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The human body is a microcosm. Heaven has the sun, moon, stars, and constellations; earth has mountains, rivers, grass, and trees; humans have the five zang organs (Zang organs: solid organs responsible for storing essence) and six fu organs (Fu organs: hollow organs responsible for transportation and transformation). None of these are beyond the realm of yin-yang qi transformation (Yin-Yang Qi Transformation: the dynamic process of vital energy governed by yin and yang principles).
Qi transformation cannot be entirely complete without bias, nor entirely smooth without reversal. Therefore, heaven sometimes experiences abnormalities, earth sometimes experiences barrenness, and humans sometimes experience disease. The onset of disease varies in its changes, but it never exceeds the two categories of internal manifestations (Nei Zheng: symptoms originating from internal organ dysfunction) and external manifestations (Wai Zheng: symptoms presenting on the surface or due to external pathogens). Its causes do not exceed the two categories of internal factors (Internal Factors: etiological factors originating within the body, primarily emotional) and external factors (External Factors: etiological factors originating outside the body, primarily climatic). What are internal factors? Joy, anger, worry, thought, sorrow, fear, and shock—these seven emotions (Seven Emotions: the seven types of emotional responses that can affect health), which belong to yin. What are external factors? Wind, cold, summer-heat, dampness, dryness, and fire—these six qi (Six Qi: the normal climatic conditions that become pathogenic when excessive or untimely), which belong to yang. Diseases manifesting from yang are mild and easily cured; diseases manifesting from yin are severe and difficult to cure. Internal medicine and external medicine follow the same principle. Taking internal medicine as an example, conditions such as madness (Feng: mental disorders), consumption (Lao: chronic wasting diseases), abdominal distension (Gu: ascites), and diaphragmatic obstruction (Ge: dysphagia/chest fullness) originate in the zang organs, belong to yin, and are difficult to cure. Conditions such as Shanghan (Cold Damage Disease: a category of febrile diseases caused by cold pathogens), malaria (Nue: periodic feverish illness), and stroke/paralysis (Fei: sudden loss of consciousness or motor function) originate in the fu organs, belong to yang, and are easy to cure. In the transmission of meridians in Shanghan, those in yang meridians are easy to cure, while those in yin meridians are not, which people generally know. Why should external medicine be different? Some arise from the zang organs, some from the fu organs, some in the skin, muscles, and bones; all are caused by stagnation of blood and qi (Blood and Qi Stagnation: impaired flow of blood and vital energy) and retention of Ying and Wei (Ying and Wei: Nutritive and Defensive qi, respectively). Those manifesting from the zang organs appear white, with flat lesions, clear and thin pus, possibly foul-smelling, accompanied by listless spirit and fatigue, belonging to yin. Those manifesting from the fu organs appear red with high swelling, thick and sticky pus, with clear spirit and bright eyes, belonging to yang; this is the general rule. Detailed analysis shows that those arising from the zang organs are due to internal factors; regardless of deficiency/excess or cold/heat, they result from qi depression (Qi Depression: stagnation of qi flow), such as Shiying (Shiying: malignant breast tumor), Shengan (Shengan: tongue ulcer/cancer), and Ruyan (Ruyan: breast cancer). With proper treatment, one can only live with the disease until death. If arising from the fu organs, they are due to external factors; their sources vary. Fire-heat may assist the heart to cause sores; cold evil may damage the heart to cause sores; dryness evil may rob the heart to cause sores; dampness evil may obstruct to cause sores. These are all due to epidemic seasonal qi (Epidemic Seasonal Qi: pathogenic climate factors prevalent during specific seasons) and should be treated according to the principle of mutual overcoming (Mutual Overcoming: the controlling relationship among the Five Elements). Additionally, when cold evil lodges, causing blood stasis and blockage, it may paradoxically present with severe alternating chills and fever, irritability, soreness, and pain resembling heat syndrome. When heat evil prevails, flesh rots with foul pus, even severing tendons and exposing bone, leading to hoarseness and sallow complexion resembling cold syndrome. There are also cases where sweat from labor meets wind, causing Ying qi to reverse into the muscle layer, making cold and heat difficult to distinguish. Furthermore, there are neither-internal-nor-external factors: accumulation from rich and sweet foods, infection from parasites/toxins, changes from sexual exhaustion, and toxicity from cinnabar/mineral drugs—all can lead to large Ding (Ding: deep-seated, hard boil) or Da Yong (Da Yong: large abscess). Even if poisoned by ingesting toxic substances, injured by falls/beating, or burned/bitten by hot water/fire/insects/animals, all result in sores and pus, ultimately caused by the non-compliance of Ying qi (Ying Qi Non-compliance: failure of nutritive qi to circulate harmoniously). So how should they be treated? It lies in examining the pulse to differentiate the syndrome. Generally, before the sore ulcerates, the pulse should be surplus (Excess Pulse: indicating excess pathogen); after ulceration, the pulse should be deficient (Deficient Pulse: indicating deficiency of healthy qi). Surplus indicates abundant toxin; deficient indicates deficient yuan qi (Yuan Qi: Original/Primordial Qi). If a deficient pulse appears before ulceration, it means fire-toxin has collapsed inward and yuan qi is deficient; if a surplus pulse appears after ulceration, it means fire-toxin is abundant and yuan qi is stagnant. By fixing the six positions (Six Positions: Cun, Guan, Chi on both wrists) of the pulse and carefully observing deficiency and excess, one must determine whether to use cold, heat, dispersion, consolidation, purgation, tonification, counter-treatment, or following-treatment. The ultimate goal is appropriateness to the condition; one must not treat rashly. Regarding the location of sores, the circulation of meridians and blood/qi is the same as in Shanghan. Shanghan has no fixed form, so mismanagement leads to complications. Although external signs have a certain form, the spread of toxic vapors (Toxic Vapors: pathogenic heat/toxins) has no fixed position. Thus, if toxin enters the heart, there is coma; if it enters the liver, there is spasm and syncope; if it enters the spleen, there is abdominal pain and distension; if it enters the lungs, there is wheezing and cough; if it enters the kidneys, there is dim vision and cold hands/feet; if it enters the six fu organs, each has its own variations, with many concurrent syndromes and repeated occurrences of the Seven Evils (Seven Evils: seven critical prognostic signs in surgery). The Classic says: "In treating disease, one must seek the root." What is the root? It is the zang organs, fu organs, yin and yang, deficiency and excess, interior and exterior, cold and heat. Grasping the root allows for appropriate use of cooling, warming, purging, and tonifying methods, minimizing medication errors. Failing to grasp the root results in a slight deviation leading to a thousand-mile error; can one not be cautious?