu* (Record of Famous Physicians), it states: "Regulate the stomach, thicken the intestines." I became even more enlightened. The theory of Huang Lian "thickening the intestines and stomach" is a later confusion of terms, not the original text of *Mingyi Bielu*. Huang Lian clears damp-heat in the stomach, restoring the stomach Qi to harmony, hence called "regulating"; Huang Lian clears damp-heat in the intestines, preventing the intestinal membrane from being consumed and falling, hence called "thickening." From this, we know that ancient scholars used words carefully; their precision is such. [Zhonggui's Note] Why can Huang Lian "thicken the intestines"? I once wrote an article discussing this. Essentially, Huang Lian has astringent and enzyme-inhibiting properties, and stimulates the intestinal mucosa and nearby lymphatic vessels, promoting lymphocyte proliferation to increase resistance and reduce inflammation. Furthermore, the pathogens of dysentery are amoebas and Shigella bacteria; Huang Lian causes a surge in lymphocytes to eliminate pathogens—this is point one. Huang Lian has anti-inflammatory effects, reducing intestinal wall inflammation—point two. Huang Lian has astringent functions, promoting the healing of intestinal ulcers—point three. Its nature is astringent and cooling, suitable for both initial and chronic dysentery—point four. Observing this, the reason why this herb can "thicken the intestines" and serve as a key drug for intestinal diseases becomes clear as melting ice.

[28] *Qianjin Fang* (Prescriptions Worth a Thousand Gold) states that those prone to toothaches often suffer from eating during lunar eclipses. Those with insight should beware. Therefore, food and drink are specifically taboo before the eclipse ends. Few know this saying, so I highlight it. Additionally, health preservationists say modern people brush teeth in the morning, which is putting the cart before the horse. Food debris accumulates in the teeth gaps throughout the day and should be brushed at night to remove all filth. Hence, "morning rinsing is inferior to evening rinsing."

[29] *Jifeng Puji Fang* (Chicken Peak Universal Health Formula) in the chapter "On Five Obstructions and Various Qi Disorders" says: This disease is neither external nor internal, neither cold nor hot, neither excess nor deficiency. Thus, drugs are difficult to effect. This disease arises from worry, thought, anger, disturbing Qi and injuring Spirit. Qi accumulates internally; when Qi moves, all symptoms appear; when Qi is still, the condition slightly calms. Palpating finds no location of the disease; observing sees no cause of color changes; listening hears no source of sound. Thus, acupuncture and medication yield no results. This is a disease of the Shen (Spirit) between thoughts. Recently, a scholar in the capital had this condition. Advised to observe quietly and nourish internally, delegating all mental efforts to others, medication then took effect. Otherwise, peace would likely never be achieved. Following this advice, combined with moxibustion on Gaohuang and Sihua acupoints and medication, recovery is certain. Sun Simiao said women have more desires than men and are twice as susceptible to disease due to love, hate, jealousy, worry, and anger, making attachments firm and emotions uncontrollable, leading to deep-rooted disease and difficult treatment. For diseases of the Shen between thoughts, relying on drugs, I fear even Lu Dan (Bian Que) would admit inability. For such cases, unless the attachment is extremely firm, one must earnestly advise quiet observation and internal nourishment. Considering the intent of ancient benevolent people, surely it is not just writing a prescription that solves the matter. However, "quiet observation and internal nourishment" is easier said than done. Only those with inherent capacity can grasp it.

[30] The method of quiet observation and internal nourishment is recorded in He Huichuan's *Wen Tang Ji Yan Fang* (Collected Effective Prescriptions from Wen Tang), concise and easy to practice. I record it here for public viewing. Yanhui, being dull and shallow in learning, rarely knows much. I once presented this item to friends interested in Mind Learning, who said the phrase "examine why this thought arose" contains infinite profound truths; curing illness is a minor matter. There are many insightful people in the world; is this true? *Collected Effective Prescriptions* states: For deficiency consumptive syndromes caused by overwork, rest, medication, and diet make them easy to treat. If caused by extreme Seven Emotions and Six Desires, medication accounts for only 30%; only the power of quiet nourishment can turn things around. Forget worldly affairs, reside in a peaceful place, clear the heart and reduce desires, eliminating selfishness regarding wine, sex, wealth, and status. Rise immediately upon waking in the morning (sleeping again leads to mental scattering and confusion). Forget self and objects, calm the Shen and sit quietly. If delusions arise, walk slowly and examine why the thought arose and how to stop it, discarding thoughts useless to body and mind. Sit when still, walk when moving. Walk for the duration of one incense stick, then rest and walk again. Achieve interdependence of heart and breath, natural respiration. Saliva production while sitting and bodily comfort upon rising are signs of efficacy. Practice starts shallow and goes deep; continuity is key. Maintain inner Shen guard in walking, standing, sitting, and lying. Half a month of practice yields miraculous results. With good aspirations, immortality is possible. Merely taking strange medicines or holding breath is harmful. [Zhonggui's Note] Sitting meditation indeed treats deficiency consumptions, especially effective for insomnia due to neurasthenia. However, excluding wandering thoughts during sitting is hardest. The Tongshan Society's "guarding the aperture" method, focusing on the Dantian during Zi and Wu hours, aims to exclude wandering thoughts. My opinion is best to hold prayer beads and softly chant "Amitabha Buddha" while sitting, engaging body, mouth, and ear simultaneously, so wandering thoughts naturally diminish. Deficiency consumptions often result from karmic retribution; only devout chanting can eliminate past evil karma. Thus, besides morning and evening meditation, patients should read Buddhist texts and health books to understand methods of cultivating mind and protecting body, practicing sincerely. Illnesses will heal. Relying solely on medicine is futile.

[31] *Xu Mingyi Lei An* (Continued Cases of Famous Physicians) records Xu Xuanzhi treating a ten-year-old boy who fell backward from a stage, vomiting bitter green liquid like vegetable juice. Xu said: "The gallbladder has inverted." If bile is exhausted, death ensues. Prescription: Wendan Tang (Warm the Gallbladder Decoction) plus Suanzaoren (Ziziphus Seed) and Daizheshi (Hematite) to correct the gallbladder, named Zhengdan Tang. One dose stopped vomiting. I had seen this case before but lacked treatment knowledge, so he died.

[32] Mild diseases become severe due to medication. Wrong medication worsens the disease; even correct medication, if too strong for a mild disease, also worsens it. I treated a woman with nausea, vomiting, dizziness, and food aversion. After two months of medication including Jiangni formulas like Zuojin Wan and Xuanfudaihzhe Tang (Daizheshi is heavy and sinking, contraindicated in pregnancy), Qi-regulating agents like Sharen, Doukou, Wuyao, Chenshen, and tonics like Liu Junzi Tang and Siwu Tang, she developed chest irritability, aversion to food smells, heaviness, pain, emaciation, lethargy, and faint breathing. A doctor diagnosed blood depletion and amenorrhea as a severe deficiency consumption, advising the family to prepare for death. Her pulse was fine and weak but showed dynamic and slippery qualities. Detailed inquiry revealed abdominal movement despite no distension. Diagnosed as Ezu (mor sickness of pregnancy), a common pregnancy ailment exacerbated by excessive medication damaging the stomach. Advised stopping medication, but she refused. Prescribed light, harmonizing, Qi-regulating, descending, and stomach-nourishing herbs. Chest discomfort eased. Subsequent adjustments with light doses gradually succeeded. Months later, she gave birth to a son. *Jingui Yaolue* states: "If the physician treats incorrectly for a month, adding vomiting and purging, one must 'cut off' [stop] treatment." "Cutting off" means stopping medicine and waiting for self-recovery. Unwilling to stop, I gave light doses.

[33] Hai Zhe (Sea Cucumber/Tunicate), 1 liang, washed clean, with four Di Li (Water Chestnuts), boiled in 2 zhong of water to 0.8 zhong, named "Xue Geng" (Snow Broth), seen in *Jiang Xue Yuan Gu Fang Xuan Zhu*. Annotation: For Liver meridian heat jue, lower abdominal attacking pain, it clears heat and stops pain swiftly. Wang Mengying's *Gui Yan Lu* says: Hai Zhe is a wonderful drug. It promotes Qi circulation, resolves stasis, eliminates phlegm, and aids digestion without harming healthy Qi. Processed with alum and salt, even after washing, its softening and knot-resolving merit remains. Suitable for asthma, chest oppression, abdominal pain, masses, distension, constipation, dysentery, and malnutrition. For cases requiring purgation but where the constitution is fragile and cannot tolerate Xiaoshi or Dahuang, I heavily use Hai Zhe, assisting with Zhishi and Houpo, achieving swift results. Hai Zhe forms from water, boiling back into water. Phlegm formed by fire boiling water is its specialty. Its cold nature clears fire and dissipates knots without harming healthy Qi. I favor it. Unsuitable for Yang-deficient or cold-damp constitutions. Effective for children's malnutrition with fire excess, bad breath, hard stool, and abdominal heat.

[34] *Suwen: Wei Lun* states: Treat Wei syndromes by exclusively targeting the Yangming. Yangming moistens Zong Jin (major sinews), which bind bones and facilitate joints. Wang Bing's annotation: Zong Jin refers to vertical tendons above and below the transverse bone in the pubic region, connecting to chest/abdomen, passing through hips/sacrum, back/abdomen, head/neck. Thus, Zong Jin cannot be defined merely as the external kidney (genitals). *Jue Lun* states: The anterior yin is the gathering place of Zong Jin. Anterior yin is the external kidney. Thus, Zong Jin can refer to the external kidney. *Wei Lun* also states: Endless thinking, unfulfilled desires, excessive sexual activity lead to Zong Jin flaccidity and Bai Yin (seminal emission). Interpreting this, "Zong Jin flaccidity" implies impotence. Yangming Stomach Fu governs the center, connects to the nose and external kidney. Syphilis toxins in Yangming cause nasal destruction or penile erosion; horses with black noses have black penises. The connection between Yangming and external kidney is evident. Therefore, treating impotence should follow *Suwen*'s principle of targeting Yangming, not merely focusing on tonifying Kidney and strengthening Yang. (This section shows deep insight consistent with medical theory. Zhonggui adds note.)

[35] *Xingxuan Yi An* (Anxin Cheng Wenpu Guanquan) states: Classics say the Kidney governs water and stores essence from all organs. Essence is stored in the Kidney, not produced by it. Like money stored in a treasury but not generated there. One must tonify the Spleen and Stomach as the source of transformation. My comment on Ye Tianshi's cases: Such flesh-and-blood有情 (sentient/nourishing) prescriptions match the classic principle "for essence deficiency, tonify with flavor." If the patient's stomach function is damaged, do not administer abruptly, aligning with Mr. Xingxuan's view. Tonifying essence requires rich/heavy substances, but they must be transformed by the Stomach and transmitted by the Spleen to slowly become essence and return to the Kidney. Rich substances transform into essence more easily than light ones, but cannot instantly become essence upon ingestion. Increasing diet increases fluids, generating blood and essence.

[36] I formulated Huisheng Dan to save difficult labors and treat postpartum blood stasis, achieving miracles, but it is unsuitable for deficiency-cold syndromes because deficiency requires tonification and cold requires warming. A woman, two days postpartum, had no lochia, abdominal pain, and vomiting. One pill of Huisheng Dan failed to stop vomiting and caused diarrhea. Consultation: Blue face, pale lips, white slippery tongue coating, right pulse wiry-slow, left pulse deep-choppy. Abdominal pain, vomiting, poor diarrhea. Prescribed Banxia, Daizheshi, Rougui, Hupo, Heijiantan, Yanhusuo, Hutao Ren, Zhigancao (warming and moving agents). Vomiting/pain subsided, lochia flowed slightly, left pulse smoothed. Two more doses: stasis moved, pain eased, diarrhea stopped. Poor appetite, fatigue. Switched to harmonizing Yuan Qi, benefiting Stomach, warming/moving Blood/Qi with small doses. Several doses restored appetite and complexion. Left lower abdomen had a fist-sized mass causing intermittent pain. Modeled after Dahuang Zhechong Wan: removed Banxia/Daizheshi, added Danggui, Zhi Chuanshanjia, Jiuzui Dibiechong (Dizheworm). Powdered, mixed with vinegar-boiled Dahuang paste and refined honey into pills. Three qian morning/evening. Within a month, mass shrank, pain ceased. Later, tonifying extraordinary meridians, warming/nourishing Liver/Kidneys cured the disease and restored vitality. Blood stasis due to cold rushed to the Stomach (one of the three urgent postpartum rush syndromes). Huisheng Dan treats these rushes well by pushing stasis down but cannot treat cold-congealed stasis. Compound pills must be evaluated against pulse/symptoms. Blindly using known pills for known diseases yields mixed results. Hence the ancient maxim: "Discuss disease first, then discuss medicine."

[37] Farmers in water regions often suffer from Hong Kong Foot (tinea pedis/gout), locally called Da Jiao Feng or Sha Mu Tui. Swelling does not subside, unlike typical cases. Caused by collateral injury, stasis congealment, Qi obstruction, and invasion of wind-damp-heat that cannot exit. Starts with painful lumps in the groin, chills/high fever, spreading down to feet. Early stage: Mash Congbai (Scallion White) with honey (warning: scallion and honey together are toxic, do not ingest), apply to groin lumps. Then boil Hai Zhe (Sea Cucumber) and Di Li (Water Chestnut) together until Hai Zhe dissolves. Drink soup with Danggui Longhui Wan (3 qian). Dissipation is ideal. If established: Huangbai (wine-fried powder) 8 liang, Hai Zhe 8 liang (do not wash/boil), mix with Congxu juice, form bean-sized pills. Take 3 qian daily with Maogen soup. Externally: Boar wood shavings decoction with Pingxiao (Mirabilite), wash frequently. Bind with blue cloth soaked in brine. Brine clears damp-heat and disperses wind-toxicity. Effective for goose-palm wind and Hong Kong foot. Avoid spicy/hot stimulating foods, especially silkworm pupae (avoid for years even after cure).

[38] For sudden syncope, stroke, epilepsy, or falls/fainting, where Qi and Blood are disturbed but unsettled, do not panic or move the patient excessively to prevent Qi collapse. Treat in situ according to syndrome. For closure syndromes, induce sneezing or give Yushu Dan/Suhe Wan to open orifices. For deficiency syndromes, fumigate with charcoal/vinegar or embrace tightly to transfer Qi, then administer Renshen soup, Ginger soup, or child's urine. Treat according to syndrome, wait for consciousness, then move to bedroom. Laypeople often move patients unnecessarily, leading to death due to ignorance of ancient methods. I add this hoping benevolent minds spread it. (Note: In summer heatstroke, move to shade first, then treat. Moving to cold ground is dangerous per *Jisheng Lun*: cold causes death in heatstroke. Move to shade, not cold ground.)