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[Li Dongyuan] Medicine worthy of emulation, starting from Fuxi, Shennong, and the Yellow Emperor, although there are many famous doctors, only a few are truly worthy of emulation. As for Hua Tuo's abdominal surgery and Wang Shuhe's acupuncture techniques, their skills were indeed miraculous. How could later generations emulate them? They are not comparable to Qibo's classic writings, Leigong's herbal processing, Yi Yin's decoctions, Jizi's Five Elements theory, Bian Que's diagnostic inquiries, Zhang Zhongjing's *Treatise on Cold Damage*, Wang Shuhe's *Pulse Classic*, Huangfu Mi's *Jia Yi Jing* (Classics of A-Bian), Wang Bing's (Qixuanzi) commentaries, Qian Yi's (Qian Zhongyang) discussions, and Zhang Yuansu's (Jiegu) formularies. These are all "living methods" that can be learned by others. How can they be compared to those myriad prescriptions and theories that merely fixate the eyes of later practitioners? Among them, those with high virtue and far-reaching conduct, strange men and unusual scholars, as well as those who live in seclusion among officials or commoners, may have one skill or principle worth observing, but they are not "living methods" applicable for a hundred generations, so I do not adopt them. Do I enjoy debating? No, I simply wish for students to observe these sages and know where to direct their admiration. If someone merely wishes to browse widely without depth, thinking that much learning yields no practical benefit, is this understanding the root?

[Wang Haizang] The discussions by Qian Yi, the *Huo Ren Shu* (Book of Vitality), Wang Chaofeng, and Wang Defu are all from the Song Dynasty; Yi Lao (Zhang Yuansu) and Shouzhen (Liu Wansu) are from the Jin Dynasty. The differences in the cold and hot nature of the medicines they used stem from this foundation. When reading and applying these books, one must also consider the suitability based on locality and era. However, it is best to emulate Zhang Yuansu and synthesize with Zhang Zhongjing's decoctions, which constitutes the unchanging great method for ten thousand generations.

[*Suwen* (Yellow Emperor's Inner Canon)] Pathogenic winds arrive swiftly like wind and rain. Therefore, skilled physicians treat at the hair and skin level; next, at the muscle level; next, at the sinew and vessel level; next, at the six fu organs; and finally, at the five zang organs. Treating diseases at the zang organ stage results in half dying and half surviving.
When a disease first begins, it can be treated with acupuncture. If the pathogen is strong, wait for it to decline before treating. Thus, for light/shallow conditions, use dispersing methods; for heavy/deep conditions, use reducing methods; for declining/weak conditions, use methods to manifest righteousness. For deficiency of form, warm with qi-tonifying agents; for deficiency of essence, tonify with flavor-rich agents. For conditions located high, induce vomiting to expel upwards; for conditions located low, use draining methods to expel downwards. For fullness in the middle, drain internally. For those with pathogens, soak the body to induce sweating. For pathogens in the skin, use diaphoresis. For fierce/harsh pathogens, press and gather them. For excess conditions, disperse and drain. Examine yin and yang to distinguish soft and hard; treat yin diseases by addressing yang, and yang diseases by addressing yin. Stabilize blood and qi, keeping each in its proper place. For blood excess, use drainage/puncture; for qi deficiency, use traction/lifting. (All found in *Yin Yang Ying Xiang Lun*)

[Zhang Zhongjing] The general rule: Spring favors emesis, summer favors diaphoresis, autumn favors purgation, and winter favors warming and moxibustion.

[Wang Haizang] Diseases affecting the formless qi of heaven should be treated with diaphoresis; diseases affecting the formed pathogens of heaven should be treated with emesis; diseases affecting the formless qi of earth should be treated by promoting urination; diseases affecting the formed pathogens of earth should be treated by promoting defecation.

[*Mai Jing* (Pulse Classic)] To treat a disease, one must first know the origin of the syndrome before attacking it.

[Li Dongyuan] For example, when treating diseases, regardless of whether it is Cold Damage, Blood Stasis, Chest Binding, Jaundice, or other miscellaneous syndromes, one must seek the cause within the Six Channels. For instance, if Jaundice presents with headache, stiffness of the waist and spine, and aversion to cold, it indicates a Taiyang syndrome; if it presents with fever, eye pain, dry nose, and inability to lie down, it indicates a Yangming syndrome; the rest follow this pattern. (It is urgent to seek causes not only in the Six Channels but also in the Five Zang organs. For example, if the face is green, pulse is wiry, prone to anger, has dysuria, difficult defecation, and tendon spasms, it indicates a Liver syndrome; if the face is red, pulse is surging, prone to laughter, has dry mouth, body heat, vexation, heart pain, and heat in the palms, it indicates a Heart syndrome; the rest follow this pattern.)

[Zhu Danxi] Treating disease requires seeking its root. Disease having a root is like grass having roots; removing leaves but not roots means the grass remains. Treating disease is like weeding; treating the zang when the disease is in the zang, or treating the interior when the disease is in the exterior, not only damages stomach qi but also aids pathogenic factors. What kind of doctor is this?
One method treats malaria accumulation and dysentery by inducing vomiting until cured. One method treats dysphagia caused by foul blood using chive juice to resolve the foul blood until cured. One method treats chancre-induced spontaneous dysentery using Long Hui Wan (Dragon Gallbladder Pill) and Chai Hu Tang (Bupleurum Decoction) until cured. Details are found in respective categories.

[Wang Haizang] Treating disease requires seeking its root. For example, abdominal pain is treated with Guizhi Jia Shaoyao Tang (Cinnamon Twig Decoction plus Peony); severe excess pain is treated with Guizhi Jia Dahuang Tang (Cinnamon Twig Decoction plus Rhubarb). Why add Shaoyao and Dahuang to Guizhi Tang rather than using them alone? Because one must address the Taiyang channel, taking Taiyang as the root. Similarly, for Chest Binding syndrome progressing downward, if the pulse is floating, do not purge; instead, first use Mahuang Tang (Ephedra Decoction) to release the exterior. After the exterior is resolved and the pulse becomes sunken, then use Xianxiong Tang (Depress the Chest Decoction) to purge. This is also seeking the root. Regarding Blood Stasis in the lower jiao, blood binding in the Bladder, this originates from the Taiyang channel, invading the formless qi first, then invading the formed blood in the Bladder.

[*Suwen*] If illness precedes reversal/disorder, treat the root. If reversal/disorder precedes illness, treat the root. If cold precedes illness, treat the root. If illness precedes cold, treat the root. If heat precedes illness, treat the root. If heat precedes middle-fullness, treat the branch. If illness precedes diarrhea, treat the root. If diarrhea precedes other illnesses, treat the root; one must regulate first, then treat other illnesses. If illness precedes middle-fullness, treat the branch. If middle-fullness precedes vexation, treat the root. People have guest qi and host qi. If urination and defecation are obstructed, treat the branch. If urination and defecation are free, treat the root. If the disease manifests with excess, treat the root first, then the branch. If the disease manifests with deficiency, treat the branch first, then the root. Carefully observe severity and mildness to adjust accordingly; for mild cases, treat both root and branch simultaneously; for severe cases, treat exclusively. If obstruction of urination/defecation precedes illness, treat the root. (*Biao Ben Bing Zhuan Lun*)

[Zhang Zhongjing] If a patient has a chronic entrenched disease and acquires an acute sudden disease, treat the acute sudden disease first, then treat the chronic entrenched disease.

[Wang Haizang] The initial treatment approach should be vigorous and fierce, meaning the medicinal potency is rapid and harsh. Since the disease is newly acquired suddenly, even if the symptoms seem light, one should use rapid and harsh formulas to eliminate them quickly. The intermediate treatment approach should balance gentleness and harshness, as the disease is neither new nor long-standing; use medicines of moderate speed to nourish righteousness and dispel pathogens synergistically. For example, if pathogens are abundant and righteous qi is scarce, use more dispelling medicines and fewer nourishing medicines. Such加减 (addition/subtraction) methods require clinical judgment. Follow seasonal timing and do not act recklessly. Add acupuncture, and the disease will heal. The final treatment approach should be broad and slow; "broad" means observing mild medicinal properties, and "slow" means administering non-toxic medicines broadly to nourish blood, qi, and center. Because the disease has been long-standing, pathogens are deeply latent, and righteous qi is weak, use good medicines broadly to nourish righteous qi while pathogens naturally depart. Adding acupuncture ensures rapid effect.
There are five methods of treating disease: Harmonizing (He), Taking/Attacking (Qu), Following (Cong), Breaking/Restraining (Zhe), and Belonging/Matching (Shu). Each has five variations, totaling twenty-five, such as Fire declining in Xu hour and Metal declining in Chen hour.
1. Harmonizing (He): For slight heat, use cool medicines to harmonize. If ineffective, proceed to Qu.
2. Taking (Qu): For slightly greater heat, use cold medicines to attack. If ineffective, proceed to Cong.
3. Following (Cong): For severe conditions, use warm medicines to follow the pathogen's nature. Medicines are warm in temperature, flavors vary. Use cold with heat, or heat with cold, or induce sweating. If ineffective, proceed to Zhe.
4. Breaking (Zhe): For extreme conditions, use counteracting methods. If ineffective, use purgative methods. If ineffective, proceed to Shu.
5. Belonging (Shu): Seek the belonging category to reduce the disease. If heat is deep in the marrow, unreachable by needles and herbs, seek its belonging to reduce it (seeking belonging follows resonance and affinity). The Classic says: For sinking conditions, use reduction. Reducing heat follows previous principles (Fire declines in Xu, Metal in Chen). If still ineffective, broaden the methods. Like Sun Tzu's warfare: in valleys, block springs; near water, guard crossings; in plains, clear fields for a thousand li. Blocking springs refers to acupuncture points. Guarding crossings refers to preempting the disease onset. Clearing fields refers to using major medicines to nourish righteous qi in emaciated patients.
Diseases have interior/exterior aspects; treatments have slow/fast aspects. Interior diseases are treated internally; exterior diseases externally. Slight disharmony of qi is regulated; greater disharmony is pacified; excessive conditions are drained/reduced. The Classic says: Regulate qi by distinguishing yin/yang, determining interior/exterior, keeping each in place. Interior treated internally, exterior externally, mild cases regulated, greater cases pacified, excessive cases drained via sweating or purging, cold/heat/warm/cool reduced by matching, following advantages.

[*Nanjing* (Classic of Difficult Issues)] Zang diseases are difficult to treat; Fu diseases are easy to treat. Why? Zang diseases are difficult because they transmit to the organ they overcome. Fu diseases are easy because they transmit to their offspring organ. This aligns with the Seven Transmissions and Intercalating Zang methods.

[Wang Haizang] If the pulse shows no disease, the Shen (Spirit) is silent but present. If the pulse shows disease, examine the presence or absence of Shen within the pulse. For example, rapid/excessive pulses indicate Heat; if forceful, there is Shen. Slow/defective pulses indicate Cold; if forceful, there is Shen. In Heat with Shen, drain the Heat, and Shen remains. In Cold with Shen, remove the Cold, and Shen remains. If Cold/Heat pulses are forceless and lack Shen, what medicine can drain Heat or remove Cold? Ignoring this and hastily draining leads to death in 80-90% of cases.

[*Suwen*] Form at ease, mind suffering: disease arises in vessels, treat with moxibustion and acupuncture. Form at ease, mind at ease: disease arises in flesh, treat with needles and stones. Form suffering, mind at ease: disease arises in sinews, treat with warming applications and stretching. Form suffering, mind suffering: disease arises in throat/esophagus, treat with various medicines. Frequent fear/startle: meridians blocked, disease arises in numbness/insensitivity, treat with massage and wine medicines. This is the Five Forms and Minds. (*Xue Qi Xing Zhi Pian*)

[Wang Haizang] *Huan Ji Bian Jing* states: Treat main diseases slowly, treat guest diseases urgently. All exterior syndromes require sweating. Floating pulse: sweat urgently; Sunken pulse: sweat slowly. All interior syndromes require purging. Floating pulse: purge slowly; Sunken pulse: purge urgently. Yang channels: sweat urgently, purge slowly. Yin channels: sweat slowly, purge urgently. Main disease: remove slowly. Guest disease: remove urgently. Qi disease in chest is self-disease (Main), treat slowly. Blood disease in chest is other-disease (Guest), treat urgently. Formless above entering abdomen below is Guest, treat urgently. Formed below entering chest above is Main, treat slowly. The Six Qi of the year are Host. Si Tian/Zai Quan intercalary Qi are Guests. Tonifying upper/treating upper uses slow formulation (avoiding blood medicines); Tonifying lower/treating lower uses urgent formulation (avoiding qi medicines). Heat in the highest region uses light agents applied gently; urgent administration causes middle-cold. If entering formed substances requiring purging, follow urgency/power. For large intestine slippage, use astringents; administer singly to reach lower parts, empty stomach before meals. Post-meal administration is harmful. This is slow treatment. Near diseases use Odd numbers (urgent then slow). Far diseases use Even numbers (urgent then slow). Lower diseases use Odd numbers (slow then urgent). Sweating uses Even numbers (slow then urgent).
*Ling Shu*: Odd/Even sweating from below nine earths; purging from above nine earths.
Li Dongyuan: Four-season medication rules apply regardless of disease type. Spring: add cooling wind-dispersing drugs. Summer: add great-cold drugs. Autumn: add warming qi drugs. Winter: add great-hot drugs. This preserves the source of transformation. Qian Yi understood this. *Neijing* says: Respect seasonal qi, do not harm heavenly harmony. Do not violate seasons or transformations. Do not harm vital qi. These are constant laws. If contrary to constants causes abnormal syndromes, use flexible treatment. E.g., alcohol consumption or extreme diet increases disease. Use weighing/adapting treatment. Flexible drugs are rarely used due to seasonal prohibitions.
[Zhu Danxi] I read Zhang Zihe's book, focusing only on attack. His view: Righteous qi cannot be diseased itself; disease occurs when pathogens lodge due to righteous qi deficiency. Removing pathogens restores righteousness. Based on disease location (upper/middle/lower, deep/shallow), he established Emesis, Sweating, and Purging. Initially, I thought this was the entirety of medical method. Then I recalled *Neijing*: Deficiency is essence/qi deficiency; Excess is pathogen abundance. Pathogens lodge only due to righteous qi deficiency. If righteous qi is sufficient, pathogens cannot enter. Thus, I doubted Zhang Zihe. I recalled *Neijing*: Yin flat and Yang secret, spirit governs; Yin/Yang separation, essence/qi ends. I recalled Zhang Zhongjing: If sweating is indicated but Chi pulse is choppy, use Huangqi Jianzhong Tang to tonify, then sweat. Thus, Zhang Zihe's book does not reflect his true intent or match *Neijing*/Zhongjing. Zhang was famous, yet his views differed greatly. I sought a master, traveling widely without success. In Zhen Ding, I found *Yuan Bing Shi* and Li Dongyuan, realizing Zhang Zihe's rashness, but still lacked certainty. In Tai Ding Yi Chou summer, I heard of Luo Taiwu via Chen Zhiyan. I visited him, was scolded several times, hesitated two months, then received him. He treated a monk with jaundice, thinness, fatigue. Cause: Monastic life, mother at home, traveled Zhejiang for 7 years, missed mother, cried daily, got sick. Age 25. Luo had him sleep nearby, fed beef/pork stomach stew for half a month, comforted him, gave silver for travel. Pulse filled slightly, gave Taoren Chengqi Tang three doses/day, expelled blood clots/phlegm. Next day, porridge. Recovered in half a month, left with silver. I realized attack methods require robust constitution. Otherwise, pathogens leave, righteous qi injured, minor illness becomes severe, severe becomes fatal. Luo listened to pulses, dictated prescriptions without fixed formulas, combining attack/tonification. I realized ancient formulas for modern diseases don't fit perfectly; one must adapt. Luo said: Using ancient formulas for modern diseases is like rebuilding an old house; materials must be reworked. I recalled Xu Xueshi: Reading Zhongjing's book, using his methods, but not sticking to his formulas is getting Zhongjing's heart. I copied Li Dongyuan's formulas, realizing treating disease after tyranny (like Han Gaozu/Shang Zhou) requires distributing wealth/grain and simple laws to restore injured qi/fatigue. Yin easily deficient, Yang easily hyperactive. Attacks must be cautious; righteous qi must be protected. Bureau Formulas serve as warning.
[Wang Haizang] Mr. Xu discussed Liang Kuanfu's case: Right hypochondriac lung area, coughing blood, panting on movement = Lung diagnosis. Fever, rapid pulse, inability to eat = Fire insulting Metal, Lung and Spleen deficiency. Lung/Spleen deficient with Fire invasion = adverse condition. Cannot tonify or purge directly. Tonifying Metal fears Metal/Fire conflict increasing cough. Purging Fire fears Fire remaining causing masses. Only use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) to support Yuan Qi, mixing small amounts of disease-treating medicine. If no effect, disease is adverse, medicine hasn't reached. Discuss with Kuanfu, wait for autumn coolness. Lung diseases dislike Spring/Summer Fire; Autumn/Winter Fire retreats. Adjust Buzhong Yiqi Tang with seasonal yin/yang rising/falling/warm/cool/cold/hot. Rising/falling follow nature; warm/cool reverse nature. Smooth logic, harmonize qi. Occasionally use Jiazhi Zhuzhu Wan for qi stagnation or Ju Fang Zhizhu Tang for fluid retention. Months later, adverse qi returns, treatment proceeds. But if complexion turns blue/red, pulse wiry/surging, it's too late. Modern medicine has Liu Hejian (purge old/new) and Zhang Yizhou (seasonal adjustment). Zhang follows *Neijing* four qi regulation. Liu follows creation's continuous renewal. Neglecting Zhang is reckless; neglecting Liu is skillless. Zhang followers may fear drastic remedies, missing chances. Liu followers may seek quick results, damaging yin/righteous qi. Combining strengths avoids faults. Vice Minister Shi's relapse suggests using Zhang's seasonal method to support Yuan Qi. Liang Kuanfu's deep initial injury may have residual stagnation; adding digestive drugs to Buzhong Yiqi Tang (Liu's method) may yield results.