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Mr. Li Shicai's book *Yi Zong Bi Du* (Essential Readings for Medical Practitioners) is widely circulated. Mr. Li's main ideas are largely derived from Wang Yutai's *Zhun Sheng* (Standard Rules), and his theoretical stance reveres the *Xue Shi Shi Liu Zhong* (Sixteen Types by Master Xue). Regarding the syndrome of stroke (Zhong Feng, 中风), he distinguishes between true and false types; regarding the treatment of diarrhea (Xie Xie, 泄泻), his legal principles are clear and explicit; regarding pain in the heart and stomach, he provides detailed annotations and distinctions; regarding cough and lower back pain, he differentiates between external contraction (Wai Gan, 外感) and internal injury (Nei Shang, 内伤); regarding swelling syndromes, he distinguishes between deficiency/excess and cold/heat, leaving no ritual unaddressed. However, there are still impure aspects within it, perpetuating past errors. For instance, in the initial discussion on Taiyang disease (Shang Han, 伤寒) transmitting to the Three Yin meridians, he erroneously cites prescriptions for direct invasion (Zhi Zhong, 直中) of the Yin meridians, mixing them into a unified treatment. When a condition begins in the Three Yang meridians and subsequently transmits to the Three Yin meridians, this is an Yang syndrome of transmission (Chuan Jing, 传经). Although the meridians belong to Yin, the pathogen is Yang. Thus, the *Shang Han Lun* states: "Fever first, then cold extremities" refers to transmitted pathogens, not the cold syndrome of direct Yin invasion; this is what is meant by "the deeper the heat, the deeper the cold extremities." Now, Mr. Li instead uses prescriptions for Yin syndromes of direct Yin invasion, stating that for mild cases, Lizhong Tang (Cinnamon Twig and Atractylodes Decoction) is used, and for severe cases, Sini Tang (Frigid Extremities Decoction) is used. Later, under the section on direct Yin invasion, he says: "If there is no fever at the onset, it is a cold syndrome, named cold syndrome of direct Yin invasion," also treating it with these two decoctions. Transmission to the Three Yin is a Yang syndrome; direct invasion of the Yin meridians is a Yin syndrome. One is cold, one is hot; the two syndromes are worlds apart, yet they are treated with one method. Is this reasonable?

Regarding the syndrome of consumptive disease (Xu Lao, 虚劳), listing Su Zi Jiang Qi Tang (Perilla Seed Descending Qi Decoction) as the first prescription under the hematemesis (Tu Xue, 吐血) section is extremely inappropriate. Mr. Danxi stated: "Bleeding from the mouth and nose is due to excess Yang and deficiency Yin; the method should be to tonify Yin and suppress Yang." He also said: "The nature of Rhinoceros Horn (Xi Jiao, 犀角) can ascend and disperse all excess fire. If used by those with Yin deficiency, how can one avoid the disaster of scattering?" Since Rhinoceros Horn is cool, pungent, and dispersing, it is contraindicated for Yin deficiency, how much more so for Perilla Seed (Su Zi, 苏子), Peucedanum Root (Qian Hu, 前胡), Pinellia Tuber (Ban Xia, 半夏), and Agarwood (Chen Xiang, 沉香), which are pungent, warm, ascending, and dispersing? Are these suitable for consumptive disease and hematemesis? This is a prescription for external contraction hematemesis and should not be listed under consumptive disease hematemesis. Because Mr. Li saw the book *Zhun Sheng*, he failed to distinguish, thus leading to mutual error through repetition. Later, Mr. Zhang Sanxi, in compiling *Zhi Fa Hui* (Compilation of Treatment Methods), uniquely deleted this prescription, showing great care.

Regarding dysentery (Li Ji, 痢疾), there are differences in cold and heat across the four seasons. Now, Mr. Li confusingly cites scriptures from *Wei Sheng Bao Jian* (Precious Mirror of Health), discussing spleen diarrhea, kidney diarrhea, and internal injury dysentery, focusing his argument on the Spleen and Kidney meridians. He does not realize that "Spleen transmitting to Kidney, Kidney transmitting to Spleen" discusses internal injury dysentery caused by the mutual transmission of the Five Zang organs, not the summer-autumn heat dysentery discussed in other texts. In Mr. Li's discussion, since he mentions dysentery arising in summer and autumn due to dampness steaming and stagnant heat, he is indeed discussing summer-autumn dysentery. He should base his argument on the Autumn Dry Metal ruling by the Yangming meridian, focusing on the Stomach and Intestines meridians, rather than dragging in the Spleen and Kidney. Summer-autumn diarrhea starting with watery stool followed by pus and blood, or vice versa, is a damp-heat syndrome of the Foot and Hand Yangming Stomach and Intestines, not a subtle evil or thief evil internal injury syndrome of Spleen-Kidney transmission. The ancients said: "When the Large Intestine is diseased, Qi condenses and flows down, forming white dysentery; when the Small Intestine is diseased, Blood condenses and flows down, forming red dysentery; when both Large and Small Intestines are diseased, red and white mix and flow down." Damp-heat from the Stomach flowing down to the Large and Small Intestines is also like this. Even according to the scriptures, it says "Intestine bleeding," "Intestine white foam," "Intestine pus and blood." All these discussions use the character "Intestine" as the subject, not "Spleen" or "Kidney," but "Intestine." Thus, we know that dysentery should primarily focus on the Intestines. Now, in Mr. Li's discussion, he abandons the primary topic of "Intestine" and focuses solely on the Spleen and Kidney viscera. So, for summer-autumn dysentery, does Mr. Li wish to tonify these two viscera, or warm them? Spleen diarrhea and kidney diarrhea involve insufficient organ Qi, being internal injury deficiency syndromes, which are Zang syndromes. Summer-autumn dysentery involves pathogens affecting the Stomach and Intestines, being external contraction excess syndromes, which are Fu syndromes. Internal injury deficiency and external contraction excess are worlds apart. Even if there is a syndrome of Shaoyin dysentery with pus and blood, it is caused by the Hand Shaoyin Heart, not the Foot Shaoyin Spleen transmitting to Kidney. Therefore, *Bao Ming Ji* calls Shaoyin dysentery "Small Intestine Diarrhea," because the Heart and Small Intestine are exterior-interior pairs; Heart transferring heat to the Small Intestine, and Small Intestine transferring heat to the Large Intestine, results in dysentery with pus and blood, because the Hand Shaoyin Heart governs Blood. Although the meridian belongs to Yin, the syndrome is a Yang pathogen, similar to Yang syndromes of Shanghan transmitting to Yin meridians.

For summer-autumn dysentery, one must first investigate the root cause. During May and June, when Si, Wu, Bing, and Ding energies prevail, the Geng Metal Large Intestine is controlled by the Summer Fire energy, pre-damaging Metal and Water. When Autumn Dry Metal rules, Metal is punished by Fire, scorching and flowing downward. Red belongs to the original color of Fire, White belongs to the original color of Metal, and thus red-and-white mixed dysentery occurs. Even if purely white without red, although not attacked by Heart Fire, it is due to excessive Autumn Dry Fire damaging the Metal position itself, causing white fluid to dissolve and flow down. This is illness acquired by following the seasonal command. Now, Mr. Li constantly drags in the Spleen and Kidney, harboring delusions of warming, tonifying, and astringing, leading to absurdities. For early-stage dysentery with Stomach and Intestines congestion and internal heat stagnation, there may appear symptoms of external cold transformation. Misidentifying this as deficiency-cold, one might recklessly add tonifying and astringing herbs to ancient pungent-warm exterior-releasing formulas, confusingly treating damp-heat and dry-heat dysentery. One does not know that ancient pungent-warm exterior-releasing methods treat cold-damp dysentery. Severe cases cause significant harm; mild cases linger and worsen. Even if some recover with warming-tonifying methods, it is not because the previous physician greatly removed accumulation and cleared Qi, nor because cold-pungent methods entered directly without guidance, suppressing the Middle Jiao, and accidentally encountering pungent-warm herbs that opened stagnation, gaining the effect of resolving knots with pungent-warm properties, rather than the power of warming-tonifying. For damp-stagnation dysentery, arising from seasonal cold-damp influences, external constraint of exterior pathogens, and internal congestion of accumulation, pungent-warm medicines are used. However, this only utilizes their pungent-warm exterior-releasing property, not their warming-tonifying property. Overusing cold-purgative methods for dysentery is indeed inadvisable, but if internal damp-fire and dry-fire arise and fail to be cleared and promoted, the Stomach and Intestines will rot instantly. Tonifying Spleen and Kidney is a later conditioning method. Therefore, it is said: observe urgency, regulate Qi and Blood; if exterior syndrome exists, sweat and disperse it; if interior syndrome is urgent, clear and promote it.

Regarding abdominal pain in dysentery, there is pain from accumulation stagnation obstruction, treated with purgatives to move it; there is pain from Qi stagnation in the Large Intestine, treated with Platycodon Root (Jie Geng, 桔梗) to open it; there is pain from Qi and Blood disharmony, treated with Peony Root (Bai Shao, 白芍) to harmonize it. Now, only the Qi stagnation item is mentioned, saying "open with Platycodon," and below it says "take Peony as the main herb," failing to distinguish the different collecting and dispersing actions of these two herbs, mixing them into the Qi stagnation section. There is also no specific section for pain requiring purgation due to accumulation, making it seem as if there is no descending method for dysentery with abdominal pain. It also says: "Add Ginger (Gan Jiang, 干姜) for aversion to cold, add Coptis Rhizome (Huang Lian, 黄连) for aversion to heat." Syndromes may have pseudo-symptoms resembling Yin-Yang combined transformation; one should examine internal symptoms and pulse, not rely solely on aversion to cold or heat.

Later, in the anal pain section, it says above: "Heat flowing downward, use Sophora Flower (Huai Hua, 槐花) and Aucklandia Root (Mu Xiang, 木香)," which is correct. It also says: "For those with accompanying cold, use Lizhong Tang." The word "accompanying" (Xia, 挟) is poorly chosen. *Yuan Bing Shi* asks: "How can cold and heat mix in the intestines and stomach?" Anal pain at onset has no logic of cold pain. Only after long-term dysentery does pain appear, indicating sinking of Yuan Qi; however, only Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to lift it, not Lizhong Tang. Because anal pain is always damp-heat flowing downward and dry-fire blocking. Even for long-term dysentery, only tonification is suitable, not warming. Even if deficient, it is not necessarily cold. If deficient and accompanied by cold, the anus would be incontinent without pain. It also says: "Ju Fang and Fu An typically use pungent-hot; Hejian and Danxi typically use bitter-cold. How rigid and inflexible!" They do not know that summer-autumn dysentery differs from four-season dysentery. Summer-autumn dysentery originates from damp-heat, differing in damp dominance vs. dry dominance, and in following-treatment vs. direct-treatment, with concerns of pathogen condensation and internal retention. Thus, pungent-dispersing is used to treat cold-damp dysentery, following *Nei Jing*: "Dampness invading internally, treat with bitter-hot; when dampness prevails, half with bitter-hot," opening the door for dampness-induced dysentery where exterior syndromes predominate. Hejian and Danxi typically use bitter-cold, likely meaning that for summer-autumn dysentery, dry-fire causes harm, and heat-toxin congests and damages the Stomach and Intestines. At this time, if one follows the method of following-treatment, dry-fire meeting pungent-warm will cause instant burning of the Stomach and Intestines. Therefore, bitter-cold promoting and clearing agents are used as direct-treatment methods, following *Nei Jing*: "Heat invading internally, treat with salty-cold; when heat prevails, treat with bitter-cold," opening the door for dry-heat-induced dysentery where interior syndromes predominate. Using warm or cold depends on whether the methods are exterior-releasing or interior-attacking. Now, Mr. Li does not elucidate the intentions of the four masters to instruct future generations, but instead slander them, causing confusion among learners. I now correct the Shanghan examples, still adhering to Mr. Zhongjing's methods: summer-autumn dysentery should be divided into dry-fire and damp-fire; four-season dysentery should be divided into external contraction and internal injury; epidemic dysentery should be divided by Six Qi and Annual Qi. In years of rain and dampness, such as the Year of Overflow, exterior-releasing methods using pungent-cool and pungent-warm treatments are appropriate. In years of drought, such as the Administration of Blazing Heat, interior-attacking methods using bitter-cold and salty-cold flavors are appropriate. This deeply manifests Mr. Li's Way and preserves Mr. Li's book.