🌿 Folk Prescriptions

In early winter of the Wanli era of the Ming Dynasty, the royal consort of Prince Zhu Sanwei of Lu, nearly 50 years old, suffered from severe fright and anger, presenting symptoms of abdominal distension resembling ascites, a mass under the right rib cage with sharp pain, unbearable restlessness, accompanied by persistent cough, expectoration, difficulty in urination and defecation, extreme emaciation, inability to eat, and unbearable suffering. Despite numerous treatments by court physicians, no improvement occurred. An announcement was posted nationwide seeking renowned physicians. Numerous prescriptions and medicines were offered, but all employed methods of reducing distension and eliminating pathogens, worsening the condition. Someone recommended Dr. Gong Tingxian for treatment. Gong examined the consort’s pulse—six pulses floating, scattered, irregular, and rapid, with tight and forceful cun pulse. He concluded the condition was critical, caused by excessive aggressive treatment damaging the spleen and stomach qi, depleting kidney water, exhausting heart blood, excessive lung fire, and overactive liver wood, with abundant damp-heat. Treatment should greatly tonify the spleen earth, nourish lung metal to restrain liver wood, nourish kidney water to subdue heart fire, calm liver wood, clear damp-heat, and lift sinking qi. Thus, he prescribed a modified version of Bu Zhong Yi Qi Tang with heavy doses of ginseng and Atractylodes, adding processed Rehmannia, Scutellaria, and Coptis, using five qian (originally three fen) of ginseng. Upon issuing the prescription, objections arose. Prince Zhu asked Gong: "Previously, physicians dared not use ginseng lightly, fearing it would exacerbate fire and trigger phlegm and asthma. If this tonification causes stagnation, won't it bring disaster?" Gong calmly replied: "Treatment should follow the pulse. The pulse is scattered and chaotic—using ginseng poses no risk." The entire court, over a thousand people, was shocked, but desperate, they tried it with only four qian of ginseng. That night, the patient slept peacefully. The next day, Prince Zhu happily asked: "It's already cold, and she eats nothing. Can cool herbs like Scutellaria and Coptis be used?" Gong answered: "In winter, Scutellaria and Coptis are indeed unsuitable, especially when appetite is absent. But lung fire must be cleared with Scutellaria; liver fire must be calmed with Coptis. This is 'following the syndrome rather than the season.'" Asked again: "With cough and phlegm, can ginseng be increased?" Answered: "The cun pulse is tight—great deficiency of vital qi. Without ginseng, how can we replenish the vital qi? This is 'following the pulse rather than the symptoms,' requiring profound insight to dare use it." Asked: "Rehmannia may clog the stomach and worsen distension. Won't it aggravate the condition?" Answered: "When lung metal is deficient, it cannot generate water. The kidney loses its source of life. Only Rehmannia can nourish it. But Rehmannia is processed, entering the kidney meridian. Combined with generous doses of ginseng and Atractylodes, it will not harm the stomach or cause distension." Prince Zhu asked again: "With severe abdominal distension and obstruction, why use tonifying herbs instead of diuretics? Won't this support the pathogen and worsen the illness?" Gong replied: "Using tonics to treat distension—initially it may worsen, but long-term use brings relief. This is precisely the principle of 'treating blockage with blockage' as stated in the *Huangdi Neijing*." At this point, Prince Zhu was convinced and ordered continued use of the original formula. After over thirty doses, Gong re-examined the consort’s pulse: left three positions stringy and rapid, right three positions large and rapid, cun pulse tight and forceful, pulse rate seven beats per breath—indicating a chance for recovery. He instructed her to take Liuwei Dihuang Wan every morning before dawn, take the decoction with ginseng-Atractylodes paste at nine o’clock, eat Taihe Wan or Jianpi Wan (tonifying qi and blood, strengthening the spleen) at noon, and take another dose of decoction in the evening. This regimen continued daily. After fifty doses, symptoms slightly improved. By one hundred doses, suffering completely disappeared. The following spring, due to the consort failing to regulate emotions, diet, and labor, she relapsed several times, but Gong still used spleen-tonifying therapy, treating for over half a year. Total ginseng consumption reached six or seven catties, fully curing her. Gong Tingxian thus gained widespread fame. Prince Zhu, impressed by his skill, presented a plaque inscribed: "Top Physician in the Medical World," and recommended him to join the Imperial Medical Bureau as a court physician.