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Pan Yu asked Qibo: "When there is complete obstruction of urination and defecation, food and drink are immediately vomited, the face is dark red like jasper, lips are scorched, drinking water also induces vomiting, and the pulse is deep and hidden. What disease is this?" Qibo replied: "This is due to Kidney deficiency with excessive cold, where Yin repels Yang." Pan Yu asked: "Why can Yin repel Yang?" Qibo said: "The Kidney belongs to the Shaoyin meridian; it dislikes cold and prefers warmth. When the Kidney is cold, Yang has no place to attach itself, rising but not descending." Pan Yu asked: "What is the reason for this?" Qibo said: "Water and Fire exist within the Kidney. Fire is stored in Water, and Water is generated by Fire internally; they root each other and mutually restrain each other. When pathogenic factors invade, Water and Fire separate, and disease arises." Pan Yu asked: "What pathogenic factor causes this separation?" Qibo said: "Both Cold and Heat pathogens can cause separation, but Cold is more severe. If the invasion of Cold is mild, the deficient Yang in the Kidney floats upward, but does not reach the degree of repulsion. If Cold pathogen is too abundant, the rejection is too firm, Yang is obstructed by Yin and its strength declines, while Yin repels Yang and its Qi becomes prosperous. Yang dares not reside in the Lower Jiao and instead rushes counterflow into the Upper Jiao. With counterflow in the Upper Jiao, how can food and drink entering the throat descend into the Stomach?" Pan Yu asked: "How should it be treated?" Qibo said: "Treat it with Heat [methods]." Pan Yu asked: "Yang excess should be subdued by Yin/Cold, and Heat should be subdued by Cold. Now Yang is above presenting as Heat, yet we do not use Cold but instead use Heat; we do not treat Yin but treat Yang. Is there another principle?" Qibo said: "The Heat in the Upper Jiao is caused by pressure from below making it hot; the rising of Yang is caused by expulsion by Yin making it rise. Therefore, the Heat in the Upper Jiao originates from Cold in the Lower Jiao. Using Yin-Cold to subdue it would only cause further harm. Thus, it is better to use Yang-Heat substances to follow its nature and treat it according to its appearance (contrary treatment), so that Yang returns and Yin naturally disperses." Pan Yu said: "Excellent."

Chen Shiduo commented: "When Yin prevails, it must be subdued by Yang; when Yang prevails, it must be subdued by Yin. Both are methods of contrary treatment."

Chapter on Spring Warmth Similar to Epidemic

Feng Hou asked Qibo: "Is the epidemic in spring caused solely by contracting Wind pathogen?" Qibo said: "Epidemics are not solely caused by Wind. However, regarding the epidemic in spring, what else could it be but Wind?" Feng Hou said: "Then is Spring Warmth the same as Spring Epidemic?" Qibo said: "Spring Epidemic is not Spring Warmth. Spring Warmth has fixed patterns/formulas, whereas Spring Epidemic does not." Feng Hou said: "If Spring Epidemic has no fixed pattern, why does its onset resemble Spring Warmth so closely?" Qibo said: "Although Spring Warmth has fixed patterns, if disturbed by seasonal Qi, the fixed patterns become unfixed, thus becoming identical to epidemic Qi." Feng Hou said: "Are there differences within the similarities?" Qibo said: "Epidemic Qi hides killing power within heat, while seasonal Qi hides life-generating power within heat." Feng Hou said: "If it hides life-generating power within heat, why are there so many deaths?" Qibo said: "Seasonal Qi refers to irregular Qi. When Zang-Fu organs encounter regular Qi, Yin and Yang harmonize; when they encounter pathogenic Qi, Yin and Yang become chaotic. Irregular Qi is pathogenic Qi; thus, encountering it leads to illness and mutual transmission." Feng Hou said: "What is the reason for those who encounter pathogenic Qi but do not get sick?" Qibo said: "Because their Zang-Fu organs are harmonious themselves, and pathogenic Qi cannot disturb them. The transmission of Spring Warmth is also due to deficiency in Zang-Fu organs." Feng Hou said: "When Zang-Fu are solid, pathogenic Qi stays away; when Zang-Fu are empty, pathogenic Qi strikes. Is this truly the case?"

Chen Shiduo commented: "Warmth resembling epidemic cannot be equated with epidemic; the differentiation is clear and crisp."

Waijing Weiyan, Volume 9

Chapter on Tonifying and Draining Yin and Yang

Lei Gong asked Qibo: "Yin and Yang in the human body are divided into Qi and Blood, which has been detailed in the Neijing. May I ask about the rest?" Qibo said: "The essence of Qi and Blood lies in whether they are in excess or deficiency. Excess Qi leads to flourishing Yang and declining Yin; insufficient Blood leads to flourishing Yin and declining Yang." Lei Gong asked: "How to treat this?" Qibo said: "For flourishing Yang and declining Yin, one should tonify Blood; for flourishing Yin and declining Yang, one should tonify Qi. For flourishing Yang and declining Yin, one should drain Qi; for flourishing Yin and declining Yang, one should drain Blood. Without deficiency and without excess, Yin and Yang will be balanced." Lei Gong asked: "Tonifying Blood makes Yin flourish and Yang decline, so there is no need to drain Qi again; tonifying Qi makes Yang flourish and Yin decline, so there is no need to heavily drain Blood." Qibo said: "Tonifying Blood to generate Yin refers to routinely tonifying Yin; draining Qi to benefit Yin refers to temporarily draining Yang. Tonifying Qi to assist Yang refers to routinely tonifying Yang; draining Blood to save Yang refers to temporarily draining Yin. Therefore, new diseases can be drained, but chronic diseases should not be lightly drained; chronic diseases should be tonified, but new diseases should not be purely tonified." Lei Gong asked: "Must treating Blood involve regulating Qi?" Qibo said: "Treating Qi should also involve regulating Blood. Qi is formless, Blood is formed. Formless generating formed is change; formed generating formless is constancy." Lei Gong asked: "What do you mean?" Qibo said: "Change treats urgent conditions; constancy treats slow conditions. When the condition is urgent, it cannot be delayed; urgently tonify Qi to generate Blood. When the condition is slow, it cannot be rushed; slowly tonify Blood to generate Qi." Lei Gong asked: "What is the reason?" Qibo said: "Qi and Blood grow mutually; it is not that Qi generates Blood while Blood cannot generate Qi. It is just that Qi generating Blood has a rapid effect, while Blood generating Qi has a slow efficacy. Urgent and swift treatment applies to sudden blood loss; slow and gradual treatment applies to after blood loss. When Qi generates Blood, Blood obtains Qi and settles, avoiding boiling up; when Blood generates Qi, Qi obtains Blood and moistens, avoiding dryness. If Blood loses tonification, Qi will collapse; if Blood is stable and Qi is tonified, Blood will reactively move." Lei Gong said: "Excellent."

Chen Shiduo commented: "Both Qi and Blood can be tonified; one should seek the root within tonification. It is best not to blindly tonify."

Chapter on Good Nourishment

Lei Gong asked Qibo: "The first three months of Spring are called Fa Chen (Sprouting and Renewing), Summer Fan Xiu (Flourishing and Beautiful), Autumn Rong Ping (Containing and Leveling), and Winter Bi Cang (Closing and Storing). The Heavenly Master recorded this in detail in 'Si Qi Tiao Shen Da Lun'. However, regulating the four seasons prevents disease, while failing to regulate them causes disease. Does 'regulating the four seasons' refer to regulating the timing of Yin and Yang, or regulating the Yin and Yang Qi of the human body? Please explain clearly." Qibo said: "Excellent question! Regulating Yin and Yang Qi depends on the person, not the season. The first three months of Spring regulate Wood Qi; regulating Wood Qi means following Liver Qi. The first three months of Summer regulate Fire Qi; regulating Fire Qi means following Heart Qi. The first three months of Autumn regulate Metal Qi; regulating Metal Qi means following Lung Qi. The first three months of Winter regulate Water Qi; regulating Water Qi means following Kidney Qi. If Liver Qi is not smooth, it goes against Spring Qi, and Shaoyang disease corresponds. If Heart Qi is not smooth, it goes against Summer Qi, and Taiyang disease corresponds. If Lung Qi is not smooth, it goes against Autumn Qi, and Taiyin disease corresponds. If Kidney Qi is not smooth, it goes against Winter Qi, and Shaoyin disease corresponds. Can the Qi of the four seasons be left unregulated? Regulation is truly difficult because Yin and Yang Qi are hard to regulate, hence people fall ill often." Lei Gong asked: "Since people are already sick, what method cures it?" Qibo said: "Humans rely on Stomach Qi as the foundation. Disorders of the four seasons lead to disease; still, one must regulate Stomach Qi. Once the Stomach is regulated, the Spleen regulates itself; once the Spleen is regulated, the Liver, Heart, Lungs, and Kidneys all become smooth." Lei Gong asked: "Why not discuss nourishing Yin and Yang beforehand?" Qibo said: "Yang roots in Yin, and Yin roots in Yang. To nourish Yang, take from Yin; to nourish Yin, take from Yang. Nourishing Yang with Yin, and Yin with Yang, values prevention. How can pathogenic factors interfere? Close your eyes and block external stimuli, look inward at the Heart and Kidney. To nourish Yang, rinse saliva and send it to the Heart; to nourish Yin, rinse saliva and send it to the Kidney. There are no other strange methods." Lei Gong said: "Excellent." Tian Lao asked: "If Yin and Yang do not violate each other, humans have no disease. Are the methods of nourishing Yang and Yin limited to regulating the Heart and Kidney?" Qibo said: "The entire Neijing book contains methods for nourishing Yang and Yin." Tian Lao said: "The changes of Yin and Yang are not constant; how can the methods of nourishing Yin and Yang be rigid?" Qibo said: "Your words are excellent. For Qi Heng diseases, one must use Qi Heng methods: preemptively regulate Heart and Kidney, nourishing Yin and Yang when healthy. However, acute illness requires swift action, and chronic illness requires patience; it depends on the condition. Therefore, sweating when inappropriate preserves Yang; sweating urgently when appropriate also preserves Yang. Purging when inappropriate preserves Yin; purging heavily when appropriate also preserves Yin. Does nourishing Yang and Yin exclusively advocate tonification over drainage? Using drainage within tonification is skillful drainage; using tonification within drainage is skillful tonification. Combining drainage and tonification, nourishing Yang without damaging Yin, and nourishing Yin without damaging Yang—this is being skilled at nourishing Yin and Yang." Tian Lao said: "Excellent."

Chen Shiduo commented: "The chapter on Good Nourishment contains profound arguments; one must not casually use drainage and tonification."

Chapter on Collapse of Yang and Yin

Niao Shi asked Qibo: "Continuous sweating in humans is always collapse of Yang." Qibo said: "Continuous sweating is not entirely collapse of Yang." Niao Shi said: "Sweating syndromes are never without Heat; Heat disease is Yang disease. Why does the Heavenly Master say it is not Yang?" Qibo said: "When Heat is extreme, Yang Qi cannot be secured, so sweating leads to Yang collapse. Urine belongs to Yin, sweat belongs to Yang. External leakage of Yang—is this not called Yang collapse? It is not entirely Yang collapse because Yang roots in Yin. External leakage of Yang is due to Yin's failure to guard. If Yin performs its duty, Yang roots in Yin and cannot leak externally. If Yin loses its duty, it cannot even care for itself, let alone hold back the scattering and loss of Yang Qi. Thus, Yang collapse stems from prior Yin collapse." Niao Shi said: "If Yin collapses, Yin departs first; why wait for Yang collapse to die?" Qibo said: "Yin and Yang root each other; they do not separate for an instant. When Yin collapses, Yang follows and collapses immediately. Thus, Yang collapse is Yin collapse; why distinguish priority?" Niao Shi said: "If Yin and Yang collapse together, one should rescue both. Yet rescuing Yang stops sweating and saves life, while rescuing Yin stops sweating but fails to save life. Why?" Qibo said: "Yin generating Yang is slow; Yang generating Yin is fast. Rescuing Yin cannot instantly restore collapsed Yang, but rescuing Yang can rapidly recover collapsed Yin. Thus, rescuing Yin is inferior to rescuing Yang. Nevertheless, how can Yin and Yang be separated? Within rescuing Yang, include methods to rescue Yin; then Yang returns and Yin naturally recovers." Niao Shi said: "The collapse of Yin and Yang is not a matter of days or hours. Why not treat it before collapse occurs?" Heavenly Master Qibo said: "Great words! Syndromes of Yin and Yang collapse are due to deficiency of Water and Fire in the Kidney. For Yang deficiency, tonify Fire to generate Water; for Yin deficiency, tonify Water to control Fire. This avoids dual collapse." Niao Shi said: "Excellent."

Chen Shiduo commented: "Collapse of Yin and Yang results from the inability of Yin and Yang to guard each other. Yang is held by Yin, Yin is held by Yang, rooted in the deficiency of Water and Fire. Deficiency leads to collapse; what doubt is there?"

Chapter on Severity Fluctuating by Day and Night

Lei Gong asked Qibo: "Can day and night distinguish the severity of disease?" Qibo said: "Diseases vary in severity; one should distinguish them by day and night." Lei Gong asked: "How to distinguish?" Qibo said: "Yang diseases are heavier by day and lighter by night; Yin diseases are lighter by day and heavier by night." Lei Gong asked: "What do you mean?" Qibo said: "Heavier by day and lighter by night occurs because Yang Qi flourishes by day and declines by night. Lighter by day and heavier by night occurs because Yin Qi flourishes by night and declines by day." Lei Gong asked: "Why are Yang diseases lighter by day and Yin diseases lighter by night?" Qibo said: "This is due to deficiency of Yin and Yang Qi." Lei Gong asked: "Please explain clearly." Qibo said: "Yang disease heavier by day and lighter by night: Yang Qi and Pathogenic Qi jointly flourish; Yang Qi is not yet depleted, struggling against the pathogen with strength, hence heavier by day. By night, Yang declines; lacking strength to fight the pathogen, and the pathogen does not fight the righteous Qi, hence lighter by night. Yin disease lighter by day and heavier by night: Yin Qi and Pathogenic Qi jointly flourish; Yin Qi is not yet depleted, struggling against the pathogen with strength, hence heavier by night. By day, Yin declines; lacking strength to fight the pathogen, and the pathogen does not fight Yin, hence lighter by day." Lei Gong asked: "If the pathogen does not fight the righteous Qi, shouldn't the pathogen retreat? Why does the disease not heal?" Qibo said: "Heavy is true heaviness; light is false light. False light appears light but is actually heavy; the pathogen re-enters deeply, how can it retreat? Moreover, severity is unpredictable: sometimes heavy by day and heavy by night, sometimes light by day and light by night, or fluctuating. This is indeterminacy of Yin and Yang, unconstrained by day and night." Lei Gong asked: "How to treat then?" Qibo said: "For heavier by day and lighter by night, assist Yang Qi to dispel pathogen; for lighter by day and heavier by night, assist Yin Qi to dispel pathogen. Neither should focus solely on dispelling pathogen. For heavy by both day and night, or light by both, or fluctuating, vigorously tonify Yin and assist Yang. One must not stick to tonifying Yang nor focus solely on dispelling pathogen."

Chen Shiduo commented: "Between day and night, severity naturally differs."

Chapter on Resolution of Yang and Yin

She Long asked Qibo: "Why do Yang diseases resolve at Xu hour (7-9 PM) and Yin diseases resolve at Yin hour (3-5 AM)?" Qibo said: "Yang disease resolving at Xu resolves through Yin. Yin disease resolving at Yin resolves through Yang. However, resolving at Xu does not start at Xu; resolving at Yin does not start at Yin. Not starting at Xu begins at Yin; not starting at Yin begins at Hai (9-11 PM). Resolving at Xu but starting at Yin is not resolving through Yin but through Yang. Resolving at Yin but starting at Hai is not resolving through Yang but through Yin." She Long asked: "Yang resolves through Yang, Yin resolves through Yin; what is the meaning?" Qibo said: "Each of the Twelve Meridians has a time of Qi flourishing; when Qi flourishes, resolution occurs." She Long asked: "May I hear the times of Qi flourishing for the Twelve Meridians?" Qibo said: "Shaoyang Qi flourishes at Yin, Mao, Chen; Taiyang Qi flourishes at Si, Wu, Wei; Yangming Qi flourishes at Shen, You, Xu; Taiyin Qi flourishes at Hai, Zi, Chou; Shaoyin Qi flourishes at Zi, Chou, Yin; Jueyin Qi flourishes at Chou, Yin, Mao." She Long asked: "Why is Shaoyin's flourishing different from other meridians?" Qibo said: "Shaoyin is Kidney Water. Water hides Fire; Fire is Yang. At Zi hour, one Yang is born; at Chou hour, two Yangs are born; at Yin hour, three Yangs are born. As Yang advances, Yin retreats. Thus, Yin diseases resolving at Zi, Chou, Yin resolve through Yang." She Long asked: "Shaoyin resolves through Yang, not Yin." Qibo said: "Heaven generates Water at One; at Zi hour Water is born, which is its flourishing ground. Thus, Shaoyin gradually resolves upon encountering Zi." She Long asked: "Shaoyang resolution starts at Yin/Mao; Shaoyin and Jueyin resolution ends at Yin/Mao. Why?" Qibo said: "Yin is the beginning of birth and entry; Mao is the gate of Heaven and Earth. Starting at Yin/Mao means Yang receives initial Qi; ending at Yin/Mao means Yin receives final Qi." She Long asked: "During the Three Yang periods, each flourishes for three hours separately; during the Three Yin periods, they flourish consecutively for three hours. Why?" Qibo said: "Yang moves vigorously, its path is long, so each flourishes in its own time. Yin moves sluggishly, its path is short, so it flourishes consecutively." She Long asked: "Yang diseases resolve at midnight, Yin diseases resolve at noon. Does this mean Yang resolves through Yang and Yin through Yin?" Qibo said: "Before midnight is Yin; after midnight is Yang. After noon is Yin; before noon is Yang. Yang diseases must show signs of resolution during Yang-flourishing times, fully resolving by midnight. Yin diseases must show signs of resolution during Yin-flourishing times, fully resolving by noon. Although Yang resolves through Yang, it actually gains Yin Qi. Although Yin resolves through Yin, it actually gains Yang Qi. This is the meaning of Yang rooting in Yin and Yin rooting in Yang." She Long said: "Excellent."

Chen Shiduo commented: "Yang resolving through Yin, Yin resolving through Yang, contains profound meaning, not superficial talk."

Chapter on True, False, and Suspected Patterns

Lei Gong asked: "You have spoken of true and false diseases. But true containing false, and false containing true, have not been discussed." Qibo said: "Cold, Heat, Deficiency, and Excess cover it all." Lei Gong asked: "How about Cold and Heat?" Qibo said: "Cold is false cold, Heat is true heat. Extreme internal heat presents external false cold symptoms; this is hyperactivity of Heart Fire. Fire extreme resembles Water; treat with Cold to resolve." Lei Gong asked: "How about Heat and Cold?" Qibo said: "Heat is false heat, Cold is true cold. Extreme lower cold presents upper false heat symptoms; this is weakness of Kidney Fire. Water extreme resembles Fire; treat with Heat to resolve." Lei Gong asked: "How about Deficiency and Excess?" Qibo said: "Deficiency is true deficiency, Excess is false excess. Failure of clearing and descending functions, difficulty digesting food, upward reflux and middle fullness—this is Stomach/Spleen false excess and Lung true deficiency. Tonifying deficiency eliminates excess." Lei Gong asked: "How about Excess and Deficiency?" Qibo said: "Excess is true excess, Deficiency is false deficiency. Obstruction of draining and diffusing functions, invasion of Wind pathogen, external manifestation of cold and heat—this is Lung false deficiency and Liver true excess. Treating excess resolves false deficiency." Lei Gong asked: "Is that all?" Qibo said: "No. Sometimes true excess and true deficiency alternate, cold and heat alternate. Appearing true but not true, appearing false but not false—this is variation of Yin and Yang, severance of Water and Fire." Lei Gong asked: "How to treat?" Qibo said: "Treat early to live, treat late to die." Lei Gong asked: "What method treats early?" Qibo said: "Rescue Stomach and Kidney Qi; then severed connections reconnect, variations stabilize." Lei Gong asked: "Water and Fire both have falsehoods, but Fire is especially hard to distinguish. What to do?" Qibo said: "True Fire often presents false cold; False Fire often presents true heat. However, there is a method to distinguish. True Heat is a Yang syndrome; True Heat presenting false cold is Yang syndrome resembling Yin, i.e., external cold internal heat. True Cold is a Yin syndrome; True Cold presenting false heat is Yin syndrome resembling Yang, i.e., external heat internal cold." Lei Gong asked: "How to finally distinguish Water and Fire in external cold/internal heat and external heat/internal cold?" Qibo said: "External cold internal heat is deficiency of True Water and dominance of pathogenic Qi. External heat internal cold is deficiency of True Fire and deficiency of righteous Qi. True Water and True Fire are the Water and Fire in the Kidney. When Kidney Fire obtains Kidney Water to support it, Fire is True Fire and Heat is True Heat. When Kidney Fire separates from Kidney Water to restrain it, Fire becomes False Fire and Heat becomes False Heat. To distinguish true and false, test with external water: True Heat resolves with water; False Heat reacts adversely with water." Lei Gong asked: "What is the treatment?" Qibo said: "Tonify Water, and False Fire resolves itself." Lei Gong asked: "Why do some False Heat syndromes improve with Hot agents?" Qibo said: "Fire in the Kidney likes to be assisted by Yin Water, and also likes to be guided by Yin Fire. Having nourished Water, using Fire to guide it allows False Fire to hide easily; this is not abandoning Water to use Fire directly." Lei Gong asked: "Please speak of the method to treat Fire." Qibo said: "Tonify True Water, and True Fire also resolves. Although, treating Fire cannot rely solely on Water. Dispelling Heat within the process of tonifying Water reveals truth when falsehood breaks." Lei Gong said: "Excellent."

Chen Shiduo commented: "Without understanding True, how can one know False? Without understanding False, how can one know True? Between True and False lies the distinction of Water and Fire. Once the true and false nature of Fire is seen through, distinguishing true and false is easy."

Chapter on Tracing Origins from Compliance and Opposition