献一得，以质高明。即如甘温除大热一事，岂真大热而可用甘温耶?是必虚热也；夫所谓虚
者，何也?气虚则心寒，寒非热也；血虚则必
燥，燥为次寒，亦非热也。其热何也?是亢极而见胜己之化也。燥为金气，热为火气，寒为
水气。燥之化热，是化其所不胜，以火克金，即经之所谓承也；寒之化热，是化其所胜，火
反侮水，即仲景之所谓横，是阴阳二气之对化也。虚热生于寒，燥热由虚生。虚、热二字，
当折看，不当连读。惟其虚也，燥也，故以甘润燥，以温煦寒也。虚燥去而热自除，是真火
蒸腾，而物转润矣。故不知者以为大热，其知者以为寒燥；不知者以为甘温除大热，其知者
以为甘温除寒燥；不知者以为反治，其知者以为正治。就其假者而言之，则谓之反；就其真
者而言之，则犹是正也。刘河间谓∶己亢过极，反似胜己之化。似也者，假之谓也。医者能
见其真，而不眩于假，斯可矣!虽然甘温除假热，固矣。而用甘温之法，又有术焉，非徒曰
甘温，遂尽厥妙也。凡病气正来者，其气多实而强；病气反来者，其气多变而幻。故《内经
》每致警于虚邪也。何者?其气既能自化，是已挟人身之灵气以为气矣。以甘温治其本原，
直捣老巢，而真相可见矣。但气灵而药不灵，往往药力为病气所据，而不得达其巢窟，将
甘
温反助病气以为虐，故药之中亦必具有灵气，而后足以与病气相敌。所谓灵者，何也?凡物
必力有余而后能化。寒燥化热，必寒燥浓积日久可知也。浓积日久者，郁结之谓也。气虚不
足以推血，则血必有瘀；血虚不足以滑气，则气必有聚。东垣诸方，多用升、柴。而滑伯仁
谓每用补剂，加桃仁等破血疏络之品，其效最捷。经谓反佐，治实热者，苦寒而佐之以热；
治虚热者，甘温亦可佐之以寒。(虚劳大热，每用热药凉服。)又，昔人论连理丸治吞酸，能
变胃而不受胃变，是皆灵之类也。病有化气，药亦有化气。如酸甘化阴，辛甘化阳是也。善
用者，且能借病之假气，以助药之真力，是即兵法之招抚者也。昔人又谓∶化气之力，甚于
本气。盖气之所以能化者，必其人之正虚，而邪气之力浓，有以胜夫人之正气，于是化良为
寇，反挟人之气，以还而伤人。如寒燥化热，非寒燥已化为热也。寒燥自在，而其力又能驱
使人身之正气为热，以为之疑阵作障于外也。所谓承制之虚也，其气最幻而最锐，故医者必
以全神全力制之，视其变化而捷应焉，乃可有济。此虚劳内伤大病之所以难治也。虚劳大病
，往往近于鬼神，非鬼神也，化气之灵者也，仍即人身本气之灵者也。
此二篇者，或论物性，或论病机，或论治法，揆之经旨，固未能发明万一；又尝综而论
之，
世间无物不本于五行也。天地之气，有常有变。风，其性升，其体寒，其用温，其化燥；
寒
，其性敛，其体湿，其用寒，其化风；暑，湿热之合也，生于郁，体用俱同湿热，其化风燥
；湿，其性重，其体热，其用湿，其化寒；燥；其性降，其体风，其用燥，其化火；火，其
性散，其体燥，其用热，其化湿。此顺化也，亦曰传化。更有对化，即湿极化燥、寒极化热
是也。对化有虚有实。传化是气机更代之常，对化是气机愤激之变，故必极而后化也。又有
兼化，亦虚化之类也。又有合化，如风合热而化燥，寒合湿而化热，亦实化之类也。五行之
气，金木皆有燥，水土皆有湿，但金燥而敛，风燥而散，土湿而热，水湿而寒，火则能燥能
湿，其燥者木亢而水不交也，其湿者土郁而木畅也。故火得风而焰长，以器掩之，而器即润
矣。此五行生化之性情也。
四时更代，成功者退，一盛一衰，互相牵制，不独天地之气然也，即人之性情亦如之。
经曰
∶怒伤肝，悲胜怒；喜伤心，恐胜喜；思伤脾，怒胜思；悲伤肺，喜胜悲；恐伤肾，思胜恐
。又胆为中正之官，谋虑久不决则伤胆也；肝为将军之官，郁怒不得发则伤肝也。恐惧不止
，注而为思；思虑不得，激而为怒；盛怒不止，郁而为悲，喜无节，则易恐；悲太过，则易
喜。此五脏性情之承制生化也。故扁鹊、华佗，皆能以激怒起沉 ，张子和亦能以引笑开痼
疾，非大具神通者乎!
至于治病之法，则以安仇之义为最奥要其义大着于《至真要论》中。如太阳寒水之胜而
克火
矣，治之者，必以甘温土性之药制水，以苦温火性之药扶火是矣。然水之亢者，不可徒制也
，必有以顺其性而导之，故复以酸温木性之药，开水气滋生之路，即以培火气发生之源也，
佐以所利，资以所生，法至密矣。而未已也，如此治之，则水必退，火必进，水哀火锐，土
气又将上僭矣。故仍以咸寒水性之药小佐其间，合酸温木性以并力制土，此所以安其屈伏，
无使胜复之相寻无已也。前贤医案，常有先用热药以愈病，后用凉药以清余患者。此类多矣
，非熟于气化，能如是乎?
总之，五行之气，有亢而后有制，有制而后有生有化，此自然之数也。故业医者，必讲
求亢
害承制生化六字，而善用之，于是每遇一病，可以逆而制之，亦可顺而导之，调其气使之平
，而生化之常复矣。试更以经义证之。经曰∶木得金而伐，火得水而灭，土得木而达，金得
火而缺，水得土而绝。此五行之相制也。又曰∶木郁达之，火郁发之，土郁夺之，金郁泄之
，水郁折之。然调其义，过者折之，以其畏也，所谓泻之。又曰∶折其郁气，资其化源，无
翼其胜，无赞其复。迎而夺之，恶得无虚；随而济之，恶得无实。又曰∶佐以所利，资以所
生，是谓得气。此五胜、五郁之治法也。故木位之主，其泻以酸，其补以辛，而厥阴遂先酸
后辛矣；火位之主，其泻以甘，其补以咸，而少阴、少阳遂先甘后咸矣。土、金、水仿此。
先用泻者，制其胜也；后用补者，安其复也。
又如气味之用，互用生化。经曰∶服寒而反热，服热而反寒者，不治五味属也。五味入
胃，各
归其所喜攻，酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾。久服增气，
物
化之常也。气增而久，夭之由也。盖以自来用药者，只求其气，不求其味。但取气寒以治热
，而不知寒之苦者入心化火也；但取气热以治寒，而不知热之咸者入肾化水也。味久则化气
者，经曰∶味归形，形归气。又曰∶五味入口，藏于肠胃，味有所藏，以养五气。故五味久
服，即增气也。味阴气阳，阳动而散，阴静而留，留则久积力浓，与脏气协议而化，用药
者
当知防微矣。李东垣曰∶同味之物，必有诸气；同气之物，必有诸味。用其味者，必审其气
；用其气者，必防其味也。
又如脉象之至，亦本六气。经曰∶天地之变，无以脉诊，闲气左右，随其所在。何者?
谓不
得以天地之气，主诊一岁，必随六气之至，分诊四时也。六气之脉奈何?曰∶厥阴之至，其
脉弦；少阴之至，其脉钩∶太阴之至，其脉沉；少阳之至，大而浮；阳明之至，短而涩；太
阳之至，大而长。其至也，或太过，或不及，更有涩极似滑，弦极似缓，虚寒似热，大热似
寒，病内寒而脉中空，邪外充而脉内陷，故承制有虚实，生化有真假，虽明者往往为所眩矣
。经曰∶脉从病反者，脉至而从，按之不鼓，诸阳皆然；诸阴之反者，脉至而从，按之鼓甚
而盛也。明乎此，而脉无遁矣，而病无遁矣，而治亦无难矣!
提出一点个人心得，以此向高明之士请教。就拿“甘温除大热”这一说法来说，难道真的是存在真正的大热证而可以使用甘温药物吗？这必定是虚热；那么所谓的“虚”，究竟是指什么呢？气虚会导致心寒，寒并不是热；血虚必然导致干燥，干燥属于次一级的寒象，也不是热。那这个热是从哪里来的呢？这是亢盛到了极点，表现出克制自己的五行属性所对应的化象。干燥对应金气，热对应火气，寒对应水气。燥的化生为热，是化生了它所不胜（即被克）的属性，以火来克金，这就是《内经》所说的“承”；寒的化生为热，是化生了它所胜（即我克）的属性，火反过来欺侮水，这就是张仲景所说的“横”，这是阴阳二气的对化现象。虚热产生于寒，燥热由虚而生。“虚”和“热”这两个字，应当拆开来看，不应当连在一起读。正因为有虚、有燥，所以用甘味药来滋润燥邪，用温性药来驱散寒气。当虚损和燥邪去除后，热自然消除，这是真火蒸腾，物体转而变得滋润的缘故。所以不了解的人认为这是大热，了解的人认为是寒燥；不了解的人认为这是使用甘温药来清除大热，了解的人认为是使用甘温药来清除寒燥；不了解的人认为这是反治法，了解的人认为这是正治法。就其假象而言，称之为反；就其本质而言，仍然是正。刘河间说：“己亢过极，反似胜己之化。”所谓“似”，就是假的意思。医生能够看到疾病的本质，而不被假象迷惑，就可以了！虽然用甘温药清除假热是确定的道理，但运用甘温药的方法，还有技巧所在，不仅仅是说甘温，就能发挥其全部妙用的。凡是病气正当令而来的，其气多实且强；病气反向而来的，其气多变且幻。所以《内经》常常警示虚邪。为什么呢？因为这种气既能自我变化，已经挟带了人体自身的灵气作为它的气了。用甘温药治疗其根本，直捣老巢，真相就显露出来了。但是人气灵而药力如果不灵，往往药力会被病气占据，而不能到达病灶，这样甘温药反而助长病气作恶，所以药物之中也必须具有灵气，然后才足以与病气相抗衡。所谓的“灵”，是什么呢？凡是事物必须力量有余才能发生转化。寒燥化为热，一定是寒燥浓重积聚日久所致。浓重积聚日久，就是郁结的意思。气虚不足以推动血液运行，则血液必有瘀滞；血虚不足以滑利气机，则气必有聚结。李东垣的方剂中，多用升麻、柴胡。而滑伯仁说每次使用补剂时，加入桃仁等破血通络的药物，疗效最快捷。《内经》提到反佐，治疗实热证，用苦寒药并佐以热药；治疗虚热证，用甘温药也可以佐以寒药。（虚劳大热，常用热药凉服。）另外，古人论述连理丸治疗吞酸，能改变胃的状态而不受胃病的改变影响，这些都是“灵”的一类表现。病有化气，药也有化气。如酸甘化阴，辛甘化阳就是如此。善于用药的人，甚至能借病气的假象，来辅助药力的真实作用，这就像兵法中的招抚策略。古人又说：化气的作用，比本气更强。气之所以能化，一定是因为人的正气虚弱，而邪气力量浓重，能够胜过人的正气，于是将良善之气转化为寇贼，反而挟带人的气，回来伤害人。如寒燥化为热，并不是寒燥本身已经变成了热。寒燥依然存在，但其力量又能驱使人身正气变为热，在外部形成疑阵作为屏障。所谓“承制”的虚象，其气最虚幻也最锐利，所以医生必须集中精神和全力来制服它，观察其变化而迅速应对，这样才能有所救助。这就是虚劳内伤大病难以治疗的原因。虚劳大病，往往接近鬼神，其实不是鬼神，而是化气的灵动，仍然就是人身本气的灵动。
这两篇文章，有的论述物性，有的论述病机，有的论述治法，推究经旨，确实未能阐明万一；我又曾综合论述，世间万物无不基于五行。天地之气，有常变。风，其性上升，其体寒，其用温，其化燥；寒，其性收敛，其体湿，其用寒，其化风；暑，是湿热结合，生于郁结，体和用都同于湿热，其化风燥；湿，其性沉重，其体热，其用湿，其化寒；燥，其性下降，其体风，其用燥，其化火；火，其性发散，其体燥，其用热，其化湿。这是顺化，也称为传化。更有对化，即湿极化燥、寒极化热就是。对化有虚有实。传化是气机更替的常态，对化是气机愤激的变异，所以必须达到极点才会转化。又有兼化，也是虚化之类。又有合化，如风合热而化燥，寒合湿而化热，也是实化之类。五行的气，金木都有燥，水土都有湿，但金燥而收敛，风燥而发散，土湿而热，水湿而寒，火则既能燥又能湿，其燥是因为木亢盛而水不交济，其湿是因为土郁结而木畅达。所以火得风则火焰延长，用器皿掩盖它，器皿就会湿润。这就是五行生化的性情。
四季更替，成功者退位，一盛一衰，互相牵制，不只是天地之气如此，人的性情也是如此。《内经》说：怒伤肝，悲能胜怒；喜伤心，恐能胜喜；思伤脾，怒能胜思；悲伤肺，喜能胜悲；恐伤肾，思能胜恐。又胆为中正之官，谋虑久决不决则伤胆；肝为将军之官，郁怒不得发泄则伤肝。恐惧不止，注而为思；思虑不得，激而为怒；盛怒不止，郁而为悲，喜无节制，则易恐；悲太过，则易喜。这是五脏性情的承制生化。所以扁鹊、华佗，都能以激怒使沉疴起死回生，张子和也能以引笑开启痼疾，这不是具备大神通的人吗！
至于治病的方法，则以安抚仇敌（即制约克制）的意义最为深奥重要，其义在《至真要论》中阐述得很清楚。如太阳寒水偏胜而克伐心火，治疗者，必须用甘温土性的药物来制约水，用苦温火性的药物来扶助火，这就对了。然而水气亢盛，不能仅仅制约，必须有顺应其性而引导它的方法，所以再用酸温木性的药物，开通水气滋生的路径，以此来培育火气发生的源头，佐以所利，资助所生，方法非常周密。但这还不够，像这样治疗，水气必退，火气必进，水衰退火锐进，土气又将上僭越。所以仍以咸寒水性的小量药物在其中佐助，配合酸温木性药物合力制约土气，这就是安抚其屈伏，不让胜复循环不已。前代医案中，常有先用热药治愈疾病，后用凉药清除余热的。这类情况很多，不熟悉气化理论，能做到这样吗？
总之，五行的气，有亢盛然后才有制约，有制约然后才有生化和转化，这是自然的规律。所以从事医学的人，必须讲求“亢害承制生化”六个字，并善于运用它，于是每当遇到一种病，可以逆而制约它，也可以顺而引导它，调节气机使之平衡，生化的常态就恢复了。试进一步用经义来证明。经文说：木得金而伐，火得水而灭，土得木而达，金得火而缺，水得土而绝。这是五行的相制。又说：木郁达之，火郁发之，土郁夺之，金郁泄之，水郁折之。然而调节其义，过者折之，以其畏惧也，所谓泻之。又说：折其郁气，资其化源，不要辅助其胜气，不要赞助其复气。迎而夺之，怎么会不虚；随而济之，怎么会不实。又说：佐以所利，资以所生，这叫做得气。这是五胜、五郁的治法。所以木位的主病，其泻用酸，其补用辛，厥阴篇就先酸后辛；火位的主病，其泻用甘，其补用咸，少阴、少阳篇就先甘后咸。土、金、水仿照此例。先用泻法，是制约其胜气；后用补法，是安抚其复气。
又如气味的作用，互用生化。经文说：服寒药反而发热，服热药反而发寒的，是不懂五味归属的缘故。五味入胃，各归其所喜攻的部位，酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾。久服增加气，是物化的常态。气增加久了，是夭折的原因。大概因为自古以来用药者，只求其气，不求其味。只取气寒来治热，却不知道寒的苦味入心会化火；只取气热来治寒，却不知道热的咸味入肾会化水。味久则化气，经文说：味归形，形归气。又说：五味入口，藏于肠胃，味有所藏，以养五气。所以五味久服，即增加气。味属阴，气属阳，阳动而散，阴静而留，留则久积力浓，与脏气协议而化，用药者应当知道防微杜渐。李东垣说：同味的物品，必有诸气；同气的物品，必有诸味。用其味者，必须审察其气；用其气者，必须防范其味。
又如脉象的到来，也基于六气。经文说：天地的变化，无法仅凭脉诊来判断，闲气左右，随着所在位置不同而变化。为什么呢？谓不能以天地之气为主来诊断一岁，必须随着六气的到来，分诊四时。六气的脉象如何？说：厥阴到来，其脉弦；少阴到来，其脉钩；太阴到来，其脉沉；少阳到来，大而浮；阳明到来，短而涩；太阳到来，大而长。其到来时，或太过，或不及，更有涩极似滑，弦极似缓，虚寒似热，大热似寒，病在内寒而脉中空，邪在外充而脉内陷，所以承制有虚实，生化有真假，即使是明眼人也往往被迷惑。经文说：脉从病反者，脉至而从，按之不鼓，诸阳皆然；诸阴之反者，脉至而从，按之鼓甚而盛也。明白这一点，脉就没有遁形的了，病就没有遁形的了，治疗也就没有困难的了！
I offer a personal insight for discussion with experts. Take, for instance, the principle of "using sweet and warm herbs to eliminate great heat." Is it truly a case of genuine great heat where sweet and warm herbs can be used? It must be deficiency heat (Xu Re). So, what does this "deficiency" refer to? Qi deficiency leads to heart cold; cold is not heat. Blood deficiency inevitably leads to dryness; dryness is a secondary form of cold, also not heat. Where does this heat come from? It arises when an excess reaches its extreme, manifesting as the transformation associated with the element that controls it. Dryness corresponds to Metal Qi, heat corresponds to Fire Qi, and cold corresponds to Water Qi. The transformation of dryness into heat is the generation of what it cannot overcome (i.e., being controlled), using Fire to control Metal; this is what the *Classic* refers to as "Cheng" (Inheritance/Support). The transformation of cold into heat is the generation of what it overcomes (i.e., controlling), where Fire reversely insults Water; this is what Zhang Zhongjing referred to as "Heng" (Lateral/Rebellious). This is the mutual transformation of Yin and Yang Qi. Deficiency heat arises from cold, and dryness-heat is generated by deficiency. The characters "deficiency" and "heat" should be read separately, not together. Precisely because there is deficiency and dryness, we use sweet herbs to moisten dryness and warm herbs to dispel cold. Once deficiency and dryness are removed, the heat naturally dissipates; this is due to the steaming action of true Fire, causing things to become moist again. Therefore, those who do not understand perceive it as great heat, while those who understand perceive it as cold-dryness; those who do not understand think sweet and warm herbs eliminate great heat, while those who understand think they eliminate cold-dryness; those who do not understand consider this a contrary treatment (Fan Zhi), while those who understand consider it a direct treatment (Zheng Zhi). Regarding its false appearance, it is called contrary; regarding its true nature, it remains direct. Liu Wansu stated: "When one's own energy becomes excessively excessive, it resembles the transformation of the element that controls it." The word "resembles" implies falsity. A physician who can see the truth and not be confused by the false appearance is qualified! Although using sweet and warm herbs to eliminate false heat is established, the method of applying sweet and warm herbs has techniques; it is not merely stating "sweet and warm" that achieves all its wonders. When pathogenic Qi arrives in its proper season, its Qi is mostly excess and strong; when pathogenic Qi arrives counter to the season, its Qi is variable and illusory. Thus, the *Inner Classic* often warns against empty pathogens (Xu Xie). Why? Because this Qi can transform itself, having already incorporated the body's spiritual Qi as its own. Using sweet and warm herbs to treat the root strikes directly at the stronghold, revealing the true state. However, if the body's Qi is agile but the medicine's power is not, the medicinal force may be occupied by the pathogenic Qi and fail to reach the stronghold, causing sweet and warm herbs to inadvertently aid the pathogen in wreaking havoc. Therefore, medicines must also possess "agility" (Ling) to sufficiently counteract the pathogenic Qi. What is meant by "agility"? All things must have surplus strength to effect transformation. Cold-dryness transforming into heat indicates that cold-dryness had accumulated densely over a long period. Dense accumulation over time is termed stagnation (Yu Jie). Qi deficiency is insufficient to push blood, leading to blood stasis (Xue Yu); blood deficiency is insufficient to lubricate Qi, leading to Qi stagnation (Qi Ju). Li Dongyuan's formulas often use Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). Hua Borren stated that adding blood-breaking and collateral-unblocking herbs like Taoren (Persicae Semen) to tonifying formulas yields the most rapid results. The *Classic* mentions adjuvant therapy (Fan Zuo): for treating excess heat, bitter-cold herbs are adjuvanted with hot herbs; for treating deficiency heat, sweet-warm herbs can be adjuvanted with cold herbs. (For great heat in consumptive diseases, hot herbs are often taken cold.) Furthermore, ancients discussed that Lianli Wan (Connected Spleen Pill) treats acid regurgitation by changing the Stomach's state without being changed by the Stomach disease; these are all examples of "agility." Diseases have transforming Qi, and medicines also have transforming Qi. For example, sour and sweet generate Yin, pungent and sweet generate Yang. Skilled practitioners can even borrow the disease's false Qi to assist the medicine's true power, akin to the military strategy of pacification. Ancients also said: the power of transforming Qi is greater than that of original Qi. The reason Qi can transform is that the person's Zheng Qi (Upright Qi) is deficient, while the pathogenic Qi is dense and powerful enough to overcome the person's Zheng Qi. Thus, beneficial Qi transforms into hostile Qi, seizing the person's Qi to harm them. In cold-dryness transforming into heat, it is not that cold-dryness has literally become heat. Cold-dryness remains, but its power drives the body's Zheng Qi to become heat, creating an illusionary array outside. The "emptiness" of Cheng-Zhi (Control and Inheritance) has Qi that is most illusory and sharpest. Therefore, physicians must concentrate their spirit and full strength to subdue it, observing changes and responding swiftly to be effective. This is why consumptive internal injury diseases are difficult to treat. Consumptive major diseases often seem like ghosts or spirits, but they are not; they are the agility of transforming Qi, which is still the agility of the body's original Qi.
These two sections discuss material properties, disease mechanisms, and treatment methods. Comparing them with the essence of the Classics, they certainly do not exhaustively explain everything. I have also synthesized them: nothing in the world is not based on the Five Elements (Wu Xing). The Qi of Heaven and Earth has constancy and variation. Wind: its nature is ascending, its substance is cold, its function is warm, its transformation is dryness. Cold: its nature is condensing, its substance is damp, its function is cold, its transformation is wind. Summer Heat (Shu): it is a combination of damp-heat, born of stagnation, its substance and function are identical to damp-heat, its transformation is wind-dryness. Dampness: its nature is heavy, its substance is hot, its function is damp, its transformation is cold. Dryness: its nature is descending, its substance is wind, its function is dry, its transformation is fire. Fire: its nature is dispersing, its substance is dry, its function is hot, its transformation is damp. This is順化 (Shun Hua - Smooth Transformation), also called transmission transformation. There is also Dui Hua (Opposite Transformation), such as extreme dampness transforming into dryness and extreme cold transforming into heat. Dui Hua can be deficiency or excess. Transmission transformation is the normal alternation of Qi mechanisms; opposite transformation is the violent change of Qi mechanisms, so transformation only occurs after reaching an extreme. There is also Jian Hua (Combined Transformation), which is also a type of deficiency transformation. There is also He Hua (Harmonious Transformation), such as wind combining with heat to transform into dryness, and cold combining with dampness to transform into heat, which are types of excess transformation. Among the Qi of the Five Elements, Metal and Wood both have dryness, Water and Earth both have dampness. But Metal's dryness is condensing, Wind's dryness is dispersing, Earth's dampness is hot, Water's dampness is cold. Fire can be either dry or damp. Its dryness occurs when Wood is excessive and Water does not interact; its dampness occurs when Earth is stagnant and Wood is free-flowing. Thus, Fire gets wind and flames lengthen; cover it with a vessel, and the vessel becomes moist. This is the nature and emotion of the Five Elements' generation and transformation.
The four seasons succeed each other, those who succeed withdraw, one prospers while the other declines, mutually restraining each other. This applies not only to the Qi of Heaven and Earth but also to human emotions. The *Classic* says: Anger injures the Liver, Grief overcomes Anger; Joy injures the Heart, Fear overcomes Joy; Pensive worry injures the Spleen, Anger overcomes Pensive worry; Sadness injures the Lung, Joy overcomes Sadness; Fear injures the Kidney, Pensive worry overcomes Fear. Also, the Gallbladder is the official of justice; prolonged indecision in planning injures the Gallbladder. The Liver is the general; suppressed anger that cannot be expressed injures the Liver. Unceasing fear turns into pensive worry; unfulfilled pensive worry激ates into anger; unceasing rage stagnates into sadness; unregulated joy makes one prone to fear; excessive sadness makes one prone to joy. This is the Cheng-Zhi Sheng-Hua (Control, Inheritance, Generation, and Transformation) of the Five Zang organs' emotions. Thus, Bian Que and Hua Tuo could revive critical conditions by inciting anger, and Zhang Zihe could cure chronic illnesses by inducing laughter. Are they not possessed of great supernatural powers?
Regarding treatment methods, the principle of "pacifying the enemy" (subduing the controlling element) is the most profound. This principle is elaborated in the *Zhi Yao Lun*. For example, if Taiyang Cold-Water is excessive and suppresses Fire, the treatment must use sweet-warm Earth-natured herbs to control Water and bitter-warm Fire-natured herbs to support Fire. However, excessive Water cannot be merely controlled; its nature must be followed and guided. Therefore, sour-warm Wood-natured herbs are added to open the path for Water's generation, thereby cultivating the source of Fire's emergence. Adjuvating with what is favorable, assisting with what generates, the method is extremely meticulous. But this is not enough. With such treatment, Water will recede, Fire will advance. As Water declines and Fire sharpens, Earth Qi will again become presumptuous. Therefore, salty-cold Water-natured herbs are slightly adjuvanted in between, combined with sour-warm Wood-natured herbs to jointly control Earth. This pacifies the subdued elements, preventing endless cycles of excess and recovery. Ancient medical cases often show using hot herbs first to cure the disease, then cold herbs to clear residual heat. Such cases are numerous. Only those familiar with Qi transformation can achieve this.
In summary, the Qi of the Five Elements has control after excess, and generation/transformation after control. This is the natural order. Thus, medical practitioners must study the six characters "Kang Hai Cheng Zhi Sheng Hua" (Excess Harm, Control, Inheritance, Generation, Transformation) and apply them skillfully. Then, encountering any disease, one can control it inversely or guide it directly, regulating Qi to achieve balance, restoring the normal cycle of generation and transformation. Let us further verify this with the Classic. The Classic says: Wood is felled by Metal, Fire is extinguished by Water, Earth is penetrated by Wood, Metal is diminished by Fire, Water is cut off by Earth. This is the mutual control of the Five Elements. It also says: For Wood stagnation, promote it; for Fire stagnation, vent it; for Earth stagnation, purge it; for Metal stagnation, drain it; for Water stagnation, reduce it. However, to regulate the meaning, excess is reduced by what it fears, which is called purging. It also says: Break its stagnating Qi, nourish its source of transformation, do not assist its excess, do not sponsor its recovery. Meeting and seizing it, how can it not be deficient? Following and assisting it, how can it not be excess? It also says: Adjuvate with what is favorable, assist with what generates, this is called obtaining Qi. These are the treatment methods for the Five Excesses and Five Stagnations. Therefore, for the main pathology of Wood, purging uses Sour, tonifying uses Pungent, hence the Jueyin chapter starts with Sour then Pungent. For the main pathology of Fire, purging uses Sweet, tonifying uses Salty, hence the Shaoyin and Shaoyang chapters start with Sweet then Salty. Earth, Metal, and Water follow this pattern. Purging first controls the excess; tonifying later pacifies the recovery.
Furthermore, the use of flavors and aromas involves mutual generation and transformation. The Classic says: Taking cold herbs but getting hotter, or taking hot herbs but getting colder, is due to ignorance of the Five Flavors' affiliations. The Five Flavors enter the Stomach and go to their preferred organs: Sour enters the Liver first, Bitter enters the Heart first, Sweet enters the Spleen first, Pungent enters the Lung first, Salty enters the Kidney first. Long-term consumption increases Qi, which is the constant of material transformation. Increasing Qi for too long is the cause of premature death. Generally, past practitioners sought only the Aroma (Qi), ignoring the Flavor (Wei). They took cold aromas to treat heat, unaware that bitter cold entering the Heart transforms into Fire; they took hot aromas to treat cold, unaware that salty heat entering the Kidney transforms into Water. Long-term flavor consumption transforms into Aroma. The Classic says: Flavor returns to Form, Form returns to Qi. It also says: The Five Flavors enter the mouth, store in the intestines and stomach; stored flavors nourish the Five Qi. Thus, long-term consumption of Five Flavors increases Qi. Flavors are Yin, Aromas are Yang. Yang moves and disperses; Yin is still and stays. Staying leads to long-term accumulation and dense power, agreeing with Zang Qi to transform. Practitioners must guard against subtle beginnings. Li Dongyuan said: Items of the same flavor must have various aromas; items of the same aroma must have various flavors. When using flavor, one must examine the aroma; when using aroma, one must guard against the flavor.
Moreover, pulse manifestations are also based on the Six Qi. The Classic says: Changes of Heaven and Earth cannot be diagnosed solely by pulses; idle Qi moves left and right, following its location. Why? One cannot diagnose a year primarily by Heaven and Earth Qi, but must diagnose the four seasons according to the arrival of the Six Qi. How are the pulses of the Six Qi? Jueyin arrival: pulse is String-like (Xian). Shaoyin arrival: pulse is Hooked (Gou). Taiyin arrival: pulse is Deep (Chen). Shaoyang arrival: pulse is Large and Floating (Da Er Fu). Yangming arrival: pulse is Short and Choppy (Duan Er Se). Taiyang arrival: pulse is Large and Long (Da Er Chang). Their arrival can be excessive or deficient. There are also cases where extreme Choppy resembles Slippery, extreme String-like resembles Slow, deficiency-cold resembles heat, and great heat resembles cold. Internal cold presents with a hollow pulse; external pathogen expansion presents with an internalized pulse. Thus, Cheng-Zhi has deficiency and excess, Sheng-Hua has true and false. Even experts are often confused. The Classic says: When the pulse contradicts the disease, the pulse follows the disease; pressing it, it does not throb, all Yang pulses are like this. When Yin pulses contradict, the pulse follows the disease; pressing it, it throbs strongly and abundantly. Understanding this, no pulse can hide, no disease can hide, and treatment will be easy!