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It is indeed subtle that the principles of Yin and Yang are profound, yet the treatment to harmonize them is difficult. When Yin and Yang are diseased, they become chaotic and fluctuating, making them elusive and hard to grasp. Taking hemorrhage as an example: Blood belongs to Yin, and Qi (Vital Energy) belongs to Yang. The nature of Yang is movement, while the substance of Yin is stillness; the quality of Yang Qi is heat, whereas the nature of Yin is cold. Yin and Yang sustain each other, akin to the relationship between Water and Fire in a state of mutual interaction (Ji Ji). Therefore, when Qi moves, Blood also moves; when Qi stops, Blood also stops. When Qi is abundant, Blood is abundant; when Qi is deficient, Blood is deficient. When Qi is hot, Blood becomes dry; when Qi is cold, Blood coagulates. If Qi is excessive and rebellious upward, Blood will manifest by flowing upwards. If Blood is deficient and sinking, Qi will also follow it into downward collapse. In treatment, for those rebellious upward, one must descend them; for those sinking downward, one must elevate them. For initial diseases where Yin and Yang are disordered, one must pacify them; for disharmonious Cold and Heat, one must harmonize them. Subsequently, investigating the root cause, if Cold is indicated, use Cold methods; if Heat is indicated, use Heat methods; if tonification is indicated, tonify; if purgation is indicated, purge. Treatment methods cannot be rigidly fixed but must be applied flexibly according to the individual.

Since blood has extravasated externally, it indicates that Yang movement has been excessive. If treatment focuses solely on using Cold herbs to suppress it, although Yin controls Yang, this addresses excess. Tonifying Qi to secure it may save blood, but it risks causing Qi to move again and again, leaving no time for rest. Purging Yin to suppress Yang leads to extreme stillness, which unfortunately cuts off the mechanism of vital generation. None of these truly grasp the essence of treating blood or understand the substance of "stillness." Nevertheless, although hemorrhage presents in various forms, one must always carefully distinguish based on Yuan Qi (Primal Qi), pulse characteristics, form-Qi, and disease-Qi. It is particularly strange that Liu Wansu (Hejian) initiated the error of claiming that all hemorrhages lack Cold patterns, leading modern mediocre physicians to treat indiscriminately and kill patients, leaving significant harm, which is truly tragic and regrettable. One should know that Cold-natured drugs for treating hemorrhage are only suitable for cases from ancient times where both the physical constitution and the disease pathogen were excess/real. Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction) is specifically for treating excess syndromes of accumulated heat in the Stomach Meridian. It can only be used temporarily and stopped once the disease is addressed; it is not a general formula for treating hemorrhage. Si Wu Tang (Four Substance Decoction), although composed of blood-invigorating herbs, uses Xiong Gui (Chuanxiong and Danggui) to unblock blood stasis; Bai Shao (White Peony Root) to astringe blood dispersion; and Sheng Di Huang (Raw Rehmannia Root) to control the blazing fire of Yin deficiency. However, these are not primarily Yin-tonifying agents. Moreover, Bai Shao is sour and cold, which may damage the generating Qi, so it is only appropriate for cases with blood stagnation or dispersion. If Yang fire is blazing intensely, wouldn't the pungent and dispersing nature of Dang Gui further assist its flaming upward tendency? Once hemorrhage has just stabilized, residual blood stasis remains, making astringency highly contraindicated. Although Sheng Di Huang, Huang Qin (Scutellaria Root), and Huang Lian (Coptis Rhizome) possess heavy cold natures capable of extinguishing lingering heat, one must consider: if Spleen deficiency fails to control blood, and blood loss further weakens the Spleen, how can one dare lightly use such cold purgatives to damage Spleen Yang? If the already deficient Spleen becomes more deficient due to cold, Yin blood cannot be retained, and hemorrhage will worsen. Only when all Qi aspects are excess and the specific indications for Xi Jiao Di Huang Tang and Si Wu Tang are present can they be used. Furthermore, administering Qi-tonifying formulas prematurely while Yang fire has not subsided disturbs Yin, which is detrimental. One must observe if there is indeed sudden Yuan Qi deficiency with compromised complexion and pulse; in such cases, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Gui Pi Tang (Restore the Spleen Decoction), Si Jun Zi Tang (Four Gentlemen Decoction), and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) are necessary. Even in cases of deficiency-cold with simultaneous Qi collapse, Shen Fu Wan (Ginseng and Aconite Pill) or Ba Wei Wan (Eight-Ingredient Pill) must be administered cautiously and slowly. These represent deviations towards cooling/purging or warming/tonifying, serving as flexible adaptations rather than standard active treatments. Only by understanding the substance of "stillness" and the causes of losing stillness can one discuss formulas for stabilizing blood.

Blood governs Yin and takes stillness as its substance; within Yin lies Yang, and within stillness lies movement. This "stillness" is not inert silence but the stillness of biological transformation. The proposed formula does not specialize in Cold herbs to avoid further damaging True Yin, nor does it abruptly use Warm herbs to avoid aiding Evil Yang. Instead, it recommends neutral, tranquil substances that are neither cloying nor drying. This not only restores Tian Yi (Heavenly One/Kidney Yin) but also balances Water and Fire, preserving the substance of stillness and perfecting the spirit of stillness. This is the fundamental method, using common herbs rather than rare ones. Studying Zhang Zhongjing's Shen Qi Wan (Kidney Qi Pill) proves it to be a valuable remedy for hemorrhage. If one argues that Shu Di Huang (Prepared Rehmannia Root) is too rich and greasy for immediate tonification, one fails to realize that for blood loss and Yin deficiency due to internal injury, tonification is essential to fill the Yin. Mu Dan Pi (Moutan Cortex) is sweet and aromatic, a fine herb for generating new tissue and resolving stasis, and it controls raging fire. However, since True Yin is depleted and Yuan Yang lacks attachment, the Spleen loses its source of nourishment, and Earth Qi becomes feeble. One must use Shan Yao (Dioscorea Rhizome) and Fu Ling (Poria) to peacefully support Stomach Qi, which differs from the warming tonification of Dang Gui and Bai Zhu (Atractylodes Rhizome). Ze Xie (Alisma Rhizome) guides deficient heat downward; Shan Zhu Yu (Cornus Fruit) secures the root meridian of blood storage. Adding Zhi Gan Cao (Honey-fried Licorice Root) pacifies the Five Fires; adding Hei Zhi Zi (Black Gardenia Fruit) converges the two collaterals. No method surpasses this, and trials have shown frequent efficacy. If lung and stomach stagnant heat occur, increase Mai Dong (Ophiopogon Tuber) and Huang Qin while reducing Shan Zhu Yu. If treating liver and kidney excess flames, do not hesitate to use Huang Lian and Huang Bo (Phellodendron Bark) assisted by Shao Yao. Even for movements of ministerial fire, bitter-cold herbs are necessary. If Ming Men (Gate of Life) True Yang is fading, warm-hot herbs may lag behind; if long-term neutral formulas fail, add Qi-tonifying Shen (Ginseng) and Bai Zhu. Incorrectly using descending-fire herbs may worsen the condition; better to delay ascending-Yang Niu Bang Zi (Arctium Fruit). Disease conditions are variable, and fixed formulas are hard to maintain. One must carefully examine the deficiency/excess of Yuan Qi, the auspiciousness/inauspiciousness of complexion and pulse, and the severity of disease Qi. Yin patterns within Yang are easier to support; Yin patterns within Yin are harder to treat. Yin patterns in meridians are easier to cure; Yang patterns in zang organs are also critical. Regarding medication—warming/cooling, tonifying/purging, new/old, smooth/rebellious—one must respond appropriately. Only then can one be clear and doubtless in mind, avoiding the grave fault of misdiagnosis and mistreatment. This is merely my limited insight; for detailed cases, refer to Xue Li Zhai's complete records.