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Wang Andao stated: In the *Huangdi Neijing* (Yellow Emperor's Inner Canon), the Yellow Emperor asked: How should severe cases of Yu syndrome (Stagnation) be treated? Qibo replied: For Wood Yu, promote its flow; for Earth Yu, attack and drain it; for Metal Yu, vent and release it. The total thirteen sentences form one chapter, which should be divided into three sections. From "Fire Yu" to the preceding nine sentences constitute one section, representing the dialogue on treating Yu. However, "Regulate its Qi" constitutes one section, which is a supplementary method after treating Yu. The three sentences "Excess should be suppressed, using that which it fears, as mentioned in 'draining'" constitute one section, which is a supplementary method after regulating Qi. Although these five methods were established by the classic for diseases caused by stagnation of the Five Movements (Wu Yun), they can certainly be expanded and applied broadly. Moreover, most diseases arise from stagnation; "Yu" implies stagnation and obstruction. Some stagnations occur due to pathogenic factors taking advantage of weakness, while others result from the intrinsic Qi of an organ stagnating without external invasion; both are considered Yu. Since Yu is not strictly confined to changes in the Five Movements, the methods of promoting flow, dispersing, attacking/draining, venting, and suppressing can naturally be expanded and applied.

For Wood Yu, "promoting flow" means ensuring smoothness and unobstructed movement. For instance, if the Liver nature is urgent, anger causes Qi rebellion, leading to distension or fullness in the hypochondrium, with fire flaring up frequently, and bitter-cold and acrid-dispersing herbs fail to cure it, then use ascending and dispersing herbs, combined with guiding herbs for the Jueyin channel, to treat it by following its nature. Similarly, if long-standing wind enters the interior causing undigested food diarrhea, or if clear wind resides below causing such diarrhea without external wind invasion, use light and ascending agents to raise and disperse it. All such cases illustrate the method of "promoting flow." Wang Lu interpreted "promoting flow" as inducing vomiting to achieve smoothness, equating "vomiting" with "flow," implying that all Wood Yu should be treated with emesis. Is this acceptable? Regarding Li Dongyuan's statement that food blockage in the Taiyin Spleen causes Metal Qi to flourish and overcome Wood, this is injury by foreign matter; how could it cause Metal to flourish? If vomiting is used to extend Wood Qi, it treats Wood Yu rather than food injury. Furthermore, using emesis for food blockage in the chest aligns with the *Neijing* principle "where it is high, induce vomiting." It is unnecessary to invoke the theory of Wood Yu to explain this.

For Fire Yu, "dispersing" means sweating and raising Yang. For example, when pores are closed and pathogenic heat is constrained internally, resolve the exterior and induce sweating to disperse it. Or, when Dragon Fire (mineral fire) is severely constrained within, bitter-cold sinking agents cannot treat it. Instead, use ascending and floating herbs assisted by sweet-warm herbs, following its nature to treat it, stopping when the pathogenic force is exhausted, such as in Li Dongyuan's *Shengyang Sanhuo Tang* (Ascending Yang and Dispersing Fire Decoction). These all exemplify the method of "dispersing."

For Earth Yu, "attacking/draining" means purgation and forcibly reducing its strength. For instance, if pathogenic heat enters the Stomach, use salty-cold agents to purge and eliminate it. If there is abdominal fullness and distension with intense internal heat, and the patient has robust Qi and excess condition, apply purgation. If the pathogenic force is too strong to be cleared at once, forcibly reduce its momentum to weaken it. For dysentery caused by damp-heat, where mild agents are ineffective, use purgation or forcible reduction to restore balance. These all exemplify the method of "attacking/draining."

For Metal Yu, "venting/releasing" means promoting diuresis and unblocking Qi. For example, Lung Metal is the source of Kidney Water. If Lung Metal is scorched by fire, its functions fail, original Qi stagnates, and the water passages close. One should regulate Lung transformation and moisten to facilitate flow. If Lung Qi is excessive, causing chest oppression and orthopnea (difficulty breathing while lying flat), only Lung-Qi-regulating agents can effectively unblock it. These all exemplify the method of "venting." Wang Lu argued that including "resolving the exterior" between "promoting diuresis" and "benefiting urination" splits them into two treatments, which is illogical and should be deleted.

For Water Yu, "suppressing" means controlling, attacking, and gradually weakening its momentum. For edema diseases where Water Qi overflows and blocks the water passages, since Earth controls Water, but now Spleen Earth Qi is weak and fails to control Water, resulting in Water insulting Earth, treatment should tonify Spleen Earth and support its transportation and transformation, enabling it to control Water so it dares not invade, allowing water passages to open before recovery. If the disease is too advanced for these methods to quickly control, use water-draining drugs to attack and suppress, or employ the three methods of "removing accumulation," "opening the ghost gate" (sweating), and "purifying the hollow organs" (urination), selecting appropriate ones to gradually calm the condition. Wang Lu criticized suppressing rebellious Qi as a water-treatment method, stating that failing to assess deficiency/excess, duration, and depth leads to reckless treatment and frequent death.

However, prolonged pathogenic presence damages righteous Qi. Even after pathogens are removed, can righteous Qi recover immediately? Without harmoniously regulating righteous Qi to restore its position and normal state, the subtleties of treatment are incomplete. Hence, "regulate its Qi." If regulation leaves Qi still excessive and unruly, tonify what it fears (its controller) to suppress it. For example, if Wood is excessive, tonify Metal to subdue Wood. What is feared is the controller; thus, "excess is suppressed by what it fears." Things are pleased when their desires are met and displeased when thwarted. By thwarting with what it dislikes, it is called "draining." Wang Lu did not fully grasp this intent, so I elucidate it. Practical application may vary.

Zhu Danxi said: Yu syndrome is accumulation without dispersion; what should ascend does not, what should descend does not, what should transform does not. There are six types of Yu: Qi, Dampness, Phlegm, Heat, Blood, and Food. Qi Yu presents with chest and hypochondriac pain, deep-choppy pulse. Dampness Yu presents with wandering body pain or joint pain, worsening in cold-damp weather, deep-thin pulse. Phlegm Yu presents with panting upon exertion, deep-slippery pulse at Cun Kou. Heat Yu presents with stifling sensation, red urine, deep-rapid pulse. Blood Yu presents with limb weakness, ability to eat but bloody stools, deep pulse. Food Yu presents with belching sourness, abdominal fullness, inability to eat, peaceful Ren Ying pulse, tight-full Qi Kou pulse. Cangzhu (Atractylodis Rhizoma) and Fuxiong (Chuanxiong Rhizoma) generally resolve various Yus, with additions based on symptoms. For Yu in the Middle Jiao, use Cangzhu and Fuxiong to lift Qi; if food stagnation is above Qi, lifting Qi will cause food to descend. Another formula: Qi Yu uses Xiangfu (Cyperus Rhizome), Cangzhu, Fuxiong; Dampness Yu uses Baizhi (Angelicae Dahuricae Radix), Cangzhu, Fuxiong, Fuling (Poria); Phlegm Yu uses Haishi (Fossilia Arthropodi), Xiangfu, Nanting (Arisaematis Cum Bile), Gualou (Trichosanthis Fructus); Heat Yu uses Shanzhi (Gardeniae Fructus), Qingdai (Indigo Naturalis), Xiangfu, Cangzhu, Fuxiong; Blood Yu uses Taoren (Persicae Semen), Honghua (Carthami Flos), Qingdai, Xiangfu, Chuanxiong; Food Yu uses Cangzhu, Xiangfu, Shanzha (Crataegi Fructus), Shenqu (Massa Medicata Fermentata), Zhensha (Magnetitum) stir-fried seven times in vinegar. All utilize Yueju Wan (Yueju Pill) to resolve various Yus.

Wang Jiezhai said: Mr. Danxi’s treatment focuses on Blood, Qi, and Phlegm, so the key medication principles are three: Qi disorders use Sizijunzi Tang (Four Gentlemen Decoction), Blood disorders use Siwu Tang (Four Substances Decoction), Phlegm disorders use Erchen Tang (Two Aged Decoction). He also stated that chronic diseases belong to Yu, establishing Yueju Wan for treating Yu. Since Qi, Blood, and Phlegm disorders often involve Yu, or Yu leads to disease, or disease leads to Yu, or mismedication causes Yu, I always incorporate Yu-methods when using these three formulas. Thus, these four methods represent the major principles of medication.