命门之义，《内经》本无，惟越人云∶肾有两者，非皆肾也。左者为肾，右者为命门。
命门者，诸神精之所舍，原气之所系，男子以藏精，女子以系胞也。余以其义有未尽，且有
可疑，故着有《三焦包络命门辨》，附梓《类经》之末，似已尽其概矣。然而犹有未尽者，
恐不足以醒悟后人。兹因再悉其蕴，条列于下。
一、命门为精血之海，脾胃为水谷之海，均为五脏六腑之本。然命门为元气之根，为水
火之宅。五脏之阴气，非此不能滋。五脏之阳气，非此不能发。而脾胃以中州之土，非火不
能生，然必春气始于下，则三阳从地起，而后万物得以化生。岂非命门之阳气在下，正为脾
胃之母乎？吾故曰∶脾胃为灌注之本，得后天之气也；命门为化生之源，得先天之气也，此
其中固有本末之先后。观东垣曰∶补肾不若补脾。许知可曰∶补脾不若补肾。此二子之说，
亦各有所谓，固不待辨而可明矣。
一、命门有火候，即元阳之谓也，即生物之火也。然禀赋有强弱，则元阳有盛衰；阴阳
有胜负，则病治有微甚，此火候之所以宜辨也。兹姑以大纲言之，则一阳之元气，必自下而
升，而三焦之普KT ，乃各见其候。盖下焦之候如地土，化生之本也；中焦之候如灶釜，
水谷之炉也；上焦之候如太虚，神明之宇也。下焦如地土者，地土有肥瘠而出产异，山川有
浓薄而藏蓄异，聚散操权，总由阳气。人于此也，得一分即有一分之用，失一分则有一分之
亏。而凡寿夭生育及勇怯精血病治之基，无不由此元阳之足与不足，以为消长盈缩之主，此
下焦火候之谓也。中焦如灶釜者，凡饮食之滋，本于水谷，食强则体壮，食少则身衰，正以
胃中阳气，其热如釜，使不其然，则何以朝食午即化，午食申即化，而釜化之速不过如此。
观灶釜之少一炬则迟化一顷，增一炬则速化一时，火力不到，则全然不化，即其证也。故脾
胃之化与不化，及饮食之能与不能，亦总由阳明之气有强与不强，而阴寒之邪有犯与不犯
耳。及其病也，则渐痞渐胀，或隔或呕，或十化其三五，或膨聚而不消，或吞酸嗳腐而食气
不变，或腹疼肚痛而终日不饥，或清浊不分，或完谷不化。盖化则无不营运，不化则无不留
滞。营运则为气为血，留滞则为积为痰。此其故，谓非胃气之不健乎？而何以不健，谓非火
候之无力乎？今见治痞治胀，及治吞酸嗳腐等症，无论是热非热，动辄呼为胃火，余烬其几
，尚能堪否？此中焦火候之谓也。上焦如太虚者，凡变化必着于神明，而神明必根于阳气。
盖此火生气，则无气不至，此火化神，则无神不灵。阳之在下则温暖，故曰∶相火以位，阳
之在上则昭明，故曰君火以明。是以阳长则阴消，而离照当空。故五官治而万类盛，阳衰则
阴胜，而阳为阴抑，故聪明夺而神气减。而凡人之声色动定及智愚贤不肖之有不齐者，何非
阳德为之用，此上焦火候之谓也。此以三焦论火候，则各有所司，而何以皆归之命门？不知
水中之火，乃先天真一之气，藏于坎中，此气自下而上，与后天胃气相接而化，此实生生之
本也。是以花萼之荣在根柢，灶釜之用在柴薪。使真阳不发于渊源，则总属无根之火矣。火
而无根，即病气也，非元气也。故《易》以雷在地下而为复，可见火之标在上，而火之本则
在下。且火知就燥，性极畏寒。若使命门阴胜，则元阳畏避，而龙火无藏身之地，故致游
散不归，而为烦热格阳等病。凡善治此者，惟从其性，但使阳和之气直入坎中，据其窟宅
而招之诱之，则相求同气，而虚阳无不归原矣。故曰∶甘温除大热，正此之谓也。奈何昧者
不明此理，多以虚阳作实热，不思温养此火，而但知寒凉可以灭火，安望其尚留生意而不使
之速毙耶！此实医家第一活人大义，既从斯道，不可不先明斯理。倘三焦有客热邪火，皆凡
火耳，固不得不除。而除火何难，是本非正气火候之谓也。学人于此，当深明邪正二字，则
得治生之要矣。
一、命门有生气，即干元不息之几也。无生则息矣。盖阳主动，阴主静；阳主升，阴主
降。惟动惟升，所以阳得生气；惟静惟降，所以阴得死气。故干元之气，始于下而盛于上，
升则向生也；坤元之气，始于上而盛于下，降则向死也。故阳生子中而前升后降，阴生午中
而前降后升。此阴阳之岐，相间不过如毛发，及其竟也，则谬以千里，而死生之柄，实惟此
毫厘升降之机耳。又如水暖则化气，化气则升无不生也；水寒则成冰，成冰则降无不死也。
故肾气独沉，则奉生者少，即此生气之理也。至若人之生气，则无所不在，亦无所不当察。
如脏腑有生气，颜色有生气，声音有生气，脉息有生气，七窍有生气，四肢有生气，二便有
生气。生气即神气，神自形生，何不可辨？衰者速培，犹恐不生，尚堪伐乎？而况其甚者乎。
故明师察此，必知孰者已亏，孰者犹可，孰者能益生气，孰者能损生气，孰者宜先攻病气以
保生气，孰者宜先固生气以御病气。务思病气虽如此，生气将如何；见在虽如此，日后将如
何。使不有原始要终之明，则皆寸光之流耳。
虽然，此徒以斯道为言也。而斯道之外，犹有说焉。夫生气者，少阳之气也。少阳之气
，有进无退之气也。此气何来，无非来自根本；此气何用，此中尤有玄真。盖人生所贵，惟
斯气耳。而出入之权在呼吸，斯气数之宝藏也。河车之济在辘轳，实转运之神机也。其进其
退，其得其失，总在生息之间，而彭殇之途于斯判矣。经曰∶得神者昌，失神者亡。即此生
气之谓也。予见遭剥于是者不可胜纪，故特明其义于此。
一、命门有门户，为一身巩固之关也。经曰∶仓廪不藏者，是门户不要也。水泉不止者
，是膀胱不藏也。得守者生，失守者死。又曰∶肾者，胃之关也。关门不利，故聚水而从其
类也。又曰∶北方黑色，入通于肾，开窍于二阴。是可见北门之主，总在乎肾，而肾之政令
，则总在乎命门。盖命门为北辰之枢，司阴阳柄，阴阳和则出入有常，阴阳病则启闭无序。
故有为癃闭不通者，以阴竭水枯，干涸之不行也；有为滑泄不禁者，以阳虚火败，收摄之无
主也。阴精既竭，非壮水则必不能行；阳气既虚，非益火则必不能固，此固其法也。然精无
气不行，气无水不化，此其中又有可分不可分之妙用，亦在乎慧者之神悟，有非可以笔楮尽
者。
一、命门有阴虚，以邪火之偏胜也。邪火之偏胜，缘真水之不足也。故其为病，则或为
烦渴，或为骨蒸，或为咳血吐血，或为淋浊遗泄。此虽明是火证，而本非邪热实热之比。盖
实热之火其来暴，而必有感触之故；虚热之火其来徐，而必有积损之因。此虚火实火之大有
不同也。凡治火者，实热之火可以寒胜，可以水折，所谓热者寒之也；虚热之火不可以寒胜
，所谓劳者温之也。何也？盖虚火因其无水，只当补水以配火，则阴阳得平而病自可愈。若
欲去火以复水，则既亏之水未必可复，而并火去之，岂不阴阳两败乎。且苦寒之物，绝无升
腾之生气，而欲其补虚，无是理也。故予之治此，必以甘平之剂，专补真阴，此虽未必即愈
，自可无害，然后察其可乘，或暂一清解，或渐加温润，必使生气渐来，庶乎脾可健则热可
退，肺渐润则嗽渐宁，方是渐复之佳兆，多有得生者。若但知知、柏为补阴，则愈败其肾，
而致泄泻食减，必速其殆矣。
命门的概念，《黄帝内经》中原本没有，只有扁鹊（越人）说：“肾脏有两个，并非都是肾。左边的是肾，右边的是命门。”
命门，是各种精神精华藏舍的地方，也是原气系连的根本所在。男子依靠它来藏精，女子依靠它来维系子宫。我认为它的含义还有未尽之处，且存在可疑之处，因此撰写了《三焦包络命门辨》，附刻在《类经》的末尾，似乎已经概括了其大概内容。然而仍然有未尽之处，恐怕不足以唤醒后人。现在我将再次详尽阐述其深意，分条列述如下。
第一条：命门是精血之海，脾胃是水谷之海，二者都是五脏六腑的根本。然而命门是元气的根本，是水火居住的宅邸。五脏的阴气，没有它就不能滋养；五脏的阳气，没有它就不能生发。而脾胃作为中州的土，没有火就不能运化，但必须春天的生气始于下方，那么三阳之气才从地而起，之后万物才能化生。这难道不是命门的阳气在下，正是脾胃的母亲吗？所以我说道：脾胃是灌注的根本，得到的是后天之气；命门是化生的源头，得到的是先天之气，这其中本来就有本末先后的区别。看李东垣说：“补肾不如补脾。”许知可说：“补脾不如补肾。”这两个人的说法，也各有其道理，确实不需要辩论就可以明白了。
第二条：命门有“火候”，也就是所谓的元阳，即生物之火。然而禀赋有强弱之分，则元阳有盛衰之别；阴阳有胜负之势，则疾病治疗有轻重缓急之异，这就是为什么需要辨别火候的原因。这里姑且从大纲来说，一阳的元气，必然从下方向上升起，而三焦的普遍作用，于是各自显现其征候。大概下焦的征候像大地土壤，是化生的根本；中焦的征候像锅灶釜甑，是水谷的炉子；上焦的征候像广阔的天空，是神明的居所。下焦像大地土壤，土地有肥沃贫瘠之分，出产便不同；山川有深厚浅薄之别，储藏便不同，聚散的控制权，总由阳气决定。人在这里，得到一分就有一分的效用，失去一分就有一分的亏损。而凡是寿命长短、生育能力以及勇敢怯懦、精血疾病的根基，无不由此元阳的充足与否，作为消长盈缩的主宰，这就是下焦火候的含义。中焦像锅灶釜甑，凡是饮食的滋养，本源于水谷，食物强壮则身体壮实，食物少则身体衰弱，正因为胃中的阳气，其热度如同锅釜，如果不这样，那么为什么早上吃的饭中午就能消化，中午吃的饭傍晚就能消化，而锅釜消化的速度不过如此。看锅灶如果少一把柴火则延迟一个时辰消化，增加一把柴火则加速一个时辰消化，火力不到，则完全不能消化，这就是病症的表现。所以脾胃的消化与不消化，以及饮食的吸收与不吸收，也总归由阳明之气有强与不强，以及阴寒之邪有侵犯与不侵犯罢了。等到生病时，则逐渐痞塞逐渐胀满，或者膈阻或者呕吐，或者十分之中只能消化三五分，或者膨胀积聚而不能消散，或者吞酸嗳腐而食物气味不变，或者腹痛肚痛而整天不觉得饿，或者清浊不分，或者完谷不化。大概能消化的无不运行营运，不能消化的则无不留滞。运行营运则化为气化为血，留滞则化为积化为痰。这个原因，能说不是胃气不健壮吗？而不健壮的原因，能说不是火候无力吗？现在看到治疗痞证胀证，以及治疗吞酸嗳腐等症状，无论是有热还是没有热，动辄称之为胃火，剩下的余烬还能承受吗？这就是中焦火候的含义。上焦像广阔的天空，凡是变化必定体现在神明上，而神明必定根源于阳气。大概这火产生气，则没有气不到的地方；这火化生神，则没有神不灵验的。阳气在下面则温暖，所以说：相火安守其位；阳气在上面则昭明，所以说：君火保持光明。因此阳气增长则阴气消退，如太阳当空照耀。所以五官治理而万物繁盛；阳气衰退则阴气胜，而阳气被阴气抑制，所以聪明丧失而神气减弱。而凡人的声音容貌动静以及智慧愚笨贤良不肖的不一致，何尝不是阳德在起作用，这就是上焦火候的含义。这里以三焦论述火候，则各有职司，为什么都归属于命门呢？不知道水中的火，是先天真一之气，藏在坎卦之中，这股气从下向上，与后天的胃气相接而化生，这实在是生生不息的根本。所以花萼的繁荣在于根柢，锅灶的作用在于柴薪。如果真阳不从渊源发出，则总属于无根之火。火如果没有根，就是病气，而不是元气。所以《易经》以雷在地下象征复卦，可见火的表象在上，而火的根本则在下面。而且火趋向干燥，本性极畏寒冷。如果使命门阴气胜，则元阳畏惧躲避，而龙火没有藏身之地，所以导致游散不归，而出现烦热格阳等疾病。凡是善于治疗这些病的，只顺从其本性，只要使阳和之气直接进入坎中，占据其窟穴来招引诱惑它，则同类相求，虚阳没有不回归本源的。所以说：甘温除大热，正是说的这个意思。奈何糊涂的人不明白这个道理，多把虚阳当作实热，不想着温养这把火，只知道寒凉可以灭火，哪里还指望它能保留生机而不使其迅速死亡呢！这确实是医家第一救人的大义，既然从事这条道路，不可不先明白这个道理。倘若三焦有客热邪火，那都是凡火罢了，固然不得不除去。而除去火有什么难的，这本就不是正气火候的含义。学习的人在这一点上，应当深刻明白“邪”与“正”两个字，就得到治病救生的关键了。
第三条：命门有生发之气，即乾坤元不停息之机微。没有生发就会停止。大概阳主动，阴主静；阳主升，阴主降。只有动只有升，所以阳得到生发之气；只有静只有降，所以阴得到死气。所以乾元之气，始于下方而盛于上方，上升则趋向生存；坤元之气，始于上方而盛于下方，下降则趋向死亡。所以阳生于子时而在前升后降，阴生于午时而在前降后升。这是阴阳的分歧，相间不过像毛发那样细微，等到最终结果，则谬以千里，而生死的权柄，实在就在这毫厘升降的机微而已。又比如水暖则化为气，化为气则上升无不生发；水寒则结成冰，结成冰则下降无不死亡。所以肾气独沉，则奉养生机的就少，就是这个生发之气的道理。至于人的生发之气，则无处不在，也没有不应当考察的。比如脏腑有生发之气，面色有生发之气，声音有生发之气，脉象呼吸有生发之气，七窍有生发之气，四肢有生发之气，大小便也有生发之气。生发之气就是神气，神从形体产生，怎么不可以辨别呢？衰弱的要迅速培补，还担心不能生发，怎么能砍伐呢？何况那些更严重的呢。所以高明的老师考察这点，一定知道谁已经亏损，谁还可以挽救，谁能益发生发之气，谁能损害生发之气，谁应该先攻治病气以保护生发之气，谁应该先巩固生发之气以抵御病气。务必思考病气虽然如此，生发之气将如何；现在虽然如此，日后将如何。如果不具备追本溯源、明了始终的智慧，则都是目光短浅之辈。
虽然如此，这只是用这个道理论述罢了。而这个道之外，还有说法。所谓生发之气，就是少阳之气。少阳之气，是只进不退的气。这股气从哪里来，无非来自根本；这股气有什么用，其中的玄妙真实更加深奥。大概人生所珍贵的，只有这股气罢了。而出入的权力在于呼吸，这是数之宝藏。河车（精气）的济助在于辘轳（提转），实在是转运的神机。它的进退，它的得失，总在生息之间，而长寿与夭折的途径就在这里判定了。经文说：得神者昌，失神者亡。就是说的这种生发之气。我见到遭受剥蚀败坏于此的不可胜数，所以特意在此阐明其义理。
第四条：命门有门户，是一身巩固的关键关卡。经文说：仓廪不收藏的，是门户不坚固。水泉不止的，是膀胱不收藏。能够守住者生，失去守者死。又说：肾，是胃的关口。关门不利，所以积水而跟随其同类。又说：北方黑色，内通于肾，开窍于前后二阴。由此可见北门的主宰，总在于肾，而肾的政令，总在于命门。大概命门是北极星的枢纽，掌管阴阳权柄，阴阳调和则出入有常度，阴阳有病则启闭无序。所以有的出现小便癃闭不通，是因为阴竭水枯，干涸而不能通行；有的出现滑泄不禁，是因为阳虚火败，收摄没有主宰。阴精既然枯竭，不壮水则一定不能通行；阳气既然虚弱，不益火则一定不能固摄，这是固定的法则。然而精没有气不能运行，气没有水不能化生，这其中又有可分不可分的微妙作用，也在于聪慧者的神悟，有不是笔墨所能尽述的。
第五条：命门有阴虚，是由于邪火偏胜。邪火偏胜，缘于真水不足。所以它导致的疾病，有的是烦渴，有的是骨蒸潮热，有的是咳血吐血，有的是淋浊遗精泄泻。这虽然是明显的火证，但本质上不同于邪热实热。大概实热的火来得猛烈，而一定有感触外邪的缘故；虚热的火来得缓慢，而一定有积损内伤的原因。这虚火实火有很大的不同。凡是治疗火证，实热的火可以用寒凉战胜，用水势折服，所谓热者寒之；虚热的火不能用寒凉战胜，所谓劳者温之。为什么呢？大概虚火因为无水，只应当补水以配合火，则阴阳得以平衡而病自然痊愈。如果想要去火以恢复水，则既已亏损的水未必可以恢复，而且连同火一起去掉，岂不是阴阳两败吗？况且苦寒的药物，绝无升腾的生发之气，想要用它补虚，是没有道理的。所以我治疗这种情况，一定用甘平的药剂，专门补益真阴，这虽然未必立即痊愈，自然可以无害，然后观察是否有可乘之机，或者暂时清解，或者渐渐加用温润，一定要使生发之气渐渐到来，或许脾脏健运则热可退，肺脏渐润则咳嗽渐宁，这才是渐渐康复的好兆头，多有得救活的人。如果只知道知母、黄柏是补阴药，则会进一步败坏肾脏，而导致泄泻食减，必定加速其危殆。
The concept of the Mingmen (Gate of Life) was originally absent in the *Huangdi Neijing* (Yellow Emperor's Inner Canon). Only Bian Que (Yue Ren) stated: "The kidneys are two, but they are not both kidneys. The left is the kidney, and the right is the Mingmen."
The Mingmen is the residence where all spiritual essences are stored and the root where the Yuanqi (Original Qi) is attached. In men, it stores essence; in women, it connects to the uterus. I believed its meaning was not fully exhausted and contained doubts, so I wrote "Differentiation of the Sanjiao, Baoluo, and Mingmen," which was appended to the end of my work *Leijing* (Classified Classic), seemingly covering its general outline. However, there remain unexhausted aspects, which may not be sufficient to awaken future generations. Therefore, I will now elaborate on its profound implications in detail, listing them as follows.
First: The Mingmen is the sea of jing (essence) and blood, while the Spleen and Stomach are the sea of water and grain; both serve as the roots of the five zang and six fu organs. Yet, the Mingmen is the root of yuanqi (original qi) and the dwelling place of water and fire. The yin qi of the five zang cannot nourish without it, and the yang qi of the five zang cannot emerge without it. The Spleen and Stomach, being the earth of the central region, cannot transform without fire. However, spring qi must begin from below, allowing the three yang meridians to rise from the earth, after which all things can be transformed and born. Is this not because the yang qi of the Mingmen is below, serving precisely as the mother of the Spleen and Stomach? Thus, I say: The Spleen and Stomach are the roots of infusion, receiving post-heaven qi; the Mingmen is the source of transformation, receiving pre-heaven qi. There is inherently a sequence of root and branch, priority and posteriority here. Li Dongyuan said: "Tonifying the kidney is inferior to tonifying the spleen." Xu Zhike said: "Tonifying the spleen is inferior to tonifying the kidney." These two scholars' statements each have their rationale, which is clear without need for debate.
Second: The Mingmen possesses "fire degree" (huohou), which refers to yuan yang (original yang), i.e., the fire that generates life. However, due to variations in innate constitution, yuan yang has prosperity or decline; with the victory or defeat of yin and yang, disease treatment varies in severity. This is why the fire degree requires differentiation. Speaking generally, the one-yuan qi must rise from below, and the universal function of the Sanjiao (Triple Burner) then manifests its signs. Roughly speaking, the sign of the Lower Jiao is like soil, the root of transformation; the sign of the Middle Jiao is like a stove or pot, the furnace for water and grain; the sign of the Upper Jiao is like the vast sky, the mansion of spirit (shen). The Lower Jiao being like soil: fertile vs. barren land yields different produce; deep vs. shallow mountains store differently. The control of gathering and dispersing lies entirely with yang qi. In humans, gaining one part yields one part of utility; losing one part incurs one part of deficit. All foundations of longevity, fertility, courage, timidity, jing, blood, and disease treatment depend on whether this yuan qi is sufficient or insufficient, governing growth and shrinkage. This is the meaning of the Lower Jiao fire degree. The Middle Jiao being like a stove: dietary nourishment originates from water and grain; abundant food leads to robustness, scarce food to weakness. This is because the yang qi in the stomach heats like a pot. If not so, how could morning food digest by noon, and noon food by evening? The speed of digestion in a pot is thus. Observing the stove: adding one stick of wood accelerates digestion by an hour; removing one delays it. Without sufficient fire, no digestion occurs—this is the pathological manifestation. Thus, whether the Spleen and Stomach digest or not, and whether food is absorbed or not, depends on whether Yangming qi is strong or weak, and whether cold-pathogenic factors invade or not. Upon illness, one experiences gradual stagnation and distension, obstruction or vomiting, partial digestion (e.g., 30-50% of 10 parts), bloating without resolution, acid regurgitation and belching of rotten food, abdominal pain with loss of appetite, confusion of clear and turbid, or undigested food in stool. Digestion leads to circulation and transformation into qi and blood; non-digestion leads to accumulation and phlegm formation. Is this not due to unhealthy stomach qi? And why is it unhealthy? Is it not due to weak fire degree? Currently, treating stagnation, distension, acid regurgitation, etc., practitioners often label any heat as "stomach fire." Can the remaining embers withstand such treatment? This is the meaning of the Middle Jiao fire degree. The Upper Jiao being like the vast sky: changes manifest in shen (spirit), which roots in yang qi. This fire generates qi, reaching everywhere; this fire transforms shen, making it effective. Yang below provides warmth ("Minister Fire maintains its position"); Yang above provides brightness ("Ruler Fire maintains clarity"). When yang grows, yin recedes, like the sun illuminating the sky; organs function well, and all things flourish. When yang declines, yin prevails, suppressing yang; intelligence diminishes, and spirit wanes. Variations in human voice, appearance, movement, wisdom, and virtue are all due to the function of yang virtue. This is the meaning of the Upper Jiao fire degree. Discussing fire degree via the Sanjiao, each has its jurisdiction, yet why attribute all to the Mingmen? The fire within water is the pre-heaven true one qi, hidden in Kan (Water trigram). This qi rises from below, connecting with post-heaven stomach qi to transform, forming the root of continuous generation. Just as flower vitality depends on roots, and stove function on firewood, if true yang does not issue from its source, it becomes rootless fire. Rootless fire is pathogenic qi, not original qi. Hence, the *I Ching* uses Thunder under Earth (Fu hexagram) to show fire's surface is above, but its root is below. Fire seeks dryness and fears cold. If Mingmen yin prevails, yuan yang retreats, leaving Dragon Fire without shelter, causing it to scatter and leading to symptoms like vexation, heat, and floating yang. Effective treatment follows its nature: allowing harmonious yang qi to enter Kan directly, occupying its lair to attract it, ensuring similar energies seek each other, and floating yang returns to its origin. Thus, "sweet-warmness removes great heat" applies here. Ignorant practitioners mistake floating yang for excess heat, failing to warm-nourish this fire, relying only on cold-cooling agents to extinguish fire, hastening death. This is the paramount principle of saving lives in medicine. One must understand this deeply. If there is exogenous heat or evil fire in the Sanjiao, these are ordinary fires that must be removed. Removing ordinary fire is easy, as it is not the genuine qi fire degree. Students must clearly distinguish between "evil" and "righteous" to grasp the essence of preserving life.
Third: The Mingmen possesses sheng qi (vital/generating qi), which is the subtle mechanism of unceasing Qianyuan (Heavenly Origin). Without generation, there is cessation. Yang governs movement; Yin governs stillness. Yang governs ascending; Yin governs descending. Movement and ascent yield yang's generating qi; stillness and descent yield yin's death qi. Thus, Qianyuan qi starts below and peaks above; ascending leads to life. Kunyuan (Earthly Origin) qi starts above and peaks below; descending leads to death. Yang arises at Zi hour (midnight), rising first then descending; Yin arises at Wu hour (noon), descending first then rising. The divergence of yin and yang is finer than hair, yet leads to differences of a thousand li. The handle of life and death lies in this minute mechanism of ascent and descent. Water warming turns to vapor, rising and generating; water freezing turns to ice, descending and dying. Thus, Kidney qi sinking alone results in less life-supporting qi, illustrating this principle. Human generating qi is ubiquitous and must be observed everywhere: in zang-fu, complexion, voice, pulse/respiration, seven orifices, limbs, and urination/defecation. Generating qi is shen qi (spiritual qi); spirit arises from form, so it is discernible. Declining qi needs rapid tonification; how can it be depleted further? Wise physicians assess who is deficient, who is salvageable, who enhances generating qi, who damages it, who should attack pathogenic qi first to protect generating qi, and who should consolidate generating qi to resist pathogenic qi. They consider: although pathogenic qi is present, what happens to generating qi? Although currently stable, what will happen later? Without understanding origins and endings, one is short-sighted.
However, this discusses the Dao. Beyond this, there is more. Generating qi is Shaoyang (Lesser Yang) qi, a qi that advances but does not retreat. It comes from the root; its use is profound. Life values this qi most. Breath controls entry and exit, storing this qi. Jing (essence) transport relies on rotation, the divine mechanism of transformation. Its advance/retreat and gain/loss occur within breathing/life cycles, distinguishing long life from premature death. The classic states: "Those with Shen prosper; those who lose Shen perish." This refers to generating qi. I have seen countless cases of depletion, hence clarifying this meaning.
Fourth: The Mingmen has a gate/passage, the key to the body's consolidation. The classic says: "If the granary does not store, the gate is not secure." "If water springs do not stop, the Bladder does not store." Those who maintain security live; those who lose it die. Also: "The Kidney is the gate of the Stomach." If the gate is obstructed, water accumulates. Also: "North corresponds to black, enters through the Kidney, opens at the two yin orifices." Thus, the master of the North Gate is the Kidney, whose orders come from the Mingmen. The Mingmen is the pivot of the North Star, controlling yin and yang. Harmonized yin and yang ensure regular entry/exit; diseased yin and yang cause disordered opening/closing. Some suffer urinary retention due to yin exhaustion and water drying up; others suffer incontinence due to yang deficiency and fire failure, lacking control. Exhausted jing requires nourishing water to flow; deficient yang requires benefiting fire to consolidate. This is the standard method. However, jing cannot move without qi, and qi cannot transform without water. There is a subtle interplay of separability and inseparability, understood by the wise beyond words.
Fifth: Mingmen yin deficiency results from the predominance of evil fire. Evil fire predominates due to insufficiency of true water. Diseases include vexation/thirst, bone-steaming fever, hemoptysis/hematemesis, stranguria/enuresis/spermatorrhea. Though appearing as fire syndromes, they differ from evil/excess heat. Excess heat arises suddenly from external contact; deficient heat arises slowly from internal depletion. Treating excess heat: overcome with cold, subdue with water ("treat heat with cold"). Treating deficient heat: cannot overcome with cold ("treat labor/deficiency with warmth"). Why? Deficient heat lacks water; one must replenish water to balance fire, restoring yin-yang equilibrium. Attempting to remove fire to restore water fails because lost water is hard to recover, and removing fire harms both yin and yang. Bitter-cold herbs lack ascending generating qi and cannot tonify deficiency. My treatment uses sweet-neutral formulas to specifically tonify true yin. While not instantly curative, it causes no harm. Then, observing opportunities, one may temporarily clear-resolve or gradually add warm-moistening agents, aiming for gradual return of generating qi. When Spleen strengthens, heat retreats; when Lung moistens, cough calms. This indicates recovery, saving many lives. Relying solely on Zhi Mu (Anemarrhenae Rhizoma) and Huang Bai (Phellodendri Cortex) as yin-tonics damages the Kidney, causing diarrhea and poor appetite, hastening danger.