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Chapter 75 states: The classics say, "When the East is excess and the West is deficiency, drain the South and tonify the North." What does this mean?

The response is: Metal, Wood, Water, Fire, and Earth should balance each other.

The East corresponds to Wood, and the West to Metal. If Wood desires to be excessive, Metal should restrain it; if Fire desires to be excessive, Water should restrain it; if Earth desires to be excessive, Wood should restrain it; if Metal desires to be excessive, Fire should restrain it; if Water desires to be excessive, Earth should restrain it. The East corresponds to the Liver (Gan), indicating Liver excess; the West corresponds to the Lung (Fei), indicating Lung deficiency. Treatment involves draining the South (Heart/Fire) and tonifying the North (Kidney/Water). The South belongs to Fire, which is the son of Wood; the North belongs to Water, which is the mother of Wood. Water overcomes Fire. The son can make the mother full, and the mother can make the son empty. Therefore, draining Fire and tonifying Water aims to allow Metal to restrain Wood. The classics state: "If one cannot treat the deficiency, what need is there to ask about the rest?" This refers to this principle.

Various commentaries on this chapter have failed to fully elucidate Yuèrén's (Bian Que) intent. Only Xu's *Jing Shi* comes close. I will now elaborate on its meaning. "East excess, West deficiency" means the East is Wood corresponding to the Liver, and the West is Metal corresponding to the Lung. The five Zang organs correspond to the Five Elements and should remain balanced, not biased towards excess. If one organ becomes excessively strong, disease arises, requiring supplementation and drainage for regulation. The method of regulation mentions draining the South and tonifying the North because Southern Fire is the son of Wood, and Northern Water is the mother of Wood. According to the natural way of the Five Elements, if Wood is excessive, Metal should restrain it; if Fire is excessive, Water should restrain it; if Earth is excessive, Wood should restrain it; if Metal is excessive, Fire should restrain it; if Water is excessive, Earth should restrain it. This is natural logic. Currently, the Eastern Liver is excessive, and the Western Lung is deficient. How can deficient Metal restrain Wood? Treatment should suppress the excessive and support the deficient. Thus, we drain Southern Fire and tonify Northern Water, which is "draining the son when the parent is excessive." Fire is the son of Wood, and Water is the mother of Wood. Draining Fire weakens Fire, thereby depleting the mother's Qi (Wood), reducing Fire's momentum so it cannot oppress Metal. Tonifying Water further weakens Fire and consumes Wood's Qi, hence "Water overcomes Fire." Since Wood's Qi is drained, Metal is not oppressed, and the deficient state naturally recovers, allowing Metal to function in restraining Wood. Since Water controls Fire, its power increases, making Wood's mother (Water) overcome Wood's son (Fire). The phrases "son makes mother full" and "mother makes son empty" imply that since Wood's son (Fire) is controlled by Wood's mother (Water), Fire benefits Water's Qi ("son makes mother full"), while Water controlling Fire deprives Fire of Qi ("mother makes son empty"). Contextually, these terms refer to Liver Wood. Suppressing Wood supports Metal. Yuèrén feared misunderstanding and clarified: draining Fire and tonifying Water allows Metal to restrain Wood. If one does not know how to treat Lung deficiency and only treats one meridian, other diseases cannot be cured. Regarding the phrase "Metal cannot restrain Wood," Hua Shi argued the character "bu" (not) is a superfluous character and should be deleted, which is correct.

Hua Shi notes: "Metal cannot restrain Wood" likely contains a superfluous "not". East excess, West deficiency, draining South, tonifying North implies Wood, Metal, Fire, Water seeking mutual balance. The desire for Wood, Fire, Earth, Metal, Water to be full represents the Five Elements' greed for dominance. Their mutual balance uses overcoming relationships to curb this greed. The classics say: "If one Zang is unbalanced, the element that overcomes it balances it." East is Liver, West is Lung. If East is excessive, West must be deficient; otherwise, how could East be overly excessive? Drain or tonify, the goal is to suppress excess and aid deficiency, following the path of moderation. Water overcomes Fire. Draining Southern Fire takes the son's Qi, making it consume the mother's surplus. Tonifying Northern Water benefits the son's Qi, preventing it from consuming the mother. Thus, excess retreats, suppression advances, Metal restrains Wood, and East/West no longer suffer bias. Yuèrén's intent is that East is overly excessive and West is deficient. Draining Fire suppresses Wood; tonifying Water aids Metal, allowing Metal to equilibrate with Water, hence "allowing Metal to restrain Wood." If "Metal cannot restrain Wood," the text becomes contradictory. If Liver Wood is not excessive and Lung Metal is not deficient, draining Fire and tonifying Water would exacerbate excess and deficiency (making excess more excess and deficiency more deficient). Chapter 81 clarifies this. Cai Jiufeng agrees that mutual control泄s excess. The conclusion "If one cannot treat the deficiency, what need is there to ask about the rest" warns against those who know constants but not variations. The main point is Liver excess and Lung deficiency, treated by draining Fire and tonifying Water.

A question arises: "Son makes mother full, mother makes son empty." Shouldn't we drain Fire and tonify Earth? Because if the son has surplus, it doesn't consume the mother's Qi; if the mother is deficient, it cannot nourish the son. Draining Fire takes the son's Qi to consume the mother's surplus; tonifying Central Earth benefits the mother's Qi to nourish the son. Why drain Fire and tonify Water? Answer: This is Yuèrén's brilliance, achieving two goals at once. Draining Fire reduces Wood's Qi and removes Metal's oppression. Tonifying Water benefits Metal's Qi and controls Fire's brightness. Tonifying Earth only aids Metal, lacking dual utility. Hence, Water is tonified instead of Earth.

Another question: "Mother makes son full, son makes mother empty" is the Way of Five Elements. Why does Yuèrén say "son makes mother full, mother makes son empty"? Answer: These are different theories. "Mother makes son full, son makes mother empty" refers to Five Element generation/production. "Son makes mother full, mother makes son empty" refers to acupuncture manipulation (giving/taking). Chen Siming cites Zhang Zhongjing: "Wood attacking Metal is called Heng (Horizontal)." The *Neijing* says: "Excess Qi controls what it overcomes and insults what it cannot overcome." Liver excess and Lung deficiency represent Wood insulting Metal. Normally Metal restrains Wood, but if Wood is too strong, Metal's attempt leads to conflict, harming both. Lung deficiency relies on Earth, but Earth is also controlled by Wood. Thus, Water is chosen as Metal's son and Wood's mother. Draining Fire and tonifying Water makes Water overcome Fire. Fire becomes weak and draws Qi from Wood, reducing Wood. Water, as Wood's mother, makes the son (Wood) empty. Wood becomes balanced, relieving Metal's oppression, restoring Metal. Water, as Fire's son, makes the mother (Fire) full. Chen's theory is logical but constrained by the word "not," making it forced. Deleting "not" aligns better with Chapter 81. Hua Shi's explanation is less clear than Chen's. However, viewing Wood as Fire's mother and Water as Metal's son fits logically but misses Yuèrén's deeper intent.

Wang remarks: Reading this, I sigh at Yuèrén grasping the classics while lamenting later generations losing them. Ancients said: Do not read commentaries first. Savor the text yourself to find new insights, then compare with commentaries. Otherwise, preconceived notions block true understanding. I admire this advice. This chapter is perfect. Later debates are unreliable. "Excess drains, deficiency tonifies" is common knowledge. Everyone knows to drain Heart (Fire) for Liver (Wood) excess. Few know to tonify Kidney (Water) instead of Spleen (Earth) for Lung (Metal) deficiency. Only Yuèrén knew this. Common sense suggests Heart Fire excess causes Liver Wood excess ("son makes mother full") and Spleen Earth deficiency causes Lung Metal deficiency ("mother makes son empty"). Standard treatment would drain Heart and tonify Spleen. Yuèrén differs: "Son makes mother full" refers to Fire (son) and Wood (mother), consistent with common sense. But "Mother makes son empty" refers to Water (mother) and Wood (son), differing from common sense. "Son makes mother full" explains etiology (Fire assists Wood, causing excess). "Mother makes son empty" explains treatment (Tonify Water to drain Fire). Tonifying Water strengthens Water to overcome Fire; as Fire declines, Wood declines. This is "mother making son empty," a form of non-treatment. If applied to Spleen/Lung, why not tonify Spleen? Fire fears Water. With Fire strong and Water weak, Fire is unafraid and uncontrollable. Only by nourishing Water can it be overcome. "Water overcomes Fire" is key. Although both draining Fire and tonifying Water are mentioned, tonifying Water is crucial. Later scholars claim only draining Fire is needed, or that draining Fire equals tonifying Water, contradicting Yuèrén. If tonifying Water were unnecessary, the text wouldn't mention it. If Water is not deficient but Fire is suddenly hyperactive, tonifying Water might not be needed. But if Fire hyperactivity stems from Water deficiency, not tonifying Water is wrong. Without tonifying Water, symptoms temporarily subside but return, becoming chronic. Bitter-cold drugs only drain Fire邪 (evil) but do not nourish Kidney True Yin. To nourish True Yin, Rehmanniae Radix (Dihuang) and Phellodendri Cortex (Huangbai) are essential. Reasons: Liver excess is caused by Heart assisting Liver and Lung failing to control Liver. Lung deficiency is caused by Heart controlling Lung and Spleen failing to generate Lung due to Liver control. Draining Fire and tonifying Water reduces Wood, allowing Metal to control Wood (East not excessive). Metal balances, allowing Earth to generate Metal (West not deficient). If we followed "tonify mother for deficiency," we would tonify Spleen for Lung deficiency. But Liver is strong and controls Earth deeply. Daily Spleen tonification cannot counteract strong Liver. Even if Earth generates Metal, Metal is controlled by Fire, resulting in net loss. Hence, Water is tonified, not Earth. Some worry tonifying Water feeds Wood, increasing Wood. They prefer draining Fire alone. But Wood is already excessive; it doesn't need feeding. Moreover, severe Water deficiency cannot be quickly restored to generate Wood. If it could generate Wood, it would overcome Fire. Others argue tonifying Water prevents it from consuming the mother, thus saving Metal. But Metal is extremely deficient due to Fire control and Earth failure, unable to sustain itself. How can it be consumed by Water? If Lung deficiency were due to Water consumption, that would be absurd. Even if Water doesn't consume Metal, Metal may not recover. The "not" in "Metal cannot restrain Wood" should be deleted. Draining Fire and tonifying Water allows Metal to restrain Wood. "Cannot treat deficiency" refers to Lung deficiency. This method cleverly restores Metal without directly tonifying Earth or Metal. Those who don't understand this cannot treat deficiency and are incompetent. Hence, "If one cannot treat the deficiency, what need is there to ask about the rest?" The earlier concept of mutual balancing is self-evident. Yuèrén is a near-sage; his words deserve respect. I clarify here to correct misunderstandings.

Note: Bo Ren learned acupuncture from Gao Dongyang, focusing on needle techniques. Andao focused on herbal medicine. Yuèrén integrated both. Students studying this chapter gain much insight into supplementation and drainage methods.