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In the spring of Jiashen year, Mr. Wang Zhití's second son, Wang Zexi, had a temperament prone to sudden anger and joy. He suffered repeatedly from blood disorders (Xue Zheng) but failed to observe dietary and lifestyle restrictions, indulging in sexual activity. His complexion was dark blue-black, accompanied by bone-steaming tidal fever (Gu Zheng Chao Re). Due to binge drinking for several consecutive nights and displeasure with his servants, his anger flared up, forcing blood to vomit violently. Initial treatments were ineffective. Four days later, I was invited to examine him; his six pulses were wiry and hard, lacking stomach qi (Wei Qi). I stated that this condition might be salvageable only with Ginseng (Renshen). Suspecting its use, he refused. I tentatively prescribed a mild formula to calm blood and regulate qi. After four doses, he only expectorated a few mouthfuls of blood each morning, and his wheezing and distension subsided. I remarked: "Although symptoms have gradually decreased, the pulse has not recovered at all. Without strictly following Ge Kejiu's method of using single Ginseng (Du Shen Fa), recovery is impossible. However, it may be too late." He then realized his error. However, due to a temporary lack of funds, when his request for debt repayment from neighbors was not immediately fulfilled, he slammed the table and shouted in anger, causing blood to surge upward uncontrollably. At that time, Shao Shilong, who was present and skilled in pulse diagnosis, also stated that Metal and Water (Lung and Kidney) had already failed, and according to medical principles, it was incurable. He died that night.

In the spring of Guiwei year, Commissioner Zhu Liu Jian, aged fifty, struggled with infertility. He neglected moderation in alcohol and sex, and his diet and daily routine were improper. His face and eyes appeared dark blue-black; upon anger, he would faint. He suffered from severe constipation accompanied by rectal bleeding, and dysuria with blood resembling knife-cutting pain. Previous treatments used fire-clearing and dampness-draining formulas, which exacerbated the condition. The pulse was deep and slow, with the two Chi positions showing a choppy quality. I said: "This is exhaustion of Kidney Water, failing to nourish Liver Blood, leading to deficiency fire flaming upward and transferring heat to the Large Intestine and Small Intestine, forcing blood downward. Consequently, the bowels become dry, hindering the ascent and descent of Qi, causing painful obstruction during defecation. One must use sweet-warm tonics to nourish the source and support Liver Wood. When Yin blood becomes abundant, body fluids will fill, and dysuria and constipation will resolve naturally." He agreed, noting no one had previously discussed this approach. I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), removing Chai Hu, doubling Renshen, adding Niuxi, and slightly adding Rougui. For pills, I used Jiawei Bawei Wan (Modified Eight-Ingredient Pill) with added Renshen, Congrong, and Yuanzhi. After more than a month of consumption, he gradually recovered.

In early autumn of Renwu year, while visiting Lin Xingong, a government-supported student (Xiangsheng) in Ningguo Prefecture, a fellow society member, Zheng You, mentioned being plagued by illness for a month, suffering greatly despite multiple treatments without improvement. Upon detailed inquiry, I learned he suffered from dysuria (Lin Zheng). I said: "Dysuria varies by deficiency/excess and cold/heat. You are under thirty, with robust primordial Qi, yet you endured travel fatigue, irregular diet, and enjoyed strong liquor, resulting in accumulated heat in the Spleen. It was the hot season, with Ding Fire (Heart Fire) ruling and Bing Fire (Small Intestine Fire) assisting. Thus, Heart transferred heat to the Small Intestine, and the five fires scorched internally, causing upper Jiao Lung dryness with thirst, and lower Jiao Kidney dryness leading to dysuria accumulation. Previous formulas like Bazheng San and Wulin San focused solely on treating dysuria, ignoring the need to clear the water source and nourish Lung Metal, hence their ineffectiveness." I prescribed Er Chen Tang combined with Xiaochaihu Tang, adding Longdancao, Zhimu, Maidong, and Mutong. After the first dose, symptoms reduced; after several doses, he fully recovered. Soon after, he took the imperial examination with clear mental clarity.

The aforementioned decoction, Xiaochaihu Tang with Longdancao, clears Liver Fire. Since the Liver is the mother of the Heart, if the mother is tranquil, the child cannot be restless. Moreover, Longdancao is highly effective for various excess-heat dysurias. Renshen, Zhimu, Maidong, and Huangqin are essential herbs for benefiting the water source, clearing Metal, and moistening dryness. Although Mutong is said to promote urination and guide herbs into the Heart, its function extends beyond merely dispersing heat stagnation in the Small Intestine. Paired with Er Chen Tang, it strengthens the Spleen, thereby accelerating the distribution of medicinal efficacy.