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Mr. Zha Shaochuan, aged forty-three, had a long-standing history of asthma (asthma). Each time it attacked, his whole body felt as if burning, qi (vital energy) surged upward, breathing was short and rapid, and the pulse indicated loud phlegm sounds like boiling water. After seven days and nights of wheezing, he gradually calmed down through sweating (diaphoresis). He usually indulged in drinking alcohol without stopping all night, engaged in sexual intercourse after getting drunk, and did not avoid wind and cold. A clan member taught him to use Shi Gao (Gypsum Fibrosum), Ma Huang (Ephedrae Herba), Xing Ren (Armeniacae Semen Amarum), Zhi Qiao (Aurantii Fructus), and Xi Cha (Fine Tea), each one liang, decocted into a large dose and drunk, named "Wu Hu Tang" (Five Tigers Decoction). Whenever asthma struck, he used this to ward it off; upon drinking it, the attack stopped immediately. It worked repeatedly with each recurrence, effective as quickly as a drumstick hitting a drum. He was very pleased and regarded it as a life-preserving elixir. During his stay in Datong for one month, Ma Huang and Shi Gao became scarce in the county market.

Little did he know that desires are infinite, while the harmonious qi (vital energy) in the stomach is limited. Within three years, the number of times he drank Wu Hu Tang could hardly be counted, yet no one knew how much the harmonious qi in his stomach had been damaged. Consequently, his abdomen became distended like an inverted winnowing basket, and both legs swelled smoothly and stiffly like pillars. Clear fluid oozed incessantly from sores and ulcers inside and outside his body, emitting a fishy odor day and night, making it impossible for him to sleep on a pillow for five months. Doctors were summoned from Yizheng to Yangzhou, and inquiries were made about doctors in Jingkou (Zhenjiang); Mr. Zhang was considered the best. He was consulted extensively for a month, but there was no effect whatsoever. Then, leaving Jingkou for Gusu, passing through Jiaxing and Hangzhou, all famous doctors were invited to treat him, but the condition worsened. He was carried back to Yanzhen Town, where the renowned local doctor was Wu Yu Fang. First, he visited Dr. Wu, who declined out of fear; then he went to Dr. Fang, who examined him for a long time and said, "Your illness is extraordinary; only an extraordinary person can cure it." Mr. Zha said, "Sir comes from a family of great physicians; previously in Lianghuai, everyone looked up to you. I wish to enjoy your diagnosis. Why abandon me and make me seek an extraordinary person? Who else in this world is extraordinary but you?" Dr. Fang said, "Alas, Mr. Sun Shengsheng from your noble hometown has a reputation shaking the Three Wu regions. He has returned home and stays indoors. You must urgently invite him to treat you, or you may recover safely." Mr. Zha asked which village Mr. Sun Shengsheng lived in and what he looked like. Dr. Fang wrote down my surname, residence, and location and gave it to him. Upon returning, he earnestly requested Mr. Cheng Gongshan to introduce and welcome me. This was one day after the Major Cold solar term.

Upon arrival, I saw Mr. Zha sitting on a high chair, breathing heavily and wheezing, his body hot and restless. He was wrapped in cotton quilts, his feet placed in a fire box, surrounded by five basins of fire front, back, left, and right. He wore a velvet hat, covered with a marten fur hood, and over that, a cloth band. His nose was covered with a velvet sleeve. Heavy curtains were set at the door, yet he still shivered with fear of cold. His pulse was floating, large, and powerless. His complexion showed white with hidden bluish hues. I slowly asked, "When did the aversion to cold and body heat begin?" He replied, "Ten days ago." I said, "Based on the complexion and pulse, I have grasped the general picture. Having seen many famous doctors in several prefectures, what diagnosis did they give, and what prescriptions did they propose? Please describe them in detail." He said, "The opinions varied greatly. Sir's learning is profound and insight true; I am willing to follow your command." I said, "Your illness is abdominal fullness due to qi deficiency. The treatment method should be to warm and tonify the lower yuan (lower energizer). People only know how to promote urination, not realizing that difficulty in urination stems from insufficient qi in the lower jiao (lower burner), which cannot seep into the bladder channel to flow. If one promotes urination too hastily, water will overflow and flood the skin, flowing down to the scrotum, even causing swelling, rupture, and collapse. If the lower jiao is strengthened, urination will naturally become smooth. Imagine a steamer pot: when fire burns underneath, the water and fire intensify, and the qi within the steamer naturally rises like mist or dew. The *Neijing* states: 'The upper jiao opens and develops, disseminates the flavors of grain and food, warms the body, fills the flesh, moistens the hair, like mist and dew irrigating.' This is called qi. Thus, it is said that the upper jiao is like mist. When clear yang rises, turbid yin descends; descending, it becomes urine. Thus, it is said that the lower jiao is like a ditch. Ditch refers to water channels. It means the lower jiao is the official of drainage, from which waterways emerge. Human sweat is this mist and dew qi; urine is the descending qi. Qi is the mother of water; water is transformed from qi. Hence, it is also said: 'Qi transformation allows for excretion.' Viewing all principles together, the root cause is the robustness of the primordial qi in the lower jiao, enabling ascending and descending changes. Clear yang rises, turbid yin descends, representing the harmony of Heaven and Earth (Tai hexagram). If yang does not rise and yin does not descend, it represents the stagnation of Heaven and Earth (Pi hexagram). Pi means obstruction/blockage. This is how distension and fullness arise. Your illness originated from Wu Hu Tang, leading to cold in the zang organs and generating fullness disease." He said, "Good. Now I finally know the source of my illness. However, recently my body is hot, hands are hot, and there is a burning sensation in the chest and diaphragm, while external aversion to cold persists. Which is heat and which is cold?" I said, "Zhongjing stated that cold damage (Shanghan) must involve aversion to cold because the pathogenic cold is in the exterior; it should first be dispersed. The burning sensation in the chest and diaphragm is due to yin excess repelling yang, where deficient yang fire is driven upward by cold pathogens; it is not true heat. The classics say 'water flows to wetness, fire goes to dryness.' Once the lower yuan is warmed, the heat will naturally descend." He said, "Yes, I leave the prescription entirely to you."

I prescribed Zi Su Ye (Perillae Folium), Ma Ti Xin (likely a local herb or typo for another, kept as is), Zhi Gan Cao (Prepared Licorice Root), Fang Feng (Saposhnikoviae Radix), Bai Dou Ren (Arecae Seed), Cang Zhu (Atractylodis Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Ren Shen (Ginseng Radix), Qiang Huo (Notopterygii Rhizoma et Radix), and Sheng Jiang (Zingiberis Rhizoma Recens). One dose resulted in slight sweating. All surrounding fires were removed, leaving only one basin under the feet, and the head covering was taken off. Only the nose remained sensitive to cold. Therefore, I used Fang Feng and Huang Qi (Astragali Radix), two liang each, decocted in water, placed in a vessel, and let the steam fumigate the nose. After the time it takes to drink a meal, it stopped. Fumigation was done three times a day. The next day, the nose cover was also removed. Vomiting persisted, so Ren Shen Wen Dan Tang (Ginseng Warm Gallbladder Decoction) with Ding Xiang (Caryophylli Flos) was administered, stopping vomiting after one dose. Hearing that carp promotes urination, he ate two jin half ounces of carp in one day. At night, the distension became extreme, and he urgently sought my help. I said, "With the disease severity like this, undoubtedly due to such indulgence, how can astringent agents resolve it?" After deep contemplation, I used Ping Wei San (Peaceful Stomach Powder), one liang, mixed with one liang of olive flesh, decocted in water and drunk. Two doses stabilized the condition. However, abdominal distension and difficulty in urination prevented him from sleeping on a pillow. Therefore, I used Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) added with Sha Ren (Amomi Fructus), Bu Gu Zhi (Psoraleae Fructus), Chi Xiao Dou (Vigna Semen Rubrum), and Gui Xin (Cinnamomi Ramulus), administered continuously for four doses, resulting in slightly increased urination. Subsequently, Zun Zhong Wan (Respect Pill) was taken three times daily, five pills per dose. After five days, urination became smooth, allowing him to sleep directly on the mat. Adhering to this regimen, abdominal distension gradually subsided. In two months, he was mostly recovered; in three months, he walked in the marketplace. The townspeople believed my reputation began with treating Mr. Zha.