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This refers to the positional relationships of the Zang and Fu organs. The Heart and Lung are located proximally (closer to the surface/exterior), while the Liver and Kidney are located distally (further from the surface/exterior); the Spleen and Stomach reside in the center. The Three Yang meridians (Taiyang, Yangming, Shaoyang) and the Gallbladder also have proximal and distal distinctions: the upper third of the body is considered proximal, and the lower two-thirds are considered distal. (If the physician's insight is profound and their adaptation appropriate, then when the prescription formula has an odd number of ingredients, the dosage ratio should be even; when the formula has an even number of ingredients, the dosage ratio should be odd. In this manner, for proximal conditions, use an even-numbered formula and administer it frequently; for distal conditions, use an odd-numbered formula and administer it sparingly. Hence it is said: small formulas have many ingredients, large formulas have few ingredients.) If the odd-numbered formula fails to cure, employ an even-numbered formula; this is called a "Chong Fang" (Repeated/Complex Formula). If the even-numbered formula also fails, employ a counter-assistance method (Fan Zuo) to achieve the cure; this is what is meant by cold, heat, warmth, and coolness following the nature of the disease. (In prescribing, it is better to use mild drugs than heavy ones, non-toxic drugs rather than toxic ones, and small dosages rather than large ones. Therefore, if the odd formula does not dispel the pathogen and the even formula leaves the disease present, reverse the approach by assisting with drugs that share the same qi as the disease to capture it. Heat opposes cold, and cold contradicts heat. Minor heat can be subdued by cold herbs; minor cold can be eliminated by heat herbs. However, extreme cold or heat will inevitably contend with drugs that contradict their nature and resist opposing qi. Just as different sounds do not resonate and different qi do not combine, physicians may hesitate to attack. If attacked, the pathogenic qi and medicinal qi will clash, leading to self-imposed closure and retention of cold or heat. Thus, the Sages act in reverse to align the qi, causing resonance and combination, allowing cold and heat to intermingle so that they eventually transform from opposition to unity, softening hardness and breaking rigidity. This discusses the principles of formulating prescriptions, which do not depart from odd and even numbers but must exhaustively master their systems.)

Jun (Emperor) herb: 1, Chen (Minister) herbs: 3, Zuo (Assistant) herbs: 9; this is the system of a Large Formula. For distal conditions with mixed odd/even ingredient counts, increase the dosage. Large formulas have few ingredients; few means doubling. The Liver and Kidney are distal; decoctions and powders should be taken frequently and in larger amounts.
Jun herb: 1, Chen herbs: 2; this is the system of a Small Formula. For proximal conditions with mixed odd/even ingredient counts, decrease the dosage. Small formulas have many ingredients; many means multiplying by nine. The Heart and Lung are proximal; decoctions and powders should be taken frequently but in smaller amounts.
Huan (Slow): Tonifying the Upper Jiao or treating upper body diseases requires slow-acting formulas. Slow action results in thin scent and flavor; treating the primary condition slowly addresses the Root (Ben).
Ji (Urgent): Tonifying the Lower Jiao or treating lower body diseases requires urgent/fast-acting formulas. Urgent action results in thick scent and flavor; treating secondary/exogenous conditions urgently addresses the Branch (Biao).
Qi (Odd): Jun 1, Chen 2 is an odd-numbered formula. Jun 2, Chen 3 is also an odd-numbered formula. Yang numbers are odd.
Ou (Even): Jun 2, Chen 4 is an even-numbered formula. Jun 2, Chen 6 is also an even-numbered formula. Yin numbers are even.
Fu (Return/Repeat): If the odd formula fails, use the even formula; this is called a Chong Fang (Complex Formula).

Therefore, the onset of hundred diseases arises from the Root (Ben), from the Branch (Biao), from both Root and Branch, from treating the Root alone, from treating the Branch alone, from treating the Middle Qi, from treating both Root and Branch, from contrary treatment (Ni Qu), and from following treatment (Cong Qu). (Counter-assistance is called Ni Qu [Contrary Treatment]. Using odd/even formulas is called Cong Qu [Following Treatment]. Treating cold disease with cold herbs and heat disease with heat herbs is called Ni Qu. Cong means following/compliance.)
Ni (Contrary) is actually Zheng Shun (Correct Compliance). If one follows, it is Ni (Contrary). (When severe cold repels yang, treating the apparent heat with heat; when severe heat repels yin, treating the apparent cold with cold—these are all termed "Ni" at the time. Although externally using contrary methods, internally it is compliant. This Ni is correct compliance. If cold repels yang but is treated with cold, or heat repels cold but is treated with heat, although externally compliant, the Middle Qi becomes obstructed. Thus, a formula that seems compliant is actually contrary.) Hence it is said: Knowing the Branch and Root, one uses them without peril; clearly understanding Contrary and Following, one walks the right path without doubt. Not knowing these is insufficient for diagnosis and sufficient to disrupt the Classics. Crude practitioners laugh, thinking they know, saying heat diseases are not yet resolved, then cold diseases arise; confusing similar qi with different forms, they misdiagnose and disrupt the meridians. (The application of the Six Qi, crude practitioners and skilled practitioners only grasp half. The transformation of Jueyin, crude practitioners think is cold, but it is actually warm; the transformation of Taiyang, crude practitioners think is heat, but it is actually cold. Comparing these mutually, their usage loses the Way, so their learning and application do not reach half the skill of a practitioner. The Root and Branch of each meridian differ in cold and heat; speech ought to investigate the Branch, discussing the Branch should seek the Root. Speaking of Qi without exhausting Root and Branch, discussing disease without distinguishing Yin and Yang, the mind is confused about the correct principle, and treatment further disrupts the meridians; such people are called crude practitioners.) The Way of Root and Branch is concise yet comprehensive, small yet great; one can speak of one and know ten, understanding the harm of disease. Speaking of Branch and Root is easy and non-damaging; observing Root and Branch allows Qi to be regulated, clearly understanding Overcoming and Repaying. This serves as a model for all people. (This states that each of the Six Qi has its own Root and Branch, and all hundred diseases should understand Root and Branch.)

I wish to hear about the Pathogenesis (Bing Ji). All wind syndromes involving tremors and dizziness belong to the Liver. (Wind nature is movement, Wood Qi is similar.) All cold syndromes involving contraction and pulling belong to the Kidney. (Contraction means gathering; pulling means urgency. Cold substances contract, Water Qi is similar.) All Qi stagnation and fullness belong to the Lung. (High autumn air is cool, dew and smoke gather; when coolness arrives, Qi becomes hot, and if severe, Qi is exhausted. Observing material phenomena, this belongs to the Lung. Man denotes fullness; Yu denotes rushing pressure. The function of Qi is similar to Metal Qi.) All damp syndromes involving swelling belong to the Spleen. (Thin earth implies shallow water, thick earth implies deep water, flat earth is dry, high earth is wet; the presence of dampness is similar to Earth Qi.) All heat syndromes involving stupor and convulsions belong to Fire. (Fire symbolizes brightness.) All pain, itching, and sores belong to the Heart. (When the Heart is quiet, disease is mild; when agitated, pain is severe. All beginnings arise from the Heart; pain, itching, and sores originate from the Heart.) All Jue (reversal) syndromes, constipation, and diarrhea belong to the Lower Jiao. (Lower refers to the Lower Jiao, Liver and Kidney. Guarding the lower is the Qi of the Kidney. The gate and key are the Qi of the Liver. Thus, all Jue, constipation, and diarrhea belong to the Lower Jiao. Jue involves reversed Qi strength. Gu means confinement. All upward reversing Qi, inability to control excretion, irregular entry and exit, and unstable dryness and moisture are due to the guardianship of the Lower Jiao.) All Wei (withering) syndromes, wheezing, and vomiting belong to the Upper Jiao. (Upper refers to the Upper Jiao, Heart and Lung Qi. Scorching heat is the Qi of the Heart; transforming heat is the Qi of the Lung. Heat stagnates in the upper, so disease affects the Upper Jiao. These are all internal pathogenesis of the Five Zang organs.) All muteness, shivering, and loss of spiritual control belong to Fire. (Internal production of heat.) All spasms and neck stiffness belong to Dampness. (Taiyang damaged by dampness.) All rebellious Qi rushing upward belong to Fire. (The nature and function of rising flame.) All distension and abdominal enlargement belong to Heat. (Heat stagnates internally, generating Lung distension.) All sudden dryness, mania, and deviation belong to Fire. (Heat is excessive in the Stomach and four extremities.) All sudden rigidity and straightening belong to Wind. (Yang is depressed internally, Yin moves externally.) All diseases with sounds, drum-like upon percussion, belong to Heat. (Refers to audible sounds.) All diseases involving swelling, pain, soreness, and fright belong to Fire. (Excess of various Qi.) All twisting and turning, with turbid fluids, belong to Heat. (Fan Li refers to tendon twisting; Shui Ye refers to urine.) All diseases involving clear and cold fluids belong to Cold. (Discharge from above and below, including vomiting and urination.) All vomiting of sour fluid, sudden diarrhea with tenesmus belong to Heat. (Suan refers to sour fluid and foam. These are pathogens of the Twelve Meridians, with pathogenesis entering from outside.)

Thus, the *Da Yao* says: Carefully observe the pathogenesis, assign each to its category; seek those that exist, seek those that do not; hold responsible those that are excess, hold responsible those that are deficiency. First determine the five overcomings, unblock the blood and Qi, make them smooth and reaching, until peace is achieved; this is called it. (Profound is the words of the Sages. Seeking existence/non-existence, holding responsibility for excess/deficiency: if severe cold is not warmed by heat therapy, there is no Fire; if heat returns after leaving, appearing by day and hiding by night, acting seasonally, there is no Fire, one should assist Fire. If severe heat is not cooled by cold therapy, there is no Water; if heat moves and stops suddenly, appearing and disappearing intermittently, there is no Water, one should assist Water. Internal rejection with vomiting and inability to eat indicates Fire. Vomiting and regurgitating food after eating indicates no Fire. If cold is not cooled, blame lack of Water; if heat is not warmed, blame lack of Fire. If warming lasts briefly, blame Heart deficiency; if cooling lasts briefly, blame Kidney insufficiency. Excess is drained, deficiency is tonified; empty is filled, full is emptied. Let upper and lower be unobstructed, blood and Qi flow smoothly, then cold and heat harmonize naturally, and Yin and Yang regulate. This discusses pathogenesis, listing nineteen points regarding the method of good treatment.)

I wish to discuss the formulation system. Jun 1, Chen 2 is a Small Formula; Jun 1, Chen 3, Zuo 5 is a Medium Formula; Jun 1, Chen 3, Zuo 9 is a Large Formula. Cold is treated with Heat, Heat is treated with Cold; minor cases are treated contrarily (Ni), severe cases are treated following (Cong). (Minor diseases are like human fire; encountering grass ignites it, encountering wood burns it; it can be subdued by wetness, extinguished by water. Thus, contrary to its nature, it is broken and attacked. Severe diseases are like dragon fire; encountering grass flames, encountering water burns; not knowing its nature, attacking with water/wetness only makes the flame reach the sky, stopping only when materials are exhausted. Those who know its nature follow the abnormal principle: chasing it with fire causes the burning to self-extinguish and the flame to be quenched. Ni (Contrary) means attacking heat with cold, and cold with heat. Cong (Following) means attacking with cold/heat that follows its nature. Hence the formula says: Contrary is Zheng Zhi (Orthodox Treatment), Following is Fan Zhi (Reverse Treatment); follow more or less, observing the situation.) Hardness is reduced, invaders are removed, exhaustion is warmed, knots are scattered, retention is attacked, dryness is moistened, urgency is eased, scattering is gathered, damage is benefited, idleness is moved, fright is calmed, upper is lowered, lower is raised, massaged, bathed, pressed, seized, opened, developed; adapting to the matter is the goal. (Measure the syndrome, adapt to the matter.) The Emperor asked: What are Ni and Cong? The Yellow Emperor replied: Ni is Zheng Zhi (Orthodox Treatment), Cong is Fan Zhi (Reverse Treatment); follow less or more, observing the situation. (Speaking of Ni is Orthodox Treatment. Speaking of Cong is Reverse Treatment. Contrary to pathogenic Qi for Orthodox Treatment means attacking heat with cold, cold with heat; although seemingly following pathogenic Qi, it is actually Reverse Treatment.) The Emperor asked: What is Fan Zhi? The Yellow Emperor replied: Heat used with Cold, Cold used with Heat, Obstruction treated with Obstruction, Flow treated with Flow; one must subdue the master cause and first address the origin. Initially they are the same, finally they are different; this can break accumulations, dissolve hardness, harmonize Qi, and ensure cure. (Heat used with Heat: hot substances taken cold; after swallowing, the cold nature disappears, and the hot nature emerges. Cold used with Heat: cold substances taken hot. Middle fullness with Lower deficiency: open the middle, tonify severely at the lower. Small doses cause congestion, large doses promote circulation; thus middle fullness removes itself, lower deficiency becomes solid; this is Obstruction treated with Obstruction. Also, severe internal heat binding with continuous diarrhea: heat should be treated with cold, but binding must be removed; using cold purgatives disperses binding and stops diarrhea; this is Flow treated with Flow. Administer cold with heat, cool and proceed; administer heat with cold, warm and proceed. Initially same, finally different; this is called it.) Contrary and Following, Contrary then Following, Following then Contrary; unblocking Qi to make it regulated is the Way. (Ni means contrary to pathogenic Qi for orthodox treatment. Cong means following pathogenic Qi for reverse treatment. Contrary to Qi for orthodox treatment makes it compliant; following disease for reverse capture makes it harmonized, hence Ni and Cong. Below, unblock Qi, let pathways open, then Qi responds to cold/heat and transforms.)

How are diseases internal and external? From internal to external, regulate the internal; from external to internal, treat the external. (Cut off each source.) From internal to external, flourishing externally, first regulate internal, then treat external; from external to internal, flourishing internally, first treat external, then regulate internal. (All mean removing the root first.) If internal and external do not affect each other, treat the main disease. (Internal and external not affecting each other means separate diseases. This discusses three methods for treating exterior-interior patients: having Root/Branch, having sequence, and having main focus.) Treat cold with heat, treat heat with cold; regions cannot abandon the plumb line and change their way. If there is a heat patient, cooled but still hot; if there is a cold patient, warmed but still cold; both exist, new diseases arise again, how to treat? (Meaning treatment fails to resolve disease, instead generating cold/heat due to drug properties, creating new diseases.) The Yellow Emperor replied: All cases where cooling increases heat should be taken from Yin; cases where warming increases cold should be taken from Yang; this is called seeking the affiliation. (Meaning benefiting the source of Fire to eliminate Yin shadows, strengthening the master of Water to control Yang sunlight, hence called seeking affiliation. Crude practitioners are biased and shallow, attacking cold with heat, treating heat with cold; before heat treatment ends, cold illness arises; as cold attack deepens, heat disease rises again. With heat rising, middle cold remains; with cold generating, external heat does not remove. Wanting to attack cold, both become hot and halt; wanting to treat heat, thinking of cold, one stops. Advancing and retreating in battle, danger reaches extremes. How could they know the source of Zang-Fu has masters of cold, heat, warmth, and coolness! Taking the Heart need not uniformly use heat; taking the Kidney need not uniformly use cold. But benefiting Heart Yang, cold also circulates; strengthening Kidney Yin, heat is also acceptable. Or treating heat with heat, cold with cold, ten thousand attempts ten thousand complete.) The Emperor asked: Taking cold but becoming hotter, taking heat but becoming colder, what is the reason? The Yellow Emperor replied: Treating the Wang Qi (Dominant Qi), therefore it reverses. (Objects have cold/heat, Qi nature has Yin/Yang. Touching Wang Qi strengthens its function. Liver Qi is mild/warm, Heart Qi is summer-hot, Lung Qi is cool/clear, Kidney Qi is cold/chilly, Spleen Qi combines them. Thus spring using clear to treat Liver reverses to warm; summer using cold to treat Heart reverses to hot; autumn using warm to treat Lung reverses to clear; winter using heat to treat Kidney reverses to cold. This is because supplementing Wang Qi is too excessive; supplementing Wang excessively causes excessive cold/heat Qi in the Zang.)

The Five Flavors enter the Stomach, each returning to its preference; thus 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; this is the constant of material transformation. Increased Qi lasting long is the cause of premature death. (Entering Liver is Warm, entering Heart is Hot, entering Lung is Clear, entering Kidney is Cold, entering Spleen is Supreme Yin combining four Qi. All increase their flavor to benefit Qi, thus each follows the Qi function of its own Zang. Thus long-term Coptis and Sophora consumption reverses to heat; this is the category, others are similar. Only human intention is negligent and cannot carefully monitor. Hence long-term use increases Qi, constant of material transformation. Qi increasing endlessly, Zang Qi becomes biased excess, Zang has biased extinction, then there is sudden death; hence increased Qi lasting long is the cause of premature death. Therefore taking hundred medicines, lacking five flavors, borrowing four Qi, and taking long-term, although initially beneficial, long-term leads to sudden death. This is called it. Fasting from grains and taking medicine avoids sudden death; why? No grain flavor assistance. Returning to eating grains, one also dies prematurely.) Methods for regulating Qi must distinguish Yin and Yang, determine internal/external, each guard their territory; internal treated internally, external treated externally; minor cases regulated, next level balanced, excess cases captured, sweating or purging; cold, heat, warmth, coolness, decline by affiliation, following what is beneficial. (Disease has internal/external, treatment has exterior/interior. Internal treated with internal methods, external treated with external methods; next, large cases balanced with Qi-leveling methods; excess extremely unyielding, capture Qi to make it decline. Suppose small cold Qi, warm to harmonize; large cold Qi, heat to capture; severe cold Qi, purge downward. Purge unyielding, reverse to suppress; suppression incomplete, seek affiliation to decline. Small heat Qi, cool to harmonize; large heat Qi, cold to capture; severe heat Qi, sweat to release. Release unyielding, reverse to control; control incomplete, seek affiliation to decline. Hence: sweat/purge, cold/heat/warmth/coolness, decline by affiliation, following what is beneficial. You means 'what'.) Strictly follow the Way according to method, ten thousand attempts ten thousand complete, blood and Qi correctly peaceful, long possessing heavenly mandate. (Guarding the Way to act, every move hits the mark, thus able to command herbs and stones, summon spirits, blood and Qi maintain peaceful state, true nature not exhausted.)