Library

The principles and methods of medicine are subtle and profound. The key lies in having a flexible pivot within the chest (metaphor for mental acuity and diagnostic flexibility). Observation, Auscultation and Olfaction, Inquiry, and Palpation (Wang, Wen, Wen, Qie) are four essential tasks; if any one is missing, the diagnosis will be biased and incomplete.

First, observe the patient's Shen (Spirit/Mental activity) and complexion. Look at whether it is lustrous or withered, plump or emaciated, and examine sleep patterns. Lively and moist indicates life, while withered indicates death; plumpness often signifies Excess syndromes, while emaciation signifies Deficiency syndromes, as passed down through ancient and modern times. Leaning forward and curling up suggests pain inside the waist; furrowing the brow indicates headache or dizziness. Inability to raise the arms indicates shoulder and back pain; difficulty walking indicates leg pain. Crossing hands to press the chest indicates chest pain; tenderness upon pressing the umbilicus indicates abdominal pain. Being able to sit up but unable to lie flat suggests phlegm-heat complex; excessive sleeping is caused by Deficiency-cold. Facing the wall and curling up mostly indicates cold syndrome; lying on the back with body extended indicates heat syndrome tormenting. Yellowing of the body, face, and eyes indicates Spleen damp-heat; blue lips and black complexion are similar to the aforementioned cold syndromes.

Second, listen to the clarity or turbidity of the voice. Distinguish between truthful speech and delirious words. A turbid voice indicates phlegm obstruction; a clear voice originates from internal cold. Truthful speech is not Excess-heat; delirious shouting indicates deep and solidified heat. Speaking of spirits and ghosts, climbing over walls and houses, with phlegm retained in the chest and diaphragm, is diagnosed as Dian syndrome (Manic-depressive psychosis). Furthermore, if the cause persists for a long time, sudden loss of voice may lead to death.

Third, inquire about the duration of the illness, the frequency of urination and defecation during the day, and the quantity of food intake, as well as preferences for cold or hot foods. These must be discussed differently based on circumstances. If appetite is slightly maintained, treatment is easy; if no food can be taken, treatment is difficult. Preference for cold drinks confirms internal heart heat; preference for warmth belongs to Zang organ cold. Red and yellow urine truly indicates internal heat; clear urine definitely indicates interference by cold pathogens.

Fourth, Pulse-taking (Qie Mai) is the last of the four diagnostics. Floating, Deep, Slow, and Rapid pulses are the beginnings of disease differentiation. The above four diagnostics briefly outline the general principles; one should infer other cases from these examples.

Generally, to treat a disease, one must first investigate its source and probe the Bing Ji (Pathogenesis). When the Five Zang organs are not yet deficient, the Six Fu organs are not yet exhausted, the blood vessels are not yet chaotic, and the Jing Shen (Spirit) has not scattered, taking medicine will surely be effective. If the disease has already formed, only half recovery can be expected. If the disease momentum has passed (referring to the collapse of healthy Qi), life will be hard to preserve. Unless one is a enlightened physician, who can truly know by listening to sounds, observing colors, and examining the true pulse? Regarding diseases before they manifest...

Gallbladder and Liver have always been treated according to Fire. San Jiao (Triple Burner) and Pericardium (Bao Luo) are no different. Spleen and Stomach are often sought from the perspective of Dampness. Lung and Large Intestine belong to the same category of Dampness. Kidney, Bladder, Heart, and Small Intestine require temporary deliberation on Cold and Heat. Chills with exterior heat indicate warming deficiency of the Small Bladder; fever with exterior cold indicates blazing fire in the Heart and Kidney. Of the Twelve Meridians, the most definitive are: four meridians belong to Fire, four to Dampness, and four have alternating Heat and Cold. Attack the interior and release the exterior with careful consideration. Interior Heat and Interior Cold are suitable for Yueju Wan (Venture Exhaustion Decoction - *Note: Interpreted as resolving stagnation/purgation based on context*) or purging methods. Exterior Heat and Exterior Cold are suitable for sweating methods. Dampness is treated like Cold, Fire like Heat; when reaching the extremes of Cold and Heat, there are no two ways. Divide into six parts for Fire, Heat, and Cold. If Cold and Heat stall in the middle, it is a direct waste of tongue diagnosis (misdiagnosis). Heat and Cold rejecting each other indicates deep pathogenesis. "Excess leads to harm, control follows balance." Distinguish urgent Cold, count [pulse] for Heat, seek the truth of Zheng (Righteous) and Xie (Evil) via Root and Branch theory. Do not treat Wind, do not treat Dryness; once Fire is treated, Wind and Dryness are resolved. When releasing the exterior, do not attack the interior; when attacking the interior, do not release the exterior. If both exterior and interior can be attacked, distinguish the degree of priority and location (internal/external). Treating Dampness is nothing short of draining a river; this principle is very clear. Gratitude to Xuanyuan and Qibo for their grace to ten thousand generations, though alas, like a vinegar-jar fly mocking the smallness of the sky.