这个时候你去补他的外五味能起多少作用呢？起作用也是一时的作用，也是权宜之计，不是根本的方法。你应该着眼于他的太阴，他的脾胃，他的内坤元。让这部分厚壮起来，正常起来。这部分能够“万物资生”，能够“五味出焉”，那这个维生素的缺乏、矿物质的缺乏就从根本上得到了解决。这就是运用主干思维。中医的这个主干思维任何时候都不能丢。3.太阴的病候特征（1）其用有二，其病亦二上面我们谈到太阴脾胃的性用有二，其一，就是坤厚载物；其二就是万物资生。载物讲的是装载、藏纳；资生讲的是运化、变化。太阴的这样一些性用也充分体现在它的病变上，提纲条文里提到的“吐，食不下，自利”，其实就是载物出了问题。太阴坤土不能载物，那当然就会患食不下、利、吐之证。因此，食不下、利、吐这些就是太阴不能载物的一个特征。另一方面，就是资生的问题，资生障碍会影响“五味出焉”这个功能。如果这个障碍得不到及时的解除，那就会进而全面影响到太阴脾胃作为后天之本的作用。虽然，这个作用的丧失是渐进的，不会一夜之间形成，但是，值得我们高度地重视。提纲条文提到“腹满，时腹自痛”就是上述运化功能受到影响的一个表现。（2）太阴利的特点下利是太阴病的一大特点，是坤不载物的表现。这里提请大家注意，张仲景在条文里用的是“自利”两字，这就需要我们作一个区分。什么是自利呢？假如开一个大承气汤，病人吃了以后拉肚子，一天甚至拉十多次，这个算不算自利呢？显然，这个不能算自利，这个应该算“他利”。又比如，朋友到外面聚会，吃了不干净的东西，大家都下利，这个利也不叫“自利”，因为有一个很明显的导致下利的因素。所以，自利是有范围的，有特指的，没有上述这些明显的因素，他也拉肚子，他也下利，这个才能叫“自利”。这是太阴病的一大特征。太阴病的这个利除了自利的特征之外，还有一个相伴的特征就是“不渴”，这在 277 条里有明确的指示，即“自利不渴者，属太阴”，为什么要把这个“不渴”作为太阴下利的特征呢？因为一般的下利很容易发生口渴。下利就会有大量的水分丢失，所以，口渴很容易发生。而惟独太阴病的下利不伴随口渴，因此，这个不渴就具有特异性，对太阴病就具有鉴别诊断意义。（3）藏寒太阴的许多病变都与藏寒有极大的关系，所以，277 条明确指出：“自利不渴者，属太阴，以其藏有寒故也，当温之，宜服四逆辈。”藏寒对太阴各方面的性用都会造成不良影响，载物的性用会受影响，资生万物的性用也会受到影响。所以，太阴提纲条文所提到的诸证都与藏寒有直接关系。《内经》云“藏寒生满病”，而太阴提纲条文的第一个证就是“腹满”，这一方面说明了藏寒与太阴病的密切关系，另方面也说明了《伤寒论》条文的叙证次第是有严格把握的，这一点尤其值得我们重视。现在研究《伤寒论》的人太不注重这个问题，条文的次序可以任意改动，因此，对每一条文孰证在先孰证在后也就根本不在意了。太阴病为什么藏寒，我们在第三章曾作过专门讨论，大家可以参考前面的内容。藏为什么寒？当然是藏的阳气太少了。阳是主温煦的，阳少了自然就不温，这就是藏寒。因此，我们讨论引起藏寒的因素，应该围绕着阳气来谈。① 素体关系素体因素也就是先天的因素，父母媾精的时候给你的阳气就少，所以生出来以后阳气自然就弱。阳气弱，藏就会寒，这一种藏寒比较难办。因为先天的因素你没法改变，你只有通过后天来调理。后天也就是太阴，也就是脾胃。所以，藏寒的问题放到太阴篇来讨论是有特殊意义的。② 嗜食寒凉这是后天的因素，这一点非常重要，特别是我们南方人。南方人，像是南宁人，动不动就讲上火，你看 10 个病人，有 9个都说火气大。这个也热气，那个也热气，都不能吃。能吃什么呢？就能吃寒凉的东西、清火的东西。而现在要吃寒凉非常方便，打开冰箱就是了。所以，我说冰箱造出来有一半的功，一半的过。我们好不容易养就这一团阳气，让这个寒凉的、冰冷的东西下去就给糟蹋了。我在门诊看病，对上述 的 问 题 体 会 很 深。病 人 只 要 是 本 地 人，有80% ～ 90% 平常都在喝凉茶。有的病人已经虚寒得很厉害了，用附子尚恐不及，可病人还在喝凉茶，医生还在清热。看到这样的情况，真是十分痛心。造成上述的局面，很显然是两方面的因素。一方面是病人的医学知识太贫乏，这方面我们应该加强医学知识的普及；另一方面就是我们医生，医生根本弄不清阴阳，也跟着病人凑热闹。病人说热，他就跟着清热，也不管脉证是否真的有热。是热是寒、是实是虚这是要有实据的。不能光听病人的一面之词。现在确实有很多的人稍吃一点煎炒就咽喉痛，就鼻出血，这是不是真的有火热呢？这个也还得看舌脉，看是否真的有火热的证据。我曾经在前面举过一个例子，久旱的土地本身很干，很需要水，可是我们把水淋下去以后它却不吸收，水又从旁边流走了。看起来好像是土里面的水太多了，满出来了，可实际上干得很，一点水都没有渗下去。为什么呢？土地太板结了，土一点也不松动，所以它不吸水。对这一点农民非常有经验，对久旱的土地，对板结的土地，要淋水前必须先松土。先把土的“经络”疏通，“经络”疏通了，再一淋水，它就全部吸收了，再也不漫溢出来。人的情况也是这样，你吃一点油炸的东西就上火，甚至闻到一些油炸的东西也上火，是不是你体内的火太多了？阳气太旺了？实际往往不是这么回事。是你的经络堵了，气血不通了。经络不通，这就像上面的淋水一样，稍微淋一点，它就会漫出来。所以，稍微吃一点油炸你就咽喉痛。咽喉痛了，病人认为热，医生也当成热，于是就用寒凉，就打青霉素。殊不知寒则凝滞，寒凉下去，青霉素下去，经络只会越来越堵，越来越不通。就这样三五年，七八年，甚至十余年，寒凉的药还在用，可是这个“火”照“上”不误。真是苦海无边，迷不知返啊！我们看临床上的这类“上火”病人，有几个见得到火热的真凭实据呢？大多数没有！舌脉上反映的多是一派虚寒景象。这个时候你给他用温药，附子、干姜、肉桂放胆用去。温热药下去，经络的凝滞温通了，松动了，再多的“火”它也能吸纳。加上真水不寒，汞火不飞。再去吃油炸，再去打火锅，怎么就没事了呢？清末名医郑钦安云：“医学一途，不难于用药，而难于识症。亦不难于识症，而难于识阴阳。”因此，作中医的应该在阴阳寒热的辨识上下功夫。如果阴阳识不清，寒热辨不准，没有热你去清热，结果受害的是什么呢？当然是阳气。阳气的功用大家应该知道，特别是《素问·生气通天论》讲的“阳气者，若天与日，失其所则折寿而不彰”，如果为了一个咽喉痛把阳气损伤了，这个代价就太惨重了。现在有不少的人喜欢中医，为什么呢？因为他们认为中医药没有副作用。而做中医的本身也这样认为。我是坚决反对这种认识的，我以为中医的副作用可能比西医还大。何以见得？因为西医的副作用很容易识别，每一药物有什么副作用它会清楚地告诉你。青霉素容易导致过敏，它提醒你必须做皮试。利福平容易引起肝肾功能损害，这就告诉你要定期做肝肾检查，以便对有可能出现的肝肾功能损害作及时的处理。可中医呢？中医披着一层没有副作用的外衣，什么都可以用，什么人都可以吃，其实这是草菅人命。如果把阳气耗损了，这个副作用就不仅仅是肝肾损害的问题，而是要折寿的问题。中医治病是以偏救弊，用寒去治热，用热去治寒。热者寒之，前提是真正有热，你才用寒。如果没有热，你也用寒，那结果会怎样呢？这就是《内经》说的“久而气增，夭之由也”。所以，诸位能说中医没有副作用吗？中医的副作用太可怕了！要不然古人怎么会说“庸医杀人不用刀”呢。你要想做中医，尤其想做一个好的中医，这个问题千万不能含糊。这是由寒凉引出的一段话，这个问题不但患者要注意，医生尤其要注意。③ 烦劳太过《内经》讲：“阳气者，烦劳则张。”这个张是什么意思呢？就是弛张，就是向外，就是发泄释放。前面我们曾经讲过，太阴一个很重要的功用就是开。太阴一开，阳气就入内，阳气入内以后，不但温养藏府，而且得到休养生息。倘若烦劳，则阳气必外张而不得入内，不得入内则阳不蓄养，久之亦亏虚而藏寒。故烦劳太过者，阳气多易亏损。此亦与太阴开机障碍相关。④ 作息非时阳气的耗损可由多方面的原因造成，没有吃生冷、没有吃寒凉，会不会造成阳气损伤呢？同样会的。比如我们作息非时，也可以成为耗损阳气的一个原因。前面曾谈到“冬三月，此谓闭藏”，在这样一个闭藏的时期，我们的作息也要与它相应。就是要“早卧晚起，必待日光”，如果冬三月，天地在闭藏，你不闭藏。你还是很晚睡觉，那这个阳气就得不到应有的蓄养，得不到蓄养当然就会亏损。阳气亏损了自然会藏寒，藏寒了就会导致“腹满而吐，食不下，自利益甚，时腹自痛”的发生。诸位应该清楚，饮食靠什么来消化呢？靠阳气来消化。现在相当多的医生碰到病人“食不下”只会用山楂、麦芽、神曲，这些药有没有用呢？当然有用。在的确有食滞的情况下，用上这些药是会很见效的。可是如果不是食滞，这个舌脉根本不是食滞的舌脉，而是一个阳虚的舌脉，藏寒的舌脉，那这个“食不下”就不是上述这些消导药所能解决。这个时候必须温养阳气，必须用理中汤一类。理中汤下去，阳气起来了，病人自然就胃口大开。（4）谏议之官谏议之官出自《素问》遗篇“刺法论”中，在《素问·灵兰秘典论》中曾经谈到十一个官，即“心者，君主之官”、“肺者，相傅之官”、“肝者，将军之官”、“胆者，中正之官”、“膻中者，臣使之官”、“脾胃者，仓廪之官”、“大肠者，传道之官”、“小肠者，受盛之官”、“肾者，作强之官”、“三焦者，决渎之官”、“膀胱者，州都之官”。在这十一官里，除脾胃外，都是单独谈。惟到“仓廪之官”的时候，将脾胃合起来了。合起谈，脾胃各自的功能特性就不容易区分。所以，到《素问·刺法论》里，就将脾胃的官位区别开了。原来的“仓廪之官，五味出焉，”继续由胃来担当，而脾则定为“谏议之官，知周出焉”。将脾定为“谏议之官”真是太重要了，单是脾家的这一定位，你就应该知道《刺法论》非等闲之论。切莫以为其为遗篇而小视之，若轻视此论，那就当面错过了。谏议为古官名，后称谏议大夫。何为谏？《说文》徐注曰：“谏者，多别善恶以陈于君。”所以，谏议之官是一个非常重要的官位，他享有特权，可以将任何的善恶之事直接面禀君王。有了谏议之官，君王就不会被蒙在鼓里，就不会因一面之词而作出错误的决断。也就是有了这个谏议之官，君主才会真正的神而明之，才不会做昏君。这就是所谓的“知周出焉”。所以，这个“知周”实际上是针对“君主之官”而言的。《易·系辞》所云“知周乎万物而道济天下，故不过”，就是讲的这个意思。君王要想没有过失，要想真正的知周乎万物而道济天下，就要靠这个“谏议之官”。通过上面这段文字，我们应该对“谏议之官”的意义有所了解。人的生命，乃至国家的兴衰，虽系于“君主之官”，然而君主却要仰仗“谏议”方能神明，方能知周，从而道济天下无有过失。可见这个“谏议”的官位非同寻常，不是小可之辈能够担当的。要担当这个非常之位，至少得有三个条件。第一就是要正直，不正无以明是非，无以别善恶，故《广雅》释谏为“正也”；第二必须重义，倘无义薄云天之气概，你瞻前顾后，畏首畏尾，时时想着要保乌纱，那这个谏议就名存实亡。《旧唐书·职官志》言：“凡谏有五，一曰讽谏，二曰顺谏，三曰规谏，四曰致谏，五曰直谏。”要是没有这个义，就是一谏也难以做到；第三就是要有大度，要大公无私。如果你的亲朋好友，如果是给过你好处的人，他有恶你也不谏；如果是你的怨敌，你就无事生非，那这个“谏”也就失去了根本的意义。从“谏议之官”的三个基本条件回看《素问》的“刺法论”，就知道“谏议”的这个官位非脾莫属。因为只有脾具备这些条件。脾属坤土，具坤之性。我们翻开《周易》，其坤卦之六二云：“直方大。不习无不利。”何为“直方大”呢？其后之象云：“直其正也，方其义也。君子敬以直内，义以方外。敬义立而德不孤。直方大，不习无不利。则不疑其所行也。”由此“直方大”，则知脾为“谏议之官”的条件是完全具备的。又，坤卦云：“积善之家，必有余庆。积不善之家，必有余殃。臣杀其君，子杀其父，非一朝一夕之故。其所由来者渐矣。由辩之不早辩也。”积者，言坤厚载物也。故非坤无以言积。然而这个“积”有善与不善的区别，积善则有余庆，积不善则有余殃。臣杀其君，子杀其父，虽是骇人听闻的事。但却非一朝一夕所能造就。
At this time, how much effect can you achieve by supplementing his "external five flavors"? Even if there is an effect, it is temporary and merely a stopgap measure, not a fundamental solution. You should focus on his Taiyin (Taiyin syndrome), his Spleen and Stomach, and his internal Kun Yuan (the fundamental energy belonging to Yin, characterized by stillness and bearing). Let this part become robust and function normally. When this part can "generate all things" (all living things rely on it for growth and transformation) and "produce the five flavors" (the source of the five flavors), then deficiencies in vitamins and minerals will be fundamentally resolved. This is the application of "main trunk thinking." This main trunk thinking in Traditional Chinese Medicine (TCM) must never be discarded.
3. Characteristics of Taiyin Disease Manifestations
(1) Two functions, two corresponding diseases
As mentioned above, the functional properties of the Taiyin Spleen and Stomach are twofold: first, the thick Earth bears all things; second, it generates all things. "Bearing all things" refers to loading and storing; "generating all things" refers to transportation, transformation, and change. These functional properties of Taiyin are fully reflected in its pathological changes. The symptoms mentioned in the outline clause—"vomiting, inability to eat, spontaneous diarrhea"—actually indicate problems with "bearing all things." If the Taiyin Kun Earth cannot bear things, naturally, one will suffer from inability to eat, diarrhea, and vomiting. Therefore, inability to eat, diarrhea, and vomiting are characteristics of Taiyin's failure to bear things. On the other hand, there is the issue of generation. Obstacles in generation will affect the function of "producing the five flavors." If this obstacle is not resolved promptly, it will comprehensively affect the role of the Taiyin Spleen and Stomach as the "Root of Post-Heaven Existence." Although the loss of this function is gradual and does not happen overnight, it deserves our high attention. The outline clause mentions "abdominal fullness and occasional spontaneous abdominal pain," which is a manifestation of the aforementioned transportation and transformation function being affected.
(2) Characteristics of Diarrhea in Taiyin Disease
Diarrhea is a major characteristic of Taiyin disease, representing the manifestation of Kun Earth failing to bear things. Here, we draw everyone's attention to the fact that Zhang Zhongjing uses the term "spontaneous diarrhea" (Zili) in the clauses, which requires us to make a distinction. What is "spontaneous diarrhea"? Suppose Da Cheng Qi Tang (Major Order the Qi Decoction, a formula for purging heat and accumulation) is prescribed, and after taking it, the patient has diarrhea, even more than ten times a day. Does this count as "spontaneous diarrhea"? Obviously, this does not count as "spontaneous diarrhea"; it should be considered "forced diarrhea" (Tali). For example, friends gather outside, eat unclean food, and everyone suffers from diarrhea. This type of diarrhea is also not called "spontaneous diarrhea" because there is a very obvious factor causing the diarrhea. Therefore, "spontaneous diarrhea" has a specific scope and definition. Only when a person has diarrhea without these obvious factors can it be called "spontaneous diarrhea." This is a major characteristic of Taiyin disease. Besides the characteristic of spontaneity, another accompanying feature of diarrhea in Taiyin disease is "absence of thirst." This is clearly indicated in Clause 277: "Spontaneous diarrhea with absence of thirst belongs to Taiyin." Why is "absence of thirst" used as a characteristic of Taiyin diarrhea? Because general diarrhea easily leads to thirst. Diarrhea involves the loss of large amounts of water, so thirst occurs easily. However, only in Taiyin disease does diarrhea not accompany thirst. Therefore, this "absence of thirst" is specific and has differential diagnostic significance for Taiyin disease.
(3) Cold in the Zang Organs
Many pathological changes of Taiyin are closely related to cold in the Zang organs. Therefore, Clause 277 explicitly states: "Spontaneous diarrhea with absence of thirst belongs to Taiyin, due to cold in the Zang organs. It should be warmed, and Si Ni Lei (Si Ni Decoction category) is suitable." Cold in the Zang organs adversely affects all functional properties of Taiyin. The function of bearing things will be affected, and the function of generating all things will also be affected. Thus, all symptoms mentioned in the Taiyin outline clause are directly related to cold in the Zang organs. The *Neijing* states, "Cold in the Zang organs generates fullness diseases." The first symptom in the Taiyin outline clause is "abdominal fullness." This一方面 illustrates the close relationship between cold in the Zang organs and Taiyin disease, and另一方面 shows that the sequence of symptom description in the *Shanghan Lun* (Treatise on Cold Damage) clauses is strictly controlled, a point especially worthy of our attention. Currently, researchers of the *Shanghan Lun* pay too little attention to this issue, arbitrarily changing the order of clauses, and thus disregarding which symptoms come first and which come later in each clause. We discussed specifically why Taiyin disease involves cold in the Zang organs in Chapter 3; readers can refer to the previous content. Why is there cold in the Zang organs? Naturally, it is because there is too little Yang Qi (Yang Energy) in the Zang organs. Yang is primarily responsible for warming and nourishing. With less Yang, there is naturally no warmth; this is what is meant by cold in the Zang organs. Therefore, when discussing factors causing cold in the Zang organs, we should center around Yang Qi.
① Constitution
Constitutional factors refer to congenital factors. If your parents transmitted less Yang Qi during conception, your Yang Qi will naturally be weak after birth. Weak Yang Qi leads to cold in the Zang organs. This type of cold in the Zang organs is relatively difficult to manage. Because congenital factors cannot be changed, you can only regulate through post-natal factors. Post-natal factors refer to Taiyin, i.e., the Spleen and Stomach. Therefore, discussing cold in the Zang organs in the Taiyin chapter has special significance.
② Preference for Cold and Raw Foods
This is a post-natal factor, which is very important, especially for people in Southern China. People in the South, such as those in Nanning, often talk about "getting internal heat." Look at 10 patients, and 9 say they have excessive fire/heat. They feel this is hot, that is hot, and cannot eat anything. What can they eat? Only cold foods and cooling foods. Now, eating cold food is very convenient; just open the refrigerator. So I say the invention of the refrigerator has half merit and half fault. We painstakingly nurture a ball of Yang Qi, but letting cold, icy substances go down ruins it. In my outpatient practice, I have deeply experienced the above issues. Among local patients, 80% to 90% regularly drink herbal cooling teas. Some patients are already severely deficient and cold; even using Fuzi (Aconiti Lateralis Radix Praeparata) might not be enough, yet the patients continue drinking cooling teas, and doctors continue clearing heat. Seeing such situations is truly heartbreaking. The causes of the above situation are obviously twofold. On one hand, patients' medical knowledge is too poor; we should strengthen the popularization of medical knowledge. On the other hand, it is us doctors who do not understand Yin and Yang at all and join in the fun with patients. If a patient says they are hot, the doctor follows suit and clears heat, regardless of whether the pulse and signs truly indicate heat. Whether it is heat or cold, excess or deficiency, there must be objective evidence. One cannot rely solely on the patient's one-sided account. Indeed, many people now experience sore throat and epistaxis (nosebleed) after eating slightly fried or roasted foods. Is this truly internal heat/fire? This still requires looking at the tongue and pulse to see if there is real evidence of heat/fire. I once gave an example earlier: dry land after a long drought is itself very dry and needs water greatly, but when we pour water on it, it does not absorb it; the water flows away from the side. It looks as if there is too much water in the soil, overflowing, but actually, it is very dry, with not a drop of water seeping in. Why? The soil is too compacted, not loose at all, so it does not absorb water. Farmers are very experienced in this regard. For dry, compacted land, one must loosen the soil before watering. Once the "meridians" of the soil are unblocked, upon watering, it absorbs everything completely without overflowing. Human conditions are the same. If you get "internal heat" (shanghuo) from eating a little fried food, or even smell it and feel heated, is it really because you have too much fire inside? Is your Yang Qi too vigorous? Actually, it is often not the case. Your meridians are blocked, and Qi and Blood are not flowing freely. Blocked meridians are like pouring water on compacted soil; a slight amount will overflow. So, eating a little fried food causes a sore throat. The patient thinks it is heat, the doctor also treats it as heat, so cold medicines are used, or penicillin is injected. Little do they know that cold causes stagnation. As cold medicines and penicillin are administered, the meridians become increasingly blocked and obstructed. Over three to five years, seven or eight years, or even ten-plus years, cold medicines are still used, but this "fire" continues to "flare up." It is truly boundless suffering, lost and unable to return! Looking at such "internal heat" patients in clinical practice, how many show true evidence of heat/fire? Most do not! The tongue and pulse mostly reflect a picture of deficiency-cold. At this time, you should boldly use warm medicines such as Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma), and Rougui (Cinnamomi Cortex). When warm medicines are taken, the stagnation in the meridians is warmed and unblocked, becoming loose, and any amount of "fire" can be absorbed. Coupled with the fact that True Water is not cold and Mercury Fire does not fly away, even eating fried food or hot pot becomes harmless. Zheng Qin'an, a famous physician of the late Qing Dynasty, said: "In the path of medicine, it is not difficult to prescribe drugs, but difficult to identify syndromes. Nor is it difficult to identify syndromes, but difficult to distinguish Yin and Yang." Therefore, TCM practitioners should strive to discern Yin-Yang and cold-heat. If Yin and Yang are not distinguished clearly, and cold and heat are not identified accurately, clearing heat when there is no heat—what is the result? Naturally, it harms the Yang Qi. Everyone should know the functions of Yang Qi. Especially as stated in the *Suwen: Shengqi Tongtian Lun*: "The Yang Qi of man is like the sky and the sun; if it loses its proper place, lifespan is shortened and brilliance is obscured." If Yang Qi is damaged for the sake of a sore throat, the cost is too heavy. Nowadays, many people like TCM because they believe Chinese herbal medicine has no side effects. Doctors themselves also think so. I firmly oppose this view; I believe the side effects of TCM may be greater than those of Western medicine. How can this be seen? Because Western medicine side effects are easy to identify; every drug clearly tells you what its side effects are. Penicillin easily causes allergies, reminding you to perform a skin test. Rifampicin easily causes liver and kidney damage, telling you to undergo regular liver and kidney checks to handle potential damage promptly. But what about TCM? TCM wears a cloak of having no side effects; anything can be used, anyone can take it. In reality, this is treating human life lightly. If Yang Qi is depleted, the side effect is not just liver and kidney damage, but a reduction in lifespan. TCM treatment aims to correct imbalance by using opposites: using cold to treat heat, and heat to treat cold. "For heat, use cold" presupposes true heat exists before using cold. If there is no heat and you still use cold, what will be the result? This is what the *Neijing* says: "Long-term increase of Qi [due to mismatched treatment] is the cause of premature death." So, can you say TCM has no side effects? The side effects of TCM are terrifying! Otherwise, why would the ancients say, "An incompetent doctor kills without a knife"? If you want to be a TCM practitioner, especially a good one, this issue must not be vague. This is a digression triggered by cold and raw foods; this issue requires attention not only from patients but especially from doctors.
③ Excessive Mental Labor
The *Neijing* states: "When Yang Qi is subjected to mental labor, it expands outward." What does "expand" mean here? It means relaxation, moving outward, and releasing. As mentioned earlier, an important function of Taiyin is "opening." When Taiyin opens, Yang Qi enters inward. After entering inward, Yang Qi not only warms and nourishes the Zang-Fu organs but also rests and regenerates. If there is excessive mental labor, Yang Qi must expand outward and cannot enter inward. If it cannot enter inward, Yang Qi is not stored and nurtured. Over time, it becomes deficient, leading to cold in the Zang organs. Therefore, those with excessive mental labor are prone to Yang Qi depletion. This is also related to obstacles in the opening mechanism of Taiyin.
④ Irregular Rest and Activity
Yang Qi depletion can be caused by various reasons. Without eating raw or cold foods, can Yang Qi still be damaged? Yes, it can. For example, irregular rest and activity schedules can also cause Yang Qi depletion. Earlier, we mentioned, "The three months of winter are called 'closing and storing'." During such a period of closing and storing, our rest and activity schedules should correspond to it. We should "go to bed early and rise late, waiting for sunlight." If during the three months of winter, when Heaven and Earth are closing and storing, you do not close and store—if you sleep very late—then this Yang Qi will not receive the necessary storage and nurturing. Without storage and nurturing, it will naturally deplete. Depleted Yang Qi naturally leads to cold in the Zang organs. Cold in the Zang organs leads to the occurrence of "abdominal fullness and vomiting, inability to eat, worsening spontaneous diarrhea, and occasional spontaneous abdominal pain." Everyone should understand: what helps digest food? It is Yang Qi that aids digestion. Many doctors nowadays, when encountering patients with "inability to eat," only use Shan Zha (Crataegi Fructus), Mai Ya (Hordei Fructus Germinatus), and Shen Qu (Massa Medicata Fermentata). Are these herbs useful? Of course, they are. In cases of definite food stagnation, using these herbs is very effective. However, if it is not food stagnation—if the tongue and pulse do not reflect food stagnation but rather a Yang deficiency tongue/pulse and a cold-in-Zang tongue/pulse—then this "inability to eat" cannot be solved by the aforementioned digestive herbs. At this time, Yang Qi must be warmed and nourished, and formulas like Lizhong Tang (Regulate the Middle Decoction) must be used. When Lizhong Tang takes effect, Yang Qi rises, and the patient's appetite naturally opens up.
(4) The Official of Remonstrance
The title "Official of Remonstrance" comes from the lost chapter "Ci Fa Lun" of the *Suwen*. In the *Suwen: Ling Lan Mi Dian Lun*, eleven officials were discussed: "The Heart is the Official of the Monarch," "The Lung is the Official of the Chancellor," "The Liver is the Official of the General," "The Gallbladder is the Official of Justice," "The Chest Center (Dan Zhong) is the Official of the Envoy," "The Spleen and Stomach are the Official of Granary," "The Large Intestine is the Official of Transmission," "The Small Intestine is the Official of Reception," "The Kidney is the Official of Strength," "The San Jiao (Triple Burner) is the Official of Irrigation," "The Bladder is the Official of the Capital." Among these eleven officials, except for the Spleen and Stomach, each is discussed separately. Only when reaching the "Official of Granary" are the Spleen and Stomach combined. Discussing them together makes it difficult to distinguish their respective functional characteristics. Therefore, in the *Suwen: Ci Fa Lun*, the official positions of the Spleen and Stomach were distinguished. The original "Official of Granary, producing the five flavors" continued to be borne by the Stomach, while the Spleen was designated as the "Official of Remonstrance, where comprehensive knowledge arises." Designating the Spleen as the "Official of Remonstrance" is extremely important. Just based on this designation alone, you should know that the *Ci Fa Lun* is not an ordinary treatise. Do not underestimate it because it is a lost chapter; if you slight this theory, you miss it face-to-face. "Jian Yi" (Remonstrance) was an ancient official title, later known as Jianyi Dafu (Grand Master of Remonstrance). What is "Jian" (Remonstrate)? Xu's annotation in *Shuowen Jiezi* says: "To remonstrate is to distinguish good and evil and present them to the ruler." Therefore, the Official of Remonstrance is a very important position, enjoying the privilege to directly report any matter of good or evil to the Monarch. With the Official of Remonstrance, the Monarch will not be kept in the dark nor make wrong decisions based on one-sided accounts. It is precisely because of this Official of Remonstrance that the Monarch can truly be divine and enlightened, avoiding being a foolish ruler. This is what is meant by "comprehensive knowledge arises." Therefore, this "comprehensive knowledge" is actually directed towards the "Official of the Monarch." As stated in the *Yijing: Xici*: "Comprehensive knowledge covers all things, and the Dao assists the world, thus there are no errors." This conveys this meaning. If the Monarch wants to have no faults and truly possess comprehensive knowledge to assist the world with the Dao, he must rely on this "Official of Remonstrance." Through the above text, we should understand the significance of the "Official of Remonstrance." Human life, and even the rise and fall of nations, depends on the "Official of the Monarch," yet the Monarch relies on "remonstrance" to be enlightened and knowledgeable, thereby assisting the world without error. Thus, the position of "remonstrance" is extraordinary and cannot be undertaken by trivial persons. To undertake this exceptional position, at least three conditions are required. First, one must be upright; without uprightness, one cannot clarify right and wrong or distinguish good and evil. Hence, *Guangya* defines "Jian" as "upright." Second, one must value righteousness. Without a spirit of righteousness reaching the clouds, if you hesitate and fear consequences, always thinking of preserving your position, then the remonstrance exists in name only. The *Old Book of Tang: Treatise on Officials* states: "There are five types of remonstrance: first, indirect remonstrance; second, compliant remonstrance; third, corrective remonstrance; fourth, earnest remonstrance; fifth, direct remonstrance." Without righteousness, even one remonstrance is hard to achieve. Third, one must be magnanimous and impartial. If relatives and friends, or those who have benefited you, do evil and you do not remonstrate against them; or if your enemies, you create trouble out of nothing, then the essence of "remonstrance" is lost. Returning to the *Suwen: Ci Fa Lun* from the three basic conditions of the "Official of Remonstrance," we know that this position of "remonstrance" belongs exclusively to the Spleen. Only the Spleen possesses these conditions. The Spleen belongs to Kun Earth and possesses the nature of Kun. Opening the *Zhouyi* (Book of Changes), the second line of the Kun Hexagram states: "Upright, square, great. Without practice, nothing is unfavorable." What does "upright, square, great" mean? The subsequent Image Commentary says: "Upright is its correctness; square is its righteousness. The gentleman is upright within through reverence, and square without through righteousness. When reverence and righteousness are established, virtue is not solitary. Upright, square, great, without practice, nothing is unfavorable. Then he does not doubt his actions." From this "upright, square, great," we know that the Spleen fully meets the conditions to be the "Official of Remonstrance." Furthermore, the Kun Hexagram states: "A family that accumulates goodness will have abundant blessings. A family that accumulates badness will have abundant misfortune. Ministers killing their rulers, sons killing their fathers, are not the result of a single morning or evening. Their origin is gradual, arising from not distinguishing early enough." "Accumulate" refers to the thick Earth bearing all things. Thus, without Kun, there is no concept of accumulation. However, this "accumulation" distinguishes between good and bad. Accumulating goodness brings abundant blessings; accumulating badness brings abundant misfortune. Ministers killing rulers and sons killing fathers, though shocking, are not accomplished in a single morning or evening.