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Mr. Min Wenchuan developed a swelling and toxin above the anus. After more than a month, pus ruptured, but slight movement caused continuous bleeding of fresh blood. His stool was dry and hard, his chest and diaphragm felt full and distended, and he had no appetite. The pulse at both Cun (inch) positions was short and weak; the Guan (bar) position was wiry; the Chi (cubit) positions were surging and slippery. This indicates Qi deficiency with Blood heat, sinking to the lower part of the body. The treatment principle should be tonification and lifting. Otherwise, hemorrhoids or anal fistulas may develop, which is concerning. Prescription: Huangqi (Astragali Radix) 2 qian, Danggui Shen (Angelicae Sinensis Radix), Diyü (Sanguisorbae Radix), Huaihua (Sophorae Flos), Zhike (Aurantii Fructus Immaturus) each 1 qian, Shengma (Cimicifugae Rhizoma), Qinjiao (Gentianae Macrophyllae Radix) each 7 fen, Jingjie Sui (Schizonepetae Spica) 5 fen, Gancao (Glycyrrhizae Radix et Rhizoma) 3 fen. After taking the medicine, the chest and diaphragm felt relaxed, but bitter taste in the mouth was severe. Jiu Lian (Scutellariae Radix prepared with wine) and Lianqiao (Forsythiae Fructus) 5 fen each were added to the previous prescription, and the patient recovered.

Mr. Li Guyu defecated immediately after every meal, with slight tightness and distension of the abdominal skin, and fullness and oppression in the chest and diaphragm. Other physicians administered Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma), which worsened the obstruction and fullness. His urine was clear and long. I palpated his pulse: the left Cun position was choppy; the right Cun position was slippery, feeling like a soybean under pressure, and pulsating vigorously (drum-like). The Guan and Chi positions were wiry and small, while the left Chi position was long and vigorous. Based on the pulse, it was determined that accumulated phlegm was stagnating in the Lung and could not be expelled, leading to instability in the Large Intestine's function of securing stool. The treatment principle should follow Zhu Danxi’s method for treating his uncle using emesis. Vomiting would remove the phlegm accumulation in the Upper Jiao, and the stool would naturally become solid. First, Jiegeng (Platycodonis Radix) and Luobozhi (Brassicae Semium) each 3 qian, Baidouren (Cardamomi Fructus), Juhong (Citri Reticulatae Pericarpium), Shanzhiren (Gardeniae Semen) each 1 qian, Chuanxiong (Ligustici Chuanxiong Rhizoma) 5 fen, Shengjiang (Zingiberis Rhizoma Recens) 3 slices, Congbai (Allii Fistulosi Bulbus) 3 stalks were decocted in water and taken to induce vomiting. About half an hour after ingestion, nausea occurred, and clear phlegm was vomited. Although the urge to vomit persisted, the phlegm accumulation was sticky and stubborn, making it difficult to expel. Then, 1 he of Luobozhi was ground into a paste mixed with Jiangshui (fermented rice water) and honey, and half a bowl was given to drink. Only then were over two bowls of sticky phlegm vomited. Previously, stool passed simultaneously with urination. After vomiting, urination became independent and smooth, occurring three or four times consecutively, after which the chest and abdomen felt relaxed. Initially fearful of emesis, he suddenly felt relieved and comfortable. Stool was retained for five days, at which point he began to believe my diagnosis was correct. Subsequently, Erchen Tang (Two-Cured Decoction) was modified with Baizhu (Atractylodis Macrocephalae Rhizoma), Xuanfuhua (Inulae Flos), and Maiya (Hordei Fructus Germinatus) for conditioning, leading to complete recovery.