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Wherever it is stated that herbs should be cut into pieces the size of hemp seeds or beans, it is synonymous with "chewing" (Ju). "Chewing" was an ancient practice. In ancient times, without iron knives, people used their teeth to crush herbs until they were the size of hemp seeds or beans for decoction, ensuring the medicinal liquid remained clear and was easily absorbed and dispersed in the intestines after ingestion. Today, people use knives to cut herbs into pieces the size of hemp seeds or beans, which is a simplified method of "chewing".

Ancient scales only had units of Zhu (铢) and Liang (两), with no unit called "Fen" (分). Currently, ten grains of millet weigh one Zhu (each Zhu is approximately 0.17 milligrams), six Zhu make one Fen (falling tone), four Fen make one Liang, and sixteen Liang make one Jin (Li Gao stated: Six Zhu equal one Fen, which is equivalent to 2.5 Qian today; twenty-four Zhu equal one Liang. Ancient texts stating three Liang refer to one Liang today, and two Liang refer to 6.5 Qian today).

When modern practitioners say "equal parts" (Deng Fen), they do not mean the weight unit "Fen", but rather that the quantity of each herb in terms of Liang is identical. This is mostly used for preparing pills and powders.

In preparations of pills and powders, "Dao Gui" (a measure of volume) refers to one-tenth of a "Fang Cun Bi" (square-inch spoon), roughly equivalent in volume to a Sophora japonica seed. A "Fang Cun Bi" is a spoon shaped as a square inch, where the amount of powder scooped is defined by what does not fall off. "Wu Bi" refers to using the edge of a contemporary five-Zhu coin inscribed with "Wu Zhu", scooping powder until it does not fall off. One "Cuo" (pinch) equals four Dao Gui (Bi is synonymous with spoon).

For herbs measured by Sheng (升) and He (合), this is because herbs vary in density and weight, making scale measurement inaccurate; thus, volume measurement is used. Ten Cuo make one Shao (勺), ten Shao make one He, and ten He make one Sheng. A Sheng vessel has an upper diameter of one cun, a lower diameter of six fen, and a depth of eight fen. When filling with powdered herbs, keep it level and gently shake to flatten (Li Shizhen stated: One ancient Sheng is equivalent to 2.5 He today).

Whenever a prescription specifies a certain number of Ba Dou (Crotonis Fructus, 巴豆), due to variations in size, the heart, skin, and husk should be removed, with one Fen weighing sixteen pieces. For Fu Zi (Aconiti Lateralis Radix Praeparata, 附子) and Wu Tou (Aconiti Radix, 乌头), after removing the skin, half a Liang weighs one piece. For Zhi Shi (Aurantii Fructus Immaturus, 枳实), after removing the pith, one Fen weighs two pieces. For Ju Pi (Citri Reticulatae Pericarpium, 橘皮), one Fen weighs three pieces. Three medium-sized Da Zao (Jujubae Fructus, 大枣) weigh one Liang. One bundle (Lei) of Gan Jiang (Zingiberis Rhizoma, 干姜) weighs one Liang.

Whenever a prescription specifies Ban Xia (Pinelliae Rhizoma, 半夏) as one Sheng, after washing, it should weigh five Liang. Shu Jiao (Zanthoxyli Pericarpium, 蜀椒) one Sheng weighs three Liang. Wu Zhu Yu (Evodiae Fructus, 吴茱萸) one Sheng weighs five Liang. Tu Si Zi (Cuscutae Semen, 菟丝子) one Sheng weighs nine Liang. Ting Li Zi (Lepidii Semen, 葶苈子) one Sheng weighs four Liang. She Chuang Zi (Cnidii Fructus, 蛇床子) one Sheng weighs three and a half Liang. Di Fu Zi (Kochiae Fructus, 地肤子) one Sheng weighs four Liang. Since these seeds vary in density and weight, if precise weighing is difficult, a level Sheng is taken as standard.

(Note: The original text repeats a paragraph regarding Ban Xia, Shu Jiao, etc.; this translation consolidates them to avoid redundancy.)

Whenever a prescription specifies Gui Zhi (Cinnamomi Ramulus, 桂枝) as one chi, after peeling, it should weigh half a Liang. Gan Cao (Glycyrrhizae Radix et Rhizoma, 甘草) one chi weighs two Liang. One bundle of unspecified grass weighs three Liang. One handful weighs two Liang.

When decocting herbal soups, initially use low heat to bring the water to a gentle boil. The amount of water depends on the prescription. Generally, for twenty Liang of herbs, use one Dou of water to reduce to four Sheng; this is the critical point to master. However, for purgative soups, raw potency is desired, so use less water to extract more juice; for tonic soups, thorough cooking is desired, so use more water to extract less juice. Herbal soups should be taken warm; hot liquids are easier to swallow, while cold ones may induce vomiting.

When instructed to divide the dose into two or three servings, adjust based on the progression of the disease, the patient's strength or emaciation, and the severity of the illness. Do not rigidly adhere to the prescription; flexibility is key.

When pill sizes are described as "fine hemp," it refers to Sesamum indicum seeds (Hu Ma); they need not be perfectly flat, just roughly comparable. Millet and broomcorn millet are similar. "Large hemp seeds" correspond to three fine hemp seeds. "Hu Dou" refers to Vigna unguiculata subsp. sesquipedalis (Qing Ban Dou), corresponding to two large hemp seeds. "Small beans" refer to Phaseolus angularis (Chi Xiao Dou), corresponding to three large hemp seeds. "Large beans" correspond to two small beans. "Sophora japonica seeds" (Wu Tong Zi) correspond to two large beans. "Bullet pellets or egg yolks" correspond to forty Sophora japonica seeds.

One Jin of Mi (Honey, 蜜) equals seven He. One Jin of Zhu Gao (Porcine Adipose Tissue, 猪膏) equals one Sheng and two He.

Appendix: Diagrams of the Three Yang and Three Yin Meridians

The Foot-Taiyang Bladder Meridian originates at the inner canthus, ascends to the forehead, and intersects at the vertex. Its straight branch enters the brain from the vertex, emerges, descends separately along the nape, runs along the medial shoulder blade, parallel to the spine to the loins, enters the back muscles, connects with the Kidney, and belongs to the Bladder. Another straight branch descends from the loins, parallel to the spine, through the buttocks into the popliteal fossa. A collateral branch separates from the shoulder medially, passes through the scapula, runs parallel to the spine, crosses the hip joint, follows the lateral thigh, descends along the posterior aspect, merges into the popliteal fossa, descends through the calf muscle, emerges behind the lateral malleolus, follows the Jinggu point, and reaches the lateral side of the little toe.

The Foot-Yangming Stomach Meridian originates at the side of the nose, crosses at the root of the nose, runs alongside the Taiyang meridian, descends along the lateral nose, enters the upper gum, emerges around the lips, meets at Chengjiang below the lower lip, follows the post-mental groove down to the mandible, emerges at Daying, follows Jiache, ascends anterior to the ear, passes through Guanchong, follows the hairline to the forehead. A collateral branch descends from before Daying to Renying, follows the throat, and enters the Supraclavicular Fossa. It descends through the diaphragm, belongs to the Stomach, and connects with the Spleen. A straight branch descends from the Supraclavicular Fossa along the medial breast, down beside the umbilicus, into the Qi Street. A collateral branch originates from the lower opening of the stomach, runs inside the abdomen to the Qi Street, where it joins the main channel, descends through Biguan, reaches Futu, descends to the knee patella, follows the lateral tibia, reaches the dorsum of the foot, and enters the lateral space of the second toe. A collateral branch descends three cun below the knee to Lianquan, entering the lateral space of the second toe. Another branch separates from the dorsum, enters the space between the great toe, emerges at its tip.

The Foot-Shaoyang Gallbladder Meridian originates at the lateral canthus, ascends to the temporal angle, descends behind the ear, follows the neck, runs anterior to the Hand-Shaoyang meridian, reaches the shoulder, crosses behind the Hand-Shaoyang meridian, and enters the Supraclavicular Fossa. A collateral branch enters the ear from behind, emerges anterior to the ear, and reaches the lateral canthus. Another branch separates from the lateral canthus, descends to Daying, merges with the Hand-Shaoyang meridian, reaches the infraorbital region, descends to Jiache, follows the neck to merge with the Supraclavicular Fossa, descends into the chest, pierces the diaphragm, connects with the Liver, belongs to the Gallbladder, follows the hypochondrium, emerges at the Qi Street, surrounds the pubic region, and transversely enters the hip joint. A straight branch descends from the Supraclavicular Fossa under the axilla, follows the chest past the costal margin, merges with the hip joint channel, follows the lateral thigh, emerges at the lateral knee, descends anterior to the fibula, reaches the end of the Juegu bone, emerges anterior to the lateral malleolus, follows the dorsum of the foot, and enters the space between the fourth and fifth toes. A collateral branch separates from the dorsum, enters the space between the great and second toes, follows the medial aspect of the metatarsals, emerges at the tip, penetrates the nail bed, and emerges at the hair tuft.

The Foot-Taiyin Spleen Meridian originates at the tip of the great toe, follows the medial white flesh border, passes behind the medial malleolus (He Gu), ascends anterior to the medial malleolus, ascends the medial leg, follows the posterior tibia, crosses anterior to the Foot-Jueyin meridian, ascends the medial knee and thigh, enters the abdomen, belongs to the Spleen, connects with the Stomach, ascends through the diaphragm, flanks the pharynx, connects with the base of the tongue, and spreads under the tongue. A collateral branch separates from the stomach, ascends through the diaphragm, and pours into the Heart.

The Foot-Shaoyin Kidney Meridian originates below the little toe,斜趋 (diagonally approaches) the Yongquan point in the center of the sole, emerges below RanGu, follows the posterior medial malleolus, enters the heel, ascends the medial calf, emerges at the medial tibial border, ascends the posterior medial thigh, pierces the spine, belongs to the Kidney, and connects with the Bladder. A straight branch ascends from the Kidney, pierces the Liver and diaphragm, enters the Lung, follows the throat, and flanks the base of the tongue. A collateral branch emerges from the Lung, connects with the Heart, and pours into the chest.

The Foot-Jueyin Liver Meridian originates above the hair tuft of the great toe, ascends along the lateral dorsum of the foot, one cun from the medial malleolus, ascends eight cun above the ankle, crosses posterior to the Foot-Taiyin meridian, ascends the medial thigh, enters the pubic region, passes around the genitalia, reaches the lower abdomen, flanks the Stomach, belongs to the Liver, connects with the Gallbladder, ascends through the diaphragm, distributes in the hypochondrium, follows the posterior throat, ascends to the Ying-Sang, connects with the eye system, ascends to the forehead, and intersects with the Du Meridian at the vertex. A collateral branch descends from the eye system to the cheek interior, circles the inner lips. Another branch separates from the Liver, pierces the diaphragm, and pours into the Lung.

Appendix: Acupuncture and Moxibustion Points for Shanghan

In Taiyang disease, if after taking Guizhi Tang (Cinnamon Twig Decoction) there is increased irritability without relief, first puncture Fengchi (GB20) and Fengfu (GV16), then administer Guizhi Tang for cure.

[Commentary] Fengchi (GB20) is located posterior to the temporal region. The temporal region refers to the Nangkong area. "Posterior" means adjacent to the Yuzhen bone, within the hairline at the back, in the depression outside the large tendon, where pressure induces sensation in the ear. It is the intersection of the Foot-Shaoyang and Yangwei Mai meridians. Puncture 3 cun (depth); for thick muscle, 5 cun. Retain needle for 7 breaths. Moxibustion is prohibited. Fengfu (GV16) is located one cun above the nuchal hairline, in the depression within the large tendons. Rapid speech causes muscle elevation; cessation causes it to drop. It is the intersection of the Du Mai and Yangwei Mai meridians. Puncture 3 cun; for thin muscle, 2 cun. Remove needle upon patient's exhalation. Moxibustion is prohibited. Why puncture Foot-Shaoyang and Du Mai for Taiyang pathogen? Fengfu is on the midline, Fengchi on the third lateral line, Taiyang on the second. Thus, Fengchi and Fengfu flank the Taiyang meridian. Moreover, both intersect the Yangwei Mai, the commander of all Yang meridians. Puncturing them allows Yang Qi to vent, dispelling Taiyang pathogens.

If Taiyang headache persists beyond seven days and resolves spontaneously, it is because the pathogen has exhausted its course in the meridian. If it threatens to transmit to the next meridian ("Zai Jing"), puncture the Foot-Yangming meridian to prevent transmission and ensure cure.

[Commentary] Zhang Zhongjing states "puncture Foot-Yangming" but Cheng Wuji did not specify the point. Pang Ha's *Zong Bing Lun* suggests tonifying Shangsanli (ST36). The logic implies tonification strengthens meridian Qi to prevent transmission. However, Zhang Zhongjing's intent was likely "Ying Er Duo Zhi" (meeting and reducing), i.e., draining Heat from the meridian to prevent transmission. Pang Ha’s confusion of draining with tonifying is erroneous. Zhang Xuan’s *Zuan Lun* suggests puncturing Chongyang (ST42), which corresponds to the Fuyang pulse mentioned by Zhang Zhongjing for diagnosis, not treatment. Zhang’s view derives from Shi Zan’s commentary and is not authoritative. ST36 is located three cun below the knee, between the tendons lateral to the tibia. With the knee bent and foot lowered, deep pressure stops the dorsal pedal artery, confirming the point. Puncture 5 cun, retain for 7 breaths.

In Shanghan, abdominal fullness and delirium with a floating and tight Cun Kou pulse indicate Liver overacting on Spleen, named "Zong" (Vertical). Puncture Qimen (LR14).

Shanghan with fever, aversion to cold, extreme thirst for water, abdominal fullness, spontaneous sweating, and free urination indicates impending resolution. This is Liver overacting on Lung, named "Heng" (Horizontal). Puncture Qimen (LR14).

In women with Wind Strike, fever and aversion to cold, with menstruation occurring, if after seven to eight days the fever subsides, pulse becomes slow, body cools, but hypochondriac fullness resembles Jie Xiong syndrome and delirium occurs, this is Heat entering the Blood Chamber. Puncture Qimen (LR14) to drain excess.

In Yangming disease, bleeding and delirium indicate Heat entering the Blood Chamber. If only head sweats, puncture Qimen (LR14) to drain excess; generalized sweating indicates cure.

In concurrent Taiyang and Shaoyang disease, with stiff neck/headache, dizziness, intermittent Jie Xiong-like symptoms, and epigastric hardness, puncture Dazhui (GV14), Feishu (BL13), and Ganshu (BL18). Strictly avoid sweating therapy; sweating leads to delirium. If the pulse is wiry and delirium persists for five to six days, puncture Qimen (LR14).

[Commentary] *Tu Jing* states Qimen (LR14) is located 1.5 cun lateral to Burong (ST19), directly below the nipple, at the end of the second rib near the abdomen. The "second rib" is counted from below. The rib end is the tip of the costal cartilage. Puncture 4 cun; adjust for obesity.

In concurrent Taiyang and Shaoyang disease, with stiff neck/headache, dizziness, intermittent Jie Xiong-like symptoms, and epigastric hardness, puncture Dazhui (GV14), Feishu (BL13), and Ganshu (BL18). Strictly avoid sweating therapy; sweating leads to delirium. If the pulse is wiry and delirium persists for five to six days, puncture Qimen (LR14).

In concurrent Taiyang and Shaoyang disease, with epigastric hardness, stiff neck, and dizziness, puncture Dazhui (GV14), Feishu (BL13), and Ganshu (BL18). Strictly avoid purgation.

[Commentary] *Tu Jing* states Dazhui (GV14) is in the depression above the first thoracic vertebra. Puncture 5 cun, retain 3 breaths, drain via 5 inhalations. Feishu (BL13) is bilateral, 1.5 cun lateral to the spinous process of the third thoracic vertebra. Puncture 3 cun, retain 7 breaths, drain upon arrival of Deqi; obese patients may receive 5 cun. Ganshu (BL18) is bilateral, 1.5 cun lateral to the spinous process of the ninth thoracic vertebra. Puncture 3 cun, retain 6 breaths. Zhang Zhongjing’s indication for concurrent Taiyang-Shaoyang disease involves combined pathogens, hence puncturing Dazhui, Feishu, and Ganshu aligns with draining principles.

In Shaoyin disease, two to three days after onset, with normal mouth sensations and aversion to cold on the back, moxibustion is indicated, followed by Fuzi Tang (Aconite Decoction).

[Commentary] "Moxibustion" does not specify the point. Chang Qizi suggests Ge Guan (BL17) on the Foot-Taiyang meridian, specifically for back aversion to cold. Located below the seventh thoracic vertebra, 3 cun bilateral. Sit upright to locate. Moxa 5 cones. Since Taiyang is the exterior of Shaoyin, external moxa warms the exterior, while internal Fuzi warms the interior.

In Shaoyin disease with vomiting and diarrhea, if hands and feet are not cold but feverish, prognosis is good. If the pulse is absent, moxa the Shaoyin meridian for 7 cones.

[Commentary] "Moxa Shaoyin" does not specify the point. Chang Qizi suggests Taixi (KI3). The classics state the Yuan source of the Kidney is Taixi, located in the depression behind the medial malleolus where the artery beats.

In Shaoyin disease with diarrhea and pus/blood in stool, acupuncture is permissible.

[Commentary] "Acupuncture" does not specify points. Chang Qizi suggests Youmen (KI21) and Jiaoxin (KI8) of the Foot-Shaoyin meridian. Guo Yong suggests moxibustion. Youmen (KI21) is one cun below Jiawei (CV15), 0.5 cun lateral to Juque (CV14), in the depression. Treats dysentery with pus/blood. Puncture 5 cun, moxa 5 cones. Jiaoxin (KI8) is two cun above the medial malleolus, anterior to Shaoyin, posterior to Taiyin, between the tibia and tendon. Treats bloody/white dysentery. Puncture 4 cun, retain 5 breaths, moxa 3 cones. Both views are valid.

In Shaoyin disease with diarrhea, faint and choppy pulse, vomiting, sweating, frequent defecation with scant output, warm the upper jiao with moxibustion.

[Commentary] "Moxibustion" does not specify the point. Chang Qizi suggests Taichong (LR3). Guo Yong suggests Taixi (KI3). Neither treats vomiting/sweating with urgency/diarrhea effectively. Youmen (KI21) treats dry heaving, vomiting, urgency, and diarrhea, making it the appropriate choice.

In Shanghan, six to seven days later, with faint pulse, cold hands/feet, and irritability, moxa the Jueyin meridian. If coldness does not return, death ensues.

[Commentary] "Moxa Jueyin" does not specify the point. Chang Qizi suggests Taichong (LR3). As the invested point of Foot-Jueyin, Taichong pulse determines life/death. Located two cun distal to the metatarsophalangeal joint of the great toe, in the dorsal depression where the artery is palpable. Moxa 3 cones.

In Shanghan with rapid pulse and cold hands/feet, moxibustion is permissible.

[Commentary] "Moxibustion" does not specify the point. Chang Qizi suggests Taichong (LR3). Since the previous case of cold extremities used Taichong, this case of cold extremities should also use Taichong.