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Ni Qingyun suffered from Ge Qi (obstruction in the chest/diaphragm) for fourteen days. He could not swallow a single grain of rice. Initially, he vomited clear water, then green water, followed by black water, and finally foul-smelling water. His breathing was nearly extinct, and other physicians had given up treatment.

I happened to examine him and promised that he could be saved. However, his family did not believe me. I said, "Give me one full day and night. First, administer six doses of Lizhong Tang (Regulate the Middle Decoction) to prevent his condition from deteriorating to death. Tomorrow morning, we will adjust the prescription; one dose will completely restore his health."

His family said, "The illness has reached this point; not even a drop of water can enter the throat. How can he take six doses of medicine?" I replied, "As long as these sweet and warm medicines enter the mouth, the patient will surely accept them willingly without further need for worry." His sons, some of whom were students and others soldiers, understood the reasoning. They collectively asked, "Since there is an excellent prescription, why not administer it immediately to see results? Why must we use Lizhong Tang first and then proceed with other treatments? What is the meaning behind this?"

I explained, "The *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) states: 'For patients who suffer from persistent belching, Xuanfu Daizhe Shi Tang (Inula and Hematite Decoction) is the primary treatment.' Regarding this specific case, I have two reasons for my sequential approach. Firstly, the black water represents fluid at the bottom of the stomach, and the foul water represents intestinal fluid. Since these fluids are being expelled, it indicates that the stomach's Yin fluids (body fluids) have been depleted for a long time. Therefore, I dare not use Banxia (Pinellia Rhizome), which is drying, as it would further damage the stomach. Secondly, the patient's vital Qi (vital energy) is on the verge of extinction, with only a thread remaining. If I were to use Daizhe Shi (Hematite), a heavy and descending substance, immediately, it might cause the Qi to cut off abruptly. Thus, I must first use Lizhong Tang to regulate Yin and Yang, facilitating the descent of Qi, so that Daizhe Shi can subsequently achieve its miraculous effect. This momentary profound consideration aligns with methods tested over millennia; why doubt it?"

Upon reviewing Zhang Zhongjing's formulas, I noticed that the original prescription used Wei Jiang (Baked Ginger) rather than Gan Jiang (Dried Ginger). Furthermore, considering that Gan Jiang is more drying than Banxia, I hesitated to use it. However, I reasoned: "The belching originates from Qi rising from the Lower Jiao (Lower Burner); the vomiting involves water from the intestines. Yin pathogens have invaded Yang positions. Given the prolonged lack of food intake, numerous Ascaris (roundworms) likely reside in the diaphragm area. Without the pungent heat of Gan Jiang, the worms would not descend, and the rebellious Qi above would not subside either. The subtlety lies here. Why cling rigidly to conventions?" The sons privately remarked, "Words that are grand yet not exaggerated—this physician resembles such a person. Let us try this medicine and observe if it works."

After administration, they indeed requested more medicine. After three doses, the patient could speak, saying, "My internal Qi has slightly connected, but I fear recovery is too rapid. It is prudent to wait until dawn before taking more." The prescription was adjusted appropriately the next morning. However, before taking the next dose, the family invited previous doctors to consult. All physicians strongly opposed it, and the family refused to administer the subsequent three doses. I held a cup of the previous medicine and urged them to administer it, stating, "I will change the prescription right here in front of all these doctors, and effects will be seen instantly. What else can be said?" I prepared a decoction using only Xuan Fu Hua (Flower of Inula), mixed with two teaspoons of Daizhe Shi powder, and gave it to the patient. Upon entering the mouth, the patient said, "Excellent medicine! My Qi has already turned into the Dantian (Lower Elixir Field). I only fear this medicine is hard to obtain." I replied, "It is easy to get."

The patient had not removed his clothes or closed his eyes for fourteen days due to extreme exhaustion. When he attempted to undress to sleep, exposure to cold air triggered another episode of vomiting. Administration of the previous medicine stopped it immediately. He desired congee. Allowed half a bowl, his intense hunger led him to consume two bowls, and shortly after, six bowls. Vomiting recurred, but stopped immediately upon administering the medicine. Later, anger caused him to strike a maid, triggering another bout of vomiting, which also ceased immediately with the medicine. Thereafter, vomiting ceased entirely. He remained extremely fatigued. He took twenty doses of tonic medicines and one jin (approx. 500g) of pill medicine, recuperating for two months before he could travel far. Only then did he regret having taken fewer than the prescribed two doses of Lizhong Tang earlier.

Mr. Hu Youchen stated: "Xuanfu Daizhe Shi Tang has repeatedly achieved miraculous results in medical cases. Yet, physicians are reluctant to trust and use it. By thoroughly reading the preceding and following cases, one will naturally resolve any doubts."