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This must be due to the retention of tangible pathological products, not merely the presence of intangible turbid qi.

Chi (48 years old): Back coldness is caused by fluid retention. Whenever exposed to cold or subjected to physical/mental fatigue, wheezing, coughing, and rebellious qi occur, with pathogens gathering in the chest and diaphragm. After a day, as qi descends and phlegm becomes thick, the condition naturally alleviates. The disease has persisted for many years, and being middle-aged, one cannot afford rest. It is proposed that using the method from *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) during exacerbation can be effective; treating cough solely with lung-targeted herbs is ineffective.

Zhu (30 years old): This is an internal deficiency syndrome; deficiency should be tonified. The pulse is deficient and hollow (*Kou Mai*), indicating depletion of essence in the lower jiao. Tonification of Liver and Kidney essence and blood is indicated.

Li (27 years old): A chronic illness lasting two years is certainly not due to Wind-Cold, Summer-Heat, or Dampness. According to reports, there is abdominal borborygmus and disharmony, hardness under the left hypochondrium extending to the lower abdomen, and enlargement of one testicle. According to Zhang Hezi, the Seven Types of Hernia are mostly related to the Liver. Male excessive sexual indulgence often damages the Chong and Ren vessels. For this condition, acrid-aromatic qi-moving herbs are suitable for young adults (since essence, blood, and yang qi defend against lower jiao yin-cold, and since the extraordinary vessels are damaged by indulgence, acrid-aromatic herbs to circulate qi should be used first).
Fennel Seed, Tangerine Kernel, Poria, Alisma, Toosendan Fruit, Aucklandiae Radix, Gardenia Seed, Green Tangerine Peel
Form into pills with water.

Li (40 years old): Foul and abnormal odors enter through the mouth and nose and settle at the *Mu Yuan* (separate origin/membrane source), causing loss of appetite and vomiting/rebellious qi; this is a pathology of the Middle Jiao. Promoting the unblocking of turbid obstruction is the correct treatment, while dispersing clear cold is contraindicated (use *Da Yuan Yin*).
Tsaoko Cardamom, Areca Seed, Agastache Stem, Magnolia Bark, Apricot Seed, White Cardamom, Pinellia Rhizome, Ginger Juice
Although foul odor belongs to intangible turbid qi, adhering to the *Mu Yuan*, it inevitably condenses with tangible turbid stagnation, leading to loss of appetite, vomiting, aversion to cold, fever, and firm aggregation of turbid pathogens. Only *Da Yuan Yin* can eliminate this.

Gu (20 years old): Internal damage originates from visceral yin deficiency. Due to unfulfilled desires in youth, ministerial fire flickers, causing essence to leave its proper position. Although essence and blood have form, once depleted, they cannot be fully restored by medicine. It is essential to strengthen the Stomach to ensure food intake, as ancients said "essence is generated from grain." As the disease persists, yin essence becomes depleted and dry, gradually affecting yang positions. The stomach appetite is listless, lacking central support, like an uncontrolled temple fire. Yang governs consumption, leading to emaciation and throat pricking pain. *Chu Shi Yi Shu* discusses deficiency consumptive diseases, stating first that men's spirit scatters first, making it difficult to treat. This illustrates the principle of lower damage affecting the middle and upper jiao. Bowel movements occur every three days but are dry and rough; the five fluids are dried up, all rooted in the Kidney. The Kidney dislikes dryness; salty flavor tonifies, assisted by bitter flavor to firm yin. If doctors do not follow meridian principles and treat indiscriminately, how can success be expected? (The Kidney's spirit and essence are foundational, like fish in water; sufficient essence leads to robust spirit. Since kidney essence is scarce and cannot nourish the mind upwards, the spirit scatters first due to essence decline. Lower damage affecting the upper, where turbid fire disturbs the mind, represents the profound mechanism of lower damage affecting middle and upper.)
Ginseng, Donkey-hide Gelatin, Fresh Rehmannia Root, Poria with Hostwood, Tortoise Shell, Biota Seed
Select herbs that clear yin without being greasy or cloying. Prepare early for the Stomach to absorb food and generate essence; add a small amount of Phellodendron Bark.

Yu (Shen Ya Qian, 50 years old): In men at middle age, the lower primal source is deficient first (As people reach middle age, vital qi becomes shallower; Liver and Kidney essence and blood fail to regenerate due to declining true yang. One must not injure the generating yang, which would lead to loss without return, hence the lower primal source is deficient first). The yang within the yin of the Kidney fails to provide warmth and nourishment. Yin fails to bear upwards, resulting in thirst, frequent urination, and urine resembling brine. *Nei Jing* distinguishes between residual heat and residual cold. Upper and Middle Xiao (Wasting-Thirst) are governed by qi-heat; Lower Xiao is managed by securing the Kidney, steaming yang to transport body fluids (Having clarified the cause of Lower Xiao and distinguished the treatments for the Three Jiao, this becomes a famous case record.)