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Han Dynasty's Zhang Zhongjing treated Shanghan (Cold Damage), establishing 113 formulas, which is the ancestor of using formulas. Among them, the principles of addition, subtraction, separation, and combination are most excellent. For example, adding Gegen (Puerariae Radix) to Guizhi Tang (Cinnamon Twig Decoction) results in Guizhi Jia Gegen Tang (Cinnamon Twig with Pueraria Decoction); this is the method of addition. Removing Shaoyao (Paeoniae Radix Alba) from Guizhi Tang results in Guizhi Qu Shaoyao Tang (Cinnamon Twig without White Peony Root Decoction); this is the method of subtraction. Removing Shaoyao and adding Fuzi (Aconiti Lateralis Radix Praeparata) to Guizhi Tang is the method of simultaneous addition and subtraction. Guizhi Er Mahuang Yi Tang (Two Parts Cinnamon Twig and One Part Ephedra Decoction) and Guizhi Er Yueshi Yi Tang (Two Parts Cinnamon Twig and One Part Yuebi Decoction) represent the method of combination (merging two formulas). Guizhi Mahuang Ban Ge Tang (Half-and-Half Cinnamon Twig and Ephedra Decoction) represents a method of combination combined with separation. Since disease conditions change in myriad ways, formulas cannot be rigidly fixed. Therefore, there are instances where cold and hot herbs are used together in one formula, such as Zhang Zhongjing's Fuzi Xie Xin Tang (Aconite Draining the Epigastrium Decoction). There are instances where purgation and tonification are used together, such as Tao Hua's (Tao Shi's) Huanglong Tang (Yellow Dragon Decoction). There are also cases where herbs with opposing properties are used together, such as Hu Qia treating phlegm-stasis by adding Gancao (Licorice Root) to Shizao Tang (Ten Jujube Decoction), or Zhu Danxi treating consumption by administering Lianxin Yin (Lotus Plumule Infusion) together with Yuanhua (Genkwa Flower). Furthermore, Zhu Danxi treated a woman using Siwu Tang (Four Substance Decoction), removing Chuanxiong (Ligustici Rhizoma et Radix), doubling Dihuang (Rehmanniae Radix), and adding Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqi (Astragali Radix), Huangbai (Phellodendri Cortex), Gancao (Licorice Root), and Renshen (Ginseng Radix). After one dose, she suffered abdominal distension and diarrhea, blindness, and muteness. Zhu Danxi deduced that the disease was deep-seated and the medication lacked the effect of counteracting assistance (fan zuo). He then administered the same decoction after stir-frying it, and she recovered. This demonstrates that for the same formula, raw versus cooked application yields vastly different results. The principles of Jun (Sovereign), Chen (Minister), Zuo (Assistant), and Shi (Envoy) must especially be understood. For instance, Liujunzi Tang (Six Gentlemen Decoction) specifically tonifies Qi, so Renshen (Ginseng Radix) is the Sovereign herb; Siwu Tang (Four Substance Decoction) specifically tonifies Blood, so Danggui (Angelicae Sinensis Radix) is the Sovereign herb. One must not mix them chaotically, lest one lose the main objective. To become a physician, if one first understands the methods of formulating prescriptions, achieving efficacy will not be difficult.

I treated a Mrs. Wang for redness and swelling of both eyes. Her left Guan pulse was deep, rapid, slightly choppy, and faint. This indicated Liver injury by constrained fire, suitable for Xiaoyao San (Free and Easy Wanderer Powder). However, since it was the summer season, I feared Chaihu (Bupleuri Radix) might further ascend and agitate the fire, so I removed it and added Qinghao (Artemisiae Annuae Herba), resulting in recovery. I also treated Mr. Xie, who had excessive Fire and deficient Water, suitable for Liuwei Wan (Six-Ingredient Pill with Rehmannia). However, he had star-shaped opacities in the eyes, making astringent herbs unsuitable, so I removed ShanYuzhu (Corni Fructus) and added Nvzhenzi (Ligustri Lucidi Fructus), resulting in recovery. I also treated another Mr. Xie whose eyes showed red veins drooping downwards. This was due to overwork and excessive worry injuring the Spleen, leading to Spleen Fire punishing Lung Metal. GuiPi Tang (Restore the Spleen Decoction) was appropriate. However, there was still constrained fire in the Spleen, and I feared Muxiang (Aucklandiae Radix) was too drying and could break Qi, so I removed it and added Maidong (Ophiopogonis Radix) to moisten the Lung, resulting in recovery. I also treated Mr. Wu for Jueyin headache. His Qi and Blood were inherently deficient, and his Spleen and Kidney meridians were affected by Cold pathogens, causing a white opacity and red barrier in the left eye with scars below. A warming and tonifying agent was appropriate. But if only Spleen Cold is dispelled, Kidney Water is not warmed; if only Kidney Cold is dispelled, Spleen Earth is not warmed. I combined Lizhong Tang (Regulate the Middle Decoction) and Liyin Jian (Infusion to Nourish Yin) to treat him, resulting in recovery. These various methods cannot be fully summarized here. As long as one adapts to the syndrome, one can avoid the error of carving a mark on the boat to find the sword.

If symptoms are similar, formulas should not be used interchangeably. For example, in Yin syndromes resembling Yang, the patient has swollen eyes and red face, irritability, sore throat, slight body heat, and constipation, resembling a Yang syndrome. However, although thirsty, they cannot drink. The pulse is deep, fine, slow, and faint, or superficially rapid and forceful but deeply weak and powerless. This is Water extreme resembling Fire. As Wang Taipu stated: "Body heat with a rapid pulse that does not beat forcefully upon pressure" is named Yin Excess repelling Yang (Yin Sheng Ge Yang), not Heat. Tongmai Sini Tang (Pulse-Reviving Counterflow Cold Decoction) with doubled Fuzi (Aconiti Lateralis Radix Praeparata) and Renshen (Ginseng Radix) is suitable to reconnect True Yang Qi. If cold-natured herbs are administered, death follows immediately. In Yang syndromes resembling Yin, the patient has slightly red eyes, cold limbs, lethargy, resembling a Yin syndrome. However, they can drink water, have hard constipation, and dark scanty urination. Even if loose stool passes, it is side-flowing fluid, not cold diarrhea. The pulse may be deep, but upon palpation, it is slippery, rapid, and forceful. Wang Taipu stated: "Patient with cold body and厥冷 (cold extremities), yet pulse is slippery and rapid, beating forcefully upon pressure" is named Yang Excess repelling Yin (Yang Sheng Ge Yin), not Cold. Mild cases use Baihu Tang (White Tiger Decoction); severe cases use Chengqi Tang (Order the Qi Decoction). If warm-hot herbs are administered, the physician kills the patient.

There is also the method of distant treatment (Ge Zhi). As stated in the *Suwen* Chapter on Six Sections and Viscera Images: "Arrival before time is excess, which attacks the element that does not overcome it and conquers the element it overcomes." Zhang Jiebin said that among the Five Elements, the one that overcomes me is "that which does not overcome me," and the one I overcome is "that which I overcome." For example, if Wood Qi is excessive, Metal cannot control it, and Wood insults Metal, attacking "that which does not overcome me." I once treated a case of eye pain, Spleen diarrhea, and vomiting using only Sijunzi Tang (Four Gentlemen Decoction) with success. This condition arose because Spleen Earth was weak and could not generate Metal to control Wood. During spring, Shaoyang (Lesser Yang) was dominant, Metal Qi was dormant, and Wood carried Ministerial Fire to punish Lung Metal, causing eye pain and vomiting, which then suppressed Spleen Earth, causing diarrhea. If one attacks Liver Wood directly, Wood cannot be controlled. Only by using the distant treatment method—tonifying Earth to generate Metal, and generating Metal to control Wood—can Metal receive support, preventing Wood from attacking "that which does not overcome me." This aligns with Li Dongyuan's idea of tonifying Earth to level Liver. However, diseases are infinite, and ancient formulas cannot cover all variations. Thus, one must formulate prescriptions based on the syndrome, offering unique insights.

Once, a patient named Gan injured his right eye with smelting stone. The black pupil was damaged, vision was unclear, and the eye sockets were swollen and painful. Another patient, Mrs. Chou, burned her left eye with fire. The black pupil was ruined, and pain was unbearable. Neither case was recorded in *Feihong Ji*, *Longmu Lun*, *Yinhai Jingwei*, *Yuanji Qiwei*, *Shenxi Yaohan*, nor in any major physician's collected works. I reasoned that smelting stone is Yang in nature, and when calcined into ash, its nature becomes even more fierce. Injury to the eye causes blood coagulation and fluid depletion. I prescribed a formula using earthworm mud from leek fields boiled in water for oral administration. Swelling and pain subsided immediately. Subsequently, cooling-blood herbs restored vision. Earthworms possess Earth virtue and correspond to the Zhen constellation. Their nature is salty and cold, effectively clearing heat. The mud is particularly sweet and cold, draining heat and detoxifying. Mud from leek fields is essential. Leeks enter the Blood aspect and move Qi; moving Qi reduces swelling, and clearing heat stops pain. Regarding fire burns, the nature is dry and fierce, burning the eye severely. I used aged rapeseed oil for irrigation. Swelling and pain subsided immediately. Rapeseed is pungent, warm, and non-toxic. Aging dissipates some pungency and warmth. The eye suffers from dryness and bitterness; this oil moistens it, reducing pain. Its pungent-warm flavor disperses stagnation, resolving swelling. If students carefully identify the disease source and master Materia Medica, what reason would there be to fear difficult treatments?