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Qian Yi stated: When a Liver disease occurs in Autumn, when Wood energy is prosperous, the Liver Qi is strong and overcomes Lung Metal. One should tonify the Lung and drain the Liver. In mild cases, the Liver disease will recede; in severe cases, the lips will turn white, leading to death.

When a Lung disease occurs in Spring, when Metal energy is prosperous, the Lung Qi is strong and overcomes Liver Wood. One should drain the Lung. In mild cases, the Lung disease will recede; in severe cases, Jing Feng (Convulsions) will inevitably occur. If the complexion is red, convulsions should be expected, indicating Liver Qi deficiency, with the eyes showing a pale cyan color.

When a Heart disease occurs in Winter, when Fire energy is prosperous, the Heart Qi is strong and overcomes Kidney Water. One should tonify the Kidney and treat the Heart. In mild cases, the Heart disease will recede; in severe cases, there will be downward protrusion of the rectum and muteness, indicating Kidney Qi deficiency and emptiness.

When a Kidney disease occurs in Summer, where Water overcomes Fire (referring to the interaction where Kidney Water counters Heart Fire), the Kidney Qi is strong and overcomes Heart Fire. One should drain the Kidney. In mild cases, the Kidney disease will recede; in severe cases, palpitations and convulsions will occur.

For Spleen diseases, the treatment for the other four Zang organs can be modeled on this principle. Smooth patterns are easy to treat, while counter-flow patterns are difficult. Spleen deficiency manifests as redness and yellowing of the face and eyes. When the Five Zang energies oppose each other, treatment should be based on the specific symptoms.

For example, if a Lung disease presents with Liver symptoms such as teeth grinding and frequent yawning, it is easy to treat because Liver deficiency cannot overcome the Lung. However, if there is staring eyes, loud crying, neck stiffness, and restlessness, it is difficult to treat. This is because prolonged Lung disease leads to deficiency and cold, while Liver Qi becomes strong and solid, counter-acting the Lung. One must observe the duration and excess-deficiency status of the pathogenic factor: for deficiency, tonify the Mother organ; for excess, drain the Child organ.

Zhang Yuansu (Jiegu) stated: When Liver Qi overcomes Lung Metal, it is a Liver disease. If the Liver disease manifests as convulsions accompanied by Lung deficiency symptoms such as panting and shortness of breath, appearing during the Shen, You, and Xu hours, this is "True Excess" (Zhen Qiang). The *Neijing* states: "Being controlled but unable to control others is called True Excess." The treatment method should involve tonifying the Spleen and Lung while draining the Liver, primarily using Dao Chi San (Gardenia Decoction) and Xie Huang San (Drain Yellow Powder).

Commentary: Liu Zongnong said: These are all pathological mechanisms of the Five Zang organs overcoming each other, adhering to the principles of the generation and restriction cycles of the Five Elements. Generally, infants in swaddling clothes have no Seven Emotions or Six Desires; their physical form is fragile, blood and Qi are not yet settled, and the Zang-Fu organs and spirit are not fully developed. Therefore, they suffer from diseases of Zang Qi excess, deficiency, overcoming, and invasion. However, laypeople often fail to understand this principle, mistakenly attributing these conditions to external contractions or internal injuries, leading to many wrongful deaths due to inappropriate medication. How tragic! Moreover, Qian Yi's discussions were somewhat brief; fortunately, Zhang Yuansu supplemented them. Now, by specifically referencing and adding to these works, we provide an enduring benefit.

Zhang Yuansu stated: What comes from behind is Excess Evil (Shi Xie). The Child can cause the Mother to become excessive. The Ghost-Thief (the element that controls the Mother) harms the Mother, and the Child then invites the Wife (the element controlled by the Mother) to assist, thus it is called Excess Evil.

What comes from ahead is Deficiency Evil (Xu Xie). The Mother brings the Ghost-Thief of the Child, causing the Child to become deficient through the Mother. The *Neijing* states: "The Child can make the Mother excessive, and the Mother can make the Child deficient." This is what is meant.

When the Wife (controlled element) overcomes the Husband (controlling element), it is Slight Evil (Wei Xie). When the Husband overcomes the Wife, it is Thief Evil (Ze Xie). The treatment method should be to drain the Ghost-Thief and tonify the affected Zang organ. When the Zang organ is diseased by itself, it is Correct Evil (Zheng Xie); tonify if deficient, drain if excessive. The *Neijing* states: "To nourish the sprout, one must surely consolidate the root; to cut down the lower, one must let the upper wither. To reverse the root and attack the source is to destroy the true essence."

Commentary: Liu Zongnong said: This discusses the way of the Five Elements' generation and restriction. The meaning is found in Chapter 50 of the *Nan Jing* and the subsequent discussion on the essential treatments for tonifying and draining the Five Zang organs; reference should be made to them.