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A question was raised: "When food accumulation fills and blocks the chest, causing stagnation and obstruction there, inducing vomiting to expel the damaged substances will bring peace once the substances are gone. The chest is the domain of the Taiyin Lung meridian; Wood depression (Wood Qi stagnation) occurs when Jueyin Liver Wood Qi is suppressed below. Therefore, vomiting is used to extend it, to smooth and diffuse Yang Qi and harmonize Wind-Wood Qi. This vomiting method essentially drains the stagnation of Taiyin. What is meant by Wood depression? Please explain." The answer was: "This is a profound and spiritual principle. Without expounding on the Great Dao, one cannot reach this understanding.

Between heaven and earth, within the six directions, there are only Water and Fire! Fire belongs to Yang, representing ascending and floating qualities; in Heaven it manifests as substance, and on Earth as function. Water belongs to Yin, representing descending and sinking qualities; on Earth it manifests as substance, and in Heaven as the function of withering and storing. When their Qi interacts above and below, the Eight Trigrams are formed. From the perspective of medical texts, this corresponds to ascending/descending and warm/cool/cold/hot seasonal changes, aligning with the Eight Trigrams. If Heavenly Fire is above and Earthly Water is below, Heaven and Earth do not interact, and Yin and Yang cannot support each other. The way of all things and the principles of the Great *I Ching* would be extinguished. Thus, the classics state that 'Yang alone does not generate, Yin alone does not grow.' How can Heaven and Earth Yin and Yang intersect? It is said that Yang originates from Yin, and Yin originates from Yang. If one does not understand the root, one does not understand the Dao. Therefore, the Qi of the Six Yang meridians arises from the Earth, hence 'Yang originates from Yin.' In the human body, this means the Qi of the Six Fu organs grows, develops, and disperses within the Stomach Earth. Since Yang Qi inspires all tangible phenomena in Heaven, becoming floating and dispersed; when things reach their extreme, they reverse, and Yang transforms into Yin. Once the power of the Six Yang's ascending and floating reaches Heaven and exhausts itself, the Way of Yang ends. Consequently, it inspires the Six Yin's tangible Yin Water in Heaven and outside. The top line (Shang Liu) has no position and must return downward; this is the image of Old Yang transforming into Yin, indicating that the source of the Five Zang organs lies in Heaven. Heaven corresponds to the human Lung, hence 'Yin originates from Yang,' as stated in 'Water flows from its high source.' The source of the human Five Zang organs is the Lung. The Lung is located on the back, and the back corresponds to Heaven. Thus, the Cold growth of the Foot-Taiyang Bladder meridian has its source in Shen (the earthly branch), so Yin Cold descends from here, forming the gradual coldness of Autumn harvest. Descending to the ground, it forms Winter storage, hiding within the Nine Springs beneath the Six Yang meridians. Therefore, the Qi of the Five Zang organs arises in Heaven. In the human body, the source of the descending and storing Qi of the Five Zang organs comes from above the Lung Qi. Its flow moves downward. Since Yin Qi descends and sinks, all tangible phenomena are stored in the Earth, becoming sinking. When things reach their extreme, they reverse, and Yin transforms into Yang. Once the power of the Six Yin's descending and sinking reaches the Earth and exhausts itself, the Way of Yin ends. This is Old Yin transforming into Yang. The first nine (Chu Jiu) has no position. The Qi of the four seasons in a year ends and begins again, moving up and down without end, like a circle without beginning or end.

Moreover, Taiyin represents the descending Qi of Lung Metal, which should reside in the lower body. Now it resides in the upper body instead, suppressing Jueyin Wind Wood, which is forced to reside below, unable to ascend. Hence it is called Wood depression. Therefore, vomiting is induced to expel the obstructing tangible Earth-transformed substances, allowing the Taiyin Autumn Lung to descend and store in the lower body, restoring its original nature to subdue excess, thereby enabling the Hand and Foot Jueyin Wood to extend. Yuan Qi (Original Qi) stretches, and its desire for smooth upward diffusion finds its proper place. Furthermore, Metal controls Wood. By using vomiting to attack it, Metal Qi weakens. The nature of Metal is to descend. This is 'treating obstruction with obstruction' (using a blocking method to treat blockage), returning to the root. Residing above, it suppresses Wood; thus, vomiting is used to extend it. This is draining Metal to assist Wood. Examining the meaning of 'Wood depression should be reached' (Mu Yu Ze Da Zhi) in the *Nei Jing*, it refers solely to food damaging Taiyin tangible substances, obstructing the chest, suppressing Jueyin Wood Qi to hide below, preventing it from extending above. There is no other interpretation, discussed from the perspective of excess conditions caused by the Six Exogenous Pathogens. Zhang Zhongjing's *Shanghan Lun* states: "Regretful irritability and inability to sleep, without prior sweating or purging, is called Real Irritability, treated with Geng Ti San (Melon Seed Powder); if it follows erroneous sweating, vomiting, or purging, it is called Deficiency Irritability, treated with Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction)."

The old man wishes for physicians to treat Yin-Yang syndromes without error in tonification and drainage. Even if patients do not understand medicine, they should clearly know their disease and whether tonification or drainage is indicated. I have recorded the principles regarding excess and deficiency of Form and Qi, and the indications for tonification and drainage, from Volume 2, Chapter 5 of the *Huangdi Zhenjing* (Yellow Emperor's Classic of Acupuncture) at the front, with my own annotations attached.

"The Yellow Emperor asked: 'What is the reversal and順 (shun/compliance) of Form and Qi?' Qibo answered: 'If Form and Qi are deficient but Pathogenic Qi is excessive, this indicates pathogen victory; urgent drainage is required. If Form and Qi are excessive but Pathogenic Qi is deficient, urgent tonification is required. If both Form/Qi and Pathogenic Qi are deficient, this indicates deficiency of both Yin and Yang Qi; acupuncture must not be used. Acupuncture would cause double deficiency, leading to exhaustion of Yin and Yang, depletion of Blood and Qi, emptiness of the Five Zang organs, withering of sinews, bones, and marrow. The elderly would perish, and even the robust would not recover. If both Form/Qi and Pathogenic Qi are excessive, this indicates excess of both Yin and Yang; urgent drainage of the pathogen is required to regulate deficiency and excess. Thus, it is said: Drain what is excessive, Tonify what is deficient. This is what is meant.

"It is said: If acupuncture fails to distinguish reversal and compliance, True Qi and Pathogenic Qi clash. Tonifying fullness causes Yin and Yang to overflow, intestines and stomach to distend, Liver and Lung to become internally distended, and Yin and Yang to become confused. Draining deficiency causes meridians to become empty, Blood and Qi to枯竭 (dry up), intestines and stomach to contract, skin to become thin and adherent, hair and pores to wither, and death to be hastened. Thus, it is said: The essence of acupuncture lies in knowing how to regulate Yin and Yang. Regulating Yin and Yang makes Jing Qi radiant, combining Form and Qi to keep Shen (Spirit) contained within.

"It is said: Superior practitioners level Qi, intermediate practitioners disrupt Mai (Pulse/Vessels), inferior practitioners sever Qi and endanger life. Thus, inferior practitioners must be extremely cautious. They must examine diseases of the Five Zang changes, responses of the Five Pulses, excess and deficiency of meridians, and texture of skin before selecting points."

The sage's benevolent heart has been detailed sufficiently, making further words unnecessary. However, fearing that people in markets, farms, and mountains may not understand literary language, I use vernacular terms to explain them. When a disease surges like a tide, if the Pathogenic Qi and spirit increase, this is Pathogenic Qi excess, indicating pathogen victory; urgent drainage is needed using cold, cool, sour, and bitter agents. If during the surge, the spirit and Qi are fatigued and weak, this is Pathogenic Qi deficiency, indicating True Qi deficiency; urgent tonification is needed using acrid, sweet, warm, and hot agents. Regardless of whether Form/Qi is excessive or deficient, one only considers whether Pathogenic Qi is excessive or deficient. Deficient is tonified, excessive is drained. For example, if Pathogenic Qi is excessive, urgent drainage with cold agents is needed because the pathogen is strong; if Pathogenic Qi is deficient, urgent tonification with acrid, sweet, warm, and hot agents is needed because True Qi is deficient.

Form (Xing) refers to the physical body: skin, sinews, bones, and blood vessels. Excess form is excess; emaciation is deficiency. Qi refers to breath in the nose and mouth. If labor is performed as usual, Qi is excessive. If panting, shortness of breath, or insufficient respiration occurs, Qi is deficient. Thus, Form and Qi refer to Blood and Qi in the body. Indications for tonification and drainage do not depend solely on this, but on the disease state during its peak. If Pathogenic Qi increases during the peak, it is pathogen victory, requiring urgent drainage. If spirit is weak, speech is powerless, or the patient is reluctant to speak during the peak, it is True Qi deficiency, requiring urgent tonification. If a patient has deficient Form/Qi and also deficient Pathogenic Qi during the surge, this indicates deficiency of both Yin and Yang. Acupuncture is contraindicated; tonification with sweet herbs is appropriate, but not with heavy doses. Moxibustion should not cease until effective; the Qihai (Sea of Qi) point, 1.5 cun below the umbilicus, is used.

In using herbs, one must follow the Four Seasons; otherwise, compliance becomes reversal. The Four Seasons are Spring Ascension, Summer Floating, Autumn Descent, and Winter Sinking. These are the transformations of Heaven and Earth's ascending/floating and descending/sinking. Transformation occurs in Spleen Earth, representing the appropriateness of the Four Seasons. One should use acrid, sweet, warm, and hot herbs, and those with thin flavors, such as various Wind herbs, to assist Spring Ascension and Summer Floating. These herbs drain Autumn Harvest and Winter Storage. In the human body, they correspond to Liver and Heart. Conversely, sour, bitter, cold, and cool herbs, along with bland-draining herbs, assist Autumn Descent and Winter Sinking, corresponding to Lung and Kidney in the human body. Practitioners should adhere to these methods and not neglect them!"