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The right hypochondrium is affected by the Fire pathogen. The pathological condition presents with such rebellious Qi dynamics, for which tonification or purgation are generally contraindicated. Tonifying Metal (Lung) risks causing Metal and Fire to contend, thereby exacerbating wheezing and coughing; purging Fire risks failing to clear the pathogenic factor while allowing the accumulation of *pi* masses (abdominal lumps) to intensify. At this juncture, it is most appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Since Yuanzhuang has deficient Qi, one should harmonize him with medicinal herbs that treat disease. Having heard that medication was administered without effect, I surmise that the rebellious nature of the disease is severe and the medicinal force has not yet reached the site of pathology. One ought to discuss thoroughly with Kuanfu, anticipating that by the time autumn coolness arrives, the condition may stabilize. This is because Lung diseases dislike the Fire qi of spring and summer, which recedes in autumn and winter. It is proper to adjust the Yiqi Tang according to the rising and falling of Yin and Yang across the four seasons, as well as the floating/sinking and warming/cooling/cold/heat properties: follow the principle of rising and sinking, but counteract cold and heat. Following the principles to harmonize the Qi constitutes the general strategy for treatment. Upon observing specific syndromes, modify the prescription accordingly. If one feels Qi stagnation, take Jiannian Zhizhu Wan (Modified Atractylodes and Aurantium Pill) intermittently; or some may take Jiannian Zhizhu Tang (Modified Atractylodes and Aurantium Decoction) intermittently. After several months, the rebellious Qi may slightly return. Once the rebellious Qi returns, other therapeutic methods can be applied. However, if the complexion has already turned cyanotic or crimson, and the pulse has become wiry or flooding, it would be too late.

In recent times, medical theorists have advocated either Liu Hejian (Liu Wansu) or Zhang from Yizhou (Zhang Yuansu). Zhang’s medication is based on the rising and falling of Yin and Yang across the four seasons, with additions and subtractions, which aligns with the meaning of "Regulating Spirit According to the Four Qi" in the *Neijing*. A physician who does not understand this acts recklessly. Liu’s medication focuses on pushing out the old and bringing forth the new, preventing any slight stagnation, which aligns with the principle of continuous creation in nature. A physician who does not understand this lacks skill. However, those advocating Zhang may not fully grasp his subtleties and thus dare not administer drugs that might cause *mingxuan* reactions (severe adverse reactions indicating a turning point), leading to many cases of missed opportunities and untimely death. Those advocating Liu may not fully comprehend Liu’s depth, achieving only immediate effects at the cost of damaging Yin and righteous Qi, leaving disasters for later days. If one can utilize the strengths of both schools while avoiding their drawbacks, the therapeutic methods will likely succeed.

Regarding Vice Commissioner Shi, without seeing the complexion and pulse, prediction is impossible. Given that he recovered but symptoms recurred, it is advisable to adopt Zhang’s approach, using medication based on the seasonal Yin-Yang rising and falling to support the Primordial Qi, hoping that upon recovery, he will remain cured. For Kuanfu, the initial pathogenic invasion must have been deep, and the ingested harmful substances were likely not fully digested and guided out at the time. Stagnation and delay may have generated other syndromes, leading to the current state. It is advisable to emulate Liu’s principle of pushing out the old and bringing forth the new, adding mild digestive herbs to the Yiqi Tang, hoping for gradual relief.

Yuanming Gao (Round Brightness Ointment), transmitted by Professor Wang, the Imperial Physician.
Huaiying (Sophorae Flos, half jin, soaked in four jin of river water for two nights, decocted to yield two sheng of juice); Huanglian (Coptidis Rhizoma, four liang); Huangqin (Scutellariae Radix, three liang); Dahuang (Rhei Radix et Rhizoma, one liang); Zhizi (Gardeniae Fructus, fourteen seeds). The above five herbs are cut into pieces the size of mung beans, soaked in six sheng of river water overnight, and decocted to yield three sheng of juice. The Huaiying dregs and the dregs of the five herbs are combined with four sheng of water and decocted to yield two sheng. Combining these with the previous five sheng of juice, place them in a copper pot. Use charcoal fire, alternating between moderate and low heat. Add four jin of purified honey. To purify honey: heat four sheng of honey in a pot gently without boiling. When foam floats to the surface, remove immediately, cover with paper, let cool, then remove impurities adhering to the paper. Warm the honey again, filter through silk cloth into the medicinal juice, and simmer for approximately one double-hour (shi). Add thirteen liang of calcined stones: Jinxingshi (Auripigmentum), Yinxingshi (Orpiment), Daizheshi (Haematitum), Pusaishi (Kaolinite), Hanshuishi (Natrii Sulfas), Zishiyingshi (Fluoritum), Yunmushi (Muscovite) (all pounded fine with a small amount of Baifan/Alumen); Huashi (Talcum); Jingquanshi (Sodalite); Xuanjingshi (Natron) (each one liang, separately ground to fine powder); Huangdan (Minii Oxidum, three liang, ground extremely fine). The above materials are quenched and baked clean, weighed at two liang, added to the juice, and simmered for another shi. Add the following: Tonglv (Chalcanthite, half liang, ground); Qingyan (Halitum, half liang, ground); Xiongzhu dan (Sus scrofa domestica gall bladder juice, seven bladders); Baixiangding (Vomica, one he, soaked in water, ground, and the clear juice extracted); Ying tiao (Accipiter gentilis muscle, three qian, or its juice). Simmer all medicines until transformed into ointment. Stir constantly with locust or willow branches during simmering to prevent dust entry. Simmer in a clean room and store in porcelain vessels. After cooling, add the following fine powders; do not add while hot, as heat destroys medicinal potency. Ruxiang (Olibanum), Moyao (Myrrha), Qingfen (Calomel), Ruiren (Pruni Armeniacae Semen, peeled, each half liang); Zhusha (Cinnabaris); Niuhuang (Bovis Calculus); Naobi (Borneolum Syntheticum); Xuexie (Dracaenae Sangue); Xingren (Armeniacae Semen Amarum, peeled, half liang); Nanbengsha (Borax, one qian). Each of the above is separately ground to an extremely fine powder. Zhenzhu (Margarita), Shanhu (Corallium), Zi Bei (Concha Arcae), Sha (Realgar), Shixie (Calcitum), Baifan (Alumen), Lüfan (Chalcanthite), Pu Xiao (Natrii Sulfas) (each one qian); Pen Xiao (Natrii Sulfas crystallized, half qian). Mix these with the reserved original clear medicinal juice, grind together until extremely fine and smooth, stir into the ointment to ensure uniformity. Apply as usual for miraculous efficacy.