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[Background Information]
Book: *Xu's Commentary on Ye Tianshi's Late-Life Prescriptions (Authentic Edition)*
Author: Ye Tianshi
Dynasty: Qing
Chapter: Renshen Jianzhong Tang / Zhuye Dihuang Tang / Suhexiang Wan
Category: Formulas

[Original Text Translation]

Zhu (Xinkaihe Bridge, 16 years old): The body is emaciated and the complexion sallow. Fever arises during Yin hours. In his prime, summer heat prevailed; True Yin failed to generate. Autumn dryness aggravated coughing. This condition is most prone to cause consumptive debility.

Li (36 years old): Turbid filth is knotted in the middle jiao. Thirst with drinking leads to vomiting.

Currently, when people are exposed to turbid miasma, they often resort to *Gua Sha* (scraping). *Suhexiang Wan* (Styrax Pills) far surpasses other medicines, but frequent use makes it overly potent/heavy.

Cheng (47 years old): Muscle color is pale white. Pulse is wiry on the right and slow/weak on the left. Stool has been loose for a long time. Belching and hiccups cease not. Previously, due to vomiting roundworms, sour and bitter herbs were used to harmonize the stomach and regulate the liver. The patient reported that after taking the medicine, he had no appetite and felt fullness/stuffiness in the epigastrium. This indicates weak Yang of the Middle Palace (Spleen/Stomach), and the taste was too sour and turbid. Sour and bitter belong to Yin, so they did not target the disease. It is proposed to move the Yang Qi of the Middle Jiao. Pungent flavors can overcome sourness. (Commentary: If one does not know how to transform and adapt medications, one will inevitably damage the Yang of the Spleen and Stomach first. Only a very flexible practitioner can enter the Dao [of medicine].)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Yizhiren (Alpinia Oxyphylla Fructus), Shengjiang (Fresh Ginger Rhizome), Huluba (Trigonella Foenum-graecum Seed), Houpo (Magnolia Officinalis Bark).

Li (Qianjing, 21 years old): Engaged in farming labor, all meridians and collaterals throughout the body were active. Carrying heavy loads in summer led to blood loss twice. Moreover, there was prior bloody diarrhea. Blood gathered in the collaterals; collaterals are the outer shields of the Zang-Fu organs. Stillness nourishes blood and calms it; it must take one year to consolidate. (Commentary: Blood gathers in collaterals, so circulating drugs are not used because bleeding occurs above and below; using blood-moving drugs again is inadvisable. Tonification will achieve its effect naturally.)
Shudi (Prepared Rehmannia Root), Guishen (Angelica Sinensis Root Body), Qizi (Lycium Barbarum Fruit), Shayuanzi (Astragalus Complanatus Seed), Fuling (Poria), Shanyao (Dioscorea Opposita Rhizome), Duzhong (Eucommia Ulmoides Bark), Bajitian (Morinda Officinalis Root), Chuanhu (Dendrobium Nobile Stem).

Xu (18 years old): Emission occurs with dreams. This is Heart movement causing Spirit to wander and Essence to scatter. Use the method of communicating Heart and Kidney.
Shudi (Prepared Rehmannia Root) boiled in water, Yurou (Cornus Officinalis Fruit), Yuanzhi (Polygala Tenuifolia Root), Sheng Longgu (Fossilized Mammal Bones), Fushen (Poria with Hostwood), Shichangpu (Acorus Tatarinowii Rhizome), Qianshi (Euryale Ferox Seed), Xianglianrou (Lotus Seed Embryo).
Medication is profound and subtle.

Gu (23 years old): Every-third-day malaria (*Sanri Nue*) erupts by entering the Yin meridians, lasting several months before subsiding. The malaria heat is interior, robbing and damaging Liver Blood and Kidney Essence. During the late summer, the generation of Yin did not recover, leading to added chills, fever, and sweating. This disease injures and becomes consumption (*Lao*). Flesh wastes away, form becomes soft. One must abstain from sexual desire to generate Essence and Blood, which has the principle of replenishment. Herbs and grasses are emotionless and useless here. (Commentary: Malaria pathogens cannot be forcibly arrested. Arresting them stops chills and fever temporarily, but latent pathogens remain, forcing and burning Essence and Blood, leading to inevitable discomfort. Over time, pathogens cannot reach the exterior, Essence and Blood daily diminish, day by day deepening, inevitably extending into consumptive injury.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Hechejiao (Placenta Gelatin), Fushen (Poria with Hostwood), Yurou (Cornus Officinalis Fruit), Wuwei Zi (Schisandra Chinensis Fruit), Qianshi (Euryale Ferox Seed), Shanyao (Dioscorea Opposita Rhizome), Jianlian (Lotus Seed).
Chen Qishan also died from this; an exact argument.

Cao (21 years old): Voice originates from the Lung, relying entirely on the vigor of Yuan Sea (Kidney) Qi, allowing Yin within Yang to bear upwards, so voice naturally resonates. After eating persimmon cakes, vomiting ensued. Examining their nature: sweet and cold, clearing Lung heat. However, deficient cough and scattered Qi do not accept it. Renshen and Gancao are sweet and warm, and have shown efficacy. For a man in his fifties, Lower Yuan declines daily. Metal and Water share the same source. Complexion is sallow, withered, lacking luster. It is entirely Lower Deficiency and Upper Excess. Fortunately, food intake continues, preventing sudden catastrophe. Over years and months, how can there be quick success?
Ejiao (Donkey-Hide Gelatin), Tiandong (Asparagus Cochinchinensis Root), Heidoupi (Black Soybean Skin), Jizihuang (Chicken Egg Yolk), Dashengdi (Rehmannia Glutinosa Root).
After twenty doses, take Liuwei Dihuang Wan plus Wuwei Zi and Chuanhu.

Wang (50 years old): Visceral Truth is connected to the eyeballs, not just the Liver orifice. Middle age: Five Fluids are insufficient. Yang carries internal Wind, invading clear orifices. Brightness is obscured by Yang turbidity, not caused by Six Qi pathogenic factors. Method should be sour-astringent and sweet-slow tonification. However, Liuwei Dihuang Decoction is ultimately a balanced formula for Three Yin and Three Yang, not fitting precisely. (Commentary: Excess requires ascending Clear and descending Turbid; Deficiency requires sour-astringent and sweet-tonifying. This is the major method for treating photophobia and dim vision.)
Chaoji Gouqi (Charred Lycium Barbarum Fruit), Juhua Tan (Chrysanthemum Charcoal), Yurou (Cornus Officinalis Fruit), Wuwei Zi (Schisandra Chinensis Fruit), Renshen (Codonopsis Ginseng Radix et Rhizoma), Zhigancao (Honey-fried Licorice Root).
Photophobia eye disease, though related to internal injury, has causes that cannot be exhausted in one aspect. Some initially contract seasonal pathogens, wind-fire disturbs, causing photophobia. Some have Yang carrying internal wind, brightness disturbed by turbid Yang, causing photophobia. Some have turbid Yin from Lower Jiao floating upward, daring not oppose sunlight, causing photophobia.

Sun (Beihao, 26 years old): Qi stagnation prevents Blood flow; must regulate Qi within Blood.
Nanzha (Southern Hawthorn Fruit), Sheng Xiangfu (Raw Cyperus Rotundus Rhizome).
Separately decoct Siwu Tang, incorporate into it, bake, fry, and grind into powder. (Commentary: Formula formulation is extremely ingenious.)
Yimuao Wan (Motherwort Paste Pills). Siwu Tang is Yin, turbid, and stagnant; obtaining Zha and Xiangfu allows circulation. Zha and Xiangfu are Qi-dry and pungent; obtaining Siwu Tang provides moistening. Both Qi and Blood are regulated; dryness and dampness harmonize. Further benefiting from Motherwort to move Blood, Qi within Blood becomes smooth. Even with Phlegm stagnation and Blood coagulation, it can be taken.

Xu (24 years old): Initial diagnosis noted edema of the lower jiao ankles and heels. Using methods to secure/restrain Liver and Kidney diseases provided relief. But chest and epigastrium were not comfortable. Changing to open and drain Qi in Blood caused discomfort again. Face lacked luster, stuffiness felt like hunger. Should be discussed as Deficiency. No quick success. (Commentary: Shift in hierarchical approach.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Guixin (Cinnamon Twig), Fuling (Poria), Chao Danggui (Fried Angelica Sinensis Root), Weijiang (Baked Ginger), Zhigancao (Honey-fried Licorice Root).

Wu (34 years old): Managing household complexities, accompanied by anger. Liver and Spleen disharmony. Distension extends from hypochondrium to epigastrium. Wood invades Central Earth, hindering appetite and causing lack of hunger. Regulate Qi, soothe depression, harmonize the Middle Palace. (Commentary: Resolving depression always involves Yueju method.)
Nanzha (Southern Hawthorn Fruit), Sheng Xiangfu (Raw Cyperus Rotundus Rhizome), Shenqu (Medicated Leaven), Fuling (Poria), Gouteng (Uncaria Rhynchophylla Hook), Juhong (Citrus Reticulata Pericarpium Rubrum).

Zhao (33 years old): Epigastric pain radiating to the spine, even extremities become cold. Asked about postpartum mass and diarrhea in the past, now stagnation and leakage with spinal soreness and heaviness. *Neijing* states: Yin Wei Mai disease suffers from heart pain. Physicians do not harmonize the Wei Mai, treating Yin and Yang differently. To treat pain by breaking and descending Qi, how shallow is such insight! (Commentary: For women with chronic epigastric pain, it must originate from the Extraordinary Vessels. Once used one jin of Lurongjiao [Deer Antler Gelatin] to treat fourteen years of unceasing epigastric pain.)
Lurong (Deer Antler without Bone), Jiaoshuang (Deer Antler Frost), Danggui (Angelica Sinensis Root), Xiaohui (Fennel Fruit), Gouqi (Lycium Barbarum Fruit), Baijili (Tribulus Terrestris Fruit), Fuling (Poria), Congrong (Cistanche Deserticola Stem).

Shen (32 years old): In prime of life, complexion shows flesh wasting. Pulse fine on left, empty on right. This is Essence damage in men, True Qi failing to govern reception and storage. Self-reported pounding Qi sensation and pain in lower abdomen. Disease form, pulse, and symptoms are already in the Lower Jiao. Treating Lung cough is a great error. Miscellaneous treatments prolong consumptive debility daily. (Commentary: Pounding Qi in lower abdomen indicates extreme deficiency of Guan Yuan and Qi Hai; Ming Di True Qi has dispersed, irretrievable,窜ming upwards from below. Method is untreatable.)
Xueshi Bawei Wan (Xue’s Eight-Ingredient Pill) (3 qian).

Jin (65 years old): Heat injures Qi level. Dampness from undigested water and grain remains in Stomach collaterals. Autumn coolness has arrived. Declining years, Qi is weak. Summer latent pathogens have not gone.
Propose Dongyuan’s Qing Shu Yi Qi (Clear Summerheat and Benefit Qi), removing cloying drugs. (Commentary: Always, those with vigorous constitution contracting seasonal biased Qi have original Qi to rotate the seasonal biased Qi, silently transforming it. In declining years with weak Qi, external pathogens dominate.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Shenqu (Medicated Leaven), Shengma (Cimicifuga Racemosa Rhizome), Gegen (Pueraria Lobata Root), Zexie (Alisma Orientale Rhizome), Guangpi (Citrus Reticulata Pericarpium), Mugua (Chaenomelis Fructus), Chuanlian (Coptis Chinensis Rhizome).

Zhao (23 years old): In youth, Jue syndrome was cured by filling Essence and securing retention. Knowing that in youth/prime, emotional thoughts arise internally, Yin Fire erupts, disturbing Spirit/Mind. This summer, heat reduced appetite, Jue occurred, followed by turbid urine. Heat entered injuring Yin. If not abstaining from desire, efficacy is unlikely. (Commentary: Injuring Yin, heat enters and damages Stomach Yin. Do not be deceived.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Fuling (Poria), Bian Dou (Lablab Album Seed), Zhigancao (Honey-fried Licorice Root), Chao Maidong (Fried Ophiopogon Japonicus Root), Chuan Shihu (Dendrobium Nobile Stem).
Yin Fire best disturbs Spirit/Mind. Observe lamp wick coal head: falling with fire, flame rushes up, fire on cup shakes restlessly. Is this not a clear proof?

Liu (37 years old): Mental exertion disturbs Heart Yang, secretly consuming fat/fluids. Above: palpitations, fright, Qi timidity. Below: intestines dry, difficult stool. Complexion dark, flesh thin. Warm tonification not accepted. First imitate Xu Zhicai’s “Slippery can remove astringency.” (Tailors cut according to body; those holding responsibility for life, should they not treat according to person? This dark complexion and thin flesh, why not using warm tonification is high.)
Baiziren (Biota Seed Songtan), Songziren (Pine Nut), Yuliren (Apricot Kernel Prunus Armeniaca), Dongkuizi (Malva Verticillata Seed), Dusuzi (Perilla Fructus), Mahren (Hemp Seed).
Using these seeds pleases Heart, further nourishes Intestine fluids. Precise and pure, passing the golden needle secretly.

Zhu (16 years old): Night fever persists. Tongue crimson, body dry. Previous discussion: Latent Summerheat injuring Yin. Used Zhuye Dihuang Tang without response. This is congenital thin endowment. At Summer Solstice, Yin does not generate. Yin Deficiency generates Heat, forming signs of Consumption. (Commentary: Cooling without cooling means no Water.)
Sancai Tang plus Danpi (Moutan Cortex) and Guipi (Phellodendron Bark).

Zhao (57 years old): Dizziness and heart palpitations for twenty years. Approaching old age, Blood consumed, Yang transforms into Internal Heat. Recently reduced food intake. Do not lean towards cold or hot. Use sweet-soft to slow heat and extinguish wind, avoiding dry-heat damaging Stomach. (Commentary: Good Yang Qi, once Blood is consumed, transforms into Internal Heat. This is a variation of Yin Deficiency generating Internal Heat. Very new.)
Guiyuan (Longan Aril), Gouqi (Lycium Barbarum Fruit), Tiandong (Asparagus Cochinchinensis Root), Shengdi (Rehmannia Glutinosa Root), Fushen (Poria with Hostwood), Baiziren (Biota Seed Songtan).
Sweet-soft medicinal flavors are mild, can slow heat and extinguish wind. Sweet generates fluids, Soft nourishes Yin. Key regulation for elderly. Elderly with chronic illness must fully support Stomach Qi. All miscellaneous inferior medicines must not be administered, as they damage Stomach Qi.

Tao (29 years old): Summerheat adhering blocks wandering Qi. Only heat, no chills. Sores not healed. Pathogen causes joint pain, limb swelling. Follow Zhongjing’s Wet-Warm example. Use Cangzhu Baihu Tang.

Yang (26 years old): Pulse void and rapid. Chronic cough with spurting blood. Labor induces chills and fever.
Hujian Wan (Tiger Crouching Pill) (4 qian).

Gu (22 years old): Young and strong. Winter did not store Essence. Mid-Spring internal heat summons Wind. Called Wind-Warm. Cough internal injury, slightly combined with external pathogen. Treating pathogen must combine nourishing Righteousness. (Commentary: Elegant and suitable.) Ancients said Warm Pathogens forbid sweating and purging, meaning Yin and Yang Qi cannot be injured again. One reversal, then another, disease deepens daily. Complexion yellow-white lacking luster. Pulse shape extremely void, sinking to Chi position. (Observation of color and cutting pulse is extremely detailed.) Asking: Frequent cough, Qi not舒展 (comfortable), must have nausea/vomiting. Obviously Kidney Deficiency, poor intake. Liver Yang and Yin Fire rush up, invading Stomach causing vomiting, steaming Lung causing throat itch. Not causing sudden catastrophe relies on water/grain not decreasing, safely received. Examining: Blood must gather in collaterals. Qi attacks, heat burns, collateral blood surges upward. Essence and Blood tangible damage. Herbs/grasses emotionless cannot regenerate. Blood loss benefits Qi, urgently consolidating the acute. Treatment method: Calm mind, quiet spirit. Must emotional thoughts not arise, abstain from desire, Kidney safe, thus Essence and Blood generate/gather. If frequent and unceasing, even peaceful nourishment cannot expel disease. (Commentary: Wind-Warm although due to external contraction, necessarily Liver/Kidney internal deficiency. Winter not storing Essence, Minister Fire flows upstream, summoning external pathogens, Warm pathogens sink interior, dragging Dragon/Thunder. Latent interior burns fluids/juices. Rushing upward causes cough and blood loss. Purely seeing internal injury evil signs.)
Renshen (Codonopsis Ginseng Radix et Rhizoma), Shudi (Prepared Rehmannia Root), Chuanhu (Dendrobium Nobile Stem), Wuwei Zi (Schisandra Chinensis Fruit), Nvzhenzi (Ligustrum Lucidum Fruit), Fushen (Poria with Hostwood), Piaotan Tian Dong (Float-washed Asparagus Root), Ziyi Hutao Rou (Purple-skin Walnut Kernel).
Sancai Tang plus receiving/gathering, assisting with filling Yin.

Chen (16 years old): Autumn Dryness Cough.
Sangye (Mulberry Leaf), Chuanbeimu (Fritillaria Cirrhosa Bulb), Nanshashen (Adenophora Stricta Root), Nan Huafen (Trichosanthes Kirilowii Root Powder), Yuzhu (Polygonatum Odoratum Rhizome).

Xiao (21 years old): Latent Summerheat constrained upward.
Lianqiao (Forsythia Fruit), Fei Huashi (Flying Talc), Da Zhuye (Large Bamboo Leaf), Bai Xingren (White Apricot Kernel), Xiangbei (Fritillaria Thunbergii Bulb).
Formulas and medicines are all exquisite and subtle.

Zhang (Fengmen, 69 years old): Elderly, Lower Deficiency, much Phlegm. Entering night, Chong Qi rises (This is Yang not returning inward). Rising/sitting, new coolness invades internally. Kidney Water floods, Qi not received/stored. Often takes Shenqi Wan.