典藏书目

In the subtle search for the flame of fire, ensuring it does not extinguish, diseases of extreme cold and extreme heat can be brought to equilibrium. The discussions in the "Brocade Bag" are also exquisite.

The Yellow Emperor said: Excellent. Why does taking cold medicines result in heat symptoms, and taking hot medicines result in cold symptoms? What is the reason? Qibo replied: This occurs because the treatment supplements the "Wang Qi" (Prosperous Qi of the season), leading to a contrary reaction.

Wang Bing explained: Objects have cold and heat properties; medicinal natures have yin and yang distinctions. If one encounters the "Wang Qi," its effect is strengthened. The Qi of the Liver is mild and warm; the Qi of the Heart is summer-heat and hot; the Qi of the Lung is cool and clear; the Qi of the Kidney is cold and biting; the Qi of the Spleen encompasses various characteristics. In spring, one should treat the Liver with clearing methods; using warming methods instead would be incorrect. In summer, one should treat the Heart with cooling methods; using heating methods instead would be incorrect. In autumn, one should treat the Lung with warming methods; using clearing methods instead would be incorrect. In winter, one should treat the Kidney with heating methods; using cooling methods instead would be incorrect. These errors arise from excessively supplementing the "Wang Qi." Excessive supplementation of "Wang Qi" causes the inherent cold or heat of the Zang organs to become excessive.

Wu Kun explained: Spring corresponds to Wood, Summer to Fire, Autumn to Metal, and Winter to Water. Attempting to reverse their nature when they are prosperous is contrary to Heaven's timing. Therefore, in spring, one cannot make the Wood Qi un-warm; in summer, one cannot make the Fire Qi un-hot; in autumn, one cannot make the Metal Qi un-cool; in winter, one cannot make the Water Qi un-cold. Thus, treating during the time of the "Wang Qi" means humans cannot defy Heaven's timing, resulting in a contrary outcome.

Zhang Zhicong (Note: "Wang" is interchangeable with "Wang" [prosperous], pronounced with the departing tone) stated: This discusses the principle that medicinal flavors and aromas should not be used exclusively. The four seasons possess Cold, Heat, Warmth, and Coolness; the Five Zang organs correspond to Sour, Bitter, Pungent, and Salty flavors. Both the five flavors and four aromas must be harmonized in use. Exclusive use leads to excessive dominance. For instance, exclusive use of cold medicines allows Winter's Cold Qi to dominate, causing hot medicines to induce cold symptoms; exclusive use of hot medicines allows Summer's Heat Qi to dominate, causing cold medicines to induce heat symptoms. This is the disharmony caused by biased use of aromas. Exclusive use of Bitter flavor enters the Heart, strengthening Fire Qi; exclusive use of Salty flavor enters the Kidney, strengthening Water Qi. This is the discordance caused by biased use of flavors. Generally, the five flavors generate five Qi. Long-term consumption increases the corresponding Zang Qi. Over time, increased Qi leads to yin-yang imbalance or even severance.

Ma Shi explained: If treating the relevant organ fails to resolve the disease, it is because the Heart governs Summer. Supplementing its "Wang Qi" causes excessive Heat, preventing Water generation; thus, despite using cold medicines, Heat persists. The Kidney governs Winter. Supplementing its "Wang Qi" causes excessive Cold, preventing Fire generation; thus, despite using hot medicines, Cold persists.

Zhang Ji's commentary: The term "Fan" (Reverse) refers to Fan Zhi (Contrary Treatment). This chapter mentions "Ni Zhe Zheng Zhi" (Opposite condition treated oppositely = Standard Treatment) and "Cong Zhe Fan Zhi" (Following condition treated similarly = Contrary Treatment), depending on whether the pathogen is minor or major. Li Shizhen stated: In spring, add pungent-warm herbs like Bohe (Mint) and Jingjie (Schizonepeta); in summer, add pungent-hot herbs like Xiangru (Elsholtzia) and Shengjiang (Fresh Ginger); in late summer, add sweet-bitter-pungent-warm herbs like Renshen (Ginseng), Baizhu (Atractylodes), and Huangbai (Phellodendron); in autumn, add sour-warm herbs like Shaoyao (Peony) and Wumei (Mume Fruit); in winter, add bitter-cold herbs like Huangqin (Scutellaria) and Zhimu (Anemarrhena). This is called "Cong" (Following), which belongs to Contrary Treatment. Contrary Treatment is also a sage's method, but if one fails to assess severity and quantity, merely supplementing "Wang Qi," it differs from true "Cong Zhe Fan Zhi."

The Yellow Emperor asked: What if this happens without supplementing "Wang Qi"? Qibo replied: You ask thoroughly! This is unrelated to the specific Zang organs associated with the five flavors. When five flavors enter the Stomach, they return to their preferred organs: Sour first enters the Liver, Bitter the Heart, Sweet the Spleen, Pungent the Lung, and Salty the Kidney. Long-term consumption increases Qi, which is the normal transformation of substances. However, prolonged increase in Qi leads to premature death.

Zhang Ji's commentary: Medicines have Jun (Monarch), Chen (Minister), Zuo (Assistant), and Shi (Envoy) roles; they exhibit Ni (Opposing), Cong (Following), Zheng (Standard), and Fan (Contrary) actions; they vary in density, thinness, weight, and lightness; and there are Wei (Fear), E (Aversion), and Xiang Ke (Mutual Restriction) interactions. The Monarch is primary, Minister assists, Assistant supports, Envoy guides; this is the origin of formula formulation. Opposing attacks pathogens, Following harmonizes Qi, Contrary treats differently, Standard suits the condition; these are treatment principles. Dense aroma is Yang within Yang; thin aroma is Yin within Yang. Dense flavor is Yin within Yin; thin flavor is Yang within Yin. Thinness promotes circulation; density promotes nourishment and purging. "Wei" implies fearing mutual restriction; "E" implies aversion to difference. Within fear and aversion, mutual achievement is possible. It depends on formulating according to the disease, weighing density and quantity, avoiding Qi increase that leads to death; this is the work of an superior physician.

The *Ling Shu: Mai Du* chapter states: Meridians are the main channels; branches extending horizontally are Luo Vessels (Collaterals); divisions of Luo vessels are Sun Vessels (Sun Collaterals). Where pathogenic Qi is excess and blood stasis exists, it must be rapidly eliminated. Excess conditions require draining (Xie); deficiency conditions require decoctions for tonification.

Zhang Zhicong explained: This discusses how the sixteen zhang two chi measurement applies only to main meridians. Branches are Luo vessels, and finer branches are Sun vessels. Main meridians nourish Zang-Fu internally and connect to the body externally; those visible on the skin surface are all Luo vessels. Excess pathogenic Qi with blood stasis in Luo vessels requires rapid elimination. Pathogens external require draining; internal deficiency requires herbal tonification. This emphasizes that Blood and Qi originate from Zang-Fu generation.

Ma Shi explained: This discusses the meaning of Jing (Meridian), Luo (Collateral), and Sun (Sun Collateral) vessels, and the methods of acupuncture and herbal medicine. "Jing as interior" refers to straight-running meridians like the Hand-Taiyin Lung Meridian from Zhongfu to Shaoshang, located in the "interior" (Jing Sui/Channel Tunnels). Horizontal branches, such as Lieque connecting to the Hand-Yangming Large Intestine Meridian, are Luo vessels. Divisions of Luo vessels are Sun vessels, like grandchildren of children, finer than regular Luo vessels. If blood vessels in Luo/Sun are full, rapid elimination is needed. "Rapid elimination" means draining excess pathogens. For deficiency, only herbal tonification is used.

Zhang Ji's commentary: For deficiency, herbal tonification must be combined with pulse and syndrome differentiation. Pulses have true/false variations; medicines have opposing/following actions. Congenital Yang deficiency requires tonifying Mingmen; acquired Yang deficiency requires warming Stomach Qi. Congenital Yin deficiency requires tonifying Kidney Water; acquired Yin deficiency requires tonifying Heart and Liver. The Heart is the master of Blood; the Liver stores Blood. Six pulses that are flooding and forceful indicate True Yin deficiency; Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is indicated. If the Right Cun pulse is flooding, add Maidong (Ophiopogon) and Wuweizi (Schisandra). If True Yang deficiency with false Yang floating, add Rougui (Cinnamon Bark) and Fuzi (Aconite). String-taut, rapid, or fine-rapid pulses indicate both True Yin and Yang damage; heavily use Liuwei Dihuang Wan with small amounts of Rougui and Fuzi, using fire to regulate fire. Once following the controlling cycle, fire can be restrained, allowing Yin to grow. If pulses are not fine but flooding, not moderate but string-taut/rapid, this approaches "Stomach Qi absent" (death pulse). Tonifying True Yang to quell false Yang, and borrowing True Fire to protect Spleen Earth, is the supreme theory for tonifying Kidney True Yin and Yang. For six pulses that are floating, large, and powerless, this indicates Middle Qi deficiency and Ying Blood depletion; Yangrong Tang (Nourish Ying Decoction) minus Chenpi (Tangerine Peel) is indicated. Six pulses that are deep, fine, and powerless require greatly tonifying the Middle Jiao with acrid-warm herbs to promote drug action; this explains the use of Muxiang (Aucklandia) in Guipi Tang (Restore the Spleen Decoction) and Rougui (Cinnamon Bark) in Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction). Ancient use of Jiang (Ginger) and Zao (Jujube) also promotes Spleen-Stomach transport. Six pulses that are slow, delayed, and extremely minute require urgent Yang rescue; mild cases use Renshen Lizhong Tang (Ginseng Regulate the Middle Decoction), severe cases use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction); no Yin-natured drugs should be mixed. Six pulses that are fine and rapid, powerless upon deep pressure, indicate simultaneous congenital and acquired Yin-Yang deficiency; take Liuwei Wan (Six-Ingredient Pill) in the morning, Yangrong Tang (minus Chenpi) or Shiquan Tang (minus Chuanxiong, replace Shudi with Shu Di) at night. If both Cun pulses are flooding and Chi pulses are powerless, use Bawei Dihuang Wan (Eight-Ingredient Pill) plus Niuxi (Achyranthes) and Wuweizi; if Chi pulses are powerless and Cun pulses are very weak, use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction). Additions and subtractions require flexible judgment. For example, if Shiquan Dabu Tang is indicated but Lung pulse is flooding, remove Xiong (Chuanxiong) and add Maidong/Wuweizi; if six pulses are powerless, double Baizhu (Atractylodes), use only Danggui (Angelica), and avoid Renshen, Dihuang, and Shaoyao. Regarding Dihuang, Shudi (Prepared Rehmannia) can be heavily dosed up to 2-3 liang; Shanzhuyu (Cornus) should not exceed 3-4 qian, as sour flavors mask the dispersing nature of other herbs. This is a general overview of tonification; careful consideration is required in clinical practice.

The *Ling Shu: Lun Tong* chapter records: The Yellow Emperor asked: How do we know who can tolerate toxic medicines? Shaoyu replied: Those with thick stomachs, dark complexion, large bones, and obesity can tolerate toxins; those who are thin with thin stomachs cannot.

Zhang Zhicong explained: This re-discusses the combination of Shaoyin and Yangming. Yangming resides in the center, belonging to Earth, governing food reception, relying on Shaoyin Qi to ascend. Wu-Gui combine to transform into Fire. Fire and Earth Qi combine to steam and separate the essence of water and grain. Thus, those with thick stomachs, dark complexions, large bones, and obesity have abundant Shaoyin and Yangming Qi, enabling them to tolerate toxins.

Ni Shi explained: The Middle and Lower Jiao mutually support each other, leading to strong sinews/bones and thick muscles. This annotation should be read together with *Su Wen: Jue Lun*.

Zhang Jiebin explained: Thick stomach indicates solid Zang organs; dark complexion indicates solid exterior; large bones indicate strong physique; fat flesh indicates abundant blood; thus, they can tolerate harsh toxins. Those with thin flesh and thin stomachs lack Qi and Blood fundamentally and cannot tolerate toxins.

Zhang Ji's commentary: The meaning of tolerating or not tolerating toxins has been seen previously.