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The life and death of all things fundamentally depend on Yang Qi (Yang Energy). However, nowadays, eight or nine out of ten patients suffering from Yin Deficiency (Yin Xu) do not realize that this "Yin" is precisely the root of Yang Qi. Yin cannot exist without Yang, nor can Yang exist without Yin. Therefore, the growth of things arises from Yang; while their maturation is accomplished by Yin. Thus, to tonify Yin, one should first tonify Yang. Since Liu Hejian's theory of Fire-Heat gained prominence, Zhu Danxi advocated using bitter-cold herbs as a divine elixir for tonifying Yin, a view universally adopted. People easily observe obvious Heat Syndromes (Re Zheng), but often fail to recognize subtle Cold Syndromes (Han Zheng); furthermore, distinguishing between Deficient Fire (Xu Huo) and Excess Fire (Shi Huo) is particularly difficult. Little do they know that among those ill due to Excess Heat, only three or four out of ten are affected, whereas six out of ten suffer from Deficient Fire. Excess Heat is pathogenic fire. When pathogenic fire is rampant, Yuan Qi (Primal Qi) is essentially unharmed, so it can be subdued with bitter-cold herbs; however, excessive dosage will inevitably damage Yuan Qi. Deficient Fire is the depletion of True Yin (Zhen Yin). How can bitter-cold herbs replenish insufficient True Yin? People only know that nourishing Yin can descend fire, but do not understand that tonifying Yang can generate Water (metaphorically generating Yin fluids). Hence I say: If the words of Liu [Wansu] and Zhu [Zhenheng] do not cease, the Way of Huangdi and Qibo will remain obscure.

Zhang Zhongjing stated in *Shanghan Lun* (Treatise on Cold Damage Diseases): "When a disease originates from Yang and purgation is wrongly applied, heat enters and forms Jie Xiong (Chest Binding); when a disease originates from Yin and purgation is wrongly applied, internal deficiency leads to Pi Qi (Stagnant Qi)." He further said: "Early purgation in Yang Syndromes results in Jie Xiong; early purgation in Yin Syndromes results in Pi Qi." While everyone understands that Jie Xiong and Pi Qi result from premature purgation, few can accurately distinguish the terms "Yin" and "Yang," leading to doubt. Does "Yin-Yang" here refer to the Yin-Yang of Exterior-Interior (Biao-Li)? Or does it refer to the Yin-Yang of Wind-Cold and Qi-Blood? Or does it refer to the Yin-Yang of the Zang-Fu organs of the Three Yang and Three Yin meridians? Regarding "Yang Syndromes" and "Yin Syndromes," does it mean Yang pathogens' heat constitutes Yang Syndromes, and Yin pathogens' cold constitutes Yin Syndromes? If Yin-Yang refers to Exterior-Interior, then disease originating from Yang implies a Yang Syndrome belonging to the Exterior, which should not be purged; erroneous purgation leads to Jie Xiong, which is clear. But if disease originating from Yin implies a Yin Syndrome belonging to the Interior, which properly requires purgation, why does erroneous purgation lead to Pi Qi instead? This indicates that the Yin-Yang mentioned here does not refer to Exterior-Interior. If Yin-Yang refers to Wind-Cold and Qi-Blood, Wind is Yang; Yang pathogens injure Wei Qi (Defensive Qi), which governs Qi; injuring Qi leads to Jie Xiong. Cold is Yin; Yin pathogens injing Ying Blood (Nutritive Blood), which governs Blood; injuring Blood leads to Pi Qi. However, Jie Xiong is an Excess Pathogen with severe symptoms, while Pi Qi is a Deficient Pathogen with mild symptoms. How could Yang pathogens injuring formless Qi result in the Excess syndrome of Jie Xiong, while Yin pathogens injuring tangible Blood result in the Deficiency syndrome of Pi Qi? This indicates that the Yin-Yang mentioned here does not refer to Wind-Cold injuring Qi or Blood. If Yang/Yin Syndromes refer to the Three Yang/Three Yin meridians, diseases of the Three Yang meridians belong to the Fu organs. For example, Taiyang, Yangming, and Shaoyang diseases are in the Exterior, requiring sweating rather than purgation; erroneous purgation causes pathogenic factors to enter the Interior, forming Jie Xiong, which is correct. But diseases of the Three Yin meridians belong to the Zang organs. For instance, Taiyin, Shaoyin, and Jueyin diseases are in the Interior, where purgation is appropriate. Yet, if purgation is deemed appropriate, why does erroneous purgation lead to Pi Qi? This indicates that the Yin-Yang mentioned here does not refer to the Zang-Fu of the Three Yin and Three Yang. If Yang Syndromes refer to Heat caused by Yang pathogens, early purgation causing Jie Xiong is correct. But if Yin Cold Syndromes are purged, death would ensue, not merely Pi Qi. Thus, this "Yin Syndrome" cannot refer to Middle-Jiao Cold Yin Syndromes. Therefore, "Early purgation in Yang Syndromes causes Jie Xiong" needs no debate, but "Early purgation in Yin Syndromes causes Pi Qi" remains doubtful. Zhang Zhongjing provided no explicit text, and famous physicians since Cheng Wuji and Xu Shuwei have failed to elucidate this. Some interpret the "Yin" in Yin Syndrome as Yin Cold, others as Ying Blood, others as the Three Yin meridians; discussions abound without a definitive conclusion. After repeated reflection, I conclude that the "Yin" in this Yin Syndrome refers to the Meridians. The Three Yang meridians have both Meridian and Fu aspects; the Three Yin meridians have both Meridian and Zang aspects. Disease in the Meridian allows for sweating but forbids purgation. If Wind-Cold remains in the Three Yin Meridians, the pathogen stays at the surface of the muscles; thus, early purgation causes Pi Qi. This means disease in the Meridian injures the Zang, causing the pathogen to enter and form Pi Qi. Therefore, if the pathogen is in the Three Yin Meridians, sweating is allowed; if it enters the Three Yin Zang organs, purgation is allowed; if it is in the Meridian but has not entered the Zang, purgation is forbidden. Thus, disease originating in Taiyin is still originating from the Yin Meridian; erroneously purging the Yin Meridian causes Pi Qi. Although this distinction is correct, regarding the "Three Yin," which includes Taiyin, Shaoyin, and Jueyin: Foot Jueyin is First Yin, Foot Shaoyin is Second Yin, and Foot Taiyin is Third Yin. When generally referred to as "Three Yin," does it mean Taiyin, Shaoyin, or Jueyin? Cold damage pathogens begin with the Foot Taiyang Bladder Meridian of the Three Yang; the Bladder is the head of the Three Yang. If the pathogen is in the Three Yang meridians, sweating is indicated, but erroneous purgation causes Jie Xiong. The Three Yin meridians begin with the Foot Taiyin Spleen Meridian; the Spleen is the head of the Three Yin. If the pathogen is in the Foot Taiyin Spleen Meridian, sweating is indicated and purgation is forbidden; erroneous purgation causes Pi Qi. Thus, "Yin" here refers to the Taiyin Spleen Meridian. Wang Haizang discussed Pi Qi with Li Dongyuan, stating it arises from blood and should be treated by benefiting the Central Region (Zhong Zhou). The Central Region is the Spleen. The Spleen can be tonified but not purged; tonifying when purgation was needed leads to Pi Qi. This is what is meant.