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1. Contemporary physicians, when treating diseases, only know how to observe the branch manifestations (Biao, secondary symptoms or superficial aspects) but do not know how to investigate the root cause (Ben, primary etiology or fundamental condition), and often use "branch and root" as an excuse. They say: "When the condition is urgent, treat the branch; when it is slow, treat the root." How can this be said to understand the meaning of "seeking the root" in the *Huangdi Neijing* (Yellow Emperor's Inner Canon)? Thus, they only see the urgency in the disease itself, while completely failing to realize that the urgency lies in preserving life. Which aspect should be considered slow? Which should be urgent? Which requires immediate attention today, and which requires even more urgent attention tomorrow? Since they do not understand the distinction between urgency and slowness, they often lead to mutual misinterpretation, making any discussion of branch and root moot!

2. Stroke syndromes are entirely caused by internal injury, with no external contraction involved. Since there is no external contraction, dispersing methods must absolutely not be used. If wind-treating medicines are overused, mild cases will inevitably become severe, and severe cases will die quickly.

3. The treatment of Shanghan (Cold Damage) hinges entirely on the concepts of Excess (Shi) and Deficiency (Xu). Excess patterns are easy to treat, while deficiency patterns are difficult. This is because the patient's Yuan Qi (Original Qi) is originally deficient, making it difficult for pathogenic factors to be resolved. When treating Shanghan complicated by deficiency, if one does not employ methods to support the healthy qi and expel pathogens, but only knows how to attack the pathogen, the more one attacks, the more deficient the qi becomes; the more deficient the qi, the more inevitable death becomes. In cases of extreme deficiency, even slight tonification may be of little benefit, and those who focus solely on treating the branch will certainly die.

4. Yang Meridian diseases in Shanghan are different from Yang Syndromes. A Yang Meridian disease refers to pathogens located at the exterior; a Yang Syndrome refers to heat located in the interior. If there are no pulse signs or symptoms of interior excess heat, yet one treats a Yang Meridian disease as a Yang Syndrome and recklessly uses cold-cooling medicines to treat fire, causing exterior and interior pathogens to combine and become intractable, such patients will certainly die.

5. The onset of dysentery occurs most easily in individuals with weak Spleen and Kidney. It results from indulging in cold foods due to heat, thereby damaging Zang-Fu Qi. This is a disease caused by human behavior, not by seasonal climate. Current practitioners of dysentery only know how to treat the heat of the season, but fail to address the cold induced by human habits. Why is this so? Moreover, dysentery often occurs in late autumn. At this time, the summer heat has dissipated, so one cannot rigidly adhere to the theory of heat toxicity. As autumn coolness arrives, how can one bear to recklessly use cold-cooling medicines? Such practitioners, ignorant of both human factors and seasonal changes, are far off the mark. There is no harm greater than this. One should ponder my words carefully.

6. Children's Blood and Qi are not yet fully developed, akin to the tender shoots and sepals of seedlings. Once injured, they invariably wither. Therefore, daily cultivation and nourishment are most appropriate; one must not recklessly use digestive-promoting and stagnation-resolving methods. If there is indeed food stagnation causing distension and pain, temporary digestion promotion is suitable. If there is indeed Wind-Cold causing fever, temporary dispersal is suitable. If there is indeed Excess Heat, Phlegm, and Fire, temporary clearing is suitable. These are situations where treating the branch is unavoidable. Outside of these, if there are no acute emergency branch symptoms, but rather frequent appearances of sallow complexion, emaciation, abdominal distension with slight fever, loose stools, fatigue, etc., these are all due to Spleen and Kidney insufficiency and weak Blood and Qi. However, contemporary physicians seeing these merely attribute them to food accumulation and Phlegm-Fire, knowing only to use digestion promotion and even more cooling methods. Day after day, they deplete and erode, causing Yuan Qi to diminish daily. When encountering other illnesses later, the body will be unable to sustain itself. This is a major malpractice in pediatric practice, which must not go unnoticed.

7. Fever during chickenpox or smallpox eruption in children is a normal sign. Without fever, toxins cannot be expelled. The power of this steaming heat is the power of Yuan Qi. From eruption to suppuration, from scabbing to healing, all rely on this heat power as the main driver. This is indeed the vital spirit of the eruption process, indispensable and beyond doubt. Only when the heat is severe and the toxin is heavy is it necessary to clear fire to resolve the toxin. However, this is only applicable when there are true internal heat pulse and symptom signs, allowing for cooling treatment. This applies to only one or two out of dozens of cases. If there is no internal heat, but only external heat, this is the normal sign of the eruption and must not be treated by attacking heat, which would drain the power of Yuan Qi and damage the source of Spleen and Kidney. Regrettably, modern dermatologists specializing in eruptions know nothing of this. Upon seeing fever, regardless of Excess or Deficiency, they immediately speak of detoxification and act with cooling medicines. This often damages the Spleen, leading to reduced appetite, and causes diarrhea upon scabbing, resulting in death. These are common occurrences. This error is most frequent and must not go unnoticed.

8. If pustules do not rise, and this is due to overwhelming toxins preventing eruption, this is a hopeless condition and need not be treated. If there are no other critical signs but the pustules do not rise, it is generally due to insufficient Yuan Qi. By tonifying Blood and Qi, eruption will occur without exception. Recently, I have seen specialists in eruptions, upon encountering this condition, mostly using toxic substances like silkworms or pangolin scales to force eruption. Observers regard this as a miraculous effect, unaware that eruption not rooted in the foundation harms Yuan Qi through excessive depletion, leading to internal exhaustion. Using this to mislead people is something one should deeply reflect upon.

9. Menstrual stagnation and retrogression, or delayed menstruation, are always due to insufficiency of the Chong and Ren vessels. If one does not cultivate Blood and Qi, but only knows how to unblock meridians and drive out stasis, Blood will dry up daily, leading to conditions such as metrorrhagia and blood exhaustion, without limit.

10. Injuries caused by emotional desires often manifest as hematemesis, hemorrhage, or intermittent fever. These are diseases of damaged True Yin. If one only knows how to treat fire without nourishing Yin, Yin will consume away daily, eventually forming Laozai (consumptive tuberculosis/chronic wasting syndrome).

11. Phlegm syndromes must have a cause. Phlegm itself does not cause disease; rather, disease generates phlegm. If one only knows how to treat phlegm without understanding its origin, phlegm will worsen, and there will be no way to eliminate it.

12. Abdominal distension and fullness are primarily related to the Spleen and Stomach. Although the Spleen and Stomach may be deficient, distension does not necessarily follow immediately. If one only knows how to promote digestion, Middle Qi will become more deficient, and distension will worsen daily.

13. Qi stagnation and chest obstruction are primarily due to Spleen deficiency failing to transport, leading to retention. If one does not nourish the Spleen but only knows how to break Qi stagnation, the Qi pathway will gradually decline, eventually forming Yige (dysphagia/esophageal obstruction) diseases.

14. Short, scanty, and red urine is common in individuals suffering from fatigue, Qi deficiency, and Yin deficiency. If these are uniformly treated as Fire and exclusively using cold-cooling medicines, the resulting complications will be unpredictable.

15. A deficient pulse with heat symptoms is not genuine Fire. If treated as Heat and cold-cooling medicines are used indiscriminately, mild cases will become severe, and severe cases will result in death.

16. If the disease is fundamentally a major deficiency but treated with slight tonification, the medicinal strength will not reach the pathology, providing no benefit. If one suspects this is an error and switches to draining/purging methods, death will ensue.

17. Diseases have urgency, and effects have speed. If one seeks rapid results for a chronic condition, one inevitably changes doctors frequently. Frequent doctor changes mean few competent physicians and many mediocre ones. The few cannot overcome the many, and the matter will surely fail.

18. Physicians must be selected for their virtue and competence, especially in critical moments, one must not be casual. Encountering petty characters who arrogantly defend their own views and overturn others' diagnoses is unfortunate; they often confuse right and wrong, posing significant risks to life.

19. The Classic states: "A Renying pulse that is large and firm indicates injury by Cold; a Qikou pulse that is firm and large indicates injury by food." This originally referred to the Maiyang and Taiyin meridians to distinguish exterior and interior. However, Wang Shuhe identified the left side as Renying and the right as Qikou, leading later generations to differentiate external contractions by the left pulse and internal injuries by the right pulse. Does the left have no internal injury, nor the right any external contraction? This is a great fallacy! A great fallacy!

20. The Classic states: "Diseases arising internally should first be treated by addressing Yin, then Yang; reversing this order exacerbates the condition. Diseases arising externally should first be treated by addressing the Exterior, then Interior; reversing this order exacerbates the condition."

21. Patients skilled in taking medicine can judge the suitability and quality of prescriptions by smell and taste, without needing to ingest them first. It is pitiable that ignorant people, knowing only to take medicine when they see it without understanding the nature of medicine, and seeking doctors when they see them without understanding the essence of medical practice, are truly lamentable.