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If Xue Lizhai (Xue Ji) frequently used Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder), and Gu Feng, Dong Zhuang, and others frequently used Zi Shui Sheng Gan Yin (Nourish Water to Generate Liver Decoction), none are as effective as my method. Xiao Yao San should also be used with moxibustion, because Chai Hu (Bupleuri Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) are not suitable for those with Yin deficiency and flourishing fire.

Zhang Jingyue (Zhang Jiebin) seemed never to have read Xue Lizhai's works in his lifetime. He did not know until his death that hypochondriac pain was caused by disease of the Liver meridian; this is truly lamentable. For example, a case record mentions treating his relative's severe hypochondriac pain, which was entirely absurd reasoning. Fortunately, it was cured by moxibustion. This is exactly the same as cases where hiccups failed all treatments but improved immediately after moxibustion at Xuli (CV15).

In general, diarrhea involves many Fire syndromes.

Diseases of leukorrhea and turbid discharge often result from blazing Liver Fire steaming upward to affect the Stomach and attacking the Lungs. The Lung governs Qi; when Qi is weak, it cannot distribute fluids properly. Instead, due to the rapid nature of Fire, fluids are forced downward. The Bladder, as the reservoir, relies on Qi transformation. Additionally, the Liver governs free flow; if it dictates action, discharge becomes continuous and profuse. If it were merely Damp-Heat in the Stomach without Liver Fire, it would manifest as phlegm above and diarrhea below. Ancient and modern medical records rarely preserve cases of leukorrhea and turbid discharge, likely because practitioners failed to grasp their essence and thus treatment was ineffective. As for cases caused solely by Damp-Heat, even pharmacy workers can distinguish them using cooling and drying methods alone.

Zhao Xianke's Note: This is indeed a solid argument.

Baobi (Bladder Bi Syndrome) could be named Niao Geng Bing (Urine Obstruction Disease). Aromatic-drying herbs, if misused, can kill patients, yet few people in the world know this. Observing Zhang Shiwan's treatment of Min Shaojiang, who suffered uncontrollable distension and pain after mistakenly taking Mu Dan Pi (Moutan Cortex) and Bai Zhu, illustrates this point.

Zhang Jingyue treated the condition of Lady Zhu, mother of Hanlin Academician Zhu. It was Wind Bi caused by Yin deficiency with Yang floating outward, a mild form of stroke-like illness. Once the fall occurred, the disease was set in stone. One cannot attribute success to Ginger and Aconite. It is unclear why the term "Yin Syndrome" was inserted. His general understanding can be inferred from this.

Feng Chu-zhan treated a Wind Bi case of a surnamed Cui. This was also a disease of Yin deficiency with Yang floating outward; if severe, it becomes stroke-like. His treatment method was largely sound but had minor flaws. Saying that Yin hides inside and forces Yang outside is as vague as Zhang Jingyue calling Lady Zhu's condition a "Yin Syndrome." This is likely because few study the topic of Wind Bi.

After contracting Cold Damage, Malaria, or Dysentery, if闷结 (stifling obstruction) occurs, it is caused by improper use of purgatives or exterior-releasing methods. Investigating the root, these are diseases of Blood dryness. Regarding Wind Bi, the pathology stems from Dryness-Fire generating Wind. Physicians ignorant of the term "Wind" often indiscriminately use Wind-drugs, leading to death. Those who survive should take heed.

Zhao Xianke's Note: For any disease caused by Internal Wind, regardless of the syndrome, Wind-drugs are contraindicated. Doctors fail because they do not distinguish between External and Internal Wind, leading to errors upon intervention.

Observing the case in *Yi Tong* regarding Zheng Qingshan in gynecology, who went mad due to mixed joy and grief, medical practitioners should feel pity. Ambitious scholars must avoid such practices. His statement that "one must not ignore medicine" is not the words of a sage.

Whenever there is heart and abdominal pain with red lips and vomiting of white foam, or excessive appetite, it mostly belongs to Parasite Syndromes.

Individuals with Yin deficiency and flourishing fire, when initially taking dry-hot, rigid drugs like Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Preparata), Gan Jiang (Zingiberis Rhizoma), and Yu Jin (Corni Fructus), may initially benefit greatly. This is called "plundering treatment." Ignorant people do not know when to stop. Over time, vessels rupture, and the situation cannot be reversed. I have witnessed dozens of such cases.

When both urine and feces exit through the anterior yin (genitals), Ji Ling Gao (Collection of Spirits Paste) is appropriate, using heavy doses of Ren Shen (Ginseng Radix et Rhizoma) to tonify the Lung and moisten the intestines. The Lung and Large Intestine are interior-exteriorly related and govern Qi. The Lung is the official of ministerial guidance, governing regulation. When the Lung is nourished, intestinal dryness clears. Combined with Gou Qi Zi (Lycii Fructus), Tian Dong (Asparagi Radix), and Mai Dong (Ophiopogonis Tuber) to nourish dried blood, normal function returns, and clear and turbid substances separate naturally.

Recent specialists and mediocre doctors treat postpartum conditions exclusively with dry-hot warming tonics, killing people like flies.

Zhao Xianke's Note: Not only in postpartum cases, but also in vomiting, diarrhea, malaria, dysentery, asthma, flaccidity, bi-syndrome, swelling, phlegm-fluid retention, abdominal pain, hernia, and masses, crude practitioners invariably diagnose them as Cold, failing to realize that Heat is common.

Feng Chu-zhan's daughter-in-law took Ba Wei Wan (Eight-Ingredient Replenishing Pill) excessively during pregnancy, resulting in her child contracting Leprosy (or severe infectious disease) within 100 days.

Postpartum lochia stagnation has two types: one is stasis requiring blood-invigorating, the other is Blood deficiency requiring tonification.

Liver Fire disease presents like malaria, because the Gallbladder is the palace of the Liver; Liver disease affects the Gallbladder.

Postpartum diseases mostly belong to Yin deficiency; treatment must nourish Ying (Nutritive Qi). If Qi and Blood are tonified simultaneously, mixed with rigid agents like Ginger and Aconite, it either prolongs the illness or leaves sequelae. Clinicians must be cautious.

Extreme Fire resembling Water is a sign of reversal at the extreme. Many suffering from this are killed by dry-hot warming tonics; how tragic!

Xue Lizhai stated that postpartum Yin Qi is greatly deficient, and Yang Qi tends to escape equally with Yin, suggesting recovery without medication. This highlights Xue's lifelong inability to use strong Yin-nourishing methods. Feng Chu-zhan treated a postpartum head-sweating case, adhering strictly to Xue's method and withholding medicine, causing the family to seek a mediocre doctor who ruined the patient. This was an error of rigidity without flexibility.

Zhao Xianke's Note: Fearful of Yin deficiency, they dare not rescue Yin, clinging to the vulgar saying that postpartum requires warmth. To say "Yang escaping is welcome" is nonsense. This is not just a flaw but a fallacy. No wonder Xu Huixi ranked Xue as the chief among mediocre doctors.

For acne/rubella complicated by lower back pain and recent sexual intercourse, it is most difficult to treat. I believe administering a large dose of Zuo Gui Yin (Left Restoring Decoction) can surely save the patient.

Medicine lacking true knowledge but offering superficial opinions can easily mislead people. Wise individuals should be cautious.

The eruption of Measles originates in the Lungs and Stomach. Treatment should only aim to loosen and penetrate. All Wind-dryness and Cold-Heat agents are contraindicated. I often encounter cases where exterior-releasing was excessive, leading to lingering symptoms. Using Di Huang (Rehmanniae Radix), Gou Qi Zi, Di Gu Pi (Lycii Cortex), Mai Dong, Gua Lou Ren (Trichosanthis Semen), and Sha Shen (Glehniae Radix) for three to four doses usually stops coughing, reduces fever, and ensures safety. If Lu Dongzhuang used Gui Zhi and Fu Zi, it was because bitter-cold drugs had been overdosed previously. Thus, his prescription was specific and not applicable to all cases.

In critical illnesses, with relatives and friends filling the room and discussing endlessly, it only confuses the mind. This must be known. I once diagnosed a child whose left palm was curled. Inquiry revealed that during childhood convulsions, the mother held him too tightly. After recovery, the hand could not extend. If initial treatment had used large doses of Kidney and Liver Yin-nourishing herbs, full extension would likely have returned. Alas, few possess this knowledge.

Edema is mostly caused by Damp-Heat. Although Spleen deficiency is cited, one must examine the length, clarity, and turbidity of urine, and the consistency and color of stool before treating. If one blindly attributes it to Spleen deficiency and recklessly tonifies with Ren Shen and Bai Zhu, the illness will linger.

The Liver meridian夹胃 (passes through the Stomach) and pierces the diaphragm. It is said that diseases generated by this meridian include chest fullness. Therefore, carbuncles and sores in the chest originate from the Liver. However, this syndrome is hardest to distinguish clearly. It corresponds to the *Neijing*'s description of internal abscesses containing large amounts of pus and blood. A famous doctor in my hometown suffered from this. Colleagues diagnosed him but failed to recognize it as an abscess. They administered mixed remedies of Ren Shen, Fu Zi, Ding Xiang (Caryophylli Flos), and Gui Xin (Cinnamomi Cortex). Only after vomiting foul-smelling pus long later did he realize the truth, but it was too late.

Pulse characteristics of strong Cun (inch) and weak Chi (cubit) mostly indicate Yin deficiency with flaming fire. Mistakenly taking Ba Wei Wan often leads to lingering harm.

Regardless of internal or external diseases, for those with Yin deficiency, taking Qi-moving herbs like Ren Shen and Huang Qi (Astragali Radix) is not only useless but harmful.

In various diseases with flourishing Fire and sweating, sudden astringency to stop sweat will aggravate other symptoms.

Misusing hot drugs for Liver Qi Stagnation always leads to major disasters.

Liver Wood is like the Dragon; its changes are unpredictable, and so are its pathological manifestations. The wise, encountering internal injury syndromes, seek the root. Then, the branch symptoms can be traced systematically. This is a secret unrevealed by heaven, earth, antiquity, or modernity. The *Neijing* briefly states: "The Liver is the thief of ten thousand diseases." Six characters suffice. Perhaps sages did not wish to exhaust the details, fearing that the power of life and death should not be wielded by everyone. After decades of clinical practice, I finally grasped this. It is but one insight from thousands of reflections. Gentlemen of the world, do not neglect this.

Zhao Xianke's Note: The Lung governs the exterior of the body; the Liver governs the interior. Five pathogenic influences enter via the Lung; Seven Emotions diseases arise from the Liver. This is my longstanding view. Wei Zhi excels in internal injuries, and these words resonate with me. The Dragon's nature is hard to tame and unpredictable. Only by exploring the classics can one understand the principles without falsehood.