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Visceral Qi has both excess and deficiency patterns. If the disturbance is caused by flourishing Yang and declining Yin water, follow Liu Hejian’s treatment method: purge heat to rescue Yin water. If the disturbance is due to insufficient Yang deficiency, the more deficient the Yang becomes, one should follow Li Dongyuan’s approach: first tonify Stomach Qi, then clear and drain the fire. If Yang deficiency fails to keep its position and fire attacks the Yin, according to Li Dongyuan’s theory, raise Yang from the Yin level to extract it; if flourishing Yang enters the Yin, follow Zhang Zhongjing’s method of purgation. If Yin essence deficiency cannot control the moving fire, use Master Zhu Danxi’s method of benefiting essence and blood, strengthening Kidney water to calm it. If visceral Qi excess and fire occur simultaneously, first purge the excess; if the affected organ’s Qi and blood are deficient, first tonify the deficiency, then clear the fire; if fire and Qi contend and stagnate without moving, it will trigger visceral Qi disorders (etc.). In milder cases, the main approach is to scatter fire, as visceral Qi stagnation causes the fire.

Generally speaking, hematuria (blood in urine), strangury with blood, and hematochezia (blood in stool) differ in that they exit through different orifices (anterior or posterior), yet because their pathological origins vary, the treatment principle of distinguishing root and branch remains consistent. There are dozens of herbs for dispersing blood and stopping bleeding; the only slight difference lies in the guiding and assistant herbs targeting specific meridians. Hematuria is caused by heat lodging in the Lower Jiao. Why do materia medica still use warm-tonifying and yang-strengthening herbs like Cuscutae Semen (Tusizi, 菟丝子), Cynomorii Herba (Roucongrong, 肉苁蓉), Dipsaci Radix (Xuduan, 续断), and Cervi Cornu (Lujiao, 鹿角) as main ingredients? The *Neijing* states: "Where pathogenic factors gather, Qi must be deficient." Li Dongyuan stated: "Fire and Yuan Qi are incompatible; when one prevails, the other declines." Fire is heat. Since Kidney Qi runs wild due to heat, one must use true Yin herbs of this organ to tonify deficiency and secure the scattering Wei Qi. Since Qi and Blood rely on each other for function, what is there to doubt?

The *Neijing* contains several passages on excessive damp-earth of Spleen and Stomach leading to fluid accumulation, fullness, and diaphragmatic obstruction, but does not mention the term "Tan" (Phlegm). It was Zhang Zhongjing who first divided fluid retention into four categories: 1. Tan-Yin (Phlegm-Fluid), 2. Xuan-Yin (Hanging Fluid), 3. Yi-Yin (Overflowing Fluid), 4. Zhi-Yin (Supporting Fluid). The meaning of "Tan" appeared later with Liu Hejian. In his analysis of the Six Qi and Five Movements, under the section on Exuberant Fire, he stated: Phlegm-saliva in conditions like wind-stroke and wind-leprosy arises because Yin water is deficient and heat is severe, causing body fluids to surge and accumulate in the chest and diaphragm; heat and dryness transform these into phlegm-saliva. Chu Yushi said: Saliva is the fluid of the fatty meridians throughout the body. Under the section on Damp-Earth, he stated: When dampness is excessive, it leads to fluid accumulation, fullness, diaphragmatic obstruction, abdominal distension, and cholera-like vomiting/diarrhea. He also said: Phlegm in wheezing and coughing results from external contraction of wind-cold, which transforms into heat, and heat generates phlegm. Zhang Dairen considered retained fluid merely as accumulated water. He further stated that the four types of fluid retention are named based on clinical manifestations. There are five ways retained fluid arises: 1. Due to Qi depression: stagnant Qi allows Liver Qi to invade Spleen, causing Spleen Qi to fail in moistening, resulting in retained fluid; 2. Due to fatigue and drinking: exhaustion weakens Spleen-Stomach power; lying down after drinking prevents dispersion into vessels, causing retained fluid; 3. Due to emotional strain: prolonged worry stagnates Liver Qi; prolonged overthinking knots Spleen Qi, causing retained fluid; 4. Due to excessive alcohol: alcohol damages Metal (Lung/Intestines), bladder fails to secrete, causing retained fluid; 5. Due to summer heat and cold drinks: scorching heat dries fluids; excessive intake of cold water combined with inactivity causes retained fluid. He also classified phlegm into five types: Wind-Phlegm, Heat-Phlegm, Damp-Phlegm, Wine-Phlegm, and Food-Phlegm. Following Zhang and Liu, Zhu Danxi believed that at the onset of phlegm-fluid, whether due to improper diet, external six excesses, internal seven emotions, or rich flavors, grain Qi fails to ascend and nourish, causing Ying and Wei Qi to stagnate and generate upper jiao heat. Thus, body fluids fail to circulate, accumulate easily, form masses via Qi, and become phlegm. Once phlegm-fluid accumulates, it transforms and spreads, causing various diseases: vomiting, reverse regurgitation, wheezing/fullness, coughing/reversal of Qi, diaphragmatic belching, acid regurgitation, heartburn, abdominal distension, epigastric fullness, pain, diarrhea, inability to eat with upward rushing, headache, vertigo, throat obstruction, foot swelling, hernia; spreading to the exterior causes chills/fever, swelling, joint pain; gathering in the Heart causes mania, epilepsy/fainting, muteness. All human diseases involve phlegm as a pathogen; these masters described the origin and progression of phlegm disease. Later generations argued that treating phlegm-fluid requires warmth to move it, or that phlegm caused by fire appears as water transformation, feeling cold while actually being hot. Zhu Danxi largely rejected these views, exclusively praising Changsha’s (Zhang Zhongjing’s) methods for the four fluid types: exterior patterns treated with sweating, interior excess with purging/draining, stagnation with guiding, depression with raising, heat with cooling, cold with warming, blockage with unblocking, deficiency with tonifying/nourishing. This deeply aligns with the *Neijing*’s principle of treating according to suitability. I believe phlegm-fluid originates either from Spleen-Stomach or the Six Meridians; though origins differ, the pathogenesis and symptoms are similar. Treatment must address the source of the pathogen before addressing the site of disease. One might ask: Phlegm-fluid arises from Taiyin damp-earth transformation in Spleen-Stomach; does it not also arise from the Six Meridians? Chu Yushi said saliva is the fluid of fatty meridians throughout the body; is this not the infusion of fluids from the Six Meridians internally and externally? Tracing its origin in the meridians, as the *Neijing* states: Drink enters the Stomach, floats and overflows with essence, scatters essence to the Spleen, ascends to return to the Lung, regulates water passages, descends to transport to the Bladder; water essence distributes everywhere, traversing the Five Meridians. It also states: Water entering the meridians forms blood. The Five Zang transform five fluids: Heart produces sweat, Liver produces tears, Lungs produce nasal mucus, Spleen produces saliva, Kidneys produce spittle. Thus, meridian fluids and blood are all transformed from distributed water essence. However, meridians rely on Stomach Qi as their root; therefore, what is transformed is also the harmonious Earth virtue of Stomach Qi within the Six Meridians, thus returning to dampness and nourishing the hundred bodies. If transformation is poor, water accumulates and fails to move, causing harm like floating dampness. Thus, when abundant water mixes with blood, failing to nourish Qi movement, or failing to transform into fluid for Wei Qi use, it gathers in meridians to cause disease: cold makes it clear like fluid, heat makes it turbid like phlegm. If subjected to wind-fire pressure, it surges and reaches everywhere; no phlegm-fluid pathology is greater than this.