“Surrounding Wei to Rescue Zhao” refers to a tactical strategy in which an attacking enemy is forced to retreat by striking at its rear strongholds. The term originates from the Battle of Guiling during the Warring States period, when the State of Qi came to the aid of the State of Zhao; the key figures in this battle were the military strategist Sun Bin and the commander Tian Ji.
Reflections on “Surrounding Wei to Rescue Zhao”
In 354 B.C., the army of the State of Wei besieged Handan, the capital of the State of Zhao. The two sides fought and held their positions for over a year, leaving Zhao weakened and Wei exhausted. At this point, the State of Qi responded to Zhao’s plea for help by sending Tian Ji as commander and Sun Bin as military strategist to lead an army of 80,000 to rescue Zhao. Where should they launch their attack? At first, Tian Ji planned to march directly on Handan. However, Sun Bin argued that to untangle a tangled ball of thread, one must not pull it forcefully by hand; to mediate a fight between others, one must not directly join the fray. To lift the siege, one must avoid the strong and strike the weak, hitting the vital point. He advised Tian Ji: “At present, the State of Wei’s elite forces are all concentrated in Zhao, leaving its interior vulnerable. If we lead our troops to strike deep into the Wei capital, Daliang, seize its key transportation routes, and attack its unguarded areas—advancing toward Daliang itself—Wei will inevitably abandon Zhao and turn its forces back to defend itself. The Qi army can then, taking advantage of Wei’s exhaustion, intercept them on their return journey at the pre-selected battlefield of Guiling. The Wei army suffered a crushing defeat, and the siege of Zhao was thus lifted. Sun Bin used the strategy of besieging Wei to rescue Zhao from its peril; this is a very famous military case in Chinese history and was later listed by military strategists as one of the most important of the Thirty-Six Stratagems.
When reading this historical account, while appreciating the wisdom of our ancestors, it becomes even more meaningful if we connect the story to our own work. As a clinician, my thoughts naturally turn to clinical practice: can the strategy of “Encircling Wei to Rescue Zhao” be applied in clinical settings?
I. Treating the Heart Through the Kidneys: Encircling “Water” to Treat “Fire”
In clinical practice, I have observed that many patients with kidney yang deficiency—due to this deficiency, kidney water cannot be properly warmed and transformed—experience the accumulation of dampness and fluid in the body, which transforms into pathogenic fluid (yin xie) and further damages the body’s yang qi. The heart governs fire in the human body, and water overcomes fire. When pathogenic fluid ascends and disturbs the heart, it leads to a decline in heart fire and a weakness of heart yang. Patients then present with symptoms such as chest tightness, pain, irregular heartbeat, and worsening of symptoms when exposed to cold. Western medicine often diagnoses such patients with coronary heart disease, while Traditional Chinese Medicine refers to this as “chest bi syndrome.” The pulse pattern typically presents as “weak yang, taut yin”—that is, a weak pulse at the cun position of the left wrist, accompanied by taut and tight pulses at the guan and chi positions.
When treating such patients, TCM practitioners typically focus on the heart—warming and unblocking the heart meridians and invigorating heart yang—which yields very good results. However, because the pathogenic cold-yin cannot be completely dispelled overnight, the condition often recurs. If, in addition to addressing the heart directly to combat the pathogenic cold-yin, we try to approach the issue from another angle—by controlling the source of the pathogenic cold—using a strategy of “surrounding Wei to rescue Zhao”—the treatment will take effect more quickly.
Let’s look at the following case. The patient, Mr. Chen, a 60-year-old man, has experienced chest tightness and pain accompanied by palpitations for the past six months. The symptoms fluctuate in severity; at their worst, he feels a sense of oppression in the chest, experiences difficulty breathing, and exhibits cyanosis of the lips. He also reports soreness and distension in the lower back, frequent urination at night, and the production of large amounts of thin, white phlegm. He was diagnosed with coronary heart disease at the hospital and has been taking Compound Danshen Tablets, Rapid-Acting Jiu Xin Pills, enteric-coated aspirin, and Betaloc on a long-term basis. Three days ago, after being exposed to cold, his palpitations, chest tightness, and chest pain worsened; they were slightly relieved after taking Rapid-Acting Jiu Xin Pills. Unwilling to be hospitalized, he sought treatment from a TCM practitioner. His tongue coating was thin, white, and slippery; his cun pulse was weak, while his guan and chi pulses were taut and tight.
This is a classic case of chest bi syndrome, where cold phlegm and cold beverages obstruct the chest. With deficient heart yang, cold water and heart fire are in constant conflict, and the heart fire is gradually weakening; therefore, invigorating heart yang is the most urgent priority.
However, the formation of cold phlegm and cold fluids originates in the kidneys. The patient suffers from kidney yang deficiency; as a result, fluids cannot be properly warmed and transformed, and the essence of food is not converted and utilized but instead transforms into phlegm-dampness, which accumulates internally. Containing kidney water, enhancing the kidneys’ ability to store and retain, and reducing the upward invasion of phlegm and fluid is the top priority.
Consequently, I prescribed the following formula to the patient: Whole Trichosanthes Fruit, Leek White, Cinnamon Twig, Salvia Root, Raw Oyster Shell, and Alisma. After taking one dose, the patient’s chest tightness and chest pain were significantly relieved. After taking the formula for more than ten days, the symptoms disappeared. For the past six months, the patient has not taken any Western medicine, and the chest tightness has not recurred.
The above formula is not my own original creation; it is a modified version of the Trichosanthes, Allium, and Cinnamon Twig Decoction. It is easy to understand why Danshen is used to nourish the blood and the heart, as well as to invigorate blood circulation and unblock the meridians, and why Alisma is used to drain dampness and eliminate fluid retention. But why use raw oyster shell? Can raw oyster shell really strengthen the heart?
The raw oyster in this prescription targets the kidneys to enhance their ability to “seal and store.” It draws phlegm, dampness, cold, and fluid retention downward within the body, and then, through Alisma’s ability to drain dampness, expels these pathogenic fluids from the body.
The kidneys govern water, and the heart governs fire; water overcomes fire. When kidney water excessively suppresses heart fire, a situation arises where water overpowers fire—known as “overcoming” in the Five Elements theory. The standard treatment would be to replenish heart fire, which is the simplest and most direct approach. However, if we shift our perspective to address the issue through the kidneys—that is, through water—it is akin to “surrounding Wei to rescue Zhao.” By expelling water pathogens from the body through the kidneys’ ability to store and contain, we can achieve twice the result with half the effort.
Some patients frequently experience nightmares in which they see deceased loved ones and prefer to sleep on their stomachs; this is caused by a deficiency of heart yang. For such patients, using Guizhi, Danshen, raw oyster shell, and black beans can resolve the issue. Nourishing heart fire, nourishing heart blood, consolidating kidney water, and draining dampness work synergistically; once the dampness is eliminated, the fire becomes vigorous. For patients who also suffer from deficiency of heart qi, adding some ginseng will yield even better results.
Those who have studied Traditional Chinese Medicine in depth may wonder: “Containing kidney water” relies on astringent properties, while “draining dampness and fluid retention” relies on dispersing properties. Since containing and dispersing are inherently contradictory, how can we ensure that containing does not interfere with dispersing, and that dispersing does not interfere with containing?
In fact, this is precisely why I chose raw oyster shell. During the process of consolidation, raw oyster shell preserves the body’s vital energy (zhengqi) without trapping pathogenic factors (xieqi). As a result, the diuretic herbs effectively eliminate only the pathogenic factors, rather than the body’s essential substances. To borrow a phrase from TCM theory, this is “expelling pathogens without harming the healthy” and “closing the gate without letting the invaders through”—this is the unique property of raw oyster shell.
Apart from raw oyster shell, are there any other herbs with similar effects?
Consider Liuwei Dihuang Wan, a formula used to treat kidney yin deficiency. Why are Alisma and Cornus officinalis included? Alisma drains dampness but can deplete yin, while Cornus officinalis, with its sour and astringent nature, conserves the body’s vital energy. Together—one draining, one astringing—they remove impurities while preserving the essence, following the same principle as the combination of raw oyster shell and Alisma discussed above.
Once you understand these principles, take another look at Gui Zhi Jia Long Gu Mu Li Decoction. You’ll realize that the combination in this classic formula actually harnesses oyster shell’s ability to contain kidney water—a strategy of “surrounding Wei to rescue Zhao”—to enhance the yang-warming power of Gui Zhi!
II. Treating the Liver Through the Lungs: “Surrounding Metal” to Treat “Wood”
Excessive mutual restraint among the Five Elements can lead to shifts in the progression of disease within the body. Treating the element that is being restrained merely addresses the symptoms; treating the element that is in excess addresses the root cause.
In daily life, many people enjoy staying up late, which unknowingly damages the body’s kidney yin, causing deficient fire to rise upward. Combined with a preference for spicy foods, this deficient fire becomes even more severe, and spicy foods also tend to exacerbate lung fire. On one hand, kidney yin is depleted; water fails to nourish wood, leaving the liver undernourished and causing liver fire to become excessive. On the other hand, lung metal is overly vigorous, excessively suppressing liver wood, which impedes the smooth flow and regulation of liver qi, leading to liver qi stagnation that transforms into fire. For such patients, treatment that focuses on tonifying kidney water and employing methods to nourish the kidneys and liver may be effective, but if the excessive lung metal is not properly channeled, the condition will continue to recur. When Metal over-restrains Wood, adopting methods to drain Metal while simultaneously supporting Wood can yield excellent therapeutic results. This strategy is akin to “surrounding Wei to rescue Zhao.”
There are actually many patients with this condition. On the one hand, upward-reversing Qi from the Lung and Stomach may manifest as throat discomfort; in severe cases, this leads to chronic throat dryness. Excessive dispersal of Lung Qi can also cause increased dandruff. Furthermore, excessive Lung Fire deprives the hair of nourishment, resulting in increasingly severe hair loss; Since the lung and large intestine are paired organs, severe cases may lead to constipation or even bleeding hemorrhoids.
On the other hand, when the lung’s Metal fails to properly perform its functions of gathering and descending—and since the lung is the upper source of Water—insufficient gathering and descending leads to a shortage of kidney Water. Patients may develop kidney Yin deficiency, manifesting as soreness and weakness in the lower back and knees, easy fatigue, hot flashes and night sweats, heat in the palms and soles, yellow urine, and dry stools. Female patients may present with scanty menstrual flow and irritability.
Furthermore, when Lung Metal becomes hyperactive and excessively restrains Liver Wood, a “Metal Overpowering Wood” pattern may arise. The patient’s Liver Qi becomes suppressed, disrupting its normal dispersing function, and easily leading to Liver Qi stagnation transforming into fire. Once Liver Qi stagnation transforms into fire, it damages Kidney Water—the “child” stealing the “mother’s” Qi—further exacerbating Kidney Yin deficiency.
What appears to be a simple case of deficient fire rising upward and the qi of the lungs and stomach surging upward ultimately involves all the internal organs due to the interdependent and restraining relationships of the Five Elements. When treating the liver, one must not forget to treat the lungs. Strategies such as “surrounding Wei to rescue Zhao” and “making a show of attacking the east while striking the west” are of great importance in the process of diagnosing and prescribing treatments in Traditional Chinese Medicine.
I would like to recommend a formula for treating patients with the above symptoms: 20 grams of Scrophularia root, 15 grams of Polygonum cuspidatum, 15 grams of black plum, 10 g of mint, and 10 g of raw licorice.
This formula may seem ordinary, yet it can treat many diseases caused by “Metal overcoming Wood.” What exactly does this include? Any condition presenting with a bitter taste in the mouth, dry throat, restlessness, depression, breast tenderness during menstruation in women, a tongue with tooth marks, and a pulse that is floating and full at the right cun position and stagnant at the left guan position falls into this category.
In this formula, Scrophularia nourishes the yin of the liver and kidneys, while Polygonum cuspidatum clears stagnant fire from the liver and gallbladder; Black Plum, with its sour taste, tonifies liver qi; its astringent nature helps to consolidate the Metal element of the lungs, enhancing the lungs’ descending function to achieve the effect of “Metal generating Water”; Peppermint soothes the liver and relieves stagnation, much like a spring breeze caressing willow branches; and Licorice harmonizes the properties of the other herbs.
Although the formula consists of five herbs, its therapeutic principle is grounded in the Liver and Lung. It is highly effective in regulating various conditions caused by deficient fire rising upward, which leads to excessive Metal overcoming Wood.
III. Diseases Caused by Excessive Overcoming: Each Has Its Own Treatment Principles
When the mutual overcoming of the Five Elements becomes excessive, it is called “excessive overcoming.” As discussed earlier, Water overcoming Fire, Metal overcoming Wood, as well as Wood overcoming Earth, Earth overcoming Water, and Fire overcoming Metal—all fall under this category.
In the case of Wood overcoming Earth, Wood represents the Liver, while Earth represents the Spleen and Stomach. Clinically, many patients with chronic hepatitis B present with weakness of the Spleen and Stomach and a lack of appetite. Regulating the Spleen and Stomach is, of course, an obvious first step; however, treating the Spleen also requires regulating the Liver—just as “rescuing Zhao” requires “besieging Wei.” If Liver Qi stagnation remains untreated and treatment focuses solely on the Spleen and Stomach, it is tantamount to neglecting the root cause in pursuit of the branches. This principle applies not only to Spleen deficiency caused by chronic hepatitis B but also to many other cases of Spleen deficiency.
In clinical practice, pediatric patients often present with spleen-stomach deficiency, loss of appetite, restlessness, hyperactivity, and a preference for cold drinks. Upon pulse diagnosis, one will find that the child’s left Guan pulse is firm and strong, while the right Guan pulse is weak and lacking in force. This indicates that the Liver’s Wood is excessively overpowering the Spleen’s Earth, resulting in “Wood Overcoming Earth.” Why is this the case? Because in children, the Liver is often in excess while the Spleen is often deficient. Therefore, while strengthening the Spleen, it is necessary to soothe the Liver; only by treating the Spleen through the Liver can one achieve relatively rapid results.
“Earth over Water” and “Fire over Metal” are also very common in clinical practice. Following the principle of “surrounding Wei to rescue Zhao,” we can summarize them as follows:
The treatment approach for “Water over Fire” is to “surround Water to rescue Fire,” that is, to “surround” the Kidney and “rescue” the Heart.
The treatment approach for “Fire over Metal” is to “surround Fire to rescue Metal,” that is, to “surround” the Heart and “rescue” the Lung.
The treatment approach for “Metal over Wood” is to “surround Metal to rescue Wood,” that is, to “surround” the Lung and “rescue” the Liver.
The treatment approach for Wood over Earth is to “encircle” Wood and “rescue” Earth, that is, to “encircle” the Liver and “rescue” the Spleen.
The treatment approach for Earth over Water is to “encircle” Earth and “rescue” Water, that is, to “encircle” the Spleen and “rescue” the Kidney.
Here, “encircle” can be understood to mean “attack”; in terms of treatment methods, this corresponds to purgative therapy. “Rescue” can be understood to mean “tonify”; in terms of treatment methods, this corresponds to tonifying therapy.
