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For those who engage in mental or physical labor, it is essential to take frequent breaks and rest to preserve the already depleted Yuan Qi (Original Qi). This is because Qi is rooted in respiration; when respiration is regulated, Qi becomes harmonious. When Qi is harmonious, it flows freely throughout the body, ensuring the peace and harmony of all meridians, resulting in a clear and tranquil spirit and mind. Even under labor, one will not suffer excessively. The method for regulating respiration involves sitting upright in silence and stillness, clearing the mind according to the environment, keeping both mouth and eyes closed, and breathing slowly in and out through the nose, allowing nature to take its course without deliberate cognitive effort. If excessive force is applied, it may instead obstruct the natural, unceasing True Qi, causing stagnation and blockage. (This is a subtle method for treating Consumption Disease [Xu Lao]; imitating and practicing it yields reliable results, surpassing the efficacy of herbal medicines.)

When using tonifying herbs, one must first eliminate pathogenic factors. Only after the pathogens are removed can the tonics take effect. This is akin to washing clothes: one must first remove dirt and grease before applying any polish. If one focuses solely on tonification without recognizing the need to purge pathogens, tonification will inevitably cause harm. (This is the true principle of medication application, applicable to all diseases, but particularly critical for Consumption Disease.)

Consumption Disease [Xu Lao] is indeed often due to Yin Blood deficiency. Even if the sages were to rise again, they would acknowledge this as Yin Blood deficiency. Therefore, do herbs such as Sheng Di Huang (Raw Rehmannia Root), Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis), Zhi Mu (Anemarrhena Rhizome), Xuan Shen (Scrophularia Root), Tian Dong (Asparagus Tuber), and Mai Dong (Ophiopogon Tuber) lack efficacy? Is it wrong for the world to follow and practice them? However, these herbs are both cold-cooling and moistening. When the Spleen and Stomach function is already weakened and food intake has not decreased, using them to treat superficial symptoms is acceptable. But if taken in large amounts or over a long period, they will inevitably deplete the source of transformation and production in the Spleen and Stomach, leading to anorexia and reduced food intake. The Classics state: "Blood is the essence of water and grain, transformed by the Spleen." It also states: "The Spleen is the Ultimate Yin." Human Yin deficiency is essentially Spleen deficiency. Once the Earth element of the Spleen is deficient, the source of transformation and production is exhausted; how can it transport and transform water and grain to generate Yin Blood? Therefore, those administering tonic medicines must constantly adjust based on changes in diet. Whenever dietary intake decreases and coughing intensifies, one should urgently harmonize the Spleen and Stomach and use herbs that promote Qi circulation and clear the Lungs. Physicians with the responsibility of saving lives cannot be rigid and fail to adapt!

A guest visited me and asked: "A patient suffering from a severe illness and long-term deficiency presents with a sallow and emaciated complexion, reduced appetite, and edema in both feet, persisting for over a year. There is no doubt that Qi and Blood have sunk. Should we quickly administer Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)? Instead, the patient developed hypochondriac fullness, abdominal distension, vomiting of foul matter, and inability to eat. What should be done?" I replied: "Based on your description, this is indeed a case of Qi deficiency with sinking. However, the teachings of the ancients imply more than their words suggest. While deficiency requires tonification, within deficiency there is often co-existing excess (pathogenic retention). Blindly tonifying here means the deficiency remains unaddressed while the excess becomes rampant. Furthermore, although sinking Clear Qi needs to be raised, a patient with sinking Clear Qi likely also has Turbid Qi stagnant in the upper jiao. Blindly raising Qi here means the Clear Qi fails to ascend while the Turbid Qi becomes entrenched. Your worsening condition after using ascending and tonifying methods is largely due to this reason." The guest asked: "How do you know there is excess within the deficiency and Turbid Qi above?" I said: "By observing the symptoms. External manifestations such as aversion to distension, phlegm-cough, sore throat, abdominal pain with diarrhea, and interference with eating are what we call 'excess' conditions combined with Turbid Qi in the upper jiao. In such cases, ascending and tonifying methods must be carefully weighed. However, these are obvious symptoms. More difficult to detect are symptoms that appear present but are actually hidden. For example, no nausea but occasional chest oppression and restlessness; no abdominal distension but dull stabbing pain in the intercostal region; no phlegm-cough or sore throat but occasional sensations of globus hystericus or choking; no pain or diarrhea but irregular bowel movements with incomplete evacuation; no dietary intolerance but occasional satiety and discomfort. These symptoms also indicate excess conditions combined with Turbid Qi in the upper jiao. Ascending and tonifying drugs must be used only after careful consideration. This requires meticulous attention and precise reasoning. Therefore, when using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), one must examine appropriately and observe in detail to avoid adverse effects."

This segment of symptom examination is extremely refined. Such analysis applies to all Spleen and Stomach disorders, not just those treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).