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The key to treating disease lies first in distinguishing the properties of medicinal substances. When medicines are used appropriately, they save lives; when used inappropriately, they cause death. For those with fierce and pungent properties, people easily know them; however, among those that are extremely mild and ordinary, even subtle differences can lead to failure (medical mishaps), requiring profound study to avoid harm. I recall once treating acne vulgaris with deficiency patterns using Sijunzi Tang (Four Gentlemen Decoction); although it was very safe and steady, there were occasional cases of drying up and death because the dryness of Baizhu Rhizoma Atractylodis Macrocephalae and the leaching nature of Poria (Fu Ling) caused great harm; for patients with Yin deficiency, using Siwu Tang (Four Substances Decoction) could still incur blame because Xiong (Chuanxiong Rhizoma) and Gui (Danggui Radix Angelicae Sinensis) are acrid and dispersing, consuming Yin. Fu Ling and Baizhu have extremely mild properties, while Xiong and Gui have a Yin-nourishing yet slightly acrid nature, yet they can still leave behind harm. As for summerheat-heat or cholera, taking Shengjiang Tang (Fresh Ginger Decoction) causing immediate detriment is recorded in books innumerable. Furthermore, there are cases where the medicine does not match the syndrome, but due to its ability to "pull seedlings to help them grow" (forcing improvement), or having minor effects on superficial symptoms, while its harm manifests only later; or where the disease is severe but the medication is light, leading to resistance between medicine and pathogen, causing initial discomfort upon ingestion. If the patient, unaware of this, changes doctors, it leads to confusion. Such cases are particularly obscure and unpredictable. One must carefully discuss the relationship between medicine and disease, understanding how they constrain or oppose each other, to use them appropriately. For instance, Qi deficiency requires purely sweet-warm formulas without any draining or consuming agents, as time is of the essence. If chronic illness has led to Stomach deficiency, only Ren Shen (Ginseng Radix et Rhizoma) or Renshen Dihuang preparations should be used; adding Chao Baizhu (Stir-fried Rhizoma Atractylodis Macrocephalae), Erchen Tang (Two-Cured Decoction), Danggui, or Chuanxiong would be inappropriate. Similarly, for extreme Yin deficiency with blood loss, purely sweet and moistening methods like Sancai Fumai (Three Immortals Pulse-Replenishing Method) should be used, but Guizhi Ramulus Cinnamomi and Shengjiang must be removed. Extending this to women's pregnancy and postpartum conditions, whether from excessive uterine bleeding or long-standing stagnation, ascending and dispersing agents must not be used. In syndromes transforming into dryness or heat, no acrid-warm or bitter-dry agents should be included. It is common to see severe diarrhea worsened by Weiling Tang (Weiling Decoction) because Zhuling Polyporus and Zexia Alisma excessively promote drainage, inadvertently assisting downward flow. Generally, cold syndromes forbid cooling agents, heat syndromes forbid acrid-warm agents; deficiency forbids draining, excess forbids astringing; upward rebellion requires descending rather than ascending; downward leakage requires securing rather than descending; scattering requires converging rather than dispersing; stagnation requires venting rather than astringing. When medicines correspond to the condition, the disease heals; when they conflict, the disease progresses.

For the emaciated, the elderly, pregnant women, and postpartum women, if they present with excess syndromes, attacking pathogens should be done early, while healthy Qi is not yet severely damaged and pathogens have not deeply penetrated. Do not fear attack therapies; delaying allows pathogens to damage healthy Qi, making rescue impossible. In such critical moments, there are methods to revive the dying. When I treat major diseases, I invariably use large doses of potent medicines, repeatedly achieving miraculous effects: for major dispersion, Ephedrae Herba (Mahuang) and Notopterygii Rhizoma et Radix (Qianghuo) are primary; for major purgation, Rhei Radix et Rhizoma (Dahuang) and Natrii Sulfas (Mangxiao) are essential; for major warming, Aconiti Lateralis Radix Praeparata (Fuzi), Zingiberis Rhizoma (Ganjiang), and Cinnamomi Cortex (Rougui) are primary; for major clearing, Gypsum Fibrosum (Shigao) and Coptidis Rhizoma (Huanglian) are primary; for major tonification, Ginseng Radix et Rhizoma (Renshen) and Astragali Radix (Huangqi) are primary; for major Yin nourishment, Rehmanniae Radix Praeparata (Shudihuang), Asparagi Tuber (Tian Dong), and Ophiopogonis Tuber (Mai Dong) are primary. Whenever encountering major excess syndromes, large doses are necessary: Dahuang from 5 qian to 1 liang; for major cold syndromes, Fuzi increased from 3 qian to 6 qian; for major clearing syndromes, Shigao increased from 8 qian to 5 liang. Only then can rapid efficacy be achieved, turning danger into safety. Therefore, medicine values experience and observation. It is not for modern mediocre and ignorant practitioners who substitute light medicines or use mere fen to half a qian, hoping for revival—this is akin to a fool talking about dreams. Medicinal properties arise from their specific natures, possessing unique functions, utilizing generation and restriction to correct imbalances; they cannot be replaced by other substances.

However, the way of using medicines follows a sequence. When pathogens invade the Upper Jiao, Heart, Lung, head, eyes, or clear orifices, light and clear agents are suitable, not heavy ones; otherwise, the medicine may exceed the site of disease and damage the Middle and Lower Jiao. For stagnation syndromes, treatment should start with light venting and moistening, avoiding bitter-heavy, hot, or astringent-tonic agents, which are not only ineffective but also aggravate the disease. Conversely, for women with metrorrhagia and metrostaxis, heavy doses are required to be effective; using light doses is like stirring soup to stop boiling, benefiting nothing. For severe diarrhea, decoctions pass through the site quickly and do not linger, so powdered medicines should be used for slow cessation. For madness, venereal sores, and epidemics, heavy purgative doses are appropriate; light agents are difficult to effect. The methods listed above are all personal experiences verified over time, recorded here for study and as models for successors.

Lan notes: The principles of using medicine are stated precisely and in detail. Using large doses for major diseases ensures effectiveness, preventing situations where healthy Qi is weak and pathogens are strong, making rescue difficult; these are words born of daily experience. Mentioning Shigao up to 5 liang, Dahuang up to 1 liang, and Rougui/Fuzi up to 5-6 qian reflects the legacy method from *Neijing*: "If there is pathology, there is no harm [to healthy Qi]" (pathogens bear the brunt). However, this requires the practitioner's talent and insight, and their courage and decisiveness. Students must read carefully, think deeply, and speculate profoundly to understand intuitively and reach subtlety, following in the footsteps of good physicians, thereby honoring the guidance provided.