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Regarding the disease known as "Hongxiang Jiao" (a condition characterized by swelling, pain, weakness, or numbness in the feet), there was no specific name for it since ancient times. It was first recorded by Su Jing of the Jin Dynasty. Its symptoms include headache, aversion to cold, and fever, resembling Taiyang Bing (Taiyang Disease) [Taiyang Disease: a syndrome caused by pathogenic factors affecting the Taiyang meridian], but the illness originates with swelling and pain in the feet and knees, which differs from Taiyang Bing. If rebellious Qi moves upward, resembling Feng Jue (Wind Reversal) [Wind Reversal: a condition where Qi rebels upward causing dizziness or fainting] with severe pain, even leading to syncope, this differs from Wind Reversal. If both legs are weak and flaccid, resembling Wei Bi (Flaccidity and Obstruction) [Flaccidity and Obstruction: syndromes involving muscle weakness and painful obstruction], with intermittent onset and pain confined only to the feet, this differs from Wei Syndrome (which leads to permanent disability once manifested) and Bi Syndrome (where pain location is不定/unfixed). The cause of this disease often stems from consuming rich wines and liquors, allowing damp-heat to ascend and then descend; or from treading on cold water and mud, allowing clear dampness to rise from below. When these two types of dampness interact, it is named Yong Ji (Stagnation Disease) [Stagnation Disease: a disease caused by pathological stagnation].

Since Li Dongyuan proposed that Southern Hongxiang Jiao, caused by external invasion of clear dampness, should be treated as a cold pattern, while Northern Hongxiang Jiao, caused by internal injury from wine and dairy, should be treated as a damp-heat pattern, later practitioners became rigidly attached to these views, forming Northern and Southern schools. They held conflicting执念 (obsessions), failing to realize that even if the North lacks low-lying damp terrain, exposure to rain and dew, stepping in sweat, or removing boots/shoes while sweating and being exposed to wind can cause blood coagulation in the feet. Is this not similar to the dampness of the South? All such cases belong to external invasion. Even if the South lacks dampness from dairy products, excessive food intake combined with transmission from Zang-Fu organs, where fluids and grain residues accumulate in the middle and descend, is this not similar to the dampness of the North? All such cases belong to internal injury. If scholars can apply these principles flexibly and comprehensively, they will handle ten thousand situations correctly.

As for the *Zhi Yao Da Yao Lun* (Treatise on the Great Essentials of Direct Principles) listing nineteen pathogenesis mechanisms, it omitted Dryness (Zao) patterns because Dryness often combines with Wind-Heat transformation. Thus, it only mentioned Wind-Heat, implying Dryness within it. Liu Hejian specifically supplemented this meaning in his work *Yuan Bing Shi* (Original Causes of Diseases), yet the meanings were not fully elucidated. I dare to elaborate further. Regarding Dryness combining with Wind transformation: The Classics state, "Wind can overcome Dampness; when Dampness is removed, Dryness naturally arises." Initially, excessive Wind causes Dryness to affect the Lung (Metal), resulting in excess Wood Qi insulting its unconquered element (Metal), making Metal more susceptible to evil. Subsequently, excessive Dryness affects the Liver (Wood), causing Wood Qi to become hyperactive and harmful. The controlling element (Metal) retaliates against the excess Wood. Consequently, symptoms such as stiff sinews and tendons, trismus (lockjaw), wind-induced epilepsy, dry scaly skin, and rapid contraction arise.

Regarding Dryness combining with Heat transformation: Heat is Fire. The *I Ching* states, "Nothing dries things more than Fire." Initially, depletion of True Yin leads to Fire that overcomes Metal, forming Dryness. Once Metal is diseased, it cannot generate Water to control Fire, exacerbating Dryness. Symptoms include polyphagia (excessive hunger), dysphagia (difficulty swallowing), gastric dryness, constipation, urinary retention, and signs of intense dryness and withering. Heat generates Wind, Wind generates Dryness, and Dryness generates Heat, creating a cycle of mutual overcoming and retaliation. When marrow and fluids are completely depleted, it is evident that Dryness is not a minor ailment.

Causes of Dryness include: External factors such as Yangming Dryness Metal ruling the year with strong Dryness transformation; or prolonged labor under wind and sun, frequently near fire and dryness. Internal factors include unregulated Seven Emotions, damaging Spirit and depleting Blood; or excessive purging, sweating, and vomiting during serious illnesses, leading to loss of body fluids. Neither-internal-nor-external factors include excessive consumption of pungent and hot foods, inappropriate use of warming tonics for deficiency-wasting diseases, or taking mineral medicines that induce Dryness. All these theories lead to extreme Heat generating Wind, Wind and Fire fanning each other, latent Fire within Yin, and boiling body fluids, deepening the Dryness pattern.

Therefore, Dryness on the exterior causes wrinkled skin, itching, sores, and brittle nails; Dryness in the Middle Jiao causes dry Spleen and Stomach and polyphagia; Dryness in the Upper Jiao causes nasal dryness and throat dryness; Dryness in the Lower Jiao causes difficult defecation and urinary retention. Combined with Heat, it causes flaccidity of hands and feet; combined with Wind, it causes spasms and epilepsy. Deficiency with Dry-Heat leads to consumptive cough; Excess with Dry-Heat leads to mania; with Phlegm and Food retention, it leads to dysphagia. The method for treating Dryness should observe the principle of a boiling cauldron: Blood is like the soup/water, Qi is like the fire. If the fire is fierce and the soup boils vigorously, one must add water to extinguish the fire to prevent exhaustion. This is akin using bitter-cold herbs like Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), Shi Gao (Gypsum Fibrosum), Pu Xiao (Natrii Sulfas), and Da Huang (Rhei Radix et Rhizoma) as symptomatic treatments to clear and descend Fire, preventing Blood from weakening and Dryness from worsening. If the pot has boiled for too long and is nearly dry, one must add fresh water to overcome the fire. This is akin using sweet-cold and sweet-warm herbs like Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Radix), Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Bai Shao (Paeoniae Radix Alba) as root treatments to tonify Qi and Blood, moistening Dryness and restraining Fire.

Ancient sages said, "Do not treat Wind, do not treat Dryness; when you treat Fire, Wind and Dryness are resolved." However, are there no Cold-Dryness patterns? I examined *Yi Lei Yuan Rong*, which lists five methods for treating Dryness: In the North, the pulse is slow, indicating Cold-Dryness, suitable for warm-hot herbs like Gui Zhi (Cinnamomi Ramulus), Fu Zi (Aconiti Lateralis Radix Praeparata), Liu Huang (Sulfur), Gao Liang Jiang (Galangal Rhizome), and Ba Dou (Crotonis Fructus). Thus, Dryness also combines with Cold. Zhang Jingyue discussed Xiao Ke (Wasting-Thirst) saying: "If Yang prevails, it consumes Yin; can Yin prevailing not consume Yang?" The Classics state: "Transferring Cold to the Lung creates Lung Xiao (Lung Wasting-Thirst); drinking one unit and urinating two units is a fatal, untreatable condition." Yet, I used Ba Wei Wan (Eight-Ingredient Pill) and Gui Pi Tang (Restore the Spleen Decoction) to cure an official. Similarly, for dry fecal impaction, some cases stem from Zang Cold causing Blood枯 (withering) and Qi stagnation due to cold, presenting with poor appetite and faint pulse, classified as Yin Constipation. These are treated with Ban Liu Wan (Half-Sulfur Pill) or Xiang Fu Tang (Cyperus Decoction). Since Xiao Ke and constipation are major Dryness patterns, and some belong to Yin-Cold, Hai Zang's (Zhang Yuansu's) statements are not far-fetched. Understanding common sense and adapting flexibly leads to infinite subtlety, ensuring one does not fail in their duty as a guardian of life.