。此火之来，俱系枢之不利，寒之所致。若因火炽而更寒之，则火益烈而真元亡矣。故治之
不但欲其肾之安，更不可不固膀胱之阳，不但欲其肝之润，更不可不疏胆之气。（炳章按∶
如此辗转牵引，殊属支离，若如此则五脏无一不败，亦非草木所能治，岂固阳疏胆所能愈耶
心肾相交，全凭升降，而心气之降，由于肾气之升，肾气之升，又因心气之降。夫肾属
水，
火性炎上，如何而降？盖因火中有真阴，故火亦随阴而降至于肾，则生肾中之水，升降者水
火，其所以使之升降者，水火中之真阴真阳也。真阴真阳者，心肾中之真气也。故肾之后天
，心之先天也。心之后天，肾之先天也。欲补心者须实肾，使肾得升，欲补肾者须宁心，使
心得降，六味丸丹皮、茯苓，所以宁心也。地黄、山药，所以实肾也，乃交心肾之法也。
人之生死本乎神，神居于心，心为火，故火者，生命之原也。戊癸化火，戊为土，癸为
水，水为先天，土为后天，二天化火之原，人之所赖以生者也。
凡人不知所以生，则不知所以死，不知所以死，则不知所以病，不知所以病，则不知所
以治，故知生知死，乃知病知安，而知所以治矣。人之所以生者神也，神之所以安者气也，气得
其平，则神安而无病，气失其序，则神散而死亡。神气者，人之性命也。神者，心也；气者
，肾也。心肾二脏，人之性命所寄也，顾不重哉！故脉贵有神，形贵有气，神气可治，虽危
可救。神气愦乱，虽安必危。然神气之所以因之衰旺者胃也，能治病者，必不可忘胃。故经
云∶胃气为本，然肾为胃关，人生之来，其原在肾，人病之来，亦多在肾，肾者命之根也。
肾脉不伤，危也可许其生，肾脉有害，安也亦虑其危。盖肾伤则先天伤，而后天之胃无根，
亦必受害。凡久病而不死者，肾伤未及胃也，及胃立死矣。故断病之诀，在此二天，一伤则
病，两伤则死。既两伤矣，尚欲救之，愚人也；两不伤而医者死之，医人之罪也。见病不先
察此二天，不知医者也；能医者，专以此二天为务。此医门之秘谈也。
验案
一人每至夜，则颈项强硬，喉痛舌干吐痰，至天明则诸病皆退，此阳虚不能上达也。盖
夕则阳气下降于丹田，上焦之阳不足，故阴火炽于上而生诸病，至旦则阳气从丹田上升，阳升阴
降而诸病退矣。治法用补中益气汤。（炳章按∶此证为津液不足者多，补中益气未见合法，
此公以阳不升上之论，亦未知果效否。观病须别有证据，方可定其属阴属阳，未可执此一证
，即定其为上焦阳虚也。）
这种火气的产生，都是由于枢机不利，由寒邪所致。如果因为火势炽盛而再用寒凉药去治疗它，那么火势会更加猛烈，导致真元耗亡。所以治疗时，不仅希望肾脏安宁，更不可不固护膀胱的阳气；不仅希望肝脏滋润，更不可不疏利胆腑的气机。（炳章按：如此辗转牵连，实属支离破碎，如果这样理解，那么五脏没有不败坏的，也不是草木药物所能治疗的，难道固护阳气和疏利胆气就能痊愈吗？）
心肾相交，完全依靠升降运动，而心气的下降，是由于肾气的上升；肾气的上升，又是因为心气的下降。肾属水，火性炎上，怎么会下降呢？这是因为火中蕴含真阴，所以火也随着阴液而降至于肾，从而滋生肾中的水。升降的是水火，使水火得以升降的，是水火中的真阴和真阳。真阴和真阳，就是心和肾中的真气。所以肾的后天之气，是心的先天之气；心的后天之气，是肾的先天之气。想要补益心脏，必须充实肾脏，使肾气能够上升；想要补肾，必须宁心安神，使心气能够下降。六味丸中的丹皮、茯苓，是用来宁心的；地黄、山药，是用来实肾的，这就是交通心肾的方法。
人的生死根本在于神，神居于心中，心属火，所以火是生命的本源。戊癸化火，戊为土，癸为水，水是先天，土是后天，先天与后天化生火的根源，是人赖以生存的基础。
大凡人不知道生命的道理，就不知道死亡的道理；不知道死亡的道理，就不知道生病的原因；不知道生病的原因，就不知道治疗的原理。所以懂得生与死，才能懂得病与安，进而懂得如何治疗。人之所以能生存，是因为有神；神之所以安宁，是因为有气。气得其平和，则神安宁而无病；气失其秩序，则神涣散而死亡。神和气，是人的性命所在。神，对应心；气，对应肾。心和肾两脏，是人的性命所寄托的地方，难道不重要吗！所以脉象贵在有神，形体贵在有气，神气尚存可治，即使病情危重也可挽救。神气昏乱，即使看似平安也必然危险。然而神气之所以因此衰旺，关键在于胃。能治病的人，一定不能忘记胃。所以经典说：胃气为本。但是肾是胃的关隘，人出生时的本源在肾，人生病时的根源也多在肾，肾是命的根基。肾脉如果不受伤，即使危重也可以许诺其生机；肾脉受损，即使看似平安也要担忧其危险。因为肾受伤则先天受损，而后天的胃也就失去了根基，也必然受害。凡是久病而不死的，是因为肾伤尚未波及胃；一旦波及胃，立刻就会死亡。所以诊断疾病的诀窍，在于考察这两个“天”（先天之肾与后天之胃），一个受伤则病，两个都受伤则死。既然两个都受伤了，还想救它，那是愚笨的人；两个都没受伤却被医生治死，是医生的罪过。见到疾病不先察验这两个“天”，是不懂医的人；真正懂医的人，专门致力于考察这两个“天”。这是医门的秘密谈话。
验案
有一人每到夜晚，就出现颈项强硬、喉痛、舌干、吐痰的症状，到了天亮这些病症都消退，这是阳虚不能上行达于头面。大概傍晚时阳气下降入丹田，上焦阳气不足，所以阴火在上部炽盛而产生各种病症，到了早晨阳气从丹田上升，阳升阴降，各种病症就消退了。治疗方法使用补中益气汤。（炳章按：此证多为津液不足者，使用补中益气汤未见得合法，这位先生以阳气不升上的理论来解释，也不知是否真的有效。观察病情必须有其他证据，才可以确定属于阴还是属于阳，不可仅凭这一个症状，就断定它是上焦阳虚。）
The emergence of this fire is all due to the dysfunction of the pivot mechanism, caused by cold pathogenic factors. If one treats it with cold-natured herbs because the fire is blazing, the fire will become even more intense, leading to the exhaustion of the True Yuan (True Origin/Essence). Therefore, in treatment, not only should one seek to calm the Kidney, but one must also secure the Yang Qi of the Bladder; not only should one seek to moisten the Liver, but one must also disperse the Qi of the Gallbladder. (Bingzhang notes: Such interlinked reasoning is fragmented and disjointed. If this were the case, none of the five Zang organs would remain intact, and herbal medicine would be ineffective. How could securing Yang and dispersing Gallbladder Qi lead to a cure?)
The interaction between the Heart and Kidney relies entirely on the ascending and descending movements. The descending of Heart Qi is due to the ascending of Kidney Qi, and the ascending of Kidney Qi is due to the descending of Heart Qi. The Kidney belongs to Water, while Fire has a nature that flares upward; how can it descend? This is because within Fire lies True Yin (True Essence of Yin), so Fire descends along with Yin to the Kidney, thereby generating Water within the Kidney. What ascends and descends is Water and Fire; what causes them to ascend and descend is the True Yin and True Yang within Water and Fire. True Yin and True Yang are the True Qi (Vital Energy) within the Heart and Kidney. Thus, the acquired aspect of the Kidney is the congenital aspect of the Heart, and the acquired aspect of the Heart is the congenital aspect of the Kidney. To tonify the Heart, one must solidify the Kidney, allowing Kidney Qi to ascend; to tonify the Kidney, one must calm the Heart, allowing Heart Qi to descend. In Liuwei Wan (Six-Ingredient Pill with Rehmannia), Mu Dan Pi (Moutan Cortex) and Fu Ling (Poria) are used to calm the Heart; Di Huang (Rehmanniae Radix) and Shan Yao (Dioscoreae Rhizoma) are used to solidify the Kidney. This is the method for facilitating the interaction between the Heart and Kidney.
Life and death depend fundamentally on Shen (Spirit/Mind). Shen resides in the Heart, and the Heart belongs to Fire; thus, Fire is the origin of life. Wu and Gui transform into Fire. Wu represents Earth, and Gui represents Water. Water is congenital, and Earth is acquired. The origin of the transformation of these two aspects into Fire is what sustains human life.
If people do not understand the principle of life, they cannot understand the principle of death. If they do not understand death, they cannot understand disease. If they do not understand disease, they cannot understand treatment. Therefore, understanding life and death allows one to understand disease and health, and consequently, how to treat. That which gives life to humans is Shen; that which keeps Shen at peace is Qi. When Qi is balanced, Shen is peaceful and free from disease; when Qi loses its order, Shen scatters, leading to death. Shen and Qi constitute human life and destiny. Shen corresponds to the Heart; Qi corresponds to the Kidney. The Heart and Kidney are the vessels where life and destiny reside; are they not important! Therefore, the pulse should ideally possess Shen, and the form should possess Qi. If Shen and Qi are present and treatable, even critical conditions can be saved. If Shen and Qi are confused and chaotic, even seemingly stable conditions are dangerous. However, the reason Shen and Qi decline or flourish depends on the Stomach. One who can treat diseases must never forget the Stomach. Thus, the classics state: "Stomach Qi is the root." Yet, the Kidney is the gate of the Stomach. At birth, the origin lies in the Kidney; in illness, the root often lies in the Kidney. The Kidney is the root of life. If the Kidney pulse is uninjured, survival can be promised even in critical states; if the Kidney pulse is harmed, danger must be feared even in apparently healthy states. This is because injury to the Kidney injures the Congenital (Pre-heaven) aspect, causing the Acquired (Post-heaven) Stomach to lose its root and suffer accordingly. Those who survive long-term illnesses have Kidney injury that has not yet affected the Stomach; once the Stomach is affected, death ensues immediately. Thus, the key to diagnosing disease lies in examining these two "Heavens" (Congenital Kidney and Acquired Stomach). Injury to one leads to disease; injury to both leads to death. If both are injured and one still attempts to save the patient, it is foolishness; if neither is injured but the doctor causes death, it is the doctor's sin. A physician who does not first examine these two Heavens upon seeing a disease is ignorant; a competent physician focuses exclusively on these two Heavens. This is a secret discourse of the medical profession.
Case Record
A certain person experienced stiffness of the neck and upper back, sore throat, dry tongue, and expectoration every night, with all symptoms subsiding by dawn. This is due to Yang deficiency failing to ascend. Generally, in the evening, Yang Qi descends into the Dantian, resulting in insufficient Yang Qi in the Upper Jiao. Consequently, Yin Fire blazes in the upper region, generating various symptoms. By morning, Yang Qi rises from the Dantian; as Yang ascends and Yin descends, the symptoms subside. The treatment method involves using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). (Bingzhang notes: This condition is mostly due to insufficiency of body fluids. Using Buzhong Yiqi Tang may not be appropriate. This gentleman's theory of Yang failing to ascend is uncertain in efficacy. Observing disease requires other evidence to determine whether it belongs to Yin or Yang; one cannot definitively diagnose Upper Jiao Yang deficiency based solely on this symptom.)