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The *Tianzhen Lun* (Treatise on the True Nature of Antiquity) states: The physiological cycle for women is based on the number seven, and for men, on the number eight. When a woman reaches forty-nine years old (7 x 7), the Ren Mai (Conception Vessel) becomes deficient, the Chong Mai (Penetrating Vessel) declines, Tian Gui (essence related to reproductive maturity) is exhausted, and menstruation ceases. When a man reaches sixty-four years old (8 x 8), the Zang-Fu organs all decline, sinews and bones become loose and weak, Tian Gui is depleted, the pulse is weak, and the form is withered. If a woman exceeds sixty years or a man exceeds seventy years, they have surpassed their natural constant lifespan. For those who reach an advanced age, if food and clothing are abundant and prepared, descendants diligently provide care, obeying and respecting their elders, practicing filial piety, regulating their diet, adapting to cold and warmth, aligning with the spirit of heaven above, and conforming to human ethics below, this is following the Way of Heaven!

For elderly people, emaciated form and weak Qi are naturally so. However, for men and women over seventy who have ruddy complexions, strong physical form and Qi, undiminished appetite, yet often suffer from constipation and internal heat, what is the reason? Generally, frailty is common in the elderly; those who reverse this trend either possess robust True Yang, full Blood Sea, and strong Qi, or, upon palpation of the pulses at both wrists, exhibit a large, tight, and rapid pulse, which is a sign of longevity in the elderly. Since the True Qi of the elderly has declined, this condition arises from an excess of Deficient Yang Qi filling the body tissues, resulting in large pulses in both hands, doubled food intake, persistent redness of the cheeks, and healthy spirit—all assisted by Deficient Yang Qi. They may frequently experience irritability, thirst, chest-heat, and dry stool. One should simply use ordinary herbal decoctions at any time to gently resolve symptoms, which will naturally stabilize within three to five days. As long as Deficient Yang Qi is maintained, food intake remains normal, which is Heaven granting them extra life. One must absolutely not, due to slight heat, frequently use purgatives to promote drainage, or bitter-cold herbs to dissipate heat. If Deficient Yang Qi retreats and returns to the True Essence, the form and Qi will become even more emaciated, Zang-Fu organs will weaken, producing much cold-damp phlegm, making recovery impossible.

For those who never had Deficient Yang Qi and are always fatigued, treatment relies entirely on carefully measuring herbal decoctions, frequently adding warming and tonifying herbs, and adjusting congee, as the primary method of nourishment and treatment!

It is common to see people treating diseases in the elderly as if they were young adults, indiscriminately prescribing herbal decoctions and recklessly applying acupuncture to attack the disease, seeking rapid cure. Little do they know that for those of advanced age, Blood and Qi have already declined, Spirit and Essence are diminished, danger looms like a candle in the wind, and myriad diseases easily attack. Vision and hearing may no longer be sharp, limbs may not move freely; the body feels weary, head and eyes dizzy, Wind-Qi unsmooth, and chronic diseases flare up intermittently; there may be constipation or diarrhea, cold or heat sensations. These are all normal states for the elderly. Failing to treat according to these patterns, and tightly using needles and drugs to insist on complete recovery, often leads to new perils because of this.

Moreover, drugs used to attack pathogens may induce vomiting, sweating, release the exterior, or promote urination. Because the elderly differ from the young whose True Qi is robust, even after sweating, vomiting, or purging, they may not immediately face critical danger. However, for frail elderly persons, sweating causes Yang Qi to leak; vomiting causes Stomach Qi to rebel upward; purging causes Yuan Qi (Original Qi) to collapse, leading immediately to unexpected accidents. This is a major taboo in caring for the elderly.

Generally, medication for the elderly is merely a supportive method. Only mild, smooth, Qi-regulating, appetite-enhancing, tonifying, and harmonizing herbs should be used. One must not administer drugs bought in markets, gifted by others, whose formulas and flavors are unknown, or harsh "wild wolf-tiger" type drugs. Careful scrutiny is essential. If chronic diseases exist or flare up occasionally, one should follow the disease manifestations and use harmonizing herbal decoctions to regulate smoothly; within three to five days, matters will naturally settle. Then, adjust the diet, following the methods of dietary therapy, preparing dishes according to the nature of the foods. This is the best approach!