钱氏曰五脏相胜轻重肝脏病见秋木旺肝强胜肺也宜补肺泻肝轻者肝病退重者唇白而死
肺病见春金旺肺胜肝当泻肺轻者肺病退重者目淡青必发惊更有赤者当搐为肝怯当目淡青
色也
心病见冬火旺心强胜肾当补肾治心轻者病退重者下窜不语肾怯虚也
肾病见夏水胜火肾胜心也当治肾轻者病退重者悸动当搐也
脾病见四旁皆仿此治之顺者易治逆者难治脾怯当面目赤黄五脏相反随证治之
又曰如肺病又见肝证切牙多呵欠者易治肝虚不能胜肺故也若目直大叫哭项急烦闷者难治
盖肺病久则虚冷肝强实而反胜肺也视病之新久虚实虚则补母实则泻子
洁古曰肝胜肺则肝病身热发搐又见肺虚喘而气短病见于申酉戌时是肝真强也内经曰受所
制而不
能制谓之真强法当补脾肺而后泻肝导赤散泻黄散肺胜肝则肺病喘嗽气盛见于寅卯辰时木之位
又以见肝怯少力正为鬼贼所克法当补肝泻肺若肺病嗽久虚羸无实不得泻肺只宜用地黄丸补之
不可服泻白散何谓也经云虚则补实则泻之
按此谓五脏相胜病机不离五行生克制化之理者盖小儿初在襁褓未有七情六欲只是形体脆
弱血
气未定腑脏精神未完所以有脏气虚实胜乘之病但世俗不审此理往往遇是率指为外感内伤而用
药致枉死者多矣悲夫矧钱论脱略幸而洁古补之今特参附诚所谓无穷之惠也
洁古曰五脏子母虚实鬼贼微正若不达旨意不易得而入焉
在前者为实邪
子能令母实拒鬼贼不敢伤于母其子又引母所克者妻相助故曰实邪也
在后者为虚邪
母引子之鬼贼至由此母能使子虚也内经曰子能令母实每能令子虚此之谓也
妻来乘夫为微邪
未来乘妻为贼邪
法当泻鬼补本脏
本脏自病为正邪
法当虚则补之实则泻之内经曰滋苗者必固其根伐下者必枯其上逆其根则伐其本伐其本则
败其真矣按此以五行生克之道论也义见难经五十难及后五脏治要论宜参考之
心主热自病或大热泻心汤主之
实则烦热黄连泻心汤主之
虚则惊悸生犀散主之
肺乘心微邪
喘而壮热泻白散
肝乘心虚邪
风热煎大羌汤下大青丸
脾乘心实邪
泄泻身热泻黄散
肾乘心贼邪
恐怖恶寒安神丸
按乘者犹乘车之乘也大抵五脏之病相乘伏匿隐显莫测以上但言本病乘胜之道故以五脏治
要附
于左宜参考焉凡心脏得病必先调其肝肾两脏肾者心之鬼肝气通则心气和肝气滞则心气乏此心
病先求于肝清其源也五脏受病必传其所胜水能胜火则肾之受邪必传于心故先治其肾逐其邪也
故其退肾也益肝气两方或诊其脉肝肾两脏俱和而心自生疾然后察其心家虚实治之
肺主燥自病则喘嗽燥则润之
实则喘而气盛泻白散
虚则喘而少气先益黄散而后阿胶散
心乘肺贼邪
热而喘嗽先地黄丸中导赤散后阿胶散
肝乘肺微邪
恶风眩冒昏愦嗽羌活散
肾乘肺实邪
增寒嗽清利百部丸
脾乘肺虚邪
体重吐痰泄泻嗽人参白术散
凡肺之得疾必先观心之虚实若心火炎盛铄金即当先抑心气后吃肺药若心气和即更看脾脉
若脾
气虚冷即不能相生而肺家生气不足则风邪易感故患肺寒者皆脾虚得之若脾气盛实则亦痞膈中
焦而大肠与肺表里不能相通夫中焦热隔则肺大肠不通其毒热之气必上蒸于肺而生疾故患肺热
者多脾实得之心气盛泻之脾气虚者益之脾气实者通之然后随其肺之寒热以治之故有抑心气益
脾气通脾气三药若诊其脉气心脾两脏俱和而肺自生疾则但察肺家虚实而治之
肝主风自病则风搐拘急肝苦急急食甘以缓之佐以酸苦以辛散之
实则风搐力大泻青丸
虚则风搐力少地黄丸
心乘肝实邪
壮热而搐利惊丸凉惊丸主之
肺乘肝贼邪
气盛则前晨呵欠微搐法当泻肺先补本脏补肝地黄丸主之泻肺泻白散主之
脾乘肝微邪
多睡体重搐先当定搐泻青丸主之搐止再见后证则别立法治之
肾乘肝虚邪
增寒呵欠搐羌活膏
凡肝得病必先察其肺肾两脏根其病之所起然后复其肝家本脏之虚实方可治疗然肾者肝之
母金
者木之贼今肝之得病若非肾水之不能相生必是肺金之鬼来相攻击不得不详审而求之故其来在
肺先治其肺攻其鬼也其来在肾先补其肾滋其根也然后审其肝家本脏之虚实而寒温之
脾主湿自病则泄泻多睡体重昏倦脾苦湿急食苦以燥之
实则泄泻赤黄睡不露睛泻黄散
虚则泄泻白色睡露睛白术散
肝乘脾贼邪
风泻而呕茯苓半夏汤主之
心乘脾虚邪
壮热体重而泻羌活黄芩苍术甘草汤主之
肺乘脾实邪
能食不大便而呕嗽煎槟榔大黄汤下葶苈丸
肾乘脾微邪
恶寒泄理中丸之类
凡脾之得病必先察其肝心两脏之虚实根其源之所起然后救疗盖肝是脾之鬼心是脾之母肝
气盛
则鬼胜心气亏则脾家生气不足盛者抑之则退亏者益之则不乏故有抑肝气益心气两药诊其脉肝
心两脏俱和则是脾自生疾察其虚实而治
肾主寒自病则足胫寒而逆人之五脏惟肾无实小儿疮疹变黑啖则是肾实水克退心火是以水
能制火也
心乘肾微邪
内热不恶寒桂枝丸
肺乘肾虚邪
喘嗽皮涩寒百部丸
肝乘肾实邪
拘急气搐身寒理中丸
脾乘肾贼邪
体重泄泻身寒理中丸
本脏虚弱是自己正令不行乃鬼贼之所克害当补本脏之正气假令肺病喘嗽时于初春见之法
当补
肾见于夏救肺见于秋泻肺见于冬补心泻本脏乃名寒嗽大抵五脏各至本位即气盛不可更补到所
克位不可更泻五行之间惟肾之一脏母盛而子反受邪而物之性有不可一概论者肺肾是也何则肺
属
金射于皮毛所主者气肾属水主于骨髓所藏者精气之轻浮能上而不能下精之沉重能下而不能上
此物性之然今肺之盛盖热之作也气得热而上蒸则肺不能下生于肾而肾受邪矣急食凉药解之使
脏气温和自能下生于肾此肾之病必先求之于肺若肺脏安和而肾忽然受病者不过脾之湿相刑于
肾而生疾所以有解肺热去脾邪两药若脾肺两脏俱和而肾自生疾亦察其本脏而治之
钱乙说：五脏之间存在相克的关系，病情有轻重之分。肝脏发病时，若正值秋季木气旺盛，肝气强盛而克制肺金，应当补肺气、泻肝气。轻症则肝病自愈，重症则嘴唇发白而死。
肺部发病时，若正值春季金气旺盛，肺气强盛而克制肝木，应当泻肺气。轻症则肺病自愈，重症则眼睛颜色淡青，必定引发惊风；如果眼睛发红，应当出现抽搐症状，这是因为肝气怯弱所致（注：此处原文逻辑似有倒置或特定语境，通常目淡青为肝色，但原文言“当搐为肝怯”，故直译）。
心脏发病时，若正值冬季火气旺盛，心气强盛而克制肾水，应当补肾气、治心病。轻症则病愈，重症则目光下视、不能言语，这是肾气怯弱虚损的表现。
肾脏发病时，若正值夏季水气胜火（注：此处原文“水胜火”可能指季节或病机传变，依原文直译），肾气强盛而克制心火，应当治疗肾脏。轻症则病愈，重症则心悸动、应当出现抽搐。
脾脏发病时，其余四脏的病变规律皆可参照此法治疗。顺证容易治疗，逆证难以治疗。脾脏怯弱时，面目呈现赤黄色。五脏之间相互反克，需根据具体证候进行治疗。
又说：如肺病又见到肝的症状，如咬牙、多打哈欠的，容易治疗，这是因为肝虚不能克制肺的缘故。如果眼睛直视、大声叫哭、项背强急、烦闷的，难以治疗，这是因为肺病日久导致虚冷，肝气强实反而克制肺脏。观察疾病的新久虚实，虚证则补其母脏，实证则泻其子脏。
张元素（洁古）说：肝气克制肺金，则肝病表现为身体发热、抽搐，又见肺虚喘促、气短，病症出现在申、酉、戌时，这是肝气真正强盛。《内经》说：“受制约而不能制约对方，称为真强。”治疗方法应当先补脾肺，然后泻肝，可用导赤散、泻黄散。肺气克制肝木，则肺病表现为喘嗽、气盛，病症出现在寅、卯、辰时，正值木气之位，又见肝气怯弱、无力，正是被鬼贼之邪所克。治疗方法应当补肝、泻肺。如果肺病咳嗽日久，身体虚弱消瘦，没有实证，不得泻肺，只宜用地黄丸滋补，不可服用泻白散。为什么呢？经书说：“虚则补之，实则泻之。”
按语：这说的是五脏相克的病机，不离五行生克制化的道理。大概小儿初在襁褓之中，没有七情六欲，只是形体脆弱，气血未定，脏腑精神未完备，所以有脏气虚实相胜相乘的疾病。但世俗之人不明了这个道理，往往遇到这些情况，一律指为外感内伤而用药，导致枉死者很多，可悲啊！况且钱乙的论述较为简略，幸好张元素加以补充，今天特别参详附注，这真是无穷无尽的恩惠啊。
张元素说：五脏母子虚实、鬼贼微正的关系，如果不领会旨意，不容易入门。
在前者为实邪。子能令母实，拒绝鬼贼不敢伤害母亲，其子又引来母亲所克制的“妻”相助，所以称为实邪。
在后者为虚邪。母亲引来子的鬼贼到来，由此母亲能使子虚损。《内经》说：“子能令母实，母能令子虚”，说的就是这个意思。
治疗方法应当虚则补之，实则泻之。《内经》说：“滋苗者必固其根，伐下者必枯其上，逆其根则伐其本，伐其本则败其真矣。”按语：这是以五行生克之道来论述，义理见于《难经·五十难》及后文《五脏治要论》，宜参考。
肝木乘袭心火，为虚邪。
症状：风热。
方剂：煎大羌汤，送服大青丸。
按：所谓“乘”，犹如乘车之乘。大体上五脏之病，相乘伏匿，隐显莫测。以上只说了本病相乘胜的道理，所以将《五脏治要》附于左侧，宜参考。凡是心脏得病，必须先调理肝肾两脏。肾是心的鬼贼（水克火），肝气通畅则心气和，肝气滞涩则心气乏，这是心病先求治于肝，清其源头。五脏受病，必传其所胜。水能胜火，则肾之受邪必传于心，所以先治肾，驱逐邪气。所以退肾邪也益肝气。或者诊察脉象，若肝肾两脏都调和而心自生病，然后察其心家虚实进行治疗。
心火乘袭肺金，为贼邪。
症状：热而喘嗽。
方剂：先用地黄丸合导赤散，后用阿胶散。
肝木乘袭肺金，为微邪。
症状：恶风、眩冒、昏愦、嗽。
方剂：羌活散。
脾土乘袭肺金，为虚邪。
症状：体重、吐痰、泄泻、嗽。
方剂：人参白术散。
凡是肺脏得疾，必须先观察心脏的虚实。如果心火炎盛，灼伤肺金，就应当先抑制心气，后吃肺药。如果心气调和，再看脾脉。如果脾气虚冷，就不能相生，而肺家生气不足，则风邪易感，所以患肺寒者都是脾虚导致的。如果脾气盛实，也会痞塞中焦，而大肠与肺表里相应，不能相通。如果中焦热隔，则肺与大肠不通，其毒热之气必上蒸于肺而生疾病，所以患肺热者多是脾实导致的。心气盛则泻之，脾气虚者益之，脾气实者通之。然后随其肺之寒热来治疗。所以有抑心气、益脾气、通脾气三药。如果诊察脉气，心脾两脏都调和而肺自生病，则只察肺家虚实而治疗。
肝主风，自病则风搐拘急。肝苦急，急食甘以缓之，佐以酸苦，以辛散之。
心火乘袭肝木，为实邪。
症状：壮热而搐。
方剂：利惊丸、凉惊丸主治。
肺金乘袭肝木，为贼邪。
症状：气盛则前晨呵欠微搐。
方法：当泻肺，先补本脏。补肝用地黄丸主治，泻肺用泻白散主治。
脾土乘袭肝木，为微邪。
症状：多睡、体重、搐。
方法：先当定搐，用泻青丸主治。搐止再见后证则别立法治之。
凡是肝脏得病，必须先察知肺肾两脏，探究病因所在，然后恢复肝家本脏的虚实，方可治疗。然而肾是肝之母，金是木之贼。现在肝脏得病，如果不是肾水不能相生，必然是肺金之鬼来相攻击，不得不详细审察而寻求根源。所以其来在肺，先治其肺，攻其鬼；其来在肾，先补其肾，滋其根。然后审察肝家本脏的虚实而施以寒温之法。
脾主湿，自病则泄泻、多睡、体重、昏倦。脾苦湿，急食苦以燥之。
肝木乘袭脾土，为贼邪。
症状：风泻而呕。
方剂：茯苓半夏汤主治。
心火乘袭脾土，为虚邪。
症状：壮热、体重而泻。
方剂：羌活黄芩苍术甘草汤主治。
肺金乘袭脾土，为实邪。
症状：能食不大便而呕嗽。
方剂：煎槟榔大黄汤，送服葶苈丸。
凡是脾脏得病，必须先察知肝心两脏的虚实，探究根源所在，然后救疗。盖肝是脾的鬼贼，心是脾的母亲。肝气盛则鬼胜，心气亏则脾家生气不足。盛者抑制它则衰退，亏者补益它则不乏。所以有抑肝气、益心气两药。诊察脉象，若肝心两脏都调和，则是脾自生病，察其虚实而治疗。
肾主寒，自病则足胫寒而逆。人的五脏中只有肾无实证（注：此处指小儿肾常虚，或特指某种语境下的肾无纯实，结合下文“小儿疮疹变黑啖则是肾实”看，此处可能有争议，但依原文直译）。小儿疮疹变黑干陷，则是肾实，水克退心火，是以水能制火也。
肝木乘袭肾水，为实邪。
症状：拘急、气搐、身寒。
方剂：理中丸。
脾土乘袭肾水，为贼邪。
症状：体重、泄泻、身寒。
方剂：理中丸。
本脏虚弱是自己正气不行，乃是被鬼贼所克害，应当补本脏的正气。假令肺病喘嗽，时在初春见到，方法应当补肾；见于夏季，救肺；见于秋季，泻肺；见于冬季，补心、泻本脏，这才名叫寒嗽。大体上五脏各至本位即气盛，不可更补；到所克之位，不可更泻。五行之间，只有肾这一脏，母盛而子反受邪，而物的性质有不可一概而论的，肺肾就是如此。为什么呢？肺属金，射于皮毛，所主者是气；肾属水，主于骨髓，所藏者是精气。气的轻浮能上而不能下，精的沉重能下而不能上，这是物性的自然。现在肺之盛，大概是热邪作祟，气得热而上蒸，则肺不能下生于肾，而肾受邪了。急食凉药解之，使脏气温和，自能下生于肾，这是肾之病必先求之于肺。如果肺脏安和而肾忽然受病，不过是脾之湿相刑于肾而生疾病，所以有解肺热、去脾邪两药。如果脾肺两脏都调和而肾自生病，亦察其本脏而治疗。
Qian Yi stated: The five zang organs have a relationship of mutual restriction, and the severity of illness varies. When the Liver organ is diseased, if it coincides with autumn when Wood qi is prosperous, Liver qi becomes strong and overacts on Lung Metal; in this case, one should tonify Lung qi and drain Liver qi. In mild cases, the Liver disease resolves spontaneously; in severe cases, the lips turn white, leading to death.
When the Lung organ is diseased, if it coincides with spring when Metal qi is prosperous, Lung qi becomes strong and overacts on Liver Wood; one should drain Lung qi. In mild cases, the Lung disease resolves spontaneously; in severe cases, the eyes appear pale blue, inevitably triggering convulsions (Jing Feng); if the eyes are red, twitching symptoms should occur, which indicates Liver qi deficiency (Note: The original text logic seems inverted or context-specific, usually pale blue eyes indicate Liver color, but the text states "convulsion due to Liver weakness", so it is translated literally).
When the Heart organ is diseased, if it coincides with winter when Fire qi is prosperous, Heart qi becomes strong and overacts on Kidney Water; one should tonify Kidney qi and treat the Heart disease. In mild cases, the illness resolves; in severe cases, the gaze lowers, and speech is lost, indicating Kidney qi deficiency and vacuity.
When the Kidney organ is diseased, if it coincides with summer where Water overcomes Fire (Note: This may refer to seasonal or pathological transmission, translated literally), Kidney qi becomes strong and overacts on Heart Fire; one should treat the Kidneys. In mild cases, the illness resolves; in severe cases, palpitations occur, and convulsions should be expected.
When the Spleen organ is diseased, the patterns for the other four zang organs can be inferred by analogy. Smooth (Shun) patterns are easy to treat; reverse (Ni) patterns are difficult to treat. When the Spleen is weak, the face and eyes appear red and yellow. When the five zang organs mutually counter-restrict, treatment should be based on specific syndromes.
Furthermore, he said: If Lung disease presents with Liver symptoms, such as teeth grinding and frequent yawning, it is easy to treat because Liver deficiency prevents it from restricting the Lung. However, if the eyes are fixed, there is loud crying, neck stiffness, restlessness, and oppression, it is difficult to treat. This is because prolonged Lung disease leads to vacuity-cold, while strong Liver excess counter-restricts the Lung. Observing the newness or chronicity and vacuity or excess of the disease: for vacuity, tonify the mother organ; for excess, drain the child organ.
Zhang Yuansu (Jiegu) stated: When Liver wood overacts on Lung metal, Liver disease manifests as body heat and convulsions, accompanied by Lung deficiency wheezing and shortness of breath. The symptoms appear during the Shen, You, and Xu hours, indicating true Liver excess. As stated in the *Nei Jing*: "Being restricted but unable to restrict others is called true excess." The treatment method should first tonify the Spleen and Lung, then drain the Liver, using Dao Chi San and Xie Huang San. When Lung metal overacts on Liver wood, Lung disease manifests as wheezing, coughing, and abundant qi, appearing during the Yin, Mao, and Chen hours, which correspond to the Wood position. This also shows Liver weakness and lack of strength, being attacked by the "Ghost" (restrictive) pathogen. The treatment method should tonify the Liver and drain the Lung. If Lung disease involves chronic coughing, emaciation, and no excess signs, draining the Lung is contraindicated; instead, Di Huang Wan should be used for tonification. Xi Bai San should not be taken. Why? The classics state: "Tonify vacuity, drain excess."
Commentary: This discusses the pathology of five-zang mutual restriction, adhering to the principles of Five Element generation and restriction. Generally, infants in swaddling clothes have no seven emotions or six desires; their bodies are fragile, qi and blood are unsettled, and zang-fu spirits are incomplete. Thus, they suffer from diseases of zang qi excess, deficiency, overaction, and multiplication. However, laypeople often fail to understand this principle, mistakenly attributing these conditions to external invasions or internal injuries, leading to many wrongful deaths. It is tragic! Moreover, Qian's discussions were somewhat brief; fortunately, Zhang Yuansu supplemented them. Today, we specifically reference and annotate them, which is indeed an infinite benefit.
Zhang Yuansu stated: The relationships of mother-child excess/deficiency and ghost/micro-righteousness among the five zang organs are complex. Without grasping the essence, it is hard to enter the field.
Those occurring earlier constitute Excess Pathogens (Shi Xie). The child makes the mother excess, rejecting the Ghost so it cannot harm the mother. The child also invites the "Wife" (the element the mother restricts) to assist, hence called Excess Pathogen.
Those occurring later constitute Deficiency Pathogens (Xu Xie). The mother invites the Ghost of the child, thereby causing the child to become deficient. The *Nei Jing* states: "The child can make the mother excess, and the mother can make the child deficient," referring to this.
When the Wife attacks the Husband, it is a Micro Pathogen (Wei Xie).
When the attack has not yet reached the Wife, it is a Thief Pathogen (Ze Xie).
The treatment method should drain the Ghost pathogen and tonify the affected zang organ.
Self-disease of the affected zang organ is a Righteous Pathogen (Zheng Xie).
The treatment method should follow: tonify vacuity, drain excess. The *Nei Jing* states: "To nourish the sprout, one must solidify the root; to cut down from below, one must wither the top. Reversing the root cuts the foundation; cutting the foundation destroys the true essence." Commentary: This discusses the Way of Five Elements generation and restriction. The meaning is found in Chapter 50 of the *Nan Jing* and the subsequent "Discussion on Essential Treatments for Five Zang Organs"; please refer to them.
Heart governs Heat. Self-disease manifests as high fever, treated with Xie Xin Tang.
Excess manifests as irritability and heat, treated with Huang Lian Xie Xin Tang.
Deficiency manifests as palpitations and fright, treated with Sheng Xi San.
Lung Metal overacting on Heart Fire (Micro Pathogen):
Symptoms: Wheezing and high fever.
Formula: Xie Bai San.
Liver Wood overacting on Heart Fire (Deficiency Pathogen):
Symptoms: Wind-heat.
Formula: Decoct Da Qiang Tang, administer Da Qing Wan.
Spleen Earth overacting on Heart Fire (Excess Pathogen):
Symptoms: Diarrhea and body heat.
Formula: Xie Huang San.
Kidney Water overacting on Heart Fire (Thief Pathogen):
Symptoms: Terror and aversion to cold.
Formula: An Shen Wan.
Commentary: "Overacting" (Cheng) is like riding a vehicle. Generally, diseases of the five zang organs involve hidden and unpredictable interactions. The above only describes the principles of self-disease and mutual overaction; therefore, the "Essential Treatments for Five Zang Organs" is attached on the left for reference. Whenever Heart disease occurs, one must first regulate the Liver and Kidney. Kidney is the Ghost of Heart (Water restricts Fire). If Liver qi flows freely, Heart qi harmonizes; if Liver qi stagnates, Heart qi becomes deficient. This means treating the source of Heart disease via the Liver. When any zang organ is diseased, it transmits to what it restricts. Since Water restricts Fire, Kidney pathogens transmit to the Heart; thus, treat the Kidney first to expel the pathogen. Therefore, expelling Kidney pathogens benefits Liver qi. Alternatively, if pulse diagnosis shows both Liver and Kidney harmonious but Heart disease arises spontaneously, examine the Heart's excess or deficiency and treat accordingly.
Lung governs Dryness. Self-disease manifests as wheezing and coughing; dryness requires moistening.
Excess manifests as wheezing and abundant qi, treated with Xie Bai San.
Deficiency manifests as wheezing and shortness of breath, initially treated with Yi Huang San, followed by E Jiao San.
Heart Fire overacting on Lung Metal (Thief Pathogen):
Symptoms: Heat with wheezing and coughing.
Formula: Initially use Di Huang Wan combined with Dao Chi San, followed by E Jiao San.
Liver Wood overacting on Lung Metal (Micro Pathogen):
Symptoms: Aversion to wind, vertigo, dizziness, confusion, and coughing.
Formula: Qiang Huo San.
Kidney Water overacting on Lung Metal (Excess Pathogen):
Symptoms: Increased chills and coughing.
Formula: Qing Li Bai Bu Wan.
Spleen Earth overacting on Lung Metal (Deficiency Pathogen):
Symptoms: Heaviness, phlegm expectoration, diarrhea, and coughing.
Formula: Ren Shen Bai Zhu San.
Whenever Lung disease occurs, one must first observe the Heart's excess or deficiency. If Heart fire blazes and scorches Metal, suppress Heart qi first, then treat the Lung. If Heart qi is harmonious, check the Spleen pulse. If Spleen qi is deficient and cold, it cannot generate, leading to insufficient Sheng qi in the Lung, making it susceptible to Wind pathogens. Thus, Lung cold diseases often stem from Spleen deficiency. If Spleen qi is excessive and solid, it causes obstruction in the middle jiao. Since Large Intestine and Lung are interior-exterior related, they cannot communicate. If middle jiao heat obstruction prevents Lung-Large Intestine communication, toxic heat steams upward to the Lung, causing disease. Thus, Lung heat diseases often stem from Spleen excess. Tonify deficient Heart qi, drain excessive Heart qi, tonify deficient Spleen qi, and unblock excessive Spleen qi. Then, treat the Lung according to its cold or heat. Hence, there are three methods: suppressing Heart qi, benefiting Spleen qi, and unblocking Spleen qi. If pulse diagnosis shows both Heart and Spleen harmonious but Lung disease arises spontaneously, examine the Lung's excess or deficiency and treat accordingly.
Liver governs Wind. Self-disease manifests as wind convulsions and stiffness. Liver suffers from urgency; urgently consume sweet flavors to relax it, assist with sour and bitter flavors, and disperse with pungent flavors.
Excess manifests as forceful wind convulsions, treated with Xie Qing Wan.
Deficiency manifests as weak wind convulsions, treated with Di Huang Wan.
Heart Fire overacting on Liver Wood (Excess Pathogen):
Symptoms: High fever with convulsions.
Formula: Li Jing Wan or Liang Jing Wan.
Lung Metal overacting on Liver Wood (Thief Pathogen):
Symptoms: Abundant qi, morning yawning, and slight convulsions.
Method: Drain the Lung, first tonify the affected zang. Tonify Liver with Di Huang Wan; drain Lung with Xie Bai San.
Spleen Earth overacting on Liver Wood (Micro Pathogen):
Symptoms: Somnolence, heaviness, and convulsions.
Method: First stabilize convulsions with Xie Qing Wan. After convulsions stop, treat subsequent symptoms separately.
Kidney Water overacting on Liver Wood (Deficiency Pathogen):
Symptoms: Increased chills, yawning, and convulsions.
Formula: Qiang Huo Gao.
Whenever Liver disease occurs, first examine the Lung and Kidney, trace the origin of the disease, then restore the Liver's intrinsic excess or deficiency before treating. Kidney is the Mother of Liver; Metal is the Ghost of Wood. If Liver disease arises, unless it is due to Kidney Water failing to generate, it must be Lung Metal attacking. One must carefully investigate the source. If the source is in the Lung, treat the Lung first to attack the Ghost; if the source is in the Kidney, tonify the Kidney first to nourish the Root. Then examine the Liver's intrinsic excess or deficiency and apply cold or warm treatments.
Spleen governs Dampness. Self-disease manifests as diarrhea, somnolence, heaviness, and fatigue. Spleen suffers from dampness; urgently consume bitter flavors to dry it.
Excess manifests as yellow diarrhea, sleeping with eyes partially open, treated with Xie Huang San.
Deficiency manifests as white diarrhea, sleeping with eyes fully open, treated with Bai Zhu San.
Liver Wood overacting on Spleen Earth (Thief Pathogen):
Symptoms: Wind diarrhea and vomiting.
Formula: Fu Ling Ban Xia Tang.
Heart Fire overacting on Spleen Earth (Deficiency Pathogen):
Symptoms: High fever, heaviness, and diarrhea.
Formula: Qiang Huo Huang Qin Cang Zhu Gan Cao Tang.
Lung Metal overacting on Spleen Earth (Excess Pathogen):
Symptoms: Ability to eat but constipation, vomiting, and coughing.
Formula: Decoct Bing Lang Da Huang Tang, administer Ting Li Wan.
Kidney Water overacting on Spleen Earth (Micro Pathogen):
Symptoms: Aversion to cold and diarrhea.
Formula: Li Zhong Wan and similar formulas.
Whenever Spleen disease occurs, first examine the excess or deficiency of the Liver and Heart, trace the source, then intervene. The Liver is the Ghost of Spleen; the Heart is the Mother of Spleen. If Liver qi is excessive, the Ghost prevails; if Heart qi is deficient, Spleen Sheng qi is insufficient. Suppress the excessive to reduce it; tonify the deficient to prevent scarcity. Hence, there are two methods: suppressing Liver qi and benefiting Heart qi. If pulse diagnosis shows both Liver and Heart harmonious, the Spleen disease arises spontaneously; examine its excess or deficiency and treat accordingly.
Kidney governs Cold. Self-disease manifests as cold and reversal of the lower legs and feet. Among the five zang organs, only the Kidney is considered without pure excess (Note: Context implies pediatric Kidney is often deficient, or specific context applies). In children, if varicella lesions turn black and dry, it indicates Kidney excess, where Water restricts Heart Fire, demonstrating Water's ability to control Fire.
Heart Fire overacting on Kidney Water (Micro Pathogen):
Symptoms: Internal heat, no aversion to cold.
Formula: Gui Zhi Wan.
Lung Metal overacting on Kidney Water (Deficiency Pathogen):
Symptoms: Wheezing, coughing, rough skin, and cold.
Formula: Bai Bu Wan.
Liver Wood overacting on Kidney Water (Excess Pathogen):
Symptoms: Stiffness, qi convulsions, and body cold.
Formula: Li Zhong Wan.
Spleen Earth overacting on Kidney Water (Thief Pathogen):
Symptoms: Heaviness, diarrhea, and body cold.
Formula: Li Zhong Wan.
When the affected zang is weak, its own righteous qi fails to function, and it is harmed by the Ghost pathogen. One must tonify the righteous qi of the affected zang. For example, if Lung disease presents with wheezing and coughing in early spring, the method is to tonify the Kidney; if seen in summer, rescue the Lung; if seen in autumn, drain the Lung; if seen in winter, tonify the Heart and drain the affected zang. This is named Cold Cough. Generally, when each zang reaches its own position, its qi is prosperous and should not be further tonified; when it reaches the position it restricts, it should not be further drained. Among the Five Elements, only the Kidney exhibits a pattern where the Mother is excessive, and the Child suffers the pathogen. The nature of things cannot be generalized; Lung and Kidney are examples. Why? Lung belongs to Metal, extends to the skin and hair, and governs Qi. Kidney belongs to Water, governs bone marrow, and stores Essence. Qi is light and floating, able to ascend but not descend; Essence is heavy and sinking, able to descend but not ascend. This is the natural nature of things. Now, Lung prosperity is generally caused by Heat. Qi heated steams upward, preventing Lung from descending to generate Kidney, thus harming the Kidney. Urgently consume cool medicines to resolve this, allowing zang qi to harmonize and naturally descend to generate the Kidney. This means Kidney disease must first seek its cause in the Lung. If the Lung is harmonious but the Kidney suddenly suffers disease, it is likely due to Spleen Dampness punishing the Kidney. Hence, there are two methods: resolving Lung heat and removing Spleen pathogens. If both Spleen and Lung are harmonious but Kidney disease arises spontaneously, examine the Kidney itself and treat accordingly.