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In summer, yin-cold lurks within the body; treatment should be sought from the perspective of cold-dampness. It is proposed to use Lizhong Tang (Regulate the Middle Decoction) to warm and regulate Spleen-Yang. After taking the medicine, diarrhea ceased, vomiting decreased, and the tongue coating receded somewhat.

This arises because Spleen-Yang was previously deficient. The "inferior earth" (Spleen with weak transportive function) easily generates dampness; due to insufficient Yang Qi, cold generates internally. Since there are no external pathogens interfering, it is a disease originating from the body's own constitution. Now that the medication has hit the mark, one need only increase the dosage within the formula, rather than seeking other herbs outside the formula. The reason for not abruptly adding Yin-nourishing medicines is likely due to the concern that patients with obesity are prone to Yang deficiency, and we fear further damaging their Yang. The Classic states: "Human Yang Qi is like the sky and the sun; if it loses its proper place, life is shortened and brilliance is lost. Thus, the movement of heaven depends on the brightness of the sun." Where sunlight does not reach, dampness often abounds, just as thin soil cannot retain warmth. The Classic also states: "The Spleen dislikes dampness; urgently eat bitter substances to dry it." If Spleen-Yang becomes robust, one may hope for the restoration of transportive function. The previous prescription, when increased in dosage, proved effective, sufficient to show that the disease was heavy while the medication was light. However, during midsummer, using large doses of Ginseng and Aconite for over twenty days without curing the illness reveals the severity of this deficiency-cold condition, which is indeed formidable. Remain calm and steadfastly adhere to this method; success will come naturally when the effort is sufficient.

An Bo notes: Hua Shi said that low, damp places must be exposed to the scorching sun to dry out; this case is similar.

The illness began with occasional dizziness and collapse. Physicians attributed it to "sudden deficiency with pathogen invasion" and aggressively administered sweet-warm, potent tonics. This exacerbated chest distension, vomiting, anorexia, and constipation. Occasionally, floating Yang surged upward, causing facial redness and dry lips and mouth. However, the pulse remained harmonious, sleep was stable, and speech was clear. Investigating the cause, it stems from lower Kidney-Yuan deficiency, where Water fails to nourish Wood, leading to rampant Liver-Wind. Upon onset, symptoms resemble stroke or syncope. The Classic states: "All wind syndromes involving dizziness and tremors belong to the Liver." Heavy warm-tonifying medicines agitated Liver-Yang. The chest distension, vomiting, anorexia, and constipation are none other than Liver-Wind disturbing the Stomach, obstructing the descending function of Stomach-Qi. If it were truly True-Yang flying away and Lei-Long Fire failing to hide, the pulse would necessarily be floating, large, and rootless, and symptoms would include restlessness with no moment of peace. Moreover, how could the previous warm-tonifying prescriptions have been ineffective yet worsened the condition? The formulated strategy of calming the Liver and soothing the Stomach still has room for discussion. Since Liver-Yang surges violently, non-piercing (shell/mineral) substances are insufficient to subdue its might; with Wood-Fire boiling, sour flavors are the only means to restrain the flame. It is suggested to add Oyster Shell (Muli) and Mume Fruit (Wumei) to the formula, which would be more appropriate. Frequent expectoration of phlegm-saliva inevitably injures Stomach fluids; adding Dendrobium (Chihu) and Sugarcane Juice to nourish Yin and preserve fluids is particularly fitting.

An Bo notes: Liver-Wind syndrome results from Liver-Yang consuming Kidney-Water, leading to dried-up Water and blazing Wood. Thus, it rises upward causing collapse, phlegm-misting the mind; rising outward causing dizziness, vomiting, palpitations, insomnia, spasms, convulsions, and tinnitus. Various malignant manifestations vary greatly. Quack doctors, failing to recognize this, use hot tonics to aid fire, leading to death, a number too great to count. Therefore, this is recorded as a warning to mediocre physicians.