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Qi deficiency in obese individuals generates cold; cold generates dampness; dampness generates phlegm. Blood deficiency in thin individuals generates heat; heat generates fire; fire generates dryness. Therefore, obese people are prone to cold-damp conditions, while thin people are prone to heat-dry conditions. Distinguishing cold, heat, dampness, and dryness based on body shape is derived from external observation. However, diseases occurring within the Zang-Fu organs also differ in terms of cold, heat, dampness, and dryness, which must be known. The *Yu Kui Jin Yao* states: "The treatment of the Liver has always been similar to that of Fire; the Sanjiao (Triple Burner) and Pericardium are no different. For the Spleen and Stomach, seek the cause in dampness; the Lung and Large Intestine belong to the category of dampness. For the Kidney and Bladder, Heart and Small Intestine, discuss cold and heat flexibly according to the situation. Chills with exterior heat indicate involvement of the Bladder (Taiyang channel); fever with exterior cold indicates blazing fire in the Heart and Kidney. Among the twelve channels, the most definitive rule is: four channels belong to Fire, four channels belong to Dampness, and four channels have both heat and cold at times. Carefully consider whether to attack the interior or release the exterior. Interior heat with exterior cold is suitable for Yueju Wan (Pill for Resolving Depression); exterior heat with exterior cold is suitable for sweating to resolve. Dampness is treated like Cold; Fire is treated like Heat. When it comes to distinguishing cold and heat, there are no two ways. Divide the condition into six parts; if Fire/Heat and Cold stop midway, it is empty talk. When Heat and Cold repel each other, the pathogenesis is profound. Excess leads to harm, while control brings balance. A tight pulse indicates Cold, a rapid pulse indicates Heat; this is the correct distinction between Zheng (Excess) and Xie (Deficiency). Treating both root and branch is the true wonderful principle. Do not treat Wind alone; do not treat Dryness alone. Once Fire is treated, Wind and Dryness will be resolved. When releasing the exterior, do not attack the interior; when attacking the interior, do not release the exterior. If both exterior and interior can be attacked, distinguish the order and the proportion of internal and external treatments. There is nothing better than draining water like a river to treat dampness; this principle is very clear. Gratitude to Xuanyuan Huangdi (Yellow Emperor) for his grace to all generations, yet alas, vinegar-jar chickens laugh at the smallness of the sky."

The generation of diseases is due to external contraction or internal injury leading to Fire and Dampness; Dampness generating Heat; Fire generating Phlegm. These are the only four factors. If it is a new disease in young and strong individuals, if it is Dampness, use drying methods; if it is Fire, use purging methods; if Dampness generates Heat, use drying dampness combined with clearing heat; if Fire generates Phlegm, use purging fire combined with resolving phlegm. This leaves no room for omission. If it is an old, weak person with a chronic disease, one should half-attack and half-nourish. For Qi deficiency with damp-heat, phlegm, and fire, use Sijunzi Tang (Four Gentlemen Decoction) to tonify Qi while simultaneously drying dampness, clearing heat, resolving phlegm, and purging fire. For Blood deficiency with phlegm-fire and damp-heat, use Siwu Tang (Four Substance Decoction) to nourish Blood while simultaneously purging fire, resolving phlegm, clearing heat, and drying dampness. In this way, attacking evil and tonifying deficiency are applied together, which is acceptable. Thus I say: For young and strong people with new diseases, attacking evil is primary; for old and weak people with chronic diseases, tonifying deficiency is paramount. As for Yin deficiency with moving Fire, and Spleen/Stomach weakness: True Yin belongs to Water; Spleen and Stomach belong to Earth. Although Earth likes dryness, too much dryness causes vegetation to wither; although Water likes moisture, too much moisture causes vegetation to rot. Therefore, formulas for tonifying the Spleen/Stomach and Kidney must achieve an appropriate balance of moistening and drying, and should be modified according to the disease.