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Yin and Yang are the way of heaven and earth, the general principles of all things, the parents of change, the origin of life and death, and the residence of spiritual activities. (All changes, life and death, and the divine workings of heaven and earth and all things do not go beyond the principle of Yin and Yang; therefore, Yin and Yang are the root of all affairs.) In treating diseases, one must seek the root. (Since all affairs and changes originate from Yin and Yang, and disease mechanisms, drug properties, pulse conditions, and therapeutic discussions are most closely related to this, those who treat diseases must necessarily seek the root, whether it be the root of Yin or the root of Yang. Once the root is found, treatment can then be applied. The word "root," when considered as a whole, is singular; when analyzed, it is infinite. What is meant by "singular as a whole" is Yin and Yang; there is no one who understands affairs without understanding Yin and Yang, nor is there one who understands diseases without understanding Yin and Yang. This is the great root of heaven and earth and all things, which must not be ignored. What is meant by "infinite when analyzed" is that where there is change, there is manifestation; where there is manifestation, there is a root. In all matters, there is a root that cannot be disregarded. Death takes life as its root; to save from death, one must not harm life. Evil takes righteousness as its root; to attack evil, one must protect righteousness. Yin takes Yang as its root; where Yang exists, there is life; where Yang is exhausted, there is death. Stillness takes movement as its root; with movement, there is vitality; without movement, there is stagnation. Blood takes Qi as its root; where Qi comes, there is flow; where Qi goes, there is coagulation. Symptoms take the pulse as their root; an auspicious pulse indicates a good prognosis, while an inauspicious pulse indicates a poor one. The earlier condition is the root of the later condition; what comes from here must go back here. Acute conditions are the root of chronic conditions; who is urgent and worrisome, who is slow and carefree? Interior conditions are the root of exterior conditions; exterior fullness does no harm, but interior collapse is terrifying. Lower parts are the root of upper parts; to nourish the shoots, one must first consolidate the roots; to cut the lower, the upper must wither. Deficiency is the root of excess; removing excess is not difficult, but attacking deficiency is unbearable. Truth is the root of falsehood; the shallow only know the present, while the profound see clearly amidst ambiguity. As for physicians, the root lies in learning and ability; only when learning and ability are sufficient to fully explore the subtleties of seeking the root can one discuss treatment. *Huainanzi* says: "The reason Bian Que was esteemed was that he knew the cause of disease; the reason sages were esteemed was that they knew the origin of chaos.") Follow their will. (The application of following is most crucial. If one does not follow, one cannot guide according to the trend, which is not the way of a person who understands flexibility.) Therefore, entering a country, ask about customs; entering a home, ask about taboos; ascending the hall, ask about etiquette; facing patients, ask about their preferences. (Asking about what makes patients comfortable is the way of following.) For internal heat and wasting-thirst, cold methods are suitable; for internal cold conditions, hot methods are suitable. (The following discusses the appropriate methods for treating diseases. Internal heat refers to heat within. Wasting-thirst refers to intense internal heat leading to polyphagia, polydipsia, and emaciation. Wherever heat is internal, cold methods are suitable for treatment; wherever cold is internal, hot methods are suitable. These are all ways to follow the disease condition to rescue it.) Heat in the stomach leads to rapid digestion, causing a hanging heart sensation and easy hunger. (Rapid digestion means food is easily digested. Hanging heart refers to stomach fire flaming upward, scorching heart blood, causing inner restlessness. 'Hanging' means unrest. Stomach heat causes rapid digestion, hence easy hunger.) The skin above the umbilicus feels hot. Heat in the intestines leads to yellow, mushy stools. (The area above the umbilicus is the division between the stomach and small intestine; thus, heat in the skin above the umbilicus indicates heat in the intestines. Yellow, mushy stools result from damp-heat in the stomach transmitting to the small intestine. 'Mush' refers to rotting. The above two sections are examples of heat conditions suitable for cold methods.) The skin below the umbilicus feels cold. Cold in the stomach leads to abdominal distension; cold in the intestines leads to borborygmus and undigested stool diarrhea. (Cold skin below the umbilicus is due to cold in the stomach and intestines. Cold in the stomach prevents transformation and transportation, causing abdominal distension; cold in the intestines causes Yin Qi stagnation, preventing the separation of clear and turbid, leading to borborygmus and undigested stool diarrhea. These are all examples of cold conditions suitable for hot methods.) Cold in the stomach and heat in the intestines lead to both distension and diarrhea. (The text previously stated that cold in the intestines causes diarrhea; here it states that heat in the intestines also causes diarrhea. Thus, there are differences between heat diarrhea and cold diarrhea. Heat diarrhea is called 'intestinal filth,' and cold diarrhea is called 'loose stool.') Heat in the stomach and cold in the intestines lead to rapid hunger and lower abdominal pain and distension. (Heat in the stomach causes rapid digestion, hence rapid hunger. Cold in the intestines causes Yin Qi to gather and fail to move, leading to severe lower abdominal pain and distension. The above two sections should be treated according to their cold and heat, adapting to what is suitable.) The stomach desires cold drinks, and the intestines desire hot drinks. Prohibiting them goes against their will, while complying with them worsens the disease. (Those with heat in the stomach desire cold drinks, and those with cold in the intestines desire hot drinks. The urgency and slowness of treatment should have a sequence. However, desires and aversions are hard to satisfy simultaneously, especially since wealthy people often act on their whims. This is why following is difficult, and treatment must have method.) Inform them of the consequences, and guide them toward what is suitable. In spring and summer, treat the branch first and the root later; in autumn and winter, treat the root first and the branch later. (This states that treatment has fixed rules, and there are situations where private desires cannot be accommodated. Thus, the treatment of root and branch is cited to illustrate the general principle. Spring and summer are seasons of growth; it is suitable to first nourish Qi to treat the branch. Autumn and winter are seasons of storage; it is suitable to first consolidate Essence to treat the root.) Adapt to contradictions. (Adapting to contradictions means tactfully accommodating their feelings.) Diet and clothing should adapt to cold and warmth: in cold weather, do not shiver; in hot weather, do not sweat excessively. Food and drink should not be scalding hot nor freezing cold. When cold and warm are moderate, Qi is maintained, and pathogenic factors do not arise. ('Adapt' means appropriate. This discusses finding the appropriateness within compliance. For example, regarding diet and clothing, if the law allows for cold, it should be slightly cold, not so cold as to cause shivering; if it allows for heat, it should be slightly hot, not so hot as to cause sweating. Similarly, if one desires hot food, it should not be scalding; if one desires cold, it should not be freezing. When cold and heat are moderate, Yuan Qi is maintained, and pathogenic factors have no opportunity to arise. This is the use of the method of following. Otherwise, governing people and self-cultivation, governing others and oneself, governing small and large matters, governing states and families—none can succeed by going against the norm.) Qi varies in quantity, diseases vary in severity, treatment varies in urgency, and formulas vary in size. (The Five Movements and Six Qi have excess and deficiency, hence "Qi varies in quantity." Human diseases inevitably fluctuate with Qi, so the urgency of treatment and the size of formulas must correspond to the severity of the condition.) Qi has high and low positions, diseases have near and far locations, symptoms have interior and exterior aspects, and treatment has light and heavy approaches. The goal is to ensure the medicine reaches the affected area. (Annual Si Tian and Zai Quan Qi create high and low positions of Qi. Meridians and Zang-Fu organs have upper and lower divisions, creating near and far disease locations. Interior is called Zhong, exterior is called Wai. Slow conditions require light treatment; urgent conditions require heavy treatment. 'Ensuring the medicine reaches the affected area' means reaching the site of the disease and seeking its established cause.) *Da Yao* says: One Sovereign and two Ministers constitute a Odd formula; Two Sovereigns and four Ministers constitute an Even formula; Two Sovereigns and three Ministers constitute an Odd formula; Two Sovereigns and six Ministers constitute an Even formula. (*Da Yao* is an ancient method. The herb that treats the main disease is the Sovereign, used in double dosage; herbs assisting the Sovereign are Ministers. Odd numbers are Yang numbers, known as 'Single Formulas'; Even numbers are Yin numbers, known as 'Compound Formulas.' Thus, 1 Sovereign + 2 Ministers = 3 (Odd); 2 Sovereigns + 3 Ministers = 5 (Odd). Both are Odd formulas. 2 Sovereigns + 4 Ministers = 6 (Even); 2 Sovereigns + 6 Ministers = 8 (Even). Both are Even formulas. Odd formulas belong to Yang and are light; Even formulas belong to Yin and are heavy.) For near diseases, use Odd formulas; for far diseases, use Even formulas. For diaphoresis, do not use Even formulas; for purgation, do not use Odd formulas. (Near diseases are upper and Yang, so Odd formulas are used for their light and slow action. Far diseases are lower and Yin, so Even formulas are used for their heavy and urgent action. Diaphoresis does not use Even formulas because Yin is heavy and cannot reach the exterior. Purgation does not use Odd formulas because Yang rises and cannot descend. Citing Odd/Even and Yin/Yang distinguishes the general principles of diaphoresis and purgation. Do not the properties and flavors of Yin/Yang come after Odd/Even? Hence, the following text elaborates. The subtle meaning here is not just about the odd/even count of ingredients, but to elucidate the meaning of formula structure. Students should deepen their understanding through this. 'Odd' is pronounced like 'Ji'.) For tonifying the upper and treating upper diseases, the formula should be slow; for tonifying the lower and treating lower diseases, the formula should be urgent. Urgency requires strong flavor and property; slowness requires weak flavor and property. Ensuring the medicine reaches the affected area is what this refers to. (Slow formulas for the upper aim to retain and spread in the upper part; urgent formulas for the lower aim to reach the lower Jiao directly. Thus, urgency requires strong flavor/property; slowness requires weak flavor/property. If a slow formula has strong flavor/property, it acts harshly and leaves quickly. If an urgent formula has weak flavor/property, it is soft and fails to advance. Only when slowness, urgency, strength, and weakness are balanced can the medicine reach the disease site and capture the essence of treatment. This is the key to formula formulation, hence repeated for emphasis.) If the disease is far and the medicine's flavor/property is absorbed mid-way, control the timing of food intake to ensure it reaches the target without violating these principles. (If the disease is deep, the medicine must pass through the stomach. If administered improperly, the medicine may be absorbed by the Spleen and Stomach before reaching the disease. Thus, food intake should regulate this, allowing the medicine to reach both near and far targets. To reach far targets, take medicine before meals; food pushes the medicine further. To reach near targets, take medicine after meals; food blocks the medicine, keeping it local. By analogy, speed of administration, root vs. tip usage, and decoctions, pastes, pills, and powders all have specific applications, never exceeding these principles.) Therefore, the way to balance Qi is: for near diseases using Odd or Even formulas, make the dosage small; for far diseases using Odd or Even formulas, make the dosage large. Large dosages have fewer ingredients; small dosages have more ingredients. More ingredients go up to nine; fewer ingredients go down to two. (Balancing Qi means correcting imbalance. Upper is near, lower is far. Near and far diseases have Yin/Yang and Exterior/Interior distinctions, so Near and Far formulas use combinations of Odd and Even. E.g., Odd formula with Even ingredient weights, or Even formula with Odd ingredient weights. Near diseases with Odd/Even use small dosages; small means many ingredients (up to nine), light weight, weak potency, reaching only near areas. Far diseases with Odd/Even use large dosages; large means few ingredients (down to two), heavy weight, potent action, reaching far areas. This is the method of combining Odd and Even. If a near disease uses a large dosage, the medicine overwhelms the disease (punishing the innocent). If a far disease uses a small dosage, the medicine fails to reach the disease (like horses and cattle running in opposite directions). "Near use Odd, Far use Even" describes the constant rule; "Near with Odd/Even, Far with Odd/Even" describes variable application. Knowing change and constancy allows for flexible response.) If Odd formulas fail, use Even formulas; this is called Chong Fang (Repeated Formula). If Even formulas fail, use reverse adjuvant therapy to achieve the effect. This involves Cold, Hot, Warm, and Cool, reversing to follow the disease nature. (This demonstrates flexible adaptation. If an Odd formula fails, there is a mismatch, so switch to an Even formula. Alternating Odd and Even is called "Chong Fang," later known as "Compound Formula." If Even formulas also fail, investigate the subtle, extreme, true, and false aspects, and use reverse adjuvants. Reverse adjuvant means the drug shares the nature of the disease to comply with it. E.g., treating cold with hot drugs, but cold rejects heat; add a cold adjuvant to facilitate entry. Treating heat with cold drugs, but heat rejects cold; add a hot adjuvant. E.g., taking cold drugs hot, using heat to move cold; taking hot drugs cold, using cold to move heat. These are subtle uses of reverse adjuvants, aiming to guide according to the trend.) The uses of the Five Flavors in Yin and Yang: Pungent and Sweet disperse and are Yang; Sour and Bitter induce vomiting and purging and are Yin; Salty induces vomiting and purging and is Yin; Bland promotes渗泄 (diuresis and opening orifices) and is Yang. These six flavors either astringe or disperse, relax or tense, dry or moisten, soften or harden. Act according to their benefits to harmonize Qi and bring it to balance. (Vomit is 'Yong', purge is 'Xie', diuresis/opening is 'Shen Xie'. Pungent disperses and moistens; Sweet relaxes; Sour astringes and tenses; Bitter dries and hardens; Salty softens; Bland promotes diuresis. Rising and light are Yang; descending and heavy are Yin. Acting according to their benefits harmonizes Qi.) Some diseases cannot be cured by regulating Qi alone. Whether toxic or non-toxic, the focus is on treating the disease, adjusting the formula size accordingly. (Non-Qi regulation refers to diseases not caused by Qi dysfunction. Four categories of disease origin: 1. Internal formation due to Qi movement, e.g., accumulations, masses, tumors, goiters, tuberculosis, epilepsy. 2. External formation due to Qi movement, e.g., abscesses, ulcers, warts, hemorrhoids, edema, red eyes, rashes, swelling, itching. 3. Internal disease not due to Qi movement, e.g., retained fluids, food stagnation, overeating/starvation, labor injury, old food, cholera, emotional disturbances (grief, fear, anger, joy, longing, worry). 4. External disease not due to Qi movement, e.g., miasma, demons, insect/snake venom, gu poison, flying corpse, ghost strike, trauma, falls, wind/cold/summerheat/damp invasion, stabbing, cutting, beating. These four categories have various treatments: internal only, internal and external, external only, external and internal, internal then external, external then internal, toxic attack, non-toxic guidance. Heavy/light, slow/fast, astringent/dispersing, moistening/drying, softening/hardening—all have appropriate uses. Some need toxicity, some do not. Focus on treating the disease appropriately. Thus, formula size and weight are determined by the disease.) Formula principles: 1 Sovereign, 2 Ministers = Small formula; 1 Sovereign, 3 Ministers, 5 Assistants = Medium formula; 1 Sovereign, 3 Ministers, 9 Assistants = Large formula. Cold is treated with Heat; Heat is treated with Cold. (Treating cold with hot, heat with cold, is Zheng Zhi (Direct Treatment).) Minor diseases are treated inversely (Ni Zhi); major diseases are treated conformingly (Cong Zhi). (Minor diseases, e.g., Yang disease causes heat, Yin disease causes cold, true signs are visible, disease is minor, so inverse treatment (Zheng Zhi) is used. Major diseases, e.g., extreme heat mimics cold, extreme cold mimics heat, false signs are hard to distinguish, disease is severe, so conforming treatment (Fan Zhi) is used.) Hardness is reduced; invaders are removed; exhaustion is warmed; knots are scattered; retention is attacked; dryness is moistened; tension is relaxed; dispersion is gathered; loss is supplemented; leisure is moved; fright is calmed; upper is vomited; lower is purged; massage is applied; bathing is done; pressure is applied;劫夺 (robbery/severe attack) is used; opening is performed; dispersing is done. Suit the matter as the goal. (Warm means nourish. Leisure means chaotic running. Move means circulate stagnation. Calm means pacify. Upper means vomit. Massage means rubbing. Pressure means pursue hidden pathogens. Robbery means seize strong pathogens. Suit the matter means appropriate to the situation. Direct/Conforming treatment noted above. Cong Shao (conform minority): one same, two different. Cong Duo (conform majority): two same, one different. Adjust based on severity. Full conformity is natural for complete reversal. Treatment has direct/conforming aspects because disease has minor/major severity. Severity depends on true/false signs. Cold/Heat and Excess/Deficiency have true/false. True signs use Direct Treatment; false signs use Conforming Treatment. True Cold: pulse deep/thin/weak/slow,厥逆 (cold limbs), vomiting, abdominal pain, undigested stool diarrhea, clear frequent urination. Even with fever, patient wants clothes. Floating heat outside, sinking cold inside. True Heat: pulse rapid/forceful/sliding/big/excess, irritability, panting, fullness, loud voice, constipation, dark scanty urine, fever pushing away clothes, distension/pain/heat/thirst. These are true diseases. True Cold needs warming; True Heat needs clearing. This is Direct Treatment. False Cold: Yang disease resembles Yin, Fire extreme resembles Water. Exterior cold, interior heat. Pulse rapid/forceful or deep/beating. Body cold, dislikes clothes. Hot constipation. Thirst craving drink. Foul intestinal filth. Dislike of cold is not true cold; it is clearly heat. "Extreme heat mimics cold transformation," also "Yang excess blocking Yin." False Heat: Yin disease resembles Yang, Water extreme resembles Fire. Exterior heat, interior cold. Pulse faint/weak or rapid/deficient or floating/big/rootless or string-taut/choppy. Body hot but spirit quiet. Delirious speech but weak voice. Virtual mania stops when restrained. Mosquito-bite-like spots, pale red/fine. Likes cold water but drinks little. Red tongue coating but keeps blankets. Frequent urination. Loose stool. Dislike of heat is not true heat; it is clearly cold. "Extreme cold mimics heat transformation," also "Yin excess blocking Yang." These are false diseases. False Cold: clear internal heat; internal clear, floating Yin retreats. False Heat: warm true Yang; internal warm, deficient fire returns to source. This is Conforming Treatment. Regarding Excess/Deficiency: Extreme Deficiency has Excess symptoms (False Excess); Extreme Excess has Deficient symptoms (False Deficiency). Deficiency is Zheng Qi deficiency: pale face, tired form, weak spirit, timid Qi, spontaneous sweating, incontinence, nocturnal emission, vomiting/blockage, long-term aggressive treatment, shortness of breath resembling asthma, over-labor, sudden shock/depression. Although exterior signs resemble Excess, weak pulse without spirit indicates Deficiency requiring tonification. Excess is Xie Qi excess: exterior blockage in meridians, interior knotting in Zang-Fu, Qi stagnation, Blood stasis. Pulse and disease both strong indicate Excess requiring attack. Excess and Deficiency are often similar, requiring differentiation of truth. If Zheng Qi is deficient, even if Xie Qi is excess, do not attack, lest Zheng Qi collapse before Xie Qi leaves, leading to sudden death. Treat Deficient-Xie by first protecting Zheng Qi. If Zheng Qi exists, no harm occurs. Tonification contains attack: tonifying Yin attacks Heat, tonifying Yang attacks Cold. No case of restored Zheng Qi with lingering Xie Qi, nor exhausted Zheng Qi with preserved life. If unavoidable, weigh urgency, adjust dosage, embed attack in defense.) As for Heat used with Cold, Cold used with Heat, Obstruction treated with Obstruction, Flow treated with Flow, one must subdue the main pathology and address the cause first. Initially similar, finally different. Can break accumulations, dissolve hardness, harmonize Qi, ensure cure. (Heat used with Cold: e.g., severe internal cold requires hot treatment, but extreme cold rejects hot drugs. Take hot drugs cold. After swallowing, cold body dissipates, hot nature activates. Compliance is maintained, great benefit achieved. This is "Heat used with Cold." Cold used