The Essential Prescriptions from the Golden Chamber
“Five Forces Reading Together”
Daily Progressing One Step
Diseases of the Organs and Meridians: The First Section on Symptoms and Patterns
Key Text Explanation
01
Preventing Disease Before It Occurs
【Original Text 1.1】Question: Why does the superior physician treat disease before it occurs??Master: The superior physician, when seeing a disease of the liver, knows that the liver affects the spleen, and thus must first strengthen the spleen. If the spleen is strong and not affected by evil, then there is no need to tonify it. The intermediate physician does not understand this transmission; when seeing a liver disease, they only treat the liver without addressing the spleen.
【Original Text 1.2】If a person can cultivate caution and not allow evil winds to disturb the meridians, and if the meridians are in harmony without transmitting to the organs, then they can be treated; if the limbs feel heavy and stagnant, then guiding, breathing exercises, acupuncture, and topical applications should be used to prevent the nine orifices from being blocked; furthermore, one must not violate the laws of nature, avoid harm from animals, and in the bedroom, ensure there is no depletion. When consuming food, one should moderate the temperature and flavors, avoiding excess that leads to decline, as illness will have no way to enter the pores. The pores are where the San Jiao (Triple Burner) connects with the Yuan Qi (Original Qi), and the texture refers to the skin and organ patterns.
What is preventing disease before it occurs?
The concept of preventing disease before it occurs in TCM has been passed down for thousands of years. According to Master Wu Bingcai, it mainly refers to treating the organs before they become ill. This includes three aspects:Preventing disease before it occurs, treating disease early, and preventing the transmission of existing diseases.Preventing disease before it occurs: The organs that are not yet ill should be protected from becoming sick, allowing them to approach a state of “harmony”.Treating disease early: If a disease is present, it should be treated as soon as possible to prevent it from deepening into an incurable condition.Preventing transmission of existing diseases: Existing diseases should be prevented from spreading to other meridians and organs.For example, when experiencing an external invasion of wind and cold, the initial stage is a Taiyang (Greater Yang) exterior syndrome. Timely treatment can resolve it with one or two doses. If there is no timely and correct intervention and treatment, the pathogenic factors may penetrate deeply, leading to difficult-to-treat diseases.☀︎ RegardingSeeing a liver disease, knowing that the liver affects the spleen, one must first strengthen the spleen.This statement is well-known among seasoned TCM enthusiasts. Literally understood, if the liver has issues, the liver and spleen must be treated together, because of the Five Element relationship between the liver and spleen. When treating the liver, one must first tonify the spleen to prevent liver disease from affecting the spleen, which is a classic scenario of preventing disease before it occurs.However, is it really that simple?After reading Cheng Menxue’s interpretation of the Golden Chamber, I realized its deeper meaning.① Deficiency and excess, supplement the insufficient, reduce the excessive. (Insufficient must be supplemented, excessive must be reduced.)② Liver disease can transmit to the spleen; if it is real, it can transmit; if it is deficient, it cannot transmit.③ When liver disease is real and the spleen is deficient, one must drain the excess and tonify the deficiency; if the liver has excess evil but the spleen is not deficient, one can directly drain the liver without needing to tonify the spleen. Because a strong spleen does not suffer from evil, there is no need to tonify it in advance.This is the true essence of the superior physician preventing disease before it occurs.
02
Liver and Spleen Treated Together
【Original Text】When treating liver disease, sour herbs are used to tonify, bitter herbs are used to assist, and sweet herbs are used to adjust. Sour enters the liver, bitter enters the heart, and sweet enters the spleen. The spleen can harm the kidneys; if kidney qi is weak, water does not flow; if water does not flow, heart fire becomes excessive, which harms the lungs; if the lungs are harmed, then metal qi does not flow; if metal qi does not flow, then liver qi becomes excessive, leading to self-recovery of the liver. This is the key to treating the liver and tonifying the spleen. If the liver is deficient, this method is used; if it is real, it is not used. The classics say: “Deficiency and excess, supplement the insufficient, reduce the excessive,” this is its meaning. The same applies to other organs.
【Explanation】
“Using sour to tonify” must be viewed with discernment.
Sour is astringent to the liver, but it is not necessarily tonifying to the liver. When there is evil qi, sour is not used to astringe evil qi.
For example, when there is liver wind, we may use Wumei Wan (Mumei Pill); at this time, the effect of Wumei Wan is not to tonify the liver with sour, but to extinguish the wind, thus sour is used to attack the evil.
How does liver disease affect the spleen??
In practice, treating liver disease by affecting the spleen is very instructive. Teacher Nan Dao shared Master Wu Bingcai’s clinical experience on how to affect the spleen when treating liver disease..
1️⃣ When there is liver excess, one must drain the liver while considering the spleen;
Draining liver herbs can also drain the spleen; for example, in Long Dan Cao (Gentian) Decoction, herbs like Long Dan Cao and Huang Qin (Scutellaria) are bitter and cold, which can damage spleen qi. When used in large doses, they can easily harm the spleen and stomach qi. Therefore, when using these draining liver herbs for liver excess, even if the spleen is not deficient, one must consider protecting spleen qi. For example, use smaller doses, more frequently, and prefer to use less rather than overdo it.
2️⃣ Spleen deficiency must be treated with spleen tonics;
When there are clear symptoms of spleen deficiency, such as weak right pulse and loose stools, then spleen tonics like Dang Shen (Codonopsis), Bai Zhu (Atractylodes), and Si Jun Zi Tang (Four Gentlemen Decoction) should be used.
3️⃣ When the liver is deficient, nourishing the earth can benefit the wood;
When the liver is deficient and needs tonification, it should be combined with spleen tonification. Because the liver stores blood, and the spleen governs blood. If some qi tonics are used in conjunction with blood tonics, it is easier to nourish; simply tonifying may not be effective, and combining with spleen function yields better results.
4️⃣ Spleen tonification often requires simultaneous treatment of the liver and spleen;
When tonifying the spleen, it is often necessary to also soothe the liver. When moving the spleen, one can add herbs that enter the liver, such as Chen Pi (Tangerine Peel), Mai Ya (Barley Sprout), or Zhi Shi (Bitter Orange), Bai Shao (White Peony). The spleen and liver are treated together.
5️⃣ Protecting the spleen does not mean only using tonics;
Protecting the spleen cannot rely solely on tonics. The spleen’s function is already weak; simply tonifying may not be effective. It is better to combine with some qi-moving herbs for better results.
03
Wind
【Original Text 1.2】Human beings are endowed with the five constants, growing and thriving due to the influence of wind. Although wind can give life to all things, it can also harm all things, just as water can float a boat but can also capsize it. If the five organs’ Yuan Qi is unobstructed, the person is peaceful and harmonious; if evil wind invades, many will perish. There are three main types of phlegm (chèn) that do not exceed three categories: one is when the meridians are affected by evil, entering the organs, causing internal issues; the second is when the limbs and nine orifices are obstructed, causing external skin issues; the third is when external objects like animals or sharp instruments cause harm. By detailing these, all diseases can be understood.Wind can give life to all things; here, wind refers to the harmonious wind, which is the normal qi of a person, mainly the liver qi. The spring qi connects to the liver, representing a normal physiological phenomenon.
Wind can harm all things, referring to the wind of the six evils.
The five organs’ true qi should be abundant, allowing for smooth flow, thus enhancing resistance to disease, leading to the saying, “When the righteous qi is present, evil cannot invade.”
There are many types of diseases, but they can be categorized into three:
1. When the meridians are affected by evil, entering the organs, the evil qi takes advantage of the deficiency, leading to internal conditions. There may also be a foundation of internal injury.
2. When the skin is affected by evil, causing disease on the surface, leading to obstruction of the limbs and nine orifices, this is an exterior condition.
3. Harm caused by external objects like animals, sharp instruments, or insects.
04
Observation Diagnosis
【Original Text 1.3】Question: When a patient shows a certain complexion on their face, what can be said about it? Master: If the tip of the nose is blue, and there is abdominal pain with cold, it indicates death. If the abdomen is cold and painful, it also indicates death. If the tip of the nose is slightly black, there is water qi. If the complexion is yellow, there is cold in the chest; if it is white, it indicates loss of blood. If it is slightly red and out of season, it indicates death; if the eyes are perfectly round, it indicates convulsions, which are untreatable. Additionally, blue indicates pain, black indicates labor, red indicates wind, yellow indicates constipation, and bright colors indicate retained fluids.
The nose is the “king of the face” and belongs to the spleen, serving as a representative for facial observation diagnosis.
~ A blue nose indicates liver color; symptoms show abdominal pain, indicating liver attacking the spleen;
~ A blue nose, combined with extreme cold sensitivity, indicates deficiency of yang qi;
~ A slightly black nose indicates water color, belonging to the kidneys, suggesting water qi.
~ A yellow complexion indicates overall yellowing, suggesting water retention in the chest. Yellow belongs to the spleen; if the spleen is insufficient, it cannot distribute the essence of water and grains to the limbs and body, leading to water retention in the chest cavity.
~ A white complexion indicates loss of blood. If blood cannot nourish the face, it indicates excessive blood loss.
~ Loss of blood with a slightly red complexion indicates a floating yang sign. This is due to blood loss affecting yin, which cannot contain yang.
At this time, the pulse is very important; one must observe whether the pulse is large or thin; if it is large, it is very dangerous.
~ Perfectly round eyes, indicating direct gaze, often seen in convulsive diseases, suggest strong wind evil, leading to the loss of the essence of the five organs. A direct gaze often indicates liver wind, which is critical but not necessarily fatal.
This section is presented in a dialogue format regarding facial observation diagnosis; in reality, the master only provides some examples. More detailed study of observation diagnosis is needed from the “Huangdi Neijing” to later observation diagnosis texts.
05
Listening to the Voice
【Original Text 1.4】Master: If the patient’s voice is quiet, and they express surprise, it indicates bone joint disease; if the voice is hoarse and unclear, it indicates heart and diaphragm disease; if the voice is chirping and thin, it indicates head disease. One version states pain.
Surprise indicates that the patient was originally quiet, but when the joints move, they experience pain, indicating they cannot move without pain.Hoarseness indicates that the voice cannot be produced well due to a blockage in the heart or diaphragm.Chirping and thin voice indicates headache, but they cannot speak loudly; speaking loudly causes head pain, so they can only speak softly.
【Original Text 1.5】Master: If the breath raises the shoulders, it indicates a firm heart; if the breath draws up the upper qi, it indicates cough; if the mouth is open and breath is short, it indicates lung atrophy with saliva.
Raising the shoulders indicates a firm heart—lifting the shoulders indicates a blockage in the heart.Drawing up the upper qi indicates cough—lifting the shoulders while coughing indicates some shortness of breath.It is somewhat labored.Opening the mouth with shortness of breath indicates lung atrophy with saliva—shortness of breath, similar to pneumothorax, accompanied by some pain.★ The key is to distinguish between deficiency and excess.【Original Text 1.6】Master: If the breath is shallow and rapid, the disease is in the middle jiao; if it is real, it can be treated immediately; if it is deficient, it cannot be treated. If it is in the upper jiao, the breath is rapid; if it is in the lower jiao, the breath is deep; these are all difficult to treat.Shallow and rapid breath indicates that the disease is in the middle jiao; if it is real, it can be treated immediately—this indicates that the breath is stuck in the middle jiao due to water retention. Da Xian Zhong Wan (Major Sinking the Chest Pill) can be used. If it is deficient, it is difficult to treat because the spleen and kidneys cannot hold qi.In the upper jiao, the breath is rapid—indicating rapid breathing.In the lower jiao, the breath is deep—indicating that one must take a deep breath, which is caused by kidney qi deficiency.☀︎ Cheng Menxue’s insights on distinguishing sounds in diagnosis:
① In the early stages of illness, the middle qi is real, thus the voice is strong and loud; in chronic illness, the middle qi is deficient, thus the voice is low.
② Short sounds indicate deficiency, while long sounds indicate excess.
Short sounds indicate deficiency, while long sounds indicate excess.
③ A clear and bright voice, even in chronic illness, is not a problem; a hoarse and rapid voice, even in early illness, indicates a poor prognosis.
④ Prolonged cough with a hoarse voice indicates dryness and depletion of fluids, which is difficult to treat and should be supplemented; sudden illness with a hoarse voice indicates external cold and internal stagnation, which should be opened and is easier to recover.
⑤ A muffled voice indicates nasal congestion externally, and fullness internally; a stuttering voice indicates external sores on the tongue and internal phlegm.
⑥ Wild speech indicates mania, while quiet speech indicates depletion.
⑦ Deficiency is indicated by a low voice, while excess is indicated by delirium.
Deficiency presents as mumbling, with low, intermittent speech; excess presents as rambling, with a higher voice and restlessness.
⑧ Strong heart qi leads to laughter, while lung qi deficiency leads to sadness.
⑨ Joyful laughter indicates organ restlessness, which should be nourished; angry shouting indicates liver fire, which should be cleared.
⑩ Dry heaving indicates gallbladder fire, while vomiting indicates phlegm and fluid.
⑪ Spleen pain leads to belching, stomach disease leads to vomiting, and belching indicates food injury, while belching indicates qi stagnation.
⑫ In the early stages of illness, hiccups with a heavy, short, and frequent voice indicate mild illness in the lungs and stomach; in chronic illness, hiccups with a low, long voice indicate severe illness in the liver and kidneys.
06
Pulse Diagnosis 【Key Point】
【Original Text 1.7】Master: The pulse at the cun (inch) position moves according to its seasonal timing; for example, if the liver is associated with the color blue, each season corresponds to its color. If the liver is blue but the pulse is white, it indicates a disease.
The cun pulse in the Golden Chamber does not necessarily refer to the cun, guan, and chi (inch, bar, and cubit) pulses; if only the cun pulse is mentioned, it refers to the cun pulse. Sometimes, if the cun pulse is followed by the chi pulse, it refers to the cun pulse alone.
★ Any mention of pulse diagnosis is a key focus for first-time learners of the Golden Chamber.
Regarding pulse diagnosis, it is recommended to study “Sixteen Lectures on Pulse Diagnosis” and the “Huangdi Neijing” along with other pulse diagnosis texts.
【Original Text 1.8】Question: What does it mean to have something that has not yet arrived but is present, something that is present but not arriving, something that has arrived but does not leave, and something that has arrived but is excessive??Master: After the winter solstice, at midnight of the Jiazi (first of the 60-year cycle), the Shaoyang (Lesser Yang) begins to rise, marking the beginning of yang. When the time has not yet reached Jiazi, the weather is warm, which is what is meant by something that has not yet arrived but is present; when Jiazi has arrived but the weather is not warm, this is what is meant by something that is present but not arriving; when Jiazi has arrived but the weather is extremely cold, this is what is meant by something that has arrived but does not leave; when Jiazi has arrived and the weather is warm like summer in May or June, this is what is meant by something that has arrived but is excessive.
This section’s “arrival” and “non-arrival” refer to the relationship between seasonal changes and weather. If the expected weather does not match the seasonal changes, it can easily lead to the occurrence of diseases.Common experience indicates that if it should rain but does not, or if it remains dry for too long, it can lead to illness. If it should snow in winter but does not, it can also lead to illness.【Original Text 1.9】Master: If the pulse is floating at the front, the disease is on the surface; if it is floating at the back, the disease is internal. If there is low back pain and stiffness, one must be short of breath and extreme.Floating at the back—understand this as the relative floating and sinking of the cun and chi pulses.
How to understand a floating pulse that is not a surface condition but indicates an internal disease? This can be understood as the relative floating and sinking of the cun and chi pulses; even if the pulse is not floating, the chi pulse may be slightly higher than the cun pulse, which can be recorded as “chi floating above cun”.
In spring, if the chi pulse is higher than the cun pulse, it indicates that the yang qi is unable to rise, suggesting an internal disease, and one can use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
In spring, if both cun pulses are slightly floating compared to both chi pulses, it is a normal pulse. If the cun pulse is floating, one must consider a surface condition.
One must analyze the formation of the pulse based on symptoms.
【Original Text 1.11】Question: If the pulse is deep and large, it indicates excess; if it is deep and slippery, it indicates qi; if the real qi collides with the blood qi, it leads to death if it enters the organs, and recovery if it enters the bowels. What does this mean??Master: If the lips and mouth are blue, and the body is cold, it indicates death if it enters the organs; if the body is warm and sweating, it indicates recovery if it enters the bowels.
【Original Text 1.12】Question: If the pulse is weak, it indicates death if it enters the organs, and recovery if it enters the bowels. What does this mean??Master: This is not just one disease; it applies to all diseases. For example, if a sore from immersion starts at the mouth and flows to the limbs, it can be treated; if it flows from the limbs back to the mouth, it cannot be treated. Diseases on the outside can be treated, while those that have entered the interior lead to death.
Blue lips and mouth, cold body, indicate death if it enters the organs—this indicates internal closure and external escape;Knowing the body is warm and sweating indicates recovery if it enters the bowels.The key to judging the prognosis of a disease is to analyze whether yin and yang can harmonize, and whether the flow of qi and blood between the exterior and interior is smooth. Entering the organs or entering the bowels essentially determines whether this is a favorable or unfavorable condition, whether it is worsening or improving.Entering the organs indicates that the disease has penetrated deeply and worsened, indicating a poor prognosis. Entering the bowels indicates that the disease is moving from the interior to the exterior, indicating a favorable trend towards recovery.
07
Treatment Order: Rescue the Interior and the Exterior
【Original Text 1.14】Question: When a disease is urgent, what should be prioritized: rescuing the interior or the exterior??Master: For diseases, if one treats the lower part, and the patient continues to have diarrhea without stopping, and experiences body pain, one must urgently rescue the interior; if the body pain resolves and the bowel movements self-regulate, one must urgently rescue the exterior.
【Original Text 1.15】When a chronic disease is exacerbated by an acute illness, one should first treat the acute illness, and then treat the chronic disease.
The order of treatment for simultaneous exterior and interior diseases is crucial.
The order of treatment largely determines the outcome. One must prioritize treating the exterior before the interior, or vice versa, depending on the specific condition.
Generally, one should first treat acute illnesses, such as colds, and then treat chronic diseases.
Note: Two excellent discussions. The order of treatment largely determines the outcome. First treat the cold, then treat the chronic disease.
However, sometimes, timely treatment of a new illness must also consider the impact of chronic diseases.
08
Location of Disease
【Original Text 1.16】Master: Each of the five organ diseases has its own characteristics for recovery; each organ disease has its own dislikes, and each follows what it does not like to become ill. If a patient does not respond to food that they should eat, but instead thinks about it excessively, they will definitely develop a fever.
【Original Text 1.17】When diseases are in the organs, they should be attacked according to their characteristics. For example, if there is thirst, one should use Zhu Ling Tang (Polyporus Decoction); the rest should be similar.
① In clinical practice, treatment and care should be based on the physiological characteristics of the five organs.
② Pay attention to the patient’s likes and dislikes, analyzing the underlying mechanisms.
③ When using herbs to attack evil, one must understand where the disease is located, and can use guiding herbs to ensure the medicinal properties reach the disease location.
Alright, let’s stop the review here.
I welcome everyone to learn the Essential Prescriptions from the Golden Chamber together.
