阳，天道也；阴，地道也。非天之阳，地亦不凝，而万物不生；非地之阴，天亦无根据，
而万物不成。天主动，无一息之静，使稍不动，则失其健运之机，而万物屯矣；地主静，无
一息之动，使稍不静，则失其贞凝之义，而万物否矣。人身之阳，法天者也，一失其流行之
机，则百病起；人身之阴，法地者也，一失其安养之义，则百害生。阴阳二气，固不可稍偏
而或失也。夫所谓阳者，乃人身之真阳。真阳，阴中之阳，非燥烈无济之亢阳。亢阳无阴则
为火，如天之久旱酷暑，不得不藉甘霖以消其亢厉，故丹溪发补阴之论，补阴正所以济阳也
。王太仆谓壮水之主，以制阳光者，此也。所谓阴者，乃人身之真阴。真阴，阳中之阴，非
坚凝寒结之浊阴。浊阴无阳则为水，如天之重阴凛冽，不得不藉皓日以致其睛和，故先哲发
扶阳之论，扶阳正所以济阴也。王太仆谓益火之原，以消阴翳者，此也。
夫干为阳，坤为阴，乾坤化为坎离，是天地为阴阳之体，水火为阴阳之用。用伤则体害
。水火有过不及之弊，在天地则不能无旱涝之灾，在人则不能无燥湿之患，其理一也
阴，人之形也；阳，人之气也。大凡形质之失宜，莫不由气行之失序。故地之万物不生
，又皆由天之旱涝失节。人身一分阳气不到之处，则此处便有病；然阴阳互根，凡阳所到之
处，皆阴所到之处，若阳到而阴不到，则此处亦有病。
阴阳又当审其虚实。外感实证，先病阳；内伤虚证，先病阴。病阳者，肺主之；病阴者
，脾、胃、肾主之。外感上焦阳气郁闭，治以开豁，通天气也；中焦阳气燥结，治以苦辛攻
下、苦辛开化，平地气也。（治实火，要使邪有出路，若纯用苦寒，逼邪深入，而无出路，
非
中焦阳气下陷，不能上升于肺，治以升补，使地气上腾乎天也；下焦阳气外越，不能下归于
肾，治以温纳，使天气下降于地也。盖先天真一之气，自下而上，与后天胃气，相接而生，
而为人身之至宝。若人真阴受伤，致精不能化气，气即不能归精，于是肾中龙火内烁，而见
骨蒸等证；龙火外越，而见发热、颧红、面赤等证。一火兴而五火炽，将见肝之风火雷火，
心之离火，胃之燥火，又必相因而起，而见有余之象。非有余也，实下元不足所致耳！经曰
∶少火生气，壮火食气。火在丹田以下为少火，即真火；火离丹田而上为壮火，即虚火。虚
火，水中之火，不得再以水灭之固也。奈何世执丹溪法，而用知母、黄柏之苦寒以扑灭之，
势必愈治愈剧，如雨愈大龙愈腾，欲其潜藏也得乎？不独苦寒不可用也，即甘凉亦当慎投。
其在初病，本原未伤者，甘凉清润，犹可获效；若高年以及久病，本原已伤者，法当治以温
润，引火归原，如云开日出而龙乃潜也。浊阴可温，桂、附、干姜辛热之属，不得不用；若
阴中阳虚，而药偏刚燥，恐阳未能扶，而阴又被劫，法当治以温润，纳气归原。经曰∶气纳
为宝。盖气纳则归肾，不纳则不归肾。气不归肾者，谓肺气不得归肾，并谓脾胃之气不得归
肾也。
夫肾为先天五脏之始，始数一，一，水数也。金为水源，水天本一气也。脾胃为后天五
脏之成，成数五，五，土数也。土为万物之母，故精、神、气、血，皆胃气所生，又皆肾气
助之以生。胃为人之地，肾为地中之天气，胃、肾又本一气也，经故曰∶肾为胃关。夫所谓
胃气者，谷气也。经曰∶营为水谷之精气，卫为水谷之悍气。又曰∶精气生于谷气。故“气
”
水谷精气生于胃，输于脾，由脾上输于肺，则为气，从肺回下，入心化血，入肾化精，是生
之者胃，升之者脾，降之者肺，地天交泰，胃、脾、肺又本一气也。经故曰∶脾为谏议之官
，
曰∶饮食伤脾，则又何说？曰∶饮食不节，遏郁脾气，脾气为其所郁，则不能散精，而湿斯
停矣。是谓伤逆，非脾之过也，良由饮食不节所致耳！
夫人生天地间，天气固重，地气尤重。盖人在天中，（离地而上，凡空处皆谓之天。人
在
通，而人莫名其妙，亦莫得自主，故凡天之六气，病患之天气者，人不能尽避之。附于地上
，实而可据，人得以自主，故凡七情之病，由人事所致者，多病患之地气以及天气。病地气
，则胃、肾为重。然肾虽主地气，而实为地中之天气。肾属天一所生之水，而为人之先天者
，此也。其有胎元薄弱，先天不足者，人不得而主之，又恃调摄后天，以补先天之不足。若
是者，胃气不尤重哉？重胃气非即所以重肾气哉？
夫胃为中土，胃气赖五脏之气以生化。如地无堤防之土，则水无收束，无水则燥，
无火则滥，无木则实，无金则死是也。然五脏之气，又赖胃气以成功。如金无土则不生，木
无土则不载，水、火无土则无本原，脾土无胃土则不滋润是也。故脾胃谷气，不得到肺，则
肺之脾胃虚；脾胃谷气，不得到心，则心之脾胃虚；脾胃谷气，不得到肝，则肝之脾胃虚；
脾胃谷气，不得到肾，则肾之脾胃虚；胃之谷气，不得到脾，则脾之胃虚。若是者，脾胃顾
不重哉？内伤百病，可不首固脾胃哉？请申言之。肺之脾胃虚，则热自内生，热则不能生水，
而
嗽、肿满诸湿证，是亦肺气不得归肾也。医学云喘，在肾为虚，在肺为实。夫所谓实者，非
真实也，乃肺之阳虚不化，致水上溢高源耳！金寒水冷，非温润纳气不可；邪水射肺，非辛
淡输水扶气不可。心之脾胃虚则热，热则燥，君弱者臣自强，血虚者肝自旺，火水未济，致
生虚烦、心热、不寐等证，是心气不得归肾也。或曰∶心属火，火性炎上，如何下降？肾属
水
交于肾水；肾属水，而肾中有气，是水中有真阳，故肾水随真阳上升，以交于心火。夫真阴
真阳者，心肾中之真气也。故欲补心者，先实肾，使肾得升；欲补肾者须宁心，使心得降。
肝之脾胃虚则热，热则燥，肝血一亏，肝气即亢，或风雷激搏，致生头疼、呕吐等证；或木
火刑金，致生干咳、吐血等证；或燥木侮土，致生胁痛、呕吐、蛊、膈等证，是肝气不得归
肾也。夫治肝较他脏尤难。他脏之邪，可移之出腑，若胆虽为肝之腑，而一囊胆汁，藏而不
泻，而无出路，虽属腑而与脏无殊，故肝病较他脏为难治。则惟有清润以濡之、咸柔以潜之
，沃水以生木也；甘润以缓之，培土以载木也；微苦以降之，使木火不上僭也；平润以纳之
，导木火得下潜也；血能含气，气不耗血，而肝自平矣。其肝有湿热者，方可用苦降、辛通
、酸泄之剂；气不条达者，方可用木郁达之之法。彼破气、耗血诸品，岂可妄用，以伐生气
，以耗肝阴也哉？肾之脾胃虚则热，热则燥，肾阴一亏，肾阳即亢，或骨蒸、发热，或吐血
、梦遗，或上咳、下利，是肾气不得归肾也。治法亦不外清润、温润，以增水养火而已矣；
甘润、甘平，以固水火中之脾胃而已矣。脾之胃虚则中土自病，或因思虑过度，或因饥饱失
宜，以致气结化湿，血结化燥，湿困脾阳，燥伤脾阴等证。胃病则不能散输精气于脾，脾病
则不能上输精气于肺，地气不上腾，则天气不下降，是脾胃之气不得归肾也。此则非寒热温
凉所能纳也，法当病燥则治燥，病湿则治湿，取纯甘之味，扶土生金，顺其升降之性以纳之
耳！
总之，内伤百病，不起于先天，即起于后天；起于后天，又必病及先天。五脏中有一脏
不秉生成之气，则形气病，形病不能无害于气，气病不能无害于形，此不易之道，相因之理
也。但治之者，不可无标本先后之分。夫阴阳、脏腑、气血，有各自为病者，有相因而至者
，有去此适彼者。用药之法，如腑病宜开通，不得以脏药犯之；脏病宜补益，不得以腑药犯
之。腑病将及脏，治腑尤须顾脏，脏病将入腑，治脏必兼理腑。腑入脏，脏入腑，又有轻重
之异，药亦不得不随其轻重而用之。更有病虽在腑，而原起于脏，则重在治脏；病虽在脏，
而原起于腑，则重在治腑。盖病虽在此，不必治此，治此反剧；病已去此，犹当顾此，罔顾
此则损。此阴阳标本先后轻重之大略也。
要之，天地与人，不外阴阳二气。天之阴阳失，相燮理之；人之阴阳失，医燮理之。良
相、良医，总在调剂阴阳，使之两得其平焉已矣。
阳，代表天道；阴，代表地道。如果没有天的阳，地也无法凝聚，万物便无法生长；如果没有地的阴，天也就没有依托，万物便无法成就。天主动，没有一刻的静止，如果稍微不运动，就会失去健运的机能，万物就会停滞；地主静，没有一刻的运动，如果稍微不静止，就会失去贞固凝结的意义，万物就会闭塞不通。人身之阳，效法天，一旦失去其流行的机能，百病就会兴起；人身之阴，效法地，一旦失去其安养的意义，百害就会发生。阴阳二气，确实不可稍有偏颇而失其平衡。
所谓阳，是指人身之真阳（Zhen Yang, True Yang）。真阳是阴中之阳，并非那种燥烈而无助益的亢阳（Kang Yang, Hyperactive Yang）。亢阳若无阴制约则化为火，如同天空久旱酷暑，不得不借助甘霖来消除其猛烈，所以朱丹溪提出补阴的理论，补阴正是为了济助阳。王冰（Wang Bing, courtesy name Taipu）所说的“壮水之主，以制阳光”，就是这个道理。所谓阴，是指人身之真阴（Zhen Yin, True Yin）。真阴是阳中之阴，并非那种坚凝寒结的浊阴（Zhuo Yin, Turbid Yin）。浊阴若无阳温煦则化为水，如同天空重阴凛冽，不得不借助皓日以使天气晴和，所以先哲提出扶阳的理论，扶阳正是为了济助阴。王冰所说的“益火之原，以消阴翳”，就是这个道理。
乾卦象征阳，坤卦象征阴，乾坤变化化为坎离卦，这是天地作为阴阳的体，水火作为阴阳的用。用受损则体受害。水火有过与不及的弊端，在天地之间就不能没有旱涝灾害，在人身上就不能没有燥湿的病患，其中的道理是一样的。
阴，是人的形体；阳，是人的气机。大凡形质的失宜，无不由于气机运行的失序。所以大地万物不生，也都由于天的旱涝节气失调。人身有一分阳气不到的地方，那里就有病；然而阴阳互根，凡是阳气到达的地方，都是阴气到达的地方，如果阳气到了而阴气不到，那里也有病。
阴阳又应当辨别其虚实。外感实证，先伤阳；内伤虚证，先伤阴。病在阳者，由肺所主；病在阴者，由脾、胃、肾所主。外感导致上焦阳气郁闭，治疗以开豁为主，以通天气；中焦阳气燥结，治疗以苦辛攻下、苦辛开化为主，以平地势。（治疗实火，要使邪气有出路，如果纯用苦寒药，逼迫邪气深入，而没有出路，就不是正道了。）中焦阳气下陷，不能上升于肺，治疗以升补为主，使地气上腾于天；下焦阳气外越，不能下归于肾，治疗以温纳为主，使天气下降于地。大概先天真一之气，自下而上，与后天胃气相接而生，这是人身至宝。如果人真阴受伤，致使精不能化气，气即不能归精，于是肾中龙火（Long Huo, Dragon Fire, referring to ministerial fire in the kidney）内烁，出现骨蒸等证候；龙火外越，出现发热、颧红、面赤等证候。一火兴起而五火炽盛，将会见到肝之风火雷火、心之离火、胃之燥火，又必然相因而起，表现出有余的现象。这并不是真正的有余，实在是下元不足所致！《内经》说：“少火生气，壮火食气。”火在丹田以下为少火，即真火；火离开丹田而上为壮火，即虚火。虚火是水中之火，不能再用水去灭它固然正确。奈何世人拘执于朱丹溪的方法，使用知母、黄柏的苦寒药去扑灭它，势必越来越严重，就像雨越大龙越腾飞，想让它潜藏怎么可能呢？不仅苦寒不可用，就是甘凉药也应当谨慎投用。如果在初病，本原未伤者，甘凉清润还可以获得疗效；如果是高龄以及久病，本原已伤者，治法应当用温润，引火归原，如同云开日出而龙乃潜藏。浊阴可以用温药，桂枝、附子、干姜等辛热药物，不得不用；如果阴中阳虚，而药偏刚燥，恐怕阳未能扶助，而阴又被劫夺，治法应当用温润，纳气归原。《内经》说：“气纳为宝。”大概气纳则归肾，不纳则不归肾。气不归肾，是指肺气不得归肾，并指脾胃之气不得归肾。
肾为先天五脏之始，始数为1，1是水数。金为水源，天水本是一气。脾胃为后天五脏之成，成数为5，5是土数。土为万物之母，所以精、神、气、血，都由胃气所生，又都靠肾气助之以生。胃是人之地，肾是地中之天气，胃、肾又本是一气，所以《内经》说：“肾为胃关。”所谓胃气，就是谷气。《内经》说：“营气是水谷之精气，卫气是水谷之悍气。”又说：“精气生于谷气。”所以“气”由水谷精气生于胃，输于脾，由脾上输于肺，则为气，从肺回下，入心化血，入肾化精，这是生之者胃，升之者脾，降之者肺，地天交泰，胃、脾、肺又本是一气。《内经》所以说：“脾为谏议之官。”如果说饮食伤脾，又怎么解释呢？回答说：饮食不节，遏郁脾气，脾气被其所郁，则不能散精，湿气就停聚了。这叫伤逆，不是脾的过错，实在是由饮食不节所致！
人生天地间，天气固然重要，地气尤其重要。大概人在天中，（离地而上，凡空处皆谓之天。人在其中），通而不明，人也莫名其妙，也不能自主，所以凡是天之六气，病患属于天气的，人不能完全避开。附于地上，实而可据，人得以自主，所以凡是七情之病，由人事所致的，多病患属于地气以及天气。病地气，则以胃、肾为重。然而肾虽主地气，而实为地中之天气。肾属天一所生之水，为人之先天，就是这个原因。如果有胎元薄弱，先天不足的，人不能自主，又依靠调理后天，以补先天之不足。像这样的人，胃气不是更重要吗？重视胃气不就是重视肾气吗？
胃为中土，胃气依赖五脏之气以生化。如同地无堤防之土，则水无收束，无水则燥，无火则滥，无木则实，无金则死。然而五脏之气，又赖胃气以成功。如同金无土则不生，木无土则不载，水、火无土则无本原，脾土无胃土则不滋润。所以脾胃谷气，不得到肺，则肺之脾胃虚；脾胃谷气，不得到心，则心之脾胃虚；脾胃谷气，不得到肝，则肝之脾胃虚；脾胃谷气，不得到肾，则肾之脾胃虚；胃之谷气，不得到脾，则脾之胃虚。像这样的人，脾胃难道不重要吗？内伤百病，可不首先巩固脾胃吗？请让我进一步阐述。肺之脾胃虚，则热自内生，热则不能生水，而出现咳嗽、肿满诸湿证，这也是肺气不得归肾。医学上说喘证，在肾为虚，在肺为实。所谓实者，并非真实之邪，而是肺之阳虚不化，致水上溢高源耳！金寒水冷，非温润纳气不可；邪水射肺，非辛淡输水扶气不可。心之脾胃虚则热，热则燥，君弱则臣自强，血虚则肝自旺，火水未济，导致产生虚烦、心热、不寐等证候，这是心气不得归肾。有人说：心属火，火性炎上，如何下降？肾属水，而肾中有气，是水中有真阳，故肾水随真阳上升，以交于心火。夫真阴真阳者，心肾中之真气也。所以欲补心者，先实肾，使肾得升；欲补肾者须宁心，使心得降。肝之脾胃虚则热，热则燥，肝血一亏，肝气即亢，或风雷激搏，导致产生头疼、呕吐等证候；或木火刑金，导致产生干咳、吐血等证候；或燥木侮土，导致产生胁痛、呕吐、蛊、膈等证候，这是肝气不得归肾。治疗肝病比其他脏腑尤为困难。其他脏腑的邪气，可以移之出腑，若胆虽为肝之腑，而一囊胆汁，藏而不泻，而无出路，虽属腑而与脏无殊，所以肝病较他脏为难治。则惟有清润以濡之、咸柔以潜之，沃水以生木也；甘润以缓之，培土以载木也；微苦以降之，使木火不上僭也；平润以纳之，导木火得下潜也；血能含气，气不耗血，而肝自平矣。其肝有湿热者，方可用苦降、辛通、酸泄之剂；气不条达者，方可用木郁达之之法。那些破气、耗血诸品，岂可妄用，以伐生气，以耗肝阴也哉？肾之脾胃虚则热，热则燥，肾阴一亏，肾阳即亢，或骨蒸、发热，或吐血、梦遗，或上咳、下利，这是肾气不得归肾也。治法亦不外清润、温润，以增水养火而已矣；甘润、甘平，以固水火中之脾胃而已矣。脾之胃虚则中土自病，或因思虑过度，或因饥饱失宜，以致气结化湿，血结化燥，湿困脾阳，燥伤脾阴等证候。胃病则不能散输精气于脾，脾病则不能上输精气于肺，地气不上腾，则天气不下降，这是脾胃之气不得归肾也。此则非寒热温凉所能纳也，法当病燥则治燥，病湿则治湿，取纯甘之味，扶土生金，顺其升降之性以纳之耳！
总之，内伤百病，不起于先天，即起于后天；起于后天，又必病及先天。五脏中有一脏不秉生成之气，则形气病，形病不能无害于气，气病不能无害于形，这是不易之道，相因之理也。但治之者，不可无标本先后之分。夫阴阳、脏腑、气血，有各自为病者，有相因而至者，有去此适彼者。用药之法，如腑病宜开通，不得以脏药犯之；脏病宜补益，不得以腑药犯之。腑病将及脏，治腑尤须顾脏，脏病将入腑，治脏必兼理腑。腑入脏，脏入腑，又有轻重之异，药亦不得不随其轻重而用之。更有病虽在腑，而原起于脏，则重在治脏；病虽在脏，而原起于腑，则重在治腑。盖病虽在此，不必治此，治此反剧；病已去此，犹当顾此，罔顾此则损。此阴阳标本先后轻重之大略也。
总而言之，天地与人，不外阴阳二气。天之阴阳失，由宰相燮理之；人之阴阳失，由医生燮理之。良相、良医，总在调剂阴阳，使之两得其平焉已矣。
Yang represents the Way of Heaven; Yin represents the Way of Earth. Without the Yang of Heaven, Earth cannot condense, and all things cannot be born; without the Yin of Earth, Heaven has no foundation, and all things cannot be accomplished. Heaven is active, with not a moment of stillness; if it moves slightly less, it loses its mechanism of vigorous operation, and all things stagnate. Earth is still, with not a moment of movement; if it remains slightly stiller, it loses its meaning of firm consolidation, and all things become blocked. The Yang of the human body models Heaven; once its mechanism of circulation is lost, hundreds of diseases arise. The Yin of the human body models Earth; once its meaning of nourishment and peace is lost, hundreds of harms occur. The Qi of Yin and Yang must indeed not deviate slightly from balance.
What is called Yang refers to the True Yang (Zhen Yang) of the human body. True Yang is Yang within Yin, not the hyperactive Yang (Kang Yang) that is dry, fierce, and unhelpful. Hyperactive Yang without Yin transforms into Fire, just as prolonged drought and intense heat in the sky require sweet rain to dissipate its fierceness. Therefore, Zhu Danxi proposed the theory of tonifying Yin; tonifying Yin is precisely to assist Yang. Wang Bing (Taipu) said, "Strengthen the master of Water to control the sunlight," which refers to this principle. What is called Yin refers to the True Yin (Zhen Yin) of the human body. True Yin is Yin within Yang, not the turbid Yin (Zhuo Yin) that is solid, congealed, cold, and knotted. Turbid Yin without Yang transforms into Water, just as heavy clouds and biting cold in the sky require the bright sun to bring clarity and warmth. Therefore, ancient sages proposed the theory of supporting Yang; supporting Yang is precisely to assist Yin. Wang Bing said, "Benefit the source of Fire to dissipate the shadow of Yin," which refers to this principle.
The Qian trigram symbolizes Yang, and the Kun trigram symbolizes Yin. Qian and Kun transform into Kan and Li; thus, Heaven and Earth are the substance of Yin and Yang, while Water and Fire are their function. If the function is damaged, the substance suffers. Water and Fire have the drawbacks of excess and deficiency. In Heaven and Earth, this inevitably leads to droughts and floods; in humans, it inevitably leads to dryness and dampness disorders. The principle is the same.
Yin is the physical form of humans; Yang is the Qi (vital energy) of humans. Generally speaking, any maladjustment of physical form stems from the disorder of Qi circulation. Thus, just as all things on Earth do not grow due to the irregularity of Heaven's drought and floods, where there is one point of Yang Qi that does not reach in the human body, there is disease. However, Yin and Yang are mutually rooted; wherever Yang reaches, Yin also reaches. If Yang reaches but Yin does not, there is disease there as well.
One must also examine whether Yin and Yang are deficient or excessive. Excess syndromes from external contraction first affect Yang; deficiency syndromes from internal injury first affect Yin. Diseases affecting Yang are governed by the Lung; diseases affecting Yin are governed by the Spleen, Stomach, and Kidney. For external contraction causing stagnation and closure of Yang Qi in the Upper Jiao, treatment involves opening and clearing to facilitate the flow of Heavenly Qi. For Yang Qi dryness and knotting in the Middle Jiao, treatment involves bitter-pungent purgation and bitter-pungent resolution to level the earthly Qi. (When treating Excess Fire, one must ensure an exit path for the pathogen; using purely bitter-cold herbs forces the pathogen deeper without an exit, which is incorrect.) For Middle Jiao Yang Qi sinking and failing to ascend to the Lung, treatment involves ascending and tonifying to raise Earthly Qi to Heaven. For Lower Jiao Yang Qi escaping outward and failing to descend to the Kidney, treatment involves warming and receiving to lower Heavenly Qi to Earth. Essentially, the Primordial One Qi of congenital origin ascends from below and connects with the acquired Stomach Qi to generate life, making it the greatest treasure of the human body. If True Yin is injured, causing Essence to fail to transform into Qi, Qi fails to return to Essence. Consequently, the Dragon Fire (Ministerial Fire) in the Kidney scorches internally, presenting symptoms such as bone-steaming fever; if Dragon Fire escapes outward, it presents with fever, malar flush, and facial redness. When one Fire rises, the Five Fires blaze. One will see Wind-Fire, Thunder-Fire of the Liver, Li-Fire of the Heart, and Dryness-Fire of the Stomach arising sequentially, manifesting as excess signs. This is not true excess but rather insufficiency of the Lower Yuan! The Classic states: "Lesser Fire generates Qi; Greater Fire consumes Qi." Fire below the Dantian is Lesser Fire, i.e., True Fire; Fire rising above the Dantian is Greater Fire, i.e., Deficient Fire. Deficient Fire is Fire within Water; it is correct that it should not be extinguished with Water again. Yet, why do people rigidly adhere to Danxi's method, using bitter-cold herbs like Anemarrhena Rhizome (Zhimu) and Phellodendron Bark (Huangbai) to extinguish it? This inevitably makes the condition worse, like rain causing the dragon to soar higher—how can one expect it to hide? Not only should bitter-cold herbs be avoided, but even sweet-cool herbs should be used cautiously. In early stages, when the root is uninjured, sweet-cool and moistening methods may still be effective. However, in the elderly or those with chronic illness where the root is already injured, the treatment should use warm-moistening methods to guide Fire back to its origin, like clouds parting and the sun appearing so the dragon hides. Turbid Yin can be treated with warming herbs; pungent-hot herbs like Cinnamon Twig (Guizhi), Aconite Root (Fuzi), and Zingiberis Rhizoma (Ganjiang) are indispensable. If there is Yang deficiency within Yin, and the medication is too acrid and drying, one fears Yang will not be supported while Yin is further depleted. The treatment should use warm-moistening methods to receive Qi back to its origin. The Classic states: "Receiving Qi is precious." Receiving Qi means it returns to the Kidney; not receiving means it does not. Failure of Qi to return to the Kidney refers to Lung Qi failing to return to the Kidney, and also Spleen-Stomach Qi failing to return to the Kidney.
The Kidney is the beginning of the five viscera of congenital origin, starting with the number 1, which is the Water number. Metal is the source of Water; Heaven and Water are originally one Qi. The Spleen and Stomach are the completion of the five viscera of acquired origin, completing with the number 5, which is the Earth number. Earth is the mother of all things; thus, Essence, Spirit, Qi, and Blood are all generated by Stomach Qi and assisted by Kidney Qi. The Stomach is the Earth of man, and the Kidney is the Heavenly Qi within Earth; Stomach and Kidney are originally one Qi. Hence, the Classic states: "The Kidney is the gate of the Stomach." What is called Stomach Qi is Grain Qi. The Classic states: "Ying-Qi is the refined Qi of water and grain; Wei-Qi is the fierce Qi of water and grain." It also says: "Refined Qi is born from Grain Qi." Thus, "Qi" is produced as refined Qi from water and grain in the Stomach, transmitted to the Spleen, transported upward by the Spleen to the Lung to become Qi, descends from the Lung, enters the Heart to transform into Blood, and enters the Kidney to transform into Essence. The Stomach generates it, the Spleen raises it, the Lung lowers it. Heaven and Earth interact; Stomach, Spleen, and Lung are originally one Qi. Hence, the Classic says: "The Spleen is the official of advice." If one asks how diet injures the Spleen, the answer is: Irregular diet stifles and depresses Spleen Qi. Depressed Spleen Qi cannot scatter essence, leading to dampness retention. This is called injury and reversal, not the fault of the Spleen, but caused by irregular diet.
Humans live between Heaven and Earth. While Heavenly Qi is important, Earthly Qi is particularly crucial. Humans exist within Heaven (the space above the ground is called Heaven). Connected yet obscure, humans lack autonomy. Thus, regarding the Six Qi of Heaven, patients affected by Heavenly Qi cannot avoid them entirely. Attached to the ground, solid and reliable, humans have some autonomy. Thus, diseases caused by Seven Emotions and human affairs mostly affect Earthly Qi and Heavenly Qi. Diseases of Earthly Qi prioritize the Stomach and Kidney. Although the Kidney governs Earthly Qi, it is essentially the Heavenly Qi within Earth. The Kidney belongs to Water born from Heaven Number 1, constituting the congenital origin. For those with weak fetal origin and congenital insufficiency, humans cannot control this but rely on regulating the acquired to supplement the congenital. In such cases, is Stomach Qi not even more important? Is valuing Stomach Qi not valuing Kidney Qi?
The Stomach is Central Earth. Stomach Qi relies on the Qi of the five viscera for transformation and production. Like earth without dikes, water has no containment; without water, it is dry; without Fire, it floods; without Wood, it is solid; without Metal, it dies. Conversely, the Qi of the five viscera relies on Stomach Qi to succeed. Like Metal needing Earth to grow, Wood needing Earth to support, Water and Fire needing Earth for their origin, and Spleen Earth needing Stomach Earth to be moist. Therefore, if Spleen-Stomach Grain Qi does not reach the Lung, the Lung's Spleen-Stomach is deficient; if it does not reach the Heart, the Heart's Spleen-Stomach is deficient; if it does not reach the Liver, the Liver's Spleen-Stomach is deficient; if it does not reach the Kidney, the Kidney's Spleen-Stomach is deficient; if Stomach Grain Qi does not reach the Spleen, the Spleen's Stomach is deficient. Are the Spleen and Stomach not important? Shouldn't the treatment of internal injuries prioritize consolidating the Spleen and Stomach? Let me elaborate. Lung Spleen-Stomach deficiency leads to internal heat; heat fails to generate Water, resulting in cough, edema, and fullness due to dampness. This is also Lung Qi failing to return to the Kidney. Medicine states that asthma is deficiency in the Kidney and excess in the Lung. The so-called excess is not true excess but Lung Yang deficiency failing to transform, causing Water to overflow from the high source. Cold Metal and cold Water require warm-moistening and receiving Qi; Evil Water attacking the Lung requires pungent-light diuresis and supporting Qi. Heart Spleen-Stomach deficiency leads to heat; heat leads to dryness. When the Ruler is weak, the Minister becomes strong; when Blood is deficient, the Liver becomes hyperactive. Fire and Water fail to interact, causing vexation, heart heat, and insomnia. This is Heart Qi failing to return to the Kidney. Some ask: The Heart belongs to Fire, and Fire flares upward; how does it descend? The Kidney belongs to Water, but contains Qi within Water, i.e., True Yang. Thus, Kidney Water rises with True Yang to interact with Heart Fire. True Yin and True Yang are the True Qi of the Heart and Kidney. To tonify the Heart, one must first solidify the Kidney to allow ascent; to tonify the Kidney, one must calm the Heart to allow descent. Liver Spleen-Stomach deficiency leads to heat; heat leads to dryness. Once Liver Blood is deficient, Liver Qi becomes hyperactive, potentially causing headache and vomiting due to wind-thunder agitation; or Wood-Fire insulting Metal, causing dry cough and hemoptysis; or dry Wood insulting Earth, causing hypochondriac pain, vomiting, abdominal masses, and dysphagia. This is Liver Qi failing to return to the Kidney. Treating Liver diseases is harder than other viscera. Pathogens in other viscera can be transferred out through the fu organs. Although the Gallbladder is the paired organ of the Liver, storing bile without excreting it, lacking an exit, it is similar to a zang organ. Thus, Liver diseases are difficult to treat. Treatment involves clearing and moistening to nourish, salty-softening to submerge, watering to generate Wood; sweet-moistening to缓 (soothe), cultivating Earth to support Wood; slightly bitter to descend, preventing Wood-Fire from usurping; neutral-moistening to receive, guiding Wood-Fire to subside. Blood contains Qi; if Qi does not consume Blood, the Liver calms itself. Only if the Liver has Damp-Heat can bitter-descending, pungent-unblocking, and sour-draining formulas be used; only if Qi is stagnant can the method of dispersing stagnant Wood be applied. How could qi-breaking and blood-consuming herbs be used recklessly to destroy vital Qi and consume Liver Yin? Kidney Spleen-Stomach deficiency leads to heat; heat leads to dryness. Once Kidney Yin is deficient, Kidney Yang becomes hyperactive, presenting with bone-steaming, fever, hemoptysis, nocturnal emission, upper cough, or lower diarrhea. This is Kidney Qi failing to return to the Kidney. Treatment involves clearing-moistening and warm-moistening to increase Water and nourish Fire; sweet-moistening and sweet-neutral to consolidate the Spleen-Stomach within Water and Fire. Spleen Stomach deficiency causes Central Earth disease itself, due to overthinking or irregular eating, leading to Qi knotting transforming into dampness and Blood knotting transforming into dryness, dampness trapping Spleen Yang, and dryness injuring Spleen Yin. Stomach disease fails to scatter refined essence to the Spleen; Spleen disease fails to transport refined essence to the Lung. If Earthly Qi does not ascend, Heavenly Qi does not descend; this is Spleen-Stomach Qi failing to return to the Kidney. This cannot be handled by cold, hot, warm, or cool methods alone. The method is to treat dryness with dryness remedies and dampness with dampness remedies, using pure sweet flavors to support Earth and generate Metal, following their ascending and descending nature to receive them.
In summary, internal injury diseases originate either from congenital or acquired factors; originating from acquired factors, they inevitably affect the congenital. If one of the five viscera does not receive the generating Qi, form and Qi become diseased. Form disease harms Qi, and Qi disease harms form. This is an immutable principle. However, treatment must distinguish between root and branch, priority and sequence. Yin-Yang, Zang-Fu, and Qi-Blood may cause disease independently, sequentially, or shift from one to another. The method of medication: Fu organ diseases should be opened and unblocked, not treated with Zang herbs; Zang organ diseases should be tonified, not treated with Fu herbs. If Fu disease approaches Zang, treating Fu must consider Zang; if Zang disease enters Fu, treating Zang must manage Fu. When Fu enters Zang or Zang enters Fu, severity varies, and medication must adjust accordingly. Furthermore, if disease is in the Fu but originates in the Zang, focus on treating the Zang; if disease is in the Zang but originates in the Fu, focus on treating the Fu. Even if the disease is here, one need not treat here; treating here may worsen it. Even if the disease has left here, one must still consider here; ignoring here causes damage. This is the general principle of Yin-Yang, root-branch, priority, and severity.
Ultimately, Heaven, Earth, and humans are encompassed by the two Qi of Yin and Yang. Imbalance of Heavenly Yin-Yang is regulated by the Chancellor; imbalance of Human Yin-Yang is regulated by the Physician. A good Chancellor and a good Physician both aim to harmonize Yin and Yang, achieving equilibrium for both.