【Zangfu and Meridians】The Huangdi Neijing (Yellow Emperor’s Inner Canon) is one of the four classic texts of Traditional Chinese Medicine (TCM) (the Huangdi Neijing, the Nanjing, the Shanghan Lun, and the Shennong Bencao Jing). It is the earliest existing medical classic in China’s medical treasure trove. The text theoretically establishes the TCM concepts of “Yin-Yang and the Five Elements Theory,” “Pulse Theory,” and “Zangxiang Theory.” It is divided into two parts: the Ling Shu and the Su Wen, traditionally attributed to the Yellow Emperor, and has been passed down orally through generations, later supplemented and developed by physicians and medical theorists, culminating in its compilation during the Spring and Autumn and Warring States periods. Through dialogues and Q&A between the Yellow Emperor, Qi Bo, and Lei Gong, it elucidates the mechanisms and pathology of diseases while advocating for the treatment of diseases before they manifest, emphasizing health preservation, life nurturing, longevity, and vitality. It is indeed the outline of TCM!
【Summary】For any issue related to tendons, treat the liver. For any issue related to bones, treat the kidneys. For any issue related to muscles, treat the spleen and stomach. For any issue related to blood vessels, treat the heart. For any issue related to skin and hair, treat the lungs.【Five Zang Organs】1. Heart: The heart is the residence of the spirit, the master of blood, and the root of the pulse. It belongs to the fire element in the Five Elements; physiological functions include: ① governing blood vessels; ② governing consciousness; the heart opens to the tongue, connects with the pulse in the body, manifests on the face, expresses joy in emotions, and sweat in fluids. The heart is interrelated with the small intestine.2. Lung: The lung is the place of the corporeal soul and the master of qi, belonging to the metal element; physiological functions include: ① governing qi and controlling respiration; ② governing the dispersing and descending of qi; ③ regulating the water pathways; ④ governing the hundred vessels and treating stagnation (congestion); assisting the heart in regulating the circulation of qi and blood; the lung connects to the throat, manifests on the skin, expresses in hair, opens to the nose, expresses worry in emotions, and produces mucus in fluids. The lung is interrelated with the large intestine.3. Spleen: The spleen is the source of qi and blood transformation, the foundation of postnatal life, and stores intention, belonging to the earth element. Physiological functions include: ① governing transportation and transformation; ② governing the rising of clear qi; ③ governing blood containment; it opens to the mouth, connects with the flesh, governs the four limbs, manifests on the lips, expresses thought in emotions, and produces saliva in fluids; the spleen is interrelated with the stomach.4. Liver: The liver is the place of the ethereal soul, the storehouse of blood, and the root of tendons, belonging to the wood element, governing the rising and movement. Physiological functions include: ① governing the smooth flow of qi; ② storing blood; it opens to the eyes, connects with the tendons, manifests on the nails, expresses anger in emotions, and produces tears in fluids; the liver is interrelated with the gallbladder.5. Kidney: The kidney is the foundation of pre-natal essence, stores will, and the waist is the organ of the kidneys, belonging to the water element; physiological functions include: ① storing essence, governing growth, development, and reproduction; ② governing water; ③ governing the reception of qi; it is associated with bones, governs the production of marrow, manifests in hair, opens to the ears and the two yin (anus and perineum), expresses fear in emotions, and produces saliva in fluids; the kidney is interrelated with the bladder.【Six Fu Organs】1. Gallbladder: Physiological function: stores and excretes bile, the gallbladder governs decision-making.2. Stomach: Physiological function: receives and digests food and drink, the stomach descends to harmonize.3. Small Intestine: Physiological function: governs the reception and transformation of substances, separating the clear from the turbid, “the small intestine governs fluids.”4. Large Intestine: Physiological function: transmits and transforms waste, the large intestine governs fluids.5. Bladder: Physiological function: stores and excretes urine, relying on the kidney’s qi transformation function.6. San Jiao: Physiological function: facilitates the flow of original qi, governs the qi mechanism and transformation, and serves as the pathway for water and fluids.【Twelve Meridians Flow】In a day, there are twelve time periods, each corresponding to a meridian, connecting end to end like a loop. Mastering your body means mastering the secret to longevity and health!Midnight: 23:00-1:00 Gallbladder Meridian: Deep sleep! The gallbladder needs metabolism; if a person sleeps at this time, the gallbladder can complete its metabolism. At this time, the heart’s function is weakest; if there are heart patients, prepare the Huoxiang Zhengqi Pill.Ox Hour: 1:00-3:00 Liver Meridian: Deep sleep! This is the best time for liver repair; waste blood needs to be eliminated, and fresh blood needs to be produced, completed during the Ox Hour. One must enter deep sleep to provide the liver with sufficient energy. If one does not sleep, the liver continues to output energy to support thinking and actions, failing to complete metabolism, leading to liver disease.Tiger Hour: 3:00-5:00 Corresponding Meridian: Lung Meridian: The transformation of yin and yang begins at this moment, transitioning from yin to yang. The human body also enters a phase of yang dominance and yin decline. At this moment, the lung meridian is most active. The liver provides blood to the lungs, which then distributes it throughout the body. At this time, the body requires a large amount of oxygen. Patients with lung diseases such as asthma should take medication during the Tiger Hour for better efficacy than during the day.Rabbit Hour: 5:00-7:00 Large Intestine Meridian: Bowel movement! Drink a cup of warm water before defecation. At this moment, the large intestine meridian is vigorous, absorbing moisture and nutrients from food and expelling waste.Dragon Hour: 7:00-9:00 Stomach Meridian: Don’t forget breakfast! At this time, gastric acid is continuously secreted; if one goes hungry for too long, there is a risk of gastric ulcers, gastritis, duodenitis, and cholecystitis!Snake Hour: 9:00-11:00 Spleen Meridian: Drink water! (Drink more water at this time) The spleen is the overall coordinator of digestion, absorption, and excretion. The spleen is the foundation of postnatal life. To nourish the spleen: Job’s tears, red beans, and yam porridge. Throughout the day, drink about 2000ml of water, approximately five bottles of mineral water; keep drinking and avoid any beverages.Horse Hour: 11:00-13:00 Heart Meridian: Take a short nap. The heart drives blood circulation, nourishes the spirit, qi, and tendons. A short nap is greatly beneficial for heart health, allowing one to be energetic in the afternoon and evening. *Napping should not exceed 30 minutes, as it may disrupt sleep and lead to insomnia at night.Goat Hour: 13:00-15:00 Small Intestine Meridian: The small intestine meridian adjusts the nutrition of the body throughout the day. If there is heat in the small intestine, the body will experience belching and gas. Therefore, lunch should be eaten before 1:00 PM to ensure that nutrients are absorbed into the body.Monkey Hour: 15:00-17:00 Bladder Meridian: Urination! The bladder expels fluids from the body. If there is heat in the bladder, it can cause bladder cough, which is coughing and involuntary urination. The bladder is most active, and it is suitable to drink more water. At this time, do not hold urine, as it may lead to “urinary retention.”Rooster Hour: 17:00-19:00 Kidney Meridian: The kidneys are the essence of reproduction and the essence of the five zang and six fu organs. The kidneys are the root of pre-natal essence. After the Monkey Hour, the body expels fire and detoxifies, and the kidneys enter the time for storing essence. This is a time for men. For those with kidney function issues, massaging the kidney meridian at this time is most effective.Dog Hour: 19:00-21:00 Pericardium Meridian: The pericardium meridian. This time creates conditions for peaceful sleep. Maintain a calm mindset.Pig Hour: 21:00-23:00 San Jiao Meridian: Time to sleep! This is when the body’s largest fu, the San Jiao meridian, operates, governing all qi and facilitating the water pathways. During the Pig Hour, the San Jiao connects with the hundred vessels. One can rest and rejuvenate.【Pathological Mechanism Explanation】1. Adhere to the pathological mechanism, each serving its purpose In studying diseases, it is essential to grasp the mechanism of onset—whether it belongs to a specific zang or fu organ or is due to cold or heat.The nineteen pathological mechanisms can generally be categorized into two aspects: the five zang organ mechanisms (heart, liver, spleen, lung, kidney, upper, lower) and the six qi mechanisms (fire, heat, wind, cold, dampness). The five zang organ mechanisms are defined by their location of disease, while the six qi mechanisms are defined by their nature of disease. The location of disease must have a corresponding nature, and the nature of disease cannot be separated from its location.Therefore, the five zang organ mechanisms are essentially variations of the six qi, and the variations of the six qi are pathological responses arising from the imbalance of qi, blood, yin, and yang in the zang and fu organs.For example, “all types of counterflow belong to the lower”.Counterflow syndrome is divided into two types: one refers to the counterflow of the four limbs due to the imbalance of yin, yang, qi, and blood. The other refers to the fainting syndrome characterized by loss of consciousness. This is mostly related to liver and kidney changes. “Solid” refers to the inability to pass urine and stool. “Leakage” refers to the inability to retain urine and stool (some believe that solid and leakage refer to bowel movements). Solid and leakage are mostly related to changes in the large intestine, bladder, and kidneys, thus also belonging to the lower jiao.【Counterflow Syndrome】 1. Counterflow of the limbsCold limbs, pale complexion, cold sweat, lethargy, and a weak pulse. It can be divided into cold counterflow and heat counterflow.1. Cold CounterflowDue to internal accumulation of cold, the yang qi is weak below; when cold accumulates, blood flow is obstructed, and when yang qi is weak, warming and circulation are ineffective, leading to the appearance of cold counterflow syndrome. The treatment should warm the center and disperse cold, using Si Ni Tang with modifications.2. Heat CounterflowCommon in high fever diseases, excessive heat burns and injures fluids, leading to a decline in yin qi below and an excess of yang qi, where extreme yang leads to counterflow of cold, with internal heat and external cold, resulting in the sudden appearance of cold limbs and sweating. As stated in the Shanghan Lun, “If there is heat in the front, there must be counterflow in the back; if the counterflow is deep, the heat is also deep.” Symptoms include chest and abdominal heat, delirium, thirst, and a red tongue with a rapid or deep and slow pulse. The treatment should revive yang and rescue the emergency, clearing heat and detoxifying, using Shenfu Decoction with Huanglian, Huangqin, Muli, and Longgu for treatment.2. Fainting SyndromeRefers to sudden loss of consciousness, cold limbs, but with a gradual recovery. The causes of this syndrome are numerous, as recorded in the Huangdi Neijing, including violent fainting, boiling fainting, thin fainting, and corpse fainting. There are also qi fainting, blood fainting, pale fainting, and roundworm fainting. All are caused by the disorder of qi and blood, divided into deficiency and excess types.1. Excess Syndrome① Liver Yang Excess: Violent anger harms the liver, causing liver qi to rise, blood to follow the qi upward, leading to qi and blood stagnation, obscuring the clear yang. As stated in the Suwen, “Great anger leads to the cessation of qi, and blood accumulates above, causing fainting.” Clinical symptoms include sudden fainting, loss of consciousness, clenched teeth, purple lips, and a red face, with a wiry pulse. The initial treatment should be to open the orifices with acrid and cool herbs, using An Gong Niu Huang Wan, followed by blood-activating and qi-regulating methods, using Tong Yu Decoction (from Jingyue Quanshu) with Tianma, Gouteng, and Shijue Ming for treatment.② Phlegm Turbidity Obstruction: Usually due to excessive phlegm, combined with anger causing qi to rise, phlegm follows the qi upward, obstructing the clear orifices, leading to sudden fainting, accompanied by phlegm sounds in the throat, foaming at the mouth, cold limbs, a white and slippery tongue coating, and a submerged and slippery pulse. The treatment should promote qi and resolve phlegm, using Guo Phlegm Decoction with Baijiezi and Shichangpu.③ Heat and Dampness: Usually due to pre-existing yin deficiency and yang excess, combined with summer heat, leading to sudden fainting. As stated in the Suwen, “Yang qi, when overworked, expands, and essence is exhausted, leading to accumulation in summer, causing fainting.” The initial treatment should be An Gong Niu Huang Wan to open the orifices, and after waking, use San Wu Xiangru Decoction with Dan Nan Xing, Shichangpu, and Huangqin to clear heat and benefit qi.2. Deficiency Syndrome① Blood Deficiency Fainting: Seen in cases of excessive blood loss, where qi follows the blood and cannot ascend to the head, leading to fainting. Clinical symptoms include loss of consciousness, pale complexion, a pale tongue, and a submerged and weak pulse. The treatment should be Ren Shen Yang Rong Tang to tonify qi and blood.② Qi Deficiency Fainting: Due to deficiency of the source qi, insufficient essence, or qi deficiency leading to descent, where clear yang cannot ascend, resulting in sudden fainting, pale complexion, sweating, and cold limbs, with a submerged and weak pulse. The initial treatment should be Shenfu Decoction to tonify qi and revive yang, followed by Ba Zhen Tang to tonify both qi and blood.3. Solid Leakage 1. Clinical Analysis of ConstipationThe formation of stool mainly occurs in the large intestine. As stated in the Suwen, “The large intestine is the organ of transmission and transformation.” It is also related to the spleen, stomach, and small intestine, where food and drink are processed in the stomach, transformed by the spleen, and the small intestine separates the clear from the turbid, transmitting the waste to the large intestine, where water is absorbed to form stool. Therefore, as stated in the Lingshu, “Food and drink reside in the stomach, forming waste, and both descend to the large intestine.” If there is cold or heat in the large intestine, its function may be either excessive or deficient, affecting stool formation. Additionally, during the transportation of food and drink, the spleen, stomach, and small intestine are involved, and any changes in these organs’ functions or invasion by external pathogens can also affect stool formation.① Heat Constipation: Due to accumulation of heat in the stomach and intestines, or during the course of a heat illness, or residual heat after a heat illness, scorching the fluids, leading to dry intestines and constipation. Accompanied by symptoms of fever, red face, bad breath, dry throat, short and red urine, yellow and dry tongue coating, and a slippery and forceful pulse. The treatment should be Ma Zi Ren Wan to clear heat and moisten the intestines.② Cold Constipation: Due to yang deficiency or cold accumulation in the intestines, leading to stagnation of qi, internal generation of cold, and inability of yang qi to move, resulting in dry intestines, with clear and long urine, pale tongue, and a submerged and slow pulse. The treatment should warm the intestines and expel cold, using Wen Pi Tang with Da Huang, adding Dang Gui, Rou Cong Rong, and Xing Ren for warming and moistening.③ Deficiency Constipation: Due to dryness of blood and fluids or prolonged illness leading to qi deficiency, resulting in weak transmission and difficulty in stool formation. Those with blood deficiency often present with a pale complexion and occasional dizziness and palpitations. Those with qi deficiency may present with a pale complexion, shortness of breath, and sweating. For blood deficiency, the treatment should be Run Tang Wan to nourish blood and moisten the intestines (see Shen’s Book of Respecting Life). For qi deficiency, the treatment should be Huang Qi Tang to benefit qi and moisten the intestines (see Jin Kui Yi). Analysis: Due to intestinal obstruction, clear qi cannot ascend, turbid qi cannot descend, and the clear and turbid mix, obstructing the intestines, leading to abdominal distension, constipation, hardness, and pain, accompanied by loss of appetite, vomiting, white and greasy tongue coating, and a tight pulse. The treatment should be Mang Xiao Tong Jie Tang to open the blockage.2. Clinical Analysis of DiarrheaDiarrhea is like water leaking, while the force is gentle; diarrhea is direct and urgent, with slight differences, clinically referred to as diarrhea. Diarrhea is also related to changes in the functions of the spleen, stomach, large intestine, and small intestine, or the invasion of wind, cold, and dampness, particularly dampness being the most significant. As stated in the Huangdi Neijing, “Excess dampness leads to leakage,” where excessive dampness harms the spleen, and if water and dampness are not transformed, it leads to diarrhea, while the spleen yang relies on the fire to warm; insufficient fire can also lead to diarrhea.① Food Diarrhea: Due to spleen deficiency and liver excess, where the spleen governs transportation and the liver governs smooth flow; if the liver is excessive, it can invade the spleen, and if the spleen is deficient, it cannot perform its duties, leading to disordered ascending and descending, and the clear and turbid are not separated, resulting in undigested food and diarrhea. Clinically, it often presents with watery stools, undigested food, abdominal distension, and intermittent pain and diarrhea, with pain not relieved after defecation. The treatment should be Pain Diarrhea Formula with additions of Ge Gen and Sheng Ma to support the spleen and suppress the liver.② Damp-Heat Diarrhea: Often due to overeating or consuming spoiled food, damaging the spleen and stomach, leading to spleen deficiency and dampness stagnation, food accumulation transforming into heat, and damp-heat accumulating in the large intestine, resulting in diarrhea. Clinical symptoms include loose stools, foul-smelling, intermittent pain and diarrhea, burning sensation in the anus, and possibly accompanied by fever, yellow and thick tongue coating, and a rapid pulse. The treatment should be Qin Lian Ge Gen Tang to clear heat and drain dampness.③ Cold-Damp Diarrhea: Due to cold dampness invading the spleen and stomach, obstructing the spleen’s healthy function, leading to the inability to separate clear from turbid, resulting in diarrhea. Clinical symptoms include watery stools, dark like water, with some solid feces resembling duck droppings, accompanied by clear and long urine and cold limbs. The treatment should be Fuzi Lizhong Tang combined with Pingwei San to warm the center, disperse cold, strengthen the spleen, and drain dampness.④ Profuse Diarrhea (Damp Diarrhea): Due to pre-existing spleen deficiency, combined with dampness invasion, leading to internal stagnation of water and dampness, resulting in profuse diarrhea. Clinical symptoms include watery stools, profuse like water, pale in color, with no abdominal pain, accompanied by a heavy body and chest tightness, and reduced urination. The treatment should be Weiling San to warm the spleen, dry dampness, and promote urination.⑤ Slippery Diarrhea: Due to qi deficiency leading to descent, causing the large intestine to slip, and qi not being able to consolidate. Clinical symptoms include both food and fluids passing down, with diarrhea like a torrent, no abdominal pain, and intermittent episodes. The treatment should be Bu Zhong Yi Qi Tang with additions of He Zi and Rou Dou Kou to tonify the center and consolidate the descent.⑥ Early Morning Diarrhea: Due to deficiency of the Mingmen fire, where the fire does not warm the earth, leading to weak transformation, occurring at dawn when yang qi should rise but has not yet risen, and the extreme yin qi invades the large intestine, resulting in diarrhea. Clinical symptoms include early morning bowel sounds and diarrhea, with relief after defecation, cold limbs, pale tongue, and a submerged and thin pulse. The treatment should be Si Shen Wan to warm and tonify the Mingmen fire.3. Clinical Analysis of Urinary RetentionRetention also includes urinary retention. Retention refers to difficulty urinating, with a short volume, and the condition is relatively mild; closure refers to the desire to urinate but being unable to, with bladder distension and urgency, and the condition is more acute. They are often referred to together as retention and closure. The occurrence of retention and closure mainly involves the kidneys and bladder.As stated in the Suwen, “The bladder is the official of the state, where fluids are stored; when qi transforms, it can be expelled.” Due to damp-heat in the bladder or obstruction in the bladder, the bladder loses its function of storing fluids, leading to urinary retention. However, the fundamental qi transformation relies on the kidneys, which govern the two yin and control the opening and closing; when kidney yang is deficient, qi transformation fails, and opening and closing become abnormal, leading to urinary retention.Additionally, difficulty urinating is closely related to the spleen and lungs; the lungs are the upper source of water. If heat obstructs the lungs, the lungs fail to clear and regulate fluids, which cannot descend to the bladder, leading to urinary retention. The spleen is the middle state, governing the transportation of water and dampness; if heat accumulates, the circulation of fluids is obstructed, preventing fluids from descending to the bladder, resulting in urinary retention.① Lung Heat Qi Obstruction: Clinical symptoms include dripping urination, yellow and red color, accompanied by fever, shortness of breath, dry throat, and a thin yellow tongue coating, with a rapid pulse. The treatment should be Qing Fei Yin to clear lung heat and promote urination.② Damp-Heat Accumulation in the Middle Jiao: Due to damp-heat accumulation in the middle jiao, the San Jiao water pathways are obstructed, and qi transformation fails, leading to difficulty urinating. Often accompanied by abdominal distension and thirst. If damp-heat accumulates in the skin, it may present with a yellow complexion, yellow and greasy tongue coating, and a rapid pulse. The treatment should be Yin Chen Wu Ling San to clear heat, strengthen the spleen, and drain dampness.③ Damp-Heat Accumulation in the Bladder: Due to damp-heat accumulation in the bladder, obstructing qi transformation, clinical symptoms include difficulty urinating, abdominal distension, bladder urgency, thirst, red tongue, yellow and greasy tongue coating, and a rapid pulse. The treatment should be Ba Zheng San to clear heat, drain dampness, and promote urination.④ Kidney Yang Deficiency: Due to insufficient Mingmen fire, qi transformation fails, and clear fluids cannot ascend while turbid fluids cannot descend to the bladder, leading to reduced urination and retention. Often accompanied by lower back pain and weakness, and if water overflows the skin, it leads to edema, with a pale tongue and a submerged and thin pulse. The treatment should be Ba Wei Wan or You Gui Yin to warm yang and promote urination.⑤ Bladder Obstruction: Due to blood stasis and turbid essence, accumulating in the lower jiao, obstructing the bladder, leading to difficulty urinating, or urination in a thin stream, or sand-like particles in the urine, often accompanied by urinary pain and lower abdominal distension. The treatment should be Ba Zheng San combined with Shi Wei San with modifications (Jin Qian Cao, Bian Xu, Qu Mai, Shi Wei, Dong Kui Zi, Hai Jin Sha, Huai Niu Xi, and Ji Nei Jin) to clear heat, drain dampness, and promote urination. For blood in the urine, add Xiao Ji and Han Lian Cao.2. Adhere to the pathological mechanism, each serving its purpose In the original text of the nineteen pathological mechanisms from the Suwen, there is a phrase, “Adhere to the pathological mechanism, each serving its purpose, those who have it seek it, and those who do not have it seek it.” The first two sentences have been analyzed above, and it is not difficult to understand what is meant by “those who have it seek it, and those who do not have it seek it.” I believe this phrase is a further summary and extension of the nineteen pathological mechanisms. Clinical analysis must grasp the mechanism of onset—whether the nature of the disease is cold or heat, and whether the location of the disease is upper or lower, while also studying the symptoms that have appeared and those that are about to appear. Here, we can take a few examples of the pathological mechanisms caused by fire from the nineteen pathological mechanisms.1. All types of heat, dizziness, and convulsions belong to fireDizziness refers to unclear vision, and severe dizziness leads to a feeling of heaviness in the heart, accompanied by varying degrees of mental disturbance. Convulsions refer to muscle stiffness and spasms. This sentence indicates that high fever, mental confusion, stiffness, and convulsions are mostly related to the mechanism of heat. Zhang Jingyue believes that “heat evil harms the spirit, leading to dizziness, and excessive yang harms the blood, leading to convulsions,” all caused by excessive heat.Why does excessive heat lead to mental disturbances and convulsions? The head is the meeting place of all yang and the residence of the six spirits; when the clear yang rises to the head, the spirit is clear and the vision is bright. If excessive heat rushes upward, disturbing the clear yang, it leads to mental confusion and unclear consciousness. This is often seen in severe heat conditions. In warm diseases, it is often due to heat entering the nutrient blood and evil transmission to the pericardium. The pericardium has a role in replacing the heart in governing the spirit, and the evil transmission to the pericardium can disturb the spirit, leading to mental confusion and disturbances. Excessive heat burns and injures yin, depleting fluids, leading to blood dryness and qi deficiency, which causes stiffness and convulsions.Clinical manifestations include:① Excessive heat and yang: External invasion of summer heat or prolonged external evil transforming into fire, with excessive heat rushing upward, leading to symptoms of restlessness, delirium, and mental confusion. Accompanied by high fever, red tongue, yellow and dry tongue coating, and a forceful and rapid pulse. Excessive heat harms blood, leading to convulsions. The treatment should be Huanglian Jiedu Tang to clear the heart and drain fire. If jaundice occurs due to damp-heat, it is advisable to add Yin Chen, Bai Jiang Cao, Water Buffalo Horn, Xuan Shen, and Mu Dan Pi to clear heat, drain dampness, and reduce jaundice.② Qi and nutrient heat: Seen during the course of warm diseases, clinical symptoms include high fever, delirium, and a red tongue, often accompanied by convulsions. Heat injures blood vessels, leading to rashes. The treatment should be Qing Ying Tang with modifications to clear the heart, open the orifices, and cool the nutrient blood.③ Heat causing liver wind: High fever burns, extreme heat generates wind, and wind and fire assist each other, disturbing the clear yang, leading to mental confusion. Excessive heat and wind lead to convulsions, and in severe cases, it can lead to opisthotonos, with a red tongue and a wiry and rapid pulse. The treatment should be Qing Wen Bai Du San with modifications to clear heat, drain fire, and pacify the liver.2. All types of mouth closure, teeth clenching, and fear belong to fire“Closure” refers to the inability to open the mouth, with tight teeth, and inability to speak clearly. “Shivering” refers to cold shivers. “Clenching” refers to jaw clenching. “Fear” refers to anxiety and restlessness, where the spirit is not at peace. This clause indicates that if symptoms such as mouth closure, jaw clenching, cold shivers, and mental disturbances appear, the mechanism of the disease is mostly related to fire.These symptoms often manifest before high fever, during the stage of conflict between righteousness and evil, when the external evil invades the body, and the evil desires to penetrate, while the righteous desires to resist the evil, leading to a struggle between yin and yang, where yin evil is dominant, and yang qi is suppressed, leading to the appearance of symptoms such as mouth closure, cold shivers, and jaw clenching. When yang is excessive and yin recedes, it leads to heat. As stated in the Suwen, “It first arises in the hair, then extends to the body, with cold shivers and jaw clenching, and when the cold recedes, both internal and external become hot, with a headache as if it is breaking, and a thirst for cold drinks.” During the time of excessive heat, the disturbance of the spirit leads to feelings of anxiety and restlessness.3. All types of counterflow belong to fireVarious symptoms of counterflow are often related to heat. “Counterflow” refers to the reversal of direction, while “rushing upward” means suddenly moving upward. The functions of the body’s zang and fu organs have specific directions of operation, known as “qi mechanism”; if the qi mechanism is disordered, it is termed “qi counterflow.” For example, if stomach qi counterflows, it leads to vomiting, belching, and hiccups; if liver qi counterflows, it leads to liver fire rising and liver yang excess; if lung qi counterflows, it leads to coughing and wheezing… Among the symptoms listed above, only some are caused by heat. However, “if qi is excessive, it is fire”; fire is a yang evil, characterized by heat, and its nature is upward. Fire evil breaking counterflow can lead to qi counterflow and upward movement as a disease. For example, under physiological conditions, lung and stomach qi descend smoothly; if subjected to fire evil, it can lead to qi counterflow and upward movement as a disease.Clinical analysis:① Vomiting: The mechanism is generally due to stomach qi counterflow, divided into excess heat and deficiency cold types. If fire evil rises, it belongs to excess heat, with vomiting often occurring suddenly or immediately after eating, forceful and loud, with a yellow tongue coating and a forceful pulse. The treatment should be to clear heat, descend, and stop vomiting.② Belching: The disease belongs to stomach qi deficiency and cold, where qi stagnation is not smooth, and transformation is disordered. If it is due to fire, phlegm and fire may be excessive in the stomach, leading to foul-smelling belching, accompanied by abdominal distension. The treatment should be Er Chen Tang with additions of Chuan Huanglian to clear fire, descend, and resolve phlegm; it may also occur due to overeating, often leading to belching after meals, accompanied by sour regurgitation and noisy stomach sounds. The treatment should be to strengthen the spleen, harmonize the stomach, and resolve food stagnation.③ Hiccups: If the syndrome is due to heat, it is often due to internal heat of the yangming, with constipation, leading to stomach qi counterflow. Clinical symptoms include strong and forceful hiccups. The treatment should be Zhu Ye Shi Gao Tang to clear the stomach and descend. If the syndrome is due to deficiency cold, it is often seen in spleen and kidney yang deficiency, with counterflow of qi, leading to weak hiccups, where qi does not connect. This condition is often severe, and the treatment should be to tonify the spleen and kidneys, harmonize the stomach, and descend, using Xuanfu Dai Zhe Tang with additions of Fuzi, Ganjiang, and Wuzhuyu.4. All types of agitation and mania belong to fire“Agitation” refers to restlessness, with hands and feet moving about, and internal and external unrest. It differs from “annoyance,” which refers to anger in the chest without external manifestation, but both involve mental disturbances. “Mania” refers to wild and unrestrained behavior, with little sleep and restlessness, often caused by phlegm-fire disturbance and unsettled spirit.Clinical analysis:① Phlegm-fire disturbing the heart: Due to emotional stagnation, leading to phlegm and fire, which obstructs the heart orifices, resulting in mania. Clinical symptoms include unpredictable crying and laughing, incoherent speech, singing loudly, and running away from home, often seen in schizophrenia or manic-depressive disorders. The treatment should be Longshi Guo Phlegm Pill combined with Qingxin Wan to clear the heart, resolve phlegm, and open the orifices.② Heat disturbing the spirit: Often seen during the course of external heat diseases, with excessive heat disturbing the spirit, such as in yangming excess syndrome, with abdominal fullness, dry constipation, restlessness, and delirium, even leading to behaviors such as touching clothes and being restless. The treatment should be Da Chengqi Tang with modifications to drain heat and preserve yin. If the warm evil transmits to the pericardium, disturbing the spirit, leading to restlessness, delirium, and mental confusion, accompanied by thirst, a red tongue, yellow coating, and a rapid pulse. The treatment should be Qingying Tang to clear the heart and open the orifices, cooling the blood and detoxifying.5. All types of swelling, pain, and fright belong to fire“Swelling” has two interpretations: ① edema, ② swelling of the dorsum of the foot. The term “pain” refers to mild pain that is difficult to describe. This clause is more appropriate for swelling of the dorsum of the foot, as “edema” has already been discussed in “All types of damp swelling belong to the spleen,” and should not be repeated, and swelling due to edema is rare. Therefore, it can be interpreted as swelling of the dorsum of the foot accompanied by pain, heat, and even fright.Unexplained swelling and pain of the dorsum of the foot, even leading to heat and fright, are often due to internal accumulation of heat and stagnation of qi and blood, mostly belonging to surgical diseases.In the pathological mechanism of “all types of mouth closure, teeth clenching, and fear belong to fire,” the appearance of symptoms such as mouth closure and cold shivers is due to the struggle between yin and yang, where yang desires to express, and yin desires to contract, leading to a temporary phenomenon where yang cannot overcome yin, and yin dominates. However, as the disease progresses, what symptoms will appear? The fire evil disturbing the spirit will lead to feelings of heaviness and confusion in the heart. Or due to heat damaging fluids, leading to dryness and symptoms of convulsions. Additionally, it is possible that fire heat will lead to symptoms of agitation and mania.Therefore, Zhang Ji believes that each of the nineteen pathological mechanisms only illustrates one aspect of symptoms, and does not comprehensively discuss the mechanism of “fire”; thus, it is necessary to study why this symptom appears and what other symptoms may arise, hence the phrase “those who have it seek it, and those who do not have it seek it,” drawing inferences from one instance, striving for differentiation, and not isolating one aspect for analysis, but rather conducting a comprehensive analysis, which is the essence of the nineteen mechanisms.【Conclusion】 The basic spirit and main content of the Huangdi Neijing include: holistic concepts, Yin-Yang and Five Elements, Zangxiang and meridians, etiology and pathogenesis, diagnostic methods and treatment principles, preventive health care, and the theory of qi dynamics, etc. The “holistic concept” emphasizes that the human body and the natural world are a whole, and that the structure of the human body and its various parts are interconnected. The “Yin-Yang and Five Elements” theory explains the relationship of opposition and unity between things. The “Zangxiang and meridians” study the physiological functions, pathological changes, and interrelationships of the five zang organs, six fu organs, twelve meridians, and eight extraordinary meridians.The “etiology and pathogenesis” elucidate the internal mechanisms of whether various pathogenic factors affect the human body and the occurrence and changes of diseases. The “diagnostic methods and treatment principles” are the basic principles of TCM in understanding and treating diseases. The “preventive health care” systematically expounds the theories of health preservation in TCM, summarizing important experiences in disease prevention. The “theory of qi dynamics” studies the impact of natural climate on human physiology and pathology, and uses this as a basis to guide people in seeking benefits and avoiding harm.
Copyright Notice: We emphasize sharing; the images and text are sourced from the internet, and the copyright belongs to the original author. If there is any infringement, please inform us, and we will promptly delete and apologize.
Click the text below to learn more exciting content:
Fermented Chinese Medicine---A New Chapter in Inheriting Chinese Medicine Culture
Promoting Traditional Chinese Medicine Culture for the Health of the People---Intangible Cultural Heritage---Intangible Herbal Communication
Intangible Herbal Communication: Usage, Applicable Population, and Precautions
What are the advantages of Intangible Herbal Communication compared to massage, moxibustion, and cupping?
Brief Analysis: Eastern Pharmacist Movement Therapy