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Headache that persists for a long time without healing is called Tou Feng (Head Wind). Tou Feng often damages the eyes, as stated in medical texts. However, there is another type of sudden, severe manifestation characterized by mental confusion and limb convulsions, which is incurable; this has not been mentioned by former sages. I once witnessed the son of Old Man Huang Shutang, who was about ten years old, suffering from recurrent headaches. Passing by his home on other business, I saw the child crying and wailing. Upon inquiry, the old man explained the situation. The prescriptions provided by the doctor consisted entirely of acrid and dispersing herbs. I said: "This is due to congenital deficiency, where Liver Wood fails to be nourished by Kidney Water, leading to the upward冒 (assault) of Wind-Yang. Acrid dispersing methods are inappropriate." The old man requested a prescription, so I prescribed Gui Shao Di Huang Tang (Cinnamon Twig, White Peony, and Rehmannia Decoction). Confused by others' advice, he discarded it and continued with the original doctor, who thought the previous medicine was too mild and added Xixin (Asarum) and Bencao (Ligusticum), resulting in severe headache and syncope overnight, along with spasms of the hands and feet. He urgently sought my help. I said: "Liver Wind has stirred; it cannot be saved." The old man pleaded for rescue, so I reluctantly used Shudi (Prepared Rehmannia), Dangshen (Codonopsis), Maidong (Ophiopogon), Ejiao (Donkey-hide Gelatin), Zhigancao (Honey-fried Licorice), Mahren (Hemp Seed), Zao Rou (Jujube Flesh), Fushen (Poria with Hostwood), and Baishao (White Peony), combined with Fu Mai Tang (Pulse-Recovering Decoction), incorporating Ouli (Oyster Shell), Guiban (Turtle Shell), and other bivalve/shellfish minerals for their subduing properties. It proved ineffective, and I declined further treatment. Subsequent doctors were also unsuccessful, and after several days of delay, he died. Subsequently, I encountered a young boy surnamed Qiu and a girl surnamed Fang, presenting identical symptoms, both of whom were incurable. Analyzing the pathogenesis, this syndrome belongs to Tou Feng (Head Wind) affecting the vertex, characterized by deficiency below and excess above. Treatment should address the upper disease by treating the lower part. The physicians misunderstood the etiology and recklessly used acrid dispersing methods, causing the condition to deteriorate; the logic is clear. While many cases of pain and syncope are treatable, once this specific syndrome involves mental confusion, it becomes untreatable. Is this not what the *Neijing* refers to when it says, "When severe, it enters the Kidney; internal depletion leads to syncope, resulting in aphasia and flaccidity"? In Volume One, there is a case of Madam Zheng, which I cured, but it was merely fortunate.

An Bo's Note: Liver Wind and Liver Syncope became prevalent after the Taiping Rebellion. This is largely due to the artificiality and affectation of human emotions over a long period. Why? When the Taiping forces were rampant, people were too busy struggling for survival to indulge in rage that makes hair stand on end.

Brother Xiuqiao was over fifty years old and had been trading in Weiyang (Yangzhou). He had been ill for months, seeing many doctors, yet the more he was treated, the worse he became. I arranged for him to be transported home by boat. His appearance was emaciated and withered, and his movements were difficult. His pulse was wiry, forceful, and lacked softness. Asking about the origin of the illness, he recounted that last winter, an abscess appeared in his lower abdomen, gradually causing pain radiating to the Zhongwan (CV12) area, accompanied by occasional nausea and vomiting. At that time, although his appetite decreased, he could still eat one bowl of soft rice. As spring arrived, the condition worsened daily; even thin gruel caused vomiting. His body wasted away, muscles depleted, constipation set in, and skin became dry. Various medicines had been tried with no effect. Recently, he developed a strong aversion to the smell of medicine, vomiting immediately upon ingestion. How do you advise me? I said: "A physician diagnosing an illness is like an official judging a case. To judge a case, one must understand the facts; to diagnose an illness, one must clarify the principles." Analyzing the pulse and symptoms, the pathogenesis was clear to me. A wiry pulse corresponds to the Liver; various pains belong to the Liver. The Jueyin Liver meridian circulates through the lower abdomen. Tracing back, it stems from habitual emotional distress, where Liver Qi stagnates and fails to flow smoothly, causing lower abdominal pain. The Liver is the "General," possessing a rigid and impatient nature. Physicians administered acrid, aromatic, warm, and drying herbs to relieve pain, which consumed Liver Yin and allowed the angry Liver Wood to become even more rampant, attacking the Stomach and causing vomiting. Thus, the Liver is the root of the disease, and the Stomach is the site of transmission. The chaotic use of multiple drugs further damaged Stomach Qi. The Stomach is the Sea of Water and Grain, the source of Qi and Blood. If it cannot accept food, how can Qi and Blood be generated? Without blood to moisten the skin, it becomes withered; without blood to moisten the intestines, they become dry. Yang Qi knots in the upper, while Yin fluids decline in the lower. Moving towards the path of Ye Ge (Dysphagia/Esophageal Obstruction), how can mere herbs reverse this withering and restore moisture? The *Classic* states: "All cases of obstruction, withering, drying, stiffness, and cracking belong to Dryness." Dryness should be treated with moistening methods; thus, the treatment principle is not difficult. However, moistening agents are often cloying and stagnant. With empty Stomach Qi, vomiting, and aversion to medicinal odors, how can they be forced down? Studying ancient treatments for simultaneous Qi and Blood deficiency, one must first tonify Qi, for Qi is the commander of Blood. Among Qi-tonifying herbs, Ginseng is paramount because it can restore Yuan Qi (Original Qi) from nothingness. Furthermore, Li Dongyuan stated: "For vomiting caused by deficient heat in the Stomach and prolonged deficiency of Grain Qi, obtaining the Yin of five grains to harmonize it will stop the vomiting without medication." Therefore, I carefully selected Shen Mi Yin (Ginseng and Rice Drink), which has a mild and harmonious flavor, likely fitting the pattern. Thus, two qian of Ginseng were decocted with aged rice water daily. Indeed, he tolerated it without vomiting. After ten days, his diet increased and complexion improved. Then, Shen Ru Tang (Ginseng and Milk Decoction) was combined and taken for two months. Bowel movements became smooth, skin became lustrous, and he recovered. For such a severe condition, only these two formulas were used, without any other ingredients. Simplicity of prescription and specificity of action are indeed trustworthy.

An Bo's Note: Since the disease has persisted for a long time, it belongs to Deficiency; hence, Ginseng can be tolerated. Otherwise, the principle that "the Liver has no tonification method" would have rendered this approach useless.