Wang Junchuan, Grand Marshal, presented with vomiting of retained food stagnation, severe pain in the umbilical and abdominal region, coldness of both hands and feet, and a faint and fine pulse. After taking Fuzi Lizhong Wan (Aconite Pill to Regulate the Middle), his condition worsened; his pulse became floating and large but fine upon deep pressure. He was then prescribed Shenfu Tang (Ginseng and Aconite Decoction) for one dose and recovered immediately.

Zhao Wenqing, Clerk of the Ministry, suffered from incessant vomiting, expelling sour-tasting material. The Qi Kou pulse at the radial artery was two to three times larger than the Ren Ying pulse at the carotid artery. He urgently requested medication. I said, "This is food stagnation constrained in the upper jiao; it should be induced to vomit, no medicine is needed." We waited for him to vomit naturally. He expelled clear fluid without sour odor, the Cun pulse gradually diminished, and the pulses at the feet gradually recovered. By the next morning, vomiting ceased, and by noon, all pulses returned to normal, and he remained peaceful without further medication. Later, when he passed through Suzhou while serving in Shaanxi, he visited me, engaging in refreshing conversation with greater warmth than before. He often comforted me verbally, mindful of my retirement in the countryside.

A scholar presented with sallow complexion, discomfort in the chest and diaphragm, acid regurgitation, and belching of rotten odors. Having strictly taken Qi Li Hua Tan (Regulating Qi and Resolving Phlegm) medicines, he developed loose stools, poor appetite, and fatigue. This was Spleen and Stomach Deficiency Cold. He was treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Pao Jiang (Prepared Ginger) and Mu Xiang (Aucklandia Root), gradually improving, while simultaneously taking Si Shen Wan (Four Spirits Pill) to restore Yuan Qi. For such cases where Middle Qi is deficient, Ren Shen Li Zhong Tang (Ginseng Pill to Regulate the Middle) or Bu Zhong Yi Qi Tang (Pill to Supplement the Middle and Enrich the Qi) plus Mu Xiang and Gan Jiang (Dried Ginger) may be used. If ineffective, Zuo Jin Wan (Left Metal Pill) or Yue Ju Wan (Pill to Resolve Depression) may be sent. If there is Middle Qi Deficiency Cold, Fu Zi (Aconite Root) must be added, or Fu Zi Li Zhong Tang (Aconite Pill to Regulate the Middle) used, which invariably leads to recovery.

A Guozijian student (Shangshe), due to improper diet, developed distension in the chest and abdomen, belching, and acid regurgitation. Self-prescribing Er Chen Tang (Two-Cured Decoction), Zhi Shi (Immature Bitter Orange), Huang Lian (Coptis Rhizome), Cang Zhu (Atractylodes Rhizome), and Huang Bai (Phellodendron Bark), his previous symptoms worsened, and he additionally developed swelling and pain in the toes with exudate between the toe webs. I treated him with Bu Zhong Yi Qi Tang plus Fu Ling (Poria) and Ban Xia (Pinellia Tuber), resulting in recovery. For edema of the legs and feet, or if accompanied by aversion to cold and fever, vomiting, the same formula is used.

Hu Zhizhi, a scholar, after failing the imperial examinations, developed fullness and oppression in the chest and diaphragm, and loss of taste in food. Taking Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) caused intermittent vomiting; taking Er Chen Tang, Huang Lian, and Zhi Shi caused phlegm surging and shortness of breath; adding Zi Su (Perilla Leaf) and Zhi Ke (Bitter Orange Peel) led to wheezing, coughing, and abdominal distension; adding Hou Po (Magnolia Bark) and Fu Pi (Areca Peel) resulted in difficult urination; adding Bing Lang (Areca Seed) and E Zhu (Curcuma Rhizome) caused diarrhea and abdominal pain. All belonged to Deficiency Cold. Six Jun Zi Tang plus Sheng Jiang (Fresh Ginger) and Rou Gui (Cinnamon Bark) was given for two doses with little effect. An additional 1 qian of Fu Zi was added; after two doses, symptoms slightly receded, and after several doses, six or seven parts out of ten improved. Finally, Ba Wei Wan (Eight-Ingredient Pill) cured him completely.

Another Shangshe presented with vomiting of phlegm-saliva, fever, thirst, and chest diaphragm stuffiness. Using Qing Qi Hua Tan (Clearing Qi and Transforming Phlegm) and Fire-Descending medicines worsened the previous symptoms, leading to spontaneous discharge of phlegm-saliva. I said, "Vomiting phlegm-saliva indicates Stomach Qi Deficiency Cold; fever and thirst indicate the Stomach's inability to generate fluids; chest diaphragm stuffiness indicates Spleen Qi deficiency. One must use Ren Shen (Ginseng Root), [missing character, likely Huang Qi or Bai Zhu], Dang Gui (Angelica Sinensis), and Bai Zhu (Atractylodes Macrocephala Rhizome) to warm and tonify the Spleen and Stomach, generate Yang Qi, and let all diseases retreat." He did not believe this, continued taking the previous medicines, and all deficiency symptoms appeared. He requested treatment again. I said, "Inability to eat, incessant hiccups, diarrhea, abdominal pain, and cold extremities constitute the 'Five Deficiencies'; irritability, heat, and thirst indicate Floating Yang escaping outward; a flooding pulse that feels like it is about to vanish indicates imminent death." Someone asked, "If so, will he die during the day or night?" I said, "With a flooding pulse, he will die during the day." It proved true.

My mother, Tai Yi Ren, aged sixty-five, in February of the spring of Ji Mao year, after hearing external gossip post-prandially, felt offended. She vomited sour water, experienced internal heat and thirst, refused solid food, drank only cold water, had an unruly large Qi Kou pulse, and a bluish-red face. This was Damp-Heat and Depressed Fire in the Stomach. Medications taken orally were immediately vomited up. On the third day, she vomited sour matter; on the seventh day, sour yellow water; on the eleventh day, bitter water. The pulse became increasingly flooding, and she still preferred cold water. Initially, a decoction of Huang Lian alone was prepared, chilled, and given in small amounts. By the twentieth day, Bai Zhu and Bai Fu Ling (White Poria) were added. By the twenty-fifth day, Chen Pi (Tangerine Peel) was added. By the thirty-seventh day, Dang Gui and Zhi Gan Cao (Honey-fried Licorice Root) were added. By the sixtieth day, she could take half a cup of clear rice drink, gradually advancing to thin congee, and recovered through regulation.

A woman presented with acid regurgitation, belching of rotten odors, vomiting of phlegm-saliva, and a pure white complexion. Using Er Chen Tang, Huang Lian, and Zhi Shi caused fever, thirst, and abdominal distension. I said, "This is Spleen and Stomach damage, ultimately transmitting to Cold in the Middle." Disbelieving, she continued treating it as Fire, resulting in limb swelling resembling Gu disease (abdominal tumor/ascites). I treated her with Liu Jun Zi Tang plus Fu Zi and Mu Xiang. Her Stomach Qi gradually awakened, food intake increased, and the Deficient Fire returned to its channel. Subsequently, Bu Zhong Yi Qi Tang plus Pao Jiang, Mu Xiang, Fu Ling, and Ban Xia was taken concurrently, leading to complete recovery.

Another woman, quiet and prone to worry, presented with chest diaphragm discomfort, poor appetite, abdominal distension, acid regurgitation, and a bluish-yellow face. Others used Shu Li (Ventilating and Draining) agents. I said, "This is Spleen Deficiency with Fullness; one must benefit Stomach Qi." Disbelieving, she continued using them. Her chest diaphragm indeed became full, and food intake decreased further. I treated her with Tiao Zhong Yi Qi Tang plus Xiang Fu (Cyperus Rhizome), Sha Ren (Amomum Fruit), and Pao Jiang, gradually improving. Later, she recovered with Liu Jun Zi Tang plus Chuan Xiong (Ligusticum Rhizome), Dang Gui, Bei Mu (Fritillaria Bulb), Jie Geng (Platycodon Root), and Pao Jiang.

Lu stated: My mother has long suffered from heart and abdominal pain. Each attack was accompanied by chest fullness, vomiting,厥逆 (Jue Ni - reversal cold/extremity coldness), red face, numb lips, dry throat and tongue, intermittent chills and fever, and a flooding pulse. The masses treated it as Phlegm-Fire; it stopped repeatedly but recurred. In the spring of Yisi year, fever became frequent and severe, and medications aggravated it. Mr. Zhu Cunmo claimed it was caused by cold-cooling medicines and wished to use Ren Shen and Bai Zhu formulas. I doubted that pain admits of tonification, so I invited Mr. Lizhai (Xue Ji) to judge. Upon diagnosis, the Master sighed, "This is due to cold-cooling medicines damaging True Yang; Interior True Cold with Exterior False Heat. Moreover, the pulse is wiry and flooding with abnormal characteristics, indicating Spleen Qi damage with Liver Pulse overacting. One must only warm and tonify the Stomach." He prescribed Bu Zhong Yi Qi Tang plus Ban Xia, Fu Ling, Wu Zhu Yu (Evodia Fruit), and Mu Xiang. One dose showed efficacy. My mother had been restless all night for over a month since the onset; now she sleeps soundly until dawn, the flooding pulse instantly收敛 (contracts), abnormal pulses vanish, and all symptoms are resolved. The Master's insight must have a foundation! My mother's remaining years are bestowed by the Master. Gratitude for the medical virtue shall never be forgotten till death. I respectfully record this, begging that it be attached as a medical case and collected by historians into the chapters of Cang Gong (Chunyu Yi), to remain immortal, allowing future generations to observe and reflect. On an auspicious day in the spring of Yisi, Jiajing era, Lu, a devoted son from Chen Lake, bowed and wrote.

A woman, over thirty years old, suddenly lost her appetite, drinking three to five bowls of clear tea daily and eating little fruit for over three years. Her menstruation was always delayed and scanty. I considered this Spleen Qi depression and used Gui Pi Tang (Restore the Spleen Decoction) plus Wu Zhu Yu. Within a few doses, her diet returned to normal. If a person suffers from Spleen and Kidney Deficiency leading to anorexia, Si Shen Wan should be used.

A woman, over twenty years old, had not eaten properly for two years, consuming only clear tea and fruits daily. Her face was slightly yellow and puffy, her body shape normal, able to walk, but she felt fatigued. The Liver and Spleen pulses were wiry and floating, faint and stagnant upon deep pressure. I used Liu Jun Zi Tang plus Mu Xiang and Wu Zhu Yu. She discharged much phlegm accumulation, her appetite suddenly improved, though she became emaciated and bedridden for over a month. Continued administration of Liu Jun Zi Tang-like formulas brought stability.

For women suffering from this condition, see *Nv Ke Cuo Yao* (Essentials of Gynecology).