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The *Ling Shu* (Spiritual Pivot) states: The blood, qi, and spirit of a person are what sustain life and circulate throughout one's vital existence. The meridians (Jing Mai) are what transport blood and qi, nourish yin and yang, moisten the sinews and bones, and facilitate the smooth movement of joints. The Wei Qi (Defensive Qi) is what warms the muscles, fills the skin, thickens the interstices (Cou Li), and controls the opening and closing of pores. The Zhi Yi (Will and Intent) is what governs the spirit, gathers the soul and hun, adapts to cold and heat, and harmonizes joy and anger. Therefore, when blood and qi are harmonious, the meridians flow smoothly, Ying Qi (Nutritive Qi) returns to balance yin and yang, the sinews and bones become strong, and the joints move freely. When Wei Qi is harmonious, the muscles are supple, the skin is soft, and the interstices are dense. When Will and Intent are harmonious, the spirit is focused and upright, the hun and po do not scatter, regret and anger do not arise, and the five zang organs are not invaded by pathogenic factors. When cold and heat are appropriate, the six fu organs digest food and drink, wind-bi does not occur, the meridians are unobstructed, and the limbs and joints are at peace. Thus, deficiency and excess are the root of all diseases. Tonification and purgation are the guiding principles of treatment. The Classics state: Where pathogenic factors gather, healthy qi must be deficient. Whenever "deficiency" is mentioned, it refers to the depletion of essence and qi; whenever "excess" is mentioned, it refers to the predominance of pathogenic factors. Therefore, deficiency leads to susceptibility to pathogens, and the presence of pathogens manifests as excess. The Classics state: "When pathogenic factors are abundant, there is excess; when essence and qi are depleted, there is deficiency." This is the meaning. If pathogenic factors outweigh the root, then purgation serves as tonification, which is tonification within purgation. If the root outweighs pathogenic factors, then tonification serves as purgation, which is purgation within tonification. Furthermore, ascending and descending are the key summaries of disease mechanisms. Ascending corresponds to Spring Qi, Wind transformation, and the Wood image; thus, ascending has the meaning of dispersing. Descending corresponds to Autumn Qi, Dryness transformation, and the Metal image; thus, descending has the meaning of gathering. For example, if dietary irregularities and overwork cause Yang Qi to sink, one should use methods to raise Yang and benefit Qi; if diarrhea persists, one should raise Yang and benefit the Stomach; if constrained Fire is hidden internally, one should raise Yang to scatter Fire. For profuse diarrhea due to Dampness, directly using methods to raise Yang and remove Dampness is indicated; these cases require ascending methods. If Yin deficiency means Water is insufficient to control Fire, and Fire flares upward in emptiness, the symptoms include cough with much phlegm, hematemesis, epistaxis, headache, toothache, bitter taste, dry tongue, bone-steaming tidal fever, which is called the syndrome of Upper Heat and Lower Deficiency. One should use herbs such as Maidong (Ophiopogonis Radix), Beimu (Fritillariae Bulbus), Pipaye (Loquat Leaf), Baishao (Paeoniae Radix Alba), Niuxi (Achyranthis Bidentatae Radix), and Wuweizi (Schisandrae Fructus) to direct Qi downward. When Qi descends, Fire naturally descends, and Qi returns to its origin. Further supplementing with herbs that nourish Water and replenish Essence to save the root will cure the symptoms; these cases require descending methods. There is also the method of "treating obstruction with obstruction," such as abdominal distension due to Spleen deficiency in the Middle Jiao, or Qi failing to return to its source due to Kidney deficiency, leading to fullness and rebellion in the Upper Jiao. Using the sweet nature of Renshen (Ginseng Radix et Rhizoma) to tonify Yuan Qi, and the sour nature of Wuweizi (Schisandrae Fructus) to gather deficient Qi, allows the Spleen to transform and transport normally, resolving distension, and the Kidney to store and consolidate, allowing Qi to return, clearing the Upper Jiao, and calming rebellion. There is also the method of "treating patency with patency," such as dysentery with heat due to Cold Damage, or dry feces in the intestines, where Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) must be used to purge for relief. Or persistent dysentery due to Summerheat, which heals with Liuyi San (Six-to-One Powder) to clear heat and remove accumulation. However, treating cold with hot herbs and treating heat with cold herbs is the Direct Treatment (Zheng Zhi). Treating heat disease with hot herbs or cold disease with cold herbs is the Contrary Treatment (Cong Zhi). Because different sounds do not resonate, and different energies do not combine, diseases of extreme cold or heat inevitably resist contrary energies. A skilled practitioner reverses the assistant herbs to match the energy, mixing cold and heat so that they initially appear similar but ultimately differ. If heat is below but cold pathogen rejects from above, add hot herbs as assistants to cold herbs. The *Nei Jing* states: To regulate the reversal of cold and heat, cold and hot energies must proceed together; thus, hot herbs taken cold, after passing the diaphragm, lose their cold nature, and their hot nature activates. If cold is above but floating fire rejects from above, add cold herbs as assistants to hot herbs; after passing the diaphragm, the hot nature dissipates, and the cold nature activates. This avoids emotional resistance while achieving great benefit, curing the disease, and eliminating vomiting and irritability. This is called "treating cold with hot usage" and "treating heat with cold usage," making same sounds resonate easily and same energies combine easily, avoiding rejection. The Classics state: "First determine the primary focus, then subdue the cause." It is like extinguishing fire in water can be done by smothering with dampness or quenching with water. Minor illnesses are similar. Major illnesses are like the fire of dragons and thunder; encountering dampness makes flames rise, encountering water increases burning, but under the sun, the fire self-extinguishes. This is the ultimate truth. When using hot herbs, avoid hot seasons; this is because the disease originates in cold, requiring hot treatment, but the administered hot formula should only hit the target without overdose, for overdose causes heat disease. When using cold herbs, avoid cold seasons; this is because the disease originates in heat, requiring cold treatment, but the administered cold formula should only hit the target without overdose, for overdose causes cold disease. Therefore, to nourish Yin, stay away from bitter-cold herbs to avoid damaging Stomach Qi; to benefit Yang, stay away from acrid-dispersing herbs to avoid leaking Qi; dispelling wind should not be overly drying; clearing summerheat should not lightly use purgation; postpartum conditions forbid cold-cooling herbs; dysentery forbids astringent herbs. However, the Qi of the four seasons of heaven and earth moves within the six directions. Humans reside in the intersection of Qi and must be affected by it. Spring Qi generates and ascends; Summer Qi grows and disperses; Late Summer Qi transforms and softens; Autumn Qi gathers and condenses; Winter Qi stores and sinks. Human Qi naturally connects; generating follows it, growing spreads it, transforming solidifies it, gathering肃ly acts on it, storing consolidates it. This is medicine following Heaven. In warm springs and hot summers, Yuan Qi leaks outward, and Yin Essence is insufficient, so medicine should nourish Yin. In cool autumns and cold winters, Yang Qi hides inward, do not lightly open up, so medicine should nourish Yang. This is medicine adapting to seasons, tonifying insufficiently to harmonize Qi. Having warned against violating Heavenly Harmony, one must also prevent excess, embodying the great virtue of Heaven and Earth. Ignorant people abandon the root for the branch: using acrid-cool in Spring to attack Liver, salty-cold in Summer to suppress Fire, bitter-warm in Autumn to drain Metal, acrid-hot in Winter to dry Water, calling them seasonal medicines. This completely loses the principle of the *Nei Jing* regarding counteracting sages. Summer contains hidden Yin, Winter contains hidden Yang, which can be inferred. However, within one Qi phase, beginning and end are similar; within one day, cold and warmth differ greatly. There are times of abnormality and deviation: during extreme heat, one may contract cold syndromes; during extreme cold, one may contract heat syndromes. If syndrome outweighs season, abandon season for syndrome; if season outweighs syndrome, abandon syndrome for season. Excess of the Six Qi becomes Six Pathogens (Liu Yin); Six Pathogens causing disease become external diseases, as Heaven's Qi enters from outside. Seven Emotions moving internally become internal diseases, as Human Qi rises from within. This is the major method of weighing and treating with medicine, the constant law observed for ten thousand generations, which even if sages rose again, could not change. However, those with constitutionally biased Yin or Yang should follow treatments beyond the norm. For example, if constitutionally Yin-deficient, even in deep winter, if Yin Essence is exhausted, Water is insufficient to control Fire, Yang has no basis, leaks outward as heat, or sweats excessively, medicine should nourish Yin. If following the season, mistakenly using acrid-warm herbs will surely cause immediate death. If constitutionally Yang-deficient, even in midsummer, if Yang Qi is insufficient, it cannot defend the exterior, exterior deficiency cannot withstand wind-cold, shivering and trembling occur, craving hot food and heavy furs, although the weather is hot, it is insufficient to counter true Yang deficiency. The disease is deficiency-cold, medicine should warm and tonify. If following the season, mistakenly using bitter-cold herbs will surely cause immediate death. Thus, the subtlety of flexible adaptation lies in the individual. Humans are born receiving the Yin and Yang Qi of Heaven and Earth, and strength/weakness depends on the Luck of Heaven and Earth. When Heaven and Earth first opened, Qi was dense, so received Qi was strong; as time passed, Qi became thin, so received Qi became weak. Thus, ancient people lived past a hundred years; now seventy is considered rare. As the Qi of Heaven and Earth thins, humans weaken accordingly, reducing longevity and spirit, and thus blood, qi, and zang-fu organs decline. Therefore, medication adjustments must gradually change, not sticking rigidly to ancient methods or lightly using harsh agents. Moreover, in late eras, competition deepens, damage and destruction are hard to resolve, Yuan Qi becomes thin, diseases multiply, deficiency is common, excess is rare. In clinical practice, one must guard against attacking agents, favor warming and tonifying, strictly forbid cold-cooling, reduce the use of Didang Tang (Attacking Blood Decoction) and Chengqi Tang (Directing Downward Decoctions), and increase the use of Buzhong Yiqi Tang (Tonify the Middle and Benefit Qi Decoction) and Guipi Tang (Restore the Spleen Decoction). This is the urgent task of current treatment methods. If a disease requires hot herbs, start with warm ones; if it requires cold herbs, start with clearing ones. Even if stagnation needs resolving, first nourish Stomach Qi; even if pathogens need expelling, disperse them timely, do not overdose to damage blood and qi. Blood and qi are what humans rely on for life. When blood and qi are abundant, hundred pathogens are repelled externally, how can disease arise? When blood and qi are deficient, all pathogens converge, hundred diseases grow. Nine out of ten diseases of the world are deficiency, yet among physicians' prescriptions, hardly one is tonifying. How can they know that one error in medication turns excess into deficiency, and deficiency into death? They die from medicine, not from disease. Moreover, ancient formulators had the clear insight of a mirror and the earnest heart of saving lives. With a specific disease, they prescribed specific herbs, using large dosages but few ingredients, like elite troops taking one route, sufficient to break fortifications and capture kings. Later generations, lacking the insight of former sages, merely wandering in worldly hesitation, reduced dosages but increased ingredients, like setting broad attacks hoping for a chance encounter. Alas! Although technique is rough, the heart is more bitter. Since categories are numerous, attacks must be mixed. Mild diseases may heal through procrastination, but how can severe diseases be cured by chance! Although some herbs have powerful effects, they ultimately belong to the flowers of grass and trees. They must rely on human Zheng Qi (Upright Qi) for support. Without proper operation of the formula, efficacy is not achieved. If Zhong Qi (Middle Qi) is extremely deficient, even administering Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma) cannot rapidly purge. If Ying Yin (Nutritive Yin) is withered, even administering Qianghuo (Notopterygii Rhizoma et Radix) and Mahuang (Ephedrae Herba) cannot induce sweat. If Yuan Yang (Yuan Yang) is exhausted, even administering hot herbs feels no heat. If True Yin is consumed to the extreme, even administering cold herbs feels no cold. If Zheng Qi is severely injured, even administering tonifying herbs feels no tonification. Unless the physician has firm, unwavering vision, and the patient focuses single-mindedly, how can daily progress and success be achieved?