解放后，先生精神振奋，政治热情很高，全力以赴地投身于工作。他极力拥护党的中医政策，力主中西医互相学习，互相团结，互相结合。于一九五二年受到毛主席接见之后，曾写信给毛主席。信中有云：医之活人，何分中西，存心一也，但其理法不同耳。今逢毛主席洞察其旨，发扬数千年之文化，何幸如之。愿努力发挥，以期理法臻于至善，达于全球，使病者有所依，必先从教育人才始。先生的心愿得到了毛主席的支持。先生生前参与中央领导同志的医疗保健工作，辛勤努力，获得高度评价，故又曾多次受到周总理的接见。先生尝以诊务过忙，无暇著述，不克将经验心得总结出来，公诸于世，贡献给人民，颇引以为憾。故在晚年常深夜执笔，其遗稿如《脏腑发挥》、《时斋医话》等，皆此时所留。一九五五年三月十日出诊之中，忽觉腹痛寒战，勉力把六位病家诊毕，思回寓所调治恢复，讵料从此病势日益加重。先生自知不起，遂对亲属谆谆嘱咐；儿孙弟子等，凡从我学业者，应尽其全力为人民很好服务，以亟我未尽之志。十一月二十三日先生不幸故去，享年七十一岁。先生逝世后，周总理亲任治丧委员会主任委员，并亲往寓所吊唁。对于先生辛勤的一生，党和政府给予了崇高的荣誉。
强调辨证，以保护元气为主
先生主张：中医在临床上不能见病不见人，即不能见树不见林，而应从人出发，照顾到病人的整体。先生特别强调元气在人体所起的重要作用。他认为《内经》所谓邪之所凑，其气必虚及精神内守，病安从来这两句话，就是指病邪之能使人体发病，都是由于人身元气不足的缘故，若人体本身自卫的元气很充足，病邪就不足为患。所谓乘虚而入，无虚则病邪何从而入乎?是故元气充足，内腠闭拒，虽大风苛毒，弗之能害。
先生在辨证论治方面，力主医之治病，首先在于认证；将证认清，治之则如同启锁，一推即开。认证之法，先辨阴阳，以求其本，病本既明，虚实寒热，则迎刃而解。他强调阴阳为两纲，表、里、虚、实、寒、热为六要，不同意把阴、阳、表、里、虚、实、寒，热并列为八纲。他指出：辨证论治，全凭纲要。纲者两纲，曰阴曰阳，要者六要，曰表、里、虚，实、寒、热。徐灵胎言之綦详，亦即张景岳之所谓两纲六变者也。人之疾病，千变万化，但总不外乎阴阳，故医者临证，必须先审阴阳，因为病因证脉与药皆有阴阳。阴阳既明怡自无讹。其间且有错综现象,阴中有阳，阳中有阴，二者相间，彼此多少，疑似之间，更须明辨。具体一个病进而求之，则疾病之部位亦存在表里，正邪之消长与虚实若何?若论疾病之征象自有寒热之分，但其间情况复杂，如由表入里，由里达表，寒热错综，虚实互见等，必须审慎辨识。总之，表、实、热三者，概于阳；里、寒、虚三者，可概于阴。故阴阳者，医道之总纲领也。至于六要者，病变之关键也。医者既须提纲挈领，又要把握关键，则病无遁情，了如指掌矣。辨证既明，论治用药更应详酌，故有时参、术、硝、黄，俱能起死，芩、连、姜、附，尽可回生。喻嘉言尝谓：医不难于用药，而准于认证。故必先议病，而后议药。朱丹溪亦主张：认证为先，施治为后。若但知以执某方治某病，不论因时、因地、因人,不审何脉、何因、何证，是冀病以就方，非处方以治病。辨之不明，焉能用之无误?施治之妙，实由于辨证之准确。寒、热、虚、实，不昧于证，而又不惑于证；汗、吐、下、和，不违于法，而又不泥于法。否则疑似甚多，临证莫决，见病治病，十难效一。先生非常推崇徐灵胎氏《病因人异论》中的论述。徐灵胎云：天下有同此一病，而治此则效，治彼则不效，且不惟无效而反有大害者，何也?则以病同而人异也。夫七情六淫之感不殊，而受感之人各殊。或气机有强弱，质性有阴阳，生长有南北，性情有刚柔，筋骨有坚脆，肢体有劳逸，年力有老少，奉养有膏粱藜藿之殊心境有忧劳和乐之别。更加天时有寒暖之不同，受病有深浅之各异，一概施治，则病情虽中，而于人之气体迥乎相反，则利害亦相反矣。故医者必细审其人之种种不同，而后轻重缓急，大小先后之法因之而定。
先生深韪是论，在临床上切实遵守，并加以发扬光大之。先生确信：无论祛邪与扶正，都是为了达到恢复和充足元气的目的。至于祛邪扶正之孰先孰后，那就必须在辨证之时，参机应变了。先生说:邪之与正，二者并重，扶正可以祛邪，祛邪即可安正，是互为因果者也。而孰先孰后，则必须因人、因地、因时而施，绝不可先有主见。固然经有邪气盛则实，精气夺则虚之明训，示人正气之虚，是由于被邪劫夺，倘不被劫夺，正气无由致虚；其所以被劫夺者，系于邪气之盛。此时，若直捣巢穴，扫灭邪氛，使不再劫夺正气，其病自愈，亦即祛邪为重也。初病急病，诚可以一扫而痊，久病缓病，其人虚象毕露，则当顾其正气所谓养正邪自除，亦即扶正当先也。盖病有久暂不同、缓急之异，则祛邪与扶正之治，妙用在灵活：有宜急祛其邪而后调其正者，有宜先固其正徐退其邪者，有宜寓攻于补者，有宜攻补兼施者。似此轻重先后，当随证制宜，凡病皆应如此，则可不致拘执有偏耳。
熟悟经旨，不泥于古
先生主张，志于医者，首先应该熟读《内经》而后逐步细心参悟经旨。阅读诸家医论，一定要抱着实事求是的客观态度，掌握取长舍短，去芜存华的治学方法，力辟食古不化或断章取义。他反对妄用成方，说：兵刑杀人，显而易见，然用药误杀人，医者尚不自知，较之兵刑杀人者，更为险毒，尤有过而无不及者也，实可憾叹。不怪吴鞠通氏早有鉴于斯，并于《温病条辨》自序曰；呜呼!生民何辜不死于病而死于医，是有医不若无医也，学医不精，不若不学医也。朱彬氏亦有其死于病者十之二三，死于医者十之八九之论。如临床时所见热病无汗，而庸医妄称是足太阳表证，投以麻黄汤，服之汗出不止而殒者不鲜；更见风温、湿温证，动辄柴胡、升、桂、细辛、姜、附之风药升提，使伏热邪气不惟不能荡散，反陷入心包，无不神昏厥逆而毙，虽急投局方至宝丹、清营汤、紫雪丹等渝涤中宫而幸存生命者，亦不过百人中之一二而已。近又尝闻有人终日研究仲景之在汉时用药圭铢，折合今日分量若干，而照拟之于临床。用之得当功效立见，屡见不鲜，此用心良苦，非执一方而治一病，是知《伤寒论》乃东汉末方书，未必能与今日完全契合。盖因天时、地理、人体皆有变异故也。先生常说，他数十年来遍历大江南北，罕见因寒而伤之真伤寒病，盖阴阳循环，皆天地气运使然也。《内经》曰：必先岁气，毋伐天和。按今之甲子，运行后天，湿土主事，四序反常，阳亢阴虚，湿热彰盛，故辛温滋腻之品，实用之在所必慎，至中元甲子，后四十年，阴阳始能渐次互转。下元甲于，虽主阳虚，而辛腻之味，仍须审慎酌裁。朱丹溪宗经旨而阐发，创阴常不足，阳常有余之说，此非偶然或偏于一隅而立，实有至理存焉，夫茫茫尘世，疾患难测，医者若因所学不精，则不能随机应变，治之必乏于术矣。或殒其生，或待其毙，生民者不惟不能生，而反成害民者也。年复一年，枉死者何止几千万计。民生涂炭，宁不诫哉!
重视旰脾之关系
先生在对待肝脾之间的某些病机方面的认识上，就我们浅薄的理解，其至旨乃本风雨寒热，不得虚邪，不能独伤人，卒然逢疾风暴雨而不病者，盖无虚，故邪不能独伤人，此必因虚邪之风与其身形，两虚相得，乃客其形的经旨。指出内因是一切疾病发生和变化的基础。他既然强调正气存内，邪不可干，因而他认为正气受伤，才导致发病，也就是指两虚相得的内虚，是发生一切疾病的主要根据。至于使正气受伤的原因方面，他首先强调脾为后天之本，以及脾、胃、肝三者的相互关系，尤其重视脾和肝之间的生克制化关系，亦即土侮木(脾病可以传肝)与木乘土(肝病可以传脾)的关系。在他所著《脾胃病论》一文中说；脾象土而主肉(脾象土，主肌肉)藏意而恶湿(脾藏意与志，湿伤肉故恶湿)，寄在中央(中央黄色入通于脾，故曰寄在中央)，养于四旁(脾气散精以滋养南心、北肾、东肝、西肺，故曰养于四旁)，王于四季，正王于长夏。为统血之脏，而主四肢，思为其志，胃为其表，心是其母，足太阴是其经。饮食不节，劳而过倦，皆伤于脾。木气太过(肝气过盛)，克伤于脾，甘虽主之，过反伤脾。忧愁不解，亦足饬脾。脾伤则病遂乘之：脾经受湿郁热发黄；脾经受寒病苦注泄，脾太过则令人四肢不举，不及则令人九窍不通。尤于土败木贼，湿气留滞，七情内伤，六淫外袭，饮食不节，房劳致虚，脾土之阴受伤，转运之官失序，遂成胃虽纳谷，脾不运化，阳自升而阴自降，乃成天地不交矣。于是清浊相混，隧道壅塞，气留血滞，郁而不行，万病丛生之源也……又论胃曰：《灵枢·五味》曰：胃者五脏六腑之海也，水谷皆入于胃，五脏六腑皆禀气于胃。《素问·玉机真藏论》曰；五藏者皆禀气于胃，胃者五藏之本也。《素问·五藏别论》曰：胃者，水谷之海，六府之大源也。五味入口，藏于胃以养五藏气。因而知胃气乃人生之根本。胃气壮，则五脏六腑皆壮，身体各部亦无不壮，反之则五脏六腑及身体皆弱。是以《素问·平人气象论》有云：平人之常气禀于胃(平人之常气，即所谓有生之正气，谷入于胃，五脏六腑皆以受气，故曰平其所以平，赖有此气之禀于胃耳)，胃者平人之常气也。人无胃气曰逆。逆者死。《难经·十五难》曰：胃者水谷之海，主禀四时，皆以胃气为本，是谓四时变病，死生之要会也。足阳明是其经，与脾为表里一体。总此以现，胃乃重要脏器，宜如何慎宝之，自不待言。然人恒漠视，弗自珍重：外因则恣贪口腹，饮食不节，忽略卫生，内因则不自惩忿，激扰肝阳，动来乘土。遂致病态百出，此其大端也……先生在临床中特别注意湿和热两种邪气的轻重及其争峙的情况。他指出：数十年来临证中，湿家兼热致病者十有八九，此天地气运使然也。盖湿热之由来，乃木旺土衰，木气乘于土败而贼之所致者也。是以湿重则热增，湿蒸于中，热淫于内，湿愈重而愈生热，热愈重而湿愈生，湿热蒸腾，则邪为湿固矣，当今医者不可不察。并提出在脾、胃、肝相互关系的基础上脾湿和肝热是导致人体发生一切疾病的两大主要因素。基于以上所说，可以想见他对脾和胃、湿和热是如何重视。因此先生在临床辨证时，特别强调脾、胃和肝三者的结合。设若在此三者之间的某一环节上发生了故障，就会产生一系列的问题，亦即其所谓脾胃有病必系肝，肝病必系于脾胃者也。
在外感温热病方面，先生认为人体内的郁热伏气往往是感受温热病的先决条件。他说：夫外感温热病者，时或先赖于体内之郁热伏气，而后感于天地厉气淫邪而成，况乎六淫之风、寒、暑、湿、燥，五气皆可化火，然又皆附于风。风者四时皆有，善行而数变，百病之长也。然则《内经》有云：内腠闭拒，虽大风疴毒弗之能害。是以内因之郁热伏气乃外感温热发病之本也。叶香岩曰：温邪上受，首先犯肺。此时病邪在表，投以辛凉解表之轻剂即可迎刃而解，若郁热伏气盛，或初感解之未当，及误治误补使邪内陷者，亦可逆传心包，此时病已入里，投以辛凉祛邪之重剂即可效如桴鼓；若邪为湿困，热深厥亦深者，临证中反见阴象，此热极似寒之假寒者也，倘辨证不清，误用热药，必使立毙。然则只投凉化寒凝之品，不惟温热不得解，反使邪愈加闭固，轻者废，重则不治，此时当施以苦淡渗化湿邪之法，并以辛凉清热之物，佐芳香辛散之味，以攘开其湿邪外围，不使湿热相搏而直捣其巢穴，则固邪易解，热退厥除，病可瘥也。下面仅举三个病例以阐证其论。
例一，吴姓，女。初以内蕴湿热，寒热相搏，兼客外邪，遂致头痛，咳嗽，鼻塞声重，咽痛，口渴，发烧而恶寒，痰涎壅盛，大便结，舌苔黄腻，脉弦数。此温邪上受，首先犯肺者也，亟宜清热解表以肃肺络。
鲜苇根30克，生石膏(先煎)24克，银花、连翘、杏仁各9克，薄荷叶(后煎)，苏子霜各4．5克，条黄芩6克，板蓝根9克，辛荑花6克，全瓜萎18克，元明粉3克，鲜荷叶1张，紫雪丹(冲服)1．8克。
例二，刘姓，男。肝胃两阳并盛，内热兼感时邪，初起解之未当，遂致热邪内陷于心包。神昏，谵语，有时抽搐，壮热，口大渴思冷，二便失利，大便已七日未下，舌质红，苔糙垢，舌心根部有黑褐色苔，脉大而数，右寸关均盛，亟宜重剂辛凉芳化，佐以熄风。
生石膏(先煎)、鲜九节菖蒲根(捣汁兑入)、鲜茅根，鲜苇根各30克，莲子心6克，天竺黄、白僵蚕各9克，生滑石12克，薄荷叶(后煎)4．5克，龙胆草、知母、地骨皮各9克，青竹茹、忍冬花、忍冬藤各12克，焦栀子9克，鲜荷叶1张，双钩藤(后煎)9克，全蝎2枚，嫩桑枝18克，酒川军(开水泡兑)、元明粉(冲服)各4．5克，局方至宝丹(冲服)1粒。
After liberation, the Master was spirited and politically enthusiastic, devoting himself wholeheartedly to his work. He strongly supported the Party's Traditional Chinese Medicine (TCM) policy and advocated mutual learning, unity, and integration between TCM and Western medicine. After being received by Chairman Mao in 1952, he wrote a letter to him, stating: "In healing people, what does it matter whether one is a TCM or Western doctor? The intention is the same, though the principles and methods differ." He expressed his gratitude that Chairman Mao understood this essence and promoted millennia of culture. He wished to strive for perfection in theory and method, spreading them globally so that patients would have reliance, emphasizing that this must begin with educating talent. His wishes were supported by Chairman Mao. During his lifetime, he participated in the healthcare of central leaders, working diligently and receiving high praise, which led to multiple receptions by Premier Zhou Enlai. He often regretted that busy clinical duties left no time for writing, preventing him from summarizing his experience and contributing it to the people. Thus, in his later years, he often wrote late into the night; his posthumous manuscripts, such as *Fa Hui Zang Fu* (Elaboration on Viscera and Bowels) and *Shi Zhai Yi Hua* (Medical Conversations from Shi Zhai), were all left during this period. On March 10, 1955, while making house calls, he suddenly felt abdominal pain and chills. After勉强 finishing six consultations, he intended to return home to rest and recover, but unfortunately, his condition worsened daily. Realizing he was dying, he earnestly instructed his relatives; "Children, grandchildren, and disciples who studied under me should do their best to serve the people well, fulfilling my unfulfilled aspirations." The Master passed away on November 23, sadly at the age of seventy-one. After his death, Premier Zhou Enlai served as the chairman of the funeral committee and visited his residence to mourn. The Party and government bestowed high honors upon his diligent life.
Emphasizing Syndrome Differentiation, Prioritizing the Protection of Yuan Qi (Primal Vital Energy)
The Master advocated that in clinical practice, TCM cannot see the disease without seeing the person, nor see the tree without seeing the forest; one must start from the person and consider the patient's wholeness. He particularly emphasized the important role of Yuan Qi in the human body. He believed that the two sentences from *Nei Jing* (Inner Canon of the Yellow Emperor)—"Where evil gathers, Qi must be deficient" and "If spirit is kept within, how can disease arise?"—mean that pathogenic factors cause disease only because of the deficiency of the body's Yuan Qi. If the body's self-defensive Yuan Qi is sufficient, pathogens are not a threat. As the saying goes, "Entering through deficiency," if there is no deficiency, how can pathogens enter? Therefore, when Yuan Qi is sufficient, the interior pores close and resist; even strong winds and severe toxins cannot harm.
Regarding syndrome differentiation and treatment (Bian Zheng Lun Zhi), he insisted that treating disease first requires identifying the syndrome (Ren Zheng). Once the syndrome is clearly identified, treatment is like unlocking a door—it opens with a push. The method of identification begins with distinguishing Yin and Yang to find the root; once the root is clear, deficiency/excess and cold/heat are easily resolved. He emphasized Yin and Yang as the two main guidelines (Liang Gang) and Exterior/Interior, Deficiency/Excess, Cold/Heat as the six essentials (Liu Yao), disagreeing with listing Yin, Yang, Exterior, Interior, Deficiency, Excess, Cold, and Heat equally as the Eight Principles (Ba Gang). He pointed out: "Syndrome differentiation relies entirely on guidelines. The guidelines are two: Yin and Yang; the essentials are six: Exterior, Interior, Deficiency, Excess, Cold, Heat." Xu Lingtai explained this in detail, which is also what Zhang Jingyue called "Two Guidelines and Six Variations." Human diseases change infinitely but ultimately fall within Yin and Yang. Therefore, clinicians must first examine Yin and Yang, as etiology, syndromes, pulses, and herbs all possess Yin-Yang attributes. Once Yin and Yang are clear, errors will naturally be avoided. There may be complex phenomena where Yin contains Yang and Yang contains Yin, alternating in varying degrees, requiring careful distinction. For a specific disease, one must seek its location in terms of Exterior/Interior, the balance of healthy vs. pathogenic Qi, and Deficiency/Excess. Regarding symptoms, there is a division of Cold/Heat, but situations are complex, such as progression from Exterior to Interior or vice versa, mixed Cold/Heat, and intermingled Deficiency/Excess, all requiring prudent identification. In summary, Exterior, Excess, and Heat are generally categorized as Yang; Interior, Cold, and Deficiency are generally categorized as Yin. Thus, Yin and Yang are the general guidelines of medical practice. The six essentials are the keys to pathological changes. A clinician must grasp both the general outline and the key points to understand the disease thoroughly. Once syndrome differentiation is clear, medication selection should be carefully considered. Ginseng (Renshen) and Atractylodes (Baizhu) can revive the dying, just as Scutellaria (Huangqin), Coptis (Huanglian), Ginger (Shengjiang), and Aconite (Fuzi) can restore life. Yu Jiayan said: "Medicine is not difficult in prescribing, but in accurate syndrome identification." Thus, one must discuss the disease before discussing the medicine. Zhu Danxi also advocated: "Identification first, treatment second." If one merely knows to use a specific formula for a specific disease, regardless of time, place, or individual, without examining pulse, etiology, or syndrome, one expects the disease to fit the formula, rather than the formula to treat the disease. If differentiation is unclear, how can treatment be error-free? The subtlety of treatment lies in the accuracy of syndrome differentiation. One must not be confused by Cold, Heat, Deficiency, and Excess, nor rigidly adhere to Sweating, Vomiting, Purging, and Harmonizing methods. Otherwise, many ambiguities will arise, leading to indecision in clinic and low efficacy. The Master highly praised Xu Lingtai's discussion in *Bing Yin Ren Yi Lun* (Discussion on Disease Etiology and Individual Differences). Xu stated: "There are cases where the same disease is cured in one person but fails in another, causing harm. Why? Because although the disease is the same, the individuals differ." People have different emotional responses to the Seven Emotions and Six Evils. Their Qi mechanisms vary in strength, constitutions in Yin/Yang, origins in North/South, temperaments in Rigidity/Flexibility, bones/muscles in Strength/Brittleness, limbs in Work/Rest, ages in Young/Old, diet in Rich/Poor, and mental states in Sorrow/Joy. Combined with seasonal temperature differences and varying depths of pathology, uniform treatment may hit the disease but miss the individual, leading to opposite outcomes. Therefore, clinicians must carefully examine individual differences to determine the appropriate severity, urgency, size, and sequence of treatment.
The Master deeply agreed with this view, strictly adhered to it clinically, and expanded upon it. He firmly believed that whether dispelling pathogens or supporting healthy Qi, the goal is to restore and suffuse Yuan Qi. Regarding the order of dispelling pathogens versus supporting healthy Qi, one must adapt flexibly during syndrome differentiation. He said: "Pathogens and Healthy Qi are equally important. Supporting Healthy Qi can dispel pathogens, and dispelling pathogens can stabilize Healthy Qi; they are mutually causal." However, the sequence must depend on the individual, place, and time, never with preconceived notions. Although classics state "Excess of pathogenic Qi leads to Excess patterns, loss of Essence-Qi leads to Deficiency patterns," indicating that Healthy Qi deficiency results from pathogenic robbery, if not robbed, Healthy Qi would not become deficient. When pathogens are rampant, attacking the nest directly to eliminate the pathogen allows the disease to heal spontaneously, prioritizing pathogen dispersion. For acute initial illnesses, a sweeping cure is possible. For chronic, slow illnesses where deficiency signs are obvious, one must care for Healthy Qi, following the principle "Nourish the Healthy, and Pathogens will remove themselves," prioritizing support. Since diseases vary in duration and urgency, the treatment of dispelling pathogens and supporting Healthy Qi must be flexible: some require urgent pathogen dispersion followed by Healthy Qi regulation; some require stabilizing Healthy Qi first to slowly retreat pathogens; some involve embedding attack within tonification; others require simultaneous attack and tonification. Such priorities should be adapted to the syndrome. This prevents bias.
Studying Classics Deeply, Not Being Bound by Antiquity
The Master advocated that those aspiring to be physicians must first read *Nei Jing* thoroughly and then gradually comprehend its essence. When reading various medical theories, one must maintain an objective attitude of seeking truth from facts, mastering the method of adopting strengths and discarding weaknesses, eliminating dross and retaining essence, and vigorously opposing rigid adherence to ancient texts or taking things out of context. He opposed the reckless use of established formulas, saying: "Weapons and punishments kill visibly, but medicinal errors killing patients are unknown to the physician, being more insidious and dangerous than weapons, exceeding them in harm, truly lamentable." No wonder Wu Jutong foresaw this early in the preface to *Wen Bing Tiao Bian* (Systematic Differentiation of Warm Diseases): "Alas! How innocent are the people, not dying of disease but of doctors. Having a doctor is worse than having none; if one does not study medicine precisely, it is better not to study it at all." Zhu Bin also argued that "two or three tenths die of disease, eight or nine tenths die of doctors." For example, in clinical practice, heat diseases without sweat are wrongly diagnosed as Foot-Taiyang Exterior Syndromes by mediocre doctors, treated with Mahuang Tang, leading to profuse sweating and death. More commonly, Wind-Warmth and Damp-Warmth cases are treated with ascending drugs like Chaihu, Shengma, Guizhi, Xixin, Jiang, and Fuzi, causing latent heat pathogens to sink into the Pericardium, resulting in coma and convulsions and death. Even with urgent administration of Zhibao Dan, Qingying Tang, or Zixue Dan to cleanse the middle Jiao, survival rates are one in a hundred. Recently, he heard of someone studying Zhang Zhongjing's Han dynasty dosages and applying them clinically. While effective when used correctly, this shows knowledge that *Shanghan Lun* (Treatise on Cold Damage) is a late Eastern Han formula book, not necessarily fully applicable today due to changes in climate, geography, and human bodies. The Master often said that traveling north and south for decades, he rarely saw true Shanghan caused by cold, as Yin-Yang cycles are driven by heaven and earth. *Nei Jing* says: "First consider the annual Qi, do not violate Heaven-Harmony." According to current Jiazi cycles, operating in the Post-Heaven phase, Wet-Earth dominates, seasons are abnormal, Yang is hyperactive and Yin deficient, and Damp-Heat is prevalent. Therefore, Acrid-Warm and cloying substances must be used with caution. It will take forty years after the Middle Yuan Jiazi for Yin-Yang to gradually reverse. In the Lower Yuan Jiazi, although Yang deficiency prevails, Acrid-Cloying flavors still require prudent judgment. Zhu Danxi elaborated on the classic teaching, creating the theory "Yin is often insufficient, Yang is often excessive." This was not accidental or biased but based on profound truth. In this vast world, diseases are unpredictable. If physicians lack precise knowledge, they cannot adapt, lacking technique, potentially causing death or waiting for death, harming rather than saving people. Countless lives are wasted yearly. Is this not a warning for the suffering of the people?
Valuing the Relationship Between Liver and Spleen
Regarding the pathogenesis between the Liver and Spleen, our shallow understanding suggests his core principle follows the classic: "Wind, rain, cold, and heat, unless combined with Empty-Evil, cannot alone harm people. Those who encounter sudden storms but do not get sick have no deficiency, thus Evil cannot harm alone. This must be due to Empty-Evil wind meeting the body's deficiency, two deficiencies combining to invade the form." This points out that internal factors are the basis of all disease occurrence and change. Emphasizing "When Healthy Qi exists internally, Evil cannot interfere," he believed that damage to Healthy Qi causes disease, referring to the internal deficiency from the combination of two deficiencies as the main basis for all diseases. Regarding causes of Healthy Qi damage, he first emphasized the Spleen as the Root of Post-Heaven existence and the relationship among Spleen, Stomach, and Liver, especially the generating/restricting relationship between Spleen and Liver, i.e., Earth insulting Wood (Spleen disease transmitting to Liver) and Wood overcoming Earth (Liver disease transmitting to Spleen). In his article *Pi Wei Bing Lun* (Discussion on Spleen and Stomach Diseases), he said: "The Spleen resembles Earth, governs flesh, stores Yi (Intellect), and dislikes Dampness... resides in the Center... nourishes the four sides... rules the four seasons, specifically Long Summer. It is the organ governing blood, ruling the four limbs, with Si (Pondering) as its emotion, Stomach as its exterior, Heart as its mother, and Foot-Taiyin as its meridian. Irregular diet and overwork both injure the Spleen. Excessive Wood Qi (Liver Qi excess) damages the Spleen; Sweet flavor governs it, but excess harms it. Unresolved sorrow also hurts the Spleen. When Spleen is injured, disease follows: Damp-Heat stagnation causes jaundice; Cold causes diarrhea; Spleen excess causes inability to move limbs; Spleen deficiency causes blockage of the nine orifices. Especially when Earth fails and Wood attacks, Dampness lingers, Seven Emotions injure internally, Six Evils attack externally, irregular diet, and sexual exhaustion injure Spleen-Yin, disrupting transport functions. Thus, although Stomach receives food, Spleen fails to transform; Yang rises and Yin descends, forming a state where Heaven and Earth do not interact. Clear and turbid mix, tunnels block, Qi stagnates and Blood stasis forms,郁 (stagnation) prevents flow, becoming the source of myriad diseases..." He also discussed the Stomach: "*Ling Shu·Wu Wei* says: 'Stomach is the Sea of Five Zang and Six Fu organs...'*Su Wen·Yu Ji Zhen Zang Lun* says: 'Five Zang all receive Qi from Stomach; Stomach is the root of Five Zang.'*Su Wen·Wu Zang Bie Lun* says: 'Stomach is the Sea of Water and Grain, the great source of Six Fu organs.' Knowing that Stomach Qi is the root of life. Strong Stomach Qi makes all organs strong; weak Stomach Qi makes all organs weak. Thus *Su Wen·Ping Ren Qi Xiang Lun* says: 'Normal Qi of peaceful persons is derived from Stomach... Persons without Stomach Qi are termed Rebellious. Rebellious means death.'*Nan Jing·Fifteenth Nan* says: 'Stomach is the Sea of Water and Grain, ruling the four seasons, all based on Stomach Qi...'" Thus, the Stomach is a vital organ. However, people neglect it: externally, gluttony and irregular diet; internally, anger agitating Liver-Yang, which then attacks Earth. This leads to various pathologies. The Master paid special attention to the severity and confrontation of Damp and Heat pathogens. He pointed out: "For decades, 80-90% of cases involved Dampness combined with Heat, due to heavenly and earthly Qi movements. Damp-Heat arises from Wood flourishing and Earth declining, with Wood Qi attacking failing Earth. Heavy Dampness increases Heat; Damp steams internally, Heat floods internally. Heavy Damp generates more Heat; heavy Heat generates more Damp. Damp-Heat steaming solidifies the pathogen. Modern physicians must observe this." He proposed that based on the Spleen-Stomach-Liver relationship, Spleen-Dampness and Liver-Heat are the two main factors causing all diseases. Thus, in clinical differentiation, he emphasized combining Spleen, Stomach, and Liver. If a fault occurs in any link, a series of problems arises, i.e., "Spleen/Stomach disease must relate to Liver; Liver disease must relate to Spleen/Stomach."
Depressed Heat and Latent Qi are also Main Causes of External Warm-Thermal Diseases
Regarding external warm-thermal diseases, the Master believed that depressed heat and latent Qi within the body are often prerequisites for contracting warm-thermal diseases. He said: "External warm-thermal diseases sometimes rely on internal depressed heat and latent Qi first, then contract heaven-earth harsh Qi and licentious pathogens. Moreover, the Six Evils' Wind, Cold, Summer-Heat, Dampness, Dryness, all five Qi can transform into Fire, yet all attach to Wind. Wind exists in all four seasons, moves swiftly and changes frequently, being the chief of a hundred diseases. Yet *Nei Jing* says: 'Interior pores close and resist; even strong winds and severe toxins cannot harm.' Thus, internal depressed heat and latent Qi are the root of external warm-thermal onset." Ye Tianshi said: "Warm pathogens enter from above, first attacking the Lung." At this stage, pathogens are in the Exterior; light Acrid-Cool exterior-resolving agents can resolve them easily. If depressed heat and latent Qi are strong, or initial resolution was improper, or mis-treatment/mis-tonification caused pathogens to sink inward, they may reversely transmit to the Pericardium. At this point, pathogens have entered the Interior; heavy Acrid-Cool pathogen-dispelling agents can be effective like a drumbeat. If pathogens are trapped by Dampness, deep Heat leads to deep Cold extremities (Jue), presenting Yin signs clinically, which is false Cold resembling extreme Heat. If differentiation is unclear and hot medicines are mistakenly used, death will follow instantly. Conversely, only using cooling agents to resolve cold coagulation will not resolve warmth-heat but further close the pathogens, leading to disability or untreatable conditions. At this time, Bitter-Bland leaching methods to transform Dampness should be applied, assisted by Acrid-Cool clearing agents and aromatic acrid-dispersing flavors to break the Dampness perimeter, preventing Damp-Heat interaction and allowing direct attack on the nest. Then fixed pathogens are easy to resolve, Heat recedes, Cold extremities disappear, and the disease heals. Below are three cases to illustrate this argument.
Case 1: Ms. Wu. Initially, internal Damp-Heat clashed with external pathogens, causing headache, cough, nasal congestion with heavy voice, sore throat, thirst, fever with aversion to cold, profuse phlegm-saliva, constipation, yellow greasy tongue coating, and wiry-rapid pulse. This is Warm pathogens entering from above, first attacking the Lung. Urgently clear Heat and resolve Exterior to purify Lung collaterals.
Fresh Reed Rhizome 30g, Raw Gypsum (decocted first) 24g, Honeysuckle Flower (Jinyinhua), Forsythia (Lianqiao), Apricot Seed (Xingren) each 9g, Mint Leaf (Bohe, decocted later), Perilla Fruit Frost (Suzishuang) each 4.5g, Scutellaria (Huangqin) 6g, Isatis Root (Banlangen) 9g, Magnolia Flower (Xinyi) 6g, Whole Trichosanthes Fruit (Quanguagua) 18g, Niter Powder (Yuanmingfen) 3g, Fresh Lotus Leaf 1 sheet, Zixue Dan (dissolved) 1.8g.
Case 2: Mr. Liu. Liver and Stomach Yang both excessive, internal Heat combined with seasonal pathogens. Initial resolution was improper, causing Heat pathogens to sink into the Pericardium. Coma, delirium, occasional convulsions, high fever, intense thirst for cold drinks, dysfunction of urination and defecation, no bowel movement for seven days, red tongue body, rough dirty coating, black-brown coating at the root, large-rapid pulse, Right Cun and Guan positions both full. Urgently apply heavy Acrid-Cool aromatic transformation, assisted by extinguishing Wind.
Raw Gypsum (decocted first), Fresh Nine-Joint Acorus Root (crushed juice added), Fresh Imperata Rhizome (Baimaogen), Fresh Reed Rhizome each 30g, Lotus Plumule (Lianzixin) 6g, Gentian Root (Longdancao), Anemarrhena (Zhimu), Ground Tree Bark (Digupi) each 9g, Green Bamboo Shavings (Qingzhuru), Honeysuckle Flower (Jinyinhua), Honeysuckle Vine (Jinteng) each 12g, Fried Gardenia (Jiaoshanzi) 9g, Fresh Lotus Leaf 1 sheet, Uncaria (Gouteng, decocted later) 9g, Full Scorpion (Quanxie) 2 pieces, Tender Mulberry Branch (Sangzhi) 18g, Wine-processed Rhubarb (Jiu Chunjun, soaked in boiling water and mixed), Niter Powder (Yuanmingfen, dissolved) each 4.5g, Ju Fang Zhibao Dan (dissolved) 1 pill.