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Li Dongyuan stated: The *Neijing* records, "Yin deficiency generates internal heat" (see details in the "Hot Disease" section), and also states, "Labor exhausts Qi." Labor leads to panting and sweating, causing both internal and external Qi to dissipate outwardly, thereby resulting in Qi exhaustion. If emotions such as joy and anger are not regulated, daily routines are irregular, and there is physical strain, all these damage the body's Qi. When Qi declines, ministerial fire becomes hyperactive; when ministerial fire is hyperactive, it overacts upon Spleen Earth. Since the Spleen governs the four limbs, the patient feels fatigued, hot, lacking energy for movement, reluctant to speak or act, experiencing surface heat, spontaneous sweating, and mental restlessness. During the illness, one should sit quietly with a calm mind to nourish Qi, use sweet-cold herbs to clear and drain fire-heat, use sour-flavored herbs to astringe dissipated Qi, and use sweet-warm herbs to tonify Middle-Jiao Qi. The *Neijing* states, "For labor, warm it; for loss, warm it." The *Jingui Yaolue* states that a large but empty pulse in a healthy person indicates labor, and recommends treating it with Huangqi Jianzhong Tang (Astragalus Decoction to Build the Middle). This is the intended meaning.

I respectfully note: Mr. Zhu Danxi said, "The prescription for treating disease must first attend to the Yuan Qi (Original Qi)." This is because most diseases arise from deficiency. Therefore, regarding fatigue and exhaustion syndromes, which have many causes, the discussions on treatment by Li Dongyuan and Zhu Danxi are quite detailed. However, this differs from Xu Sun (Deficiency Damage) syndromes. There are cases where illness leads to deficiency, such as those caused by Shanghan (Cold Damage), Summerheat, improper diet, or chronic illness. There are also cases where deficiency leads to damage, such as emaciation and flaccidity after illness, or consumptive diseases. These Xu Sun conditions differ significantly from simple fatigue. Generally, illness leading to deficiency is milder because the pathogenic factor is shallow and the Yuan Qi is not yet exhausted. Conversely, if one labors excessively shortly after recovering from an illness, or indulges in improper diet, physical fatigue, sexual excess, or emotional disturbances, leading to Yang exhaustion and Yin weakness, worsening into severe emaciation, this "deficiency leading to damage" constitutes a serious condition because the pathological process has progressed and the Yuan Qi is depleted. I believe these should be treated differently: For illness-induced deficiency, fatigue insufficiency, and other syndromes accompanied by deficiency, one should follow the theories of Li Dongyuan and Zhu Danxi. For deficiency-induced damage, one should expand upon and apply the treatments proposed by Li Dongyuan and Zhu Danxi.

See the "Wei Men" (Flaccidity Section) for details.
See the "Re Men" (Heat Section) for details.
See the "Han Men" (Cold Section) for details.
See the "Zhi Xia Men" (Dysentery Section) for details.
See the "Zhong Feng Men" (Wind Stroke Section) for details.
See various sections for details.

Zhu Danxi said: Blood and Qi are the spirit of the body. If the spirit is depleted, pathogens enter easily. In cases where both Blood and Qi are deficient, phlegm lodges in the Middle Jiao, obstructing the ascending and descending mechanisms, preventing normal function, causing the twelve organs (Twelve Palaces) to lose their respective duties, resulting in delirious vision, hearing, speech, and movement. How can using methods to attack pathogens cure the disease?

The son of my colleague Fu Xianmu, aged seventeen, became thirsty due to labor in summer and drank plum juice excessively. He then suffered three or four sudden frights, leading to delirious speech and hallucinations, resembling possession by evil spirits. His pulses were both deficient, wiry, deep, and rapid. I said, "Rapid pulse indicates heat; deficient and wiry pulse indicates great fright. Additionally, sour juice stagnates in the Zhongwan (CV12). Treatment requires tonifying deficiency, clearing heat, and guiding out phlegm stagnation for the disease to settle." I prescribed a concentrated decoction of Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Huangqin (Scutellariae Radix), and Huanglian (Coptidis Rhizoma), adding Zhuli (Bambusa Textilis Caulis Juice) and Jiangzhi (Zingiberis Recensis Juice). After ten days, there was no improvement, and everyone blamed the medicine. I realized his deficiency had not recovered and phlegm had not been guided out, so I continued the previous formula adding Jingli (Bambusa Textilis Caulis Juice). After another ten-plus days, he recovered.

My maternal cousin, after becoming drunk and overeating one day, spoke deliriously and saw visions, accurately recounting events from his deceased elder brother's life. His uncle scolded him, saying, "You ate too much fish, meat, and wine; this is caused by phlegm." He was given a large bowl of salt water to induce vomiting, expelling more than a liter of phlegm. He then sweated profusely, slept deeply for one night, and recovered.

Furthermore, Mrs. Jin, in her prime, fell ill after returning from a summer banquet. Her mother-in-law questioned why she had arranged the seating improperly. Feeling ashamed, she developed a condition characterized by disordered speech, occasionally interjecting, "This servant did not mean to [be improper]." Her pulses were wiry and rapid. I said, "This is not ghosts or gods, but a disease. Tonify the Spleen, guide out phlegm, and clear heat; she will recover in a few days." Her younger brother did not believe me and consulted several shamans who sprayed water and chanted spells. After more than ten days, she died. Someone asked, "Illness does not involve ghosts; how could treating it with 'evil' methods lead to death?" I replied, "In summer, attending a banquet involves external steaming heat and spicy foods that suit the palate, creating internal stagnant heat. Moreover, with pre-existing accumulated phlegm, compounded by shame and depression, the interaction of phlegm and heat is indescribable. Now, using a magic ruler to startle him startles his Shen (Spirit), causing Blood to become restless. Spraying magic water colds and closes the skin pores, preventing sweat from venting. If sweat cannot vent, heat burns internally. If Blood is not peaceful, Yin is consumed, and Yang cannot stand alone. Why would he not die? Some say the *Waitai Miyao* includes a section on exorcism and incantations; can this be discarded? I say, shifting Jing (Vitality) and changing Qi is a minor art, suitable only for minor illnesses. If there is internal deficiency-pathogen and external excess-pathogen, there are established methods; what use are talismans? Only talisman water can treat upper Jiao heat-phlegm; drinking a sip of cool liquid clears and refreshes. But if applied to internal injury with deficiency, or during winter severe cold, talisman water entering the stomach will freeze the Stomach Qi and cause death. This statement can only be shared with those who understand."