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In the upper position (Cun), the Chi pulse does not respond. In years of Nan Zheng (Southern Polity), if the Three Yin meridians govern the Heaven (San Tian), the Cun pulse does not respond; if the Three Yin meridians govern the Earth (Zai Quan), the Chi pulse does not respond, and this applies to both left and right hands equally.

Article 2: Clarifying the Law that Medication Should Not Distantly Avoid Cold or Heat (One Law, Expounding One Passage from *Nei Jing*) Generally, in treating diseases, one should avoid using cold medicines during cold periods and hot medicines during hot periods; this is the constant rule. Not avoiding cold or heat constitutes a variable approach. If one does not understand the distinction between the constant and the variable, and treats all cases uniformly, it will brew endless disasters; this is the fault of the physician.

To release the exterior (Biao) does not require distancing oneself from heat; to attack the interior (Li) does not require distancing oneself from cold. If one neither releases the exterior nor attacks the interior, but instead exposes the patient to cold or heat, causing cold and heat to invade internally as thieves, the disease will worsen. Therefore, if one does not distance oneself from heat, heat will arrive; if one does not distance oneself from cold, cold will arrive. When cold arrives, diseases such as hardness and obstruction, abdominal fullness, urgent pain, and diarrhea arise. When heat arrives, diseases such as fever, vomiting and diarrhea, cholera-like disorders, carbuncles and sores, mental confusion and depression, dysentery with continuous discharge, black spots on the skin, swelling, vomiting, nasal congestion with epistaxis, deformation of bone joints, muscle pain, hemorrhage, bloody stool, and strangury arise.

In treating diseases, only when releasing the exterior does one not distance oneself from heat; otherwise, one must distance oneself from heat. Only when attacking the interior does one not distance oneself from cold; otherwise, one must distance oneself from cold. To distance oneself when one should not, or not to distance oneself when one should, results in harms that are beyond description.

Article 3: Clarifying the Law Regarding the Failure to Simplify Prescriptions (One Law, Expounding Two Passages from *Nei Jing*) Whenever prescribing, if the roles of Sovereign (Jun), Minister (Chen), Assistant (Zuo), and Courier (Shi) are not distinguished, resulting in chaotic complexity, and drugs are arbitrarily added, making the medication completely mismatched with the disease, this is the fault of the physician.

Simplifying a prescription is like tightening a bag. If a full bag is not tightened, its contents will leak. If a prescription is formed but not simplified, the divine efficacy (Shen) will not reside within it.

Practitioners of medicine should simplify prescriptions for treating diseases and achieve refinement through simplification. The *I Ching* states: "Penetrating the meaning leads to spiritual profundity, thereby enabling application." Without obtaining refinement, how can one enter spiritual profundity? Having a prescription without simplification means there is no divine efficacy residing in it; hence it is said that "the divine does not reside." Zang organs have high and low positions, Fu organ qi has distances near and far, disease patterns have exterior and interior distinctions, and medication has heavy and light properties. Adjusting the quantity and harmonizing the speed and slackness ensures the medicinal qi reaches the disease site. Thus, avoiding excess and deficiency constitutes "simplification" (Yue).

Knowing how to simplify before the number of herbs is full qualifies one as a craftsman, but not as a teacher for the world.

What is there to simplify if the number of herbs is not yet full? Therefore, speaking of simplification implies that it is not feasible unless the prescription is full. Consequently, those who know how to simplify when the prescription is not full are likely unlearned and incompetent individuals. However, compared to those who do not know simplification at all, their errors are slightly less severe. I have observed physicians using potent and heavy formulas who frequently achieved miraculous cures; yet, upon examining their karmic retribution, they suffered harsher consequences than those using mild and light formulas. Is this not because their merit was accidental, failing to outweigh their fault? Alas! Where can one find a wise person of upright conduct without flaw, who walks safely on dangerous paths and whose adaptive measures always conform to canonical principles?

Article 4: Clarifying the Law Regarding the Failure to Simplify Medications (One Law, Expounding Two Passages from *Nei Jing*) Using medication excessively or insufficiently is never moderate. Insufficiency can be corrected by adding treatment, but excess leaves residual drug action after the disease is gone, causing more severe harm; this is the physician's error.

The Yellow Emperor asked: "For toxic and non-toxic drugs, is there a principle of limitation?" Qibo answered: "Diseases vary in duration and novelty, and formulas vary in size. There is a fixed system for toxic and non-toxic drugs. For drugs with major toxicity, stop when six-tenths of the disease is removed; for drugs with common toxicity, stop when seven-tenths is removed; for drugs with moderate toxicity, stop when eight-tenths is removed; for non-toxic drugs, stop when nine-tenths is removed. Use grains, meats, fruits, and vegetables for dietary nourishment to complete the recovery. Do not overdo it, lest you injure the healthy Qi."

Drugs of the Lower Grade with fierce toxicity should be stopped when six-tenths of the disease is removed; drugs of the Middle Grade, with toxicity inferior to the Lower Grade, should be stopped when seven-tenths is removed; drugs of the Upper Grade with minor toxicity should be stopped when eight-tenths is removed. Among the Upper, Lower, and Middle Grades, there are all non-toxic and mild drugs, which should be stopped when nine-tenths of the disease is removed. This is the standard system.

The use of toxic or non-toxic drugs depends primarily on the disease being treated, and dosages are determined according to the severity and size of the condition.

A good formula is one that can break up accumulations, cure diseases, resolve emergencies, and save lives from death. It is not necessarily true that having toxicity first is correct and non-toxicity later is wrong, or that non-toxicity is wrong and toxicity is correct. One must measure the severity and size of the disease to formulate accordingly. The *Rites of Zhou* ordered medical officers to collect toxic drugs for medical affairs, indicating that non-toxic drugs can be used for health preservation but are insufficient to overcome serious diseases. A common malpractice among contemporary physicians is selecting dozens of non-toxic drugs to avoid blame. Such approaches fail to eliminate even two or three parts of the disease. They employ techniques akin to nurturing an abscess, sitting idle while wasting time, delaying until patients die—a situation seen everywhere. How can they expect themselves to live long and their descendants to enjoy longevity?

Article 5: Clarifying the Law Regarding the Failure to Enumerate Five Errors (One Law, Explaining Five Passages from the Classic) In diagnosing diseases, failing to inquire about the Three Constants (social status changes), not knowing how to use analogical reasoning, failing to observe the patient's spirit and mind, and disregarding sage teachings, acting recklessly without fear, constitute the physician's fault.

Before diagnosing, one must ask about past experiences of nobility followed by baseness. Even without external pathogenic invasion, disease arises internally, named Tuoying (Depletion of Ying). Past wealth followed by poverty is named Shijing (Loss of Jing). The Five Qi remain stagnant, and pathogens merge. Crude physicians diagnose, believing the issue lies neither in the Zang-Fu nor in physical deformity, feeling doubtful and unable to name the disease. The body wastes away daily, Qi becomes deficient and Jing depleted. The disease deepens without Qi, accompanied by shivering and sudden fright. Deep disease results from external depletion of Wei Qi and internal deprivation of Ying Qi. Even skilled physicians may err due to lack of understanding of the condition; this is the first error in treatment.

The error lies in not asking about the origin of the condition.

When intending to diagnose, one must ask about diet and living conditions. Sudden joy followed by sudden sorrow, or initial joy turning to sorrow, all damage Essence-Qi. When Essence-Qi is exhausted and destroyed, the physical form deteriorates. Sudden anger injures Yin, sudden joy injures Yang. Rebellious Qi ascends, filling the vessels and separating from the form. Foolish physicians treat without knowing tonification or sedation, lacking understanding of the condition. The essence is daily stolen, and evil Qi merges. This is the second error in treatment.

The error lies in not knowing that patients suffer from the Seven Emotions differently.

Those skilled in pulse diagnosis must use analogical reasoning and comparison with abnormal states (Qiheng), understanding calmly and deliberately. A practitioner who lacks this knowledge renders diagnosis worthless; this is the third error in treatment.

Analogical reasoning is highly valued by physicians. Like an experienced judge handling cases not covered by law, one uses analogy to decide, leaving no detail unexamined. "Qiheng" refers to examining whether the disease is abnormal or ordinary. "Congrong" means carefully considering and comparing when using analogical methods to distinguish pathological mechanisms, avoiding carelessness and brevity.

Diagnosis involves the Three Constants: one must ask about noble/base status. Loss of power after being a feudal lord, or failure to become a king, causes spiritual injury even without external pathogens, leading to bodily decline. Poverty after wealth causes dry skin and contracted sinews, leading to flaccidity and spasms. If the physician cannot be strict, cannot move the patient's spirit, and shows outward weakness, the treatment order becomes chaotic, the disease remains untreatable, and medical practice fails. This is the fourth error in treatment.

This error stems from the inability to admonish the patient seriously, inspire reverence and spiritual movement, remove worries, and merely showing outward weakness while yielding to others.

Physicians must know the beginning and end of diseases and understand residual symptoms. Pulse taking and inquiry must consider gender differences. Separation, divorce, frustration, worry, fear, anger, and joy cause the Five Zang to become empty and the Five Qi to leave their posts. If the physician does not understand this, what talk of medical skill is there?

Observing the beginning and end of Qi and color reveals residual symptoms of onset. Differentiating normal pulses in men and women, and internal injuries from the Seven Emotions: separation from loved ones causes the Hun (Ethereal Soul) to wander; cutting off desires causes the Yi (Intellect) to be lost; accumulated worries exhaust the Shen (Spirit); lingering resentment causes bitterness in the Zhi (Will); sorrow causes obstruction and stagnation; fear causes instability and loss of control; rage causes confusion and disorder; excessive joy causes dispersion and lack of storage. From these eight factors, the Five Zang become empty, and Blood and Qi leave their posts. If the physician does not reflect and understand, how can they speak of medicine?

Great injury from former wealth severs sinews and vessels. Although the body regains movement, the moistening function does not cease. Injury and collapse condense, lingering and attaching to Yang, forming pus and alternating chills and fever. Crude physicians treat hastily, disrupting Yin and Yang, causing the body to disintegrate, limbs to spasm, and death to come soon. Physicians who cannot clarify this, do not ask about the onset, and only predict death are crude doctors. This is the fifth error in treatment.

Non-proportional damage restores the body, but fluids are not nourished. Internal knotting of Blood and Qi lingers and does not dissipate. Attaching to Yang vessels transforms into pus; lingering in the abdomen manifests externally as alternating chills and fever. Not only are the unlearned considered crude physicians, but even those who master the classics of three generations, yet fail to distinguish the Three Constants in diagnosis and do not guard against the Five Errors in treatment, are also considered rough practitioners.

All five errors stem from incomplete mastery of skills and ignorance of human affairs.

Article 6: Clarifying the Law Regarding the Failure to Verify Four Errors (One Law, Recording Two Passages from the Text) Treating diseases without distinguishing symptoms and pulses, and deceiving people with unorthodox methods lacking proper lineage, is the most despicable and hardly worthy of blame.

The twelve meridians and three hundred sixty-five collaterals are well-known to everyone and followed by practitioners. The reason for not achieving perfect success is lack of spiritual focus, unruly intent, and disconnect between internal and external states, leading to doubt and danger.

Lack of spiritual focus prevents sharing in fortune and misfortune (accurate prognosis). Unruly intent prevents responding to infinite changes. Disconnect between internal and external prevents integrating complexion and pulse analysis. How can one avoid doubt and danger?

Failing to distinguish Yin and Yang in diagnosis is the first error in treatment. Failing to complete apprenticeship, practicing random eclectic arts, presenting fallacies as Dao, changing names to claim credit, and recklessly using Bian stones, leaving subsequent harm to the body, is the second error in treatment. Failing to adapt to the living conditions of the poor, rich, and noble; the thickness or thinness of seating; the cold or warmth of the physique; and the suitability of diet; failing to distinguish bravery from timidity; and not knowing analogical reasoning, leads to self-confusion rather than self-clarity. This is the third error in treatment. Failing to ask about the onset of disease, including worries, dietary irregularities, excessive lifestyle, or toxic injuries, and suddenly palpating the Cun Kou pulse without prior context, allows one to diagnose nothing. Making wild claims and names, becoming trapped by crudeness, is the fourth error in treatment.