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Chapter 7 of 9
温病条辩
Sweat is the product formed by the co-evaporation of the human body's yang qi (the functions of warming and promoting) and yin essence (nourishing substances such as fluids, blood, and essence). The Inner Classic says that human sweat can be compared to rain in the heavens and on earth. In the generation of sweat, yang qi serves as the motive force, and yin essence serves as the material.
If yin essence is in surplus but yang qi is insufficient, sweat cannot be expelled normally; when sweat fails to come out, the condition is critical. If yang qi is in surplus but yin essence is insufficient, sweat often tends to escape on its own; if one forcibly induces sweating at this point, it will lead to convulsions (spasmodic contraction and twitching of sinews and vessels), which are also a critical sign. Sometimes, even when methods of fumigation and scorching heat are used and still no sweat is produced, the condition is equally dangerous.
There is one scenario: when yin essence is in surplus and yang qi is insufficient, and moreover one is bound by the killing and constricting qi of cold pathogens, sweat cannot emerge on its own. In this case, one must use pungent-warm, thin-flavored, and rapidly-acting medicinals to mobilize yang qi. Zhang Zhongjing's treatment of cold damage followed this line of thinking. The entire Treatise on Cold Damage consistently focuses on rescuing yang qi.
Another scenario: when yang qi is in surplus and yin essence is insufficient, and moreover one is scorched by the warm-heat ascending pathogen, sweat escapes on its own, or fails to emerge. In this case, one must use pungent-cool substances to check inappropriate sweating, and use sweet-cool and sweet-moistening substances to nourish yin essence as the source of sweat, thereby creating the conditions for normal sweating. This book's treatment of warm diseases consistently focuses on rescuing yin essence.
This constitutes the broad distinction between cold damage, where sweating must not be withheld, and warm disease, where sweating must absolutely not be induced. Since the Tang and Song dynasties, many people have failed to understand this principle, and so each wrote their own treatises on cold damage, yet brought calamity upon patients suffering from warm disease. How lamentable! Is this a problem of natural law, or a failure of human agency?
Sweat is the product of the union and transformation of yang qi and yin essence. Cold damage is characterized by cold pathogens binding the exterior and yang qi being suppressed, so the treatment method focuses on pungent-warm substances to assist yang and induce sweating. Warm disease is characterized by heat pathogens injuring yin and yin essence being insufficient, so the treatment method focuses on pungent-cool and sweet-cold substances to rescue yin. Although both involve "sweating," the pathological mechanisms differ, and the treatment directions are completely opposite.
The ancients viewed sweating as the result of coordination between yang qi and body fluids, which shares some相通 points with modern medicine's understanding of thermoregulation, sweat gland secretion, and fluid balance. Excessive sweating in warm disease can exacerbate dehydration and electrolyte imbalance, which indeed has clinical value. However, statements such as "if no sweat comes out, death ensues" or "re-inducing sweating leads to convulsions" should be understood from the perspective of acute and critical cases in ancient times, and should not be applied mechanically.
In daily life, sweating from exercise, bathing, or saunas should be moderate, avoiding profuse drenching sweat that injures fluids and depletes qi. During fever or the recovery phase of febrile illness, one should especially avoid blindly "covering up to induce sweat"; instead, one should replenish fluids and maintain a light diet. 🌊
Someone asks: Heaven has six qi—wind, cold, summer-heat, dampness, dryness, and fire. The classics list disease patterns for wind, cold, summer-heat, and dampness, but why are dryness and fire not singled out? Are dryness and fire not pathogenic?
Some say: The Plain Questions states that injury by wind in spring, injury by summer-heat in summer, injury by dampness in autumn, and injury by cold in winter—this is because the four qi each have their designated command in the four seasons, and thus each has its designated disease. Dryness and fire have no designated command, so they do not constitute diseases on their own but are housed within the myriad diseases. This is just as earth has no fixed position but thrives in the concluding periods of the four seasons—Chen, Xu, Chou, and Wei. Dryness and fire are not mentioned because there are no independent dryness or fire diseases.
Wu Jutong considers this explanation forced and conjectural, unworthy of belief. The reason is that believing the classics too excessively leads instead to far-fetched interpretations. In reality: spring wind, summer fire, long summer damp-earth, autumn dryness, and winter cold—this is the distribution of the five phases across the four seasons. The Inner Classic states "illness occurring before the summer solstice is warm disease," which is disease due to fire qi. "Injury by summer-heat in summer" refers to the central earth of long summer. "Injury by dampness in autumn" refers to the remnants of damp-earth qi in early autumn. As for injury by dryness in mid-autumn, this is likely the result of textual脱落 over the ages. Yu Jiayan's supplementation of autumn dryness was correct, but he should not have forcibly altered the classical text. Comparing "earth thriving in the four seasons" with "dryness and fire" is a grave error. What thrives in the four seasons is damp-earth, not dryness and fire.
Wu Jutong emphasizes that the six qi should correspond completely with the four seasons and five phases, and one cannot conclude that dryness and fire are non-pathogenic simply because of omissions in the classical texts. This reminds us that when reading the classics, one must integrate clinical reality and neither die from clinging to literal words nor arbitrarily alter the classics.
The doctrine of the five movements and six qi is a theory concerning the relationship between ancient meteorology, calendrical systems, and disease, and it has some foundation in historical observation, though it should not be mechanically calculated. Wu Jutong's suspicion of textual脱落 in the classics demonstrates a consciousness of philological textual criticism.
Seasonal climate changes do affect the human body's condition. Early autumn may still harbor dampness, while late autumn tends toward dryness. One should adjust routine and diet according to seasonal transitions, without superstitions attachment to any single fixed health preservation method. 🍂
Zhang Zhongjing's Treatise on Cold Damage is indeed the golden rule and jade regulation of medicine, yet it is extremely difficult to annotate. Because of the great temporal distance, there are textual脱落 in the middle, and later people have made unauthorized additions, making it impossible to resurrect Zhongjing to ask which passages come first, which come later, where texts are missing, and which are spurious additions. One can only harbor doubts pending further investigation, follow what is credible, and critically examine what is not.
Early annotators such as Lin Yi and Cheng Wuji mostly followed the text and glossed it sequentially, unable to thoroughly develop the essential meanings, yet their pioneering efforts were not without merit. In the Ming dynasty, Master Fang Zhongxing (Fang Youzhi) painstakingly investigated, tracing back to origins, and although not every point aligns, the general framework was already in place. Yu Jiayan wrote the Shang Lun Pian, supplementing its omissions and developing meanings not expressed by Fang, which may count him as a meritorious servant of Zhongjing; however, he should not have vigorously vilified Fang. Master Lin Beihai printed Fang's Qian Tiao Bian, appending the Shang Lun Pian, and item by item criticized Yu's plagiarism, rendering clear judgments. After Yu, Gao's annotation Shang Lun Fa Ming also had some insightful points, but generally暗袭ed Fang's work while overtly honoring Yu, and again forcefully attacked Yu. Liu Jue'an then rose to refute Gao, just as Lin Beihai had refuted Yu.
Others such as the Hou Tiao Bian by Zheng and Cheng have little value. Shu Chiyuan's Ji Zhu takes Yu Jiayan as primary, also quoting Cheng, but goes so far as to be unaware of Fang's Qian Tiao Bian, taking Yu's plagiarized theories from Fang as Yu's original creations. The collected annotations of Shen Munan, Zhang Yincang, and Cheng Yunlai are readable. Ke Yunbo authored the Lai Su Ji, which is clever and argumentative with some可取ment, but its preface attacks Fang and Yu regarding the annotation of the Da Qing Long pattern with harsh wording. Wu Jutong cites Ke's theory of "wind divided into yin and yang," pointing out its self-contradiction: claiming both yang-wind and yin-wind, while violating the Inner Classic's correct method of "when wind prevails internally, treat with pungent-cool" ; and claiming yin-wind is bitingly cold while also saying heat prevails internally—a logical confusion.
Fang Youzhi established the theory of "wind injuring the defensive, cold injuring the constructive, and wind-cold jointly injuring both defensive and constructive." Although this may not entirely equal Zhongjing's original intent, it provided later students with clear organization, and its merit should not be forgotten. Yu, Gao, and Ke remedied biases and saved errors with genuine insight, but they should not have established their own schools to the point of obscuring the merits of predecessors. Later students should prioritize illuminating the Dao and benefiting the world, rather than competing for fame and victory.
This piece is an academic historical review. Wu Jutong both reveres the classics and opposes blind adherence; he acknowledges the contributions of annotators while criticizing sectarianism and plagiarism. The core is "reserving doubts while preserving truth, embracing inclusiveness, and grounding everything in clinical practice."
The textual versions, annotators, and scholarly lineages of classical Chinese medicine literature are extremely complex. Modern research should likewise value philological textual criticism and academic criticism, avoiding the erasure of predecessors' contributions based on personal preference.
When learning any traditional knowledge, one should maintain critical thinking: respect the classics without being superstitious about literal words, and learn from others without blindly following schools of thought. 🧠
The Inner Classic says: Wind is the chief of the hundred diseases. It also says: Wind is skilled at moving and frequently changes. Why is wind the chief of the hundred diseases?
Forty-five days after the winter solstice, at midnight, the qi of lesser yang is born. By the fifteen days before the beginning of spring, when the Greater Cold festival arrives, the jueyin wind-wood assumes its command, dispersing and discharging the yang qi of the entire year to transform and give birth to the myriad things. Therefore, wind is not originally a thing that harms people. If a person's interstices are tight and their essence-qi is sufficient, how could disease arise from wind? Conversely, when upright qi is insufficient, disease arises.
The nature and manifestations of wind differ: spring wind rises from below upward; summer wind traverses transversely through the air; autumn wind descends from above downward; winter wind sweeps along the ground. Directions have due and diagonal positions, corresponding to the four seasons and eight nodal periods. At the beginning of spring, wind arises from the northeast, called "tiao wind" (harmonious wind). If it comes from a direction not appropriate to the season, it is called "chong wind" (assaulting wind), also known as deficient evil thief wind.
Wind also frequently carries other qi in combination: in early spring it carries cold-water qi; in late spring it carries fire-heat qi; in early summer the wood qi has not entirely faded while fire gradually arises; in long summer it combines with summer-heat, dampness, and wood qi; in early autumn it carries dampness qi; in late autumn it combines with cold-water qi; in early winter it carries dryness-metal qi; in mid-winter cold-water assumes command; in late winter it again foretells the spring wind. The changes of the five movements and six qi are also often transmitted through wind, which is why it is said that wind is the commander of the six qi and the leader of all diseases—hence it is the chief of the hundred diseases.
Wind frequently changes—for example, a morning south wind in summer may within moments turn west, then north, then east, and with it the weather shifts from clear and hot to rainy and cold. In all four seasons, wind carries a cooling quality, because wood takes water as its mother; it transforms and turns hot because wood generates fire.
When predecessors treated wind, they often held fast to Guizhi Tang (Cinnamon Twig Decoction) as the ancestral formula, or only used pungent-warm medicinals such as Notopterygium, Saposhnikovia, Bupleurum, and Pueraria. This failed to observe wind's combinations and transformations, and the essential meaning of the Inner Classic. In the Cold Damage treatise, Guizhi Tang treats "wind combined with cold," which is a variation in treating wind; if wind is not combined with cold, one should follow the Inner Classic's correct method: "when wind prevails internally, treat with pungent-cool, assisted by bitter-sweet." Why is pungent-cool correct? Wind belongs to wood; pungent-cool belongs to metal; metal can control wood. Wind transforms and turns hot; pungent-cool, bitter-sweet can transform it into cooling qi.
Wind heads the list of external contractions, but wind rarely causes disease alone, mostly combining with cold, heat, dampness, dryness, or summer-heat. In treating wind, one cannot indiscriminately use pungent-warm to induce sweating without distinguishing its combinations. Wind combined with cold may use pungent-warm; wind combined with heat must use pungent-cool. This is the core of distinguishing wind's "substance and function."
The ancients used "wind" as a general term for environmental climatic factors, encompassing temperature, humidity, airflow changes, and so on. In modern medicine, respiratory infections and allergies are not explained by "wind," but avoiding wind and keeping warm can indeed reduce certain triggers for externally contracted diseases.
During seasonal transitions, after sweating, and during sleep, pay attention to avoiding wind, especially not allowing cold drafts to blow directly on you. Spring is windy; one should protect the mouth, nose, and neck.💨
Confucian books are divided into Classics, Masters, Histories, and Collections; medical books can also be divided this way. The Miraculous Pivot, Plain Questions, Shennong's Classic of the Materia Medica, Classic of Difficult Issues, Treatise on Cold Damage, and Golden Cabinet and Jade Case are the Classics of the medical gate. The various annotators' discourses, medical cases, materia medica, and formula books belong to the Masters, Histories, and Collections. The Classics are pure and refined; the Masters, Histories, and Collections are miscellaneous and broad—this is the natural order.
Students of medicine must revere the Classics, otherwise there is no foundation and they may drift into heterodox paths. However, revering the Classics excessively, to the point of dying beneath the letters, is also the fault of the worthy. Mencius said, "To believe every word in a book is worse than having no book."
The unworthy do not know there are Classics; they merely inherit family craft techniques, following old routines. When seeing patients, they rely only on glib speech, and upon slight contact with a patient immediately write prescriptions. This was already the case in the Han dynasty, let alone later ages. This is also why the medical Dao is often not illuminated and often not practiced.
The Classics are the source, but they must be studied and applied flexibly. Neither abolish the Classics nor die under them. In clinical practice, one cannot rely on glib speech but must carefully differentiate patterns.
This reflects a common problem in traditional medical education: either disparaging the Classics or being doctrinally obsessed with antiquity. Modern TCM education likewise needs to balance Classics and clinical practice, inheritance and innovation.
When reading health knowledge, do not just look at fragments of folk remedies; return to reliable knowledge systems while exercising rational judgment.📖
This book's first formula uses Guizhi Tang because in early spring, residual cold has not yet dissipated. Although the condition is called wind-warmth, its qi belongs to lesser yang, and lesser yang is directly adjacent to jueyin, which is rooted in cold water. Therefore, at the onset, patterns of aversion to cold are still numerous, and so Guizhi Tang is used to begin, like an essay taking up the context of the preceding passage.
However, the true beginning of this book's therapeutic approach actually lies with Yinqiao Powder.
Wu Jutong's personal annotation: the distribution of the six qi across the four seasons is the constant principle, but in diagnosis one must know that summer can also have cold diseases, winter can also have warm diseases, and the following spring and summer may still harbor the previous year's latent summer-heat. These intricate interweavings and changes all depend on accurate pattern differentiation. The general examples state: except for cold damage, which follows Zhongjing's methods, the four-season miscellaneous contractions should be clearly distinguished. Later students at the clinical bedside, if they determine it is cold damage, should use Zhongjing's methods regardless of season; if they determine it is a warm-heat disease among the six qi other than cold damage, they should seek treatment within this book. The Upper Jiao chapter's differential diagnosis of suspected cold damage, warm disease, and summer-heat patterns is the most detailed.
Although warm disease studies differ from cold damage studies, during early spring residual cold, Guizhi Tang may be temporarily used as a transitional measure; the core therapeutic approach is Yinqiao Powder's pungent-cool exterior resolution. Most importantly, one must never mechanically judge disease nature by season.
Modern diagnosis and treatment of externally contracted diseases likewise cannot merely look at the season; one must determine cold-heat properties based on manifestations such as fever, aversion to cold, thirst, and sore throat. Yinqiao Powder remains a representative formula for pungent-cool exterior resolution and is still used in clinical research today.
Externally contracted diseases are common during seasonal transitions. Do not self-diagnose wind-cold or wind-heat based merely on "spring" or "winter," and do not casually induce sweating.🏥
Predecessors, because they believed the Classics excessively, mixed the six qi into the Treatise on Cold Damage, treating warm-heat conditions entirely with pungent-warm medicinals. Even when clear-sighted people felt this was wrong, they were unable to establish an alternative standard. Wu Jutong lamented that the medical Dao was not illuminated, and so, overestimating his own ability, wrote this book—not to contend for fame, nor with any private intention of surpassing the wise ancients.
The contents recorded in this book are relatively concise. For instance, in the summer-heat patterns, formulas such as Dashun Powder, Lengxiang Yinzi, and Jiangshui Powder are not included. On the one hand, predecessors already had them, so repetition is unnecessary; on the other hand, the sheer volume would intimidate readers. Therefore, this book merely roughly establishes the diagnostic and therapeutic framework of the Triple Burner and the six pathogenic qi, hoping that later worthies will further expand it.
The author states his own writing position: not to exhaust everything, but to establish a Triple Burner pattern-differentiation framework. Scholarship values correct direction, not necessarily covering every detail.
Medical theoretical systems are often continuously refined by later generations. Wu Jutong's clear self-awareness also reminds us to understand the historical background and limitations of works when reading the classics.
When learning health knowledge, do not crave completeness; first establish a basic framework, then gradually deepen it through practice.🌿
The cold epidemic commonly referred to by people presents with these symptoms: severe aversion to cold, high fever, headache, and painful aching of bones and joints. Although feverish, the patient is not very thirsty. During an outbreak, people from the same neighborhood present with similar symptoms, as if driven by a common force. This differs from warm disease, where headache and bone pain are milder but thirst is pronounced—hence the name "cold epidemic."
If, among the six qi, Cold-Water governs the year (Sitian) or is in the corresponding position (Zai Quan), or if the five movements indicate an excessive Cold-Water year, or if the guest qi is Cold-Water, such illnesses may appear regardless of season. Before the pathogen transforms into heat with aversion to cold, one may use acrid-warm agents to resolve the exterior; once it has transformed into heat, resembling wind-warmth, one should use acrid-cool methods to clear heat. The principle remains unified.
Both cold epidemic and warm disease are seasonal external-contraction conditions, but early-stage cold and heat manifestations differ, and treatment should vary based on whether heat transformation has occurred. The key remains pattern differentiation.
The ancient "cold epidemic" and "warm disease" may correspond to various modern epidemic infectious diseases. Regardless of the pathogen, treatment should be staged according to clinical presentation, without relying exclusively on cold-cool or acrid-warm methods.
During flu seasons or similar outbreaks, if many around you exhibit similar symptoms, prioritize rest, isolation, and seeking medical attention—do not self-diagnose based on cold-heat presumptions. 🦠
Diseases inherently have fixed names, yet recent times have seen fabricated names—absent in antiquity but present today—mostly coined by laypeople unfamiliar with true nomenclature, resulting in chaotic treatment and harm to patients.
For example, the ancients designated "Stagnant Discharge" (Zhi Xia) and "Intestinal Strangury" (Chang Pi) for purulent, bloody stools, now commonly miscalled "dysentery" (Li Ji). "Li" implies slippery discharge; "Zhi" implies stagnant blockage—opposing meanings—yet treatment has not deviated greatly.
More seriously, conditions like uterine prolapse (Yin Ting), vulvar erosion (Yin Shi), vulvar itching (Yin Yang), and vulvar growths (Yin Jun) were already documented in ancient texts, typically attributed to Liver channel depression and Damp-Heat pouring downward. Recently, northerners call these by bizarre names absent from classical literature, nor do such diseases truly exist. Folk treatments employ needling, hooking, and surgical cutting—nine out of ten patients die from such cutting. The anterior genital area is where the Kidney and Liver channels intertwine; the Chong, Ren, and Du meridians diverge front and back from this region—how can knives and hooks be recklessly applied? Even cases of Liver-depression hypochondriac pain, amenorrhea with chills and fever are treated with deep needling. For boys with hemorrhoids, hernias, abdominal masses, and malnutrition (Gan Ji), practitioners also attribute them to fabricated names and treat with needling and cutting—this is even more abhorrent.
Another example: summerheat midsummer abdominal pain with cholera-like symptoms but no vomiting or diarrhea, marked by restlessness and a sense of impending death, is a yin-congealing mass pattern (Pi Zheng). Bitter, acrid, aromatic, and hot medicinals can resolve it; if it transforms into true cholera, it is actually less severe. Today it is called "Sha syndrome," with names like "intestinal twisting Sha" and "black Sha," and such entries even appear in formula texts. Lay practitioners scrape the joints with copper coins, causing qi and blood to alternately open and close; when yang qi moves freely, blockage resolves, pain lessens, and the patient recovers. However, for twelve hours after recovery, the patient must not drink water, lest yin qi congeal, pathogenic qi lodge in the collaterals, and recur upon exposure to cold or anger—then scraping is repeated.
Although scraping belongs to yang-unblocking methods capable of temporary rescue, the water restriction is difficult to enforce, and residual pathogens commonly persist. Worse still, some employ scraping for warm diseases. Warm disease is a yang pathogen; scraping unblocks yang too urgently, swiftly exhausting yin fluids. Even with subsequent treatment, recovery is nearly impossible—some die from convulsions, others from unbearable itching.
Wu Jutong laments: without proper names, treatment is inevitably harmed. Students must examine this closely.
Disease nomenclature must be standardized, and diagnosis must be accurate. Fabricated names lead to erroneous treatment—especially the fallacies of treating local surface symptoms as independent diseases, or misapplying yang-unblocking scraping methods to warm diseases.
This chapter carries strong critical significance. Ancient folk therapies like scraping (Gua Sha) may relieve certain symptoms in specific circumstances, but cannot replace proper diagnosis—much less be recklessly applied to high fever or warm disease. Wu Jutong already clearly identified these risks and harms.
Do not trust folk fabricated disease names or dangerous procedures like "cutting," "hooking," or "needling"; for bodily abnormalities, seek care at formal medical institutions. ⚠️
Seasonal warm diseases often resemble cold damage (Shang Han). Cold damage originates from the Foot Taiyang, yet this text states warm disease begins at the Hand Taiyin—but why does the Hand Taiyin also govern external contraction? And why do Hand Taiyin patterns resemble those of Foot Taiyang?
The hands and feet are distinguished as upper and lower; yin and yang hold inverted and upright meanings—they must not be conflated. Su Wen states in "Plain Questions: Discussion of Normal Pulses of the Human Qi": "The visceral essence resides highest in the Lung, which moves Nutrient (Ying) and Defensive (Wei) qi, yin and yang." The lung occupies the highest position, governing the qi of the entire body, and is capable of moving Ying and Wei. In early external contraction, disease typically advances from the Wei (defensive) aspect to the Ying (nutritive) aspect, from the yang realm to the yin realm. The Foot Taiyang channel resembles a great gate, governing the interior from the exterior, unifying Ying, Wei, yin, and yang; the Hand Taiyin Lung is like a floral canopy, resembling Heaven, governing the lower from the upper, enveloping the interior from the exterior, and also unifying Ying, Wei, yin, and yang. Hence they broadly correspond.
Yet in detail, differences remain: the orifices of Taiyang govern discharge, while those of Taiyin govern both discharge and intake; Taiyang's orifices open below, whereas Taiyin's open above. In study, one must seek differences amidst similarities and verify similarities amidst differences.
Warm disease typically begins at the lung-defense level, resembling early-stage Taiyang exterior patterns of cold damage, but disease location differs with regard to upper/lower and pathogen nature differs as well. Wu Jutong establishes the Hand Taiyin as the initial site of warm disease, providing theoretical grounding for acrid-cool lung-diffusing methods.
Early manifestations of respiratory infectious diseases—such as sore throat, cough, and fever—correspond to lung-defense symptoms. The ancients already recognized that warm disease often enters through the mouth, nose, and lung-defense pathway, aligning with modern understanding of respiratory infection transmission.
During respiratory disease outbreaks, maintain oral and nasal hygiene, wear masks, ensure adequate ventilation, and protect the lungs. 😷
The discussions on Dryness qi in the previous three burner chapters primarily addressed patterns of heat transformation and fluid injury, treated with acrid-sweet and slightly cool methods, without yet addressing the cold transformation of dryness. Cold transformation of Dryness qi is actually its inherent corrective nature. Su Wen states: "What Yangming reaches is clear and forceful"—this refers to cold dryness, clear and cool. Su Wen further states: "Dryness, though urgent, nourishes"—because Earth is the mother of Metal, and Water is the child of Metal; extreme dryness awaits fluid recovery.
This text places mostly cold-desiccation conditions under the Cold-Dampness or Latent Summerheat categories, such as abdominal pain with vomiting. Su Wen states: "When Dryness excess overcomes, the people suffer frequent vomiting, heart-hypochondriac pain with inability to turn," which describes this exact condition. Treatment employs bitter-warm methods—this constitutes the orthodox Nei Jing approach to treating dryness.
Previous authors have claimed that among the six qi, only Dryness fails to cause disease, arguing that Dryness is subsumed under Cold as its close relative, consequently mistaking dry diseases for cold diseases. In truth, among the six qi, only Dryness governs killing—how could it fail to cause illness? Careful reading of Su Wen resolves this naturally.* In autumn, dampness accumulates internally while new cool Dryness qi assaults externally, so dryness and dampness coexist, and confusion arises most readily. Crude practitioners face this phenomenon when dampness signs have not resolved while dryness signs already appear. One must first separate Summerheat, Dampness, and Dryness, then distinguish Cold and Heat, to achieve accuracy.
Dryness encompasses not only the "desiccating and injuring fluids" heat-transformation aspect but also a "clear, forceful, cold dryness" cold-transformation aspect. Autumn dryness frequently coexists with damp pathogenic factors; the core of pattern differentiation lies in distinguishing Cold from Heat and Dryness from Dampness.
As autumn cools and dries, respiratory and cutaneous dryness symptoms commonly appear, yet some presenting with fear of cold, anhidrosis, and dry cough reflect cool dryness.
The ancients' differentiation of cool dryness and warm dryness retains clinical relevance today.
In autumn, maintain hydration, but avoid excessive cold foods. Dryness and dampness may coexist; daily diet should favor gentle moistening rather than excessive water intake or raw-cold items. 🍐
Heaven generates the myriad things through the six qi: Wind, Cold, Summerheat, Dampness, Dryness, and Fire—transforming infinitely. The patterns by which humans contract external pathogens and become ill likewise derive from these. Recent scholars only know that excess of the six qi is called the Six Excesses (Liu Yin), yet Nei Jing never exhaustively accounted for the intricate permutations of six-qi transformations.
Six qi harming humans cannot maintain clean boundaries without concurrent combinations. Multiplying six by six yields thirty-six basic diseases. The great numbers of Heaven and Earth begin with one and complete at three—three times three yields nine, nine times nine yields eighty-one, at which point the pitch-pipe numbers of the Yellow Bell (Huang Zhong) are complete. For six-qi diseases, multiplying thirty-six by thirty-six yields 1,296 patterns, which exhausts the external contraction spectrum—this without even accounting for internal injuries. Factoring internal injuries yields endless permutations.
Yet modern practitioners confronted with any external contraction simply employ one "Chai-Hu Jie-Ji Decoction" (Bupleurum Muscle-Resolving Decoction)—is this not absurd?
External contraction etiology is complex and frequently interdependent; one formula cannot universally treat all cases. Wu Jutong employs mathematical reasoning to demonstrate disease diversity—though his numerical extrapolations bear philosophical characteristics—ultimately opposing mechanistic formula-based therapy.
The "36 × 36" numerical model employs numerological reasoning rather than scientific epidemiological data. However, its emphasis on external disease complexity and individual variability resonates with modern precision pattern-recognition concepts.
Colds, influenza, and other external contractions cannot all be treated as a single entity—individual differences and etiological specifics deserve utmost attention. If unwell, do not indiscriminately self-administer internet's "universal formulas." 💊
Treat external contraction like a general commanding battle: value dispatch speed, adapt to unfolding circumstances, eliminate pathogens thoroughly, and handle follow-up with meticulous care. Pacify affliction one day earlier, and the patient suffers one day less harm.
Treat internal damage like a prime minister governing the dynasty: remain composed and patient, observe changes calmly, project unassuming achievements—yet guide the patient toward longevity step by step.
Treat upper burner conditions with featherlike lightness: without light, clear, ascending medicinals, one cannot reach the site of disease. Treat middle burner conditions with balance as precise as a scale: without harmonizing, leveling methods, one cannot settle the middle burner. Treat lower burner conditions with gravity like a steelyard weight: without heavy, downward-sinking medicinals, one cannot reach the lower burner depths.
This represents the pinnacle of therapeutic rules: external contraction demands speed and decisiveness; internal damage demands gradual, patient regulation. The maxims—upper burner like a feather, middle like a scale, lower like a weight—emphasize that distinct affected loci require differently weighted medications: light, balanced, or heavy.
This parallels the modern approach of "treat acute manifestations aggressively while nurturing root causes in chronic conditions," while embodying precise localization matched with dosage strategies. Upper burner diseases must not sump with heavy turbid medicines; lower burner conditions cannot be dismissed merely as surface-level—remaining core axioms of contemporary prescription principle.
Handle acute problems promptly; do not procrastinate. For chronic conditions, maintain patience and prolonged gentle care; seek lasting outcomes rather than tempting hasty kills. ⚖️
Since the Tang and Song dynasties, practitioners treating Warm-Heat disorders have routinely employed acrid-warm diaphoretics at onset. When the patient failed to improve, they resorted to heavy bitter-cold medicinals, including Scutellaria (Huang Qin), Coptis (Huang Lian), Anemarrhena (Zhi Mu), and Phellodendron (Huang Bai), only to worsen desiccation with each administration. Liu Hejian fell into similar errors. Bitterness first enters the heart; bitterness can promote dryness transformation; dryness qi transforms into fire—which correspondingly produces tooth stiffness, blackened tongue with shortening, cracked dark bleeding lips, all signs interpreted as "extreme fire resembles water."
Wu Youke's criticism of bitter-cold therapy was justified, yet he failed to recognize bitter-cold promoting desiccation transformation, contending only that Coptis guards yet does not move, whereas Rhubarb (Da Huang) moves yet does not guard. Actually, Coptis cannot be readily applied, while Rhubarb—equally bitter-cold—can drive down with an impact a hundred-fold stronger than Coptis; how could it become more lightly applied?
Wu Jutong states that when employing Pu-Ji Xiao-Du Yin at the start of warm disease, he deletes Scutellaria and Coptis unfailingly, fearing they will lead pathogens inward and harm the middle and lower burners. In formulas where Scutellaria and Coptis prove indispensable, he always adds or ample sweet-cold medicinals to predominate, aiming only to clear heat and protect yin fluids from destructive dryness transformation. If yang hyperactivity prevents sleep or lower burner fire-heat renders Stools inappropriate, governing diarrhea with regular purging in individuals prone to loose stools—only then may they be used heavily. In the Damp-Heat categories, far from prohibiting Scutellaria and Coptis, they form essential components, since Damp-Heat requires bitter-cold patterns to dry dampness. Hence, "accurately employed medicinals align with exuberant completion"—physicians bear no likes or Dislikes for substances, only apposite choice.*
Bitter-cold medicinals do not equate routinely, Qing-Heat panaceas. In Warm Disease onsets, bitter-cold desiccation harms yin and can help fire stagnate; For Damp-Heat conditions, however, bitterness designed precisely at Drying and clearing applies correctly. As always, appositeness of properties tounted war patterns Must Empaths follow by primary arbiter—
Modern pharmacology shows Coptis possessing alkaloids, antibiotics-properties pot-like properties respectively.
Do not take Coptis, Phellodendron, & other bitter-cold medicinals, concoct substantial liver/bowel harmful tendencies upon self-admin., lead abuse allaying system: Reapply as prescribed or stop overly liberal consumption of “the” formulations damage to gut fire-stuffs.
In terms of specific treatment methods: blood disorders in the upper jiao are attributed to the qi of the lungs or the heart; blood disorders in the middle jiao are attributed to the qi of the stomach or the spleen; blood disorders in the lower jiao are attributed to the qi of the liver, the kidneys, and the eight extraordinary vessels. In treating water and blood disorders, the "unblocking" method is sometimes used, like opening branch channels of a river; at other times, the "blocking" method is employed, like reinforcing and raising the dikes. However, these are only symptomatic treatments after illness has already occurred, not the strengthening of the root before the onset of disease.
Treating blood disorders involves more than merely supplementing blood—it requires regulating qi. Qi generates blood, moves blood, and governs blood. Bleeding or blood disorders in the upper, middle, and lower jiao should be treated by addressing the qi of the corresponding viscera and bowels.
Modern medicine also emphasizes that anemia and bleeding cannot be addressed solely by blood transfusion or iron supplementation; the underlying causes must be identified, such as malnutrition, hematopoietic dysfunction, coagulation disorders, or vascular factors. The TCM concept that "qi generates blood" can be understood as the influence of the body's overall functional state on the blood.
Avoiding prolonged overexertion and staying up late, which deplete qi, while engaging in moderate exercise and maintaining a regular diet, helps harmonize qi and blood. 💪
The human body has nine orifices: seven above and two below. The upper orifices pertain to yang, and the lower orifices pertain to yin. The correspondence between yin and yang, odd and even, was not elaborated upon in The Yellow Emperor's Classic of Internal Medicine (Neijing); Wu Jutong's discussion supplements this.
The upper orifices are predominantly yang in nature, yet the ears, eyes, nose, and mouth each have their own yin and yang aspects: the ear perceives formless sound, making it the supreme yang within yang; the eye perceives visible form and color, making it yin within yang; the nose perceives formless odor, making it yang within yin; the mouth tastes the five flavors of physical substances, making it the supreme yin within yin. Their external shapes are vertical or horizontal, single or paired. Though outwardly there are seven orifices, the number eight is hidden within, because the generating and completing numbers of yin and yang differ.
Among the lower orifices, the anterior orifice governs transformation and generation, being yang within yin—externally appearing as one orifice, internally it actually comprises two; the posterior orifice governs discharge of turbidity, being the supreme yin within yin—one both internally and externally. Though appearing as two orifices on the surface, the number three is concealed within.
Wu Jutong used the concepts of yin-yang, odd-even, and the generating and completing numbers to explain the structure and function of the nine orifices, holding that the subtle principle lies in the character "hù" (mutuality)—that is, the mutual rooting and mutual use of yin and yang.
Using yin-yang and numerological symbolism to explain the form and function of the sensory orifices embodies the ancient concept of "the human body as a microcosm." The core is not anatomical, but rather emphasizes the connection between the opening and closing of the orifices and the movement of yang qi.
This chapter is a philosophical deduction based on symbolic numerology and lacks a basis in modern anatomy and physiology. Its value lies in inspiring the ancients to view the sensory orifices from a holistic and functional perspective, rather than serving as a scientific basis for understanding bodily structure.
The orifices of the ears, eyes, mouth, and nose should be used in moderation—avoiding prolonged staring, listening, speaking, overeating, and dietary partiality—maintaining proper openness and closure. 👀👂
The Yellow Emperor's Classic of Internal Medicine elaborated in detail on the head, feet, abdomen, back, meridians, and viscera, but did not provide an overarching discussion on the physical form of the human body as a whole. Wu Jutong supplements this discussion: the human body stands upright between heaven and earth, being straight and tall, neither leaning nor inclining—this is the image of Wood. In heaven, this corresponds to the primordial force (yuan), and among the five constant virtues, it corresponds to benevolence (ren). Heaven endows benevolence to humanity, and therefore the human form stands upright—a characteristic not shared by creatures with scales, shells, feathers, or fur.
Confucius said, "Humans are born with uprightness," and Cheng Zi said, "The principle of life is fundamentally upright"—both speaking of how humans should walk the path of righteousness. The human body has neither scales, shells, hair, nor feathers, belonging to the category of "naked creatures" (luochong). The naked belong to Earth, and Earth governs faithfulness (xin). Thus, humans receive benevolence from Heaven and faithfulness from Earth, possessing essence, spirit, ethereal soul, corporeal soul, mind, intention, and will, in order to practice filial piety, brotherly respect, loyalty, and faithfulness. Mencius said, "All things are complete within me," and also said, "Only the sage can fully actualize his physical form." The Classic of Filial Piety states, "Of all things under heaven, the human being is the most noble."
Therefore, physicians must understand the human form before they can treat disease.
This chapter connects the human upright posture and lack of fur or feathers with Confucian five constant virtues and the virtues of Heaven and Earth, emphasizing that humans are a holistic unity of form and spirit, and that physicians should uphold the principle that "the human is noble."
Upright posture is indeed related to human evolutionary development, but concepts such as "Wood image," "benevolence," and "faithfulness" belong to ancient moral philosophy and cannot be taken as medical facts. The rational core lies in this: medicine should focus on the human being as a whole, rather than viewing only localized diseases.
Maintaining an upright posture, attending to sitting, standing, and walking form, while cultivating emotional well-being and nurturing both form and spirit, are important aspects of traditional health cultivation. 🧘
This content is based on classical Chinese medicine texts and is provided solely for traditional cultural learning and study. It does not constitute any medical diagnosis, medication, or treatment advice. If you feel unwell, please seek timely medical attention.