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The intention behind the ancients' formulation of prescriptions was subtle, exquisite, and detailed, beyond full comprehension. This was because they carefully examined the condition of the disease, differentiated the meridians involved, referenced the properties of herbs, and deliberated on the dosage weights. Regarding the diseases they treated, there was not the slightest deviation. Therefore, there was no need for rare or extraordinary substances or techniques; yet, for chronic, intractable, and perilous ailments, administration of these formulas often yielded miraculous effects. These were the prescriptions of the pre-Han period.

However, the diseases afflicting the people are countless and inexhaustible. If a separate prescription were to be formulated for every single disease, when would it ever end? Thus, the ancients employed methods of modification (Jiajian). When the general nature of the disease was similar but the manifested symptoms differed, there was no need to establish an entirely new prescription. Instead, within the existing prescription, modifications were made based on the specific variations in symptoms.

For instance, in the *Shanghan Lun* (Treatise on Cold Damage), Guizhi Tang (Cinnamon Twig Decoction) is used to treat Taiyang disease (disease pattern caused by pathogenic invasion of the Taiyang meridian). If stiffness of the neck and back is present, Guizhi Jia Gegen Tang (Guizhi Decoction with Pueraria) is used; if wheezing occurs, Guizhi Jia Houpo Zizi Tang (Guizhi Decoction with Magnolia Bark and Apricot Seed) is used; if, after purgation, the pulse is rapid and the abdomen is full, Guizhi Qu Shaoyao Tang (Guizhi Decoction without Peony Root) is used; if aversion to cold worsens, Shaoyao is removed and Fuzi (Aconite Lateralis Radix Praeparata) is added. These are examples of modification by individual herbs. If one considers Guizhi Mahuang Ban Ge Tang (Half-Guizhi Half-Mahuang Decoction), this represents a modification combining two prescriptions. If Gui Zhi Gan Cao Long Gu Mu Li Tang (or specifically adding Gui Zhi to Guizhi Tang for Ben Tun syndrome) is used for Ben Tun (a condition characterized by gas rushing upward from the lower abdomen), this represents modification by adjusting the dosage weight of herbs.

Nevertheless, when modifying only one or two herbs, although the name of the original formula remains unchanged, the specific herbs added or removed must be clearly stated. For example, when Shaoyao (Peony Root) is doubled and Yi Tang (Maltose) is added to Guizhi Tang, it is not named "Guizhi Jia Yitang Tang" but rather Jianzhong Tang (Middle-Boosting Decoction). Although the ingredients may be similar, the therapeutic principle differs, and thus the name is different. The strictness of ancient methods was such that later physicians, failing to understand this principle yet wishing to claim authority by using ancient names, would take one or two herbs from an ancient prescription and label the entire mixture as that prescription. For example, using Chai Hu (Bupleuri Radix) leads them to call it Xiao Chai Hu Tang (Minor Bupleurum Decoction), unaware that the efficacy of Xiao Chai Hu Tang lies primarily in the use of Ren Shen (Ginseng Radix et Rhizoma). Using Zhu Ling (Polyporus) and Ze Xie (Alisma Rhizoma) leads them to call it Wu Ling San (Five-Ingredient Powder with Poria), unaware that the subtlety of Wu Ling San resides specifically in Gui Zhi (Cinnamomi Ramulus). By removing the key herbs and mixing in others, yet still applying the original name, they find the treatment ineffective. Not blaming themselves, they either blame the disease or the herbs, claiming that ancient prescriptions cannot treat modern diseases. Alas! Even if one correctly identifies the disease and uses an ancient prescription, if the application is disjointed and chaotic, how can there be efficacy? Consequently, people warn each other that ancient prescriptions are difficult to use, not realizing that this completely misses the essence of ancient formulations, thereby offering no benefit to the disease and causing harm instead.

So, what should be done? The answer is: If the patient's condition matches an ancient prescription, use the prescription in its entirety. If there are additional symptoms, modify it according to ancient principles. If it does not fully match, follow the principles of the ancient prescription to select, discard, increase, or decrease the herbs used. Ensure that no herb is mismatched to the symptoms. Naturally, this will not deviate from the methods of the ancients, and the administration of the medicine will surely yield miraculous results.