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Jiang (Left): Qi rebellion in the left hypochondrium attacks the chest, leading to stagnation and accumulation over time, obstructing food intake and causing distension. The physician used rhubarb (Rhei Radix et Rhizoma) and mirabilite (Natrii Sulfas) for purgation, injuring the formless primordial qi, resulting in borborygmus and diarrhea, with a hard mass forming in the epigastrium. Pulse diagnosis revealed a strong left pulse and a weak right pulse; decreased appetite and poor transport indicate hyperactive Liver Wood and deficient Spleen Earth, inevitably leading to vomiting and reflux. The proposed treatment is to harmonize the Liver and unblock the Fu organs, descending turbidity and dispelling distension. Prescription: White Peony Root (Paeoniae Radix Alba), Oyster Shell (Concha Ostreae), Aurantium Fructus Immaturus (Zhi Ke), Trichosanthes Seed (Gua Lou Ren) (all stir-fried), Green Tangerine Peel (Qing Pi), Amomum Fruit Husk (Sha Ren Qiao), Alpinia Officinarum Rhizome (Yi Zhi Ren) (roasted), Poria (Fu Ling), Prepared Pinellia Tuber (Zhi Ban Xia), Roasted Ginger (Wei Jiang). After five doses, symptoms improved, appetite increased, and the mass softened and shrank. Remove Zhi Ke and Gua Lou Ren; add Codonopsis Root (Dang Shen) and Raw Atractylodes Macrocephala Rhizome (Sheng Zhu) to support Spleen Yang, after which the right pulse also strengthened.

Zhang: Accumulation in the lower abdomen. Self-medicated with rhubarb (Rhei Radix et Rhizoma), Curcuma Longa Rhizome (Yu Jin), and Aurantium Fructus (Zhi Shi), expelling stasis multiple times, providing temporary relief. Relying on robust constitution, he used these aggressively for years. I stated that accumulations wax and wane with primordial qi; when primordial qi declines, pathogenic factors occupy the space. Repeated purgation ultimately damages Spleen primordial qi. The Classics state: "For large accumulations, they may be removed." However, stop when half the accumulation is reduced; supporting the Spleen while eliminating accumulation is the stable approach. Formula: Six Gentlemen Decoction (Liujunzi Tang) base, added with Costus Root (Mu Xiang), Green Tangerine Peel (Qing Pi), Angelica Sinensis Root Tail (Gui Wei), Corydalis Rhizome (Yan Hu Suo), White Peony Root (Bai Shao), and Cinnamon Bark (Guan Gui), made into water-pillets. This will gradually dissipate the stagnation without damaging true Yuan Qi.

Brother of Fang: A palpable mass (Lei accumulation) in the lower left abdomen, suffering from dragging pain upon cold exposure. Previously, needle pricking at the Yuan-source point relieved pain. Now, the chronic condition recurs with fatigue. The swollen mass cannot withstand harsh purgation. Following the precedent of long-standing pain injuring collaterals, combined with salty substances to soften hardness, the main treatment should be effective. However, the lower Jiao is deep, governed by the Liver Meridian of Foot-Jueyin and its sinews, making direct access difficult. Prescription: Fennel Fruit (Bo Hui Xiang), Tangerine Seed (Ju He) (both wine-roasted), Angelica Sinensis Root (Dang Gui), Mustard Seed (Xu), Chives Seed (Jiu Zi) (stir-fried), Corydalis Rhizome (Yan Hu Suo), Fenugreek Seed (Hu Lu Ba) (both wine-fried), Oyster Shell (Mu Li) (vinegar-processed), Agarwood (Chen Xiang) (decocted juice taken). After three doses, pain ceased, swelling subsided, and the mass softened.

Nephew of Fang: Stagnation and distension in the upper right hypochondrium, feeling swollen and tense upon pressure, gradually interfering with full meals. Following the "softening" method from *Shishi Milu*, use Raw Atractylodes Macrocephala Rhizome (Sheng Zhu), Poria (Fu Ling), Medicated Leaven (Shen Qu), Dioscorea Hypoglauca Tuber (Di Li Fen), Turtle Carapace (Bie Jia) (roasted), White Peony Root (Bai Shao), Prepared Pinellia Tuber (Zhi Ban Xia), White Mustard Seed (Bai Jie Zi), Magnolia Bark (Hou Po), Cinnamon Heart (Gui Xin), and Codonopsis Root (Lu Shen). Made into honey pills; taking them followed by food enhances efficacy.