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[Li Dongyuan] Medicines possess the properties of Cold (Han), Heat (Re), Warm (Wen), and Cool (Liang), as well as the flavors of Sour (Suan), Bitter (Ku), Acrid/Pungent (Xin), Salty (Xian), Sweet (Gan), and Bland (Dan). Each has specific functions, which must be thoroughly understood. The Qi (vital energy/flavor) and Wei (flavor/taste) of medicines differ from homogeneous substances where all members share the same flavor and Qi. For substances sharing the same Qi, they necessarily contain various flavors; for those sharing the same flavor, they necessarily contain various Qis. They utilize each other mutually, varying in intensity (thick/concentrated vs. thin/dilute), resulting in unequal natures and effects. Those who formulate prescriptions must clarify their specific uses. The Classics state: Flavor belongs to Yin; concentrated flavor is Pure Yin, while dilute flavor is Yang within Yin. Qi belongs to Yang; concentrated Qi is Pure Yang, while dilute Qi is Yin within Yang. Concentrated flavor induces purgation/drainage, while dilute flavor promotes unblocking/venting. Dilute Qi causes dispersal/sweating, while concentrated Qi generates heat. It is also said: Acrid and Sweet flavors disperse and belong to Yang; Sour and Bitter flavors induce vomiting and drainage and belong to Yin; Salty flavor induces vomiting and drainage and belongs to Yin; Bland flavor promotes渗泄 (seeping and draining) and belongs to Yang. All these flavors have distinct capabilities: Acrid can resolve nodules and moisten dryness; Bitter can dry dampness and soften hardness; Salty can soften hardness; Sour can astringe and relieve tension/spasms; Sweet can moderate urgency; Bland can open orifices. When utilizing the flavor of a medicine, one must ascertain if its Qi is appropriate; when utilizing the Qi, one must ascertain if its flavor is suitable. By identifying the root and branch of the disease, the cold-heat and deficiency-excess states of the Zang-Fu organs, and the severity and urgency of the condition, one selects the Qi and flavor of medicines to formulate prescriptions according to symptoms. Thus, prescriptions follow the structure of Sovereign (Jun), Minister (Chen), Assistant (Zuo), and Courier (Shi), involving principles of weight, urgency, size, direct treatment (Zheng Zhi), and contrary treatment (Fan Zhi). The Sovereign herb treats the main disease; the Minister assists the Sovereign; the Courier responds to the Minister. These are employed to suit the pathology and assist in completing the prescription's therapeutic action. A prescription with one Sovereign and two Ministers follows the Odd (Qi) method. Two Sovereigns and four Ministers follow the Even (Ou) method. Two Sovereigns and three Ministers follow the Odd method. Two Sovereigns and six Ministers follow the Even method. For diseases near the throat (upper body), use the Odd method; for distant ones (lower body), use the Even method. Diaphoretic prescriptions do not use odd numbers; purgative prescriptions do not use even numbers. Tonifying the upper or treating upper diseases requires a slow/gentle formulation; tonifying the lower or treating lower diseases requires an urgent/intense formulation. "Urgent" refers to concentrated Qi and flavor; "Slow/Gentle" refers to dilute Qi and flavor. Dilute formulations should be taken in small doses frequently; concentrated formulations should be taken in large doses at once. One must also understand the five types of Qi stagnation: Wood stagnation is resolved by venting (emesis to ensure smooth flow); Fire stagnation is resolved by dispersing (sweating to ensure diffusion); Earth stagnation is resolved by seizing/removing (purgation to eliminate obstruction); Metal stagnation is resolved by draining (releasing the exterior and promoting urination); Water stagnation is resolved by restraining (controlling rebellious upward movement). Mastery of these five methods constitutes the major principles of treating disease.

[Su Wen] The Yellow Emperor asked: How should diseases not cured by regulating Qi be treated? Regarding toxic and non-toxic medicines, which should be used first or last? I wish to hear the principle. Qibo replied: Whether toxic or non-toxic, the choice is primarily based on the disease being treated, and the size of the prescription is determined accordingly. The Yellow Emperor asked: Please explain this system. Qibo said: One Sovereign and two Ministers constitute a Small Prescription; one Sovereign, three Ministers, and five Assistants constitute a Medium Prescription; one Sovereign, three Ministers, and nine Assistants constitute a Large Prescription. Cold is treated with Heat; Heat is treated with Cold. Minor disorders are treated oppositely (Ni Zhi/Direct Treatment); severe disorders are treated similarly (Cong Zhi/Contrary Treatment). Hardness is reduced; invaders are expelled; exhaustion is warmed; accumulation is scattered; retention is attacked; dryness is moistened; tension is relaxed; dispersion is gathered; deficiency is supplemented; lethargy is moved; fright is calmed. Upper disorders are lowered; lower disorders are raised; massage and bathing are applied; forceful and劫夺 (snatching/seizing) methods are used; opening and dispersing methods are employed. The goal is to suit the condition. The Yellow Emperor asked: What are Direct and Contrary treatments? Qibo said: Direct treatment is Zheng Zhi (Orthodox Treatment); Contrary treatment is Fan Zhi (Reverse Treatment). Depending on the number of symptoms, observe the situation to decide. The Yellow Emperor asked: What is Contrary Treatment? Qibo said: Treating heat with cold (but using warm administration/combinations), treating cold with heat (but using cold administration/combinations), using obstructive methods for obstruction (Se Yin Se Yong), using draining methods for diarrhea (Tong Yin Tong Yong). One must subdue the dominant pathogen and address the cause first. Initially, the treatment may seem similar to the disease manifestation, but ultimately it differs. This allows breaking accumulations, dissolving hardness, harmonizing Qi, and ensuring cure. (From *Zhi Zhen Yao Da Lun*). This describes the treatment for diseases caused by internal Qi imbalance.

The Yellow Emperor asked: What about diseases cured by regulating Qi? Qibo said: Whether using Direct or Contrary treatment, mixing opposition with compliance, or compliance with opposition, the key is to dredge Qi to restore harmony. This is the way.

This describes the treatment for diseases where internal Qi was originally balanced but became diseased due to external pathogens. Diseases caused by internal Qi imbalance have weak roots; only minor pathogens can be treated directly. If the pathogen is severe, direct treatment causes rejection, leading to danger; thus, one treats by following the pathogen's trend. Conversely, diseases with originally balanced Qi have strong roots; regardless of severity, both direct and contrary treatments can be applied.

The Yellow Emperor asked: What is meant by Sovereign, Minister, etc., in prescriptions? Qibo said: The herb that treats the main disease is the Sovereign; the herb assisting the Sovereign is the Minister; the herb responding to the Minister is the Courier. This does not refer to the Superior, Middle, and Inferior categories of herbs. The Yellow Emperor asked: What are the Three Categories? Qibo said: They clarify the distinction between good and bad qualities.

[Li Dongyuan] The Sovereign herb is used in the largest quantity, the Minister next, and the Assistant least. Herbs targeting the same symptom are used in equal proportions. In usage, Qi and Flavor are primary; tonification and purgation depend on flavor, while Qi changes with seasons. The herb treating the main disease is the Sovereign. For example, to treat Wind, Fangfeng (Saposhnikovia Root) is the Sovereign. To treat Upper Jiao Heat, Huangqin (Scutellaria Root) is the Sovereign. To treat Middle Jiao Heat, Huanglian (Coptis Rhizome) is the Sovereign. To treat Dampness, Fangji (Stephania Root) is the Sovereign. To treat Cold, Fuzi (Aconite Lateral Root) and similar herbs are Sovereigns. Other concurrent symptoms are treated by Assistants and Couriers. This is the essence of formulation. For instance, Zhang Zhongjing formulated Guizhi Tang (Cinnamon Twig Decoction) for Exterior Deficiency. Guizhi (Cinnamon Twig) is Acrid and Hot, disperses and aids Yang, is light in texture, and "what belongs to Heaven亲近s the Upper." Thus, Guizhi is the Sovereign, with Gancao (Licorice Root) and Shaoyao (Peony Root) as Assistants. If Yang pulse is choppy and Yin pulse is string-like, abdominal pain and tension are expected. Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is formulated. Shaoyao is Sour and Cold, astringes and tonifies the Center, and "what belongs to Earth亲近s the Lower." Thus, Shaoyao is the Sovereign, with Guizhi and Gancao as Assistants. One treats Exterior Deficiency, the other Interior Deficiency, each stating its specific indication. Later practitioners should apply these principles flexibly to avoid errors. For resolving Wind-Cold, Fangfeng is Sovereign, Gancao and Baizhu (Atractylodes Macrocephala Rhizome) are Assistants. The Classics say: Acrid and Sweet disperse and belong to Yang. Wind is best dispersed by Acrid taste. Fangfeng is Sweet and Acrid and a general wind remedy, hence Sovereign. For resolving Cold Damage (Shanghan), Gancao is Sovereign, Fangfeng and Baizhu are Assistants, as Cold is best dispersed by Sweet taste. If additional symptoms exist, adjust based on the syndrome, selecting dosages according to Sovereign-Minister relationships. For acute red swollen eyes, Fangfeng and Huangqin are Sovereigns to drain fire; Huanglian and Danggui (Angelica Sinensis Root) are Assistants to harmonize blood, plus channel-specific guiding herbs. For chronic dim vision, Shudihuang (Prepared Rehmannia Root) and Danggui are Sovereigns; Qianghuo (Notopterygium Rhizome) and Fangfeng are Ministers; Giju (Chrysanthemum Flower) and Gancao are Assistants. For dysentery with abdominal pain, Baishaoyao (White Peony Root) and Gancao are Sovereigns; Danggui and Baizhu are Assistants; bleeding cases are treated according to Sanjiao (Triple Burner) heat. For watery diarrhea, Fuling (Poria) and Baizhu are Sovereigns; Shaoyao and Gancao are Assistants. For various Wind syndromes, Fangfeng is Sovereign, with symptom-specific herbs as Assistants. For cough, Wuweizi (Schisandra Fruit) is Sovereign; Banxia (Pinellia Tuber) is Assistant for phlegm; Ejiao (Donkey-hide Gelatin) is Assistant for wheezing; Huangqin is Assistant depending on presence of heat; only dosages vary. For difficult urination, Huangbai (Phellodendron Bark) and Zhimu (Anemarrhena Rhizome) are Sovereigns; Fuling and Zexie (Alisma Rhizome) are Assistants. For Lower Jiao Dampness, Cao Longdan (Gentiana Scabra Root) and Fangfeng are Sovereigns; Gancao and Huangbai are Assistants. For hemorrhoids/fistulas, Cangzhu (Atractylodes Lancea Rhizome) and Fangfeng are Sovereigns; Gancao and Shaoyao are Assistants, adjusted by specific symptoms. For various sores, Huanglian and Danggui are Sovereigns; Gancao and Huangqin are Assistants. For malaria, Chaihu (Bupleurum Root) is Sovereign, with channel-guiding herbs based on the time of onset as Assistants.

These are the major principles of medication. Detailed syndromes follow below; treat each case by adjusting medications individually.