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Chen (Zhapu, 50 years old) Swallowing solid food causes no pain, but swallowing water inevitably feels obstructed. This indicates pathology in the Qi aspect of the Lung. The Lung resembles an empty suspension and governs exhaled air; Qi stagnation generates heat. The treatment method should be to clear and purify the Qi aspect. (The syndrome differentiation is extremely detailed and precise, utilizing herbs that regulate the Qi aspect.)
Lianqiao Xin (Forsythiae Fructus Calyx), Huashi Kuai (Talcum), Niu Bang Zi (Arctii Fructus), Sheng Gancao (Glycyrrhizae Radix et Rhizoma Prepared), Nan Huafen (Trichosanthis Radix), Pipa Ye (Eriobotryae Folium).

Zhang (64 years old) Despite advanced age, he continues to manage business affairs. Mental fatigue and overwork have injured the Ying (Nutritive) aspect, causing heart pain radiating to the back. The physician used Fuzi (Aconiti Lateralis Radix Preparata), resulting in severe pain, indicating that harsh and rapid-acting drugs are unsuitable.
Fuling Guizhi Tang (Poria and Cinnamon Twig Decoction) without Shaoyao (Paeoniae Radix Alba).
Although *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) mentions "heart pain penetrating the back, back pain penetrating the heart" treated with acrid-hot drugs like Wutou (Aconiti Radix) and Fuzi, one must carefully examine if it is deficiency-cold in the Qi aspect and not in the Ying-Blood aspect before direct use. If the disease is in the Ying aspect, dryness has injured Yin fluids.

Zhu (22 years old) Summer heat and autumn dryness have injured the Qi aspect, causing chest fullness, frequent belching, and dry stool constipation. For upper jiao dryness, clear the Lung; do not use heavy, cloying, or descending-tonic methods. (Distinguishing whether a disease is in the Qi or Blood aspect upon first encounter is a hallmark of skilled physicians.)
Da Shashen (Glehniae Radix), Yuzhu (Polygonati Odorati Rhizoma), Su Zi (Perillae Fructus), Sang Ye (Mori Folium), Maidong Zhi (Ophiopogonis Juice), Mi Chao Juhong (Citri Reticulatae Pericarpium Prepared with Honey).

Guan (32 years old) Chronic fatigue leads to rebellious Qi, with Liver-Gallbladder heat rising, causing hemoptysis and sticky phlegm. Since this condition exists, alcohol must be avoided and labor prevented. Medicines should harmonize the Yang of the Liver and Stomach; when Yang is harmonious, Qi flows smoothly, and chest-hypochondriac pain resolves naturally. (Fatigue causes Qi to rebel upward; the character "Lao" (fatigue) consists of two "Huo" (fire) above, symbolizing the rise of Ministerial Fire. Thus, downward-moving herbs are predominant. Harmonizing Liver-Stomach Yang ensures smooth Qi descent.)
Taoren (Persicae Semen), Danpi (Moutan Cortex), Gouteng (Uncariae Ramulus cum Uncis), Shanzha (Crataegi Fructus), Zhipi (Gardeniae Pericarpium), Jinhu (Dendrobii Caulis), Fuling (Poria), Maren (Cannabis Semen).

Weng (44 years old) Sleeping outdoors in summer allowed cold-dampness to enter the Yin collaterals from below. The lower abdomen is hard, condensed, and palpable, with tendons on both sides pulling tightly. He reports nocturnal emissions. However, fixed tangible masses are not indications for tonification; they should be treated similarly to hernia, as this is a disease of the collaterals. (The treatment method is balanced and comprehensive.)
Nanmuxiang (Aquilariae Lignum Resinatum), Chuanshanjia (Manis Squama), Jinlingzi (Meliae Fructus), Juhe (Citri Reticulatae Pericarpium Viride), Yanhu (Corydalis Rhizoma), Ezhu (Curcumae Rhizoma), Shexiang (Moschus).
Pills made with Congbai Zhi (Allii Fistulosi Juice).

Shen (40 years old) Years of blood loss followed by chronic cough indicate internal damage cough. When phlegm is abundant, treating the cough is useless. Hoarseness and loss of voice confirm the consumptive nature. (Treatment focuses purely on essence.)
Huangjing (Polygonati Rhizoma), Baiji (Bletillae Rhizoma), Yiyiren (Coicis Semen), Fuling (Poria).
Decoct these four herbs into a paste; take one cup of cow's milk in the morning.

Chen (64 years old) Three years ago, anger and cold caused bedridden fever, followed by phlegm-cough. Diet remains normal, but the cough persists.
Excessive thinking causes Left Ascension to exceed limits, leading to insufficient Right Descent. Moreover, after sixty years, the Lower Yuan is necessarily deficient, allowing Dragon Fire to flare upward. How can the cough heal? Ancients stated that chronic cough in the elderly should be addressed from the Liver and Kidney perspective, not merely by resolving phlegm and clearing dryness. It is proposed to use Duqi Wan (Eight-Ingredient Pill with Rehmannia) plus Jiao Chenxiang (Aquilariae Lignum Resinatum) and Zi Yi Hetao Rou (Walnut Kernel with Membrane). (The Stomach meridian runs from head to foot; Stomach Qi descends via the Bladder and Large Intestine. When Liver Fire rises, Lung Qi fails to descend. Regardless of external or internal injury, Qi rebellion is common. Astringing and securing is the correct treatment.)

Ye (Gaoqiao, 51 years old) Overwork causes blood stasis to overflow upwards and downwards, accompanied by chest oppression, regurgitation, and vomiting. First, use acrid-moistening herbs to circulate Qi within the blood. (When blood overflows, Qi within the blood is obstructed. An excellent treatment method.)
Chao Taoren (Persicae Semen Prepared), Jiangxiang Mo (Dalbergiae Odoriferae Lignum Powder), Fuling (Poria), Su Zi (Perillae Fructus), Da Ma Ren (Cannabis Semen), Mi Chao Juhong (Citri Reticulatae Pericarpium Prepared with Honey).

Gu In previous years, mental labor agitated Heart Yang, causing it to hyperactive upwards, carrying Gallbladder Ministerial Fire and Kidney Dragon Fire. Fire hidden in Yin organs rises directly to the vertex, piercing all orifices. This arises from internal emotional disturbance, unlike fire from external Six Evils. Cooling lung herbs were ineffective; switch to guiding fire back to its source to treat the Kidney. Pulse is firm and beating against the finger; warming and tonifying downward are contraindicated. Following Dongyuan and Wang Shanfu's method, use Zishen Wan (Kidney-Nourishing Pill). (This explains why ancients emphasized clearing the mind and reducing desires for regulation.)

Ye (Dongshan, 50 years old) Alcohol and meat generate heat, transforming dampness into phlegm. Worry and anxiety cause Qi stagnation assisting fire, leading to middle jiao rejection and food obstruction in the elderly. The acridity of Jiang Banxia (Pinelliae Rhizoma Preparatum) opens; the bitterness of Lou (Trichosanthis Fructus) and Lian (Scutellariae Radix) descends. This follows the ancient principle: for phlegm due to Qi stagnation, descending Qi is primary. Phlegm is generated by heat, so clearing fire is essential. However, bitter-acid descending methods are often damaging and unsuitable for middle-aged individuals seeking only short-term relief. It is proposed to select formulas that do not injure Stomach Qi and can be used long-term in winter. (When tangible and intangible aspects are jointly injured, Middle Qi declines. Tonification is inappropriate, nor is harsh purging. Only sweet-cold herbs nourishing the Stomach, slightly acrid-cool to vent stagnant fire, avoid injuring the Stomach while allowing long-term use. This gradually harmonizes the middle jiao and secretly unblocks obstruction. How ingenious!)
Tian Bei Li Zhi (Sweet North Pear Juice, 5 jin), Laifu Zhi (Radish Juice, 5 jin).
Mix evenly and decoct into a paste.
Phlegm is congealed body fluid. Before congealing, fluid is a treasure; after congealing, turbidity becomes filth. When disease reaches fluid exhaustion, only ascending Qi-fire scorches, leading to immediate dryness. Fortunately, phlegm-drink provides some nourishment. Nourishing fire requires adding oil; acrid-cool moistening and clearing, sweet-cold Stomach nourishment establish a method without fault, achievable only by masters.

Guo (40 years old) Qi obstruction in the throat extends to the epigastrium; contact between food and Qi causes vomiting. The disease has lasted a year, with gradual fecal impaction. Qi descent and circulation depend entirely on the Lung. Qi obstruction implies stagnant body fluids, upper dryness, and lower dryness. The Lung governs Qi in the Upper Jiao; thus, clear dryness in the Qi aspect. (All Qi depressions belong to Lung dryness. Throat Qi obstruction is solely attributed to the Lung, showing mature skill.)
Pipa Ye (Eriobotryae Folium), Tu Lou Pi (Trichosanthis Pericarpium), Sang Ye (Mori Folium), Chi Su Zi (Perillae Fructus Rubra), Ku Xingren (Prunus Armeniaca Seed Bitter), Hei Shan Zhi (Gardeniae Fructus Charred).

Wang Constitution features Hyperactive Yang and Deficient Yin. Frequent travel in Guangdong, where the earth is thin and Yang ascends and dissipates, leads to blood loss, cough, aversion to cold, rising fire, and night sweats. All indicate Yin injury with Yang failing to enter and interact. Physicians treating cough by focusing only on the Lung will prolong the disease to a critical state. (Rising fire causes aversion to cold. Yang disperses horizontally, warming hands, feet, and body. If fire rises to the vertex, limb extremities lose warmth, hence aversion to cold.)
Shu Di (Rehmanniae Radix Preparata), Qianshi (Nelumbinis Semen), Wuwei Zi (Schisandrae Fructus), Fushen (Poria with Hostwood), Jian Lian (Nelumbinis Plumula), Chao Shanyao (Dioscoreae Rhizoma Prepared).

Hou (42 years old) Phlegm-fluid retention and recurrence are detailed in *Jin Gui Yu Han Jing*. Zhang Zhongjing distinguishes internal and external: internal fluid treats the Kidney, external fluid treats the Spleen. A general theory states fluid pathogens should be harmonized with warm medicines. Recurrences over several years in spring, summer, and autumn were due to seasonal cold-warmth contact. Now frequent attacks worsen past conditions, indicating declining Lower Yuan after middle age in men. (Phlegm is bound by fire; fluid belongs to Yin pathogen. Internal cold persons lack True Yang to drive circulation, causing water-fluid retention. Kidney deficiency with water flooding easily forms fluid; thus, warm medicines are necessary to harmonize.)
Duqi Wan plus Kanqi (Adiposum Renale Caninum) and Hetao Rou (Walnut Kernel).

Zhuang (Changshun Cloth Shop, 29 years old) Listing the pathology, essence rots below due to deficiency of Yang within Yin in the Kidney. Kidney Fire stores True Yang internally, preferring warmth to generate Yang spontaneously. (Yang within Yin of the Kidney warms and nourishes true essence, preventing rot.) Using ginger, cinnamon, wutou, and fuzi (dry-hot) would injure the Kidney with dryness. (Warmth is Spring Ascending Qi, promoting growth; dry-heat is like summer's fierce sun or autumn's killing frost, boiling blood and depleting true essence, so it should not be lightly administered.)
Luwei (Cervi Cornu Degelatinatum), Da Hui (Foeniculi Fructus), Rongrong (Cibotii Rhizoma), Tusizi (Cuscutae Semen), Yang Shen (Ovis Testis), Yunling (Poria), Bajie (Morindae Officinalis Radix), Guishen (Angelicae Sinensis Radix), Guzhi (Dipsaci Radix), Jiu Zi (Allii Tuberosi Semen), Shechuangzi (Cnidii Fructus).

Yang (30 years old) San Nu (Triadic Malaria) is pathogen in Yin manifesting. From autumn to winter, chills and fever are vague. He reports mental fatigue causes chest/epigastric fullness. Fatigue injures Yang; propose warming and nourishing the Ying aspect, also a method to expel pathogen. (Expelling pathogen relies on warming/nourishing Ying, consolidating Zheng to dispel evil.)
Renshen (Ginseng Radix), Guishen (Angelicae Sinensis Radix), Guixin (Cinnamomi Ramulus), Fuling (Poria), Zhi Gancao (Glycyrrhizae Radix et Rhizoma Preparata), Chao Hei Shuqi (Polygalae Radix Charred), Lao Shengjiang (Zingiberis Rhizoma Recens), Nanzao Rou (Zizyphi Fructus Pulpa).

Ge (37 years old) Loss of essence injures Yin, failing to gather, causing Kidney Dragon Fire to flicker like lightning. Quack doctors, seeing sore throat, hoarseness, and cough, use more cold-cooling and strong descending herbs, akin to pouring rain during a thunderstorm, making lightning fiercer. Kidney meridian ascends along the throat, loops under the tongue, connects collaterals, emerges at ear orifices. Must obtain Five Fluids from Yin to nourish upwards, preventing Dragon Light from shooting up. In winter, Qi should submerge; lacking grasp and storage below, Yang rising in mid-spring will worsen; Yin failing to generate in mid-summer is dangerous. (Consumption reached extreme limits; what method remains? Though no formula is given, the major principle is clear.)
Heaven and Earth generate endlessly; Qi mechanism never stops for a breath. Humans inherit the elegance of Yin-Yang and Five Elements, connecting breathlessly and vein-to-vein with Heaven-Earth vital Qi. Reliance is on充盈 Essence-Qi-Spirit, coordinating transformation to generate and continue endlessly. If internal Essence-Qi is robbed, vitality breaks. What blame lies in Qi transformation?

Qian (12 years old) Epileptic convulsions and coma occur daily. He reports pain below the navel in the lower abdomen. This is childhood Yin weakness. Occasionally abnormal shapes/sounds cause fright Qi entering the Liver. Jueyin Chong Qi disturbs consciousness, causing sudden collapse and unconsciousness. (Acid to gather Soul, Bitter to clear Heart, calm Spirit; Acrid to open knots and move phlegm; Warm to unblock Yang and drain turbidity.)
Wumei Rou (Mume Fructus), Chuanlian (Coptidis Rhizoma), Baishao (Paeoniae Radix Alba), Chuanjiao (Zanthoxyli Pericarpium), Ganjiang (Zingiberis Rhizoma), Guizhi (Cinnamomi Ramulus).

Yang (33 years old) Fifteen years postpartum, unable to conceive. Masses, heart pain, Qi rushing indicate Chong Mai disease. Long duration makes quick results difficult. (Draining turbidity, eliminating stagnation, warming lower, unblocking Yang, using attacking methods.)
Nan Shanzha (Crataegi Fructus South), Fuling (Poria), Ezhu (Curcumae Rhizoma), Xiangfu (Cyperi Rhizoma), Chao Xiao Huixiang (Foeniculi Fructus Minor Prepared), Congbai (Allii Fistulosi Bulbus).

Ma (32 years old) Vertex abdominal pain, dysuria, difficult defecation.
Longhui Wan (Dragon Gallbladder Pill, 2 qian).
This is a syndrome of Liver Fire closure, counter-attacking and rampant.

Chen (63 years old) San Nu is pathogen entering Yin meridians, due to declining strength and weak Shaoyin Kidney. (Grasping Shaoyin provides control.) Summer-autumn heat-damp-wind entered from Mu Yuan, sinking inward. Winter cold contracts; the home of stored Yang becomes occupied by pathogen. Healthy Qi enters internally, contacting pathogen. Due to long pathways, it takes three days to meet and manifest. Pathogens resolved via sweating are Yang pathogens entering Fu organs, suitable for purgation. Now pathogen remains in Yin meridians and collaterals, attacks become slower. Pathogen consumes Five Fluids, prolonging disease, wasting muscles. Seasonal climate changes sustain human vital truth; how can herbs search out subtle pathogens? (Writing style and spirit reach perfection.) Remaining latent pathogen in collaterals requires mid-spring Yang rising vigorously, leaving no hiding place for latent pathogens. (Removing root causes is future-oriented, but current regulation is key to occupying good ground, step-by-step precision.) Today's priority: avoid violent cold, abstain from greasy/turbid foods, protect Stomach to prevent complications. (Cause, location, mechanism, and burden of disease are vividly depicted. Treatment requires waiting for Heaven-Earth Qi to ascend/dissipate to leverage momentum. Patience yields half effort, double result. This applies to all matters, why not medical principles?)
Sheng Muli (Ostreae Concha), Huangbai (Phellodendri Cortex), Qing Ejiao (Asini Corii Colla Clear), Tian Guizhi (Cinnamomi Ramulus Sweet), Bei Xixin (Asari Radix et Rhizoma North), Hanshuishi (Halloysitum Rubrum).
Deep disease requires deep medication.

Wang (64 years old) Daily exertion causes back pain radiating to hypochondrium and left scapula, curling to fingertips, eventually numbness. The back is where Yang Qi travels. Chronic fatigue disperses Yang; Wind pathogen enters collaterals from meridians. Liver is the Wind store; Blood injury allows pathogen invasion. Qi deficiency increases pain at night entering Yin. Yang Qi declines, Yin pathogen invades Yang. Consulting Dongyuan. (Yang naturally generates and protects blood. Chronic fatigue injures Yang, failing to generate or protect blood against pathogens. Internal Wind moves, secretly inviting Yin pathogen to invade Yang, how can there be no pain?) Preparation...