Library

(There are seven rules in total)

For men, from eight to sixty-four years old, and for women, from seven to forty-nine years old, this corresponds to the natural numbers of Dayan (Dayan numbers refer to an ancient divination system symbolizing the generation of heaven and earth). When ill, the essence and blood (Jing-Xue, the fundamental substances of life) are primary. Beyond these ages, the body experiences only decline without growth; such individuals are considered elderly. Treatment should focus exclusively on regulating Qi (Vital Energy), and one cannot treat them according to standard case protocols. However, since the deterioration of social customs, men tend to deplete their essence earlier. Thus, at forty or fifty years old, they have already reached middle age, and it is highly appropriate to use tonifying formulas (Bu Ji). For those in their prime who suffer from sexual exhaustion, only clearing heat (Tui Re) is necessary, without the need for tonification. Widows and nuns are not devoid of emotions; due to loneliness and resentment, they are prone to emotional stagnation. Treatment should first aim to dissipate their depression (San Yu). As for chronic diseases, one must trace the pathogenesis along the meridians (Jing Luo), reverse-engineer the source of the pathogenic factors (Xie Qi), and then address the specific symptoms. These are the crux of understanding disease progression and the core principles of prescribing.

When discussing diseases, one must distinguish between concurrent meridian involvement (Jian Jing), exclusive meridian involvement (Zhuan Jing), chaotic meridian involvement (Cuo Jing), and latent meridian involvement (Fu Jing). Only then can the principal and secondary aspects be identified, allowing for the differentiation of root and branch (Biao Ben) to formulate a prescription. Concurrent meridian involvement, such as Liang Gan (simultaneous contraction of exterior and interior meridians); exclusive meridian involvement, such as Tai Yang Exterior Syndrome (Tai Yang Biao Zheng, a syndrome caused by pathogenic invasion of the Tai Yang meridian); chaotic meridian involvement, such as Hu Huo Disease (a condition characterized by erosion and ulceration of the throat and genital/anal regions); and latent meridian involvement manifesting reversely, such as extreme heat mimicking cold (Zhen Re Jia Han).

Prescriptions for various diseases follow ancient methods: Zhang Zhongjing’s approach to exogenous diseases (Wai Gan), Li Dongyuan’s approach to endogenous injuries (Nei Shang), Liu Wansu’s aggressive elimination of pathogens, and Zhu Danxi’s comprehensive synthesis serve as canonical guidelines. These are weighed against Five Movements and Six Qi (Yun Qi, a theory relating climatic cycles to health), local geography and climate, and innate constitution (Bing Fu). For instance, people in northern desert regions use prescriptions from the *Huimin Ju Fang* (Official Formulary of the People's Welfare Bureau), which often contain pungent, hot herbs like musk. This is suitable because northerners naturally have cold constitutions and consume fishy, mutton-rich diets. Zhu Danxi, residing in the southeast, debated this incessantly. I once compared patients to hexagrams in the *I Ching* (Book of Changes) and prescriptions to line statements; just as divination yields different outcomes of auspiciousness, inauspiciousness, regret, or hesitation, the medical principle that "physicians should not adhere rigidly to fixed formulas" becomes clear.

When studying ancient prescriptions, one must imagine seeing the patient’s constitution and the contemporary Yun Qi and local climate firsthand to understand the author’s intent. Those that can serve as canonical guidelines are the laws of prescribing; those representing temporary adjustments are references. This entirely depends on truly knowing the properties of herbs and clearly perceiving the nature of the disease. I often sit cross-legged in deep meditation late at night when prescribing for others, sometimes taking ten days before I can put pen to paper.

Disease is like a bellows (Tuo), and the prescription is like the nozzle (Yue). Using ten thousand nozzles for one bellows would harm the bellows. In the world, some possess an empirical formula that occasionally hits the mark by chance, yet they use it lightly without careful assessment. Why?

Beyond the Jun-Chen-Zuo-Shi (Monarch-Minister-Assistant-Courier) hierarchy of herbal compatibility, there is a "biao shi" (marker guide) herb. If the formula uses pungent herbs to reach the Metal element (Lung/Metal association), one selects a single meridian-guiding herb and doubles the dosage of the pungent component, thereby achieving rapid efficacy.

Prescriptions need not contain many ingredients. Just look at Zhang Zhongjing’s formulas; how concise and pure they are! Zhu Danxi claimed that Li Dongyuan believed "the more, the better." Does this imply that physicians inherently lack talent?