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Congenital Yuan Yang (Primordial Yang) relies entirely on the nourishment of postnatal Qi derived from water and grain. When Stomach Qi is vigorous, it accepts food; Middle Qi can then fill and protect the Zang-Fu organs. Furthermore, Essence is born from grain, and the Yin aspect also borrows this to become abundant. Since food intake has decreased to seven-tenths of the usual amount, how can one not urgently support the Spleen and Stomach?

Patient Gao (Lumu, 20 years old): In youth, the pulse was small and choppy, indicating a Yin syndrome. A mass (Jia) appeared on the left side of the umbilicus, which has gradually enlarged and lengthened over the years; this belongs to the location of the Small Intestine. The Small Intestine has lost its function of transformation and transmission, resulting in bowel movements only once every ten days. However, the Spleen and Stomach constrain the body fluids, preventing them from circulating. Ancient practitioners would certainly use warm unblocking and slow purging methods. As long as the intestinal congestion is cleared without hindering the Spleen (because bowel movements occur only once every ten days, the mass on the left of the umbilicus indeed points to the Small Intestine location; the patient is clever).

Hemp Seed (Cannabis Fructus), Cinnamon Heart (Cinnamomi Cortex), Peach Kernel (Persicae Semen), Rhubarb (Rhei Radix et Rhizoma).
Made into honey pills, take two qian per dose.

Medicines that generally clear intestinal congestion inevitably hinder the Spleen and Stomach because decoctions have a sweeping effect. Now changed into pills, taking only two qian, allowing the medicine to gradually accumulate and flow into the intestines daily. This method of unblocking and draining originates from Pi Yue Wan (Spleen Restriction Pill) (which is Tao Ren Cheng Qi Tang added with moistening intestinal herbs).

Patient Feng (Ningbo, 25 years old): Ulcers appeared on the face; after healing, headache occurred, and the jaw was locked open. The head and face are areas where Yang Qi circulates freely, and turbid Qi is not allowed to remain. After external ulcers heal, pathogenic factors obstruct deeply into the bones and joints. Wind-dispersing medicines only reach the skin and fascia. The Upper Jiao has abundant Qi, but blood-invigorating medicines cannot intervene in the upper meridians (This seems ordinary when explained, yet others cannot articulate it; every word is profound truth).

Horn Needle (Jiao Zhen), Beecomb (Feng Fang), Light Fermented Soybean (Dan Dou Chi), Toothed Soap Fruit (Ya Zao), Sweet Melon Seed (Tian Gua Di), Soybean Sprout (Da Dou Juan).

Reading Tianweng's prescriptions, although intended for patients, the formulation is refined and the discussion thorough. The principles of treatment awaken the deaf and blind of the current era, teaching practitioners where to begin treatment. Those who learn this will have direction and will not panic when a disease presents itself. This is a merit benefiting thousands of generations.

Patient Han (Haizhou, 45 years old): Only the abdomen is distended. The pulse is wiry and empty on the right, and gradually weak on the left. This is distension caused by Yang injury due to chronic fatigue, a complication of long-term illness, unlikely to be cured (The diagnosis is clear and appropriate; treating diseases becomes less ambiguous).

Da Zhen Sha Wan (Great Needle Sand Pill), three qian.

Patient Hua (Nanjing, 22 years old): Long-standing stomach pain, vomiting clear fluid, dry and hard stools. Medication is no longer usable.

Peach Kernel (Persicae Semen), Ginger Juice (Jiang Zhi), Poria (Fu Ling), Corydalis Rhizome (Yan Hu Suo), Pinellia Tuber (Ban Xia), Tangerine Peel White (Guang Pi Bai).

Patient Lu (Taicang, 32 years old): Yin damage leading to Jia and diarrhea, treated with sour astringents and sweet tonics.

Ginseng Root (Ren Shen), Spirit of Poria (Fu Shen), Stir-fried White Peony Root (Chao Bai Shao), Charred Prepared Rehmannia Root (Shu Di Tan), Roasted Licorice Root (Zhi Gan Cao), Schisandra Berry (Wu Wei Zi).
Made into pills with Yam Paste (Shan Yao Jiang).

Patient Zhu (Jingjiang, 25 years old): Hemorrhage since spring; after bleeding stopped, phlegm-cough persisted. The left pulse is fine and rapid, indicating Yin deficiency labor cough. Fortunately, appetite remains unchanged, so...

Prepared Rehmannia Root (Shu Di), Cornus Fruit (Yu Rou), Cloud Poria (Yun Fu Ling), Chinese Yam (Shan Yao), Asparagus Tuber (Tian Dong), Schisandra Berry (Wu Wei), Ophiopogon Tuber (Mai Dong), Donkey-hide Gelatin (E Jiao), Turtle Shell (Gui Ban), Phellodendron Bark (Huang Bo).

Patient Yuan (Lili, 29 years old): Anal ulcer with pus discharge for nearly a year. Qi sinks downward, Jing and Blood are damaged. Tonify the Lower Jiao, assist in firming Yin and clearing heat.

Ginseng Root (Ren Shen), Prepared Rehmannia Root (Shu Di), Lotus Seed Meat (Hu Lian Rou), Sea Cucumber (Hai Shen), Poria (Fu Ling), Phellodendron Bark (Huang Bo).

Patient Shen (Dongshan, 29 years old): Vomiting immediately after eating, prolonged indigestion. Stomach lacks Yang. Turbid Qi rebels upward, failing to descend into the intestines. Stools are hard and obstructed.
Take Ban Liu Wan (Half-Sulfur Pill), one and a half qian.

Heat generates clarity, Cold generates turbidity. Middle Yang is declining, so Yin turbidity rebels from below upwards, causing hard and obstructed stools. Ban Liu Wan is the most slippery and moistening among warming agents. It not only drains turbidity and unblocks Yang but also directs Qi downward and subdues rebellion.

Patient Qian ( Jiashan, 36 years old): Emotional disharmony, disease originating internally. Due to pain, acid regurgitation, and vomiting, Qi rushes when lying down, likely originating from below. Propose to drain Liver Wood to calm Earth.

Evodia Fruit (Wu Yu - soaked), Ginseng Root (Ren Shen), Poria (Fu Ling), Toosendan Fruit Flesh (Chuan Lian Rou), Dried Ginger (Gan Jiang), Pinellia Tuber (Ban Xia - stir-fried).

Patient Gu (Lai'an County, 46 years old): This disease originates from phlegm-fluid retention cough or external cold, triggered by fatigue (Yang Qi is extremely thin). Attacks cause chest and epigastric Qi distension, vomiting of thin saliva and turbid foam. The condition subsides when phlegm thickens and Qi descends. These are turbid fluids accumulating over time. For two years, there has been gradual epigastric stuffiness interfering with eating. At the anus and sacrum, sitting is fine, but standing or walking causes constant sensation of Qi sinking. If there is a sensation of needing to defecate, Kidney deficiency failing to secure is evident. Previously, phlegm-cough was treated via the Lung. If not using acrid release, then cold descending was used, leading to stubborn disease.

Shen Qi Wan (Kidney Qi Pill) added with Walnut Meat (Hu Tao Rou) and Agarwood (Jiao Chen Xiang).

Kidney deficiency causes Qi to fail to return to its origin. It cannot warm and nourish Spleen Yang to transform food, leading to long-term accumulation of fluid pathogens and Yin turbidity. This is Kidney deficiency causing further Spleen deficiency. With Kidney Qi failing to secure, rebellious Qi and fluid overflow cause chest and epigastric distension. Only by securing with Kidney Qi can all symptoms be resolved.

Patient He (32 years old): Wine drinkers often have poor bowel movements. Hemorrhage from running and labor is due to wine and sexual excess. Stopping bleeding and managing cough involves only clearing, descending, and moistening herbs. Voice becomes hoarse daily. Lung萎 (Fei Wei - Lung Flaccidity) and Qi exhaustion make this a difficult-to-treat condition.

Ginseng Root (Ren Shen), Poria (Fu Ling), Coix Seed (Mi Yi Ren), Roasted Licorice Root (Zhi Cao), Bletilla Tuber (Bai Ji), Polygonatum Rhizome (Huang Jing).

This formula tonifies both Spleen and Lung. Due to Lung Flaccidity and Qi exhaustion, it follows the principle of strengthening Earth to generate Metal, attending to both mother and child.

In Si Jun Zi Tang (Four Gentlemen Decoction), Coix Seed replaces Atractylodes Macrocephala Rhizome (Bai Zhu), adding Bletilla Tuber and Polygonatum Rhizome to cultivate the Central Palace. This is the method of strengthening the center to benefit the four extremes.

Patient Jiang (Yancheng, 57 years old): Oppression and discomfort on both sides of the hypochondrium and diaphragm (Disease of the Middle and Upper Jiao). Vomiting with blood. Outside the Zang-Fu organs, there must be collaterals binding together, with blood gathering in the collaterals (Stasis in collaterals gradually forms Blood Ge). Middle-aged exertion consumes Blood. Qi attacking the collaterals brings suffering that is hard to describe. One should promote circulation in the Blood aspect to harmonize collaterals, preventing stasis, thereby avoiding dysphagia and regurgitation (Such accumulated blood is like Xue Lizhai treating Wu Sima's blood stasis between Lung and Stomach).

New Crimson Silk (Xin Jiang), Green Onion Stem (Qing Cong), Tangerine Leaf (Ju Ye), Peach Kernel (Tao Ren), Uncaria Ramulus cum Uncis (Gou Teng), Trichosanthes Peel (Tu Lou Pi).

Liver Qi originally resides in the Lower Jiao; tranquility generates Yang. Movement causes rebellion into the collaterals, leading to blood stasis and long-term changes.
Unblocking collaterals and dispersing stasis, extinguishing wind, regulating Jueyin Blood and Qi, achieves such clarity, agility, and sharpness.

Patient Wu (Dangkou, 46 years old): Yellowish-white complexion, emaciated and spiritless. Abdominal distension with protruding umbilicus, cold and swollen heavy feet. Self-describes feeling like wearing a bag of sand. Previously treated distension with purgatives, which injured Yang (Inserted diagnostic comment), yet distension remained. This is turbid Yin locking closed, severe injury to True Yang. The presentation indicates an untreatable condition. Medication seeks principle: warmth to unblock Yang and drain turbidity.

Raw and Stir-fried Aconite Root (Sheng Chao Fu Zi), Pepper Seeds (Jiao Mu), Stir-fried Dry Ginger (Chao Huang Gan Jiang), Stir-fried Fennel Fruit (Chao Xiao Hui), Plantago Seed (Che Qian Zi).

Injuring Yang injures Foot-Taiyin Spleen and Foot-Shaoyin Kidney. Thus, Raw Aconite, Pepper Seeds, and Stir-fried Ginger are used to warm and unblock Spleen and Kidney Yang. Fennel warms the Bladder (Taiyang organ). Plantago Seed is added to promote urination.

Patient Shen (Changshan, 20 years old): Beating, cursing, loud shouting, and exertion caused Qi rebellion and loss of voice. Although Yin deficiency with brain leakage is present, light and ascending methods should be used to clear the Upper Jiao.

Mulberry Leaf (Sang Ye), Loquat Leaf (Pi Pa Ye), Raw Licorice Root (Sheng Gan Cao), Fritillaria Bulb (Xiang Bei), Coix Seed (Mi Yi Ren), Large North Glehnia Root (Da Bei Sha Shen).

Patient Jiang (Fengqiao, 19 years old): In youth, Yin Fire was unsettled. Emotions easily stirred. Anger and Fire rebelled into collaterals, causing blood to overflow upwards. Appetite is poor. Qi rushing and blood rising require massage to descend Qi. If blood does not retreat from the anal gate, blood displaced in collaterals may coagulate and obstruct. The next day, Qi will surely surge upwards (After blood and Qi stabilize, tonifying Yin is indispensable, focusing on unblocking stasis; insight is mature).

Perilla Seed (Du Su Zi), Agarwood Powder (Xiang Mo), Stir-fried Peach Kernel (Chao Tao Ren), Moutan Bark (Fen Dan Pi - stir-fried), Stir-fried Hawthorn (Chao Nan Zha), Coix Seed (Yi Yi Ren).
Add juice of old leek white parts.

Using medication at this level can be called precise selection.

Patient Cheng (Huizhou, 46 years old): This is a chronic phlegm-fluid disease, triggered by fatigue, anger, and cold (Rooted in Lung and Kidney insecurity). It has lasted ten years and cannot be eradicated.