典藏书目

Danxi stated in *Jingyao* (Essentials): When Yang Qi is stagnant in the Yin aspect, the pulse presents as Floating (Fu), Surging (Hong), Wiry (Xian), or Rapid (Shu); when Yin Qi is stagnant in the Yang aspect, the pulse presents as Deep (Chen), Fine (Xi), Weak (Ruo), or Choppy (Se). Stagnation of Yang should be treated with Cold (Han) methods, and stagnation of Yin should be treated with Heat (Re) methods. Upon careful examination of its meaning, "Yang stagnation" and "Yin stagnation" should actually be sought through the lens of "Heat treatment" and "Cold treatment." Although Cold and Heat can certainly be discussed in terms of Yin and Yang, the "Yin" and "Yang" mentioned here clearly refer to Qi and Blood. There is nothing else to say.

If Heat pathogen stagnates in the Qi level, does it imply there is no Cold stagnation? If Cold pathogen stagnates in the Blood level, does it imply there is no Heat stagnation? Why assume that Cold cannot injure Qi and Heat cannot injure Blood? In my view, Qi belongs to Yang and circulates outside the vessels; Blood belongs to Yin and circulates inside the vessels. They move together, distribute throughout the body, circulate endlessly without stopping, which is called the Pulse. During one exhalation, the pulse moves three cun; during one inhalation, it moves three cun. Together in one respiratory cycle, it covers six cun. The entire body's meridians total eighty-one zhang. When encountering Heat, movement accelerates and becomes excessive; when encountering Cold, movement slows down and falls short. Bias from the Five Flavors (Wu Wei) and intensity of the Seven Emotions (Qi Qing) cause Qi stagnation. Body fluids become thick, accumulate over time, and transform into Fluid Retention (Yin) or Phlegm (Tan), seeping into the vessels, disturbing the Blood, causing turbidity, obstructing circulation, or becoming turbulent like boiling water. This is what is meant by "Yin stagnating in Yang," which is essentially "Blood stagnating in Qi," a disease of the Qi level.

Today, people sometimes use medicines that assist the pathogen, adding illness upon illness. Blood disorders increase daily, overflowing from the vessels, blocking channels, hindering ascending and descending functions, and disrupting transformation and transportation. This is what is meant by "Yang stagnating in Yin," which is essentially "Healthy Qi stagnating in Blood." Diseases are divided into Cold and Heat types, which should be attributed to constitutional deficiency and mixed pathogenic factors. How can one simply equate Yang with Heat and Yin with Cold? Floating, Surging, Wiry, and Rapid pulses are signs of Qi diseases; how can they be hastily diagnosed as Heat syndromes? Deep, Fine, Weak, and Choppy pulses are signs of Blood diseases; how can they be hastily diagnosed as Cold syndromes? These are the root causes of ten thousand diseases, extending far beyond just scabies, sores, ulcers, carbuncles, and gangrene. I hope everyone will evaluate whether this is correct.

[Clarifying the Origin and Progression of Sores and Ulcers]

Dongyuan stated: *Shengqi Tongtian Lun* records: "When Ying Qi does not follow its course and reverses within the flesh and tissue, abscesses and swellings arise." It also says: "Changes due to rich food and drink lead to large carbuncles; susceptibility is like holding an empty vessel." *Yinyang Yingxiang Lun* records: "The dampness of the earth, when contracted, harms the skin, flesh, sinews, and vessels." This indicates that external Dampness impairs the flow of Ying Qi. Both Ying and Wei Qi originate from Ying Qi. Ying Qi is Stomach Qi and Transporting Qi. Ying Qi is the root; if the root reverses and fails to function normally, damaged by Dampness, sores and ulcers form. "Changes due to rich food and drink" also refers to excessive consumption of rich flavors causing Ying Qi to reverse and condense in the meridians, forming sores and ulcers. This pathogen is neither in the exterior nor the interior, but resides in the middle of the meridians. All statements in *Neijing* mention that these conditions arise from the reversal of Ying Qi.

Reviewing various discussions on sores and ulcers, many state that two Heats clashing transform into pus; some only mention Heat transforming into pus; others say Dampness governs sores, where Cold transforms into Heat to form pus. These are all sources of sores and ulcers. One should use channel-guiding herbs at the affected site and differentiate between Yin and Yang syndromes based on manifestations. Draining Ying Qi addresses the root, as the primary issue is the reversal of Ying Qi. If Fire, Dampness, and Heat combine to destroy muscle and form pus and blood, this is secondary treatment.

One should observe nature for analogy: In a year, summer heat is the greatest, yet things do not rot then. Rotting occurs when Autumn Dampness prevails. Observing the human body: In febrile diseases, Heat manifests but does not destroy muscle. This logic is clear. "When the root and branch do not correspond, the pathogen cannot be subdued." One who knows one thing and understands a hundred can be considered a superior physician.

"When Ying Qi does not follow its course and reverses within the flesh and tissue, sores and ulcers arise." Moreover, Ying Qi is Stomach Qi. Food enters the Stomach, first transmits to the Spleen, then ascends to the Lung. The Lung directs Qi to all vessels, reaching the skin and hair, moving along the Yang pathways, descending to the Zang-Fu organs, and manifesting at the Cun Kou (radial artery). Today, wealthy individuals lack moderation, consuming fatty and sweet foods mixed with rich flavors. Over time, these strong-smelling and tasting substances, being Yang within Yang, fail to enter the orifices. Instead of moving along Yang pathways, they reverse into Yin pathways, stagnating in the flesh. Dampness becomes dominant. According to the generating cycle, "the child can strengthen the mother," leading to excessive Fire. With Heat and Dampness prevalent, Kidney Water is attacked. If irregularities further damage True Water, the Kidneys suffer. Prolonged deficiency leads to transformation into Heat and Dampness rising upward. Such sores often appear on the back or head, representing the most severe type of large carbuncle. If toxic vapors affect the Lungs or Spleen/Stomach regions, the toxicity is moderate. If affecting other meridians, it is less severe. Wherever Heat-Damp toxins settle, ulceration occurs. Thus, the classic states: "Rich food changes lead to large carbuncles; susceptibility is like holding an empty vessel." Just as an empty vessel accepts anything, the body accepts the toxin easily.

The treatment for large carbuncles must drain Ying Qi. From the perspective of root and branch, the initial injury is the root. Without using Bitter-Cold agents as the principal herb, pain and suffering cannot be relieved. For painful sores, using aromatic herbs like Frankincense (Ruxiang) and Myrrh (Moyao) for pain relief rarely reduces pain. If meridians are unblocked and internal stagnation removed, pain will cease. Bitter-Cold agents relieve pain; once swallowed, pain stops immediately. This is a divine medicine.

Eating meat during sores and ulcers is self-sabotage. Sores and ulcers arise from Ying Qi disorders; supplementing them now is akin to giving up. Even with medication, healing is impossible. For Dampness entering from outside causing boils, one should take medicine and use acupuncture. For small boils or infant sores, if oral medication is refused, cover the infant with warm clothing to warm the blood vessels; bleeding will stop immediately. Otherwise, if vessels are stagnant and needling is performed, pathogens will not be expelled, healthy flesh will be injured, and the sore will worsen.

For sores and ulcers presenting with facial redness, despite latent severe Heat, purgatives for the interior are forbidden because Yang Qi is constrained and pathogens reside in the meridians. One should release the exterior. Thus, it is said: "Fire constraint requires dispersal." Even if constipation persists for days, focus on releasing the exterior to disperse Yang Qi, adding mild moistening herbs. If Wind pulse or Wind syndrome is present, exterior-releasing Wind herbs facilitate bowel movement. If dryness and constipation prevail, moistening is essential; avoid purgatives.

Sore-related syncope, commonly called coma, should be treated with sweating to achieve recovery. Regarding diagnosis and treatment of sores, one must follow *Suwen*, *Zhenjing*, *Shengji Zonglu*, Yilao’s treatise on sores, and methods from various schools. This is crucial. At the bedside, careful examination is required.

In summary: *Shengji Zonglu* details names and appearances of sores but relies heavily on Cold-Cooling herbs without flexible adaptation. Only the theories of Yilao and Dongyuan deeply extract the principles of *Zhenjing* and summarize key pulse-disease-treatment examples. Scholars who master these discussions will have clear understanding when treating patients clinically.