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Between the Great Void, there is but a single, undifferentiated mass of Qi. Through its swirling interaction and mutual agitation within the Great Void, all things are generated. Those who receive mixed Qi become beasts and plants; those who receive pure Qi become humans. However, even among those with pure Qi, there are differences in density (thickness/thinness) and strength. Furthermore, when invaded by the Six Qi (Six Climatic Factors: Wind, Cold, Summer Heat, Dampness, Dryness, Fire) externally and assaulted by the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright) internally, various diseases arise. Diseases manifest as cold or heat, exterior or interior, with thousands of symptoms and signs that cannot be fully enumerated. Ultimately, they fall only between "Deficiency" (Xu) and "Excess" (Shi). Thus, the Classics state: "For deficiency, tonify; for excess, drain." Alas! Deficiency and Excess are the standards for diagnosing disease, while Tonification and Draining are the major principles of treatment!

Since Zhang Zhongjing (the Prefect of Changsha), wise sages have emerged in succession, each specializing in specific schools and establishing divergent views. Various theories dance around; some lean towards draining (e.g., Dai Ren/Zhang Congzheng), while others lean towards tonifying (e.g., Li Zhihe/Li Shizhen's predecessor in this context, likely referring to Li Dongyuan or similar figures depending on interpretation, but here explicitly named "Lizhai"). Since there is bias, there must be drawbacks. Since there are drawbacks, differentiation is necessary! I privately believe that the techniques of these two gentlemen, one tonifying and one draining, though different, both reach their utmost perfection. In terms of the merit of the Sages, nothing could add to it. However, diseases in the world are not necessarily all Excess; thus, regarding those biased towards draining, I fear that patients with Deficiency will suffer harm. They are not necessarily all Deficiency; thus, regarding those biased towards tonifying, I fear that patients with Excess will also suffer harm. Gaining one aspect while losing another, being clear on one side but obscure on the other—is this truly the great completion of the Dao of medicine?

Zhang Changsha (Zhang Zhongjing) was not like this. When tonification is appropriate, he tonifies without bias towards tonification; when draining is appropriate, he drains without bias towards draining. He follows the syndrome regarding Deficiency and Excess, and applies tonification and draining according to the timing/opportunity. Alas! This can truly be called the Great Completion. Comparing them to ancient sages, Dai Ren and Lizhai, in relation to Zhang Changsha, are like Boyi and Liuxia Hui in relation to Confucius. The necessity of not neglecting either tonification or draining is like the impossibility of wearing only fur coats or only hemp clothes regardless of the season. Yet now, without examining Deficiency and Excess, people cause tonification and draining to be biased separately. This is like failing to examine the different climates of winter and summer yet wanting to rely solely on fur or hemp for protection. Is this logical?

Therefore, it is said: "In Shaoyin disease, if there is diarrhea with undigested food, indicating interior cold and exterior heat, Tongmai Sini Tang (Pulse-Reviving Four Reversals Decoction) should be used." It is also said: "In Shaoyin disease, if there is spontaneous diarrhea of clear water, purely green in color, Da Chengqi Tang (Major Order the Qi Decoction) is suitable." From this, it is evident that tonification and draining cannot be neglected. In today's world, people favor tonification and dislike draining, prefer warmth, and fear cold. They view Radix Astragali Preparata (Huangqi, 黄芪) [Note: Text says Dahuang/Mangxiao as snake/scorpion, implying harsh purgatives]... wait, text says "Dahuang Mangxiao, viewed as snakes and scorpions". So: They view Rhubarb (Da Huang) and Mirabilite (Mang Xiao) as terrifying as snakes and scorpions; they view Dried Ginger (Gan Jiang) and Aconite Root (Fu Zi) as sweet as maltose syrup. When Mirabilite and Rhubarb achieve efficacy, they say: "This only seeks temporary relief, and will inevitably lead to middle-jiao cold disorders later." If Ginger and Aconite are misapplied and fail, they say: "Even Ginger and Aconite do not work, so we attribute it to fate." This is extremely thoughtless. Therefore, all medical books that lean towards tonification are prevalent in the world, with printing blocks expanding daily. As for Dai Ren's book, it is rarely circulated or recited. I privately worry that students learning medicine will clamor for these biased tonification books and neglect formulas for draining excess. Consequently, "deficient patients become more deficient, and excess patients become more excessive," and the resulting drawbacks will be beyond description.

I have commissioned artisans to carve the woodblocks to spread its transmission. I only hope that this book will circulate alongside Lizhai's book. When draining is appropriate, learn from Dai Ren; when tonification is appropriate, learn from Lizhai. Do not allow an imbalance of tonification and draining, so that the common people may jointly ascend to the realm of benevolence and longevity!

Written by Watanabe Eigan Anpu at the Sleep Crane Pavilion under the Pine Tree in Luoyang, on the Full Moon Day of the Eighth Month in the Xinmao Year of Zhengde.