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The *Yin Yang Ying Xiang Da Lun* (Great Treatise on Yin and Yang Corresponding to Phenomena) states: Yin and Yang are the way of heaven and earth, the general principles of all things, the parents of change, the origin of life and death, and the residence of spiritual transformation. In treating disease, one must seek the root (This clarifies that the changes and life/death of all things in heaven and earth do not go beyond Yin and Yang. Those who observe this can attain spiritual clarity. Therefore, when treating disease, although there are myriad complexities, one must seek the root, which may be in Yin or in Yang. Once Yin and Yang are understood, where can the pathogenic factors escape? Huangqin Lian (Scutellariae Radix and Coptidis Rhizoma), Jiang Fu (Zingiberis Rhizoma Preparatum and Aconiti Lateralis Radix Preparata) can all restore vitality; Renshen Shu (Ginseng Radix and Atractylodis Macrocephalae Rhizoma), Xiao Huang (Mangxiao and Rheum Palmatum) can all raise the dying. If these are not distinguished, fearing attack or tonification, worrying about heat or cold, one will inevitably err and be ridiculed by the sages. Can the root really be ignored?).

The *Zhi Zhen Yao Da Lun* (Great Treatise on the Most Essential Truths) states: Carefully guard the disease mechanism (Bing Ji, the critical point of disease pathology), assign each to its corresponding category. For what exists, investigate it; for what does not exist, investigate it. For excess, hold it accountable; for deficiency, hold it accountable. One must first understand the mutual overcoming among the Five Elements (Wu Sheng), unblock the blood and Qi, make them harmonious and unobstructed, thereby achieving peace. This says that although symptoms are numerous, each should be carefully observed, but they ultimately do not go beyond deficiency and excess. "Carefully guarding" refers to preventing changes. The term "mechanism" describes the unevenness of causes, so treatment cannot be rigid. "Category" refers to differences among the Five Zang organs, Six Fu organs, Seven Emotions, Six Qi, social status, age, constitution (deficiency/excess), disease origin (root/branch), wind from five directions, luck cycles (overcoming/rebounding), and temperament (slow/hasty). It also includes conditions like "Tuo Ying" (loss of nourishment due to falling from nobility to poverty) and "Qi Li Shou" (departure of Qi due to falling from wealth to poverty). One must examine their respective categories and manage treatment accordingly. The phrases "For what exists, investigate it; for what does not exist, investigate it" mean that upon encountering a symptom, one must examine the presence or absence of its corresponding nature. The phrases "For excess, hold it accountable; for deficiency, hold it accountable" are the main outline of this chapter, distinguishing deficiency and excess among various categories for treatment. However, extreme deficiency may resemble excess, and extreme excess may resemble deficiency, so detailed differentiation is essential. "First understand Wu Sheng" means, for example, if Wood is excessive, Metal should level it. "Unblocking blood and Qi" does not solely rely on attacking methods. Tonification may make blood and Qi flow; warming may harmonize them; clearing may regulate them; unblocking may adjust them. One must adapt to circumstances, not sticking to fixed methods to respond to infinite changes. This is the great method for treating deficiency and excess, and the key to the entire *Nei Jing*.

One sovereign herb and two minister herbs constitute the Odd (Ji) system; two sovereign and four minister herbs constitute the Even (Ou) system; two sovereign and three minister herbs constitute the Odd system; two sovereign and six minister herbs constitute the Even system (Sovereign herbs have few types but heavy doses; minister herbs have many types but light doses. Odd systems follow Yang; Even systems follow Yin). Thus it is said: Diseases near use Odd formulas; diseases far use Even formulas. Sweating does not use Even formulas; purging does not use Odd formulas (Diseases in the upper part are near, belong to Yang, so Odd formulas are used for their light and slow action. Diseases in the lower part are far, belong to Yin, so Even formulas are used for their heavy and rapid action. Sweating does not use Even formulas because Yin is deep and cannot reach the exterior. Purging does not use Odd formulas because Yang rises and cannot descend). Tonifying the upper or treating upper diseases uses slow preparations; tonifying the lower or treating lower diseases uses rapid preparations. Rapid preparations have strong flavors and odors; slow preparations have weak flavors and odors. Making the medicinal effect reach precisely where needed is called this (Upper medicines should be slow, to linger in the upper part; lower medicines should be rapid, to reach the lower Jiao directly. To be rapid, flavors and odors must be strong; to be slow, they must be weak. Proper balance of speed and strength ensures the medicine reaches the disease site, ensuring efficacy). If the disease is distant and the medicine's flavor is absorbed mid-way, control it with food intake without exceeding regulations (If the disease site is far, the medicine must pass through the Stomach. Without regulation, the medicine's effect might be consumed before reaching the disease site. Food intake serves as the limit to ensure appropriate distance. "Guo" means to reach. To keep medicine near, take it after meals so food carries it to stay upper; to send it far, take it before meals so food drives it quickly downward. Medication has speed variations, root/tip has ascending/descending properties, flavors have slow/fast effects, and formulations vary (decoction, pill, paste, powder). All must comply with rules, not exceeding limits). Therefore, the way to balance Qi is: For near diseases using Odd or Even formulas, make small doses. For far diseases using Odd or Even formulas, make large doses. Large doses have fewer ingredients; small doses have more ingredients. More than nine; less than two (Near and far diseases have Yin/Yang and Exterior/Interior distinctions, so Near and Far formulas have Odd/Even combinations. Either Odd formula with Even dosage, or Even formula with Odd dosage, this is Odd/Even interplay. Near diseases with Odd/Even formulas use small doses, small means many ingredients up to nine. Many ingredients mean light dosage, slow nature, reaching only near diseases. Far diseases with Odd/Even formulas use large doses, large means few ingredients, stopping at two. Few ingredients mean heavy dosage, focused nature, reaching far diseases directly. These are variations of Odd/Even interplay). If the Odd formula fails, use the Even formula, this is called Chong Fang (Repeated Formula). If the Even formula fails, use counter-assistance to achieve the result, meaning Cold/Hot/Warm/Cool follow the disease nature (This is a flexible method. Initially using Odd formula fails, change to Even, alternating Odd and Even is Chong Fang. Chong means repetition. If Even also fails, seek subtle truth/falsehood, use counter-assistance. Counter-assistance follows disease nature, e.g., treating Cold with Hot but Cold rejects Heat, add slight Cold to enter; treating Heat with Cold but Heat rejects Cold, add slight Hot to enter. E.g., Cold medicine taken hot, Hot medicine taken cold, all are flexible applications. Wang Taipu said: Heat opposes Cold, Cold opposes Heat. Slight Heat is overcome by Cold, slight Cold is eliminated by Heat. Great Cold and Great Heat struggle against opposing natures and repel different Qi. Thus the Sage uses counter-assistance to match Qi, making sound correspond to sound, Qi seek Qi).

Pungent and Sweet disperse and belong to Yang; Sour and Bitter induce vomiting/purging and belong to Yin; Salty induces vomiting/purging and belongs to Yin; Bland drains and belongs to Yang. These six flavors either astringe or disperse, either relax or tense, either dry or moisten, either soften or harden. Act according to their benefits, regulate Qi to achieve balance (Yong means vomit; Xie means purge; Shen Xie means promote urination. Pungent disperses/moistens; Sweet relaxes; Sour astringes/tenses; Bitter dries/hardens; Salty softens; Bland drains. Act according to benefit, Qi balances).

Cold treated with Heat; Heat treated with Cold. Minor cases treated oppositely (Ni); severe cases treated similarly (Cong) (Meaning seen above). Hardness reduced; invaders removed; exhaustion warmed; stagnation dispersed; retention attacked; dryness moistened; tension relieved; scattering gathered; loss benefited; leisure promoted; fright calmed; upper lowered; massaged/bathed; pressed/captured; opened/ventilated. Adapt to the situation (Wen means Sweet-Warm removes Great Heat; Yi means leisure. Hunger/fullness/overwork/leisure cause disease. Too much leisure stagnates Qi/Meridians, so promote movement. Shang means vomit. Mo means massage. Bo means besiege. Shi Shi Wei Gu means stop when appropriate, not too much to hurt Zheng Qi, not too little to leave Evil).

Opposite treatment is Zheng Zhi (Orthodox Treatment); Similar treatment is Fan Zhi (Reverse Treatment). Follow less or follow more, observe the case (Follow less: one similar, two opposite; Follow more: two similar, one opposite. Case refers to disease. Observe severity to determine ratio).

Heat caused by Cold usage; Cold caused by Heat usage. Blockage treated with blockage; Diarrhea treated with purgation. Subdue the master cause, address the original cause. Start same, end different. Break accumulations, dissolve hardness, harmonize Qi, ensure cure (Cold disease needs Hot, but severe Cold repels Hot, so take Hot medicine cold. This is Heat caused by Cold usage. Heat disease needs Cold, but severe Heat repels Cold, so take Cold medicine hot. This is Cold caused by Heat usage. Blockage treated with blockage: e.g., Lower Jiao Qi deficiency, Middle Jiao Qi stagnation. Dispersing fullness empties Lower further; tonifying Lower worsens Middle fullness. Not knowing root, attacking fullness first: medicine temporarily reduces, then returns, Qi emptier, disease worse. Not knowing small dose stagnates, large dose unblocks, harshly tonify Lower, Lower solidifies, Middle fullness clears. Diarrhea treated with purgation: e.g., Heat-diarrhea or Cold-diarrhea. Cold treated with Hot purgation, Heat treated with Cold purgation. Subduing master cause addresses root. Addressing original cause seeks etiology. Start same (Orthodox), End different (Reverse). Understanding Reverse Treatment cures all diseases).

Treatments with Cold that increase Heat: seek Yin. Treatments with Heat that increase Cold: seek Yang. This is seeking the category (Using Cold medicine for Heat disease increases Heat: not Fire excess, but Yin deficiency. Yin deficiency leads to Fire hyperactivity, so tonify Yin, Yang retreats. Using Hot medicine for Cold disease increases Cold: not Cold excess, but Yang deficiency. Yang deficiency leads to Yin Cold, so tonify Yang, warm Water-Fire, Cold dissipates. Seeking category means seeking root. Water and Fire sought in Kidney. Wang Taipu said: Enlarge Fire source to eliminate Yin shadow; Strengthen Water lord to control Sun brightness. Liu Wei Di Huang Wan and Ba Wei Di Huang Wan are examples).

Five Flavors enter Stomach, return to preferred organs. Sour enters Liver first; Bitter enters Heart first; Sweet enters Spleen first; Pungent enters Lung first; Salty enters Kidney first. Long-term use increases Qi, normal transformation. Increased Qi over time causes premature death (Increasing Qi aids its organ. E.g., Huanglian bitter enters Heart clears Fire, long-term use aids Heart Fire. Five flavors return to meridians, long-term use increases Qi, increased Qi leads to death, be cautious).

*Yin Yang Ying Xiang Da Lun* states: Lightness dispersed; heaviness reduced; decline manifested (Light in Exterior, disperse; Heavy in Interior, reduce/purge; Decline not tonified remains hidden, tonification restores life, hence "manifest"). Form deficiency warmed by Qi; Essence deficiency supplemented by Flavor (Method of manifestation. Yang Qi decline forms deficiency, warm with Qi restores form. Yin Marrow depletion essence deficiency, supplement with Flavor restores essence). High location, induce vomiting; Low location, drain thoroughly (High: Upper Jiao disease. Yong: vomit, push out high. Low: Lower Jiao disease. Jie: drain down, guide fluids down, promote urination/defecation. Or Yun: honey/gall bladder suppositories. Jie: Cheng Qi Tang, Di Dang Tang). Middle fullness, purge internally (Middle fullness not Qi deficiency, e.g., distension with fluid/stasis, Cold Damage chest binding constipation. Nei corresponds to Zhong). With Evil, soak body to sweat (Zi: soak, e.g., peach branch bath, decoction fumigation. Or exterior Evil heavy, medicine ineffective sweating, or winter cold, dispersion useless, soaking necessary). Skin level, sweat and release (Skin Evil shallow, meridian-specific sweating suffices). Fierce Evil, press and astringe (Han: urgent. Feng: fierce, anger injuring Liver. An: suppress, sour-astringent like Shaoyao). Excess, disperse and purge (Yin Excess: Ding, Jiang, Gui, Fu disperse Cold. Yang Excess: Qin, Lian, Zhi, Bai purge Fire). Examine Yin/Yang, distinguish Soft/Hard (Examine disease Yin/Yang, apply medicine Soft/Hard). Yang disease treat Yin; Yin disease treat Yang (Yang excess injures Yin, treat Yin water lord; Yin excess injures Yang, treat Yang water-fire). Stabilize Blood/Qi, keep in place (Blood/Qi treatment distinct, do not confuse). Blood excess, decant (Guide down like draining river). Qi deficiency, pull and guide (Lift up like pulling object).

*Wu Chang Zheng Ji Da Lun* states: Disease old/new, formula big/small, drug toxic/non-toxic, standard rules apply (Old disease big dose; new disease small dose. Non-toxic many use; toxic few use). Great toxicity treat disease, remove 60%; common toxicity remove 70%; slight toxicity remove 80%; non-toxic remove 90% (Insufficient medicine no cure; excessive medicine hurts Zheng Qi. Great toxicity remove 60%, stop. Light toxicity bearable, non-toxic long-term). Grains/meat/fruits/vegetables, diet nutrition finishes it, do not exceed, hurt Zheng Qi (Residual evil cleared by diet nutrition. Excessive medicine hurts Zheng Qi). First consider annual Qi, do not violate Heaven Harmony (Five Lucks ordered, Six Qi regular, Four Seasons commands, Yin/Yang rhythm, all Annual Qi. Human Qi responds growth/storage, this Heaven Harmony. Ignorance violates Annual Qi, harms Heaven Harmony).

*Liu Yuan Zheng Ji Da Lun* Yellow Emperor asks: Pregnant woman, how to use toxic drugs? Qibo says: With cause, no injury, no injury either (Pregnancy Chong Shen. Du Zhi use toxic drugs. Gu cause, e.g., large accumulation. Have cause use drug, disease bears drug, pregnant woman safe, fetus safe). Emperor asks reason. Qibo says: Large accumulation, can invade, reduce majority then stop (Large accumulation needs toxic drugs, but reduce majority then stop, same as Great toxicity remove 60%).

My commentary: Treatment rules recorded in classics, flexible application comes from heart. Following map loses horse, order reverses, errors occur. Mencius says: Craftsmen give rules, not skill. Measure Yin/Yang, Odd/Extraordinary, decide at Ming Tang, examine start/end, skilled in rules.