Inheriting the fire of Qi Huang, a public account with substance and warmth.
Ai Yu Xiang Tang
1. Q&A on Yang Deficiency
Question: Why do the head and face feel cold? Answer: The head is the apex of all Yang, where Yang Qi is abundant, thus it can withstand cold. If it cannot withstand cold, it indicates Yang deficiency. The treatment should be Jian Zhong Tang (Jian Zhong Decoction) with Fu Zi (Aconite) added to warm and tonify Yang for self-recovery. Jian Zhong Tang: Gui Zhi (Cinnamon Twig) 9 qian, Bai Shao (White Peony) 6 qian, Gan Cao (Licorice) 6 qian (roasted), Sheng Jiang (Fresh Ginger) 9 qian, Da Zao (Jujube) 12 pieces, Yi Tang (Honey) 5 qian, Fu Zi 3 qian.
Explanation of the Medication: Gui Zhi is warm and spicy, able to support the heart Yang. Sheng Jiang is spicy and dispersing, able to resolve stagnation. Fu Zi is very spicy and hot, strongly reinforcing the original Yang. Combined with the sweetness of Gan Cao and Da Zao, the spicy and sweet can transform Yang. When Yang Qi transforms and moves, Yin pathogens will be eliminated, and Qi will naturally recover, allowing one to withstand cold again. However, excessive spicy heat may harm Yin and blood, so Bai Shao, which is bitter and neutral, and Yi Tang, which is sweet, are included to balance and transform Yin. This condition is primarily due to insufficient Yang, hence the formula contains more warming and spicy herbs while also transforming Yin, which is a clever use of medication. This formula is a general prescription for Yang deficiency by Zhang Zhongjing, and the herbs can be adjusted in weight and quantity according to the patient’s needs, making it applicable for over a hundred types of Yang deficiency symptoms, all of which will respond promptly.
This answer directly concludes that the cold sensation in the head and face is due to Yang deficiency. The head and face are the apex of all Yang, and they are the parts of the body most resistant to cold. When Yang Qi is strong, they are exposed and do not become ill. If they feel cold, it is due to Yang deficiency. Zheng’s use of Xiao Jian Zhong Tang with Fu Zi for treatment, along with a detailed explanation of the medication’s purpose, is very appropriate. It is noted that Xiao Jian Zhong Tang is a general formula for treating Yang deficiency by Zhang Zhongjing, adept at adjustments and modifications, capable of treating over a hundred types of Yang deficiency symptoms, demonstrating remarkable insight.
The formula consists of Gui Zhi Tang with double Bai Shao and Yi Tang added, aiming to warm and dispel cold, with spiciness to promote circulation, and sweetness to alleviate urgency. It is generally used for Tai Yang disease and Spleen Yang deficiency symptoms. In fact, it can be applied to any condition of physical weakness with abdominal pain, palpitations, night sweats, nosebleeds, nocturnal emissions, hot hands and feet, fatigue and pain in the limbs, frequent urination with large amounts, etc. In modern times, it has been used to treat weak children with colds, nocturnal urination, diabetes, pulmonary tuberculosis, anemia, and gastritis. Adding Yin Yang Huo (Epimedium) treats impotence, adding Yin Chen (Artemisia) treats jaundice, and adding Long Chi (Dragon Bone) treats hypertension, all achieving significant effects. If adding Dang Gui (Angelica) and Huang Qi (Astragalus), it has even more nourishing and strengthening effects, truly deserving to be a key formula for treating Yang deficiency.
The author has used Jian Zhong Tang with Ding Xiang (Clove) to treat various stomach pains with repeated success, as Ding Xiang is warm and spicy, able to warm the middle and descend counterflow, warming the stomach and assisting Yang. Adding Po Guo Zhi (Citrus Peel), Yi Zhi Ren (Alpinia) and Sang Qiao (Silkworm) treats frequent urination in the elderly, and nocturnal enuresis in children, with a success rate of 90%, as all three herbs can nourish the kidney and Ming Men (Gate of Life), benefiting Qi and solidifying the kidneys, with the function of reducing urination.Question: Is there a difference between fear of cold and aversion to wind? Answer: Aversion to wind is when one feels discomfort upon encountering wind, unlike fear of cold, which is a general fear of cold without the presence of wind. Aversion to wind is associated with fever, stiff neck, and spontaneous sweating, which Zhang Zhongjing categorized under Tai Yang wind injury symptoms, primarily treated with Gui Zhi Tang. Fear of cold, on the other hand, is associated with fever, stiff neck, and no sweating, categorized under Tai Yang cold injury symptoms, primarily treated with Ma Huang Tang. For those with chronic illness, if there are no symptoms of fever or headache, but they have aversion to wind, it indicates external deficiency (insufficient Yang to protect the exterior). In contrast, fear of cold indicates internal Qi deficiency (the original Yang is weak internally and cannot fill the body). Those with aversion to wind can be treated with Huang Qi Jian Zhong Tang, while those with fear of cold can be treated with Fu Zi Gan Cao Tang. New and chronic illnesses, fear of cold and aversion to wind, have a significant difference, which scholars should be aware of. Gui Zhi Tang: Gui Zhi 9 qian, Bai Shao 6 qian, Gan Cao 6 qian (roasted), Sheng Jiang 9 qian, Da Zao 12 pieces. Ma Huang Tang: Ma Huang 6 qian, Gui Zhi 3 qian, Xing Ren (Apricot Kernel) 2 qian, Gan Cao 2 qian (roasted). Huang Qi Jian Zhong Tang: (same as above with Huang Qi added). Fu Zi Gan Cao Tang: Fu Zi 1 liang, Gan Cao 6 qian (roasted). Explanation of the Medication: Gui Zhi Tang is a formula that harmonizes Ying and Wei. Gui Zhi is warm and spicy, able to transform Tai Yang Qi; Sheng Jiang is spicy and dispersing, able to promote all stagnation. Gui Zhi and Sheng Jiang share the same Qi, combined with the sweetness of Gan Cao, can regulate the Yang Qi throughout the body, hence it is said that spicy and sweet transform Yang. Once Yang Qi transforms, there is fear that Yin does not transform with it, and the pathogen may not be expelled immediately, thus the addition of Bai Shao, which is bitter and neutral, and Da Zao, which is sweet and neutral, balances the Yin fluids, hence it is said that bitter and sweet transform Yin. When Yin and Yang harmonize, the body is naturally free of stagnation, hence it is said that when Ying and Wei harmonize, the illness is cured. Zhang Zhongjing further recommends taking congee to assist, as it extracts the essence of food and water to produce sweat, and also strengthens the righteous Qi to overcome the evil Qi. Note that Ma Huang Tang is a strong sweating formula. Since cold injures the Tai Yang Ying portion, the pathogen is at the skin surface (the superficial layer of the muscle), and the surface Qi is not flowing, which is more severe than Gui Zhi symptoms, hence Ma Huang, being light and clear, is used to open the skin and hair as the monarch. When the skin and hair are opened, the pathogen has a route to exit, but if it does not exit immediately, Xing Ren is used to facilitate it, allowing the Qi mechanism to benefit, and the pathogen will not dare to linger. Gan Cao is used to harmonize the middle and assist the righteous Qi, further supporting Gui Zhi to reach the skin surface, where the cold pathogen is met with Gui Zhi’s warm and spicy properties, which cannot help but disperse, thus exiting from the skin surface. Zhang Zhongjing does not recommend taking congee, fearing it would assist Ma Huang and cause excessive sweating. (The term ‘sweating’ has profound meaning. Sweat is essentially blood, which is a nourishing substance for Ying. How can it be allowed to exit? If one does not understand that cold pathogens obstruct and stagnate, causing Qi and blood to be unimpeded, it leads to illness. At this time, the blood cannot nourish Ying, and if it is allowed to exit, it is to remove the old and bring in the new. Patients should not fear sweating; when sweat is produced, the pathogen is expelled. Physicians should not avoid sweating; when there is illness, the appropriate medication must be used. In summary, recognizing symptoms is crucial.) Note that Huang Qi Jian Zhong Tang is a formula that combines Gui Zhi Tang with Yi Tang and Huang Qi. Gui Zhi Tang is the ancestral formula for harmonizing Ying and Wei, and Huang Qi can solidify the exterior Qi. Yi Tang has the ability to tonify the middle. If a person with a long-standing aversion to wind has insufficient middle Qi and weak exterior Qi, now with Gui Zhi Tang harmonizing Yin and Yang, Huang Qi and Yi Tang can guard the exterior and support the middle, how could the illness not recover? Note that Fu Zi Gan Cao Tang is a formula that skillfully supplements both the front and back. Fu Zi is spicy and hot, able to supplement the original Yang, while Gan Cao is sweet, able to supplement the postnatal Spleen. When the earth receives fire, the middle Qi can recover (Fu Zi supplements the original fire, and when the fire is strong, it can generate Spleen earth, hence it is said that the middle Qi can recover). If a person with a long-standing fear of cold has insufficient original Yang, they cannot resist the cold Yin Qi, hence they fear cold. Now with Fu Zi, the original fire is revived, and with Gan Cao, the postnatal Spleen earth is established, how could the fear of cold not be resolved? Question: Why does the head and face suddenly swell, appearing bluish-white, feeling heavy and drowsy, and when closing the eyes, one feels as if floating without support? Answer: This is due to the true Qi of Shao Yin rising. It originates from the weakness of the monarch fire, which cannot restrain the multitude of Yin, causing Yin Qi to rise and block the vast space, resulting in swelling. Hence the face appears bluish-black, and the excessive Yin Qi forces out the original Yang, causing one to feel as if floating without support when closing the eyes. At this time, a small amount of true Yang is blocked by the multitude of Yin, and if one wishes to return to the root, it is necessary to eliminate the multitude of Yin, and the true Yang must be revived. Question: When the illness is about to heal, and all external pathogens have retreated, why does the whole body and face swell? Answer: This is due to insufficient middle Qi and scattered original Qi. When a patient is disturbed by external pathogens, Qi and blood are greatly depleted, and the middle Qi cannot recover suddenly. Now that the external pathogens have retreated, the Yin Qi of the lower jiao takes advantage of the deficiency of the middle earth, causing it to rise and scatter, resulting in swelling throughout the body. Although it is said that the monarch fire is weak and insufficient to control Yin, this symptom is actually due to the deficiency of the Spleen earth, which cannot control water, leading to an overflow of water Qi, which can be termed edema. One aspect is that the Spleen earth is too weak to suppress fire, and the fire does not sink, causing the true Yang Qi to overflow, resulting in swelling throughout the body, which can be termed Qi edema. In summary, it is not necessary to distinguish which is Qi edema and which is water edema; it is important to know that when Qi moves an inch, water moves an inch; when Qi moves throughout the body, water moves throughout the body, indicating that the original Qi is scattered, and the Yin water is also scattered. Those treating the illness do not need to see swelling and treat swelling; they should recognize that the weakness of the earth cannot control water, and thus they should greatly tonify the earth to control water. They should recognize that the original Yang is overflowing, and the earth is thin and cannot suppress it, and thus they should greatly tonify the earth to suppress fire. When the fire is suppressed, the Qi will be hidden; when the Qi is hidden, the water will return to its home, and how could there be swelling? The classics say: “Fire cannot be stored without earth,” which is the secret to understanding the essence of virtual swelling. Moreover, there is another analogy: try placing a paper over the steam on a steamer, and in a moment, the paper will become wet. From this, it can be inferred that when Qi moves, water moves; when Qi is suppressed, water is suppressed, which can be without doubt. This symptom can be treated with Li Zhong Tang (Regulate the Middle Decoction) with added Sha Ren (Amomum) and Fu Ling (Poria) to warm and tonify the earth for self-recovery.Question: Why do both eyes suddenly swell like peaches, with a splitting headache, shortness of breath, and a bluish-black face and lips? Answer: This is due to the true Yang of the original being violently rising along the liver wood. The original Yang resides in the kidney, and when the Yin is excessively strong, a thread of original Yang rises with the Yin Qi. Water is the mother of wood; when the mother is ill, the child is affected, hence it rises along the liver wood, and the Jue Yin pulse meets at the top, with true Qi attached to the pulse rising. The Yang Qi violently rises, hence the splitting headache. The liver opens to the eyes, hence the swelling appears like peaches. Shortness of breath occurs as the Yin pathogen rises and obstructs the clear pathway, creating a disconnect between the upper and lower. The bluish-black face and lips are all due to a mass of Yin Qi. The original Yang has risen and is on the verge of escape. At this time, if one views it as a Yang symptom and uses cooling and dispersing medications, they will die within days. The treatment should be Si Ni Tang (Frigid Extremities Decoction) to return Yang and dispel Yin, which can cure.Question: Why do both ears swell suddenly, with slightly red skin and a bluish hue, slight pain, high fever, bright red cheeks, no thirst, and a tongue with a bluish-white coating, with a floating and empty pulse? Answer: This is due to the original Yang overflowing, with Qi attached to Shao Yang rising. Both ears are located in the Shao Yang region, and now swelling slightly with pain and redness with a bluish hue, along with bright red cheeks and no thirst, indicates that the fire of Shao Yang is strong. If it were due to wind or cold obstruction, there would be symptoms of headache, body pain, and alternating chills and fever; if it were due to internal depression, there would be feelings of worry and unresolved emotions. Upon careful examination, there is no evidence of external factors, thus it is undoubtedly due to insufficient original Yin. Insufficient original Yin can arise from various causes. It can be due to long-term damage to the Spleen and Stomach, leading to insufficient transformation; it can be due to excessive sexual activity, leading to insufficient original Yang and weak transport capacity, resulting in gradual Yin blood deficiency, which cannot nourish the wood, leading to dryness and various symptoms such as redness, swelling, pain, ear deafness, bitterness in the mouth, rib pain, and muscle spasms. This highlights the importance of the balance of original Yin and Yang, as the body relies on both to maintain health. Question: Why does the tip of the nose swell and turn red, the upper gums swell and hurt, with constipation, irritability, and thirst for cold drinks? Answer: This is due to insufficient original Yin in the stomach, with excessive stomach fire damaging Yin blood. The Qi of original Yin is essential for maintaining balance; if it is insufficient, there will be no risk of red, swollen, and fiery symptoms. People often attribute this to wind or fire pathogens, not realizing that the original Yin has been depleted internally. When Yin is deficient, fire becomes excessive, leading to various fire symptoms. The symptoms presented by the patient indicate that they have the symptoms of Yang Ming syndrome, with excessive stomach fire and severely depleted Yin blood. It is important to note that blood contains original Yin, and Qi contains original Yang. When the patient’s original Yin is insufficient, fire arises, and when fire becomes too intense, it further damages the blood. Therefore, it is said that “strong fire consumes Qi,” meaning that the consumption of Qi leads to the depletion of original Yin. Many physicians mistakenly believe that Gui Zhi and Fu Zi are invigorating fire, not realizing that they are actually tonifying the deficiency of original Yang, which is essential for those with Yang deficiency, not suitable for those with excessive fire and Yin deficiency. The treatment for this condition should focus on draining fire and rescuing Yin, primarily using Da Cheng Qi Tang (Major Order the Qi Decoction).Question: Why do both eyes have red veins, with severe pain, a swollen tongue, and difficulty urinating? Answer: This is due to insufficient original Yin, with fire boiling in Shao Yin. The inner and outer corners of the eyes belong to the heart and small intestine, and the insufficient original Yin in these two channels leads to excessive original Yang, resulting in illness. This is a guest pathogen, and it does not necessarily require wind or cold obstruction to manifest. Understanding this principle allows one to grasp the relationship between the balance of Yin and Yang. The eye sockets are where the essence of the five organs gathers, and they cannot tolerate even a slight guest pathogen. If a guest pathogen enters, it can lead to various eye diseases. The term “guest pathogen” refers to external factors such as wind, cold, heat, dampness, dryness, and fire, as well as internal factors such as the imbalance of original Yin and Yang. When the original Yin is insufficient, fire will be excessive, leading to solid pathogens, which can cause redness, swelling, and severe pain. Conversely, when the original Yang is insufficient, Yin will be excessive, leading to weak pathogens, which may not present with swelling or pain. If there is swelling and pain, it indicates that the original Yang is escaping, and one must look for evidence of Yin. If there is no evidence of Yin, it indicates solid fire, which is crucial for diagnosis. Although there are many types of eye diseases, they can generally be categorized into four types: Yin, Yang, deficiency, and excess. The eye diseases are associated with the five organs, known as the five wheels. The wind wheel corresponds to the liver, the blood wheel corresponds to the heart, the Qi wheel corresponds to the lungs, the water wheel corresponds to the kidneys, and the flesh wheel corresponds to the spleen. There are also eight compartments, which correspond to the eight trigrams. The key is not in the details but in understanding the balance of Yin and Yang. This condition, with swollen eyes and a swollen tongue, and difficulty urinating, indicates heat in the heart and small intestine. The treatment should focus on nourishing Yin and clearing heat, primarily using a large dose of Dao Chi San (Guide Out the Red Powder), adding Ren Shen (Ginseng) and Huang Lian (Coptis) as the main ingredients.Question: Why does the throat hurt, with a dry cough and no phlegm, five hearts feeling hot, and a desire to drink cold? Answer: This is due to insufficient original Yin, with excessive fire in Shao Yin affecting the lungs. The pulse of Shao Yin runs through the throat, and the pain in the throat is due to excessive fire, while the cough in the lungs is due to fire pressure. The absence of phlegm indicates that the fire is strong and the fluids are depleted. The five hearts feeling hot indicates that the original Yin is deficient, leading to the invasion of evil fire, and the desire to drink cold indicates a need for Yin to cool down. The treatment should focus on clearing heat, moistening dryness, and rescuing Yin, primarily using Huang Lian A Jiao Tang (Coptis and Donkey-hide Gelatin Decoction).Question: Why does a postpartum woman experience minor ailments two to three days after delivery, and after taking medications to move blood and break stagnation, it leads to swelling all over the body, and after taking medications to reduce swelling, it worsens with breast swelling and loss of appetite, and rectal pressure, causing severe pain? Answer: This is due to inappropriate medication leading to blood depletion. After childbirth, women often experience blood loss, and if blood is deficient, there will be symptoms of stagnation, abdominal pain, breast swelling, and blood dizziness. It is essential to use warming, blood-moving, and Qi-regulating medications, and not to excessively use blood-breaking and stagnation-breaking herbs. Those who mistakenly focus solely on breaking stagnation do not realize that warmth allows stagnation to resolve on its own, and active blood allows stagnation to disperse. This condition arises from inappropriate use of medications, leading to severe symptoms. It is crucial to support Yang Qi to generate blood; if one does not support Yang and instead depletes it, how can Yin blood be generated? How can stagnation be resolved? Now that blood is depleted and original Qi is unsupported, the body becomes scattered, leading to swelling. At this point, it is essential to gather the original Yang, and if one is still concerned, taking medications to reduce swelling will only worsen breast swelling and rectal pressure, leading to severe pain. The treatment should focus on significantly replenishing blood, as blood replenishment will provide support for Qi, and with Qi support, swelling will naturally resolve. The formula should be Dang Gui Bu Xue Tang (Angelica Blood-Tonifying Decoction), adding Lu Rong (Deer Antler Velvet), Bai Jiang (Black Ginger), Mai Ya (Barley Sprout), Gan Cao (Licorice), and green onion wine.Question: Why does a patient have a foul mouth odor, yellow complexion, thirst for cold drinks, persistent hiccups, and continuous diarrhea, yet walks normally? Answer: This is due to insufficient original Yin, with excessive stomach fire. There are two types of foul mouth odor: one is due to the leakage of original Qi, where the mouth is extremely foul, the tongue is moist and slightly yellow, and the person lacks spirit, showing full Yin symptoms. The other is due to excessive stomach fire, where the mouth is foul, the tongue is dry and yellow, and the person is thirsty for cold drinks. Hiccups indicate that fire is rising, while persistent diarrhea indicates that fire is descending. The fact that the person walks normally indicates that fire is assisting. The treatment should focus on draining fire, primarily using Da Cheng Qi Tang.Question: Why does a patient have a dry cough with no phlegm? Answer: This is due to insufficient original Yin, leading to lung dryness. The lungs are metal and the source of water. Insufficient original Yin leads to lung dryness, which cannot produce water. Lung dryness is caused by insufficient original Yin and the rise of evil fire. When fire is excessive, it overcomes metal, leading to lung dryness. When lung Qi is dry, a dry cough occurs. The treatment should focus on bitter and sweet to transform Yin and nourish blood, primarily using Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction), combined with Dang Gui Bu Xue Tang.Question: Why do women suddenly laugh and cry, speaking unusually, appearing mad or insane? Answer: This is due to the inability of true water to ascend to the heart, leading to heart heat and a lack of control over the spirit. The human body relies on the balance of water and fire. Water and fire depend on each other; when fire descends, the kidneys are warm, and when water rises, the heart is cool. This is the subtlety of Yin and Yang inversion. The symptoms presented by the patient clearly indicate that true Yin is insufficient, unable to ascend to the heart, leading to the generation of heart heat. The heart is the master of the spirit; when heat is excessive, the spirit becomes confused, leading to unusual laughter and speech, resembling madness. Many texts refer to this as heat entering the blood chamber, but they do not fully grasp this principle. They do not realize that the heart is the source of blood. The blood chamber is where the Chong Mai resides. When heat enters, it does not necessarily lead to madness; it can simply indicate excessive heat and confusion. The treatment should focus on nourishing Yin and clearing heat, primarily using Zhi Zi Shi Tang (Gardenia and Shichangpu Decoction).Question: Why does a patient cough up yellow phlegm several times after breakfast, feel hot in the five hearts, be irritable, thirsty, and have a rapid pulse? Answer: This is due to extreme deficiency of original Yin, with excessive fire and depletion of fluids. The symptoms of excessive heat, thirst, and desire for cold drinks, along with irritability, cough with yellow phlegm, resemble the symptoms of Bai Hu Decoction (White Tiger Decoction). However, the pulse is thin and rapid, indicating blood deficiency and heat. This indicates that blood deficiency leads to internal heat, which is not the same as the symptoms of Bai Hu Decoction. At this time, physicians should not be reckless; they must carefully assess the situation. Upon further investigation, the symptoms of irritability, thirst, and fever from external pathogens are often accompanied by headache, body pain, and chills. However, the symptoms of blood deficiency leading to excessive heat, thirst, and irritability arise from internal damage, such as coughing blood, prolonged cough, postpartum blood loss, or emotional distress affecting the heart and spleen. The pulse will be thin and rapid, and there will be no significant headache, body pain, or chills. Therefore, one should not hastily use Bai Hu Decoction, as it can cause significant harm. The treatment should focus on significantly replenishing true Yin, primarily using Du Shen Tang (Ginseng Decoction) or Dang Gui Bu Xue Tang.Question: Why does a patient who drinks excessively feel hot all over and have shortness of breath, thirst for cold drinks, and no headache, body pain, or chills? Answer: This is due to accumulated dampness generating heat, with excessive heat damaging blood. Those who indulge in alcohol easily develop damp-heat symptoms. The nature of alcohol is strong and dispersive, and once it enters the stomach, the alcohol quickly spreads throughout the body. When the strong nature passes, dampness remains in the middle jiao. If the middle earth is strong, dampness is easily eliminated; if the middle Qi is weak, dampness is difficult to disperse. Over time, the middle Qi becomes more deficient, and dampness leads to illness, flowing into the limbs and causing phlegm-fire symptoms. When physicians see phlegm-fire symptoms in the limbs, they often treat them as such, with few achieving recovery. My approach is to warm the middle and eliminate dampness, using warming and sweetening herbs. If this condition arises from long-term damp accumulation leading to heat, the heat will press on the lungs, causing shortness of breath, and the heat will damage fluids, leading to thirst. The treatment should focus on clearing heat, drying dampness, and promoting upward movement, primarily using Ge Gen Huang Lian Huang Qin Tang (Pueraria, Coptis, and Scutellaria Decoction).Question: Why do elderly patients experience difficulty with bowel movements? Answer: This is due to severe blood deficiency, which cannot moisten the channels. Elderly individuals often experience both Qi and blood deficiency. When Qi is strong, blood naturally thrives; when Qi is weak, blood naturally declines. However, elderly individuals have varying degrees of constitution, and one cannot generalize that both Qi and blood are deficient. Some may have strong Yang and remain spirited, while others may have thin constitutions and suffer from chronic illnesses, leading to insufficient vitality and poor digestion, resulting in blood deficiency. There are also cases where external pathogens enter the Yang channels, transforming into heat pathogens that settle in the intestines, causing constipation. Additionally, there may be cases of excessive Yin and weak Yang in the lower jiao, leading to inability to transform Yin and causing constipation. The diagnosis should focus on clearing the symptoms. If an elderly patient has constipation without external symptoms, it is primarily due to blood deficiency, and the treatment should focus on bitter and sweet to transform Yin, primarily using Dang Gui Bu Xue Tang with honey, or Gan Cao Gan Jiang Tang, or Ma Ren Wan (Sesame Seed Pill).Question: Why does a man experience persistent erection without retraction? Answer: This is due to the original Yin being on the verge of depletion, leaving the Yang isolated. The erection of the Yang organ indicates strong Yang. When Yang is strong, it should naturally generate Yin; if Yin is not generated, it leads to Yang being isolated. At this time, the treatment should focus on rescuing Yin and significantly tonifying the original Yin, primarily using Du Shen Tang or Liu Wei Di Huang Wan (Six Flavor Rehmannia Pill).Question: Why does a patient feel heat in both legs up to the knees at midnight, with irritability, and why does it resolve by noon? Answer: This is due to blood deficiency and excessive Yang. The human body relies on the balance of Yin and Yang. Yang is born from the child to the hour, gradually increasing until noon, when it begins to decline, similar to the movement of the sun. If a patient experiences chills and abdominal pain at midnight, it indicates that the Yin is beginning to rise, while Yang is declining. If the patient’s Yang is insufficient and encounters excessive Yin, the excessive Yin obstructs the movement of Yang Qi, leading to abdominal pain. This is due to the excessive decline of Yang, which cannot resist the multitude of Yin, resulting in this condition. The treatment should focus on supporting Yang and suppressing Yin, primarily using Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) with added Sha Ren and Bai Shao.Question: Why does a healthy person suddenly experience abdominal pain and diarrhea several times a day, with undigested food, yet feels energetic? Answer: This is due to insufficient original Yin in the lungs, leading to excessive dryness in the lungs. When diarrhea occurs with undigested food, it is often attributed to the failure of the Spleen and Stomach. However, excessive dryness in the lungs can also lead to this symptom. The lungs and large intestine are interrelated; when the lung Qi is excessively dry, it can lead to rapid descent of food into the large intestine, resulting in frequent diarrhea. If the Spleen fails to digest food, the patient will feel fatigued. In cases of diarrhea, if the stool is yellow, it indicates excessive stomach fire; if it is white, it indicates a lack of fire in the lower jiao; if it is green, it indicates cold transformation; if it is thick and muddy, it indicates cold in the organs; if it is white and thin, it indicates heat in the lungs. The treatment should focus on clearing dryness, primarily using Gan Ju Tang (Sweet Orange Decoction) with added Er Dong (Winter Melon), Di Gu Pi (Lycium Bark), Sang Pi (Mulberry Bark), Huang Qin (Scutellaria), Xing Ren (Apricot Kernel), and Bai Mi (Honey).Question: Why does a patient experience a dry cough and itchy skin? Answer: This is due to insufficient original Yin, which cannot moisten the lungs, leading to lung dryness. A dry cough indicates blood deficiency and lung dryness. The lungs govern the skin; when lung Qi is clear, it regulates the skin and organs. When lung Qi is excessively dry, it leads to various symptoms. If fluids do not circulate internally, it can lead to lung atrophy, organ stagnation, intestinal dryness, and other symptoms. If fluids do not circulate externally, it can lead to skin dryness, muscle atrophy, and itching. This condition indicates blood deficiency and lung dryness, and the treatment should focus on clearing dryness and nourishing the blood, primarily using Dang Gui Bu Xue Tang with Gan Cao Gan Jiang Tang, adding Wu Wei Zi (Schisandra) and Bai Mi (Honey).Those who engage in this field must understand the mechanisms of Qi and blood circulation in the body. The roots of Qi and blood are in the lower body, cultivated in the middle, and expressed in the upper body. The root is represented by the circle, cultivation by the square, and expression by the triangle. The lungs govern Qi, while the heart governs blood. The outer circle is formed by the Qi of heaven, while the inner circle is formed by the Qi of earth. Heaven encompasses earth, and earth is formed by heaven, creating a harmonious whole. When earth Qi rises, it indicates the original Yang; when heaven Qi descends, it indicates the original Yin. Thus, breathing is the interaction of Yin and Yang. When one exhales, Qi moves, and blood follows; when one inhales, blood moves, and Qi follows. Although breathing is categorized as Yin and Yang, in reality, when one rises, both Qi and blood rise; when one descends, both Qi and blood descend, creating a continuous cycle. Therefore, the distinction between Yin and Yang is based on the upper and lower body. The ancients feared that people would not understand this principle, so they illustrated it with diagrams to clarify the concepts of Yin and Yang. The concepts of heaven and earth are referred to as pre-heaven, while the six trigrams are referred to as post-heaven. Modern people focus solely on post-heaven discussions of Yin and Yang, neglecting the pre-heaven discussions of the rise and fall of Yin and Yang, which indicates a lack of understanding of the essence while being unaware of the root. If one can grasp the principles of the rise and fall of Yin and Yang, they can learn to adapt to the path of healing.Question: Why do muscles contract and not extend? Answer: This is due to blood deficiency, which cannot nourish the muscles, leading to muscle dryness. Muscle dryness can arise from various causes. Although it is said that water nourishes wood, in reality, the functions of water and fire are governed by the heart and lungs. The lungs govern Qi, while the heart governs blood. When lung Qi is excessively dry, it leads to insufficient nourishment of the muscles, resulting in muscle contraction. When muscle dryness is severe, it leads to contraction and inability to extend. The treatment should focus on clearing dryness and nourishing blood, primarily using Shao Yao Gan Cao Tang (Peony and Licorice Decoction), or adding Er Dong and Bai Mi.Question: Why do elderly individuals often experience forgetfulness and repeat their words? Answer: This is due to extreme deficiency of original Yin, leading to a lack of control over the spirit. The heart generates blood, and the spirit resides in the blood. The spirit is associated with fire and Qi, which is the original Yang. When Qi and blood are insufficient, the spirit becomes weak. This is not simply due to excessive heat leading to confusion. The treatment should focus on nourishing blood, primarily using Dang Gui Bu Xue Tang or Du Shen Tang, or Ren Shen Jujube Tang.Question: Why does a patient experience a prolapse of several inches of the large intestine, with a burning sensation in the anus, coarse breathing, and a desire for cold drinks? Answer: This is due to insufficient original Yin in the lungs, leading to excessive fire in the lungs and large intestine. Prolapse of the rectum can be categorized into Yang deficiency and Yin deficiency. Yang deficiency leads to prolapse due to extreme weakness of original Qi, resulting in inability to restrain. The patient will feel fatigued and lack spirit, and will thirst for hot drinks, showing full Yin symptoms. In contrast, Yin deficiency leads to prolapse due to excessive fire in the lower jiao, which forces it out. The patient will not feel fatigued and will thirst for cold drinks, showing full heat symptoms. Both conditions often arise after severe diarrhea. Physicians must accurately identify the nature of Yin and Yang to achieve effective treatment. This condition is primarily due to Yin deficiency and excessive fire, leading to fire pressing on the lungs, causing shortness of breath, and fire pressing on the intestines, causing prolapse. The treatment should focus on nourishing Yin and draining fire, primarily using Da Huang Huang Lian Xie Xin Tang (Rhubarb and Coptis Heart-Draining Decoction) or Ge Gen Huang Lian Huang Qin Tang.Question: Why does urination cause severe pain, with thirst for cold drinks? Is this a symptom of dysuria? Answer: This is due to insufficient original Yin in the bladder, leading to damage from evil fire. The symptoms indicate that the evil has invaded the Tai Yang, transforming into heat evil that settles in the bladder, causing pain during urination, thirst, and a desire for cold drinks. The treatment should focus on transforming Qi and promoting urination, primarily using Wu Ling San (Five Ingredient Powder). This condition is similar to dysuria, which is also a bladder condition. The ancients distinguished between blood dysuria, Qi dysuria, sand dysuria, stone dysuria, and labor dysuria, but in summary, it can be categorized into Yin and Yang. Many cases of Yang deficiency lead to dysuria, often arising from nocturnal emissions, where the patient feels the need to retain Qi but cannot, leading to pain during urination. The treatment should focus on significantly supporting original Yang, promoting Qi transformation, and allowing for smooth urination. When physicians see pain during urination, they often assume it is due to fire, but they should not hastily use Gui Zhi and Fu Zi without understanding the underlying principles. In cases of Yin deficiency, excessive fire should be treated with nourishing kidney formulas, such as Liu Wei Di Huang Wan, Wu Ling San, or other similar formulas. Alternatively, Fu Zi Xie Xin Tang can also be used.This content is for clinical reference only; non-professional doctors should not attempt acupuncture or medication.
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Ai Yu Xiang Tang
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