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Disorder of Ying and Wei (Nutritive and Defensive Qi). If their movement is insufficient, internal transformation fails and external nourishment is lacking. If their movement is excessive, the branches become strong while the trunk becomes weak. Bias towards Ying leads to Yin excess; bias towards Wei leads to Yang excess. Thus, a hundred diseases arise. This is the natural principle. Therefore, are not Ying and Wei the major key to sustaining life? Physicians treating diseases should follow the instruction in *Neijing* (*The Yellow Emperor's Classic of Internal Medicine*) to guard the meridians and pay special attention to Ying and Wei. Reading *Jingui Yaolue* (*Essential Prescriptions from the Golden Cabinet*), it states: "When Ying and Wei are unfavorable, abdominal fullness and borborygmus in the hypochondrium occur, with qi chasing each other and rotating." When both Ying and Wei are deficient and minute, the Triple Burner loses its control, the four limbs lose connection, and the body becomes emaciated. This further demonstrates the importance of Ying and Wei. Take dysentery as an example. Cases with cold-heat exterior symptoms are known to relate to Ying and Wei. Outside of this, because mild disease affects the Fu organs and severe disease affects the Zang organs, all consider it an internal disease. However, who knows that Wang Kentang, in *Zhengzhi Zhunsheng* (*Standard for Diagnosis and Treatment*), attributes the old and new accumulations in dysentery primarily to Ying and Wei. The phrase "guard the meridians" in *Neijing* is but one aspect of this. I select it for its clarity and simplicity to verify this point. He said: "Accumulations have distinctions between old and new. Old accumulations are formed from qi, blood, food, and phlegm. New accumulations arise shortly after old ones are cleared. However, old accumulations are suitable for purgation, while new accumulations are contraindicated for purgation. Why? The digestion of water and grain and the transport of waste in the intestines and stomach are the functions of Ying and Wei sprinkling and arranging within the Six Fu organs. Now, if there is pathogenic factor in the intestines and stomach, the rhythm of Ying and Wei movement is obstructed, preventing transformation. Thus, Wei qi stagnates and fails to disperse, and Ying qi becomes stagnant and fails to flow. Consequently, food accumulation and phlegm stop in the stomach, and residue remains in the intestines, joining with qi stagnation and blood stasis to form dysentery. It must be purged to unblock the obstruction. After purging, if ascending and descending still fail to operate, and clear and turbid still fail to separate, then Wei qi stagnates again, and Ying qi becomes stagnant again, forming new accumulations. How can one purge again? One should only regulate Wei qi and harmonize Ying blood to balance yin and yang. Then, ascending and descending will follow proper rhythm, and accumulations will resolve naturally without stagnation."

[17] There is a distinction between shortness of breath (Duan Qi) and deficiency of qi (Shao Qi). Deficiency of qi refers to having insufficient qi to speak. *Neijing* states: "Speaking faintly, only speaking again after a whole day, this is loss of qi (Duo Qi)." Shortness of breath is inability to continue breathing, resembling panting but not true panting, as if qi rushes upward. Thus, it resembles panting but without shoulder shaking, and resembles groaning but without pain. *Jingui Yaolue* states: "In a healthy person without cold or heat, shortness of breath and inability to breathe fully indicates excess." Without cold or heat, and without exterior pathogens, it is known that shortness of breath is not due to pathogens binding externally and blocking hair pores, causing respiratory difficulty. Rather, it is likely due to interior excess caused by pathogens, such as phlegm, food, or fluid retention, obstructing the ascending and descending qi. This clause should be read in conjunction with Clause 8.

[18] Learning medicine is like learning chess. Medical books are like chess manuals. Those skilled in chess do not achieve ease and proficiency without devoting themselves wholeheartedly to the manual. However, consulting the manual during a game to respond to the opponent is rigid and stereotyped, leading to inevitable defeat. Is medicine any different? Using rigid prescriptions to treat living patients, forcing the condition to fit the prescription, how can human life bear this? Thus, ancient sages said: "Consulting the manual in chess guarantees defeat; using rigid prescriptions in medicine endangers the patient." Zhu Danxi also said: "Ancient prescriptions and new diseases, how can they match? Clinging to them may even kill." From this, we see that empirical single prescriptions passed down in the world often only label the disease treated without distinguishing pulse and syndrome. Among these, mild and bland herbs, even if mismatched, cause little harm if tried. But for harsh and fierce herbs, users must be cautious. I personally witnessed a woman who used Ledum powder (Miduoseng) to arrest malaria, and a man who used Qishe wine to treat gout; both died instantly,无异 to poisoning. Zhang Shiwan also said: "Some ask why modern treatments for jaundice often use herbal folk remedies. In remote areas, this is understandable. But ignorant people in cities also imitate this. Would benevolent men not feel pained seeing this? I have seen many die from vomiting and diarrhea due to yuan depletion after consuming juices of Phytolacca root, bitter melon, Jiushanguanlong, Xueliqing, and Luchong. The list is endless. Once, a pregnant woman with jaundice was mistakenly treated with Citrullus colocynthis (Gua Di) insufflated into the nose, causing vomiting, reflux, wheezing, and chest fullness, leading to fetal qi rushing upward, resulting in death amidst tragic cries. At that moment, what method could save her? The answer is: this is due to past karma,无异 to moths flying into fire. To save others, one must widely publish warnings to prevent future mistakes, preserving the intent of benevolence. As for saving the overturned cart, I am powerless." According to this, the harm of herbal folk remedies is particularly severe. Although Citrullus colocynthes insufflation for jaundice is a method from Zhang Zhongjing, it caused death because the pregnancy contraindication was unknown. "Using rigid prescriptions endangers the patient" is indeed true. Regarding Phytolacca root, at least the name is known, so if mistaken, one might identify the error and attempt rescue. However, there are those who use herbal medicines, passing them down辗转, falsely claiming them as secret formulas. They only recognize the shape and color of herbs, picking and using them. Even the user cannot name them, and they crush and pound them first, making identification impossible. Thus, they mystify the theory to deceive people. If treatment succeeds, everyone spreads the news, marveling at its miracle. Later, encountering the same disease, they boldly use it without doubt. If one dose fails, they try two or three. Little do they know that what works here may not work there, because diseases vary in depth, constitutions in strength, and syndromes in cold-heat and deficiency-excess. One cannot simply use one herb to rule all cases of a named disease. Moreover, herbal medicines often have specific potency and fierce nature. If the herb matches the disease, effect is swift; if not, disaster follows quickly. I deeply hope wise people who value their lives follow the precept of "not daring to taste what is not understood." Do not treat life as a tool for testing herbs. Persuade others to understand that even experts must carefully examine conditions before prescribing. How can one lightly take herbs with a侥幸 mindset, risking unforeseen disasters?

[19] Lou Quanshan's *Yixue Gangmu* uses carbonized herbs for metrorrhagia, based on the principle that blood stops when black. Xiangfan San uses Cyperi Rhizoma (Xiangfu) soaked in vinegar overnight, stir-fried to charcoal, retaining its nature. One liang mixed with Er qian of Alum (Baifan), taken empty-stomach with rice water. Another method uses Mint Decoction, which is better. (Xu Xueshi said: For persistent lower bleeding or five-color leukorrhea, Cyperi Rhizoma is a sacred herb for women.) This treats qi stagnation using qi-moving carbonized herbs. Wulingzhi San treats metrorrhagia using Trogopteri Dung (Wulingzhi) stir-fried until smoke ceases, powdered. Take one qian with warm wine. Another method takes three qian, decocted with half a cup each of water, wine, and child's urine, named Choudao San. This treats blood impurity using blood-invigorating carbonized herbs. Jingjie San treats metrorrhagia. Light a lamp with sesame oil, place many wicks, and burn Schizonepetae Herba (Jingjie) over it until charred. Powder it. Take three qian with child's urine. This treats qi sinking using lifting carbonized herbs. For persistent metrorrhagia, regardless of duration, use Psoraleae Fructus (Huai'er) burned to charcoal, powdered, taken with wine using a square-inch measure. This treats blood heat using blood-cooling carbonized herbs. Rusheng San treats metrorrhagia. Use one liang each of Palm Fruit (Zonglv) and Mume Fructus (Wumei), and one liang five qian of Dried Ginger (Ganjiang). Burn all to charcoal, retain nature, powder finely. Take two qian with Mume wine, empty-stomach. Chronic cases cure within three doses. This treats blood cold using blood-warming carbonized herbs. Palm Fruit and Alum powdered, taken with wine, two qian per dose. This treats blood loss using astringent carbonized herbs. Note that for the same metrorrhagia and same use of carbonized herbs, the differentiation is so clear. Treating disease and prescribing herbs prioritizes identifying the syndrome; one can infer other cases from this. (Charcoal originally written as ash.)

[20] *Chesheng Babian Jingnei* states: "Inside the body, there are three nobilities: Heat as the source of life, Blood as nourishment, and Qi as movement and sensation. Thus, Heart, Liver, and Brain are noble, and the rest obey." Blood generation relies on food transformation. Food passes through teeth, then the stomach cauldron. Coarse and fine parts enter the large collaterals. Fine parts rise to Liver and Brain to form blood; coarse parts become dregs. At this stage, Spleen separates fine from coarse, Gallbladder collects harmful substances, and Kidney/Spleen store untransformed matter. Though Gallbladder and Kidney are blood-forming organs, Liver alone transforms and condenses, generating the qi of body nature. Thus, Liver is noble. Heart generates internal heat and nurturing qi; Brain generates subtle sensory qi. Thus, they are equally noble. Question: How do the three nobles generate qi? Answer: Liver receives semi-transformed nutrients via orifices, gradually transforming them fully into blood through innate power. The essence of blood transforms into blood dew, called the qi of body nature. This qi is finest, connecting hundred vessels, opening hundred orifices, guiding blood throughout the body. One part of blood enters Heart via large collaterals, first entering right orifice, then left, becoming subtle, half-transforming into dew, called nurturing qi. This qi guides fine blood to preserve original heat. One or two parts of this dew ascend to Brain via large collaterals, becoming finer and more refined, forming sensory qi, integrating with five senses and four limbs. *Zhuzhi Qunwei* states: "The human body is merely dampness and heat. Heat constantly consumes dampness; without nourishment, skin burns and body destroys. Thus, blood is the material for nourishment." Blood moves in vessels. Vessels have general collaterals. Two collaterals emerge from Liver, one up, one down, branching into smaller vessels until subtle. They penetrate internal organs and external flesh. Their number is indefinite. Vessel shapes resemble mechanisms. Smooth ones guide blood flow; slanted ones retain blood; horizontal ones advance blood. Vessel force preserves blood; without union, they break. Blood combines with phlegm to flow smoothly; combines with Gallbladder to avoid stagnation; combines with body-nature qi to open orifices without blockage. Two large collaterals emerge from Heart, one up, one down, subdividing the body, similar to Liver collaterals. Difference: Liver guides and preserves blood; Heart specifically guides heat and nurturing pathways. Heart breathes in new qi and expels old, directly connecting to the body. Vessels respond to this. If response lags, cold-heat syndromes arise. Physicians must deduce disease sources from the pulsation of three positions. Brain scatters sensory qi, functioning in sinews. Since Brain is distant from the body, it cannot reach all limbs directly. It connects via neck vertebrae and spinal marrow to spread everywhere. Brain skin has inner soft and outer hard layers, protecting life and initiating sinews. Six pairs of sinews emerge from Brain. One pair crosses neck to below chest, hanging before stomach opening; others remain in neck, guiding qi to five senses, enabling movement or sensation. Thirty pairs of sinews emerge from spinal marrow, with fine branches reaching every skin area. Where connecting to skin, they slightly resemble skin, drawing qi to fill the body. Sinew structure has pulp inside and skin outside, resembling Brain, serving as the main link between Brain and body. Heart and Liver vessels also resemble this structure, transmitting innate nature to the body. Heart, Liver, and Brain have fixed limits; they rely on sinew and vessel momentum to maintain and connect with the body, fulfilling their duties. Otherwise, how would these three manage and protect the seven-foot body, ensuring nourishment and sensation function effectively? Wu Ke's commentary states: This discussion focuses on Liver, Heart, Brain, and Sinew, concepts not found in *Lingshu* and *Suwen*. The above two excerpts are recorded from manuscript medical books, author unknown. The theory is similar to Western texts like *New Anatomy*. Western texts also align with Wang Xunchen's *Yilin Gaicuo*. These should be consulted by physicians, as visual observation surpasses speculation. However, their explanations of organ functions and qi dynamics have debatable points. *Chongqing Tang Suibi* evaluates Western books: believe the credible, omit the doubtful. This is correct. Xu Ranshi of Renhe, in his postscript to *Yilin Gaicuo*, cites *I Ching*: "Heaven and Earth establish positions; Mountain and Lake communicate qi." Inside the body shell, material positions are fixed. Digestion transforms essence, fluids, blood, and excreta; this is qi communication. I suspect Mr. Wang emphasizes fixed positions but fails to expand upon qi communication. These words are pertinent.

[21] *Neijing* states: "The fierce qi of Stomach ascends through the throat, rushes to the head, and circulates externally through various orifices." This explains that head sweating is due to damp-heat steaming upward with the fierce qi of Stomach. Also, some people sweat on the head immediately after eating. Severe cases have steam rising from the head like smoke,俗称 "steamer head." This is likely because food and drink qi rush upward with the fierce qi of Stomach upon ingestion, a congenital trait.

[22] He Xichi's *Yi Que* song on water for decoction: "Rapid flowing water aids purgation; receding wave water is best for inducing vomiting (i.e.,逆流 water). Boiling water with rising vapor induces sweating; Ganlan Laoshui has similar intent. Pickled mustard water induces vomiting for phlegm and food; Huoluan can be treated with Yin-Yang water. Fresh well water or rootless water clears irritability, removes heat, and nourishes yin. Earth soil浆 detoxifies and clears summerheat; winter snow and ice are miraculous for febrile epidemics. There is also light qi-transformed water, whose miracles few know. It adjusts ascending/descending, replenishes fluids, nourishes water, clears metal, and benefits spleen." Ganlan water is made by stirring water in a basin ten thousand times with a ladle, also called Laoshui. Ancients said water is salty and heavy; stirring makes it sweet and clear, avoiding aiding Kidney qi and benefiting Spleen/Stomach. Stirring ten thousand times symbolizes movement turning to stillness. I believe this latter explanation is closer to truth. Examining Zhang Zhongjing's Ganlan water formulas reveals its meaning. Qi-transformed water is made by evaporating water, like distilling flower dew, also called Qi Han Shui or Water Dew. *Neijing* says: "Earth qi rises as clouds; Heaven qi falls as rain." Clouds are water transforming to qi; rain is qi transforming to water. Water to qi allows fluids to rise, moistening upper dryness; qi to water allows moisture to descend, nourishing lower depletion. Using steam to transform water back to qi has cyclic wonder and ascending-descending mechanism. It can be used for decoction. For dry-heat syndromes with thirst, drinking it is appropriate.

[23] Wu Weiquan treated dry stool constipation and hematochezia with 7 parts raw tofu milk and 3 parts water chestnut juice, totaling one teacup. Boil tofu milk, add small amount of rock sugar, mix with water chestnut juice, take warm on empty stomach. Water chestnut is sweet, cold, and slippery, opens stomach, digests food, clears heat, stops bleeding. Tofu milk clears heat, disperses blood, descends turbid qi from Large Intestine. *Jiming Lu* treats leukorrhea with dampness excess using Songshi Zhudu Wan, taken with plain tofu milk morning. He Huichuan's *Wentang Jiyian Fang* treats chronic phlegm-fire with two liang maltose and one bowl tofu milk, boiled and taken frequently cures. Egg and tofu milk taken together also works long-term. Eggs remove wind in throat. I treated a child with throat wind, using clear, light, sweet, cool method with slight acrid herbs. Symptoms stopped and started. Someone advised swallowing one raw egg daily with a hole pricked in top. Within ten eggs, cured without recurrence. This proves eggs remove throat wind.

[24] *Jiming Lu* recipe for dysphagia (Ye Ge): Remove hairs from Coptidis Rhizoma (Huanglian), cut finely, two liang. Add nine bowls water, boil to six bowls. Add six bowls water, boil to three bowls. Immerse one ingot each of red gold and patterned silver, two liang each, in the decoction. Wash fifty large river snails, place upside down in plate. Use Huanglian juice to touch the snail umbilicus; they melt into water in moments. Filter half a bowl through silk. Combine snail water, Huanglian juice, and metals in porcelain pot. Boil to half a bowl. Add small half bowl Radish Juice (Lufu); if no radish, use concentrated juice from Radish Seed. Boil to half bowl. Add small half bowl Leek Juice. Add small half bowl Biota Orientalis Leaf Juice (Cebai). Add small half bowl Pear Juice. Add small half bowl Bamboo Sap (Zhuli). Add small half bowl bright white child's urine. Stop boiling when reduced to half a bowl. Remove metals. Add one large bowl human milk, one large bowl goat milk, one large bowl cow milk. Boil to one bowl. Form paste. Seal in porcelain jar, bury in earth for one Fushi (12 hours). Take one tea spoon, dissolved in boiling water. Severe cases cure in three doses. If unable to swallow liquids, place paste on tongue to seep into throat, allowing self-feeding. After cure, eat porridge for one month before solid food. This formula clears fire, resolves phlegm, removes stasis, directs qi downward, nourishes Ying, moistens dryness. Secret transmission from He Peiyuan family in Jingkou. Can挽救 critical conditions. Gu Songyuan's *Yi Jing* names it Zaizao Dan. *Neijing* states: "Binding of Three Yang causes obstruction." Three Yang binding refers to heat in Large Intestine, Small Intestine, and Bladder. Small Intestine heat dries blood vessels; Large Intestine heat prevents defecation; Bladder heat depletes fluids. All Three Yang bound causes constipation. Downward blockage forces reversal upward, causing inability to swallow. Ancients described dysphagia as blood exhaustion and stubborn disease, requiring large doses. This formula is precisely prepared, concentrated paste, potent, matching Yu Jia Yan's principle of "changing stomach without being changed by stomach." The care of skilled practitioners is thus.

[25] *Chongqing Tang Suibi* states: Akebia Caulis (Mutong) is bitter, thus draining Heart fire via Small Intestine. Materia Medica says it is sweet and bland, or slightly acrid. Have you not tasted it or asked? Mutong was formerly named Tongcao. Current Tongcao was formerly named Tongduomu. Claiming Mutong is sweet/bland may be a transmission error of Tongcao. Actually, current Mutong is extremely bitter and inferior. People say Coptis (Huanglian) is bitter, but Huanglian is bitter and clear; Mutong is bitter and turbid. Ye's medical case used Aloe (Luhui) in decoction; Xu commented: "Taste it yourself to know bitterness." Apply this to Mutong. Mutong is extremely rapid and sharp, not suitable for high doses. Friend Shen Xingtian saw a child who accidentally took heavy dose Mutong decoction. Urine became incontinent, followed by white fluid like semen, dying in agony. After death, semen-like beads remained at urethral orifice. Users of Mutong must be cautious.

[26] Human body has inner/outer layers and upper/lower sections. Inner/outer and upper/lower interact like breathing, pulling each other. For example, purgation causing diarrhea drains lower interior, causing upper interior qi to sink. With upper interior empty, exterior surface qi enters internally with pathogens, causing Jie Xiong (Constraint Chest). For example, releasing exterior causing sweat vents upper exterior, causing interior qi to follow out. With upper interior empty, lower interior yin qi blocks upward, causing Pi Men (Stagnant Oppression). Understanding this, forbid excessive sweating above, caution against purgation below. Reading Zhang Zhongjing's *Shanghan Lun* on Jie Xiong and Pi syndromes becomes clear as melting ice/snow. This is from Gao Xueshan's *Shanghan Shanglun Pian Bensi*. Since ancient famous doctors, none did not use yin-yang ascending/descending, fullness/emptiness, waxing/waning...