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Yang represents the Way of Heaven; Yin represents the Way of Earth. Without the Yang of Heaven, Earth cannot condense, and all things cannot be born; without the Yin of Earth, Heaven has no foundation, and all things cannot be accomplished. Heaven is active, with not a moment of stillness; if it moves slightly less, it loses its mechanism of vigorous operation, and all things stagnate. Earth is still, with not a moment of movement; if it remains slightly stiller, it loses its meaning of firm consolidation, and all things become blocked. The Yang of the human body models Heaven; once its mechanism of circulation is lost, hundreds of diseases arise. The Yin of the human body models Earth; once its meaning of nourishment and peace is lost, hundreds of harms occur. The Qi of Yin and Yang must indeed not deviate slightly from balance.

What is called Yang refers to the True Yang (Zhen Yang) of the human body. True Yang is Yang within Yin, not the hyperactive Yang (Kang Yang) that is dry, fierce, and unhelpful. Hyperactive Yang without Yin transforms into Fire, just as prolonged drought and intense heat in the sky require sweet rain to dissipate its fierceness. Therefore, Zhu Danxi proposed the theory of tonifying Yin; tonifying Yin is precisely to assist Yang. Wang Bing (Taipu) said, "Strengthen the master of Water to control the sunlight," which refers to this principle. What is called Yin refers to the True Yin (Zhen Yin) of the human body. True Yin is Yin within Yang, not the turbid Yin (Zhuo Yin) that is solid, congealed, cold, and knotted. Turbid Yin without Yang transforms into Water, just as heavy clouds and biting cold in the sky require the bright sun to bring clarity and warmth. Therefore, ancient sages proposed the theory of supporting Yang; supporting Yang is precisely to assist Yin. Wang Bing said, "Benefit the source of Fire to dissipate the shadow of Yin," which refers to this principle.

The Qian trigram symbolizes Yang, and the Kun trigram symbolizes Yin. Qian and Kun transform into Kan and Li; thus, Heaven and Earth are the substance of Yin and Yang, while Water and Fire are their function. If the function is damaged, the substance suffers. Water and Fire have the drawbacks of excess and deficiency. In Heaven and Earth, this inevitably leads to droughts and floods; in humans, it inevitably leads to dryness and dampness disorders. The principle is the same.

Yin is the physical form of humans; Yang is the Qi (vital energy) of humans. Generally speaking, any maladjustment of physical form stems from the disorder of Qi circulation. Thus, just as all things on Earth do not grow due to the irregularity of Heaven's drought and floods, where there is one point of Yang Qi that does not reach in the human body, there is disease. However, Yin and Yang are mutually rooted; wherever Yang reaches, Yin also reaches. If Yang reaches but Yin does not, there is disease there as well.

One must also examine whether Yin and Yang are deficient or excessive. Excess syndromes from external contraction first affect Yang; deficiency syndromes from internal injury first affect Yin. Diseases affecting Yang are governed by the Lung; diseases affecting Yin are governed by the Spleen, Stomach, and Kidney. For external contraction causing stagnation and closure of Yang Qi in the Upper Jiao, treatment involves opening and clearing to facilitate the flow of Heavenly Qi. For Yang Qi dryness and knotting in the Middle Jiao, treatment involves bitter-pungent purgation and bitter-pungent resolution to level the earthly Qi. (When treating Excess Fire, one must ensure an exit path for the pathogen; using purely bitter-cold herbs forces the pathogen deeper without an exit, which is incorrect.) For Middle Jiao Yang Qi sinking and failing to ascend to the Lung, treatment involves ascending and tonifying to raise Earthly Qi to Heaven. For Lower Jiao Yang Qi escaping outward and failing to descend to the Kidney, treatment involves warming and receiving to lower Heavenly Qi to Earth. Essentially, the Primordial One Qi of congenital origin ascends from below and connects with the acquired Stomach Qi to generate life, making it the greatest treasure of the human body. If True Yin is injured, causing Essence to fail to transform into Qi, Qi fails to return to Essence. Consequently, the Dragon Fire (Ministerial Fire) in the Kidney scorches internally, presenting symptoms such as bone-steaming fever; if Dragon Fire escapes outward, it presents with fever, malar flush, and facial redness. When one Fire rises, the Five Fires blaze. One will see Wind-Fire, Thunder-Fire of the Liver, Li-Fire of the Heart, and Dryness-Fire of the Stomach arising sequentially, manifesting as excess signs. This is not true excess but rather insufficiency of the Lower Yuan! The Classic states: "Lesser Fire generates Qi; Greater Fire consumes Qi." Fire below the Dantian is Lesser Fire, i.e., True Fire; Fire rising above the Dantian is Greater Fire, i.e., Deficient Fire. Deficient Fire is Fire within Water; it is correct that it should not be extinguished with Water again. Yet, why do people rigidly adhere to Danxi's method, using bitter-cold herbs like Anemarrhena Rhizome (Zhimu) and Phellodendron Bark (Huangbai) to extinguish it? This inevitably makes the condition worse, like rain causing the dragon to soar higher—how can one expect it to hide? Not only should bitter-cold herbs be avoided, but even sweet-cool herbs should be used cautiously. In early stages, when the root is uninjured, sweet-cool and moistening methods may still be effective. However, in the elderly or those with chronic illness where the root is already injured, the treatment should use warm-moistening methods to guide Fire back to its origin, like clouds parting and the sun appearing so the dragon hides. Turbid Yin can be treated with warming herbs; pungent-hot herbs like Cinnamon Twig (Guizhi), Aconite Root (Fuzi), and Zingiberis Rhizoma (Ganjiang) are indispensable. If there is Yang deficiency within Yin, and the medication is too acrid and drying, one fears Yang will not be supported while Yin is further depleted. The treatment should use warm-moistening methods to receive Qi back to its origin. The Classic states: "Receiving Qi is precious." Receiving Qi means it returns to the Kidney; not receiving means it does not. Failure of Qi to return to the Kidney refers to Lung Qi failing to return to the Kidney, and also Spleen-Stomach Qi failing to return to the Kidney.

The Kidney is the beginning of the five viscera of congenital origin, starting with the number 1, which is the Water number. Metal is the source of Water; Heaven and Water are originally one Qi. The Spleen and Stomach are the completion of the five viscera of acquired origin, completing with the number 5, which is the Earth number. Earth is the mother of all things; thus, Essence, Spirit, Qi, and Blood are all generated by Stomach Qi and assisted by Kidney Qi. The Stomach is the Earth of man, and the Kidney is the Heavenly Qi within Earth; Stomach and Kidney are originally one Qi. Hence, the Classic states: "The Kidney is the gate of the Stomach." What is called Stomach Qi is Grain Qi. The Classic states: "Ying-Qi is the refined Qi of water and grain; Wei-Qi is the fierce Qi of water and grain." It also says: "Refined Qi is born from Grain Qi." Thus, "Qi" is produced as refined Qi from water and grain in the Stomach, transmitted to the Spleen, transported upward by the Spleen to the Lung to become Qi, descends from the Lung, enters the Heart to transform into Blood, and enters the Kidney to transform into Essence. The Stomach generates it, the Spleen raises it, the Lung lowers it. Heaven and Earth interact; Stomach, Spleen, and Lung are originally one Qi. Hence, the Classic says: "The Spleen is the official of advice." If one asks how diet injures the Spleen, the answer is: Irregular diet stifles and depresses Spleen Qi. Depressed Spleen Qi cannot scatter essence, leading to dampness retention. This is called injury and reversal, not the fault of the Spleen, but caused by irregular diet.

Humans live between Heaven and Earth. While Heavenly Qi is important, Earthly Qi is particularly crucial. Humans exist within Heaven (the space above the ground is called Heaven). Connected yet obscure, humans lack autonomy. Thus, regarding the Six Qi of Heaven, patients affected by Heavenly Qi cannot avoid them entirely. Attached to the ground, solid and reliable, humans have some autonomy. Thus, diseases caused by Seven Emotions and human affairs mostly affect Earthly Qi and Heavenly Qi. Diseases of Earthly Qi prioritize the Stomach and Kidney. Although the Kidney governs Earthly Qi, it is essentially the Heavenly Qi within Earth. The Kidney belongs to Water born from Heaven Number 1, constituting the congenital origin. For those with weak fetal origin and congenital insufficiency, humans cannot control this but rely on regulating the acquired to supplement the congenital. In such cases, is Stomach Qi not even more important? Is valuing Stomach Qi not valuing Kidney Qi?

The Stomach is Central Earth. Stomach Qi relies on the Qi of the five viscera for transformation and production. Like earth without dikes, water has no containment; without water, it is dry; without Fire, it floods; without Wood, it is solid; without Metal, it dies. Conversely, the Qi of the five viscera relies on Stomach Qi to succeed. Like Metal needing Earth to grow, Wood needing Earth to support, Water and Fire needing Earth for their origin, and Spleen Earth needing Stomach Earth to be moist. Therefore, if Spleen-Stomach Grain Qi does not reach the Lung, the Lung's Spleen-Stomach is deficient; if it does not reach the Heart, the Heart's Spleen-Stomach is deficient; if it does not reach the Liver, the Liver's Spleen-Stomach is deficient; if it does not reach the Kidney, the Kidney's Spleen-Stomach is deficient; if Stomach Grain Qi does not reach the Spleen, the Spleen's Stomach is deficient. Are the Spleen and Stomach not important? Shouldn't the treatment of internal injuries prioritize consolidating the Spleen and Stomach? Let me elaborate. Lung Spleen-Stomach deficiency leads to internal heat; heat fails to generate Water, resulting in cough, edema, and fullness due to dampness. This is also Lung Qi failing to return to the Kidney. Medicine states that asthma is deficiency in the Kidney and excess in the Lung. The so-called excess is not true excess but Lung Yang deficiency failing to transform, causing Water to overflow from the high source. Cold Metal and cold Water require warm-moistening and receiving Qi; Evil Water attacking the Lung requires pungent-light diuresis and supporting Qi. Heart Spleen-Stomach deficiency leads to heat; heat leads to dryness. When the Ruler is weak, the Minister becomes strong; when Blood is deficient, the Liver becomes hyperactive. Fire and Water fail to interact, causing vexation, heart heat, and insomnia. This is Heart Qi failing to return to the Kidney. Some ask: The Heart belongs to Fire, and Fire flares upward; how does it descend? The Kidney belongs to Water, but contains Qi within Water, i.e., True Yang. Thus, Kidney Water rises with True Yang to interact with Heart Fire. True Yin and True Yang are the True Qi of the Heart and Kidney. To tonify the Heart, one must first solidify the Kidney to allow ascent; to tonify the Kidney, one must calm the Heart to allow descent. Liver Spleen-Stomach deficiency leads to heat; heat leads to dryness. Once Liver Blood is deficient, Liver Qi becomes hyperactive, potentially causing headache and vomiting due to wind-thunder agitation; or Wood-Fire insulting Metal, causing dry cough and hemoptysis; or dry Wood insulting Earth, causing hypochondriac pain, vomiting, abdominal masses, and dysphagia. This is Liver Qi failing to return to the Kidney. Treating Liver diseases is harder than other viscera. Pathogens in other viscera can be transferred out through the fu organs. Although the Gallbladder is the paired organ of the Liver, storing bile without excreting it, lacking an exit, it is similar to a zang organ. Thus, Liver diseases are difficult to treat. Treatment involves clearing and moistening to nourish, salty-softening to submerge, watering to generate Wood; sweet-moistening to缓 (soothe), cultivating Earth to support Wood; slightly bitter to descend, preventing Wood-Fire from usurping; neutral-moistening to receive, guiding Wood-Fire to subside. Blood contains Qi; if Qi does not consume Blood, the Liver calms itself. Only if the Liver has Damp-Heat can bitter-descending, pungent-unblocking, and sour-draining formulas be used; only if Qi is stagnant can the method of dispersing stagnant Wood be applied. How could qi-breaking and blood-consuming herbs be used recklessly to destroy vital Qi and consume Liver Yin? Kidney Spleen-Stomach deficiency leads to heat; heat leads to dryness. Once Kidney Yin is deficient, Kidney Yang becomes hyperactive, presenting with bone-steaming, fever, hemoptysis, nocturnal emission, upper cough, or lower diarrhea. This is Kidney Qi failing to return to the Kidney. Treatment involves clearing-moistening and warm-moistening to increase Water and nourish Fire; sweet-moistening and sweet-neutral to consolidate the Spleen-Stomach within Water and Fire. Spleen Stomach deficiency causes Central Earth disease itself, due to overthinking or irregular eating, leading to Qi knotting transforming into dampness and Blood knotting transforming into dryness, dampness trapping Spleen Yang, and dryness injuring Spleen Yin. Stomach disease fails to scatter refined essence to the Spleen; Spleen disease fails to transport refined essence to the Lung. If Earthly Qi does not ascend, Heavenly Qi does not descend; this is Spleen-Stomach Qi failing to return to the Kidney. This cannot be handled by cold, hot, warm, or cool methods alone. The method is to treat dryness with dryness remedies and dampness with dampness remedies, using pure sweet flavors to support Earth and generate Metal, following their ascending and descending nature to receive them.

In summary, internal injury diseases originate either from congenital or acquired factors; originating from acquired factors, they inevitably affect the congenital. If one of the five viscera does not receive the generating Qi, form and Qi become diseased. Form disease harms Qi, and Qi disease harms form. This is an immutable principle. However, treatment must distinguish between root and branch, priority and sequence. Yin-Yang, Zang-Fu, and Qi-Blood may cause disease independently, sequentially, or shift from one to another. The method of medication: Fu organ diseases should be opened and unblocked, not treated with Zang herbs; Zang organ diseases should be tonified, not treated with Fu herbs. If Fu disease approaches Zang, treating Fu must consider Zang; if Zang disease enters Fu, treating Zang must manage Fu. When Fu enters Zang or Zang enters Fu, severity varies, and medication must adjust accordingly. Furthermore, if disease is in the Fu but originates in the Zang, focus on treating the Zang; if disease is in the Zang but originates in the Fu, focus on treating the Fu. Even if the disease is here, one need not treat here; treating here may worsen it. Even if the disease has left here, one must still consider here; ignoring here causes damage. This is the general principle of Yin-Yang, root-branch, priority, and severity.

Ultimately, Heaven, Earth, and humans are encompassed by the two Qi of Yin and Yang. Imbalance of Heavenly Yin-Yang is regulated by the Chancellor; imbalance of Human Yin-Yang is regulated by the Physician. A good Chancellor and a good Physician both aim to harmonize Yin and Yang, achieving equilibrium for both.