Yin-Yang Transformation and Treating Disease by Seeking the Root

The Cold, Heat, Dryness, Dampness, Wind, or Fire seen on the surface of an illness is not necessarily the true generative root of that illness. Chen Dingsan links deficiency/excess of root qi → relative strength of governing and transforming qi → direction of transformation → final disease manifestation into a causal chain. At the same time, he points out that disease may arise from the root, the manifestation, or central qi; treatment may therefore take the root, take the manifestation, take central qi, or in some situations use a counter-direction or follow-direction approach.

“Treat disease by seeking the root” does not mean that every disease must be treated through one fixed “root organ.” It means identifying which layer actually generated this particular disorder and in which direction its qi-transformation proceeded.

1. Disease arising from the root: the root body is struck directly; the endowed root qi loses its normal regulation.
2. Disease arising from the manifestation: the gateway or exterior is attacked; external defense loses harmony.
3. Disease arising from central qi: the pivot fails; interior–exterior transformation loses control.

Causal chain of transformation: root Water/Fire deficiency–excess → competition between governing and transforming qi → transformation toward Yin or Yang → terminal clinical manifestation.

Corresponding treatment choices in the root–manifestation–central-qi model are: take the root (directly treat the root), take the manifestation (treat the exterior/manifest layer), or take central qi (harmonize the pivot).

Many passages in Zhang Zhongjing’s Guilin ancient text concerning mistaken treatment or prohibitions against sweating, purging, and vomiting can be read through this lens: they demonstrate what happens when the root, manifestation, and central qi are not distinguished, or when their priority is reversed within the transformation chain.

Original Passage from Exploring the Sources of Medicine

“When the governing qi is abundant, the transforming qi follows it; when the transforming qi is abundant, the governing qi follows it. In all cases, the process does not depart from deficiency or excess of the root qi. Yin is easily abundant and Yang easily declines. Among human diseases, Yin abundance is common and Yang abundance less common; Yang transforming under Yin is easy, while Yin transforming under Yang is difficult. … Each channel has its own nature and tendencies. When channel qi is harmonious, the channels mutually communicate and assist one another, and the tendencies of any single channel are not excessively exposed. When one channel becomes diseased, its root qi becomes manifest.”

“What follows the root is generated and transformed from the root; what follows manifestation and root has the transformations of manifestation and root; what follows central qi takes central qi as the transformation. Therefore the hundred diseases may arise from the root, from the manifestation, or from central qi. Some are successfully treated by taking the root, some by taking the manifestation, some by taking central qi, some by taking both manifestation and root, some by counter-direction treatment, and some by following-direction treatment. … Therefore, knowing manifestation and root allows their use without danger; understanding change, reversal, and sequence allows correct action without obstruction—this is what is meant.”