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The patient regained slight consciousness, but the sound of wailing and severe pain penetrated to neighboring homes. All physicians stated: "The pulse is fine as a silk thread; it is incurable" (When pain is extreme, the pulse often becomes fine and hidden).

The next day, a beggar monk came to the door. The family declined him, citing illness in the household. The monk said, "Why not ask me?" The family, having no other strategy, reluctantly allowed him entry. After one glance, the monk declared, "This is caused by accidentally ingesting snake essence." (His skills are truly miraculous! In the world, there are those who have read medical books thoroughly yet fail to recognize a single syndrome, claiming to be Confucian physicians. People, trusting their scholarship, consequently trust their medical skill, leading to mutual confusion. Although they kill daily without repentance or awakening, it is no wonder that eccentric hermits hide their tracks and retreat. It is truly lamentable.) He took a pill from his broken pouch, ground it with water, and administered it. After a short while, the patient sat up and vomited several objects resembling sparrow eggs. The monk said, "It is not finished yet." Subsequently, he vomited filth everywhere, expelling an object the size of a chicken egg. The monk said, "Now it is correct." Upon dissection, it was found to be a small snake coiled within blood clots. Seeing people, it immediately moved, making upward and downward motions. The illness had vanished, astonishing and subduing the entire family (I too am convinced). When asked for the reason, he replied, "It is old grain from many years ago; snakes mated upon it, and residual slime adhered to it. Accidentally entering the abdomen, this object formed. Soon it will be expelled through the chest and abdomen." The monk simply wrapped the snake and left. This case presented chaotic and turbulent symptoms, which were difficult to stabilize; only by distinguishing Yin and Yang could success be achieved. Although this syndrome was not Cholera (Huo Luan), the disease departed rapidly, resembling Dry Cholera (Gan Huo Luan) caused by food stagnation. Moreover, the turbulence of the condition was even more severe than that of Cholera. Without the talent to defeat enemies, possessing only empty scholarly fame, how could one quell such great chaos? Using medicine is like using troops; the beggar monk possessed this ability. I cite this case as a warning for restoring order, advising against employing personnel based solely on seniority or qualifications. Whenever sudden severe abdominal pain occurs after eating, without other corroborating symptoms, it is mostly due to accidental ingestion of toxic substances. Heavy use of Zijin Dan (Purple Gold Pill) or Yushu Dan (Jade Pivot Pill) ground and administered seems also effective.

Yang Suyuan treated his second son, who suffered from Dry Cholera in the summer of the Renzi year. Symptoms included fever without thirst, dry mouth with no tongue coating, all six pulses hidden, pain in the epigastrium radiating to the chest and hypochondrium, with a surging intensity. Initially, a bowl of Earth Slurry (Di Jiang) was given, slightly stabilizing the condition, but shortly after, it recurred. Therefore, Da Cheng Qi Tang (Major Order the Qi Decoction) was administered directly. One dose caused the pain to descend to the umbilicus; a second dose caused it to descend further, settling in the right corner of the lower abdomen. Pressing elicited pain; non-pressing felt normal compared to a healthy person. From onset to this point, two hours had passed. The patient urgently desired food, so Mung Bean Porridge was cooked and given. After eating, everything returned to normal. Only in the right corner of the lower abdomen did pressing reveal a small lump with dull pain. Consequently, heavy doses of Dang Gui (Angelicae Sinensis Radix), Gou Qi Zi (Lycii Fructus), and Gua Lou Ren (Trichosanthis Semen) were used, assisted by Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos), with a small amount of Niu Xi (Achyranthis Bidentatae Radix) to guide the action. After about an hour, sounds were heard in the abdomen, and a purple-black blood clot, approximately five cun long, was passed. The painful lump in the lower abdomen disappeared. This treatment method originated from a momentary subjective opinion, yet it resulted in recovery. It is recorded here to consult Mr. Ban Chi, asking for his opinion. Note: Most Cholera cases arise from Summerheat-Heat; thus, even slight exposure easily allows pathogens to enter the Ying (Nutritive) level. Ancients used pricking to release blood, and internally administered Yi Mu Cao Tang (Leonurus Decoction), Lotus Root Juice, and Child's Urine, all to treat pathogens in the Ying level. Yang Gongzi had a dry tongue with no coating and no thirst, and pain extended to the hypochondrium. This implies he likely had undetected collateral damage previously, allowing pathogens to exploit the flaw. Xiao Yao San's Rhubarb and Mirabilite are also blood-invigorating agents; when Qi moves, stasis descends, so the pain gradually subsided. When the mass remained and only hurt upon pressure, and hunger/ability to eat returned, it further indicated that Qi-level pathology had been cleared, while Blood-level pathogens remained latent. Direct attack with Da Cheng Qi Tang was unnecessary; instead, moistening transformation and indirect guidance were adopted. With proper manipulation, I admire his superior clinical insight.

Zhang Jingyue claimed that the pathway for food digestion must pass through the lower right corner of the lower abdomen before exiting into the Large Intestine (Guang Chang). He boasted this came from experience, though ancients never mentioned it. Presumably, he once treated a person who ate dough knots (Mian Jiao); various attempts with Ba Dou (Croton Seed) and Da Huang (Rhei Radix et Rhizoma) failed. Wei Liuzhou commented: Judging by this, Zhang Jingyue had many regrets in his lifetime clinical practice. Dough knots travel from the Stomach to the Intestines; reaching the lower abdominal corner, how could it cause such intense pain? Furthermore, being fist- or egg-sized suggests the person likely had pre-existing hernia issues, triggered by eating dough or perhaps sexual exertion that day, causing such distension. Hence, purgatives were ineffective, while warm, acrid, aromatic herbs like Wood Fire Incense Wine stopped the pain. As for the claim that food exits via the lower right abdominal corner into the Large Intestine, it is laughable. The Classics state the Small and Large Intestines are coiled sixteen times; thus, twisting left and right is evident. How can they be like tubes or bags going straight down? Alas! Regarding Yang Gongzi's pain in the lower right abdomen, if not for his father's profound insight, contemporary physicians would likely have misdiagnosed it as food stagnation. I append Wei's words to broaden understanding, warning those who revere Zhang Jingyue.

Tian Xuefan (Jin Yuan) from Shanyin wrote *Shi Xing Huo Luan Zhi Mi* (Clarifying Epidemic Cholera), correcting the popular notion of "Diao Jiao Sha" (Hangman's Cholera). He argued this is True Cold directly invading the Jueyin Liver Meridian, i.e., Cholera with muscle cramping. Initial symptoms include abdominal pain (or none), watery diarrhea occurring dozens of times in moments, followed by limb convulsions, vomiting, inability to open the mouth, cold limbs, hoarseness, faint pulse, shortened tongue, sunken eye sockets, upward gaze, cyanotic hands and feet, or hard, rope-like protruding blue veins over the body, sweating, and absent pulse. Acute cases die from morning to evening. Slow cases die in two to three or five to six days. Physicians often mistake it for Summerheat-Dampness, wrongly administering cooling purgatives. Or they mistake it for Sha Qi, wrongly administering Sha medicines. Few survive. The appropriate formula is Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang (Angelica Four Reversal Decoction plus Evodia and Fresh Ginger Decoction), decocted and taken cold. Mild cases heal in two to three doses; severe cases recover instantly with continued dosage. It is a divine prescription. For vomiting, add Zhi Ban Xia (Prepared Pinellia Tuber) 3 qian and Dan Gan Jiang (Lightly Dried Ginger) 1 qian. For excessive thirst and yellow tongue coating, add Jiang Zhi Chuan Lian (Ginger-processed Coptis Rhizome) 5 fen as a counter-agent, following the Classic principle of "treating heat with cold." For colicky abdominal pain named "cramping entering the abdomen," add Jiu Chao Mu Gua (Wine-fried Quince Fruit) 3 qian. For cold limbs extending past elbows and knees with cyanosis, add Zhi Fu Zi (Prepared Aconite Lateral Root) 3 qian. These manifestations are all signs of the Liver Meridian. The reason is that the True Yang in Kan (Kidney/Water) is forced outward by pathogenic cold, known as internal true cold with external false heat. Differentiation by pulse alone removes hesitation.

While Cold invading Jueyin causing Cholera cramps may exist, one cannot generalize epidemic diseases based on this. If it were truly Cold invading Jueyin with vomiting, diarrhea, and sweating, Wu Zhu Yu Tang (Evodia Decoction) modified or Mei Wan Method (Mume Pill) should be used, not Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang. Because Dang Gui Si Ni Tang is originally Gui Zhi Tang (Cinnamon Twig Decoction) plus Dang Gui, Tong Cao (Tetrapanacis Medulla), and Xi Xin (Asari Radix), designed to unblock vessels and release the exterior; it is not suitable for conditions with sweating and absent pulse. When the pulse is unreliable, thirst, yellow tongue coating, and preference for cold drinks are definitive evidence for distinguishing True Heat from False Cold. To reverse this logic and offer wild interpretations is excessively deceptive. Scholars discussing war on paper, fond of presumptuous arguments, confuse the world and deceive the people; this is typical. It must be辨析 (analyzed/clearly distinguished). Hence, it is appended here.