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*Weisheng Baojian* records: A man named Shi from Zhending, aged forty-two, was originally thin. In autumn, he reluctantly drank several cups of sour wine. Soon after, abdominal pain occurred, which then progressed to unceasing diarrhea. After more than ten days, blood appeared in the stool following defecation; the blood color was either red or purple, accompanied by borborygmus and intermittent abdominal pain. Various physicians attributed this to blood heat and treated him with Shaoyao Bopi Wan (Peony and Phellodendron Pill), but it was ineffective. The patient still had no appetite; upon eating, he vomited acidic fluid. His body became even thinner, his complexion was greenish-yellow and lusterless, he experienced epigastric fullness and distension, disliked cold substances, felt dry mouth, and occasionally suffered from irritability and restlessness, unable to sleep peacefully. Upon pulse diagnosis, the pulse was wiry, fine, slightly weak, and slow; his hands and feet were slightly cold. *The Classic of Internal Medicine* states: "In Jie Yin syndrome, one sheng of blood is passed via stool; if it recurs twice, two sheng are passed; if three times, three sheng." It also says: "When pathogenic factors reside in the five zang organs, the yin meridians become disharmonious; when yin meridians are disharmonious, blood stagnates." Jie Yin disease refers to the internal knotting of yin qi, preventing its outward circulation. With nowhere to distribute, it infiltrates the intestines, leading to hematochezia. External moxibustion was applied to Zhongwan (CV12), Zusanli (ST36), Qihai (CV6), etc., and internally, Pingwei Diyutang (Stomach-Pacifying Coptis and Sanguisorba Decoction) was administered, resulting in recovery.

Note: This treatment case exemplifies a method for internal injury. It should be read in conjunction with the section on "Accumulation and Mass" regarding the onset of accumulation.

Danxi stated: *The Classic of Internal Medicine* says: "When a person reaches forty, their yin qi naturally halves, and their daily activities decline." It also says: "Males experience essence exhaustion at sixty-four, and females experience menstruation cessation at forty-nine." Considering the formation of yin qi, it suffices only for twenty years of use, already predisposed to deficiency. Human desires are boundless; how can one indulge in lust given this yin qi that is difficult to generate yet easy to deplete?

Respectfully noted: Some say, *The Classic of Internal Medicine* states: "Ying (Nutritive) qi is the refined essence of food and drink. It harmonizes the five zang organs and distributes to the six fu organs, thereby entering the vessels. It comes continuously, generated by the spleen, governed by the heart, received by the liver, disseminated by the lungs, and excreted by the kidneys, irrigating the whole body. The eyes receive it to see, the ears receive it to hear, the hands receive it to grasp, the palms receive it to hold, the feet receive it to walk, the zang organs receive it to produce fluids, and the fu organs receive it to generate qi. Thus, entry and exit, ascent and descent, moistening and unblocking are all caused by this. Injected into the vessels, when scant it is choppy, when abundant it is firm. Due to daily nourishment from diet, yang generates yin; juice is extracted, transformed, and reddened into blood. When generation and transformation are vigorous, the meridians rely on this for growth; when exhausted, the hundred vessels become empty. How can one not carefully nurture it? Therefore, it is said that blood is the spirit qi; maintaining it preserves life, losing it leads to death. Hence, abundant blood means robust form, weak blood means frail form; calm spirit generates yin, physical exertion causes yang hyperactivity; yang excess inevitably leads to yin decline. Why speak of yang abundance generating yin blood? Generally, this refers to the normal state of qi and blood, where yin follows yang, circulating within with qi. Without yin to restrain, how can qi stand firm? Thus, in terms of pathology, (yin) is easy to treat, unlike (yang). Since yang is often deficient and further damaged, yang easily becomes hyperactive and yin easily becomes scarce, as seen in the theory that 'yang is often in excess, yin is often insufficient.' The meridians state: 'The pathway of yang is solid/excess, the pathway of yin is hollow/deficient. The yin pathway is often deficient, yang is often in excess, yin is often insufficient.' From birth until fourteen, meridian qi circulates; at forty-nine, menstruation ceases. This shows how difficult yin blood is to generate and how easy it is to deplete. Once yin qi is injured, the resulting syndromes manifest as: reckless upward movement causing hematemesis and epistaxis; depletion externally causing consumptive fever; downward leakage causing rectal bleeding; slight bladder heat causing stranguria and hematuria; infiltration into intestines causing wind-intestinal bleeding; yin deficiency with yang pounding causing metrorrhagia; dampness steaming with heat coagulation causing dysentery; extreme heat causing putrefaction resulting in purulent blood; fire extreme resembling water with purple-black blood color; heat surpassing yin causing sores; dampness stagnating in blood causing itching and urticaria; skin becoming cold bi; accumulation above causing forgetfulness; accumulation below causing mania; falls and fright causing internal congealing of stasis. If divided by location, the upper half corresponds to heaven's yang, the lower half to earth's yin. These are merely examples of manifested syndromes. To treat blood diseases, one must use blood-specific herbs. Seeking such herbs, one primarily refers to Siwu Tang (Four Substances Decoction). Hejian detailed the method of adjunctive formulas based on syndromes, called Liuhe Tang (Six Harmonies Decoction). Therefore, I present the key principles of their flavors and actions, which must not be overlooked. Chuanxiong Rhizoma (Chuanxiong) is a qi herb within blood herbs, enters the Liver Meridian, has acrid and dispersing properties, moving blood stasis within qi. Dihuang Radix (Dihuang) is a blood herb within blood herbs, enters the Kidney Meridian, has sweet and cold properties, generating true yin deficiency. Danggui Radix (Danggui) is divided into two parts, the main herb for treating blood, enters the Liver Meridian, has acrid and warm properties; used wholly, it invigorates blood and guides it to its respective meridian. Baishao Radix (Baishao) is a yin branch herb, enters the Spleen Meridian, has sour and cold properties, harmonizing blood and treating deficiency-type abdominal pain. If seeking yin herbs, one must take these as the standard. *Pi Wei Lun* states: "A skilled practitioner adjusts according to the meridians, selecting one or two suitable herbs as the primary treatment." This specifically discusses blood diseases and seeking blood-related herbs. For qi deficiency and blood weakness, one should follow Changsha's (Zhang Zhongjing) principle: "Tonify blood deficiency with Ginseng Radix et Rhizoma (Renshen); yang abundance generates yin blood." As for Siwu Tang, it only generates blood, suitable for blood branch injury without qi deficiency. Adjunctive herbs include Taoren (Persicae Semen), Honghua (Carthami Flos), Sumu (Pterocarpus Indicus Lignum), Xuexue (Draconis Sanguis), and Mudanpi (Moutan Cortex), suitable for blood stasis; Puhuang (Typhae Pollen), Ejiao (Colla Corii Asini), Diyu (Sanguisorbae Radix), Baicaoshuang (Carbonized Herbs), and Zonglühui (Livistonae Frondis Cinis), suitable for metrorrhagia; Ruxiang (Olibanum), Moyao (Myrrha), Wulingzhi (Trogopterori Faeces), and Lingxiaohua (Campsis Grandiflora Flos), suitable for blood pain; Congrong (Cynomorii Herba), Suoyang (Cynomorchii Herba), Niuxi (Achyranthis Bidentatae Radix), Gouqizi (Lycii Fructus), Yimucao (Leonuri Herba), Xiakucao (Prunellae Spica), and Baiguiban (Testudinis Carapax et Plastrum Carbonatum), suitable for blood deficiency; dairy products, suitable for blood dryness; Ganjiang (Zingiberis Rhizoma) and Guizhi (Cinnamomi Ramulus), suitable for blood cold; Shengdihuang (Rehmanniae Radix) and Kushen (Sophorae Flavescentis Radix), suitable for blood heat. These represent the general principles of direct treatment. By applying them analogously, one can adapt to infinite variations.