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Furthermore, in the Upper Jiao Chapter, discussing a case of damp malaria, it states: "Severe pain and discomfort in the bone joints, frequent vomiting, pulse resembling normal (without significant abnormality), only fever without aversion to cold, this is called Warm Malaria (Wen Nue), treated primarily with Guizhi Baihu Tang (Cinnamon Twig and White Tiger Decoction)." Although this originates from the text of *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), Wu Jutong himself notes in his commentary: "Yin Qi (Yin Energy) is damaged first, Yang Qi (Yang Energy) acts alone and hyperactively, thus there is only fever without aversion to cold, causing muscle emaciation." The subsequent paragraph discusses Bi Malaria (or Dan Malaria), stating: "Only fever without aversion to cold, or slight chills with predominant heat, dry tongue and thirst. This is due to Yin Qi being damaged first and Yang Qi acting alone, named Dan Malaria (Dan Nue), treated primarily with Wuzhi Yin (Five Juices Drink)." The above two paragraphs discuss Warm Malaria and Bi/Dan Malaria respectively, both claiming that Yin Qi is damaged first and Yang Qi acts alone. The two syndromes are indistinguishable and mutually confused. According to *Neijing* (The Inner Canon): "Injured by Wind pathogen first, then by Cold pathogen, hence fever precedes chills, named Warm Malaria." It also says: "Yin Qi is damaged first, Yang Qi acts alone, hence only fever without chills, causing muscle emaciation, named Dan Malaria." Thus, Warm Malaria and Dan Malaria have different etiologies and distinct clinical manifestations, with distinctions between internal injury and external contraction. *Jingui Yaolue* discusses Dan Malaria with text identical to *Neijing*; its discussion of Warm Malaria is slightly abbreviated but does not confuse it with Dan Malaria. Generally, *Neijing* discusses disease origins, while *Jingui Yaolue* discusses treatment methods; although the texts differ, the intent is similar. Wu Jutong used the *Neijing* text regarding Dan Malaria as an annotation for Warm Malaria, confusing the two syndromes. Had he not read *Neijing · Malaria Chapter*? Furthermore, in the Lower Jiao Chapter, there is a statement: "Autumn dampness hidden internally, winter cold added externally," citing scripture as evidence, which particularly violates logical principles. I have another essay, *Suwen Biyi* (Clarifying Doubts in Suwen), inviting experts to judge.

Regarding Wu Jutong's claim, "All warm diseases begin in the Upper Jiao, affecting the Hand Taiyin Lung Meridian," he established Yinqiao San (Honeysuckle and Forsythia Powder) as the primary formula. Wu Keyi discussed plague (Wenyi), stating pathogens accumulate at the Mu Yuan (Moyuan/Root of Abdomen), thus creating Dayuan Yin (Reach the Root Decoction) as the primary formula. This is like Zhang Zhongjing discussing Shanghan (Cold Damage): tight pulse with no sweat indicates Ma Huang Tang (Ephedra Decoction); slow pulse with sweating indicates Gui Zhi Tang (Cinnamon Twig Decoction). Since pathogens differ and the depth of invasion varies, the weight and strength of formulas must differ. Fengwen (Wind-Warmth) is a light and clear pathogen damaging the Lung, a light and clear organ, hence starting from Hand Taiyin. Wenyi (Plague) is a turbid and foul pathogen damaging the Stomach opening and accumulating at the Mu Yuan, because the Stomach is the Sea of Water and Grain, where turbidity gathers. If Wu Jutong claims it starts from Hand Taiyin, he is discussing Fengwen. Yinqiao San consists of light and clear herbs, suitable for treating Fengwen. Yet he groups Plague into the same category and criticizes Wu Keyi, unaware of his own confusion, instead criticizing others. This is indeed superficial.

Someone asks about the location of Mu Yuan, with one theory placing it at the upper opening of the Stomach. Please explain in detail to determine its location, otherwise, one might mistake the Diaphragm (Gemo) for Mu Yuan. I reply: Examining the character "Yuan" (Original/Root), it seems to refer to the spacious interior of the body cavity. Because it is spacious, it can harbor pathogens. Scripture states: "Upper Jiao is like mist, Middle Jiao is like fermentation, Lower Jiao is like a ditch." Among spacious areas, none exceeds the space between the Lung and Stomach in the Upper Jiao. Because it accumulates Yang Qi without turbid residues, it is described as "like mist" and called the Sea of Qi. *Suwen · Ju Tong Lun* states: "Cold pathogen lodges between the intestines and stomach, below the Mu Yuan, causing small collaterals to contract tightly, resulting in pain." This implies Mu Yuan is located between the lower Lung and upper Stomach. *Malaria Chapter* states: "Pathogens internally press against the Five Zang organs and horizontally connect to the Mu Yuan." Since it presses internally against the Zang organs, yet horizontally connects to the Mu Yuan outside the Zang-Fu, Mu Yuan serves as the boundary of Half-Exterior Half-Interior, located between the lower Lung and upper Stomach, close to the Diaphragm. Therefore, equating Mu Yuan directly with the Diaphragm seems incorrect. However, if one insists the Diaphragm is not Mu Yuan, they are still connected. For instance, light and clear Fengwen pathogens entering Hand Taiyin connect internally to the chest and Lung, causing cough and chest fullness without tongue coating or appetite loss. If turbid pathogens like severe Plague or Damp-Warmth are contracted, epigastric stuffiness, aversion to food, and thick greasy tongue coating occur because it is near the Stomach opening; hence ancients said pathogens enter Mu Yuan. Situated between Exterior and Interior, pathogens travel through the Three Jiao via the Central Pathway, making exterior and interior treatments unsuitable. Thus, Wu Keyi created Dayuan Yin. Since it is not a Hand Taiyin syndrome, how could Wu Jutong's Yinqiao Sin treat it? Moreover, writing aims to clarify principles and benefit humanity. Principles are infinite, but right and wrong are fixed; the more we debate, the clearer the truth becomes. I dare not be self-assured, so I seek corrections to illuminate this path, aiding future generations. (*Yimen Banghe Chuji*)

Chai comments: Zhang Xuguxu stated: "This critique was completed between the Jiaqing era and Yixiu of Daoguang. When Mr. Wu Jutong visited Shaoxing, I entrusted my manuscript to friends for his review, but received no response. I do not know if he agreed." I believe *Wenbing Tiaobian* (Systematic Differentiation of Warm Diseases) has many flaws. Zhang belonged to the Ye Tianshi school, sharing similar academic views with Wu Jutong, so this critique only touched upon minor deficiencies, less than one-tenth of the whole. Wu Jutong had no answer, seemingly acknowledging imperfections in his learning. We must not blindly follow without discerning strengths and weaknesses. Yun Tieqiao saw the crux of the issue, but during the rise of the anti-traditional medicine faction, he feared overshadowing the main topic and dismissed trivial debates. Now, the influence of Wu's learning surpasses the past, with people revering his work as a classic. This is why I cannot remain silent regarding the Ye and Wu schools.

Postscript

Regarding the purpose of this book, the preface did not fully elaborate, so I briefly outline my thoughts on the topic selection as supplementary explanation:

Currently, a new wave of technological revolution is rising globally, significantly impacting various scientific disciplines and inevitably affecting Chinese medical science. Faced with this situation, enlightened figures in the medical field realize this vigorous global movement poses a serious challenge to developing Chinese medicine. To accelerate progress and narrow the gap, they advocate "taking what is useful," actively introducing cutting-edge technologies like computers into medicine. Undoubtedly, borrowing strengths and using foreign resources for China is necessary. Medical colleagues must not ignore this. However, to ensure Chinese medicine remains invincible in this wave, joins world advanced medical sciences, and contributes to humanity, we must calmly analyze the situation, handle the relationship between foreign and traditional technologies, and decide strategies based on China's reality. While urgency is needed to catch up, we must not let urgency cloud our judgment. Relying solely on enthusiasm and frantically learning foreign technology while ignoring our advantages and unique strengths is detrimental. In 1980, the National Conference on Traditional Chinese Medicine (TCM) and Integrated Chinese and Western Medicine proposed the policy: "Development of TCM, Western Medicine, and Integrated Chinese and Western Medicine forces simultaneously, coexisting long-term." Achieving organic integration to create a unique new Chinese medical system is the direction. With clear direction and policy, realizing this goal requires more than just following foreign advancements. Otherwise, "if they advance and we learn, when we learn they advance," we will always lag behind. "Revitalizing TCM aligns with the prospects of scientific and technological development" and "matches new international trends." We must recognize this fully. Regarding China's medical structure, Western medicine has more personnel and stronger power, while TCM has fewer and weaker resources. Walking on two legs, one strong and one weak, hinders integrated medicine development in the long run. Domestically and internationally, China faces a shortage of successors and skills in TCM research, whereas Japan has ignited a fervent study of TCM, boasting superior industrial and tech levels, predicting their dominance in Oriental Medicine within 10-15 years. In this context, I believe while introducing foreign technology, we must focus on developing and supporting TCM, implementing party policies, revitalizing TCM, and laying a solid foundation for integration. This preserves national characteristics and prevents falling behind. As Comrade Yang Chao said: "It would be disgraceful if Japanese catch up in 15 years, brand 'Oriental Medicine,' and we merely follow." Therefore, all patriots in medicine, especially TCM practitioners, must recognize the importance of revitalizing TCM, promoting national essence, catching up with world standards, and bringing glory to the country.

Revitalizing TCM involves many tasks: improving herb management, developing emergency TCM services, running TCM institutions well, and inheriting traditions. None can be ignored. But prosperity depends on talent, and academic flourishing relies on democracy. Grasping the key link makes everything else fall into place. Obviously, improving the shortage of talent and skills and implementing "Let a hundred flowers bloom, let a hundred schools of thought contend" is crucial. Historically, no regime valued TCM as much as the current government and Party. Yet, the severe shortage appears in such favorable circumstances. Why? How to solve it? This has been my repeated contemplation. My preliminary view is: Traditional apprenticeship is largely replaced by school education. In exogenous febrile diseases, schools use a single school's theory as national textbooks, producing students uniform in Ye School views, leading to "exclusive reverence" and numerous弊端. If unchanged, talent will dwindle, and diverse schools will lose heirs. Long-term, revitalization will fail ("a whip too short to reach the horse's belly"). Based on this, strategically, I aim to shake the Ye School's long-standing dominance as a breakthrough for revitalization. Thus, building on published papers, I wrote this book as an initial attempt.

In summary, the current TCM status urgently requires reform. Reform brings progress, change brings prosperity; stagnation leads nowhere. This is undeniable and inevitable! I hope the TCM community stops chanting the old tune "Warm pathogens enter from above, first attacking the Lung." We should abandon sectarianism, stop malicious attacks, and seriously reflect on critiquing Ye School academics. All schools should pursue truth, centering on revitalizing TCM and China, engaging in friendly academic debate. Let us unite to cultivate talent, flourish academia, elucidate febrile disease laws, study interception and reversal methods, relieve suffering, and strive tirelessly!

Chai Zhongyuan
August 1984