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Xiaolian Wang Yu's father, aged over sixty. The six pulses were all wiry and firm (Xian Lao). The three positions on the right hand (Cun, Guan, Chi) were extremely expansive in floating, middle, and deep palpation, while the left hand was slightly better; externally, he felt fullness in the evening and had difficulty with bowel movements. This is Earth (Spleen/Stomach) being controlled by Wood (Liver Qi), where the Spleen and Stomach fail to transport fluids, indicating a deficiency of Middle Qi. It is appropriate to tonify the Spleen and Stomach to generate Lung Metal, so Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, with added herbs to astringe Lung Metal and generate new fluids. After two doses, he felt slightly relieved in the chest, but experienced dizziness in the body; this is Zheng Qi (Upright Qi) attempting to recover and Xie Qi (Pathogenic Qi) gradually retreating, hence the Ming Xuan (dazzling/dizzy reaction). After taking several more doses, upon re-examination, the firm pulse had disappeared, and the second Chi position (Kidney pulse) became surging. This indicates both True Yin and True Yang are deficient, requiring mild tonification. Ba Zhen Tang (Eight Treasures Decoction) was used, and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) was taken at night. The large intestine gradually moistened, and after a few more doses, he fully recovered.

Qiu Sheng, aged eighteen. In January, due to excessive consumption of fermented dough cakes, soups, and noodles, he subsequently felt unwell, with fever and headache. I was invited to examine him; the pulse was slightly tight, [text missing]... He consulted another doctor who prescribed Chai Ping Tang (Bupleurum and Pinellia Decoction) for one dose, but the illness did not subside. Returning in the evening to examine him, the pulse was surging with sweating, yet severe abdominal pain that could not be pressed. Yuan Ming Fen (Mirabilite) dissolved in water was used to administer Dao Zhi Wan (Guide Out Stagnation Pills), 2 qian; the pain reduced by half, but distension remained. Another dose of the previous pill was given, resolving the fullness and distension as if released, leaving only abdominal pain, and adding symptoms resembling malaria. (All these symptoms are due to dead blood in the stomach; why not add heavier amounts of Tao Ren [Peach Kernel]?) I examined him again; the six pulses were all fine and wiry. This is Spleen Earth being overcome by Liver Wood, further damaged by excessive purging. Warm tonification is indicated. Li Zhong Tang (Regulate the Middle Decoction) for two doses eliminated the abdominal pain. Due to recurrence of fullness from overeating, examination showed the pulse remained wiry and fine as before. The same formula was still used; by warming the Spleen and Stomach, food digested naturally, and all symptoms resolved.

Tang Ruyu's mother, born prematurely at seven months of gestation. Afterwards, every bowel movement was very difficult, requiring two or three hours to feel relief; various treatments were ineffective. I said: The Qi and Blood of the Lung and Large Intestine [text missing]... After several months of regulation, she recovered. (I often observe that when chicks first hatch, inside the anus there is still a piece of tissue colored like egg yolk. This shows that human and animal development forms the intestines and stomach last. Born at seven months, intestinal strength is incomplete; methods to nourish blood, strengthen sinews, and firmly consolidate the intestines must be employed, adjusting dynamically throughout life.)

A woman, aged fifty. The Cun pulses on both hands were floating and surging; the Chi pulses on both hands were small; the right Guan pulse was wiry. She had no appetite and suffered from dizziness. I said: Floating and surging Cun pulses indicate disease primarily causing dizziness, and also indicate turbidity in the upper Jiao (Diaphragm). This is because Yang Qi is deficient and floats upward, unable to return to its root and restore origin, leading to deficiency-cold in the Dantian. Unable to warm and nourish the Spleen and Stomach, the right Guan pulse becomes wiry, resulting in indigestion and poor intake. Ideally, Yang Qi should be gathered and returned to the lower Jiao Dantian. Once the lower Jiao is warm, the Spleen and Stomach will naturally strengthen, and food and water will transform naturally. Gui Zhi (Cinnamon Twig) and Bai Shao (White Peony Root) each 6 fen, Wu Wei Zi (Schisandra Berry) 2 fen, Fu Ling (Poria) 1 qian, Hei Jiang (Black Ginger/Roasted Ginger) 3 fen, Ren Shen (Ginseng) 5 fen, Du Zhong (Eucommia Bark) 1 qian, Po Gu Zhi (Cibotium Rhizome) 5 fen, Zhi Cao (Honey-fried Licorice) 4 fen, Ban Xia (Pinellia Tuber) soaked in decoction 1 qian, plus Wei Jiang (Roasted Ginger). After more than ten doses, she recovered.

Jiang Huaiqu, aged sixty. He habitually vomited white foam for decades. Suddenly, he felt a sensation of obstruction in his throat and told me. I said: This is deficiency-cold of the Spleen and Stomach. Ren Shen (Ginseng) should be used to regulate and tonify Middle Qi. He declined due to poverty, instead boiling pickled vegetables in white sugar juice, holding it in his mouth, and spitting it out. After six or seven days, he developed loose stools, five to six times daily, with mental fatigue and lack of appetite. Upon examination, the six pulses beat only twice, stopping after three to five beats, resembling Que Zhuo Mai (Bird Pecking Pulse). This is severe deficiency of Yuan Qi (Original Qi), unable to [text missing], suddenly becoming floating, surging, coarse, and large, beating seven to eight times per breath, with fever, mouth ulcers, and tongue lesions. This is a syndrome of floating Deficient Yang. I considered that the pulse already fell into a difficult-to-treat category. Moreover, continuous vomiting of foam indicates Kidney Water flooding and Spleen deficiency failing to control. [Prescription missing]. The illness subsided slightly. Relapse occurred with slight exertion; several doses reduced it again, but relapse followed further exertion. Two or three months later, he could not tolerate medicine, nor was it effective. He died after five or six days. The sages said: Coarse pulses are difficult to treat. I record this case as proof.