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In the sixth month of Gengchen year of Zhiyuan era, Xu Bowei was fifty-four years old. His Zhongqi (Qi of the Middle Jiao/Spleen and Stomach) was originally weak. He suffered from Shanghan disease (Exogenous febrile disease) for eight or nine days. The physician, seeing his severe heat syndrome, administered cold-natured purgative medicines. Additionally, he ate three or four pears, which injured the Spleen and Stomach. This resulted in cold limbs and frequent episodes of fainting and confusion. I palpated his pulse; it beat with intermittent pauses that sometimes recovered spontaneously, which is a Knotted Pulse (Jie Mai). His Heart also palpitated, and he had incessant belching. His complexion changed to greenish-yellow, his spirit diminished, he did not wish to open his eyes, lay fatigued, and disliked people speaking or laughing. I treated him with Zhigancao Tang (Honey-Fried Licorice Decoction). Cheng Wuji stated: "Tonification can remove weakness." The sweetness of Renshen (Ginseng Radix et Rhizoma) and Dazao (Ziziphus Jujuba Fruit) tonifies deficient Qi; the pungency of Guizhi (Cinnamon Twig) and Shengjiang (Zingiberis Rhizoma Recens) benefits righteous Qi. When the Five Zang organs are atrophic and weak, and Yingwei (Nutritive and Defensive Qi) flow is dried up, moistening agents are used to lubricate them. The sweetness of Haren (Arillus Jujubae), Ejiao (Colla Corii Asini), Maimendong (Ophiopogonis Radix), and Dihuang (Rehmanniae Radix) lubricates the meridians, benefits blood, restores the pulse, and unblocks the Heart. Adding Renshen and Guizhi urgently supports righteous Qi; Shengdi Huang (Rehmanniae Radix Preparata) is halved to avoid damaging Yang Qi. One or two doses were decocted and taken, but there was no effect. I waited again to observe. Comparing the pulse and symptoms, could it be that the medicines were stale or corrupted, causing the ineffectiveness? I purchased medicines with stronger aroma and flavor, decocted and administered them. The symptoms reduced by half, and after further administration, he became stable.

All medicinal insects, plants, and trees have specific origins; their roots, leaves, flowers, and fruits have specific harvesting times. If the origin is incorrect, the nature and flavor will differ slightly; if the timing is incorrect, the nature and flavor will be incomplete. Furthermore, new and old materials differ, as do refined and coarse qualities. If one uses them without selection, any ineffectiveness is the fault of the physician. The *Neijing* states: "Prepare substances according to the annual climate." This refers to the essence and specialization of aroma and flavor. During preparation, one must exercise caution.

When patients take medicine, one must select someone to decoct it. One who understands the rules of decoction should be trusted. It is necessary to have reliable, respectful, sincere, and attentive individuals decoct the medicine. The decoction vessel (Diao) must be free of grease and fishy odors. Fresh, clean, sweet water is best. The amount of water should be measured, and slow fire should be used for decoction according to the required proportion. Filter the dregs with gauze and administer the clear liquid. There will be no failure in efficacy.

For diseases located in the upper part, frequent small doses are preferred; for diseases in the lower part, large single doses are preferred. Small doses nourish Ying (Nutritive Qi) in the upper part, while large doses strongly tonify the lower part.