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I have examined Li Dongyuan's view that tonifying the spleen is superior to tonifying the kidney. Xu Shumi (Scholar Xu) argued that tonifying the kidney is superior to tonifying the spleen. Both sages presented their arguments with profound intent. However, physicians of the world fail to distinguish between the left and right kidneys and do not understand their differences, simply claiming "both are correct." They do not realize that Li Dongyuan's statement refers to the fact that kidney-tonifying medicines are often rich and cloying; although beneficial to the kidney, they specifically hinder the spleen. It is better to strengthen and tonify the middle qi (Middle Jiao Qi) to aid the source of transformation and transportation. Once dietary intake is sufficient, essence and blood will naturally flourish. Thus, by tonifying the spleen, the kidney benefits as well. Here, "kidney" refers to the left kidney.

As for Xu Shumi's theory, it posits that when spleen qi is weak, it cannot transport and transform; when spleen qi is deficient and cold, it cannot grow and produce. This is due to the insufficiency of the mother qi (Kidney Qi), causing the child organ (Spleen) to lose its support. Physicians of the world merely attempt to support the middle qi but often see no effect. Therefore, they established methods to tonify the mother, creating formulas such as Six Spirit Pill (Sishen Wan) and Two Spirits Pill (Ershen Wan). These warm the fire of the Mingmen (Gate of Life), generate Earth (Spleen/Stomach), seek the root, and differ entirely from conventional methods. Here, "kidney" refers to the right kidney. Thus, the kidney has left and right aspects, and treatments differ accordingly.

Li Dongyuan's method of tonifying the spleen is indeed excellent, but it applies specifically to cases where the kidney is not damaged and only the spleen is weak. If essence and blood are depleted, leading to yin deficiency and fever, one fears that without strengthening water (tonifying Kidney Yin), the raging fire cannot be extinguished, and without tonifying the kidney, the root cannot be secured. Can one rely solely on mild and slow-acting remedies, claiming them as the "Kingly Way," leisurely waiting for results, and merely propping up the middle qi?

Although consumptive diseases damaging the kidney also impair spleen qi, the treatment principle cannot abandon the spleen to treat only the kidney. Therefore, bitter-cold herbs like Phellodendri Cortex (Huangbai) and Anemarrhenae Rhizoma (Zhimu), as well as sweet-cold herbs like Asparagi Radix (Dongguai/Tian Dong) and Ophiopogonis Radix (Maidong), along with Scrophulariae Radix (Xuanshen), are increasingly unsuitable for yin deficiency; they merely damage yin further. Although Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is said to tonify the kidney, its ingredients such as Dioscoreae Rhizoma (Shanyao), Poria (Fuling), and Corni Fructus (Shanzhuyu - noted in text as Shizao) are also items that benefit the spleen. Although Shudihuang (Prepared Rehmannia Root) is rich and cloying, after steaming and sun-drying processing, it particularly does not offend stomach qi. Without offending stomach qi first, yet still being able to help distribute medicinal power to the five zang organs, there is none other than Liuwei Dihuang Wan. That this formula tonifies both spleen and kidney is known even without wisdom.

If the true yang of the right kidney is insufficient, leading to mental confusion, timidity, shortness of breath, panting and fatigue upon movement, aversion to cold, impotence, or if spleen and stomach are deficient and cold, resulting in poor appetite, nausea, vomiting, chest and epigastric fullness and distension, heavy pain in the umbilical and abdominal regions, loose stools, or frequent vomiting and diarrhea: although these phenomena clearly belong to spleen diseases, they are actually caused by the deficiency of the mother organ (Kidney). All should employ the method of benefiting the source of fire (Warming Kidney Yang) and cultivating the true yang of the right kidney; nothing surpasses this approach.

In my opinion, the Ling Shu (Spiritual Pivot) and Su Wen (Basic Questions) contain profound meanings of yin and yang in every word and mysteries of water and fire in every sentence. Through the millennia, those who could comprehend these teachings and grasp their truth include Wang Bing (Grand Secretary Wang) in the Jin Dynasty, Xu Shumi in the Tang Dynasty, and Xue Lijia and Zhang Jingyue in the Ming Dynasty. A mere few individuals truly understood the Dao, elucidated the secrets of the Mingmen, and exhausted the distinctions between water and fire, establishing theories and treatments that far surpassed other sages. Other predecessors might have thoroughly discussed the principles of yin and water-fire, but when applied in practice, they lacked definite insight, often relying on attachments and violating norms, forcing their statements. Furthermore, since Liu Wansu (Liu Shouzhen) promoted the theory of Fire-Heat, patients with false heat suffered; Zhu Danxi used bitter-cold herbs to tonify yin, causing those with kidney deficiency to lose their lives.

However, Elder Li Dongyuan left a sixteen-character instruction: Excess fire can be purged using Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian); Deficient fire can be tonified using Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi). He clearly distinguished excess and deficiency, preserved and harmonized the spleen and stomach, avoiding the misuse of mixed prescriptions that harm the world. This was somewhat superior to the approaches of Liu and Zhu. Yet, he failed to propagate the meaning of yin and water-fire, which is indeed a defect. Nevertheless, his work Shanghan Huo Huo Lun (Treatise on Differentiating and Confusing Cold Damage) still benefited the world.

Zhang Jingyue stated: "If the words of Liu [Wansu] and Zhu [Danxi] do not cease, then the grace of Xuanyuan and Qibo [founders of TCM] will not be manifest." This is truly a demon on the path of medicine and a calamity for the people. Alas, people of this world lack understanding of flexible wisdom,偏执 (biasedly) adhering to Liu and Zhu, competing in reverence, harming lives, and wrongfully killing the innocent, remaining in a long dream without waking. This is why Zhang Jingyue vigorously refuted heretical doctrines, clarified orthodox teachings, and could not restrain himself from engaging in debate. I am thus moved to reflect.