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In all diseases that localize to a specific area, there must be a root cause located within the Zang-Fu organs. One should seek the root and treat it accordingly, rather than treating generically. For instance, nasal polyps or numbness and distending pain in the fingers: although the symptoms appear at the most superficial extremities, the root originates from the deepest levels. Why is this? Because the pathogenic factor travels along a specific meridian without spreading elsewhere. If injured by external pathogens, how could it be so localized? There are cases where external pathogens injure a specific part causing disease; this occurs when stagnation enters the blood vessels, resulting in swelling and pain. However, for disorders of the Qi level that localize persistently, fail to heal over time, or recur intermittently, they invariably have an internal root. This may be due to pathogenic factors overflowing from the Zang-Fu into their corresponding meridians, or due to deficiency of the Zang-Fu leading to insufficient meridian Qi, allowing pathogens to invade the void. Treatment depends on observing accompanying symptoms to differentiate excess and deficiency. Generally, when pathogens overflow from the Zang-Fu, there are changes in Shen (Spirit/Mind), manifesting as abnormalities in diet, urination, or defecation.

The world knows only that slippery diarrhea damages Qi, but does not know that slippery diuresis damages Qi even more; it knows that frequent urination damages Yin, but does not know that using strong diuretics such as Poria (Fuling, 茯苓), Alisma (Zexie, 泽泻), and Akebia (Mutong, 木通) which fail to promote urination, damages Yang even more. Recently, physicians have been confused by the saying that "promoting clear and smooth urination is a quick method for treating disease." Regardless of the condition, they indiscriminately use Poria (Fuling, 茯苓) and Polyporus (Zhuling, 猪苓) along with Alisma (Zexie, 泽泻). This often leads to the collapse of True Qi sinking downward and pathogens sinking inward, resulting in lingering, unresolved conditions. They do not understand that the ancients' intent was that when the Qi transformation of the Sanjiao (Triple Burner) is smooth, urine flows naturally; this is called "Harmony of the Interior" (Li He). Clear and smooth urination is merely a sign of this harmony. Later generations should seek methods to harmonize the interior, not merely promote urination. The Bladder is closely attached to the Mingmen (Gate of Vitality); it is the first pass where the Yuan Qi (Original Qi) of the Mingmen exudes and inhales. The *Nei Jing* (Inner Canon) states that the Sanjiao and Bladder correspond to the hair pores and interstices. This is because Yuan Qi circulates in the Bladder, fills the Sanjiao, and reaches the skin and hair. Now, draining the Bladder is directly draining the root of Yuan Qi's exhalation. Therefore, those with Yin deficiency should not undergo diuresis, and those with Yang deficiency especially should not.

Qian Yizhi said: For minor heat-toxins, resolve toxicity; for major heat, promote urination. Li Dongyuan said: When the Lung is affected by heat pathogens, the source of fluid metabolism and Qi transformation is cut off, causing cold water flow to cease; when the Bladder is affected by damp-heat, causing retention and constriction, leading to inability to urinate, Mutong (Akebia Caulis, 木通) should be used. Zhu Eryun said: When urination is smooth, fire pathogens from all meridians descend and exit via the urine. Fire accumulating internally may require unblocking the large intestine if heat is bound in the gut residues (turbid pathway, not clear pathway); or it may require promoting urination if heat pathogens overflow into the blood vessels of the Sanjiao, blocking the clear pathway. In such cases, Yin-nourishing herbs like Rehmannia (Shengdi Huang, 生地) and Trichosanthes Root (Tian Hua Fen, 花粉) should be used to restore fluids, making the heat pathogen float and retreat from the blood vessels into the fluid medium, then drained out together with diuretic herbs. Thus, smooth urination generates Yin and retards Fire. There are also cases where heat and turbidity bind together. Zhang Zhongjing had Yuzhu San, and Tao Jie'an had Huanglong Tang, both combining Siwu Tang (Four Substances Decoction) and Chengqi Tang (Order the Qi Decoction). Hu Zongxian further stated that one should first nourish Yin and invigorate blood to prevent toxins from adhering to the Liver, before using Chengqi Tang to purge. This represents sequential treatment methods. Thus, water accumulation internally requires promoting urination; fire accumulation internally also essentially involves promoting urination.

Zhang Zhongjing treated Cold Damage water accumulation with Wuling San (Five-Ling Powder), advising patients to drink warm water abundantly. Was the accumulated water insufficient to be drained? Actually, this syndrome, though called water accumulation, also involves heat accumulation. Water and heat each bind to one side. Using Alisma (Zexie, 泽泻), Poria (Fuling, 茯苓), and warm water together allows both pathogens to be expelled simultaneously, preventing heat from rising after water is removed. Moreover, since exterior pathogens were not yet cleared, Guizhi (Cinnamon Twig, 桂枝) in the formula both promotes Bladder Qi transformation and clears exterior pathogens. Pathogenic water cannot induce sweating; it must borrow the essence of warm water to vaporize and induce sweat. How meticulous is this technique! Using one formula and method to resolve interior pathogens while also resolving exterior pathogens—how rapid is this approach!

Ancient methods for promoting urination are countless, generally falling into two categories: nourishing Yin and regulating Qi. Before promoting urination, substantial work must be done; smooth urination is merely a verification sign. Today's physicians do not seek the reason for promoting urination, applying it indiscriminately to any disease; nor do they seek the method, using only Alisma (Zexie, 泽泻) and Poria (Fuling, 茯苓) directly. In exterior contraction, this causes pathogens to sink inward; in interior injury, it causes True Yang to leak downward. Worse still are absurd theories. Once urination is promoted, Wei Qi suddenly sinks, ascending Qi hides, and symptoms temporarily vanish. Physicians claim the disease has improved, deceiving the patient's family, then shirk responsibility to subsequent doctors. Everyone knows that misusing Mahuang (Ephedra Herb, 麻黄) and Guizhi (Cinnamon Twig, 桂枝) causes sweating collapse, and misusing Xiaoshi (Mirabilite, 芒硝) and Dahuang (Rhubarb Root, 大黄) causes purgative collapse. But no one knows about "seeping collapse" from misusing Zexie (Alisma, 泽泻) and Fuling (Poria, 茯苓). Although seeping herbs are used, urination may not visibly increase; Yuan Qi collapses invisibly. This disaster is particularly severe in pediatrics today. Regardless of the disease, once diuresis is applied, the child becomes listless, Middle Qi fails, speech ceases, and wheezing ensues. Physicians then attribute this to Qi stagnation and use descending/purging methods, leading to slight convulsions, drooping eyelids, cold sweat on the forehead, and loss of Hun (Ethereal Soul). Generally, childhood illnesses are mostly Wind-Cold, milk stasis, or prolonged lying on wet mats causing dampness injury. Summer excessive hugging transfers adult body heat and sweat qi into the child's body and abdomen. Treatment should focus on dispersing, opening, and transforming, assisted by clearing and descending. Seeping, draining, astringent, and binding herbs should never be lightly tried.