《医贯》曰∶冬时严寒，杀厉之气，触冒之而实时病者，乃名伤寒。不即发者，寒
毒藏于肌肤，至春变为温，至夏变为暑病，暑病者，热极重于温也。既变为温，则不得
复言其为寒，不恶寒而渴者是也。其麻黄、桂枝为即病之伤寒而设，与温热何与？受病
之原虽同，所发之时则异，仲景治之，当别有方，缘皆遗失而无征，是以各家议论纷
纷，至今未明也。然则欲治温病者，当如何？予有一法，请申而明之。《经》曰∶
不恶寒而渴者是也。不恶寒则知其表无寒邪矣，曰渴，则知肾水干枯矣。盖缘其人素有
火者，冬时触冒寒气，虽伤而亦不甚，惟其有火在内，寒亦不能深入，所以下即发。而
寒气伏藏于肌肤，自冬至三四月，历时既久，火为寒郁于中亦久，将肾水熬煎枯竭，
盖甲木，阳木也。藉癸水而生，肾水既枯，至此时强木旺，无以为发生滋润之本，故发
热而渴，非有所感冒也。海藏谓∶新邪唤出旧邪，亦非也。若复有所感冒，又当恶寒
矣，予以六味地黄滋其水，以柴胡辛凉之药舒其木郁，随手而应，此方活人者多矣，又
因此而推展之。凡冬时伤寒者，亦是郁火症，其人无火，则为直中矣。惟其有火，故
由皮毛而肌肉，肌肉而脏腑，今人皆日乃寒邪传热，寒变为热，既曰寒邪，何故入内而
反为热？又何为而能变热耶？不知即是本身中之火，为寒所郁而不得泄，一步反归一
步，日久则纯热而无寒矣。所以用三黄解毒，解其火也。升麻、葛根，即火郁发之
也。三承气，即土郁则夺之，小柴胡汤，木郁达之也。此理甚简而易，只多了传经六经
诸语，支离多歧。谓凡症有发热者，旨有头疼项强，目痛鼻干，胁痛口苦等症，何必拘
为伤寒局？伤寒方以治之也。予于冬月正伤寒，独麻黄、桂枝二方，作寒郁治，其余俱
不恶寒者，作郁火治，此赵氏之创论也。闻之者，孰不骇然。及阅虞天民《至人传》
曰∶传经伤寒是郁病，及考之《内经》，帝曰∶人伤于寒，而传为热，何也？歧伯曰∶
寒气外凝，内郁之理，腠理坚致，玄府闭密，则气不宣通，湿气内结，中外相薄，寒
盛热生，故人伤于寒，转而为热，汗之则愈，则外凝内郁之理可知矣。观此则伤寒为
郁火也。明矣。
《经》曰∶木郁则达之，火郁则发之，士郁则夺之，金郁则泄之，水郁则折之。然
调其气，过者折之，以其畏也。所谓泻之，注《内经》者，谓达之、吐之也，令其条达
也。发之、汗之也，令其疏散也。夺之、下之也，令其无壅碍也。泄之，谓渗泄解表，
利小便也。折之，谓制其冲逆也。谓凡病之起，多由于郁，郁者，抑而不通之义，《内
经》五法，为因五运之气所乘而致郁也。丹溪云∶气血冲和，百病不生，一有怫郁，诸
病生焉。又制为六郁之论，立越鞠丸以治郁，曰气、曰湿、曰热、曰痰、曰血、曰
食，而以香附、抚芎，苍术，开郁利气为主，谓气郁而湿滞，湿滞而成热，热郁而成
痰，痰滞而血不行、血滞而食不消化，此六者，柏因为病者也。此说出而《内经》之旨
始晦，《内经》之旨又因释注之误而复晦，此郁病之不明于世久矣。苟能神而明之，扩
而充之，其于天下之病，思过半矣。且以注《内经》之误言之，其曰达之，谓吐之，吐
中有发散之义，盖凡木郁，乃少阳胆经半表半里之病，多呕酸吞酸症，虽吐亦有发散之
益，但谓无害耳。焉可便以吐字该达字耶？达者，畅茂调达之义，王安道曰∶肝性急，
怒气逆， 胁或胀，火时上炎，治以苦寒辛散而不愈者，则用升发之药，加以厥阴报使
而从治之。又如久风入中为飨泄者，及不因外风之入而清气在下为飧泄者，则以轻扬之
剂，举而散之。凡此之类。皆达之之法也火郁则发之，发之，汗之也。东垣升阳散火
汤是也。使势穷则止，其实发与达不相远，盖火在木中，木郁则火郁，相因之理。达
之，即所以发之，即以达之之药发之，无有不应者，但非汗之谓也。汗固能愈。然火郁
于中，未有不蒸蒸汗出，须发之得其术耳。土郁夺之，谓下夺之，如中满腹胀，势甚而
不能顿除者，非方轻之剂可愈，则用咸寒峻下之剂，以劫夺其势，而使之平，此下夺之
义也。愚意谓夺不止下，如胃亦土也，食塞胃中，下部有脉，上部无脉，法当吐不吐则
死。《内经》所谓∶高者因而越之，以吐为上夺，而衰其胃土之郁，亦无不可。金郁泄
之，如肺气 满，胸凭仰息，非解利肺气之剂，不足以疏通之，只解表二字，足以尽泄
金郁之义，不必更渗泄利小便，而渗利自在其中。况利小便，是涉水郁之治法矣。独水
郁折之难解，愚意然调其气四句，非总结上文也。乃为折之二字，恐人不明，特反复说
此四句，以申明之耳。意谓水之郁而不通者，可调其气而愈。如《经》曰∶膀胱者，
州都之官，津液藏焉，气化则能出矣。肺为肾水上源。凡水道不通者，升举肺气，使上
窍通则下窍通，其过者，淫溢于四肢浮肿，如水之泛滥，须折之以其畏，水之所畏者，
土也。土衰不能制之，而寡于畏，故妄行。兹惟补其脾土，俾能制水，则水道自通，不
利之利，即所谓泻之也。如此说则折字与泻字于上文接续，而折之之义益明矣。然东方
先生木，木者，生生之气，即火气空中之火，附于木中，木郁则火亦郁于木中矣。不
特此也，火郁则土自郁，土郁则金亦郁，金郁则水亦郁，五行相因，自然之理，朱子所
谓节节推去，可知可尽，惟其相因也。予以
一方治其木郁，而诸郁皆因而愈。一方者何？逍遥散是也。方中惟柴胡、薄荷二味最
妙，盖人身之胆木，乃甲木少阳之气，气尚柔嫩，象草穿地，始出而未伸，此时如被寒
风一郁，即萎软抑遏，而不能上伸，不上伸则下克脾土，而金水并病矣。惟得温风一
吹，郁气即畅达，盖木喜风，风摇则舒畅，若寒风则畏矣。温风者，所谓吹面不寒杨柳
风也，木之所喜也。柴胡、薄荷，辛而温者，惟辛也，故能发散。温也，故入少阳。
古人立方之妙如此，其甚者，方中加左金丸，左金丸止黄连、吴茱萸二味，黄连但治
心火，而吴茱萸则气燥，肝气亦燥，同气相求，故入肝以平木，木平不生火，火平不刑
金，金平能制木，不直伐木而佐金以制木，此左金之所以得名也。犹未也，继用六味，
加柴芍以滋肾水，俾水能生木。逍遥散者，风以散之，地黄饮者，雨以润之，木有不得
其天者乎？此法一立，木火之郁既舒，自不下克，土亦滋润无燥 之病，金水自得相
生，予谓一法可通五法者，如此岂惟是哉！推之大之，其益无穷。凡寒热往来，似疟非
疟，恶寒恶热，呕吐吞酸嘈杂，胸痛胁痛，小腹胀闷，头晕盗汗，黄胆温疫，疝气飨泄
等症，皆对症之方，推而伤风、伤寒、伤湿，除直中外，凡外感者，俱作郁看，以逍
遥散加减出入，无不获效。如小柴胡汤、四逆散、羌活汤，大同小异，然不若此方之响
应也。神而明之，变通之妙存乎人耳。倘一服即愈，少顷复发，或频发而愈甚，此必属
上寒下热之假症也，则此方不可复投，当改用温补之剂，如阳虚以四君子汤加温热药；
阴虚者则以六味汤中加温热药；其甚者，必须用热药冷冻饮料之法，使不拒格而不入也。是
《经》所谓∶病有微甚，治有逆从，先医殚心竭虑，阐明至理，以创于前，但相传既
久，气化转薄，后学可不细心揣摩，更神化之以继其后。
《医贯》中说：冬季严寒，具有杀伤力的厉气，如果人触冒这种寒气而立即发病的，才称为伤寒。如果不立即发病，寒毒就会潜伏在肌肤之间，到了春天就变为温病，到了夏天就变为暑病。所谓暑病，就是热势极盛，比温病更重。既然已经变成了温病，就不能再说它是寒邪了，其表现是不怕冷而且口渴。麻黄汤、桂枝汤是为即时发生的伤寒所设立的，与温热病有什么关系呢？虽然受病的根源相同，但发作的时间不同。张仲景治疗这类疾病，应当有另外的方剂，只是因为这些方子已经遗失而无法考证，所以各家议论纷纷，至今没有弄清楚。那么，想要治疗温病的人，应该怎么办呢？我有一种方法，请让我详细说明。《内经》说：“不怕冷而且口渴的就是（温病）。”不怕冷，就知道体表没有寒邪；说口渴，就知道肾水干枯了。大概是因为这个人素来体内有火，冬天时触冒寒气，虽然受伤但并不严重，只因为体内有火，寒气也不能深入，所以当下就发病。而寒气伏藏在肌肤之间，从冬至到三四月，历时已久，火被寒气郁遏在中焦也很久了，将肾水煎熬枯竭。甲木属于阳木，依靠癸水（肾水）而生，肾水既已枯竭，到了这个时候，强旺的肝木缺乏发生和滋润的根本，所以出现发热和口渴，这并不是外感感冒所致。海藏（张元素）说这是新邪唤出旧邪，也不对。如果又有所感冒，就应该怕冷了。我用六味地黄丸滋补肾水，用柴胡等辛凉的药物疏解肝木的郁结，随手见效，这个方子救活的人很多，我又由此推展延伸。凡是冬天得伤寒的人，也是郁火证，如果这个人没有内火，那就是直中脏腑了。只因为他有内火，所以病邪由皮毛传入肌肉，由肌肉传入脏腑。现在的人都说是寒邪传变入里化热，寒变成了热，既然说是寒邪，为什么进入体内反而变成热？又怎么能变热呢？不知道这本身就是体内的火，被寒气郁遏而不能宣泄，一步步向内归并，日子久了就纯热而无寒了。所以用三黄解毒汤，是为了清解火邪。升麻、葛根，就是“火郁发之”的方法。三承气汤，就是“土郁则夺之”的方法。小柴胡汤，就是“木郁达之”的方法。这个道理很简单易懂，只是多了传经六经的各种说法，支离破碎且多歧义。如果说凡是症状有发热、头痛项强、目痛鼻干、胁痛口苦等的，何必拘泥于伤寒的框架？用治伤寒的方子去治疗它们。我在冬天遇到真正的伤寒，唯独麻黄汤、桂枝汤这两个方子，当作寒郁来治，其余都不怕冷的，都当作郁火来治，这是赵献可（赵氏）的创论。听到的人，谁不感到惊骇。等到阅读虞天民《至人传》时说：“传经伤寒是郁病”，以及考察《内经》，黄帝问：人伤于寒，却传变为热，为什么呢？岐伯答：寒气在外凝结，导致内部郁滞，腠理坚实致密，玄府闭锁，气机不能宣通，湿气在内结聚，内外相互搏击，寒盛则热生，所以人伤于寒，转而为热，发汗就能痊愈，这样外凝内郁的道理就可以知道了。看这一点，就知道伤寒是郁火，非常明显了。
《内经》说：木郁则达之，火郁则发之，土郁则夺之，金郁则泄之，水郁则折之。然而调理气机，过盛的要用折法，因为那是它畏惧的。所谓的泻，注《内经》的人解释为达之、吐之，意思是使其条达舒畅。发之、汗之，意思是使其疏散。夺之、下之，意思是使其没有壅塞阻碍。泄之，是指渗泄解表，利小便。折之，是指制约其冲逆之势。说凡是疾病的起因，多由于郁，郁的意思是压抑而不通畅。《内经》的五法，是因为五运之气相乘而导致郁结。朱丹溪说：气血冲和，百病不生，一旦有怫郁，诸病就产生了。他又制定了六郁的理论，创立越鞠丸来治疗郁证，分为气、湿、热、痰、血、食六种，以香附、抚芎、苍术为主药，开郁利气，认为气郁则湿滞，湿滞而成热，热郁而成痰，痰滞则血不行，血滞则食不消化，这六种情况，都是因病产生的。这个学说出来之后，《内经》的宗旨才开始晦暗，《内经》的宗旨又因为注解的错误而再次晦暗，这个郁病的不明于世已经很久了。如果能够神妙地理解它，扩大并充实它，对于天下的疾病，思虑就超过一半了。况且拿注解《内经》的错误来说，其中说“达之”是吐之，吐中有发散的意思，大概凡是木郁，是少阳胆经半表半里的病，多有呕吐酸水、吞酸的症状，虽然吐也有发散的好处，但说无害罢了。怎么可以用吐字概括达字呢？达的意思是畅茂调达。王安道说：肝性急，怒气逆乱，胁肋或胀，火时常上炎，用苦寒辛散药治疗无效的，就用升发之药，加上厥阴报使而从治。又如久风入中成为飧泄的，以及不因外风侵入而清气在下成为飧泄的，就用轻扬之剂，举而散之。凡此之类，都是达之法。火郁则发之，发之，就是汗之。东垣的升阳散火汤就是例子。使病势穷尽就停止，其实发与达不相远，盖火在木中，木郁则火郁，这是相因的道理。达之，就是用来发之，即用达之的药来发之，没有不应验的，但这并不是指汗法。汗固然能愈，然而火郁于中，没有不出蒸蒸大汗的，必须发之得其方法而已。土郁夺之，谓之下夺，如中满腹胀，病势很盛而不能立刻消除的，不是轻剂的方子可以治愈，就用咸寒峻下的剂，以劫夺其病势，使之平复，这就是下夺的意义。我的意思认为夺不止于下，胃也属土，食物堵塞胃中，下部有脉，上部无脉，法当用吐法，不吐就会死。《内经》所谓：高者因而越之，以吐为上夺，从而衰减胃土的郁结，也没有不可以。金郁泄之，如肺气胀满，胸膈倚靠仰面呼吸，不用解利肺气的药剂，不足以疏通它，只解表二字，足以尽泄金郁之义，不必再渗泄利小便，而渗利自在其中。况且利小便，是水郁的治疗法了。唯独水郁折之难以理解，我的意思认为“然调其气”四句，不是总结上文，而是为了说明“折之”二字，恐怕人不明白，特意反复说这四句，来申明它。意思是水之郁而不通的，可以调其气而愈。如《内经》说：膀胱者，州都之官，津液藏焉，气化则能出矣。肺为肾水上源。凡是水道不通的，升举肺气，使上窍通则下窍通，那些过盛的，淫溢于四肢浮肿，如水之泛滥，须用折法以其所畏，水之所畏者，是土。土衰不能制水，而寡于畏，所以妄行。这里只有补其脾土，使其能制水，则水道自通，不利之利，就是所谓的泻之。这样说则折字与泻字于上文接续，而折之的意义更加明确了。然而东方属木，木者，生生之气，即火气空中之火，附于木中，木郁则火亦郁于木中了。不仅如此，火郁则土自郁，土郁则金亦郁，金郁则水亦郁，五行相因，是自然之理，朱子所说的节节推去，可知可尽，正因为它们相因。我用一方治疗其木郁，而诸郁都因此痊愈。一方是什么？逍遥散是也。方中惟独柴胡、薄荷两味最妙，盖人身之胆木，乃甲木少阳之气，气尚柔嫩，像草穿地，刚出而未伸，此时如果被寒风一郁，就萎软抑遏，而不能上伸，不上伸则下克脾土，而金水并病了。只有得到温风一吹，郁气即畅达，盖木喜风，风摇则舒畅，若寒风则畏惧了。温风者，所谓吹面不寒杨柳风也，是木所喜欢的。柴胡、薄荷，辛而温者，惟辛也，故能发散。温也，故入少阳。古人立方之妙如此。其严重的，方中加左金丸，左金丸止黄连、吴茱萸二味，黄连但治心火，而吴茱萸则气燥，肝气亦燥，同气相求，故入肝以平木，木平不生火，火平不刑金，金平能制木，不直伐木而佐金以制木，这就是左金之所以得名的原因。还不够，继用六味地黄丸，加柴胡、白芍以滋肾水，使水能生木。逍遥散者，风以散之，地黄饮者，雨以润之，木有不得其天性的吗？此法一立，木火之郁既舒，自然不下克，土亦滋润无燥之病，金水自得相生，我认为一法可通五法，就像这样，岂止是这样！推之大之，其益无穷。凡是寒热往来，似疟非疟，恶寒恶热，呕吐吞酸嘈杂，胸痛胁痛，小腹胀闷，头晕盗汗，黄疸温疫，疝气飧泄等症状，都是对症之方，推而广之，伤风、伤寒、伤湿，除直中外，凡是外感者，都当作郁来看待，以逍遥散加减出入，无不获效。如小柴胡汤、四逆散、羌活汤，大同小异，然而不如这个方子响应迅速。神而明之，变通之妙存乎人耳。如果一服即愈，少顷复发，或频发而愈甚，这必属上寒下热的假症，则此方不可再投，当改用温补之剂，如阳虚以四君子汤加温热药；阴虚者则以六味汤中加温热药；其严重的，必须用热药冷冻饮料之法，使不拒格而不入也。这是《内经》所谓：病有微甚，治有逆从，先医殚心竭虑，阐明至理，以创于前，但相传既久，气化转薄，后学可不细心揣摩，更神化之以继其后。
The *Yi Guan* (Canon of Medicine) states: In winter, when severe cold and lethal qi are encountered, if illness occurs immediately upon exposure, it is named Cold Damage (Shanghan). If it does not manifest immediately, the cold toxin hides in the skin and muscles; by spring it transforms into Warm Disease (Wenbing), and by summer into Summerheat Disease (Shubing). Summerheat disease is characterized by extreme heat, heavier than warm disease. Once transformed into warm disease, it can no longer be referred to as cold; its manifestations are aversion to cold absent and thirst present. Mahuang Tang (Ephedra Decoction) and Guizhi Tang (Cinnamon Twig Decoction) were established for immediate-onset Cold Damage; what do they have to do with warm-heat diseases? Although the origin of the pathogen is the same, the time of onset differs. Zhang Zhongjing should have had separate formulas for treating these conditions, but because these formulas have been lost and cannot be verified, various schools have debated endlessly, and the matter remains unclear to this day. So, how should one treat warm diseases? I have a method; let me explain it clearly. The *Neijing* (Inner Canon) says: "Those who are not averse to cold but are thirsty." Not being averse to cold indicates that there is no cold pathogen on the exterior; thirst indicates that Kidney Water (Jin Ye, body fluids) is dry and depleted. This is generally because the person has inherent internal fire. When exposed to cold in winter, although injured, the damage is not severe; because there is internal fire, the cold cannot penetrate deeply, so the disease manifests immediately. However, the cold qi lies dormant in the skin and muscles. From winter solstice to the third or fourth month of spring, after a long duration, the fire is depressed within by the cold for a long time, boiling and depleting the Kidney Water. Jia Wood (Liver/Gallbladder Yang Wood) is Yang Wood, relying on Gui Water (Kidney Yin/Water) for nourishment. Since Kidney Water is depleted, when the strong Wood becomes prosperous at this time, it lacks the root for growth and moistening, resulting in fever and thirst. This is not due to an external contraction. Haizang (Zhang Yuansu) claimed that new pathogens awaken old ones, which is also incorrect. If there were a new contraction, there would be aversion to cold. I use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) to nourish the Water, and Chaihu (Bupleuri Radix) and other acrid-cool herbs to soothe the depression of Wood. It works instantly, and many people have been saved by this formula. I have further expanded upon this. All cases of Cold Damage contracted in winter are also Depressed Fire syndromes. If the person lacks internal fire, it is a direct transmission (Zhizhong) to the organs. Because they have internal fire, the pathogen moves from hair follicles to muscle, and from muscle to zang-fu organs. Nowadays, people say that cold pathogens transmit inward and transform into heat, that cold changes into heat. If it is said to be a cold pathogen, why does it enter the interior and turn into heat? How can it change into heat? They do not realize that this is the fire within the body itself, depressed by cold and unable to vent, step by step retreating inward. After many days, it becomes purely heat without cold. Therefore, Sanhuang Jiedu Tang (Three-Yellow Detoxification Decoction) is used to clear the fire. Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Radix) employ the method of "venting depressed fire" (Huo Yu Fa Zhi). The Three Chengqi Decoctions (San Chengqi Tang) employ "purging earth depression" (Tu Yu Duo Zhi). Xiaochaihu Tang (Minor Bupleurum Decoction) employs "reaching wood depression" (Mu Yu Da Zhi). This principle is simple and easy to understand, but it has been obscured by the complex theories of meridian transmission and the Six Channels, leading to fragmentation and divergence. If one claims that any syndrome with fever, headache, stiff neck, eye pain, nasal dryness, hypochondriac pain, and bitter taste must be treated as Cold Damage, and uses Cold Damage formulas, this is misguided. In winter, for true Cold Damage, I treat only Mahuang Tang and Guizhi Tang as Cold Depression. For all others where aversion to cold is absent, I treat them as Depressed Fire. This was the innovative theory of Zhao Xianke (Zhao Shi). Those who heard of it were naturally shocked. Later, reading Yu Tianmin's *Zhiren Zhuan*, it stated: "Transmitted Cold Damage is a Depressed Disease." Examining the *Neijing*, the Yellow Emperor asked: "When humans are injured by cold, why does it transmit and become heat?" Qibo answered: "Cold qi condenses externally, causing internal depression. If the pores (Couli) are tight and the sweat glands (Xuanfu) closed, qi cannot circulate freely. Dampness knots internally, and external and internal factors clash; severe cold generates heat. Thus, injury by cold turns into heat, and sweating cures it." From this, the principle of external condensation and internal depression is known. Observing this, it is clear that Cold Damage is Depressed Fire.
The *Neijing* states: "For Wood depression, reach it (Da); for Fire depression, vent it (Fa); for Earth depression, purge it (Duo); for Metal depression, drain it (Xie); for Water depression, restrain it (Zhe)." However, regulating qi, excess is restrained by the method it fears, which is called purging. Commentators on the *Neijing* interpreted "reaching" and "vomiting" as making things smooth and unobstructed. "Venting" and "sweating" mean dispersing. "Purging" and "downward draining" mean removing obstruction. "Draining" refers to渗泄 (promoting urination/drainage) and releasing the exterior. "Restraining" means controlling rebellious upward movement. It is said that most diseases arise from depression (Yu), meaning suppression and lack of flow. The five methods in the *Neijing* address depression caused by the overacting of the Five Movements (Wuyun). Zhu Danxi said: "When Qi and Blood are harmonious, no disease arises; once there is stagnation, various diseases occur." He formulated the theory of Six Depressions and created Yueju Wan to treat them: Qi, Dampness, Heat, Phlegm, Blood, and Food. He used Xiangfu (Cyperi Rhizoma), Fuxiong (Chuanxiong Rhizoma), and Cangzhu (Atractylodis Rhizoma) to open depression and promote Qi flow, arguing that Qi depression leads to Dampness stagnation, Dampness stagnation creates Heat, Heat depression creates Phlegm, Phlegm stagnation impedes Blood flow, and Blood stagnation impairs Food digestion. These six are pathological products. With this theory emerging, the intent of the *Neijing* became obscure, and further obscured by erroneous commentaries, leaving the understanding of Depressed Diseases unclear for a long time. If one could divine and expand upon this, one would understand more than half of all diseases in the world. Regarding the errors in commenting on the *Neijing*: stating that "reaching" means vomiting is flawed. Vomiting contains a dispersing quality. Generally, Wood depression involves the Shaoyang Gallbladder channel, half-exterior and half-interior, often presenting with acid regurgitation. Although vomiting has some dispersing benefit, saying it is harmless is insufficient. One cannot equate "vomiting" with "reaching." "Reaching" means flourishing and smooth flow. Wang Andao said: "The Liver is impatient; anger causes Qi rebellion, distension in the hypochondrium, and fire flaming upward. If bitter-cold and acrid-dispersing herbs fail, use ascending and dispersing herbs, combined with Jueyin guiding herbs for counter-treatment." Similarly, for chronic wind entering the middle causing loose stools, or clear Qi sinking causing loose stools without external wind, use light and ascending agents to lift and disperse. All these are methods of "reaching." "Venting fire" means sweating. Dongyuan's Shengyang Sanhuo Tang is an example. Stop when the pathogenic force is exhausted. Actually, venting and reaching are not far apart. Fire resides within Wood; Wood depression causes Fire depression, a causal relationship. Reaching is a way to vent; using reaching herbs to vent yields results, though this is not merely sweating. Sweating can cure, but when fire is depressed internally, profuse sweating often occurs; one must vent it correctly. "Purging earth depression" means downward purging. For fullness and abdominal distension with severe pathology that cannot be quickly resolved, light formulas are ineffective; use heavy, salty-cold purgatives to seize the momentum and calm it. This is the meaning of downward purging. My view is that purging is not limited to downward action. The Stomach belongs to Earth. If food blocks the Stomach, with pulse present below but absent above, vomiting is indicated; failure to vomit leads to death. The *Neijing* says: "For high locations, induce vomiting (Yue)." Using vomiting as supreme purging to alleviate Stomach Earth depression is acceptable. "Draining metal depression" applies to Lung Qi fullness, chest oppression, and仰息 (breathing with difficulty lying flat). Without herbs that resolve and benefit Lung Qi, unblocking is impossible. The term "releasing the exterior" fully covers the meaning of draining Metal depression; there is no need to additionally promote urination, though drainage is inherent. Moreover, promoting urination is the treatment for Water depression. Only "restraining water depression" is difficult to interpret. I believe the four sentences "regulating qi..." are not a summary of the previous text, but specifically explain "restraining," fearing misunderstanding, repeating these points to clarify. It means water depression and blockage can be cured by regulating Qi. As the *Neijing* states: "The Bladder is the official of the reservoir, storing fluids; when Qi transforms, they exit." The Lung is the source of Kidney Water. For blocked water pathways, lifting Lung Qi opens the upper orifices, which then opens the lower orifices. For excess, overflowing into limbs causing edema like flooding, one must restrain it by its fear. What Water fears is Earth. If Earth is weak and cannot control Water, lacking restraint, it acts recklessly. Here, tonifying Spleen Earth allows it to control Water, so water pathways clear naturally. The "benefit without draining" is the so-called purging. With this explanation, "restraining" connects with "purging" in the text, clarifying the meaning of restraining. Furthermore, the East corresponds to Wood. Wood is the vital energy of generation, i.e., Fire in the void attached to Wood. Wood depression causes Fire depression within Wood. Not only this: Fire depression causes Earth depression; Earth depression causes Metal depression; Metal depression causes Water depression. The Five Elements interact causally, a natural law. As Zhu Xi said, pushing forward step by step, it is knowable and exhaustive. Because they are causally linked, I use one formula to treat Wood depression, and all depressions heal consequently. What is this formula? Xiaoyao San (Free and Easy Wanderer Powder). Among its ingredients, Chaihu (Bupleuri Radix) and Bohe (Menthae Haplocalycis Herba) are the most excellent. The Gallbladder Wood in the human body is the Shaoyang Qi of Jia Wood. Its Qi is tender, like grass piercing the ground, just emerging but not yet extending. If depressed by cold wind at this stage, it wilts and is suppressed, unable to extend upward. Failure to extend leads to attacking Spleen Earth, causing Metal and Water diseases simultaneously. Only with warm wind can the depressed Qi flow smoothly. Wood likes wind; wind shaking brings comfort, whereas cold wind is feared. Warm wind is the "willow wind that does not chill the face," which Wood loves. Chaihu and Bohe are acrid and warm. The acridity allows dispersion; the warmth enters Shaoyang. Such is the subtlety of ancient formula creation. For severe cases, add Zuojin Wan (Left Metal Pill) to the formula. Zuojin Wan contains only Huanglian (Coptidis Rhizoma) and Wuzhuyu (Evodiae Fructus). Huanglian treats Heart Fire, while Wuzhuyu is drying; Liver Qi is also drying. Like attracts like, so it enters the Liver to calm Wood. Calmed Wood does not generate Fire; calmed Fire does not attack Metal; calmed Metal controls Wood. Instead of directly attacking Wood, it assists Metal to control Wood; hence the name Zuojin. This is not enough; subsequently use Liuwei Dihuang Wan added with Chaihu and Baishao (Paeoniae Radix Alba) to nourish Kidney Water, enabling Water to generate Wood. Xiaoyao San uses wind to disperse; Dihuang Yinzi (Rehmannia Elixir) uses rain to moisten. Can Wood fail to receive its natural destiny? Once this method is established, the depression of Wood and Fire is relieved, naturally ceasing to attack downward. Earth becomes moistened without dryness; Metal and Water naturally generate each other. I say one method can encompass the five methods, as such. Is it only this? Expanding it, the benefits are infinite. For symptoms such as alternating chills and fever, malaria-like but not malaria, aversion to cold and heat, vomiting, acid regurgitation, dyspepsia, chest and hypochondriac pain, lower abdominal fullness, dizziness, night sweats, jaundice, epidemic febrile diseases, hernia, and loose stools, this is a targeted formula. Extending it, for wind strike, Cold Damage, and dampness injury, excluding direct transmission, all external contractions should be viewed as depression. Use Xiaoyao San with modifications, and there will be no failure. Xiaochaihu Tang, Sini San (Frigid Extremities Powder), and Qianghuo Tang are largely similar but inferior in responsiveness to this formula. Divine understanding and flexible application depend on the practitioner. If cured after one dose but relapsing shortly after, or frequently relapsing with worsening severity, this must be a false syndrome of upper cold and lower heat. Do not administer this formula again; switch to warming and tonifying agents. For Yang deficiency, use Sijunzi Tang (Four Gentlemen Decoction) with warming herbs; for Yin deficiency, use Liuwei Tang with warming herbs. For severe cases, use the method of administering hot medicine cold to prevent rejection. This aligns with the *Neijing*: "Diseases vary in severity; treatments follow contrary or compliant principles." Early physicians exerted great effort to elucidate profound truths and innovate beforehand. But as transmission continues, Qi transformation thins. Should later learners not carefully ponder and further divine transformations to continue the lineage?