Library

According to the *Ling Shu* (Spiritual Pivot): The Five Zang Organs are where the Spirit, Huna, Po, Yi, and Shen are stored; the Six Fu Organs receive food and fluids and facilitate their transformation and transportation.
The Qi within connects internally to the Five Zang Organs and externally links to the collateral branches of the joints. The floating Qi that does not follow the meridians is called Wei Qi (Defensive Qi), while the Qi that travels along the meridians is Ying Qi (Nutritive Qi). Yin and Yang follow each other, and the interior and exterior supplement each other, forming a cycle without beginning or end. Therefore, the *Classic* states: In treating disease, the internal Qi is the treasure. This is truly an eternal maxim for medical practice across all generations. The *Ling Shu* also says: Examine the Wei Qi, for it is the mother of a hundred diseases. Essentially, within the human body, only Qi matters. Zong Qi (Pectoral/Ancestral Qi) is the great primordial Qi in the Dantian, just as Taiji exists between Heaven and Earth. Wei Qi is the Yang Qi that operates throughout the body, akin to Taiji moving to generate Yang; Ying Qi is the Yin Qi that remains rooted and secure within, akin to Taiji stillness generating Yin. Within the world, only Qi ascends and descends, while water follows Qi; thus, Heaven envelops Water, and Water supports Earth. A unified Qi ascends and descends in the Great Void, and Water does not participate in this movement; therefore, the ebb and flow of tides merely follow Qi, they do not occur independently. Similarly, the human body is primarily governed by Qi, while Blood is like Water; one cannot equate Blood with Ying Qi. Those who claim that Blood is Ying Qi contradict the intent of the Classics. The chapter "Ying Wei Sheng Hui" (Meeting of Ying and Wei) in the *Ling Shu* states: "Ying Qi transforms into Blood to nourish the living body." Thus, it is Ying Qi that transforms into Blood, so how can Blood be considered Ying? Hence, Qi is called "Zong" because it is the master of Qi; it is called "Wei" because it encircles the exterior and defends against external pathogens; it is called "Ying" because it guards the interior and consolidates the center. Zong Qi, Wei Qi, and Ying Qi—can these be distinguished too roughly?

It is easy to treat diseases that match the symptoms, but difficult to treat those with deceptive presentations. Currently, skilled physicians find this difficult, largely because they understand the变幻 (changes/variations) of Deficiency and Excess, and the discrepancies between true and false Cold and Heat. Unskilled physicians, on the contrary, find it easy, largely because they are unaware of the dangers of tonifying Deficiency when it is actually Excess, or purging Excess when it is actually Deficiency, and fail to grasp the profound subtleties of Yin-Yang creation and transformation; their success is often merely accidental. Moreover, given the myriad complexities of symptoms, how can they all be recorded in books? Even if literature is extremely extensive, it must rely on the physician's sensitivity and insight. Zhu Danxi said: A physician must adapt to circumstances on the spot, like a general facing an enemy or a boatman navigating waters. If one cannot hit the mark according to the changing situation, would one not feel ashamed? Li Dongyuan (Jiegu) said: The movements of the Six Qi are uneven, and the rules of ancient and modern times have changed; old prescriptions for new diseases rarely fit perfectly. Xu Xueshi said: I read Zhang Zhongjing’s books and adhere to his methods, but I do not rigidly stick to his formulas. This is truly grasping the essence of Zhang Zhongjing. Therefore, the key to medical art lies first in grasping the general principle. Once the general principle is understood, details can be analyzed clearly, and the meridians become distinct. The *Nei Jing* states: He who knows the essentials needs only one word to conclude; he who does not know the essentials will scatter endlessly. Reviewing famous discussions, all prioritize distinguishing symptoms. Alas, distinguishing symptoms is indeed not easy. Pulse patterns may resemble each other, and symptoms may appear similar. Water and Fire may be hyperactive and restraining each other; Yin and Yang may look alike. Severe Excess may present with signs of Emaciation (weakness); mistakenly using tonification will aggravate the disease. Extreme Deficiency may present with vigorous manifestations; mistakenly using purgation will cause unjust suffering. Yin syndromes may resemble Yang syndromes; clearing heat will surely lead to death. Yang syndromes may resemble Yin syndromes; warming will further injure. Accumulations in the middle jiao indicate Excess. In severe cases, the patient may be silent and unwilling to speak, limbs unwilling to move, or suffer from dizziness, blurred vision, or loose stools. These are all examples of "Severe Excess presenting with Weak Signs," just as overeating leads to lethargy and a desire to lie down. Spleen and Stomach damage indicates Deficiency. In severe cases, there may be distension, inability to eat, Qi stagnation, and difficulty defecating. These are examples of "Extreme Deficiency presenting with Vigorous Signs," just as prolonged hunger leads to loss of appetite. Spleen and Kidney Deficiency-Cold constitute a True Yin Syndrome. When Yin is extremely abundant, it often repels Yang to the exterior, causing redness of the face and eyes, cracking of the mouth and tongue, tossing of hands and feet, and confused speech. This resembles Yang syndrome, just as in the harsh cold of deep winter, water freezes; hardness is a sign of Yang strength. Unresolved pathogenic heat constitutes a Yang Syndrome. When Yang is extremely abundant, it often leads to Jue (Cold Extremities). In Jue, there is no breath at the nose and mouth, and the hands and feet are cold. This resembles Yin syndrome, just as in the scorching heat of midsummer, trees exude sap; sap is a sign of Yin softness. Generally, since symptoms cannot always be trusted, one should refer to pulse diagnosis. If the pulse is also untrustworthy, one must rely on deep palpation and prolonged observation. False symptoms manifest on the surface, so superficial pulse taking yields false results; true symptoms hide within, so deep and prolonged palpation can distinguish them. An Excess pulse remains consistent throughout; a Deficient pulse fluctuates, becoming large and small intermittently. It is like meeting someone for the first time; one cannot immediately know their true character. Only after knowing them for a long time can one see their true nature. If one judges Excess based on a momentary large pulse, or Deficiency based on a momentary small pulse, how erroneous would that be! One must observe repeatedly and for a long time, then the truth of Deficiency and Excess becomes clear. However, even if the pulse diagnosis is accurate, one should not rely solely on it. One must also examine the constitution (thick or thin), the duration of the illness, and whether previous treatment was mistaken, integrating all factors. Otherwise, one falls into the trap of following conventions blindly. Furthermore, Zang organ disorders often mimic Fu organ disorders; Blood changes are close to Qi dynamics. Regulating Qi focuses on Yang and ascending; regulating Blood focuses on Yin and descending. A difference of a hair's breadth leads to a mistake of a thousand miles. Do we not consider that people entrust their lives to us? How can we seek merit lightly? Those who harm people are not worth discussing. Even if one occasionally succeeds, how can one face one's conscience? What is hard to clarify is intuition; what is hard to exhaust is words. I only wish that those aspiring to benevolence and longevity, beyond reading books, will learn to connect insights from daily life and habits. When treating patients, even if the pathogenesis seems simple, one must examine it thoroughly. Once the root and branch are clear, one must proceed with extreme caution. Being aware and prudent is essential. One must exercise independent judgment with precision and detail, avoiding negligence due to doubt or fear. If uncertain, one must repeatedly consult the pulse. It is better to observe more and prescribe less. Remember, medicine controls life and death; its purpose is to cure disease and prolong life. Do not sacrifice life to treat disease, which is like sacrificing the body for the house—where are the root and branch? For patients who are not severely deficient, excessive use of warming and tonifying herbs may cause errors but will not necessarily kill; subsequent administration of cooling herbs can restore efficacy. However, if a deficient patient is mistakenly treated with bitter-cold draining herbs, it is like trying to revive the dead or reattach severed limbs; even with subsequent warming and tonification, recovery is impossible. Consider the ancient saying: "As long as one point of Yang Qi remains, death does not occur." This is truly correct.