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Phlegm-toxin, conversely harming the harmonious and neutral qi; if acupuncture is performed when it is not indicated, blood and qi will scatter and dissipate, and joints will become contracted and shriveled; if Daoyin (a therapeutic practice combining breathing and physical movement) is performed when not indicated, true qi will be exhausted and damaged, and pathogenic qi will act recklessly; if massage is performed when not indicated, muscles will swell, and sinews and bones will excessively relax; if steaming and moxibustion/warming compresses are used when not indicated, yang qi will deviate outward, and yin qi will gather internally; if warm bathing is performed when not indicated, scalding of the skin will occur, and heat will generate within the muscles; if methods to induce joy and pleasure are used when not indicated, spirit and qi will be lost, and mental state will be unpleased; if soothing and gentle methods are used when not indicated, qi stagnation and willpower fracture will occur, leading to forgetfulness and damage to one's aspirations. Generally speaking, treatment must conform to appropriateness. The pulse conditions and disease manifestations are briefly described as follows: If the pulse is not tight and rapid, do not induce sweating; if the pulse is not urgent and rapid, do not use purgation; if there is no chest and epigastrium fullness/stiffness, and the chi pulse is weak and faint, do not induce vomiting; if joints are not urgent/painful, and Ying and Wei (nutritive and defensive) qi are not obstructed, do not use acupuncture; if yin qi is not excessive and yang qi is not deficient, do not use moxibustion; if there is no exogenous pathogen inside, do not perform Daoyin; if there is no pernicious external qi, do not perform massage; if the skin is not bi-syndrome (obstructed), do not use steaming/warming compresses; if muscles are not cold, do not use warm bathing; if the spirit is not condensed or confused, do not use methods to induce joy; if qi is not rushing urgently, do not use soothing methods. Those who follow these principles will live; those who oppose them will die. (From *Zhong Zang Jing*)

The *Classic* states: Recognize the biao (branch/symptom) and ben (root/cause), only assist the ben. Treat a thousand people, and none will be harmed. If Spleen Earth is deficient, warm and tonify to benefit the source of fire (Mingmen Fire); if Liver Wood is deficient, moisten and nourish to strengthen the master of water (Kidney Yin); if Lung Metal is deficient, use sweet and缓和 (gentle) methods to cultivate the foundation of Earth; if Heart Fire is deficient, use sour and astringent methods to nourish the ruler of Wood (Liver); if Kidney Water is deficient, use pungent and moistening methods to preserve the ancestor of Metal (Lung). This is the root principle for treating deficiency. If Wood desires excess, Metal should level it; if Fire desires excess, Water should level it; if Earth desires excess, Wood should level it; if Metal desires excess, Fire should level it; if Water desires excess, Earth should level it. This is the root principle for treating excess. When Metal is controlled by Fire, draining the Heart requires protecting the Lung first; when Wood is injured by Metal, leveling the Lung requires tonifying the Liver first; when Earth is invaded by Wood, damaging the Liver requires supporting the Spleen first; when Water is overwhelmed by Earth, clearing the Spleen requires nourishing the Kidney first; when Fire is constrained by Water, suppressing the Kidney requires nurturing the Heart first. This is the root principle for treating pathogens. ○ Diseases belonging to deficiency should be treated with缓 (slow/gentle) methods. Deficiency means the snatching away of essence and qi. Since the disease is deep-seated and stubborn, treatment must proceed in steps and order. Therefore, treating deficiency has no quick method, nor any miraculous method, just as a house impoverished for years, empty inside, cannot be restored in a morning or evening. Diseases belonging to excess should be treated with 急 (urgent/fast) methods. Excess means the victory of pathogenic qi. Since pathogens not quickly driven out cause spreading harm, treating excess has no slow method, often employing miraculous methods, like thieves in the house, requiring immediate expulsion through open doors to achieve peace. This is the method of urgency and slowness in disease mechanisms. ○ One must know that for a healthy person to fall ill, it must be because the Water and Fire organs (Kidneys and Heart) first became diseased; for a disease to become severe, it must be because the Water and Fire pathways reached their extreme; for a disease to become critical, it must be because the Water and Fire qi are about to collapse. Thus, minor diseases may result from Qi and Blood imbalance, but major diseases must result from the harm of Water and Fire. To treat minor diseases by abandoning Qi and Blood, and to treat major diseases by abandoning Water and Fire, is truly like climbing a tree to catch fish; how can this succeed? (From *Feng Shi Jin Nang*)

In all treating diseases, only when releasing the exterior (Biao) does one not stay far from hot herbs; if not releasing the exterior, one must stay far from hot herbs; only when attacking the interior (Li) does one not stay far from cold herbs; if not attacking the interior, one must stay far from cold herbs. To stay far when one should not, or not to stay far when one should, brings harms beyond count. ○ Nowadays, most patients with exogenous diseases have concurrent endogenous injuries; medication must distinguish carefully. For example, if it is 70% exogenous and 30% endogenous, then in the medicines for exogenous disease, one should use緩 (gentle) and small doses, and use Ginger and Jujube to harmonize the Middle Jiao as guides, so as not to greatly disturb Zheng Qi (healthy qi) or cause fatigue from sweating and bleeding. If it is 70% endogenous and 30% exogenous, then medication should focus entirely on endogenous injury. Because people with endogenous injury, even with slight exogenous factors, immediately fall ill, unlike robust individuals who must feel deeply heavy pathogens before illness manifests. ○ In general, treating Yin diseases, if one can transform them into Yang, they will heal without medicine. Even if they do not heal, using one dose of Yin-category medicine, such as Si Wu Er Lian Tang (Four Substances with Two Ligustrum Decoction) or Liu Wei Di Huang Tang (Six-Ingredient Rehmannia Pill), to correct the deviation, will ensure recovery. ○ Those who raise a thousand fish must place shellfish/mollusks in the pond; otherwise, the fish will float and scatter during thunderstorms. Although fish are submerged creatures, their nature enjoys movement. By using mollusks, which are sinking and still things, to guide the fish to lie still and inactive, it is seeking what is similar in nature, a principle connecting to profound mysteries. Thus, to treat the flying away of True Yang (floating Yang), if one does not use turtles and soft-shelled turtles to guide it downward to submerge, it cannot be done. (Yu Jiayan)

*Jiu Tang Shu · Tan Bin Lu* states: In treating diseases with medicine, there are cases where the remedy matches the disease exactly; one needs only to use a single herb directly attacking the disease. Once the medicinal power is pure, the disease heals immediately. Nowadays, people cannot differentiate pulses, nor recognize the source of disease, relying only on conjecture, using many herbs. This is like hunting: not knowing where the rabbit is, sending out many men and horses to enclose an empty area, hoping for accidental capture. Is such medical treatment not negligent? Suppose one herb happens to match the disease, but is mixed with others; they restrain each other, and their momentum fails to act, hence difficulty in healing. (From *Zhi Xin Lu*)

To treat disease, first remove the root cause, then one can use astringents. To wash clothes, one must first remove grease and dirt, then one can apply powder and decoration. (Zhu Danxi)

Benefit the source of Fire to eliminate Yin shadows (Yin-cold pathogens); strengthen the master of Water to control Solar brightness (deficient flaming fire). ○ Benefit the Yang of the Heart, and even cold conditions can circulate; strengthen the Yin of the Kidney, and even heat conditions can be treated. (Wang Taipu)

Save the person first, then treat the disease. A doctor should treat the person, not just the disease. ○ In treating exogenous syndromes, preserving Body Fluids is always the primary principle. ○ Pushing out the old brings forth the new; bringing forth the new pushes out the old. ○ For new endogenous injuries, tonification should be early; for new exogenous injuries, dispersion must be cautious not to be excessive. For long-standing endogenous injuries, tonification should be vigorous and fast; for long-standing exogenous injuries, dispersion must not be vigorous or fast. ○ There are endogenous injuries resembling exogenous ones; this type of "Fire" cannot be dispersed, for dispersing causes loss of Yin; it cannot be suppressed by frost and snow (metaphor for cold herbs), for suppressing extinguishes the fire. Indeed, without water, fire cannot be saved; without rooted water, it is insufficient to save fire that has lost its root. ○ What are Deficiency and Excess? There is Yin Deficiency, Yang Deficiency, and Congenital Yin/Yang Deficiency. What is Yin Deficiency? It is Blood Deficiency. What is Yang Deficiency? It is Qi Deficiency. For Blood Deficiency, tonify Blood, such as Si Wu Tang (Four Substance Decoction); for Qi Deficiency, tonify Qi, such as Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). For congenital Yin Deficiency, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) or Zuo Gui Wan (Left Restoring Pill); for congenital Yang Deficiency, use Ba Wei Di Huang Wan (Eight-Ingredient Pill with Rehmannia) or You Gui Wan (Right Restoring Pill). For Yang Deficiency caused by excessive attack/draining, such as using cold/cool herbs causing Yang to be restrained and unable to rise, use Ren Shen (Ginseng), Bai Zhu (Atractylodes), Huang Qi (Astragalus) to warm; if severe, use Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark) to assist; if more severe, use Ba Wei Di Huang Wan or You Gui Wan to rescue from the origin. For Yin Deficiency caused by excessive attack/draining, such as using dispersing herbs causing Body Fluids to dry up, use Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root), Shu Di Huang (Prepared Rehmannia) to nourish, and Gou Qi Zi (Goji Berry), Gui Lu Jiao Ning (Turtle and Deer Antler Gelatin) to fill. (From *Ji Ren Bian*)

When diagnosing pulses, if both left and right sides show disease, treat the right side, because the Qi of Heaven and Earth moves from right to left; if upper and lower both show disease, treat the lower part, because the Qi of all things moves from bottom to top. Thus, if Heart and Lung both have disease, treat at Dan Zhong (Conception Vessel 17); if Liver and Spleen both have disease, treat at the Stomach; if both Kidneys have disease, treat the right Kidney, emphasizing the right side. If Heart and Liver both have disease, treat the Liver; if Liver and Kidney both have disease, treat the Kidney; if Heart and Kidney both have disease, also treat the Kidney; if Spleen and Lung both have disease, treat the Spleen; if Spleen and Kidney both have disease, treat the Kidney; if Lung and Kidney both have disease, also treat the Kidney, emphasizing the lower part. Furthermore, if Lung and Left Kidney both have disease, treat the Left Kidney; if Heart and Right Kidney both have disease, treat the Right Kidney, also emphasizing the lower part. If Lung and Liver both have disease, treat the Lung; if Kidney and Spleen both have disease, treat the Spleen, also emphasizing the upper/right side. Someone asks: If Heart and Spleen both have disease, why speak of treating Fire and tonifying Earth in reverse? Correct. Treating Fire and tonifying Earth refers to treating the Foot Shaoyin (Kidney) channel, which is also treating upper disease by addressing the lower. If treating the Hand Shaoyin (Heart) channel, one cannot tonify the Spleen, and will instead overact upon the Lung. Therefore, when Heart and Spleen both have disease, treat Earth to drain dampness; if Heart Pathogen is prosperous, Spleen Earth becomes dry, and both organs are regulated. Thus, treating the lower can regulate the upper, treating the right can regulate the left; both are treating the root, while treating the branch is not discussed here. (Wei Litong)

As for Earth being born from Fire, one should supplement according to Fire, yet there is a subtle principle. Yangming Stomach Earth is born following Shaoyin Heart Fire; thus, to tonify Stomach Earth, one should tonify Heart Fire. The Gui Pi Tang (Restore the Spleen Decoction) supplements from the "outer home" of Fire (Liver Wood, as Wood generates Fire), causing Wood to generate Fire, and Fire to generate Earth. Taiyin Spleen Earth is born following Shaoyang Ministerial Fire; thus, to tonify Spleen Earth, one should tonify Ministerial Fire. The Ba Wei Wan (Eight-Ingredient Pill) combines Water and Fire achieving mutual interaction to steam and rot food. ○ Nowadays, those speaking of tonifying the Lung use Ren Shen (Ginseng) and Huang Qi (Astragalus); clearing the Lung use Huang Qin (Scutellaria) and Mai Dong (Ophiopogon); astringing the Lung use Wu Wei Zi (Schisandra) and He Zi (Chebula); draining the Lung use Ting Li Zi (Lepidium Seed) and Zhi Ke (Aurantium Fruit). For mild diseases, isn't there some effect! But if the root and origin are depleted, it is irrelevant. Generally, the Qi of Lung Metal returns to store within Kidney Water during sleep; Daoists call this "Mother hides in the palace, Son hides in the mother's womb." The Lung is called the Delicate Organ, fearing heat and cold. If there is Fire in the Kidney, Metal fears Fire punishment and dares not return; if there is no Fire in the Kidney, Water is cold and Metal is cold, and it dares not return. This may manifest as wheezing and distension, coughing and hiccups, insomnia, and anorexia, like a dog that has lost its home. At this time, wanting to tonify the Mother (Earth/Spleen) to benefit the Child (Metal/Lung) makes wheezing and distension worse; if one clears or drains, Lung Qi decreases daily, and death approaches. Only astringent methods seem reasonable, but without entering through the proper door, how can one enter? *Ren Zhai Zhi Zhi* states: The Lung emits Qi, the Kidney receives Qi; the Lung is the Master of Qi, the Kidney is the Root of Qi. Whenever Qi rebels upward from below the umbilicus, this is Kidney Deficiency failing to receive Qi and return it to its origin. Do not merely engage in treating the Lung; either strengthen the Master of Water, or benefit the Source of Fire, so that Fire is generated within Water. ○ Hemoptysis and fever do not necessarily constitute Tuberculosis (Lai Fei); continuing to take Si Wu Tang (Four Substance Decoction) and Zhi Bai Di Huang Wan (Anemarrhena, Phellodendron, and Rehmannia Pill) leads to Tuberculosis. Chest fullness and blooming, depression and discomfort do not necessarily constitute Drum Distension; continuing to take Shan Zha (Hawthorn) and Shen Qu (Medicated Leaven) leads to Drum Distension. Facial edema and swelling, blocked and difficult urination do not necessarily constitute Edema; continuing to take diuretic/damp-draining drugs leads to Edema. Qi stagnation and chest obstruction do not necessarily constitute Dysphagia (Ye Ge); continuing to take Qing Pi (Aurantium Peel) and Zhi Ke (Aurantium Fruit) leads to Dysphagia. (Zhao Yangkui)

People know tonification as tonification, but do not know that draining is also tonification; they know draining as draining, but do not know that tonification is also draining. Thus, tonifying Blood to benefit Ying (Nutritive) Qi, without moving Qi, causes Blood coagulation; tonifying Qi to assist Wei (Defensive) Qi, without invigorating Blood, causes Qi stagnation. (*Yi Xue Ru Men*)

When treating deficiency pathogens, one must first protect Zheng Qi (Healthy Qi); if Zheng Qi exists, harm will not occur. Moreover, tonification contains the intent of draining; indeed, tonifying Yin is to drain Heat, and tonifying Yang is to drain Cold. There is no case in the world where Zheng Qi recovers while pathogens remain, nor is there a case where Zheng Qi exhausts while life does not perish. ○ Wood of the East has no deficiency that cannot be tonified; tonifying the Kidney is tonifying the Liver. Water of the North has no excess that cannot be drained; draining the Liver is draining the Kidney. Hence, Liver and Kidney are treated together. The Kidney corresponds to Northern Gui Water, trigram Kan, image Dragon; Dragon hides at the sea bottom, when Dragon rises, Fire follows. The Liver corresponds to Eastern Yi Wood, trigram Zhen, image Thunder; Thunder hides in the marsh, when Thunder rises, Fire follows. Hence, Yi and Gui share the same source. (Li Shicai)

The theory of "Yi and Gui sharing the same source" seeks the reason behind it. Liver is Xun Wood, Kidney is Kan Water; in Hetu (River Map), 2 and 7 share the palace; in Luoshu (Lo Shu Square), 2 and 7 are connected; this is why Water and Wood share the same root, and thus the two Fires also share the same root. People know Water generates Wood, but do not know Wood also generates Water, seeking similar energies. Verifying with Five Elements: Jia Wood is born in Hai, this is Yang Water generating Yang Wood; Gui Water is born in Mao, this is Yin Wood generating Yin Water; the principle is clear. Further verifying with the human body: Sour is the taste of Wood. Thinking of sour causes teeth to chatter and saliva to produce; Wood generating Water, its induction is very swift. Thus, Water indeed generates Wood, and tonifying Wood also generates Water. Liu Wei Wan (Six-Ingredient Pill) is a Kidney-tonifying formula, yet it uses Shan Zhu Yu (Cornus) to tonify the Liver; the principle is subtle! Observing that Yi and Gui share the same source, how can physicians lightly speak of felling Wood or calming the Liver? (From *He Luo Jing Yun*)

Treatment of the Liver has several types: If Water is deficient and Wood has nothing to grow from, use Di Huang Wan (Rehmannia Pill), which is the principle of Yi and Gui sharing the same source; if Earth is deficient and Wood has nothing to plant on, use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), which is slowing the Liver and cultivating Earth; if the primary channel has Blood Deficiency with Fire, use Xiao Yao San (Free and Easy Wanderer Powder) to clear Fire; if Blood Deficiency without Fire, use Gui Pi Tang (Restore the Spleen Decoction) to nourish Yang. As for the method of tonifying Fire, it is the same as for the Kidney; but the treatment of draining Fire is similar to the Heart. Zuo Jin Wan (Left Metal Pill) uses Huang Lian (Coptis) alone as the sovereign herb, applying the method of "draining the son when in excess" to directly curb its flaming upward trend; Wu Zhu Yu (Evodia) seeks similarity, guiding Heat downward, and using pungent-warm properties to open depression, punishing resistance, thus serving as the assistant herb. However, this is suitable only if Wood Qi is excess and Earth is not deficient. (Hu Tianxi)

*Nei Jing*: Turbid Qi staying above causes distension; Clear Qi staying below causes undigested stool diarrhea. These four sentences are crucial methods for treating the Upper and Lower Jiao. Thus, for treating chest and diaphragm fullness, use descending herbs like Niu Xi (Achyranthes) and Fu Ling (Poria); for treating chronic diarrhea, use ascending herbs like Sheng Ma (Cimicifuga) and Chai Hu (Bupleurum). This must be known. (Wu Huangchi)

Current treatments for Qi disorders only seek the Spleen and Lung, not the Kidney, hence few effects. The Moving Qi in the Kidney region is the root of the five zang and six fu organs, the root of the twelve meridians, the gate of respiration, and the source of the San Jiao (Triple Burner). Some due to excessive sexual activity, or innate weakness, Kidney Channel insufficiency, Qi has no restraint, leading to much stagnation and various diseases. Physicians only know regulating Qi, but Qi becomes harder to regulate, and using harsh purgatives kills more than half. Others attribute it to Spleen Deficiency failing to transport and transform, engaging in Spleen tonification, merely prolonging life for years, ultimately dying. This is the fault of not knowing to tonify the Kidney; one should use Po Gu Zhi (Cistanche/Floorseed), Hui Xiang (Fennel), Hu Lu Ba (Trigonella) as main treatments. ○ Whenever using Qi-regulating herbs, one must combine with Blood-harmonizing herbs as assistants. There is no case where Qi is stagnant but Blood is harmonious; if Blood is not harmonious, Qi becomes more stagnant. (Wang Yutai)

There are three methods for treating Qi Deficiency: For Upper Qi Deficiency, ascend and lift it; for Lower Qi Deficiency, receive and return it; for Middle Qi Deficiency, warm and tonify it. ○ The subtlety of using medicine must exert effort from deficiency. Once falling into excess, progress is hard. Treating headache by treating the head is a major taboo for physicians. (Zhou Shenzhai)

Seeing phlegm, do not treat phlegm; seeing blood, do not treat blood; having no sweat, do not induce sweat; having heat, do not attack heat; when wheezing arises, do not consume Qi; when essence leaks, do not astringe. (Wang Yingzhen)

Clearing urine in high fever also embodies the meaning of removing firewood from under the cauldron (treating the root). ○ Wind-treating herbs must combine with Blood-nourishing herbs to constrain dryness; Blood-nourishing herbs must combine with wind-searching herbs to move stagnation. (*Yi Fang Ji Jie*)

Treating wind, first treat Blood; when Blood moves, wind naturally extinguishes. (Chen Liangfu)

For fat bodies, Fire is precious; for thin bodies, Dampness is precious. Thus, fat people cannot tolerate cooling, and thin people cannot tolerate warming tonification. ○ The Liver is tonified by dispersing; Heart and Kidney are tonified by gathering/astringing; Spleen is tonified by drying; Lung is tonified by moistening; Intestines and Stomach are tonified by unblocking. Ancients used Da Huang (Rhubarb) as a tonifying agent because intestinal blockage prevents Qi circulation. (*Yi Tang San Ji*)

Do not see heat and throw cool herbs; do not see cough and regulate the Lung. ○ Disharmony of the nine orifices all belongs to Stomach disease; when upper and lower interactively diseased, treat the Middle Jiao. ○ When Yuan Qi (Primal Qi) is already damaged and disease does not heal, give Sweet Herbs. To regulate Yang Qi, recommend Jian Zhong (Build the Middle Decoction); to care for Yin Fluids, administer Mai Mai Gan Jiao Tang (Rehmannia, Licorice, and Cinnamon Decoction / Pulse-Nourishing Decoction). ○ Three methods for treating Liver disease: Pungent dispersal to regulate function, Sour draining to regulate substance and function, Sweet缓 (gentleness) to benefit function. (Ye Tianshi)

Diseases injured by emotions should be treated primarily by harmonizing the Liver, opening the Heart, awakening the Spleen, and resolving depression. However, light medicines and slow treatment are required to gradually recover. Using heavy medicines will反而 injure Stomach Qi. ○ Many exogenous diseases carry food retention; one must consider that food is wrapped by pathogens, dispersing the pathogens allows food to descend. Mixing digestive aids into dispersing herbs re-injures Stomach Juice, leading to many cases of sinking and closure. Wind often carries Summerheat, Dampness, Cold, or Dryness-Fire, or anger, fatigue, sexual activity, Liver Qi, old masses, and various blood syndromes; all are exogenous diseases, none lacking accompaniment. The value lies in adapting to symptoms, deliberating thoroughly, to avoid errors. (*Wu Yi Hui Jiang*)

Having this form results in this disease; the disease is caused by the form. However, among the Six Evils invading humans, the form receives them, and aromatic/flavor medicines can treat them. Among the Seven Emotions injuring humans, the form also receives them, but the arising of Seven Emotions stems from Mind and Consciousness; thus, their pathology is difficult to fully treat with herbs and needles. As the *Classic* says: Anger can overcome Thought, Sorrow can overcome Anger, etc., using the formless to treat the formless, using mutual overcoming to obtain mutual generation, containing infinite profound meanings. I suffered from melancholy injuring Spirit, hundred medicines ineffective, fortunately attained success in official career, using Joy to open Melancholy, and the stubborn disease healed. How could this be treated by herbs and needles! ○ Formulas state: Stop treating disease when it has diminished by more than half; do not overdose, for excess反而 injures Zheng Qi. Generally, attacking disease, after removing more than half, one should nourish Zheng Qi and assist in dispelling pathogens; when Zheng Qi is full, pathogens naturally exhaust. If one insists on completely attacking pathogens before tonifying Zheng Qi, both Zheng Qi and pathogens will exhaust. ○ For abscesses, swellings, and nodules, people mostly view them as surgical diseases. Li Zai considers this due to Kidney Water depletion, Liver Fire and Blood dryness; the method should nourish Kidney Water, generate Liver Blood, using Liu Wei Tang (Six-Ingredient Decoction). For those with large swellings in chest/flank like buckets, or broken like mushrooms/pomegranates, regardless of size, all treat with the aforementioned method. ○ Also discusses Scrofula (Luo Li) as Liver Channel Blood dryness, should clear Liver Fire, nourish Kidney Water; if treated merely as Phlegm, it often becomes a bad syndrome. (*Zhe Gong Man Lu*)

In treating diseases, if one does not observe the winds of the five directions, diet, residence, which are different, and applies uniform treatment, the medicine misses the disease; this is the physician's fault. ○ In treating diseases, if one does not distinguish new disease/excess pathogens from old disease/Zheng Deficiency, losing order of urgency and sequence, resulting in "excessifying excess and deficiencyifying deficiency," this is the physician's crime. (*Yi Men Fa Lv*)