Library

Zhu Danxi stated: According to the discussions following the *Neijing* (Inner Canon), it is generally believed that this condition results from external wind-pathogen invasion. However, due to geographical differences between the north and south, one cannot apply a single standard universally. Only Liu Hejian’s assertion that improper lifestyle management leading to kidney water failing to control heart fire is extremely correct. Speaking from the present perspective, in the two regions of the northwest, there are indeed cases of true wind-stroke, but they are rare; whereas in the southeast, people mostly suffer from damp-earth generating phlegm, phlegm generating heat, and heat generating wind.

Regarding Danxi’s citation of the *Neijing* and subsequent texts claiming all such conditions are caused by external wind-pathogen invasion, he was unaware that whenever the *Neijing* mentions "wind," it refers to external contraction, which originally did not mean what later generations called "Zhong Feng" (Wind Stroke). This can be understood by observing the concept of five types of Shanghan (Cold Damage) in the *Nanjing* (Classic of Difficult Issues). Does Danxi’s statement align with the original intent of the *Neijing*? As for people in the southeast, their condition stems merely from damp-phlegm generating heat, and heat generating wind. This merely reiterates Hejian’s theory of excessive heat, rather than referring to conditions like "Fei Feng" (Non-Wind). Are all these heat diseases? Even if attributed to phlegm, how can we assume there is no cold-phlegm? Why must phlegm generate heat, and heat generate wind? Furthermore, if it is not "Fei Feng," then fine; but if it is wind, it exists in both north and south. It may be true that the scarcity of cold in the southeast makes it less likely to be fatal, but claiming that wind pathogens are scarce there is incorrect. If it is not phlegm, then fine; but if it is phlegm, it also exists in both north and south. While external dampness from soil and water is more common in the southeast, internal dampness from dairy products is particularly prevalent in the northwest. Although phlegm is fundamentally activated by dampness, its presence depends on the spleen: when the Spleen Qi is robust, there is no phlegm; when weak, phlegm appears; when failing, phlegm becomes severe. Thus, it is evident that illness generates phlegm, not that phlegm generates illness. There has never been a case where treatment misses the root cause yet expects recovery.

Furthermore, Danxi stated: Hemiplegia is largely due to phlegm. Lesions on the left side belong to dead blood and stasis, treated with Siwu Tang (Four Substance Decoction) added with Tao Ren (Peach Kernel), Hong Hua (Safflower), Zhuli (Bamboo Sap), and Jiangzhi (Ginger Juice); lesions on the right side belong to phlegm and Qi deficiency, treated with Erchen Tang (Two-Aged Decoction) or Sijunzi Tang (Four Gentlemen Decoction) added with Zhuli and Jiangzhi.

This statement by Danxi seems plausible, hence widely accepted, yet it contains inaccuracies. In the human body, Blood and Qi are inseparable; how can the left be exclusively associated with Blood disease and the right with Phlegm-Qi disease? Danxi’s reasoning appears to be based on the Liver belonging to Wood and residing on the left, governing Blood; the Lung belonging to Metal and residing on the right, governing Qi; and the Spleen belonging to Earth, residing in the southwest, thus also on the right, governing Dampness and Phlegm. However, this is merely applying the theoretical sequence of Five Elements and directions. Does this imply there is no Wood in the west or no Metal in the east? Moreover, every meridian has left and right aspects, and every Zang organ possesses both Blood and Qi. For instance, the great collateral of the Stomach emerges below the left breast, indicating that Spleen and Stomach Qi also emanate from the left. How can one claim the left is not Spleen, the right is not Liver, the left must be Blood disease, and the right must be Phlegm-Qi disease? Then how should differentiation be performed? Only the *Neijing*’s method of distinguishing Blood and Qi via Yin and Yang, and assessing severity via left and right, is most appropriate. The Classic states: "Left and right are the pathways of Yin and Yang." It also says: "Excess Yin causes Yang pathology; excess Yang causes Yin pathology." Additionally: "In women, the right is Ni (Rebellious/Severe), the left is Shun (Smooth/Mild); in men, the left is Ni, the right is Shun." Yang pathology refers to Qi disease; Qi belongs to Yang, and when Yin pathogens overcome it, disease occurs. Yin pathology refers to Blood disease; Blood belongs to Yin, and when Yang pathogens overcome it, disease occurs. Shun indicates mild disease; for men, manifestation on the right is favorable; for women, manifestation on the left is favorable. Ni indicates severe disease; for men, manifestation on the left is feared; for women, manifestation on the right is feared. By using this method for differentiation, combined with pulse and complexion analysis to investigate etiology, one can determine whether the issue lies in Qi or Blood, and whether the severity is high or low, thereby arriving at the truth. To assert that the left must be Blood disease and the right must be Phlegm-Qi disease would inevitably lead to treating phlegm only as phlegm and blood only as blood, punishing areas without fault, and rarely avoiding error.