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Among the Six Qi (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), only Dryness is particularly difficult to treat, for nothing is drier than Fire. Fire exists in all twelve meridians. When Yin and Yang are harmonious, Zang-Fu organs are strong, Ying and Wei (Nutritive and Defensive Qi) are solid, Cold and Heat are balanced, and emotions like anger and joy are calm, each meridian functions appropriately, flames do not surge upward, and where would Dryness come from? Once injured, Fire arises subsequently. For instance: if Wind stagnates and does not disperse, Wind and Fire stir up causing Dryness; or if Heat obstructs and remains unresolved, Heat generates more Heat exacerbating Dryness; or after prolonged illness, Yin deficiency causes Deficient Fire to flare up leading to Dryness. Externally, skin and hair become withered; superiorly, the throat becomes dry and the mouth parched; centrally, there is incessant irritability and thirst. The *Classic* states: "All cases of astringency, withering, drying up, stiffness, and cracking belong to Dryness." 'Drying up' means lack of body fluids. 'Dry' means lacking moisture. 'Stiff' means lacking flexibility. 'Cracking' refers to skin fissures. 'Astringent' means that just as various objects are smooth when moist but sticky/astringent when dry. However, 'Dry' corresponds to Heaven and belongs to Metal of Dryness; 'Kun' (Earth) corresponds to Earth and belongs to Soil of Dampness. Therefore, astringency is the transformation of Metal of Dryness, which is why the autumn pulse is astringent. 'Astringent' implies obstruction/stagnation, all caused by Dryness. Yet, the manifest aspect of Dryness stems from Wind and Fire, while its root lies in the Spleen and Kidney. This is because Spleen Essence fails to transport, and Kidney Yin fails to ascend, causing the Lung to lose its source of transformation, thereby revealing these symptoms! Treatment should focus on generating fluids, nourishing blood, nourishing Yin, and moistening Dryness. If the Cun (inch) pulse is strong and the Chi (cubit) pulse is weak, it is due to lack of fire under the pot, causing the lid to dry out; one should employ the method of "tonifying Fire within Water".

Liangge San (Cooling the Diaphragm Powder)
See Shanghan Section.

Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Gardeniae Fructus (Shanzhi) (equal parts, another version includes Scutellariae Radix/Huangqin), decocted in water and taken orally.

Liujun Dihuang Tang (Six-Ingredient Rehmannia Pill)
See Laozai Section.

Regarding Dryness damaging the body, the Lung Metal's nature is inherently dry; when Metal is affected by Heat transformation, it becomes even drier and more astringent. Wind can overcome Dampness, and Heat consumes fluids. The *Classic* states: "Wind, Heat, and Fire are Yang; Cold, Dampness, and Dryness are Yin." However, although Dryness and Dampness differ slightly, Metal of Dryness, though belonging to Autumn Yin, differs in nature from Cold and Dampness, resembling Wind, Heat, and Fire instead, manifesting as increased hardness, dryness, and astringency. This is the Large Intestine undergoing Heat transformation into Dryness and astringency. Similarly, paralysis and stroke often result from Fire-Heat consuming Blood, blocking the Xuanfu (pores/capillaries), preventing infiltration, and causing the Lung to be constrained by Fire unable to produce sound. The *Classic* says: "The Lung governs voice." Limb pain and deformity are caused by the combination of Wind, Dampness, and Heat, leading to hemiplegia, speech impediments, and uncontrolled limbs. The *Classic* states: "All warmth, withering, drying up, stiffness, and cracking belong to Dryness." Metal is the source of generating Water. If this source of generation is cut off, it cannot irrigate the whole body or nourish the bones and tissues, resulting in withering without moisture. The *Classic* states: "Metal and Water are the beginning and end of generation"; also, "Below the position of Wood, Metal Qi succeeds it." Generally, things transform following growth, and things complete following killing/restriction. If the force of growth is heavy and restriction is light, Qi dissipates and fails to gather; if restriction is heavy and growth is light, Qi gathers and becomes astringent/blocking. Astringency damages the distribution of Qi, preventing both ascending Sheng (growth) Qi and descending Shou (gathering) Qi, thus causing Dryness and astringency. Furthermore, accumulation of Dryness/Dampness Qi in the Lung, Stomach, and Kidney meridians can lead to Xiao Ke (Wasting-Thirst syndrome). Yu Jiayan stated: "For conditions where Stomach fluids are dried up and Deficient Fire flares up, using cold/cooling herbs causes Fire to rise further. Merely knowing to contend with Fire, repeatedly using Anemarrhenae Rhizoma (Zhimu) and Fritillariae Bulbus (Beimu) yields no results. One must realize that the Stomach is the Mother Qi of the Lung. In the *Jin Gui Yao Lue*, Maimendong Tang (Ophiopogon Decoction) uses Ophiopogonis Radix (Maidong), Ginseng Radix et Rhizoma (Renshen), Oryza Sativa (Jingmi), Glycyrrhizae Radix et Rhizoma (Gancao), and Jujubae Fructus (Dazao) to greatly tonify Middle Qi and generate fluids. Then Fire retreats, fluids generate, and where is Dryness?"

Fire's damage to humans is already severe; reaching Dryness is even deeper, evolving from Fire. Metal's form is inherently dry, yet its ability to generate Water relies on Kun Yin ascending, allowing Water Essence to distribute widely, so although it has a dry form, it does not become truly dry. When Spleen Ying (Nutritive) blood is insufficient and Kidney Yin is deficient, Fire scorches and injures Metal, True Zang pulses appear, vitality is exhausted, and the source of transformation is depleted. Metal loses its function of generating Water, Wood loses its image of nourishing Metal, mother and child fail to generate each other, and the Yin pathway mechanisms cease. Consequently, the Heart Master of Blood finds no Blood to generate, the Spleen Controller of Blood finds no Blood to control, and the Liver Storehouse of Blood finds no Blood to store. Moreover, internal Fire flares higher, making Zang-Fu organs extremely dry and withered. It is appropriate to use heavy, turbid, flavor-rich medicines to severely tonify True Yin, or light, aromatic, acrid-dispersing medicines to clear constrained Fire. If it is Floating Lone Yang from the Dantian, it should be guided back and stored; one should add astringents to Yin-tonifying decoctions and avoid clearing measures. However, Dryness-Heat syndromes, though appearing excess, are actually deficiency. Once Yin-tonification takes effect, symptoms gradually reveal deficiency-cold. Never lightly use cold/cooling herbs, lest they damage the Spleen and Stomach, further cutting off the mechanism of transformation, which is termed "Earth death, incurable." Thus, treating Fire syndromes may sometimes require cold/cooling herbs, but for Dryness syndromes, only moistening agents are suitable. To treat Wind-Dryness, nothing beats nourishing Blood; to treat Heat-Dryness, nothing beats strengthening Water. Alas, ancient sages did not fully elucidate this. Is Zhang Chen Yide's humble opinion correct, you who are wise? Regarding Cold-Dryness, although constipation and dry blockage are seen, it is actually due to extreme Yin-Cold, like warm water turning into layered ice cracks in deep winter. The ancient formula Banshu Wan (Half-Sulfur Pill) was designed with profound intent.