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It is said that cold pathogens damage the *xing* (form/body structure), while heat pathogens damage *qi* (vital energy). Both form and qi can be self-damaged. The "deficiency" mentioned here actually stems from "excess." Because of this excess, self-injury occurs; once self-injured, it manifests as deficiency.

The *Jinkui Zhenyan* (True Words of the Golden Coffer) states: In winter... *Anqiao* (massage and stretching exercises) present different diseases in each season. Why? This is because the *yang qi* (positive energy) of the five zang organs are all latent within the kidneys. Their activity depth varies with movement, leading to disease, thus presenting differently across the four seasons.

All pain belongs to *shi* (excess syndrome); pain diminishes with *li* (free flow/unblocking). The world generally interprets "li" as purgation (downward draining), which is incorrect. For instance, if pain is at the exterior (*biao*), it is excess; if pain is at the interior (*li*), it is also excess; if pain involves blood and qi, it is likewise excess. If at the exterior, sweating releases it, and pain subsides. If at the interior, purgation drains it, and pain subsides. If involving blood and qi, dispersing and moving it resolves the pain. How can the character "li" be interpreted solely as purgation? One should interpret "li" as "tong" (unblocking/free flow) or "dao" (guiding). Thus, "all pain is excess, pain diminishes with free flow": sweating achieves unblocking and guiding, which is "li"; purgation achieves unblocking and guiding, which is also "li"; dispersing qi and moving blood are all methods of unblocking and guiding to achieve "li." Hence, the classic says: "All pain is excess, pain diminishes with free flow." It also says: "When there is free flow, there is no pain; when there is pain, there is no free flow." This is what is meant.

Regarding "those that are high, suppress them," it does not mean that everything high must be suppressed. It is because the original position was low, but due to error, it was raised too high; therefore, it must be suppressed to lower it. If it were originally high, why suppress it?

Regarding "those that are low, elevate them," it does not mean that everything low must be elevated. It is because the original position was high, but due to error, it was drained down too much; therefore, it must be elevated to raise it back. If it were originally low, why elevate it?

If water pathogen resides in the domain of Wood (Liver), this comes from the mother organ ("following from behind"), constituting a *xu xie* (deficiency pathogen). Although it is a deficiency pathogen for Water (Kidney), the Wood (Liver) itself has become deficient.

If fire pathogen resides in the domain of Water (Kidney), this comes from the child organ ("following from ahead"), constituting a *shi xie* (excess pathogen). Although it is an excess pathogen for Fire (Heart), the Wood (Liver) itself has become excessive. The classic states: "The child can make the mother excessive."

If both wrists show a *xian* (wiry) pulse without exterior symptoms, this indicates East (Liver) excess. This is caused by a significant deficiency of West (Lung) qi, resulting from the deficiency of the mother organ. One should strongly tonify Spleen qi, mildly tonify Lung qi, strongly drain Heart fire, and mildly drain Kidney water. Discussions on miscellaneous diseases state: "First regulate qi, then discuss other conditions." This is a condition of deficiency in the primary meridian. The *Nanjing* (Classic of Difficult Issues) states: "East is excess, meaning West is deficient." It also says: "To drain the pathogen, first tonify the deficiency." This refers to such cases. For such conditions, warm medicines should be used to tonify the Spleen, employing drying agents that tonify qi, such as *Yihuang San* (Yellow-Protecting Powder) combined with Baizhu (Atractylodis Macrocephalae Rhizoma), Banxia (Pinelliae Rhizoma), Fuling (Poria), and Gancao (Glycyrrhizae Radix et Rhizoma). If caused by alcohol consumption, add Ze Xie (Alismatis Rhizoma). For dryness in the Hand-Foot Yangming meridians, *Yihuang San* is used to dry dampness and tonify qi, thereby strengthening Earth to drain Wood. To drain fire, Qingpi (Citri Reticulatae Pericarpium Viride) may be used to drain Liver wood; Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Shengdihuang (Rehmanniae Radix), and Huanglian (Coptidis Rhizoma) in equal parts, with Huangqin (Scutellariae Radix) doubled. Whenever using medicine for tonification, one employs the "Sheng shu" (generative numbers) of various formulas, such as Lizhong Wan (Regulate the Middle Pill) and Jianzhong Tang (Establish the Middle Decoction). When using purgation, one employs the "Cheng shu" (completed numbers) of various formulas, such as Qixuan Wan (Seven Unblocking Pills) and Qisheng Wan (Seven Sages Pills).