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The *Classic of Difficult Issues* (Huangdi Neijing) states: Yin and Yang are the primary origins of all things. Water belongs to Yin, and Fire belongs to Yang. Therefore, although the mechanisms of disease are complex, they can be summarized in one word: Yin and Yang.

Observe that nature has four seasons, which generate the climatic factors of Cold, Heat, Dryness, Dampness, and Wind. Humans have five Zang organs, which generate the emotional responses of Joy, Anger, Sorrow, Worry, and Fear. Although the ailments of the five Zang organs differ, they ultimately do not go beyond the Heart and Kidney. The Heart and Kidney are the dwellings of Yin and Yang, and the foundations of Water and Fire. This illness arises from day-and-night overexertion, leading to a failure of communication between the Heart and Kidney (Heart Fire failing to descend to warm Kidney Water, and Kidney Water failing to ascend to control Heart Fire), resulting in a loss of mutual interaction between Water and Fire. Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) circulate; when they move through the Yang aspects, the person is awake; when they move through the Yin aspects, the person sleeps. If Wei Qi cannot enter the Yin, the person remains awake but cannot sleep. The physician used Buxin Dan (Heart-Nourishing Pill) and Yangxin Tang (Heart-Nourishing Decoction) to calm the spirit and stabilize the will, which was not improper. However, one must understand that the Heart is an organ of emptiness and spirituality. Herbal medicines lack sentience; without employing substances with spiritual properties as guides, how can efficacy be expected? I propose adding pure sweet-tasting substances such as Guiban (Tortoise Shell), Hu Jing (Tiger Eye), Longchi (Dragon Bone), Hupo (Amber), and Zhenzhu (Pearl). It is likely there will be a response.

An Bo’s Note: This discussion indeed articulates what others have not said. I propose further incorporating Cishi (Magnetite), taking advantage of its black color to enter the Kidney, allowing it to ascend and interact with the Heart. This would make the spiritual consciousness active and responsive to the Heart’s empty and spiritual nature. I wonder if this aligns with your thoughts.

Pulse diagnosis revealed a deep, hidden, and indistinct pulse. Symptoms included cold extremities, snoring, cold breath from the mouth and nose, and confused consciousness. This resulted from damage to the True Yuan (Original Qi) internally, with Direct Invasion by Yin-Cold pathogenic factors, and external collapse of Yang Qi. The situation is critical. The *Inner Canon* states that human Yang Qi is like the sky and the sun. Now, freezing cold condenses and stagnates, and Yang Qi is obscured by Yin-miasma. Unless heavy doses of Yang-reinforcing herbs are used, how can the scattered Original Qi be restored? The True Yang of the human body is like the moving horse lantern on Mount Ao; the figures bowing, dancing, flying, and walking are all present, yet the key lies only in a single spark of fire. When the fire is strong, movement is fast; when weak, movement is slow; when extinguished, motion ceases, yet the shell of the bowing and dancing figures remains. The prescription uses Renshen (Ginseng Root) and Fuzi (Aconite Lateral Root) in heavy dosages, administered frequently day and night. Materia Medica states that Renshen can restore Yuan Qi from the realm of nothingness, while Fuzi is a general who breaches gates and captures passes. As long as even a trace of Yang remains, death does not occur. However, given that the pulse and symptoms are so deteriorated, achieving the feat of stabilizing the extreme crisis is exceedingly difficult.

An Bo’s Note: This is a case of Collapse of Yang. Urgently applying Moxibustion with Fupian (Prepared Aconite) to Qihai (CV6, Sea of Qi) and Guanyuan (CV4, Gate of Origin), several hundred moxa cones, might possibly save the patient.