Inheriting the legacy of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
【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 our medical treasure trove. Theoretically, it established 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, passed down orally through generations, and later supplemented and developed by physicians and medical theorists, culminating in written form 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 occur, as well as promoting health preservation, longevity, and vitality. It is indeed the outline of TCM!
【Summary】As long as it is a problem with the tendons, treating the liver is correct.As long as it is a problem with the bones, treating the kidneys is correct.As long as it is a problem with the muscles, treating the spleen and stomach is correct.As long as it is a problem with the blood vessels, treating the heart is correct.As long as it is a problem with skin diseases and hair, treating the lungs is correct.【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 fire in the Five Elements; physiological functions: ① governs blood vessels; ② governs consciousness; the heart opens to the tongue, connects with the pulse in the body, its manifestation is on the face, in emotions it corresponds to joy, and in fluids, it corresponds to sweat. The heart is interrelated with the small intestine.2. Lung: The lung is the place of the corporeal soul, the master of qi, belonging to metal in the Five Elements; physiological functions: ① governs qi and controls respiration; ② governs the dispersing and descending of qi; ③ regulates the water pathways; ④ governs the hundred vessels and treats stagnation (congestion); assists the heart in regulating the circulation of qi and blood; the lung connects to the throat, manifests on the skin, its manifestation is in hair, opens to the nose, in emotions it corresponds to worry, and in fluids, it corresponds to mucus; the lung is interrelated with the large intestine.3. Spleen: The spleen is the source of the transformation of qi and blood, the foundation of postnatal life, and stores intention, belonging to earth in the Five Elements. Physiological functions: ① governs transportation and transformation; ② governs the rising of clear qi; ③ governs the containment of blood; opens to the mouth, connects with the flesh in the body, governs the four limbs, its manifestation is on the lips, in emotions it corresponds to thought, and in fluids, it corresponds to saliva; 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. It belongs to wood in the Five Elements, governing the rising and movement. Physiological functions: ① governs the smooth flow of qi; ② stores blood; opens to the eyes, connects with the tendons in the body, its manifestation is in the nails, in emotions it corresponds to anger, and in fluids, it corresponds to tears; 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 water in the Five Elements; physiological functions: ① stores essence, governs growth, development, and reproduction; ② governs water; ③ governs the reception of qi; in the body, it corresponds to bones, governs the production of marrow, its manifestation is in hair, opens to the ears and the two yin (anus and perineum), in emotions it corresponds to fear, and in fluids, it corresponds to saliva; 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, separates 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 the movement of 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 without end. Mastering your own body means mastering the secret to longevity and health!Zi Hour: 23:00-1:00 Gallbladder Meridian: Deep sleep! The gallbladder needs metabolism; if a person sleeps during this time, the gallbladder can complete its metabolism. At this time, the heart’s function is weakest; if there are heart patients, prepare the emergency heart pill.Chou Hour: 1:00-3:00 Liver Meridian: Deep sleep! This is the best time for liver repair; the waste blood needs to be eliminated, and fresh blood needs to be produced, completed during this time. 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.Yin 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 time of yang flourishing and yin declining. 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 Yin hour for better results than during the day.Yin 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.Chen 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!Si 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, and continue to drink; do not drink any beverages.Wu 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 can greatly benefit 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.Wei 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 burp and pass gas. Therefore, lunch should be eaten before 1:00 PM so that nutrients can be absorbed into the body.Shen 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 can lead to “urinary retention.”You 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 Shen hour, the body discharges fire and detoxifies, and the kidneys enter the time of storing essence. This is a time for men. For those with kidney function issues, massaging the kidney meridian at this time is most effective.Xu Hour: 19:00-21:00 Pericardium Meridian: At this time, create conditions for peaceful sleep. Maintain a calm mindset.Hai Hour: 21:00-23:00 San Jiao Meridian: Time to sleep! This is when the San Jiao, the largest fu organ, operates, governing all qi and unblocking the water pathways. During the Hai hour, the San Jiao connects with the hundred vessels. One can rest and recuperate.【Pathological Mechanism Explanation】1. Adhere to the pathological mechanism, each in its own category When studying diseases, it is essential to grasp the mechanism of onset—whether it belongs to a zang or fu organ or is due to cold or heat.The pathological mechanisms can generally be summarized into two aspects: the five zang organ mechanisms (heart, liver, spleen, lung, kidney, upper, lower) and the six qi mechanisms (fire, heat, wind, cold, damp). The five zang organ mechanisms refer to the location of the disease, while the six qi mechanisms refer to the nature of the disease. The location of the disease must have a corresponding nature, and the nature of the disease cannot be separated from the location. Therefore, the five zang organ mechanisms are nothing but the changes of the six qi, and the changes of the six qi are pathological responses resulting 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 part.”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 fainting and loss of consciousness. It is mostly related to liver and kidney pathologies. “Solid” refers to the inability to pass urine and stool. “Diarrhea” refers to the inability to hold urine and stool (some believe that solid and diarrhea refer to bowel movements). Solid and diarrhea are mostly related to the pathologies of the large intestine, bladder, and kidney, thus also belonging to the lower jiao.【Counterflow Syndrome】 1. Counterflow SyndromeCold limbs, pale complexion, cold sweat, lethargy, and a dull expression, with a deep and thin pulse. It can be divided into cold counterflow and heat counterflow.1. Cold CounterflowDue to internal cold, the yang qi is weak below, and the cold causes blood circulation to be obstructed. The weakness of yang qi leads to an inability to warm and transport, resulting in cold counterflow syndrome. The treatment should warm the middle and disperse cold. Use Si Ni San with modifications for treatment.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 heat trapped inside and cold outside, resulting in counterflow syndrome with 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, initial heat followed by counterflow, red tongue, and rapid or deep and slow pulse. The treatment should revive yang and rescue the emergency, clear heat and detoxify, using Shenfu Decoction with Huanglian, Huangqin, Muli, and Longgu for treatment.2. Fainting SyndromeRefers to sudden fainting and loss of consciousness, with cold limbs, but with a chance of gradual awakening. The causes of this syndrome are numerous. The Huangdi Neijing records various types of fainting, such as 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 injures the liver, causing liver qi to rise, blood to follow the qi upwards, qi and blood to be obstructed, and clear yang to be obscured. 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. First, use pungent and cool herbs to open the orifices, such as An Gong Niu Huang Wan, and then use methods to invigorate blood and smooth qi, such as Tong Yu Decoction (from Jingyue Quanshu) with Tianma, Gou Teng, and Shijue Ming for treatment.② Phlegm Turbidity Obstruction: Usually, phlegm is abundant, and due to anger, qi rises, phlegm follows the qi upwards, obstructing the clear orifices, leading to sudden fainting, accompanied by phlegm sounds in the throat, foaming at the mouth, cold limbs, white and slippery tongue coating, and a deep and slippery pulse. The treatment should move qi and resolve phlegm, using Guo Phlegm Decoction with Baijiezi and Shichangpu.③ Summer Heat Scorching: Usually, yin deficiency and yang excess, combined with summer heat, disturb the clear yang, leading to sudden fainting. As stated in the Suwen, “Yang qi, when overworked, becomes exhausted, accumulating in summer, causing fainting.” First, use An Gong Niu Huang Wan to open the orifices with pungent and cool herbs, and after awakening, 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, pale tongue, and a deep and thin pulse. The treatment should use Ren Shen Yang Rong Tang to tonify qi and blood.② Qi Deficiency Fainting: Due to deficiency of the source qi, insufficient original qi, or qi deficiency sinking, clear yang cannot rise, leading to sudden fainting, pale complexion, sweating, and cold limbs, with a deep and weak pulse. First, use Shenfu Decoction to tonify qi and revive yang, then use Ba Zhen Tang to tonify both qi and blood.3. Solid Diarrhea Clinical AnalysisThe 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. The food and drink are processed in the stomach, transformed by the spleen, and the small intestine separates the clear from the turbid, with the waste transmitted to the large intestine, where water is absorbed to form stool. Therefore, as stated in the Ling Shu, “Food and drink are usually stored 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 process of food and drink transformation, it also involves the spleen, stomach, and small intestine; any changes in the function of these organs or invasion by external pathogens can affect stool formation.① Heat Constipation: Due to heat accumulation 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 fever, red face, bad breath, dry throat, short and red urine, yellow and dry tongue coating, and a strong and forceful pulse. The treatment should use Ma Zi Ren Wan to clear heat and moisten the intestines.② Cold Constipation: Due to yang deficiency or cold in the organs of the elderly, intestinal qi stagnation, internal cold, and yang qi not moving, leading to dry intestines, difficulty in bowel movements, clear and long urine, pale tongue, and a deep and slow pulse. The treatment should warm the intestines and expel cold, using Wen Pi Tang with Da Huang, Dang Gui, Rou Cong Rong, and Xing Ren for warming and moistening.③ Deficiency Constipation: Due to dry blood and fluids or due to prolonged illness leading to qi deficiency, resulting in difficulty in bowel movements. Those with blood deficiency often have a pale complexion and may feel dizzy and have palpitations. Those with qi deficiency may have a pale complexion, shortness of breath, and sweating. For blood deficiency, use Run Chang Wan to nourish blood and moisten the intestines (see Shen’s Zunsheng Book). For qi deficiency, use Huangqi Tang to benefit qi and moisten the intestines (see Jin Kui Yi). Analysis: Due to intestinal obstruction, clear qi cannot rise, turbid qi cannot descend, 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 use Mang Xiao Tong Jie Tang to open the obstruction.2. Diarrhea Clinical AnalysisDiarrhea is like water leaking, the flow is gentle, while diarrhea is direct and urgent, with slight differences, clinically referred to as diarrhea. Diarrhea is also due to changes in the functions of the spleen, stomach, large intestine, and small intestine, or due to the invasion of wind, cold, and damp pathogens, particularly dampness being the most important. As stated in the Huangdi Neijing, “Excess dampness leads to leakage;” excessive dampness injures the spleen, and water and dampness cannot transform, leading to diarrhea, while 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, the spleen governs transformation, and the liver governs smooth flow; if the liver is excessive, it can invade the spleen, and if the spleen is deficient, it cannot transform properly, leading to undigested food and diarrhea. Clinically, it is often seen as clear and watery stools, undigested food, abdominal distension, and intermittent pain and diarrhea, with pain not relieved after diarrhea. The treatment should use the Pain Diarrhea Formula with 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 accumulation, food stagnation 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 may be accompanied by fever, yellow and thick tongue coating, and a rapid pulse. The treatment should use Qin Lian Ge Gen Tang to clear heat and drain dampness.③ Cold-Damp Diarrhea: Due to cold and damp pathogens injuring 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 clear and watery stools, dark like water, with some formed feces resembling duck droppings, accompanied by clear and long urine and cold limbs. The treatment should use Fuzi Lizhong Tang combined with Pingwei San to warm the middle, disperse cold, strengthen the spleen, and drain dampness.④ Damp Diarrhea (also known as Dong Diarrhea): Usually due to spleen deficiency, combined with dampness, leading to internal water and dampness accumulation, resulting in diarrhea. Clinical symptoms include clear and watery stools, shooting out like water, color like muddy water, no abdominal pain, accompanied by heaviness and chest tightness, and scanty yellow urine. The treatment should use Weiling Tang to warm the spleen, dry dampness, and promote urination.⑤ Slippery Diarrhea: Due to qi deficiency sinking, the large intestine is slippery, and qi cannot contain it. Clinical symptoms include both food and fluids passing down, diarrhea like a torrent, no abdominal pain, with intermittent occurrences, and lingering symptoms. The treatment should use Buzhong Yiqi Tang with He Zi and Rou Dou Kou to tonify the middle and stabilize the descent.⑥ Early Morning Diarrhea: Due to the decline of the Mingmen fire, insufficient warmth for the earth, and inability to transform, occurring at dawn when yang qi should rise but has not yet risen, and the extreme yin qi invades the large intestine, leading to diarrhea. Clinical symptoms include early morning bowel sounds and diarrhea, with relief after defecation, coldness in the lower limbs, pale tongue, and a deep and thin pulse. The treatment should use Si Shen Wan to warm and tonify the Mingmen fire.3. Urinary Retention Clinical Analysis“Solid” also includes urinary retention. Retention refers to difficulty urinating, with scanty output, while closure refers to the desire to urinate but being unable to, with bladder distension and urgency, and the condition is more acute. Commonly referred to as urinary retention. The occurrence of urinary retention is mainly related to the kidneys and bladder.As stated in the Suwen, “The bladder is the organ of the state, storing fluids; 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 the opening and closing are 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 cannot clear and regulate, and fluids cannot be transported down to the bladder, leading to urinary retention. The spleen is the middle state, governing the transformation 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 thirst, with a thin yellow tongue coating and a rapid pulse. The treatment should use 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 is hindered, leading to difficulty urinating. Often accompanied by abdominal distension and thirst. Damp-heat steaming the skin may also lead to yellowing of the face, thick yellow tongue coating, and a slippery and rapid pulse. The treatment should use 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, thick yellow tongue coating, and a rapid pulse. The treatment should use 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 rise, while turbid fluids cannot descend to the bladder, leading to scanty urination and retention. Often accompanied by lower back pain and weakness in the knees; if water overflows the skin, it leads to edema, with a pale tongue and a deep and thin pulse. The treatment should use Ba Wei Wan or You Gui Yin to warm yang and promote urination.⑤ Bladder Obstruction: Due to blood stasis and dampness accumulation in the lower jiao, obstructing the bladder, leading to difficulty urinating, or urination in a thin stream, or sand and stones in the urine, often accompanied by painful urination and lower abdominal pain. The treatment should use 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, Ji Nei Jin) to clear heat, drain dampness, and promote urination. For blood in the urine, add Xiao Ji and Han Lian Cao.2. Those who have seek it, those who do not have seek it In the original text of the nineteen pathological mechanisms in the Suwen, there is also the phrase “Adhere to the pathological mechanism, each in its own category, those who have seek it, those who do not have seek it.” The first two sentences have been analyzed above and are not difficult to understand. What does “those who have seek it, those who do not have seek it” mean? I believe this sentence 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, and also study 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, 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, and convulsions are mostly related to the mechanism of fire. Zhang Jingyue believes that “heat evil injures the spirit, leading to dizziness, and excessive yang injures the blood, leading to convulsions,” all caused by excessive heat.Why does excessive heat lead to mental disturbance 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 upwards, disturbing the clear yang, it leads to mental confusion and dizziness. This is often seen in severe cases of excess heat. In warm diseases, it is often due to heat entering the nutrient blood and evil qi transmitting to the pericardium. The pericardium has a role in replacing the heart in governing the spirit, and the heart governs clarity; thus, evil qi transmitting to the pericardium can disturb the spirit, leading to mental confusion and other psychological symptoms. Excessive heat burns and injures yin, depleting blood and drying fluids, leading to insufficient nourishment of the tendons, causing 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 upwards, leading to irritability, delirium, and other mental symptoms, accompanied by high fever, red tongue, yellow and dry tongue coating, and a strong and rapid pulse. Excessive heat injures blood, and the tendons lose nourishment, leading to convulsions. The treatment should use 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 Peony Root to clear heat, drain dampness, and reduce jaundice.② Qi and blood both burning, evil invading the pericardium: Seen in the course of warm diseases, clinical symptoms include high fever, delirium, red tongue, and convulsions. Heat injures blood vessels, leading to rashes; the treatment should use Qing Ying Tang with modifications to clear the heart, open the orifices, and cool the blood to detoxify.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, even leading to opisthotonos, with a red tongue and a wiry and rapid pulse. The treatment should use Qing Wen Bai Du San with modifications to clear heat, drain fire, and pacify the liver.2. All types of restrictions, such as mouth closure and trembling, belong to fire“Restriction” refers to the inability to open the mouth, with tight jaws, unable to speak clearly. “Trembling” refers to shivering and shaking. “Drumming” refers to a drumming sound in the throat. “Loss of spirit” refers to anxiety and restlessness, with the spirit not being in control. This clause indicates that if symptoms such as mouth closure, trembling, drumming, and abnormal mental states 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 deeply while the righteous desires to resist the evil, leading to a struggle between yin and yang, with yin evil being predominant and yang qi being suppressed, leading to the inability of yang to express itself and the predominance of yin.When external yin and cold are predominant, symptoms such as mouth closure, trembling, and drumming may appear. When yang is excessive and yin recedes, yang qi is released, leading to heat. As stated in the Suwen, “It first arises in the hair, then it becomes apparent, with trembling and drumming, pain in the waist and spine; when the cold recedes, both inside and outside 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 upwards belong to fireVarious symptoms of counterflow qi rising are mostly related to fire. “Counterflow” means to go against the natural direction, while “rising” means suddenly moving upwards. The organs of the human body have specific directions of function, known as “qi mechanism.” If the qi mechanism is disordered, it is termed “qi counterflow.” For example, if stomach qi rises, it leads to vomiting, belching, and hiccups; if liver qi rises, it leads to liver fire rising and liver yang excess; if lung qi rises, it leads to coughing and wheezing… Among the symptoms listed above, only some are caused by fire. However, “excess qi is fire,” as fire is a yang evil, characterized by heat, and its nature is to rise. Fire evil breaking counterflow can cause qi to rise and become a disease. For example, under physiological conditions, the qi of the lung and stomach descends smoothly; if subjected to fire evil, it can cause qi to rise and become a disease.Clinical analysis:① Vomiting: The mechanism is generally due to stomach qi rising, divided into excess heat and deficiency cold types. If the fire evil rises, it belongs to excess heat, and vomiting often occurs suddenly or immediately after eating, with a strong and loud sound, yellow tongue coating, and a strong pulse. The treatment should clear heat, descend counterflow, and stop vomiting.② Belching: The disease belongs to stomach qi deficiency and cold, with qi stagnation and poor movement. If it is due to fire, phlegm and fire may be abundant in the stomach, leading to foul-smelling belching, accompanied by abdominal distension. The treatment should use Er Chen Tang with Chuan Huanglian to clear fire, descend counterflow, and resolve phlegm; it may also occur due to overeating, often belching after meals, accompanied by sour swallowing and noisy stomach sounds. The treatment should tonify the spleen and harmonize the stomach, aiding digestion and descending counterflow.③ Hiccups: If the syndrome is due to heat, it is often due to internal heat of the yangming, with constipation, and stomach qi rising. Clinical symptoms include strong and forceful hiccups. The treatment should use Zhuye Shigao Tang to clear the stomach and descend counterflow. If the syndrome is due to deficiency cold, it is often seen in spleen and kidney yang deficiency, with counterflow qi rising, leading to weak hiccups, and the condition is often severe. The treatment should tonify the spleen and kidneys, harmonize the stomach, and descend counterflow, using Xuanfu Daizhi Tang with 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 is different from “irritation,” which refers to anger in the chest without external manifestation, but both involve abnormal mental states. “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 distress, phlegm transforms into fire, burning fluids and generating phlegm, which obstructs the heart orifices, leading to mania. Clinical symptoms include unpredictable crying and laughing, incoherent speech, singing loudly, and running away, often seen in schizophrenia or manic-depressive disorder. The treatment should use Ling Shi Gun Tan Wan combined with Qingxin Wan to clear the heart, resolve phlegm, and open the orifices.② Heat disturbing the spirit: Often seen in the course of external heat diseases, with real heat burning and disturbing the spirit, such as in yangming excess syndrome, with abdominal fullness, dry constipation, irritability, delirium, and even restlessness, with a yellow tongue and a rapid pulse. The treatment should use Da Chengqi Tang with modifications to drain heat and preserve yin. If the warm evil transmits to the pericardium, disturbing the spirit, leading to irritability, delirium, and mental confusion, accompanied by thirst, red tongue, yellow coating, and rapid pulse. The treatment should use Qingying Tang to clear the heart, open the orifices, and cool the blood to detoxify.5. All types of swelling and pain belong to fire“Swelling” has two interpretations: ① edema, ② swelling of the dorsum of the foot. The term “pain” refers to pain that is not severe but 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 dampness swelling belong to the spleen,” and should not be repeated. Therefore, it can be interpreted as swelling of the dorsum of the foot accompanied by pain, heat, and even anxiety.Unexplained swelling and pain of the dorsum of the foot, even leading to heat and anxiety, are often caused by internal fire heat and qi and blood stagnation, mostly belonging to surgical diseases.In the mechanism of “all types of restrictions belong to fire,” symptoms such as mouth closure and trembling occur 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 disturbance of the spirit by fire evil will lead to feelings of heaviness in the heart. Or due to heat damaging fluids, leading to dryness and symptoms of convulsions. Additionally, it is also 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 the 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 seek it, those who do not have seek it,” drawing inferences from one instance, striving for differentiation, and not isolating one aspect for analysis, but 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, and the theory of qi dynamics, etc. The “holistic concept” emphasizes that the human body itself 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” focus on studying 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” elucidates the internal mechanisms of whether various pathogenic factors act on the human body and whether diseases occur and change. The “diagnostic methods and treatment principles” are the basic principles of TCM for understanding and treating diseases. The “preventive health” systematically elaborates on TCM health preservation theories, summarizing important experiences in health preservation and 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.This is for clinical reference only; non-professional doctors should not attempt acupuncture or medication.
Copyright Statement: Edited by Yi Dan, Proofread by Feng Tu / Based on publicly available information from the internetCopyright belongs to the original author.
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