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I once read Mr. Zhao's (Zhao Xianke) book *Yi Guan* (Canon of Medicine), which elucidates the theory of innate Water and Fire, deeply grasping the subtle principles of Yin and Yang from Master Liu Shouzhen's *Suwen Bingji Qi Yi Baoming Ji*. This represents a unique insight that aligns with the profound teachings of Xuanyuan and Qibo, standing out as an exceptional view in the hall of medicine. However, while his discussion on innate Water and Fire can indeed serve as a standard for all generations, I dare to point out a few errors in his discussion of symptoms and treatments.

For instance, in his initial discussion of the "Twelve Officials" theory from the *Neijing* (Classic of Internal Medicine), he claims that the official of the Heart is not the Heart itself, but rather another "Heart Master" existing in the formless realm of Wuji, with the Mingmen (Gate of Life) serving as the monarch. Mr. Zhao's argument concerns the formless Water and Fire of the innate state, whereas the *Neijing* discusses the有形 (form/have-shape) zang-fu organs of the postnatal state. Now, using the formless principle of the innate state to discuss postnatal conditions only leads to confusion and error for later learners.

He further states that those who practice health preservation should pay attention to tonifying Fire, comparing it to a lamp on Mount Ao: when the fire is extinguished, there is no movement; when the fire is vigorous, movement is rapid. He fails to consider that Fire should not be active; activity leads to disease. Rapid movement leads to premature exhaustion and decay; if Fire is too vigorous, a single torch turns to ashes instantly. Therefore, practitioners of health preservation must pursue stillness rather than activity. To say that vigorous Fire leads to rapid movement is to recklessly encourage the bias towards excessive Fire tonification in later generations.

The Way of Yin and Yang cannot be neglected or biased. If Yin is vigorous, Yang becomes deficient; if Yang is vigorous, Yin is exhausted. If either side becomes excessive, disease arises. Mr. Zhao establishes a theory of "Yang without Yin," which has the drawback of biasing towards tonifying Yang.

Regarding the discussion of Shanghan (Cold Damage), specifically under the item of dry mouth and thirst, he places heavy emphasis on Rehmanniae Radix Preparata (Shudihuang) for nourishing Yin. However, late-stage Shanghan involves deficiency heat, while early-stage Shanghan involves excess heat. Using the cloying and stagnation-inducing nature of Rehmanniae Radix Preparata in the early stage of thirst caused by Shanghan will cause pathogenic heat to stagnate, hinder the digestion of food qi, and worsen the thirst. Moreover, dry mouth and thirst belong to disorders of the Yangming Qi level. Mr. Zhao fails to distinguish between Qi and Blood levels, claiming instead to nourish the True Yin of the Kidney. Ignoring that the pathogenic heat has not yet been eliminated, daily administration of Yin-nourishing herbs is of no benefit to the condition. Zhang Zhongjing did not include formulas for nourishing Yin and blood in the items regarding dry mouth and throat because such herbs are intended for treating internal injuries characterized by blood deficiency and fever, not for external contractions caused by pathogenic heat.

In his discussion of blood disorders, he often conflates external contractions and internal injuries. He cites the *Neijing*'s statement that when Taiyang governs the year and Cold dominates excessively, people suffer from vomiting blood and bloody diarrhea, and then applies this to formulas like Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) from *Jingui Yaolue* for treating hematemesis due to external contraction. He does not realize that the "Cold dominating excessively" discussed in the *Neijing* refers to Six Excesses of Cold pathogens on the body surface, causing obstruction and fever. The pathogenic heat stagnates in the Taiyang channel and cannot vent outward, leading to bleeding from the mouth and nose. Thus, the *Shanghan Lun* (Treatise on Cold Damage) states that if Taiyang Shanghan is not treated with Mahuang Tang to induce sweating, it may lead to epistaxis and hematemesis. Mr. Zhao mistakenly interprets the Cold of Taiyang dominance as deficiency-cold and treats it with warm methods, failing to clearly distinguish between external and internal causes. Such legislation is most likely to cause harm.

His discussion on ministerial fire resembling dragon and thunder fires contains further flaws. The principles of dragons and thunder are detailed in the *Zhouyi* (Book of Changes). The celestial imagery of dragons and thunder belongs to the Qian trigram, representing pure Yang. The first line (Chiu Jiu) represents hiding; the second line (Jiu Er) represents appearing; the top line (Shang Jiu) represents hyperactivity. This illustrates that initial Yang at the bottom should not be utilized until it rises to the fifth line (Jiu Wu), attaining the position of strength and dignity. At the top line, Yang is at its extreme, resulting in "Hyperactive Dragon brings regret." Thunder belongs to the Zhen trigram, associated with the East and Wood (Jia). It signifies one Yang moving initially beneath two Yins, shaking the earth. When two Yangs appear above, the hexagram becomes Xun, and both Dragon and Thunder act according to their season. Ancients compared this to Fire in the Liver and Kidney because these two organs govern Wood and Water respectively, yet both contain Ministerial Fire, hence "Yi and Gui share the same source." When True Water of these two organs is insufficient, Yang becomes vigorous and Yin deficient, causing Ministerial Fire to flare up. Treatment should cultivate the True Yin of the Liver and Kidney to restrain it, preventing Yang from reaching extremes, similar to the dynamics of Qian's top line and Li's nine-four line.

Mr. Zhao claims that Dragon-Thunder Fire "dims when wet, blazes when meeting water, and self-extinguishes when fed with fire," advocating the use of acrid-hot drugs like Cinnamomi Cortex (Guizhi) and Aconiti Lateralis Radix Preparata (Fuzi) to warm-tonify True Fire. He ignores that Dragon-Thunder Fire operates only after the Spring Equinox and before the Autumn Equinox, when Shaoyang Ministerial Fire, Shaoyin Sovereign Fire, and Taiyin Dampness combine. One Earth element cannot overcome two Fires; one Yin is pressured by two Yangs. With Yang above and below and Yin residing solely in the middle, the hexagram forms Li. Heat prevails, heavenly Qi descends, and earthly dampness ascends. Dragons rise from the sea, water falls from heaven, or vice versa, shaking the earth and producing thunder. Lightning generates as Li attaches to Heaven. Upper and lower combine, causing Fire and Thunder to roar, forming the Xihe (Biting Through) hexagram. When clouds move and rain falls, the weather cools, and Dragon-Thunder hides. Ancients noted that dragons and snakes emerging occurs only in summer. Mr. Zhao argues that in winter, Yang is below, so Dragon-Thunder stays below following similar Qi; in summer, Yin is below, so Dragon-Thunder cannot settle and rises above. If true, where do turtles and tortoises (Yin creatures) hide in summer and appear in winter? Why do Dragon-Thunder fires appear exclusively in spring and summer and belong exclusively to Zhen and Li? Zhen belongs to the East, rising position, Heavenly Stems Jia/Yi, Earthly Branches Yin/Mao. Li belongs to the South, bright position, Heavenly Stems Bing/Ding, Earthly Branches Si/Wu. Fire is born in Yin, enters office in Si, and peaks in Wu. Zi and Chou represent the beginning of creation; Kan represents nascent Yang hidden between two Yins, unable to activate. In Yin month, Yin begins to peel away, showing signs of vibration and shock. When thunder rolls across the world, the hexagram is Wuwang (Innocence), and all things grow. In Xun, two Yangs are above, and all things are orderly. In Li, Yang is above and below, and all things meet. Hence, "Emerging from Zhen, Aligning at Xun, Meeting at Li."

Guai (Breakthrough) ends with Qian (Creative); Qian returns to the Southern innate position, then one Yin is born below five Yangs, forming Gou (Coming to Meet). Yang extreme yields Yin; Yin grows gradually. Fire moves above, Lake moves below, forming Kui (Opposition). Lake meets Fire, Water and Fire extinguish each other, Lake and Fire transform, then one Yin advances, two Yangs retreat, forming Dui (Joyous). Dragon-Thunder hides until Bo (Splitting Apart) completes Kun (Receptive). Kun returns to the Northern innate position, Yang reverses, one Yang is born below five Yins, forming Fu (Return). Yin ends at Guai, Guai completes Qian; Yang ends at Bo, Bo completes Kun. Thus, Dragon-Thunder Fire emerges in Ze Tian Guai (Lake over Heaven, five Yangs) and stores in Shan Di Bo (Mountain over Earth, five Yins). Clearly, Dragon-Thunder Fire is pure Yang. Dongyuan said: "Fire draws water up; water rises, hot dragon appears, water rises from earth; it cannot be called cold." Using acrid-hot drugs to suppress this is erroneous.

"Guiding Fire back to its source" using Fuzi and Guizhi treats True Yang deficiency causing rootless Fire to float upward, as seen in Daiyang (Floating Yang) or Yin restlessness, not Dragon-Thunder Fire. Dragon-Thunder Fire stems from Liver-Kidney True Yin deficiency, causing Ministerial Fire to flare up. Water is deficient, Fire is vigorous, rushing from below to above suddenly, like burning waste. Conversely, floating deficient Yang and True Yang deficiency involve peeling bed and skin, forced by Yin pathogens. This resembles Five Yangs below with one Yin nearly exhausted above (Pure Yang), or Five Yins below with one Yang nearly exhausted above (Pure Yin). Like Qian's top line ("Hyperactive Dragon brings regret") or Kun's top line ("Dragon fights in the wild"), Extreme Yang and Extreme Yin are worlds apart. Liver belongs to Wood, from which Fire is born; Kidney belongs to Water, the origin of Fire. Yet both rely on True Yin pairing. Water moistens Wood, allowing Fire to reside safely. If True Yin is depleted, Wood loses nourishment, turning soft to hard; Water dries, Wood parches, leading to uncontrollable flames. This Fire, due to True Water deficiency and Ministerial Fire excess, differs from Six Excess pathogens or external added Fire treated with bitter-cold purgatives. Nor should one follow "Fire depression requires dispersion" using ascending-dispersing methods. Treatment should nourish Yin to control Fire, like adding oil to a lamp to let the flame extinguish naturally. Using secret Liver-Kidney Pill, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), combined with Zishen Wan (Nourish Kidney Pill) is appropriate. Ancients said: "Strengthen the master of Water to calm Solar Light." Solar Light refers to Dragon-Thunder Fire; Strengthening Water means Nourishing Yin and Descending Fire. Mr. Zhao advocates acrid-hot treatment, which is "Tonifying the source of Fire to eliminate Yin shadows." How can this be acceptable?