Library

Shengshengzi said: The *Ling Shu Jing* (Spiritual Pivot) states, "Sweat is the fluid of the Heart." It also says, "Those who lose excessive sweat will lose blood; those who lose excessive blood will not sweat." Therefore, many people today consider sweat to be the blood of the Heart. I believe that all five Zang organs can produce sweat, not just the Heart. The *Su Wen · Bie Lun Mai Jing* (Treatise on Differences in Meridian Physiology) states, "When food intake is excessively full, sweat comes from the Stomach. When startled and essence is depleted, sweat comes from the Heart. When carrying heavy loads and traveling far, sweat comes from the Kidney. When running fast and fearing, sweat comes from the Liver. When the body shakes with labor and hardship, sweat comes from the Spleen."

Sweat is nothing more than a movement of Qi. This Qi is the essence of the five grains. When Qi is still, it transforms into blood to nourish the body (*Ling Shu Jing* states: "Blood is the spirit Qi"; blood and Qi have different names but are of the same category). When disturbed, it disperses outward to become sweat (Qi disperses outward before it has time to transform into blood). The *I Ching* (Book of Changes) states, "Earth Qi rises to become clouds; Heaven Qi descends to become rain." The *Su Wen · Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin-Yang Correspondences) states, "Human sweat may be named after the rain of heaven and earth." This is indeed the reason (Wang Bing, courtesy name Qixuanzi, commented: "Human sweat excretes through the skin and pores; this is the venting of Yang Qi. However, when analogized to between heaven and earth, it resembles clouds rising and rain descending.")

Shengshengzi said: The *Nei Jing* (Inner Canon) contains discussions on the Five Depressions (Wu Yu), stating, "For Wood Depression, promote its free flow; for Fire Depression, vent it; for Earth Depression, purge it; for Metal Depression, drain it; for Water Depression, control it." Although it generally mentions the term "Depression," it does not explicitly describe the symptoms of depression, nor does it clearly explain the meanings of promoting free flow (Da), venting (Fa), purging (Duo), draining (Xie), and controlling (Zhe). Later scholars interpreted "promoting free flow" as emesis, "venting" as diaphoresis, "draining" as releasing the exterior and promoting urination, "purging" as purgation, and "controlling" as suppressing rebellious Qi. While these interpretations may not be entirely incorrect, they likely do not fully capture the original meaning of the classic. Therefore, I will analyze the symptoms of the Five Depressions in detail and expound upon their treatment methods.

When any of the five Zang organs is out of balance, depression occurs. "Promoting free flow" (Da) refers to smoothing or unblocking; "venting" (Fa) refers to dispersing upward/outward; "draining" (Xie) refers to dredging; "purging" (Duo) refers to removing forcefully; and "controlling" (Zhe) refers to cutting off or restraining. Why? The *Nei Jing* states: For Wood Depression, promote its free flow. Wood depression is Liver depression. "Promoting free flow" means smoothing and unblocking. The nature of Wood is ascending; if it becomes stagnant and fails to flow smoothly, depression occurs. Thus, symptoms such as hypochondriac pain, tinnitus, sudden dizziness and collapse, and blindness are all symptoms of Wood Depression. One should smooth and unblock them to restore their natural state of upright resilience (For example, if food blocks the chest, preventing Liver and Gallbladder Qi from ascending, causing severe chest and abdominal pain, one should use emesis to vent pathogens located above, thereby soothing Wood Qi. This aligns with the principle 'for pathogens above, induce vomiting.' If Wood is depressed below, causing chronic hypochondriac pain, mild cases use Chai Hu and Chuan Xiong to lift and open, which is also the intent of promoting free flow; severe cases use Dang Gui Long Hui Wan to suppress and attack, which is also the intent of unblocking).

For Fire Depression, vent it. Fire depression is Heart depression. "Venting" means dispersing upward/outward. The nature of Fire is flaming upward; if it becomes stagnant and fails to flow smoothly, depression occurs. Thus, symptoms such as blurred vision and chest oppression, red eyes, shortness of breath, sores and ulcers, thirst, yellow urine, sudden stiff collapse, vomiting and acid regurgitation, convulsions, and mania are all symptoms of Fire Depression. One should vent and disperse them to return to their natural state (For example, if there is heat in the five centers and high fever due to excessive consumption of cold foods suppressing Yang Qi within the Spleen and Earth, formulas like Huo Yu Tang or Sheng Yang San Huo Tang are used to vent it. This also means following the nature of Fire to scatter it. If endless thoughts and unfulfilled desires cause depression and unhappiness, leading to phlegm production, loss of appetite, or dysfunctional Qi mechanism resembling drunkenness or idiocy, herbs like Mu Xiang, Shi Chang Pu, Sheng Jiang, and Xiong Huang are used to guide and move Qi, which is also the intent of venting. For turbid urine, sores, and tongue ulcers, formulas like Huang Lian Jie Du Tang, Dao Chi San, or Ba Zheng San are used to guide downward, which is also the intent of dispersing).

For Earth Depression, purge it. Earth depression is Spleen depression. "Purging" means forcefully removing. The nature of Earth values dryness; only through dryness can it transport and transform fine essences to distribute to other organs. If it becomes obstructed and damp, depression occurs. Thus, symptoms such as swelling and fullness, stuffiness, edema, difficulty in urination and defecation, abdominal pain, and distension are all symptoms of Earth Depression. One should remove and purge them to restore its healthy transportation function (For example, if there is obstruction in the abdomen with great fullness and solidity, formulas like Zhi Shi Dao Zhi Wan, Mu Xiang Bin Lang Wan, or Cheng Qi Tang are used to purge downward, following the principle 'for fullness in the middle, drain from within.' If dietary injury damages the Spleen, causing stuffiness and increasing phlegm, Ju Ban Ji Zhu Wan is used; if worry and thought cause knotting, loss of appetite, and slight abdominal tension, Mu Xiang Hua Zhi Tang or Xiao Pi Wan are used to eliminate and grind stagnation, which is also the intent of purging. For various damp swellings, edema, and damp-heat jaundice, formulas that solidify the Spleen and promote water metabolism to dry dampness are used, which is also the intent of purging).

For Metal Depression, drain it. Metal depression is Lung depression. "Draining" means dredging. Metal values emptiness and clarity; if it becomes obstructed and dense, depression occurs. Thus, symptoms such as cough and asthma, sore throat and hoarseness, chest fullness and panting, raising shoulders and pulling the neck, skin heat, nasal congestion, and vomiting pus are all symptoms of Metal Depression. One should dredge and drain them to restore its clear descending function (For example, for wind-cold injury with cough, nasal congestion, formulas like Shen Su Yin or Ren Shen Bai Du San are used, which follow the intent of dredging. For retained fluid in the chest and diaphragm, or water-fluid invading the Lung causing sounds like a water fowl in the throat, or lung abscess with vomiting of pus and blood, Ting Li Da Zao Xie Fei Tang is used, which follows the intent of draining).

For Water Depression, control it. Water depression is Kidney depression. "Controlling" means cutting off or restraining. Water values tranquility; if it becomes turbulent and obstructed, depression occurs. Thus, symptoms such as cold saliva surging upward, edema and abdominal distension, stiffness in the waist and knees, and difficulty bending and stretching are all symptoms of Water Depression. One should cut off and restrain them to guide their normal downward flow (For example, if Kidney Qi is depressed and pathogenic water surges upward causing cold saliva, herbs like Fu Ling and Ze Xie are used to guide downward, which is the intent of cutting off. For waist and umbilical pain preventing bending and twisting, or symptoms resembling Ben Tun disease, Gui Xin is used to restrain it; for urinary retention with pain, prolonged hyperactivity without excretion leading to white turbidity, herbs like Xiao Hui Xiang, Ze Xie, and Huang Bo are used, which is also the intent of cutting off). These are all methods of straightening what is bent. By understanding the general principles, the rest can be deduced. If one interprets "promoting free flow" as emesis, "venting" as sweating, "draining" as releasing the exterior and promoting urination, "purging" as purgation, and "controlling" as suppressing rebellious Qi, although these have some validity, they may not fully capture the canonical meaning. Furthermore, the text later states, "However, regulate the Qi; for excess, control it, according to what it fears, which is called purging." I believe "excess" refers to hyperactive dominance. "Controlling" means restraining. For instance, if Wood is excessive, assist with Pungent flavors; if Fire is excessive, assist with Salty flavors, etc., attacking what it fears. Thus it is said, "If any of the five Zang organs is out of balance, the dominating organ is pacified; they mutually nourish and克制 each other." This is what is meant.