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In the late autumn of the Ren-Shen year of the Chongzhen era, my father, having completed his official duties in Linqiong, was invited by a senior gentleman from our hometown, Mr. Yang Danfang, to tour Heshan. I joined them. At noon, after drinking until half-drunk, amidst laughter and joy, he suddenly lost his voice, fainted, and collapsed. A sawing sound emanated from his throat, his limbs became flaccid, and his pulse was deep and hidden. I instructed servants to slowly help him into a monk's room, cover him tightly with thick quilts, and send someone home to fetch Ginseng Radix et Rhizoma (Renshen, 人参). Shortly after, the Confucian physician, Mr. Liu, arrived. I said, "This is due to inherent deficiency of True Qi, allowing external pathogens to invade. Without a large dose of Ginseng Radix et Rhizoma (Renshen, 人参) and Aconiti Lateralis Radix Praeparata (Fuzi, 附子), it is impossible to restore the nearly exhausted Yang." Although Mr. Liu agreed with my words, he doubted whether using two taels of Ginseng Radix et Rhizoma (Renshen, 人参) and three qian of Aconiti Lateralis Radix Praeparata (Fuzi, 附子) was too much. I replied, "A larger dose of Ginseng Radix et Rhizoma (Renshen, 人参) has the effect of penetrating up, down, inside, and outside. If not administered urgently, it will inevitably lead to spontaneous sweating and urinary incontinence, causing the collapse of Yuan Qi (Original Qi, 元气) both above and below, making it incurable." I took full responsibility and urged that the decoction be boiled strong and灌ed into him. After about the time it takes to eat a meal, his eyes could move. He was given another dose, sighed several times, and his pulse gradually recovered. The next day, he was completely cured and wished to return. I advised him to stay in the temple for ten days to recuperate before traveling. Had this condition been mistaken for Wind or Fire, and treated with clearing heat and resolving phlegm agents containing Calculus Bovis (Niuhuang, 牛黄), Borneolum Syntheticum (Bingpian, 冰片), and Moschus (Shexiang, 麝香), depleting True Yang, there would have been no hope for survival.

At that time, the Prince of Neijiang in the Shu Prefecture suffered from the same condition. Physicians insisted it was Wind and indiscriminately administered Pills of Calculus Bovis (Niuhuang Wan, 牛黄丸), Huoluo Dan (Live-Through Meridian Pill, 活络丹), and Suhexiang Wan (Styrax Pill, 苏合丸). Nine days later, he died.

In the winter of the Jia-Shen year, a villager west of the West Gate, over fifty years old, had recently recovered from stroke. Mistakenly eating diseased beef, he suffered from frantic thirst, drinking incessantly. After several cycles, swelling and sweating appeared under both armpits and along the hypochondrium. Fine worm-like threads emerged on the skin, the testicles felt heavy, urine contained blood and dribbled continuously, and the ears were dry and itchy without relief. Previous physicians treated him with herbs for expelling parasites and promoting urination, but multiple treatments failed. I said, "This is caused by Damp-Heat in the Liver and Spleen meridians. The Liver governs Wind, and the Spleen governs Dampness. When Wind and Dampness interact, Heat is generated; when Heat and Dampness generate each other, worms are formed. Thus, it manifests in the Liver region." I prescribed Xiao Chai Hu Tang (Minor Bupleurum Decoction, 小柴胡汤) and Liu Yi San (Six-to-One Powder, 六一散), added with Gentianae Radix (Longdancao, 龙胆草) and Rehmanniae Radix (Shengdi, 生地). After four doses, he was cured.

That winter, Zha Junqiu, a Xialiu (scholar-official candidate) from Nanjing, was around forty years old. Accustomed to indulging in sexual activities, he traveled to Fujian for an official appointment. Upon reaching Xianxia Ridge, he was robbed by bandits. Shocked, worried, and depressed, just a few days after stopping his carriage, he developed alternating chills and fever, with unbearable pain radiating from his back to his left arm. I happened to be treating his co-resident friend, Qin Yingnan from Jiangxi, for Yang Deficiency Cold Damage, who had just recovered. Hearing thunderous cries for help from the left wall, Qin went to check and found Zha calling out, so he bowed and asked me to diagnose him. Zha lay comatose on the couch, unable to speak about his illness. I observed his complexion was purely dark, with a slight purple-black tint on the left cheek and slightly red-white on the right. Palpating the pulse, the left three positions were forceful against the fingers, becoming more solid upon deeper pressure. The right Spleen and Lung pulses were superficially surging and robust, but upon deep pressure, the right Chi position was completely deficient. I reasoned that since this disease lacked Taiyang, Yangming, or Shaoyang exterior symptoms, it must involve internal carbuncles/ulcers, compounded by severe Wood insulting Metal (Liver insulting Lung). A surnamed Zhu, Zha's brother-in-law, standing nearby, asked why I thought so. I said, "This disease stems from deficiency of both Liver and Kidney." Zhu asked again, "What diseases do Liver and Kidney primarily cause?" I said, "The Kidney pulse is floating, rapid, and firm. This indicates habitual excessive sexual activity, leading to blazing fire. The Liver pulse is similar. Wood injures Earth, Earth becomes deficient, Kidney Water dries up, failing to nourish Liver Wood, resulting in a wiry and strong pulse, manifesting as True Organ Pulse. The strength mixed with choppy quality indicates Metal punishing Wood. There should be emotional stagnation, such as grief, mourning, loss of wealth, or shock and anger injuring the spirit, all of which injure Wood." Zhu and three or five companions clapped their hands in admiration, saying, "Your insight is divine." Only then did they reveal the preceding events and pressed me to prescribe. I added, "Even if external diseases are evident, consolidating the interior and nourishing the root is essential." The first dose used Ginseng Radix et Rhizoma (Renshen, 人参), Angelicae Sinensis Radix (Danggui, 当归), and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) each at 3 qian, Cinnamomi Cortex (Guixin, 桂心) at 1 qian, assisted by Lonicerae Japonicae Flos (Jinyinhua, 忍冬), Asini Corii Colla (Ejiao, 阿胶), Glycyrrhizae Radix et Rhizoma (Gancao, 甘草), Rehmanniae Radix Preparata (Shudi, 地黄), and Paeoniae Radix Alba (Baishao, 白芍). He immediately felt vigorous and able to eat. After the second dose, the arching pain in the back and arm worsened significantly. I was summoned again. Observing severe symptoms but a slow pulse, indicating the toxin was not attacking inward—a favorable sign—I kept the previous prescription but increased Ginseng Radix et Rhizoma (Renshen, 人参) to 5 qian, Cinnamomi Cortex (Guixin, 桂心) to 2 qian, and added Arctii Fructus (Niubangzi, 牛蒡子) at 1 qian. After taking it, the heat in the affected area subsided, pain decreased, and he requested a bowl of porridge. He desired wine, and I approved his drinking. By the fourth watch (10 PM - 2 AM), the ulcer burst, discharging five or six bowls of yellow pus. The next day, upon re-examination, the pulse was soggy and slow. I said, "Do not worry; it is merely weak Yuan Qi (Original Qi, 元气)." I continued with the previous formula, increasing Ginseng Radix et Rhizoma (Renshen, 人参) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) each to 1 liang, Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) to 7 qian, Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) and Myristicae Semen (Roukou, 肉蔻) each to 3 qian, assisted by Lonicerae Japonicae Flos (Jinyinhua, 忍冬), Achyranthis Bidentatae Radix (Nixi, 牛膝), Boswelliae Resina (Ruxiang, 乳香), and Citri Reticulatae Pericarpium (Chenpi, 陈皮), while reducing Cinnamomi Cortex (Guixin, 桂心) to only 1 qian. After one dose, residual pus gradually decreased, new flesh grew, and appetite returned. Zha finally realized and said, "Without you, I would have turned to earth." After eight doses, the wound healed seventy to eighty percent. Occasionally, a Bu Lang (Ministry Official), a classmate of Zha, visited and saw me, exclaiming in surprise, "How can you use Ginseng Radix et Rhizoma (Renshen, 人参), Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), and Cinnamomi Cortex (Guixin, 桂心) for a severe toxic ulcer, adding fire to fire?" Zha was also skeptical and followed the advice to hire a surgeon surnamed Lv. Mr. Lv strongly criticized my method as absurd and instead prescribed large doses of Scutellariae Radix (Huangqin, 黄芩), Forsythiae Fructus (Lianqiao, 连翘), Scrophulariae Radix (Xuanshen, 玄参), Aurantii Fructus Immaturus (Zhike, 枳壳), Magnoliae Officinalis Cortex (Houpo, 厚朴), Poria (Fuling, 茯苓), and Alismatis Rhizoma (Zexie, 泽泻), applying Zhuhu Shengji Gao (Pearl Yellow Regenerating Flesh Ointment, 珠黄生肌膏) externally. Initially, he felt better, but for five consecutive days, he did not invite me. Thinking of him as a lone traveler, I visited uninvited. He declined three times with excuses. Within ten days, he sent messengers galloping to invite me three times. I had already left for another place and returned four days later. Rushing to see him, I found Zha speaking with difficulty, the ulcer flowing black water, restless and craving water, unable to eat, incontinent of urine and feces, and feet cold as ice. The pulse was rapid and scattered. I told him to prepare for death. Five days later, he died. The Ministry Official present looked at me and asked, "Why use tonics for a toxic ulcer?" I said, "Treating disease based on pulse is an unchanging principle of eternity. Carbuncles and ulcers generally fall into four categories: First, young people with robust Yuan Qi (Original Qi, 元气) and pulse, normal diet, caused by mistakenly eating dry-hot foods, should be treated with bitter-cold purgatives to clear fire. Second, those not very old, with intact Yuan Qi (Original Qi, 元气) and pulse, caused by sorrow and depression injuring the Liver, should be treated with cooling and qi-regulating agents. Third, those with habitual excessive sexual activity, dried-up Water and rampant Wood, or combined with worry and fatigue injuring Middle Qi, presenting in middle-aged or elderly individuals with depleted Yuan Qi (Original Qi, 元气) and Stomach Qi, should be treated with warm and neutral tonics. Now, Zha Junqiu fits this third category. Reversing this leads to 'tonifying excess and draining deficiency,' costing one's life. Another type of ulcer involves internal rupture eroding viscera, or appearing without pain or itch, indicating exhaustion of Yuan Qi (Original Qi, 元气); these are incurable. Today, impostors pretend to be doctors, treating symptoms blindly, killing with every movement. Surgeons are particularly low-class; seeing any ulcer, regardless of deficiency or excess, they aggressively attack. How can this not hasten death? Zha Junqiu's impending death is not solely due to that servant Lv." The Ministry Official was initially ashamed and speechless.