Library

Zhao Yangkui stated: Yang commands Yin, and blood follows Qi. In ancient times, treating blood disorders required first regulating Qi; in cases of blood loss with Qi collapse, tonifying Qi was prioritized, hence the theory that "tonifying blood does not necessarily rely on Siwu Tang (Four Substance Decoction)." For example, in cases of blood deficiency causing fever, the Buxue Tang (Blood Tonifying Decoction) was created, using Huangqi (Astragali Radix) as the sovereign drug at one liang, and Danggui (Angelicae Sinensis Radix) as the minister drug at four qian. With more Qi-tonifying herbs than Blood-nourishing ones, the aim is to generate Yang so that Yin may grow. Similarly, in cases of massive hemorrhage where life is critically endangered, Dushen Tang (Single Ginseng Decoction) of one liang is decocted and taken in one dose, using purely Qi-tonifying herbs. At this moment, tangible blood cannot be generated quickly, but the slightest trace of Qi must be urgently secured, allowing the intangible to generate the tangible. This reflects the subtlety of Yin and Yang, which originally stems from non-being. Thus it is said: "The nameless is the beginning of heaven and earth."

Spring and autumn, day and night, are the gates of Yin and Yang. The twelve two-hour periods correspond to the Yin and Yang of the five Zang organs. Physicians rely entirely on this to understand the root of disease and apply appropriate treatments. Among these, the Winter Solstice and Summer Solstice are most critical. "Solstice" means extremity. When Yin reaches its extreme, Yang is born; life emerges from death, and being arises from non-being. When Yang reaches its extreme, Yin is born; being returns to non-being. This is the difference between Yang transformation and Yin change. However, particular emphasis is placed on the Winter Solstice. One might ask: At the Winter Solstice, when one Yang is born, conditions should gradually become warmer. Why does severe cold occur, with ice and snow intensifying? At the Summer Solstice, when one Yin is born, conditions should gradually cool. Why does muggy heat occur, with scorching heat intensifying? Is there an explanation? The answer is: This follows the principle that what is coming advances, and what has succeeded retreats. In the subtle and hidden stages, this is not easily understood. When Yang hides below, it forces Yin upward, similar to well water vaporizing while solid ice forms. When Yin is born below, it repels Yang upward, similar to well water becoming cold while thunder and lightning combine. Today, patients present with red faces, thirst, irritability, wheezing, and coughing. Who would not say this is extreme fire excess? Yet who knows it is actually forced by kidney Yin-cold? Many have died from administering cooling medicines. Those discussing Yin and Yang mention Qi and Blood, which is correct. But do they know that Fire is the root of Yang Qi, and Water is the root of Yin Blood? Observing heaven and earth, the sun is the essence of Fire, so Qi follows it; the moon is the essence of Water, so tides follow it. However, this Yin-Yang and Water-Fire originate from the same root, flowing endlessly, paired yet inseparable. Because they share one root and do not separate, Yin and Yang each serve as the root for the other: Yang roots in Yin, and Yin roots in Yang. Without Yang, Yin cannot be generated; without Yin, Yang cannot transform. One draws Yin from Yang, and Yang from Yin. Each seeks its belonging and traces its root. People only know that Water and Fire are Yin and Yang, but do not know that Water and Fire are the roots of Yin and Yang. Even those who know Water and Fire are Yin and Yang often mistakenly identify Heart and Kidney as the true embodiment of Water and Fire. This is why the Dao remains obscure and unpracticed.

Yin and Yang are abstract names; Water and Fire are physical realities; Cold and Heat are excessive atmospheric influences; Water and Fire are the true Yuan Qi of humans. Diseases caused by excessive atmospheric influences can be attacked with Cold or Hot medicines. Diseases caused by disturbances of true Yuan Qi should be regulated by the true properties of Water and Fire. If one does not seek their proper belonging, the medicine will not enter the channels. Primordial Water and Fire originally belong to the same palace. Fire takes Water as its master, and Water takes Fire as its origin. Therefore, when seeking Yin, one seeks Water within Fire, ensuring the essence does not deplete; when seeking Yang, one seeks Fire within Water, ensuring the light does not extinguish. Thus, diseases of extreme Cold and Heat can be balanced. Those with constitutions biased toward Cold or Heat cannot comprehend this.

Earth and Metal parasitically grow from their mother organ. Therefore, to tonify Earth and Metal, one must tonify the mother from the place of parasitic growth. Hence, Li Dongyuan's "Treatment Separated by Two Organs" involves tonifying the mother; his "Treatment Separated by Three Organs" involves the mother's extended family. Because Earth and Metal are parasitic, their death is true death. Only Water and Fire are born from the True, so their death is not true death; they find life in despair. Thus, among the Five Elements, I alone emphasize Water and Fire, and their subtle interactions of generation and restriction stem from the primordial root, differing from worldly theories.

Wang Zhongxuan said: When Wind disease reaches its extreme, it resembles Dryness-Metal patterns, presenting with wrinkled, peeling, dry, and astringent skin. When Heat disease reaches its extreme, it resembles Cold-Water patterns, presenting with shivering and cold limbs. When Earth disease reaches its extreme, it resembles Wind-Wood patterns, presenting with damp stagnation and heat eruption. When Metal disease reaches its extreme, it resembles the Two Fires (Heart Fire and Ministerial Fire), presenting as Sanxiao (Wasting-Thirst), carbuncles, ulcers, and sores. When Water disease reaches its extreme, it resembles Damp-Earth patterns, presenting with edema of the feet and flesh rotting. Thus, tracing from root to branch reveals the source; tracing from branch to root reveals what it bears. Only then can a physician avoid confusion by symptoms, and a patient avoid confusion by drugs, allowing discussion of treatment.

Hua Borun said: Jueyin and Taiyang meridians have little Qi and much Blood; Taiyin and Shaoyin meridians have little Blood and much Qi; Yangming has abundant Qi and Blood; Shaoyang has much Qi and little Blood. Both men and women possess these Qi and Blood dynamics. Men use Qi more, so Qi is often deficient; women use Blood more, so Blood is often deficient. Therefore, men's diseases mostly reside in the Qi level, while women's diseases mostly reside in the Blood level. The secular view that men have much Qi and women have much Blood is absurd.

Yu Jiayan said: When a disease manifests with excess, it inevitably affects other Zang organs and Qi mechanisms; it is best to treat the root first to prevent invasion into other Fu organs or Qi levels. When a disease manifests with deficiency, it is inevitably affected by other Zang organs and Qi mechanisms; it is best to treat the branch first to prevent further damage to the root organ.

Spring growth is based on Winter storage; Summer growth is based on Spring growth; this applies to all seasons. Thus, if Winter storage fails, Spring growth cannot arrive; if Spring growth fails, Summer growth cannot arrive. Not understanding the timing of nature means not knowing how to nourish and store; from where can the path of health preservation be remedied?

Nan Jing (Classic of Difficult Issues), Chapter 22, states: The classics speak of "Is Dong" (Movement) diseases and "Suo Sheng Bing" (Generated) diseases, where one meridian transforms into two diseases. The meaning remains unclear. I say: This discusses the sequence of diseases governed by Ying (Nutrient) and Wei (Defensive) Qi. One meridian transforming into two diseases refers to the same meridian manifesting two types of pathology due to different depths. When pathogenic factors enter shallowly, Qi stagnates and fails to circulate, so Wei Qi is diseased first. As pathogens penetrate deeper, Blood becomes obstructed and fails to nourish, so Ying Qi is diseased. Thus, Ying Qi disease occurs after Wei Qi disease. If Wei Qi did not first exhibit "Is Dong" pathology, how could Ying Qi subsequently exhibit "Suo Sheng Bing" pathology?

Zhu Danxi said: Human Fire can be subdued by dampness or extinguished by water; various bitter-cold herbs can drain excess Fire. Dragon-Lei Fire flares up when encountering dampness and burns brighter with water; it is extinguished only by sunlight. Guizhi Tang (Cinnamon Twig Decoction) and Fuzi (Aconiti Lateralis Radix Praeparata) control Ministerial Fire. Fire in a well burns hotter when water is added but is extinguished by soil; this is also Yin Fire.

Su Wen (Plain Questions) states: For conditions where cold treatment fails to resolve heat, treat the Yin; for conditions where heat treatment fails to resolve cold, treat the Yang. This is called "seeking their belonging." Wang Taipu said: "Tonify the source of Fire to dissipate Yin shadows; strengthen the master of Water to control Solar brightness." In cases where cold treatment fails to resolve heat, people only know to use cold to treat heat, unaware that persistent heat stems from insufficient True Water. In cases where heat treatment fails to resolve cold, people only know to use heat to treat cold, unaware that persistent cold stems from insufficient True Fire. Therefore, treating the Yin aims to supplement insufficient Kidney Water to control excess Heart Fire; treating the Yang aims to supplement insufficient Heart Fire to overcome excess Kidney Water. "Belonging" is determined by the "Master." Seeking belonging means addressing deficiencies of Water and Fire by targeting the Heart and Kidneys.

Zhang Sanxi said: Prolonged Qi stagnation injures Middle Qi; attacking methods are contraindicated. Instead, tonify the Middle and Qi, assisting with Qi-moving herbs like Chuanxiong (Ligustici Chuanxiong Rhizoma) and Xiangfu (Cyperi Rhizoma). Additionally, Nan Jing states: Blood provides nourishment; Qi provides warmth. For all Qi disorders, if Qi-moving herbs fail, adding small amounts of Xiong (Chuanxiong) and Gui (Danggui) to move Blood can cure the condition; this has been repeatedly verified.

After blood loss, if high fever, great thirst, and fever appear resembling Baihu Tang (White Tiger Decoction) syndrome, the distinguishing feature is a large but empty pulse that does not persist. Misusing cooling agents will cause death. Use Danggui Buxue Tang (Danggui Tonifies Blood Decoction), comprising Huangqi (Astragali Radix) one liang and Danggui (Angelicae Sinensis Radix) five qian. Generally, post-illness coughing and hemoptysis with a large and knotted pulse indicate injury to the Yang collaterals of the Upper Jiao; lower bleeding or hematuria indicates injury to the Yin collaterals; both are fatal.

When Blood fails to return to its origin, blame is placed on Stomach Cold. If cooling medicines repeatedly fail, equal parts of Zhi Gancao (Prepared Glycyrrhizae Radix) and Pao Ganjiang (Prepared Zingiberis Rhizoma) can guide Blood back to its source, yielding wonderful results.

Xue Lizhai said: For anyone suffering from dietary irregularities, overwork, or improper living habits, any apparent Fire symptoms belong to internal True Cold and external False Heat. Thus, the abdomen prefers warmth and is comforted by hot hands pressing on it, while the mouth fears cold substances. Since both Form-Qi and Disease-Qi are deficient, the method must focus purely on tonifying Original Qi.

After middle age, swelling around the teeth is due to Qi deficiency causing Fire to float upward; tonifying the Middle resolves it naturally.

Han Feixia said: For Lung Qi deficiency causing cough and spontaneous sweating, with a slow pulse and poor appetite, one should first tonify the Spleen. This is the principle of "tonifying the mother when deficient."

Zhang Sanxi said: Cases of tidal fever resembling deficiency, with chest oppression and back pain, which do not respond to tonics, are Phlegm disorders. Tidal fever follows Qi movement, so heat accompanies fluid retention. Treatment should target Phlegm-Fluids.

Danxi said: When Yang is vigorous, it generates Yin. After blood loss, Ren Shen (Ginseng Radix), Shu Dihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), and Dihuang (Rehmanniae Radix) should be used for major tonification. If delayed for a long time, Deficient Fire damages the Lung, making such tonification difficult.

In summer, irritability and thirst should not be immediately attributed to Summerheat, nor treated with Xiangru (Elsholtziae Herba) or Yiyuan San (Benefit Origin Powder); careful consideration is needed. If the pulse is large and empty, accompanied by spontaneous sweating, irritability, and thirst, following strenuous travel, without exposure to cold or sexual exhaustion, it may be treated as Summerheat.

Li Shicai said: To rescue the Kidney, one must base treatment on Yin Blood. Blood is Yin, governing descent; when deficient, it floats upward, requiring astringency and suppression. To rescue the Spleen, one must base treatment on Yang Qi. Qi is Yang, governing ascent; when deficient, it sinks downward, requiring lifting and raising.

For consumptive diseases approaching death, Dushen Tang (Single Ginseng Decoction) has great power and can be relied upon. Thus, in tonifying Yin, Zhu Danxi's cases of treating consumption used Ginseng in seven out of ten instances. Ge Kejiu's famous prescriptions for treating consumption also utilized Ginseng in seven out of ten cases. Since Hao Gu's theory of Lung Heat damaging the Lung and Jiezhai's warning that Ginseng causes death have fixed later generations' perspectives, many willingly use bitter-cold herbs until death, which is truly lamentable. One must realize that if the Lung channel itself has heat, indicated by a solitary excess pulse, Ginseng is indeed inappropriate. However, if Metal is overwhelmed by Fire, the Lung is depleted, and only Ginseng can save it.

Kidney Yin deficiency leads to failure to store Essence; Liver Yang hyperactivity leads to failure to secure Qi, because the Kidney governs closure and storage, while the Liver governs dispersion and flow.

There is no backward-flowing water in the world, and no upward-flowing Phlegm in the human body. Therefore, skilled physicians treat Qi rather than Phlegm directly. When Qi flows smoothly, body fluids follow Qi smoothly.

There is no other method to treat Phlegm than strengthening the Spleen; there is no other method to strengthen the Spleen than removing Dampness. When Dampness is removed, the Spleen strengthens naturally; when the Spleen strengthens, Phlegm dissipates naturally. This is the method of treating deficiency and addressing the root. There is no other method to treat Phlegm than clearing Fire; there is no other method to clear Fire than smoothing Qi. When Qi descends, Fire clears naturally; when Fire clears, Phlegm transforms naturally. This is the method of treating Phlegm and addressing the branch.