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The nineteen pathogenesis patterns in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) indeed represent the essential principles for investigating disease mechanisms. The concluding statement, "For those that exist, seek their origin; for those that do not exist, seek their origin; for those that are excess, investigate them; for those that are deficiency, investigate them," serves to answer the principle stated at the beginning of the chapter: "Excess conditions are treated by reducing, deficiency conditions are treated by tonifying." This summarizes the core methods of the nineteen pathogenesis patterns, representing the profound transmission of wisdom from the ancient sages. Liu Wansu overlooked the context and omitted these sixteen characters, selecting only the nineteen pathogenesis patterns to compose the *Yuanbing Shi* (Treatise on the Origins of Disease). He biasedly discussed excess qi and solid pathogens, attributing seventy to eighty percent of them to Fire (Huohuo), while completely neglecting insufficiency and deficiency pathogens. Furthermore, he stated that treatment should merely reduce excessive qi and avoid mistakenly treating its accompanying transformations. With such assertions, how can patients with deficiency conditions endure? Regarding the general principles of pathogenesis, each belongs to a specific category. Diseases transformed from excess belong to Excess syndromes. What is called "excess" refers to the hyperactivity of True Qi (Zhengqi, healthy energy). Diseases transformed from pathogenic invasion belong to Deficiency syndromes. What is called "deficiency" refers to False Qi (Jiaqi, pathogenic manifestation mimicking deficiency). Therefore, when pathological manifestations exist, fearing they may be false signs of qi, one must also investigate the "existing" symptoms. When pathological manifestations do not exist, fearing pathogens may be hidden within, such as Cold overcoming and transforming into Fire, Dryness overcoming and transforming into Wind, or Cold latent causing restlessness, Heat latent causing cold limbs, one must also investigate the "non-existing" symptoms. When disease manifestations appear similar to Excess, fearing the judgment of excess may be inaccurate, one must scrutinize the "excess" condition. When disease manifestations appear similar to Deficiency, fearing the judgment of deficiency may be untrue, one must scrutinize the "deficiency" condition. These sixteen characters are the crux of pathogenesis. To discard them entirely now is like having a boat without a helmsman, or an army without a commander. This is indeed a lapse even for wise scholars!

Sun Simiao stated that there are 404 types of diseases in the human body. Those recorded in the *Suwen* (Basic Questions) and *Lingshu* (Spiritual Pivot) have detailed the mechanisms of most diseases, eight or nine out of ten. As for the sources of pathogenic factors, externally they are no more than the Six Excesses (Liuyin): Wind, Cold, Summerheat, Dampness, Fire, and Dryness; internally, they are no more than the Seven Emotions (Qiqing): Joy, Anger, Worry, Thought, Fright, Fear, and Sorrow. These manifest among the Twelve Zang-Fu organs, meridians, skin, and hair, resulting in disease. Where then is there any so-called "strange" disease? Even if there are claims of strange diseases, such as entering temples or climbing tombs, encountering Flying Corpse, Ghost Strike, or Rongwu, these arise because the person's Qi and Blood are weak, allowing pathogens to enter due to deficiency. They present as delirious evil spirits, appearing as if possessed by deities, thus seeming strange! Therefore, the *Lingshu* also mentions symptoms of Yellow Corpse Ghost, Green Corpse Ghost, White Corpse Ghost, Red Corpse Ghost, and Black Corpse Ghost. Are any of these not manifestations of inherent weakness in the Five Zang organs? Mediocre physicians, ignorant of pathogenesis, upon encountering unfamiliar symptoms, immediately label them as strange diseases and speculate based on Phlegm (Tan), saying, "Strange diseases mostly belong to Phlegm." Phlegm is not a disease itself. There is no independent entity called "phlegm" in the human body; phlegm is essentially the body's Jin-Ye (body fluids). How can one point to phlegm as an excuse for strangeness? Although Wang Yinjun wrote about Phlegm diseases, listing various symptoms, he merely traced the unpredictable changes of phlegm and never considered it strange. The assertion that strange diseases mostly belong to Phlegm is actually mediocre physicians lacking knowledge of disease mechanisms, using this notion to conceal their incompetence. How sad!