Library

Ancient people once said, "Whenever I fall ill, I constantly write the character 'death' (Si) on my chest. This causes all kinds of thoughts and worries to cease, allowing the mind to find peace. This is superior to taking medicine; it is truly a supreme miraculous prescription." The reason is that if one does not exercise caution when ill, death will inevitably follow. Those who understand this principle can surely purify their hearts and restrain their desires, exercising caution in all matters, thereby achieving recovery from illness. Otherwise, even with good medicine, there is no salvation. Some people in the world, upon falling ill, indulge their passions and act arbitrarily, thus harming themselves; this is indeed ignorance of the fear of death. There is another group who, knowing well they should fear death, are afraid others will perceive their condition, so they conceal it and do not speak of it, or when the illness is already severe, they force a light attitude to deceive others. These people, though knowing to fear death, instead bring about their own demise, which is even more laughable!

I hold that the function of the Heart is thought, and the Spleen also governs thought. If a patient engages in excessive thinking, it causes the Heart Fire to move recklessly, and the Fires of the Five Zang Organs rise together, further injuring the Spleen Qi, while other organs remain diseased. Therefore, writing "death" serves as a self-admonition; when all worries cease and the Heavenly Ruler (Mind/Shen) is tranquil, even if disease exists, healing occurs without medication. Thus, ancient people stated that concealing illness and refusing medical help, or being arrogant and unreasonable, constitute incurable diseases, and this has its reasons.

Among fever syndromes in the world, several resemble Taiyang Disease (Shanghan). Their treatments differ significantly, with External Contraction (Wai Gan) and Internal Injury (Nei Shang) being the key distinctions. Zhang Zhongjing's discussion of Shanghan (Cold Damage) and Shangfeng (Wind Strike) belongs to External Contraction. Because Wind-Cold pathogens invade from the exterior and move from the surface inward, treatment should employ methods to release the exterior and disperse the pathogen; this is the rationale behind Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction). Since these illnesses occur immediately after exposure during the cold months of winter and spring, they are termed Shanghan, and medicinal use should employ acrid-hot substances to overcome the cold. If the season is not cold, the medication must change. For example, in the warm month of spring, acrid-cool medicines should be used; in the hot month of summer, sweet-bitter-cold medicines should be used. Hence it is said: "Winter Cold Damage that does not manifest immediately may transform into Warm Disease in spring and Heat Disease in summer," and treatment methods must vary according to the season. Another type is Winter Warm Disease, described as "having the qi of a different season"; although winter is the time of cold, warmth disease occurs instead. This indicates improper heavenly timing where Yang Qi leaks abnormally; medications should not be warm or hot. Another type is seasonal Cold Epidemic, occurring during warm times. Although warmth prevails, cold becomes the pathogen due to improper heavenly timing where Yin Qi rebels abnormally; medications should not be cold or cool. Another type is the Tianxing Wenyi (Seasonal Warm Epidemic) Heat Disease, which often occurs between spring and summer, affecting entire households similarly. This is caused by Liqi (Miasma/Qi of Pestilence) of Heaven and Earth; treatment should consider the seasonal climate and Yùn (Luck/Cycle) theory, employing acrid-cool, sweet-bitter-cold medicines proposed by Liu Hejian (Liu Wansu) to clear heat and detoxify. All the above conditions involve external contraction of Heaven and Earth pathogens.

Regarding dietary irregularities and fatigue leading to Internal Injury of Yuan Qi (Original Qi), this involves the sinking of True Yang and the internal generation of Deficiency Heat. Therefore, Li Dongyuan proposed the theory of Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), using sweet-warm medicines such as Renshen (Ginseng Radix) and Huangqi (Astragali Radix) to greatly tonify Qi and lift the sinking Qi. This uses Qi-tonifying herbs to supplement Qi deficiency. Furthermore, mental overwork and sexual excess cause Internal Injury to True Yin. Once Yin Blood is damaged, Yang Qi becomes hyperactive and transforms into Fire. This is termed Yin Deficiency with Hyperactive Fire, characteristic of Laozha (Consumption) syndrome. Therefore, Zhu Danxi proposed the theory of "Yang Excess and Yin Insufficiency," using Siwu Tang (Four Substances Decoction) plus Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) to nourish Yin, causing Fire to descend naturally. This uses Blood-nourishing herbs to supplement Blood deficiency. Tonifying Qi and Nourishing Yin both belong to Internal Injury syndromes. One treats sinking Yang Qi by tonifying Qi to lift it; the other treats rising Yang Fire by nourishing Yin to descend it. One lifts, one descends; they are completely different.

There is also Summerheat Injury occurring in summer. Although it belongs to External Contraction, it resembles Internal Injury and differs greatly from Shanghan. Cold damages the Form; Cold pathogens lodging in the exterior present as Excess syndromes, so sweating is appropriate. Summerheat damages Qi; Original Qi is damaged by Heat, leading to consumption and insufficiency (Deficiency syndromes), so tonification is appropriate. This is what Li Dongyuan referred to as Qing Shu Yi Qi (Clearing Summerheat and Augmenting Qi). Additionally, due to seasonal summer heat, overconsumption of cold foods damages the interior, or excessive exposure to cool winds damages the exterior. This is not Summerheat harming the person, but self-inflicted illness due to the summer context. Treatment should employ acrid-hot exterior-releasing or acrid-warm middle-regulating medicines, similar to Shanghan treatment methods. In all these cases, the external manifestations are similar, but the realities differ; treatment methods are diverse and must not err. Therefore, one must carefully examine whether it is truly Shanghan, Shangfeng, or Cold Epidemic; if so, use Zhang Zhongjing's method. If it is Warm Disease or Plague, use Liu Hejian's method. If it is Qi Deficiency, use Li Dongyuan's method. If it is Yin Deficiency, use Zhu Danxi's method. Only then can errors that harm people be avoided.

Today, people see fever symptoms and uniformly classify them as Shanghan External Contraction, rashly using diaphoretic drugs to release the exterior. If the fever persists after sweating, they use exterior-releasing drugs to cool the muscles. If the case is actually Deficient, would this not lead to death? Occasionally, some know that fever belongs to Deficiency and use tonifying drugs, yet they fail to distinguish between Qi and Blood. They may tonify Blood for Qi disorders, or tonify Qi for Blood disorders, misleading many. Thus, External Contraction vs. Internal Injury, Cold Disease vs. Heat Disease, Qi Deficiency vs. Blood Deficiency are like ice and charcoal opposing each other. If treatment errs, mild diseases will become severe, and severe diseases will lead to death. Should one not fear this? Cases of excessive alcohol and sex damaging the True Yin of the Spleen and Kidney, presenting with coughing and expectoration, epistaxis, hematemesis, hemoptysis, and spitting blood, if mistakenly administered sweet-warm medicines like Renshen (Ginseng Radix) and Huangqi (Astragali Radix), will result in worsening conditions daily. Overconsumption renders them untreatable. Sweet-warm substances aid Qi; Qi belongs to Yang. When Yang is vigorous, Yin is further depleted. The aforementioned conditions involve Yin-Blood Deficiency and Yang-Fire Hyperactivity; bitter-sweet-cold medicines should be taken to generate Blood and descend Fire. People of the world do not recognize this, often taking Renshen and Huangqi as tonics. I have seen many die from taking these.

I maintain that the preceding discussions and treatment validations appear in various categories.