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Mr. Zheng Jingnan from Yanzhen had been bedridden for over a year, with all treatments proving ineffective. He was formerly robust and plump, but now emaciated to the point of being mere bones; his food intake was minimal, and distinguished scholars from Xindu all declined to treat him. His family mentioned that in previous years, Lady Rong, the concubine of Fangshi, suffered from *Gu* syndrome (a difficult abdominal accumulation disorder resembling insect bites), and contemporary physicians had also resigned their posts. I took up the case, seeking my consultation at that time. It was the fifteenth day of the sixth lunar month. Upon palpating his pulse, the left side was wiry and large (*Xian Da*), the right Guan position was slippery and large (*Hua Da*), while both Chi positions were imperceptible. He experienced nausea, his abdomen was sunken and thin like an inverted tile, borborygmi sounded like thunder without cease day or night, urination was obstructed, skin and sclerae were yellow like gold, there was a mass in the abdomen as large as a plate pulsating incessantly, feet and knees were cold below, and he could not retain food. After carefully contemplating the pathogenesis, I reasoned that the transition from obesity to emaciation indicated phlegm-fluid retention (*Tan Yin*). Although his body was thin, his eyes were bright and spirited. I initially prescribed *Wu Yin Tang* (Five Drinks Decoction) tentatively to observe the disease's trend before making further modifications. The prescription consisted of *Inulae Flos* (Xuanfu Hua) 8 fen, *Psoraleae Fructus* (Pogu Zhi) 1 qian, *Cinnamomi Ramulus* (Rou Gui) 3 fen, *Atractylodis Rhizoma* (Baizhu), *Poria* (Fuling), *Alismatis Rhizoma* (Zexie), *Citri Reticulatae Pericarpium* (Chenpi), and *Pinelliae Tuber* (Banxia) each 8 fen, along with three slices of *Zingiberis Rhizoma Recens* (Shengjiang), decocted in water and taken orally. After two doses, nausea and borborygmi ceased. By the next morning, food intake slightly improved, and the whole family was delighted. His father-in-law, Mr. Cheng Zhongshan, who was a bosom friend (*Shi Jiao*) of mine, heard of the patient's recovery and was surprised, unaware that it was due to my treatment, so he came to visit. Upon seeing me, he clapped his hands and shouted with joy, saying, "I knew it was you." Pointing to his nephew, he told him, "This is the gentleman I often spoke of to you. I heard he had been retained for a long time by gentry in West Wu, but unexpectedly returned; this is indeed the fortune of my son-in-law." We conversed for two days before parting. At the time of separation, Jingnan's diet had slightly increased, urination was smooth, the jaundice on his skin and face had faded, and signs of vitality gradually returned. Unexpectedly, more than half a month later, provoked by frustrating events, he became angry, vomited phlegm again, lost his appetite, and his family panicked. They urgently requested my diagnosis. The Cun positions on both wrists were slippery and large, the left Guan position was wiry, stiff, and beating against the finger, the right Guan position was also slippery, large, and forceful, while both Chi positions were deep and minute. I said to him, "The illness is severe, and the pulse differs from before. I dare not promise a complete cure, but I will do my utmost. The recovery is due to the efficacy of the medicine and your good fortune." It was the first day of the seventh lunar month. I stayed to observe him for seven days, administering one dose daily. The formula included *Ginseng Radix* (Renshen), *Citri Reticulatae Pericarpium* (Chenpi), *Pinelliae Tuber* (Banxia), *Poria* (Fuling), *Cyperi Rhizoma* (Xiangfu), *Oriza Sativa Semen* (Baidouren - likely referring to Coicis Semen/Job's tears or similar, contextually used here as Baidou Ren), *Coptidis Rhizoma* (Huanglian), *Inulae Flos* (Xuanfu Hua), *Malta* (Maiya), and *Glycyrrhizae Radix et Rhizoma* (Gancao). After three doses, nausea stopped, and thick phlegm was passed in the stool, containing blood stasis. This was caused by extreme anger. Thus, the Classics state: "Anger injures the Liver; severely, it leads to hematemesis." Upper vomiting and lower purging may also present with red spots in the sputum, which is a sign. Later, *Liu Junzi Tang* (Six Gentlemen Decoction) was modified with added *Malta* (Maiya), *Coptidis Rhizoma* (Huanglian), *Eriobotryae Folium* (Pipaye), and *Dolichos Lablab Semen Album* (Baibiandou) for regulation. The condition stabilized, and the plate-sized abdominal mass gradually diminished to the size of a finger. Muscle mass regenerated, allowing him to get out of bed and walk. People in the market marveled at this.

Later, it was reported that in the twelfth lunar month, he fell into depression and anger again, developing scrofula (*Luoli*) on his neck. A surgeon punctured and ulcerated it with caustic medicines, and he took centipede-based detoxifying drugs, but ultimately the wound failed to heal, leading to his death. How tragic!