郁病多在中焦。六郁例药，诚得其要。中焦者，脾胃也。胃为水谷之海，法天地，生万物，体乾坤
健顺。备中和之气，五脏六腑皆禀之以为主，荣卫天真皆有谷气以充
大。东垣谓人身之清气、荣气、运气、卫气、春升之气，皆胃气之别称。然岂尽胃气，乃因胃气以
资其生。故脾胃居中，心肺在上，肾肝在下。凡有六淫、七情、劳役妄动，故上下所属之脏气；致有虚实
克胜之变。而过于中者，其中气则常先四脏，一有不平，则中气不得其和而先郁，更因饮食失节停积、
痰饮寒湿不通，而脾胃自受者，所以中焦致郁多也。今药兼升降而用者，苍术，阳明药也，气味雄壮辛烈，
强胃健脾，开发水谷气，其功最大；香附子，阴血中快气药也，下气最速，一升一降以散其郁；抚芎，手足
厥阴药也，直达三焦，俾生发之气，上至目头，下抵血海，疏通阴阳气血之使也。然此不专开中焦而已，且
胃主行气于三阳，脾主行气于三阴，脾胃既有水谷之
气行，从是三阴三阳各脏腑自受其燥金之郁者，亦必用胃气可得而通矣，天真等气之不达者，亦可得而伸
矣！况苍术尤能径入诸经，疏泄阳明之湿，此六郁药之凡例，升降消导，皆自《内经》变而致之，
殆于受病未深者设也（云云）。下郁乃燥之别名，属肺金之化。治郁之法，有中外四气之异。在表者汗之。
在内者下之。兼风者散之。热微者寒以和之；热甚者泻阳救水，养液润燥，补其已衰之阴。兼湿者审其温之
太过不及，犹土之旱涝也。寒湿之胜，则以苦燥之，以辛温之；不及而燥热者，则以辛温之，以寒调之。
大抵须得仲景治法之要，各守其经气而勿违。
郁病多发生在中焦。治疗六郁的用药法则，确实抓住了关键。所谓中焦，就是指脾胃。胃是水谷汇聚的海，效法天地，化生万物，具备乾坤健顺的特性，备有中和之气，五脏六腑都依赖它作为主宰，营气、卫气和天真之气都有赖于谷气来充盛壮大。李东垣说，人身上的清气、荣气、运气、卫气、春升之气，都是胃气的别称。但这并不完全等同于胃气，而是因胃气而得以资生。所以脾胃位居中央，心肺在上，肾肝在下。凡是受到六淫、七情、劳役等妄动的影响，导致上下所属脏腑之气发生变化，出现虚实克制胜复的变化。而病邪过于中焦时，其中气则常常先于四脏受到影响，一旦有不平之处，中气就不能调和而首先发生郁滞，再加上饮食失节导致停积、痰饮寒湿不通，使得脾胃自身受病，所以中焦致郁的情况很多。现在使用的药物兼具升降作用：苍术是阳明经药，气味雄壮辛烈，能强胃健脾，开发水谷之气，功效最大；香附子是阴血中理气的药物，下气最快，一升一降以疏散郁结；抚芎（川芎）是手足厥阴经药，直达三焦，使生发之气上至头目，下抵血海，是疏通阴阳气血的使者。然而这不仅仅专治中焦之郁，而且胃主将气行于三阳经，脾主将气行于三阴经，既然脾胃有了水谷之气运行，那么三阴三阳各脏腑自身受到燥金之郁的，也必然依靠胃气才能通达，天真等气的不通者，也可以得到舒展！况且苍术尤其能直接进入各条经络，疏泄阳明经的湿气。这是治疗六郁药物的凡例，升降消导之法，都是从《内经》变化而来，大概是针对病情尚未深重的患者设立的。下郁乃是燥的别名，属于肺金的化生。治疗郁的方法，有表里内外四气的不同。在表的用汗法。在里的用下法。兼风邪的用散法。热轻微的用寒凉药调和；热严重的泻阳救阴，养液润燥，补益已经衰弱的阴气。兼湿邪的要审视其温补太过或不及，就像土地的旱涝一样。寒湿偏胜的，用苦味药燥湿，用辛温药散寒；不及而燥热的，用辛温药（此处原文逻辑似有矛盾，通常燥热宜润或清，但依原文翻译），用寒凉药调和。大抵必须掌握张仲景治法的要领，各自固守其经气而不违背。
Depression disorders mostly occur in the Middle Jiao (Middle Burner). The principles of medication for the Six Types of Depression indeed capture the essence. The Middle Jiao refers to the Spleen and Stomach. The Stomach is the Sea of Water and Grain, modeling Heaven and Earth, generating all things, embodying the vigorous and compliant nature of Qian and Kun, and possessing the Qi of Harmony and Equilibrium. All Zang and Fu organs rely on it as their master; Ying Qi (Nutritive Qi), Wei Qi (Defensive Qi), and Tian Zhen Qi (Innate Vital Qi) are all enriched by Gu Qi (Grain Qi). Li Dongyuan stated that the Clear Qi, Ying Qi, Yun Qi (Transporting Qi), Wei Qi, and Spring Ascending Qi in the human body are all alternative names for Wei Qi (Stomach Qi). However, they are not entirely identical to Wei Qi but are generated with its assistance. Therefore, the Spleen and Stomach occupy the central position, the Heart and Lungs are above, and the Kidneys and Liver are below. Whenever affected by the Six Exogenous Pathogens (Liu Yin), Seven Emotions (Qi Qing), or excessive labor and movement, the Qi of the upper and lower Zang organs undergoes changes, leading to variations of deficiency, excess, and mutual overcoming. When pathogenic factors overly affect the Middle Jiao, the Zhong Qi (Central Qi) is often impacted before the other four Zang organs. If there is any disharmony, the Central Qi fails to maintain harmony and becomes depressed first. Furthermore, due to irregular diet causing stagnation, and the blockage of Phlegm-Fluids, Cold-Dampness, the Spleen and Stomach suffer directly, which explains why depression in the Middle Jiao is common.
The current prescription employs herbs with ascending and descending properties: Cang Zhu (Atractylodis Rhizoma) is a Yangming meridian herb with a robust, pungent, and acrid flavor; it strengthens the Stomach and Spleen and develops Gu Qi, boasting the greatest efficacy. Xiang Fu Zi (Cyperi Rhizoma) is an herb that moves Qi within Yin Blood, descending Qi most rapidly; together, one ascends and one descends to dissipate depression. Fu Xiong (Chuanxiong Rhizoma) is a herb for the Hand and Foot Jueyin meridians, reaching the Triple Burner directly, allowing the Ascending and Generating Qi to reach the eyes and head above and the Blood Sea below, serving as the agent to unblock Yin-Yang and Qi-Blood. However, this does not merely treat Middle Jiao depression. The Stomach governs moving Qi into the Three Yang meridians, while the Spleen governs moving Qi into the Three Yin meridians. Once Gu Qi circulates through the Spleen and Stomach, the organs of the Three Yin and Three Yang, even if suffering from Dryness-Jin depression, can be unblocked relying on Stomach Qi, and the blocked Tian Zhen Qi and others can be extended! Moreover, Cang Zhu can particularly enter various meridians directly to vent Dampness in the Yangming meridian. These are the general principles for treating the Six Depressions; methods of ascending, descending, resolving, and guiding out originate from modifications of the *Nei Jing* (Inner Canon), likely designed for cases where the disease has not yet penetrated deeply.
Lower Depression is another name for Dryness, belonging to the transformation of Lung Metal. Methods for treating depression vary according to exterior-interior and four Qi characteristics. For those in the Exterior, use sweating. For those in the Interior, use purgation. For those complicated by Wind, use dispersing. For mild heat, harmonize with cold-natured herbs; for severe heat, purge Yang to save Yin, nourish fluids, moisten dryness, and tonify the depleted Yin. For those complicated by Dampness, assess whether warmth was applied excessively or insufficiently, akin to drought or flood in soil. For excess Cold-Dampness, use bitter-drying herbs and pungent-warm herbs; for insufficiency leading to Dryness-Heat, use pungent-warm herbs (Note: Text implies specific context) and cold-natured herbs to harmonize. Generally, one must grasp the essentials of Zhang Zhongjing's treatment methods, adhering strictly to the Qi of each meridian without deviation.