Library

Suppose the condition manifests as excess in the upper part, it should be suppressed. It is not that any excess in the upper part must necessarily be suppressed; rather, it is because the root lies in deficiency of the lower part presenting with a false appearance of excess, so suppressing the upper part guides the Qi downward. If there were originally true excess in the upper part, why would suppression be necessary?

Suppose the condition manifests as sinking or deficiency in the lower part, it should be lifted. It is not that any deficiency in the lower part must necessarily be lifted; rather, it is because the root lies in surplus above and insufficiency below leading to sinking, so lifting the lower part restores the Qi upward. If there were originally true excess in the lower part, why would lifting be necessary?

Zhang Zhongjing treated exterior deficiency by formulating Guizhi Tang (Cinnamon Twig Decoction). Guizhi (Cinnamomi Ramulus) is pungent and hot, possessing dispersing properties, aiding Yang, and being light in texture. Following the principle that "what belongs to Heaven tends toward the Upper," Guizhi serves as the Jun (Sovereign) herb; Shaoyao (Paeoniae Radix Alba) and Gancao (Glycyrrhizae Radix et Rhizoma) serve as Chen (Minister) herbs assisting it. When the Yang pulse is choppy (Se) and the Yin pulse is taut (Xian), according to medical principles, acute abdominal pain should occur. Zhang Zhongjing then formulated Xiaojianzhong Tang (Minor Construct the Middle Decoction). Shaoyao is sour and cold, primarily governing astringency and tonifying the Middle Jiao. Following the principle that "what belongs to Earth tends toward the Lower," Shaoyao serves as the Jun herb; Guan Gui (Cinnamomi Cortex) and Gancao serve as Chen herbs assisting it. The former treats exterior deficiency, the latter treats interior deficiency, each stating its primary function. Those who use ancient formulas in later generations, if they can extend knowledge by analogy, will understand the original intent and avoid errors.

In the sixth month of Gengchen year of the Yuan Dynasty, Xu Bowei was forty-four years old. His Zhong Qi (Middle Qi/Spleen-Stomach Qi) was inherently weak. He had suffered from Shanghan (Cold Damage) for eight or nine days. The physician, seeing severe heat, administered cooling purgatives. Additionally, he ate three or four pears, injuring the Spleen and Stomach. Symptoms included cold limbs, frequent mental confusion, and lethargy. I was invited to treat him. Palpation revealed a pulse that beat but occasionally stopped, sometimes recovering on its own; this is a Jie Pulse (Knotted Pulse). There was also palpitations (Xin Dong Ji), incessant hiccups and belching, a complexion of greenish-yellow, reduced spirit, unwillingness to open the eyes, fatigue and desire to lie down, and aversion to hearing people speak. I treated him with Zhigancao Tang (Honey-Pounded Licorice Decoction). Cheng Wuji stated: "Tonification can remove weakness. Renshen (Ginseng Radix et Rhizoma) and Dazao (Ziziphi Jujubae Fructus) are sweet and tonify deficient Qi. Guizhi and Shengjiang (Zingiberis Rhizoma Recens) are pungent and benefit righteous Qi. With atrophy and weakness of the five Zang organs, and exhaustion of Ying and Wei circulation, moistening agents are used. Mahuang Ren (Arillused Semen Armeniacae Amarum), Ejiao (Colla Corii Asini), Maimendong (Ophiopogonis Radix), and Dihuang (Rehmanniae Radix Preparata) are sweet, moistening the meridians and benefiting blood, restoring the pulse and unblocking the Heart. Adding Guizhi and Renshen urgently supports righteous Qi; reducing Shengdihuang (Rehmanniae Radix) avoids damaging Yang Qi." The herbs were chopped and one liang dose was decocted and taken, but there was no effect. I reconsidered whether the pulse and disease matched, wondering if the herbs were stale and ineffective. I went again to the market, selected herbs with strong aroma and flavor, and decocted them again. After taking the medicine, the illness decreased by half; after another dose, he recovered. Generally speaking, herbs and insects grow in specific places, and their roots, leaves, flowers, and fruits are harvested at specific times. Losing the proper place causes slight differences in nature and flavor; losing the proper time results in incomplete aroma and flavor. Moreover, fresh and old materials differ, and refined and coarse qualities vary. If not carefully selected and used, and treatment fails, it is the physician's fault. The Neijing states: "Prepare substances according to the annual climate to obtain the essence of their aroma and flavor." During processing and compounding, one should pay close attention.