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Food stagnation in the stomach leads to disharmony of Qi mechanism. The treatment should follow the principle of "guiding according to the trend," employing emesis (inducing vomiting) as the optimal strategy. If food is vomited out immediately after ingestion, it indicates a lack of Yang fire (Yang Qi). In this case, warming and tonifying the Middle Jiao (Spleen and Stomach) is appropriate, and the accumulation will naturally dissipate. Whenever irregular diet damages the ascending and descending functions of Qi, causing a sensation of nausea or discomfort in the epigastrium (heart below), possibly accompanied by anger leading to stifled depression, recovery can be achieved through emesis. These are all applications of the method of "guiding according to the trend." If vomiting occurs immediately after eating, Wang Bing (Wang Taipu) stated: this is due to the absence of Fire. Internally, there must be concomitant Cold and accumulation. The treatment should focus on warming and tonifying the Middle Jiao, using Lizhong Tang (Regulate the Middle Decoction) with Licorice removed, adding Mume Fructus (Wumei), Fresh Ginger (Shengjiang), and phlegm-resolving herbs. (The Qian Ben version includes an additional herb, Aurantium Fructus (Zhike).) This belongs to the method of "guiding according to the trend" while simultaneously incorporating the intent of regulating the Middle Jiao.

There are four corresponding principles among treatment methods; mastering these correspondences can restore life. Diaphoresis (sweating), Warming, Emesis, and Purgation (draining down) must be applied accurately without error. If these correspondences are lost, life cannot be preserved. There are four main methods for treating diseases: diaphoresis, warming, emesis, and purgation; these are the standards for physicians. Failing to use diaphoresis when indicated is an error; if diaphoresis fails to induce sweating, it indicates that the Wei Qi (Defensive Qi) or external pathogens are obstructed. Failing to use warming when indicated is an error; if warming fails to take effect, it indicates that Yang Qi has collapsed. (Wang Xushan said: Deficiency patterns cannot tolerate harsh tonification.) Failing to use emesis when indicated is an error; if emesis fails to expel contents, it indicates that Stomach Qi has exhausted. Failing to use purgation when indicated is an error; if purgation fails to promote bowel movement, it indicates that the intestinal transmission function is blocked. Whenever diaphoretic, warming, emetic, or purgative herbs are used but the condition remains unresponsive, these are omens of death. Therefore, it is said: following the disease trend leads to survival, opposing it leads to death.

Physicians must be clear during clinical practice, observing complexion and spirit to determine life and death, pressing the abdomen to distinguish deficiency and excess, and relying on tongue inspection and auscultation/olfaction of voice. For various syndromes, first observe form and color, then inspect sound. The Classics state: complexion and pulse should be examined in conjunction. The Five Colors correspond to the Four Seasons, with Yellow belonging to Earth being the correct color. If Yellow appears in the complexion and a Moderate pulse (Huan Mai) appears in the pulse, it indicates the presence of Stomach Qi. Yellow is the color of Earth; Earth resides in the center and among the five colors. A slight hint of yellow is considered a good complexion. Complexion should not be overly red; a purely red complexion indicates the manifestation of the True Zang Color (True Organ Color), which signifies death. (Wang Xushan said: A purely red complexion is a sign of Yang Qi floating outward, so its appearance inevitably leads to death. The manifestation of True Zang Color also inevitably leads to death; however, True Zang Colors include Green, Yellow, White, and Black, not just Red.) Therefore, as long as the True Zang Color does not appear, one knows it is not yet a sign of death. If the pulse energy carries a moderate quality and the complexion shows a hint of yellow, one knows that Stomach Qi has not failed, and death is not certain. The eyes are the gathering place of the essence of the whole body. Spirit is stored internally and manifested externally; with spirit, the gaze is bright and clear, with normal white and black sclerae; in Excess patterns, the eyes shine brightly; in Deficiency patterns, they appear hazy and dim. If spirit is lost, vision becomes dull and unclear, unable to distinguish near from far. Further inspect the Pulse Spirit (Mai Shen); does it exist? If both eye spirit and pulse spirit are lost, death is undoubtedly decided. The tongue is the sprout of the Heart. Redness indicates Heat; white coating indicates Cold; purple color indicates extreme Hyperactivity of Heart Fire and Excess Heat. Inspect the pulse again; if it is indeed a surplus pulse, the treatment should urgently employ purgation. A black tongue indicates extreme Heat with no vitality. A yellow tongue combined with diarrhea and cracked lips/mouth indicates exhaustion of fluids (Water Drying Up); this is not Excess Heat but False Heat. Due to extreme deficiency of Kidney True Yang failing to transform and generate body fluids, large doses of warming and tonifying herbs are appropriate, slightly mixed with sweet-cold herbs to promote the generation of Metal (Lung) and Water (Kidney), thereby resolving dryness and restoring life. Using purely cooling herbs would instead drain True Yang, leading inevitably to death. Furthermore, short tongue combined with retraction of the scrotum: if the pulse is forceful, it is Heat; if the pulse is deficient, it is Cold; in either case, it is undoubtedly a death sign. Voice originates from the Dantian; a loud and clear voice indicates Spirit. Muffled or hoarse voice indicates Phlegm-Fire abundance; heavy at the beginning and light at the end indicates Deficiency; light at the beginning and heavy at the end indicates Excess. Cursing speech with a strong voice indicates Stomach Heat. Loss of voice in severe illness is a death sign. Silence in the patient indicates extreme Deficiency; ability to speak suggests the disease may resolve. Delirious speech (Zhenyu), repetitive weak speech (Zhengsheng), and moaning all indicate Yin Deficiency with internal instability, which are not auspicious signs. Diagnosing the pulse: if there is Spirit, survival is possible; if there is no Spirit, death ensues. Panting is due to Phlegm; treatment should clear the Lungs and descend Fire. If ineffective, examine the cause based on the pulse, and warming and tonifying should be adopted; warming the Kidney and descending Fire will alleviate panting. (If accompanied by external contraction, dispersing methods should also be used.) Abdominal palpation is used to verify deficiency and excess. Non-tenderness upon pressure indicates Deficiency; if the pulse is indeed insufficient, despite fever, warming and tonifying are appropriate. Tenderness upon pressure indicates Excess; if the pulse is indeed forceful, urgent purgation is required for recovery.
A sunken or collapsing Forehead (Tianting) is a death sign. Because Tianting belongs to Yang, if Yang does not ascend, Yin cannot generate; the有形 (form-based) body belongs to Yin; if Yin does not generate, the form will deteriorate and cease to exist, thus confirming it as a death sign.
The poem states: If practicing medicine without understanding Qi, what basis will treatment methods have? It is laughable for those within the profession to lack true understanding. Do not treat Phlegm merely when Phlegm is seen; do not attack Heat merely when Heat is seen; do not deplete Qi when Panting arises; do not clear blood merely when Bleeding is seen; do not induce sweating when there is no sweat; do not use astringents merely for Spermatorrhea. Understanding the mechanism within is to become a hero among physicians.