人受气以成形，气失其平则成病，故肝木太旺则肝亢矣。肝亢则害脾，脾害则不能生金
而防水，故木亢则金水亦俱伤。斯时当以扶金为要，金扶则木制而木平，木平则能和土而水不泛
，金得生矣。若肺金太旺，则肺亢矣，肺亢则不能生水而害木，木病则脾亦损。斯时当扶火
以制金，火旺则金暖而平，金平则能生水而制木，木和则无伤于脾矣。又若脾胃过于湿热，
饮食思虑，则脾胃之气亢，脾土亢，则伤肾而不能生金，金弱则水之化原绝，而肾益衰。期
时当疏木以制土，土平则金水俱平矣。又如肾亢则水泛，泛则水失其流行之道，而不能生木
，木伤则邪干于土，而脾胃亦伤，故当补火以生脾，脾旺则水有所制而平矣。火亢、水亢、
木亢、金亢，一有所亢，皆不能无累于脾，脾有累，则后天气伤，后天伤，则先天不能成其
生生之气，治宜用纳气法。盖胃气为中土之阳，脾气为中土之阴，脾不得胃气之阳，则多下
陷，胃不得脾气之阴，则无以转运，而不能输于五脏，脾既不输，则心亦无以奉生而化赤，
心不化赤，则心火弱不能制肺金，金既无制，则下降之令不行，于是五脏中失其和平者多矣
。夫脾气由心而至肺，肺得气而行下降之令，入心为血，入肝入脾亦为血，入肾为精，自入
为液。五脏和则能互为生克，相生相克，相制相化，而无过与不及之病，所谓气得其平也。
其不能平者，或因六气之感，则外伤而不平，或因饮食劳倦欲事七情，则内伤而不平，不平
于先天者，必伤于后天，伤于后天者，必害于先天，一有所伤害，则多气不纳肾之患。故医
者必先审其起病之由，而察其何脏亢？何脏弱？亢者则以所承制之，盖子能报父仇也。弱者则
以生化求之，盖制则能生化也。而以脾为要，盖五脏之气，皆能奉脾土归气于先天之原，万
万物赖阳而生，从土而发，土不得阳，则不能制水，水无以生化，则反来侮土，土自救
无暇，焉能复生金乎？金水寒则坚滞而不能生化，虽有微火，亦不明也，岂能化金水之寒乎？急宜
桂附姜参救之，盖阳者胃脘之阳也，救之而不愈者有之，未有不救而能自生者也。（炳章按
∶胃中为冲和之气，故能化物，若燥热则为偏驳之气矣，且古人以胃为阳土，最喜清润，何
能受桂附之辛燥乎？唯脾土寒湿者，与之相宜耳。）
古人云∶泻其有余，因不足者泻之。补其不足，因有余者补之。何以言之？假使木气盛
者，由肺气有亏，当泻南方以制肝，使火不相克，则肺自清矣。若金不足而火盛，火盛则水亏，
脾土因亢而不生，当补脾以养金，滋阴以降火，则水自生而血自长，土常不足，再无有余。
（炳章按∶然则古人又有敦阜之说，何以通之？）
气血以冲和为上，偏胜者乃邪胜也，非气血有偏胜也。泻其有余，是泻邪也。以邪气反
胜，正气不足，当却邪以卫正，补其不足，是补正也。因正气不足，邪从虚入，当扶正以却邪。
气血均平，邪从何入？气有余者非言气之有余，而言火之有余也。因血不足，气过盛则化而
为火，五脏空虚，烧灼真阴，为害甚大。夫人之一身，气以血为主，血以气为先。
血以气为先，故当补血中之气。四物加肉桂，血热者不宜。气以血为
主，则当补气中之血，保元加血药，治病不可忘血，亦不可忘气。忘血则四肢不能用，脾无
统也；忘气则体无管摄，肺无主也。气血互相周流，生生不息。和平之药，疏畅气血，宜多
不宜少；寒热之药，不过却病，宜少不宜多，多则伤脾胃，切宜谨慎。虚中有实，正虚便生
实邪，实中有虚，邪实皆由本虚，故实者以泻为补，虚者以补为泻，总不外亢则害，承乃制
之道也。（炳章按∶数语格言，放手桂附，开口芩连者，切宜记之。）
水者所以生木也，水泛则木浮，必得土克水而后能生木，木者所以生火也，木盛则自焚
，必得金克木而后能生火。火生土，火炎则土燥，必得水克火而后能生土。土生金，土重则金埋，
必得木克土而后能生金。金生水，金寒则水冷，必得火克金而后能生水。此生克制化之道也
五行不克则不生，在五脏亦然。人徒知克我者为贼邪，而不知克我者为夫也。盖女无夫
则不生，五脏无克亦不生，如水生木，木不生于江湖河海而生于浓土，土克水而生也。故相生之
道，人皆知之，相克之义，举世莫知。经云∶承乃制，制则生化，有志歧黄者，宜详味焉。
气运之理，非一言能尽，大端要知五运属地，六气属天。故五运有过不及，而生病多在
有形之血肉筋骨，六气之有过不及，而生病多在无形之气。其过与不及，则会主气客气，主运客
运之五行生制旺衰而论。如主克客，客克主，或运克气，气克运，或一克三，三克一，其生
化之异，亦如克之彼此多寡也。其间又有主客运气，相助相解之不同，太过不及平气之不一
。总之，当其位值其时则正，非其位违其时则邪，如政恒其德，无过不及，则虽克我者亦同
化，故不恒其德，则有过有不及，有余而往，不足随之，随往随动，动则成败倚伏生焉。有
胜则必有复，则虽我克我生者，亦必来复，既有胜复则病生，病之浅深轻重生死之期，则再
察其人之本原，或相需，或相背，以定其止发。至于用药，又当详当时气运中，何运何气为
害伤人，然后定夺，不得豫以一定之法，该其细也。（王胥山曰，运气之详载于书传者，所
谓一定之法也，但亦只明其大略而已。至于气化迁流则有常变之殊，盛衰之别，先后之异，
真伪之杂，细微反复之间，未经一一指示，神明变通之道，全在学人深思而自得之，勿为纸
上陈言所印定则善矣。慎斋谓须详当时气运中，何运何气为病伤人，当时二字大宜着眼，慎
经曰∶寒暑燥湿风火，天之阴阳也，三阴三阳上奉之；木火土金水，地之阴阳也，生长
化收藏下应之。三阴三阳者，六气也，地也而本乎天；生长化收藏，五运也，天也而本乎地。辰
戌年，太阳奉寒；寅申年，少阳奉暑；卯酉年，阳明奉燥；丑未年，太阴奉湿；巳亥年，厥
阴奉风；子午年，少阴奉火。本乎天者，始于天而还复于天，故曰上奉。甲己之年化应土，
乙庚之年收应金，丙辛之年藏应水，丁壬之年生应木，戊癸之年长应火，本乎地而还应于地
，故曰下应。总之，五运六气，本一气也，而有阴阳升降，相生相制之义，故有天干地支十
与十二之殊，亦遂有水火木金土，风寒暑湿燥火五与六之别，其实不过一气，升降上下于天
天元纪曰∶所以欲知天地之阴阳者，应天之气，动而不息，故五岁而右迁；应地之气，
静而守位，故六期而环会。盖五运起于甲，终于癸，甲与己合为土，乙与庚合为金，丙与辛合为
水，丁与壬合为木，戊与癸合为火。每岁一运，五岁则金木水火土五行，每岁一迁，由左而
之右，所谓地道右旋也。六气则子午为君火，丑未为湿土，寅申为相火，卯酉为燥金，辰戌
为寒水，已亥为风木，本于天而流行于地，地位乎中，乘天之运，以为营运气化者也，故六
运循环而定位也。然六气本天也，五运本地也。本在地则用在天，故动而不息；本在天则用
在地，故静而守位，此五运六气阴阳天地体用互为动静也。故知体而不知用，知用而不知
体，则于五运六气之动静，犹未明也。未明五六相需动静之机，则治病用药多差矣。凡五岁
之中，当辨其过与不及之殊，五六相生相克比和之别，则体用分明，强弱了了，生死病安之
道，即五年十年之内，俱可预期也。能预期者，能预推五年十年之气化也。六气定，五运迁
，人身之气血盛衰生死，亦随之转流而无差也。若其人真元完固无损者，
则能不随之而转流，故人贵保元，而治病者，亦以保元气为首务也
。人病时行之证，是感一时之气也。如子午年君火司天，则人必多暑伤者矣。然暑气虽一，
而人之禀气不同，则受病亦异。人但知医病，未知医天。六气在外则为天，在内则为人中之
天，即知医天，恐亦不能医人中之天也，医云乎哉！
五运六气俱右旋，倘迁入地而左旋则为逆，所谓子能令母实也。如辰戌年寒水司天，司
天者
寒水而化燥金则实，金实则左迁，至湿土，入地而逆转矣，能无病乎？故辰戌年有湿土之病
，当以润药治之。盖润者水也，水行则湿土得流，有生金之功，无实金之弊矣。此天逆而入
地，药顺而违天也。司天主一年天气，如子午年，君火司天，则一年之天气，无非君火司事
。丑未年湿土司天，则一年之天气，无非湿土司事。除司天外。其左右间则为客气矣。分上
下半年者，不过上半年为天气之升，下半年为地气之降。在泉者地气用事也。总之子午丑未
岁，则本乎天者君火也，湿土也；本乎地者燥金也，寒水也。本乎天者气也，本乎地者血也
。故子午年气病当清，血病当润；丑未年气病当燥，血病当温也。余以类推。
凡人一身，自首至足，皆有经络联之，无断而不接之处，但其中有五行之别。凡五行经
络，遇其所生则为根，遇其所克则隐伏，遇其所属则为表为枝。如肺脉起自中焦，中者土也，土
生金，故起于此。其络循胃口，胃亦土也。譬如瓜藤然，其老根则本也，其节遇土，复生小
根，遇木则生枝果。肺络大肠，大肠为金之表，如木之枝；肺为金之里，如木之本。人之首
，人之根本，故五脏经络皆倒垂，粗者为经，细者为络。
人禀受气以形成形体，气失去平衡就会生病，所以肝木过旺就会导致肝气亢盛。肝气亢盛就会伤害脾土，脾土受损就不能生肺金并防止水泛，因此木气亢盛会导致金和水都受到损伤。此时应当以扶持肺金为关键，肺金得到扶持就能制约肝木使肝气平和，肝气平和就能调和脾土而水不泛滥，肺金得以滋生。如果肺金过旺，就会导致肺气亢盛，肺气亢盛就不能生肾水并伤害肝木，肝木有病则脾土也会受损。此时应当扶持心火以制约肺金，心火旺盛则肺金温暖而平和，肺金平和就能生肾水并制约肝木，肝木调和就不会伤害脾土了。又比如脾胃过于湿热，加上饮食和思虑过度，导致脾胃之气亢盛，脾土亢盛就会伤害肾水而不能生肺金，肺金虚弱则肾水的化源断绝，肾更加衰弱。此时应当疏泄肝木以制约脾土，脾土平和则肺金和肾水都平和了。再如肾气亢盛则水液泛滥，泛滥则水失去正常流通的规律，不能生养肝木，肝木受伤则邪气侵犯脾土，脾胃也受到伤害，所以应当补益心火以生脾土，脾土旺盛则水有所制约而平和。心火亢盛、肾水亢盛、肝木亢盛、肺金亢盛，只要有一脏亢盛，都会牵连到脾土，脾土受累，则后天之本受损，后天受损，先天之精就不能生成生生不息的气，治疗适宜用纳气法。因为胃气是中土的阳气，脾气是中土的阴气，脾如果没有胃气的温煦，就容易下陷；胃如果没有脾气的滋润，就无法转运，也不能输送营养到五脏，脾如果不输布精微，心也就没有物质基础来化生血液，心血不能化生，则心火虚弱不能制约肺金，肺金既然没有制约，其肃降的功能就不能执行，于是五脏中就失去了和平的状态。脾气由心传至肺，肺得到气而执行肃降的功能，进入心脏化为血，进入肝脏和脾脏也化为血，进入肾脏化为精，进入自身化为津液。五脏调和就能互为生克关系，相生相克，相互制约转化，而没有太过或不及的病症，这就是气得其平。那些不能平和的，有的因为六气的外感，导致外伤而不平；有的因为饮食劳倦、房事七情内伤，导致内伤而不平。先天不平必然伤害后天，伤害后天必然损害先天，一旦有所伤害，就会出现多气不纳于肾的病患。所以医生必须先审察发病的原因，观察是哪一脏亢盛？哪一脏虚弱？对于亢盛的脏腑就用其所不胜的五行去制约它，就像儿子能为父亲报仇一样。对于虚弱的脏腑就用生化之法去求治，因为制约之后才能生化。而以调理脾土为关键，因为五脏之气，都能奉归脾土，进而归于先天的本源。万物依赖阳气而生发，从土中萌发，土如果没有阳气，就不能制约水，水无法生化，就会反过来侮犯脾土，土自救尚且无暇，怎么能再生肺金呢？金水寒冷则坚滞而不能生化，即使有微弱的火，也不明亮，怎么能化解金水的寒凉呢？急需桂枝、附子、干姜、人参来救治，因为阳气就是胃脘的阳气，救阳如果无效的情况也有，但没有不救阳而能自行恢复的。（炳章按：胃中是冲和之气，所以能消化食物，如果是燥热则是偏驳之气了，而且古人认为胃为阳土，最喜欢清润，怎么能承受桂枝、附子的辛燥呢？只有脾土寒湿的人，才适合使用。）
古人说：泻其有余，是因为不足者（被乘）而泻之。补其不足，是因为有余者（所胜）而补之。为什么这么说？假如木气盛，是由于肺气有亏虚，应当泻南方心火以制约肝木，使火不克制金，那么肺自然清凉了。如果金不足而火盛，火盛则水亏，脾土因为亢盛而不生金，应当补脾以养肺金，滋阴以降火，那么水自然生出而血自然增长，土常处于不足状态，就没有余气了。（炳章按：然而古人又有“敦阜”的说法，如何解释通融？）
气血以冲和为上等，偏胜的是邪气胜，不是气血本身有偏胜。泻其有余，是泻邪气。因为邪气反胜，正气不足，应当祛除邪气以护卫正气，补其不足，是补正气。因为正气不足，邪气从虚处侵入，应当扶助正气以祛除邪气。气血均平，邪气从哪里侵入？气有余并不是说气本身的有余，而是说火的有余。因为血不足，气过盛则化而为火，五脏空虚，烧灼真阴，危害很大。人的身体，气以血为主宰，血以气为先导。血以气为先导，所以当补血中的气。四物汤加肉桂，血热者不宜。气以血为主宰，则应当补气中的血，保元汤加血药，治病不可忘记血，也不可忘记气。忘记血则四肢不能用，因为脾统血的功能丧失；忘记气则身体无管摄，因为肺主气的功能丧失。气血互相周流，生生不息。平和的药物，疏通畅达气血，宜多用不宜少；寒热的药物，不过是为了祛病，宜少用不宜多，多了则伤害脾胃，务必谨慎。虚证中有实证，正气虚便产生实邪，实证中有虚证，邪气实皆由本虚引起，所以实证以泻为补，虚证以补为泻，总不外乎“亢则害，承乃制”的道理。（炳章按：这几句格言，对于那些放手用桂枝附子，开口就说是黄芩黄连的人，务必牢记。）
水是用来生木的，水泛滥则木漂浮，必须得到土的克制水后才能生木。木是用来生火的，木过盛则自焚，必须得到金的克制木后才能生火。火生土，火炎上则土干燥，必须得到水的克制火后才能生土。土生金，土重则金埋没，必须得到木的克制土后才能生金。金生水，金寒则水冷，必须得到火的克制金后才能生水。这是生克制化的道理。五行不互相克制就不能生长，在五脏也是如此。人们只知道克我的是贼邪，却不知道克我的也是夫（配偶/制约者）。因为女子没有丈夫就不能生育，五脏没有克制也不能生长，如水生木，木不是生于江湖河海而是生于泥土，土克水而生木。所以相生的道理，人们都知道，相克的含义，举世无人知晓。经书说：承乃制，制则生化，有志于岐黄之术的人，应该仔细体味。
气运的道理，不是一句话能说完的，大端要知道五运属地，六气属天。所以五运有过与不及，生病多在形体的血肉筋骨；六气有过与不及，生病多在无形的气。其过与不及，会结合主气客气、主运客运的五行生克制化旺衰来论述。如主克客，客克主，或运克气，气克运，或一克三，三克一，其生化的差异，也像克制的彼此多少一样。其间又有主客运气，相助相解的不同，太过、不及、平气的不一。总之，当其位值其时则为正，非其位违其时则为邪，如政令恒守其德，无过与不及，那么即使是克我的也会同化，所以不恒守其德，就有过与不及，有余而来，不足随之，随着往来而动，动则成败倚伏产生。有胜气则必有复气，那么即使是我和我生的，也必来报复，既有胜复则病生，病的浅深轻重生死之期，则再察病人的本源，或相需，或相背，以确定停止或发作。至于用药，又应当详查当时气运中，何运何气为害伤人，然后定夺，不能预先用一定的方法概括其细节。（王胥山说，运气详细记载在书传中的，所谓一定的方法，但也只说明大概而已。至于气化迁流则有常变的不同，盛衰的区别，先后的差异，真伪的混杂，细微反复之间，没有一一指示，神明变通之道，全在学人深思而自得，不要被纸上陈言所固定就好。慎斋说须详查当时气运中，何运何气为病伤人，“当时”二字非常值得着眼。慎经说：寒暑燥湿风火，是天的阴阳，三阴三阳上奉之；木火土金水，是地的阴阳，生长化收藏下应之。三阴三阳，是六气，地而本乎天；生长化收藏，是五运，天而本乎地。辰戌年，太阳奉寒；寅申年，少阳奉暑；卯酉年，阳明奉燥；丑未年，太阴奉湿；巳亥年，厥阴奉风；子午年，少阴奉火。本乎天的，始于天而还复于天，所以说上奉。甲己之年化应土，乙庚之年收应金，丙辛之年藏应水，丁壬之年生应木，戊癸之年长应火，本乎地而还应于地，所以说下应。总之，五运六气，本是一气，而有阴阳升降，相生相制的意义，所以有天干地支十与十二的不同，也有水火木金土风寒暑湿燥火五与六的区别，其实不过是一气，升降上下于天。《天元纪》说：所以想知道天地阴阳的，应天之气动而不息，所以五岁而右迁；应地之气静而守位，所以六期而环会。盖五运起于甲，终于癸，甲与己合为土，乙与庚合为金，丙与辛合为水，丁与壬合为木，戊与癸合为火。每岁一运，五岁则金木水火土五行，每岁一迁，由左而之右，所谓地道右旋也。六气则子午为君火，丑未为湿土，寅申为相火，卯酉为燥金，辰戌为寒水，已亥为风木，本于天而流行于地，地位乎中，乘天之运，以为营运气化者也，故六运循环而定位也。然六气本天也，五运本地也。本在地则用在天，故动而不息；本在天则用地，故静而守位，此五运六气阴阳天地体用互为动静也。故知体而不知用，知用而不知体，则于五运六气之动静，犹未明也。未明五六相需动静之机，则治病用药多差矣。凡五岁之中，当辨其过与不及之殊，五六相生相克比和之别，则体用分明，强弱了了，生死病安之道，即五年十年之内，俱可预期也。能预期者，能预推五年十年之气化也。六气定，五运迁，人身之气血盛衰生死，亦随之转流而无差也。若其人真元完固无损者，则能不随之而转流，故人贵保元，而治病者，亦以保元气为首务也。人病时行之证，是感一时之气也。如子午年君火司天，则人必多暑伤者矣。然暑气虽一，而人之禀气不同，则受病亦异。人但知医病，未知医天。六气在外则为天，在内则为人中之天，即知医天，恐亦不能医人中之天也，医云乎哉！
五运六气俱右旋，倘迁入地而左旋则为逆，所谓子能令母实也。如辰戌年寒水司天，司天者寒水而化燥金则实，金实则左迁，至湿土，入地而逆转矣，能无病乎？故辰戌年有湿土之病，当以润药治之。盖润者水也，水行则湿土得流，有生金之功，无实金之弊矣。此天逆而入地，药顺而违天也。司天主一年天气，如子午年，君火司天，则一年之天气，无非君火司事。丑未年湿土司天，则一年之天气，无非湿土司事。除司天外，其左右间则为客气矣。分上半年下半年者，不过上半年为天气之升，下半年为地气之降。在泉者地气用事也。总之子午丑未岁，则本乎天者君火也，湿土也；本乎地者燥金也，寒水也。本乎天者气也，本乎地者血也。故子午年气病当清，血病当润；丑未年气病当燥，血病当温也。余以类推。
凡人一身，自首至足，皆有经络联之，无断而不接之处，但其中有五行之别。凡五行经络，遇其所生则为根，遇其所克则隐伏，遇其所属则为表为枝。如肺脉起自中焦，中者土也，土生金，故起于此。其络循胃口，胃亦土也。譬如瓜藤然，其老根则本也，其节遇土，复生小根，遇木则生枝果。肺络大肠，大肠为金之表，如木之枝；肺为金之里，如木之本。人之首，人之根本，故五脏经络皆倒垂，粗者为经，细者为络。
Human beings receive Qi to form their physical bodies; when Qi loses its balance, disease occurs. Therefore, if Liver Wood is excessively vigorous, Liver Qi becomes hyperactive (Liver Hyperactivity). Liver Hyperactivity harms Spleen Earth; once Spleen is harmed, it cannot generate Lung Metal and prevent Water from overflowing. Thus, Wood Hyperactivity causes damage to both Metal and Water. At this time, the priority should be to support Lung Metal. When Metal is supported, it controls Wood, bringing Wood to equilibrium. Once Wood is balanced, it can harmonize Earth, preventing Water from flooding, allowing Metal to be nourished. If Lung Metal is too vigorous, Lung Qi becomes hyperactive. Lung Hyperactivity fails to generate Kidney Water and harms Liver Wood; if Liver Wood is diseased, Spleen Earth is also damaged. In such cases, Heart Fire should be supported to control Metal. When Fire is vigorous, Metal becomes warm and balanced. Balanced Metal can generate Water and control Wood; harmonized Wood will not harm Spleen. Furthermore, if Spleen and Stomach are overly damp-heat, compounded by diet and excessive thought, Spleen-Stomach Qi becomes hyperactive. Spleen Earth Hyperactivity damages Kidney Water, failing to generate Lung Metal. Weak Metal cuts off the source of Water transformation, causing further Kidney decline. Here, one should soothe Liver Wood to control Earth; once Earth is balanced, Metal and Water will also balance. Similarly, if Kidney Qi is hyperactive, Water floods. Flooding disrupts the normal flow of Water, preventing it from generating Wood. Damaged Wood allows pathogenic factors to invade Earth, harming Spleen and Stomach. Thus, Heart Fire should be tonified to generate Spleen Earth; a robust Spleen constrains Water, restoring balance. Whether Heart Fire, Kidney Water, Liver Wood, or Lung Metal is hyperactive, any single organ's excess inevitably affects the Spleen. Spleen impairment damages the Postnatal Root; Postnatal damage prevents the Prenatal Essence from generating life-sustaining Qi. Treatment should employ methods to grasp Qi (Na Qi Fa). Stomach Qi represents the Yang of Central Earth, while Spleen Qi represents its Yin. Without Stomach Yang, Spleen Qi tends to sink; without Spleen Yin, Stomach cannot transport and transform, nor distribute nutrients to the Five Zang organs. If Spleen does not distribute, the Heart lacks material basis to transform blood. If Heart fails to transform blood, Heart Fire weakens and cannot control Lung Metal. Uncontrolled Metal fails to descend, leading to disharmony among the Five Zang. Spleen Qi moves from Heart to Lung; Lung receives Qi and executes descending functions. Entering the Heart, it becomes Blood; entering Liver and Spleen, it becomes Blood; entering Kidney, it becomes Essence; entering itself, it becomes Fluids. Harmonious Zang organs mutually generate and control each other, avoiding excess or deficiency, achieving Qi equilibrium. Disharmony arises from external Six Qi influences or internal injuries due to diet, fatigue, emotions, or sexual activity. Prenatal imbalance harms Postnatal; Postnatal injury damages Prenatal. Any injury leads to failure of Qi to grasp into the Kidney. Physicians must first determine the cause of onset, identifying which Zang is hyperactive and which is deficient. Hyperactive Zang should be controlled by its conquering element (like a son avenging his father); deficient Zang should be treated via generation and transformation (since control enables transformation), with emphasis on regulating Spleen Earth. All Zang Qi ultimately returns to the Prenatal Source via Spleen. All things rely on Yang for growth, emerging from Earth. Without Earth's Yang, Water cannot be controlled; ungenerated Water rebels against Earth. If Earth is busy saving itself, how can it generate Metal? Cold Metal and Water stagnate; even slight Fire may not illuminate them, let alone warm them. Urgent treatment requires Guizhi Tang (Cinnamon Twig Decoction), Fuzi (Aconite Root), Shengjiang (Fresh Ginger), and Renshen (Ginseng Root) to rescue Yang, as Yang resides in the Stomach cavity. Rescue may fail sometimes, but spontaneous recovery without rescue is impossible. (Bingzhang notes: The Stomach contains harmonious Qi for digestion; dryness-heat implies biased Qi. Ancients viewed Stomach as Yang Earth, preferring clear-moistening qualities, unsuitable for acrid-dry herbs like Cinnamon and Aconite. These are suitable only for Cold-Damp Spleen Earth.)
Ancients stated: Drain excess because of deficiency; tonify deficiency because of excess. Why? If Wood Qi is strong due to Lung Qi deficiency, drain Southern Fire to control Liver Wood, preventing Fire from conquering Metal, thus clearing the Lungs. If Metal is deficient and Fire is strong, Fire strength depletes Water. Spleen Earth, overactive, fails to generate Metal. Tonify Spleen to nourish Metal, yin-nourish to descend Fire, generating Water and increasing Blood. Constant Spleen deficiency leaves no excess. (Bingzhang notes: How does this reconcile with the concept of "Piling Up"?)
Qi and Blood prioritize harmony; excess indicates pathogenic victory, not inherent Qi/Blood imbalance. Draining excess removes pathogens. Since pathogens overpower due to righteous Qi deficiency, expel pathogens to protect righteousness. Tonifying deficiency strengthens righteous Qi. Pathogens enter through deficiency; thus, support righteousness to expel pathogens. With balanced Qi/Blood, where do pathogens enter? "Excess Qi" refers to Excess Fire. Blood deficiency with excessive Qi transforms into Fire, emptying Five Zang and burning True Yin, causing great harm. In the body, Qi is master of Blood; Blood leads Qi. Since Blood leads Qi, tonify Qi within Blood. Siwu Tang plus Rougui (Cinnamon Bark) is unsuitable for Heat-Blood. Since Qi masters Blood, tonify Blood within Qi. Baoyuan Tang plus Blood-tonifying herbs. Do not forget Blood or Qi in treatment. Forgetting Blood impairs limbs (Spleen fails to govern Blood); forgetting Qi impairs body control (Lung fails to govern Qi). Qi and Blood circulate mutually, generating endlessly. Harmonious medicines that smooth Qi/Blood should be used generously; cold/hot medicines for disease removal should be sparing, as excess harms Spleen/Stomach. Caution is vital. Deficiency with Excess arises from righteous deficiency producing pathogenic excess; Excess with Deficiency stems from root deficiency. Thus, draining excess acts as tonification for Excess; tonifying deficiency acts as drainage for Deficiency. This follows the principle: Hyperactivity causes harm, subjugation brings control. (Bingzhang notes: Remember these maxims regarding the indiscriminate use of Cinnamon/Aconite or Scutellaria/Phellodendron.)
Water generates Wood; flooding Water makes Wood float, requiring Earth to control Water to generate Wood. Wood generates Fire; excessive Wood burns itself, requiring Metal to control Wood to generate Fire. Fire generates Earth; blazing Fire dries Earth, requiring Water to control Fire to generate Earth. Earth generates Metal; heavy Earth buries Metal, requiring Wood to control Earth to generate Metal. Metal generates Water; cold Metal chills Water, requiring Fire to control Metal to generate Water. This is the way of generation and control. Without mutual control, there is no generation, applicable to Five Zang. People know conquering elements are "Thieves," but fail to see they are also "Spouses." Just as a woman needs a husband to bear children, Zang organs need control to grow. Water generates Wood, but Wood grows in fertile soil, not just rivers, because Earth controls Water to enable Wood's growth. Everyone knows generation; few understand control. Classics say: Subjugation brings control; control enables transformation. Those pursuing Qihuang medicine should ponder this deeply.
Qi-Yun theory is complex. Generally, Five Yun belong to Earth, Six Qi belong to Heaven. Excess/deficiency in Five Yun affects solid tissues (flesh, bones); in Six Qi, affects无形 Qi. Analysis involves Host/Guest Qi, Host/Guest Yun, and Five Elements' generation/control/waning/prospering. Interactions include Host conquering Guest, Guest conquering Host, Yun conquering Qi, Qi conquering Yun, or 1-to-3/3-to-1 conquests. Variations in transformation mirror the degree of conquest. Differences exist in Host/Guest Yun assisting or resolving conflicts, and in Overabundance, Deficiency, or Balanced Qi. Generally, being in the correct position/time yields Zheng (Orthodox); incorrect position/time yields Xie (Pathogenic). If virtue is constant without excess/deficiency, even conquering elements harmonize. Lack of constancy leads to excess/deficiency; what comes in excess goes out deficient. Movement creates success/failure. Victory necessitates retaliation. Even conquered/generated elements retaliate. Retaliation causes disease. Disease severity/death timing depends on the patient's root constitution (mutual need or opposition) to predict onset/remission. Medication must analyze current Qi-Yun to identify harmful Yun/Qi, avoiding rigid formulas. (Wang Xushan comments: Books detail fixed rules, but Qi transformation has constants/variables, prosperity/decline, sequence, truth/falsehood, subtleties. Divine adaptation requires deep study, not mere textual adherence. Shen Zhai emphasizes "current" Qi-Yun. Classic: Cold/Heat/Dryness/Dampness/Wind/Fire are Heaven's Yin/Yang, served by Three Yin/Three Yang. Wood/Fire/Earth/Metal/Water are Earth's Yin/Yang, responding with Growth/Transformation/Storage/Consumption. Three Yin/Three Yang are Six Qi, Earth based on Heaven. Growth/etc. are Five Yun, Heaven based on Earth. Chen/Xu years: Taiyang serves Cold. Yin/Shen: Shaoyang serves Heat. Mao/You: Yangming serves Dryness. Chou/Wei: Taiyin serves Dampness. Si/Hai: Jueyin serves Wind. Zi/Wu: Shaoyin serves Fire. Heaven-based starts/returns to Heaven ("Shang Feng"). Earth-based responds to Earth ("Xia Ying"): Jia/Ji -> Earth; Yi/Geng -> Metal; Bing/Xin -> Water; Ding/Ren -> Wood; Wu/Gui -> Fire. Five Yun/Six Qi are one Qi with Yin/Yang ascent/descent, generation/control. Hence Heavenly Stems/Earthly Branches differ (10 vs 12), and Elements/Climate differ (5 vs 6), yet essentially one Qi moving up/down. *Tianyuan Ji*: To know Heaven/Earth Yin/Yang: Heaven Qi moves incessantly, shifting right every five years. Earth Qi stays still, circling every six periods. Five Yun start Jia, end Gui. Jia-Ji combine as Earth; Yi-Geng as Metal; Bing-Xin as Water; Ding-Ren as Wood; Wu-Gui as Fire. Each year one Yun; five years cycle Metal/Wood/Water/Fire/Earth, shifting left-to-right (Earth's Right Rotation). Six Qi: Zi-Wu Jun Fire; Chou-Wei Wet Earth; Yin-Shiang Minister Fire; Mao-You Dry Metal; Chen-Xu Cold Water; Si-Hai Wind Wood. Heaven-based, circulating on Earth. Earth sits central, riding Heaven's Yun for circulation. Six Yun cycle in fixed positions. Six Qi originate in Heaven; Five Yun in Earth. Earth-origin uses in Heaven (moving); Heaven-origin uses in Earth (still). This is mutual dynamic/static of Body/Function in Yin/Yang/Heaven/Earth. Knowing Body without Function, or Function without Body, leaves Yun-Qi dynamics unclear. Unclear dynamics lead to treatment errors. In five-year cycles, distinguish excess/deficiency, generation/control/harmony of 5 and 6. Clear Body/Function, strength/weakness predicts health/disease for 5-10 years. Predicting means forecasting Qi transformation. Fixed Six Qi, migrating Five Yun dictate human Qi/Blood prosperity/decline/death. Those with intact Yuan Qi resist this flow. Preserving Yuan Qi is paramount for patients and physicians. Seasonal diseases stem from transient Qi. E.g., Zi-Wu years, Jun Fire governs Heaven, causing many heat injuries. Though Heat Qi is uniform, individual constitution varies disease manifestation. People treat disease, not Heaven. Six Qi outside is Heaven; inside is "Heaven within Man." Even knowing Heaven-treatment, treating "Heaven within Man" is difficult. Is this all medicine can do?
Five Yun/Six Qi rotate right; if entering Earth and rotating left, it is adverse ("Son makes Mother full"). E.g., Chen/Xu years, Cold Water governs Heaven. Cold Water transforms to Dry Metal, making Metal full. Full Metal shifts left to Wet Earth, reversing underground. Illness ensues. Chen/Xu years feature Wet Earth disease, treated with moistening herbs. Moistening is Water; Water flows, allowing Wet Earth to move, benefiting Metal generation without Metal excess. This is Heaven reversing into Earth, medicine following but opposing Heaven. Si Tian (Governor) dictates annual weather. Zi-Wu: Jun Fire governs, so Heaven is Jun Fire. Chou-Wei: Wet Earth governs, so Heaven is Wet Earth. Besides Si Tian, adjacent are Guest Qi. First half year: Heaven Qi ascending. Second half: Earth Qi descending. Zai Quan (Underground) is Earth Qi acting. Zi-Wu/Chou-Wei years: Heaven-based are Jun Fire/Wet Earth; Earth-based are Dry Metal/Cold Water. Heaven-based is Qi; Earth-based is Blood. Zi-Wu: Qi disease clears, Blood disease moistens. Chou-Wei: Qi disease dries, Blood disease warms. Others follow analogy.
The body, head to foot, has meridians connecting everything, no breaks, differing by Five Elements. Meridions meeting their generator become roots; meeting their conqueror hide; meeting their owner become branches/surface. Lung meridian starts at Middle Jiao (Earth); Earth generates Metal, so it starts here. Its collaterals follow Stomach (also Earth). Like melon vines: old roots are base; nodes meeting Earth sprout small roots; meeting Wood sprout branches/fruits. Lung connects Large Intestine (Metal's surface, like Wood branch); Lung is Metal's interior (like Wood root). Head is human root; thus Five Zang meridians hang upside down. Thick are Jing (Main), thin are Luo (Collateral).