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I have resided in Jiangning since coming of age. Due to changes in water and soil, I contracted an illness and lay bedridden for several decades, nearly dying on multiple occasions, until I was cured by Traditional Chinese Medicine (TCM). After recovering, I paid attention to medical studies, intending to use it as a means to prevent and treat diseases, not daring to harbor the ambition of practicing medicine professionally. Several years later, when I began to socialize occasionally, I saw people referring to their illnesses as "Taiyin Spleen Meridian" (Taiyin Spleen Meridian disease), which puzzled me. Their treatment methods involved inducing hunger without eating, using aromatic and drying drugs that attack and purge, such as Cangzhu (Atractylodis Rhizoma), Houpo (Magnoliae Officinalis Cortex), Sharen (Amomi Fructus), and Kouren (Amomi Fructus Rotundus). The Taiyin Spleen is merely one of the twelve meridians of the hand and foot. If discussing diseases of its meridian and zang-fu organs, conditions such as jaundice (Dan), edema (Zhong), diarrhea and dysentery (Xielì), vomiting (Ǒutù), distension and fullness (Zhangman), retained phlegm (Tingtan), and food stagnation (Jishi) are numerous. Their treatment principles vary greatly among tonification (Bu), purgation (Xie), warming (Wen), and clearing (Qing). Why mix them all under the name "Taiyin Spleen Meridian" disease with uniform treatment? If loss of appetite is considered a spleen disease and generally called so, why is cough and asthma not called "Taiyin Lung Meridian"? By analogy, palpitations and fright could be called "Shaoyin Heart Meridian," and hernia or masses could be called "Jueyin Liver Meridian." Although Zhang Zhongjing's *Shanghan Lun* (Treatise on Cold Damage Disorders) mentions Taiyang, Shaoyang, Yangming, Taiyin, Shaoyin, and Jueyin syndromes, it refers to diseases occurring in these meridians presenting with specific symptoms, never naming "Taiyin Spleen Meridian" as a disease entity itself. It is understandable if patients do not know the terminology, but how can physicians casually use such terms? This shows a profound lack of thought! Moreover, regarding loss of appetite, if it is due to food stagnation and aversion to food, hunger might be acceptable. But if it is due to spleen deficiency failing to transport and stomach weakness leading to satiety, where is there time for tonification, let alone enduring hunger while continuing to use aromatic and drying purgatives to seek efficacy? Do they completely ignore the principle that "abundance of grain leads to prosperity, and presence of Stomach Qi means life"? Is there any logic in making people long-term hungry and continuously using purgative aromatic drugs over months to achieve results? I have harbored doubts until now, traveling everywhere, without finding an opportunity to consult experts for correction. In the Yichou year, I temporarily returned to my old residence in Jinling. I enjoyed boat trips with Mr. Wang Zicun, who showed me his essay "Refutation of Errors Regarding Taiyin Spleen Meridian." I read it several times; its analysis of principles was detailed and clear, and its dissection of symptoms meticulous. It was sufficient to break the local customs of Jinling and benefit the people, a significant merit! Hearts are the same, principles are the same. My long-standing doubts suddenly found resonance. Therefore, I encouraged him to print and publish it for the public. Mr. Wang declined, fearing offense to his peers. Alas! Mutual refinement is the way of friendship. If one gains insights and seeks correction from peers, is this not a path to mutual improvement? Why hesitate? Thus, I wrote this postscript at the end, hoping Cunzhou would consider it.

**Explanation of Three Formulas for Dysentery by Mr. Ni Hanchu from Shanyin**

**First Formula:** Treats early-stage dysentery (Lìjí), whether bloody or whitish, with tenesmus (Líjíchòuzhòng), fever, abdominal pain, mixed colors, or resembling fish brains. Use this formula for all such cases.

Chuan Huanglian (Coptidis Rhizoma), Tiao Huangqin (Scutellariae Radix), Baishao Yao (Paeoniae Radix Alba), Shan Zha Rou (Crataegi Fructus) each 1 qian 2 fen; Zhike (Aurantii Fructus), Taoren (Persicae Semen, peeled and crushed) 1 qian; Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen), Qingpi (Citri Reticulatae Pericarpium Viride) each 8 fen; Danggui (Angelicae Sinensis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Diyu (Sanguisorbae Radix) each 5 fen; Honghua (Carthami Flos, wine-fried) 3 fen; Guang Muxiang (Aucklandiae Radix) 2 fen.

If the stool is purely white, remove Diyu and Taoren, add Juhong (Citri Reticulatae Pericarpium Rubrum) 4 fen, double the Muxiang, and酌情 (at discretion) add Jiudahuang (Rhei Radix et Rhizoma, wine-fried) 1-2 qian for severe stagnation.

**Note:** Dysentery arises from the Hand-Taiyin Small Intestine Meridian and Hand-Yangming Large Intestine Meridian. The Small Intestine is the official of reception and transformation, rotting and fermenting food and drink. The Large Intestine is the official of transmission, conveying waste. If these meridians are externally affected by summer-heat, dampness, wind, and steaming vapors, and internally injured by raw, cold, greasy, and rich foods, the function of reception and transformation fails, unable to separate clear from turbid or convey waste properly. Thus, tenesmus occurs, pus and blood form, abdominal pain arises, and defecation is frequent yet ineffective, all signs of obstruction and stagnation. Anciently called "Zhexia" (Stagnant Downward), now called "Li," it essentially means failure to pass freely. White color indicates Large Intestine involvement; Geng Metal is white and pairs with the Lung, so the disease is in the Qi level. Red color indicates Small Intestine involvement; Bing Fire is red and pairs with the Heart, so the disease is in the Blood level. Generally, it is caused by Damp-Heat (Shīrè); there is no theory distinguishing cold from heat based on red or white. Only if prolonged qi deficiency leads to prolapse and sliding should Ginseng, Atractylodes, Chebula, and Chestnut be used to secure, avoiding warming tonification, which is the correct method for dysentery. Note that dysentery and diarrhea are distinct paths; dysentery is an intestinal disease, diarrhea is a spleen disease, unrelated. Diarrhea involves cold and heat; dysentery involves only damp-heat. Diarrhea is mostly deficiency-cold; dysentery differs only in duration. Although ancient texts mention names like Daxia, Changpi, Zhexia, and Guaji, they are actually caused by dampness stagnating and transforming into heat. Only after prolonged duration does it become deficiency-cold. Misusing astringents and tonics at onset causes serious harm. Mr. Ni's three formulas all use Huangqin and Huanglian to clear heat, Shan Zha and Houpo to eliminate stagnation, Danggui, Diyu, Taoren, and Honghua to clear blood stasis, Zhike, Juhong, Muxiang, and Binglang to clear qi stagnation, and raw Baishao to relieve tenesmus and constrain the spleen. Following Mr. Ri Zhao's prescription, every hundred uses yield hundred successes.

**Second Formula:** For dysentery lasting more than ten days, use half raw and half cooked herbs.

Huangqin, Huanglian, Baishao: each fried 6 fen, raw 4 fen; Shan Rou (Crataegi Fructus) 1 qian; Juhong, Qingpi, Binglang, Diyu each 4 fen; Danggui 5 fen; Taoren 6 fen; Honghua 3 fen; Muxiang 2 fen; Gancao (roasted) 2 shao, raw 2 fen.

**Third Formula:** For chronic dysentery lasting a month, with weak spleen and stomach and slippery incontinence.

Huangqin (wine-fried), Huanglian (wine-fried) each 6 fen; Baishao (wine-fried) 4 fen; Danggui 5 fen; Renshen (Panacis Ginseng Radix) 5 fen; Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried) 5 fen; Zhi Gancao (Prepared Licorice Root) 5 fen; Juhong 6 fen.

All three formulas prioritize Huangqin and Huanglian, adjusting tonification and purgation as appropriate. Why do current practitioners absolutely avoid Huangqin and Huanglian for dysentery? Because they treat dysentery solely with purgative methods. They fail to realize that bitter flavors dry dampness; even for heat-type diarrhea, why avoid Huangqin and Huanglian?

**Zisheng Wan (Nourishing Life Pill)**

Wang Kentang said: When I first met Miao Zhongchun, I saw him chewing pill-sized balls from his sleeve. I asked, and he said: "It is a secret transmission named Zisheng Wan. Hungry people eat it and feel full; full people eat it and feel hungry." I recorded the formula but did not believe its digestive power. After a heavy meal, I took two pills and went straight to sleep. Waking up, I felt no stagnation, and then believed in its efficacy. The late Gongjian Elder had high age, weak spleen, little appetite, and much phlegm. My preservation in old age relied entirely on this formula, so I specially record it for the world.

Baizhu (soaked in rice water, steamed with yellow earth, sun-dried nine times, earth removed, sliced, baked dry) 3 liang; Yiyiren (Coicis Semen, washed and fried yellow) 3 liang; Renshen (steamed ripe, baked dry) 3 liang; Shan Zha Rou (steamed and baked dry) 2 liang; Shenqu (fried) 2 liang; Ju Pi (soaked, washed, membrane removed, dried) 2 liang; Baifuling (Poria, skin removed, water-flown to remove fascia, steamed with human milk) 1.5 liang; Gan Shanyao (Dioscoreae Rhizoma, fried yellow) 1.5 liang; Maiya Fen (Hordei Fructus Germinatus powder) 1.5 liang; Qianshi (Euryales Semen, shell removed, steamed) 1.5 liang; Baibiandou (Phaseoli Semen, skin removed, fried) 1 liang; Lianzi (Nelumbinis Semen, heart removed, steamed) 1 liang; Zhi Gancao 5 qian; Jiegeng (Platycodonis Radix, soaked in rice water, fried) 5 qian; Huoxiang (Agastaches Herba) 5 qian; Baidoukou (Amomi Fructus Rotundus) 3.5 qian; Chuanlian (Coptidis Rhizoma, ginger juice fried) 3.5 qian; Zexie (Alismatis Rhizoma, steamed) 3.5 qian. For pregnancy, replace Zexie with Sharen. Make pills with refined honey. Take 2 qian per dose, chew finely with light ginger soup. Can also be made into small pills. Those unable to afford Renshen may use Yangshen (American Ginseng); Dangshen is inferior.

Luo Qianfu in *Yizong Jinjian* said: This formula originated with Miao Zhongchun to treat spleen deficiency and fetal instability during pregnancy. Fetal nourishment begins in the Foot-Shaoyin Kidney Meridian and grows via the Foot-Yangming Stomach Meridian; thus, the Foot-Yangming is the root of fetal growth. If deficient, Yuan Qi cannot nourish the fetus nor self-nourish. Hence, in the third month, when the Yangming nourishes the fetus, vomiting occurs. Severe cases miscarry in the third or fifth month due to Yangming qi deficiency failing to secure. Ancient fetal-calming formulas often use Xiong and Gui, which may cause slipping. This formula uses Ren, Zhu, Fu, Cao, Lian, Qian, Shanyao, Biandou, and Yiyi for their sweet and flat nature to tonify spleen yuan; Chenpi, Qu, Bai, Sha, Kou, Huo, Jie for their aroma to regulate stomach qi; and Huanglian to clear and dry damp-heat. It avoids the cloying nature of Shenling Baizhu San and the drying nature of Xiangsha Zhizhu Wan. It tonifies and moves, achieving perfect harmony, securing the fetus permanently against slipping. Men taking it harmonizes the middle and nourishes the stomach; named Zisheng, truly not in vain.

In the Xinmao year, I returned to Yuezhong. My mother's aunt had been bedridden for months. She was seventy-eight, rising three to four times nightly to urinate, eating several times daily totaling less than one bowl. Constant abdominal pain, emaciation, difficulty rising/sitting, weak voice. Physicians used "tonifying fire to generate earth" methods, such as Yougui Wan and Sishen Wan, without effect. I reasoned that spleen/stomach disorders are unsuitable for decoctions in the elderly, who cannot tolerate harsh tonics. Spleen/stomach cannot transport rich foods; strong tonics act like rich food, blocking the pivot. Better to use Zisheng Wan for simultaneous elimination and tonification. I administered this pill. Within days, abdominal pain decreased, diarrhea ceased. After ten days, appetite improved. She recovered in a month. Seven years later, she has taken pills continuously, now eighty-four, eating two bowls per meal. This confirms Mr. Kentang's words. It is cultivating the Post-Heaven to supplement the Pre-Heaven, like Nuwa mending the sky. I reveal this formula to share with friends. Qianlong Dingyou Year, Pingru respectfully recorded.

**Zuojin Wan (Left Metal Pill)**

Chuan Huanglian (fried) 6 liang; Wu Zhuyu (soaked in boiling water, fried) 1 liang. Make pills with water.

Hu Tianxi in *Yizong Jinjian* said: There are several methods for treating the Liver. If Water is deficient and Wood lacks generation, use Dihuang Wan (Earth-Pet Origin is one source). If Earth is deficient and Wood lacks support, use Ren, Ling, Zhu, Cao to soothe the liver and cultivate earth. If the organ itself has blood deficiency with fire, use Xiaoyao San to clear fire. If blood deficiency lacks water, use Siwu Tang to nourish yin. Tonifying fire aligns with the Kidney. Clearing fire aligns with the Heart. Zuojin Wan uses Huanglian as sovereign, following the "purge the son when excess" method to directly curb upward flaming. Wu Zhuyu follows affinity, guiding heat downward, and using pungent-drying properties to open liver depression and punish obstruction, serving as assistant. However, this requires solid organ qi and non-deficient earth to be suitable. "Left Metal" means Wood is controlled from the left by Metal. It specifically treats Liver Organ Excess Fire causing left hypochondriac pain.

**Note:** Currently, whenever胁肋胀痛 (hypochondriac distension/pain) or Liver-Spleen disharmony occurs, Zuojin Wan is indiscriminately used. This ignores the meaning of Zuojin. *Jingui Yaolue* states: "When seeing Liver disease, first solidify the Spleen." If Spleen is deficient and overwhelmed by Liver Wood, using Huanglian to purge Heart Fire only knows to purge the Liver's son, ignoring the Spleen's mother. One must weigh severity and urgency, avoiding bias.

**Dendrobium is Not a Liver Herb**

Dendrobium grows between water and rocks, blooms in autumn, yellow skin, white flesh, sweet, bland, slightly salty. Enters Heart, Kidney, Spleen, Stomach meridians. Strengthens yin, benefits essence, clears heat, treats bi-syndrome. Thin qi, thick flavor, Yin within Yang. People mistakenly call it a Liver herb. What is the basis? Five colors, flavors, and qi entering five zang organs is an immutable principle. Liver belongs to Wood, green color, sour taste, musky odor. Items with these enter Liver/Gallbladder. None with yellow/white color and sweet/bland taste enter the Liver. However, Liver suffers from tension; sweet flavors relax it. Dendrobium's sweet/bland nature relaxes the Liver, suitable as an assistant, but not as a primary Liver-soothing drug. Since discussing Zuojin Wan's Liver treatment, I mention this by association.

**Discussion on Wool Rash**

I resided in Jinling for over forty years, traveled through eleven provinces, met hundreds of knowledgeable physicians, never hearing of "Wool Rash." Between Xinmao and Renchen Qianlong years, a visiting physician promoted this theory, treating by rubbing chest/back with buckwheat flour. Old Jinling doctors over sixty had never seen this disease or treatment, so skepticism prevailed. The visitor cited three sources: *Zhengzhi Zhunsheng* (Therapeutic Manual) Carbuncle section (Puyang Biography), *Yizong Jinjian* Carbuncle annotation, and *Shuoling Tanwang*. Rational people doubted but couldn't refute the origin, so enthusiasts amplified it. I am concerned, so I refute point-by-point, not to mock, but to prevent confusion harming lives. I cite classics and reason, asking scholars to judge.

*Zhengzhi Zhunsheng* cites Puyang: In Wansli Dinghai year, a woman sold wool in Jintai, then vanished. Soon, people in the capital developed buboes that grew large and painful, many dying. Bubo contained wool. A Daoist transmitted a formula: black bean and buckwheat powder applied, hair fell off, cured.

*Shuoling Tanwang*: In Chongzhen Guiwei year, epidemic in capital. Disease started with red dot on back containing a strand of wool. No survivors. Countless deaths.

*Yizong Jinjian* Carbuncle Annotation: Wool Carbuncle presents with chills/fever, resembling cold damage. Red dots like rash on front/back chest. Purple-black spots are old; pale red are young. Use Chan Su Wan or Wuwei Xiaodu Yin to induce sweating.

**My Note:** These three accounts describe: 1. Epidemic carbuncle; 2. Toxic eruption on back resembling rash; 3. Carbuncle with red dots on chest/back. None explicitly say "Rash." Some curable, some fatal, some cured by sweating. Differences are clear. How can we confuse them as "Wool Rash," a common seasonal disease? First account: Woman sold wool, developed bubo with hair inside. This is epidemic evil. Bubo is large, variable location, contains wool-like hair. Named "Wool Carbuncle" is approximate. Originally didn't say "Wool Rash." Likely occurred during spring/autumn epidemics. Wansli Dinghai was an isolated incident. Second account: Severe epidemic, toxin on back, red dot like rash containing hair. Called "Wool Epidemic" is okay, "Wool Rash" is not. Fatal unless treated. If the Daoist formula worked, why unknown? Third account: Carbuncle with red dots. Doesn't specify if hair is in carbuncle or dot, or if removal is needed. *Jinjian* is imperial, written by Imperial Physicians. Citing *Zhunsheng*, they dared not omit nor fully trust, so added notes. Imperial Physician Wu likely hadn't seen it, guessed it arose in Danzhong/Back-Shu points, suggested sweating. He only said "Wool Carbuncle," not "Wool Rash."

Summary: Diseases have normal and abnormal patterns. Carbuncle and Rash are vastly different. Carbuncle hurts, Rash doesn't. Carbuncle is large, Rash is fine. Carbuncle is localized, Rash covers body. Cannot call it Wool Rash just because Carbuncle has wool. Even citing *Shuoling* (back red dot, epidemic, hair) and *Jinjian* (chest/back red dot, carbuncle, spot), only lesions exclusive to these areas can be called Wool Epidemic/Carbuncle. Neither explicitly says "Wool Rash." If lung heat cough causes rash, is it Wool Rash? If Yangming heat causes macules (red spots), is it Wool Rash? Then all measles/rashes contain wool? The proposer isn't baseless, but lacks clarity. Don't treat Ming Dynasty disaster anomalies as盛世 (prosperous era) common diseases. Mixing rashes/measles with wool theory, treating only by removing hair, causes deep harm. Rational people must examine carefully.

*Benzao* Soybean entry: Controls cattle/horse plague poison. *Yijian Zhi*: Jingkang Year 2 Spring, capital epidemic. Stranger prescribed black soybeans 2 he, roasted licorice 1 qian, decocted and drunk frequently. Cured instantly. Soybean treats epidemic poison. Buckwheat entry: Bitter, cool, sheds hair/regrows. The Daoist used these two: one for poison, one for hair, saving lives temporarily. Now, visitors see occasional prickly heat/rash on chest/back and teach rubbing with buckwheat flour for months. Hair naturally sticks and falls off. Mistaking body hair for wool is absurd!

However, if Wool Carbuncle/Epidemic exists, what is its origin? *Song Taishi Shu*: Mountain people are hairy and thin, absorbing Wood Qi. *Suwen*: Hair creatures belong to Wood. Hair disasters arise from Shaoyang Wood Qi excess, combined with damp-heat steaming. Like mold growing on sauce starter in summer Shaoyang hours. Qi changes. Classics: Liver/Gallbladder belong to Wood, smell musky. Coarse hair derives from Wood Qi. Wool Carbuncle/Epidemic is a Shaoyang Meridian disease. Wood evil insults Metal, erupts in Lung area (Danzhong/Back-Shu), produces hair and musky smell, resembling sheep. Hence the name. Does the human body really have sheep wool?

Shaoyang is Pivot, Taiyang is Opening, Yangming is Closing. If Pivot moves outward to Taiyang, sweat resolves it. Hair transforms. If Pivot stagnates inward to Yangming, enters viscera, coma/death ensues, hair appears. If encountering this, should unblock Wood depression, disperse Lung evil. Early/shallow: Jingfang Baidu San plus Douchi to sweat. Late/deep: Fangfeng Tongsheng San to resolve exterior and interior. If skin breaks and hair appears, and epidemic prevails, the Daoist formula is still valid. Ultimately, Carbuncle and Rash are skin diseases, not to be viewed as ordinary ailments. While epidemics may have Wool Carbuncle/Rash, it is not true that all rashes contain wool.

*Wuchang Zheng Da Lun*: Fuhe Era, Wood virtue circulates... Its creatures are hairy. Weihe Era, called Shengsheng... Its creatures are hairy/furred... Faisheng Era... Its creatures are hairy/furred. Jueyin Sovereign Heaven: Hairy creatures quiet... Shaoyang Sovereign Heaven: Feathered creatures quiet, Hairy creatures breed... Qi Transformation Great Discourse: Year Metal Excess... Dryness prevalent... Year Metal Deficiency... Internal storage in hypochondrium, external in skin/hair. Also: Virtue, transformation, administration, decree, change, disaster... Objects follow, humans respond. Also: Dao stays long... signifies inspection... Dao leaves quickly... signifies missed errors... Long stay and circle... signifies discussing disaster and virtue.