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A question was asked: The *Neijing* (Classic of Internal Medicine) states, "The eyes see when they receive blood; the palms grasp when they receive blood; the fingers manipulate when they receive blood." It also states, "The eyes are the essence of the five zang and six fu organs." From this, it can be observed that a person must have abundant jing-qi (vital essence and qi) internally before their spiritual brilliance can manifest externally. Why did you treat Governor Fei Ruqing's illness primarily with wind-dispelling herbs? Have you not considered that wind-dispelling herbs are generally drying in nature?

I replied: You only know that Shudi Huang Jing (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis), Gou Qi Zi (Lycium Fruit), and Ju Hua (Chrysanthemum Flower) can nourish kidney water, nourish blood, and brighten the eyes. Do you not know that the Governor served in the military, exposed to wind, frost, rain, and dew, allowing pathogens to infiltrate the exterior and lie dormant within? Several years ago, he suffered from He Xi Feng (Crane Knee Wind, a type of bi syndrome affecting the knee joints). Crane Knee Wind refers to the obstruction of the knee joints by wind-cold-dampness. Later, although he experienced red eyes, excessive tearing, photophobia, and pain in the brow bones upon onset, people attributed this to Kidney Water Deficiency and Liver Wood Hyperactivity, causing deficient fire and liver yang to ascend. This interpretation is indeed plausible.

However, one must understand that every zang and fu organ in the body has specific cooperative relationships. Zang organs are yin, and fu organs are yang. Yang qi naturally ascends but must be guided to descend; if it does not descend, there is a risk of dispersion and hypermobility. Yin qi naturally descends but must be guided to ascend; if it does not ascend, there is a risk of sinking and collapse. Therefore, Pi (Spleen) is Yin Earth; its qi moves upward to raise the clear yang. Wei (Stomach) is Yang Earth; its qi moves downward to descend the turbid yin. Thus, Gan (Liver) qi combines with Pi qi to ascend, thereby generating Xin Xue (Heart Blood); Dan (Gallbladder) qi combines with Wei qi to descend, thereby transforming Ming Huo (Ministerial Fire).

Whenever the Governor's eye disease flares up, his pulse is fine, soggy, and indistinct, and his tongue coating is thick, greasy, and white. Considering his previous conditions such as Crane Knee Wind, I deduced that he had damp-cold in the Stomach, causing Yangming Stomach Qi to fail to descend. Consequently, Dan Jing (Gallbladder Meridian) Qi could not attach itself to Stomach Qi to descend. Meanwhile, Gan Mu (Liver Wood) continued to ascend, while Dan Mu (Gallbladder Wood) suddenly lost its ability to descend. With only Liver ascent and no Gallbladder descent, the Liver's ascent fails to serve as the source for generating Heart Blood and instead causes harmful turbulence and upward rebellion. Since the eyes are the orifice of the Liver, to cure the eyes, one must extinguish the Liver; to extinguish the Liver, one must descend the Gallbladder; to descend the Gallbladder, one must descend the Stomach.

Why does Stomach Qi fail to descend? Because it is obstructed by dampness. Wind-dispelling herbs can overcome dampness and unblock the trend of turbulent rebellion, which explains why they yielded repeated success.

Another question arose: At the time of onset, there were no symptoms such as chest/epigastric fullness or vomiting/regurgitation. How can you be certain it is a Stomach disease without doubt?

I answered: The stool must be obstructed/constipated. This aligns with the principle that "disharmony in the nine orifices all relates to the Stomach." Moreover, during the illness, the tongue coating is greasy and turbid; after recovery, the turbid coating completely disappears. This external manifestation provides reliable evidence. Would a Yin Deficiency pattern present like this?

Another question: If the medication was appropriate, why did the condition recur frequently without eradicating the root cause?

I answered: Stomach disease transmits to the Gallbladder, and Gallbladder disease transmits to the Liver. This is not originally a primary Liver disease. However, during the initial few episodes, physicians used cooling herbs to suppress it and yin-nourishing herbs to tonify it. This caused the pathogenic factor of turbulent rebellion to hide deeply within the collaterals, making the root difficult to eradicate. Once triggered by external wind, the disease recurs—this is the underlying mechanism.

Another question: I have heard that wind-dispelling herbs were ineffective, but Chai Hu Tang (Bupleurum Decoction) cured it. Why?

I answered: Wind-dispelling herbs can only unblock the trend of turbulent rebellion but cannot clear heat. When the qi rebels and rotates upward, stagnation generates heat. Chai Hu (Bupleuri Radix) is the specialized herb for dispersing Gallbladder meridian stagnation; it both dissipates stagnant, vigorous qi and resolves stagnant heat. Because there is heat within the stagnation, wind-dispelling herbs cannot treat it, whereas Chai Hu can.

Another question: I have heard that besides eye disease, stomach pain also occurred. What method did you use to stop it?

I answered: I did not specifically aim to stop it. Initially, regulating qi was ineffective, and warming/unblocking methods failed. I then recalled that Xuan Yin (Hanging Fluid), one of the Five Drinks, can cause pain. I administered Ban Xia (Pinelliae Rhizoma) and Tian Nan Xing (Arisaematis Rhizoma Preparata) to attack the phlegm-fluid retention. After the bowels moved freely, the pain ceased spontaneously. This is another manifestation of Stomach disease.

Another question: I have heard that besides stomach pain, severe vertigo also occurred. Can all ailments be attributed to phlegm-dampness?

I answered: Vertigo cannot occur without phlegm. I used Dao Tan Tang (Phlegm-Resolving Decoction) administered with Bai Jin Wan (White Gold Pill), achieving results as swift as striking a drum with a mallet. If this were not due to phlegm-dampness, what else would it be?

Someone said: I understand now. Your point is that the flare-up of eye disease is not due to Liver deficiency, but rather because damp-phlegm in the Stomach obstructs the descent of Gallbladder Qi, leading to excessive ascent of Liver Qi. Stomach pain occurs because the Stomach is obstructed by damp-phlegm, preventing the smooth descent of Qi. Vertigo is what is referred to as Phlegm accumulation in the Stomach with rebellious Gallbladder Qi. Although the diseases differ, their source is identical. I comprehend your explanation.