《内经》论内伤，首言七情。曰∶怒伤肝，悲胜怒（金胜木）；喜伤心，恐胜喜（水胜火）
；思伤脾，怒胜思（木胜土）；悲伤肺，喜胜悲（火胜金）；恐伤肾，思胜恐（土胜水）。此七情
之病，还以七情治之也。又曰∶百病皆生于气，怒则气上（怒则气逆，甚则呕血及飧泄，故
气上），喜则气缓（喜则气和志达，营卫通利，故气缓。若喜失之太过，则心气又涣散不收矣
）。悲则气消（悲则心系急，肺布叶举，上焦不通，营卫不散，热气在胸中，故气消），恐则
气下（恐则精却，却则上焦闭，闭则气还，还则下焦胀，故气下），惊则气乱（惊则心无所倚
，神无所归，虑无所定，故气乱），劳则气耗（劳则喘息、汗出，内外皆越，故气耗），思则
气结（思则心有所存，神有所归，正气留而不行，故气结），寒则气收，热则气泄（寒则腠理
闭，气不行，故气收。热则腠理开，营卫通，汗大泄，故气泄。指外感言）。治法∶不外急
者缓之（甘），散者收之（酸），抑者散之（辛），惊者平之（酸、甘镇摄），劳者温之（甘温），损
者益之（甘平），结者散之（辛润），寒者热之，热者寒之之类。《难经》论五劳，谓自上损下
者，一损肺（咳嗽），二损心（盗汗），三损胃（食减便溏），四损肝（善怒、筋缓），五损肾（淋
漏），过胃则不治；自下损上者，一损肾（遗浊、经闭），二损肝（胁痛），三损脾（食减、胀、
泻、肌消），四损心（惊悸、不寐），五损肺（咳喘），过脾则不治。又曰∶损其肺者，益其气
；损其心者，调其营卫；损其脾者，调其饮食，适其寒温；损其肝者，缓其中；损其肾者，
益其精。《金匮》谓肺劳损气，心劳损神，脾劳损食，肝劳损血，肾劳损精，与《难经》同
义。后人又于五劳推为六极。六极者，数转筋，指甲痛，为筋极；牙疼，踵痛，足痿不耐久
立，为骨极；面无华色，头发堕落，为血极；肤如虫行，体肉干黑，为肉极；肌无膏泽，目
无精光，羸瘦肌痒，搔则为疮，为精极。然则内伤首言七情者，原病之所由起也；分言五劳
者，明病之所由起、所由传也；推言六极者，穷病之所至极也。一言以蔽之，不外精、气、
神三者而已矣。且夫精也、气也，人身之一阴一阳也；神者，又贯乎阴阳之中，相为交纽者
也。
请征诸天地。天一生水，水降于下，其浊者凝而为土以成地，地所生之草木为地毛，石
为地骨，金为石之君，亦地骨之类，火虽生于地，实即天之阳气蕴蓄于地中者。是天地者，
太极一气之所化也。水为天之精，火为天之气，而水火默运于天地之间，时行物生，终而复
始，又为天地之神。是天地者，亦精气神一气之所生生化化者也。天之神气，根据地以为基；
人之神气，根据形体以为归宿。故朱子谓太极为阴含阳；邵子谓阳为阴之父，阴为阳之母。凡
此皆言根阴根阳，相为交纽，而不可须臾离者也。以人言之，人身囫囵一个形躯，禀父母之
精血凝结而成，犹水之澄清在下，其浊者凝聚为土以成地体。水为天一之原，水即人之天也
。金为水源，水天本一气也，故天与水隔则为讼，水行天上则为需。水之浊者凝而为地，是
地本水之渣滓凝结而成。故人后天生于先天，其形质皆为水类，内外百体，皆赖水养，而火
即寓于水之内。包地之内外，皆天气也；包人之内外，皆阳气也。天之阳气，蕴蓄于地中；
人之阳气，蕴蓄于肾中。天之阳气，天心默运于宇宙之间；人之阳气，人心默运于形体之间
。人具百体，心生最先；（西学谓妊胎二十日，心已成模。）百体先死，心死最后。心本血
结而
夫人形体皆属阴物，只有心中一点真阳，得之有生之始，以为本性之灵，明生生之化机。所
谓真阳者，心之神也。经虽有心藏神、肺藏魄、肝藏魂、脾藏意、肾藏智（水性活泼，故主
智）。之分，而要皆心之所之而有所主者也；虽有喜伤心、悲伤肺、怒伤肝、思伤脾、恐伤
肾之分，而要皆心之动而有所累者也。（观《大学》心有所忿HT 云云便知）。古歌云∶别有些
儿奇
人事纷扰，神气外用，不能内交心身，是为否。否者，疲也，否则为未济。夜间安寐，如万
物归根，神气来复，内交心身，是为泰。泰者，安也，安则为既济，是为外坎离。人能动静
交相养，使神气常交于心身，则真阳之气根据形躯之阴以为归宿，心身之坎离交，而心肾之坎
离自断无不交之理！阴阳交则平，不交则病，相离则死。故曰内伤百病，不外精、气、神三
者而已矣；精、气、神三者，又不外神气与精交与不交二者而已矣。
请析言之。劳力者伤气，经所谓汗出喘息，内外皆越，劳则气耗是也。气耗则阳虚，阳
虚必生内寒，内寒必生内湿。虚则气浮，脉多浮虚豁大，又或阳虚气陷，按之不鼓，沉细无
力，故仲景谓脉虚为劳，脉大亦为劳。见证多怯寒、少气、自汗、喘乏、头眩、心悸、食减
无味、腹胀飧泄、吞酸嗳腐、面黄而浮、反不觉瘦，或蒸蒸发热，必兼体倦、自汗，甚至中
虚不运，不能砥柱中流，虚热上浮，吐血成碗、面黄、舌淡，而无热象。此等虚热，用劳者
温之之法，如建中、保元、归脾之类，分轻重用之，所谓形不足者，补之以气是也。尤须息
劳静养，复其耗散之气，自可就痊。否则阳虚不复，伤及真阳，阳痿精寒，寒精自滑，吸短
偏卧，又须加温润甘平及血肉有情诸品，如枸杞、沙苑、菟丝、芦巴、制首乌、山药、扁豆
、破故、鹿胶、羊肾、淡菜、海参之类，填补阴中之阳，以固脾胃。又或阳伤及阴，气不化
精，湿转为燥，脉变短数、潮热、骨痛、上咳、下利。此自上损下，由肺及肾者也，若过胃
泄泻，则治疗难矣。另有一种劳力伤气之病，因一时负重，偶然伤力，气逆于上，胸胁疼痛
，甚则呼吸亦痛，咳嗽带红。此等伤气，宜用结者散之之法，如蒌皮、大贝、紫菀、杏仁、
枇杷叶，轻降肺中逆气。吐红加苏子、三七汁、郁金汁、怀牛膝、丹参、藕汁之类，辛润以
化之，与肺劳损气治法不同。
若劳心者伤神，又重于劳力伤气者也。或卷牍烦剧，或百计图谋，心神无片刻之静，心
体无安养之时，由是君火内沸，销烁真阴，不但伤神，并能伤精，阳不根据阴，自阴不潜阳，
阴虚必生内热，内热必化内燥，脉多细涩，甚而数涩，或浮弦搏指，皆阴虚化刚之象。见证
多惊悸、怔忡、心热、盗汗、虚烦不寐，甚则君火引动相火，伤及真阴，干咳、吐血、遗滑
、淋浊、骨蒸潮热，诸证丛生。此亦自上损下，由心及肾者也。治法必以甘凉育阴，及血肉
诸品，填补精液，如补心、固本、复脉、生脉、三才、六味、二至、二仙、五阴之类，随其
轻重用之，所谓精不足者，补之以味是也。尤须安心静养，以后天真阴招摄先天真阳，俾心
阳下交于肾，肾阴上交于心，阴平阳秘，乃克有济。
更有七情伤神之辈，为害尤甚。尝见情志怫郁，悲忧思虑过度，心阳郁结，而肝、脾、
肺之气亦因之郁结。肝叶撑张，则为胀为痛，多怒多烦；脾不输精，肺不行水，则生痰生饮
，嗳腐吞酸，食减化迟，大便作燥，不燥则泻。在初起时，宜用抑者散之之法。夫散非发散
之谓，亦非辛香破耗之谓。如逍遥散法，不用散而用汤，减去白术，借柴胡之微辛以达之，
酌加蒌皮、薤白、贝母、杏仁、柏子仁、当归、酸枣仁、远志、生谷芽之类，辛润以开之。
诸仁皆阴中含阳，生机内寓，最能调畅心神。或再佐牡蛎、决明、龟板、鳖甲之类，咸柔以
软之；桑叶、钗斛之类，微苦以清之。稍久则气结者血亦结，或纳谷不顺，或大便燥结，或
咽中作梗（俗名梅核气）。此噎膈将成之候，又须加阿胶、肉苁蓉、枸杞、蔗汁、梨藕汁、牛
乳、白蜜、韭汁、姜汁之类，甘润、辛润、咸润以流畅之。尤须怡情静养，庶可获效。乃世
俗治法，往往见其气结，即用香附、元胡、木香、砂仁、青皮、浓朴、乌药诸燥药，以为辛
香流气。不知此无形之结，由于太虚之体默运无权，遂至窒碍不通，岂有用辛香破耗之药，
重伤气血而能转为流畅之理？且结则营卫涩滞，气不运水，必然生痰生饮，或虽见自利，而
艰涩不爽。此皆因结而燥，因燥而湿之见证，与阳虚化湿者有霄壤之分，又岂有用温燥之药
而能治因燥致湿之理？往往愈治愈结，胀痛日增，气血益虚，默运之权益窒，由是成膈、成
蛊、成劳，不治者多。不观诸《内经》乎！曰∶二阳之病发心脾，有不得隐曲，女子不月，
其传为风消，传为息贲者，死不治。夫二阳，胃也。发心脾者，谓二阳之病，发于心脾者也
。思为脾志，实本于心，故张鸡峰谓噎膈为神思间病。心脾气结，饮食渐减，病及二阳。阳
明为多血之经，血乃水谷之精气，赖脾气以散输，奉心君而化赤。今心神受伤，困及其子，
饮食不嗜，生化无资；冲脉上隶阳明，阳明虚则血海（冲为血海）干涩，是以不月。观女子不
月，而男子少精可知。血虚则生热，热烁则化燥，肌肉干瘦，如风消物，故曰风消。心火无
制，上烁肺金，金燥则不能运布水精以归正化，津液留于胸中，变为痰饮，咳嗽不已，传为
息贲（气奔迫而为喘也），何治之有？此郁损心脾化燥之一端也。若悲怒恐惊，更易耗伤心肾
肝胆精血，尤宜大剂润养，佐以镇摄神志，最忌耗散破削，致之不救。又见悲忧思虑过度，
郁损心神。心主血，诸脉皆属于心，心气结而诸脉中营气自不能循其常度，将见始也气结，
既也血结，结则隧道拘挛，往往腹中有硬块成形之患，肝胆经脉所过部位，有瘰 成串之患
，甚有生乳岩、结核、内疽、附骨、对口、发背等证。体干，故坚硬；内附筋骨，故不红肿
；血燥，故溃后少脓；肌肉坚硬，故溃后生管，甚则成硬弦多骨之类。皆刚象也，皆燥征也
，与湿热凝于肌肉，外生痈肿，易溃而多脓水者不同。凡人膈膜以上属天气，头为诸阳之会
，背为阳中之太阳。凡对口、发背、偏枯、痿痹之类，多属燥病。推原其故，多由郁损心神
，耗及肝脾肾阴所致；又或因吸受天之燥邪而发，或因贪食煎 及金石桂附诸燥药而发
。经曰∶热中、消中，不可服膏粱芳草石药，石药发癫，芳草发狂，不可不知。以上诸证，
皆
瘕，妄用攻坚破积；勿以瘰 为痰核，妄用行气消痰；勿以内疽为阴寒证，妄用辛燥破削
。夫古人阴疽之称，谓其结于血分也，非谓其为阴寒也。或曰∶寒则凝滞，冬月水泽腹坚，
非寒结乎？曰∶必水少而腹始坚，未有长江大河而腹坚者。且寒与燥同源，严寒干结之气，
即是燥邪，故冬月地多坚白坼裂。坚为刚象，而非柔象，此固理之显见者也。试观王洪绪《
外科全生集》中阳和二方，以大剂熟地、鹿胶润补为主，借芥子之辛润，流通营气；熟地与
麻黄并用，麻黄仅用十分之一，借以轻达卫气；因血结日久，阳气不得行于其间，故稍佐姜
、桂之温。姜、桂气温热而体微润，在其人无热证者，服之神效，若稍见热证，则又宜速去
姜、桂矣。凡此皆郁损心神，由气及血，化成燥证，散见于内外者也。若是者，心为君主之
官，顾不重哉！
若劳、色伤精之辈，更有甚焉者。先动心以伤神，既劳力以伤气，终纵情以伤精。伤精
则阴亏，阴亏则易动相火，愈动愈伤，一旦精、神、气三者皆耗，多致不起。脉证较劳心伤
神者更重。治法亦不外填补真阴。但久则阴虚不复，真阴不能招摄真阳，真阳即不能归附真
阴，由是龙火上炎，一火兴而五火炽，满腔皆虚阳充塞，而见颧红、面赤、喉干、咽痛、咳
喘、音哑、五心如烙、筋急酸疼、骨痛如折、上咳、下利，种种危证。古法往往见龙雷飞越
，用知、柏苦寒直折，非徒无益于真阴，而又残害乎脾胃。春山先生曰∶龙雷为水中之火，
春夏湿升水旺之时，龙雷多动，雨势愈大，电光愈腾，必得西方风起，天之燥气下降，龙雷
乃藏。介类禀干金之燥气，得坎水之阴精，滋阴潜阳，较胜于丹溪用知、柏多多矣。古法又
有用桂附六味，以为导龙归海，在阴不甚虚者，或阴虚夹寒湿者，暂用有效，若阴液大亏之
人，再以刚燥耗阴，受其害者多矣。或曰∶景岳先生云∶丹田暖则火就燥，下元固则气归精
，甘温能除大热，又何不可用之乎？曰∶是也。夫阴中之阳，如温泉之气。试观温泉之气，
其为燥阳之气乎？抑为雾露之溉乎？春日阳从地起，太和元气，且温且润，故草木得之含液而
萌芽，肾气亦犹是也。知此则当拣体质温润者用之，质润属阴，气温属阳，方与肾之本体相
合。许学士云∶补肾不若补脾。夫补脾非燥脾之谓，凡甘平、甘淡，皆能补脾。孙真人云∶
补脾不若补肾。夫补肾非凉肾之谓，凡清润、温润、平润而味甘者，皆能补肾中之脾胃。补
脾、补肾，原两不相碍也。草木有汁则长青而不枯，人有液则长濡而不燥。欲作长明灯，须
《内经》论述内伤，首先提到七情。说：怒伤肝，悲能胜怒（金克木）；喜伤心，恐能胜喜（水克火）；思伤脾，怒能胜思（木克土）；悲伤肺，喜能胜悲（火克金）；恐伤肾，思能胜恐（土克水）。这七情引起的疾病，就用七情来治疗它。又说：各种病都生于气，怒则气上（发怒则气逆，严重时会呕血或完谷不化的泄泻，所以叫气上），喜则气缓（喜悦则气和志意通达，营卫通畅，所以气缓。如果喜乐过度，心气就会涣散不收），悲则气消（悲伤则心脉拘急，肺叶扩张，上焦不通畅，营卫不能布散，热气郁结在胸中，所以气消），恐则气下（恐惧则精气退缩，退缩则上焦闭塞，闭塞则气还返，还返则下焦胀满，所以气下），惊则气乱（惊吓则心神无依，神志无所归附，思虑无法安定，所以气乱），劳则气耗（劳累则喘息、出汗，内外之气皆外越，所以气耗），思则气结（思考则心意专注，神志有所归着，正气停留而不运行，所以气结），寒则气收，热则气泄（寒冷则腠理闭塞，气机不行，所以气收。炎热则腠理开泄，营卫通畅，大汗淋漓，所以气泄。这里指外感邪气而言）。治法：不外乎急者用甘味药缓之，散者用酸味药收之，抑者用辛味药散之，惊者用酸、甘味药镇摄之，劳者用甘温药温之，损者用甘平药补益之，结者用辛润药散之，寒者用热药治之，热者用寒药治之等等。《难经》论述五劳，谓从上往下损伤的，一损肺（咳嗽），二损心（盗汗），三损胃（食欲减退、大便溏薄），四损肝（易怒、筋脉弛缓），五损肾（淋证、遗精漏下），超过胃的就不好治了；从下往上损伤的，一损肾（遗精浊液、月经闭止），二损肝（胁痛），三损脾（食欲减退、腹胀、腹泻、肌肉消瘦），四损心（惊悸、失眠），五损肺（咳嗽气喘），超过脾的就不好治了。又说：损及肺的，要补益其气；损及心的，要调和其营卫；损及脾的，要调节饮食，适应寒温；损及肝的，要舒缓其中气；损及肾的，要填补其精。《金匮要略》说肺劳损伤气，心劳损伤神，脾劳损伤食运，肝劳损伤血，肾劳损伤精，这与《难经》的意思相同。后人又在五劳基础上推演为六极。六极是：频繁转筋，指甲疼痛，称为筋极；牙疼，脚跟痛，足痿软不能久立，称为骨极；面色无华，头发脱落，称为血极；皮肤像虫爬行，身体肌肉干枯发黑，称为肉极；肌肉没有光泽，眼睛没有神采，消瘦且肌肉瘙痒，抓挠后生疮，称为精极。既然这样，内伤首先讲七情，是说明病因的来源；分述五劳，是阐明疾病的起因和传变；推演六极，是穷尽疾病发展到极致的状态。一言以蔽之，不外乎精、气、神三者罢了。况且精和气，是人身的阴和阳；神，又贯穿于阴阳之中，相互交纽连接。
请参照天地之道。天一生水，水下降于下，其中的浑浊部分凝结成为土以形成地，地所生长的草木是地的毛发，石头是地的骨骼，金属是石头的君主，也属于地骨一类，火虽然生于地，实际上就是天的阳气蕴蓄在地中的表现。所以天地，是由太极一气所化生的。水是天的精华，火是天之气，而水火在天地之间默默运行，万物生长，循环往复，又是天地之神。所以天地，也是由精、气、神一气所生生不息的。天的神气，以地为根基；人的神气，以形体为归宿。所以朱熹说太极包含阴阳；邵雍说阳是阴的父亲，阴是阳的母亲。凡此种种都是说根植于阴和阳，相互交纽，片刻不可分离。从人来说，人身是一个完整的躯壳，禀受父母的精血凝结而成，就像水澄清在下，其中的浑浊部分凝聚成土以形成地体。水是天一的原初，水就是人的天。金是水的源头，水和天本是一气，所以天和水分隔则为讼卦，水行于天上则为需卦。水的浑浊部分凝结为地，地本是水的渣滓凝结而成。所以人后天生命源于先天，其形质都属于水类，内外百骸，都依赖水滋养，而火就寓含在水之内。包裹地内外的是天气；包裹人内外的是阳气。天的阳气，蕴蓄在地中；人的阳气，蕴蓄在肾中。天的阳气，天心在宇宙间默默运行；人的阳气，人心在形体间默默运行。人具备百体，心脏最先形成；（西医认为怀孕二十天，心脏已具雏形）。百体先死，心脏最后死亡。心脏本是血的凝结，而人的形体都属于阴物，只有心中有一点真阳，从有生之初获得，作为本性的灵明，昭示生生变化的机理。所谓真阳，就是心的神。经文虽然有“心藏神、肺藏魄、肝藏魂、脾藏意、肾藏智（水性活泼，所以主智）”的区别，但归根结底都是心所主宰并有所主导的；虽然有“喜伤心、悲伤肺、怒伤肝、思伤脾、恐伤肾”的区别，但归根结底都是心动而受到牵连。（看《大学》中说心有所忿懥等就知道）。古歌说：别有些儿奇，人事纷扰，神气外用，不能内交于心身，这就是否卦的状态。否，就是疲乏，否就是未济。夜间安睡，如同万物归根，神气来复，内交于心身，这就是泰卦的状态。泰，就是安宁，安就是既济，这就是外坎离。人如果能动静互相滋养，使神气常交于心身，那么真阳之气依托形体的阴作为归宿，心身的坎离相交，而心肾的坎离自然没有不交的道理！阴阳相交则平和，不相交则生病，相分离则死亡。所以说内伤百病，不外乎精、气、神三者罢了；精、气、神三者，又不外乎神气与精相交或不相交这两种情况罢了。
请详细分析。劳力者伤气，经文所说出汗喘息，内外之气皆外越，劳则气耗就是这样。气耗则阳虚，阳虚必然产生内寒，内寒必然产生内湿。虚则气浮，脉象多浮虚豁大，或者阳虚气陷，按之不鼓指，沉细无力，所以张仲景说脉虚为劳，脉大也为劳。见证多为怯寒、少气、自汗、喘乏、头晕、心悸、食欲减退无味、腹胀完谷不化的泄泻、吞酸嗳腐、面色黄而浮肿、反而不觉消瘦，或者蒸蒸发热，必定兼有体倦、自汗，甚至中焦虚弱不能运化，不能砥柱中流，虚热上浮，吐血如碗、面色黄、舌淡，而没有热象。这种虚热，用“劳者温之”的方法，如小建中汤、保元汤、归脾汤之类，根据轻重使用，这就是所谓的“形不足者，补之以气”。尤其需要息劳静养，恢复耗散之气，自然可以痊愈。否则阳虚不复，伤及真阳，出现阳痿、精冷、寒精自滑、呼吸短促偏卧，又须加温润甘平及血肉有情之品，如枸杞、沙苑子、菟丝子、葫芦巴、制何首乌、山药、扁豆、破故纸、鹿角胶、羊肾、淡菜、海参之类，填补阴中之阳，以固护脾胃。或者阳伤及阴，气不能化精，湿转为燥，脉变短数、潮热、骨痛、上咳、下利。这是自上损下，由肺及肾的情况，如果过胃出现泄泻，治疗就难了。另有一种劳力伤气的病，因为一时负重，偶然伤力，气逆于上，胸胁疼痛，严重时呼吸也痛，咳嗽带血。这种伤气，宜用“结者散之”的方法，如瓜蒌皮、大贝母、紫菀、杏仁、枇杷叶，轻降肺中逆气。吐红加苏子、三七汁、郁金汁、怀牛膝、丹参、藕汁之类，用辛润之法化解，与肺劳损气的治法不同。
如果是劳心者伤神，比劳力伤气更重。或者卷宗文书繁杂，或者百计图谋，心神没有片刻安静，心体没有安养的时候，由此君火在内沸腾，销烁真阴，不但伤神，也能伤精，阳不依附于阴，阴不能潜藏阳，阴虚必然产生内热，内热必然化为内燥，脉象多细涩，甚至数涩，或者浮弦搏指，都是阴虚化刚的征象。见证多为惊悸、怔忡、心热、盗汗、虚烦不寐，严重时君火引动相火，伤及真阴，干咳、吐血、遗精滑泄、淋浊、骨蒸潮热，各种病症丛生。这也是自上损下，由心及肾的情况。治法必须以甘凉育阴，及血肉有情之品，填补精液，如天王补心丹、固本丸、复脉汤、生脉散、三才汤、六味地黄丸、二至丸、二仙汤、五阴煎之类，根据轻重使用，这就是所谓的“精不足者，补之以味”。尤其需要安心静养，以后天真阴招摄先天真阳，使心阳下交于肾，肾阴上交于心，阴平阳秘，才能成功。
更有因七情伤神的，危害尤其严重。曾见情志抑郁，悲忧思虑过度，心阳郁结，而肝、脾、肺的气也因之郁结。肝叶撑张，则发生胀满疼痛，多怒多烦；脾不能输布精微，肺不能通调水道，则生痰生饮，嗳腐吞酸，食欲减退消化迟缓，大便干燥，不干燥则腹泻。在初起时，宜用“抑者散之”的方法。这里的散不是发散的意思，也不是辛香破耗的意思。如逍遥散法，不用散剂而用汤剂，减去白术，借柴胡的微辛以通达之，酌情加入瓜蒌皮、薤白、贝母、杏仁、柏子仁、当归、酸枣仁、远志、生谷芽之类，用辛润之法开通之。诸仁类药物都在阴中含阳，生机内寓，最能调畅心神。或者再佐以牡蛎、决明子、龟板、鳖甲之类，用咸柔之法软化之；桑叶、石斛之类，用微苦之法清之。稍久则气结者血亦结，或者进食不顺，或者大便燥结，或者咽中作梗（俗名梅核气）。这是噎膈将成的征兆，又须加阿胶、肉苁蓉、枸杞、蔗汁、梨藕汁、牛奶、白蜜、韭汁、姜汁之类，用甘润、辛润、咸润之法流畅之。尤其需要怡情静养，才可以获效。然而世俗治法，往往见其气结，就用香附、延胡索、木香、砂仁、青皮、厚朴、乌药等燥药，以为辛香流气。不知道这种无形的结，是由于太虚之体默运无权，导致窒碍不通，岂有用辛香破耗的药，重伤气血而能转为流畅的道理？而且结则营卫涩滞，气不运水，必然生痰生饮，或者虽然见到自利，但艰涩不爽。这都是因结而燥，因燥而湿的见证，与阳虚化湿有天壤之别，岂有用温燥的药而能治因燥致湿的道理？往往愈治愈结，胀痛日增，气血益虚，默运之权益发窒塞，由此成膈、成蛊、成劳，不治的多。不看《内经》吗？说：二阳之病发心脾，有不得隐曲，女子不月，其传为风消，传为息贲者，死不治。夫二阳，就是胃。发心脾者，是说二阳的病，发于心脾。思是脾的情志，实则本于心，所以张鸡峰说噎膈是神思之间的病。心脾气结，饮食渐减，病及二阳。阳明是多血之经，血是水谷的精气，赖脾气以散输，奉心君而化赤。现在心神受伤，困及其子，饮食不嗜，生化无资；冲脉上隶阳明，阳明虚则血海（冲为血海）干涩，所以不月经。看女子不月经，可知男子少精。血虚则生热，热烁则化燥，肌肉干瘦，像被风吹干的物体，所以叫风消。心火无制，上烁肺金，金燥则不能运布水精以归正化，津液留于胸中，变为痰饮，咳嗽不已，传为息贲（气奔迫而为喘也），有什么可治的？这是郁损心脾化燥的一个方面。若悲怒恐惊，更易耗伤心肾肝胆精血，尤宜大剂润养，佐以镇摄神志，最忌耗散破削，导致不救。又见悲忧思虑过度，郁损心神。心主血，诸脉皆属于心，心气结而诸脉中营气自然不能循其常度，将见始也气结，既也血结，结则隧道拘挛，往往腹中有硬块成形之患，肝胆经脉所过部位，有瘰疬成串之患，甚至有生乳岩、结核、内疽、附骨疽、对口疮、发背等证。体干，所以坚硬；内附筋骨，所以不红肿；血燥，所以溃后少脓；肌肉坚硬，所以溃后生管，甚至成硬弦多骨之类。都是刚象，都是燥征，与湿热凝于肌肉，外生痈肿，易溃而多脓水者不同。凡人膈膜以上属天气，头为诸阳之会，背为阳中之太阳。凡对口、发背、偏枯、痿痹之类，多属燥病。推究其原因，多由郁损心神，耗及肝脾肾阴所致；又或因吸受天之燥邪而发，或因贪食煎炸及金石桂附诸燥药而发。经说：热中、消中，不可服膏粱芳草石药，石药发癫，芳草发狂，不可不知。以上诸证，都不是瘕积，妄用攻坚破积；不要以瘰疬为痰核，妄用行气消痰；不要以内疽为阴寒证，妄用辛燥破削。古人称阴疽，是说其结于血分，不是说其为阴寒。有人说：寒则凝滞，冬月水泽腹坚，不是寒结吗？回答说：必须水少而腹始坚，未有长江大河而腹坚者。而且寒与燥同源，严寒干结之气，即是燥邪，所以冬月地多坚白坼裂。坚为刚象，而非柔象，这确实是显而易见的道理。试看王洪绪《外科全生集》中的阳和汤方，以大剂熟地、鹿角胶润补为主，借芥子的辛润，流通营气；熟地与麻黄并用，麻黄仅用十分之一，借以轻达卫气；因血结日久，阳气不得行于其间，故稍佐姜、桂之温。姜、桂气温热而体微润，在其人无热证者，服之神效，若稍见热证，则又宜速去姜、桂矣。凡此皆郁损心神，由气及血，化成燥证，散见于内外者也。若是者，心为君主之官，顾不重哉！
如果是劳欲伤精之辈，更有甚焉者。先动心以伤神，既劳力以伤气，终纵情以伤精。伤精则阴亏，阴亏则易动相火，愈动愈伤，一旦精、神、气三者皆耗，多致不起。脉证较劳心伤神者更重。治法亦不外填补真阴。但久则阴虚不复，真阴不能招摄真阳，真阳即不能归附真阴，由是龙火上炎，一火兴而五火炽，满腔皆虚阳充塞，而见颧红、面赤、喉干、咽痛、咳喘、音哑、五心如烙、筋急酸疼、骨痛如折、上咳、下利，种种危证。古法往往见龙雷飞越，用知母、黄柏苦寒直折，非徒无益于真阴，而又残害乎脾胃。春山先生曰：龙雷为水中之火，春夏湿升水旺之时，龙雷多动，雨势愈大，电光愈腾，必得西方风起，天之燥气下降，龙雷乃藏。介类禀干金之燥气，得坎水之阴精，滋阴潜阳，较胜于丹溪用知、柏多多矣。古法又有用桂附六味，以为导龙归海，在阴不甚虚者，或阴虚夹寒湿者，暂用有效，若阴液大亏之人，再以刚燥耗阴，受其害者多矣。或者说：景岳先生说：丹田暖则火就燥，下元固则气归精，甘温能除大热，又何不可用之乎？回答说：是的。夫阴中之阳，如温泉之气。试观温泉之气，其为燥阳之气乎？抑为雾露之溉乎？春日阳从地起，太和元气，且温且润，故草木得之含液而萌芽，肾气亦犹是也。知此则当拣体质温润者用之，质润属阴，气温属阳，方与肾之本体相合。许学士云：补肾不若补脾。夫补脾非燥脾之谓，凡甘平、甘淡，皆能补脾。孙真人云：补脾不若补肾。夫补肾非凉肾之谓，凡清润、温润、平润而味甘者，皆能补肾中之脾胃。补脾、补肾，原两不相碍也。草木有汁则长青而不枯，人有液则长濡而不燥。欲作长明灯，须
The *Neijing* (Classic of Internal Medicine) discusses internal injury, first mentioning the Seven Emotions. It states: Anger injures the Liver; Sorrow overcomes Anger (Metal overcomes Wood); Joy injures the Heart; Fear overcomes Joy (Water overcomes Fire); Pensive worry injures the Spleen; Anger overcomes Pensive worry (Wood overcomes Earth); Sorrow injures the Lung; Joy overcomes Sorrow (Fire overcomes Metal); Fear injures the Kidney; Pensive worry overcomes Fear (Earth overcomes Water). These diseases caused by the Seven Emotions are treated with the Seven Emotions themselves. It further states: All diseases arise from Qi. Anger causes Qi to ascend (anger leads to rebellious Qi; in severe cases, vomiting blood or undigested diarrhea occurs, hence "Qi ascends"); Joy causes Qi to relax (joy leads to harmonious Qi and unobstructed will, allowing Ying and Wei to flow freely, hence "Qi relaxes". However, if joy is excessive, Heart Qi becomes scattered and unrestrained); Sorrow causes Qi to dissipate (sorrow makes the Heart vessel tense and lung lobes expand, obstructing the Upper Jiao, preventing Ying and Wei from dispersing, causing heat to stagnate in the chest, hence "Qi dissipates"); Fear causes Qi to descend (fear causes Essence to retreat; retreat leads to closure of the Upper Jiao; closure causes Qi to return; return leads to distension of the Lower Jiao, hence "Qi descends"); Shock causes Qi to become chaotic (shock leaves the Heart without support, the Spirit without refuge, and thoughts without focus, hence "Qi becomes chaotic"); Labor causes Qi to be consumed (labor leads to panting and sweating, with Qi escaping both internally and externally, hence "Qi is consumed"); Pensive worry causes Qi to knot (pensive worry keeps the mind focused and the Spirit attached, causing righteous Qi to stagnate and not flow, hence "Qi knots"); Cold causes Qi to contract; Heat causes Qi to leak (cold closes the interstices, stopping Qi flow, hence "Qi contracts"; heat opens the interstices, allowing Ying and Wei to flow and sweat profusely, hence "Qi leaks". This refers to external pathogenic factors). Treatment methods: For urgency, use sweetness to moderate it; for scattering, use sourness to astringe it; for depression, use pungency to disperse it; for shock, use sourness and sweetness to calm and secure it; for labor, use sweet-warmth to warm it; for deficiency, use sweetness and neutrality to tonify it; for knotting, use pungency and moisture to scatter it; for cold, use heat; for heat, use cold, etc. The *Nanjing* (Classic of Difficult Issues) discusses Five Exhaustions, stating that damage from top to bottom involves: First damage to the Lung (cough), Second damage to the Heart (night sweats), Third damage to the Stomach (reduced appetite and loose stools), Fourth damage to the Liver (irritability and flaccid tendons), Fifth damage to the Kidney (strangury and leakage); beyond the Stomach, it is untreatable. Damage from bottom to top involves: First damage to the Kidney (seminal emission and amenorrhea), Second damage to the Liver (hypochondriac pain), Third damage to the Spleen (reduced appetite, distension, diarrhea, and muscle wasting), Fourth damage to the Heart (palpitations and insomnia), Fifth damage to the Lung (cough and wheezing); beyond the Spleen, it is untreatable. It further states: For Lung damage, tonify its Qi; for Heart damage, regulate Ying and Wei; for Spleen damage, regulate diet and adapt to cold and warmth; for Liver damage, soothe its interior; for Kidney damage, replenish its Essence. The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states that Lung exhaustion damages Qi, Heart exhaustion damages Shen, Spleen exhaustion damages digestion, Liver exhaustion damages Blood, and Kidney exhaustion damages Essence, which aligns with the *Nanjing*. Later scholars expanded the Five Exhaustions into Six Extremities. The Six Extremities are: frequent spasms and nail pain constitute the Tendon Extremity; toothache, heel pain, and foot weakness preventing prolonged standing constitute the Bone Extremity; lack of luster in the face and hair loss constitute the Blood Extremity; skin feeling like insects crawling and dry, dark flesh constitute the Flesh Extremity; lack of luster in muscles and eyes, emaciation, itchy muscles that ulcerate upon scratching constitute the Essence Extremity. Thus, internal injury first mentions the Seven Emotions to explain the origin of disease; it details the Five Exhaustions to clarify the cause and transmission of disease; and it deduces the Six Extremities to describe the ultimate progression of disease. In summary, it concerns only Jing (Essence), Qi, and Shen (Spirit). Moreover, Jing and Qi represent Yin and Yang of the human body; Shen penetrates both Yin and Yang, serving as their connecting link.
Consider this in terms of Heaven and Earth. Heaven generates Water; Water descends below, and its turbid part condenses into Earth to form the ground. Plants and trees growing on Earth are its hair; stones are its bones; metals are the rulers of stones and also belong to the category of Earth's bones. Fire, though born from Earth, is actually the Yang Qi of Heaven stored within the Earth. Thus, Heaven and Earth are transformed from the One Qi of Taiji. Water is the essence of Heaven, Fire is the Qi of Heaven, and Water and Fire silently operate between Heaven and Earth, generating things and cycling endlessly, constituting the Spirit of Heaven and Earth. Therefore, Heaven and Earth are also products of the continuous generation and transformation of Jing, Qi, and Shen. The Spirit and Qi of Heaven rely on Earth as their foundation; the Spirit and Qi of humans rely on the physical body as their abode. Thus, Zhu Xi stated that Taiji contains Yin and Yang; Shao Yong stated that Yang is the father of Yin, and Yin is the mother of Yang. All these statements emphasize rooting in Yin and Yang, interconnecting inseparably. From a human perspective, the human body is a complete form, formed by the congealing of parents' Jing and Blood, similar to clear water settling at the bottom, with turbid parts condensing into Earth. Water is the origin of Tianyi (One from Heaven); Water is thus the Heaven of man. Metal is the source of Water; Water and Heaven are originally One Qi. When Heaven and Water are separated, it forms the hexagram Song (Conflict); when Water flows in Heaven, it forms the hexagram Xu (Waiting). The turbid part of Water condenses into Earth, meaning Earth is formed from the dregs of Water. Therefore, postnatal life originates from prenatal essence; the physical form belongs to the Water category. All internal and external organs rely on Water for nourishment, while Fire resides within Water. The weather surrounds the inside and outside of Earth; Yang Qi surrounds the inside and outside of humans. The Yang Qi of Heaven is stored in the Earth; the Yang Qi of humans is stored in the Kidneys. The Yang Qi of Heaven operates silently in the universe through the Heart of Heaven; the Yang Qi of humans operates silently in the body through the Human Heart. Among the hundred organs, the Heart forms first (Western medicine holds that the heart model forms twenty days after conception). Among all organs, the Heart dies last. The Heart is essentially a congealment of Blood, while the human body consists of Yin substances. Only the Heart possesses a point of True Yang, acquired from the beginning of life, serving as the spiritual nature and illuminating the mechanism of life. This True Yang is the Shen of the Heart. Although the classics state "Heart stores Shen, Lung stores Po, Liver stores Hun, Spleen stores Yi, Kidney stores Zhi" (Water is active, so it governs Zhi), ultimately, all are directed and governed by the Heart. Although there are distinctions such as "Joy injures Heart, Sorrow injures Lung, Anger injures Liver, Pensive worry injures Spleen, Fear injures Kidney," ultimately, all are movements of the Heart that cause disturbance. (This can be understood by observing the *Daxue* saying the Heart has resentments, etc.). An ancient song says: There is something miraculous; worldly affairs disturb, Shen and Qi are used externally, unable to interact internally with the Heart and Body, resulting in Pi (Stagnation). Pi means fatigue; Pi corresponds to Weiji (Not yet completed). Nighttime sleep is like all things returning to the root; Shen and Qi return, interacting internally with the Heart and Body, resulting in Tai (Peace). Tai means peace; peace corresponds to Ji Ji (After completion), representing the external Kan and Li. If humans can nurture each other through movement and stillness, keeping Shen and Qi constantly interacting with the Heart and Body, then the True Yang Qi relies on the Yin of the physical body as its abode. When the Kan and Li of the Heart and Body interact, the Kan and Li of the Heart and Kidney will naturally interact. When Yin and Yang interact, there is peace; when they do not interact, there is disease; when they separate, there is death. Thus, it is said that internal injuries involve only Jing, Qi, and Shen; and Jing, Qi, and Shen involve only whether Shen/Qi and Jing interact or not.
Let us analyze this in detail. Labor damages Qi, as described in the classics: sweating and panting, with Qi escaping internally and externally, leading to Qi consumption. Qi consumption leads to Yang deficiency; Yang deficiency generates internal cold; internal cold generates internal dampness. Deficiency causes Qi to float, often presenting with a floating, empty, large pulse, or if Yang deficiency causes Qi to sink, the pulse is deep, fine, and weak, not drumming under pressure. Thus, Zhang Zhongjing stated that a deficient pulse indicates Lao (exhaustion), and a large pulse also indicates Lao. Symptoms often include aversion to cold, shortness of breath, spontaneous sweating, panting and fatigue, dizziness, palpitations, reduced appetite with no taste, abdominal distension with undigested diarrhea, acid regurgitation and belching, yellow and puffy complexion without obvious emaciation, or steaming fever accompanied by fatigue and spontaneous sweating. In severe cases, Middle Jiao deficiency fails to transport, leading to floating deficiency heat, massive hematemesis, yellow complexion, pale tongue, and absence of heat signs. For such deficiency heat, use the method of "warming the laboring," such as Jianzhong Tang (Middle-Joint Decoction), Baoyuan Tang (Preserve Origin Decoction), or Guipi Tang (Restore the Spleen Decoction), according to severity. This is what is meant by "tonifying Qi to supplement insufficient form." It is essential to rest and cultivate stillness to restore consumed Qi for recovery. Otherwise, Yang deficiency will not recover, damaging True Yang, leading to impotence, cold semen, spontaneous emission, shortness of breath, and sleeping on one side. In such cases, add moistening, warming, sweet-neutral, and animal-derived tonics such as Gouqi (Lycium Fruit), Shayuanzi (Astragali Complanati Semen), Tusizi (Cuscutae Semen), Huba (Piperis Longi Fructus), Zhi Heshouwu (Prepared Polygoni Multiflori Radix), Shanyao (Dioscoreae Rhizoma), Bian Dou (Lablab Seed), Poguzi (Psoraleae Fructus), Lujiao Jiao (Colla Cornus Cervi), Yangshen (Oviductus Ovis), Dancai (Mussel), Haishen (Sea Cucumber), etc., to tonify Yang within Yin and strengthen the Spleen and Stomach. Or, if Yang damage extends to Yin, Qi fails to transform Essence, and dampness turns to dryness, the pulse becomes short and rapid, with tidal fever, bone pain, upper cough, and lower diarrhea. This is damage from top to bottom, spreading from Lung to Kidney. If it reaches the Stomach causing diarrhea, treatment is difficult. Another type of Qi-damaging illness due to labor arises from sudden heavy lifting or strain, causing Qi to rebel upward, leading to chest and hypochondriac pain, severe respiratory pain, and coughing up blood. For this Qi injury, use the method of "scattering knots," such as Loupi (Trichosanthis Pericarpium), Dabeimu (Fritillariae Thunbergii Bulbus), Ziwan (Asteli Radix), Xingren (Armeniacae Semen Amarum), Pipaye (Loquat Leaf), to gently direct rebellious Lung Qi downward. For hemoptysis, add Suzi (Perillae Fructus), Sanqi juice, Yujin juice, Huainiuxi (Achyranthis Bidentatae Radix), Danshen (Salviae Miltiorrhizae Radix), Ou juice, etc., using pungent-moistening methods to resolve it, differing from the treatment of Lung exhaustion damaging Qi.
If mental labor damages Shen, it is more severe than physical labor damaging Qi. Whether burdened by complex documents or engaging in endless schemes, the Shen has no moment of rest, and the Heart has no time for nourishment. Consequently, Minister Fire boils internally, consuming True Yin. This not only damages Shen but also Jing. Yang does not root in Yin, and Yin cannot anchor Yang. Yin deficiency generates internal heat, which transforms into internal dryness. Pulses are often fine and choppy, even rapid and choppy, or floating, wiry, and forceful, indicating Yin deficiency transforming into rigidity. Symptoms include palpitations, tremors, heart heat, night sweats, vexation, and insomnia. In severe cases, Minister Fire stirs Minister Fire, damaging True Yin, leading to dry cough, hemoptysis, seminal emission, strangury, bone-steaming tidal fever, and various complications. This is also damage from top to bottom, spreading from Heart to Kidney. Treatment must use sweet-cool methods to nourish Yin, and animal-derived products to replenish fluids, such as Xinbao Wan (Heart-Nourishing Pill), Guben Wan (Root-Firming Pill), Maiguan Tongmai Tang (Vessel-Opening Pulse-Unblocking Decoction), Shengmai San (Generate the Pulse Powder), Santang (Three Immortals Decoction), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Erzhi Wan (Two Solstice Pill), Erxian Tang (Two Immortals Decoction), Wuyin Jian (Five-Yin Decoction), etc., according to severity. This is what is meant by "tonifying flavor to supplement insufficient Essence." It is essential to calm the mind and cultivate stillness, using postnatal True Yin to attract prenatal True Yang, allowing Heart Yang to descend to the Kidney and Kidney Yin to ascend to the Heart, achieving Yin-Yang balance and stability.
Furthermore, those injured by the Seven Emotions suffer even greater harm. I have seen cases where emotional depression, excessive sorrow, worry, and thought cause Heart Yang to knot, leading to knotting of Liver, Spleen, and Lung Qi. Distended Liver lobes cause distension and pain, irritability, and vexation. Impaired Spleen transport and Lung water distribution generate phlegm and fluid retention, belching, acid regurgitation, reduced appetite, slow digestion, dry stools, or diarrhea. In the early stages, use the method of "dispersing depression." Here, "disperse" does not mean releasing the exterior nor using pungent-aromatic destructive herbs. For example, in Xiaoyao San (Free and Easy Wanderer Powder), use decoction instead of powder, remove Baizhu (Atractylodis Macrocephalae Rhizoma), borrow Chaihu's mild pungency to reach, and酌情 add Loupi, Xiebai (Allii Macrostemonis Bulbus), Beimu (Fritillariae Bulbus), Xingren, Baiziren (Biota Seed), Danggui (Angelicae Sinensis Radix), Suanzaoren (Ziziphi Spinosae Semen), Yuanzhi (Polygalae Radix), Sheng Guya (Sprouted Grain), etc., using pungent-moistening methods to open. Seeds contain Yang within Yin, harboring vitality, best for soothing the Heart Spirit. Alternatively, add Muli (Concha Ostreae), Juemingzi (Cassiae Semen), Guiban (Carapax Testudinis), Biejia (Plastronis Testudinis), using salty-softening methods; Sangye (Mori Folium), Shihu (Dendrobii Caulis), using slightly bitter methods to clear. After some time, Qi knotting leads to Blood knotting, difficulty eating, dry stools, or globus hystericus (plum-pit qi). This is a precursor to Yige (dysphagia). Add Ejiao (Colla Corii Asini), Rongrong (Cistanche), Gouqi, Sugarcane juice, Pear/Ounce juice, Milk, Honey, Leek juice, Ginger juice, using sweet-moistening, pungent-moistening, and salty-moistening methods to smooth. Cultivate emotions and rest to achieve efficacy. However, common treatments often see Qi knotting and immediately use Xiangfu (Cyperi Rhizoma), Yuanhu (Corydalis Rhizoma), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus), Qingpi (Citri Reticulatae Pericarpium Viride), Houpo (Magnoliae Officinalis Cortex), Wuyao (Linderae Radix), assuming pungent-aromatic Qi-moving properties. They fail to realize that this invisible knot stems from the failure of the Great Void's silent operation, causing obstruction. How can pungent-aromatic destructive herbs, which severely damage Qi and Blood, lead to smoothness? Knotting causes stagnant Ying and Wei, and Qi failing to move Water generates phlegm and fluid. Even if diarrhea occurs, it is difficult and incomplete. These are signs of dryness due to knotting, and dampness due to dryness, vastly different from dampness due to Yang deficiency. How can warming-drying herbs treat dampness caused by dryness? Often, treatment worsens the knot, increasing pain and distension, depleting Qi and Blood, further obstructing silent operation, leading to Yige, Gu (abdominal mass), or Lao, with many untreatable cases. Does one not read the *Neijing*? It says: Diseases of the Two Yangs originate in the Heart and Spleen. If there is hidden distress, women may have amenorrhea. If it transmits to Fengxiao (wind-wasting) or Xiben (breath-gathering), it is fatal and untreatable. The Two Yangs refer to the Stomach. Originating in Heart and Spleen means the Stomach disease originates in the Heart and Spleen. Thought is the emotion of the Spleen, rooted in the Heart. Thus, Zhang Jifeng stated that Yige is a disorder of Shen and thought. Heart and Spleen Qi knotting reduces food intake, affecting the Two Yangs. Yangming is a channel of abundant Blood; Blood is the essence of food and drink, dispersed by the Spleen, and transformed into red by the Heart Monarch. Now, Heart Shen is injured, affecting its child (Liver/Gallbladder or Spleen/Stomach depending on context, here implying Spleen), leading to lack of appetite and no resources for transformation. The Chong Mai connects to Yangming; Yangming deficiency leads to dryness of the Sea of Blood (Chong Mai), causing amenorrhea. Observing female amenorrhea, we know male sperm is scarce. Blood deficiency generates heat; heat consumes and creates dryness; muscles become thin and dry like wind-blown objects, hence "Fengxiao." Uncontrolled Heart Fire scorches Lung Metal; dry Metal cannot distribute fluids for proper transformation; fluids remain in the chest, becoming phlegm-fluid; persistent cough transmits to Xiben (gas rushing causing wheezing). What treatment remains? This is one aspect of Heart-Spleen knotting transforming into dryness. If sorrow, anger, fear, or shock consume Heart-Kidney and Liver-Gallbladder Jing and Blood, large doses of moistening tonics with calming agents are essential. Avoid destructive dispersants. Excessive sorrow and thought also damage Heart Shen. The Heart governs Blood; all vessels belong to the Heart. Heart Qi knotting prevents Ying Qi in vessels from flowing normally. Initially Qi knots, then Blood knots. Knotting causes constriction of tunnels, leading to abdominal masses or scrofula along Liver/Gallbladder meridians. Severe cases develop breast cancer, tuberculosis, internal abscesses, osteomyelitis, carbuncles on the neck/back. Dryness makes them hard; attachment to bones/muscles prevents redness/swelling; Blood dryness results in little pus after ulceration; hard muscles lead to sinuses and bone sequestra after ulceration. These are rigid signs and dryness indicators, unlike abscesses from Damp-Heat in muscles, which ulcerate easily with much pus. Above the diaphragm belongs to Heaven's Qi; the head is the meeting of all Yang; the back is Taiyang within Yang. Carbuncles, paralysis, and flaccidity are mostly dryness diseases. Tracing the cause, they stem from Heart Shen damage consuming Liver/Spleen/Kidney Yin, or inhaling Heaven's dryness pathogen, or consuming fried foods and drying herbs like Shijin, Guifu. The classics say: Do not use rich foods, aromatic herbs, or mineral drugs for Re-center or Xiao-center; mineral drugs cause madness, aromatic herbs cause frenzy. None of the above conditions are Jia/Ji masses; do not use harsh breaking agents. Do not mistake scrofula for Phlegm nodules; do not use Qi-moving phlegm-resolving herbs. Do not mistake internal abscesses for Cold patterns; do not use pungent-drying destructors. Ancient people called Yin Abscesses "Yin" because they knot in the Blood level, not because they are Cold. Some ask: Cold causes stagnation; winter ice is hard, isn't that Cold knotting? I reply: Hardness requires insufficient Water; rivers are never hard. Cold and Dryness share a source; severe cold dryness is Dryness pathogen, hence winter earth cracks. Hardness is rigid, not flexible, an obvious truth. Observe Wang Hongxu's *Yanghe Tang* in *Waike Quansheng Ji*: It uses large doses of Shudi (Rehmanniae Radix Preparata) and Lujiao Jiao (Colla Cornus Cervi) for moistening tonification, borrowing Mustard seed's pungent-moistening quality to circulate Ying Qi; Shudi combined with Mahuang (Ephedrae Herba), using only 1/10 Mahuang to lightly reach Wei Qi; because long-standing Blood knotting prevents Yang Qi circulation, slightly add Jiang (Zingiberis Rhizoma) and Gui (Cinnamomi Ramulus) for warmth. Jiang and Gui are warm-hot in nature but slightly moist in substance; effective in patients without heat signs, but should be removed quickly if heat signs appear. These are all examples of Heart Shen damage spreading from Qi to Blood, forming dryness patterns visible internally and externally. Is the Heart, as the Sovereign Official, not important!
Those injured by labor and sexual indulgence suffer even more. First, moving the Heart damages Shen; then, labor damages Qi; finally, indulgence damages Jing. Jing damage leads to Yin deficiency; Yin deficiency easily stirs Minister Fire, worsening the damage. Once Jing, Shen, and Qi are all consumed, death often ensues. Pulse and symptoms are more severe than Heart-Shen injury. Treatment also focuses on tonifying True Yin. However, chronic Yin deficiency fails to recover; True Yin cannot attract True Yang, and True Yang cannot attach to True Yin. Dragon Fire flares upward; one fire rises, five fires blaze, filling the body with deficient Yang. Symptoms include malar flush, red face, dry throat, sore throat, cough/wheeze, hoarseness, burning palms/soles/chest, tendon stiffness/pain, bone-breaking pain, upper cough, lower diarrhea, and other critical signs. Ancient methods often saw Dragon-Lei flying away and used Zhi Mu (Anemarrhenae Rhizoma) and Huang Bai (Phellodendri Cortex) bitter-cold to suppress directly, which harms neither True Yin nor the Spleen/Stomach. Mr. Chunshan said: Dragon-Lei is Fire within Water. In spring/summer, when dampness rises and Water is strong, Dragon-Lei moves more, rain increases, lightning flashes. Only when Western winds rise and Heaven's Dryness descends does Dragon-Lei hide. Shellfish inherit the Dryness of Metal and obtain the Yin Essence of Kan. They nourish Yin and subdue Yang, far superior to Danxi's use of Zhi Mu and Huang Bai. Ancient methods also used Gui Fu Liu Wei (Guifu Dihuang Wan) to guide Dragon back to the sea. Effective for mild Yin deficiency or Yin deficiency with Cold-Damp, but harmful for severe Yin fluid depletion due to drying effects. Some ask: Mr. Jingyue said: Warm Dantian attracts Fire to Dryness; solid Lower Yuan returns Qi to Essence; Sweet-Warmth can remove great heat. Why not use it? I reply: Yes. Yang within Yin is like hot spring vapor. Is it dry Yang Qi or misty irrigation? Spring Yang rises from Earth; the Great Harmony Qi is warm and moist, allowing plants to sprout with fluid. Kidney Qi is the same. Knowing this, select patients with warm-moist constitutions. Moist quality belongs to Yin; warm temperature belongs to Yang, matching the Kidney's original nature. Xu Xueshi said: Tonifying Spleen is better than tonifying Kidney. Tonifying Spleen does not mean drying Spleen; sweet-neutral and sweet-light herbs can tonify Spleen. Sun Simiao said: Tonifying Spleen is better than tonifying Kidney. Tonifying Kidney does not mean cooling Kidney; clearing-moistening, warming-moistening, neutral-moistening sweet herbs can tonify the Spleen-Stomach within the Kidney. Tonifying Spleen and Kidney do not hinder each other. Plants with juice stay green and don't wither; humans with fluids stay moist and don't dry. To make a long-burning lamp, one must...