大凡物理有常有变，运气所主者，常也；异于所主者，皆变也。常则如本气，变则无所不至，而各有所占，故其候
有从逆淫郁胜复太过不及之变，其法皆不同。若厥阴用事，多风而草木荣茂，此之谓从。天气明洁，燥而无风，此之谓
逆。太虚埃昏，流水不冰，此之谓淫。大风折木，云物混扰，此之谓郁。山泽焦枯，草木凋落，此之谓胜。大暑燔燎，
螟蝗为灾，此之谓复。山崩地震，埃昏时作，此之谓太过。阴森无时，重云昼昏，此之谓不及。随其所变，疾疠应之，
皆视当时当处之候。虽数里之间，但气候不同，而所应全异，岂可胶于一定？
岁运有主气、有客气。常者为主，外至者为客。初之气厥阴，以至终之气太阳者，四时之常序也，故谓之主气。惟
客气本书不载其目，故说者多端，或以甲子之岁，天数始于水下一刻；乙丑之岁，始于二十六刻；丙寅岁始于五十一刻；
丁卯岁始于七十六刻者，谓之客气。此乃四分历法，求大寒之气，何与岁运。又有相火之下，水气乘之；土位之下，风
气乘之，谓之客气。此亦主气也，与六节相须，不得为客。凡所谓客者，岁半以前，天政主之；岁半以后，地政主之。
四时常气为之主，天地之政为之客，逆主之气为害暴，逆客之气为害徐。调其主客，无使伤 ，此治气之法也。（沈存
中）
少角之运，岁木不及，侮而乘之者金也。金不务德，故以燥胜风，时则有白露早降，收气率行。其变为肃杀，其灾
为苍陨，名为少角，而实与大商之岁同。少征之运，岁火不及，侮而乘之者水也。水不务德，故以寒胜热，时则有寒氛
凝惨，地积坚冰。其变为凛冽，其灾为霜雹，名为少征，而实与大羽之岁同。少宫之运，岁土不及，侮而乘之者木也。
木不务德，故以风胜湿，时则有大风飘暴，草偃沙飞，其变为张发，其灾为散落，名为少宫，而实与大角之岁同。少商
之运，岁金不及，侮而乘之者火也。火不务德，故以热胜燥，时则有火延焦槁，炎赫沸腾。其变为销铄，其灾为燔炳，
名为少商，而实与大征之岁同。少羽之运，岁水不及，侮而乘之者土也。土不务德，故以湿胜寒，时则有泉涌河衍，涸
泽生鱼。其变为骤注，其灾为霖溃，名为少羽，而实与大宫之岁同。通乎此，则知岁在涸流之纪，而河决大水，固可以
类而推之也。（刘温舒）
天地之间，气有偏胜，而无以救之，则万物之所存者几希矣！是故风热湿燥寒，五者各司一气，生长化收藏；五者
各司一时，以顺相乘，然后能循环以相生；以逆相胜，然后能循环以相救。故曰五气之运，犹权衡也，高者抑之，下者
视之，化者应之，胜者复之。化者应之，气之平也，五气之相得也；胜者复之，气之不平也，五气之相贼也；气平而相
得者，所以通其常；气不平而相贼者，所以观其变。古之明乎此而善摄生者，何尝不消息盈虚，以道御神耶？（刘温舒）
太阳司天之政，岁宜以苦燥之温之。阳明司天之政，岁宜以苦辛汗之清之散之，又宜以咸。少阳司天之政，岁宜以
咸宜辛宜酸，渗之泄之渍之发之，观气寒温，以调其气。太阴司天之政，岁宜以苦燥之温之，甚者发之泄之，不发不泄，
则湿气外溢，肉溃皮坼，而水血交流。少阴司天之政，岁宜咸以软之而调其上，甚则以苦发之，以酸收之而安其下，甚
则以苦泄之。厥阴司天之政，岁宜以辛调之，以酸润之。（纂经旨）
岁以阳为首，正正也，寅引也。少阳之气始于泉下，引阳升而在天地人之上，即天之分，五谷草木皆甲拆于此时也。
至立夏少阴之火，炽于太虚，则草木盛茂，垂枝布叶，乃阳之用阴之体，此所谓天以阳生阴长。《经》言岁半以前，天气
主之，在乎升浮也。至秋而太阴之运，初自天而下逐，阴降而彻地，则金振燥令，风厉霜飞，品物咸殒，其枝独在，若
乎毫毛。至冬则少阴之气，复伏于泉下，水冰地坼，万物周密，阴之用阳之体也，此所谓地以阳杀阴藏。《经》言岁半以
后，地气主之，在乎降沉也。饮食入胃，而精气先输脾归肺，上行春夏之令，以滋养周身，乃清气为天者也。升已而输
膀胱，行秋冬之令，为传化糟粕，转味而出，乃浊阴为地者也。若夫顺四时之气，起居有时，以避寒暑，饮食有节，及
不暴喜怒，以颐神志，常欲四时均平，而无偏胜则安。不然损伤脾胃，真气下溜，或下泄而久不能升，是有秋冬而无春
夏，乃生长之用，陷于陨杀之气，而百病皆起，或久升不降，亦病焉。（王安道）
《天元纪大论》等篇，以年岁之支干，分管六气，盖已失先圣之旨矣。年岁之支干，天下皆同，且通四时不变也。
天气之温暑寒凉，民病之虚实衰旺，东西南北之殊方，春夏秋冬之异候，岂有皆同之理？此其妄诞，盖不待深论而可知
也。近世伤寒论法，则以得病日之干支为主，其源亦出于此，决不可用。盖金木水火土之气，各主一时，当时则为主气，
为司天。非其时而有其气，则为客气。与时正相反者，则谓在泉，为其气伏于黄泉之下而不见也。治疗之法，用热远热，
用寒远寒，所谓必先岁气，毋伐天和也。春时木气司天，则四方皆温；夏时火气司天，则四方皆热；夏秋之交，土气司
天，则四方皆湿；秋则皆凉；冬则皆寒。民病往往因之，此则理之易见者也。其有气与时相反者，则所谓客气者也，故
治疗之法，亦有假者反之之说，观此则运气之说，思过半矣，（何柏斋）
足相火属胆。配肝，主血者也。手相火属三焦，配肾之命门，主精者也。肝与命门皆属风木，木中有火，则精血之
中有热气也。然精血体润，水也。火与水相守，故不发，至发而为热，则皆精血将枯之所致也，譬木枯则火易焚耳。故
相火发者难治，今虚劳骨蒸之病，皆相火发热之证也，小水不能减大火，法当补阴，则热自退。（何柏斋论丹溪相火主动
等误）
人之脏腑以脾胃为土，盖人之饮食，皆入于胃而运以脾，犹地之土也。然脾胃能化物与否，实由于水火二气，非脾
胃所能也。火盛则脾胃燥，水盛则脾胃湿，皆不能化物，乃生诸病水肿之证。盖水盛而火不能化也，火衰而不能化水，
故水之入于脾胃，皆渗入血脉骨肉，血亦化水，肉发肿胀，皆自然之理也。导其水，使水气少减；复补其火，使二气平
和，斯病去矣。丹溪谓脾失运化，由肝木侮脾，乃欲清心经之火，使肺金得令，以制肝木，则脾土全运化之职，水自顺
道，乃不为肿，其词迂而不切。（何柏斋）
夫阳常有余，阴常不足者，在天地则该乎万物而言，在人身则该乎一体而言，非直指气为阳而血为阴也。《经》曰∶
阳中有阴，阴中有阳。正所谓独阳不生，独阴不长是也，姑以治法兼证论之∶曰气虚者，气中之阴虚也，治法用四君子
汤，以补气中之阴。曰血虚者，血中之阴虚也，治法用四物汤，以补血中之阴。曰阳虚者，心经之元阳虚也，其病多恶
寒，责其无火，治法以补气药中，加乌附等药，甚者三建汤、正阳散之类。曰阴虚者，肾经之真阴虚也，其病多发热，
责其无水，治法以补血药中，加知母、黄柏等药，或大补阴丸、滋阴大补丸之类。夫真水衰极之候，切不可服乌附等补
阳之药，恐反助火邪而烁真阴。元阳虚甚之躯，亦不可投芎苓等辛散淡渗之剂，恐反开腠理而泄真气。昧者谓气虚即阳
虚，止可用四君子，断不可用芎辛之属。血虚即阴虚，止可用四物，决不可用参 之类，殊不知血脱益气，古圣人之法
也。血虚者，须以参 补之，阳生阴长之理也。惟真阴虚者将为劳极，参 固不可用，恐其不能抵当，而反益其病耳，
非血虚者之所忌也。如《明医杂着》谓血病治气，则血愈虚耗；又曰血虚误服参 等甘温之药，则病日增；服之过多，
则死不治，何其不达理耶？（虞天民）
西北二方，在人为肾水肺金所居之地，二藏常恐其不足。东南二方，在人为肝木心火所居之位，二藏常恐其有余。
《难经》曰∶东方实，西方虚，泻南方，补北方，即此之义也。夫肾水既实，则阴精时上奉于心肺，故东方之木气不实，
而西方之金气不虚，此子能令母实，使金得以平木也。是故水日以盛，而火日以亏，此阴精所奉于上，而令人寿延也。
若夫肾水一虚，则无以制南方之心火，故东方实而西方虚，其命门与胞络之相火，皆挟心火之势，而来侮所不胜之水，
使水日亏而火日盛，此阳精所降于下，故令人寿折也。（虞天民）
蔡西山《脉经》有《论三焦》一篇，后引《礼运记》曰∶上焦若窍，中焦若编，下焦若渎，然未曾发明其义。新安
孙景思氏，因推其义而解之曰∶上焦若窍，窍者窍漏之义，可以通达之物，必是胃之上脘。《经》曰∶上焦在胃之上口，
主纳而不出是也。中焦若编，编者编络之义，如有物编包之象，胃之外有脂如网，包罗在胃之上，以其能磨化饮食，故
《脉诀》云∶膏凝散半斤者此也，是必脾之大络，此为中焦，《经》曰∶主腐熟水谷是也。下焦若渎，渎者沟渎之义，可
以决渎，可以传导，乃是小肠之下曰阑门，泌别水谷，自此而厘清浊之所，此为下焦，《经》曰∶在膀胱上口主泻而不藏；
又曰∶主出而不纳；又曰，下焦为传化之府；又曰三焦为水谷之道路，气之所终始也。盖水谷之所入，自上而中，自中
而下。至于糟粕转输，传道而下，一无底滞如此，尤可表其为有形明矣。所谓形者，非谓脏腑外别生一物，不过指其所
而为形耳。按蔡西山据《礼运记》而言，《白虎通·性情篇》，沤亦作编，二说安得俱误？恐沤与编，殆相似而讹之耳。
（俞子容）
近时医者，多执前人肝常有余，肾常不足之说，往往举手便用平肝之剂。按《圣济经》云∶原四时之所化，始于木；
究十二经之所养，始于肝；女子受娠一月，是厥阴肝经养之，肝者乃春阳发动之始，万物生长之源，故戒怒养阳，使先
天之气，相生于无穷。所以肝主色，气和则体泽，气伤则枯槁，故养肝戒忿，是摄生之切要也，不可泥前说。（俞子容）
《甲乙经》曰∶丈夫以右为命门，左为肾；女子以左为命门，右为肾。无求子曰∶男子先生右肾，女子先生左肾，
是以命门为子宫，左肾为血海。张洁古云∶男女皆左为肾。右为命门。男子主藏精者，气海也。女子主系胞者，血海也。
所主者异，受病则一也，此说当为定论。（俞子容辨冲为血海）
虚者补之，实者泻之，虽三尺童子。皆知之矣。至于五实五虚，岂可与泛泛虚实同药哉？夫一身犹一国也，如寻邑
百万围昆阳，此五实证也，故萧王亲犯中坚而督战。如河内饥而又经火灾，此五虚证也，故汲黯不避矫诏而发仓。此可
与达权通变者论，不可与贪常嗜损者说也。夫五实为五脏俱太过，五虚为五脏俱不及，《内经》言此二证皆死，非谓必死
也，谓不救则死，救之不得其道亦死也。其下复言，浆粥入胃，则虚者活；身汗后利，则实者活，此两言自是前二证之
治法也。后人只以之断验死生，见虚者浆粥不入，实者汗利俱闭，便委之死地，岂不谬哉？夫浆粥入胃而不注泄，则胃
气和，胃气和，则五虚皆实也，是以生也。汗以泄其表，利以泄其里，并泄则上下通，上下通则五实皆启矣，是以生也。
（张子和）
虚损之微者，真火尚存，服寒凉药犹可。虚损之甚者，真火已亏，药以寒凉，岂能使之化为精血，以补其虚乎？
虚损之证，皆下寒上热，盖所谓水火不交者也。其重感于寒者，则下焦作痛，不感寒者则不痛，至于上焦燥热则一
也。上焦方苦烦热，得寒凉之药则暂快，遂以为药之功，故喜服之。不知寒凉之药，不久下注，则下元愈寒。火热为寒
所逼，上行则上焦复热愈甚，展转反复，遂至沉锢而不可救，是则以寒凉补阴，非徒无益而且有害，世人盖阴受其害而
不知也。治之补以寒凉，佐以温热，补三佐二，空心凉服，所谓热因寒用者也，久则精生热退，而病愈矣。（何柏斋）
《经》云∶阴虚生内热，奈何？曰∶有所劳倦，形气衰少，谷气不盛，上焦不行，下脘不通，胃气热，热气熏胸中，
故内热。嗟夫！此内伤之说之原乎。夫人身之阴阳，有以表里言者；有以上下之分言者；有以气血言者；有以身前身后
言者；有以脏腑言者；有以升降呼吸之气言者；余如动静语默起居之类甚多，不必悉举。此所谓阴虚之阴，其所指与数
者皆不同。盖劳动之过，则阳和之气，皆亢极而化为火矣，况水谷之气又少入，是故阳愈甚而阴愈衰矣。此阴虚之阴，
盖指身中之阴气与水谷之味耳，或以下焦阴阳为言，或以肾水真阴为言，皆非也。夫有所劳役者，过动属火也。形气衰
少者，壮火食气也。谷气不盛者，劳伤元气，则少食而气衰也。上焦不行者，清阳不升也。下脘不通者，浊阴不降也。
夫胃受水谷，故清阳升而浊阴降，以传化出入，滋荣一身也。今胃不能纳，而谷气衰少，则清无升而浊无降矣。故曰∶
大凡事物的规律有常态和变态之分，由岁运所主导的是常态；与岁运所主不同的，就是变态。常态时气候表现如本气（司天在泉之气）那样正常；变态则变化多端，且各有对应的征象，所以其气候候象有顺从、逆乱、过度、淫滥、郁结、胜复、太过、不及等变化，其治疗法则也各不相同。如果厥阴风木主事，风气盛行而草木繁茂，这叫做“从”。天气清明洁净，干燥而无风，这叫做“逆”。天空昏黄尘埃弥漫，流水不结冰，这叫做“淫”。大风折断树木，云物混乱扰攘，这叫做“郁”。山泽焦枯，草木凋谢零落，这叫做“胜”。酷热如火焚烧，螟蝗成灾，这叫做“复”。山崩地震，尘土飞扬昏暗不时出现，这叫做“太过”。阴森寒冷没有定时，厚重的云层使白天昏暗，这叫做“不及”。随着气候的变异，疫病随之产生，都要观察当时当地的气候候象。即使相隔数里之间，只要气候不同，所引发的疾病就完全不同，怎么能拘泥于固定的模式呢？
岁运有主气和客气之分。常规的是主气，外来的是客气。初之气为厥阴，直到终之气为太阳，这是四季的正常顺序，所以称为主气。只有客气本书没有列出其条目，所以解说者说法众多，有的人认为甲子年，天数始于水下一刻；乙丑年，始于第二十六刻；丙寅年，始于第五十一刻；丁卯年，始于第七十六刻的，称为客气。这是四分历法，推算大寒节气的气运，这与岁运有什么关系呢？又有说法认为，相火之下，被水气乘袭；土位之下，被风气乘袭，称为客气。这也是主气，与六节相应，不能称为客。凡是所谓的客，指岁半以前，由天政（司天之气）主导；岁半以后，由地政（在泉之气）主导。四时的常气是主，天地之政是客，违背主气致病暴急，违背客气致病缓慢。调和主客之气，不要使其造成伤害，这是治气的法则。（沈括）
少角运，即岁木不及，被金侮而乘之。金不施恩德，所以以燥胜风，此时会有白露早降，收敛之气盛行。其变化为肃杀，其灾害为草木苍老陨落，名为少角，实际上与大商（金运太过）之年相同。少征运，即岁火不及，被水侮而乘之。水不施恩德，所以以寒胜热，此时会有寒气凝滞凄惨，地面堆积坚冰。其变化为凛冽，其灾害为霜雹，名为少征，实际上与大羽（水运太过）之年相同。少宫运，即岁土不及，被木侮而乘之。木不施恩德，所以以风胜湿，此时会有大风飘暴，草倒沙飞，其变化为张发（风势张扬），其灾害为散落，名为少宫，实际上与大角（木运太过）之年相同。少商运，即岁金不及，被火侮而乘之。火不施恩德，所以以热胜燥，此时会有火势蔓延焦枯，炎热沸腾。其变化为销铄，其灾害为燃烧，名为少商，实际上与大征（火运太过）之年相同。少羽运，即岁水不及，被土侮而乘之。土不施恩德，所以以湿胜寒，此时会有泉水涌出河流泛滥，干涸的沼泽生出鱼来。其变化为骤雨倾注，其灾害为霖雨溃决，名为少羽，实际上与大宫（土运太过）之年相同。通晓这些道理，就知道岁运处于涸流之纪（水运不及）时，河决大水，自然可以类推了。（刘温舒）
天地之间，气有偏胜，如果没有办法补救，那么万物能存活的就很少了！所以风、热、湿、燥、寒，这五种气各自主管一种气化功能，负责生长化收藏；这五种气各自主管一个时节，顺着次序相生，然后才能循环相生；逆着次序相克，然后才能循环相救。所以说五气的运行，就像秤锤一样，高的地方压制它，低的地方抬起它，化生之气应和它，胜复之气回应它。化生之气应和，是气的平衡，是五气相得；胜复之气回应，是气的不平衡，是五气相贼；气平衡而相得，是用来通达常态；气不平衡而相贼，是用来观察变态。古代通晓此理并善于养生的人，何尝不是通过消长盈虚的道理来驾驭精神呢？（刘温舒）
太阳司天之政，这一年适宜用苦味燥湿，用温性药物。阳明司天之政，这一年适宜用苦辛发汗，用清散之法，又适宜用咸味。少阳司天之政，这一年适宜用咸、辛、酸味，渗利、泄下、浸渍、发汗，观察气的寒温，以调畅其气。太阴司天之政，这一年适宜用苦味燥湿，用温性药物，严重的用发汗或泄下法，如果不发汗不泄下，湿气就会外溢，肌肉溃烂皮肤破裂，水和血交流混杂。少阴司天之政，这一年适宜用咸味软坚，调理上部，严重的用苦味发越，用酸味收敛，安固下部，严重的用苦味泄下。厥阴司天之政，这一年适宜用辛味调畅，用酸味滋润。（《纂经旨》）
岁以阳为首，正是阳气发动，寅字意为引伸。少阳之气始于地下，引导阳气上升而在天地人之上，这就是天的分野，五谷草木都在此时破壳发芽。到了立夏，少阴之火炽盛于天空，草木茂盛，垂枝展叶，这是阳的作用、阴的形体，这就是所谓“天以阳生阴长”。《内经》说岁半以前，天气主导，在于升浮。到了秋天，太阴的运化，起初从天向下追逐，阴气下降彻入大地，于是金气振作燥令，风厉霜飞，万物凋零，只剩下树枝，好像毫毛一样。到了冬天，少阴之气，又潜伏于地下，水结冰地裂开，万物周密闭藏，这是阴的作用、阳的形体，这就是所谓“地以阳杀阴藏”。《内经》说岁半以后，地气主导，在于降沉。饮食进入胃中，精气先输送给脾归并于肺，上行顺应春夏的命令，以滋养周身，这就是清气属于天。升发之后输送到膀胱，下行顺应秋冬的命令，作为传化糟粕，转化味道而出，这就是浊阴属于地。如果顺应四时之气，起居有定时，以避开寒暑，饮食有节制，以及不暴怒喜怒，以颐养神志，常常希望四时均衡平和，而没有偏胜就能安康。不然损伤脾胃，真气下溜，或者下泄而不能久升，这就只有秋冬而没有春夏，使得生长的作用，陷于陨杀之气，百病都由此而起，或者久升不降，也会生病。（王安道）
《天元纪大论》等篇，用年岁的支干来分管六气，大概已经失去了先圣的本意了。年岁的支干，天下都是一样的，并且贯通四季不变。天气的温暑寒凉，民众疾病的虚实衰旺，东西南北不同地域的差异，春夏秋冬不同季节的候象，难道有全都相同的道理吗？这种荒诞不经的说法，不用深入论述就可以知道。近世讨论伤寒的方法，则以得病那天的干支为主，其源头也出于此，绝对不可用。因为金木水火土之气，各自主管一时，正当其时就是主气，就是司天。非其时而出现其气，就是客气。与时令完全相反的，就称为在泉，因为其气潜伏在黄泉之下而不显现。治疗的法则，用热药要避开热时，用寒药要避开寒时，这就是所说的必须首先了解岁气，不要破坏天和。春季木气司天，则四方皆温；夏季火气司天，则四方皆热；夏秋之交，土气司天，则四方皆湿；秋季则皆凉；冬季则皆寒。民众的疾病往往因此产生，这是容易看到的道理。如果有气与时令相反的，就是所谓的客气，所以治疗的法则，也有针对假象反其道而行之的说法，看了这些，对运气学说的理解就超过一半了。（何柏斋）
足部相火属于胆。配合肝，肝是主管血的。手部相火属于三焦，配合肾之命门，是主管精的。肝与命门都属于风木，木中有火，那么精血之中就有热气了。然而精血体润，属水。火与水相守，所以不发作，等到发作成为热证，都是精血将枯竭所致，比如木头干枯则火容易燃烧。所以相火发作难以治疗，现在的虚劳骨蒸病，都是相火发热之证，小水（小便）不能减大火，治法应当补阴，热自然消退。（何柏斋论丹溪相火主动等误）
人的脏腑以脾胃为土，大概人的饮食，都进入胃而由脾运化，就像地上的土一样。然而脾胃能否消化食物，实际上取决于水火二气，不是脾胃本身能决定的。火盛则脾胃燥，水盛则脾胃湿，都不能消化食物，乃产生各种水肿之证。大概是水盛而火不能化，火衰而不能化水，所以水进入脾胃，都渗入血脉骨肉，血也化为水，肉发生肿胀，这都是自然的道理。疏导其水，使水气稍微减少；再补其火，使二气平和，病就好了。朱丹溪说脾失运化，是由于肝木侮脾，于是想清心经之火，使肺金得令，以制约肝木，那么脾土全权行使运化职能，水自然顺道而行，就不为肿，他的言辞迂腐而不切实际。（何柏斋）
所谓“阳常有余，阴常不足”，在天地而言包括万物，在人身而言包括一体，并不是直接指气为阳而血为阴。《内经》说：阳中有阴，阴中有阳。这正是所谓独阳不生，独阴不长的意思，姑且结合治法和证候来讨论：说气虚的，是气中的阴虚，治法用四君子汤，以补气中的阴。说血虚的，是血中的阴虚，治法用四物汤，以补血中的阴。说阳虚的，是心经的元阳虚，其病多怕冷，责之于无火，治法在补气药中，加入乌头、附子等药，严重的用三建汤、正阳散之类。说阴虚的，是肾经的真阴虚，其病多发热，责之于无水，治法在补血药中，加入知母、黄柏等药，或大补阴丸、滋阴大补丸之类。真水衰竭至极的时候，切不可服用乌头、附子等补阳的药，恐怕反而助长火邪而灼烧真阴。元阳极度虚弱的身躯，也不可投用川芎、茯苓等辛散淡渗的药剂，恐怕反而打开腠理而泄漏真气。愚昧的人认为气虚就是阳虚，只可用四君子汤，断不可用川芎、辛夷之类。血虚就是阴虚，只可用四物汤，决不可用人参之类，殊不知血脱益气的古圣人之法。血虚者，须用人参补之，这是阳生阴长的道理。只有真阴虚者将要发展为劳极，人参固然不可用，恐怕不能抵挡，反而加重病情罢了，这不是血虚者的禁忌。如《明医杂著》说血病治气，则血更虚耗；又说血虚误服人参等甘温的药，则病日益增加；服用过多，则死不治，多么不通达事理啊！（虞天民）
西北二方，在人体是肾水、肺金所居之地，这两脏常担心其不足。东南二方，在人体是肝木、心火所居之位，这两脏常担心其有余。《难经》说：东方实，西方虚，泻南方，补北方，就是这个意思。既然肾水充实，那么阴精时常上奉于心肺，所以东方的木气不实，而西方的金气不虚，这是子能令母实，使金得以平抑木。所以水日渐旺盛，而火日渐亏损，这是因为阴精上奉，从而使人寿命延长。如果肾水一虚，就不能制约南方的心火，所以东方实而西方虚，其命门与胞络的相火，都挟带心火的势头，来侮弄所不胜的水，使水日渐亏损而火日渐旺盛，这是阳精下降于下，所以使人寿命折损。（虞天民）
蔡西山《脉经》中有《论三焦》一篇，后引用《礼运记》说：上焦若窍，中焦若编，下焦若渎，然而未曾阐明其义。新安孙景思氏，因此推究其义并解释它说：上焦若窍，窍是漏孔的意思，可以通达之物，必定是胃的上脘。《内经》说：上焦在胃之上口，主纳而不出，就是这样。中焦若编，编是编络的意思，如有物体编织包裹之象，胃的外面有脂肪像网一样，包罗在胃的上面，因为它能磨化饮食，所以《脉诀》说：膏凝散半斤的就是这个，必定是脾的大络，这就是中焦，《内经》说：主腐熟水谷，就是这样。下焦若渎，渎是沟渠的意思，可以决渎，可以传导，乃是小肠之下曰阑门，泌别水谷，从这里厘分清浊的地方，这就是下焦，《内经》说：在膀胱上口主泻而不藏；又说：主出而不纳；又说，下焦为传化之府；又说三焦为水谷的道路，气之所终始。大概水谷的摄入，自上而中，自中而下。至于糟粕转输，传道而下，一无底滞如此，尤其可以表明其为有形之物是很明显的了。所谓形，不是说脏腑之外另外生出一个物体，不过是指其所处位置而为形罢了。按蔡西山依据《礼运记》来说，《白虎通·性情篇》，沤也写作编，两种说法怎么能都错呢？恐怕沤与编，大概相似而讹误罢了。（俞子容）
近时的医生，多固执前人“肝常有余，肾常不足”的说法，往往举手便用平肝的药剂。查考《圣济经》说：推究四季的化生，始于木；探究十二经的滋养，始于肝；女子受孕一月，是厥阴肝经滋养，肝是春阳发动的开始，万物生长的源泉，所以戒怒养阳，使先天之气，相生于无穷。所以肝主色，气和则身体润泽，气伤则枯槁，所以养肝戒忿，是摄生的切要之处，不可拘泥于前人的说法。（俞子容）
《甲乙经》说：男子以右为命门，左为肾；女子以左为命门，右为肾。无求子说：男子先生右肾，女子先生左肾，是以命门为子宫，左肾为血海。张洁古说：男女皆左为肾，右为命门。男子主藏精的是气海。女子主系胞的是血海。所主的职能不同，受病的机理则一样，这种说法应当定为定论。（俞子容辨冲为血海）
虚证用补法，实证用泻法，即使是三岁小孩也知道。至于五实五虚，怎么能与普通泛泛的虚实同药治疗呢？全身犹如一个国家，如王寻率领百万大军包围昆阳，这是五实证，所以萧王（刘秀）亲自冲击中坚督战。如河内饥荒又经过火灾，这是五虚证，所以汲黯不避违抗诏书之罪而开仓放粮。这可以与懂得变通的人谈论，不可以与贪恋常规、嗜好损害的人说。五实是五脏都太过，五虚是五脏都不及，《内经》说这两种证候都死，不是说必然死，是说如果不救治则死，救治不得其道也会死。下面又说，浆粥进入胃中，则虚证可活；身体出汗后大便通利，则实证可活，这两句话自然是前两种证候的治法。后人只用它来判断生死，见虚者浆粥不入，实者汗利俱闭，就放弃他们任其死亡，岂不荒谬吗？浆粥进入胃中而不注泄，则胃气和平，胃气和平，则五虚都变为实，所以能生。发汗以泄其表，泄下以泄其里，表里双泄则上下通畅，上下通畅则五实都开启，所以能生。（张子和）
虚损轻微的，真火尚存，服用寒凉药还可以。虚损严重的，真火已亏，药性寒凉，怎么能使之化为精血，以补其虚呢？虚损之证，都是下寒上热，也就是所谓水火不交。其重感于寒的，则下焦作痛，不感寒的则不痛，至于上焦燥热则是一样的。上焦正苦烦热，得到寒凉药则暂时爽快，于是认为是药的功劳，所以喜欢服用。不知道寒凉药，不久下注，则下元更寒。火热被寒所逼，上行则上焦复热更甚，辗转反复，遂至沉锢而不可救，这是以寒凉补阴，不仅无益而且有害，世人大概暗中受害而不知道。治疗时用寒凉补阴，佐以温热，补三佐二，空心凉服，这就是所谓热因寒用，久了则精生热退，病就好了。（何柏斋）
《内经》说：阴虚生内热，为什么呢？回答说：有所劳倦，形体正气衰少，谷气不盛，上焦不通行，下脘不通畅，胃气热，热气熏蒸胸中，所以内热。唉！这是内伤学说的起源吧！人身之阴阳，有以表里说的；有以上下分的；有以气血说的；有以身前身后分的；有以脏腑说的；有以升降呼吸之气说的；其余如动静语默起居之类很多，不必全部列举。这所谓阴虚之阴，其所指的与上述几种都不同。大概是劳动过度，则阳和之气，都亢极而化为火矣，何况水谷之气又少摄入，所以阳更盛而阴更衰了。这阴虚之阴，大概是指身中之阴气与水谷之味罢了，或以下焦阴阳来说，或以肾水真阴来说，都不对。有所劳役的，过动属火。形体正气衰少的，壮火食气。谷气不盛的，劳伤元气，则少食而气衰。上焦不行的，清阳不升。下脘不通的，浊阴不降。胃受纳水谷，所以清阳升而浊阴降，以传化出入，滋荣一身。现在胃不能纳，而谷气衰少，则清无升而浊无降。所以说：
Generally, the laws of things have both constant and variable aspects. What is governed by the annual climate (Yunqi) is constant; what differs from what is governed is variable. When constant, it manifests like the original Qi (the dominant Qi of the year); when variable, changes occur everywhere, each with its specific manifestation. Therefore, climatic signs may vary in accordance, opposition, excess, pervasion, stagnation, counteraction, superabundance, or deficiency, and their treatment methods differ accordingly. If Jueyin Wind-Wood governs, wind prevails and plants flourish; this is called "accordance" (Cong). The weather is clear and clean, dry without wind; this is called "opposition" (Ni). The sky is hazy with dust, flowing water does not freeze; this is called "pervasion" (Yin). Strong winds break trees, clouds and objects are chaotic; this is called "stagnation" (Yu). Mountains and marshes are scorched and dry, plants wither and fall; this is called "superiority" (Sheng). Extreme heat burns like fire, locusts cause disaster; this is called "counteraction" (Fu). Earthquakes and landslides occur, dust rises and darkens intermittently; this is called "superabundance" (Taiguo). It is gloomily cold at any time, heavy clouds darken the day; this is called "deficiency" (Bují). Following these variations, epidemics respond, all depending on observing the local and timely climatic conditions. Even within a few li, if the climate differs, the resulting diseases will be entirely different. How can one adhere rigidly to fixed rules?
Annual climate involves Main Qi (Zhǔqì) and Guest Qi (Kèqì). The regular aspect is Main Qi; the external arrival is Guest Qi. From the First Qi (Jueyin) to the Final Qi (Taiyang), this is the normal sequence of the four seasons, hence called Main Qi. The book does not list the items for Guest Qi, so commentators have various views. Some say that in the Jiazi year, the heavenly number starts at the first ke (quarter-hour) of water; in the Yichou year, it starts at the 26th ke; in the Bingyin year, at the 51st ke; in the Dingmao year, at the 76th ke; this is called Guest Qi. This is the Quarter-Part Calendar method for calculating the Qi of Major Cold, which has nothing to do with Annual Climate. Others say that below Xianghuo (Ministerial Fire), Shuiqi (Water Qi) takes advantage; below the position of Tu (Earth), Fengqi (Wind Qi) takes advantage; this is called Guest Qi. This is also Main Qi, corresponding to the Six Sections, and cannot be called Guest. Whatever is called Guest refers to: before the middle of the year, Tianzheng (Heavenly Government/Si Tian) governs; after the middle of the year, Dizheng (Earthly Government/Zai Quan) governs. The constant Qi of the four seasons is Master; the governance of Heaven and Earth is Guest. Violating the Master's Qi causes violent harm; violating the Guest's Qi causes slow harm. Harmonizing Master and Guest Qi, preventing injury, is the method of treating Qi. (Shen Kuo)
Shaojiao (Lesser Horn/Wood) operation indicates Wood Deficiency of the year, bullied and attacked by Metal. Metal fails to exert virtue, thus Dryness overcomes Wind. At this time, White Dew falls early, and the Qi of Harvest proceeds. Its variation is solemn killing; its disaster is the withering of greenery. Named Shaojiao, it is actually the same as a year of Da Shang (Great Metal/Excess Metal). Shaozheng (Lesser Note/Fire) operation indicates Fire Deficiency of the year, bullied and attacked by Water. Water fails to exert virtue, thus Cold overcomes Heat. At this time, cold mist condenses miserably, and the ground accumulates hard ice. Its variation is biting cold; its disaster is frost and hail. Named Shaozheng, it is actually the same as a year of Dayu (Great Water/Excess Water). Shaogong (Lesser Center/Earth) operation indicates Earth Deficiency of the year, bullied and attacked by Wood. Wood fails to exert virtue, thus Wind overcomes Dampness. At this time, there are violent gusts, grass bends, and sand flies. Its variation is expansion and eruption; its disaster is scattering. Named Shaogong, it is actually the same as a year of Dajiao (Great Wood/Excess Wood). Shaoshang (Lesser Market/Metal) operation indicates Metal Deficiency of the year, bullied and attacked by Fire. Fire fails to exert virtue, thus Heat overcomes Dryness. At this time, fire spreads causing scorching and drying, intense heat boils. Its variation is melting and dissolving; its disaster is burning. Named Shaoshang, it is actually the same as a year of Dazheng (Great Fire/Excess Fire). Shaoyu (Lesser Pitch/Water) operation indicates Water Deficiency of the year, bullied and attacked by Earth. Earth fails to exert virtue, thus Dampness overcomes Cold. At this time, springs surge and rivers overflow, dried marshes produce fish. Its variation is sudden pouring rain; its disaster is inundation. Named Shaoyu, it is actually the same as a year of Dagong (Great Earth/Excess Earth). Understanding this, one knows that in the year of Heliu Ji (Dried Stream Era/Water Deficiency), where rivers burst and great waters flood, one can deduce by analogy. (Liu Wenshu)
Between Heaven and Earth, Qi has partial excess, but if there is no way to remedy it, the survival of all things would be slim! Therefore, Wind, Heat, Dampness, Dryness, and Cold—the five—each govern one Qi, responsible for Growth, Flourishing, Transformation, Harvest, and Storage. Each governs one season; following the order allows them to generate each other in a cycle; opposing the order allows them to overcome each other in a cycle to rescue balance. Thus, it is said that the movement of the Five Qi is like a balance scale: high points are suppressed, low points are lifted, transforming Qi responds, overcoming Qi counters. Transforming Qi responding indicates Qi equilibrium and harmony among the Five Qi; Overcoming Qi countering indicates Qi imbalance and mutual destruction among the Five Qi. Equilibrium and harmony allow passage through constancy; Imbalance and destruction allow observation of variability. Did ancient masters who understood this and were good at preserving life not adjust to waxing and waning, governing spirit with Dao? (Liu Wenshu)
When Taiyang governs the Heaven (Si Tian), the year should use Bitter to dry and Warm to warm. When Yangming governs the Heaven, the year should use Bitter and Acrid to induce sweating, Clear and Disperse, and also use Salty. When Shaoyang governs the Heaven, the year should use Salty, Acrid, and Sour,渗利 (percolate/drain), purge, soak, and sweat, observing the cold and warmth of Qi to regulate it. When Taiyin governs the Heaven, the year should use Bitter to dry and Warm to warm; severe cases require sweating or purging. If not sweated or purged, Dampness overflows externally, muscles ulcerate, skin splits, and water and blood mix. When Shaoyin governs the Heaven, the year should use Salty to soften and regulate the upper part; severe cases use Bitter to vent, Sour to astringe and secure the lower part; very severe cases use Bitter to purge. When Jueyin governs the Heaven, the year should use Acrid to regulate and Sour to moisten. (Zuan Jing Zhi)
The year begins with Yang, which is correct and upright; Yin leads. Shaoyang Qi begins underground, leading Yang to rise above Heaven, Earth, and Man, which is the domain of Heaven. Grains and plants sprout at this time. By Lixia (Start of Summer), Shaoyin Fire blazes in the vast sky, plants flourish, branches hang, leaves spread. This is Yang's function and Yin's form, known as "Heaven generates by Yang, grows by Yin." The Classic says: Before mid-year, Heavenly Qi governs, focusing on ascending and floating. In autumn, Taiyin's operation descends from heaven, Yin sinks to penetrate earth. Metal振 (rings out) the Dry command, wind sharpens, frost flies, all things perish, only branches remain like hairs. In winter, Shaoyin Qi returns to hide underground, water freezes, earth cracks, all things are dense and hidden. This is Yin's function and Yang's form, known as "Earth kills by Yang, stores by Yin." The Classic says: After mid-year, Earthly Qi governs, focusing on descending and sinking. Food enters the stomach, essence is first transported to Spleen and returned to Lung, ascending to follow the commands of Spring and Summer, nourishing the whole body. This is Clear Yin belonging to Heaven. After ascending, it transports to Bladder, descending to follow the commands of Autumn and Winter, transmitting and transforming dregs, changing flavor and exiting. This is Turbid Yin belonging to Earth. If one follows the Qi of the four seasons, rests regularly, avoids cold and heat, eats moderately, and controls anger and joy to nurture spirit and will, maintaining balance without excess, one remains safe. Otherwise, Spleen and Stomach are damaged, True Qi flows downward, or leaks down and cannot ascend for long. This results in having only Autumn and Winter, lacking Spring and Summer. The function of growth falls into the Qi of destruction, and all diseases arise. Or if ascending for too long without descending, disease also occurs. (Wang Andao)
Chapters like *Tianyuanji Dalun* assign the six Qi to the earthly branches and heavenly stems of the year, which seems to have lost the intent of the sages. The earthly branches and heavenly stems are the same throughout the world and unchanged across the four seasons. The temperature of the weather (warm, hot, cold, cool), the deficiency or excess of people's diseases, the differences between east, west, south, and north, and the varying conditions of spring, summer, autumn, and winter—how could they all be the same? This absurdity is obvious without deep discussion. Recent methods for discussing Cold Damage focus on the stem and branch of the day the illness began, originating from this, and must not be used. The Qi of Metal, Wood, Water, Fire, and Earth each govern a specific time. When it is the proper time, it is Main Qi and Si Tian. When it appears out of season, it is Guest Qi. When it is exactly opposite to the season, it is called Zai Quan (In Spring), because its Qi hides under the yellow springs and is not seen. Treatment principles: Use Hot remedies avoiding Hot times; use Cold remedies avoiding Cold times. This is "First know the annual Qi, do not violate Harmony of Heaven." In Spring, Wood Qi governs Heaven, so all directions are warm. In Summer, Fire Qi governs Heaven, so all directions are hot. At the transition of Summer and Autumn, Earth Qi governs Heaven, so all directions are damp. In Autumn, all are cool. In Winter, all are cold. People's diseases often follow this, an easily observable principle. If Qi opposes the season, it is Guest Qi. Thus, treatment principles include reversing false appearances. Understanding this, one grasps more than half of the theory of Yunqi. (He Bozhai)
Foot Ministerial Fire belongs to Gallbladder. Paired with Liver, which governs Blood. Hand Ministerial Fire belongs to Sanjiao, paired with Mingmen of Kidney, which governs Essence. Liver and Mingmen both belong to Wind-Wood. Wood contains Fire, so there is hot Qi within Essence and Blood. However, Essence and Blood are moist and belong to Water. Fire and Water guard each other, so they do not flare up. When they flare up as heat, it is caused by the depletion of Essence and Blood, like dry wood catching fire easily. Therefore, flaring of Ministerial Fire is difficult to treat. Diseases like consumptive fever with bone-steaming are manifestations of Ministerial Fire heat. Small urine (urination) cannot reduce Great Fire; the method should be to tonify Yin, then heat recedes naturally. (He Bozhai on Danxi's errors regarding Ministerial Fire moving)
Human organs consider Spleen and Stomach as Earth. Human food enters the Stomach and is transported by the Spleen, just like soil on earth. However, whether Spleen and Stomach can transform substances depends on Fire and Water Qi, not merely Spleen and Stomach itself. Excess Fire makes Spleen and Stomach dry; Excess Water makes them damp. Neither can transform substances, leading to various edema syndromes. Essentially, Water is excessive and Fire cannot transform it; Fire is weak and cannot transform Water. Thus, water entering Spleen and Stomax infiltrates blood vessels and bones, blood transforms into water, and flesh swells. This is natural logic. Guide the water to reduce its Qi slightly; then tonify Fire to balance the two Qi, and the disease will go. Danxi said Spleen loss of transformation is due to Liver Wood bullying Spleen, so he wanted to clear Heart Fire, let Lung Metal take command, control Liver Wood, so Spleen Earth fully performs transformation, Water flows smoothly, and swelling does not occur. His words are pedantic and impractical. (He Bozhai)
"The Yang is often in excess, Yin is often deficient" applies to all things in Heaven and Earth, and to the whole body in humans. It does not directly mean Qi is Yang and Blood is Yin. The Classic says: Yang contains Yin, Yin contains Yang. This means alone Yang does not generate, alone Yin does not grow. Let us discuss via treatment and symptoms: Saying Qi Deficiency is Yin Deficiency within Qi; treatment uses Sijunzi Tang to tonify Yin within Qi. Saying Blood Deficiency is Yin Deficiency within Blood; treatment uses Siwu Tang to tonify Yin within Blood. Saying Yang Deficiency is Yuan Yang Deficiency of Heart Meridian; symptoms often include aversion to cold, blamed on lack of Fire. Treatment adds Aconite and similar drugs to Qi-tonifying medicines; severe cases use Sanjian Tang or Zhengyang San. Saying Yin Deficiency is True Yin Deficiency of Kidney Meridian; symptoms often include fever, blamed on lack of Water. Treatment adds Anemarrhena and Phellodendron to Blood-tonifying medicines, or Dabu Yin Wan or Ziyin Dabu Wan. When True Water is extremely depleted, one must absolutely not take Aconite or similar Yang-tonifying drugs, lest they assist Fire Evil and scorch True Yin. For bodies with extreme Yuan Yang Deficiency, one must not administer Xiong (Chuanxiong) or Ling (Poria) etc., acrid-dispersing and bland-leaching agents, lest they open pores and leak True Qi. Ignorant people think Qi Deficiency is Yang Deficiency, usable only with Sijunzi, never with Chuanxiong or Acrid types. Blood Deficiency is Yin Deficiency, usable only with Siwu, never with Ginseng etc. They do not know that "Tonifying Qi for Blood Loss" is the method of ancient sages. For Blood Deficiency, Ginseng must be used, based on the principle that Yang generation promotes Yin growth. Only for True Yin Deficiency progressing to extreme exhaustion is Ginseng inadvisable, fearing it cannot withstand and may worsen the condition; this is not a contraindication for general Blood Deficiency. As *Mingyi Zazhu* claims treating Qi for Blood disease makes Blood more deficient; or taking sweet-warm drugs like Ginseng for Blood Deficiency increases disease daily; taking too much leads to untreatable death—how ignorant of reason! (Yu Tianmin)
The Northwest two regions are where Kidney Water and Lung Metal reside in humans; these two organs often fear deficiency. The Southeast two regions are where Liver Wood and Heart Fire reside; these two organs often fear excess. *Nan Jing* says: East Excess, West Deficiency, Drain South, Tonify North. This is the meaning. Since Kidney Water is solid, Yin Essence constantly offers up to Heart and Lung, so Eastern Wood Qi is not excessive, and Western Metal Qi is not deficient. This is "Child makes Mother solid," allowing Metal to calm Wood. Thus, Water grows daily, Fire declines daily. This is Yin Essence offering upward, leading to longevity. If Kidney Water becomes deficient, it cannot control Southern Heart Fire, so East is Excess and West is Deficient. The Ministerial Fire of Mingmen and Bao Luo (Uterus/Lining) joins Heart Fire's momentum to bully the unconquerable Water, making Water decline daily and Fire grow daily. This is Yang Essence descending downward, leading to shortened lifespan. (Yu Tianmin)
Cai Xishan's *Mai Jing* has an article "On Sanjiao," later citing *Li Yun Ji*: "Upper Jiao is like a hole, Middle Jiao is like weaving, Lower Jiao is like a ditch." However, he did not explain the meaning. Sun Jingsi of Xin'an inferred and explained: Upper Jiao like a hole—hole means leakage/passageway, something that can communicate must be the Upper Wan of Stomach. *Classic* says: Upper Jiao is above the mouth of Stomach, governs intake but not output. Middle Jiao like weaving—weaving means network. Like something woven around, outside Stomach is fat like a net wrapping above Stomach, because it grinds and transforms food. *Mai Jue* says: "Gao Ning San Ban Jin" refers to this. It must be the Large Collateral of Spleen, which is Middle Jiao. *Classic* says: Governs rotting and ripening of water and grain. Lower Jiao like a ditch—ditch means canal, can drain and conduct. It is Lanmen below Small Intestine, separating water and grain, clarifying turbid here. This is Lower Jiao. *Classic* says: Above bladder opening, governs excretion not storage; also: Governs exit not intake; also: Lower Jiao is Fu of transmission; also: Sanjiao is the path of water and grain, where Qi ends and begins. Food enters from top to middle, middle to bottom. Waste transfers and transmits downward without obstruction. This clearly shows it is tangible. "Form" does not mean an extra object outside organs, but pointing to its location as form. Cai Xishan relied on *Li Yun Ji*. *Baihu Tong · Xingqing Pian* writes "Ou" also as "Bian". How can both be wrong? Probably "Ou" and "Bian" are similar and corrupted. (Yu Zirong)
Recent doctors often stick to the previous saying "Liver often Excess, Kidney often Deficient," using Liver-calming formulas immediately. Checking *Shengji Jing*: Origin of four seasons' transformation starts with Wood; investigation of twelve meridians' nourishment starts with Liver; when a woman conceives for one month, Jueyin Liver Meridian nourishes it. Liver is the start of Spring Yang activation, source of all things' growth. So, guard against anger to nurture Yang, letting Pre-heaven Qi generate infinitely. Thus, Liver governs color; Qi harmonious means luster, Qi injured means withered. Nurturing Liver and guarding against resentment is crucial for health preservation. Do not stick to the old saying. (Yu Zirong)
*Jia Yi Jing* says: Men take Right as Mingmen, Left as Kidney; Women take Left as Mingmen, Right as Kidney. Wuqiuzi says: Men are born with Right Kidney first, Women with Left Kidney first. Thus, Mingmen is Uterus, Left Kidney is Sea of Blood. Zhang Jiegu says: Both men and women take Left as Kidney, Right as Mingmen. Men govern storing Essence via Qi Sea. Women govern connecting Uterus via Sea of Blood. Their functions differ, but pathology is the same. This view should be definitive. (Yu Zirong on Chong being Sea of Blood)
Deficiency is tonified, Excess is drained. Even a three-year-old child knows this. But how can Wushi (Five Excess) and Wuxu (Five Deficiency) be treated with ordinary deficiency/excess herbs? The whole body is like a state. Like Wang Xun besieging Kunyang with a million troops—this is Wushi syndrome. Thus, King Xiao (Liu Xiu) personally charged the center. Like Hene suffering famine and fire—this is Wuxu syndrome. Thus, Ji An defied imperial decree to open granaries. This can be discussed with those who understand flexibility, not with those clinging to routine and harming themselves. Wushi is Five Zang all excessive; Wuxu is Five Zang all deficient. *Neijing* says both die, not meaning inevitably die, but if not saved, they die; if saved improperly, they also die. It further says: If porridge enters Stomach, Deficiency lives; if body sweats and bowels move, Excess lives. These two statements are the treatment for the previous two syndromes. Later generations only use them to judge life and death. Seeing Deficiency patients unable to take porridge, or Excess patients with closed sweat and bowels, they abandon them to death. Is this not absurd? If porridge enters Stomach without leaking, Stomach Qi is harmonious. Harmonious Stomach Qi makes Wuxu become Shi (Excess/Strength), so they live. Sweating drains Exterior; purging drains Interior. Draining both opens Upper and Lower. Open Upper and Lower, and Wushi opens, so they live. (Zhang Zihe)
Slight deficiency damage: True Fire still exists, cold-cooling drugs are acceptable. Severe deficiency damage: True Fire is depleted. Can cold-cooling drugs transform into Essence and Blood to tonify deficiency? Deficiency damage syndromes are always Cold below and Heat above, i.e., Water and Fire not interacting. Those severely affected by Cold have Lower Jiao pain; those not affected by Cold do not. But Upper Jiao dry-heat is the same. Upper Jiao suffers烦热 (irritating heat); getting cold drugs brings temporary relief, so they think it is the drug's merit and like taking them. They do not know cold drugs eventually sink downward, making Lower Yuan colder. Fire/Heat, forced by Cold, ascends, making Upper Jiao heat worse. Cycle repeats until entrenched and incurable. Thus, using cold to tonify Yin is not only useless but harmful. People suffer secretly without knowing. Treatment: Tonify with cold, assist with warm. Three parts tonify, two parts assist. Take empty stomach, cool. This is "Hot due to Cold use." Long term, Essence generates, heat retreats, disease cures. (He Bozhai)
*Classic* says: Yin Deficiency generates internal heat. Why? Answer: Due to fatigue, Form and Qi decline, Grain Qi is not abundant, Upper Jiao does not circulate, Lower Wan does not connect. Stomach Qi is hot, hot Qi steams chest. Hence internal heat. Alas! This is the origin of Internal Injury theory! Human Yin and Yang can be described by Exterior/Interior, Upper/Lower, Qi/Blood, Front/Back, Zang-Fu, Ascending/Descending Breath, and many others like movement/speech/rest. Not all need listing. This "Yin" in Yin Deficiency differs from the above. Over-labor makes Yang-Harmonious Qi hyperactive and turn to Fire. Plus, less Grain Qi enters. Thus Yang is stronger, Yin weaker. This "Yin" in Yin Deficiency refers to internal Yin Qi and Grain Flavor. Speaking of Lower Jiao Yin-Yang or Kidney True Yin is incorrect. Labor/overwork is excessive movement, belonging to Fire. Decline of Form/Qi is Strong Fire consuming Qi. Scarcity of Grain Qi is labor injuring Original Qi, leading to poor appetite and Qi decline. Upper Jiao not circulating is Clear Yang not ascending. Lower Wan not connecting is Turbid Yin not descending. Stomach receives water/grain, so Clear Yang ascends, Turbid Yin descends, transmitting and entering/exiting, nourishing the body. Now Stomach cannot receive, Grain Qi declines, so Clear has no ascent, Turbid has no descent. Thus it is said: