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The ancient sages said that if medicines are used appropriately, even toxic substances like Aconitum carmichaelii (Fuzi, 附子) and Aconitum kusnezoffii (Wutou, 乌头) can achieve therapeutic effects. Conversely, if used inappropriately, even tonics like Ginseng Radix (Renshen, 人参) and Poria (Fuling, 茯苓) can cause harm. So how should medicines be administered?

In the past, a person suffered from Yangming Stomach-Fu syndrome (a pattern of excess heat in the stomach and intestines), for which the indicated treatment was Chengqi Decoction (Chengqi Tang, 承气汤). However, he mistakenly took tonics such as Ginseng Radix (Renshen, 人参) and Atractylodes Macrocephala Rhizome (Baizhu, 白术), nearly dying. Later, when he developed fever due to Yang deficiency from another illness, which was suitable for treatment with Ginseng Radix (Renshen, 人参) and Atractylodes Macrocephala Rhizome (Baizhu, 白术), he feared taking them because of the previous incident and refused to use them. This resulted in his condition lingering and worsening. This is akin to giving up eating altogether because one has choked on food. Alas! The same medicinal substances, depending on whether they are used appropriately or not, can determine life or death. This further highlights the necessity for patients to select skilled physicians.

Ignorant common people often arbitrarily use one or two single-herb prescriptions, believing they can produce immediate and remarkable results while saving money. Who would not be pleased to follow such advice? However, this approach is only effective for those who are physically robust, possess exceptional constitution, and have a digestive system capable of tolerating toxicity. If a patient’s primordial Qi (Yuanqi, 元气) is slightly deficient, accidental ingestion can lead to rapid collapse. Such cases have been witnessed frequently. These words are written as a warning.

The principles of acupuncture and moxibustion are extremely profound and subtle. One must accurately and meticulously locate acupoints, consider the patient’s body type (fat/thin, tall/short), and exercise careful judgment. If performed with precision down to the hair’s breadth, a single application can surpass the efficacy of hundreds of herbs. Today, those who claim proficiency in this art are like blind men groping for a path, thereby causing more harm. Note: The text here refers specifically to moxibustion (implied by context of "external fire") as a draining method rather than a tonifying one. Even if considered tonifying, it is tonification within draining. If both Essence (Jing, 精) and Qi (Qi, 气) are depleted, dare one apply it recklessly? Generally, for patients with Yang deficiency, coldness, and deep-slow pulses, using external heat (moxibustion) to support internal heat is therapeutically appropriate. However, for diseases characterized by Yin deficiency with hyperactive fire and rapid pulse with fever, moxibustion will immediately cause harm. The *Neijing* (Inner Canon) and Li Dongyuan (Li Dongyuan, 李东垣) have discussed this in detail.

Nowadays, even if a patient selects a renowned physician and obtains an excellent prescription, if the herbs are not genuine geographical varieties (Daodi herbs, 地道药材) and are adulterated with fakes, it will not only fail to work but also cause harm. Examples include: Adenophora Radix (Shashen, 沙参) passed off as Ginseng Radix (Renshen, 人参); Medicago sativa root (Muzhugen, 苜蓿根) passed off as Astragalus Membranaceus Root (Huangqi, 黄芪); Ligusticum sinense rhizome head (Gaoben tou, 藁本头) passed off as Ligusticum chuanxiong Rhizome (Chuanxiong, 川芎); Fritillaria thunbergii Bulb (Zhebeimu, 浙贝母) passed off as Fritillaria cirrhosa Bulb (Chuanbeimu, 川贝母); Coptis chinensis Rhizome from Guangdong (Guanghuanglian, 广黄连) passed off as Sichuan Coptis Rhizome (Chuanhuanglian, 川黄连); Morinda officinalis root substitute (Ziliangen, 紫楝根) passed off as Morinda officinalis Root (Bajitian, 巴戟天); Southern Angelica sinensis (Nandanggui, 南当归) substituted for Qin Gui (Qingu, 秦归 - likely referring to a specific type or origin of Angelica); Zhejiang Rehmannia glutinosa Root Preparata (Zhedihuang, 浙地) substituted for Huai Shan Yao (Huaidihuang, 怀地黄); Jian Yam (Jianshanyao, 建山药) substituted for Huai Yam (Huai shanyao, 怀山药); Evodia fruit leaf (Dingqieye, 丁茄叶) passed off as Agastache rugosa Herb (Huoxiang, 藿香); Dyed Notopterygium Root (Randuohuo, 染独活) passed off as Angelica sinensis Root (Danggui, 当归); Coarse Gypsum Fibrosum (Cu eguan, 粗鹅管) passed off as Halloysitum (Zhongru, 钟乳); Golden Lotus root (Jinliangen, 金莲根) passed off as Cistanche Deserticola Stem (Roucongrou, 肉苁蓉); Zhejiang Lycium barbarum Fruit (Zhegouqi, 浙枸杞) passed off as Gansu Lycium barbarum Fruit (Gan gouqi, 甘枸杞); Yellow Seed-like substance (Huangsi zi, 黄丝子) passed off as Cuscuta Chinensis Seed (Tusizi, 菟丝子); Western Schisandra chinensis Fruit (Xi wuweizi, 西五味) confused with Northern Schisandra (Bei wuweizi, 北五味); Aristolochia debilis root (Duheng, 杜蘅) confused with Asarum Europaeum Root (Xixin, 细辛); Liquidambar resin (Fengxiang, 枫香) mixed with Boswellia carterii Resin (Ruxiang, 乳香); Black bundle (Heishu, 黑束 - likely a local name for a dark resinous wood) confused with Aquilaria Sinensis Wood (Chenxiang, 沉香); Sand and stones mixed with Trogopterus Dung (Lingzhi, 灵脂); Bovine glue (Niu jiao, 牛胶) passed off as Donkey-hide Gelatin (Ejiao, 阿胶); Sichuan Aconitum Carmichaelii Lateral Root Preparata (Chuanwu, 川乌) passed off as Aconitum Carmichaelii Lateral Root Preparata (Fuzi, 附子); Earth Stephania Tetrandra Root (Tu fangji) and Wild Horse Liver (Yemagan) confused with Polygonum multiflorum Root (Heshouwu, 何首乌). There are countless such examples. While petty merchants sell counterfeit goods, gentlemen must possess the discernment to distinguish truth from falsehood.