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About two *li* from my residence, there is a place named Qiankengkou. A woman developed fever and headache ten days before the Qingming Festival. The physician prescribed Jiwei Qianghuo Tang (Nine-Ingredient Notopterygium Decoction) and Shishen Tang (Ten-God Decoction), but to no avail; instead, thirst worsened, and her tongue turned black like coal. Another physician then administered Rushen Baihu Tang (Miraculous White Tiger Decoction) and Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), also without effect; diarrhea became incessant, consciousness clouded, limbs cold, respiration faint, and she had been unable to consume even a grain of rice for fourteen days. Her family prepared shrouds and coffin, awaiting death. Coincidentally, I was sweeping ancestral tombs near her home. Her son heard of this and urgently sought my help, pleading for a consultation. Her pulse was fine as a spider's thread. I said: This is an epidemic condition. It should be treated with Lizhong Tang (Regulate the Middle Decoction) combined with Shengmai San (Generate the Pulse Powder). After two doses, by midnight, her spirit slightly revived, and she drank half a cup of rice soup. By morning, the pulses in all six positions gradually appeared. Rejoicing, I told her son: Recovery is assured. As the classics state, if the pulse is faint yet continuous, life remains. I continued with the previous prescription. By evening, diarrhea ceased, thirst disappeared, the coal-like discoloration on the center of the tongue faded, and her spirit became clear and tranquil. Subsequently, I prescribed Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), each 5 qian; Pao Jiang (Prepared Zingiberis Rhizoma) and Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma), each 2.5 qian; Mai Men Dong (Ophiopogonis Tuber) 3 qian; and Wu Wei Zi (Schisandrae Fructus) 15 grains. Decocted in water, taken at any time. Within a few days, she fully recovered.

Congxian, the eldest son of the Grand Scholar of our clan, suffered from dysentery at age seven, with red and white, thick and sticky discharge, predominantly red. His intake of food and drink was scant, and his physique and qi were weak. At that time, the Grand Scholar was preparing for the metropolitan examination in Nanjing. His brother, Congming, who knew me well, invited me to examine him. Upon examination, I stated: This case cannot be treated conventionally. The method must be tonification. Congming replied: It is said that without accumulation, there is no dysentery; thus, the method should first be purgation. To use tonification now without purging, how will the accumulation be expelled? I answered: What you discuss is the general rule. In treating disease, it is crucial to first observe the symptoms. Ancients employed either attack followed by tonification, or tonification followed by attack, prescribing according to the syndrome, not rigidly adhering to conventions. Now, the patient is emaciated and weak, with a bluish complexion, indicating significant constitutional deficiency and poor dietary intake; hence, I use tonification. It is better to have excess righteous qi; even if it does not perfectly match expectations, measures can still be taken. If one rigidly follows conventional purgation, what if complications arise? Congming agreed and requested medicine. I prescribed Sijunzi Tang (Four Gentlemen Decoction) added with Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Huang Lian (Coptidis Rhizoma), and Shan Zha (Crataegi Fructus). After three doses, the disease neither improved nor worsened. Some women in the household questioned my expertise in pediatrics and suggested consulting Dr. Xia. On the day of Summer Solstice, Dr. Xia remarked to me: Fortunately, purgation was not used initially, leading to this delay. He asked why. I explained: Danxi stated that if the anus resembles a hair tube, it is incurable. Currently, the anus has a bamboo-tube appearance; how can purgation be used? However, tonification is also unnecessary; Xianglian Wan (Amomum and Coptis Pill) and Liuyi San (Six-to-One Powder) could resolve it. After three doses, dysentery became more frequent, the condition worsened, accompanied by nausea and extreme exhaustion. Another physician, Wang Hengchun, was consulted. He also prescribed Xianglian Wan and Huangqin Shaoyao Tang (Scutellaria and Peony Decoction). Dysenteric discharges occurred day and night beyond count, and food could not enter the mouth. The women believed them because both physicians were renowned, so they sequentially invited them. Only Congming persisted in inviting me. Upon observing his form and spirit, which were vastly different from before, I knew the middle qi was extremely deficient; only Lizhong Tang would suffice. I prescribed Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma), each 2.5 qian; Jiu Chao Bai Shao Yao (Wine-processed Paeoniae Radix Alba) and Bai Fu Ling (Poria), each 1 qian; Zhi Gan Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) and Pao Jiang (Prepared Zingiberis Rhizoma), each 0.8 qian; and Rou Gui (Cinnamomi Cortex) 0.3 qian. After four doses, dysentery halved. Reducing the dosage of the previous formula by half and administering another six doses, appetite returned, and dysentery stopped. Although thick and sticky discharge ceased, blood and water still passed three to five times daily, and muscles had not regenerated. I pondered the cause: likely, the malnutrition syndrome (Gan Disease) arose from deficiency. Using Rusheng Wan (Miraculous Sage Pill) to treat the Gan Disease would lead to complete recovery.