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Sun Wenyuan treated the son of the Cheng family, aged fifteen, who suffered from dysentery in summer. After a month of treatment by other doctors, the dysentery stopped but was followed by swelling and pain in the bones and tendons, with heat at the painful sites, milder during the day and heavier at night, muscle wasting, and reduced appetite. Some advocated treating it as Baihu Lijie Feng (White Tiger Joint Pain Wind), others as Hexi Guchui Feng (Crane Knee Drumstick Wind), causing severe pain. Upon examination, the pulse was fine and choppy in both hands. Sun said: This is Post-Dysentery Wind (Feng syndrome occurring after dysentery). It is likely due to improper treatment of dysentery, leading to stagnation of cold-dampness, filth, and blood stasis in the meridians. Over time, Qi and Blood are damaged by the pain. This condition involves both deficiency and excess, making it extremely difficult to diagnose and prescribe. If tonifying deficiency, the swelling worsens; if promoting circulation, the pain intensifies. Only Da Fangfeng Tang (Great Saposhnikovia Decoction) from *Ju Fang* can be used. The prescription consists of Fangfeng (Radix Saposhnikoviae), Shudi Huang (Prepared Rhizoma Dioscoreae Hypoglaucae), Huang Qin (Radix Scutellariae), Renshen (Radix Ginseng), Baishao (Radix Paeoniae Alba), Danggui (Radix Angelicae Sinensis), and Duzhong (Cortex Eucommiae), each 1 qian; Baizhu (Rhizoma Atractylodis Macrocephalae) 1.5 qian; Qianghuo (Rhizoma et Radix Notopterygii), Niuxi (Radix Achyranthis Bidentatae), Gancao (Radix Glycyrrhizae), and Huixiang (Fructus Foeniculi), each 0.5 qian; Chuanxiong (Rhizoma Chuanxiong) 0.7 qian; plus three slices of Shengjiang (Rhizoma Zingiberis Recens). After taking thirty doses, he recovered.

Chen Sansan treated a scholar who, after dysentery, suffered from spasmodic pain in the lower back and legs, unable to bend or straighten. This was caused by Kidney deficiency allowing invasion of Wind-Cold-Dampness. He was cured with two doses of Duhuo Jisheng Tang (Angelica Pubescens and Dogwood Decoction).

Dou Cai treated a man who was lethargic and lay down immediately after eating, causing food retention in the Middle Jiao, inability to eat, and limb fatigue. Dou prescribed fifty moxa cones on Zhongwan (CV 12), along with Fenqi Wan (Qi-Dispersing Pill) and Dingxiang Wan (Clove Pill), resulting in recovery. Another patient with Spleen-Qi deficiency liked cold foods, which were indigestible, and often had breath smelling like rotting eggs. He was cured by Caoshen Dan (Grass God Elixir). Quanzhen Jin Ye Dan (Complete True Golden Fluid Elixir) would also have been effective. (Original note: Since the Spleen and Stomach are injured by food, one must not use digestive or purgative methods again. Only by using warming and transforming methods will the Spleen and Stomach regain their normal transportation.)

Another patient ate cold foods in summer, injuring Lung Qi, leading to cough and chest oppression. He first took one hundred Jin Ye Dan (Golden Fluid Elixir) pills, resulting in one bowel movement and a reduction of pain by three points, then took Wuge San (Five Obstructions Powder) for recovery. However, symptoms recurred frequently. Five years later, a severe relapse occurred. After five hundred moxa cones applied to Zhongfu (LU 1), foul-smelling flatulence was expelled, and the disease never returned. (Physicians of the world fail to investigate the cause, often claiming that summer heat injures the Lung, prescribing a batch of cold-natured drugs, leading to water retention and serious illness. Original note.)

Wang stated: There was a person who loved roasted goose and grilled meats, consuming them daily. Everyone feared he would develop carbuncles and sores, but he eventually did not fall ill. It was learned that he drank a bowl of boiled tea every night, revealing that tea can resolve the toxicity of grilled meats.

Gong Zicai treated a man who, after labor, ate over ten persimmons, then drank several bowls of cold water, and shortly after, ate several bowls of hot noodles. This resulted in severe abdominal pain. Examination revealed deep and faint pulses in all six positions, with the Qi Kou (cun position of the radial artery) slightly full. This was caused by the struggle between Cold and Heat. He was given Fuzi (Radix Aconiti Lateralis Preparata), Ganjiang (Rhizoma Zingiberis), Rougui (Cortex Cinnamomi), Zhishi (Fructus Aurantii Immaturus), Shanzha (Fructus Crataegi), Shenqu (Massa Medicata Fermentata), Ezhu (Rhizoma Curcumae Longae), and Xiangfu (Rhizoma Cyperi), and the pain stopped after one dose. Later, when his whole body became feverish, he was given Xiao Chaihu Tang (Minor Bupleurum Decoction) for one dose and recovered.

Another patient ate several jin of lamb meat in December. The cold fat from the lamb solidified and blocked the chest and diaphragm, causing severe distension and suffocation. All physicians were helpless. Examination showed pulses present in all six positions. A large jar of yellow wine was heated and poured into a large vat. The patient sat inside while people gently slapped his chest, abdomen, and back. Two people blew into his ears, and hot liquor was forced down his throat. Then, Wan Yi Wan (Ten Thousand Billion Pill) was administered, leading to vomiting and diarrhea, and recovery.

Tao Jian'an treated a patient whose illness was caused by eating lamb and wading through water, causing stagnation in the chest. A disciple asked: "This disease cannot be treated with purgatives, nor can it be induced to vomit. What method should be used?" Tao said: "It is suitable to take one qian of Pi (Arsenic)." The disciple did not believe it and tried other medicines without success. Finally, following Tao's advice, one dose induced vomiting and cured the disease. The disciple asked: "Arsenic kills people; how can it cure diseases?" Tao said: "Sheep blood and dog blood greatly resolve arsenic toxicity. Lamb meat combined with arsenic induces vomiting, and arsenic combined with lamb loses its killing power. Therefore, I know it can be cured." (*Hangzhou Fu Zhi*).

Tang Shouyuan treated a woman who, while eating lamb, heard a call and responded before swallowing. A month later, the disease started, lasting two years. Tang said: "There must be retained food in the chest." The family said: "It has lasted two years." Tang said: "Try my medicine." Soon, she vomited heavily, expelling a piece of lamb wrapped in phlegm, and recovered. (*Pinghu County Gazetteer*).

Wang Haizang treated Qin Sheng, who liked to consume Tian Sheng Cha (Natural Tea) and cold foods, forming accumulation and stubborn cold. The pulse was neither floating nor sunken, extremely forceful upon pressing up and down, inside and out, hard and unyielding, protruding against the finger, impossible to count beats, and impossible to describe size. This is the Yin Syndrome Drumming Pulse. Fire circulating in the body gathered in the chest, pressured by cold Qi, thus beating strongly and forcefully. He was given Zhenwu Tang (True Warrior Decoction), Sini Tang (Frigid Extremities Decoction), Lizhong Tang (Regulate the Middle Decoction) and pills, assisted by Baishao (Radix Paeoniae Alba) and Huixiang (Fructus Foeniculi) to prevent fire from rising abnormally. Taking one hundred pills daily, he sweated at night and recovered.

Sun Wenyuan treated Dong Xunyang, aged sixty-seven, who had Spleen and Stomach disorders. Due to excessive consumption of melons and fruits, he suffered from chest and epigastric distension and pain, unresponsive to other doctors. The pulse at Cun and Guan was wiry and tight. Sun said: "The injury from melons and fruits results in an excess of Cold-Dampness. The Classics state: 'When Cold invades excessively, treat with Acrid-Warm.' However, melons and fruits cannot be resolved without Mosher (Shexiang) and Cinnamon Bark (Rougui). Using Gaoliangjiang (Rhizoma Alpiniae Officinarum) and Xiangfu (Rhizoma Cyperi) each 1 liang as Sovereign, Rougui (Cortex Cinnamomi) 5 qian as Minister, and Shexiang (Moschus) 1 qian as Assistant, taken 2 qian per dose mixed with wine. After swallowing, the chest felt relaxed. By the next day, he felt hungry. After three doses, he could groom himself and receive guests as if healthy.

Ma Er Yin Di'an, aged fifty-five, suffered from heart and abdominal distension and pain due to excessive consumption of eel rolls. Physicians failed to use emesis and hastily used Xiaoshi (Natrii Sulfas) and Dahuang (Radix et Rhizoma Rhei) to purge. Bowels remained obstructed, and pain worsened. Muxiang Binglang Wan (Aucklandia and Areca Nut Pill) was used, followed by Dachengqi Tang (Major Order the Qi Decoction) and Xiaochengqi Tang (Minor Order the Qi Decoction). For over ten days, the condition deteriorated; no stool or food intake, urine only drops. Baibingzi (White Cake Pill) was taken for five days, Beiji Wan (Emergency Pill) for three days, yet pain became unbearable. Gan Sui (Radix Kansui), Yuan Hua (Flos Genkwa), Daji (Radix Euphorbiae Pekinensis), and Qianniu (Semen Pharbitidis) were taken for three days, stopping even the few drops of urine. Thirty-plus moxa cones on Zhongwan (CV 12) were ineffective. Sun arrived, observing dark complexion, hidden spirit, loud voice, but a belly large as a basket, unable to turn. Pulses were slippery and large in both hands, especially strong at Chi. Sun said: "Initially, food was stuck above the diaphragm. The method should be emesis. The *Suwen* says: 'For what is above, induce vomiting.' It is easy. But mistaken purging injured the Spleen, losing its transport function, hence more purging led to more distension. Harsh purgatives made it worse. Now, use Liujunzi Tang (Six Gentlemen Decoction) to awaken the Spleen, adding Muxiang (Radix Aucklandiae) and Sharen (Fructus Amomi) to aid movement. Then use emesis to expel previous medicines. Do not worry about constipation, only worry about uncontrollable diarrhea. Calculating the ingested drugs: Xiaoshi and Dahuang 5 jin, Badou (Semen Crotonis) and Baibingzi 5-6 liang, plus harsh agents. Fortunately, the drug action hasn't fully proceeded, so there is still hope. Otherwise, it would be like a bottle with the bottom removed, pouring out everything. The injury is in the Upper and Middle Jiao, Lower Yuan is intact, hence Chi pulses show spirit. Complexion is dark, Qi is solid, root is unmoved, salvageable. After medication, severe abdominal pain indicated drug efficacy. Switched to Ren Shen Lu (Deer Antler of Ginseng), Fangfeng Lu (Deer Antler of Saposhnikovia), Shengma (Rhizoma Cimicifugae), and Jiegeng (Radix Platycodonis) each 3 qian, decocted. Shortly after, goose feather probed the throat, vomiting out over ten bowls of previous medicine. Patient said: 'I see light now.' It was Si hour. Sun predicted stool at You hour, advised preparing several jin of Renshen. At Wu hour, Zhibao Dan (Treasure of Life Elixir) was given to warm Middle Qi. Between Wei and Shen hours, turbid Qi descended, feeling slightly relieved. By evening, one bowel movement, slight urination. Prescribed Renshen and Baizhu 5 qian each, Paojiang (Prepared Ginger) 3 qian, Fuling (Poria) 2 qian, Muxiang 0.5 qian, Gancao 0.5 qian, Chenpi (Pericarpium Citri Reticulatae) 1 qian, decocted. At Fourth Watch, another bowel movement, urination resumed. Next day, over ten diarrheal episodes. Lizhong Wan (Regulate the Middle Pill) and decoction were taken together. Distension vanished, appetite returned. After seventy-two days of diarrhea and over two jin of Renshen, he recovered.

Wu Jiuyi suffered morning abdominal pain and diarrhea for half a year, green stool, abdominal distension. Everyone diagnosed Spleen-Stomach diarrhea, moxa Guanyuan (CV 4) thirty times, took Spleen-Kidney tonics, all ineffective. He knew medicine, noting absent pulses at Cun and Chi, only deep and slippery at Guan, worrying about chronic diarrhea causing pulse disappearance. Sun diagnosed: "Fear not, this is Phlegm-Food Accumulation Diarrhea in Middle Jiao. Accumulation blocks the middle, hiding Cun and Chi pulses. Method: purge accumulation. Tonifying was wrong." Given Baohe Wan (Preserve Harmony Pill) 2 qian plus three Beiji Wan pills at dawn. By Si hour, half a bucket of thick accumulation passed, pain resolved. Next day, all pulses appeared. Treated with Dongyuan Muxiang Huazhi Tang (Aucklandia Regulating Stagnation Decoction) for regulation and recovery.

Wang's wife had a belly large as a basket, hard as stone, occasional pain. Mixed treatments for a month worsened distension and urinary retention. Warming Lower Yuan tonics caused bursting distension. She sought remedies desperately. Pulses at Guan were flooding, slippery, and forceful, unyielding to pressure, indicating Excess. Though severe, curable. Cause: Mother secretly fed her cooked chicken and ox tongue via maids. Frequent cold food intake caused accumulation and distension, mistakenly treated as Deficiency, worsening the condition. Jikuai Wan (Accumulation Mass Pill) was used three times, resolving distension and mass. Baohe Wan regulated for a month until recovery.

Huang Lusù said: While in Linjiang, after mistakenly using Houpo (Cortex Magnoliae Officinalis) damaging Middle Qi, I accidentally ate a piece of dog meat and felt stagnation. With weak Middle Qi, I dared not add Shanzha etc. Materia Medica states dog meat is indigestible, but decocting Genlu Gen (Radix Asparagi) juice helps digestion. Following this, mild right hypochondriac pain occurred, escalating to severe pain the next day, unbearable. Sitting and lying were difficult, turning caused knife-like pain. Palpation revealed a mass like an egg in the right hypochondrium. Formulas say right hypochondriac pain belongs to Food or Phlegm accumulation. Some advocate attacking, others supporting Righteous Qi to eliminate Evil. One doctor advocated attacking, warning of mass formation. I disagreed, adhering to supporting Righteous Qi. During extreme pain, I avoided medicine, resting quietly. When pain subsided slightly and Qi stabilized, I used Liujunzi Tang plus Muxiang to regulate gradually, achieving recovery. Had I believed in attacking, I might have died. (Mr. Huang has a deficient-cold constitution, preferring warming tonics; this is not a universal rule. His prescriptions were half-tonic, half-draining, hence effective, unlike pure tonics.)

Zhang Jingyue treated a Shangshe (scholar-official), nearly thirty, who ate boiled dumplings at noon. By early evening (Chu Geng), pain appeared below the lower abdomen to the right corner, stagnating and hardening like a fist, size of a goose egg, excruciating. Clearly Food Accumulation. Estimated it entered the Large Intestine, where "Unblocked means no pain." Given Muxiang Binglang Wan, pain persisted. Suspected slow drug action, gave Shenshou Wan to purge, ineffective. Concluded cold nature of drugs caused stagnation. Gave Beiji Wan, resulting in heavy diarrhea, but hardness and pain remained. Zhang was at a loss. Reflecting, he reasoned: Dough stagnation requires Garlic to kill; Qi stagnation requires Muxiang to move. Deep stagnation needs sharp guides. Used Huojiu (Fire Wine) to grind Muxiang, instructed chewing a large raw garlic clove, washed down with Muxiang wine. One dose reduced pain slightly. Three to four doses stopped pain, appetite returned, but abdominal mass remained. Dissipated after half a year. Thus, to resolve food stagnation, even Dahuang and Badou may fail; moving Qi is priority. Also learned dietary passage goes from lower abdomen right corner to Changchang (Large Intestine), unknown before.

Commentary: Observing this, Zhang Jingyue had many regrets in practice. Dumplings entering stomach/intestines reaching lower abdomen corner shouldn't cause such pain or form fist/egg masses. Likely pre-existing Hernia (Han Shan), triggered by damp-heat from dough or sexual exertion that day, causing rupture. Hence purging failed, but acrid-warm aromatic Muxiang and Fire Wine stopped pain. Claiming food passes directly from lower abdomen right corner to Large Intestine is laughable. Classics state Small and Large Intestines coil sixteen times; they twist and turn, not like tubes or bags going straight down. Alas!

Zhang Luyu treated Ye Mou with Food Retention and Cold, pulses at Cun and Guan rough, rapid, and blurred, Chi deep and hardening on pressure. Able to walk, but pulse lacked harmony, indicating old Qi in Lower Abdomen. Inquiry confirmed years of Cold Hernia. Declined medication. Died that night from abdominal fullness. Asked why death was predicted for minor illness: "When Stomach is full, Intestines are empty; when Intestines are full, Stomach is empty. Alternating fullness and emptiness allows Qi to reside. Now, mass in Chest, accumulation in Intestines, both upper and lower trapped. Can we ensure they don't attack each other? Know that Jue Tong entering abdomen, Hongjiao (Gout) rushing to Heart, etc., are all Yin Evil struggling. Long stagnation carries Yin Fire upward. If Yuan Qi in Chest is strong, Evil stays down. Now filled with retained food, reversing causes fullness above and below, leaving no room for Righteous Qi, risking sudden collapse. Hence avoiding medication, though unaware of immediate death." (*Shanghan Lun*: Patients with pre-existing masses dying when disease enters Three Yin is called Zang Jie, merging new and old evils.)

Pediatrician Wang Wufu treated summer food retention with vomiting, fever, head distension, spontaneous yellow diarrhea, skin prickling sensation. Six pulses blurred, faint, feet cold. Self-diagnosed Yin Cold, took Wuji San (Five Accumulations Powder), fever intensified, coma. Day 3: continuous diarrhea, delirium, worse at night. Some suspected Summerheat, gave Xiangru Yin (Elsholtzia Decoction), causing steaming sweat on head/face, panting, cold feet. Some suspected Extreme Cold, but blurred pulses suggested Yang Collapse, wanting aggressive Renshen and Fuzi. Others suspected Yin Syndrome, denying steaming sweat possibility, noting pulse void but symptoms hot, suggesting Renshen Baihu Tang. Debate unresolved. Zhang Jingyue diagnosed: "With such pulses, but severe pain on pressing Epigastrium, and gray thorns on tongue, it is Food filling the Center, failing to circulate, causing such pulses." Gave Liangge San (Cooling膈 Powder) to purge. One dose cleared mind, pulses rose. If Renshen/Fuzi given, outcome uncertain?

Guimao Lantern Festival, Zhou and Xu sons drank at Shiwan's study, fell ill with hangover next day. Wanted Ge Hua Tang (Flos Sophorae Immaturis Decoction) for detoxification. Zhang said: "Though specific for alcohol injury, constitutions vary. Zhou drank heavily, face hot, thirsty. Alcohol Qi moves to Yang/Muscle levels. Thirst indicates Heat injuring Stomach Qi. Releasing further consumes fluids." Prescribed Sijunzi Tang minus Gancao, adding Huoxiang (Herba Agastaches), Muxiang, Weige Gen (Prepared Radix Puerariae), Ze Xie (Rhizoma Alismatis). Recovered instantly. Xu had chronic spermatorrhea, face turned blue after drinking. Liver/Gallbladder active, Kidney Qi injured, Alcohol Qi moved to sinews/bones, rising to face. Ge Hua is Stomach herb, useless here. Prescribed Wuling San (Five Ingredient Powder with Poria) plus Renshen, doubled Rougui. After eating time, urine looked like soap pod juice, recovered. (Medication must match constitution, not stick to fixed formulas. Applies to all diseases, not just alcohol.)

Chai Yuqing treated Hanlin Academician Chen Wenshan, high fever and coma, misdiagnosed by contemporary physicians for days, critical. Renying pulse slow, no external pathogen. Qi Kou flooding and solid, thick tongue coating. Pressing chest caused grimacing pain, indicating Food Retention in Chest. Repeated exterior-releasing drugs were contrary to pathology, explaining worsening. Xiaochengqi Tang purged twice, clearing spirit and fever.

Zhang Feichou treated Xie Yuanhai, who drank Huojia (Fire Liquor) in summer, leading to good appetite and easy hunger. Half month later, abdominal distension, dry stool, reduced intake. Draining/Clearing Fire drugs failed. Left pulse fine/rapid, Right pulse rough/stagnant. Initially Fire strengthened Stomach (good appetite), then Fire scorched Stomach Fluids (difficult transport), causing stagnation/distension/reduced intake. Stop spicy/hot foods. While Yuan Qi remains, remove stagnation and restore fluids. Long-term regulation needed. Zhishi Daozhi Tang minus Huanglian/Baizhu, plus Ge Gen. One dose opened bowels/moved stagnation. Then Spleen-strengthening/Qi-regulating. Three days later, small Shengmai San plus Weirui/Weige Gen. Recovered in half month.

Zhang Sanxi treated a man with fever/headache for seven days. Left pulse peaceful, Right Cun/Guan wiry/tight/forceful, internal injury from retained food. Erchen Tang plus Zhishi, Houpo, Zhata (Charred Hawthorn), Chaihu. Three doses, plus Huangqin, headache resolved. Fever lingered. Zhishi Daozhi Wan 100 pills, bowel movement, recovered.

A woman had nightly fever starting at midnight, fading at dawn. Took Siwu Tang, worsened with vomiting. Left Guan slightly tense, Right Cun/Guan wiry/rapid/forceful. Inquired: Ate pear after menstruation, fever started afternoon. Exactly Danxi's description: Stomach Weakness, excessive cold food suppressing Yang Qi in Spleen Earth. Disease due to Blood Deficiency. Shengyang Sanhuo Tang (Raise Yang Scatter Fire Decoction), one dose fever gone. Then Siwu Tang minus Dihuang, plus Zhishi/Zhuren/Chenpi, Spleen-strengthening/Blood-nourishing, recovered.

Zhang Sanxi said: When I first met Miao Zhongchun, he chewed pill-sized objects from his sleeve. Asked, he said: Secret recipe. Hungry become full, full become hungry. Prescribed it, named Zisheng Wan. I was delighted but skeptical of its digesting power. Took two pills after heavy meal, slept. Woke up, no stagnation, believed in its efficacy. Zisheng Wan Composition: Baidoudou 1 liang, Shanyao 1.5 liang, Renshen 3 liang, Baizhu (Earth-fried) 3 liang, Lianrou 1 liang, Qianshi 1.5 liang, Juhong 2 liang, Jiegeng 0.5 liang, Zhigancao 0.5 liang, Baixiangren 0.35 liang, Houpo 1 liang, Shanzha Rou 2 liang, Huanglian 0.35 liang, Shenqu 2 liang, Huoxiang 0.5 liang, Fuling 1.5 liang, Zexie 0.35 liang, Yiyiren 3 liang, Maiya 1.5 liang. Honey pills, 2 qian each, one dose normally, two after meals. Wang Jinsan said: *I Ching* says, "Great is the Kun Yuan, all things depend on Sheng (Life/Nourishment)." Named formula accordingly. San Jiao and Five Zang Sheng Qi rely entirely on Spleen/Stomach for transformation. Earth resides in center, associated with Five Elements. San Jiao receives Qi from Five Zang. Thus regulating Spleen/Stomach regulates San Jiao. Baidoudou/Shanyao tonify Metal-Earth; Renshen/Baizhu tonify Central Earth; Lianrou/Qianshi tonify Water-Earth; Juhong/Jiegeng/Gancao/Doukou move Upper Jiao Qi for transmission; Maiya/Yiyiren/Fuling/Zexie regulate Lower Jiao Qi for transformation. San Jiao Qi moves, Five Zang Qi fills, life flourishes.