人之一身。不外阴阳。而阴阳二字。即是水火。水火二字。即是气血。水即化气。火即化血。何以言水即化气
哉。气着于物。复还为水。是明验也。盖人身之气。生于脐下丹田气海之中。脐下者肾与膀胱。水所归宿之
地也。此水不自化为气。又赖鼻间吸入天阳。从肺管引心火。下入于脐之下。蒸其水使化为气。如易之坎
卦。一阳生于水中。而为生气之根。气既生。则随太阳经脉为布护于外。是为卫气。上交于肺。是为呼吸。五
脏六腑。息以相吹。止此一气而已。然气生于水。即能化水。水化于气。亦能病气。气之所至。水亦无不至焉。
故太阳之气达于皮毛则为汗。气挟水阴而行于外者也。太阳之气。上输于肺。膀胱肾中之水阴。即随气
升腾。而为津液。是气载水阴而行于上者也。气化于下。则水道通而为溺。是气行水亦行也。设水停不化。
外则太阳之气不达。而汗不得出。内则津液不生。痰饮交动。此病水而即病气矣。又有肺之制节不行。气
不得降。因而癃闭滑数。以及肾中阳气。不能镇水。为饮为泻。不一而足。此病气即病水矣。总之。气与水本
属一家。治气即是治水。治水即是治气。是以人参补气。以其生于北方。水中之阳。甘寒滋润。大生津液。津
液充足。而肺金濡润。肺主气。其叶下垂以纳气。得人参甘寒之阴。内具阳性。为生气化水之良品。故气得
所补益焉。即如小柴胡。仲景自注云。上焦得通。津液得下。胃气因和。是通津液即是和胃气盖津液足。则
胃上输肺。肺得润养。其叶下垂。津液又随之而下。如雨露之降。五脏戴泽。莫不顺利。而浊阴全消。亢阳不
作。肺之所以制节五脏者如此。设水阴不足。津液枯竭。上则痿咳。无水以济之也。下则闭结。制节不达于
下也。外则蒸热。水阴不能濡于肌肤也。凡此之证。皆以生水为治法。故清燥救肺汤。生津以补肺气。猪苓
汤。润利以除痰气。都气丸。补水以益肾气。即如发汗。所以调卫气也。而亦戒火攻以伤水阴。故用白芍之
滋阴。以启汗源。用花粉之生津。以救汗液。即此观之。可知滋水即是补气。然补中益气汤。六君子。肾气丸。
是皆补气之方也。何以绝不滋水哉。盖无形之水阴。生于下而济于上。所以奉养是气者也。此水则宜滋
有形之水质。入于口而化于下。所以传道是气者也。此水则宜泻。若水质一停。则气便阻滞。故补中汤。用
陈术以制水。六君子。用苓半以利水。肾气丸。亦用利水之药。以佐桂附。桂附以气药化水。苓泽即以利水
之药以化气。真武汤尤以术苓利水为主。此治水之邪。即以治气。与滋水之阴。即以补气者。固并行而不
悖也。且水邪不去。则水阴亦不能生。故五苓散去水邪。而即能散津止渴。并能发汗退热。以水邪去。则水
阴布故也。然水阴不滋。则水邪亦不能去。故小柴胡通达津液。而即能下调水道。总见水行则气行。水止
则气止。能知此者。乃可与言调气矣。何以言火即化血哉。血色。火赤之色也。火者心之所主。化生血液。以
濡周身。火为阳。而生血之阴。即赖阴血以养火。故火不上炎。而血液下注。内藏于肝。寄居血海。由冲任带
三脉。行达周身。以温养肢体。男子则血之转输。无从觇验。女子则血之转输。月事时下。血下注于血海之
中。心火随之下济。故血盛而火不亢烈。是以男子无病。而女子受胎也。如或血虚。则肝失所藏。木旺而愈
动火。心失所养。火旺而益伤血。是血病即火病矣。治法宜大补其血。归地是也。然血由火生。补血而不清
火。则火终亢而不能生血。故滋血必用清火诸药。四物汤所以用白芍。天王补心丹所以用二冬。归脾汤
所以用枣仁。仲景炙甘草汤所以用二冬阿胶。皆是清水之法。至于六黄汤。四生丸。则又以大泻火热为
主。是火化太过。反失其化。抑之即以培之。清火即是补血。又有火化不及。而血不能生者。仲景炙甘草汤
所以有桂枝。以宣心火。人参养荣汤所以用远志肉桂。以补心火。皆是补火生血之法。其有血寒血痹者。
则用桂枝细辛艾叶干姜等。禀受火气之药。以温达之。则知治火即是治血。血与火原一家。知此乃可与
言调血矣。夫水火气血。固是对子。然亦互相维系。故水病则累血。血病则累气。气分之水阴不足。则阳气
乘阴而干血。阴分之血液不足。则津液不下而病气。故汗出过多则伤血。下后亡津液则伤血。热结膀胱
则下血。是水病而累血也。吐血咳血。必兼痰饮。血虚则精竭水结。痰凝不散。失血家往往水肿。瘀血化水。
亦发水肿。是血病而兼水也。盖在下焦。则血海膀胱。同居一地。在上焦。则肺主水道。心主血脉。又并域而
居。在躯壳外。则汗出皮毛。血循经脉。亦相倚而行。一阴一阳。互相维系。而况运血者即是气。守气者即是
血。气为阳。气盛即为火盛。血为阴。血虚即是水虚。一而二。二而一者也。人必深明此理。而后治血理气。调
阴和阳。可以左右逢源。又曰血生于心火。而下藏于肝。气生于肾水。而上主于肺。其间运上下者。脾也。水
火二藏。皆系先天。人之初胎。以先天生后天。人之既育。以后天生先天。故水火两藏。全赖于脾。食气入胃。
脾经化汁。上奉心火。心火得之。变化而赤。是之谓血。故治血者。必治脾为主。仲景炙甘草汤。皆是此义。以
及大黄下血。亦因大黄秉土之色。而大泄地道故也。地黄生血。亦因地黄秉土之润。而大滋脾燥故也。其
余参 。运血统血。皆是补脾。可知治血者。必以脾为主。乃为有要。至于治气。亦宜以脾为主。气虽生于肾
中。然食气入胃。脾经化水。下输于肾。肾之阳气。乃从水中蒸腾而上。清气升而津液四布。浊气降而水道
下行。水道下行者。犹地有江河。以流其恶也。津液上升者。犹土膏脉动。而雨露升也。故治气者必治脾为
主。六君子汤。和脾利水以调气。真武汤。扶脾镇水以生气。十枣陷胸等汤。攻脾夺水以通气。此去水邪以
补气之法也。又有水津不灌。壮火食气。则用人参滋脾以益气。花粉清脾以和气。凡治气者。亦必知以脾
为主。而后有得也。李东垣治病。以气为主。故专主脾胃。然用药偏于刚燥。不知脾不制水固宜燥。脾不升
津则宜滋。气分不可留水邪。气分亦不可无水津也。朱丹溪治病以血为主。故用药偏于寒凉。不知病在
火脏宜寒凉。病在土脏宜甘缓也。此论不专为失血立说。然治血者。必先知之。而后于调气和血。无差爽云。
人的整个身体，不外乎阴阳。而“阴阳”这两个字，指的就是水火；“水火”这两个字，指的就是气血。水能够转化为气，火能够转化为血。为什么说水能化气呢？因为气附着在物体上，又会还原为水，这是明显的验证。大概人体的气，产生于脐下丹田气海之中。脐下的部位是肾与膀胱，这是水汇聚的地方。但这水不能自动化为气，又依赖鼻腔吸入的天阳之气，通过肺管引导心火，下行进入脐下，蒸腾水分使其化为气，就像《易经》中的坎卦，一阳爻生于水中，成为生气的根本。气既然生成，就随着太阳经脉布散护卫于体表，这就是卫气（行于脉外、具有防御功能的气）。向上交于肺，就成为呼吸。五脏六腑，气息相互吹动，止于此一气罢了。然而气生于水，又能化水；水由气化，也能致病。气到达的地方，水也没有不到的地方。所以太阳之气通达皮毛就成为汗，这是气挟带水阴运行于体外的表现。太阳之气，向上输送到肺，膀胱和肾中的水阴，就随着气升腾，成为津液，这是气载着水阴运行于上方的表现。气在下焦气化，则水道通畅而排出小便，这是气行则水也行的表现。如果水停滞不化，外则太阳之气不能通达，汗就无法排出；内则津液无法生成，痰饮交互发动，这是病水进而导致病气。又有肺的制节功能不行，气不得下降，因而出现小便不通或滑数等症状，以及肾中阳气不能镇摄水液，导致成饮成泻，情况不一而足，这是病气进而导致病水。总之，气和水本属一家，治气就是治水，治水就是治气。所以人参补气，是因为它生于北方，得水中之阳，味甘性寒滋润，大生津液。津液充足，则肺金得到濡润。肺主气，其叶下垂以纳气，得到人参甘寒之阴，内具阳性，是生气化水的优良药物。所以气得以补益。就像小柴胡汤，张仲景自己注释说：“上焦得通，津液得下，胃气因和。”这是说通调津液就是调和胃气。盖津液充足，则胃气上输于肺，肺得到润养，其叶下垂，津液又随之而下，如同雨露降下，五脏都受到润泽，没有不顺利的，而浊阴完全消除，亢阳不再发作。肺之所以能制节五脏，就是这样的道理。如果水阴不足，津液枯竭，向上则痿弱咳嗽，是因为无水来济助；向下则闭结不通，是制节功能不达于下；向外则蒸热，是水阴不能濡润肌肤。所有这些证候，都以生水为治疗方法。所以清燥救肺汤，生津以补肺气；猪苓汤，润利以除痰气；都气丸，补水以益肾气。就像发汗，是用来调护卫气的，但也忌讳用火攻法伤害水阴。所以用白芍滋阴，以开启汗源；用天花粉生津，以挽救汗液。由此看来，可知滋水就是补气。然而补中益气汤、六君子汤、肾气丸，这些都是补气的方剂，为什么完全不滋水呢？大概无形的水阴，生于下而济助于上，是用来奉养这气的。这种水适宜滋补。有形的质之水，入口而在下焦转化，是用来传导这气的。这种水适宜泻除。如果水质一旦停滞，气就会阻滞。所以补中汤，用陈皮、白术来制约水湿；六君子汤，用茯苓、半夏来利水；肾气丸，也用利水的药物，来佐助肉桂、附子。肉桂、附子是用气药来化水，茯苓、泽泻则是以利水药来化气。真武汤尤其以白术、茯苓利水为主。这是治疗水邪，也就是治气，与滋补水阴，也就是补气，本来就是并行而不违背的。况且水邪不去，水阴也不能生成。所以五苓散去水邪，就能散津止渴，并能发汗退热，这是因为水邪去，则水阴布散的缘故。然而水阴不滋，水邪也不能去除。所以小柴胡汤通达津液，就能下调水道。总可见水行则气行，水止则气止。能懂得这个道理，才可以与他谈论调气。为什么说火能化血呢？血色，是火赤的颜色。火是心所主的，化生血液，以濡润周身。火为阳，而生血的阴，即赖阴血来养火。所以火不上炎，而血液下注，内藏于肝，寄居在血海，由冲脉、任脉、带脉三条经脉，运行达于周身，以温养肢体。男子则血的转输，无从观察验证；女子则血的转输，月经每月按时来潮。血下注于血海中，心火也随之而下济。所以血盛而火不亢烈，因此男子无病，而女子能受胎。如果血虚，则肝失所藏，木旺而更动火；心失所养，火旺而更伤血，这是血病即火病。治疗方法宜大补其血，当归、地黄就是这类药。然而血由火生，补血而不清火，则火终归亢盛而不能生血。所以滋血必须用清火的诸药。四物汤所以用白芍，天王补心丹所以用天冬、麦冬，归脾汤所以用酸枣仁，张仲景炙甘草汤所以用天冬、麦冬和阿胶，都是清火的方法。至于黄连解毒汤（此处原文作六黄汤，通常指三黄泻心汤或类似清热方，依原文保留）、四生丸，则以大泻火热为主。这是火化太过，反而失去其化生之功，抑制它即是培养它，清火即是补血。又有火化不及，而血不能生成的，张仲景炙甘草汤所以有桂枝，用以宣通心火；人参养荣汤所以用远志、肉桂，用以补心火，都是补火生血的方法。其中有血寒、血痹的，则用桂枝、细辛、艾叶、干姜等禀受火气的药物，以温通达之。这样就知道治火就是治血，血与火原是一家，懂得这个，才可以与他谈论调血。夫水火气血，固然是对偶的概念，但也互相维系。所以水病则累及血，血病则累及气。气分的水阴不足，则阳气乘阴而干扰血；阴分的血液不足，则津液不下而病气。所以出汗过多则伤血，误下后亡失津液则伤血，热结膀胱则便血，这是水病而累及血。吐血、咳血，必兼有痰饮；血虚则精竭水结，痰凝不散；失血的人往往水肿，瘀血化水，也会发生水肿，这是血病而兼有水。大概在下面焦，则血海与膀胱同居一地；在上面焦，则肺主水道，心主血脉，又同处一区；在躯壳之外，则汗出皮毛，血循经脉，也是相依而行。一阴一阳，互相维系。何况运血者即是气，守气者即是血。气为阳，气盛即为火盛；血为阴，血虚即是水虚。是一分为二，二合为一的关系。人必须深明此理，然后治血理气，调阴和阳，就可以左右逢源。又说：血生于心火，而下藏于肝；气生于肾水，而上主于肺。其间运化上下的是脾。水火两脏，都属于先天。人在初胎时，以先天生后天；人既已发育成熟，以后天生先天。所以水火两脏，全赖于脾。食物进入胃中，脾经化生汁液，上奉于心火，心火得到它，变化而变红，这就叫做血。所以治血的人，必须以治脾为主。张仲景的炙甘草汤，都是这个意思。以及大黄下血，也是因为大黄秉土之色，而大泄地道的原因。地黄生血，也是因为地黄秉土之润，而大滋脾燥的原因。其余人参、黄芪等，运血统血，都是补脾。可知治血的人，必须以脾为主，这才是抓住了要领。至于治气，也应以脾为主。气虽然生于肾中，然而食物进入胃中，脾经化水，下输于肾，肾的阳气，才从水中蒸腾而上。清气上升而津液四布，浊气下降而水道下行。水道下行，犹如地有江河，以流走污秽；津液上升，犹如土壤湿润脉动，而雨露升起。所以治气的人必须以治脾为主。六君子汤，和脾利水以调气；真武汤，扶脾镇水以生气；十枣汤、陷胸汤等，攻脾夺水以通气。这是去水邪以补气的方法。又有水津不灌溉，壮火消耗气，则用人参滋脾以益气，用天花粉清脾以和气。凡治气的人，也必须知道以脾为主，然后才有收获。李东垣治病，以气为主，所以专主脾胃。然而用药偏于刚燥，不知道脾不制水固然宜燥，但脾不升津则宜滋。气分不可留水邪，气分也不可无水津。朱丹溪治病以血为主，所以用药偏于寒凉，不知道病在火脏宜寒凉，病在土脏宜甘缓。这一论述不是专为失血立论，然而治血的人，必须先知道这些，然后在调气和血时，就不会有差错失误了。
The entire human body is nothing but Yin and Yang. The terms "Yin and Yang" refer to Water and Fire; the terms "Water and Fire" refer to Qi (Vital Energy) and Blood. Water transforms into Qi, and Fire transforms into Blood. Why do we say that Water transforms into Qi? Because Qi attaches to matter and reverts to Water, which is clear evidence. Generally speaking, the Qi of the human body is generated in the Dantian (Elixir Field) and Qihai (Sea of Qi), located below the navel. This area below the navel corresponds to the Kidney and Bladder, which are the destinations where Water gathers. However, this Water cannot transform into Qi on its own; it relies on the Heavenly Yang Qi inhaled through the nose, guided by the Lung channel to draw down Heart Fire, entering below the navel to steam the Water, causing it to transform into Qi. This is like the Kan trigram (☵) in the *I Ching* (Book of Changes), where one Yang line is born within Water, serving as the root of generating Qi. Once Qi is generated, it spreads and protects the exterior along the Taiyang (Greater Yang) meridian, becoming Wei Qi (Defensive Qi). It ascends to communicate with the Lung, becoming respiration. The Zang and Fu organs breathe into each other, relying solely on this one Qi. However, since Qi is born from Water, it can also transform Water; since Water is transformed by Qi, it can also cause disease. Wherever Qi reaches, Water also reaches. Therefore, when Taiyang Qi penetrates the skin and hair, it becomes sweat; this is Qi carrying Yin-Water to the exterior. When Taiyang Qi transports upward to the Lung, the Yin-Water from the Bladder and Kidneys ascends with the Qi to become Jin-Ye (Body Fluids); this is Qi carrying Yin-Water to the upper body. When Qi undergoes transformation in the lower Jiao (Lower Burner), the water passages open, leading to urination; this demonstrates that when Qi moves, Water moves. If Water stagnates and fails to transform, externally, Taiyang Qi cannot penetrate, preventing sweating; internally, Jin-Ye fails to generate, leading to the interaction of Phlegm and Fluid retention. This is a case of Water pathology affecting Qi. Furthermore, if the Lung's regulatory function fails, Qi cannot descend, resulting in urinary retention or frequent/rapid urination. If Kidney Yang Qi fails to control Water, it leads to fluid retention or diarrhea, among other conditions. This is a case of Qi pathology affecting Water. In summary, Qi and Water belong to the same family; treating Qi is treating Water, and treating Water is treating Qi. Therefore, Ren Shen (Ginseng Root) tonifies Qi because it grows in the North, possessing the Yang within Water. Its sweet and cold nature moistens and generates abundant Jin-Ye. When Jin-Ye is sufficient, Lung Metal is nourished. Since the Lung governs Qi and its leaves hang downward to receive Qi, receiving the Yin nature of Ren Shen's sweetness and coldness, while containing Yang properties, makes it an excellent agent for generating Qi and transforming Water. Thus, Qi is replenished. For example, Xiao Chai Hu Tang (Minor Bupleurum Decoction), as Zhang Zhongjing annotated: "When the Upper Jiao is unblocked, Jin-Ye descends, and Stomach Qi harmonizes." This implies that unblocking Jin-Ye is harmonizing Stomach Qi. When Jin-Ye is sufficient, Stomach Qi uploads to the Lung; the Lung is nourished, its leaves hang downward, and Jin-Ye descends further, like rain and dew falling, benefiting all Zang organs, eliminating turbid Yin, and suppressing hyperactive Yang. This is how the Lung regulates the Zang organs. If Yin-Water is insufficient and Jin-Ye is depleted, upward symptoms include flaccidity and cough due to lack of Water to assist; downward symptoms include constipation due to failed regulation reaching the lower body; outward symptoms include steaming heat due to Water failing to moisten the skin and muscles. All such syndromes are treated by generating Water. Thus, Qing Zao Jiu Fei Tang (Clear Dryness Rescue the Lung Decoction) generates Jin-Ye to tonify Lung Qi; Zhu Ling Tang (Polyporus Decoction) moistens and promotes urination to eliminate Phlegm-Fluids; Du Qi Wan (All-Qi Pill) supplements Water to benefit Kidney Qi. Regarding diaphoresis (sweating), it regulates Wei Qi, but one must avoid fire therapy that damages Yin-Water. Therefore, Bai Shao (White Peony Root) is used to nourish Yin to open the source of sweat, and Hua Fen (Trichosanthes Root) is used to generate Jin-Ye to rescue sweat fluids. From this, we see that nourishing Water is tonifying Qi. However, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), Liu Jun Zi Tang (Six Gentlemen Decoction), and Shen Qi Wan (Kidney Qi Pill) are all formulas for tonifying Qi, yet they do not explicitly nourish Water. This is because formless Yin-Water is generated in the lower body and assists the upper body to nourish this Qi; this type of Water should be nourished. Formless substance-water enters the mouth and transforms in the lower body to transmit this Qi; this type of Water should be purged. If substance-water stagnates, Qi becomes obstructed. Therefore, Bu Zhong Tang uses Chen Pi (Tangerine Peel) and Bai Zhu (Atractylodes Macrocephala Rhizome) to control dampness; Liu Jun Zi Tang uses Fu Ling (Poria) and Ban Xia (Pinellia Tuber) to promote urination; Shen Qi Wan also uses diuretic herbs to assist Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Root). Gui Zhi and Fu Zi use Qi-moving herbs to transform Water, while Fu Ling and Ze Xie (Alisma Rhizome) use diuretics to transform Qi. Zhen Wu Tang (True Warrior Decoction) focuses mainly on Bai Zhu and Fu Ling to drain dampness. This treats Water pathologies to address Qi, just as nourishing Yin-Water addresses Qi; these two approaches run parallel without contradiction. Moreover, if Water pathogens are not removed, Yin-Water cannot be generated. Therefore, Wu Ling San (Five-Ingredient Powder with Poria) removes Water pathogens, thereby dispersing Jin-Ye to stop thirst, and inducing sweating to reduce fever, because removing Water pathogens allows Yin-Water to distribute. Conversely, if Yin-Water is not nourished, Water pathogens cannot be removed. Thus, Xiao Chai Hu Tang unblocks Jin-Ye, thereby regulating the water passages. It is evident that when Water flows, Qi flows; when Water stops, Qi stops. One who understands this can discuss regulating Qi.
Why do we say that Fire transforms into Blood? The red color of blood is the color of Fire. Fire is governed by the Heart, which generates Blood to moisten the whole body. Fire is Yang, and the Yin required to generate Blood relies on Yin-Blood to nourish Fire. Thus, Fire does not flare upward, and Blood descends, storing internally in the Liver, residing in the Blood Sea, and circulating throughout the body via the Chong, Ren, and Dai meridians to warm and nourish the limbs. In men, the circulation of Blood is difficult to observe directly; in women, the circulation of Blood is evidenced by menstruation occurring monthly. Blood descends into the Blood Sea, and Heart Fire descends with it. Thus, when Blood is abundant, Fire is not hyperactive, allowing men to remain healthy and women to conceive. If Blood is deficient, the Liver loses its storage capacity, Wood becomes hyperactive and agitates Fire further; the Heart loses nourishment, Fire becomes hyperactive and injures Blood more. This is Blood pathology affecting Fire. The treatment method should greatly tonify Blood, using Dang Gui (Angelica Sinensis Root) and Di Huang (Rehmannia Root). However, since Blood is generated by Fire, if one tonifies Blood without clearing Fire, Fire will remain hyperactive and fail to generate Blood. Therefore, nourishing Blood requires clearing Fire herbs. Si Wu Tang (Four Substance Decoction) uses Bai Shao to clear Fire; Tian Wang Bu Xin Dan (Emperor of Heaven's Special Pill to Tonify the Heart) uses Dong Gen (Asparagus Tuber) and Mai Dong (Ophiopogon Tuber); Gui Pi Tang (Restore the Spleen Decoction) uses Suan Zao Ren (Ziziphus Seed); Zhang Zhongjing's Zhi Gan Cao Tang (Honey-Fried Licorice Decoction) uses Dong Gen, Mai Dong, and E Jiao (Donkey-Hide Glue). These are all methods of clearing Fire. Meanwhile, Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity, referred to here as Liu Huang Tang) and Si Sheng Wan (Four Raw Ingredients Pill) focus on purging intense Heat and Fire. This occurs when Fire transformation is excessive, losing its generative function; suppressing it is cultivating it; clearing Fire is tonifying Blood. Conversely, if Fire transformation is insufficient, Blood cannot be generated. Zhi Gan Cao Tang includes Gui Zhi to circulate Heart Fire; Ren Shen Yang Rong Tang (Ren Shen Nourishing the Vigor Decoction) uses Yuan Zhi (Polygala Root) and Rou Gui (Cinnamon Bark) to tonify Heart Fire. These are methods of tonifying Fire to generate Blood. For cases of Cold-Blood or Blood Bi (Obstruction), herbs like Gui Zhi, Xi Xin (Asarum), Ai Ye (Mugwort Leaf), and Gan Jiang (Dried Ginger), which possess Fire energy, are used to warm and unblock. Thus, treating Fire is treating Blood; Blood and Fire are originally one family. Understanding this allows one to discuss regulating Blood.
Although Water/Fire and Qi/Blood are paired concepts, they sustain each other. Water pathology affects Blood, and Blood pathology affects Qi. Insufficiency of Yin-Water in the Qi aspect allows Yang Qi to invade Blood; insufficiency of Yin-Blood in the Yin aspect prevents Jin-Ye from descending, causing Qi pathology. Excessive sweating injures Blood; purgative-induced loss of Jin-Ye injures Blood; Heat binding in the Bladder causes hematuria; this is Water pathology affecting Blood. Hematemesis (vomiting blood) and hemoptysis (coughing blood) often involve Phlegm-Fluids; Blood deficiency leads to Essence depletion and Water stagnation, with凝 (coagulated) Phlegm failing to dissipate; patients with chronic bleeding often develop edema; Blood stasis transforming into Water also causes edema; this is Blood pathology involving Water. In the Lower Jiao, the Blood Sea and Bladder share the same location; in the Upper Jiao, the Lung governs water passages and the Heart governs blood vessels, sharing the same region; outside the body, sweat exits the skin/hair, and Blood circulates in the meridians, moving in reliance on each other. Yin and Yang sustain each other. Moreover, the mover of Blood is Qi, and the guardian of Qi is Blood. Qi is Yang; excess Qi is excess Fire. Blood is Yin; Blood deficiency is Water deficiency. They are one divided into two, and two united as one. One must deeply understand this principle to effectively treat Blood and regulate Qi, harmonize Yin and Yang, and achieve success in all endeavors.
It is said: Blood is generated by Heart Fire and stored in the Liver; Qi is generated by Kidney Water and governed by the Lung. The organ that mediates between the upper and lower is the Spleen. Both Water and Fire organs belong to Pre-Heaven (Innate Constitution). In early fetal development, Pre-Heaven generates Post-Heaven (Acquired Constitution); after birth, Post-Heaven sustains Pre-Heaven. Therefore, both Water and Fire organs rely entirely on the Spleen. When food enters the Stomach, the Spleen channels transform juices, sending them upward to Heart Fire. Heart Fire transforms them into red Blood. Thus, those treating Blood must prioritize treating the Spleen. Zhang Zhongjing's Zhi Gan Cao Tang embodies this principle. Da Huang (Rhubarb Rhizome) promotes blood evacuation because it inherits the color of Earth and strongly drains the Earthly pathways. Di Huang (Rehmannia Root) generates Blood because it inherits the moisture of Earth and strongly moistens Spleen dryness. Other herbs like Ren Shen (Ginseng) and Huang Qi (Astragalus) transport and unify Blood, all functioning by tonifying the Spleen. Thus, treating Blood must prioritize the Spleen to be effective. Similarly, treating Qi should prioritize the Spleen. Although Qi is generated in the Kidneys, when food enters the Stomach, the Spleen channels transform Water, sending it downward to the Kidneys. Kidney Yang Qi then steams upward from the Water. Clear Qi ascends, distributing Jin-Ye everywhere; Turbid Qi descends, lowering the water passages. Descending water passages are like rivers on earth, flushing away filth; ascending Jin-Ye is like moist soil pulsating, raising rain and dew. Therefore, treating Qi must prioritize the Spleen. Liu Jun Zi Tang harmonizes the Spleen and promotes urination to regulate Qi; Zhen Wu Tang supports the Spleen and stabilizes Water to generate Qi; Shi Zao Tang (Ten Date Pill) and Xiong Dan Tang (Chest Trap Decoction) attack the Spleen and drain Water to unblock Qi. These are methods of removing Water pathogens to tonify Qi. When Jin-Ye fails to irrigate and Strong Fire consumes Qi, Ren Shen is used to nourish the Spleen and augment Qi, and Hua Fen (Trichosanthes Root) is used to clear the Spleen and harmonize Qi. Anyone treating Qi must know to prioritize the Spleen to succeed.
Li Dongyuan treated diseases focusing on Qi, thus emphasizing the Spleen and Stomach. However, his medications tended toward acrid-warm and drying. He did not realize that while the Spleen needs drying to control Water, it needs moistening to ascend Jin-Ye. The Qi aspect cannot retain Water pathogens, nor can it lack Jin-Ye. Zhu Danxi treated diseases focusing on Blood, thus using cold-cooling medications. He did not realize that pathology in the Fire Organ requires cold-cooling, while pathology in the Earth Organ requires sweet-moderating. This discussion is not exclusively for hemorrhage, but those treating Blood must know this first, so that in regulating Qi and harmonizing Blood, there will be no errors.