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Yu Tai Xin An (New Cases from the Jade Terrace)

Qing Dynasty · Xu Yong, *Yi Xue Ju Yao* (Essentials of Medicine)

Transferred from Folk TCM Network

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Medical Cases of Cold Syndromes

Acute conditions presenting with fever, aversion to cold (Aversion to Cold), headache, and body pain are easily identified by people. However, wheezing and coughing resulting from long-standing stagnation in the Lung Meridian can resemble Yin Deficiency Labor Cough (Chronic cough due to Yin deficiency), which must not be confused. Xi Ouzhuang, a guest tutor living outside the West Gate of the Prefecture City, suffered from heat exposure while traveling last year and previously had wheezing and coughing, which healed after taking Zibian Tang (Self-Convenient Decoction). This year, he again suffered from wheezing and coughing; taking Zibian Tang aggravated his condition. Physicians generally used Lung-Clearing and Lung-Nourishing drugs without effect. He suspected himself to have a severe Yin Deficiency syndrome, wandering in confusion and at a loss. He then invited me to diagnose him. I examined his pulse and found it tight, appearing rapid but not truly so. The previous illness was due to Summer-Heat, so Zibian Tang could cure it. This time, the illness is due to Cold Pathogen, so it worsened instead. I prescribed Xiao Qing Long Tang (Minor Blue Dragon Decoction), and he recovered.

Daoist Xu Zhaokui from the Prefecture Temple suffered from San Nüe (a type of Malaria) for a long time and firmly refused medication, recovering only after two years. After recovery, in winter, he contracted Shang Han (Cold Damage). He had high fever and headache. Physicians suspected Dong Wen (Warm Disease occurring in Winter) and mistakenly administered Acrid-Cool agents. He immediately fell into a coma and lost consciousness. Because he was comatose, physicians believed this was Heat Pathogen sinking inward, and they resigned from treatment. His master, Yang Chengzong, sought treatment from me. I diagnosed his pulse as deficient, soft, and lacking spirit, appearing rapid but not truly so. I was also alarmed, but knowing that his Middle Qi had been chronically deficient after the malaria and that he had been injured by Cold, I determined it was not Dong Wen. I immediately administered Warm-Middle agents. After one dose, he slightly revived; after two doses, he woke up; after three doses, he was stable. His intake of porridge and drinks increased day by day, but he felt a cold lump in his chest and diaphragm. I added 3 fen of Fuzi (Prepared Aconite Root) to the Warm-Middle agent, and he finally stabilized. After one month of regulation, he was secure.

Medical Cases of Macules (Fa Ban)

Using Acrid-Cool agents initially for Fa Ban (Macules/Eruptions) and Saline-Cold agents subsequently is known to everyone. However, the syndrome of Yin Macules is most prone to misdiagnosis. The son of Xu Long, a corvée laborer from Nan Hui, had body heat and macules, resembling a Fire syndrome. Physicians used standard macule-resolving formulas containing Xi Jiao (Rhinoceros Horn) etc., and the condition became critical. He lost consciousness, sang continuously, and sometimes spoke deliriously. I diagnosed his pulse as floating and disordered, empty upon pressure. His tongue was crimson and moist, without dryness or thirst. I suspected a Yin syndrome. Upon detailed inquiry into the cause, his wife said that before falling ill, he shouted that his feet were cold. This was undoubtedly a Yin syndrome. I used Jiang (Ginger) and Fu (Aconite) etc., administered cold, one dose. He slept peacefully that night. However, due to the aftermath of Yuan Yang (Primordial Yang) depletion, he was spiritually fatigued and lethargic for half a month. He took Gui Pi Tang (Restore the Spleen Decoction) for more than twenty doses and recovered.

Medical Cases of Fire Syndromes

Clearing Fire is the routine method for Fire syndromes. But there are cases requiring urgent Purging (Ji Xia - Rapid Purgation), where one must be resolute. Fan Mou from Desheng Du was comatose from the onset. Physicians used Acrid-Dispersing agents; after sweating, the disease did not resolve, leading to panic and buck-passing. I said: "If sweating does not resolve it, treatment requires purging." The previous physician asked: "What if purging causes incessant diarrhea?" I said: "The Right Guan pulse is deep and solid; there is no worry in attacking with purgatives." I used Da Cheng Qi Tang (Major Order the Qi Decoction) combined with Liang Ge San (Cool the Diaphragm Powder), and he recovered.

The young master of Yang Xizong in Nan Hui city suffered from Malaria with mild chills and fever, and normal appetite. He adhered to the rule of not taking medicine. One day, returning from burning incense at the temple, he suddenly spoke madly, as if possessed by spirits. I was invited to diagnose him. The pulse was deep and depressed, with profuse sweating (Po Han). Unable to confirm whether it was truly Re Jue (Heat Jue), I dared not abruptly use Cold-Cooling agents. I tentatively used Dan Xing (Arisaema Cum Bile) and Zhu Li (Bamboo Sap). After administration, he regained consciousness. I asked what he had taken recently; he said he drank Ginger and Jujube Decoction twice daily. Observing his tongue color—white surface with a crimson base, and lips like vermilion—I knew it was undoubtedly Heat Pathogen. It was already the third watch (late night). Seeing his condition stabilize slightly, I agreed to adjust the prescription the next day. At dawn, he invited me again, stating he was awake for less than fifteen minutes before relapsing into Jue. I used Xi Jiao Di Huang Tang (Rhino Horn and Rehmannia Decoction) combined with Da Cheng Qi Tang, promising that once stool passed, he would recover. Unfortunately, other doctors claimed death was certain if purged, causing the family much doubt. Zhang Er Chuan, a relative of the Yang family, strongly urged them to take my prescription. By the time the decoction was nearly ready in the afternoon, the patient's jaw was clenched. They forcibly poured the medicine in. After half a dose, stool passed, and the previous symptoms vanished instantly.

Yao Yufeng from Nan Hui was a physician. In autumn, suffering from alternating chills and fever, he indiscriminately used Huo Xiang Zheng Qi San (Agaricus Rectus and Magnolia Bark Powder) and Xiang Ru Yin (Elsholtzia Decoction) etc. When other doctors visited to ask about the patient, they would settle on one formula, unable to maintain their own judgment. His father, Pei Huan, seeing the critical severity, invited me. I used an urgent purgative. Previous doctors opposed it, saying this is an incurable case, why use purgatives? I waited for them to brew and administer it. He passed large amounts of accumulated filth. Subsequently, he took tonics for half a month and recovered.

Medical Cases of Treating Hidden Pulses (Mai Fu)

Youji Shu Gong of the Former Camp contracted a pathogen in early summer. Chills and fever were mild, but he had pulling pain below the right hypochondrium, restlessness, and headache on the right side, with loose stools. Physicians considered it similar to Shang Han and used Acrid-Warm exterior-releasing methods without effect. I palpated his pulse as hidden and indistinct. His tongue had gray coating, thick and wet enough to drip. Initially suspecting Dampness exceeding Heat, I used Wu Shi Da Yuan Yin (Wu's Origin-Reaching Decoction). Suspecting subsequent Cold-Heat knotting, I used Jin Tui Huang Lian Tang (Advance-Retreat Coptis Decoction), but only achieved 20-30% efficacy. Shu Gong trusted me completely, but I would not feel at ease until full efficacy was achieved. After deep contemplation, since both headache and hypochondriac pain were on the right, this indicated Heat Qi stagnating in the Yangming channel, hence the indistinct pulse. I discarded warm herbs and used exclusively San Huang Shi Gao Tang (Three Yellows and Gypsum Decoction), insisting on taking it for over twenty doses, and he recovered. At that time, Xing Gong, Garrison Commander of the Former Camp, also suffered from a Heat disease. From the onset, his tongue was crimson and he was comatose. Physicians all used Cong Chi Tang (Scallion and Fermented Soybean Decoction) to release the exterior. I used Liang Ge San to clear the middle. My prescription was rejected; he allowed his fluids to dry up for five days and died. Officials in the same camp, facing illness at different times, either believed or disbelieved, creating enmity or gratitude. Shu Gong said: "Ultimately, one cannot escape the word 'Fate'."

Appendix: Letter to Yao Jingxiu regarding your daughter's syndrome. Liver stores accumulated Heat; Lungs received sudden Cold. Thus, Chong Qi rebels upward, causing coughing and wheezing. I used Zhong Jing's Ma Xing Gan Shi Tang (Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction) to disperse external pathogens and sweep away internal Heat. Missing this opportunity to treat would inevitably lead to Lao Qie (Consumption). Due to your heavy trust, I pondered repeatedly before using this formula. After sweating, I used Qian Zhong Yang's Bu Fei E Jiao San (Tonify Lung and Donkey-Hide Gelatin Powder). After vigorously purging accumulated filth and stasis, I used Yu Shi's Qing Zao Jiu Fei Tang (Clear Dryness and Save the Lung Decoction). Shi Gao (Gypsum) eliminates residual pathogens; Ren Shen (Ginseng) tonifies Qi; E Jiao (Donkey-Hide Gelatin) nourishes Blood. This is a formula addressing both deficiency and excess. When writing the prescription, you and your son asked carefully about the prognosis. I took full responsibility, never uttering a word of alarm. The prescription and case record remain in your study for review. You received the prescription but did not use it, hesitating first, and consulted another physician who mistook the syndrome for Collapse. He proclaimed the Left pulse was absent, causing the entire family to weep bitterly. He notified matchmakers and betrothed families, claiming this syndrome was ruined by Shi Gao and is now incurable. Alas! That physician has long enjoyed fame; how can he rely on arrogant talent while ignoring ancient teachings? The pulse is merely constrained/stagnant, forced by Fire, not absent. Carefully studying ancient masters' works would reveal this profound truth. That physician called this Que Zheng (Timidity Syndrome/Deficiency Syndrome), not a seasonal pathogen. Little does he know that even at the onset of Que Zheng, one must remove evil substances. The ancient formula Bai Lao Wan (Hundred Fatigue Pills) was transmitted by Physician Chen from Xu Zhou under Zhong Jing's name. Did that physician ever study its meaning deeply? People say that physician's formula resembles mine, unaware they are worlds apart. I used Ren Shen and Shi Gao together, intending to clear Fire. That physician used Ren Shen, Wu Wei Zi (Schisandra), and Chen Pi (Tangerine Peel) together, intending specifically to tonify Deficiency. He does not know that although the major accumulation is gone, residual Fire remains. Adding even slight warming tonification fears reigniting the flames. Ren Shen should only be used in small amounts. Your excessive use of Ren Shen反而 caused the disease to worsen. North of your residence, a woman surnamed Yu suffered from latent Heat for over forty days. Others used light-clearing methods without effect; I used Shi Gao with effect. This year, Shao Yin governs the Heaven, and Yang Ming governs the Earth. This is due to Luck and Qi. That physician read Jing Yue's books but did not understand the purpose of using Shi Gao in Yu Nu Jian (Jade Maiden Decoction). How can he enter the hall, let alone the inner chamber? After the woman surnamed Yu took Shi Gao, she erupted with Summer-Toxin all over her body. Her mother did not blame the medicine but credited it. Remarkable insight in women, far surpassing men! After receiving this letter, Jingxiu's courage strengthened. I continued to aggressively use Cold-Cooling agents. He had diarrhea for five days and fully recovered.

Medical Cases of Treating the Elderly

It is known to all that the elderly have deficient Primordial Qi and diseases require supporting Primordial Qi. Yet there are cases where Yang Qi is substantial; they often take large-dose Cold drugs and manage to extend life with illness. Xie Huangming of Nan Hui city was seventy-four. Last autumn, involved in litigation in the prefecture, he was exposed to Summer-Heat on a boat and developed Wen Nüe (Warm Malaria). Mild chills, aversion to heat, chest and diaphragm stuffiness. I happened to reside in the prefecture city and used Qing Xin Liang Ge San (Clear Heart and Cool Diaphragm Powder) to stop chills and fever, followed by Ban Xia Xie Xin Tang (Pinellia Decocting the Epigastric Region Decoction) to remove stuffiness. Soon after, litigation concluded, and he returned South, taking no more medicine. By early winter, wheezing and coughing became severe. Physicians used dispersing methods, worsening the condition. Around the tenth day of the New Year, he could not sleep day or night, with basins and bowls full of phlegm and saliva. He instructed his son En Rong etc. to prepare funeral affairs, having no hope left. Fortunately, Huì friend Wang Yuting was present, suggesting still inviting me to diagnose, promising a surprising victory. The prefecture city is only separated by a river; why not send a dedicated boat to invite him back for a diagnosis? Huangming was usually frugal, but wanting to seek life from death, he had to follow Wang's advice. I also could not refuse out of friendship, so I packed and returned East. It was the night of the sixteenth of the first lunar month. After diagnosis, I knew the previous use of Acrid-Warm was mistaken but promised salvageability. The prescription used a large dose of Bai Hu Tang (White Tiger Decoction) combined with a large dose of Xi Jiao Di Huang Tang. Insisting on taking it for over forty days, he fully recovered. If one does not examine the pulse carefully but restricts treatment by age, one will surely face complaints from the grave. By the twenty-fifth year of Jiaqing, he re-entered the academy. By the fifth year of Daoguang, he was eighty-four. If he did not drink sugarcane juice or pear syrup for one day, his bowel movements became difficult. Such is the harm of mistakenly using Acrid-Warm.

Medical Cases of Malaria

Malaria with alternating chills and fever should be treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Not knowing that for those with Yin Deficiency constitutions, using it increases the patient's suffering. Yao Jingxiu of the Prefecture City suffered from Malaria in summer. Physicians administered Xiao Chai Hu Tang for over ten doses with no change. Stopping medication for two days, he suddenly experienced Jue (collapse/reversal), short tongue, vertigo, critically endangered. Living near my residence, he urgently sought diagnosis. I used a large dose of Liver-Clearing medicine. One dose brought peace. Knowing he had taken too much Chai Hu (Bupleurum), causing Liver Yin deficiency and Hyperactive Jue Yang. After recovery, his limbs were sore and numb. He used Yin-Nourishing medicine to regulate for half a year before stabilizing.

Medical Cases of Labor and Exhaustion Internal Injury

Zhang Baohua of South Gate, Nan Hui, suffered from labor and exhaustion, compounded by food stagnation, representing the Excess type of Internal Injury. The pulse was wild and large; heat and thirst were extreme. As his son was an old relative, trusted implicitly, I used Purging and Clearing Middle methods. However, due to excessive fatigue from funeral arrangements, he did not recover immediately. Relatives suspected failure to release the exterior and advised consulting another physician. The new physician said he had never sweated, indicating Heat Pathogen sinking inward, and used Cong Chi (Scallion and Fermented Soybean) etc. to induce sweating. Sweat did not come out; instead, he became comatose. He begged me to treat him again. I focused solely on clearing and descending. Gradually, his spirit cleared, and appetite improved. He recovered without ever sweating. Post-recovery, bowel movements were difficult, requiring only Da Huang (Rhubarb). He refused any tonic. Thus, we know: External pathogens should be released via sweating; Internal injuries prohibit sweating. For Internal Injury due to Deficiency (Labor/Exhaustion), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. For Food Injury with Deficiency mixed with Excess, Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill) is suitable. For pure Excess Internal Injury, Purging is appropriate. Wang Andao distinguished these very clearly.

Medical Cases of Dysentery

The mother of Gao Jushang (Prefectural Student, name Chonghu; younger brother Yaofang name Chongrui, selected and passed examination) suffered from Yang Deficiency chronic dysentery. Physicians frequently administered Warming Tonics for half a year, yet the condition worsened, occurring thirty to fifty times day and night. During my diagnosis, he only described abnormal emptiness and pain in the lower back and spine. I used Ban Long Wan (Spotted Dragon Pill) to severely tonify the Extraordinary Vessels. After one dose, the condition decreased significantly. Subsequent doses showed no further change. Taking a little Ren Shen provided brief relief. However, Jushang and Yaofang brothers argued that since their father had suffered from Zheng Chong (Palpitations) for years, the cost of Ren Shen was huge, and Ginseng cannot be taken constantly. After deep thought, I changed to Huang Qi Jian Zhong Tang (Astragalus Decocting the Middle Plus) adding Lu Jiao (Deer Antler). Physician Li Hengtang (Xiu) present praised this method: following severe tonification with promoting and unblocking Yang Qi is also a valid approach. He strongly endorsed this formula as hitting the target. Insisting on taking it for over twenty doses, he recovered.

Li Liancheng of East Gate, Nan Hui, suffered from Liver Qi distending pain. Due to excessive use of Zuo Jin Wan (Left Metal Pill), he developed incessant dysentery, loss of appetite, and others refused to feed him. Doctors changed frequently, using only Zhu (Atractylodes) and Ling (Poria). All declared it incurable, and funeral preparations were made. Forced to seek my treatment, I ordered him to take a large dose of Gui Pi Tang (Restore the Spleen Decoction) in the morning and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) in the evening, and instructed family members to tempt him to eat meat. There was immediate effect, and he fully recovered in one month.

Medical Cases of Labor and Exhaustion Internal Injury (Duplicate Entry)

Zhang Baohua of South Gate, Nan Hui, suffered from labor and exhaustion, compounded by food stagnation, representing the Excess type of Internal Injury. The pulse was wild and large; heat and thirst were extreme. As his son was an old relative, trusted implicitly, I used Purging and Clearing Middle methods. However, due to excessive fatigue from funeral arrangements, he did not recover immediately. Relatives suspected failure to release the exterior and advised consulting another physician. The new physician said he had never sweated, indicating Heat Pathogen sinking inward, and used Cong Chi (Scallion and Fermented Soybean) etc. to induce sweating. Sweat did not come out; instead, he became comatose. He begged me to treat him again. I focused solely on clearing and descending. Gradually, his spirit cleared, and appetite improved. He recovered without ever sweating. Post-recovery, bowel movements were difficult, requiring only Da Huang (Rhubarb). He refused any tonic. Thus, we know: External pathogens should be released via sweating; Internal injuries prohibit sweating. For Internal Injury due to Deficiency (Labor/Exhaustion), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. For Food Injury with Deficiency mixed with Excess, Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill) is suitable. For pure Excess Internal Injury, Purging is appropriate. Wang Andao distinguished these very clearly.

Medical Cases of Hemiplegia (Pian Ku)

Min Qinzhai from Xinchang Town was over fifty, thin, with much Fire and little Phlegm. In winter, he suddenly suffered from Hemiplegia on the left, so he resigned from his teaching post in Wu Men and returned. Physicians focused only on tonifying Qi and eliminating Phlegm, aggravating symptoms like dry throat and Bi (obstruction). The family said the root was exhausted, hence tonics failed. Inviting me to inquire, I said his pulse and symptoms were purely a mass of Fire Qi. Must use He Jian's methods for treating Fire. The formula used Er Di (Two Rehmannias), Er Dong (Two Asparas), Zhi Mu (Anemarrhena), Bai Xian Pi (Dictamnus) etc., alternating Sweet-Cold and Bitter-Cold. After two doses, he felt mentally refreshed. The patient recalled that days before falling ill, his left scapula felt like burning. Only then did he believe the theory of treating Fire was correct. Subsequently taking Hu Qian Wan (Tiger Crouching Pill), he fully recovered.

Medical Cases of Bi Syndrome (Arthralgia)

Wind, Cold, and Dampness combining to form Bi syndrome, and dispelling Wind, Cold, and Dampness, is known to all. Not knowing there are cases requiring flexibility. Dai Xingbiao of Si Jing, nearing forty, traveled to Shang Yang for tobacco business. One night, he suddenly suffered leg pain, unable to walk. Someone in his lodging familiar with medicine said Kidney Qi was chronically deficient, indicating the onset of Zhong (Stroke/Collapse), and suggested Da Zao Wan (Great Creation Pill). Dai, finding lodging inconvenient, returned by sedan chair. Physicians in the town and prefecture all used Warm drugs and Da Zao Wan. After taking it, pulling pain increased to ten degrees, both hands hurt, and sexual function atrophied. He invited me to diagnose. I said this belongs to Re Bi (Hot Bi), commonly called Liu Huo (Flowing Fire). Although the tongue coating is white, the base is actually crimson. Sexual atrophy is what Wang Jiezhai called Yu Huo (Stagnant Fire). I used San Huang (Three Yellows), Shi Gao (Gypsum), Xi Jiao Di Huang Tang etc. in large doses. Within half a month, he rose from bed. Using Hu Qian Da Bu Yin Wan (Tiger Crouching Great Tonify Yin Pill) etc., after one month, his gait was normal.

The mother of Xie Enrong, a Southern Academy Student, suffered from Hot Bi. Physicians thought it was Blood deficiency and Qi weakness, administering tonics which worsened it. I used Ling Yang Jiao (Antelope Horn), Er Dong, Yu Zhu (Polygonatum Odoratum), Zhu Li etc., meridian-unblocking agents. After several doses, he fully recovered.

Medical Cases of Wei Syndrome (Flaccidity)

Gong Zhenbang, Chief of Camp, had excessive desires and Yin deficiency. In summer, he suffered from flaccidity and weakness of feet and knees. I said it should be treated as Shu Wei (Summer-Heat Flaccidity), using Qing Shu Yi Qi Tang (Clear Summer-Heat and Augment Qi Decoction) plus Blood-Activating products. He rejected the prescription and took orthopedic medicines instead. Suddenly he fainted, heartache as if dying. He invited me again. Pulse was deficient and scattered. Sheng Mai San (Generate the Pulse Powder) plus harmonizing agents. One dose brought slight relief. His family lacked firm faith, consulting other doctors jointly. They changed to Ren Shen, Di Huang, Gui (Cinnamon), Fu Zi (Aconite). Taking it increased bloating. Another doctor treated with harmonizing and descending Qi. Bloating decreased slightly, but Yuan Qi weakened further, making support harder. Changing to Ren Shen and Bai Zhu (Atractylodes) one dose, the previous heartache returned. Forced to obey me. I said this belongs to Shaoyin Kidney Water deficiency. Switching to orthopedic medicines also depleted Qi. Ren Shen, Bai Zhu, Gui, Fu Zi consume Yin; Ju (Tangerine), Ban (Pinellia), Zhi (Magnolia), Sha (Amomum) consume Qi. None hit the target, hence worsening. Strengthening the Master of Water to control Solar Flare is the correct treatment. Using Liu Wei Di Huang Wan combined with Sheng Mai San etc., insisting on taking it for over fifty doses, he recovered.

Zhu Qiguan, soldier in Nan Hui Camp, suffered from Wei syndrome due to Damp-Heat. Seeking treatment from a fashionable physician in another county, he was told to frequently take strong-tonic rigid agents. Half a month later, Jue Yang rebelled upward, causing dizziness, tinnitus, chest agitation, Cold blocked below, feet like ice. He felt there was no hope. Friend Gu Minghe, a Military Student nearby, invited me to judge life or death. I palpated the wild and large pulse, saying this syndrome was caused by mistaken warm tonification, not a terminal case. I used Qin (Scutellaria), Lian (Coptis), Zhi Mu, Bai Xian Pi, Pig Gallbladder Juice etc., large Cold agents. One dose reduced it; twenty doses cured it.

The daughter of Xu Huafeng in the Prefecture City suffered from Wei syndrome. Feet could not separate by an inch. Skin between spine was loose and soft, like a bean bag. Physicians used miscellaneous Qi-Blood tonics without effect. I said diet was normal, disease located in Lower Jiao. Qi and Zhu stay in the Middle, cannot reach below. Si Wu Tang is indeed a key female medicine, but if aiming to fill essence and marrow, it is incompetent. Examining *Nei Jing*, Jin Wei (Sinew Flaccidity) and Gu Wei (Bone Flaccidity) all belong to Extraordinary Meridian diseases. I used raw Lu Jiao (Deer Antler), Gui Ban (Turtle Shell), Hai Shen (Sea Cucumber), Yu Jiao (Fish Maw), Lamb meat etc., animal-derived flavors, combined with Shu Di (Prepared Rehmannia), Gou Qi (Goji), Niu Xi (Achyranthes), Gui (Angelica), Shao (Peony). Insisting on taking it for over thirty doses, he fully recovered.

Medical Cases of Consumption (Xu Lao)

Lu Mou north of Tinglin Town, chronically suffered from Labor Cough, intermittent. Now asthma worsened, unable to turn sides when lying obliquely. Pulse fine and weak, resembling Qi Deficiency with Phlegm-Fluid. Physicians used Spleen-Tonifying and Qi-Regulating methods for a long time without effect, giving up on the original syndrome. I happened to be at Gu Residence in the town, invited to judge safety. I said this belongs to Lung and Kidney Yin deficiency, not Qi deficiency. Initially using Qian Shi's E Jiao San (Donkey-Hide Gelatin Powder), subsequently Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Decoction), and he recovered.

Medical Cases of Swelling (Zhong Zhang)

Wang Dixian's mother, a Prefectural Academy Student, suffered from Wheezing and Swelling. Pulse floating, no sweat, extreme thirst. Following Zhong Jing's Feng Shui (Wind Water) treatment example, and referencing Wang Jiezhai's principle of "Wheezing precedes Swelling," I used Ma Xing Gan Shi Tang, and he recovered.

Li Xiaosi of Nan Hui city suffered from isolated abdominal distension for months, various drugs ineffective. I palpated the pulse deep and minute, belonging to Yang deficiency. Using Sai Yin Sai Fa (Treating Obstruction with Obstruction method), specifically taking Li Zhong Tang (Regulate the Middle Decoction) plus Fu Zi, and he recovered.

A thirteen-year-old girl surnamed Bu in the Prefecture City first suffered from Sha Zhen (Scarlet Fever/Rash), then Malaria. Physicians used opening and draining methods excessively, leading to distension. Abdomen below hard as stone. Family suspected Deficiency, invited an old physician specializing in tonics. Unexpectedly, he said Sha Toxin attacked inward, incurable. I had just arrived in the prefecture and was invited to diagnose. I palpated the pulse deep, fine, and minute, clearly showing Spleen Deficiency. Initially using Qian Shi's Bai Zhu San (Atractylodes Powder), hardness disappeared. Subsequently using Chen Shi's Liu Shen Tang (Six Spirits Decoction), distension resolved.

Mrs. Zhang Yongchun of Desheng Du, Qi Deficient constitution, suffered from abdominal distension in autumn. Took consuming drugs excessively, abdomen swelled like drum within days. I immediately used Ji Sheng Shen Qi Wan (Kidney Qi Pill from *Prescriptions Generated from Empathy*), seeing miraculous effect. Later slight distension, repeated the former prescription, and he recovered.

Medical Cases of Jiao Qi (Beriberi/Leg Swelling)

Fang Tiehua's father, a Prefectural Student, suffered from Jiao Qi attacking upward. Physicians administered Drying-Dampness, Regulating-Qi, Unblocking-Yang agents, worsening wheezing and swelling. I said "For those heated yet feeling cold, seek Yang." Thus establishing Jia Wei Shen Qi Tang (Modified Kidney Qi Decoction). Initially no perceived benefit, nor dryness/heat. Insisting on taking it for thirty doses, he recovered.

Medical Cases of Jaundice (Fa Huang)