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Heaven covers with Qi, and Earth supports with Qi. All things fill the space between Heaven and Earth, all born of Qi. When illness occurs, none arises except through Qi. The Qi of Wind is peaceful and opens life; the Qi of Heat is warm and promotes flourishing; the Qi of Fire is hot and summer-like in its movement; the Qi of Dampness is humid and muggy, filling the air; the Qi of Dryness is clear and biting, causing desolation; the Qi of Cold is cold and misty, leading to storage. These six Qi transformations are the normal governance of seasonal changes.

When they change abnormally: the Qi of Wind becomes turbulent and angry, turning excessively cold; the Qi of Heat becomes extremely hot but turns cold; the Qi of Fire brings fierce winds and burning flames but turns to frost; the Qi of Dampness brings thunder and sudden rain but turns to fierce wind; the Qi of Dryness scatters and falls but turns damp; the Qi of Cold brings snow, frost, and hail but turns to white dust. These are the variations of the Six Qi. Thus, if Heaven is cold for a long time, treat it with heat; if cool, treat with warmth; if dark, treat with brightness; if dry/clear, treat with rain. The Qi of Heaven and Earth is stable in normalcy, causing disease in variation. How much more so for humans who receive the Qi of Heaven and Earth, with the Five Movements (Wu Yun) invading externally and the Seven Emotions clashing internally? Therefore, sages cherish Qi as a supreme treasure; fools serve external things and damage their Great Harmony. This is why Huangdi and Qibo stated that all pain stems from Qi, and all diseases arise from Qi. Hence, the theory of Nine Qi differences.

Qi is fundamentally one, but becomes nine due to different triggers. These nine are: Anger, Joy, Sorrow, Fear, Cold, Heat, Fright, Thought, and Overexertion. It is said: Anger causes Qi to rebel upwards; severely, it leads to vomiting blood or undigested stool diarrhea, because Qi rebels upward. Wang Taipu said: Anger causes Yang Qi to rebel upward, and Liver Wood overacts on Spleen Earth, hence vomiting blood and undigested stool diarrhea. Joy causes Qi to harmonize and will to reach, Ying and Wei to flow freely, hence Qi relaxes. Sorrow causes the Heart vessel to contract, Lung leaves to expand and rise, Upper Jiao to block, Ying and Wei not to disperse, Heat to stay in the middle, hence Qi dissipates. Fear causes Essence to retreat; retreating blocks the Upper Jiao; blocking causes Qi to return; returning distends the Lower Jiao, hence Qi does not move downward. Wang Taipu said: Fear causes Yang Essence to retreat upward without flowing down, and Lower Jiao Yin Qi returns without dispersing, hence gathering and distending. Although Upper Jiao is closed and Lower Jiao Qi returns, Qi does not move downward. *Xin Zheng* notes: "does not move" should be "does not move downward." Cold closes the Cou Li (pores/skin texture), Qi does not move, hence Qi contracts. Wang Taipu said: Body cold makes Wei Qi sink, so skin texture and sweat pores close tightly, Qi does not circulate, Wei Qi gathers inside without dispersing. Heat (Jiong) opens Cou Li, Ying and Wei flow, sweat pours out, hence Qi leaks. Wang Taipu said: Humans are comfortable in Yang, miserable in Yin. So heat opens skin and Cou Li, Ying and Wei flow greatly, fluids seep out, sweat pours. Fright causes Heart to have no foundation, Spirit to have no home, thoughts to have no certainty, hence Qi becomes chaotic. Overexertion causes panting and sweating, internal and external Qi both escape, hence Qi is consumed. Wang Taipu said: Fatigue and labor make Qi rush fast, hence panting. Fast-rushing Qi sends Yang outward, hence sweating. Internal and external both exceed normal limits, hence Qi is consumed. Thought causes Heart to retain focus, Spirit to settle, Zheng Qi to stay and not move, hence Qi knots. Wang Taipu said: Heart tied and not scattered, so Qi also stays. This is the discussion of Nine Qi in *Su Wen*, very detailed in changes, clear in principles.

However, the discussion of diseases caused by Nine Qi is brief, only mentioning vomiting blood and undigested stool diarrhea, ignoring others. Only *Ling Shu* discusses diseases from thought, sorrow, joy/anger, worry/grief, extreme anger, fear. It says: Those who know health must follow the four seasons and adapt to cold/heat, harmonize joy/anger and live peacefully, regulate Yin/Yang and harmonize Gang/Rou. Thus evil Qi cannot enter, ensuring long life. So fright/thought damages Shen (Spirit); damaged Shen leads to endless fear and leakage. Sorrow moving internally exhausts Essence, losing life; Joy makes Shen scatter and not store; Worry/Grief blocks Qi; Extreme Anger confuses Shen and loses control; Fear agitates Shen and prevents gathering. Fright/thought damages Shen; damaged Shen leads to self-loss of fear, muscle wasting, brittle hair, premature death in Winter; Spleen worry damages Yi (Intellect); damaged Yi leads to confusion, limbs unable to lift, brittle hair, premature death in Spring; Liver sorrow damages Hun (Ethereal Soul); damaged Hun leads to madness, forgetfulness, improper spirit, yin contraction, tendon spasm, inability to raise ribs, brittle hair, premature death in Autumn; Lung excessive joy damages Po (Corporeal Soul); damaged Po leads to madness, disregard for others, scorched skin/hair, brittle hair, premature death in Late Summer; Kidney extreme anger damages Zhi (Will); damaged Zhi leads to forgetting words, stiff waist/spine, brittle hair, premature death in Late Summer; Unresolved fear damages Jing (Essence); damaged Jing leads to bone萎 (atrophy/cold) and spontaneous seminal emission. Thus, the Five Zang store Jing; do not damage them. Damage leads to loss of control and Yin deficiency; deficiency leads to lack of Qi; lack of Qi leads to death.

*Ling Shu* discusses diseases of Shen, Yi, Hun, Po, Zhi, Jing, but lacks Cold, Heat, Fright, Overexertion. I deduce and expand upon this. Anger leads to: vomiting blood, undigested stool diarrhea, Jian Jue (Frying Syncope), Bo Jue (Thin Syncope), Yang Jue, chest fullness/hypochondriac pain; food rebellion without descent, panting/thirst/irritability, Xiao Dan (Consumption Diabetes), Fei Qi (Mass in Hypochondrium), sudden blindness, sudden deafness, tendon relaxation, carbuncles/sores externally. Joy leads to: unceasing laughter, scorched hair, internal disease, Yang Qi not gathering, severe cases become Mania. Sorrow leads to: yin contraction, tendon spasm, Muscle Bi, Mai Wei (Vessel Atrophy), frequent hematuria in men, metrorrhagia in women, sour nose/itching, blurred vision, shortness of breath, arm numbness when crying. Fear leads to: muscle wasting, bone soreness/atrophy/cold, sudden green watery diarrhea, facial heat/tight skin, impotence, jaw dislocation from fear. Fright leads to: tidal phlegm, staring eyes, mouth deviation, dementia/epilepsy, unconsciousness, stiff collapse, chronic Pain Bi. Overexertion leads to: dysphagia, panting, hemoptysis, lower back pain/bone atrophy, lung sounds, high bone destruction, impotence, hematemesis, blurred vision, deafness, scant semen in men, amenorrhea in women; severe cases lead to溃溃 (ulceration/discharge) like water rings, unstoppable. Thought leads to: insomnia, lethargy, dizziness, Middle Jiao痞 (fullness/blockage), throat obstruction, Dan Dan (Biliary Heat) with bitter vomiting, tendon atrophy, Bai Yin (White Discharge), relief after defecation/gas passage, anorexia. Cold leads to: clear/cold fluids excreted, clear/white dysentery, foul vomiting/dysentery, postprandial anorexia, hard/full painful abdomen, masses/hernias, stiffness, cold reversal/stiffness. Heat leads to: panting/vomiting acid, sudden diarrhea with tenesmus, tetany, turbid urine, drum-like abdominal distension, sores/rashes/nodules, Huo Luan (Cholera-like), depression/swelling, nasal obstruction/epistaxis, bleeding/stranguria, fever/chills, severe cases: coma/blindness, tinnitus/deafness, restlessness/madness, cursing/fear, trembling, loss of spirit control, Qi rebelling upward, sneezing/foul discharge, inability to eat, foot swelling/pain, sudden aphasia/diarrhea, sudden severe illness/death.

For these nine, *Nei Jing* has treatments based on the Five Elements overcoming each other. Anger damages Liver (Wood); Qi gathers in Liver, damaging Spleen Earth; excess Wood damages Liver itself. Joy damages Heart (Fire); Qi gathers in Heart, damaging Lung Metal; excess Fire damages Heart itself. Sorrow damages Lung (Metal); Qi gathers in Lung, damaging Liver Wood; excess Metal damages Lung itself. Fear damages Kidney (Water); Qi gathers in Kidney, damaging Heart Fire; excess Water damages Kidney itself. Thought damages Spleen (Earth); Qi gathers in Spleen, damaging Kidney Water; excess Earth damages Spleen itself. Cold damages Form (Yin); Cold defeats Heat, damaging Yang; excess Cold damages Yin itself. Heat damages Qi (Yang); Heat defeats Cold, damaging Yin; excess Heat damages Yang itself. These seven treat each other. Thus, Sorrow treats Anger (using tragic words); Joy treats Sorrow (using playful words); Fear treats Joy (using threats of death); Anger treats Thought (using insulting words); Thought treats Fear (using distracting worries). These five methods must be bizarre/unconventional to affect senses/hearing. Only those with talent can use them. Heat treats Cold: external cold uses acupuncture/quenching/warm baths to sweat; internal cold uses hot food/warm medicine. Cold treats Heat: external heat uses cool rooms/clothes/clear medicine to sweat; internal heat uses cold drinks/cold medicine. Rest treats Overexertion (*Jing*: "Overexertion requires warming"). Warm means nurturing/restoring. Modern doctors mistake "warm" for warm-tonic herbs, a great error! Qibo said: "Aim for balance." Means rest. Habituation treats Fright (*Jing*: "Fright requires leveling"). Ping means ordinary/common. Fright comes from suddenness; habituation removes fear. *Nei Jing* has profound logic here, ignored by mediocre doctors.

Modern Liu Hejian treated Five Emotions, grasping the implicit meaning: Five Emotions originate from the Heart. Thus, treat Joy/Anger/Sorrow/Fright/Thought by calming Heart Fire. Overexertion involves movement (Yang); Fright shocks the Heart (Fire); both require calming the Heart.

Modern doctors miss this, inviting criticism of cold-cool therapies. Critics gather, scholars confuse, when will public opinion settle?

Once I treated a scholar, overworked, constipated, coughing/rebellious Qi, noisy breathing, hemoptysis. I used Bitter agents: Jiedu Huanglian Tang + Muxiang, Han Fangji, decocted and sipped frequently; then Muxing Binglang Wan to drain rebellious Qi. Recovered in less than a month.

I once used a dancing prostitute to treat emotional stagnation from sorrow. I once used acupuncture accompanied by dance/flute/drums to treat heart pain from worry. I once banged doors/windows continuously to treat fear/noise sensitivity and flying Hun. I once treated a woman with insomnia from prolonged thought; I feigned drunkenness and ignored her; she got angry and slept soundly that night. I used Suanzaoren Wan for excessive worry. I used Baihu Tang regardless of season to treat summerheat. I used Wuyou San to drain winter cold-damp Bi, followed by Mahuang Tang (several taels per dose) with dates/ginger, taken hot to sweat and cure. If unresolved, use Gengti San to induce vomiting, assist sweat with fire; same for cold reversal. I treated severe summerheat where all drugs failed; I pricked his head repeatedly to bleed, curing immediately. My treatments were like taking from a bag. However, Overexertion with Qi consumption and Fear with Qi depletion are difficult to treat. Joyful people rarely get sick because meridians are relaxed.

I heard of Mr. Yang from Shandong treating a governor with persistent profuse diarrhea. Yang did not speak to the patient initially, but discussed astronomy/weather with others from Chen to Wei hours. The patient listened and forgot to defecate. Yang said: Ask what the patient likes. If they like chess, play chess; if music, provide instruments, ceaselessly. I heard of Mr. Zhuang treating someone ill from excessive joy. Zhuang felt the pulse, feigned shock, said he would fetch medicine, and didn't return for days. The patient wept, said goodbye to friends, expecting death. Zhuang knew he would recover and comforted him. Asked why, Zhuang cited *Su Wen*: "Fear overcomes Joy." These two understood the hidden gate. However, Hua Yuanhua nearly died angering a prefect; Wen Zhi was killed angering the King of Qi. In thousands, only one or two succeed, often bringing disaster. Medicine is a subtle art; if it cannot protect itself, is it truly a low skill? Alas!