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Zhang Zhongjing, in his discussion of Shaoyin disease in Shanghan Lun (Treatise on Cold Damage), states that if diarrhea stops but shallow breathing (Xi Gao) occurs, it is a death sign; if dizziness and vertigo occur, it is also a death sign. He further stated: In Huoluan (Cholera-like disorder), if diarrhea stops due to the exhaustion of blood (Wang Xue), and if the pulse cannot be felt, it is a death sign. I diagnosed two patients with Xu Sun (Deficiency Consumption). Both presented with coughing above and seminal emission below. After their seminal emissions stopped for two or three months, they died. This is because seminal emission indicates that Yin and Yang are failing to sustain each other. Although there is still essence present, Qi is still sufficient to stimulate its expulsion. If it stops, logically, spirit should become vigorous day by day, and symptoms should improve day by day. However, the body becomes increasingly debilitated, spirit increasingly declines, the pulse shape becomes increasingly thready, the rate becomes increasingly rapid, irregular and uneven, with no fixed pattern between morning and evening. This signifies the severance of Yin and Yang, where there is no Qi to stimulate the Yuan Qi (Original Qi) that has detached from its root, lingering weakly in the Middle Jiao without dissipating completely! Consequently, the cough sound becomes lower daily, respiration shorter daily, food intake fluctuates, and gradually, panting occurs upon slight movement, with unsettled spirit and mind. At this stage, tonifying Spleen causes fullness in the Middle Jiao, tonifying Lung causes congestion in the Upper Jiao. Tonifying Kidney and Mingmen (Gate of Life) with True Yin and True Yang, employing warming, nourishing, grasping, and receiving methods to guide Qi back to its origin, although these are appropriate formulas for the disease, they act as tokens of death. Why? Because the Yuan Qi in the Lower Jiao is empty and lacks a master, and the Qi operating within the five Zang organs has long failed to return to its root. Once the tonic medicine takes effect, the Qi in the Middle Jiao will descend, like the bottom falling out of a bucket, gone forever. Sun Yikui treated Ma Eryin, who suffered from food stagnation and mistakenly took heavy doses of Dahuang (Rhubarb Rhizome et Caudex), Mangxiao (Natrii Sulfas), and Badou (Crotonis Fructus). Before purgation occurred, he used Liujunzi Tang (Six Gentlemen Decoction) to rescue him, stating: "I fear that after taking the medicine, Spleen Yang will move internally, causing the properties of all medicines to activate, leading to uncontrollable severe diarrhea, like water leaking from the bottom of a bottle. One must prepare several jin of Renshen (Ginseng Radix et Rhizoma) in advance." The mechanism here is exactly the same. Kong Yuli also stated: "If dysentery stops but hands and feet are cold, the pulse becomes deep, thready, and devoid of spirit, and the patient cannot eat, it is a death sign." Zhang Zhongjing, for cases where diarrhea stops and the pulse is absent, prescribed Renshen Sini Tang (Ginseng and Aconite Decoction), not out of willingness to sit idle, but merely to do what one can. Since excretion comes from the turbid pathway and belongs to acute diseases, it is so dire; how much more so when seminal emission comes from the root of life, following chronic illness!

The nature of Liver prefers ascending and dislikes descending, prefers dispersing and dislikes constraining. The Classics state: "When Liver suffers from urgency, use pungent flavors to disperse it, use pungent flavors to tonify it, and use sour flavors to drain it." Liver is called the General, with Gallbladder attached to it; the functions of all eleven Zang-Fu organs depend on Gallbladder. Li Dongyuan said: "Wood of Gallbladder ascends with Spring Qi, and the Qi of other organs follows. Therefore, the Qi transformation of all twelve meridians of the Zang-Fu organs must rely on the Qi transformation of Liver and Gallbladder to be encouraged, so that they may flow smoothly and remain free from disease." All conditions involving Qi stagnation, Blood stasis, Phlegm-fluid retention, swelling, abdominal distension, spasms and convulsions, epilepsy and mania, accumulations and masses, epigastric fullness, dizziness, vomiting, hiccups, cough, asthma, Blood Bi syndrome, and deficiency consumption are caused by the inability of Liver Qi to flow freely. Whether due to Liver deficiency lacking strength to expand, or Liver constraint lacking ability to unblock, over time this leads to stagnant Qi and sluggish Blood, overflowing Water pathogens, and internal burning and external flaring of Fire. The cause lies in excessive labor and fatigue damaging Middle Qi, and unregulated worry and thought damaging Spirit transformation; internal injury from diet and external contraction of cold-dampness confine Spleen and Lung, inevitably affecting Liver. Thus, whether treating acute or chronic diseases, one must always incorporate methods to harmonize Liver. Harmonizing Liver means extending its depression and opening its knots; resolving Blood stasis or dispersing Phlegm, combining ascending and descending actions. When Liver is harmonized, the Qi transformation of Sanjiao (Triple Burner) is regulated, and all diseases will surely resolve. Later generations focused solely on "calming Liver," indiscriminately adding bitter-cool descending herbs to any disease, which is actually attacking Liver. Little do they know that the more constrained Liver Qi becomes, the more rebellious it grows; its nature of dispersion and drainage turns horizontal and violent in the center. Excess patterns surge violently upward; deficiency patterns collapse downward. Both possess a fierce, coercive momentum that cannot be resisted. One must follow its nature and soothe it, allowing natural transformation into nothingness. For instance, Li Dongyuan emphasized Spleen and Stomach, deliberately avoiding Wood of Liver. His chosen herbs were pungent-dispersing agents like Fangfeng (Saposhnikoviae Radix), Qianghuo (Notopterygii Rhizoma et Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), and Baizhi (Angelicae Dahuricae Radix). Even Chenpi (Citri Reticulatae Pericarpium) and Houpo (Magnoliae Officinalis Cortex) were frequently cautioned against for their qi-draining properties. Is this meaning not worthy of deep reflection? Zhu Danxi was renowned for using bitter-cold herbs, yet his focus was on opening depression. His commonly used herbs were not beyond Xiangfu (Cyperi Rhizoma), Chuanxiong, Baizhi, and Banxia (Pinelliae Rhizoma). Is this meaning not even more worthy of reflection? Thus, we understand that the ancients' method of calming Liver involved aromatic encouragement and soothing to bring peace, not using Sour-descending herbs like Baishao (Paeoniae Radix Alba) and Zhike (Aurantii Fructus Immaturus) to attack it. So, what should be done for Liver Excess? It is said: Liver excess indeed requires draining, but can all diseases be treated by draining Liver? A physician skilled in regulating Liver is skilled in treating all diseases. The Neijing states: "Ascending, descending, exiting, entering." And again: "Unclog its Qi to make it harmonious." Therefore, Li Dongyuan's discussion of Stomach Qi, Liu Wansu's discussion of Xuanfu (Mysterious Gates), Zhu Danxi's discussion of opening depression, and Ye Tianshi's discussion of unblocking collaterals, none exceed the principle of soothing Liver. What is meant by Liver Excess is that Wind and Fire flourish naturally, and the power of ascending and dispersing is excessive. Later practitioners often mistake headache and head distension caused by constraint and upward surging as Hyperactive Liver Yang. Moreover, pointing to sinking syndromes such as seminal emission, leukorrhea, irritability, and insomnia as Hyperactive Liver Yang is indeed absurd!