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(Chuan - Panting/Asthma)
Chuan (Panting): When Fire Qi is excessive, it manifests as summer heat; when deficient, it manifests as winter cold. Therefore, in Cold diseases, Qi is weak and respiration is faint; in Heat diseases, Qi is vigorous and respiration is coarse. Furthermore, Cold-Water belongs to Yin and governs slowness; Hot-Fire belongs to Yang and governs urgency and rapidity. Thus, Cold results in slow respiration and faint Qi, while Heat results in rapid respiration, coarse Qi, and panting.

(Ou - Vomiting)
Ou (Vomiting): When Heat in the Stomach and Diaphragm is excessive, vomiting occurs. This is a manifestation of Fire Qi flaming upward.

(Tu Suan - Spitting Sour Fluid)
Tu Suan (Spitting Sour Fluid): The sour taste corresponds to Liver Wood. It arises because excessive Fire controls Lung Metal, failing to balance Liver Wood, causing Liver Wood to become excessive, thus producing sourness. For instance, food becomes sour easily when heated. Some claim that spitting sour fluid is due to Cold; this is an error. Take wine, for example: its taste is bitter and nature is hot, nourishing Heart Fire. Drinking it causes ruddy complexion, coarse respiration, surging and rapid pulse, slurred speech and delirium, singing, crying, laughing, manic anger or joy, mental confusion and forgetfulness, irritability, thirst, and vomiting—all are Heat syndromes. Its vomit must be sour, clearly indicating Heat. Moreover, Heat intensifies all five flavors. The Classic states: "On earth, transformation generates the five flavors," all belonging to Earth. However, when Earth is prosperous and overcomes Water, failing to control Fire, the Fire transformation becomes excessive. Thus, eating the five flavors when hot makes them intense. Therefore, Liver Heat causes sour mouth, Heart Heat causes bitter mouth, Spleen Heat causes sweet mouth, Lung Heat causes pungent mouth, and Kidney Heat causes salty mouth. If the mouth tastes bland, it is Stomach Heat. The Stomach belongs to Earth, which is the mother of all things, so the Stomach is the root of the body, and blandness is the root of the five flavors.

Then, is spitting sour fluid a Cold syndrome? Those who rashly call it Cold only observe that patients often damage themselves with raw, hard, sticky, or slippery foods, or cold items, leading to belching and acid regurgitation. Hence, folk doctors advocate warming the Spleen and Stomach. How can they know the Classic says: "When humans are injured by Cold, it becomes a Heat disease." Generally, Cold injures the skin and hair, closing the Cou Li (pores), causing Yang Qi to stagnate and fail to circulate smoothly, thereby generating Heat. Thus, in Shang Han (Cold Damage) with surface fever, the Heat is on the surface. One should use Gan-Xin-Re (Sweet-Pungent-Hot) medicines like Ma Huang Tang (Ephedra Decoction) to disperse, opening the Cou Li, allowing sweat to release Heat until recovery. For those internally injured by cold foods, some immediately develop Yin excess and Yang deficiency, becoming Cold diseases. Others have Cold and Heat clashing, causing Yang Qi in the intestines and stomach to stagnate and generate Heat. Some suffer internal injury from cold foods but develop Heat diseases, recovering after profuse sweating releases Heat and cools the body. Or, if mild and not causing other diseases, it presents only as central sourness, commonly called "Acid Heart." The method should use warm medicines to scatter it, similar to releasing the exterior, to open intestinal and gastric stagnation, dissipating stagnant Heat and restoring harmony. If one longingly prefers sourness without cessation, warm medicines are contraindicated; instead, use Cold medicines to purge, followed by cooling medicines to regulate. Once stagnation clears and Heat dissipates, Qi harmonizes. One should avoid sticky, slippery, and greasy foods for central sourness, as these obstruct Yang Qi and cause stagnation. Like food covered in a container, heat causes it to turn sour. One should eat vegetables to promote Qi circulation.

(Bao Zhu - Sudden Profuse Diarrhea)
Bao Zhu (Sudden Profuse Diarrhea): Sudden and violent diarrhea. Excessive Heat in the intestines and stomach disrupts transmission and transformation. Since Fire nature is swift, this occurs.

(Xia Po - Tenesmus)
Xia Po (Tenesmus): A sensation of heaviness in the rectum and urgent, cramped abdominal pain. This is due to the swift nature of Fire and its ability to dry substances.

(Zhuan Jin - Muscle Cramps/Tetany)
Zhuan Jin (Muscle Cramps): The Classic calls this twisting and convulsion. Heat dries and scorches the sinews, causing spasms and pain. Fire governs burning and scorching, hence its drying and moving nature. Some attribute this to Cold invading the sinews; this is wrong. Although Cold governs contraction and pulling, it only causes cold limbs and stiffness, making flexion and extension difficult. How can this be twisting cramps! "Twisting" implies movement. Yang moves, Yin is still; this is clearly a Heat syndrome. Muscle cramps often result from extreme Heat caused by Huo Luan (Colic-Restlessness) with vomiting and diarrhea. Due to Spleen-Stomach Earth deficiency, Liver Wood becomes excessive, and Heat dries the sinews, causing cramps. Generally, thirst indicates Heat. There has never been a case of Huo Luan with cramps without thirst. Or, if not caused by vomiting/diarrhea, but by external Cold closing the Cou Li, causing Yang Qi stagnation and internal stagnant Heat drying the sinews, cramps also occur. Therefore, for various cramps, soaking in hot water opens the Cou Li, disperses Yang Qi, and cures. Because soaking in hot water cures, folk medicine wrongly suspects Cold.

(Xiao Bian Hun Zhuo - Turbid Urine)
Xiao Bian Hun Zhuo (Turbid Urine): When weather is hot, water is turbid; when cold, water is clear. This is because Water's nature is clear, while Fire's nature is turbid. Similarly, clear water boiled into soup naturally becomes turbid.

(Fu Zhang - Abdominal Distension)
Fu Zhang Da, Gu Zhi Ru Gu (Abdominal Distension Large, Drum-like upon Percussion): Qi belongs to Yang, and Yang belongs to Heat. Excessive Qi manifests this way.

(Yong, Ju, Yang, Zhen, Liu Qi, He Jie - Carbuncle, Ulcer, Sores, Rash, Tumor-Qi, Tubercles)
Yong (Carbuncle): Superficial and large. The Classic says: Heat overcoming Blood leads to carbuncle pus.
Ju (Deep Ulcer): Deep and malignant.
Yang (Sores): Small sores with heads.
Zhen (Rash): Floating small rashes.
Liu Qi (Tumor-Qi), Chi Liu (Red Tumor), Dan (Erysipelas): Heat overcoming Qi, representing the color of Fire.
He Jie (Tubercles/Nodules): When Fire Qi is excessively hot, it stagnates and knots, becoming hard like a pit in fruit. It need not be lanced; simply dissipating the Heat allows it to resolve spontaneously.

(Tu Xia Huo Luan - Vomiting, Diarrhea, and Colic-Restlessness)
Tu Xia Huo Luan (Vomiting, Diarrhea, and Colic-Restlessness): The San Jiao (Triple Burner) is the pathway for water and grain transmission. Excessive Heat disrupts this, causing vomiting, diarrhea, and Huo Luan, due to the drying and moving nature of Fire.
Some claim Heat does not cause vomiting/diarrhea, only Cold retention; this is wrong. Generally, vomiting/diarrhea with irritability and thirst indicates Heat; without thirst indicates Cold. In early Heat-type vomiting/diarrhea, there may be no thirst initially. If unceasing, fluids are lost, leading to subsequent thirst. Originally Cold cases do not thirst, but if fluids are excessively lost, dryness and thirst arise. Pure Cold pulses are deep, fine, and slow; Heat pulses are full, large, and rapid. If Qi and fluids are extremely depleted, the pulse may become weak and slow rather than full and rapid, yet it remains a Heat syndrome.

Furthermore, white stool indicates Cold; green, yellow, red, crimson, and black indicate Heat. White stool is the color of Lung. Excessive Cold-Water controls Fire, failing to balance Metal, causing Lung Metal to be excessive, hence white. Like muddy water freezing into ice, it becomes clear and bright. Green stool is the color of Liver Wood. Excessive Fire controls Metal, failing to balance Wood, causing Liver Wood to be excessive, hence green. Claiming green stool is Cold is wrong. Zhang Zhongjing's method states: Shaoyin disease with watery diarrhea, pure green color, indicates Heat in the interior; treat with Da Cheng Qi Tang (Great Order the Qi Decoction) to purge. Also, children with extreme Heat and acute convulsions often have green stool, clearly indicating Heat. Yellow stool occurs because excessive Fire weakens Water, allowing Spleen Earth to prosper, hence yellow. Red stool indicates Heat, the color of Heart Fire; crimson indicates deep Heat. Black stool is also Heat. Extreme Fire/Water may reverse and assume Water characteristics to restrain it, hence black. In Yangming disease of Shang Han, extreme Heat causes tidal fever at dusk; severely, the patient loses consciousness, picks at clothes, touches the bed, and speaks alone as if seeing ghosts. Treat with Da Cheng Qi Tang. Black stool is harder to treat than non-black; this applies to all dysentery.

However, distinguishing dysentery color to clarify Cold/Heat requires examining the color of diet and medicine. For example, a child with Heat disease, vomiting/diarrhea Huo Luan, undigested milk appearing white in stool, should not be immediately diagnosed as Cold; differentiate via pulse and signs. Generally, clear, white urine without obstruction indicates Cold; red, obstructed urine indicates Heat. If undigested food passes unchanged with no color change, foul/vomit clear/cold, clear/white urine without obstruction, cool body without thirst, and slow/fine/micro pulse, it is Cold. If food is undigested but color changes (not white), with irritability/thirst, red/yellow/obstructed urine, it is Heat. Any digested food, regardless of color or other signs, indicates Heat. Cold diarrhea with digested food has never occurred, as Cold cannot digest grains. However, if Fire is swift and Heat extreme, disrupting transmission, undigested food causes Sun Xie (undigested stool diarrhea); this exists. Zhang Zhongjing said: "Pathogenic Heat does not digest food." Yet Heat combined with Dampness causes Sun Xie.

Claiming white dysentery is Cold is wrong. If truly Cold, it cannot digest food, how could it transform into pus/blood? Dysentery transforming grain into pus/blood is like grains/meats/fruits rotting and bursting into sewage under extreme Heat/Dampness. Food in the abdomen, infected by Human Damp-Heat pathogens, naturally bursts into pus/blood. Heat manifests as red (Heart Fire); Dampness as yellow (Spleen Earth); Dryness/Stagnation as white (Lung Metal). The Classic says: "All Qi stagnation and oppression belong to the Lung," referring to Dry-Metal transformation. Wang Bing said: "Stagnation refers to rushing; the function of Qi, Metal Qi is the same." All dysenteries involve Dampness. Now saying "Qi Dryness" means Damp-Heat is extreme inside the intestines/stomach, causing stagnant Heat knotting, while Dampness causes blockage, preventing Qi/fluid circulation, resulting in intestinal dryness and incessant thirst. Assuming red-white dysentery is mixed Cold/Heat is wrong. Water/Fire, Yin/Yang, Cold/Heat are like a scale; one high means the other low, one excessive means the other deficient. How can Cold and Heat both be excessive in the intestines/stomach simultaneously causing dysentery? Like Heat generating sores with white pus—can white be Cold? It is in the skin layer, belonging to Lung Metal, hence white; next in blood vessels, Heart Fire, hence blood boils; in muscle, Spleen Earth, hence yellow pus; in sinews, Liver Wood, hence cyan pus; deep in bone, Kidney Water, hence purple-black blood. Each follows the Five Zang regions showing five colors; this is the branch (Biao). The root (Ben) is all Heat, differing only in depth. Generally, tenesmus, cramping pain, rectal heaviness, red/obstructed urine all belong to Dry-Heat. White dysentery often accompanies these, clearly indicating Heat.

One asks: If white dysentery is Heat, why do pungent-hot medicines sometimes cure it? Pungent-hot medicines can open intestinal/gastric stagnation, allow Qi/fluid circulation, moisten dryness, and harmonize Qi. Mild cases recover; severe cases with unopened stagnation worsen and die. Treating extreme Heat vomiting/diarrhea is similar. For dysentery, best is Pungent-Bitter-Cold medicine, perhaps slightly aided by Pungent-Hot. Pungent-Hot disperses/opens stagnation; Bitter dries Dampness; Cold overcomes Heat, ensuring Qi circulation. Examples include Qian's Xiang Lian Wan. Thus, treating dysentery, Huang Lian (Coptis Rhizome) and Huang Bo (Phellodendron Bark) are Sovereign herbs, being extremely bitter and great-cold, directly treating Damp-Heat. Folk transmitted pungent-hot mineral toxic drugs sometimes cure vomiting/diarrhea because they open stagnation. Though effective sometimes, they often fail and cause harm. Great toxins are used only when good medicines fail, out of necessity. If good medicines exist, even if less effective, they benefit without harm; why use great toxins and labor in vain? The Classic says: "Prefer small to large, prefer good to toxic."

Regarding Dai Xia (Leukorrhea), the principle is like dysentery, differing only in meridians and branches; the root Qi is the same. The world claims white leukorrhea is Cold; this is wrong. Dai Xia is a Ren Mai (Conception Vessel) disease. The Classic says: "Ren Mai starts below Zhong Ji, goes above the pubic hair, follows the abdomen interior, up to Guan Yuan, to the throat, over the chin, follows the face into the eyes, connecting to the tongue." Ren Mai passes over Dai Mai from the uterus, through the navel upward. The disease manifests where it crosses Dai Mai, dripping downward, hence "Dai Xia." Red/white discharge shares meaning with dysentery but excludes Cold. Generally, dizzy head/eyes, bitter mouth, dry tongue, difficult throat, red/obstructed urine, constipated stool, full/rapid pulse—all are Heat syndromes. Dai Xia often presents these. If truly Cold, how could it be so? The Classic says: "Excess causes harm, succession brings restraint." Meaning extreme excess assumes the transformation of the restraining element. Like fire smelting gold; extreme heat turns it to water. Or June extreme heat makes objects weep moisture, trees flow sap. Thus, Liver Heat excessive tears; Heart Heat excessive sweat; Spleen Heat excessive saliva; Lung Heat excessive mucus; Kidney Heat excessive spittle. Like boiling soup; extreme heat boils over, or steam condenses moisture on objects. Thus, extreme Damp-Heat in the lower Ren Mai causes fluid overflow as leukorrhea. I often see folk doctors treating white leukorrhea using recent formulas with pungent-hot medicines. Mild cases, though misdirected, may open stagnation, circulate Qi/fluids, moisten dryness, dissipate Heat, harmonize Qi, and cure. Severe cases with unopened stagnation worsen old diseases, new Heat arises, leading to death, without realization. Why not treat with Pungent-Bitter-Cold medicines according to law, allowing mild/severe cases to open stagnation, remove Dampness, eliminate dryness, dissipate Heat, harmonize Qi, and cure? No missed targets, avoiding harm.

Moreover, for all Fu Re Yu Jie (Stagnant Heat Knotting), one need not rely solely on Pungent-Sweet-Hot medicines to open. Cold medicines like Shi Gao (Gypsum Fibrosum), Hua Shi (Talcum), Gan Cao (Licorice Root), Cong Bai (Scallion White), Chi Xiao Dou (Fermented Soybean) can all open stagnation. Because the root is Heat, getting Cold disperses it. Pungent-Sweet-Hot medicines disperse because their force is strong and衝 (rushing). However, if dispersion fails, Heat worsens. For example, Gui Zhi (Cinnamon Twig) and Ma Huang (Ephedra) pungent-sweet-hot medicines attacking the exterior without hitting the pathology cause Heat to worsen. Thus, skilled users must add Cold medicines; otherwise, fearing extreme Heat causing jaundice, mania, or madness. For exterior Heat requiring sweating, use Pungent-Sweet-Hot medicines. If not hitting pathology, they cause harm; how much more for interior Heat stagnation, where sweating is inappropriate, and mistaking hot medicines for opening fails? Even for Shang Han exterior Heat stagnation, dry without sweat, inducing sweat is not because Pungent-Sweet-Hot Yang induces sweat, but because opening stagnation allows Heat steaming to induce spontaneous sweat. Otherwise, normal people without exterior stagnation taking it would not sweat thus. If Shang Han deepens, exterior Heat enters interior, and mistaking Pungent-Sweet-Hot for sweating fails to produce sweat, worsening Heat, considered fatal by ancients. Conversely, exterior Heat treated with Shi Gao, Zhi Mu (Anemarrhena Rhizome), Gan Cao, Hua Shi, Cong Bai, Chi Xiao Dou (Cold medicines) resolves with sweat; or Heat half-exterior/half-interior treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction, Cold nature) induces sweat and cures; extreme Heat treated with Da Chai Hu Tang purges; worse, Xiao Cheng Qi Tang, Tiao Wei Cheng Qi Tang, Da Cheng Qi Tang purge. Jaundice treated with Yin Chen Hao Tang purges; Chest Binding treated with Xian Xiong Tang/Pills purges. These are great-cold purgatives that hit pathology, inducing sweat and cure. Yet, middle/exterior stagnation, dry without sweat, is not merely because Pungent-Sweet-Hot Yang opens sweat. Mild cases heal spontaneously with sweat. Thus, the reason for sweating is opening stagnation, allowing Heat steaming to induce sweat! For all upper/lower/middle/exterior Fu Re Yu Jie, follow this method. Adjust based on depth and severity. Do not simply use Pungent-Sweet-Hot medicines for releasing exterior.

Generally, having form means illness is inevitable; having life means death is inevitable. Illness should be treated according to law. If critically ill and untreatable, or elderly with exhausted True Qi unable to be saved, this is not the doctor's fault. But if Yin/Yang is not examined, Ben/Biao unclear, mistaking decoctions, reinforcing Excess and draining Deficiency leading to death—who is at fault?

Take wine: bitter taste, hot nature, nourishes Heart Fire. Long-term drinking causes Fu Re Yu Jie in intestines/stomach, blocking Qi/fluid circulation, causing chest/abdominal fullness, inability to eat much. Grain Qi develops internally but cannot circulate outside intestines/stomach, causing belching or flatulence. Empty abdomen, declining grain/water, Yang Qi becomes excessive. With washing/rinsing and labor, plus hot water immersion, Yang Qi increases further, causing frequent vomiting or dizziness, commonly called "Jiu Ge" (Wine Obstruction). For exterior-interior Fu Re Yu Jie, warmth slightly opens and cures; Cold closes and worsens. Hence liking warmth and hating Cold! Current Jiu Ge patients drinking cold wine, bad wine, or forced drinking cause intestinal/gastric stagnation closure, fullness, inability to swallow. At peak desire, or drinking hot pure wine, or willing drinkers, stagnation opens, allowing heavy drinking. Overdrinking increases Yang, decreases Yin. As wine power fades, stagnation worsens, disease adds.

For Wine Heat Toxicity, drinking hot liquids again opens stagnation, restoring Qi/fluid circulation. Wine sickness patients must drink continuously; otherwise, disease worsens, inability to drink, stagnation not opened. For severe stagnation, aversion to Cold and preference for Warmth occurs. This is "Excess causes harm, succession brings restraint," where Extreme Yang resembles Yin. Folk misunderstand, calling it Cold, mistakingly using Hot medicines. Mild cases open stagnation, do not re-knot, Qi harmonizes, cures. Severe cases slightly open, but when drug power ends, stagnation worsens. Reduction is mild, addition is severe. Folk realize nothing, saying drug arrival reduces slightly, drug departure worsens disease, regretting small dosage, persisting in服用, until Fu Re is too extreme, causing central fullness, abdominal distension, and edema. If urine is obstructed and Damp-Heat internal extreme, jaundice occurs, like wet-hot objects steaming to yellow. Folk often use Ba Dou (Croton Seed), a great-toxic hot medicine, for Jiu Ge, because Pungent-Hot opens intestinal/gastric stagnation. Mild cases resolve; severe cases stagnation not opened, Fu Re worsens, disease adds. Hating fullness, they take more to purge. Sometimes opening stagnation cures, due to great toxicity and heat. Although stagnation opens, blood fluids are lost, Yin Qi damaged. Subsequently, Fu Re re-knots, disease worsens. Thinking relief during purging heals, purging repeatedly, as before, 3-5 times, Yin Qi declines, Yang Heat extreme, red/obstructed urination/defecation, jaundice, abdominal distension/edema. Or Damp-Heat internal extreme, recurrent loose stools.

Or merely dietary injury causing Fu Re Yu Jie, like wine sickness, turning into edema is not few. Ultimately unaware that internal Fu Re makes pulse deep-rapid-full, treating with Pungent-Bitter-Cold medicines, clearing stagnation, dissipating Heat, harmonizing Qi. If extreme Heat stagnation cannot open, treat with Pungent-Bitter-Cold purgatives, dissipating Heat/stagnation without knotting. "Knotting" refers to Fu Yu (stagnation) blocking Qi/fluid circulation, not hard stool. Some say edema is due to Spleen Earth deficiency failing to control Kidney Water, causing Water Qi to act recklessly. Spleen governs four limbs, so water...