【Introduction of the Expert】: Li Ke (a renowned TCM practitioner from Shanxi), Chief Consultant at the Classical TCM Clinical Research Institute of Guangxi University of Chinese Medicine. He has dedicated himself to the study of medicine with a compassionate heart. Gifted with intelligence, although he has not been directly taught by famous masters, he has grasped the essence of medicine. With 46 years of commitment to TCM clinical practice and research, he upholds the teachings of Zhang Zhongjing. He excels in integrating cold and warmth to treat critical conditions with heavy doses. Over the past fifty years, he has saved countless lives.
(1) Fundamental Views:
1. All diseases stem from the deficiency of the fundamental qi.
The fundamental qi refers to the innate kidney qi (yuan qi, yuan yang) and the acquired stomach qi (zhong qi) that together form a unified essence. These are the two essential sources of life; when they are unstable, life is at risk.
2. With stomach qi, there is life; without stomach qi, there is death. In chronic illnesses, difficult conditions, and critical situations, the first priority is to rescue the stomach qi. Preserving even a small amount of stomach qi provides a chance for survival. Treating the disease without considering the two essential sources and recklessly using harsh cold treatments is a medical error! If the stomach qi is harmed, it cannot transform food nor carry the medicinal properties. Therefore, protecting the stomach qi is the primary principle in treating diseases!
3. The stomach qi is the logistical support of the five organs, transporting the central earth and nourishing the surroundings, safeguarding the kidney qi. It is a major method for treating diseases and rescuing critical conditions, as all organs rely on qi from the stomach. Thus, the Li Zhong Tang (Regulating Middle Decoction) can treat numerous diseases.
4. The innate kidney qi is known as the fire of life. The fire god, Zheng Qinan, referred to it as: “Only this thread of true yang is the foundation of life.” Pengzi called it the “yang root.” According to the theory of the five elements, fire can generate earth. The spleen and stomach are like a cauldron, with the yuan yang as the fire at the bottom. Therefore, if the primary medicine for treating spleen and stomach diseases is ineffective, quickly warming and nourishing the life fire will naturally generate earth. Thus, Gui Fu Li Zhong Tang (Cinnamon and Aconite Regulating Middle Decoction) is also a crucial formula for rescuing stomach qi and treating numerous diseases.
5. Injury to the five organs ultimately affects the kidneys. In life-and-death situations, rescuing the yang is urgent! Preserving even a thread of yang qi provides a glimmer of hope.
(2) Insights on Cold Damage
1. The Treatise on Cold Damage consists of 397 methods, which can be summarized into two main principles: preserving stomach qi to rescue kidney qi, and rescuing kidney qi to protect stomach qi. The 113 formulas consist of only two main formulas: Li Zhong Tang and Si Ni Tang (Frigid Extremities Decoction). The Taiyang disease section has the most entries, and the methods for treatment are numerous, with the most common errors being the misuse of sweating, vomiting, and purging, which harm the stomach qi (zhong qi). To rescue from errors is to rescue the stomach qi. When the stomach qi is harmed, the ascending and descending functions are disrupted; what should rise instead sinks, and what should descend rises, leading to an imbalance in the movement of the five elements. Rescuing the stomach qi restores the central axis, normalizes the ascending and descending functions, stabilizes the four dimensions, and cures the disease. At least in the stage of yin disease, if a thread of true yang is about to perish, the entrance and exit cease, and the spirit’s mechanism is extinguished; if the ascending and descending functions cease, the qi becomes isolated and precarious. In life-and-death situations, if the yang root is about to be pulled out, breaking the yin to restore the yang is essential to save life. Learning about cold damage requires a return to the basics. As Pengzi pointed out, “The principle of cold damage is simply ‘exterior and interior cold-heat.’ This can encompass the main points of the 113 formulas, which can be summarized into three categories (zhong qi, ying wei, zang fu). Otherwise, the 113 formulas become 113 separate entities, and I become bound by the formulas (becoming a slave to the formulas), thus unable to use them!”
Pengzi used the principles of the I Ching’s He Tu to decipher the four great classics, creating a thread that connects everything, achieving great results with minimal effort. However, one must proceed step by step and avoid superficial attempts; it is essential to understand clearly. Then, through repeated practice and comprehension, success is guaranteed!
2. The six meridians of cold damage are essentially the yin and yang meridians. The three yang are unified in Yangming, and the three yin are unified in Taiyin, merely concerning the ascending and descending of the stomach and spleen and the zhong qi. The zhong qi is the fundamental qi of a person. All diseases arise from the deficiency of the fundamental qi. When the fundamental qi is strong, pathogens transform into heat and solidify, resulting in three yang diseases; when the fundamental qi is weak, pathogens transform into deficiency and cold, resulting in three yin diseases. The physician treats diseases by assisting the body’s fundamental qi. If treated correctly, yin symptoms transform into yang, moving from interior to exterior; if treated incorrectly, exterior pathogens invade the three yin, leading to perilous situations. Therefore, treating diseases requires close observation, paying attention to the emergence of turning points. At the first sign, one must assess the development trend and plan early. It is also crucial to remember: the dryness and heat of Yangming (as a symptom) can never counteract the cold and dampness of Taiyin. For symptomatic treatment, it is advisable to stop when the disease is moderate and not to over-medicate. In cases of excess, one must stop the medication; otherwise, Yangming excess can quickly transform into Taiyin deficiency, harming the zhong qi and leading to unpredictable outcomes. If the zhong qi is lost, it can instantly transform into Shaoyin’s loss of yang, leading to critical conditions that are often irretrievable.
3. Modern human constitution is often deficient, with nine out of ten being yang deficient, and it is rare to find one with yin deficiency. Among the six excesses, wind, cold, and dampness cause harm in eight or nine cases, while excess heat conditions are only one or two percent. This is true globally, regardless of geographical location or nationality; thus, one must never be careless in clinical practice.
4. An important principle arises: all external pathogens must be accompanied by internal injuries. Therefore, Ma Huang Tang (Ephedra Decoction), Yin Qiao San (Honeysuckle and Forsythia Powder), and Bai Hu Tang (White Tiger Decoction) must not be used. Only Ma Fu Xi (Ephedra and Aconite Decoction) with added Ren Shen (Ginseng), Wu Mei (Mume Fruit), and Zhi Gan Cao (Honey-fried Licorice) can treat all external pathogens, as it simultaneously opens the exterior while primarily preserving the fundamental qi. This belongs to the method of supporting the righteous and expelling the evil.
5. Every part of the human body, including the head, face, limbs, five senses, five organs, six bowels, tendons, bones, and blood vessels, is affected by the absence of yang qi, resulting in disease. Persistent cold and stubborn conditions, as well as all tumors, arise from this cause. One must understand that the path of disease is also the path of recovery. When pathogens invade the body, they penetrate from the skin and muscles through the meridians to the organs, moving from exterior to interior, from superficial to deep, accumulating layer upon layer, deeply hidden in the three yin vital areas, leading to disease. One must adhere to the teachings of the Inner Canon: “A good physician treats the skin and muscles” and “The superior physician treats the early signs,” using the Ma Fu Xi method to open the door and drive out the thief, supporting the righteous and expelling the hidden evil.
6. “A thread of true yang in the midst of the abyss is the foundation of life.” In the Treatise on Cold Damage, among the 113 formulas, 43 use Gui Zhi (Cinnamon), 24 use Gan Jiang (Dried Ginger), and 34 use Fu Zi (Aconite), with warming and promoting yang qi formulas accounting for over seventy percent of the total formulas. The focus of the medical sage is entirely on protecting the yuan yang.
7. In the past two centuries, the emergence of the Huogong school has inherited the ancient teachings, breaking through the fog, rectifying the chaos, and guiding ancient TCM back to the classical path. The emergence of ancient TCM in a circular motion, at a higher level, fully inherits the great principles of the I Ching, making ancient TCM a systematic medical science. The organic integration of the two will make ancient TCM invincible in the world.
Dr. Li Ke expresses concern about the current state of TCM, believing that “Due to multiple disruptions in the transmission of ancient TCM over the past 1800 years, this precious heritage, along with the ancient TCM tradition, is on the brink of extinction. How can we bring back our national spirit and medical spirit, restore our former glory, and fulfill the great wish of Mao Zedong that ‘Chinese medicine should first contribute to the life and health of the world’s people’?” Finally, Dr. Li elaborates on the principles of TCM clinical practice and the techniques of TCM clinical application through in-depth explanations of clinical cases. He once again highly praises the important roles of the I Ching, the Inner Canon, and the Treatise on Cold Damage, emphasizing that the differentiation of the six meridians can encompass all diseases and is a golden key to overcoming the difficult diseases of world medicine.
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