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Errors in medicine are numerous; do not assume that all remedies in the *Zhouhou Beiji Fang* (Emergency Prescriptions Kept Up the Sleeve) are golden elixirs. Let us enumerate these medical errors from the beginning, pointing them out clearly to reveal a glimpse of the whole.

The physician's error lies in the difficulty of syndrome differentiation. Distinguishing symptoms according to the Three Causes (Internal Causes, External Causes, and Non-internal/Non-external Causes) is like facing three mountains. From these three categories emerge countless pulse patterns; one must carefully examine the root cause of the disease (Treating illness requires seeking its origin; one must clearly understand where it began).

The physician's error lies in inaccurate pulse diagnosis. If the Floating (Fu), Deep (Chen), Slow (Chi), and Rapid (Shu) pulses are not clarified, even when clarified, they may become confused and change (e.g., a choppy and fine pulse in extreme heat, or a forceful pulse against the finger in extreme cold). Although the mind understands, the fingers find it hard to discern clearly (Bian Que said: The way of holding the pulse is like standing at the edge of an abyss looking up at floating clouds. One may understand in the heart, but it is difficult to clarify under the fingers).

The physician's error lies in missing the appropriate timing. Cold, Heat, Warmth, and Coolness treatments must accord with the season. The subtle shifts of time revolve endlessly; only through quiet immersion can one observe the mechanisms of transformation (The alternation of cold and heat is the constant of time; their imbalance is the variation of time. One must observe quietly and gain understanding naturally, which cannot be confined by the theories of Five Movements and Six Qi).

The physician's error lies in ignorance of the meridians. In the Twelve Meridians, one should inquire into causes frequently. If the logic of circulation within the meridians is not distinguished, Yang syndromes will inevitably transmit to the Three Yin levels (Pathogens of the Six Excesses: if the Three Yang channels are treated well, there will be no fear of transmission to the Yin).

The physician's error lies in inappropriate medication. Attack, tonification, Cold, and Heat therapies must match the syndrome. Making excess conditions more excessive and deficiency conditions more deficient is a grave error; every action must be strict and cautious (Using contradictory medications brings the greatest disaster).

The physician's error lies in attacking what is blameless (Attacking the blameless refers to attacking parts of the body that are not diseased). Medicines have specific functions and must not be mistaken. Herbs that guide others to the affected channel have different paths; dosage errors lead to recurring issues (Although herbs may not be contradictory, using them for the wrong channel is still incorrect. For example, Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhimu (Anemarrhenae Rhizoma), and Huangbai (Phellodendri Cortex) are all bitter-cold; Jiang (Zingiberis Rhizoma), Rougui (Cinnamomi Cortex), Jiaozhu (Zanthoxyli Fructus), and Yuzhu (Evodiae Fructus) are all acrid-hot. Each has its proper use, let alone others).

The physician's error lies in mismatched dosage. Treating severe diseases with light dosages makes them heavier; imbalance in weight leads to harm. This path is subtle and dangerous (Even if the medicine matches the syndrome, if the dosage does not correspond to the severity, it will not work quickly).

The physician's error lies in excessive dosage. If treating cold fails and heat arises, or if treating heat fails and cold reappears, one must pay attention when prescribing (Even if the medicine matches the disease, overuse means it no longer matches; thus, medical skill requires extensive experience).

The physician's error lies in losing track of Root and Branch. Appropriateness in urgency and slowness ensures stability. The initial disease is the Root, the subsequent is the Branch; minute details must hit the mark (When symptoms are chaotic, distinguish Root and Branch, assess urgency, and apply treatment accordingly).

The physician's error lies in abandoning the correct path. Treating without seeking the underlying nature is wrong. Strengthening Water and benefiting Fire must trace the source; the words of Wang Taipu must be recited (Wang Taipu said: If heat does not respond to heat therapy, it is due to lack of Fire; if cold does not respond to cold therapy, it is due to lack of Water. For lack of Water, strengthen the master of Water to control the sunlight; for lack of Fire, benefit the source of Fire to dissipate yin shadows. This is called seeking the underlying nature).

The physician's error lies in being ignorant of Yin and Yang. At the extremes of Yin and Yang, one loses grip. When亢 (Hyperactivity) causes harm, Cheng (Counteraction) provides regulation; the *Linglan Mibi* (Secrets of the Spiritual Palace) is most divine (Hyperactivity harms things; counteraction regulates extremes. This is the principle of mutual regulation among the Five Elements and Four Seasons).

The physician's error lies in being ignorant of Cold and Heat. Obvious Cold and Heat are easy to distinguish, but Cold containing Heat and Heat containing Cold require the true secrets of Changsha (Zhang Zhongjing). Changsha used Cold for Heat and Heat for Cold, or Cold then Heat, or Heat then Cold, or simultaneous Cold and Heat, with exquisite subtlety. These excellent methods are recorded; thorough reading and reflection lead to natural understanding. However, times change; while reading Zhang Zhongjing's books and following his methods, one need not rigidly adhere to his formulas, but rather adapt medications flexibly, which is particularly appropriate.

The physician's error lies in being ignorant of Deficiency and Excess. Obvious Deficiency and Excess are easy to treat, but Deficiency containing Excess and Excess containing Deficiency require the systematic approach of Dongyuan (Li Gao). (*Pi Wei Lun* [Treatise on the Spleen and Stomach], *Nei Wai Shang Bian* [Differentiation of Internal and External Injury], and formulas such as Buzhong Yiqi Tang [Tonify the Middle and Augment the Qi Decoction] and Zhizhu Wan [Immature Bitter Orange and Atractylodes Pill]) offer infinite benefits for generations.

The physician's error lies in lenient medication. If the syndrome belongs to external pathogens, it must be overcome. For stubborn conditions like fullness, dryness, and hardness, tea, fruits, soups, and pills offer no help.

The physician's error lies in tentative light medication. Attacking disease without protecting Yuan Qi (Primal Qi) harms the patient even if the disease is expelled. Why bother calculating with such approaches? (Light doses cause mistakes; harsh doses cause failure; both are criticized).

The physician's error lies in ignoring subtle signs. Pulse movements and symptom changes occur in the slightest degree. Effort must be made before the disease takes form; observing details as clearly as autumn hairs is required (Thinking of treatment only after disease appears is inferior; seeing the significant from the minute and preventing disaster before it sprouts is the work of a superior physician).

The physician's error lies in lacking firm conviction. Once principles are truly understood, do not change. It is like riding a boat through breaking waves; a skilled helmsman is not dazzled (For mild diseases, treatment should be easy. Firm conviction and adherence, moving forward despite obstacles, saving people from critical danger, demonstrates true knowledge).

The physician's error lies in forcing recognition of disease. If the disease is not recognized, do not force a diagnosis. Humble oneself and yield to capable experts to ensure the patient's life (Admitting ignorance is also that of a good physician).

The physician's error lies in acupuncture and knives. Acupuncture has appropriate timing and depth (If pus is ripe and not lanced, it ruptures internally; if lanced too early, Qi leaks and pus does not form. Lancing deep into superficial pus injures healthy flesh; lancing shallowly into deep pus prevents toxin exit and causes internal collapse). For hundred toxins, moxibustion should always be tried first (Garlic-partitioned moxibustion is superior to knife surgery. *Waike Zhengzong* [Orthodox Manual of External Medicine] says: Moxa until pain stops, stop moxa when pain begins). On the head and face, use the Divine Lamp (Moxibustion is unsuitable for the head and face; use the Divine Lamp illumination method. *Waike Zhengzong* says: Take one dose of Chanwu Wan [Toad Pill] internally, and illuminate externally with divine fire for three branches. This method applies not only to the head and face, but is especially important there).

The physician's error lies in despising the ignorant and poor. Ancient kings showed compassion to orphans and the needy. For critical illnesses, provide genuine relief; the desire to preserve life aligns with the vast sky (One must exert full effort and administer good medicines to save them).

The physician's error lies in failing to restrain oneself. Disliking patients who speak openly ignores that even humble advice has value, let alone peers discussing principles.

Physicians' errors are endless; patients' errors are rising. Let me count them again for you, please listen.

Patients err by losing early opportunity. Initially ignoring illness leads to daily weakness and increasing disease; even a skilled doctor finds it exhausting (Illness must be treated early).

Patients err by not speaking frankly. Concealing illness to test doctors' skill or lack thereof, knowing only what was injured or done, makes it impossible for famous doctors to guess (Da Su said: I must tell my doctor everything about my illness before pulse diagnosis. Even an average doctor can cure me if I seek recovery, not if I try to confuse the doctor).

Patients err by impatience. When there is a chance of recovery, one must take medicine. If the medicine suits the condition, the disease will remove itself; changing doctors morning and night is unnecessary (Once effective, do not change frequently).

Patients err by not assessing the trend. If the disease trend is heavy and urgent, plans must change quickly. Delaying time makes it deeper; fearing no miracle remedy for recovery remains (If ineffective, change quickly).

Patients err in taking medicine. There are tricks in taking medicine; whether cold or hot must be clear, and timing before or after meals has its way.

Patients err by anger. Qi rebels rushing to the chest without realization ignores that Liver Wood attacks Spleen Earth. Wish you to nurture your nature and protect yourself.

Patients err by sorrow and thought. Where does depression go? Often compare oneself to those worse off; knowing strength, yet守 (guard) femininity/yielding.

Patients err by talking too much. Much talk damages Qi, making recovery hardest. Advise silence, storing spirit, sitting quietly, nourishing True Qi and True Yuan.

Patients err by contracting Wind-Cold. After Wind-Cold disperses, it returns again. Like a city wall not yet solid, how can it withstand thieves destroying it further?

Patients err by not guarding the mouth. Harm from food and drink is everywhere. Suitable eating and drinking harmonize Middle Qi; enjoying food allows longevity.

Patients err by not being cautious. Ignoring life in the bedroom leads to peril. What can be done if life is endangered? Use those fond of lust as a mirror.

Patients err in rescuing suffocation (Closing the mouth with hands to rescue when the patient is faint/dizzy). When rescuing Qi obstruction, do not close the nose. If covering both nose and mouth, it is like throwing stones into a well (The nose governs respiration; closing it tightly cuts off breathing. Many people fall into this trap, so I emphasize it).

Both sides have errors that do not cease; fearing bystanders' overlapping errors, I must count them for you, observing all bystander actions.

Bystanders err by panic. Not knowing the logic, they rush chaotically, taking charge during medication use. Have they studied Qibo and Huangdi (Traditional Chinese Medicine)?

Bystanders err by leading astray. Wrongly treating shamans and witches as immortals/buddhas makes sick families prone to possession; ultimately confused and never enlightened.

There are greater errors found in medicines; let me detail them for you to heed.

Medicine errors: Fake medicine. Only authentic herbs have deep efficacy. Name without substance cannot work, wasting physicians' efforts (Large towns make finding herbs easy; remote places require careful discrimination).

Medicine errors: Loss of processing. Poor processing yields bad decoctions. Market herbs unsteamed/unfried must be assessed before trial (Washing, stir-frying, steaming, boiling, removing hearts, skins, shells, oils, tips—none can be neglected).

Medicine errors: Ugly Ginseng. Using coarse branches, dried small roots, steamed for soup mixed with tin strips. Used in formulas, they are useless (Ginseng is best as original knotty roots; steamed for soup, it loses its precious color. Can tin strips substitute ginseng?).

Medicine errors: Uneven weighing. Cheap herbs weighed heavily, expensive ones lightly. Ruler, minister, assistant, courier roles lose balance, causing failure is most annoying.

Still, medicine errors lie in water selection. Advise obtaining good water for decoction.

Decoction errors: Unclean water. Oil or dirty water causes vomiting/hiccups. During vomiting, disease worsens; even famous doctors cannot decide.

Decoction errors: Frequent water addition. Adding water when the pot boils reduces potency and effect. Do not wrongly blame the physician's bias.

These are the hundred errors in medicine. Tell you to remember them well. Remembering well makes disease easier to cure. Sharing great spring and autumn with you.