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In the first month of Jiashen year, my friend Feitian, whose constitution was inherently weak, loved to study at his desk. This led to dark urine and nocturnal emissions. During the Lantern Festival nights, he competed in chasing and playing, and when matters did not go as he wished, he suffered from the aforementioned symptoms.

He coughed up excessive phlegm. Initially, treatment with agents that descend qi and clear fire failed to improve the condition. On the 21st day, I was invited to examine him. The cun pulses on both hands were large, hollow, and expansive; the guan and chi pulses were floating, slow, and powerless. I said: Hemoptysis is not inherently difficult to treat, but when primordial qi is deficient and floats upward, the liver and kidney meridians show signs of being overcome by pathological factors. Fortunately, the pulse is not rapid, but it requires long-term administration of pure tonifying agents to restore balance. If bitter-cold agents are used erroneously, it will inevitably develop into a consumptive disease (lao zhai). I proposed Jiajian Bazhen Tang (Modified Eight-Treasure Decoction). He doubted that Ren Shen (Ginseng Radix) could treat blood disorders and still consulted the previous physician. By the 24th day, the condition worsened, and I was summoned again. After administering four doses of the previously recommended medicine, the hemoptysis stopped. After ten days, tidal fever also subsided, except that the pulse had not yet recovered. He spoke excessively, leading to persistent coughing with phlegm, and slight exertion caused frequent nocturnal emissions. I said: When Heart and Kidney fail to interact, and yin and yang are extremely deficient, one must persistently take effective prescriptions for years to achieve results. Only then did he believe my words, strictly observe dietary and lifestyle taboos, and ultimately consume seven jin of pills and over eighty decoctions before recovering. In the spring of You year, his brother invited me to examine Feitian’s pulse. Observing that the six pulses generated each other harmoniously, were gentle and vigorous, and that the two chi pulses were deep and solid, I predicted good news. Feitian stated he had been pregnant for two months. Indeed, in autumn, a son was born.

At the same time, Chen Zizhen, a xiangsheng (scholar) from outside West Gate, suffered from the same condition. After several months of ineffective treatment, on April 11th, I examined his pathology, pulse, and symptoms, which were identical to those of Lian Feitian. I proposed treating with Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma), and Shu Di Huang (Rehmanniae Radix Preparata). He argued that there is no tonification method for blood disorders, that Shu Di Huang is warm, and that Ren Shen and Bai Zhu promote fire; taking them mistakenly would cost his life. He mocked this advice and continued strictly following the previous doctor’s regimen of bitter-cold lung-clearing agents. Over a year, his condition deteriorated. By the following summer, he vomited blood incessantly. Another attempt to stop bleeding with astringent agents caused intestinal obstruction and painful distension. After more than ten days, he was near death. A surgeon was called who incised the anus with a knife, draining several basins of pus before he died.

In the summer of Guiyou year, my father, acting as magistrate of Linqiong, invited Scholar Peng Yubai to review examination papers in the official residence. I had the opportunity to converse intimately with him for five mornings and evenings. Mr. Peng often suffered from hemorrhage due to illness and sighed that repeated treatments failed. Investigating the cause, it seemed to result from prolonged study without regard for cold or heat, leading to accumulated fatigue. I believed that labor injuring Spleen and Lung would also exhaust the reproductive essence of the Kidney. I asked: Is it not because you push yourself too extreme, causing fire-heat to rise and scorch the head and face? He replied: Yes, I suffer from these accompanying symptoms. I repeatedly administered Huang Qin (Scutellariae Radix) and Huang Lian (Coptidis Rhizoma) to clear fire, but they were ineffective; my methods seemed exhausted. His six pulses were deep and slow. I prescribed Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Wu Wei Zi (Schisandrae Fructus), Rou Gui (Cinnamomi Cortex), and Ren Shen (Ginseng Radix). Mr. Peng asked: Can warming agents be used for blood disorders? I said: His deep and slow pulses indicate deficiency-cold; only warming agents can cure this type of hemoptysis. I cited medical cases from Xue Lizhai, after which he finally accepted the treatment. Initially taking only a few qian per day, gradual improvement occurred over several periods, so the dose was increased to several qian. After three months, a chronic ailment lasting five years was cured. He subsequently passed the Jiaxu imperial examination and served as a judicial officer in Zhang Commandery. When my father retired in Bingzi year, Mr. Peng invited me to the official residence, where we enjoyed even closer relations than before. He inquired about his former condition, stating it had not recurred, and that he continued taking Liuwei Dihuang Wan without interruption.