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In the three Yang meridians, Shaoyang (Lesser Yang) serves as the pivot. Under normal conditions, it ascends clear qi to the orifices; through the rotation of this pivot mechanism, it facilitates the ascending of clear and descending of turbid substances, and regulates the distribution of the Sanjiao (Triple Burner). These are all physiological phenomena. After an illness, if the clear yang qi is weak and one forces physical labor, the qi aspect is injured, causing the pivot mechanism to lack strength and lose its regulatory function.

Patient Gu (from Fengmen), although bleeding has stopped, not only experiences recurrent bleeding in winter but also suffers from choking cough, rising fire, exterior cold, and interior heat. Winter is the season for hibernation, storage, and the gathering of spirit. If a young person fails to preserve and store essence during this time, instead allowing leakage and dispersion, it indicates that the kidney yin and liver yin are internally deficient. The yang qi flickers and self-consumes. Using herbal medicines to tonify yin merely temporarily blocks the gaps of deficiency, preventing jing (essence) and blood from being nourished and calmed. One must employ subduing methods and abstain from sexual desires; remaining symptom-free for one hundred days is considered correct, whereas frequent relapses will surely be fatal. (True water nourishes true fire. Winter is when all things return to their roots. When yang qi is internally stored within yin due to negligence and injury, true fire flares alone, causing true water to dry up further. By spring, when wood qi is vigorous and yang ascends, warm-heat diseases become rampant.)

Prescription: Shu Di Huang (Prepared Rehmannia Root, charred), Fu Shen (Poria with Hostwood), Yu Rou (Cornus Fruit), Wu Wei Zi (Schisandra Berry), Hu Lian (Lotus Seed from Huzhou), Qian Shi (Euryale Seed), Nv Zhen Zi (Ligustrum Lucidum Fruit), Chuan Huo Zhu (Dendrobium Officinale Stem).

It is not only that fire qi is latent inside, simmering jing and blood, but also that by the following spring, water fails to nourish wood, leading to excessive blazing of Shaoyang Ministerial Fire. In cases of yin deficiency, fire inevitably rises, causing choking cough and hemoptysis; such outcomes were inevitable at that time.

Patient Yu (from Jintan, 26 years old), wind-heat pathogen injured the defensive yang qi. The use of dispersing and ascending herbs further disturbed the yang, causing blood to exit via the yang collaterals. The physician used Da Huang (Rhubarb Rhizome) to purge stasis downward. Downward purging further injured the yin, resulting in loss of appetite, epigastric fullness, sticky phlegm, and absence of thirst. Urgent spleen-awakening and stomach-supporting measures are needed, followed by clearing-cold treatment for the cough. There is no hope for recovery. (Defensive qi corresponds to Stomach qi. When defensive yang is injured, the yang of the Spleen and Stomach must be urgently awakened. One should treat the root cause of hemorrhage, without focusing solely on the blood aspect. Treating the root causes the branch symptoms to resolve spontaneously, unlike contemporary practitioners who treat blood merely because there is bleeding.)

Prescription: Ren Shen (Ginseng Root), Bai Shao (White Peony Root), Sheng Yi Zhi Ren (Raw Alpinia Oxyphylla Fruit), Fu Ling (Poria), Zhi Gan Cao (Honey-fried Licorice Root), Guang Chen Pi (Aged Tangerine Peel).

After taking ten doses, continue with Yi Gong San (Four Gentlemen Decoction plus Atractylodes Macrocephala Rhizome). (The blood originated from the Stomach, unrelated to the Lung or Kidney; hence, the treatment differs.)

The Stomach is the sea of abundant qi and blood, governed by the Spleen. Therefore, young people who suffer hemorrhage due to sexual excess must urgently consolidate the Spleen and Stomach over time, allowing essence to be generated from grain, thereby gradually tonifying the Liver and Kidney. How much more so in cases where wind-heat injures yang, and dispersing/ascending methods are used again, causing yang insecurity and upward hemorrhage? How can medical treatment be uniform and formulaic!

Patient Zhang (29 years old), labor fatigue injured the yang qi. (This directly points out the key issue, achievable only by experienced physicians, and should not be dismissed as cliché.) At a prime age, one should naturally maintain rest and preservation; with robust qi, recovery will occur.