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After discussing tinnitus (tinnitus) in the spring, Ancestor Hu recognized that I, Chang, adhered strictly to principles without flattery, and thus deemed me competent. By early winter, due to Pi Yue syndrome (Spleen Constraint Syndrome, characterized by constipation), he summoned me again for consultation. I administered Cistanche Herba (Rou Cong Rong), Sesame Seed (Hu Ma Zi), Dioscoreae Rhizoma (Shan Yao), and Polygoni Multiflori Radix (Shou Wu). After four doses, his bowels became moistened. This was because there was a deficiency of blood and an excess of wind in the intestines, which matched the properties of the herbs, hence the rapid efficacy. From then on, he trusted and pleased with me even more, often visiting me personally to ask for advice and opening his heart to show his condition.

At the end of winter, accidentally eating too much while exposed to wind, he suddenly vomited, emptying his stomach completely. His Stomach Qi (Stomach's physiological function) was severely damaged. When I was summoned to examine him, he had a slight fever. The pulse at the left Guan position (position corresponding to the Liver/Gallbladder) was very large. He said initially he felt discomfort in the Zhongwan area (epigastrium), but now felt Qi counterattacking to the left. Initially, pear juice did not agree with him; now, cane syrup has slightly stabilized the condition. He asked what this syndrome was. I therefore diagnosed it as a manifestation of Deficient Wind (internal wind generated by deficiency). Because the food and drink received by the Stomach were all expelled with no residue remaining, the interior became hollow like a valley, causing wind to generate internally. Additionally, the wind long accumulated in the intestines took the opportunity to enter upwards, causing unrest in the Stomach. However, when wind enters the Stomach, it must move to the left to attack the Liver Wood (Liver system) and follow its kind. Thus, Qi counterattacks to the left, and the left pulse becomes large and forceful. The *Neijing* states: "When wind dominates internally, treat it with sweet and cold substances." Both pear juice and cane syrup are sweet and cold substances appropriate for the syndrome. The fact that one worked and the other did not further indicates that the Qi deficiency in the Stomach is extreme; it cannot tolerate the descending nature of pear, but prefers the harmonizing nature of cane syrup. Therefore, I formulated a prescription using a category of sweet and cold herbs, including Ginseng Radix et Rhizoma (Ren Shen), Bamboo Sap (Zhu Li), Ophiopogonis Radix (Mai Men Dong), and Rehmanniae Radix (Sheng Di Huang). The consensus was to exclude Ginseng and not use it. After taking the medicine, gurgling sounds were heard in the abdomen, and a small amount of yellow phlegm was vomited, bringing relief to the chest. The next morning, his bowels moved freely, and the symptoms seemed to be improving.

However, there was something strange. Although the disease originated in the Stomach Meridian (Stomach channel), the Stomach pulse did not show signs of illness. Instead, the pulses of the Heart, Kidney, Liver, and Lungs in the upper, lower, and lateral positions frequently presented independently, deviating from their normal state. I explained my reasoning earnestly, arguing that this was not a sign of disease in the upper, lower, or lateral areas, but rather weakness of the Central Qi (Spleen/Stomach Qi) unable to reach the four extremities. It is like a mother who is ill and her four children lose milk, thus showing signs of hunger and deprivation. Observing that the Ancestor himself said his taste in the mouth was extremely bland, and that water reaching the throat stopped and refused to go down, it was clearly due to the failure of Stomach Qi to rotate. Old water remained in the throat, preventing the swallowing of new water. It was urgent to use Si Jun Zi Tang (Four Gentlemen Decoction) to regulate Stomach Qi. Then the pivot of the center would turn, and the mechanisms of the four sides would become smooth. The rebellious Qi of water in the throat would subside, and the bland taste in the mouth would disappear. If you do not believe this, quickly consult a knowledgeable physician. It is inappropriate to delay here and cause mistakes.

However, my words were perceived as overly severe, and they blamed me for intentionally startling them. They changed to summon two other physicians. One diagnosed it as Stroke (Zhong Feng), and the other as Cold Damage (Shang Han); their views differed. Regarding the inadvisability of using Ginseng, they all agreed. Regarding the claim that the syndrome was mild and easy to treat, they all supported it. They lightly used releasing-the-exterior herbs, resulting in profuse sweating, and they all praised this action. They disregarded the already exhausted Stomach Qi, finding it difficult to tonify, so instead they opened the pores and let the pathogen escape. Consequently, Qi rose high, spirit became scattered, and hiccups (E Ni) continued incessantly. As a last resort, they administered a dose of Coptidis Rhizoma (Huang Lian). To a nearly severed life connection, they added extreme bitterness to hasten its end. The two physicians were caught off guard and summoned me again. At this point, the pulse was greatly disordered, boiling like soup, changing frequently and pausing intermittently. The patient was unconscious and comatose, body rigid and immobile. Between the nose and philtrum, there was a patch of dark stagnation. Exhalation was smooth, but inhalation caused hiccups. Counting breaths over day and night, totaling 13,500 breaths, there were exactly 13,500 hiccups. The two physicians shifted blame, saying that the Si Jun Zi Tang (Four Gentlemen Decoction) I had previously discussed could now be used. Alas! With life hanging by a thread of respiration, can one still plan leisurely banquets? Answering based on principle, I said: "Qi has exited and does not return. Adding the cloying obstruction of Ginseng and Atractylodis Rhizoma (Bai Zhu) will lead to immediate death. Only Zhang Zhongjing’s Xuan Fu Dai Zhe Shi Tang (Inula and Hematite Decoction) can achieve miraculous results in one out of a hundred cases." After administering one dose, the severity of hiccups decreased slightly. After two doses, the dosage of Hematite (Dai Zhe Shi) was increased to five qian, and the hiccups decreased significantly. He continuously consumed congee, his spirit cleared, complexion brightened, pulse normalized, and body became light. Using Ginseng, Poria (Fu Ling), Ophiopogon (Mai Dong), Chaenomelis Fructus (Mu Gua), and Licorice Root (Gan Cao) to gently regulate for two days, he recovered as before.

This was partly because the Ancestor was simple and unadorned in his youth, retaining the posture of pine and cypress, becoming stronger with age. This was not solely due to the efficacy of the medicine. Even discussing the medicine, it was not the power of Ginseng alone, but the downward-pushing force of Hematite assisting Ginseng. When the Ancestor was critically ill, he asked why I did not come. When he improved and saw me administer medicine, he gathered courage to appreciate it. How deep was his insight! And I was also able to rely on decoctions to perform the duties of filial care. How delightful!

Mr. Hu Youchen said: The *Zuo Zhuan* (*Commentary of Zuo*) has nothing to do with military affairs, yet great generals consider it the essence of military strategy. If one's understanding of principles is insufficient, the application of the mind cannot extend. Alas! It is difficult to speak with vulgar people.