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The daughter-in-law of Mr. Fang Jinxiang suffered from cough in autumn, which was ignored. As winter approached, the condition worsened, presenting with alternating chills and fever in the afternoon. Physicians diagnosed it as an external contraction (wai gan), but medication proved ineffective, leading to physical fatigue, emaciation, poor appetite, and loose stools. Upon examination, her breathing was rapid upon movement, and her pulse was wiry and forceful without a "stomach qi" (a sign of depleted organ essence). Inquiry revealed amenorrhea for three months. I privately told Mr. Fang: This is likely a Lao syndrome (a chronic consumptive disease similar to tuberculosis); the critical period is imminent. Mr. Fang exclaimed in shock: The illness is merely cough and fever; how could it reach this state? I replied: The Classic states, "Diseases of the Two Yangs originate in the Heart and Spleen; when there are hidden grievances, women suffer from amenorrhea." If transmitted into Feng Xiao or Xi Fen (terms for severe consumptive conditions resulting from prolonged coughing), death is inevitable and untreatable. Moreover, a wiry and forceless pulse indicates a True Zang pulse (a terminal pulse indicating extreme severity). The Classic further states, "Emaciation with a large pulse and excessive Qi in the chest indicates death." Given such pulse and symptoms, survival is impossible. I declined to prescribe medicine, and the patient died ten days later.

A maiden of the Pan family, aged fifteen, initially suffered from abdominal pain, which gradually progressed to cough, chills and fever, emaciation, and poor appetite. Her pulse was fine and rapid, and her menses were delayed by three months. I stated: This is a Zhai syndrome (specifically referring to infectious pulmonary tuberculosis). I refused treatment. She died within one hundred days. I have observed that many women presenting with cough, chills and fever, rapid pulse, and amenorrhea are largely incurable, especially maidens, none of whom survive. Regardless of employing methods to tonify deficiency, clear heat, resolve depression, or regulate menstruation, no efficacy is achieved. Ancient texts offer few effective remedies. Only the *Jin Gui Yao Lue* records two formulas: Da Huang Zhe Chong Wan and Bai Lao Wan. Yu Jiayan elucidated their principles. It is my considered opinion that at the initial stage of this disease, when blood bi (obstruction) is present and Lao Zhai is impending but not yet fully formed, administering these medicines to remove old stasis and generate new blood might yield results, though this is uncertain. However, if time is delayed until Yuan Qi (vital energy) is depleted, it will be too late. I record this for discussion with wise physicians.

Mr. Fang Canlv, nearly seventy years old, had a history of abdominal pain. One night, he suddenly vomited and defecated several bowls of dark purple blood clots, accompanied by dizziness, spontaneous sweating, closed eyes, and mental fatigue. His pulse was Koushu (floating, large, and empty like a scallion stalk, indicating blood loss). I told his son: This is a Xue Tuo syndrome (critical condition of Qi collapse following massive hemorrhage). Medical classics state: "Long-standing pain often involves blood stasis." Presumably, due to years of abdominal pain, stasis had accumulated deeply. Its sudden expulsion poses a risk of syncope and collapse, particularly given his advanced age and underlying Qi deficiency. Ancients treated blood depletion with Du Shen Tang (Single Ginseng Decoction) to tonify Qi, but current ginseng prices are prohibitive. Therefore, I prescribed a large dose of Hei Guipi Tang (Black Spleen-Empowering Decoction) to nourish the source of Qi and Blood generation and consolidate the Spleen's function of containing blood. He recovered shortly thereafter. The disease recurred the following year. Although less severe than before, he felt exhausted and weak. Adhering to the previous method, he recovered again. His son, fearing recurrence, sought advice on post-treatment management. I reasoned that blood stasis must have a fixed locus ("nest"), much like water filling depressions before flowing forward. According to theory, the Stomach is the source of Blood generation, and the Spleen is the organ that controls blood. If the Spleen and Stomach are strong, Qi and Blood circulate freely, preventing stasis. The Classic compares the Six Channels to rivers and the Intestines and Stomach to the sea; flooding occurs because the rivers lack proper drainage. Thus, I prescribed two formulas: Guipi Wan (Spleen-Empowering Pill) taken in the morning and Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) taken in the evening. Both formulas were supplemented with Danshen (Salvia Miltiorrhiza Root) and Ganqi (Lithospermum Root) to promote the removal of stasis and generation of new blood. After a year of medication, the disease was completely eradicated.