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I privately hold that although medicine is a minor art, it entrusts life and death, making adaptability the most crucial aspect; one should not be stubborn. One must understand the principles of herbs (herbal properties), pulse diagnosis (pulse formulas), disease mechanisms, and therapeutic methods, as well as fully grasp the situations revealed by observation, listening/smelling, inquiry, and palpation (observing complexion, listening to voice/smelling odors, asking about history, feeling the pulse).

Herbs possess qi of cold, heat, warm, cool, and neutral natures, flavors of pungent, sweet, bland, bitter, sour, and salty, properties of ascending, descending, floating, and sinking, and functions of dispersing/venting and purging/nourishing. Pulse diagnosis requires investigating forms such as superficial, deep, slow, rapid, slippery, and choppy, and their correspondences to exterior/interior, cold/heat, excess/deficiency, as well as harmonious pulses like "a-a tender willow" and compliant pulses like "string, hook, hair, stone." Herb prescription follows the hierarchy of Sovereign, Minister, Assistant, and Envoy (the herb treating the main disease is Sovereign, used in largest quantity; assisting the Sovereign is Minister, used in lesser quantity; responding to the Minister or guiding the drug is Assistant/Envoy, used in even lesser quantity). Pulse differentiation considers age, body size, and constitution (elderly pulses are often soft/soggy, children's pulses are often rapid, thin people's pulses are often large, fat people's pulses are often fine).

Herbs are the essence of heaven and earth; medication must fit the disease (if herbs are not used indiscriminately, they will fit the disease). The pulse is the manifestation of qi and blood; the pulse values having "spirit" (strength within the pulse is called having spirit). Diseases have mechanisms of external contraction and internal injury, wind-cold, summer-heat, dampness, dryness, and fire. Treatments use agents of venting/purging, tonifying/reducing, lubricating/astringing, warming/drying, and heavy/light. External contractions differ from internal injuries (external contractions are excess syndromes, internal injuries are deficiency syndromes). Cold syndromes differ from heat syndromes (wind-cold directly attacking the interior manifests as cold, while transmitted pathogenic factors manifest as heat). External contractions are suitable for reducing methods, internal injuries for tonifying methods; cold syndromes can be warmed, heat syndromes can be cleared. If tonification and reduction are appropriate, the disease heals in an instant; if warming and clearing are mismanaged, death occurs in an instant.

External wind-cold should be resolved by channel differentiation (external wind-cold varies in transmission, so resolving by channel differentiation is necessary). Internal dietary injury involves regulating the stomach to dissolve accumulation (internal dietary injury is localized, merely requiring stomach regulation and digestion promotion). Stomach yang governs qi and reception; yang is often in excess. Spleen yin governs blood and transformation; yin is often deficient. The stomach is the root of the six fu organs (only by receiving water and grain can qi and fluids be transformed). The spleen is the source of the five zang organs (only by transforming qi and fluids can ying and wei be nourished). When stomach qi is weak, hundred diseases arise; when spleen yin is sufficient, ten thousand evils cease. Regulating the stomach and spleen is the kingly way of medicine; dietary restraint is the good prescription for dispelling disease.

Diseases often stem from cold and qi stagnation, where qi stagnation generates heat (cold refers to external wind-cold causing fever day and night; cold refers to internal raw/cold food injury causing fever in the afternoon). Or seven emotions stir fire, and fire stirring generates phlegm. Some are injured by summer-evil due to improper activity/rest, or infected by dampness due to exposure to rain/water. Others generate damp-heat due to dietary imbalance, or stir ministerial fire due to excessive sexual activity. (The above six points discuss disease mechanisms.)

Subduing ministerial fire requires nourishing true yin (the following six points discuss therapeutic methods). Dispelling damp-heat requires drying dampness and tonifying the spleen/stomach. External dampness is suitable for surface-dispersing methods; internal dampness is suitable for bland-leaching methods. Yang summer-heat can be cleared; yin summer-heat can be dispersed with warmth. Treating fire and phlegm requires distinguishing their abundance or scarcity. Investigating exterior or interior dictates using sweating or purging methods accordingly (for wind-cold, sweat it, i.e., warm dispersion; for raw/cold accumulation, purge it, i.e., warm purgation). Phlegm arises from fire, so treating fire is primary; fire arises from qi, so regulating qi is fundamental. For treating fire, mild cases can be descended; severe cases follow its nature to ascend and dissipate. For regulating qi, mild cases require adjustment; severe cases require tracing the source and dispersing. Excess fire can be purged, either from the exterior or interior (referring to external contractions). Deficient fire is suitable for tonification, either tonifying yin or yang (referring to internal injuries). Sudden illness is termed fire; strange illness is termed phlegm. Wind-cold, heat, dampness, dryness, and wind produce five different types of phlegm; warming, clearing, drying, moistening, and dispersing constitute five different treatments (warm cold-phlegm, clear heat-phlegm, dry damp-phlegm, moisten dry-phlegm, disperse wind-phlegm). Fire can generate phlegm; phlegm can generate fire. Prolonged stagnation becomes disease; prolonged disease becomes stagnation. Metal, water, wood, fire, and earth stagnations must be distinguished; draining, restraining, reaching, issuing, and seizing methods must be carefully considered (drain metal stagnation, restrain water stagnation, reach wood stagnation, issue fire stagnation, seize earth stagnation). Stagnation generates fire and phlegm to cause disease; disease consumes qi and blood leading to deficiency. Diseases vary in severity; treatments vary in counteracting or following. Mild cases are treated counteractively (using cold herbs for heat, hot herbs for cold). Severe cases are treated by following (using cold herbs for heat assisted by hot herbs, hot herbs for cold assisted by cold herbs). Diseases have root and branch; urgent cases treat the branch, chronic cases treat the root. Methods divide into attacking and tonifying: deficiency uses tonification, excess uses attack. Young and strong with new pathogens should exclusively attack; old and frail with long-term illness should combine tonification as a rule.

Long-term illness with deficiency and stagnation requires tonifying deficiency and resolving stagnation; chronic conditions may require purging or dissolving. Accumulations in the stomach/intestines can be cured by purging; masses in meridians should be dissolved to heal. Women with qi stagnation and blood stasis benefit from invigorating blood and moving qi; men have more yang than yin, so tonifying yin to match yang is appropriate. Cistanche and Dioscorea are excellent for men (because they tonify yin). Cyperus and Amomum are treasures for women (because they move qi). Qi and blood diseases must be distinguished; yang deficiency and yin deficiency must not be confused. Yang deficiency qi disease is worse during the day and better at night (Zi to Si hours are day). Blood disease yin deficiency is better during the day and worse at night (Wu to Hai hours are night). Yang deficiency generates cold, cold generates dampness, dampness generates heat (yang is qi, true fire). Yin deficiency generates fire, fire generates dryness, dryness generates wind (yin is blood, true water). Yang excess and yin deficiency generate fire, forcing blood to flow recklessly. Yin excess and yang deficiency generate cold, cold stagnates qi causing generalized edema. Yang deficiency fears external cold (yang qi is weak and cannot protect the exterior, hence fearing external cold). Yin deficiency generates internal heat (yin blood is weak and cannot anchor qi, hence generating internal heat). Tonifying yang and qi uses sweet-warm substances; nourishing yin and blood uses bitter-cold substances. Regulating qi prefers pungent-cool agents (qi belongs to yang, is formless; qi stagnation causes heat, so pungent-cool herbs are used to disperse it). Harmonizing blood requires pungent-hot agents (blood belongs to yin, is有形/form; blood stasis causes pain, so pungent-hot herbs are used to open it). Yang qi guides yin blood; yin blood relies on yang qi. Yang deficiency tonifies yang, yin deficiency tonifies yin; qi disease regulates qi, blood disease harmonizes blood. If both yin and yang are deficient, only tonify yang, as yang generation leads to yin growth; if both qi and blood are diseased, only regulate qi, as qi movement leads to blood circulation. Store ice to emit ice to control the blazing of yang qi; nourish water to control the hyperactivity of heart fire. When fire descends and water rises, the person is free of disease; when yin is peaceful and yang is secure, my body remains youthful forever.

Children are pure yang without yin; the elderly have much qi but little blood. Fat people with qi deficiency and phlegm should resolve phlegm and tonify qi; thin people with blood deficiency and fire should clear fire and nourish yin. Indulgence in rich foods causes carbuncles/fistulas due to heat-dryness; thin phlegm and poor constitution cause swelling due to cold-dampness. Northern highlands suit clearing heat and using drying methods; southern lowlands suit dispersing dampness and warming cold.