The region of Eastern Guangdong is low-lying and damp, causing the body's Yang Qi to easily dissipate. Having served in official posts for ten years, I am now exactly fifty years old. In middle age, the Yin and Yang energies are not as robust and solid as in youth; dizziness and sweating occur, which are caused by Yang Qi failing to submerge and store, leading to the transformation of internal Wind stirring the deficient spirit. The *Neijing* (Classic of Internal Medicine) states in the Zang-Fu section that the Kidney is the root, with one on the left and one on the right. Essentially, there is one Yin and one Yang, interlocking and twisting; Fire exists within Water, serving as the source of continuous generation and nurturing. Only by storing and concealing this essence without revealing it can one achieve longevity free from disease. The Liver is the "child" of the Kidney; when the Mother Qi declines, Water fails to generate Wood. Heat rises from the spine up to the vertex. Treatments using clearing or tonifying methods have been ineffective because the principle of deficient Yin within the Zang organs and solitary rising of Yang has not been investigated. Ancients held that the Kidney contains True Yang internally, which cannot be grasped without warming; the Liver houses Ministerial Fire internally, which cannot settle without clearing. The method of medication involves: filling and solidifying Essence and Qi to secure the lower part, assisting with salty flavors to guide downward, combining heavy substances to suppress, using shell/turtle-shell class materials to subdue Yang, and sour flavors to astringe. In summer, nourishing and clearing agents are added to cool the Liver. Guiding and directing these forces prevents floating Yang and internal Wind from surging.

Prepared pills made from Shu Di Huang (Rehmanniae Radix Preparata), Bei Wu Wei Zi (Schisandrae Fructus), Yu Rou (Corni Fructus), Ci Shi (Magnetitum), Qing Yan (Natrii Chloridum), Suo Yang (Cynomorii Herba), Gui Ban (Testudinis Carapax et Plastrum), Fu Shen (Poria cum Radice Xylri), Xiang Lian (Nelumbinis Semen), Tian Men Dong (Asparagi Radix), mashed pig spinal tendons, mixed with honey. Taken with warm wine.

Menstrual bleeding dripping continuously for a hundred days, accompanied by persistent stranguria and leukorrhea, indicates that the Chong, Ren, Du, and Dai vessels (Extraordinary Vessels) fail to secure and control. The pathology is in the Lower Jiao. The pulse at the Left Guan position is deep, faint, and slow; the Right side is deficient. Using only Qi-tonifying herbs merely raises Spleen Ying Qi; how can the medicine reach the site of disease? Yin-nourishing herbs are often cloying and obstructive, contradicting the condition of weak Stomach Qi and poor appetite. Examining ancient treatments for unstoppable metrorrhagia, one should first use Ju Fang Zhen Ling Dan (Vibrant Spirit Pill from the Bureau Formulas) to directly reach the Chong and Ren vessels to secure them, followed by Ren Shen Tang (Ginseng Decoction) to continue generating Qi, achieving efficacy, and then discussing further treatment.

The pulse beats 100 times per minute, rapid and thready (Kou). After years of consumptive damage without recovery, there are alternating chills and fever, and profuse sweating. Nearing half a year, coughing is severe when lying down, slightly better when sitting up. Food intake has decreased significantly, and stools are loose. This is due to injury in the Lower Jiao causing vibration of the Chong vessel Qi, leading to rebellion of all vessel Qi. Physicians administered heat-clearing and Lung-regulating, Qi-descending and phlegm-resolving drugs, which further harmed Stomach Qi. In the past, Yue Ren (Bian Que) gave the instruction that "lower damage extending to the Spleen is incurable." Here, the chills, fever, and sweating result from the non-interaction of Yin and Yang energies. The autumnal Qi is out of phase; the sky's descending function is disordered, showing a glimpse of this. If Sheng Yang (generative Yang) does not emerge, winter will be worrying. Urgently secure the scattered Yang, hoping the chills, fever, and sweating will ease before further discussion.

Jiu Ni Tang (Rescue the Perdition Decoction) minus Bai Zhu (Atractylodis Rhizoma), plus Ren Shen (Ginseng Radix).

Young children have a pure Yang constitution, prone to many heat syndromes. The illness favors the right chest, which is elevated, with difficulty exhaling; Lung Qi cannot clear and descend. Heat stagnates and steams internally, transmitting reversely to Dan Zhong (Conception Vessel point). Agitating the Heart Lord, the presentation resembles epilepsy. The Lung governs Wei Qi, the Heart governs Ying Qi; these two energies circulate in the Lung and Stomach pulses. If Ying and Wei are disharmonious, upon contact with pathogenic factors the next day, the disease erupts. Weng Zhongren stated that supporting the belly and lifting the chest indicates Lung heat obstruction. However, being under one year old and not yet nourished by grain food, the Zang-Fu organs are tender and thin. All bitter-cold, sinking-drifting, and cloying Yin-nourishing drugs are contraindicated. Moreover, the Lung is located highest; if pathogenic factors reverse into the Pericardium collateral, treatment should still focus on the upper burner. Holding the child upright rather than letting them lie flat allows Upper Qi to descend smoothly, promoting harmony between Ying and Wei.

Bo He (Menthae Haplocalycis Herba), Sang Ye (Mori Folium), Mi Yi Ren (Coicis Semen), Fu Ling (Poria), Yu Jin (Curcumae Radix), Dan Zhu Ye (Lophatheri Herba), Xian Shi Chang Pu (Acori Tatarinowii Rhizoma Fresh).

Second consultation: Xi Gua Cui Yi (Citrulli Citrullus Exocarpium), Xian Pi Pa Ye (Eriobotryae Folium Fresh), Tong Cao (Tetrapanacis Medulla), Fu Ling (Poria), Sheng Mi Yi Ren (Coicis Semen Raw), Dan Zhu Ye (Lophatheri Herba).

Third consultation: Old heat is not yet resolved; the dryness of Autumn Metal descends from heaven, preventing Upper Qi from fully smoothing. Symptoms include coughing with dryness and rebellion. Proposal: Clear heat from the Qi level.

Da Sha Shen (Glehniae Radix), Mai Dong (Ophiopogonis Radix), Hua Fen (Trichosanthis Radix), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Raw), Sang Ye (Mori Folium), Deng Xin Cao (Junci Medulla).

Fourth consultation: Observation shows the facial orifices are not refreshed, indicating Lung heat is not fully resolved. Proposal: Administer sweet-cold herbs, imitating Yu Jiayan's idea of clearing dryness.

Sang Ye (Mori Folium), Mai Dong (Ophiopogonis Radix), Li Rou (Pyrus Fructus), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Yin Hua (Lonicerae Japonicae Flos), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma Raw).

Fifth consultation: Latent summer-heat obstructs upward; after venting and descending, the head and chest have settled. However, milk and food transport is sluggish, and stools are loose several times daily. Considering that heat descended from the Lung must have transferred to the Fu organs. Examining ancient treatments for infantile diarrhea, Si Ling San (Four Poria Powder) is often used as the main formula, adhering to the intent of separating turbidity from clarity and harmonizing the middle.

Si Ling San (Four Poria Powder) plus Guang Chen Pi (Citri Reticulatae Pericarpium), Mu Gua (Chaenomelis Fructus), Sheng Gu Ya (Hordei Fructus Germinatus Raw).

It is reported that childbirth was frequent. Two years postpartum, menstruation has not yet returned, which is the root of the disease, indicating deficiency of Yin in the Lower Yuan. Early in midsummer, diarrhea began, likely due to rain, earth-dampness, tidal fog, and turbid qi inhaled through the nose and mouth. This cannot be removed by dispersing or purging. Because the constitution is very thin, the turbid qi spread, filling the Three Jiao. Above, there is coughing with phlegm and lack of hunger; below, urination and defecation are scanty and difficult. There is no exterior wind-cold, hence no chills or fever symptoms. However, Qi level obstruction causes fluids to transform into turbid phlegm; night thirst occurs, Stomach fluids are depleted, seeking water. This is a disease of root deficiency and branch excess. The Lung is located highest and is interior-exterior related to the Large Intestine. If clearing and descending do not function, urination becomes difficult.

Lu Gen (Phragmitis Rhizoma), Mi Yi Ren (Coicis Semen), Tong Cao (Tetrapanacis Medulla), Fu Ling (Poria), Sang Ye (Mori Folium), Xi Gua Cui Yi (Citrulli Citrullus Exocarpium).

Mix in Bai Kou Mo (Amomi Fructus Rotundus powder).

Second consultation: Previously discussed "deficiency unable to tolerate tonification," all due to latent pathogens from summer lodging in the Qi level. Lung Qi is the Qi of the whole body; since Qi obstruction prevents clearing and descending, all meridians cannot flow smoothly, and the Three Jiao are entirely obscured. Previous attacks on pathogens were ineffective. Guest pathogens are acquired by inhalation, different from wind-cold colds; they gather in the void and cause disaster. Therefore, select bland, tasteless, and light-Qi items to only open the upper, without disturbing the middle and lower, ensuring the void is not injured and latent Qi can be removed. Slightly assist with pungent-aromatics, not drying, imitating the meaning of repelling filth.

Jing Shuang Sang Ye (Mori Folium exposed to frost), Xian Pi Pa Ye (Eriobotryae Folium Fresh), Fu Ling (Poria), Kou Ren (Amomi Fructus Rotundus Seed), Mi Yi Ren (Coicis Semen), Lu Gen (Phragmitis Rhizoma).

Pulse is small and wiry on the right; breathing is difficult, sounds heard in the throat. At night, spirit is confused and lethargic; lower abdomen is slightly distended; urination and defecation are unsmooth. Self-reported sensation of needles piercing bones and muscles; body heavy, difficult to turn. Right Huantiao acupoint tendon is flaccid, unable to flex or extend. These are all due to sudden cold entering internally, circulating up and down, blocking Yang Qi. Furthermore, yearly winter phlegm-cough heals naturally when weather warms. In old age, Kidney True Qi declines, lacking storage and reception functions; water transforms into phlegm and floats upward. Cold enters Shao Yin, so Tai Yang Bladder Qi cannot ascend, disrupting circulation and transformation. Opening and closing lose degree, pivot mechanisms are blocked, turbid Qi rises, and phlegm-fluid rebels. Panting urgency and spirit confusion are most taboo. If using dispersing or dropping methods, fear damaging Yang and seizing Yin. Proposal: Enter Zhang Zhongjing's Xiao Qing Long Tang (Minor Blue Dragon Decoction) method. This addresses the interior of the Tai Yang exterior, harmonizing Ying and Wei without consuming Yang, resolving phlegm-fluid without draining Qi, retaining the meaning of restraining Lung rebellion and unblocking the Bladder.