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In the treatment of fire syndromes, some methods are termed "Ascending Yang and Dispersing Fire" (Shengyang Sanhuo), while others are termed "Nourishing Yin and Descending Fire" (Ziyin Jianghuo). Although it is one pathogenic factor—fire—both ascending and descending approaches are claimed to be effective in treating it.
However, ascending belongs to Yang, and descending belongs to Yin. If these two opposing methods are mixed, would this not contradict medical principles? Which cases are suitable for ascending and which for descending, and how should they be distinguished? This has been a source of doubt since ancient times, representing two extremes of debate, yet no one has been heard to clarify it thoroughly. The pathology of fire arises either from the Yin aspect or the Yang aspect. When arising from Yin, the fire originates internally; when arising from Yang, the fire is induced externally. Fire originating internally constitutes the "Fire of the Five Zang Organs" (Wuneizhi Huo) and requires clearing heat and descending. Fire induced externally constitutes "Wind-Heat Fire" (Fengre zhi Huo) and requires dispersing and ascending. Nowadays, whenever people encounter fire syndromes, regardless of whether the condition is exterior or interior, they invariably claim that Wood and Fire share the same nature, frequently labeling it as Wind-Heat, and predominantly employing the method of Ascending Yang and Dispersing Fire. Alas! This seems plausible, yet who dares to refute it? They fail to realize that the true principle allows for no confusion.
Regarding the concept of Wind-Heat, there are two interpretations: one where heat is generated due to wind, and another where wind is generated due to heat. In the case of heat generated by wind, external cold and wind constrain the exterior, causing fire to stagnate within. This is Fire of the Yang aspect caused by external contraction, where Wind is the root and Fire is the branch. In the case of wind generated by heat, extreme heat injures Yin fluids, causing fire to manifest on the exterior. This is Fire of the Yin aspect caused by internal injury, where Fire is the root and Wind is the branch. The Classic states: "In treating diseases, one must seek the root." Thus, for externally contracted fire, one should first treat the Wind; once the Wind is dispersed, the Fire will naturally subside. Therefore, ascending and dispersing are appropriate, while clearing and descending are not. For internally generated fire, one should first treat the Fire; once the Fire is extinguished, the Wind will naturally clear. Therefore, clearing and descending are appropriate, while ascending and dispersing are not. If treated oppositely, the pathogenic factors of external contraction will become more tightly closed if cleared and descended, and the internally generated fire will burn uncontrollably if ascended and dispersed. These internal and external causes can be clearly distinguished through pulse and symptom analysis.
Having reviewed medical texts, I have observed that conditions such as head and eye disorders, dental issues, throat ailments, and Yin-fire of the Zang-Fu organs are all attributed to Wind-Heat. Most practitioners simultaneously employ ascending and descending methods, combining compliant and contrary treatments. Do they not worry that ascending methods may hinder descending ones, and descending methods may hinder ascending ones? That compliant treatments contraindicate contrary ones, and vice versa? The Classic states: "For those high up, suppress them; for those low down, lift them. For cold, use heat; for heat, use cold." It also states: "If disease arises from within, treat the Yin first, then the Yang; reversing this will worsen the condition. If disease arises from the exterior, treat the outside first, then the inside; reversing this will worsen the condition." This is an unchangeable fundamental principle. Therefore, in my prescription formulation and treatment strategies, when suppression is indicated, I directly employ descending methods; when lifting is indicated, I directly employ ascending methods. Consequently, results are achieved rapidly without delay, simply because my insight is accurate and my actions are swift. Conversely, when modern practitioners cause mild diseases to become severe, and severe diseases to become critical, leading to prolonged suffering and eventual death, is this not due to errors stemming from the confusion of these two extremes? Those with wisdom must distinguish this most carefully.