积聚腹中有块，无拘左右，痛而始有形，不痛而即无形者，瘕症也（宜活血行气，如当归补血汤，加桂、麦芽）。不痛而亦有形，按之不移者，疒征病也（宜三物厚朴七气汤），有嗳腐，大便极臭，而腹中有块者，宿食积聚也（平胃散加大黄，莪术）。有痰涎不止，腹中累累觉痛，作水声者，痰湿积聚也（宜桂苓术甘汤、理中汤加砂、半）。有小腹硬满，小便不利者，血积聚于下焦也（宜五苓加桃仁、红花）。总之喜揉按者，阴之积聚，由于阳不化阴也（宜温解）。手不可近者，阳之积聚。由于气不活而血壅甚也（宜攻破）。
治积聚亦不出阴、阳两法。
痰饮痰饮者，水湿之别名也。脾无湿不生痰，水道清则饮不作。痰清而不胶者，胃阳不足以行水也（宜温中、理中汤）。痰黄而胶，喜生冷者，火旺而津枯也（宜鸡子黄连汤）。痰白、痰青、痰咸，皆由于阳不足（宜温、宜补）。痰臭、痰吐如丝不断，痰结如砂石者，皆由于阴亏火旺（宜五味子汤养血汤）。《金匮》列五饮之名，亦当熟看。
咳嗽咳而兼发热身疼者，外感也（小青龙、麻黄汤之类）。咳而不发热身痛，饱闷嗳腐臭者，饮食为病也，亦间有发热者（宜平胃散加麦、曲）。咳而身大热，喜极热汤，唇舌青白者，元阳外越，阴气上干清道也（宜吴萸四逆汤）。咳而身如瓮中，欲饮热者，肺为寒痰闭塞也（宜苓桂术甘汤加细辛、干姜、五味子）。咳而口干喜冷饮，二便不利者，肺为火逼也（宜泻白散中加苏叶、桅子）。干咳而无痰者，肺燥血虚也（宜补血汤合黑姜甘草汤，加五味子）。
咳而痰水如泉涌者，脾阳不运也（宜理中加砂、半、吴萸、茯苓）。咳症虽多，总以阴、阳两法辨之即可。
喘喘而发热、身疼者，寒邪闭塞肺窍也（宜麻黄汤倍麻）。喘而不发热、身疼，舌青、二便自利者，元气上腾也（宜潜阳丹）。喘而身大热，面赤如硃，口不渴，唇、舌青、白者，元阳外越也（宜吴萸四逆汤）。
呕吐呕吐水谷，尚欲饮冷者，热隔于中也（宜黄连生姜汤）。呕吐而欲饮极热者，寒隔于中也（宜理中加吴萸）。呕吐身热头痛者，挟外感也（宜桂枝汤倍生姜、加吴萸）。呕吐身大热而无外感，尚欲饮热者，脾阳外越也（宜附子理中加吴萸）。凡吐症发热者多，因吐气机向外，故身亦发热，以身不痛为据。
霍乱腹痛吐、泻交加，而欲饮水者，热隔于中，阻其阴、阳交通之机也（宜五苓加炒枝）。吐、泻交加而欲饮热者，寒隔于中，阻其阴、阳交通之机也（宜理中汤）。
呃逆呃逆来饮水即止者，胃火上冲也（宜大承气汤主之）。呃逆来而欲极热饮者，阴邪上干清道也（宜吴萸四逆汤）。
痢症痢症不拘赤、白，舌黄、脉有神者，燥热为病也（宜大黄木香汤）。
痢症红、白，脉无神而口不渴者，下焦阳衰，不能化下焦之精血也（宜附子理中加小茴、安桂）。痢症红、白，身大热而渴饮极热，或不渴而舌青滑者，元阳外越，而内无阳以化肠胃中之精血也（宜吴萸四逆汤）。若大热、舌黄，饮冷不休，日数十次者，胃热极也（宜白虎汤加柴、葛）。痢疾初起，发热身疼脉浮者，外感也（宜人参败毒散）。
头痛头痛如裂，身无他苦，舌青、不渴，或身大热，或脉劲者，此皆元阳外越，暴脱之候，切忌发散，法宜收纳（宜四逆汤，或潜阳丹）。头痛、身热、颈、背强痛者，风寒袭于太阳也（宜桂枝汤）。六经各有头痛，须按法治之，此不过明其危险者。
耳、目、口、鼻、唇、齿、喉各部肿痛，或发热，或不发热，脉息有神，舌黄、饮冷，二便短赤，精神饮食一切不衰者，气有馀之症也（宜清凉、升解、攻下，如小柴胡、甘桔、白虎、凉膈、导赤之类）。各部肿痛，或发热，或不发热，脉息无神，脉浮大而空，或坚劲如石，唇、口、舌青白，津液满口，喜极热汤，二便自利，间有小便赤者，此皆为气不足之症，虽现肿痛火形，皆为阴盛逼阳之的候。市医往往称为阴虚火旺，而用滋阴降火之药者极多，试问有阴虚火旺，而反见津液满口，唇、舌青滑，脉息无神，二便自利者乎？吾愿天下医生，切切不可见头治头，见肿治肿，凡遇一症，务将阴、阳、虚、实辨清，用药方不错误。
心痛心中气痛，面青、肢冷、舌滑、不渴者，寒邪直犯于心君，由君火衰极也（宜四逆汤）。心中气痛，面赤、舌黄、欲饮冷者，热邪犯于心包也（宜桅子大黄汤）。
胸、腹、胁、背、腰、肘、胯、膝，痛、肿各部肿与痛，而不喜手按者，或发热，或不发热，恶寒喜热，舌黄、便赤、脉息有神，乃为气血壅滞，皆有馀之候（宜活血、行气清凉之品）。各部或肿或痛，而喜手按者，或发热，或不发热，舌青喜热饮，二便清长，脉息无神，人困极者，乃阳衰不能运行，皆为不足之候（宜温中、行气之品）。
二便病二便不利，腹胀、烦躁、舌黄、饮冷，脉息有神者，乃阳邪闭结也（宜清凉分利、攻下之品）。二便不利，腹不满，人安静，口不渴，喜卧，脉息无神，舌青滑者，阴邪闭于下，由阳不足，不能化阴也（宜温补、回阳之品）。
辨认脉法气有馀：所现浮、洪、长、大、实、数、紧之类。（倘病现阴色不合脉，舍脉从病）。
气不足：所现沉、迟、细、微、虚、短、涩之类（倘病现阳色不合脉，舍脉从病）。
辨认诸症法气有馀：所现脉息、声音、面色、饮食、起居，一切有神。
气不足：所现脉息、声音、面色、饮食、起居，一切无神。
辨认疮法气有馀：所现红肿、高凸、痛甚、烦躁，人有神者，痈也。
辨认痘法气有馀：所现痘色紫红，或夹斑疹，顶焦、唇红、便闭之类。
辨认目疾法气有馀：所现红肿、痛胀、眵翳、障雾、赤脉、泪多、烦躁之类。
气不足：所现痛胀不甚，翳雾障膜虽多，不觉大苦之类。
辨色法气有馀：所现色紫红，口唇如硃，烦躁不宁。色不合病，舍色从病。
气不足：所现色滞暗，青白无神，唇口嘿青。病不合色，卒闭须知。
辨舌法气有馀：所现舌黄、干白、紫红、黑黄、纯干黑，烦躁，饮冷。
气不足：所现舌青滑，润黄、黑润、干黑色、或青中带黄，或黄中带白，黑而润，津液满口，其人安静，而喜热饮之类。
辨二便气有馀：所现尿短赤、黄、红、粪鞕、羊矢、极臭、极黄之类。
钦安用药金针
余考究多年，用药有一点真机，与众不同。无论一切上、中、下部诸病，不问男、妇、老、幼，但见舌青，满口津液，脉息无神，其人安静，唇口淡白，口不渴，即渴而喜热饮，二便自利者，即外现大热、身疼、头痛、目肿、口疮，一切诸症，一概不究，用药专在这先天立极真种子上治之，百发百中。若见舌苔干黄，津液枯搞，口渴饮冷，脉息有神，其人烦躁，即身冷如冰，一概不究，专在这先天立极之元阴上求之，百发百中。后列二图，学者细心参究。
寒邪外入图
寒邪外入图说今以一圈白色，喻人身一团正气，黑色喻外入之寒邪。邪犯皮肤第一层，乃太阳所主，病现头项腰背疼痛，发热恶寒，邪既入于皮肤，如盗贼之入墙垣也。看其何处空虚有隙，便得而乘之，故不必拘定一日二日之说，或入于手足之阳明，或入于手足之少阳，或入于手足之太阴，或入于手足之少阴，或入于手足之厥阴。仲景以太阳一经，包括三百九十七法，一百一十三方，论传经，是六步流行之定理，论圆通，是六步之化机，仲景恐人不知贼之去向，故标出六经提纲病情，与夫误汗、误吐、误下、当汗不汗、当下不下、当吐不吐、用药失宜、变逆匡救之道，俱在一百一十三方之中，学者务宜留心，不必执定伤寒邪入如是，须知六客亦如是也。更要明得外邪入内，闭束皮毛气机，遏郁而为身热疼痛，故发汗散邪，为治外邪初入第一要着。苟外邪从阳经而入内，寒邪亦化为热邪，热甚则伤阴，轻浅者，仲景有人参白虎、小柴胡之类以存阴，最重者，仲景有大、小承气之类以救阴。苟外邪从阴经而入内，阴寒混为一家，阴盛则阳衰，轻浅者，仲景有大、小建中、理中之类以扶阳，最重者，仲景有四逆、白通之类以回阳。余谓此即仲景治外邪入内之子午针也。
寒邪内生图
寒邪内生图说今以一圈白色，喻人身一团正气。正气旺者，外寒不入，内寒不生。夫内寒之生，由于内之正气不足，正气不足一分，身内之阴寒便生一分。故经云：气不足便是寒。究不足之原，因房劳过度者，则损肾阳；因饮食不节者，则损脾阳；因用心过度者，则损心阳。阳者气也，阳气损于何处，阴寒便生于何处，积阴日久，元阳便为阴所灭也。
在上者，仲景用桂枝以扶心阳；在中者，仲景用建中、理中以扶脾阳；在下者，仲景用四逆、白通以救肾阳。阳虚日久，不能化生真阴，阴液日亏，积之久久，血枯而虚阳又炽，反为客邪，此真可谓阴虚也，法宜甘寒养阴，切切不可妄用苦寒，故仲景有炙甘草汤、桂枝龙骨牡蛎汤、甘草黑姜汤之法，从阳以引阴，滋阴、化阴。余谓此即仲景治内伤之子午针也。诸书称痨字从火，皆是从损阳一语悟出也，惜乎解理未畅，后学无从下手，遂使由痨症而毙者多多矣。学者务要明得损阳而阴象症形足征者，照上卷阳虚门法治之。损阳不能化阴，阴液枯竭，肌肤枯搞，神气短少，吐痰胶粘，有火形可验者，照仲景炙甘草、龙骨黑姜汤之法治之，阴虚门方，亦可择取。又要识得外邪从阳经入内，以致热伤血者，亦可谓阴虚，若此而论者，是谓之真阴虚。从外而致者，苦寒、清凉、升解俱可治之，若此论者，只宜甘温微寒，从阳养阴以调之，内外之法，至此详矣。余于上卷将阳虚阴虚症形实据列出，乃辨症认症之子午针也；辛甘化阳，苦甘化阴，乃用药之子午针也；气有余便是火，气不足便是寒，乃犹是一元中之子午针也。学者务宜潜心默会，期于明白了然，幸甚幸甚。
附：禳久病不愈，一切怪症奇疮善法小神作祟亦同
凡人家中，最难免者疾病，感之轻浅，医药可愈。设或感之太重，三年两载，医药无功，此等疾病，非前世罪孽冤缠，即今生不知检束，积罪累愆之所致也。为人父，为人子，为人弟，为人兄，为人夫者，急宜反身修德，多行善功，或终身戒食牛犬，或全家斋敬九皇，或买鱼物而放生，或施棺木而修路，方便时行，阴功广积，斋诚涤滤，虔具悔罪祈恩，解厄消灾疏文，先申中宫，次申城隍，次申东岳，当空焚之，或可转危为安。余常以此法教人，应验屡屡，亦可以补医药之不逮处。
Accumulation and Mass: When there is a mass in the abdomen, regardless of whether it is on the left or right side, appearing when painful and disappearing when painless, it is called Jia syndrome (瘕症) (suitable for invigorating blood and moving qi, such as Danggui Buxue Tang [Angelica Sinensis and Astragalus Decoction] with added Guizhi [Cinnamon Twig] and Maiya [Malt]). When there is a mass that is not painful but remains fixed upon palpation, it is called Shan disease (疝病) (suitable for Sanwu Houpo Qiqi Tang). Accompanied by belching with a putrid odor, extremely foul stools, and a mass in the abdomen, it is food retention accumulation (suitable for Pingwei San with Dahuang [Rhubarb] and Ezhu [Curcuma]). With incessant phlegm-saliva, successive pain in the abdomen, and sounds of water, it is phlegm-dampness accumulation (suitable for Guiling Zhugan Tang or Lizhong Tang with Sharen [Amomum] and Banxia [Pinellia]). With hardness and fullness in the lower abdomen and difficulty urinating, it is blood accumulation in the Lower Jiao (suitable for Wuling San with Taoren [Peach Kernel] and Honghua [Safflower]). In general, masses that prefer rubbing and pressing are Yin accumulations, caused by Yang failing to transform Yin (suitable for warming and resolving). Masses that cannot be touched by hand are Yang accumulations, caused by stagnant Qi leading to severe blood stasis (suitable for attacking and breaking up).
Treatment of accumulation does not go beyond the two methods of Yin and Yang.
Phlegm-Fluids: Phlegm-fluids are another name for water-dampness. The Spleen produces phlegm only when dampness is present; if the water passages are clear, fluids do not form. Clear and non-viscid phlegm indicates insufficient Stomach Yang to transport water (suitable for warming the Middle, using Lizhong Tang). Yellow and viscid phlegm, preferring cold foods, indicates excessive Fire and dried-up Jin-Ye (suitable for Jizi Huanglian Tang). White, green, or salty phlegm all result from insufficient Yang (suitable for warming and tonifying). Foul-smelling phlegm, phlegm spitting like unbroken threads, or phlegm clumping like sand/stone all result from Yin deficiency with hyperactive Fire (suitable for Wuweizi Tang and Yangxue Tang). The *Jingui Yaolue* lists five types of fluids; one should study them thoroughly.
Cough: Cough accompanied by fever and body ache is due to external contraction (suitable for Xiao Qinglong Tang or Mahuang Tang). Cough without fever or body ache, with fullness, belching, and putrid odor, is caused by dietary issues, though fever may occasionally occur (suitable for Pingwei San with Maidong [Ophiopogon] and Shenqu [Medicated Leaven]). Cough with high fever, preference for very hot drinks, and blue-white lips/tongue indicates Yuan Yang floating outward and Yin Qi invading the clear pathways (suitable for Wuyu Sini Tang). Cough with a sensation of being covered by a pot, desiring hot drinks, indicates Lung obstruction by cold-phlegm (suitable for Linggui Zhugan Tang with Xixin [Asarum], Ganjiang [Dried Ginger], and Wuweizi [Schisandra]). Cough with dry mouth, preference for cold drinks, and difficulty in urination/defecation indicates Lung forced by Fire (suitable for Xiebai San with Suzye [Perilla Leaf] and Zhizi [Gardenia]). Dry cough without phlegm indicates Lung dryness and Blood deficiency (suitable for Buxue Tang combined with Heijiang Gancao Tang with Wuweizi).
Cough with phlegm-water gushing like a spring indicates Spleen Yang failure to transport (suitable for Lizhong Tang with Sharen, Banxia, Wuyu, and Fuling). Although cough symptoms are numerous, they can always be differentiated by the two methods of Yin and Yang.
Wheezing: Wheezing with fever and body ache indicates Cold pathogen obstructing the Lung orifices (suitable for Mahuang Tang with increased Mahuang). Wheezing without fever or body ache, with a blue tongue and normal urination/defecation, indicates Yuan Qi rising upward (suitable for Qianyang Dan). Wheezing with high fever, red face like cinnabar, no thirst, and blue-white lips/tongue indicates Yuan Yang floating outward (suitable for Wuyu Sini Tang).
Vomiting: Vomiting food/water yet desiring cold drinks indicates Heat blocking the Middle Jiao (suitable for Huanglian Shengjiang Tang). Vomiting yet desiring very hot drinks indicates Cold blocking the Middle Jiao (suitable for Lizhong Tang with Wuyu). Vomiting with fever and headache indicates concurrent external contraction (suitable for Guizhi Tang with increased Shengjiang and added Wuyu). Vomiting with high fever but no external contraction, yet desiring hot drinks, indicates Spleen Yang floating outward (suitable for Fuzi Lizhong Tang with Wuyu). Most vomiting cases involve fever because the Qi mechanism moves outward during vomiting; absence of body pain is the key indicator.
Huo Luan (Cholera-like): Abdominal pain with simultaneous vomiting and diarrhea, desiring water, indicates Heat blocking the Middle Jiao, obstructing the communication between Yin and Yang (suitable for Wuling San with fried Zhi). Simultaneous vomiting and diarrhea desiring hot drinks indicates Cold blocking the Middle Jiao, obstructing Yin-Yang communication (suitable for Lizhong Tang).
Hiccups: Hiccups that stop upon drinking water indicate Stomach Fire rushing upward (suitable for Dachengqi Tang). Hiccups desiring very hot drinks indicate Yin pathogen invading the clear pathways (suitable for Wuyu Sini Tang).
Dysentery: Dysentery, regardless of red or white discharge, with yellow tongue coating and spirited pulse, is caused by dry-Heat (suitable for Dahuang Muxiang Tang). Red and white dysentery with an unspirited pulse and no thirst indicates Lower Jiao Yang decline, unable to transform essence/blood of the Lower Jiao (suitable for Fuzi Lizhong Tang with Xiaohui and Angui). Red and white dysentery with high fever and desire for very hot drinks, or no thirst with a slippery blue tongue, indicates Yuan Yang floating outward with internal lack of Yang to transform intestinal essence/blood (suitable for Wuyu Sini Tang). High fever, yellow tongue, incessant cold drink consumption, and dozens of bowel movements daily indicate extreme Stomach Heat (suitable for Baihu Tang with Chaihu and Gegen). Early-stage dysentery with fever, body ache, and floating pulse indicates external contraction (suitable for Renshen Baidu San).
Headache: Headache like splitting, with no other discomfort, blue tongue, no thirst, or high fever, or forceful pulse, indicates Yuan Yang floating outward and sudden collapse; dispersing methods are strictly contraindicated, treatment should focus on gathering/receiving (suitable for Sini Tang or Qianyang Dan). Headache, fever, and stiffness in neck/back indicate Wind-Cold attacking the Taiyang channel (suitable for Guizhi Tang). Each of the Six Channels has its own headache patterns; this text clarifies dangerous ones.
Swelling/Pain in Ear, Eye, Mouth, Nose, Lips, Teeth, Throat: Swelling/pain with or without fever, spirited pulse, yellow tongue, desire for cold drinks, short/red urine/stool, and undiminished spirit/appetite indicates Excess Qi (suitable for cooling, ascending/resolving, purging formulas like Xiaochaihu Tang, Ganjie Tang, Baihu Tang, Liangge San, Daochi San). Swelling/pain with or without fever, unspirited pulse, large/empty or stone-hard pulse, blue-white lips/tongue, full mouth saliva, desire for very hot drinks, normal urination/defecation (occasional red urine) indicates Deficient Qi. Despite appearing as swelling/fire, these are signs of Yin excess forcing Yang out. Physicians often misdiagnose this as Yin deficiency with hyperactive Fire and use yin-nourishing/fire-clearing herbs; however, true Yin deficiency does not present with full mouth saliva, blue/slipping tongue, unspirited pulse, or normal bowels. Physicians must distinguish Yin/Yang and Deficiency/Excess clearly to avoid error.
Heart Pain: Qi-pain in the heart, blue face, cold limbs, slippery tongue, no thirst indicates Cold pathogen directly attacking the Heart Monarch due to extreme decline of Ministerial Fire (suitable for Sini Tang). Qi-pain in the heart, red face, yellow tongue, desire for cold drinks indicates Heat pathogen attacking the Pericardium (suitable for Zhizi Dahuang Tang).
Swelling/Pain in Chest, Abdomen, Flank, Back, Waist, Elbow, Hip, Knee: Swelling/pain disliking pressure, with or without fever, aversion to cold/preference for heat, yellow tongue, red stool, spirited pulse indicates Qi/Blood stagnation and Excess (suitable for blood-invigorating, qi-moving, cooling herbs). Swelling/pain liking pressure, with or without fever, blue tongue, preference for hot drinks, clear/long urination/defecation, unspirited pulse, extreme fatigue indicates Yang decline failing to circulate, and Deficiency (suitable for warming-middle, qi-moving herbs).
Urination/Defecation Disorders: Difficulty urinating/defecating, abdominal distension, irritability, yellow tongue, desire for cold drinks, spirited pulse indicates Yang pathogen closure (suitable for cooling/drainage, purging herbs). Difficulty urinating/defecating, non-distended abdomen, quiet patient, no thirst, preference for lying down, unspirited pulse, slippery blue tongue indicates Yin pathogen closing below due to Yang insufficiency failing to transform Yin (suitable for warming/tonifying, restoring Yang herbs).
Differentiating Pulse Methods: Qi Excess: Floating, surging, long, large, solid, rapid, tight pulses. (If disease signs are Yin but pulse is Yang, discard pulse and follow disease). Qi Deficiency: Deep, slow, fine, minute, empty, short, choppy pulses. (If disease signs are Yang but pulse is Yin, discard pulse and follow disease).
Differentiating Symptoms: Qi Excess: Spirited pulse, voice, complexion, diet, activity. Qi Deficiency: Unspirited pulse, voice, complexion, diet, activity.
Differentiating Sores: Qi Excess: Red/swollen, elevated, severe pain, irritability, spirited person = Carbuncle (Yong). Qi Defusion: Normal skin color/spreading swelling, no pain, unspirited person = Ulcer (Ju).
Differentiating Smallpox: Qi Excess: Purple-red spots, possibly with macules/papules, scorched apex, red lips, constipation. Qi Deficiency: Gray/sunken/flat sores, chills, blue-white lips/mouth, loose stools.
Differentiating Eye Diseases: Qi Excess: Red/swollen, painful/distended, discharge/cataracts, misty vision, red vessels, tearing, irritability. Qi Deficiency: Mild pain/distension, many cataracts/mists but no great suffering.
Differentiating Color: Qi Excess: Purple-red, lips like cinnabar, irritability. If color doesn't match disease, discard color and follow disease. Qi Deficiency: Dull/dark, blue-white unspirited, dark blue lips/mouth. If disease doesn't match color, note sudden closure.
Differentiating Tongue: Qi Excess: Yellow, dry-white, purple-red, black-yellow, pure dry-black, irritability, cold drink desire. Qi Deficiency: Blue-slipping, moist-yellow, moist-black, dry-black, or blue-with-yellow, yellow-with-white, black-moist, full mouth saliva, quiet person, hot drink desire.
Differentiating Breath: Qi Excess: Rough breath, warm exhalation, loud speech. Qi Deficiency: Weak breath, shortness, cold exhalation, faint speech.
Differentiating Saliva: Qi Excess: Incessant saliva, hot mouth, desire for water = Stomach Fire. Qi Deficiency: Incessant saliva, cold mouth, desire for hot soup = Stomach Cold.
Differentiating Urine/Stool: Qi Excess: Short/red/yellow urine, hard/sheep-dung-like/foul/yellow stool. Qi Deficiency: Clear/long urine (occasionally yellow), loose/white/green stool.
Differentiating Skin/Hair: Qi Excess: Dry/coarse skin/hair, dry/itchy skin. Qi Deficiency: Smooth/lustrous skin/hair, thin but non-itchy skin.
Differentiating Diet: Qi Excess: Large appetite, easy digestion, hunger, desire for soups/water. Qi Deficiency: Poor appetite, hard digestion, feeling full after little, preference for hard foods.
Differentiating Activity/Temperament: Qi Excess: Light body, active, angry/scolding, laughing/raving. Qi Deficiency: Heavy body, lethargic, silent, worried/sorrowful.
Qin'an's Golden Needle for Medication Use
After years of study, I have found a true principle in medication use, distinct from others. Regardless of upper, middle, or lower body diseases, and regardless of gender or age, if one sees a blue tongue, full mouth saliva, unspirited pulse, quiet demeanor, pale lips/mouth, no thirst (or thirst preferring hot drinks), and normal urination/defecation, even if external signs show high fever, body ache, headache, eye swelling, or mouth ulcers, ignore all these symptoms. Treat solely based on the primordial root of congenital establishment. This yields 100% success. Conversely, if one sees a dry-yellow tongue coating, dried-up saliva, thirst for cold drinks, spirited pulse, irritability, even if the body is cold as ice, ignore these. Seek treatment in the primordial Yin of congenital establishment. This also yields 100% success. Two diagrams follow for careful study.
Diagram of External Cold Pathogen Entering
Explanation: A white circle represents the body's righteous Qi; black represents external Cold pathogen. Invasion of the first skin layer is governed by the Taiyang channel, presenting with head/neck/back pain, fever, and aversion to cold. Like thieves entering a wall, the pathogen exploits voids. Thus, one need not adhere strictly to day-count theories. It may enter Yangming, Shaoyang, Taiyin, Shaoyin, or Jueyin channels of the hands/feet. Zhang Zhongjing used the Taiyang channel to encompass 397 methods and 113 prescriptions. Discussing transmission follows the law of Six Steps' circulation; discussing versatility follows their transformation mechanism. To prevent confusion about the pathogen's direction, he outlined the six channel提纲 (outline) conditions and errors (mis-sweating, mis-vomiting, mis-purging, etc.) within the 113 prescriptions. Students must pay attention. Note that "Six Guests" (pathogens) act similarly. Crucially, external pathogens close skin pores, trapping Qi and causing fever/pain. Sweating to scatter pathogens is the primary method for initial external invasion. If pathogens enter via Yang channels, Cold transforms to Heat, damaging Yin. Mild cases use Renshen Baihu Tang or Xiaochaihu Tang to preserve Yin; severe cases use Da/Xiao Chengqi Tang to save Yin. If pathogens enter via Yin channels, Yin/Cold merge, leading to Yang decline. Mild cases use Da/Xiao Jianzhong Tang or Lizhong Tang to support Yang; severe cases use Sini Tang or Baitong Tang to restore Yang. This is Zhang Zhongjing's "Midnight-Noon Needle" for external pathogens.
Diagram of Internal Cold Pathogen Generation
Explanation: A white circle represents righteous Qi. Strong righteous Qi prevents external Cold entry and internal Cold generation. Internal Cold arises from deficient righteous Qi; for every unit of Qi deficiency, a unit of internal Cold generates. As the classics state: "Qi deficiency is Cold." Causes of deficiency: excessive sexual activity damages Kidney Yang; irregular diet damages Spleen Yang; overthinking damages Heart Yang. Where Yang/Qi is damaged, Cold generates. Prolonged Yin accumulation extinguishes Yuan Yang. For Upper Jiao, Zhang uses Guizhi to support Heart Yang; for Middle Jiao, Jianzhong/Lizhong to support Spleen Yang; for Lower Jiao, Sini/Baitong to rescue Kidney Yang. Long-term Yang deficiency fails to generate True Yin, leading to Yin fluid depletion. Eventually, Blood dries and Empty Fire flares, becoming a guest pathogen—this is true Yin deficiency. Treatment requires Sweet-Cold to nourish Yin; never recklessly use Bitter-Cold. Hence, Zhang uses Zhigancao Tang, Guizhi Longgu Muli Tang, or Gancao Heijiang Tang to guide Yin from Yang, nourishing and transforming Yin. This is Zhang's "Midnight-Noon Needle" for internal injury. Books link "Lao" (consumption) to Fire, derived from "damaging Yang," but explanations are unclear, leading to many deaths. Students must recognize Yang damage with Yin manifestations and treat per the Yang Deficiency section above. If Yang damage fails to transform Yin, leading to fluid exhaustion, dry skin, short spirit, sticky phlegm, and fire signs, treat per Zhigancao or Longgu Heijiang Tang methods, selecting from Yin Deficiency formulas. Also, recognize that external pathogens entering Yang channels causing Heat-blood damage can be called Yin deficiency (True Yin Deficiency). Caused externally, Bitter-Cold/Cooling/Ascending methods work. Caused internally, only Sweet-Warm/Slightly-Cold methods guiding Yang to nourish Yin work. Internal/external methods are detailed here. In Volume 1, I listed actual signs of Yang/Yin deficiency as the diagnostic needle; Sweet-Acrid transforms Yang, Bitter-Sweet transforms Yin as the medication needle; "Qi excess is Fire, Qi deficiency is Cold" as the One-Yuan needle. Students must ponder deeply for clarity.
Appendix: Rituals for Chronic Illnesses, Strange Symptoms, and Miraculous Sores (Also applies to malevolent spirits)
Illnesses are unavoidable. Mild cases respond to medicine. Severe cases lasting years with no medical effect stem from past-life karma or present-life moral failings. Fathers, sons, brothers, husbands should cultivate virtue, perform good deeds, abstain from beef/dog meat, worship the Nine Emperors, release fish, donate coffins, or repair roads. Accumulate hidden merit, purify with fasting/piety, and submit repentance/prayer petitions to the Central Palace, City God, and Dongyue, burning them in the air. This may turn danger to safety. I teach this method frequently with success, supplementing medicine where it falls short.