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Redness of the eyes with blood vessels extending across the pupil.
Swelling or depression of the fontanelle.
Dryness and blackening of the nose.
Mouth opening like a fish's mouth with rapid breathing.
Irregular vomiting of worms.
Diarrhea but with good spirit.
Extreme thirst that does not stop, returning immediately after relief.
No sneezing after blowing medication into the nose.
Severe illness with dry mouth and inability to sleep.
Seasonal epidemic with blue-black spots on the lips.
Deep red cheeks, as if painted with rouge.
Dilated nostrils.
Rapid and irregular panting.

The son of Li Siceng, aged three, suffered from convulsions lasting from Mao hour (5-7 AM) to Si hour (9-11 AM). Several physicians failed to treat him, so Qian Yi was summoned. During convulsions, the child looked to the right and cried loudly. Li said: "When my son has convulsions, he is silent when looking right; when my daughter has them, she is silent when looking left and makes noise when looking right. This is because the left corresponds to Liver and the right to Lung; Liver belongs to Wood and Lung to Metal. In boys, looking right indicates Lung Qi overcoming Liver Qi; Metal punishing Wood causes conflict between the two organs, hence the sound. Treatment should reduce the excess and tonify the deficiency. Heart Excess should also be reduced, but Lung Deficiency must not be reduced. Signs of Lung Deficiency include chest oppression, restlessness, throat choking, and deep sighing. This presentation in a boy mimics a girl's pattern (Lung Deficiency), making it easier to treat than in girls. If a girl looks left during convulsions, it indicates Lung overcoming Liver. If this occurs in autumn, Lung is at its peak, and Liver cannot withstand the restriction, causing crying. One should strongly drain the Lung, then treat the Heart to support the Liver. Thus, all cases of eyes rolling back and staring are due to the Liver governing the eyes. Convulsions result from Wind-Heat battling internally; Wind belongs to the Liver, hence manifested in the eyes. Qian Yi used Xie Fei Tang (Drain Lung Decoction) to drain it. After two days, without chest oppression, it was known that Lung disease had receded. Then Di Huang Wan (Rehmannia Pill) was used to tonify Kidney. After three doses, Xie Qing Wan (Drain Green Pill) and Liang Jing Wan (Cool Spirit Pill) were given, two doses each. When using herbs to drain Heart and Liver, five days are needed for recovery; do not treat recklessly. Why is Lung Deficiency not drained? If a boy looks right, and Wood counter-punishes Metal, with Liver Excess overcoming Lung, only draining Liver is insufficient. If it is spring or summer, Metal Qi is extremely deficient, so one should tonify Lung and never drain it."

Qi Taiwei of Guangqin Residence, aged seven, had tidal fever for several days and was about to recover. Qian Yi told his father, Er Dawang: "Qi Shi's tidal fever is just calming; Ba Shi needs prevention of sudden convulsions." Qian Yi treated him, and he recovered in three days. He had foreseen that straight-looking eyes and red cheeks indicated Heat in both Liver and Heart. Sitting on a stone stool showed a desire for coolness, indicating severe Heat. His body was plump, and pulse was rapid, predicting convulsions. The timing of symptoms from Yin to Wu hours corresponds to the times when Heart and Liver are active. Treatment involved draining Heart and Liver and tonifying Kidney, leading to calmness.

Grandson of Li Sihu, born one hundred days old, had convulsions three to five times. Various doctors diagnosed Tian Diao (Heavenly Hook) or Tai Jing Xian (Fetal Startling Epilepsy) with no effect. Qian Yi administered Da Qing Gao (Great Cyan Ointment), a dose the size of a soybean, to induce sweating. Then applied Xion Fa (fontanelle application) and bathing methods, recovering in three days. Why? Infants have tender bones and muscles; wind injury overwhelms their capacity, causing convulsions. Frequent convulsions indicate mild condition because external wind is internal and triggers convulsions upon weakness. Rare convulsions indicate internal organ disease, which is incurable. Frequent convulsions suit dispersing wind-cold, hence Da Qing Gao. Do not overdose as infants are prone to deficiency and excess; too much generates heat. One dose suffices, plus external treatments.

Son of Wang family in Dongdu, suffered vomiting and diarrhea. Other doctors used purgatives, causing extreme deficiency and transforming into Slow Convulsion Syndrome. Symptoms: sleeping with eyes open, writhing limbs, and cold body. Qian Yi said: "Doctors retained Ba Zheng San etc., taken multiple times without promoting urination, leading to cold body. Ordered Qian Yi to promote urination. Qian Yi said: 'Do not promote urination; doing so will cause cold body.' Wang said: 'Body is already cold, so brought out.' Qian Yi said: 'Cannot eat due to stomach deficiency; promoting urination/stool will cause death. Long-term leads to Spleen-Stomach deficiency, cold body, and closed eyes. Fortunately, prenatal Qi is solid and hard to deplete.' Qian Yi used Yi Huang San (Yellow Guard Powder) and Shi Jun Zi Wan (Quisqualis Pill), four doses, allowing light diet. By noon, he could eat. This is because promoting urination/stool causes Spleen-Stomach deficiency-cold; one should tonify Spleen, not attack further. Later became mute; doctors treated as loss of voice. Qian Yi said: 'If mute, yet opens eyes and eats. Teeth and mouth are not tight; doctors do not understand.' Qian Yi used Di Huang Wan (Rehmannia Pill) to tonify Kidney. Because clearing/draining herbs caused Spleen-Kidney deficiency; now Spleen is solid, Kidney deficient, so tonifying Kidney ensures safety. Spent half a month speaking, one month fully recovered."

Du family of Dongdu pharmacy had a son aged five. Cough started in November, ended late March. Initially coughing with phlegm due to external wind-cold accumulating in Lung. Used pills, Ban Xia Wan (Pinellia Pill), Bian Yin Wan etc. to purge, causing Lung deficiency and worsening cough. Not cured by spring. Qian Yi examined: face pale green. Spring months belong to Liver position, time of Lung decline. Cough is Lung disease. From Nov to Mar, long duration leads to deficiency flaccidity. Purging damaged Mother-Son relationship (Spleen-Lung); Liver overcomes Lung, an adverse pattern. Hence cough, panting, choking, deep sighs. Qian Yi urgently gave Xie Qing Wan (Drain Green Pill), followed by E Jiao San (Donkey-Hide Gelatin Powder) to strengthen Lung. Next day face was dull green; Qian Yi tonified Lung, cough persisted; Qian Yi drained Liver. Draining Liver continued, adding Lung deficiency, lips white as silk. Qian Yi said: "This case is fatal, untreatable. Liver is hyperactive, Lung is deficient-heat. Lung disease occurs out of season while Liver overcomes it. Three drains of Liver failed; three tonifications of Lung failed. Life is short, hence death. If in Autumn, 3-4 out of 10 saved; in Spring/Summer, less than 1 out of 10 saved." Died of severe panting.

Li Gong, Transport Commissioner of Jingdong, had an eight-year-old grandson with cough, chest fullness, and shortness of breath. Doctor said Lung Meridian Heat, used Zhu Ye Tang (Bamboo Leaf Decoction) and Niu Huang Gao (Calculus Bovis Ointment), two doses each. Li Gong reported this. Qian Yi asked: "How to treat?" Doctor: "Clear heat, resolve saliva." Qian Yi: "What heat?" Doctor: "Lung heat causes cough; long cough produces saliva." Qian Yi: "Originally deficiency caused by wind-cold, what heat? If Lung heat, why treat Heart instead of Lung? Zhu Ye Tang and Niu Huang Gao treat Heart." Doctor felt ashamed.

Grandson of Zhang family in Dongdu, aged nine, Lung Heat. Other doctors used Rhinoceros Horn, Pearl, Dragon Bone, Musk, raw Calculus Bovis for one month without cure. Symptoms: cough and panting. Cold medicines used for one month ineffective. Qian Yi said: "Long-term cold medicines cause coldness and anorexia. Children with deficiency cannot eat; tonify Spleen first. Wait for normal diet, then drain Lung. Disease will heal." Took Spleen-tonifying medicine for two days, desired food. Qian Yi used Xie Bai San (Drain White Powder) to drain Lung, cured. Zhang asked: "Why not deficient?" Qian Yi: "Solidified Spleen first, then drained Lung, thus not deficient."

Shi Taiwei of Muqin Palace, skin eruption (smallpox/measles). Doctors treated. Prince said: "Eruption not out. Which Zang organ?" One doctor said Great Heat; another said Cold Damage. Asked which Zang? Doctor: "Spleen-Stomach." Qian Yi: "If Spleen-Stomach, why palpitations?" Doctor silent. Qian Yi: "Fetus in womb, by 6-7 months formed, consumes maternal filth entering Five Zang. By 10 months, stomach full. At birth, mouth has unclean matter. Mother wipes clean, no disease. Common practice uses Coptis juice to press tongue, claiming to remove umbilical feces/phlegm. This is maternal filth entering Zang, originally due to slight cold. Eruption not out, Five Zang show signs, one Zang receives filth. Sudden heat, cold limbs, dry red cheeks, cough/sneeze, all Five Zang signs. Yawning/drowsiness is Liver; sudden palpitations is Heart; alternating cold/heat, cold limbs is Spleen; red face/cheeks, cough/sneeze is Lung. Only Kidney has no sign, located below Fu organs, does not consume filth. All eruptions are Five Zang toxins. If eruption unifies, Liver water blisters, Liver pus, Heart macules, Spleen papules; Kidney does not consume toxin/filth, hence no signs. Black eruption belongs to Kidney, due to careless wind-cold and undernourishment, internal deficiency. Also used Bao Long Wan (Embrace Dragon Pill) several doses to cure. No other signs, so before eruption, Five Zang signs appear; after eruption, unifies to one Zang."

Wu Taiwei of Si Dawang Palace, fell from swing, developed startle convulsions. Doctors used warming herbs, no cure. Qian Yi said: "Originally Acute Startle, later generated Great Heat, must clear heat first." Used Da Huang Wan (Rhubarb Pill), Yu Lu San (Jade Dew Powder), Xing Xing Wan (Bright Star Pill), plus Calculus Bovis, Dragon Bone, Musk to resolve. No cure. Day 3, skin hot. Qian Yi: "Two more days without cure, will develop macules. Heat cannot exit. Other doctors used diaphoretic herbs initially; diaphoresis enters exterior, exterior heat generates macules. Originally at startle, should use purgative to drain startle; diaphoresis is contrary." Two days later, macules appeared. Treated with Bi Sheng Gao (Invincible Ointment), cured in seven days.

Da Wang of Muqin Residence, skin eruption. Initially treated by Doctor Li, then Qian Yi summoned. Qian Yi prescribed Bao Long Wan three doses; Doctor Li used purgatives. Eruption dense. Qian Yi said: "Purgation is acceptable. But use mild herbs, frequent milk/food, avoid wind-cold. If eruption doesn't appear in three days or slow, slightly induce; if slight induction fails, add medicine; if still no, strongly induce. If strong induction yields few, and pulse/cases are calm, eruption was sparse, do not induce again. High heat: promote urination. Low heat: resolve toxicity. If erupting well, do not induce or purge; hence only Bao Long Wan used. If scabs form and can eat, Da Huang Wan one-two stools then stop. Now purged one day early, eruption not complete but very dense, difficult to treat, this is error. Even if safe, three diseases remain: scabies, carbuncle, red eyes. Doctor Li couldn't treat; after three days, black sinking, Qian Yi summoned again. Qian Yi: "Lucky no cold, disease not exhausted." Used Bai Xiang Wan (Hundred Auspicious Pills) assisted by Niu Li Gao (Ox Plum Ointment). Black returns to Kidney. Kidney overcomes Spleen, Earth cannot control Water, hence Spleen deficiency cold tremors are hard to treat. Bai Xiang Wan drains Bladder Fu; if Fu not solid, Zang naturally not excessive. Why not drain Kidney? Kidney governs deficiency, cannot be drained. If two doses fail, add..."

Son of Xu family in Huangdu, aged three, tidal fever, convulsions every evening, slight body heat, slight eye deviation, eyes open showing whites, cold limbs, panting, stool... Qian Yi asked: "Why eye deviation/open eyes?" Answer: "Convulsion causes deviation. Why cold limbs?" Answer: "Cold reversal implies internal heat. Why panting?" Answer: "Severe convulsion. How to treat?" Answer: "Tian Jing Wan (Startle Calming Pill) instilled in nose, convulsions will stop." Qian Yi asked: "Since wind disease, warm/strong convulsions, deviation/open eyes, internal heat/cold limbs, severe panting, what medicine treats all?" Doctor Li: "All this medicine." Qian Yi: "Incorrect. Convulsions are Liver Excess. Evening slight heat is Lung tide active. Lung governs body; warmth/heat indicates Lung Deficiency. Deviation/open eyes is Liver-Lung conflict. Cold limbs is Spleen Deficiency. If Lung very deficient, use Yi Huang San, E Jiao San. After Spleen deficiency signs recede, use Xie Qing Wan, Dao Chi San, Liang Jing Wan. Recovered in nine days."

Son of Zhu Jianbu, aged five, night fever, normal morning. Doctors treated as Cold Damage or Heat, cold medicines failed. ... Bai Zhu San powder decocted one liang, juice three sheng, drink as desired. Zhu Sheng asked: "Will drinking much cause diarrhea?" Qian Yi: "Without raw water, no diarrhea; even if loose, not strange, just don't purge." Zhu Sheng: "Which disease to treat first?" Qian Yi: "Stop thirst, resolve phlegm, clear heat, clear interior, all this medicine." Finished by evening. Qian Yi checked: "Can take three more sheng." Decocted another three sheng, finished, recovered. Third day took three sheng, no thirst/phlegm. Then E Jiao San, two doses cured.

Son of Zhu Jianbu, aged three, sudden fever. Doctor: "Heart Heat, red cheeks/lips, irritability, drinking." Used Niu Huang Wan three doses... Yellow stool mush? Answer: "Stomach Qi correct, diarrhea stops itself, this is Deficiency Heat." Zhu: "What about Xie Xin Tang (Drain Heart Decoction)?" Qian Yi: "Xie Xin Tang contains Huang Lian, nature cold; long use causes diarrhea, chills Spleen-Stomach." Sat long, other doctors arrived, said Excess Heat. Qian Yi: "Deficiency Heat. If Excess, why Xie Xin Tang didn't settle, added yellow face/red cheeks, five-center irritability, anorexia/thirst?" Doctor: "If Deficiency Heat, why yellow stool mush?" Qian Yi laughed: "Yellow stool mush is due to excessive Xie Xin Tang." Qian Yi later cured with Hu Huang Lian Wan (Picrorhiza Pill).

Three sons of Zhang family ill. Oldest: sweat all over; second: head to chest; youngest: forehead only. Doctors used Mai Jian San, ineffective. Qian Yi: "Oldest: Xiang Gua Wan (Melon Pill); Second: Yi Huang San; Youngest: Shi Gao Tang (Gypsum Decoction)." Each cured in five days.

Wu Taiwei of Si Dawang Palace, Guangqin Residence, continuous vomiting/diarrhea, undigested food/grain. Doctors used tonics with ginger juice. In June... took together. Doctors said: "Vomiting/diarrhea with undigested grain requires Spleen tonification, why cold medicine?" Prince believed doctors, used Ding Xiang San three doses. Qian Yi arrived late: "Do not take this. After three days, abdominal fullness, body heat, drinking, vomiting/regurgitation." Three days later, exactly as predicted. Reason: June heat severe, hidden in abdomen causing thirst; heat damages Spleen-Stomach, causing severe vomiting/diarrhea. Other doctors used warming herbs, Upper Jiao also hot, hence panting/thirst, death in three days. Doctors couldn't treat, summoned Qian Yi to palace, saw Heat signs, used Bai Hu Tang (White Tiger Decoction) three doses, then Bai Bing Zi (White Cake Pills) to purge. Reduced dose by two fen day one; days two-three, Bai Hu Tang two doses... Brain, Musk, Calculus Bovis, Tianshu Huang, Poria, cinnabar-coated, five pills.

Son of Feng Chengwu, aged five, vomiting/diarrhea, high fever, anorexia. Qian Yi: "Less black iris, more white sclera, pale face, timid spirit. Less black iris indicates Kidney Deficiency. Black iris belongs to Water, originally timid/deficient, hence often ill. Even growing up, muscles not strong, intolerant to cold/heat, prone to deficiency/excess, Spleen-Stomach also weak. Must not indulge desires; if not maintained, die before prime age, face lacks luster like women with blood loss. Now vomiting/diarrhea/anorexia/high fever is Food Injury, cannot purge. Purging sends deficiency to Lung (cough), Heart (startle), Spleen (diarrhea), Kidney (worse deficiency). Use Xiao Ji Wan (Eliminate Accumulation Pill) to grind, slight food accumulation. If severe food injury, can purge; if not, becomes mass. Solid food inside can be purged; after finishing, tonify Spleen, must heal. Follow deficiency/excess, no failure."

Qi Taiwei of Guangqin Palace, aged seven, vomiting/diarrhea. July. Symptoms: total anorexia, lethargy, waking restless, choking, dry heaving, intermittent stool, no thirst. Doctors treated as Startle, suspecting sleep. Qian Yi: "Tonify Spleen first, then clear heat." Gave Shi Jun Zi Wan to tonify Spleen; Shi Gao Tang to clear heat. Next day used Mercury and Sulfur to purge, mixed with ginger water, one zi dose. Qian Yi: "For vomiting/diarrhea, within May, nine parts purge, one part tonify; within August, ten parts tonify, zero purge. This is Spleen Deficiency Diarrhea. Doctors treated recklessly, leading to deficiency damage; purging causes death. Should tonify Spleen immediately. Shi Jun Zi Wan would be gentle. Qian Yi left Wen Wei Yi Pi (Warm Stomach Tonify Spleen) medicine to stop. Doctor Li Sheng asked: 'Why dry heaving after eating?' Qian Yi: 'Spleen deficiency cannot eat; little fluid causes regurgitation.' Asked: 'Why green-brown water stool?' Answer: 'Intestines extremely deficient, extreme cold.' Qian Yi cured."

Son of Huang Chengwu, aged two, diarrhea. Doctors stopped it, ten days later: green-white stool, undigested milk, cold body, choking, lethargy. Doctor said critical. Qian Yi first gave Yi Pi San three doses, Bu Fei San three doses. Three days later, warm body, no choking. Then Bai Bing Zi mildly purged, Yi Pi San two doses, diarrhea stopped. Why? Diarrhea originally Spleen Deficiency Food Injury, initially did not strongly purge. Placed ten days, upper excess lower deficiency, Spleen Qi weak, affecting Lung deficiency. Tonifying Spleen-Lung, disease recedes, warms, no choking. Has food injury, still purged. Why not purge then tonify? Answer: Green stool indicates lower organ cold; purging first causes great deficiency. First solidify Spleen-Lung, then purge without deficiency, then tonify again.

Da Wang of Muqin Palace, skin eruption. Said eruption always appears, no other signs, cannot purge, use mild herbs, frequent milk/food, avoid wind-cold. If eruption not out in three days or slow, slightly induce. If eruption not many after inducing, add medicine; if add medicine no eruption, strongly induce. If after inducing not many, pulse calm no signs, eruption sparse, do not induce again. High heat: promote urination. Low heat: resolve toxicity. If not fast, do not induce/purge, only Bao Long Wan. If scabs form and can eat, Da Huang Wan one-two stools then stop. High heat: promote urination. Low heat: resolve toxicity. If black-purple dry sinking, Bai Xiang Wan purge; if not black, severe, do not purge. Body heat irritability, abdominal fullness panting, difficult urination/stool, red face/restless severe vomiting, this promotes urination. If not better, Xuan Feng San purge. If 5-7 days scabs not dry, internal heat steams skin, scabs cannot dry. Use Xuan Feng San to guide, raw Rhinoceros Horn juice to resolve, ensuring scabs form.

Daughter of Xin family, aged five, worm pain. Doctors used Croton Seed, Dry Lacquer, Realgar etc., ineffective. After five days, crying, supine sleep uneasy, pressing heart/abdomen, occasional loud cry. Face colorless, varying blue/yellow/white/black, dull eyes, white lips foaming. Day six, high chest, lying uneasy. Summoned Qian Yi, examined carefully. Used Wu Yi San (Chelidonium Powder) three doses, saw eyes still blue, greatly alarmed: "Disease critical, if more diarrhea, adverse." Next day, Xin saw Qian Yi: "Midnight indeed diarrhea." Qian Yi looked in basin, like medicine juice, stirred with stick, saw pill fragments. Qian Yi: "Child flesh thick should be Qi Excess, now signs opposite Deficiency, untreatable." Xin repeated. Asked why? Qian Yi: "Spleen deficiency/Stomach cold causes worms moving, now eyes blue, Liver overcoming Spleen, plus diarrhea, knows Qi extremely deficient. Pill fragments follow stool, Spleen-Stomach detached, shape/sign mismatch, hence death disease. Five days later critical coma, died on seventh day."