Library

Compiling books such as *Ren Zhi Zhi Fang* (Direct Guidance from Renzhai), *Bian Zhu Bing Ji* (Annotated Pathogenesis), and *Yao Xing* (Properties of Medicinals).

A hundred diseases cannot escape the eight essentials.
The Classics state: Diseases have eight essentials. If one does not understand these essentials, how can the disease be removed? They are merely Exterior (Biao), Interior (Li), Cold (Han), Heat (Re), Deficiency (Xu), Excess (Shi), Evil (Xie), and Righteous Qi (Zheng).

Treatment methods must follow three principles;
For new diseases, eliminate the evil with large doses and vigorous treatment; for slightly longer-standing diseases, eliminate evil while supporting righteousness, combining mild and vigorous approaches; for chronic diseases, medicines must be mild, treating gently and slowly.

Righteous Qi resides in the person; Yang represents the Exterior and Yin represents the Interior, a famous saying from antiquity; Evil harms the person; the Exterior is Yin and the Interior is Yang, a subtle secret of Zhang Zhongjing. Excess patterns present with surging pulse, hot skin, abdominal distension, and obstruction of urination and defecation, known as Five Excesses; Deficiency patterns present with deficient pulse, cold skin, weak breath, diarrhea/dysentery, and reduced food intake, known as Five Deficiencies. In excess cases, survival is indicated if sweating occurs and urination/defecation become unobstructed; in deficiency cases, survival is indicated if congee enters the stomach and diarrhea stops. Whenever "Excess" is mentioned, it refers to pathogenic evil; whenever "Deficiency" is mentioned, it refers to the decline of righteous Qi.
If diarrhea persists leading to Five Deficiencies, it is difficult to treat.

New diseases are mostly Cold; chronic diseases often turn into Heat.
New diseases with strong righteous Qi are mostly due to Cold-Dampness; after a long time, when the Five Qi decline, they are mostly due to Damp-Heat. For example, external contraction of Wind-Cold or internal injury from raw/cold food starts as Cold, but after stagnation for a long time, it turns into Heat. Only if cooling medicines are overused at the beginning will it become Deficient in the long run.

Internal injuries from the Five Evils require careful regulation; external contractions from the Six Exuberances must be well-dispersed through sweating.
The Five Evils refer to Zheng, Wei, Xu, Shi, Zei; the Six Exuberances refer to Wind, Cold, Summerheat, Dampness, Dryness, Fire.

Wind arises from Fire.
Whether externally contracted Wind-Evil eventually returns to the Liver, or Kidney dryness causes Liver Wood to move recklessly leading to blood dryness and internal Wind, all conditions like Bi syndrome pain and paralysis should not be treated solely with Wind-expelling herbs.

Cold is a product of Deficiency.
All Yin aspects are Deficient. The Classics say: Where evil gathers, Qi must be deficient. Thus, Shanghan (Cold Damage) often affects those with lower Jiao deficiency, requiring warming Yang and dispersing cold.

Summerheat consumes Qi, fluids, and spirit; sweet and sour astringent tonics are frequently used (to arrest sweating and tonify deficiency);
Dampness injures skin, flesh, sinews, and bones; bitter and acrid diaphoretic agents are temporarily swallowed.
External dampness should be treated by sweating. Avoid Ephedrae Herba (Mahuang) and Puerariae Radix (Gegen); use Notopterygii Rhizoma et Radix (Qianghuo) and Atractylodis Rhizoma (Cangzhu) instead. The Classics state: When Earth-dampness is severe, heat arises; treat with bitter-warm herbs, assisted by sweet-acrid ones. Internal dampness should be treated by leaching out; use Polyporus (Zuling). If ineffective, use ascending methods. The Classics state: When Qi ascends, water descends. The Fu states: In spring, disperse fire and ascend Yang; in summer, generate pulses and benefit Qi. Zhizhu Wan (Immature Bitter Orange and Atractylodes Macrocephala Pill) and Cao Kou Wan (Black Cardamom Pill) are suitable for autumn ingestion; Yigong San (Extraordinary Power Powder) and Houpo Wenzhong Tang (Magnolia Bark Decoction to Warm the Middle) are suitable for winter ingestion.

Dryness is distinguished into Excess and Deficiency.
Excess dryness involves constipation with urgent abdominal distension; treat according to constitution to promote unobstruction. Deficiency dryness involves constipation without abdominal distension, mostly due to Blood deficiency; treat with moistening.

Fire is distinguished by tonification and purgation.
Externally contracted Excess Fire should be differentiated by Exterior/Interior and purged; internally injured Deficient Fire should be differentiated by Yin/Yang and tonified. The Fu states: Excess Fire can be purged, either by purging the Exterior or the Interior; Deficient Fire can be tonified, either by tonifying Yang or Yin.

Eliminating evil is like chasing thieves; kill the ringleader but pardon the accomplices; nourishing righteousness is like dealing with petty people; rectify oneself without excessive scrutiny.
Evil should be eliminated; righteousness should be pacified. Phlegm should not be expectorated completely; Fire should not be descended too much; Qi should not be exhausted; Blood should not be tonified excessively; Dampness should not be drained to the point of injury. Excess leads to aggravation, and aggravation leads to transformation.

For instance, food stagnation in the intestines and stomach heals itself after purgation; retained fluid forming masses in collaterals requires both resolving and tonifying. Indulgence in diet leads to abundant Damp-Heat; dry Spleen Earth to restore Middle Qi.

Internal injury to Middle Deficiency eventually leads to Middle Cold.

Overindulgence in sexual activity stirs Ministerial Fire; nourish Kidney Water to consolidate Yin Essence.
The method should be to nourish Yin and descend Fire. However, excessive nourishing and descending damages Yang, making Middle Qi more deficient, Blood harder to transform, Fire more flourishing, and Water more depleted.

Qi surplus causing wheezing, fullness, and obstruction: if Fire is light, it can be descended;
if heavy, follow its nature and ascend it.

Blood insufficiency causing hematemesis, epistaxis, timidity, and consumptive disease: Metal organ should be cleared.
Yin deficiency with Fire stirring forces Blood to flow recklessly, so clearing Lung Metal is appropriate.

Qi disorders regulate Qi, and Blood has its foundation; Blood disorders regulate Blood, and Qi has no stagnation.
The Fu states: Yang Qi guides Yin Blood; Yin Blood is the foundation and return of Yang Qi. However, Qi-regulating herbs like Aucklandiae Radix (Muxiang), Cinnamomi Cortex (Guirui), Curcumae Radix (Ezhu), and Cyperi Rhizoma (Xiangfu) can also regulate Blood to mutual benefit; Blood-regulating herbs like Angelicae Sinensis Radix (Danggui) and Rehmanniae Radix (Dihuang) act awkwardly on Qi. If there is stagnant Blood and Qi, nourishing Blood allows Qi to flow naturally, which must be known.

Regulating Qi must use acrid-cool herbs to dissipate Heat.
Qi belongs to Yang and is formless. When Yang Qi stagnates, Fever arises; treat with acrid-cool herbs to dissipate it.

Harmonizing Blood must use acrid-hot herbs to transform its form.
Blood belongs to Yin and is有形 (form/material). When Yin Blood accumulates, Pain arises; treat with acrid-hot herbs to open it.

As for Phlegm stirred by Fire (due to Seven Emotions), treat Fire without delay;
When Phlegm is generated by Fire, treating Fire is primary; when Fire is generated by Phlegm, treat both. Generally, acute diseases involve much Fire, and strange diseases involve much Phlegm.

Fire caused by Qi stagnation requires increasing Qi regulation.
The Fu states: Phlegm stirred by Fire, treat Fire first; Fire caused by Qi stagnation, regulate Qi as the root.

Phlegm varies in clearing, warming, moistening, drying, and dispersing.
Clear Hot Phlegm, warm Cold Phlegm, moisten Dry Phlegm, dry Damp Phlegm, disperse Wind Phlegm. Cut hard masses, remove invading pathogens, warm the cold, scatter clumps, move retention, moisten dryness,缓急 (relieve urgency), avert scattering, tonify loss, rest the fatigued, calm fright, induce vomiting for upper excess, purge for lower excess, massage, bathe, bind,劫 (forcefully resolve), open, and develop—all are major principles.

Stagnation has different names: Da (reaching), Fa (emitting), Duo (seizing), Xie (draining), Zhe (breaking).
Wood stagnation is reached via emesis. Since Lung governs gathering and descending, it should reside below; now food blocks the chest, residing above, suppressing Jueyin Wind Wood, preventing it from reaching up, so induce vomiting to ascend Liver Wood and descend Lung Metal. Fire stagnation is emitted via sweating. Determine the meridian; if exterior collateral stagnation, sweat to disperse; if Dragon Fire interiorly stagnated, do not just use bitter-cold to descend, but use floating herbs assisted by sweet-warm to follow its nature and treat reversely, stopping when force peaks, as in Shengyang Sanhuo Tang (Ascending Yang Dispersing Fire Decoction). Earth stagnation is seized via purgation. When pathogenic heat enters Stomach, or middle fullness/distension, damp-heat dysentery occur, attack with purgatives to seize momentum and weaken it. Metal stagnation is drained via diuresis. Lung is the source of water; Qi stagnation causes chest fullness and closes drainage channels; clear Lung and benefit Qi to unblock. Water stagnation is broken by restraining its counterflow, attacking and crushing it. In edema with overflowing water qi blocking drainage, strengthen Spleen Earth to control Water, opening drainage for cure. If disease is too fierce for these methods, use water-draining drugs to attack and crush. Whether sweating, purging, or draining to calm—this is the general approach. Although long-standing evil inevitably damages righteous Qi, if righteous Qi is not balanced to return to its proper place after treating stagnation, the subtlety of treatment is not fully realized.

Long-standing stagnation generates Phlegm and Fire, worsening the disease;
Or stagnation of Qi for a long time forms Phlegm-Fire disease, or long-standing disease causes Qi-Blood stagnation. Mild stagnation requires regulation; severe cases require tracing the source and dispersing.

Disease consumes Qi and Blood, leading to Deficiency. Yang Deficiency fears external Cold, and Damp-Heat stagnation causes edema; Yin Deficiency generates internal Heat, and Wind-Dryness excess causes flaccidity and emaciation.
Qi Deficiency cannot shield the exterior, hence aversion to external Cold; Blood Deficiency cannot harmonize with Qi, hence generating internal Heat. Yang Deficiency generates Cold, Cold generates Dampness, Dampness generates Heat; Damp-Heat stagnating Qi causes whole-body edema. Yin Deficiency generates Fire, Fire generates Dryness, Dryness generates Wind; Wind-Dryness injuring sinews causes flaccidity, numbness, and emaciation. All hernia and leukorrhea belong to Wind; Scorpion (Quanxie) is a key herb for hernia.
Yang Deficiency (True Fire decline) is easily tonified with sweet-warm herbs; Yin Deficiency (True Water lack) is hard to nourish with bitter-cold herbs. In simultaneous Yin-Yang Deficiency, tonify Yang and Yin grows naturally;
In simultaneous Qi-Blood disorder, regulate Qi and Blood calms naturally.

Blood disorder causes insensibility, unawareness of pain and itch; Qi disorder causes dysfunction, immobility of limbs; simultaneous Qi-Blood disorder causes insensibility and dysfunction.

Treating Heat with Cold causes Qi congestion, preventing food intake; attacking Cold with Heat causes Qi congestion, leading to confusion and irritability.
Treating Heat disease with Cold herbs fails due to Qi congestion preventing drug action, so food/fire is rejected; treating Cold with Hot herbs fails due to Qi congestion preventing heat action, causing dizziness and irritability. Skillful practitioners must unblock Qi meridians and harmonize Yin-Yang. If Rhubarb (Dahuang) fails to unblock, apply hot compress to navel; if Aconite (Fuzi) causes irritability, add少许 (a little) child's urine or frozen drink to harmonize Yin.

When Cold cannot be warmed, benefit Heart Fu; when Heat cannot be cooled, nourish Kidney Jing.
The Fu states: To treat all Cold, benefit Heart Yang; to treat all Heat, nourish Kidney Water.

Those with longevity have balanced Yang and secure Yin; those without disease have Fire descending and Water ascending. It is also heard that Men have more Yang than Yin, so nourish Yin to match Yang; Women have Qi stagnating in Blood, so open Blood to move Qi. Fat people have Qi Deficiency and much Phlegm; expelling Phlegm and tonifying Qi is an ancient tradition; Thin people have Blood Deficiency and Fire; clearing Fire and nourishing Yin is the fixed consensus. Young and strong with shallow disease, why doubt attacking the branch? Old and weak with deep disease, consolidating the root is essential.
Phlegm, Fire, Dampness, and Heat are keys to a hundred diseases. Young/new disease: dry dampness, clear heat, expel phlegm, purge fire; Old/decrepit/chronic disease: combine attacking and tonifying. Qi Deficiency uses Sijunzi Tang (Four Gentlemen Decoction) to tonify Qi, combined with drying dampness, clearing heat, purging fire, expelling phlegm; Blood Deficiency uses Siwu Tang (Four Substances Decoction) to tonify Blood, combined with purging fire, expelling phlegm, clearing heat, drying dampness.
Elderly have much Qi and little Blood, only suitable for harmonizing; Children have Pure Yang without Yin, do not over-treat. Northwest winds are high and earth dry, often suffering from thirst, constipation, carbuncles, and ulcers;
clear heat and moisten dryness, nourish Metal and Water organs to nourish the source of transformation, avoiding excessive cooling herbs.
Southeast lands are low and watery, prone to swelling, pain, malaria, and dysentery.
Swelling resolves with activating Blood; pain reduces with promoting urination/defecation. Treating malaria with diuresis in Yin aspect forbids interception; treating dysentery with moving Qi forbids leaching even if urination is scant. Malaria patients not eating indicate food injury; dysentery patients able to eat indicate Stomach Heat. Southeast people have moving Wood and bright Fire, Yang Qi easily ascends; Northwest people have flowing Water and prosperous Earth, Yin Qi easily descends. Generally, human Yin is often insufficient, Yang often in excess, so diseases with ascending Qi are common.
Rich foods without satiety (many food toxins, generating carbuncles/ulcers); clearing heat and moistening dryness is a miraculous formula; bland diet intolerable (damaging Middle Qi, causing swelling); dispersing dampness and warming cold is a wonderful agent.
Alas! Diseases have severity; treatments have reversal and following. Mild cases use reversal treatment.
Using Cold herbs to treat Heat, Hot herbs to treat Cold—this reverses the Qi to achieve correct treatment, making it compliant.
Severe cases follow the attack.
Using Cold to treat Heat, assisted by Hot herbs; using Hot to treat Cold, assisted by Cold herbs. This follows the disease to take the opposite, achieving harmony.
Treat Cold with Cold usage, and Heat with Heat usage; treat Obstruction with Obstruction usage, and Unobstruction with Unobstruction usage.
Obstruction like edema benefits Middle tonification; Unobstruction like dysentery benefits purgation. Examining Hand/Foot Shaoyin and Taiyang four meridians, standard/root Cold/Heat are不定 (variable). Standard Cold Root Heat: use bitter-acrid great-cold, taken hot with wine to purge Heat—this is Cold used with Heat. Root Cold Standard Heat: use acrid-hot great-warm with frozen drinks to support True Yang—this is Heat used with Cold. Hand/Foot Taiyin govern gathering/storage; fullness/blockage: bitter-cold to purge fullness or sweet-warm to assist Qi—this is Cold used with Cold, Obstruction used with Obstruction. Hand/Foot Shaoyang Wind Wood: forbid sweating (fear spontaneous sweating), forbid purging (fear damaging Yin), forbid leaching (fear damaging Yang); use acrid-warm to connect to Heaven Qi, following Spring ascending command—this is Unobstruction used with Unobstruction. For standards and roots contrary and non-compliant, reverse treatment methods are established. Only Hand/Foot Yangming and Jueyin four meridians do not follow standard/root, but follow Middle treatment. Jueyin is the source of generation, its branch at Mao; Yangming is the department of肃杀 (severity/killing), its branch at You. The division of Mao and You in Yin-Yang, the Neijing says their Qi differs. Thus Hand Yangming Large Intestine likes Heat hates Cooling; Foot Yangming Stomach likes Cooling hates Heat; Foot Jueyin Liver likes Moisture hates Dryness; Hand Jueyin Pericardium Collateral is the head of twelve collaterals, not tied to Five Elements, but Kun Yuan True Earth, though governing growth, likes Quietness hates Dryness, inheriting Shaoyang Original Qi to enable generation. Thus: Sanjiao is Father of Original Qi, Pericardium is Mother of Yin Blood. These four meridians have different preferences, methods cannot be rigid, so treat from Middle. Middle is not middle-upper/lower, but taking Middle according to time.
To gather the Spirit of fright, the skillful physician strikes a stool;
Once a woman stayed upstairs, was frightened, and fainted upon hearing sounds later. Hezi said: Fright injures Gallbladder, not Heart disease. Ordered her to sit on a chair, placed a stool in front, told her to look down, then had someone strike the stool, gradually calming the fright. The Classics state: Fright is calmed by familiarity. Seeing it normally causes no fright; fright is Spirit floating upward. Striking the stool from below makes her look down, thus gathering Spirit.
To stop pain from injury, believe the soldier's fried scallion.
Once a noble guest injured his fingernail, asked for metal wound medicine to wrap it, then drank alcohol, pain did not stop. A soldier took fresh scallions, roasted them in ash fire, split them open having mucus, applied to the injury, changed ten times, wrapped with hot scallion and mucus, finished the banquet laughing and talking.
Corpse-like syncope resembling death but pulse normal: Baihui acupoint can be moxaed; Xi Ji (accumulated Qi from long reversal) with normal diet: Dao Yin method achieves success.
Not in Stomach, so diet is unaffected, acupuncture/moxibustion unsuitable, Dao Yin method suitable, see Preservation category.
Loose stools indefinite,
appearing or stopping, long unresolved.
Only because True Water is insufficient;
use Sanbai Tang plus Psoraleae Fructus (Guzhi) and Schisandrae Fructus (Wuweizi), focusing on tonifying Kidney.
Vomiting/reversal refusing intake,
food/drink completely rejected.
Must be Evil Fire rushing up.
use Qinlian Erchen Tang (Scutellaria and Coptis Two-Chen Decoction) etc., tonify Spleen and descend Fire.
Ah! Medicines do not stick to formulas, hitting the disease is wonderful; methods have no fixed body, taking Middle according to time.
Consult pulse and symptoms, establish own opinion.
Coptidis Rhizoma (Huanglian) and Sophorae Flavescentis Radix (Kushen), the Fu says many doses cause Heat;
Bitter entering Heart is Heat, Evil Fire descends and True Water flourishes. Another view: Cooling herbs damage Middle, external tidal Heat increases.
Zingiberis Rhizoma (Ganjiang) and Aconiti Lateralis Radix Praeparata (Fuzi), who knows long drinking brings disaster?
The Fu states: Fuzi and Ganjiang, long drinking causes Cold. Because True Yin burns and True Yang declines. Not due to tonifying excess causing bias, but habituation inviting transformation harm. When the organ is flourishing, tonifying too much causes organ Qi bias and premature death. Medicines should not be biased, inviting transformation harm. Thus: Medicine without five flavors, without four Qi, although gaining benefit, long-term causes sudden death.
True contains error and error contains true, recognize the mechanism;
True containing error: sticking to ancient formulas, holding to constant methods, clinging to past efficacy, thinking it true, not knowing it is error; Error containing true: once a patient had forehead carbuncle, long unresolved, doctors ineffective, accidentally hit by shop door, bleeding cured immediately.
Deficiency tonifies and Excess purges, unity has a source.
Miscellaneous diseases虽有 (although) many threads without basis, only judging by meridian Excess/Deficiency obtains the source.
Ancients said reading Zhongjing's books requires understanding Zhongjing's original intent; I also say following Danxi's methods requires Danxi's mindset. Basically, mastering Shanghan makes miscellaneous diseases clearer; mastering miscellaneous diseases makes Shanghan more integrated.
Shanghan goes from Outside to Inside, method should treat Outside first then Inside; Miscellaneous diseases go from Inside to Outside, method should treat Inside first then Outside; when both Inside/Outside injured, treatment is same.
Shanghan does not leave Exterior, miscellaneous diseases do not leave Interior. Exterior is sweating, Interior is purging, Middle is harmonizing, dosage has light/heavy/slow/fast differences. Later generations divided specialties, medical way fragmented, unable to integrate, how to adapt to changes and save lives in crisis?
Medical way is consistent, creation originates from Ancient Sages; later students should reflect, not rely on own cleverness.