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Water, therefore one should strengthen the master of water; what is meant by "master" is the left kidney. (Some consider the liver as the root and the lung as the master, which is incorrect.) The Emperor said: Excellent! When taking cold medicines, heat symptoms appear instead; when taking hot medicines, cold symptoms appear instead. What is the reason for this? (Commentary: The previous question asked about errors in treatment; this question asks about the cause of such errors.) Qibo said: It is because treating only the Wang Qi (excessive pathogenic qi), thus resulting in the opposite effect. (Commentary: Yin deficiency leads to Yang hyperactivity; Yang deficiency leads to Yin excess. Yang hyperactivity leads to fire excess; Yin excess leads to cold excess. Thus, Wang Qi is a biased qi caused by internal deficiency and a false appearance manifested externally. Unskilled physicians do not understand this principle. Seeing external cold excess, they use acrid-warm herbs, unaware that acrid-warm substances consume Qi, and as Qi is consumed, cold generates further. Seeing external fire excess, they use bitter-cold herbs alone, unaware that bitter-cold substances drain Yin, and as Yin is drained, fire blazes further. The reason for reverse heat and reverse cold lies precisely in treating the Wang Qi externally. Zhang Jingyue stated: "For example, summer is naturally hot but yin cold may be latent within, so Zhong Han (cold strike) often occurs; winter is naturally cold but yang heat may be latent within, so Nei Re (internal heat) often occurs. If one does not understand this and insists on using cold herbs in summer to treat the Wang of fire, or hot herbs in winter to treat the Wang of cold, then those with Zhong Han blocking Yang will develop heat after taking cold herbs, and those with Zhong Re blocking Yin will develop cold after taking hot herbs. This is all due to treating the Wang Qi. The same applies to spring and autumn.") The Emperor said: What if it happens without treating the Wang Qi? Qibo said: Your question is thorough! It is because one fails to consider the correspondence of the Five Flavors. When five flavors enter the stomach, they each return to their preferred organ. Therefore, sour first enters the Liver, bitter first enters the Heart, sweet first enters the Spleen, acrid first enters the Lung, and salty first enters the Kidney. Long-term consumption increases the Qi of these organs, which is the normal transformation of substances. However, long-term increase of Qi is the cause of premature death. (Commentary: "Happening without treating the Wang Qi" refers to situations where cold/heat symptoms appear inversely not during the treatment of external cold/heat. This is because the five flavors of food and medicine have specific affiliations, determined by what each organ prefers. For instance, the Liver prefers sour, so sour first enters the Liver... down to the Kidney preferring salty, so salty first enters the Kidney. Continuous entry leads to bias over time. Long-term biased use causes heat to transform into cold and cold into heat. Organ Qi becomes excessive, leading to premature death. In terms of treatment, this arises from ignorance of the affiliations of the five flavors. Thus, attempting to remove cold results in retaining cold, and attempting to remove heat results in retaining heat. The harm of misprescribing medication is equivalent to the harm of misdiagnosing pulse and symptoms. The old text reads "each returns to its preferred attack," but the meaning of "attack" is inexplicable here; it is likely a corruption of "therefore" (gu). It should be read connecting to the following text.)
The Emperor said: Excellent! What is meant by the Jun-Chen-Zuo-Shi (Sovereign-Minister-Assistant-Courier) system of prescriptions? Qibo said: The herb that primarily treats the disease is called Jun (Sovereign); the herb that assists the Jun is called Chen (Minister); the herb that responds to the Chen is called Shi (Courier). This does not refer to the Upper, Middle, and Lower categories. (Commentary: Zhang Jingyue stated: "The primary herb addressing the syndrome is called Jun. Jun herbs are few in number and heavy in dosage, serving as the mainstay. Herbs assisting the Jun are called Chen; there are slightly more in number and lighter in dosage, used to correct deficiencies in the Jun's action. Herbs responding to the Chen are called Shi; their numbers vary and dosage is even lighter, serving as guides and facilitators. This is the meaning of Jun-Chen-Zuo-Shi, not referring to the Upper/Middle/Lower categories mentioned below regarding good and bad distinctions." ) The Emperor said: What are the three categories? Qibo said: They clarify the distinct differences between good and bad properties. ("The previous text discussed prescription formulation, hence the Jun-Chen-Zuo-Shi structure. This text discusses the three categories, referring to the good and bad nature of herbs, hence the distinction of Upper, Middle, and Lower." Xin Zhengxiao states: "Shennong said: Upper herbs serve as Jun, primarily nourishing life to correspond to Heaven; Middle herbs serve as Chen, primarily nourishing nature to correspond to Humanity; Lower herbs serve as Zuo-Shi, primarily treating disease to correspond to Earth." I suspect this was not spoken by Shennong. Although herbs differ in Upper/Middle/Lower status, their goodness or badness ultimately serves to treat disease and preserve human life. Why make such forced distinctions? Neither Lin Yi nor Zhang Jingyue pondered this deeply.)
The Emperor said: Excellent! How are diseases distributed internally and externally? (Commentary: The previous question on internal/external disease received an answer focusing on Biao-Biao (Root-Branch) principles. This re-questioning seeks detailed therapeutic methods.) Qibo said: The method of regulating Qi must distinguish Yin and Yang, determine whether the location is internal or external, and respect their respective domains. Internal diseases are treated internally; external diseases are treated externally. Mild cases are regulated; moderate cases are balanced; severe cases are subdued through purgation or diaphoresis. Regarding Cold, Heat, Warmth, and Coolness, one uses substances belonging to the appropriate category to reduce the pathogen, following the most beneficial approach. (Commentary: Zhang Jingyue stated: "'Fang' means method. The principle of Yin and Yang relates to all aspects of diagnosis, pulse, and medication, requiring careful distinction. 'Zhong-Wai' refers to interior-exterior. 'Mild cases are regulated' means mild cold is harmonized with warmth, and mild heat with coolness. 'Moderate cases are balanced' means severe cold is balanced with heat, and severe heat with cold. 'Severe cases are subdued' means severe pathogens must be directly attacked; if severe externally, induce sweating; if severe internally, purge. For indications of cold, heat, warm, or cool, one must seek the corresponding category to reduce the pathogen, simply following the beneficial direction.) By strictly adhering to the Dao and methods, ten thousand treatments will be successful. With Qi and Blood in balance, one enjoys a long natural lifespan. The Emperor said: Excellent! (By observing the Dao, actions hit the mark, allowing one to command herbal minerals and invoke spiritual forces, harmonize Yin and Yang, and eliminate various diseases. Maintaining the peaceful state of Qi and Blood prevents the depletion of Tian Zhen (innate vitality). Such individuals possess flexible minds and willing spirits, keeping their essence within, thus achieving longevity.)