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Qibo stated: When Jueyin governs the Heaven (Superior Qi), the climate manifests as Wind transformation; when it governs the Earth (Inferior Qi), the taste manifests as Sour, and Cold toxins do not arise. When Shaoyin governs the Heaven, the climate manifests as Heat transformation; when it governs the Earth, the taste manifests as Bitter, and Cold toxins do not arise. When Taiyin governs the Heaven, the climate manifests as Dampness transformation; when it governs the Earth, the taste manifests as Sweet, and Dryness toxins do not arise. When Shaoyang governs the Heaven, the climate manifests as Fire transformation; when it governs the Earth, the taste manifests as Bitter, and Cold toxins do not arise. When Yangming governs the Heaven, the climate manifests as Dryness transformation; when it governs the Earth, the taste manifests as Acrid, and Dampness toxins do not arise. When Taiyang governs the Heaven, the climate manifests as Cold transformation; when it governs the Earth, the taste manifests as Salty, and Heat toxins do not arise.

Those who treat diseases must understand the laws of Six Transformations divided by governance, the generation of Five Flavors and Five Colors, and the suitability for the Zang organs, before one can discuss the threads of excess and deficiency and the origin of diseases. That which originates from Heaven is the Qi of Heaven; that which originates from Earth is the Qi of Earth. Carefully observe the appropriateness of the Qi, do not miss the mechanism of the disease. Preparing substances according to the Yearly Qi ensures no primary efficacy is missed. The "Yearly Substance" refers to the exclusive essence of Heaven and Earth. Substances not governed by the Yearly Qi have scattered Qi; although their quality may be similar, their grade differs. There are differences in the density and thinness of flavor and Qi, in the agitation or stillness of nature and function, in the magnitude of therapeutic preservation, and in the depth of power transformation. If Heavenly excessive Qi invades the lower part, use the controlling nature to level it; if Earthly excessive Qi invades the interior, use the controlling nature to treat it.

Wang Bing stated: Transformation occurring in Heaven constitutes Heavenly Qi; transformation occurring in Earth constitutes Earthly Qi. The Five Toxins are all caused by the Qi of the Five Elements; therefore, the controlled nature does not arise, and only the taste generated by the governing Heaven and governing Earth is correct. Thus, pharmaceutical workers specifically monitor the Yearly Qi, and the collected medicines will have no omissions in their primary indications. When the Five Movements are in excess, the exclusive essence makes the medicine plump and dense, using its proper flavor and Qi. When insufficient, the medicine lacks exclusivity and the Qi scatters, the substance is impure; although the form and quality are the same, the functional power differs. Therefore, when Heavenly Qi excessively invades the lower and Earthly Qi excessively invades the interior, both are treated and leveled by their controlling natures, such as Wind overcoming Dampness, or Sour overcoming Sweet.

Qibo stated: Qi has variations in quantity, forms have fluctuations in prosperity and decline, treatment has distinctions in slowness and urgency, and prescriptions have sizes of large and small. It is also said: Diseases have distances near and far, syndromes have exterior and interior locations, and treatment has degrees of lightness and heaviness. For distant conditions, use Even formulas (Ou Fang); for near conditions, use Odd formulas (Qi Fang). Sweating should not use Odd formulas; purging should not use Even formulas. Tonifying the upper or treating upper diseases requires slow-acting formulations; tonifying the lower or treating lower diseases requires rapid-acting formulations. For near conditions using Even or Odd formulas, reduce the dosage; for distant conditions using Odd or Even formulas, increase the dosage. Large formulas have fewer ingredients, small formulas have more ingredients. Many can reach nine, few can be two. If an Odd formula fails, use an Even formula; if an Even formula fails, use counter-assistance (Fan Zuo) to obtain the effect. This is referred to as Han, Re, Wen, Liang following the disease's nature.

Wang Bing stated: Zang organs have high and low positions, Fu organ Qi has near and far distances, disease syndromes have exterior and interior levels, and medicinal usage has lightness and heaviness. Single formulas are Odd; combined formulas are Even. Heart and Lung are near; Liver and Kidney are far; Spleen and Stomach are central. Intestines, Bladder, and Gallbladder also have near and far distinctions. One with profound insight weighs circumstances to suit appropriateness. If the formula is Odd but the weight is Even, or the formula is Even but the weight is Odd: for near conditions using Even formulation, take many doses; for distant conditions using Odd formulation, take few doses. This establishes the standard system: Lung takes nine, Heart takes seven, Spleen takes five, Liver takes three, Kidney takes one. In prescribing, prefer lightness over heaviness, safety over toxicity, and smallness over largeness. Therefore, if an Odd formula fails, an Even formula governs; if an Even formula fails, use counter-assistance with the Qi of the disease to obtain the effect. Minor heat is reduced by cold; minor cold is eliminated by heat. Extreme cold and heat will inevitably repel contrary Qi. Different sounds do not resonate; different Qi do not combine. Thus, reverse assistance aligns with the Qi, mixing cold and heat so they start similarly but end differently.

Li Shizhen stated: Treating against the disease nature is Standard Treatment (Zheng Zhi); treating in accordance with the disease nature is Counter-Treatment (Fan Zhi). Counter-assistance is synonymous with Counter-Treatment. For example, if Heat is below and Cold pathogen rejects above, add Hot medicine as assistant to Cold medicine; after passing the diaphragm, once the Heat dissipates, the Cold property activates. If Cold is below and Floating Fire rejects above, add Cold medicine as assistant to Hot medicine; after passing the diaphragm, once the Cold dissipates, the Heat property activates. This is the subtlety of "Cold used with Heat, Heat used with Cold." Warm and Cool follow this pattern.

Zhang Yuansu stated: Flow and change depend on the disease; mastering the disease depends on the formula; forming the formula depends on the person. There are Seven Categories of Formulas: Da (Large), Xiao (Small), Huan (Slow), Ji (Rapid), Qi (Odd), Ou (Even), and Fu (Repeated). The basis of formula structure lies in Flavor and Qi. Han, Re, Wen, Liang (Four Qi) are born from Heaven; Suan, Ku, Xin, Xian, Gan, Dan (Six Flavors) are formed from Earth. Thus, tangible is Flavor, intangible is Qi. Qi is Yang, Flavor is Yin. Acrid and Sweet disperse and emit, belonging to Yang; Sour and Bitter induce vomiting and purging, belonging to Yin; Salty induces vomiting and purging, belonging to Yin; Bland promotes seepage and purging, belonging to Yang. Whether astringing or dispersing, slowing or accelerating, drying or moistening, softening or hardening, each follows the syndrome of the Zang-Fu organs to apply specific flavors and tastes, thereby dividing the Seven Formula systems. Thus, Qi, Ou, and Fu are three types; Da, Xiao, Huan, and Ji are four methods of regulation. Hence, treatment has slowness and urgency, and formulas have large and small sizes.

[Large Formula]
Qibo stated: One Sovereign, two Ministers, nine Assistants constitute a Large formula. One Sovereign, three Ministers, five Assistants constitute a Medium formula. One Sovereign, two Ministers constitute a Small formula. It is also said: For distant conditions using Odd/Even formulas, increase the dosage; for near conditions using Odd/Even formulas, decrease the dosage. Large formulas have few ingredients, small formulas have many. Many reach nine, few are two.

Zhang Yuansu stated: Body surface is Far, interior is Near. Large and Small refer to the method of regulating Odd and Even. For instance, Xiao Chengqi Tang and Tiaowei Chengqi Tang are Small Odd formulas; Da Chengqi Tang and Didang Tang are Large Odd formulas, used because they attack the interior. Guizhi Tang and Mahuang Tang are Small Even formulas; Gegen Tang and Qinglong Tang are Large Even formulas, used because they release the exterior. Hence, sweating does not use Odd formulas; purging does not use Even formulas.

Zhang Congzheng stated: There are two types of Large Formulas: One is the Large Formula of One Sovereign, Three Ministers, Nine Assistants, suitable for diseases with concurrent syndromes and diverse pathogens that cannot be treated with one or two herbs; the other is a Large Formula with heavy dosage taken at once, suitable for diseases of the Liver, Kidney, and lower parts where the distance is far. Wang Taipu considered Heart and Lung as Near, Kidney and Liver as Far, and Spleen and Stomach as Middle. Liu Hejian considered body surface as Far and body interior as Near. In my view, the upper half of the body corresponds to three parts of Heavenly Qi; the lower half corresponds to three parts of Earthly Qi; Zhongwan is the dividing line of humanity.

[Small Formula]
Congzheng stated: There are two types of Small Formulas: One is the Small Formula of One Sovereign, Two Ministers, suitable for diseases without concurrent syndromes, with singular pathogens treatable by one or two herbs; the other is a Small Formula with light dosage taken frequently, suitable for diseases of the Heart, Lung, and upper regions, sipping slowly and finely. Yuansu stated: Liver and Kidney are distant; many doses make the Qi slow, unable to reach the lower part quickly, so large doses with few frequencies are needed to ensure rapid descent. Heart and Lung are near; few doses make the Qi urgent downward, unable to ascend, so small doses with many frequencies are needed to ensure easy dispersion and ascent. The Wang system stating Lung takes nine, Heart seven, Spleen five, Liver three, Kidney one, represents the generative numbers of the Five Zang organs.

[Slow Formula]
Qibo stated: Tonifying/treating the upper requires slow formulation; tonifying/treating the lower requires rapid formulation. Rapid means strong flavor and Qi; slow means weak flavor and Qi, reaching the target appropriately. If the disease is distant and the middle path requires flavor adjustment, guide it with food without exceeding regulations.

Wang Bing stated: For example, if the disease is in the Kidney but Heart Qi is deficient, medication should pass quickly through the Heart, not nourishing the Heart with flavors, lest Kidney medicine oppress the Heart, further depleting Heart Qi. The examples for upper/lower and near/far are similar.

Yuansu stated: The Sage treats the upper without offending the lower; treats the lower without offending the upper; treats the middle without offending either. Thus, punishing the innocent is called great confusion. Haogu stated: Treating the upper necessarily affects the lower; treating the exterior necessarily connects to the interior. Using Huangqin to treat the Lung necessarily harms the Spleen; using Rongrong to treat the Kidney necessarily harms the Heart; taking Ganjiang to treat the Middle necessarily rebels upward; taking Fuzi to tonify Fire necessarily depletes Water.

Congzheng stated: There are five types of Slow Formulas: One uses Sweet to slow, such as Gancao, sugar, honey, suitable for chest/diaphragm diseases to retain the effect. One uses Pills to slow, which act slower than decoctions/powders. One contains many ingredients, where herbs mutually constrain each other, preventing any single herb from exerting its full nature. One uses non-toxic herbs to treat, where non-toxicity ensures pure nature and slow action. One has weak flavor and Qi, which excels in tonifying/treating the upper; by the time it reaches the lower, the medicinal power has declined.

[Rapid Formula]
Yuansu stated: Strong flavor is Yin; weak flavor is Yang within Yin. Thus, strong flavor leads to downward purging; weak flavor promotes Qi movement. Strong Qi is Yang; weak Qi is Yin within Yang. Thus, strong Qi causes fever; weak Qi induces sweating.

Haogu stated: Treating the root should be slow, slowing treats the root; treating the branch should be rapid, rapid treats the branch. Exterior/Interior, Sweating/Purging all have situations requiring slowness and situations requiring rapidity.

Congzheng stated: There are four types of Rapid Formulas: One is rapid attack for acute diseases, such as wind-stroke or Guan-Ge. One is decoction/powder scouring, which disperses easily and acts fast upon swallowing. One uses toxic drugs, where toxicity surges upward or purges downward to seize the disease momentum. One has strong flavor and Qi, which directs straight downward without losing strength.

[Odd Formula]
Wang Bing stated: It is a single-substance formula.

Congzheng stated: There are two types of Odd Formulas: One uses a single herb alone, suitable for diseases in the upper and near regions. One combines herbs matching odd numbers (1, 3, 5, 7, 9), suitable for purging rather than sweating.

Yuansu stated: For instance, Xiao Chengqi Tang and Tiaowei Chengqi Tang are Small Odd formulas; Da Chengqi Tang and Didang Tang are Large Odd formulas, formulated for purging. Guizhi Tang and Mahuang Tang are Small Even formulas; Gegen Tang and Qinglong Tang are Large Even formulas, used for dispersing.

[Even Formula]
Congzheng stated: There are three types of Even Formulas: One pairs two herbs; one combines two ancient formulas (anciently called Compound Formulas), suitable for diseases in the lower and distant regions; one combines herbs matching even numbers (2, 4, 6, 8, 10), suitable for sweating rather than purging.

Taipu stated: Sweating agents without Even numbers lack sufficient Qi to emit outward; purging agents without Odd numbers cause toxic aggression leading to excess. I suppose purging is naturally easy, so single action results in isolated and weak power; sweating is difficult, so combined action results in equal and greater power? However, Zhang Zhongjing's formulas: Guizhi Tang, a sweating agent, uses five ingredients (Odd); Da Chengqi Tang, a purging agent, uses four ingredients (Even). Why? Is it adapting to circumstances with additions and subtractions?

[Compound Formula]
Qibo stated: If Odd fails, use Even; this is called Chong Fang (Double/Repeated Formula).

Haogu stated: If Odd fails, use Even; if Even fails, use Odd; hence called "Fu" (Repeat). Fu means again, double. Such as ten parts tonification, one part purging; several parts purging, one part tonification. Also, if Taiyang presents with Wind pulse, or Shangfeng presents with Cold pulse, indicating mismatched pulse and syndrome, a Compound Formula should govern.

Congzheng stated: There are three types of Compound Formulas: One combines two, three, or multiple formulas, such as Guizhi Er Yuebi Yi Tang or Wuji San. One adds other herbs to a base formula, such as adding Lianqiao, Bohe, Huangqin, Zhizi to Tiaowei Chengqi Tang to create Liangge San. One has equal weights, such as Weifeng Tang with equal parts. Taipu considered Even as Compound. Now, among the Seven Formulas, there is Even and there is Compound. Does this mean Even is the combination of two formulas, while Compound is the combination of multiple formulas?