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The methods for treating the Five Stagnations (Wu Yu) were once heard from Wang Taipu (Wang Bing). In his commentary on the *Neijing* (Inner Canon), he stated: "For Wood stagnation, promote its free flow (Da zhi)," meaning to use emesis to allow it to become smooth and unobstructed; "For Fire stagnation, vent it (Fa zhi)," meaning to use diaphoresis to allow it to disperse; "For Earth stagnation, purge it (Duo zhi)," meaning to use purgation to remove obstruction and blockage; "For Metal stagnation, drain it (Xie zhi)," meaning to use diuresis, release the exterior, and promote urination; "For Water stagnation, restrain it (Zhe zhi)," meaning to suppress it to control its rebellious upward surge. After Wang Taipu's explanation, everyone has followed it as a standard. However, I have not been entirely convinced in my heart. Upon careful examination, there seems to be room for discussion. Particularly, the phrase "restrain it" is especially difficult to understand compared to the preceding four phrases. Therefore, I repeatedly studied the classic text to seek its ultimate meaning.

According to the *Neijing*, the Yellow Emperor asked: "How should severe stagnation be treated?" Qibo replied: "For Wood stagnation, promote its free flow; for Fire stagnation, vent it; for Earth stagnation, purge it; for Metal stagnation, drain it; for Water stagnation, restrain it." Then, regulate the Qi. For excess conditions, restrain them using what they fear; this is referred to as "draining." The total of thirteen sentences form one chapter and should be divided into three sections. From "The Yellow Emperor said" up to "Water stagnation, restrain it," comprising nine sentences, constitutes the first section, which is the dialogue regarding the treatment of stagnation. The sentence "Then, regulate the Qi" forms the second section, representing the auxiliary method for treating stagnation. The three sentences "For excess conditions, restrain them using what they fear; this is referred to as 'draining'" form the third section, also an auxiliary method for regulating Qi. Although these five methods were established by the classic because diseases arise from the stagnation of the Five Movements (Wu Yun), expanding and enriching their meaning is certainly permissible. Moreover, the onset of most diseases is due to stagnation. Stagnation implies a state of obstruction and lack of free flow. It may arise from being overcome by other factors, or it may occur spontaneously due to the inherent Qi becoming stagnant without external overcoming. Is it only the changes of the Five Movements that can cause this? Since stagnation is not limited to the changes of the Five Movements, the methods of promoting free flow, venting, purging, draining, and restraining can naturally be expanded and enriched. This expansion and enrichment reflect the principle of endless adaptability. I shall briefly state them below.

"Wood stagnation, promote its free flow": "Promote" means to ensure smooth flow. For example, if the Liver nature is urgent, with angry Qi rebelling upwards, causing hypochondriac distension and frequent upward flare-up of fire, and bitter-cold and acrid-dispersing herbs fail to cure it, then use ascending and dispersing herbs, combined with guiding herbs of the Jueyin channel for counter-treatment. Similarly, if long-standing Wind enters the interior causing undigested food diarrhea, or if clear Yang fails to ascend causing undigested food diarrhea without external Wind invasion, use light and ascending agents to lift and disperse it. All such cases are methods of "promoting free flow." Mr. Wang interpreted "emesis allowing smooth flow" as "Wood stagnation, promote its free flow." Dongyuan interpreted "food blocking the chest" as follows: Food belongs to Kun Earth, the chest belongs to the Metal position. Metal governs killing and cutting, residing above with Kun Earth and flourishing in Heaven. Metal overcomes Wood, so the generating Qi of Liver Wood is buried underground—is this not Wood stagnation? By vomiting out the Yin Earth matter from the Upper Jiao, Wood becomes comfortable, and the stagnation resolves; this is "Wood stagnation, promote its free flow." I privately doubt Mr. Wang's interpretation of "Da" (promote) as "emesis." If it is Lung Metal flourishing and suppressing Liver Wood, then draining Lung Qi and raising Liver Qi would suffice; emesis is unnecessary. If it is Turbid Qi of Spleen and Stomach flowing downward while Shaoyang Clear Yang fails to ascend, then tonifying Stomach Qi and raising Yang would suffice; emesis is unnecessary. Although there is a rationale for using emesis in certain Wood stagnations, using the character "emesis" to generalize "promote" implies that all Wood stagnations require emesis, which is unacceptable. As for Dongyuan's view that food blocking the Lung sector causes Metal and Earth to flourish above and overcome Wood, I also have doubts. Metal overcoming Wood is the normal order of the Five Elements, occurring regardless of physical injury. Furthermore, if injured by an object, how could it flourish? If vomiting the object extends Wood Qi, this treats Wood stagnation rather than food injury. Using emesis for food blocking the chest aligns with the *Neijing* principle: "Where the pathogen is high, induce vomiting." It is unnecessary to invoke the theory of Wood stagnation to confuse the issue.

"Fire stagnation, vent it": "Vent" means diaphoresis and lifting. For instance, when pores are closed and pathogenic heat is constrained, resolve the exterior and induce sweating to disperse it. Similarly, if Dragon Fire is deeply constrained within, bitter-cold sinking agents are ineffective; instead, use floating and ascending herbs assisted by sweet-warm ones, following its nature for counter-treatment, stopping when the pathogenic force is exhausted, such as in Dongyuan's Shengyang Sanhuo Tang. All such cases are methods of "venting."

"Earth stagnation, purge it": "Purge" means attacking downwards and劫夺 (intercepting/overpowering) to reduce its strength. For example, if pathogenic heat enters the Stomach, use salty-cold agents to attack and remove it. If there is abdominal fullness and distension with severe internal Damp-Heat, and the patient has strong Qi, use purgation. If the pathogenic force is strong and cannot be cleared instantly, intercept its momentum to weaken it. For Dysentery caused by Damp-Heat, where mild agents are insufficient, use attacking or intercepting methods to restore balance. All such cases are methods of "purging."

"Metal stagnation, drain it": "Drain" means diuresis and promoting urination, and unblocking Qi. For example, if Lung Metal is affected by the source of Kidney Water, and Metal is scorched by Fire, its functions cease, leading to stagnation of the source and closure of the water passages. One should regulate Metal transformation and nourish Water to promote drainage. If there is Lung Qi fullness, chest oppression, and orthopnea, only agents that benefit Lung Qi can unblock it. All such cases are methods of "draining." Mr. Wang included "release the exterior" in "Metal stagnation, drain it." While diuresis drains Metal stagnation, the meaning of "release the exterior" is unclear. Does it imply that since skin and hair belong to the Lung, exterior pathogens constitute Metal stagnation, and releasing the exterior constitutes draining? If so, does any tendon disease constitute Wood stagnation and any flesh disease constitute Earth stagnation? These two words are illogical and are deleted here. Placing "release the exterior" among diuresis and urination makes them two separate treatments. If diuresis is interpreted as nourishing Lung to generate Water, and urination as directly treating the Bladder, then direct Bladder treatment is not the Lung's responsibility, so why call it Metal stagnation? This is also inconsistent. Therefore, I change it to: "Diuresis and promoting urination."

"Water stagnation, restrain it": "Restrain" means controlling, attacking, and frustrating, gradually reducing its momentum. For edema where Water Qi overflows and water passages are blocked: Earth is the element that controls Water. Now, Earth Qi is weak and cannot control Water, resulting in Water insulting Earth. Treatment should strengthen Spleen Earth and aid its transportation and transformation, enabling it to control Water and prevent invasion, thus opening water passages for recovery. If the disease is too advanced for this method, use water-draining herbs to attack and frustrate it. Or employ the three methods: removing accumulation (Qu Wan Chen Cuo), opening the ghost gate (Kai Gui Men - sweating), and cleansing the palace (Jie Jing Fu - diuresis), using them alternately to gradually calm the condition. Mr. Wang's "suppress to control rebellious surge" aims to restrain the flooding momentum. Strengthening Earth is defense; draining Water is attack; combining three methods is comprehensive strategy. Although all are water-treatment methods, failing to assess the patient's deficiency/excess, duration, and depth, and applying treatments indiscriminately, will likely lead to failure.

Although there are methods for treating the Five Stagnations, prolonged pathogenic presence inevitably damages Righteous Qi. Even after pathogens are removed, Righteous Qi cannot immediately recover. Without regulating Righteous Qi to restore its proper position and normal function after treating stagnation, the subtleties of treatment are not fully realized. Hence, "Then, regulate the Qi." If Qi remains excessive and unruly after regulation, tonify the element that overcomes it to control it. For example, if Wood is excessive, tonify Metal, as Metal controls Wood, making Wood submissive. The element that overcomes is the one feared; hence, "For excess, restrain using what it fears." What controls an element is desired by that element; what controls it against its will is unwanted. Following its desire brings joy; opposing it brings aversion. Here, we oppose it with what it fears, hence "referred to as 'draining'." Mr. Wang's explanation using salty-draining-Kidney and sour-draining-Liver theories does not fully capture the essence. Nevertheless, from "regulate the Qi" onwards reflects the original intent of the classic, so I deduce its meaning as such. However, when expanding for adaptive application, it need not be rigidly applied.