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(The previous discussion addressed conforming to contemporary trends without excessive adherence, recording methods that could be temporarily adopted to establish principles for superficial diseases. I subsequently continued this discourse, drawing inspiration from the two phrases in the *Neijing* (Classic of Internal Medicine): "For exhaustion, use warmth; for deficiency, use warmth." This led me to a state of versatile mastery, achieving effects as swiftly as shadows and echoes. As for conditions such as phlegm-fluid retention (Tan Yin), cough, palpitations (Zheng Chong), insomnia (Bu Mei), and irregular menstruation in women, these are symptoms inevitably present in consumptive disease (Xu Lao). They have been detailed in their respective sections and need not be repeated here; readers should refer to them.)

In the Song and Yuan dynasties, various physicians classified consumptive disease (Xu Lao) with numerous subtypes and names, creating chaos without order, akin to trying to untangle silk threads only to make them more knotted. Zhu Danxi had his own insights, specifically advocating for nourishing Yin. He utilized Siwu Tang (Four Substances Decoction) supplemented with herbs such as Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma). Later generations criticized this approach. In the Ming Dynasty, Xue Lizhai emerged, employing formulas such as Liu Junzi Tang (Six Gentlemen Decoction), Sijunzi Tang (Four Gentlemen Decoction), Guipi Tang (Restore the Spleen Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), alternating them with Liuwei Wan (Six-Ingredient Pill with Rehmannia), Bawei Wan (Eight-Ingredient Pill), and Yangrong Tang (Nourish the Blood Decoction). He invariably framed his arguments around the concepts of Congenital Constitution (Xian Tian) and Acquired Constitution (Hou Tian). Although his approach was superior to others, it essentially opened a door for later practitioners to seek convenience. When Zhang Jingyue appeared, he exclusively followed Xue’s emphasis on the Congenital Constitution but further divided it into Primordial Yin (Yuan Yin) and Primordial Yang (Yuan Yang). He established formulas such as Zuogui Yin (Left Restoring Drink), Zuogui Wan (Left Restoring Pill), and Dabu Yuanjian (Great Tonification of the Origin Decoction). His method consisted solely of tonification without purgation, claiming expertise. Although his discussions distinguished between Qi deficiency and Essence deficiency, his main thesis posited that Qi transforms into Water and Water transforms into Qi, with Yin and Yang rooting each other. Consequently, he did not differentiate much among formulas, universally including Shudi (Prepared Rehmanniae Radix) in every prescription and applying it to every disease. Thus, within the realm of simplicity, he opened an even simpler path. Furthermore, someone wrote in *Yaoxing* (Properties of Medicinals): "Rehmannia grows in the fertile lands of the Central Plains; its color is yellow and taste sweet. If one says it is not a primary herb for the Spleen and Stomach, I do not believe it." With this assertion, the sacred teachings of the *Shennong Bencao Jing* (Divine Farmer's Materia Medica) and *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) were completely disregarded. Xue Lizhai authored twenty-four works in total; I cannot critique every flaw. However, observing the disease origins he cited in his case records, they were mostly subjective speculations, rarely elucidating the unspoken secrets of the *Lingshu* (Spiritual Pivot) and *Suwen* (Basic Questions). The methods he employed relied on no more than twenty formulas, with chaotic modifications that failed to grasp the subtle properties described in the *Bencao Jing*. The contemporary scholar Xu Lingtai labeled him the head of quack doctors, which was an expression of justified indignation. Even Zhang Jingyue’s extensive writings on Yin and Yang deficiency were merely superficial clichés. Those who can read the *Jingui Yaolue* will know my words are not erroneous. A detailed examination of treatments for consumptive disease reveals that, apart from the *Neijing*, Bian Que was the most proficient. Upper damage should be treated via Yang, and lower damage via Yin. For conditions beyond the reach of acupuncture and moxibustion, he recommended regulating with sweet medicines. The *Jingui Yaolue* adopted this principle, establishing the Jianzhong (Build the Middle) formulas. The idea is that the way of Ying and Wei (Defensive and Nutritive Qi) treasures food intake. Normally, regulating Ying and Wei stabilizes digestion, which is the root of longevity; normally, restraining desires generates Essence, and abundant Essence leads to strength. When the disease has just begun and pulse signs are emerging, treatment relies primarily on Jianzhong Tang (Middle-Building Decoction) and Fumai Tang (Restore the Pulse Decoction). These are all herbs with the nature of "sweetness generated by sowing and reaping," strictly following the principle: "When Essence is insufficient, tonify it with flavor." Zhang Jingyue also understood the principle of sweet-warmth, sometimes varying it into sweet-cold and tranquil applications, which differed significantly from those who habitually used bitter-cold herbs to damage the Middle Jiao. However, his formulas heavily relied on Shudi, ranging from several qian to several liang, completely abandoning ancient methods. Moreover, the cloying nature of Shudi is unsuitable for the Stomach. (The *Jingui* states: The Six Fu Organs transmit and transform substances without storing them; their function is based on free flow.) Its moist and stagnant nature is not favored by the Spleen. He likely intended to use its moisturizing property to replenish Essence, unaware that Essence is generated from Grain. If the Spleen and Stomach are injured, Grain intake decreases, and over time, Blood cannot be generated. Since Blood is insufficient, it cannot transform into Essence, causing consumptive disease to worsen daily. Furthermore, patients with consumptive disease invariably have phlegm and cough and are prone to catching colds. If Shudi is used heavily and frequently, assisted by Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma), then Wind-Cold will be trapped in the skin and hair without dispersing, and Phlegm-Fire will stagnate in the chest and diaphragm without clearing. It is evident to everyone that such medication increases the disease rather than curing it. Regarding this condition, I have always strongly advocated for specific treatment methods. However, physician colleagues and patients' families firmly believed in the methods of Xue Lizhai and Zhang Jingyue. They considered formulas like Liuwei Wan, Bawei Wan, Zuogui Wan, Zuogui Yin, Buzhong Yiqi Tang, Xiaoyao San, Liu Junzi Tang, Sijunzi Tang, and Dabu Yuanjian to be neither cold nor dry, adopting these views preconceivedly and refusing to repent until death. This is indeed a calamity for the people. After the autumn examinations in the year Wushen, feeling depressed and bored, I retrieved the *Neijing*, *Jingui Yaolue*, and other texts for further study. Combining this with clinical observations of how patients recovered or deteriorated to death, I gained profound insights. I realized that in consumptive disease, few die from the illness itself, while many die from improper medication. Speaking frankly and without flattery, if Xue Lizhai and Zhang Jingyue were alive today, they would likely accept me as a candid friend. Below, I briefly present my therapeutic approaches as a wake-up call for those treating consumptive disease based on hearsay.]