人禀天地之气以生，即感天地之气以病，亦必法天地之气以治。夫天地之气，阴阳之气
也；阴阳之气，燥湿之气也。干金为天，天气主燥；坤土为地，地气主湿。干得坤之阴爻成
离，火就燥也；坤得干之阳爻成坎，水流湿也。乾坤化为坎离，故燥湿为先天之体，水火为
后天之用，水火即燥湿所变，而燥湿又因寒热而化也。水气寒，火气热。寒搏则燥生，热烁
则燥成；热蒸则湿动，寒郁则湿凝，是寒热皆能化为燥湿也。
或曰∶燥、湿二气，何以寒热皆能化乎？曰∶子欲知燥湿，曷观乾坤？干象太极，首一
画为阳，次二画为阴，干金本阳含阴也，故干为太阳，而非孤阳；坤之六画，即干之偶而并
者，坤土本阴承阳也，故坤为太阴，而非孤阴。乾坤卦象天地，请实征诸天地。宗动天，空
洞无物，无物为纯阳；宗动天最高，高则转得紧、行得健，紧而健亦为纯阳。阳之精为日，
日为真火，金位之下，火气承之，天属阳，燥亦属阳，固也。然宗动天以内之八重天，星为
少阴，月为太阴，真阳之下，真阴承之，故曰阳含阴。所以天之燥气下降，必含阴气以降，
燥热为本（因燥而热，故曰燥热，不曰热燥），寒燥为变也（因寒而燥，故曰寒燥，不曰燥寒）
。阴之精为月，月为真水，水应月而生于地，地属阴，湿亦属阴，固也。然地居天中不动，
地之阳气，即天之阳气，阴随乎阳，故曰阴承阳。所以地之湿气上升，必藉阳气乃升，寒湿
为本（因寒而湿，故曰寒湿，不曰湿寒），湿热为变也（因湿而热，故曰湿热，不曰热湿）。
窃闻天地之间有三际，最上一层为热际，次一层为冷际，地上一层为温际。盖因乎此，
观此可知天地祗此阴阳二气。而阴阳二气，又是一气，特随升降而变焉耳！
夫燥、湿二气，各主一岁之半。冬至，阳气潜藏于地，地得阳气而湿暗动，故水泉动；
交春，东风解冻，雷乃发声，东风与雷皆阳也，湿，阴也，阴随阳化，阳气渐出于地，而湿
气渐生，故草木含液而萌动；交夏，温风至，阳气尽出于地，暑热蒸腾，而湿气最盛，故土
润溽暑，大雨时行，天地之气化刚为柔；夏至，阳气尽出于地，而一阴甫生，燥气尚未行令
；交秋，凉风至，白露降，天地始肃，阳统阴降，而燥气始动；秋分以后，雷始收声，水始
涸，故湿气始收，斯时露寒霜肃，阳统阴渐降，而燥气乃行，故草木黄落；交冬，天气上升
，地气下降，天地痞塞，阳统阴全降，而燥气最盛，阳气潜藏于地下，而外无所卫，故水始
冰，地始冻，虹藏不见，天地之气化柔为刚。盖水旺于冬，实长于夏，火盛于夏，实藏于冬
，阴阳互根，大化所以循环不穷也。观此可知燥属阳中之阴，湿属阴中之阳，且未动属阴，
动则属阳。《易》曰∶吉凶悔吝生乎动。盖动则变，变则化，寒燥化为燥热，返其本也，寒
湿化为湿热，因乎变也。人能体察燥湿二气之因寒因热所由生，而以之为纲；再察其化热未
化热之变，与夫燥郁则不能行水而又夹湿，湿郁则不能布精而又化燥之理，而以之为目，纲
举目张，一任病情万状，而权衡在握矣。
且夫燥、湿二气，为时行之气，又有非时之偏气。如久旱则燥气胜，干热干冷，则燥气
亦胜；在春为风燥，在夏为暑燥，在秋为凉燥，在冬为寒燥。久雨则湿气胜，地气不收，溽
暑阴冷，则湿气亦胜。在春为风湿，在夏与初秋为暑湿，在深秋与冬为寒湿。经曰∶必先岁
气，无伐天和。俗谓外感为时气，时之为义，大矣哉！若以一定之成方，治无定之时邪，其
不知时之甚者哉！然不独当因时也，尤当因地。西北地高，燥气胜；东南地卑，湿气胜。不
独当因地也，尤当因人。六气伤人，因人而化∶阴虚体质，最易化燥，燥固为燥，即湿亦化
为燥；阳虚体质，最易化湿，湿固为湿，即燥亦必夹湿。燥也，湿也，固外感百病所莫能外
者也。
或曰∶外感有风、寒、暑、湿、燥、火之六气，子以燥、湿二气赅之，可推其故而析言
之欤？曰∶在地成形，在天为气。六气风居乎始，寒、暑、湿、燥居乎中，火居乎终。风居
乎始者，风固燥、湿二气所由动也；暑居乎中者，寒暑固燥、湿二气所由变也；火居乎
终者，火又燥、湿二气所由化也。请析言之。风在卦为巽，二阳居一阴之上，外阳内阴，且
阳倍于阴，故风为阳邪，风固善动数变而无定体者也。东方湿气动必雨，故曰湿风；西方燥
气动必旱，故曰燥风；南方暑气动必热而湿，故曰暑风；北方寒气动必冷而燥，故曰寒风；
东南之风，湿兼暑也；东北之风，湿兼寒也；西南之风，燥兼火也；西北之风，燥兼寒也。
动之得中，人物因之以生；动之太过，人物感之而病。盖燥微则物畅其机，燥甚则物即干萎
；湿微则物受其滋，湿甚则物被其腐。物如此，人可知矣。寒固燥所由生，而火又燥所由成
者也。经云∶燥胜则干。所以夏月炎暑司权，物见风日，则津汁渐干，人出汗多，则津液渐
耗，火胜则燥固也；秋冬寒凉司令，在草木则枯萎，在露则结为霜，在雨则化为雪，在水则
冻为冰，在人则手足皴裂，两间皆寒燥之气所盘结也；冬在卦为坎，一阳居二阴之中，寒冰
外凝，而燥火内济，故寒燥之病易化为燥热，经谓伤寒为热病，盖寒则燥，燥则热，理相因
也。若冬月阳不潜藏，地湿不收，则寒又必夹湿，所以冬得秋病，如病疟、病痢、病温者，
要皆兼乎湿邪耳！至于暑，即湿、热二气，互酿为害而化为燥者也。必须分别湿多、热多。偏
于湿者，化燥缓；偏于热者，化燥急。若纯热无湿，则又为中 之暑燥矣。若夫火，藏
于金、木、水、土中，而动之则出，又燥、湿二气所归宿者也。故戛金取火，钻木取火，掘
土取火（土之精凝结而为石，观取火于石，即可知取火于土之义）。海为火谷，江湖水动处，
亦皆有火，病患亦然。金火同宫，离为君火，故肺与心动为燥火，若湿与热蒸，又为湿火；
肝为震之雷火、巽之风火，故肝动为燥火，若湿与热蒸，又为湿火；肾火为龙火，龙火，水
中之火，水亏火旺，化为燥火，若湿与热蒸，又为湿火；脾属土，土为杂气，故脾火多湿火
，湿火伤及脾阴，又化为燥火。燥也，湿也，终归火化也。此地二生火，所以成之者也。他
如春温，寒化燥而夹湿者也；风温，风化燥也；温热、暑温，湿热交合为病，而偏于热者也
；湿温，湿热交合为病，而偏于湿者也；温疫，病如役扰，乃浊土中湿热郁蒸之气，而化燥
最速者也；伏暑，乃暑湿交合之邪，伏于膜原，待凉燥而后激发者也；疟疾，有暑湿合邪，
伏于膜原，有风寒逼暑，入于营舍，亦皆待凉燥而后激发者也；霍乱，有伤于暑燥，有伤于
寒燥，有伤于暑湿，有伤于寒湿，有燥夹湿、湿化燥，相因而为病者也。审是，燥、湿二气
，非风、寒、暑、火所生而化，化而成之者哉？吾故举之以为提纲。
曰∶敢问治法如何？曰∶治外感燥湿之邪无他，使邪有出路而已，使邪早有出路而已。
出路者何？肺、胃、肠、膀胱是也。盖邪从外来，必从外去。毛窍是肺之合，口鼻是肺、胃
之窍，大肠、膀胱为在里之表，又肺、胃之门户，故邪从汗解为外解，邪从二便解亦为外解
。燥属天气，天气为清邪，以气搏气，故首伤肺经气分。气无形质，其有形质者，乃胃肠中
渣滓。燥邪由肺传里，得之以为根据附，故又病胃、肠。肺与大肠，同为燥金，肺、胃为子母
，故经谓阳明亦主燥金，以燥邪伤燥金，同气相求，理固然也。湿属地气，地气氤氲粘腻，
为浊邪，然浊邪亦属是气，气从口鼻传入，故亦伤肺经气分。肺主一身气化，气为邪阻，不
能行水，故湿无由化，浊邪归浊道，故必传胃、肠，浊中清者，必传膀胱。
曰∶药之何如？曰∶汗者，人之津，汗之出者气所化，今气不化津而无汗者，乃气为邪
所阻耳！邪阻则毛窍经络不开，即胃、肠、膀胱亦因之不开，法当轻开所阻肺气之邪，佐以
流利胃肠气机，兼通膀胱气化。燥邪，辛润以开之；湿邪，辛淡以开之；燥兼寒者，辛温润
以开之；燥兼热者，辛凉轻剂以开之；湿兼寒者，辛温淡以开之；湿兼热者，辛凉淡以开之
；燥化热者，辛凉重剂以开之；湿化热者，辛苦通降以开之；燥为湿郁者，辛润之中参苦辛
淡以化湿；湿为燥郁者，辛淡之中参辛润以解燥；燥扰神明者，辛凉轻虚以开之；湿昏神智
者，苦辛清淡以开之。总之，肺经气分邪一开通，则汗自解矣。其有纳谷后即病者，气为邪
搏，不及腐化，须兼宣松和化，不使之结，后虽传里，小通之即行矣。其有感邪之重且浊者
，必然传里，传里即须攻下；若肺气未开而里证又急，又必于宣通肺气之中，加以通润胃、
肠之品。肺主天气，天气通，地气乃行耳！燥邪大肠多有结粪，必咸以软之，润以通之；湿
邪大便多似败酱，必缓其药力以推荡之，或用丸药以磨化之。燥伤津液者，滑润之品增液以
通之；湿阻气机者，辛苦之味开化以行之。要之，邪伤天气，治以开豁，天气开而毛窍经络
之清邪自开，即胃、肠、膀胱之浊邪，无所搏束，亦与之俱开，汗得解而二便解，如上窍开
而下窍自通也。若上窍未开，而强通下窍，则气为上焦之邪所阻，不能传送下行，譬如搏足
之鸟，而欲飞腾，其可得乎？邪传地道，治以通利，地气通，而胃、肠、膀胱之浊邪自通，
即毛窍经络之清邪，孤悬无根据，亦与之俱通，二便解而汗亦解，如下窍通而上窍自开也。若
下窍不通，而强开上窍，则气为胃肠之邪所阻，不得化汗外出，譬如海门淤塞，而欲众流顺
轨，其又可得乎？审若是，天道与地道，一以贯之之道也，岂有二哉？
曰∶其有人虚证实者，当何如？曰∶人虚证实，不过加以托邪之法、护正之方，究当以
祛邪为主，邪早退一日，正即早安一日，经故曰∶有故无陨，否则养痈成患，后虽欲治，不
可得而治。吾故曰∶治外邪之法无他，使邪有出路而已，使邪早有出路而已矣。
或又曰∶邪无形质，根据渣滓以为形质，然则病患不与之食可乎？曰∶非也。邪之所凑，
其气必虚，能食而不与之食，则胃气愈虚，譬如空城御敌，贼必直入而无所防，不独邪入于
胃已也，胃无谷气，则生化之源绝，五脏皆为虚器，邪且无所不入矣。曰∶然则强与之食可
乎？而亦非也。不能食而强与之食，则邪气愈遏，是 盗粮也。总之，食与不食，当视病者
之能与不能，强食固不可，禁食尤不可，但当清淡养胃，不可浓浊护邪。谚有之曰∶饿不死
的伤寒，谓知饥为有胃气，乃是不死之伤寒也。吾淮鞠通先生尝谆言之，奈何病家犹强食，
医家犹禁食，而竟昧乎大中至正之理也哉！
曰∶外感百病，不外躁、湿二气，吾闻诸子矣。敢问内伤何如？曰∶内伤千变万化，而
推致病之由，亦祗此燥湿两端，大道原不外一阴一阳也。彼古今医籍，分门别类，名色愈多
，治法愈歧，徒足炫一时之耳目，反令后学无所指归，总由未能探本穷原，以察天地阴阳之
理焉耳！请析言之。外感者，实也，虽虚而必先实；内伤者，虚也，虽实而必先虚。阳气虚
，则蒸运无力而成内湿；阴血虚，则荣养无资而成内燥；思虑过度则气结，气结则枢转不灵
而成内湿；气结则血亦结，血结则营运不周而成内燥。且也阴阳互根，气血同源，阳虚甚者
阴亦必虚，釜无薪火，安望蒸变乎精微？气虚甚者血亦必虚，车无辘轳，安望汲引以灌溉？往
往始也病湿，继则湿又化燥。阴虚甚者阳亦必虚，灯残油涸，焉能大发其辉光？血虚甚者气
亦必虚，水浅舟停，焉能一往而奔放？往往始也病燥，继则燥又夹湿。盖化湿犹自外来，（虚湿
虽从内生，然毕竟是水饮所化，犹不足中之有余病也）。化燥则从内涸矣。故因燥化湿者，
仍当以治湿为本，而治燥兼之；由湿化燥者，即当以治湿为本，而治燥兼之。此治法标本先
后之大要也。
曰∶脏腑轻重何如？曰∶凡因天气致病者为外感，外感先病患之天气；凡因人致病者为
内伤，内伤先病患之地气。故内燥起于肺、胃、肾，胃为重，肾为尤重；盖肺为敷布精液之
源，胃为生化精液之本，肾又为敷布生化之根柢。内湿起于肺、脾、肾，脾为重，肾为尤重
；盖肺为通调水津之源，脾为散输水津之本，肾又为通调散输之枢纽。若是者，脾也，胃也
，肾也，固肺所借以生、借以化者也。天气不下降，由于地气不上腾，顾可不分轻重也哉？
总之，病有燥湿，药有燥润，病有纯杂，方有变通。经曰∶知其要者，一言而终，不知其要
，流散无穷。其斯之谓与！
人禀受天地的精气而生存，也会感受天地的邪气而生病，治疗也必然效法天地的规律。所谓天地的邪气，就是阴阳的邪气；阴阳的邪气，具体表现为燥和湿的邪气。乾卦象征天，天气主燥；坤卦象征地，地气主湿。乾金得到坤土的阴爻变成离卦，火性就干燥；坤土得到乾天的阳爻变成坎卦，水性就趋下湿润。乾坤二卦化为坎离二卦，所以燥湿是先天本体的体现，水火是后天功用的表现，水火是由燥湿变化而来，而燥湿又因寒热的作用而发生转化。水气属寒，火气属热。寒气搏结则产生燥，热气灼烁则形成燥；热气蒸腾则湿气流动，寒气郁滞则湿气凝结，因此寒和热都能转化为燥湿。
有人问：燥、湿这两种邪气，为什么寒和热都能使它们发生转化呢？回答说：你想知道燥湿的道理，何不观察乾坤卦象？乾卦象征太极，第一画为阳爻，第二画为阴爻，乾金本是阳中蕴含阴，所以乾代表太阳，而不是孤阳；坤卦的六画，是乾卦两两并列而成的，坤土本是阴中承奉阳，所以坤代表太阴，而不是孤阴。乾坤的卦象对应天地，请实地验证于天地之间。宗动天（宇宙最外层）空洞无物，无物即为纯阳；宗动天位置最高，高则运转紧密、运行刚健，紧密而刚健也是纯阳的表现。阳的精粹化为日，日是真火，在金位之下，火气承接它，天属于阳，燥也属于阳，这是确定的。然而宗动天以内的八重天，星宿属少阴，月亮属太阴，在真阳之下，真阴承接它，所以说阳中蕴含阴。因此天的燥气下降时，必然包含阴气一起下降，燥热是本源（因为燥而产生热，所以叫燥热，不叫热燥），寒燥是变异（因为寒而产生燥，所以叫寒燥，不叫燥寒）。阴的精粹化为月，月是真水，水顺应月亮而在地下生成，地属于阴，湿也属于阴，这也是确定的。然而大地处于天之中静止不动，地的阳气就是天的阳气，阴随着阳运动，所以说阴中承奉阳。因此地的湿气上升时，必须借助阳气才能上升，寒湿是本源（因为寒而产生湿，所以叫寒湿，不叫湿寒），湿热是变异（因为湿而产生热，所以叫湿热，不叫热湿）。
我听说天地之间有三层境界，最上面一层是热际，中间一层是冷际，地面上方一层是温际。大概是因为这个原因，观察这些可知天地只有阴阳二气。而这阴阳二气，其实是一气，只是随着升降运动而变化罢了！
燥、湿两种邪气，各主管一年的一半时间。冬至时，阳气潜藏在地中，地得到阳气而湿气暗中萌动，所以泉水开始流动；进入春季，东风吹解冻冻，雷声响起，东风与雷都属阳，湿属阴，阴随着阳的变化而变化，阳气逐渐从地中发出，而湿气也逐渐生成，所以草木含有汁液而萌芽；进入夏季，暖风到来，阳气完全出于地面，暑热蒸腾，而湿气最旺盛，所以土地湿润、暑气闷热，大雨时常降下，天地的造化之气由刚变为柔；夏至时，阳气完全出于地面，而一阴刚刚产生，燥气尚未行使职权；进入秋季，凉风到来，白露降落，天地开始肃杀，阳统率阴下降，而燥气开始发动；秋分以后，雷声停止，水流枯竭，所以湿气开始收敛，这时露水寒冷、霜气肃杀，阳统率阴逐渐下降，而燥气才真正行使职权，所以草木枯黄掉落；进入冬季，天气上升，地气下降，天地之气痞塞不通，阳统率阴全部下降，而燥气最盛，阳气潜藏在地底下，而外部没有护卫，所以水开始结冰，地开始冻结，虹霓不见，天地的造化之气由柔变为刚。可以说水在冬季旺盛，实际上在夏季生长；火在夏季盛大，实际上在冬季潜藏，阴阳互为本根，大化循环无穷无尽。观察这些可知燥属于阳中之阴，湿属于阴中之阳，且未发动时属阴，发动后属阳。《易经》说：吉凶悔吝产生于变动。大概是因为变动就会变化，变化就会转化，寒燥转化为燥热，是返回本源；寒湿转化为湿热，是由于变异。人能体察燥湿二气因寒因热产生的原理，并以此作为纲领；再考察其转化为热或未转化为热的变化，以及燥气郁结则不能行水而又夹杂湿气，湿气郁结则不能布散精微而又转化为燥气的道理，并以此作为细则，纲举目张，任凭病情千变万化，而权衡掌握在手中了。
况且燥、湿二气，是时令流行的邪气，又有非时令的偏胜邪气。如久旱则燥气胜，干热或干冷，燥气也胜；在春季为风燥，在夏季为暑燥，在秋季为凉燥，在冬季为寒燥。久雨则湿气胜，地气不收敛，闷热阴冷，湿气也胜。在春季为风湿，在夏季与初秋为暑湿，在深秋与冬季为寒湿。医经说：必须先了解当年的岁气，不要破坏天和的自然平衡。世俗认为外感病是时气，时的意义，太大了啊！如果用固定的成方，去治疗没有固定时间的时邪，这是非常不懂时节的人啊！然而不仅应当因时制宜，更应当因地制宜。西北地势高，燥气胜；东南地势低，湿气胜。不仅应当因地制宜，更应当因人制宜。六气伤人，因人而异而转化：阴虚体质，最容易化燥，燥固然是燥，即使是湿也会化为燥；阳虚体质，最容易化湿，湿固然是湿，即使是燥也必然夹杂湿。燥和湿，确实是外感百病所不能脱离的。
有人问：外感有风、寒、暑、湿、燥、火六种邪气，您用燥、湿二气概括它们，可以推究其原因并详细分析吗？回答说：在地形成形体，在天表现为气。六气中风居首位，寒、暑、湿、燥居中，火居末尾。风居首位的原因，风确实是燥、湿二气发动的原因；暑居中的原因，寒暑确实是燥、湿二气变化的原因；火居末尾的原因，火又是燥、湿二气最终转化的结果。请详细分析。风在八卦中属巽卦，二阳爻在一阴爻之上，外阳内阴，且阳多于阴，所以风为阳邪，风确实善于变动而无定形。东方湿气发动必伴随雨，所以叫湿风；西方燥气发动必伴随旱，所以叫燥风；南方暑气发动必伴随热而湿，所以叫暑风；北方寒气发动必伴随冷而燥，所以叫寒风；东南的风，湿兼暑；东北的风，湿兼寒；西南的风，燥兼火；西北的风，燥兼寒。运动得当中正，人物依靠它生存；运动太过，人物感受它而生病。大概燥气轻微则万物生机畅达，燥气严重则万物干枯萎缩；湿气轻微则万物受到滋润，湿气严重则万物被腐蚀。万物如此，人也就可想而知了。寒确实是燥产生的原因，而火又是燥形成的原因。医经说：燥胜则干。所以夏季炎热暑气当令，物体见到风日，津液逐渐干枯，人出汗多，则津液逐渐消耗，火胜则燥确实成立；秋冬寒凉当令，在草木则枯萎，在露则结成霜，在雨则化为雪，在水则冻为冰，在人则手足皴裂，天地间都是寒燥之气盘结；冬季在八卦中属坎卦，一阳爻居于二阴爻之中，寒冰在外凝结，而燥火在内济助，所以寒燥的病容易转化为燥热，医经说伤寒是热病，大概是因为寒则燥，燥则热，道理是相联系的。如果冬季阳气不潜藏，地湿不收敛，则寒又必然夹杂湿，所以冬天得的秋天病，如疟疾、痢疾、温病等，都要兼有湿邪啊！至于暑，就是湿、热二气互相酿成危害而转化为燥。必须区分湿多还是热多。偏于湿的，化燥缓慢；偏于热的，化燥急迫。如果纯热无湿，则是中暑之燥。至于火，藏在金、木、水、土之中，而动它就出来，又是燥、湿二气归宿的地方。所以敲击金属取火，钻木取火，掘土取火（土的精华凝结成为石，看从石头取火，就可以知道从土取火的含义）。海是火的谷地，江湖水动的地方，也都有火，病人也是这样。金火同宫，离卦为君火，所以肺与心动则为燥火，如果湿与热蒸腾，又为湿火；肝为震卦的雷火、巽卦的风火，所以肝动则为燥火，如果湿与热蒸腾，又为湿火；肾火为龙火，龙火是水中之火，水亏火旺，化为燥火，如果湿与热蒸腾，又为湿火；脾属土，土为杂气，所以脾火多为湿火，湿火伤及脾阴，又化为燥火。燥和湿，最终归结为火的转化。这就是地二生火的道理，所以能成就它。其他的如春温，是寒化为燥而夹湿；风温，是风化为燥；温热、暑温，是湿热交合作病，而偏于热的；湿温，是湿热交合作病，而偏于湿的；温疫，病势如役扰，是浊土中湿热郁蒸之气，而化燥最快的；伏暑，是暑湿交合的邪气，伏藏在膜原，等待凉燥而后激发；疟疾，有暑湿合邪，伏藏在膜原，有风寒逼迫暑气，进入营舍，也都等待凉燥而后激发；霍乱，有伤于暑燥的，有伤于寒燥的，有伤于暑湿的，有伤于寒湿的，有燥夹湿、湿化燥，相继而发病的。审视这些，燥、湿二气，不是由风、寒、暑、火所生而转化，转化而成它们的吗？所以我列举它们作为提纲。
问：请问治疗方法如何？答：治疗外感燥湿邪气没有别的，就是让邪气有出路而已，让邪气尽早有出路而已。出路是什么？肺、胃、肠、膀胱就是。邪气从外来，必然从外去。毛窍是肺的合应部位，口鼻是肺、胃的窍道，大肠、膀胱是在里的表证部位，又是肺、胃的门户，所以邪气从汗解是向外解，邪气从小便大便解也是向外解。燥属于天气，天气为清邪，以气搏击气，所以首先伤害肺经气分。气没有形质，它有形质的部分，乃是胃肠中的渣滓。燥邪由肺传入里，得到这些渣滓作为依附，所以又病及胃、肠。肺与大肠，同为燥金，肺、胃互为母子，所以医经说阳明也主燥金，以燥邪伤害燥金，同气相求，道理本来就是这样。湿属地气，地气氤氲粘腻，为浊邪，然而浊邪也属于气，气从口鼻传入，所以也伤害肺经气分。肺主一身气化，气被邪气阻滞，不能行水，所以湿气无法化解，浊邪归入浊道，所以必然传至胃、肠，浊中清的部分，必然传至膀胱。
问：用药怎么样？答：汗，是人的津液，汗的出是由气所化，现在气不化津而没有汗，是因为气被邪气阻滞啊！邪气阻滞则毛窍经络不开，即胃、肠、膀胱也因此不开，治法应当轻宣开通被阻滞的肺气，佐以流利胃肠气机，兼通膀胱气化。燥邪，用辛润的方法开通它；湿邪，用辛淡的方法开通它；燥兼寒者，用辛温润的方法开通它；燥兼热者，用辛凉轻剂开通它；湿兼寒者，用辛温淡的方法开通它；湿兼热者，用辛凉淡的方法开通它；燥化为热者，用辛凉重剂开通它；湿化为热者，用辛苦通降的方法开通它；燥被湿郁者，在辛润之中参入苦辛淡以化湿；湿被燥郁者，在辛淡之中参入辛润以解燥；燥扰乱神明者，用辛凉轻虚的方法开通它；湿昏蒙神智者，用苦辛清淡的方法开通它。总之，肺经气分的邪气一旦开通，则汗自然解除。如果有进食后就发病的，气被邪气搏击，来不及腐熟消化，须兼用宣松和化的方法，不让它结聚，后来即使传入里，稍微通利即可排出。如果有感受邪气重而且浊的，必然传入里，传入里就必须攻下；如果肺气未开而里证又急迫，又必须在宣通肺气之中，加入通润胃、肠的药物。肺主天气，天气通畅，地气才能运行啊！燥邪大肠多有结粪，必须用咸味软坚，用润味通便；湿邪大便多像败酱，必须缓和药力以推荡它，或用丸药磨化它。燥伤津液的，用滑润之品增液以通之；湿阻气机的，用辛苦之味开化以行之。总之，邪气伤害天气，治疗用开豁之法，天气开则毛窍经络的清邪自开，即胃、肠、膀胱的浊邪，无所束缚，也与之俱开，汗得解而二便解，如上窍开而下窍自通。如果上窍未开，而强行通下窍，则气被上焦邪气阻滞，不能传送下行，譬如缚住脚的鸟，想要飞腾，可能吗？邪气传入地道，治疗用通利之法，地气通则胃、肠、膀胱的浊邪自通，即毛窍经络的清邪，孤立无依，也与之俱通，二便解而汗也解，如下窍通而上窍自开。如果下窍不通，而强行开上窍，则气被胃肠邪气阻滞，不得化汗外出，譬如海口淤塞，而想众流顺轨，又可能吗？审视这些，天道与地道，是一以贯之的道理，难道有二吗？
问：如果有人虚证实的情况，应当怎么办？答：人虚证实，不过是加上托邪的方法、护正的方剂，终究应当以祛邪为主，邪气早退一天，正气就早安一天，医经所以说：有故无陨（有病则病受之，不会损伤正气），否则养痈成患，后来虽然想治，也不可能治了。所以我说过：治疗外邪的方法没有别的，就是让邪气有出路而已，让邪气尽早有出路而已。
又有人问：邪气无形质，依靠渣滓形成形质，那么病人不给吃东西可以吗？答：不对。邪气聚集的地方，正气必然虚弱，能吃而不给吃，则胃气更虚，譬如空城御敌，贼寇必然直入而无处防备，不只是邪气进入胃里而已，胃没有谷气，则生化之源断绝，五脏都成为虚器，邪气就无处不入了。问：那么强行给吃东西可以吗？也不对。不能吃而强行给吃，则邪气更加遏制，这是“盗粮”（帮助敌人）。总之，吃与不吃，应当看病人能否接受，强食固然不可，禁食尤其不可，只应当清淡养胃，不可浓浊护邪。谚语说：饿不死的伤寒，谓知饥是有胃气，是不死的伤寒。我的老师鞠通先生曾经谆谆告诫，奈何病家还强食，医家还禁食，竟然不明白大中至正的道理啊！
问：外感百病，不外乎燥、湿二气，我从您这里听说了。敢问内伤怎么样？答：内伤千变万化，但推究致病的原因，也只是这燥湿两端，大道原本就不外乎一阴一阳。那些古今医籍，分门别类，名色越多，治法越分歧，徒足以炫耀一时的耳目，反而令后学无所指归，总归是没有能够探本穷源，来考察天地阴阳的道理啊！请详细分析。外感病，属实，虽然虚但必先实；内伤病，属虚，虽然实但必先虚。阳气虚，则蒸运无力而成内湿；阴血虚，则荣养无资而成内燥；思虑过度则气结，气结则枢转不灵而成内湿；气结则血也结，血结则营运不周而成内燥。况且阴阳互根，气血同源，阳虚甚则阴也必虚，釜底无薪火，怎能指望蒸变出精微？气虚甚则血也必虚，车无辘轳，怎能指望汲引以灌溉？往往起初病湿，随后湿又化为燥。阴虚甚则阳也必虚，灯残油尽，怎能大发其辉光？血虚甚则气也必虚，水浅舟停，怎能一往而奔放？往往起初病燥，随后燥又夹湿。大概化湿犹自外来（虚湿虽从内生，但毕竟是水饮所化，还是不足中的有余病）。化燥则从内涸竭了。所以因燥化湿的，仍当以治湿为本，而治燥兼之；由湿化燥的，就应当以治湿为本，而治燥兼之。这是治法标本先后的大要。
问：脏腑轻重如何？答：凡是因天气致病的是外感，外感先伤害人的天气；凡是因人致病的是内伤，内伤先伤害人的地气。所以内燥起于肺、胃、肾，胃为重，肾为尤重；盖肺为敷布精液的源头，胃为生化精液的根本，肾又是敷布生化的根基。内湿起于肺、脾、肾，脾为重，肾为尤重；盖肺为通调水津的源头，脾为散输水津的根本，肾又是通调散输的枢纽。像这样，脾、胃、肾，确实是肺所借以生、借以化的。天气不下降，由于地气不上腾，怎么可以不分别轻重呢？总之，病有燥湿，药有燥润，病有纯杂，方有变通。医经说：知其要者，一言而终，不知其要，流散无穷。说的就是这个吧！
Human beings are born by inheriting the Qi of Heaven and Earth, become ill by being affected by the pathogenic Qi of Heaven and Earth, and must be treated by following the laws of the Qi of Heaven and Earth. The pathogenic Qi of Heaven and Earth is the Yin-Yang Qi; the Yin-Yang Qi manifests specifically as Dryness (Zao) and Dampness (Shi). Qian (Heaven) represents dryness; Kun (Earth) represents dampness. When Qian Metal receives the Yin line from Kun, it transforms into Li (Fire), which naturally tends toward dryness; when Kun Earth receives the Yang line from Qian, it transforms into Kan (Water), which naturally flows downward to moisten. Thus, Qian and Kun transform into Kan and Li; therefore, Dryness and Dampness constitute the primordial substance, while Water and Fire represent postnatal function. Water and Fire are transformed from Dryness and Dampness, and Dryness and Dampness are further transformed by Cold and Heat. Water Qi is Cold, Fire Qi is Hot. When Cold condenses, Dryness arises; when Heat scorches, Dryness forms. When Heat steams, Dampness moves; when Cold stagnates, Dampness coagulates. Thus, both Cold and Heat can transform into Dryness and Dampness.
One might ask: Why can both Cold and Heat cause the transformation of Dryness and Dampness? I reply: If you wish to understand Dryness and Dampness, why not observe the hexagrams of Qian and Kun? Qian symbolizes the Supreme Ultimate; its first line is Yang, and the second is Yin. Qian Metal is fundamentally Yang containing Yin, so Qian represents Great Yang, not isolated Yang. The six lines of Kun are pairs of Qian’s lines; Kun Earth is fundamentally Yin supporting Yang, so Kun represents Great Yin, not isolated Yin. The hexagrams of Qian and Kun correspond to Heaven and Earth; let us verify this empirically in nature. The Primum Mobile (the outermost celestial sphere) is empty and void; emptiness is pure Yang. Being the highest, it rotates tightly and moves vigorously; tightness and vigor are also manifestations of pure Yang. The essence of Yang becomes the Sun, which is True Fire. Below the position of Metal, Fire Qi supports it. Heaven belongs to Yang, and Dryness also belongs to Yang—this is certain. However, within the eight heavens inside the Primum Mobile, stars belong to Lesser Yin, and the Moon to Great Yin. Beneath True Yang, True Yin supports it; thus, it is said that Yang contains Yin. Therefore, the Dryness Qi of Heaven descends only when accompanied by Yin Qi. Dry-Heat is the root (because heat arises from dryness, it is called Dry-Heat, not Heat-Dryness); Cold-Dryness is the variation (because dryness arises from cold, it is called Cold-Dryness, not Dryness-Cold). The essence of Yin becomes the Moon, which is True Water. Water corresponds to the Moon and is generated on Earth. Earth belongs to Yin, and Dampness also belongs to Yin—this is certain. However, Earth remains stationary within Heaven; the Yang Qi of Earth is the same as the Yang Qi of Heaven, with Yin following Yang. Thus, it is said that Yin supports Yang. Therefore, the Dampness Qi of Earth rises only with the assistance of Yang Qi. Cold-Dampness is the root (because dampness arises from cold, it is called Cold-Dampness, not Dampness-Coldness); Warm-Dampness is the variation (because dampness generates heat, it is called Warm-Dampness, not Dampness-Warmth).
I have heard that between Heaven and Earth there are three realms: the uppermost is the Realm of Heat, the middle is the Realm of Cold, and the one above the ground is the Realm of Warmth. Based on this, we can see that Heaven and Earth possess only Yin and Yang Qi. And these two Qi are essentially one Qi, merely changing according to their ascending and descending movements!
Dryness and Dampness each govern half of a year. At Winter Solstice, Yang Qi hides underground; Earth receives Yang Qi, causing Dampness to stir secretly, so springs begin to flow. Entering Spring, the East Wind thaws the ice, thunder sounds; both East Wind and Thunder are Yang, while Dampness is Yin. Yin transforms according to Yang. As Yang Qi gradually emerges from Earth, Dampness Qi gradually generates, so plants contain sap and sprout. Entering Summer, warm winds arrive, Yang Qi fully emerges from Earth, summer heat steams upward, and Dampness is at its peak. Thus, the soil is moist, the heat is muggy, and heavy rains occur frequently. The transformation of Heaven and Earth changes from rigid to soft. At Summer Solstice, Yang Qi fully emerges from Earth, and one Yin line is just born; Dryness Qi has not yet taken command. Entering Autumn, cool winds arrive, white dew falls, and Heaven and Earth begin to become solemn. Yang commands Yin to descend, and Dryness Qi begins to move. After the Autumnal Equinox, thunder ceases, waters dry up, so Dampness begins to收 (restrain). At this time, dew is cold, frost is solemn, Yang commands Yin to gradually descend, and Dryness Qi takes command, so plants turn yellow and fall. Entering Winter, Heaven Qi ascends, Earth Qi descends, and they block each other. Yang commands Yin to fully descend, and Dryness Qi is strongest. Yang Qi hides underground, lacking external protection, so water freezes, earth hardens, rainbows disappear, and the transformation of Heaven and Earth changes from soft to rigid. Water prospers in Winter but actually grows in Summer; Fire peaks in Summer but actually hides in Winter. Yin and Yang are roots of each other, so the great transformation cycles endlessly. Observing this, we know Dryness belongs to Yin within Yang, and Dampness belongs to Yang within Yin. Unmoved, they belong to Yin; moved, they belong to Yang. The *I Ching* says: "Good fortune, misfortune, regret, and hesitation arise from movement." Movement leads to change, change leads to transformation. Cold-Dryness transforms into Dry-Heat, returning to its root; Cold-Dampness transforms into Warm-Dampness, due to variation. If humans can comprehend the origins of Dryness and Dampness caused by Cold and Heat, using them as the main principle (Gang); and further examine their transformation into Heat or not, and the principles that Dryness stagnation prevents water circulation leading to Dampness, while Dampness stagnation prevents nutrient distribution leading to Dryness, using these as the details (Mu), then once the Gang is raised, the Mu spreads. Regardless of the myriad conditions of disease, the balance is held in hand.
Moreover, Dryness and Dampness are seasonal pathogenic factors, but there are also non-seasonal excessive factors. For example, prolonged drought makes Dryness dominant; dry heat or dry cold also makes Dryness dominant. In Spring it is Wind-Dryness, in Summer Summer-Heat Dryness, in Autumn Cool Dryness, in Winter Cold Dryness. Prolonged rain makes Dampness dominant; humid heat and cold also make Dampness dominant. In Spring it is Wind-Dampness, in Summer and early Autumn Summer-Heat Dampness, in late Autumn and Winter Cold Dampness. The Classics state: "First ascertain the annual Qi, do not violate the harmony of Heaven." Common people call exterior contraction "seasonal Qi." The meaning of "season" is profound! To use fixed prescriptions to treat pathogenic factors without fixed seasons is to severely misunderstand the season. However, one must not only adapt to the season but also to the location. Northwest terrain is high, so Dryness dominates; Southeast terrain is low, so Dampness dominates. One must not only adapt to location but also to the individual. The Six Qi harm people and transform according to the individual: Those with Yin deficiency constitution easily transform into Dryness; even if it is Dampness, it transforms into Dryness. Those with Yang deficiency constitution easily transform into Dampness; even if it is Dryness, it inevitably involves Dampness. Dryness and Dampness are indeed inseparable from all exterior-contracted diseases.
One might ask: Exterior contractions involve the Six Qi of Wind, Cold, Summer-Heat, Dampness, Dryness, and Fire. You summarize them with Dryness and Dampness. Can you deduce the reasons and analyze them? I reply: On Earth, they form shapes; in Heaven, they are Qi. Among the Six Qi, Wind is first, Cold, Summer-Heat, Dampness, and Dryness are middle, and Fire is last. Wind is first because Wind is the mover of Dryness and Dampness. Summer-Heat is middle because Cold and Summer-Heat are the transformers of Dryness and Dampness. Fire is last because Fire is the final transformer of Dryness and Dampness. Let us analyze. Wind corresponds to the Xun hexagram, with two Yang lines above one Yin line, external Yang and internal Yin, with Yang doubling Yin. Thus, Wind is a Yang pathogen; it is indeed agile, changing, and formless. In the East, Dampness moves with rain, so it is called Wind-Dampness; in the West, Dryness moves with drought, so it is called Wind-Dryness; in the South, Summer-Heat moves with heat and dampness, so it is called Summer-Heat Wind; in the North, Cold moves with cold and dryness, so it is called Cold Wind. Southeast wind involves Dampness and Summer-Heat; Northeast wind involves Dampness and Cold; Southwest wind involves Dryness and Fire; Northwest wind involves Dryness and Cold. Movement in moderation allows life; excess movement causes disease. Slight Dryness allows vitality; extreme Dryness causes withering. Slight Dampness nourishes; extreme Dampness causes rot. If things are like this, humans are no different. Cold is the origin of Dryness, and Fire is the completion of Dryness. The Classics say: "Excess Dryness leads to dryness." Thus, in midsummer, when heat reigns, objects exposed to wind and sun lose fluids gradually; humans sweating heavily consume fluids gradually. Excess Fire indeed causes Dryness. In autumn and winter, when cold rules, grasses wither, dew becomes frost, rain becomes snow, water becomes ice, and human hands and feet crack. The world is filled with Cold-Dryness Qi. Winter corresponds to the Kan hexagram, with one Yang line between two Yin lines. Ice freezes externally, while Dry-Fire warms internally. Thus, Cold-Dryness diseases easily transform into Dry-Heat. The Classics state that Cold damage is a Heat disease. Because Cold leads to Dryness, and Dryness leads to Heat, the logic is connected. If Yang does not hide in winter, and Earth Dampness does not restrain, then Cold inevitably involves Dampness. Therefore, diseases contracted in winter resembling autumn diseases, such as malaria, dysentery, and warm diseases, all involve Dampness pathogens! As for Summer-Heat, it is the mutual brewing of Dampness and Heat, transforming into Dryness. One must distinguish whether Dampness or Heat predominates. Predominant Dampness transforms into Dryness slowly; predominant Heat transforms into Dryness rapidly. Pure Heat without Dampness is Summer-Heat Dryness. As for Fire, it hides within Metal, Wood, Water, and Earth, emerging when moved, and is the destination of Dryness and Dampness. Striking metal produces fire; drilling wood produces fire; digging earth produces fire (the essence of earth condenses into stone; observing fire extraction from stone reveals the meaning of extracting fire from earth). Seas are valleys of fire; moving waters in rivers and lakes also contain fire. Patients are the same. Metal and Fire share the palace; Li is Minister Fire. Thus, Lung and Heart movement result in Dry-Fire; if Dampness and Heat steam, it becomes Wet-Fire. Liver is Zhen Thunder Fire and Xun Wind Fire; thus, Liver movement results in Dry-Fire; if Dampness and Heat steam, it becomes Wet-Fire. Kidney Fire is Dragon Fire, fire within water. When Water is deficient and Fire is hyperactive, it transforms into Dry-Fire; if Dampness and Heat steam, it becomes Wet-Fire. Spleen belongs to Earth, which is mixed Qi; thus, Spleen Fire is mostly Wet-Fire. Wet-Fire injuring Spleen Yin transforms into Dry-Fire. Dryness and Dampness ultimately return to Fire transformation. This is how Earth Two generates Fire, completing it. Other examples: Spring Warmth is Cold transforming into Dryness involving Dampness; Wind Warmth is Wind transforming into Dryness; Warmth and Summer-Heat Warmth are Dampness and Heat combining, biased toward Heat; Dampness Warmth is Dampness and Heat combining, biased toward Dampness; Warm Epidemic resembles pestilence, arising from turbid Earth Dampness and Heat stagnation, transforming into Dryness fastest; Latent Summer-Heat is Summer-Heat and Dampness combining, hiding in the Membrane Source, waiting for Cool Dryness to activate; Malaria involves Summer-Heat and Dampness combining, hiding in the Membrane Source, or Cold and Wind forcing Summer-Heat into the Ying level, both waiting for Cool Dryness to activate; Cholera involves injury to Summer-Heat Dryness, Cold Dryness, Summer-Heat Dampness, or Cold Dampness, or Dryness involving Dampness, Dampness transforming into Dryness, occurring sequentially. Examining this, are Dryness and Dampness not generated and transformed by Wind, Cold, Summer-Heat, and Fire? Hence, I present them as the outline.
Asked: How should treatment be conducted? I reply: Treating exterior Dryness and Dampness pathogens has no other method than providing an exit for the pathogen, ensuring the pathogen exits early. What is the exit? The Lung, Stomach, Intestines, and Bladder. Pathogens entering from outside must exit from outside. Hair pores are the association of the Lung; mouth and nose are the apertures of the Lung and Stomach; Large Intestine and Bladder are the exterior of the interior, and portals of the Lung and Stomach. Thus, resolving via sweat is exterior resolution; resolving via urination and defecation is also exterior resolution. Dryness belongs to Heaven Qi, which is clear pathogen. Qi battles Qi, so it first injures the Qi level of the Lung Meridian. Qi has no form; its有形 (form) part is dregs in the stomach and intestines. Dryness pathogen transmits from Lung to interior, using dregs as attachment, thus injuring Stomach and Intestines. Lung and Large Intestine are both Dry Metal; Lung and Stomach are mother and son. Thus, the Classics state Yangming also governs Dry Metal. Dryness pathogen injuring Dry Metal follows similar Qi attraction, which is natural. Dampness belongs to Earth Qi, which is misty and sticky, a turbid pathogen. However, turbid pathogen is still Qi. Qi enters via mouth and nose, injuring Lung Qi level. Lung governs whole-body Qi transformation. Blocked by pathogen, Qi cannot move water, so Dampness cannot transform. Turbid pathogen returns to turbid pathways, transmitting to Stomach and Intestines; the clear part of turbidity transmits to Bladder.
Asked: What about medication? I reply: Sweat is body fluid; its excretion is transformed by Qi. Now, if Qi fails to transform fluid and there is no sweat, it is because Qi is blocked by pathogen! Pathogen blockage closes hair pores and meridians; Stomach, Intestines, and Bladder also close. Treatment should lightly open Lung Qi blocked by pathogen, assist in smoothing Stomach and Intestine Qi mechanism, and simultaneously promote Bladder Qi transformation. For Dryness pathogen, use Acrid-Moistening to open it; for Dampness pathogen, use Acrid-Dispersing to open it; Dryness combined with Cold, use Acrid-Warm-Moistening; Dryness combined with Heat, use Acrid-Cool light agents; Dampness combined with Cold, use Acrid-Warm-Dispersing; Dampness combined with Heat, use Acrid-Cool-Dispersing; Dryness transforming into Heat, use Acrid-Cool heavy agents; Dampness transforming into Heat, use Acrid-Bitter unblocking and descending; Dryness oppressed by Dampness, add Bitter-Acrid-Dispersing to Acrid-Moistening to resolve Dampness; Dampness oppressed by Dryness, add Acrid-Moistening to Acrid-Dispersing to resolve Dryness; Dryness disturbing Spirit, use Acrid-Cool light and empty methods to open; Dampness clouding Spirit, use Bitter-Acid light and clear methods to open. In short, once Lung Qi level pathogen is opened, sweat resolves. If illness occurs after eating, Qi is battled by pathogen, unable to digest; must combine dispersing, loosening, harmonizing, and transforming to prevent knotting. Later transmission to interior requires slight unblocking. If pathogen is heavy and turbid, it must transmit to interior; interior transmission requires purgation. If Lung Qi is unopened but interior syndrome is urgent, must add Stomach and Intestine moistening/unblocking agents to Lung dispersing/opening. Lung governs Heaven Qi; when Heaven Qi opens, Earth Qi moves. Dryness pathogen often causes fecal impaction in Large Intestine; must use Salty to soften and Moistening to unblock. Dampness pathogen stool resembles spoiled sauce; must缓 (slow) drug power to push it out, or use pills to grind it down. Dryness injuring fluids requires slippery-moistening agents to increase fluid and unblock; Dampness blocking Qi mechanism requires Acrid-Bitter flavors to open and transform. Generally, pathogen injuring Heaven Qi is treated with clearing and opening. When Heaven Qi opens, clear pathogen in hair pores and meridians opens; turbid pathogen in Stomach, Intestines, and Bladder, having no constraint, also opens. Sweat resolves, and bowel/bladder resolve; as upper apertures open, lower apertures naturally open. If upper apertures are unopened but lower are forced open, Qi is blocked by Upper Jiao pathogen, unable to transport downward. Like a bird with bound feet trying to fly—is it possible? Pathogen transmitting to Earth Dao is treated with unblocking and promoting. When Earth Qi opens, turbid pathogen in Stomach, Intestines, and Bladder opens; clear pathogen in hair pores and meridains, isolated and unsupported, also opens. Bowel/bladder resolve, and sweat resolves; as lower apertures open, upper apertures naturally open. If lower apertures are unblocked but upper are forced open, Qi is blocked by Stomach/Intestine pathogen, unable to transform sweat and exit outward. Like a sea gate blocked, expecting streams to follow course—is it possible? Examining this, the Way of Heaven and Earth is consistent. Are there two ways?
Asked: What if there is Deficiency of Person and Excess of Syndrome? I reply: Deficiency of Person and Excess of Syndrome simply adds methods to support the pathogen's exit and formulas to protect Zheng Qi. Ultimately, expelling pathogen is primary. The earlier the pathogen retreats, the earlier Zheng Qi recovers. The Classics say: "If there is pathology, there will be no collapse [of Zheng Qi]." Otherwise, nurturing the carbuncle creates disaster; later, even if one wishes to treat, it cannot be done. Hence I say: Treating exterior pathogens has no other method than providing an exit for the pathogen, ensuring early exit.
Another asks: Pathogen has no form, relying on dregs for form. Is it okay not to feed the patient? I reply: No. Where pathogen gathers, Qi is deficient. If able to eat but denied food, Stomach Qi becomes more deficient. Like defending an empty city, thieves enter freely. Not only does pathogen enter Stomach, but without grain Qi, the source of generation and transformation is cut off. Five Zang become empty vessels, and pathogen enters everywhere. Asked: Then force feeding? Also no. If unable to eat but forced, pathogen is further suppressed. This is "stealing grain" [helping the enemy]. In short, eating or not depends on the patient's capacity. Force-feeding is inadvisable; fasting is especially inadvisable. Only light diet to nourish Stomach is suitable; thick/turbid foods protect pathogen. Proverb: "Starvation does not kill Cold Damage." Knowing hunger indicates Stomach Qi, meaning survival. My teacher Mr. Ju Tong often emphasized this. Why do patients still force-feed and doctors still forbid eating, ignoring the supreme truth?
Asked: Exterior Hundred Diseases are not outside Dryness and Dampness; I have heard you. May I ask about Interior Injury? I reply: Interior Injury changes infinitely, but tracing the cause reveals only Dryness and Dampness. The Great Dao is nothing but Yin and Yang. Ancient and modern medical texts categorize extensively; the more categories, the more divergent treatments, dazzling the eye temporarily but leaving students lost. This is due to failing to explore the root and origin to observe the principles of Heaven and Earth Yin-Yang. Let us analyze. Exterior contraction is Excess; even if deficient, Excess comes first. Interior injury is Deficiency; even if Excess, Deficiency comes first. Yang Qi deficiency leads to weak steaming/transport, forming Interior Dampness; Yin Blood deficiency leads to lack of nourishment, forming Interior Dryness. Overthinking binds Qi; bound Qi lacks pivot mobility, forming Interior Dampness. Qi binding leads to Blood binding; bound Blood lacks circulation, forming Interior Dryness. Moreover, Yin and Yang are roots of each other; Qi and Blood share the same source. Severe Yang deficiency implies Yin deficiency; without fire under the pot, how can essence be steamed? Severe Qi deficiency implies Blood deficiency; without a winch on the cart, how can water be drawn? Often starting with Dampness, later Dampness transforms into Dryness. Severe Yin deficiency implies Yang deficiency; with dying lamp and empty oil, how can brilliance shine? Severe Blood deficiency implies Qi deficiency; with shallow water and stopped boat, how can it surge forward? Often starting with Dryness, later Dryness involves Dampness. Transforming Dampness is still from outside (though Interior Dampness arises internally, it is derived from fluid retention, still an excess within insufficiency). Transforming Dryness is depletion from within. Therefore, if Dryness transforms into Dampness, treat Dampness as root and Dryness as branch; if Dampness transforms into Dryness, treat Dampness as root and Dryness as branch. This is the major principle of treating root and branch, priority and sequence.
Asked: What is the hierarchy of Zang-Fu? I reply: Diseases caused by Heaven Qi are exterior contractions, affecting Heaven Qi first. Diseases caused by Human factors are interior injuries, affecting Earth Qi first. Thus, Interior Dryness originates in Lung, Stomach, Kidney; Stomach is heavy, Kidney is heavier. Lung is the source of distributing fluids; Stomach is the root of generating fluids; Kidney is the foundation of distribution and generation. Interior Dampness originates in Lung, Spleen, Kidney; Spleen is heavy, Kidney is heavier. Lung is the source of regulating water fluids; Spleen is the root of distributing water fluids; Kidney is the hub of regulation and distribution. Thus, Spleen, Stomach, and Kidney are what Lung borrows to generate and transform. If Heaven Qi does not descend, it is because Earth Qi does not ascend. How can we not distinguish weight? In short, diseases have Dryness/Dampness; medicines have Drying/Moistening; diseases have purity/mixture; formulas have flexibility. The Classics say: "He who knows the key finishes in one word; he who does not know the key scatters infinitely." This is what is meant!