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I offer a personal insight for discussion with experts. Take, for instance, the principle of "using sweet and warm herbs to eliminate great heat." Is it truly a case of genuine great heat where sweet and warm herbs can be used? It must be deficiency heat (Xu Re). So, what does this "deficiency" refer to? Qi deficiency leads to heart cold; cold is not heat. Blood deficiency inevitably leads to dryness; dryness is a secondary form of cold, also not heat. Where does this heat come from? It arises when an excess reaches its extreme, manifesting as the transformation associated with the element that controls it. Dryness corresponds to Metal Qi, heat corresponds to Fire Qi, and cold corresponds to Water Qi. The transformation of dryness into heat is the generation of what it cannot overcome (i.e., being controlled), using Fire to control Metal; this is what the *Classic* refers to as "Cheng" (Inheritance/Support). The transformation of cold into heat is the generation of what it overcomes (i.e., controlling), where Fire reversely insults Water; this is what Zhang Zhongjing referred to as "Heng" (Lateral/Rebellious). This is the mutual transformation of Yin and Yang Qi. Deficiency heat arises from cold, and dryness-heat is generated by deficiency. The characters "deficiency" and "heat" should be read separately, not together. Precisely because there is deficiency and dryness, we use sweet herbs to moisten dryness and warm herbs to dispel cold. Once deficiency and dryness are removed, the heat naturally dissipates; this is due to the steaming action of true Fire, causing things to become moist again. Therefore, those who do not understand perceive it as great heat, while those who understand perceive it as cold-dryness; those who do not understand think sweet and warm herbs eliminate great heat, while those who understand think they eliminate cold-dryness; those who do not understand consider this a contrary treatment (Fan Zhi), while those who understand consider it a direct treatment (Zheng Zhi). Regarding its false appearance, it is called contrary; regarding its true nature, it remains direct. Liu Wansu stated: "When one's own energy becomes excessively excessive, it resembles the transformation of the element that controls it." The word "resembles" implies falsity. A physician who can see the truth and not be confused by the false appearance is qualified! Although using sweet and warm herbs to eliminate false heat is established, the method of applying sweet and warm herbs has techniques; it is not merely stating "sweet and warm" that achieves all its wonders. When pathogenic Qi arrives in its proper season, its Qi is mostly excess and strong; when pathogenic Qi arrives counter to the season, its Qi is variable and illusory. Thus, the *Inner Classic* often warns against empty pathogens (Xu Xie). Why? Because this Qi can transform itself, having already incorporated the body's spiritual Qi as its own. Using sweet and warm herbs to treat the root strikes directly at the stronghold, revealing the true state. However, if the body's Qi is agile but the medicine's power is not, the medicinal force may be occupied by the pathogenic Qi and fail to reach the stronghold, causing sweet and warm herbs to inadvertently aid the pathogen in wreaking havoc. Therefore, medicines must also possess "agility" (Ling) to sufficiently counteract the pathogenic Qi. What is meant by "agility"? All things must have surplus strength to effect transformation. Cold-dryness transforming into heat indicates that cold-dryness had accumulated densely over a long period. Dense accumulation over time is termed stagnation (Yu Jie). Qi deficiency is insufficient to push blood, leading to blood stasis (Xue Yu); blood deficiency is insufficient to lubricate Qi, leading to Qi stagnation (Qi Ju). Li Dongyuan's formulas often use Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). Hua Borren stated that adding blood-breaking and collateral-unblocking herbs like Taoren (Persicae Semen) to tonifying formulas yields the most rapid results. The *Classic* mentions adjuvant therapy (Fan Zuo): for treating excess heat, bitter-cold herbs are adjuvanted with hot herbs; for treating deficiency heat, sweet-warm herbs can be adjuvanted with cold herbs. (For great heat in consumptive diseases, hot herbs are often taken cold.) Furthermore, ancients discussed that Lianli Wan (Connected Spleen Pill) treats acid regurgitation by changing the Stomach's state without being changed by the Stomach disease; these are all examples of "agility." Diseases have transforming Qi, and medicines also have transforming Qi. For example, sour and sweet generate Yin, pungent and sweet generate Yang. Skilled practitioners can even borrow the disease's false Qi to assist the medicine's true power, akin to the military strategy of pacification. Ancients also said: the power of transforming Qi is greater than that of original Qi. The reason Qi can transform is that the person's Zheng Qi (Upright Qi) is deficient, while the pathogenic Qi is dense and powerful enough to overcome the person's Zheng Qi. Thus, beneficial Qi transforms into hostile Qi, seizing the person's Qi to harm them. In cold-dryness transforming into heat, it is not that cold-dryness has literally become heat. Cold-dryness remains, but its power drives the body's Zheng Qi to become heat, creating an illusionary array outside. The "emptiness" of Cheng-Zhi (Control and Inheritance) has Qi that is most illusory and sharpest. Therefore, physicians must concentrate their spirit and full strength to subdue it, observing changes and responding swiftly to be effective. This is why consumptive internal injury diseases are difficult to treat. Consumptive major diseases often seem like ghosts or spirits, but they are not; they are the agility of transforming Qi, which is still the agility of the body's original Qi.

These two sections discuss material properties, disease mechanisms, and treatment methods. Comparing them with the essence of the Classics, they certainly do not exhaustively explain everything. I have also synthesized them: nothing in the world is not based on the Five Elements (Wu Xing). The Qi of Heaven and Earth has constancy and variation. Wind: its nature is ascending, its substance is cold, its function is warm, its transformation is dryness. Cold: its nature is condensing, its substance is damp, its function is cold, its transformation is wind. Summer Heat (Shu): it is a combination of damp-heat, born of stagnation, its substance and function are identical to damp-heat, its transformation is wind-dryness. Dampness: its nature is heavy, its substance is hot, its function is damp, its transformation is cold. Dryness: its nature is descending, its substance is wind, its function is dry, its transformation is fire. Fire: its nature is dispersing, its substance is dry, its function is hot, its transformation is damp. This is順化 (Shun Hua - Smooth Transformation), also called transmission transformation. There is also Dui Hua (Opposite Transformation), such as extreme dampness transforming into dryness and extreme cold transforming into heat. Dui Hua can be deficiency or excess. Transmission transformation is the normal alternation of Qi mechanisms; opposite transformation is the violent change of Qi mechanisms, so transformation only occurs after reaching an extreme. There is also Jian Hua (Combined Transformation), which is also a type of deficiency transformation. There is also He Hua (Harmonious Transformation), such as wind combining with heat to transform into dryness, and cold combining with dampness to transform into heat, which are types of excess transformation. Among the Qi of the Five Elements, Metal and Wood both have dryness, Water and Earth both have dampness. But Metal's dryness is condensing, Wind's dryness is dispersing, Earth's dampness is hot, Water's dampness is cold. Fire can be either dry or damp. Its dryness occurs when Wood is excessive and Water does not interact; its dampness occurs when Earth is stagnant and Wood is free-flowing. Thus, Fire gets wind and flames lengthen; cover it with a vessel, and the vessel becomes moist. This is the nature and emotion of the Five Elements' generation and transformation.

The four seasons succeed each other, those who succeed withdraw, one prospers while the other declines, mutually restraining each other. This applies not only to the Qi of Heaven and Earth but also to human emotions. The *Classic* says: Anger injures the Liver, Grief overcomes Anger; Joy injures the Heart, Fear overcomes Joy; Pensive worry injures the Spleen, Anger overcomes Pensive worry; Sadness injures the Lung, Joy overcomes Sadness; Fear injures the Kidney, Pensive worry overcomes Fear. Also, the Gallbladder is the official of justice; prolonged indecision in planning injures the Gallbladder. The Liver is the general; suppressed anger that cannot be expressed injures the Liver. Unceasing fear turns into pensive worry; unfulfilled pensive worry激ates into anger; unceasing rage stagnates into sadness; unregulated joy makes one prone to fear; excessive sadness makes one prone to joy. This is the Cheng-Zhi Sheng-Hua (Control, Inheritance, Generation, and Transformation) of the Five Zang organs' emotions. Thus, Bian Que and Hua Tuo could revive critical conditions by inciting anger, and Zhang Zihe could cure chronic illnesses by inducing laughter. Are they not possessed of great supernatural powers?

Regarding treatment methods, the principle of "pacifying the enemy" (subduing the controlling element) is the most profound. This principle is elaborated in the *Zhi Yao Lun*. For example, if Taiyang Cold-Water is excessive and suppresses Fire, the treatment must use sweet-warm Earth-natured herbs to control Water and bitter-warm Fire-natured herbs to support Fire. However, excessive Water cannot be merely controlled; its nature must be followed and guided. Therefore, sour-warm Wood-natured herbs are added to open the path for Water's generation, thereby cultivating the source of Fire's emergence. Adjuvating with what is favorable, assisting with what generates, the method is extremely meticulous. But this is not enough. With such treatment, Water will recede, Fire will advance. As Water declines and Fire sharpens, Earth Qi will again become presumptuous. Therefore, salty-cold Water-natured herbs are slightly adjuvanted in between, combined with sour-warm Wood-natured herbs to jointly control Earth. This pacifies the subdued elements, preventing endless cycles of excess and recovery. Ancient medical cases often show using hot herbs first to cure the disease, then cold herbs to clear residual heat. Such cases are numerous. Only those familiar with Qi transformation can achieve this.

In summary, the Qi of the Five Elements has control after excess, and generation/transformation after control. This is the natural order. Thus, medical practitioners must study the six characters "Kang Hai Cheng Zhi Sheng Hua" (Excess Harm, Control, Inheritance, Generation, Transformation) and apply them skillfully. Then, encountering any disease, one can control it inversely or guide it directly, regulating Qi to achieve balance, restoring the normal cycle of generation and transformation. Let us further verify this with the Classic. The Classic says: Wood is felled by Metal, Fire is extinguished by Water, Earth is penetrated by Wood, Metal is diminished by Fire, Water is cut off by Earth. This is the mutual control of the Five Elements. It also says: For Wood stagnation, promote it; for Fire stagnation, vent it; for Earth stagnation, purge it; for Metal stagnation, drain it; for Water stagnation, reduce it. However, to regulate the meaning, excess is reduced by what it fears, which is called purging. It also says: Break its stagnating Qi, nourish its source of transformation, do not assist its excess, do not sponsor its recovery. Meeting and seizing it, how can it not be deficient? Following and assisting it, how can it not be excess? It also says: Adjuvate with what is favorable, assist with what generates, this is called obtaining Qi. These are the treatment methods for the Five Excesses and Five Stagnations. Therefore, for the main pathology of Wood, purging uses Sour, tonifying uses Pungent, hence the Jueyin chapter starts with Sour then Pungent. For the main pathology of Fire, purging uses Sweet, tonifying uses Salty, hence the Shaoyin and Shaoyang chapters start with Sweet then Salty. Earth, Metal, and Water follow this pattern. Purging first controls the excess; tonifying later pacifies the recovery.

Furthermore, the use of flavors and aromas involves mutual generation and transformation. The Classic says: Taking cold herbs but getting hotter, or taking hot herbs but getting colder, is due to ignorance of the Five Flavors' affiliations. The Five Flavors enter the Stomach and go to their preferred organs: Sour enters the Liver first, Bitter enters the Heart first, Sweet enters the Spleen first, Pungent enters the Lung first, Salty enters the Kidney first. Long-term consumption increases Qi, which is the constant of material transformation. Increasing Qi for too long is the cause of premature death. Generally, past practitioners sought only the Aroma (Qi), ignoring the Flavor (Wei). They took cold aromas to treat heat, unaware that bitter cold entering the Heart transforms into Fire; they took hot aromas to treat cold, unaware that salty heat entering the Kidney transforms into Water. Long-term flavor consumption transforms into Aroma. The Classic says: Flavor returns to Form, Form returns to Qi. It also says: The Five Flavors enter the mouth, store in the intestines and stomach; stored flavors nourish the Five Qi. Thus, long-term consumption of Five Flavors increases Qi. Flavors are Yin, Aromas are Yang. Yang moves and disperses; Yin is still and stays. Staying leads to long-term accumulation and dense power, agreeing with Zang Qi to transform. Practitioners must guard against subtle beginnings. Li Dongyuan said: Items of the same flavor must have various aromas; items of the same aroma must have various flavors. When using flavor, one must examine the aroma; when using aroma, one must guard against the flavor.

Moreover, pulse manifestations are also based on the Six Qi. The Classic says: Changes of Heaven and Earth cannot be diagnosed solely by pulses; idle Qi moves left and right, following its location. Why? One cannot diagnose a year primarily by Heaven and Earth Qi, but must diagnose the four seasons according to the arrival of the Six Qi. How are the pulses of the Six Qi? Jueyin arrival: pulse is String-like (Xian). Shaoyin arrival: pulse is Hooked (Gou). Taiyin arrival: pulse is Deep (Chen). Shaoyang arrival: pulse is Large and Floating (Da Er Fu). Yangming arrival: pulse is Short and Choppy (Duan Er Se). Taiyang arrival: pulse is Large and Long (Da Er Chang). Their arrival can be excessive or deficient. There are also cases where extreme Choppy resembles Slippery, extreme String-like resembles Slow, deficiency-cold resembles heat, and great heat resembles cold. Internal cold presents with a hollow pulse; external pathogen expansion presents with an internalized pulse. Thus, Cheng-Zhi has deficiency and excess, Sheng-Hua has true and false. Even experts are often confused. The Classic says: When the pulse contradicts the disease, the pulse follows the disease; pressing it, it does not throb, all Yang pulses are like this. When Yin pulses contradict, the pulse follows the disease; pressing it, it throbs strongly and abundantly. Understanding this, no pulse can hide, no disease can hide, and treatment will be easy!