余年十七，患疟几及半年，通议公恐其劳心，不令读经史，习诗文。因授以医书数种，
令于
，固病者所宜习也。受而读之，颇有会心。未几先慈劳嗽，百治不痊。次年弃养，痛天命之
不留，憾时医之无识，因是愈加研究，徒以举业相牵，终未深造，迨三十外，间为人治病，
辄应手取效。或他医误治已危者，亦多挽救。然久而愈不敢自信也，盖医之为道，广大精微
，实无涯 。浅者见浅，深者见深，尝博采诸家之说，参以管见，着述数卷，悉遭兵火，荡
焉无遗。偶录数条，苦于无书可征，幸精于斯道者赐教焉。
手足十二经脉，配合阴阳表里，犹河图洛书之数，出于天然。盖五腑属阳，五脏属阴，
手太阳为小肠丙火，阳明为大肠庚金，足太阳为膀胱壬水，阳明为胃戊土，少阳为胆甲木，此五
脏也。手太阴为肺辛金，少阴为心丁火，足太阴为脾己土，少阴为肾癸水，厥阴为肝乙木，此五藏也。手少阳三焦，厥
阴心包，虽无所主，实与足经之肝胆相通，乃知肾与膀胱为表里，与心小肠固相通也。脾与胃为表里，与
肺大肠亦相通也。手足之气，上下相应，有如此者，昔人乃云，伤寒传足不传手，真瞽说也
十二脉相为表里，分发十干，人皆知之。而不知合五行者，亦应八卦，肺属金，应乎干
天。
属火，应乎离，离主南方，心居中宫，离之象也。肾属水，应乎坎，坎主北方，肾居系阙，
坎之象也。是故肺金喜凉润，脾土应温燥，治肺病者，欲其下通乎脾，无取过润。治脾病者
，欲其上通乎肺，无取过燥，有子母相生之义焉，则地天交泰象也。心火宜下降，肾水宜上
滋。治心病者，欲其下交乎肾，勿使上炎。治肾病者，欲其上交乎心，勿使下竭，有婴 相
根据之义焉，则水火既济象也。善治者，必令相资相济；不善治者，每至相克相伤。深于易理
若夫肝胆属木，应乎震巽；胆阳主震，先于离位，故胆能生火。肝阴居巽，巽木属风，
故肝能生风。治肝胆病较难着手，仍不外从脾肺心肾四经治之。
东垣专重脾胃，有十二经脾胃病之说。纵横博辨，自成一家。但自干嘉之交，至于今日，
天下男妇多患肝气病，随人赋禀之阴阳寒热各有所受，其症变幻百出，医家率无把握，余即谓脾
胃病之变相，而要不能以东垣法治之者也。夫脾胃为后天根本，人皆借以生养，岂能为他经
作祟，其病皆肝为之耳。肝为五脏之长，而属木，一有病，则先克脾胃之土。脾胃受克，无
所生施，而诸经之病蜂起矣。约略数之，则有如胸腹胀满，左胁牵痛上连头顶眉棱等处，易
惊易怒，烦躁不寐，寒热往来，晡后潮热，喘促燥渴，干咳痰嗽，吞酸呕吐，小便淋闭，大
便或硬或溏而泻，吐血遗精，腰膝酸疼，皮毛洒淅，肌肤枯瘦，筋骨拘挛各症，分属十二经
，而一一皆系肝气之所变也。余着有《肝气论》一帙，似较之东垣《脾胃论》，更为确当。
肝经血多气少，而病曰肝气。气者火也，经云∶火生于木，祸发必克。肝经属木，木郁
则火炽，惟其郁而为火，故能遍扰诸经，而四体百骸，皆受其病。盖肝气上炎而心火生，木克土
而胃火生，木强反制金而肺火生。肝肾同源，肾有相火，君火不明，则相火失位，而肾火亦
生。《内经》所谓诸病皆属于火，丹溪所谓气有余便是火者，此也。但火亦不止一端，果系
有余之火，则知、柏、丹、栀，甚至芦荟、龙胆草，皆可用之。如属虚火，则当以补为泻，
甚或用桂、附热剂，引火归元，而火症自愈也。
世人每谓肝系五脏之贼，宜泻不宜补，因有平肝伐肝之说，不知肝木属春，生生之气，
如无此气，人何以生，岂可伐乎？善乎经曰∶木郁达之。达之哉，木喜条达，遂其条达之性，而
生机自畅，则肝得所而不为病矣。故善治肝者，不专治肝也。大抵阳虚者，中气不足，宜补
脾以培其土，土强而肝木无所侵凌。阴虚者，下元必亏，宜补肾以益其水，水足而肝木得所
滋养。如此则肝患自息，诸症悉平，古人所谓隔二隔三治法，盖如此。
补中土者，四君子汤、补中益气汤之类；补肾水者，六味地黄汤、大补阴丸之类。要莫
善于《局方》之逍遥散，用柴胡、薄荷，温散肝木，以达其郁，而加以归、芍滋阴，甘、术助阳
，茯苓利湿，煨姜和中，兼脾肾心肺而治之，实为肝病第一良方。有他症者，以意消息，自
无不效。近见《续名医类案》中，创制一方，用沙参、麦冬、生地、归身、杞子、川楝子六
味，出入加减，名一贯煎，自矜为治肝妙剂，此等和平之品，虽无大害，而断不足以治病，
妇人以血为主，薛立斋良方治妇科，专以肝脾两经为主，以肝藏血，脾统血故也。立方
多用
肝经一病，则月事不调，艰于产育，气滞血燥，浸成劳瘵。妇科之症，强半由此，则逍遥散最
为要药，随症加减，自无不宜。
《易经》损卦象辞曰∶惩忿窒欲。忿、欲二字，致损之本，不惟损德，亦且损身。盖
忿则心火上炎。欲则肾水下竭，此受病之由，即取死之道也。慎疾之君子，当切戒之！能惩能窒
，胜于服药百颗，又何患于肝病耶？
参、 、白术，阳分药也，而古人多以之治血，阳生则阴借以长也。地黄、归、芍，阴
分药
摄，必随之而涸。阴虚者，阳无所根据附，亦随之而亡。故治阳盛阴衰之人，但补其阴，毋伐
其阳。治阴盛阳衰之人，但补其阳，毋亏其阴。总不可执于一偏，而使脏气有偏胜耳。(毋
伐其阳，谓补阴剂中兼用气分药。毋亏其阴，谓补阳剂中兼用阴分药。)
体质强盛之人，不易受邪，故常无病。病发必重，治之者，切勿因循轻视。体质羸弱之
人，最易感邪，故常有病。病发则轻，治之者，不可过用重剂，宜随其人之本质而异其方法，然
亦须察看其症而斟酌之，未可执泥，以致误人。
凡气虚表弱之人，夏则易受暑热，冬则易受风寒，稍有不谨，则头痛身热。咳嗽喘渴之
症，相随而作。古人云∶服药当在未病之先。宜于夏至前后，每日服生脉散，人参、麦冬、五味
各等分。冬至前后，每日服玉屏风散，炙黄 、防风、白术各等分。此二方药只三味，而扶
正气以固表，不使感受外邪，最为得力。然尤须恪遵月令，禁嗜欲，薄滋味，以培其元，则
邪自无从而入，不可徒恃药力也。若自觉已受微邪，则此二方亦不可服。以五味收敛，白术
虚人感冒，本系轻症，不必服药。但当避风寒，节饮食，静养数日，或汗或下，自能解
散而
浸至不救，世间此种抱屈而毙者极多。而在当贵之家，及少年人为尤甚。余数十年来，所见
所闻，不可胜计，真堪悼叹！愿病者与治病者，各各慎之，毋负鄙人之婆心苦口也。
何谓误投药饵？如病在表，而攻其里，则乘虚而邪必陷；邪在里而散其表，则泄阳而气
愈伤；邪在上焦而用中焦药，则反致中满而作胀；邪在中焦而用下焦药，则引入阴分而难痊。其
尤甚者，本系内伤，微感时邪，症似伤寒，而服麻、桂、羌、防，重虚其表；本系外感兼伤
中气，症似劳怯，而服参、术、地黄，重锢其邪。此等治法，愈医愈剧，即遇明眼人，改弦
易辙，别用良方，而受困多日，已濒于死矣。
余尝着《肝气论》，调内伤发热，用逍遥散主之。外感寒热，用小柴胡汤去参主之。随
症加减，无不立愈。乃又有人谓柴胡一味，极易杀人。吁！何其固也？张景岳治受邪，有正柴胡饮
，及一柴胡、二柴胡、三柴胡、四柴胡、五柴胡等方，具见《新方八阵》。如柴胡果能杀人
，不应奉以为主，而加入各经药味。但用不得法，能贻误致毙，或亦有人。则参、 、归地
，以及本草书中常用之品，无不皆然。如世俗所谓桂枝下咽，阳盛即毙，承气入腹，阴盛即
咳嗽吐血，未必成痨也，服知柏、四物之药不止，则痨成矣。胸满不快，未必成胀也，
服山
。面目浮肿，小便闭涩，未必成水也，服木通、泽泻之药不止，则水成矣。此论本赵养葵，
确有见解。但舍却知、柏、楂、曲、青、枳、通、泻诸品，从何治病？患在无补气药以统领
之耳！前四症，皆由正气先亏所致，宜以参、 、姜、术之类参之，而后治嗽、治胀、治噎
、治水之味，得奏其功。将所指斥者，无不可用，此亦治肝病者，所宜知也。赵氏所论诸药
，犹属品味和平，不甚峻厉者。要之治病，犹治民也，用宽用猛，各适其宜。得宜，则刑罚
亦可称祥；不得宜，则礼药适滋作弊。用药犹用兵也，兵以杀贼，非以扰民。善用之，则干
戈实启太平，不善用之，则将帅皆堪召乱。故凡用药以病为主，果所当用，即如黄硝、巴豆
之导滞，莪术、三棱之破气，甘遂、大戟、芫荛、商陆之行水，亦未尝不敢效如神。又当中
病即止，不可过剂，过则生灾，医者乌可以不慎哉！
专用攻泻消导，而无补药以制之，固有弊矣。近人喜补恶泻，亦有遇病专用补剂，而不
知治其病者，究之邪气不除，则正气不复，浊气不降，则清气不升，势必愈补愈伤，而其弊有不
可胜言者矣！且即如虚损症，亦各有受病之所由来，或寒或风，或湿或火，其类不一，宜一
一清理消除，而后血气和平，自能复元无恙。否则即日服参、 ，非徒无益，而又害之也。
古人治气分之病，如四磨饮、四七汤、丁香柿蒂汤、橘皮竹茹汤，皆用参。治血分之病
，如
续命汤，治寒之理中汤、四逆汤、吴茱萸汤，治暑之清暑益气汤，治湿之中满分消汤，治燥
之麦门冬汤、琼玉膏，治火之升阳散火汤、莲子清心饮，亦无不用参。以及祛痰消积之剂，
用参、术者尤多。且仲景着《伤寒论》，为医家立方之祖，而治六经病，用参者几居其半，
益可知扶正之即以驱邪也，然此岂时医之所识哉！《内经》云∶木郁达之，言当条达也；火
郁发之，言当发散也；土郁夺之，言当攻导也；金郁折之，言当制伏也；水郁泄之，言当泄
泻也。此五句实治百病之总纲。除水火两端而外，木郁所以治风，土郁所以治食，金郁所以
治气。而其治法，又有正治从治。隔一隔二，上取下取之不同。神而明之，变化无方，不可
人之不足，由虚而损，由损而劳，由劳而极。损有五∶一损肺，皮毛槁落；二损心，血
液衰少；三损脾，饮食不为肌肤；四损肝，筋缓不收；五损肾，骨痿不起。劳有五∶一劳形，二
劳气，三劳思，四劳精，五劳神。极有六∶一气极，二血极，三精极，四肌极，五筋极，六
骨极。又有七伤∶过饱伤脾，盛怒伤肝，忧思伤心，强力伤肾，寒冷伤肺，风雨寒暑伤形，
哀乐恐惧伤神。凡患此者，修德为上，制药次之，治心为上，治身次之。
五运六气论，分别年岁。如太阳寒水司天，太阴湿土在泉之类。又有四时八节主气客气
等说，何气受邪，似有定例。而按之每年时症，实不相符。盖天时有寒暑燥湿之不同，而人之受
病因之。人性有阴阳强弱之不同，而病之变症因之。此非可以执一论也。
读仲景书而不读东垣书，知外感发热，而不知内伤之亦有发热，则杀人多矣。读东垣书
而不读丹溪书，知阳虚发热，而不知阴虚之尤易发热，则杀人多矣。读丹溪书而不读景岳书，知气
有余便是火，只宜滋阴，而不知气不足即是寒，尤当扶阳，则杀人亦多矣。仲景每用麻、桂
黄、硝，而东垣易以参、 、升、柴，此外感与内伤之辨也。丹溪专用知、柏、归、地，而
景岳易以参、附、姜、桂，此补阴与补阳之辨也。此相反而实以相成，皆不可以偏废者也。
然泥于景岳补阳之说，而阳亢阴消，亦复不无后患。又当参用河间、丹溪之法以济之，则医
之为道，庶乎备矣。是在善学人之会而通之耳。
大凡太极之理，分为阴阳。故立法不能无所偏，而流极即不能无所弊。其大者如殷周之
质文，齐鲁之强弱，洛蜀之主客，朱陆之异同，遗患且流及数世以后，而要惟医道之偏，其害为
尤甚。盖惟仲景之书，系箸超超，无法不备。此外各名医有偏长处，亦有偏短处，故不能无
弊。然诸说俱在，良方甚多，参而用之，取其长而去其短，救其弊而补其偏，则生乎其后者
仲景书名曰《伤寒》，而实兼六淫治法在内，后人得其一诀，便可出奇无穷。如《千金
》以
以桂枝羌活汤、麻黄防风汤，分有汗无汗，治疟疾之类，不可枚举。陶节庵出而尽变其法，
别制其方，不复分经论治，实为长沙叛臣。后人畏难就易，故多祖述节庵。然亦开无数变化
法门，且如再造散，用参、 、桂、附。同羌、防、细辛，治阳虚不能作汗，实为东垣、丹
溪、景岳之所自出，要亦从仲景法中变化而来。
近人吴鞠通着《温病条辨》。发明四时之病，伤寒少而温病多。如春曰风温，夏曰湿温
，曰暑湿，秋曰伏暑，曰秋燥，冬曰冬温，其症多从手太阴肺经受病(按此即邪从上焦入，说见
下条。)与伤寒邪从足太阳入者迥异。忌大汗大下，多用加减银翘散之类。此与明季吴又可
In my seventeenth year, I suffered from malaria for nearly half a year. Mr. Tongyi, fearing that it would strain my mind, did not allow me to study the Classics and History or practice poetry and prose. Instead, he gave me several medical books to learn, which is indeed appropriate for patients to understand. I accepted and read them, gaining considerable insight. Not long after, my mother fell ill with a labor-induced cough, and despite various treatments, she did not recover. The following year, she passed away. Grieving that Heaven's mandate did not spare her, and regretting the lack of discernment in contemporary physicians, I devoted myself even more deeply to the study of medicine. However, being tied to the imperial examination system, I never achieved profound mastery. Only after I was past thirty did I occasionally treat others, often achieving immediate results. Even cases where other physicians had mismanaged and left patients in critical condition, I was able to rescue many. Yet, as time went on, I became increasingly hesitant to trust my own judgment. This is because the Way of Medicine is vast and subtle, truly boundless. The shallow see only the superficial, while the deep perceive the profound. I once extensively collected theories from various schools, combined them with my own observations, and wrote several volumes, but they were all destroyed by war and fire, leaving nothing behind. Occasionally recording a few cases, I suffer from the lack of reference books and hope that those proficient in this field will offer guidance.
The twelve meridians of the hands and feet correspond to Yin and Yang, Interior and Exterior, much like the numerical patterns of Hetu (River Chart) and Luoshu (Lo River Scroll), originating from nature. The Six Fu organs belong to Yang, and the Five Zang organs belong to Yin. The Hand-Taiyang Small Intestine meridian corresponds to Bing Fire; the Hand-Yangming Large Intestine meridian to Geng Metal; the Foot-Taiyang Bladder meridian to Ren Water; the Foot-Yangming Stomach meridian to Wu Earth; and the Foot-Shaoyang Gallbladder meridian to Jia Wood. These constitute the five [Fu] aspects. The Hand-Taiyin Lung meridian corresponds to Xin Metal; the Hand-Shaoyin Heart meridian to Ding Fire; the Foot-Taiyin Spleen meridian to Ji Earth; the Foot-Shaoyin Kidney meridian to Gui Water; and the Foot-Jueyin Liver meridian to Yi Wood. These are the Five Zang organs. The Hand-Shaoyang Sanjiao (Triple Burner) meridian and the Foot-Juexin Pericardium meridian, although seemingly lacking direct organ masters, actually connect with the Foot meridians of the Liver and Gallbladder. From this, we know that the Kidney and Bladder are Interior-Exterior pairs, and also communicate with the Heart and Small Intestine. The Spleen and Stomach are Interior-Exterior pairs, and also communicate with the Lung and Large Intestine. The Qi of the hand and foot meridians responds above and below in such a manner. Ancients claimed that Shanghan (Cold Damage) transmits only through the Foot meridians and not the Hand meridians; this is truly blind talk.
The twelve meridians are mutually Interior-Exterior and distribute among the Ten Heavenly Stems, which everyone knows. But few realize that they also conform to the Five Elements and correspond to the Eight Trigrams. The Lung belongs to Metal, corresponding to the Qian trigram (Heaven). The Heart belongs to Fire, corresponding to the Li trigram. Li governs the South, and the Heart resides in the Central Palace, fitting the image of Li. The Kidney belongs to Water, corresponding to the Kan trigram. Kan governs the North, and the Kidney resides at the lumbar region, fitting the image of Kan. Therefore, Lung Metal prefers coolness and moistening, while Spleen Earth adapts to warmth and dryness. In treating Lung diseases, one should aim for Lung Qi to descend into the Spleen, avoiding excessive moistening. In treating Spleen diseases, one should aim for Spleen Qi to ascend to the Lung, avoiding excessive drying. This embodies the principle of mutual generation between Mother and Child, representing the image of Di Tian Jiao Tai (Earth and Heaven interacting). Heart Fire should descend, and Kidney Water should ascend. In treating Heart diseases, one should facilitate Heart Fire descending to interact with the Kidney, preventing it from flaming upward. In treating Kidney diseases, one should facilitate Kidney Water ascending to interact with the Heart, preventing it from exhausting downward. This embodies the meaning of infants relying on each other, representing the image of Shui Huo Ji Ji (Water and Fire both attained). A skilled practitioner ensures mutual support and regulation; an unskilled one often leads to mutual restriction and harm. Those deeply versed in the principles of the I Ching...
As for the Liver and Gallbladder belonging to Wood, they correspond to the Zhen and Xun trigrams. The Gallbladder is Yang, governing Zhen, preceding the Li position, thus the Gallbladder can generate Fire. The Liver is Yin, residing in Xun; Xun Wood belongs to Wind, thus the Liver can generate Wind. Treating Liver and Gallbladder diseases is difficult, yet it essentially involves treating from the perspectives of the Spleen, Lung, Heart, and Kidney meridians.
Li Dongyuan placed special emphasis on the Spleen and Stomach, proposing the theory of Spleen-Stomach diseases in the twelve meridians. His arguments were broad and dialectical, forming his own school. However, from the transition between the Qianlong and Jiaqing reigns to the present day, men and women across the land frequently suffer from Liver Qi disorders. Depending on individual constitutional Yin/Yang and Cold/Heat differences, symptoms vary endlessly, leaving physicians without confidence. I consider these to be variations of Spleen-Stomach diseases, but they cannot be treated using Li Dongyuan’s methods. The Spleen and Stomach are the foundation of acquired constitution, relied upon by all for nourishment. How could they become the source of trouble for other meridians? The pathology originates from the Liver. The Liver is the chief of the Five Zang organs and belongs to Wood. When diseased, it first attacks the Earth of the Spleen and Stomach. Once the Spleen and Stomach are restricted, they fail to transform and transport, causing diseases in various meridiments to arise like swarms. Roughly enumerated, these include chest and abdominal distension, pain radiating from the left hypochondrium to the vertex and brow ridge, irritability and anger, restlessness and insomnia, alternating chills and fever, afternoon tidal fever, panting and dry thirst, dry cough with phlegm, acid regurgitation and vomiting, dysuria, loose or hard stools, hematemesis and spermatorrhea, soreness and weakness of the waist and knees, aversion to wind, emaciation, and tendon spasms. These symptoms, though classified under the twelve meridiments, are all transformations of Liver Qi. I authored a volume titled *Treatise on Liver Qi*, which seems more accurate than Li Dongyuan’s *Treatise on Spleen and Stomach*.
The Liver meridian has abundant blood and scarce Qi, yet the disease is named "Liver Qi." Qi is Fire. The classics state: "Fire is born from Wood; when disaster strikes, it destroys." The Liver meridian belongs to Wood; when Wood stagnates, Fire blazes. Because it stagnates and transforms into Fire, it disturbs all meridiments, affecting the limbs and bones. Generally, Liver Qi flaming upward generates Heart Fire; Wood overcoming Earth generates Stomach Fire; excessive Wood counter-restricting Metal generates Lung Fire. The Liver and Kidney share the same source; the Kidney contains Ministerial Fire. If Sovereign Fire is unclear, Ministerial Fire loses its position, and Kidney Fire arises. What the *Neijing* calls "all diseases belong to Fire," and what Danxi called "excess Qi is Fire," refers to this. However, Fire is not of one type. If it is excess Fire, then Zhi Mu (Anemarrhena Rhizome), Huang Bo (Phellodendron Bark), Mu Dan Pi (Moutan Cortex), Zhi Zi (Gardenia Fruit), and even Lu Hui (Aloe), Long Dan Cao (Gentiana Root) can be used. If it is Deficiency Fire, one should tonify to purge, or even use hot agents like Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root) to guide Fire back to its origin, curing the Fire syndrome naturally.
People often say the Liver is the "robber" of the Five Zang organs, suitable for purging rather than tonifying, hence the concepts of calming and subduing the Liver. They do not know that Liver Wood corresponds to Spring, possessing the vital energy of growth. Without this energy, how can life exist? How can it be subdued? As the classics say beautifully: "For Wood stagnation, promote its free flow." Promoting means that Wood delights in free and smooth flow. By following this nature, vitality becomes smooth, the Liver finds comfort, and disease does not occur. Thus, a skilled Liver physician does not treat only the Liver. Generally, those with Yang deficiency have insufficient Middle Qi; they should tonify the Spleen to strengthen Earth, so that Liver Wood has no opportunity to invade. Those with Yin deficiency have deficient Lower Yuan; they should tonify the Kidney to benefit Water, so that Liver Wood receives nourishment. In this way, Liver disorders subside, and all symptoms resolve. This is what ancients called the "treating two or three steps away" method.
To tonify Middle Earth, formulas like Si Jun Zi Tang (Four Gentlemen Decoction) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) are used. To tonify Kidney Water, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) and Da Bu Yin Wan (Great Tonify Yin Pill) are used. Nothing surpasses Xiao Yao San (Free and Easy Wanderer Powder) from the *Imperial Formulary*. It uses Chai Hu (Bupleurum Root) and Bo He (Mint Leaf) to gently disperse Liver Wood and relieve stagnation, combined with Dang Gui (Angelica Sinensis) and Bai Shao (White Peony Root) to nourish Yin, Gan Cao (Licorice Root) and Bai Zhu (Atractylodes Macrocephala Rhizome) to assist Yang, Fu Ling (Poria) to drain dampness, and Wei Jiang (Roasted Ginger) to harmonize the Middle. It treats the Spleen, Kidney, Heart, and Lung simultaneously, making it the premier formula for Liver diseases. With modifications based on symptoms, efficacy is assured. Recently, I saw a formula created in *Continued Cases of Famous Physicians*, using Sha Shen (Glehnia Root), Mai Dong (Ophiopogon Tuber), Sheng Di Huang (Rehmannia Root), Dang Gui Shen (Dang Gui Head), Gou Qi Zi (Goji Berry), and Chuan Lian Zi (Sichuan Chinaberry Seed), modified flexibly, named Yi Guan Jian (One-Glance Decoction), boasting it as a miracle cure for Liver diseases. Such mild herbs, while harmless, are insufficient to cure disease. Women prioritize Blood. Xue Lizhai’s excellent gynecological formulas focus primarily on the Liver and Spleen meridians because the Liver stores Blood and the Spleen controls it. Thus, a Liver meridian disorder leads to irregular menstruation and difficulty in childbirth. Qi stagnation and Blood dryness gradually form consumptive disease. Half of gynecological symptoms stem from this, making Xiao Yao San the most essential herb, effective with symptom-based modifications.
The Image Statement of the Sun (Decrease) Hexagon in the *I Ching* says: "Restrain anger and curb desires." Anger and desire are the root of damage, harming not only virtue but also the body. Anger causes Heart Fire to flare upward; desire causes Kidney Water to exhaust downward. This is the cause of illness and the path to death. Gentleman who take care of their health must strictly avoid these! Being able to restrain anger and curb desire is better than taking a hundred pills. Why worry about Liver disease then?
Ren Shen (Ginseng Root), [Missing Character], Bai Zhu (Atractylodes Macrocephala Rhizome) are Yang-category herbs, yet ancients often used them to treat Blood disorders, because when Yang grows, Yin benefits. Di Huang (Rehmannia Root), Dang Gui (Angelica Sinensis), Bai Shao (White Peony Root) are Yin-category herbs... retention, leading to exhaustion. In Yin deficiency, Yang has no foundation and perishes with it. Therefore, in treating Yang-excess and Yin-deficiency, one should only tonify Yin and not attack Yang. In treating Yin-excess and Yang-deficiency, one should only tonify Yang and not impair Yin. One must never adhere to one extreme, causing organ Qi to become overly dominant. ("Do not attack Yang" means including Qi-category herbs in Yin-tonifying formulas. "Do not impair Yin" means including Yin-category herbs in Yang-tonifying formulas.)
Those with strong constitutions are less susceptible to pathogens and thus rarely sick. When illness occurs, it is severe; practitioners must not neglect it. Those with weak constitutions are easily infected and thus often sick. When illness occurs, it is mild; practitioners must not use heavy doses excessively. Methods should vary according to the individual’s constitution, yet symptoms must still be observed and weighed carefully. One must not be rigid, lest one err.
For those with Qi deficiency and weak exterior, summer brings susceptibility to Summerheat-Heat, and winter to Wind-Cold. Any lapse in caution leads to headache, fever, cough, panting, and thirst. Ancients said: "Take medicine before illness occurs." Around the Summer Solstice, take Sheng Mai San (Generate Pulse Powder) daily, with equal parts Ren Shen (Ginseng Root), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Berry). Around the Winter Solstice, take Yu Ping Feng San (Jade Windscreen Powder) daily, with equal parts Zhi Huang Qi (Honey-fried Astragalus Root), Fang Feng (Saposhnikovia Root), and Bai Zhu (Atractylodes Macrocephala Rhizome). These two formulas contain only three herbs but strongly support healthy Qi to secure the exterior, preventing external pathogens. This is most effective. However, one must strictly follow seasonal regulations, abstain from lust, eat bland food, and cultivate primal Qi. Then pathogens cannot enter. One cannot rely solely on medicinal power. If one feels slightly affected by pathogens, these two formulas should not be taken. Because Wu Wei Zi is astringent, and Bai Zhu... For deficient persons with colds, the condition is mild; medication is unnecessary. One should avoid wind and cold, regulate diet, and rest quietly for a few days. Sweating or purging will naturally resolve it... until it becomes incurable. Many die unjustly in such cases, especially among the nobility and youth. In my decades of experience, the sights and sounds are countless, truly lamentable! I wish patients and physicians would be cautious, not betraying my earnest advice.
What constitutes erroneous medication? If the pathogen is in the Exterior but one attacks the Interior, the pathogen sinks due to deficiency. If the pathogen is in the Interior but one disperses the Exterior, Yang leaks and Qi is further injured. If the pathogen is in the Upper Jiao but one uses Middle Jiao herbs, it causes fullness and bloating. If the pathogen is in the Middle Jiao but one uses Lower Jiao herbs, it draws the pathogen into the Yin level, making recovery difficult. The worst cases involve internal injury with slight seasonal pathogen exposure, mimicking Shanghan, yet treated with Ma Huang (Ephedra Herb), Gui Zhi (Cinnamon Twig), Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), severely damaging the exterior. Or external infection with Middle Qi injury, mimicking consumption, yet treated with Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Di Huang (Rehmannia Root), firmly trapping the pathogen. Such treatment worsens the condition. Even if a skilled physician changes tactics and prescribes good formulas, the patient suffers for days and nears death.
I once wrote *Treatise on Liver Qi*. For internal injury fever, I use Xiao Yao San (Free and Easy Wanderer Powder) as the main formula. For external cold-heat, I use Xiao Chai Hu Tang (Minor Bupleurum Decoction) minus Ren Shen (Ginseng Root). With modifications, recovery is immediate. Yet some claim Chai Hu (Bupleurum Root) kills easily. Alas, how stubborn! Zhang Jingyue, in treating pathogenic invasion, used Zheng Chai Hu Yin (True Bupleurum Drink) and formulas named Yi Chai Hu, Er Chai Hu, etc., found in *New Formulas of the Eight Arrays*. If Chai Hu really killed, it would not be used as a principal herb added to various meridian-specific ingredients. Improper use can lead to fatal delays, just as with Ren Shen (Ginseng Root), [Missing Character], Dang Gui (Angelica Sinensis), Di Huang (Rehmannia Root), and common materia medica. Secular wisdom says: "Gui Zhi (Cinnamon Twig) entering the throat, Yang-excess leads to death; Cheng Qi Tang (Order the Qi Decoction) entering the abdomen, Yin-excess leads to death." Coughing and hematemesis do not necessarily become tuberculosis; stopping Zhi Mu (Anemarrhena Rhizome), Huang Bo (Phellodendron Bark), and Si Wu Tang (Four Substance Decoction) prevents this. Chest fullness does not necessarily become distension; stopping Shan Zhi Zi (Gardenia Fruit)... Facial edema and urinary retention do not necessarily become edema; stopping Mu Tong (Akebia Stem) and Ze Xie (Alisma Rhizome) prevents this. This view originated from Zhao Yangkui and has merit. But without Zhi Mu, Huang Bo, Shan Zha (Hawthorn Fruit), Shen Qu (Medicated Leaven), Qing Pi (Bitter Orange Peel), Zhi Ke (Aurantii Fructus Immaturus), Mu Tong, Ze Xie, how does one treat disease? The problem is the lack of Qi-tonifying herbs to lead them. The first four symptoms result from prior healthy Qi deficiency. One should combine Ren Shen (Ginseng Root), [Missing Character], Sheng Jiang (Fresh Ginger), Bai Zhu (Atractylodes Macrocephala Rhizome) with cough, distension, dysphagia, and water-retention treatments to achieve success. The criticized herbs are usable; this is knowledge for Liver physicians. Zhao’s discussed herbs are mild and not harsh. Treating disease is like governing people: leniency or severity must suit the situation. Properly applied, punishment brings peace; improperly applied, rites and medicines breed fraud. Using medicine is like using troops: troops kill bandits, not harass people. Skilled use brings peace; unskilled use brings chaos. Therefore, base medication on the disease. If indicated, even Da Huang (Rhubarb Root), Mang Xiao (Mirabilite), Ba Dou (Croton Seed), E Zhu (Curcuma Rhizome), San Leng (Burreed Tuber), Gan Sui (Kansui Root), Da Ji (Spurge Root), Yuan Hua (Genkwa Flower), Shang Lu (Phytolacca Root) can be miraculous. Stop when the disease is cured; overdose causes disaster. How can physicians not be cautious!
Using only purgatives and digestives without tonics has flaws. Recent trends favor tonification over purgation. Some use only tonics without addressing the disease. Ultimately, if pathogens remain, healthy Qi does not recover; if turbid Qi does not descend, clear Qi does not ascend. Over-tonification harms. Even in consumptive diseases, origins vary: Cold, Wind, Damp, or Fire. Each must be cleared to restore balance. Otherwise, daily Ren Shen (Ginseng Root) and [Missing Character] are useless and harmful.
Ancients treating Qi-level diseases, such as Si Mo Yin (Four Grinds Drink), Si Qi Tang (Four Seven Decoction), Ding Xiang Shi Di Tang (Clove Persimmon Calyx Decoction), Ju Pi Zhu Ru Tang (Tangerine Peel and Bamboo Shaving Decoction), all used Ren Shen (Ginseng Root). Treating Blood-level diseases, such as [Missing Character] Xu Ming Tang (Continue Life Decoction), Cold-treating Li Zhong Tang (Regulate the Middle Decoction), Si Ni Tang (Frigid Extremities Decoction), Wu Zhu Yu Tang (Evodia Decoction), Summerheat-treating Qing Shu Yi Qi Tang (Clear Summerheat and Augment Qi Decoction), Damp-treating Zhong Man Fen Xiao Tang (Resolve Middle Fullness Decoction), Dryness-treating Mai Men Dong Tang (Ophiopogon Decoction), Qiong Yu Gao (Jade Paste), Fire-treating Sheng Yang San Huo Tang (Raise Yang and Disperse Fire Decoction), Lian Zi Qing Xin Yin (Lotus Seed Clear Heart Drink), all used Ren Shen (Ginseng Root). Phlegm-resolving and accumulation-dispersing agents often used Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Macrocephala Rhizome). Zhang Zhongjing’s *Shanghan Lun* (Treatise on Cold Damage), the ancestor of medical formulas, uses Ren Shen (Ginseng Root) in nearly half of its Six Meridian treatments. This shows supporting healthy Qi drives out pathogens. Do contemporary physicians recognize this? The *Neijing* states: "Wood stagnation, promote it" (free flow); "Fire stagnation, vent it" (disperse); "Earth stagnation, seize it" (purge/guide); "Metal stagnation, restrict it" (control); "Water stagnation, drain it" (diurese). These five sentences are the general outline for treating all diseases. Besides Water and Fire, Wood stagnation treats Wind, Earth stagnation treats Food, Metal stagnation treats Qi. Methods include direct and indirect approaches, treating distant targets, upper and lower extraction. Divine understanding allows infinite variation...
Human insufficiency progresses from deficiency to damage, damage to labor/consumption, and consumption to extremity. Damage has five types: 1. Lung damage, hair and skin wither; 2. Heart damage, blood and fluids decline; 3. Spleen damage, food fails to nourish flesh; 4. Liver damage, tendons relax; 5. Kidney damage, bones atrophy. Labor has five types: 1. Physical labor, 2. Qi labor, 3. Mental labor, 4. Essence labor, 5. Spirit labor. Extremity has six types: 1. Qi extremity, 2. Blood extremity, 3. Essence extremity, 4. Muscle extremity, 5. Tendon extremity, 6. Bone extremity. There are also Seven Injuries: Overeating injures Spleen, rage injures Liver, worry/thought injures Heart, forceful exertion injures Kidney, cold injures Lung, wind/rain/cold/heat injures form, sorrow/joy/fear injures spirit. For these, cultivating virtue is primary, preparing medicine secondary; treating the mind is primary, treating the body secondary.
The Theory of Five Movements and Six Qi distinguishes years, e.g., Taiyang Cold Water ruling the Heaven, Taiyin Damp Earth ruling the Earth. There are also theories of Principal and Guest Qi for seasons and festivals. Which Qi causes disease seems fixed. Yet annual seasonal illnesses often contradict this. Weather varies in Cold/Heat/Dry/Wet, affecting human causation. Human constitutions vary in Yin/Yang strength, affecting symptom variation. One cannot argue from a single premise.
Reading Zhang Zhongjing without reading Li Dongyuan means knowing external heat but not internal heat, killing many. Reading Li Dongyang without reading Zhu Danxi means knowing Yang-deficiency heat but not Yin-deficiency heat, killing many. Reading Zhu Danxi without reading Zhang Jingyue means knowing excess Qi is Fire (tonify Yin) but not deficiency Qi is Cold (support Yang), killing many. Zhongjing used Ma Huang (Ephedra Herb), Gui Zhi (Cinnamon Twig), Da Huang (Rhubarb Root), Mang Xiao (Mirabilite); Dongyuan replaced them with Ren Shen (Ginseng Root), [Missing Character], Sheng Ma (Cimicifuga Rhizome), Chai Hu (Bupleurum Root)—distinguishing external vs. internal injury. Danxi used Zhi Mu (Anemarrhena Rhizome), Huang Bo (Phellodendron Bark), Dang Gui (Angelica Sinensis), Di Huang (Rehmannia Root); Jingyue replaced them with Ren Shen (Ginseng Root), Fu Zi (Aconite Root), Sheng Jiang (Fresh Ginger), Gui Zhi (Cinnamon Twig)—distinguishing tonifying Yin vs. Yang. These opposites complement each other; neither should be neglected. However, adhering strictly to Jingyue’s Yang-tonification may cause Yang hyperactivity and Yin depletion, requiring remedies from Hejian and Danxi. Then the Way of Medicine is complete. This depends on the learner’s ability to integrate.
Taiji divides into Yin and Yang. Legislation inevitably has bias and resulting flaws. Major examples include Yin/Zhou qualities, Qi/Lu strengths, Luo/Shu factions, Zhu/Lu differences, causing generational harm. Medical bias is particularly harmful. Only Zhongjing’s book is comprehensive. Other famous doctors have strengths and weaknesses, leading to flaws. But with many good formulas available, one should select strengths, discard weaknesses, remedy flaws, and correct biases...
Zhongjing’s book is named *Shanghan* (Cold Damage) but includes Six Pathogens’ treatments. Mastering one key unlocks infinite variations. *Qian Jin Fang* (Thousand Gold Formulas) uses Gui Zhi Qiang Huo Tang (Cinnamon Twig and Notopterygium Decoction) and Ma Huang Fang Feng Tang (Ephedra and Saposhnikovia Decoction) for sweating/non-sweating malaria, among many. Tao Jie’an changed methods, creating new formulas without meridian differentiation, betraying Changsha (Zhongjing). Later generations, fearing difficulty, followed him. Yet he opened many variations. Zaizao San (Revive Life Powder) uses Ren Shen (Ginseng Root), [Missing Character], Gui Zhi (Cinnamon Twig), Fu Zi (Aconite Root) with Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root), Xi Xin (Asarum), treating Yang-deficiency inability to sweat. Originating from Dongyuan, Danxi, Jingyue, it derives from Zhongjing’s methods.
Wujutong recently wrote *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases). Clarifying four-season diseases, Shanghan is rare, Wenbing (Warm Diseases) common. Spring: Wind-Warmth; Summer: Damp-Warmth, Summerheat-Damp; Autumn: Hidden Heat, Autumn-Dryness; Winter: Winter-Warmth. Symptoms mostly start in Hand-Taiyin Lung meriment (pathogen enters Upper Jiao), distinct from Shanghan’s Foot-Taiyang entry. Avoid drastic sweating/purging; use modified Yin Qiao San (Honeysuckle and Forsythia Decoction). This contrasts with Wu Keyou of the late Ming...