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For example: A female patient surnamed Guo, aged 32. For over ten years, she suffered from continuous asthma and cough. The physician diagnosed Bronchial Asthma. She first received Western medicine treatment for several years, but the attacks became more severe. Subsequently, she underwent Traditional Chinese Medicine (TCM) treatment for several years using methods such as Tonifying the Kidney to grasp Qi, Dispersing the Lung to calm wheezing, and Supplementing Qi to calm wheezing, yet her condition did not improve. Upon detailed inquiry, it was found that her asthma and cough inevitably occurred in summer and healed spontaneously in winter; she experienced dry mouth at night, a white tongue coating, and a Ruo (soft and weak) pulse. She was prescribed Modified Maidong Decoction (a formula for nourishing Yin and moistening the Lung) for 10 doses, after which symptoms resolved, and after 50 doses, she was cured. A certain physician, puzzled by this, asked: "Why is there such a significant effect?" The answer was: "The ability to endure winter but not summer indicates Yin Deficiency. In a case of Yin Deficiency, long-term use of Qi-supplementing, Kidney-warming, fluid-transforming, and Lung-dispersing drugs would consume body fluids (Jin Ye), making recovery impossible. The cure achieved by nourishing Yin confirms that the syndrome differentiation was correct."

Another example: A female patient surnamed Xu, aged 54. She had suffered from Metrorrhagia (heavy uterine bleeding) for one month. Despite blood transfusions and hemostatic drugs, she did not recover. Inquiry revealed her hemoglobin had dropped to 3 g/dL. Her complexion was sallow and spiritless, her tongue was pale, and her pulse was Xu Da Xuan Jin Shu (deficient, large, wiry, tight, and rapid). Further inquiry into her chronic conditions revealed: "In winter, I feel aversion to cold and my limbs are not warm; in summer, my hands and feet are excessively hot and unbearable." Thus, it was stated: Aversion to cold in winter indicates Yang Deficiency; aversion to heat in summer indicates Yin Deficiency. The previous formulas failed because some were cooling and damaged Qi, while others were warming and damaged Blood. Therefore, Shisiwei Jianzhong Tang (Fourteen-Ingredient Jianzhong Decoction) was modified with Cervus Nippon Cornu Colla (Deer Antler Glue) to greatly supplement Qi, Blood, Yin, and Yang, resulting in a subsequent cure.

One must always examine the lower orifices when treating diseases.
Since the *Suwen* (Basic Questions) chapter "Wangzangielun" discussed "One must always examine the lower orifices," later generations regarded the treatment of bowel and urinary conditions as crucial, calling it "one of the four essentials of treatment." The term "lower" refers to the Two Yin Orifices (urethra and anus), which are the apertures of the Kidney and the gate of the Stomach. The *Maiyao Jingweilun* states: "When the granaries cannot be contained, it is because the gates are not guarded. Those who retain [control] live; those who lose [control] die. Thus, the two lower orifices are the locks of Stomach Qi" (*Leijing*). Therefore, Zhang Zhongjing, in the *Shanghan Lun*, besides using purgative methods for Yangming Fu-organ excess constipation and diuretic methods for Taiyang Fu-organ syndromes, also employed water-promoting and purgative methods for Bladder blood-stasis and Shaoyin critical conditions. Later, Zhang Hezi, one of the Four Masters of the Jin and Yuan dynasties, elevated the purgative method to a major principle of treatment, stating: "What the *Neijing* calls 'purging' is actually 'tonifying.' Removing old fecal matter cleans the intestines and stomach; eliminating masses promotes the flourishing of Ying and Wei. Within this non-tonification lies true tonification." Zhang Jingyue of the Ming Dynasty recognized the importance of the lower orifices and specifically discussed questioning them in his "Ten Questions" chapter, stating: "The two lower orifices are the portals of the body. Whether due to internal injury or external contraction, one must examine these to differentiate Cold, Heat, Excess, and Deficiency. The anterior orifice connects to the Bladder; its patency or obstruction, heat or lack thereof, reveals the strength of Qi transformation. In typhoid fever, if urination is clear and unobstructed, it indicates the Taiyang Qi is not severely compromised, which is an auspicious sign. The posterior orifice opens to the Large Intestine; its patency or obstruction, binding or looseness, reveals the Excess or Deficiency of Yangming. Only when stool is heat-bound and the abdomen is hard and full does it belong to Excess, warranting purgation. If stool was recently passed and is not heavily bound, or if no stool has passed for ten days but there is no abdominal distension, it is not Yangming Excess. As Zhang Zhongjing said regarding 'stool initially hard then loose,' one should not attack with purgatives; thus, loose stool, even if preceded by hardness, is not true Heat, let alone pure loose stool. Unless there are true signs of hardness, dryness, and fullness, it is not Excess, and purgation is clearly contraindicated." "People often see yellow urine and assume it is Fire (Heat), unaware that fatigue causes yellow urine, anxiety causes yellow urine, diarrhea causes yellow urine, and sexual excess damaging Yin causes yellow urine. Without accompanying symptoms like stranguria or pain indicating Heat, one should not attribute yellow urine solely to Fire. I have seen many deaths caused by forcing out withered yellow fluid. The Classic says: 'Insufficiency of Middle Qi leads to abnormalities in urination and defecation.' This meaning is clear. If urine is clear and profuse, it indicates interior pathogens are not severe and the disease is not in the Qi level, as fluids depend on Qi transformation; Qi pathology leads to urinary difficulty. Gradual improvement in urination indicates restored Qi transformation, which is highly auspicious." "The Large Intestine is the portal of the Sea of Water and Grain. The Bladder/Urethra is the portal of the Sea of Blood and Qi, and the pathway of Chong and Ren. Both orifices are governed by the Kidney and are the gates of Primordial Qi (Yuan Qi). One may only consider promoting flow or purging if true Excess pathogens are confirmed; otherwise, extreme caution is required. Do not mistakenly attack. If there is no true Excess but one recklessly purges, Primordial Qi will be drained, allowing exterior pathogens to sink deeper due to deficiency, and interior pathogens will worsen through further depletion. Therefore, in cases of Deficiency, do not force purgation. The most favorable outcome is urine transforming naturally upon receiving Qi; even if the Large Intestine is constipated for over ten days, if Ying and Wei are harmonized, natural passage will occur, so there is no need to worry. However, incontinence is unsuitable for the deficient and requires prevention." Wu Jutong’s *Wenbing Tiaobian* contains dozens of articles solely on promoting urination/defecation and securing the orifices, demonstrating that all diseases require attention to the lower orifices.

One must first remove blood vessel stagnation before regulating the body.
In the early 1960s, many outpatient patients presented as "unable to tolerate tonification despite deficiency." Some recovered with tonification. Why? Careful study of their treatment processes revealed differences in the sequence of interventions. What was different about the sequence? Invigorating Blood and expelling Stasis was employed.

Reading the *Suwen* chapter "Sanbu Jiuhoulun": "First measure the fatness or thinness of the body to adjust the Deficiency or Excess of Qi. Excess is drained, Deficiency is supplemented. One must first remove blood vessel stagnation before regulating, regardless of the disease, aiming for balance." This means that while Deficiency should be tonified and Excess drained, if Blood Stasis causes obstruction in the vessels, one must first remove this obstructive Stasis before regulating Deficiency and Excess, aiming for balance. When Zhang Zhongjing treated Xu Lao (consumptive disease) characterized by "extreme emaciation, abdominal fullness preventing eating, injuries from food, emotion, drink, intercourse, hunger, labor, and damage to meridians, Ying, and Wei," he did not use tonification first but used invigorating Blood and expelling Stasis. This aligns with removing vascular stagnation first, regardless of the specific disease, to achieve balance.

Observing patients who are "unable to tolerate tonification," they often present with numerous deficiency symptoms. Physicians, seeing deficiency upon deficiency, apply tonification repeatedly. However, tonification exacerbates the vascular stagnation, causing the condition to worsen rather than improve, creating a stubborn "intolerance to tonification" syndrome. Although *Yilin Gaicuo* claims almost every disease is due to Blood Stasis, appearing biased, physicians who use its formulas succeed because they first remove vascular stagnation before regulating, aiming for balance.

On "Unique Findings" (Du).
Modern discussions on TCM diagnosis often insist that "without combining the Four Diagnostic Methods (Inspection, Auscultation/Olfaction, Inquiry, Palpation), one cannot diagnose." Superficially reasonable, but upon closer examination, it is too vague to be practical. Which famous physician diagnoses by inspecting repeatedly, asking repeatedly, listening repeatedly, and palpating repeatedly before making a judgment or prescribing? Which senior TCM doctor, seeing 30-40 patients in half a day, has time to look left and right, ask left and right, listen left and right, and palpate left and right? It is impossible, inadvisable, and incorrect.

I was dull and loved reading since childhood, preferring immediate application. Initially, seeing one patient for half a day made it difficult to reach a conclusion, let alone prescribe. Observing senior doctors, they did not act this way. They asked patients if previous medications worked, and the response was often "very effective." Why? Because they excel at grasping unique characteristics.

Reading the *Suwen* chapter "Sanbu Jiuhoulun": "Huangdi asked: How to know the location of the disease? Qibo answered: Observe the Nine Pulses. The one that is uniquely small indicates disease; uniquely large, uniquely rapid, uniquely slow, uniquely hot, uniquely cold, or uniquely depressed indicates disease." I began to understand. Reading the "Dulun" (Chapter on Uniqueness) in *Jingyue Quanshu* clarified the principle: The way of diagnosis lies in identifying the "Unique" (Du), i.e., grasping the distinctive features.

*Jingyue Quanshu · Maishenzhang* describes three types of "Uniqueness": 1. Uniqueness of Location, 2. Uniqueness of Zang-Qi, 3. Uniqueness of Pulse Body. It states: "Uniqueness of Location means other areas are normal, but this one is slightly abnormal; the abnormality hides the pathogen. Uniqueness of Zang-Qi is not confined to location; e.g., all Hong pulses relate to the Heart, all Xian pulses to the Liver. Among the five pulses of each Zang, irregularities indicate disease; strong irregularity indicates Zang Excess, weak irregularity indicates Zang Deficiency. Uniqueness of Pulse Body refers to the Classic's description: uniquely small, large, rapid, slow, hot, cold, or depressed pulses indicate disease." I found this theory too abstract. Instead, I prefer these methods: 1. Unique color, 2. Unique pulse, 3. Unique abdominal diagnosis, 4. Unique tongue appearance, 5. Unique correspondence between Heaven and Humanity, 6. Unique similarity. These are more practical. For example: Dermatitis with intense nocturnal itching is diagnosed as Blood Dryness generating Wind, treated by nourishing and invigorating Blood to dispel Wind. Duodenal stasis with a large Chi pulse is diagnosed as Spleen-Kidney Yang Deficiency and Cold, treated by warming and tonifying Spleen and Kidney. Chronic gastritis with gastric ptosis and epigastric tenderness is diagnosed as Cold Excess binding, treated by warming the Middle and guiding out stagnation. Persistent high fever with a crimson, coating-less tongue is diagnosed as Heat entering Ying and Blood levels, treated by clearing Ying and cooling Blood. Other factors need not be considered.

The Morning and Evening of the Four Limbs and Eight Xi (Depressions).
The Four Limbs refer to the upper and lower extremities. The Eight Xi refer to the elbows, axillae, hips, and knees. As Zhang Jiabin wrote in *Leijing*: "The four limbs are the two hands and two feet. The eight xi are the elbows and axillae of the hands, and the hips and popliteal fossae of the feet. These are the joints of the limbs, hence called 'xi' (depressions). The changes of Qi and Blood in the whole body are like tides in the sea, manifesting in the eight xi." As stated in *Suwen · Wuzheng Chengxuan Pian*: "All vessels belong to the eyes; all marrow belongs to the brain; all sinews belong to the joints; all blood belongs to the Heart; all Qi belongs to the Lungs. This is the morning and evening cycle of the four limbs and eight xi." Thus, to assess the strength of Qi, Blood, sinews, marrow, and vessels throughout the body, one examines the eight xi. To regulate them, one treats the axillae, elbows, hips, and knees. To maintain health, one regulates these areas. Acupuncture and massage to regulate the body should also start from these depressions. In my youth, I suffered from various illnesses: tuberculosis, hepatitis, vasculitis, retinal hemorrhage, gastric ptosis. After following Teacher Xia Hansan of Beijing College of Traditional Chinese Medicine in physical exercise and frequently moving the four limbs and eight xi, all illnesses receded. Later, for chronic Qi, Blood, sinew, vessel, or marrow diseases resistant to treatment, I advised frequent limb movement. Those who persisted often recovered.

If the Five Zang are disharmonious, the Seven Orifices are blocked; if the Six Fu are disharmonious, stagnation remains as abscesses.
*Ling Shu* explicitly states that if the Five Zang are disharmonious, the Seven Orifices are blocked, and treating orifice diseases must prioritize the Zang. It says: "Lung Qi connects to the nose; when Lung Qi is harmonious, the nose perceives odors. Heart Qi connects to the tongue; when Heart Qi is harmonious, the tongue tastes flavors. Liver Qi connects to the eyes; when Liver Qi is harmonious, the eyes distinguish colors. Spleen Qi connects to the mouth; when Spleen Qi is harmonious, the mouth knows grains. Kidney Qi connects to the ears; when Kidney Qi is harmonious, the ears hears sounds. If the Five Zang are disharmonious, the Seven Orifices are blocked." Hence, later physicians treat orifice diseases by addressing the Zang.

*Ling Shu* also states that diseases caused by stagnation should be treated via the Six Fu organs: "If the Six Fu are disharmonious, stagnation remains as abscesses. Pathogens in the Fu cause Yang vessels to be disharmonious; Yang disharmony causes Qi stagnation; Qi stagnation leads to excessive Yang Qi. Excessive Yang makes Yin vessels unfavorable; Yin unfavorability causes Blood stagnation; Blood stagnation leads to excessive Yin Qi. Excessive Yin prevents Yang from nourishing, termed 'Guan.' Excessive Yang prevents Yin from nourishing, termed 'Ge.' When both Yin and Yang are excessive and cannot nourish each other, it is 'Guan Ge.'" Thus, Zhu Danxi’s Yueju Wan for treating Six Stagnations targets the Fu organs; Li Dongyuan’s use of Rhubarb for toxic heat swelling targets the Fu organs; *Jinkui Yaolue*’s use of Mirabilite and Poria for phlegm-fluid retention targets the Fu organs; and *Jinkui Yaolue*’s use of Rhubarb, Poria, and Mirabilite for blood stasis targets the Fu organs.

I once treated Patient Liu XX, male, 59, with generalized psoriasis for nearly 30 years. Skin lesions covered 99% of his body; skin was thickened and hard, sweating was absent, and heart, liver, and kidney functions were abnormal. Previous treatments failed, including my own 250+ prescriptions. Recalling *Ling Shu · Maidu Pian*: "If the Six Fu are disharmonious, stagnation remains as abscesses," I frequently added Rhubarb and Mirabilite to his prescription to promote bowel movements to 2-3 times daily. After three months, not only was the psoriasis cured, but ECG, liver, and kidney functions normalized.

Root and Branch (Biao Ben).
Since the *Suwen*, generations of physicians have valued "Root and Branch," yet few clearly defined what constitutes the Root and what the Branch.

Studying *Suwen* chapters "Benbo Bingzhuanlun" and "Zhi Zhen Yao Dalun," the discussion of Root and Branch covers two aspects: 1. The relationship between Yin-Yang and the Six Qi, and 2. The relationship between Etiology and Pathogenesis. Regarding treatment for the Yin-Yang/Six Qi relationship: When Shaoyang transforms into Six Qi, it manifests as Fire; Taiyin as Dampness; Shaoyin as Heat or Cold; Taiyang as Heat or Cold; Yangming as Dampness; Jueyin as Fire. Treatment varies between adjusting internal Yin-Yang and treating the Six Qi. As *Suwen · Zhi Zhen Yao Dalun* states: "The Six Qi Root and Branch differ... Shaoyang and Taiyin follow the Root; Shaoyin and Taiyang follow Root and Branch; Yangming and Jueyin do not follow Root or Branch but follow the Middle Qi. Thus, those following the Root transform from the Root; those following Root/Branch have transformations of both; those following Middle Qi transform via Middle Qi." Zhang Jiabin explains: "Shaoyang is Minister Fire, transforming from Fire; thus Fire is Root, Shaoyang is Branch. Taiyin is Damp Earth, transforming from Dampness; thus Dampness is Root, Taiyin is Branch. Shaoyin is Sovereign Fire, transforming from Heat; thus Heat is Root, Shaoyin is Branch (Yin follows Yang). Taiyang is Cold Water, transforming from Cold; thus Cold is Root, Taiyang is Branch (Yang follows Yin). Yangming is Dry Metal, transforming from Dryness; thus Dryness is Root, Yangming is Branch. Jueyin is Wind Wood, transforming from Wind; thus Wind is Root, Jueyin is Branch. Since Yangming and Taiyin are Interior-Exterior pairs, Taiyin is Middle Qi, and Metal transforms via Damp Earth. Jueyin and Shaoyang are Interior-Exterior pairs, Shaoyang is Middle Qi, and Wood transforms via Minister Fire. All these follow the Middle Qi." The *Suwen* continues: "Diseases arise from Root, Branch, or Middle Qi. Treatment may target Root, Branch, Middle Qi, Root and Branch, Reverse (Ni), or Following (Cong). Reverse is actually Correct/Following; Following is actually Reverse. Knowing Root and Branch ensures no danger; knowing Reverse and Following ensures correct action." Regarding Etiology/Pathogenesis Root and Branch: Except for abdominal fullness, urinary/bowel obstruction, and diarrhea, treatment generally addresses the etiology. *Suwen · Benbo Bingzhuanlun* states: "Regarding Yin-Yang, Reverse/Following, Root/Branch... If disease precedes reversal, treat the Root; if reversal precedes disease, treat the Root. If cold precedes disease, treat the Root; if disease precedes cold, treat the Root. If heat precedes disease, treat the Root; if heat precedes abdominal fullness, treat the Branch. If disease precedes diarrhea, treat the Root; if diarrhea precedes other diseases, treat the Root, but regulate first before treating others. If disease precedes abdominal fullness, treat the Branch; if abdominal fullness precedes vexation, treat the Root. If there is external pathogen or same Qi, and urination/defecation are obstructed, treat the Branch; if unobstructed, treat the Root."

Zhang Jingyue, in *Jingyue Quanshu · Benbolun*, clarifies: "Diseases have Root and Branch; the Root is the source of disease, the Branch is the manifestation." He advocates treating only the Root. In *Qiubenlun*, he states: "All things have a Root; treating disease prioritizes finding the Root. The Root is singular. External contraction roots in Exterior; internal injury roots in Interior; Heat disease roots in Fire; Cold disease roots in Cold; Excess pathogens root in Excess; Deficient Zheng roots in Deficiency. Observe the cause; the cause is the Root. The Root of all diseases is merely these six: Exterior, Interior, Cold, Heat, Excess, Deficiency. Knowing these allows differentiation. These six are opposites like ice and charcoal. If discussing Etiology/Pathogenesis, treatment must address the Root. If discussing Yin-Yang transforming into Six Qi, treating the Root requires adjusting Yin-Yang. In his commentary on 'Treating Disease Must Seek the Root' in *Leijing*, he says: 'Root is the source of disease. Diseases, whether in Exterior/Interior, Cold/Heat, caused by Five Movements/Six Qi, or damaging Zang-Fu/Meridians, are none other than Yin and Yang Qi, having a Root. Thus, rooting in Yin or Yang, though manifestations vary, the Root is one. Knowing where disease arises and chaos begins, and targeting it directly, is the Way of Unity.' However, when to treat the Root via Etiology versus Yin-Yang remained unclear. After forty years of reflection, I now understand: For acute diseases, the Root is the Etiology; for chronic diseases, the Root is Yin-Yang.

The Stomach is the Sea of the Five Zang and Six Fu."