Library

Yu Jiayan treated the case of Jin Jian and said: Observing his Yang syndrome (syndrome characterized by heat, excess, or exterior pathogenic factors) and Yin syndrome (syndrome characterized by cold, deficiency, or interior pathogenic factors) mixed together, it is no different from Lianggan Shanghan (Shanghan disease involving both Taiyang and Shaoyin meridians simultaneously). Zhang Zhongjing did not establish specific treatment methods, but stated that Fa Biao (releasing the exterior through sweating) and Gong Li (attacking the interior through purgation) are fundamentally different.

He further said: Flexible methods depend on the practitioner; one must comprehend them with divine clarity. It has never been taught to adhere rigidly to abstaining from medication. Thus, he used Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) to simultaneously resolve the Yin-Yang pathogens at the exterior, and Fuzi Xiexin Tang (Prepared Aconite and Gallbladder-Bile Clearing Decoction) to simultaneously resolve the Yin-Yang pathogens at the interior, resulting in a cure. Tiele commented: Chunwen (Spring-warmth disease) originally does not involve Lianggan. Jiayan, noting that the patient's condition resembled Lianggan, analogously applied Zhang Zhongjing's formulas for treatment. This truly exemplifies that flexible methods lie with the practitioner, who comprehends them with divine clarity. Currently, there are many rare diseases; treatment methods should be adaptable and flexible. Therefore, this case is cited as a model for analogical treatment.

Wang Andao, in "Neishang Yu Yi" (Further Discussion on Internal Injury), stated: Dongyuan's "Neiwai Shang Bian" (Differentiation between External and Internal Injury) says that internal heat caused by dietary irregularities and overwork is due to Yin Fire (abnormal fire arising from deficiency) attacking Kun Tu (Spleen Earth). It also states, "For exhaustion, use warming; for loss, use warming." Only warm herbs should be used to tonify Yuan Qi (Original Qi) and drain Fire Evil. The "Neijing" (Classic of Internal Medicine) says, "Warming can eliminate great heat." Regarding the term "Yin Fire," neither the "Ling Shu" (Spiritual Pivot), "Su Wen" (Basic Questions), nor "Nan Jing" (Classic of Difficult Issues) ever mentioned it, yet Dongyuan frequently refers to it. Furthermore, "For exhaustion, use warming" is intended to regulate diet, adjust daily life, calm the mind and cease distracting thoughts, awaiting the restoration of normal Zhen Qi (True Qi). This aligns with what the "Li Ji" (Book of Rites) calls "gentle demeanor to warm [the body/spirit]." However, Dongyuan now claims that warm herbs should be used to tonify Yuan Qi and drain Fire Evil, changing "tonify loss" to "warm loss," and asserting that "warming eliminates great heat" is a quote from the "Neijing." Yet, upon examining the "Neijing" thoroughly, this phrase does not exist. This is indeed a point of doubt. Tiele commented: Dongyuan is a leading figure among medical sages, yet he still deviates from the "Neijing"; how much more so for other books! How can readers approach texts carelessly? Thus, this is cited as a warning.

Zhang Huiqing said: The syndrome of Malaria (Nue Ji) is exhaustively discussed in the "Neijing." Later discussions have become overly complex, causing confusion. Here, I cite Chen Shi's "San Yin" (Three Causes) theory to illustrate its general outline. For instance, the Five-Zang Malaria mentioned internally in the "Neijing" merely distinguishes which meridian the pathogen resides in; it was never meant to imply injury by Seven Emotions (joy, anger, worry, thought, grief, fear, fright). Similarly, regarding causes neither internal nor external, some cases involve malaria pathogens disturbing the Shen (Spirit), leading to delirium resembling possession. Can ghosts truly cause malaria? As for Wei Malaria (Stomach Malaria), since it involves diet, it is clearly an internal injury. Moreover, there are cases where one first contracts malaria and then suffers from food stagnation. There is no such thing as "Food Malaria" existing solely without external pathogens. Chen's theory, based on the Three Causes, inevitably resorts to elaborate explanations. Such shadowy, derivative talk is not only unhelpful but also confuses judgment. Tiele commented: There are many such derivative fallacies. For example, in Shicai's "Zhenjia Zhengyan" (Correct Eyes of Pulse Diagnosis), every pulse description must center on Cun, Guan, and Chi positions, even dividing slow (Chi) and rapid (Shuo) pulses, claiming Cun-slow indicates upper cold, Guan-slow indicates middle cold, and Chi-slow indicates fire deficiency. In reality, if the three positions are rapid, they are all rapid; if slow, they are all slow. How can one isolate a single position's slowness or rapidity as the primary pathology? This is what Jingyue called "elaborating theories unnecessarily." One must not be misled by such examples.