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The wife of Xiao Feng, the eldest son of Wu Tai Pu from Wujiang, was the second daughter of Dong Xun Lao, the Grand Secretary of Rites. She suffered from cough, fatigue, excessive sweating, and abdominal pain, groaning incessantly for half a month. The physicians in Wujiang were ineffective. Seeking renowned doctors from near and far, such as Sheng Houhu from Gusu, Wang Houshan, and Shen Zhuting from Zhenze, they treated her in succession, yet the pain intensified.

I happened to be residing in Tiaocheng (modern Huzhou). Longshan Gong invited me to travel by fast boat with all possible speed. Upon arrival, I palpated her pulse: the left hand pulse was irregular (Sanwu Budiao), while the right hand pulse was deep and wiry (Chen Xian). Her complexion was greenish, respiration was faint, and there was a gurgling sound in her abdomen. I asked, "Did you suffer from illness last summer?" Xiao Feng replied, "I had headache, fatigue, and excessive sweating, with weakness in movement, unable to manage household affairs, but no cough or abdominal pain." In early May this year, the symptoms resembled those of last year. However, city physicians attributed it to wind-cold invasion and administered *Shensu Yin* (Ginseng and Perilla Decoction) to release the exterior, which induced the cough. Subsequently, to clear the lungs, they used *Chenxiang Untan Wan* (Agarwood and Phlegm-Draining Pill), a purgative, leading to a critical condition that seemed insupportable.

After deep contemplation, I concluded this was *Zhu Xia* disease (Summer-wasting disease). As Zhang Zhongjing stated, conditions worsening in spring and summer and improving in autumn and winter fit this pattern. Longshan Gong questioned, "Why does *Zhu Xia* cause cough?" I explained, "Originally, there was no cough; it was induced by *Shensu Yin*. Excessive sweating followed by further diaphoresis injured Lung Metal, causing dryness and cough. Why abdominal pain?" I said, "Originally, there was no abdominal pain; it resulted from cold damaging the Middle Jiao Qi during the treatment of the cough."

Subsequent physicians failed to investigate the cause of pain due to cold. Instead, adhering to the principle that 'patency relieves pain,' they used cold purgatives like *Untan* agents, severely damaging the Middle Jiao Qi. They overlooked that in the fifth lunar month, Yang Qi is dispersed outward. Sweating repeatedly leads to loss of Yang. At the Summer Solstice, Yin begins to sprout, leaving the abdomen deficient. Purging a deficient state leads to loss of Yin. With both Yin and Yang depleted, collapse is inevitable.

I wished to prescribe a formula to save her but feared reprimand from the attending physicians. Urged by Longshan Gong, I prescribed: Bai Shao (Radix Paeoniae Alba) stir-fried with wine, 5 qian; Gan Cao (Radix Glycyrrhizae) and Huang Qi (Radix Astragali), each 3 qian; Gui Zhi (Ramulus Cinnamomi), 2 qian; Da Zao (Fructus Jujubae), 2 pieces. Decoct in water, and add Yi Tang (Maltose) one he at administration. Physicians in Wujiang indeed debated vehemently. Longshan Gong said, "No need to debate. The patient relies on this for survival. Decoct and administer quickly." After ingestion, she fell into sleep from Si hour (9-11 AM) until Shen hour (3-5 PM) without waking. Previous physicians shook their heads, ordered servants to pack medical kits to leave, and told Longshan Gong, "It is Dr. Sun who hastened your sister's death. The *Bencao* states: Do not use Cinnamon Twig in summer, as it violates Heavenly Harmony. Pain should not be tonified, as it aids pathogenic factors. One dose caused unconsciousness; we are leaving."

Longshan Gong relayed this to me, and I inquired about her deep sleep. I said, "What pleases me is her sleep. Sleep generates Yin; when Yin grows, sweat can be consolidated, and pain stopped. If the prescription were inappropriate, how could this occur?" He asked the name of the formula. I said, "This is Zhang Zhongjing's *Xiao Jianzhong Tang* (Minor Construct the Middle Decoction), from *Jin Gui Yao Lue*. 'Jian' means to establish/steady; 'Zhong' refers to the Spleen/Stomach (Yangming Earth). The current abdominal pain, feeling bound, indicates tension in the Dai Mai (Girdle Vessel). According to Li Dongyuan's principles, for abdominal pain, Bai Shao is the Sovereign herb; if accompanied by aversion to cold, Gui Zhi is added. Gan Cao moderates the tension of the Dai Mai, serving as the Minister herb. The Classics state: For tension, use moderation. Green complexion and wiry pulse indicate excess Liver Qi. Liver belongs to Wood; Wood excess controls Earth. Combined with erroneous purging, the damage is extreme, hence severe pain. The Classics say: Wood withers with Cinnamon. Huang Qi assists by subduing Liver and tonifying Spleen, while also consolidating sweat and stopping pain. This explains the name 'Constructing the Middle.'"

Before I finished speaking, news came that the patient woke and requested porridge. I said, "Give it to her. Intake of grain qi establishes the root." After porridge, she slept again. By dawn, abdominal pain had completely ceased, with only slight cough remaining. I added Wu Wei Zi (Fructus Schisandrae) and Mai Men Dong (Rhizoma Ophiopogonis) to treat *Zhu Xia*, resulting in full recovery.

Longshan Gong reported the case history and prescriptions to the Grand Secretary (Dong Xun Lao). The Grand Secretary wrote to me: "You used four common herbs to revive a critical patient, shaking fame across Three Wu and spreading reputation through Two Zhes. Song Jinglian once wrote a biography for Zhu Danxi. Though I am unskilled, I hope you will detail the treatment steps so I may write a preface for posterity, providing reference for practitioners!" I responded humbly to Longshan Gong, "How have I earned such favor? However, your sister suffered excessive depletion, losing both Yin and Yang. Although cured, the wiry pulse persists, warranting caution. Advise her to avoid rage, regulate diet, withdraw from social affairs, maintain tranquility, and tonify frequently, perhaps ensuring longevity. Otherwise, in Hai month (lunar October), when Yin is extreme and Yang begins to rise, misfortune may occur. Be cautious! Be cautious!" Later, coinciding with that time, Xiao Feng had a dispute, angrily stopped medication, and indeed passed away. People in Tiaocheng praised my diagnosis as accurate and prescient.