Before the age of fifty, the patient's form, pulse, and complexion were all declining. Having lost three sons in succession, could it not be for this reason? How much more so when a grandson is also harmed! This condition cannot be cured by medication alone.
Fritillariae Thunbergii Bulbus (Chuanbeimu), Rehmanniae Radix Preparata (Shengdi), Poria (Fuling), Ophiopogonis Radix (Maidong)

The pulse is rapid and wiry; this is a syndrome of Yin deficiency, not an external contraction. Now, due to deficient fire rising, there is headache, gradually showing signs of simultaneous injury to Metal (Lung) and Water (Kidney). Only quiet rest and preservation can bring improvement; medication is secondary.
Rehmanniae Radix Preparata (Shudi), Ligustrum Lucidum Fructus (Nvzhenzi), Ophiopogonis Radix (Maidong), Testudinis Carapax et Plastrum (Guiban), Scrophulariae Radix (Yuanshen), Dan Zhu Shi (Dan Zhushi)
Form pills with jujube paste, take with warm water.

The Lung is the source of Water; excessive heat melts it, leading to the exhaustion of the water source. Spleen Earth is the mother of Lung Metal; if Earth does not generate Metal, Lung Qi has no source of generation. The Spleen, Lung, and Kidney are daily deteriorating. Without moistening fluids, how can spirit and essence return? Since the physical body is already exhausted, even if a secret prescription is formulated, it merely follows ancient common talk.

Heart Yin deficiency leads to easy sweating; Lung Yin deficiency leads to frequent coughing; Liver Yin deficiency leads to rising fire; Kidney Yin deficiency leads to fever; Spleen Yang deficiency leads to loose stools. Is this not true Yin deficiency? It is the gradual onset of a consumptive disease (Qie Zheng). One who knows only to treat the head for a headache is a good doctor; one who does not know that "treading on frost implies hard ice is coming" lacks the cautionary heart of a gentleman.
Stir-fried White Peony Root (Chao Baishao), Small Rehmannia Root (Xiao Shengdi), Ophiopogonis Radix (Maidong), Jujube (Zao), Cinnamon Twig Wood (Guizhi Mu), Honey-fried Licorice Root (Zhi Gancao), Artemisia Annua Stem (Qinghao Geng), Cloud Poria (Yunling)

The pulse is fine, rapid, and slightly weak; the tongue is dry and yellow; there is diarrhea; the body is scorched and dry without moisture. This is because excessive purgation injured Yin, allowing pathogenic heat to sink inward. This is highly concerning. The treatment method should use light clearing to dispel pathogens and bitter cold to drain heat. Whether this will work remains to be seen.
Coptis Rhizome (Chuanlian), Small Rehmannia Root (Xiao Shengdi), Human Coprolite (Renzhonghuang), Light Fermented Soybean (Dandouchi), Akebia Caulis (Mutong), Lonicerae Japonicae Flos (Jinyinhua)

Dietary irregularity indicates Taiyin (Spleen) deficiency. Ge Yichuan's *Elbow Formulas* contains a single-herb method for treating consumptive fatigue: for Shaoyin and Jueyin deficiency, use Deer Horn Powder. For Taiyin deficiency, use Divine Leaven Powder. Now, using Divine Leaven Powder.
True aged Liu Shen Qu (Six-God Leaven), ground fine and stir-fried until fragrant, four taels. After each meal, mix two qian with warm water and take.

The Middle Jiao is where Qi, Blood, and Body Fluids gather. Currently, the Stomach Qi cannot circulate in the pulse, indicating insufficiency of Yuan Qi (Primordial Qi). Sour flavors astringe and prevent leakage; pungent flavors promote flow; only sweet flavors nourish and cultivate. Because swelling issues have increased, they are rejected. A prescription is drafted for review.
Tangerine Peel (Ju Bai), Moxa (Zhu Ai), Xing Tou Cao (Xingtoucao), Ophiopogonis Radix (Maidong), Chaenomelis Fructus (Mu Gua), Schisandrae Fructus (Wuweizi)

There are fourteen types of Jue (reversal cold/convulsion), Xie (draining) is one method, Zhen (calming/pacifying) is another. Generally, because Liver Wood bends and stretches excessively, it not only insults Spleen Earth below but also disregards Lung Metal above. The calming method may face rejection/incompatibility; it is better to follow the trend and guide it, then moisten and nourish. Few would fail.
Antelope Horn (Lingyangjiao), Golden Bell Fruit (Jinling Rou), Raw Licorice Root (Sheng Gancao), Light Evodia Fruit (Dan Wuyu), Black Bean (Heidou), Raw White Peony Root (Sheng Baishao), Cloud Poria (Yun Fuling), Curcuma Aromatica Juice (Chuan Yujin Zhi)

Zhang Zhongjing stated in his book: "The malaria pulse is naturally wiry," opening the eyes of humanity. Yet, among the Three Regions and Nine Positions, not a trace of wiriness is visible. The pathogen fighting healthy Qi is not like spring wind, summer heat, or southern miasma. From this, one can deduce half the truth.
Areca Seed Kernel (Caoguoren), Stir-fried Magnolia Bark (Chao Houpo), Tangerine Peel (Chenpi), White Poria (Bai Fuling), Processed Atractylodes Macrocephala Rhizome (Zhi Cangzhu), Honey-fried Licorice Root (Zhi Cao)

The deeper the pulse is pressed, the larger it becomes, indicating insufficient Yin Qi, allowing malaria pathogens to penetrate deeply. Rhapontic Rhizome (Loulu) and Turtle Shell (Biejia) tonify Yin too excessively, which is not suitable for a sixty-year-old who labors their mind.
Ginseng Radix (Renshen), Amomum Cardamomum Seed (Kouren), Light Scutellaria Root (Dan Huangqin), Raw Oyster Shell (Sheng Muli), Rehmanniae Radix (Shengdi), Tangerine Peel (Chenpi), Small Green Tangerine Peel (Xiao Qingpi), Raw Polygonum Multiflorum Root (Sheng Shouwu), New Grain (Xingu), Ginger Juice (Jiangzhi)

Clearly, Liver Wind is ascending. The Right Chi pulse is fragmented and pounding against the finger. This is Yi-Gui same source (Liver-Kidney homology); Kidney and Liver diseases occur together. However, the Shaoyin meridian does not reach the vertex; only Jueyin reaches it. The Liver is primary, the Kidney secondary.
Antelope Horn (Lingyangjiao), Rehmanniae Radix (Shengdi), Pinelliae Tuber (Banxia), White Peony Root (Baishao), Angelica Sinensis Radix Body (Danggui Shen), Tangerine Peel (Chenpi), Poria (Fuling), Chrysanthemum Flower (Juhua), Ligustrum Lucidum Fructus (Nvzhenzi)

This is due to Metal (Lung) and Water (Kidney) failing to support each other, hence chronic cough persists. Do not merely treat the Lung. The Lung is a delicate organ; treating it further causes deficiency. The syndrome should not be treated with generic Yin-nourishing methods.
Glehniae Radix (Beishashen), Whole Solomon's Seal Rhizome (Zheng Yuzhu), Cloud Poria Spirit (Yun Fushen), Dendrobii Caulis (Chuan Shihu), Sweet Almond Seed (Tian Xingren), Raw Coix Seed (Sheng Bian Dou)

Shortness of breath and loss of voice, with a frog-like sound in the throat at times. The Right pulse is like leather. Facial edema and sallow complexion indicate Lung and Stomach involvement. Epigastric fullness and hardness. Tonification and purgation alternate, yet none are effective. It is worse than cold water, more severe than spring conditions. Propose administering Weijing Yu Bi Cheng Tang, drink three doses.
Gypsum Fibrosum (Shigao), Cinnamon Twig Wood (Guizhi Mu), White Peony Root (Baishao), Apricot Seed (Xingren), Benincasa Hispidas Pericarpium (Donggua Zi), Raw Coix Seed (Sheng Yiren)

Wood belongs to Damp-Warmth. Invading the Sanjiao, first repelling the Couli (pores/skin), mistakenly injuring the Qi of Hand-Taiyin (Lung) and Foot-Taiyin (Bladder), inevitably leading to gradual decline into deficiency consumption. This is not the fault of the disease, but the fault of treatment. Must move to a bright, quiet room. Treatment should last nearly a hundred days. Propose opening Taiyang, benefiting Taiyin.
Light Dried Ginger (with Wuweizi pounded), Poria (Fuling), Groundcherry Root Bark (Digupi), Mulberry Leaf (Sangye), Raw Coix Seed (Sheng Bian Dou), Raw Licorice Root (Sheng Gancao)

A wiry and moving pulse devoid of vitality is named "Stomach Qi Deficiency." Although not exactly "only wiry without Stomach" as described in *Nan Jing*, having this pulse in chronic illness is inadvisable. Do not administer pure Yin herbs for a long time due to blood loss; Yang Qi is suppressed, leaving Yin without support. My humble opinion is to administer Sweet-Warm formulas.
Jianzhong Decoction added with Ginseng Radix (Renshen), Honey-fried Astragalus Root (Zhi Huangqi), Angelica Sinensis Radix Body (Guishen).

The disease is in the Extraordinary Vessels; treating other meridians yields no response. Know that blood flows through clear pathways; thus, knowing Clear Qi is not肃 (purified/clear), both nasal bleeding and dizziness originate from the Du Mai (Governor Vessel). Seeking novelty is useless; using ancient methods will yield efficacy.
Rehmanniae Radix (Shengdi), Rhinoceros Horn (Xijiao - *Note: Substitute with Buffalo Horn in modern practice*), Broad Nutmeg Core (Guang Yuanye), Platycladi Cacumen (Cebaiye)
Make honey pills. Take five qian in the morning, three qian in the evening, with warm water.

Summerheat is a Yin pathogen within Heat. The Heart receives it first. Invading the Bao Luo (Pericardium), causing lethargy, muteness, mental confusion, and cold limbs, it is untreatable. Now the pulse is slow and soft, gradually showing these signs. The extremities are gradually cold, posing a risk of internal closure and external collapse. Urgently apply the method of unblocking Yang and rescuing reversal, imitating the principle of You Da Shun San. Whether this works remains to be seen.
Cinnamon Twig (Guizhi), Pinelliae Tuber (Banxia), Stir-fried White Peony Root (Jiao Baishao), Honey-fried Licorice Root (Zhi Gancao)

The Right pulse is hollow and bounding. Deafness, lower bleeding, unremitting alternating chills and fever. The Yin collaterals are injured, and Jueyin fails to control. Heat pathogens should be vented from the Extreme Yin. This is the primary principle of preserving Yin.
Artemisiae Annuae Herba (Qinghao), Anemarrhenae Rhizoma (Baizhimu), Raw White Peony Root (Sheng Baishao), Stir-fried Phellodendri Cortex (Chao Huangbai), Turtle Shell (Biejia), Fresh Lotus Leaf (Xian Heye)
One he of Rice (Yuanmi), soak in water to make liquid.

The Right pulse is seven beats per respiration, wiry. The Left pulse is six beats per respiration, tight. Coughing without ability to breathe out fully. Yin Qi is already weak. Metal and Water suffer simultaneously. Discuss administering Jingyue's Liu Jun Jian.