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Yang Rixuan, a Doctor of Taichang (Grand Secretary of the Court of Imperial Sacrifices), suffered from chills and fever. Hao Yun diagnosed his pulse and said, "Your pulse is vigorous at the beginning and weak at the end, and vigorous at the end and weak at the beginning. According to medical principles, this is called 'Fish Playing' (a metaphor for a scattered, rootless pulse resembling a fish swimming playfully in water, indicating a critical and incurable condition). It is untreatable. A few days later, he died." (From *Shaoshi Jianwen Lu*)

The *Zhen Gao* states: "Those who often fail to be cautious in serving Heaven bring upon themselves the root causes of a hundred diseases, yet they resent and blame the spirits. Sleeping in drafts or lying on dampness, yet blaming others or external factors, are all foolish people."

To serve Heaven cautiously means to think carefully before every action. Indulgence in diet and desires, and lack of moderation in yin and yang, are the primary roots of all diseases. This leads to internal deficiency and damage, while wind-dampness invades from the exterior, jointly causing such harm. How can such cases be attributed to deities? One must rely solely on medicinal arts and therapeutic treatments.

To treat illness, one must first examine its origin and observe its pathogenesis. If the five zang organs are not yet deficient, the six fu organs are not exhausted, the blood vessels are not chaotic, and the spirit is not scattered, medication will surely lead to recovery. If the disease has already formed, half recovery may be expected. If the pathological momentum has passed, life will be difficult to preserve.

Although the origins of disease are manifold, they all relate to pathogenic factors (xie qi). Pathogens are irregular causes, referring to factors that do not conform to normal physiological laws. Wind, cold, summer-heat, dampness, hunger, fullness, labor, and rest are each considered pathogens; it is not only ghostly qi and epidemics that constitute pathogens. Human vital energy resides within like a fish in water; when the water is turbid, the fish becomes emaciated; when vital energy is dimmed, the person falls ill. Pathogenic factors harming humans are particularly severe. Once the meridians are affected by such qi, it transmits to the zang-fu organs. The zang-fu organs form diseases based on their deficiency/excess and cold/heat conditions. Diseases generate each other, spreading widely throughout the body. Spirit (shen) originally resides in the body to function; once the body is invaded by pathogens, the spirit becomes chaotic. When the spirit is chaotic, spiritual entities enter; as ghostly power strengthens and divine guardianship weakens, death inevitably follows. The ancients compared this to planting poplar trees, which is an apt analogy. However, some diseases originate from ghosts/spirits and should be dispelled through prayer. Although said to be dispellable, benefit still comes from medicinal treatment, as seen in the case of Li Ziyu using Red Pills. In cases where medicinal treatment yields no benefit, expulsion is impossible, as exemplified by Jin Jinggong's disease in the gaohuang region. Generally, while the harms of ghosts/spirits are manifold, the source of disease is singular, differing only in severity. (From *Sanshuo Bencao*)

Cold damage (Shanghan) begins in the Taiyang channel, reversely transmits to the Yangming channel, and stops at the Jueyin channel. Since the Six Channels differ, so do the treatment methods. The Taiyang channel belongs to the Bladder; without inducing sweating, it cannot heal. Ephedrae Herba (Mahuang, 麻黄) must be used because Ephedra grows in Zhongmu where snow accumulates five chi deep; where Ephedra grows, snow does not accumulate. This is likely because this herb can unblock internal yang qi and repel external cold. The Yangming channel belongs to the Stomach; without purging and draining, it cannot heal. Rhizoma et Radix Rhei (Dahuang, 大黄) and Natrii Sulfas (Mangxiao, 芒硝) must be used to promote drainage. The Shaoyang channel belongs to the Gallbladder; lacking a direct exit or entry pathway, Bupleuri Radix (Chaihu, 柴胡) and Pinelliae Rhizoma (Banxia, 半夏) can promote drainage and induce sweating, assisted by Scutellariae Radix (Huangqin, 黄芩); without these, the pathogen cannot be resolved. The Taiyin channel belongs to the Spleen, which is Earth of the Central Region; its nature dislikes cold and dampness. Without Dried Ginger (Ganjiang, 干姜) and Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), warmth and dryness cannot be achieved. The Shaoyin channel belongs to the Kidney; its nature fears cold and dryness. Without Prepared Aconiti Lateralis Radix (Fuzi, 附子), warming cannot occur. The Jueyin channel belongs to the Liver, which stores blood and nourishes sinews; without warm and neutral herbs, moistening and nourishing cannot take place. This is the constant principle. Later learners, unaware of these categories, arbitrarily administer drugs, leading to chaotic symptoms and premature death. Must one not investigate and distinguish these matters? Regarding the three Yang channels, one must know the methods of sweating, purging, and harmonizing. For the Taiyin Spleen channel, if warming and drying methods fail, one should use warming and draining methods, emerging from the Yangming channel, as seen in Wenyi Wan using Rhizoma et Radix Rhei. For the Shaoyin Kidney channel, although Fuzi is used, combining it with Mahuang shows that Shaoyin also originates from Taiyang. Using Cinnamon Twig (Guizhi, 桂枝) for Jueyin indicates it emerges from Shaoyang. When the two Yang channels are constrained, they should emerge from Yangming; thus, the three Yin channels have indications for purging. Examples include Shaoyin with dry mouth and throat, and watery diarrhea; Taiyin with abdominal fullness and intermittent pain; Jueyin with curled tongue and retracted testicles—all require purging. Scholars should examine these details carefully and not prescribe rashly.