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Scrotal retraction is a disease of the Foot-Jueyin Liver Meridian, caused by extreme heat leading to withering of the sinews and subsequent dry contraction. If accompanied by constipation of both stool and urine, fever, and thirst, Da Cheng Qi Tang (Great Order the Qi Decoction) should be urgently administered to purge. If there are no signs for purging but the pulse is floating, sweating is appropriate; if the condition is mild, harmonizing is appropriate. After six or seven days, if the pulse is slightly floating and slightly slow, it indicates the presence of Stomach Qi, meaning the Stomach is not invaded by pathogenic factors, and chills and fever will likely occur, which can be resolved through profuse sweating. Cases of scrotal retraction due to Yin patterns are not included in this discussion.

Wu Keyi's *Treatise on Plague* only mentions abdominal distension in the chest, hypochondrium, and abdomen. How could one know that Jie Xiong (Chest Binding) and Pi Qi (Stagnant Qi) also occur in plague, and that many cases do not result from improper purgation? The classic states: "In Taiyang disease, when the exterior is unresolved, if the physician erroneously uses purgation, pain with resistance in the epigastrium and hardness below the heart constitute Jie Xiong (Chest Binding)." It further states: "Fullness and pain extending from below the heart to the lower abdomen, so severe that it cannot be touched, constitutes Jie Xiong (Chest Binding), treated primarily with Da Xian Xiong Tang (Great Sinking into the Chest Decoction)." "Resistance in the epigastrium" refers to issues in the chest and hypochondrium; "hardness below the heart" refers to the upper epigastrium of the Stomach. "From below the heart to the lower abdomen" refers to fullness of the entire abdomen. Generally, when exterior pathogens transmit inward, they must pass through the chest to reach the heart and abdomen. However, Da Jie Xiong (Major Chest Binding) is the most severe, Xiao Jie Xiong (Minor Chest Binding) is next, and Pi Qi (Stagnant Qi) is the least severe. The classic also states: "Disease originating from Yang, if erroneously purged, heat enters and forms Jie Xiong (Chest Binding); disease originating from Yin, if erroneously purged, forms Pi (Stagnation)." Cheng Wuji explained: "Fever with aversion to cold originates from Yang; absence of fever with aversion to cold originates from Yin." The absence of fever with aversion to cold seems to refer to cold pathogens directly striking the Yin meridians. Tao Hua and Zhang Jingyue refuted this, correctly so, yet neither achieved a true understanding of "Yin and Yang." Consequently, some argued Wind-Strike belongs to Yang while Cold Damage belongs to Yin; others argued Exterior belongs to Yang while Interior belongs to Yin. These disputes created an eternal puzzle. I believe there is no need to over-analyze the terms "Yin and Yang" in irrelevant contexts. Regardless of Major Jie Xiong, Minor Jie Xiong, Pi Qi, or Zhi Jie (Branches of Binding), all belong to Yu (Stagnation). Stagnation inevitably leads to binding; thus, the primary treatment is to open stagnation, after which the Pi binding will naturally dissipate. One must examine accompanying symptoms and diagnose the pulse. For Qi stagnation, regulate it smoothly; for Blood stagnation, invigorate and break it; for Phlegm stagnation, resolve and induce vomiting; for Exterior stagnation, disperse and harmonize; for Interior stagnation, attack and purge; for Heat stagnation, clear it; for Cold stagnation, warm it (Plague inherently lacks Cold, or results from excessive use of cold-cooling herbs, or post-sweating/purging); for Food stagnation, digest it; for Water stagnation, promote diuresis. This completes the treatment of Pi binding. Regarding Zhang Zhongjing's use of Da Xian Xiong Tang for Jie Xiong caused by erroneous purgation, it is presumed that ancient patients had robust constitution, so using Xian Xiong Tang after erroneous purgation did not cause harm. Tao Hua recognized this was unstable, arguing that the Upper Jiao is the highest part of the Clear Path, and excessive purgation damages Yuan Qi (Primal Qi). However, he dared not deeply refute it. Only Zhang Jingyue stated: "In Cold Damage, there are cases not caused by erroneous purgation, where solid pathogens transmit to the interior, causing hardness below the heart, pain radiating to the lower abdomen untouchable, which is suitable for Da Xian Xiong Tang." He continued: "For Taiyang and Shaoyang exterior pathogens unresolved, if Jie Xiong results from premature purgation, using Da Xian Xiong Tang again would mean purging after erroneous purgation, is this acceptable?" He suggested using methods from the Pi Fullness chapter, adjusting for severity with dual-release methods, or using Cong Xi Fa (Green Onion Moxibustion/Fomentation) to disperse solid pathogens in the chest. This is my experience of frequent efficacy. Although this overturns Zhang Zhongjing's cases, it is clear and profound, containing sound principles. He is truly a meritorious servant of Changsha (Zhang Zhongjing) and a precious raft for treating Jie Xiong, being the most stable and rapid method. Moreover, external fomentation is not only for Jie Xiong; in plague cases where medication fails, waiting until the sixth or seventh day—the time for sweating but without it—if slight epigastric/abdominal stuffiness and pain are felt, applying Green Onion Fomentation often resolves the condition with profuse sweating. Therefore, formulas like Xian Xiong Tang are not recorded.