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The regulation of the central Jiao (Middle Burner) relies on the Spleen and Stomach for transformation and transportation. When abdominal distension occurs due to emptiness in the middle with dryness and obstruction below, mistakenly using harsh agents to attack will result in fatal pulse signs, rendering the condition incurable. The crowd said, "No. Even if the Middle Qi is deficient, encountering purgatives should cause it to flow down as smoothly as water from a high roof, how could it not move?" Qiao (Wang Ji) said, "You only know that the Spleen is deficient and cannot tolerate cold and cool properties, but you do not know that if the Spleen perishes, then cold and cool agents have no target to act upon." The disciples knelt and said, "Indeed, if we can obtain one prescription to lend our hands, we might not feel indifferent regarding the heart of a filial son." He said, "Administering Dushen Tang (Single Ginseng Decoction) may lead to bowel movement, but the effect will be thin; it offers little benefit to the treatment. Once the prescription is obtained, there will be borborygmus (intestinal rumbling) and urination, and abdominal distension will decrease by one-third." Zhang then opened his eyes to ask about the condition, and everyone considered him reborn. The disciples asked, "Dahuang (Rhubarb Rhizome) does not promote defecation, but Renshen (Ginseng Root) does; what is the explanation?" Qiao said, "No. If the central authority is abolished, how can the vanguard receive orders? By tonifying the middle and establishing the banner (command), those who destroy hardness begin to be used. This is also Renshen utilizing Dahuang, not Renshen itself being able to induce defecation." However, although the illness slightly improved, the pulse did not return to normal, and ultimately, he was not cured. Shen (Zhang Shen) came again, intending to claim the merit for himself, and severely scolded the disciples: "You treated your father with 'non-treatment', lacking the propriety of a filial son. Now that he has risen after just one purge, what more is there to wait for?" Qiao had previously avoided Shen, estimating that further arguing would be useless. Just as the disciples asked whether it was permissible, he slowly replied, "It is merely death either way. Purging leads to death from this disease; not purging leads to delayed death. You gentlemen decide yourselves; how dare I interfere?" Shen's scolding became more urgent, and eventually, they purged again. Before long, he died. (From *Taihan Ji*.)

Wang suffered from fever, headache, and severe abdominal distension. The physician administered dispersing and releasing methods; the fever subsided, but the pain remained, and both anterior and posterior orifices were obstructed (inability to urinate or defecate). Subsequently, Dahuang (Rhubarb Rhizome) was used to unblock the bowels. Bowel movements occurred slightly, but urination was red and difficult, and distension and pain were particularly severe. It was still believed to be heat accumulation, and another purge was planned. Qiao diagnosed: "This illness originated from fatigue and internal injury (sexual excess), compounded by eating cold foods. Internal injury damages the Kidney; fatigue and cold food damage the Spleen. The Kidney governs both anterior and posterior orifices. When the Kidney is damaged, it cannot transform and transport, thus generating damp-heat leading to fullness. If one were to purge urgently, Yin would be lost, and distension and fullness would increase, which is a dangerous path." Wang bowed his head and knocked against the pillow, saying, "Truly as you say; all three conditions apply to me." Thus, Renshen Wuling San (Ginseng and Five-Ingredient Powder with Poria) was administered. After one dose, anterior orifice (urine) flowed freely; after the second dose, there was a major bowel movement, and pain soon decreased. The patient urgently sought relief for the posterior orifice (bowel movement). Qiao said, "Your six pulses are deep, thready, and rapid. You must wait two nights; only then will the Spleen Qi recover. When the Spleen obtains its mastery, damp-heat will dissipate on its own. Do not desire speed; tomorrow the large stool will naturally pass." After more than a month of regulation, he recovered. (Ibid.)