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The *Ling Shu* (Spiritual Pivot) chapter "Ci Jie Zhen Xie" (Needling to Regulate True and Evil) states: The *Zhen Qi* (True Vital Qi) is received from Heaven (congenital endowment), combines with *Gu Qi* (Grain Qi derived from food), and fills the body.

The *Su Wen* (Basic Questions) chapter "Shu Wu Guo Lun" (Discourse on Five Types of Medical Errors) states: The principle of treating disease is to regard the internal *Qi* as precious; one must follow and seek its principles. If these cannot be found, the error lies in the judgment of *Biao* (Exterior) and *Li* (Interior).

The *Su Wen* chapter "Yin Yang Ying Xiang Da Lun" (Great Discourse on Yin-Yang Correspondences) states: *Yin* and *Yang* are the Way of Heaven and Earth, the guidelines of all things, the parents of change, and the origin of life and death, [and the manifestation of] *Shen Ming* (Divine Spirit/Natural Profound Changes).

In the *Su Wen* chapter "Zhi Zhen Yao Da Lun" (Great Discourse on the Most Essential Truths), the Emperor asked: *Qi* varies in quantity, diseases vary in excess or deficiency, treatment varies in urgency or slowness, and formulas vary in size. I wish to hear their summary; how should it be done? ([The Six Qi of the Five Movements and Six Qi have excess and deficiency, hence "Qi varies in quantity." Human diseases inevitably fluctuate with the Qi, hence "diseases vary in excess or deficiency." Therefore, the urgency of treatment and the size of formulas must correspond to the severity of the condition.]) *Qibo* replied: *Qi* has high and low positions, diseases have distant and near locations, syndromes have interior and exterior manifestations, and treatments have heavy and light approaches; [the goal is to] make the medicine reach exactly where the disease is. ([Due to the *Si Tian* (Ruling Qi) and *Zai Quan* (Sitting Earth) of the year, *Qi* has high and low levels. Due to the upper and lower positions of meridians and zang-fu organs, diseases have distant and near locations. Interior is called "Zhong" (Middle/Deep), Exterior is called "Wai" (Surface/Shallow). For slow conditions, light treatment is appropriate; for urgent conditions, heavy treatment is appropriate. This means the medicinal force must reach the site of the disease, neither exceeding nor falling short of it.]) The *Da Yao* (Major Essentials) states: One Sovereign herb and two Minister herbs constitute the system of *Qi Fang* (Odd Formulas). Two Sovereign herbs and four Minister herbs constitute the system of *Ou Fang* (Even Formulas). Two Sovereign herbs and three Minister herbs constitute the system of *Qi Fang*. Two Sovereign herbs and six Minister herbs constitute the system of *Ou Fang*. (*Da Yao* refers to approximately. The herb that treats the main disease is the Sovereign; its dosage should be doubled. The herb that assists the Sovereign is the Minister; its dosage should be less than the Sovereign. Odd numbers belong to *Yang*, i.e., ancient *Dan Fang* (Single Formulas). Even numbers belong to *Yin*, i.e., ancient *Fu Fang* (Compound Formulas). Thus, 1 Sovereign + 2 Ministers = 3 herbs (Odd); 2 Sovereigns + 3 Ministers = 5 herbs (Odd). These are *Qi Fang*. 2 Sovereigns + 4 Ministers = 6 herbs (Even); 2 Sovereigns + 6 Ministers = 8 herbs (Even). These are *Ou Fang*. *Qi Fang* belongs to *Yang* and is light; *Ou Fang* belongs to *Yin* and is heavy.) Therefore it is said: For near diseases, use *Qi Fang*; for distant diseases, use *Ou Fang*. For diaphoresis (sweating), do not use *Ou Fang*; for purgation, do not use *Qi Fang*. ([Near diseases are Upper and *Yang*, so use *Qi Fang* for its lightness and slowness. Distant diseases are Lower and *Yin*, so use *Ou Fang* for its heaviness and urgency. Diaphoresis does not use *Ou Fang* because *Yin* is sinking and cannot reach the Exterior. Purgation does not use *Qi Fang* because *Yang* ascends and cannot descend downward. This section specifically uses odd/even and yin/yang to generalize sweating and purging; thus, the yin/yang nature of flavors is certainly not secondary to the odd/even count. The deeper meaning here is to elucidate the principles of formula formulation, not merely the odd/even count. Old texts read: "Diaphoresis does not use *Qi Fang*, purgation does not use *Ou Fang*." But Wang Bing's commentary says: "Exterior-releasing drugs do not use *Ou Fang*, draining-purgative drugs do not use *Qi Fang*." This commentary contradicts the text. However, Wang's reasoning is correct, and the original text seems erroneous; we now correct it to follow Wang. Note: *Qi* is pronounced jī.] For tonifying the Upper and treating Upper diseases, the formulation should be slow; for tonifying the Lower and treating Lower diseases, the formulation should be urgent. Urgent formulations have strong flavors; slow formulations have weak flavors; this ensures the medicine reaches its target. ([Slow formulation for Upper diseases aims to retain the medicine in the Upper Jiao. Urgent formulation for Lower diseases aims to reach the Lower Jiao directly. Thus, urgency requires strong flavors; slowness requires weak flavors. If a slow formula has strong flavors, it acts harshly and leaves quickly. If an urgent formula has weak flavors, it is mild and fails to advance. Only when slowness/urgency and strength/weakness are balanced can the medicine reach the disease site and achieve the therapeutic key.] If the disease is distant and the drug's flavor is absorbed along the way, food should be used to assist it, without violating the system of formulation. ([If the disease is deep, the drug must pass through the Stomach. If administered improperly, the drug may not reach the disease, and its flavor may stop midway. Therefore, food should aid the drug to ensure it reaches distant sites, which is "passing through." Examples include drinking wine or porridge to boost medicinal power. By analogy, the speed of ingestion, the ascending/descending properties of root/tip parts, and the suitability of decoctions, pastes, pills, and powders all follow specific rules, hence "do not violate the system." Wang Bing said: If the disease is in the Kidney but Heart Qi is deficient, the drug should pass through quickly. Do not nourish the Heart with flavors, or the Kidney drug will oppress the Heart, further weakening it. The same applies to other upper/lower/distant/near cases. Li Dongyuan said: The Sage treats the Upper without offending the Lower, treats the Lower without offending the Upper, and treats the Middle without offending either. Thus: "Punishing the innocent is called great confusion." Zhang Yuansu said: Treating the Upper must prevent downward transmission; treating the Exterior must connect to the Interior. Using Huang Qin (Scutellariae Radix) for the Lung hinders the Spleen. Using Cong Rong (Cistanche Caulis) for the Kidney hinders the Heart. Taking Gan Jiang (Zingiberis Rhizoma) for the Middle affects the Upper. Taking Fu Zi (Aconiti Lateralis Radix Praeparata) to tonify Fire depletes Water. Regarding medication timing, there is a tradition of pre-meal and post-meal administration. However, it is generally suitable to take medicine when the stomach is empty (long after meals). It is absolutely inadvisable to take medicine after meals, as food is received in the Stomach. Stomach Qi distributes essence to the Spleen, which transmits it to the Lung. The Lung governs regulation and distribution to the zang-fu. Thus, the Stomach is the furnace of the body. No drug enters the Six Meridians directly without passing through the Stomach. Moreover, the Lung is the Canopy, with orifices facing downward to receive steam from food. Drugs entering the Stomass must also circulate essence upward to the Lung. It is unheard of for Heart drugs to enter the Heart only after reaching the Heart space, or Lung drugs to enter the Lung only after reaching the Lung space. If Upper Diaphragm drugs are taken after meals, Stomach Qi is blocked by food, delaying the drug until digestion is complete. This seeks speed but achieves slowness. Furthermore, meridians lie within muscle tissue; drug dregs cannot reach them, only the flavors. If one claims Upper drugs must stay Upper and Lower drugs must stay Lower, then Head drugs must stay in the Head and Foot drugs in the Foot? This logic is obvious and easy to see; the error must be corrected.] Therefore, the method for balancing Qi is: For near diseases, use odd or even formulas, but prepare small doses. For distant diseases, use odd or even formulas, but prepare large doses. Large doses have fewer ingredients; small doses have more ingredients. More ingredients go up to nine; fewer go down to two. ([Balancing Qi means correcting imbalance. Near is Upper, Distant is Lower. Both have Yin/Yang and Exterior/Interior distinctions, so both use odd/even combinations. E.g., odd ingredient count with even weights, or even count with odd weights. This mutual use is subtle. Near diseases with odd/even formulas use small doses. Small doses mean many ingredients (up to nine). Many ingredients mean light individual weights, weak potency, reaching only near areas. Distant diseases with odd/even formulas use large doses. Large doses mean few ingredients (down to two). Few ingredients mean heavy individual weights, potent action, reaching deeply. This is the method of combining odd/even. If near diseases use large doses, the drug overwhelms the disease ("punishing the innocent"). If distant diseases use small doses, the drug fails to reach the disease ("like wind and horses differing in direction"). The previous text said "Near use Odd, Distant use Even," stating the constant rule. This text says "Near use Odd/Even, Distant use Odd/Even," stating the variable application. Knowing both constant and variable applications ensures infinite utility.] If *Qi Fang* fails, use *Ou Fang*; this is called *Chong Fang* (Repeated Formula). If *Ou Fang* fails, use *Fan Zuo* (Reverse Assistance) to treat it. This is what is meant by "Cold, Heat, Warm, Cool" following the disease nature. ([This shows circular flexibility. Initially using *Qi Fang*; if ineffective, there is a mismatch, so change to *Ou Fang*. Alternating *Qi* and *Ou* is *Chong Fang*, later known as *Fu Fang* (Compound Formula). If *Ou Fang* still fails, investigate the subtlety/extremity and truth/falsehood, and use *Fan Zuo*. *Fan Zuo* means the drug matches the disease nature to comply with it. E.g., treating Cold with Heat, but Cold rejects Heat; add a small amount of Cold drug to guide it in. Treating Heat with Cold, but Heat rejects Cold; add a small amount of Heat drug to guide it in. Also, taking Cold drugs hot (using heat to move cold) or Hot drugs cold (using cold to move heat) are all subtle uses of reverse assistance. Guiding according to circumstances makes effort easier. Wang Bing said: Heat and Cold oppose each other. Tiny Heat is subdued by Cold; tiny Cold is eliminated by Heat. Extreme Cold/Heat competes with opposing natures and clashes with different Qi. Different sounds don't resonate; different Qi doesn't combine. Thus, one fears attacking. Attacking causes Disease Qi and Drug Qi to clash, forming self-contained Cold/Heat barriers. Therefore, the Sage uses reverse assistants to harmonize Qi, making sound and Qi correspond, mixing Cold and Heat, so they start similar but end different. Moisture defeats hardness; rigidity breaks; fragility vanishes. Li Dongyuan said: Variation lies in the disease; controlling the disease lies in the formula; formulating the formula lies in the person. There are Seven Forms: Large, Small, Slow, Urgent, Odd, Even, Repeated. Large/Small determine Odd/Even methods. E.g., Xiao Cheng Qi Tang and Tiao Wei Cheng Qi Tang are Small Odd Formulas. Da Cheng Qi Tang and Di Dang Tang are Large Odd Formulas, used for purging the Interior. Gui Zhi Tang and Ma Huang Tang are Small Even Formulas. Ge Gen Tang and Qing Long Tang are Large Even Formulas, used for releasing the Exterior. Hence: "Sweating does not use Odd, Purging does not use Even." Zhang Yuansu said: Large Formulas have two types: 1 Sovereign, 3 Ministers, 9 Assistants. For diseases with multiple syndromes and diverse pathogens, unsuitable for 1-2 herbs. Or, large weight taken at once, for Liver/Kidney/Lower diseases with distant paths. Wang Bing considered Heart/Lung as Near, Liver/Kidney as Distant, Spleen/Stomach as Middle. Liu Wansu considered Body Exterior as Distant, Body Interior as Near. I consider: Upper half is Heaven's domain; Lower half is Earth's domain; Middle Jiao is Human's domain. Small Formulas have two types: 1 Sovereign, 2 Ministers. For diseases without complications and single pathogens, suitable for 1-2 herbs. Or, small weight taken at once, for Heart/Lung/Upper diseases, sipped slowly. Li Dongyuan said: Liver/Kidney are distant; many herbs make Qi slow, unable to reach Lower quickly. Must use large dose, few herbs, for urgent downward action. Heart/Lung are near; few herbs make Qi rush downward, unable to ascend. Must use small dose, many herbs, for easy upward dispersion. Wang's "Lung takes 9, Heart takes 7, Spleen takes 5, Liver takes 3, Kidney takes 1" refers to the generation numbers of the Five Zang. Zhang Yuansu said: Slow Formulas have five types: 1. Sweet to slow (Gan Cao, sugar, honey). For Chest/Diaphragm diseases, to retain. 2. Pills to slow. Slower than decoctions/powders. 3. Many ingredients. Mutual restraint prevents individual potency. 4. Non-toxic drugs. Pure nature, slow effect. 5. Weak flavors. Good for Upper tonification/treatment; power fades by Lower Jiao. Urgent Formulas have four types: 1. Urgent attack for urgent disease (Wind-stroke, Guan Ge). 2. Decoction/Powder scouring. Fast absorption/action. 3. Toxic drugs. Toxicity forces vomiting/purging to seize disease momentum. 4. Strong flavors. Direct descent, enduring power. Odd Formulas have two types: 1. Single herb. For Upper/Near diseases. 2. Herb count matches Odd numbers (1,3,5,7,9). Suitable for purging, not sweating. Even Formulas have three types: 1. Two herbs paired. 2. Two ancient formulas combined (ancient *Fu Fang*). Suitable for Upper/Distant diseases. 3. Herb count matches Even numbers (2,4,6,8,10). Suitable for sweating, not purging. Wang Bing said: Sweating drugs not using Even means Qi is insufficient to reach Exterior. Purging drugs not using Odd means drug toxicity attacks excessively. But Zhang Zhongjing's formulas: Gui Zhi Tang (sweating) uses 5 herbs (Odd). Da Cheng Qi Tang (purging) uses 4 herbs (Even). Is this flexible adaptation with additions/subtractions? Zhang Yuansu said: If Odd fails, use Even; if Even fails, use Odd. Hence "Repeating": Repeat means Heavy, Again. E.g., Ten Tonics, One Drainage; Multiple Drainages, One Tonification. Also, Taiyang presenting Wind Pulse, Shaoyang presenting Cold Pulse indicates Pulse-Syndrome mismatch, suitable for Compound Formula. Zhang Yuansu said: Compound Formulas have three types: 1. Combination of 2, 3, or many formulas (e.g., Gui Zhi Er Yue Bi Yi Tang, Wu Ji San). 2. Adding herbs to base formula (e.g., Tiao Wei Cheng Qi Tang plus Lian Qiao, Bo He, Huang Qin, Zhi Zi to make Liang Ge San). 3. Equal weights (e.g., Wei Feng Tang equal parts). Wang Bing equated Even with Compound. Now Seven Forms include Even and Repeated. Doesn't this mean Even is combination of two, Repeated is combination of many? Li Dongyuan said: Seven Forms, Ten Dosage Forms. Seven Forms insufficient for formula variations; Ten Dosages insufficient for dosage utility. Formula not matching syndrome is not a formula. Dosage not removing disease is not a dosage. This was established by ancient masters as standards for straightness/crookedness. Later physicians deviated. Things have natures; formulate and use them, transform and adapt them. Applied to dosages, utility is endless. The gist of Ten Dosages is scattered in *Ben Cao Cong Xin*.)

In the *Su Wen* chapter "Zhi Zhen Yao Da Lun", the Emperor asked: How are the uses of the Five Flavors and Yin/Yang? *Qibo* replied: Acrid and Sweet disperse and are *Yang*; Sour and Bitter induce vomiting/purging and are *Yin*; Salty induces vomiting/purging and is *Yin*; Bland induces seeping/drainage and is *Yang*. These six [flavors] either astringe or disperse, slow or urgent, dry or moisten, soften or harden. Act according to what is beneficial, regulate Qi to achieve balance. ([Vomiting is Yong; Purging is Xie. Seeping drainage is promoting urination and opening orifices. Acrid, Sweet, Sour, Bitter, Salty, Bland are the six natures. Acrid disperses/moistens; Sweet slows; Astringes/urgent; Bitter dries/hardens; Salty softens; Bland drains. *Zang Qi Fa Shi Lun* says: Acrid disperses, Sour astringes, Sweet slows, Bitter hardens, Salty softens. Thus, Five Flavor uses: Ascending/light are *Yang*; Descending/heavy are *Yin*. Acting according to benefit regulates Qi. Yong sounds like yǒng, like spring gushing. Ruan is same as Soft.]) The Emperor asked: What about those not cured by regulating Qi? How to treat? Which comes first, toxic or non-toxic? I wish to hear the way. ([Non-Qi regulation refers to diseases not caused by Qi disorder. Wang Bing said: Four categories of disease origin: 1. Initial Qi movement forms internal masses (accumulations, hernias, tumors, goiters, nodules, epilepsy). 2. Initial Qi movement forms external lesions (abscesses, ulcers, warts, scabies, hemorrhoids, convulsions, edema, red eyes, rashes, swelling, pain, itching). 3. Not due to Qi movement, internal disease (retained fluid, phlegm-food, hunger/fullness strain, old food, cholera, grief/fear/anger, longing/worry/knotting). 4. Not due to Qi movement, external disease (miasma, ghosts, insect/snake venom, plague, impact, falls, wind/cold/summerheat/dampness, stabbing/cutting/blowing). Of these four, some cure by internal treatment alone, some by internal/external, some by external alone, some by external/internal. Some require toxic drugs to attack; some require non-toxic drugs to guide. Heavy/light, slow/urgent, astringent/dispersing, moistening/drying, softening/hardening—all have appropriate uses.]) *Qibo* replied: Toxic or non-toxic, the treated disease is primary; adjust size according to the case. ([Meaning: As long as disease is removed and peace restored, it is a good formula. Regardless of toxicity, prioritize the disease. Formula size depends on disease severity.]) The Emperor asked: Please explain the formulation. *Qibo* replied: One Sovereign, two Ministers, is Small. One Sovereign, three Ministers, five Assistants, is Medium. One Sovereign, three Ministers, nine Assistants, is Large. ([This explains formula formulation.]) Cold is treated with Heat; Heat is treated with Cold. ([Treating Cold with Heat, Heat with Cold, is Zheng Zhi (Direct Treatment).]) Minor cases are treated oppositely (Ni); severe cases are treated similarly (Cong). ([Minor diseases, e.g., Yang disease shows Heat, Yin shows Cold, true signs are visible. Disease is minor, so treat oppositely (Ni), i.e., Direct Treatment. Severe diseases, e.g., Extreme Heat shows Cold, Extreme Cold shows Heat, false signs are hard to distinguish. Disease is severe, so treat similarly (Cong), i.e., Reverse Treatment. Wang Bing said: Minor diseases are like human fire; burn grass/wood, extinguish with water. Oppose nature to subdue. Severe diseases are like Dragon Fire; wetness increases flame, water intensifies burning. Ignoring nature, using water fails, flames rise skyward. Understanding nature, use Fire to drive Fire, flames self-extinguish. Ni means treating Heat with Cold, Cold with Heat. Cong means attacking with Cold/Heat, following nature, not necessarily identical. Hence: Ni is Zheng Zhi, Cong is Fan Zhi. Cong Shao/Cong Duo depends on the case.]) Hardness is削 (scraped/reduced); Guests are removed; Labor/Deficiency is warmed; Knots are dispersed. Retention is attacked; Dryness is moistened; Urgency/Spasm is relaxed; Scattering is gathered; Loss is benefited; Idleness/Disorder is moved; Fright is calmed. Upper ones are vomited; Lower ones are purged; Massage; Bathe; Intercept hidden pathogens; Rob overwhelming pathogenic factors; Open; Vent. Act appropriately for the matter. ([Wen is warming/nourishing. Yi is frantic/disordered. Xing is moving stagnation. Ping is calming. Shang is vomiting. Mo is massage. Bo is intercepting hidden pathogens. Jie is robbing strength. Shi Shi Wei Gu is acting appropriately for the situation.]) The Emperor asked: What is Ni and Cong? *Qibo* replied: Ni is Zheng Zhi (Direct Treatment); Cong is Fan Zhi (Reverse Treatment). Cong Shao/Cong Duo, observe the case. ([Treating Heat with Cold, Cold with Heat, opposing disease is Zheng Zhi. Treating Cold with Cold, Heat with Heat, following disease is Fan Zhi. Cong Shao: one same, two different. Cong Duo: two same, one different. Observe severity to adjust. If full reversal is suitable, fully comply. Treatment has Ni/Cong because disease has Minor/Severe. Disease severity depends on Syndrome Truth/Falsehood. Cold/Heat have Truth/Falsehood; Deficiency/Excess have Truth/Falsehood. Truth is Direct Treatment, easy to know. Falsehood is Reverse Treatment, difficult. E.g., Cold/Heat Truth/Falsehood: True Cold has deep/thin pulse, or weak/slow. Jue Ni, vomiting, abdominal pain, undigested stool diarrhea, clear frequent urine. Even with fever, prefers clothing. Floating Heat outside, Deep Cold inside. True Heat has rapid/forceful, slippery/large/excess pulse. Restlessness, panting, fullness, loud voice, constipation, dark scanty urine, fever pushing clothes off, distension/pain/heat/thirst. These are True Diseases. True Cold needs warming; True Heat needs clearing. This is appropriate...])