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Huangdi asked: What qi mechanism causes people to be prone to forgetfulness? Qibo replied: The qi in the upper part is insufficient, while the qi in the lower part is excessive; the intestines and stomach are full, but the Heart qi is deficient. Due to this deficiency, Ying (Nutritive) and Wei (Defensive) qi remain stagnant in the lower part for a long time and fail to ascend to the upper part on schedule, thus causing forgetfulness. Excessive anger that does not subside damages the Zhi (Will), and damage to the Zhi leads to a tendency to forget previous statements. When blood accumulates in the lower part and qi accumulates in the upper part, the resulting disorder causes forgetfulness. Insufficient fire is called "Fu Ming" (Hidden Brightness). In years of Fu Ming (Fire Deficiency), the diseases manifest as confusion, sorrow, and forgetfulness. When Taiyang Cold Water governs the year, cold qi descends, and Heart qi follows it upward, leading to forgetfulness. When the retaliatory qi of Taiyang becomes severe and invades the Heart, it causes forgetfulness and sorrow.

Humans have different innate constitutions. Those who receive clear qi have clear perceptual functions in the Heart, whereas those who receive turbid qi have dull perceptual functions. For those with clear Heart perception, memory has no limit; even events from thousands of centuries ago can be remembered for life after a single glance, so how could they forget what is before their eyes? For those with dull Heart perception, due to shortness of spirit, they cannot recall past events even without experiencing heartbreak. Liu Hejian stated that water is clear and bright, while fire is dull and turbid; thus, the superior resemble water in clarity, and the inferior resemble fire in dullness, which is determined by their constitution. If one's constitution is mixed with both clear and turbid elements, they cannot tolerate disturbances from external matters. Such disturbances cause a loss of spiritual clarity, resulting in forgetfulness. Qi and blood are the foundation of human spirit. The Classics state: "Stillness allows the Shen (Spirit) to reside within; restlessness causes it to dissipate." Stillness is the nature of water, while restlessness is the function of fire. Therefore, a calm nature keeps the Heart-Shen stored within, while emotional agitation causes the Heart-Shen to wander outside. Continuous agitation leads to continuous forgetting; if forgetting continues, the Shen stored within becomes scarce. When the internal Shen is scarce, one forgets immediately after speaking, or even within a single day. Thus, most people suffer from forgetfulness because they are busy and disturbed, with tangled thoughts throughout their lives, depleting the yin aspect of their qi and blood. Only those with above-average constitutions, who maintain inner clarity and are not confused by external matters, can avoid this—one in a hundred. Therefore, although medicines have the merit of calming the Heart and nourishing blood, it is better to calm the mind, transform the qi, and cultivate one's own essence. Forgetfulness caused by phlegm is merely a temporary condition. However, pathogenic factors causing forgetfulness are not limited to phlegm. Any situation where the Heart-Mind is attached to something, or where various heat-fire pathogens disturb the Heart, can lead to forgetfulness. As stated in the *Ling Shu*, excessive anger damages the Zhi, and damage to the Zhi causes forgetfulness. As stated in the *Nei Jing*, blood accumulating below and qi accumulating above causes disorder and forgetfulness. In such cases, treatment must be tailored to the specific cause.

For forgetfulness due to excessive overthinking, affecting the Heart and Spleen, Gui Pi Tang (Restore the Spleen Decoction) is indicated; add Zhu Li (Bamboo Sap) if phlegm is present. For cases due to shortness of spirit, Ren Shen Yang Rong Tang (Ginseng Decoction for Nourishing the Vitality), Xiao Ding Zhi Wan (Minor Pill for Stabilizing the Will), or Ning Zhi Gao (Calming the Will Paste) may be used. For cases due to phlegm confusing the Heart orifices, Dao Tan Tang (Phlegm-Draining Decoction) administered with Shou Xing Wan (Longevity Star Pill), or Jia Wei Fu Ling Tang (Modified Poria Decoction), is appropriate.

For deficiency in the upper part and excess in the lower part, add herbs that lift yang to the Heart-nourishing formula. If Heart Fire fails to descend and Kidney Water fails to ascend, resulting in unstable Shen and frequent forgetfulness, Zhu Que Wan (Vermilion Bird Pill) is indicated. Kong Zi Da Sheng Zhen Zhong Fang (Confucius the Great Sage Pillow-Center Formula) from *Qian Jin* consists of Gui Jia (Tortoise Shell), Long Gu (Dragon Bone), Yuan Zhi (Polygala Root), and Chang Pu (Acorus Rhizome) in equal parts, ground into powder. Take one cun bi (a measure of volume) with wine, three times daily, to enhance intelligence. The formula for treating excessive forgetfulness consists of Chang Pu (1 fen), Fu Ling (Poria), Fu Shen (Poria with Hostwood), and Ren Shen (Ginseng) each at 5 fen, and Yuan Zhi at 7 fen. Grind into powder. Take one cun bi with wine, three times during the day and once at night; effectiveness should appear within five days. *Sheng Hui Fang* uses Chang Pu and Yuan Zhi (1 fen each), ground into fine powder. Take one cun bi on Wu Zi days to open the orifices and prevent forgetfulness. *Zhou Hou Fang* treats blocked Heart orifices causing forgetfulness and errors. On Ding You days, secretly go to the market, buy Yuan Zhi, place it in the corner of a headscarf, grind into powder, and take it without others knowing. Materia Medica records that Shang Lu Hua (Phytolacca Flower) treats blocked Heart orifices and forgetfulness. Take flowers, shade-dry for 100 days, grind into powder, and take one cun bi with water at dusk. Lie down and contemplate desired matters, and you will see them clearly in your vision.