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My nephew Yuansu's wife experienced difficult labor at the end of summer. Past midnight, her family urgently knocked on my door. I rose to inquire and learned that the parturient was in a critical state. They said, "Yes, what are the symptoms?" The reply was: "The fetus has reached the vaginal opening but cannot be delivered; upon exertion, a sensation of something rushing upward from the chest and diaphragm occurs, causing unbearable pain." I pondered for a moment and said, "This must be a twin pregnancy where the placenta has separated, with one fetus positioned high and the other low. The lower fetus is ready to deliver, while the upper fetus is being pushed upward by the mother's exertion. It is precisely this upward rush that causes pathology in the chest and diaphragm. The situation is indeed perilous." However, consulting various texts such as *Chanbao* (Precious Prescriptions for Childbirth), *Liangfang* (Good Prescriptions), *Taichan Xu Zhi* (Necessities for Pregnancy and Childbirth), and works by renowned physicians, none had discussed this condition. How should it be managed? After careful consideration of the treatment method, I suddenly realized that the upper fetus must first be stabilized before the lower one can exert force to deliver. I immediately took Yiyuan San (Yuehua Powder, a formula composed mainly of Talcum and Licorice) one liang and administered it to her, instructing her to take it with Perilla Decoction, and urged strict adherence to the method. Once the medicine entered the stomach, the chest and diaphragm pain ceased. Within less than an hour, two female infants were born, and the mother remained unharmed. My second son, Tailai, asked, "Yiyuan San is not an emergency obstetric prescription; how could it achieve such efficacy?" I replied, "Perilla stabilizes the fetus and directs qi downward; Talcum lubricates and opens orifices; both are excellent agents for facilitating delivery. Essentially, medical practice relies on clinical reasoning (yi). I applied my own judgment in this case. Since this method is not recorded in standard formularies, I record it here for specialists in gynecology to reference and utilize."

A brother surnamed Shao, named Ma, suffered from vomiting at the age of fifty. His vomitus resembled rotten pig lungs, accompanied by distension in the chest and back. Physicians in the market treated him as having Fanwei (Rebellious Stomach/Regurgitation disease) without effect, and his symptoms worsened with tidal fever, irritability, and inability to ingest food. A physician from Xin'an diagnosed lung necrosis and declined further treatment. He then sought my care. Upon palpating his pulse, the cun positions of both hands were slippery and rapid, while the guan and chi positions on the left were choppy. I stated, "This is a syndrome of blood stasis and phlegm-fluid retention, not lung necrosis. If the lungs were truly necrotic, the voice would be hoarse. Now his voice is clear, yet he experiences only chest and back distension, clearly indicating blood stasis and phlegm-fluid. This condition likely resulted from anger after drinking alcohol. The liver stores blood, and the spleen controls blood. Alcohol damages the spleen, and anger damages the liver. Consequently, the body fails to store and control blood properly; blood follows rebellious qi upward and accumulates in the chest and diaphragm. Distension is relieved only after vomiting. The treatment principle should be to resolve blood stasis, regulate qi, and transform phlegm. Once qi is regulated and stasis resolved, new blood can return to its vessels, the root is corrected, and the disease foundation eliminated." I then prescribed the following: Talcum 3 qian, Licorice 5 fen, Rubia Root 2 qian, Small Thistle 1.5 qian, Peach Kernel, Fritillaria Bulb, Angelica Sinensis Tail, and Cyperus Rhizome each 1 qian, Gardenia Seed, Aurantium Fruit, and Mulberry Bark each 8 fen. After taking ten doses, he fully recovered.