谓腑脏之位也。心肺为近，肝肾为远，脾胃居中。三阳胞 胆亦有远近，身三分之上为
近，下为远也。若识见高远，权以合宜，方奇而分两偶，方偶而分两奇，如是者近而偶制，多数服之，
远而奇制，少数服之，故曰小则数多，大则数少也。）奇之不去则偶之，是谓重方。偶之不去则
反佐以取之，所谓寒热温凉，反从其病也。（方与其重也宁轻，与其毒也宁善，与其大也宁小，是
以奇方不去，偶方病在，则反其一佐，以同病之气而取之也。夫热与寒背，寒与热违。微小之热，
为寒所折，微小之冷，为热所消。甚大寒热，则必能与违性者争雄，能与异气者相格，声不同
不相应，气不同不相合，如是则且惮而不敢攻之，攻之则病气与药气杭衡，而自为寒热以开闭固守矣。
是以圣人反其以同其气，令声气应合，复令寒热参合，使其终异 同，凌润而败坚，
刚强必折，柔脆同消尔。此言约方之法，不越奇偶，而必当曲尽其制也。）
大 君一臣三佐九，制之大也。远而奇偶，制大其服也。大则数少，少则二
之。肾肝位远，服汤散不厌频而多。
小 君一臣二，制之小也。近而奇偶，制小其服也。小则数多，多则九之。心肺位近，服
汤散不厌频而少。
缓 补上治上制以缓，缓则气味薄，治主以缓，缓则治其本。
急 补下治下制以急，急则气味浓，治客以急，急则治其标。
奇 君一臣二，奇之制也。君二臣三，奇之制也。阳数奇。
偶 君二臣四，偶之制也。君二臣六偶之制也。阴数偶。
复 奇之不去则偶之，是为重方也。
是故百病之起，有生于本者，有生于标者，有生于标本者，有取本而得者，有
取标而得者，有取中气而得者，有取标本而得者，有逆取而得者，有从取而得者。（反佐
取之，是为逆取。奇偶取之，是为从取。寒病治以寒，热病治以热，是为逆取。从，顺也。）
逆，正顺也。若顺，逆也。（寒盛格阳，治热以热，热盛格阴，治寒以寒之类，皆时谓之逆，
外虽用逆，中乃顺也。此逆乃正顺也。若寒格阳，而治以寒，热格寒而治以热，外则虽顺，
中气乃道，故方若顺，是逆也。）故曰∶知标与本，用之不殆，明知逆顺，正行无问。不知是
者，不足以言诊，足以乱经。粗工嘻嘻，以为可知，言热未已，寒病复殆，同气异形，迷诊乱
经。（六气之用，粗之与工，得其半也。厥阴之化，粗以为寒，其乃是温、太阳之化，
粗以为热，其乃是寒。由此参互，用失其道，故学问识用，不达工之道半矣。夫一经之标本，
寒热既殊，言本当究其标，论标合寻其本。言气不穷其标本，论病未辨其阴阳，心既迷正理，
治益乱经，呼曰粗工。）夫标本之道，要而搏，小
而大，可以言一而知而病之害。言标与本，易而勿损，察本与标，气可令调，明知胜复。为
万民式。（此言六气各有所从之标本，而百病皆当知标本也。）
愿闻病机何如？诸风掉眩皆属于肝。（风性动，木气同之。）诸寒收引皆属于肾。（收，谓敛
也。引，谓急也。寒物收缩，水气同也。）诸气 郁皆属于肺。（高秋气凉，露气烟集，凉
至则气热，复甚则气殚，征其物象，属可知也。 谓 满。郁，谓奔迫也。气之为用，金气同之。）
诸湿肿病，皆属于脾。（土薄则水浅，土浓则水深，土平则干，土高则湿，湿气之有，土气同之。）
诸热瞀螈，皆属于火。（火象征。）诸痛痒疮，皆属于心。（心寂则病微，心躁则痛甚。百端之起，皆自
心生，痛痒疡疮，生于心也。）诸厥固泄，皆属于下。（下，谓下焦肝肾也。夫守司于下，肾之气也。
门户束要，肝之气也。故诸厥固泄皆属于下也。厥力气逆。固，谓禁固。诸有气逆上行、及固不禁，出入
无度，燥湿不恒，皆由下焦之主守也。）诸痿喘呕，皆属于上。（上，谓上焦心肺气也。炎热薄灼，
心之气也。承热分化，肺之气也。热郁于上，故病上焦。此皆五脏之疾病机，由于内动者也。）
诸禁鼓栗，如丧神守，皆属于火。（热之内作。）诸痉项强，皆属于湿。（太阳伤湿。）诸逆冲上，皆属于
火。（炎上之性用也。）诸胀腹大，皆属于热。（热郁于内，肺胀所生。）诸燥狂越，皆属于
火。（热盛于胃及四末也。）诸暴强直，皆属于风。（阳内郁而阴行于外。）诸病有声，鼓之如鼓，
皆属于热。（谓有声也。）诸病 肿，痛酸惊骇，皆属于火。（诸气多也。）诸转反戾，水液混浊，
皆属于热。（反戾，筋转也。水液，小便也。）诸病水液，澄澈清冷，皆属于寒。（上下所出，及吐出尿
出也。）诸呕吐酸，暴注下迫，皆属于热。（酸，酸水及沫也。此皆十二经络之邪，病机由于外入者也。）
故《大要》曰∶谨守病机，各司其属，有者求之，无者求之，盛者责之，虚者责之。必先五胜，疏
其血气，令其条达，而至和平，此之谓也。（深乎圣人之言，有无求之，虚盛责之，如大寒而甚，热之
不热，是无火也；热去复来，昼见夜伏，夜发昼止，时节而动，是无火也，当助其火。又如大热而甚，
寒之不寒，是无水也；热动复止，攸忽往来，时动时止，是无水也，当助其水。内格呕逆，食不得
入，是有火也。病呕而吐，食入反出，是无火也。夫寒之不寒，责其无水；热之不热，责其无火。热
之不久，责心之虚；寒之不久，责肾之少，有者泻之，无者补之，虚者补之，盛者泻之，令上下无碍，
气血通调，则寒热自和，阴阳调达矣。此言病机，计有十九而言善治之法也。）
愿言其制。君一臣二，制之小也；君一臣三佐五制之中也；君一臣三佐九，制之大也。寒
者热之，热者寒之，微者逆之，甚者从之，（夫病之微小者，犹人火也，遇草而炳，得木而燔，可以湿伏，
可以水灭，故逆其性气以折之、攻之。病之大甚者，龙火也，遇草而焰，遇水而燔，不知其性，以
水湿折之，适足以光焰诣天，物穷方止矣。识其性者，反常之理，以火逐之，则燔灼自消，焰火扑灭。夫
逆之者，谓以寒攻热，以热攻寒；从之者，谓攻以寒热从其性，用是以下方曰∶逆者正治，从者反治，
从多从少，观其事也。）坚者削之，客者除之，劳者温之，结者散之，留者攻之，燥者濡之，急者缓之，散
者收之，损者益之，逸者行之，惊者平之，上之下之，摩之浴之，薄之劫之，开之发之，适事为
故。（量病症候，适事用之。）帝曰∶何谓逆从？伯曰∶逆者正治，从者反治，从少从多，观其事
也。（言逆者，正治也。从者，反治也。逆病气而正治，则以寒攻热，以热攻寒，虽从顺病气，乃
反治法也。）帝曰∶反治何谓？伯曰∶热因寒用，寒因热用，塞因塞用，通因通用，必伏其所主，
而先其所因，其始则同，其终则异，可使破积，可使溃坚，可使气和，可使必已。（热因热用，
热物冷服，下咽之后，冷体即消，热性便发。寒固热用，冷物热服也。中满下虚，乃疏启其中，峻
补于下，少服则资壅，多服则宣通，由是而中满自除，下虚斯实，此则塞因塞用也。又大热内结，注泄不
止，热宜寒疗，结复须除，以寒下之，结散利止，此则通因通用也。投寒以热，凉而行之，投热以寒，
温而行之，始同终异，斯之谓也。）逆之从之，逆而从之，从而逆之，疏气令调，则其道也。（逆，
谓逆病气以正治。从，谓从病气而反疗。逆其气以正治，使其从顺，从其病以反取，令彼调和，故曰逆
从也。下疏其气，令道路开通，则气感寒热而为变。）
病之中外何如？从内之外者，调其内；从外之内者，治其外；（各绝其源。）从内之外，
而盛于外者，先调其内，而后治其外；从外之内，而盛于内者，先治其外，而复调其内；（皆谓先除其根。）
中外不相及，则治主病。（中外不相及，自各一病也。此言治表里之病患三法∶有标
本，有先后，有分主也。）治寒以热，治热以寒，而方土不能废绳墨而更其道也。有病热者，
寒之而热，有病寒者，热之而寒，二者皆在，新病复起，奈何治？（谓治之而病不退，反因
药寒热而随生寒热，病之新者。）伯曰∶诸寒之而热者取之于阴；热之而寒者，取之于阳，所谓
求其属也。（言益火之源，以消阴翳，壮水之主，以制阳光，故曰求其属也。夫粗工偏浅，以热
攻寒，以寒疗热，治热未已，而冷疾已生，攻寒日深，而热病更起，热起而中寒尚在，寒生
外热不除，欲攻寒则俱热不前，欲疗热则思寒又止，进退交战，危极已臻。岂知脏腑之源，有
寒热温凉之主哉！夫取心者，不必齐以热；取肾者不必齐以寒，但益心之阳，寒亦通行，强肾之
阴，热之犹可，或治热以热，治寒以寒，万举万全。）帝曰∶服寒而反热，服热而反寒，其故何
也？伯曰∶治其王气，是以反也。（物体有寒热，气性有阴阳，触王之气，则强其用也。夫肝气
温和，心气暑热，肺气清凉，肾气寒冽，脾气兼并之，故春以清治肝而反温，夏以冷治心而反热，
秋以温治肺而反清，冬以热治肾而反寒，盖由补王气太甚，补王太甚，则脏之寒热气多也。）
夫五味入胃，各归其所喜，故酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾，久而增
气，物化之常也。气增而久，夭之由也。（夫入肝为温，入心为热，入肺为清，入肾为寒，入脾为至阴
而四气兼之，皆为增其味而益其气，故各从本脏之气用尔。故久服黄连、苦参而反热者，此其类
也，余味皆然。但人意疏忽，而不能精候耳。故曰久而增气，物化之常也。气增不已，脏气偏盛，
脏有偏绝，则有暴夭者，故曰气增而久，夭之由也。是以服饵百药，不具五味，不借四气，而久服之，
虽且获益，而久必致暴夭。此之谓也。绝粒服饵，则不暴亡，斯何由哉！无五谷味资助故也。复令
食谷，其亦夭焉。）调气之方，必别阴阳，定其中外，各守其乡，内者内治，外者外治，微
者调之，其次平之，盛者夺之，汗者下之，寒热温凉，衰之以属，随其攸利，（病有中外，治有
表里。在内者，以内治法和之，在外者，以外治法和之；其次大者，以平气法平之；盛甚不已，
则夺其气令其衰也。假如小寒之气，温以和之，大寒之气，热以取之，甚寒之气，则下夺之，夺之不
已，则逆折之，折之不尽，则求其属以衰之，小热之气，凉之和之；大热之气，寒以取之；甚热
之气，则汗发之；发之不尽，则逆制之，制之不尽，则求其属以衰之，故曰∶汗之下之，寒热温
凉，衰之以属，随其攸利。攸，所也。）谨道如法，万举万全，气血正平，长有天命。（守道以行，举
无不中，故能驱役草石，召遣神灵，血气保平和之候，天真无耗竭之由。）
这是指脏腑在体内的位置关系。心和肺位于上部，距离体表较近；肝和肾位于下部，距离体表较远；脾和胃居于中间。三阳经（太阳、阳明、少阳）与胆腑也有远近之分，身体上部的三分之一为近，下部的三分之二为远。（如果医者的见识高远，权变得当，那么当方剂组成是奇数药味时，分两剂量设为偶数；当方剂组成是偶数药味时，分两剂量设为奇数。像这样，病位近的用偶数制方，多服几次；病位远的用奇数制方，少服几次。所以说，小方剂药味多，大方剂药味少。）如果奇数药味的方剂无效，就用偶数药味的方剂，这叫做重方。如果偶数药味的方剂也无效，就采用反佐法来取效，这就是所谓寒热温凉，顺从病气的性质。（处方与其重用猛药，不如轻用善药；与其用有毒之药，不如用无毒之药；与其用大剂量，不如用小剂量。因此，奇方不去病，偶方病仍在，就反过来佐以同病气性质的药物来取效。热与寒相背，寒与热相违。微小的热邪，会被寒药所折服；微小的寒邪，会被热药所消除。但是极大的寒热邪气，则必然能与违背其性质的药物争雄，能与异气相格拒，声音不同就不相应，气机不同就不相合。像这样，医生就会畏惧而不敢攻伐，一旦攻伐，病气与药气抗衡，自身就会形成寒热闭塞固守的局面。因此圣人反其道而行，使其气机相同，令声气应合，再让寒热参合，使它们最终由异转同，凌润而败坚，刚强必折，柔脆同消。这是讲制方的法则，不离奇偶，但必须详尽地掌握其制度。）
君药一，臣药三，佐药九，这是大方的制式。病位远且用药有奇有偶，加大服药量。大方剂药味少，少则加倍。肝肾位远，服用汤散不厌其烦且量多。
君药一，臣药二，这是小方的制式。病位近且用药有奇有偶，减小服药量。小方剂药味多，多则九倍。心肺位近，服用汤散不厌其烦但量少。
缓：补益上焦或治疗上部疾病，制方宜缓，缓则气味淡薄，治主病宜缓，缓则治其本。
急：补益下焦或治疗下部疾病，制方宜急，急则气味浓厚，治客病宜急，急则治其标。
奇：君药一，臣药二，是奇数的制方。君药二，臣药三，也是奇数的制方。阳数为奇。
偶：君药二，臣药四，是偶数的制方。君药二，臣药六，也是偶数的制方。阴数为偶。
复：奇方不去病则用偶方，这叫重方。
因此百病的产生，有的生于本，有的生于标，有的生于标本之间，有的取本而得愈，有的取标而得愈，有的取中气而得愈，有的取标本而得愈，有的逆取而得愈，有的从取而得愈。（反佐取之，称为逆取。奇偶取之，称为从取。寒病治以寒药，热病治以热药，称为逆取。从，即顺也。）
逆，其实是正顺。若顺，则是逆。（寒盛格阳，用热药治热象；热盛格阴，用寒药治寒象之类，当时都称之为逆，外表虽用逆法，内心实乃顺理。这种逆就是正顺。如果寒格阳，却用寒药治；热格寒，却用热药治，外表虽顺，中气反而道阻，所以方子看似顺，其实是逆。）所以说：知道标与本，使用就不会危险；明了逆与顺，正道直行无需疑问。不知道这些，不足以言诊断，足以扰乱经典。粗工嘻嘻，以为可知，说热病还没好，寒病又起，同气异形，迷乱诊断扰乱经络。（六气的作用，粗工与良工只得到了一半。厥阴的化气，粗工以为是寒，其实乃是温；太阳的化气，粗工以为是热，其实乃是寒。由此参互比较，用法失其道，所以学问识用，达不到良工的一半。一经的标本，寒热既已不同，言语本当究其标，论标应当寻其本。言气不穷尽标本，论病未辨阴阳，心既迷乱正理，治疗更加紊乱经络，呼之为粗工。）夫标本的道理，简要而博大，微小而宏大，可以言一而知十，了解病的危害。言标与本，容易而不损耗，察本与标，气可令调，明了胜复。作为万民的准则。（此言六气各有所从的标本，而百病皆应当知标本。）
希望听听病机是怎样的？各种风证引起的动摇眩晕，都属于肝。（风性主动，木气与之相同。）各种寒证引起的收缩牵引，都属于肾。（收，谓收敛；引，谓紧急。寒物收缩，水气与之相同。）各种气机郁滞，都属于肺。（高秋气凉，露气烟集，凉至则气热，复甚则气竭，征验其物象，属可知也。 谓痞满。郁，谓奔迫。气的作用，金气与之相同。）各种湿证引起的肿胀，都属于脾。（土薄则水浅，土浓则水深，土平则干，土高则湿，湿气之有，土气与之相同。）各种热证引起的昏闷抽搐，都属于火。（火象征光明。）各种痛痒疮疡，都属于心。（心静则病微，心躁则痛甚。百端之起，皆自心生，痛痒疡疮，生于心也。）各种厥逆、便秘、泄泻，都属于下焦。（下，谓下焦肝肾。守司于下，是肾之气。门户束要，是肝之气。故诸厥固泄皆属于下。厥，力气逆。固，谓禁固。诸有气逆上行、及固不禁，出入无度，燥湿不恒，皆由下焦之主守所致。）各种痿证、喘证、呕吐，都属于上焦。（上，谓上焦心肺气。炎热薄灼，是心之气。承热分化，是肺之气。热郁于上，故病在上焦。此皆五脏之疾病机，由于内动所致。）各种禁口不语、鼓栗，如丧失神志守护，都属于火。（热之内作。）各种痉证项强，都属于湿。（太阳伤湿。）各种气逆冲上，都属于火。（炎上之性用。）各种胀满腹大，都属于热。（热郁于内，肺胀所生。）各种燥狂越，都属于火。（热盛于胃及四肢末梢。）各种暴发的强直，都属于风。（阳内郁而阴行于外。）各种病有声响，叩之如鼓，都属于热。（谓有声也。）各种病肿，痛酸惊骇，都属于火。（诸气多也。）各种筋脉扭转反折，水液混浊，都属于热。（反戾，筋转也。水液，小便也。）各种病水液，澄澈清冷，都属于寒。（上下所出，及吐出尿出也。）各种呕吐酸水，暴注下迫，都属于热。（酸，酸水及沫也。此皆十二经络之邪，病机由于外入所致。）
所以《大要》说：谨慎坚守病机，各自归属其类，有的求之，无者求之，盛者责之，虚者责之。必先明五运之胜，疏其血气，令其条达，而至和平，这就叫善治。（深乎圣人之言，有无求之，虚盛责之，如大寒而甚，热之不热，是无火也；热去复来，昼见夜伏，夜发昼止，时节而动，是无火也，当助其火。又如大热而甚，寒之不寒，是无水也；热动复止，攸忽往来，时动时止，是无水也，当助其水。内格呕逆，食不得入，是有火也。病呕而吐，食入反出，是无火也。夫寒之不寒，责其无水；热之不热，责其无火。热之不久，责心之虚；寒之不久，责肾之少，有者泻之，无者补之，虚者补之，盛者泻之，令上下无碍，气血通调，则寒热自和，阴阳调达矣。此言病机，计有十九而言善治之法也。）
希望讲讲制方原则。君一臣二，制之小也；君一臣三佐五，制之中也；君一臣三佐九，制之大也。寒者热之，热者寒之，微者逆之，甚者从之。（夫病之微小者，犹人火也，遇草而炳，得木而燔，可以湿伏，可以水灭，故逆其性气以折之、攻之。病之大甚者，龙火也，遇草而焰，遇水而燔，不知其性，以水湿折之，适足以光焰诣天，物穷方止矣。识其性者，反常之理，以火逐之，则燔灼自消，焰火扑灭。夫逆之者，谓以寒攻热，以热攻寒；从之者，谓攻以寒热从其性，用是以下方曰∶逆者正治，从者反治，从多从少，观其事也。）坚者削之，客者除之，劳者温之，结者散之，留者攻之，燥者濡之，急者缓之，散者收之，损者益之，逸者行之，惊者平之，上之下之，摩之浴之，薄之劫之，开之发之，适事为故。（量病症候，适事用之。）帝曰：何谓逆从？伯曰：逆者正治，从者反治，从少从多，观其事也。（言逆者，正治也。从者，反治也。逆病气而正治，则以寒攻热，以热攻寒，虽从顺病气，乃反治法也。）帝曰：反治何谓？伯曰：热因寒用，寒因热用，塞因塞用，通因通用，必伏其所主，而先其所因，其始则同，其终则异，可使破积，可使溃坚，可使气和，可使必已。（热因热用，热物冷服，下咽之后，冷体即消，热性便发。寒固热用，冷物热服也。中满下虚，乃疏启其中，峻补于下，少服则资壅，多服则宣通，由是而中满自除，下虚斯实，此则塞因塞用也。又大热内结，注泄不止，热宜寒疗，结复须除，以寒下之，结散利止，此则通因通用也。投寒以热，凉而行之，投热以寒，温而行之，始同终异，斯之谓也。）逆之从之，逆而从之，从而逆之，疏气令调，则其道也。（逆，谓逆病气以正治。从，谓从病气而反疗。逆其气以正治，使其从顺，从其病以反取，令彼调和，故曰逆从也。下疏其气，令道路开通，则气感寒热而为变。）
病之中外情况如何？从内之外者，调其内；从外之内者，治其外；（各绝其源。）从内之外，而盛于外者，先调其内，而后治其外；从外之内，而盛于内者，先治其外，而复调其内；（皆谓先除其根。）中外不相及，则治主病。（中外不相及，自各一病也。此言治表里之病患三法∶有标本，有先后，有分主也。）治寒以热，治热以寒，而方土不能废绳墨而更其道也。有病热者，寒之而热，有病寒者，热之而寒，二者皆在，新病复起，奈何治？（谓治之而病不退，反因药寒热而随生寒热，病之新者。）伯曰：诸寒之而热者取之于阴；热之而寒者，取之于阳，所谓求其属也。（言益火之源，以消阴翳，壮水之主，以制阳光，故曰求其属也。夫粗工偏浅，以热攻寒，以寒疗热，治热未已，而冷疾已生，攻寒日深，而热病更起，热起而中寒尚在，寒生外热不除，欲攻寒则俱热不前，欲疗热则思寒又止，进退交战，危极已臻。岂知脏腑之源，有寒热温凉之主哉！夫取心者，不必齐以热；取肾者，不必齐以寒，但益心之阳，寒亦通行，强肾之阴，热之犹可，或治热以热，治寒以寒，万举万全。）帝曰：服寒而反热，服热而反寒，其故何也？伯曰：治其王气，是以反也。（物体有寒热，气性有阴阳，触王之气，则强其用也。夫肝气温和，心气暑热，肺气清凉，肾气寒冽，脾气兼并之，故春以清治肝而反温，夏以冷治心而反热，秋以温治肺而反清，冬以热治肾而反寒，盖由补王气太甚，补王太甚，则脏之寒热气多也。）
夫五味入胃，各归其所喜，故酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾，久而增气，物化之常也。气增而久，夭之由也。（夫入肝为温，入心为热，入肺为清，入肾为寒，入脾为至阴而四气兼之，皆为增其味而益其气，故各从本脏之气用尔。故久服黄连、苦参而反热者，此其类也，余味皆然。但人意疏忽，而不能精候耳。故曰久而增气，物化之常也。气增不已，脏气偏盛，脏有偏绝，则有暴夭者，故曰气增而久，夭之由也。是以服饵百药，不具五味，不借四气，而久服之，虽且获益，而久必致暴夭。此之谓也。绝粒服饵，则不暴亡，斯何由哉！无五谷味资助故也。复令食谷，其亦夭焉。）调气之方，必别阴阳，定其中外，各守其乡，内者内治，外者外治，微者调之，其次平之，盛者夺之，汗者下之，寒热温凉，衰之以属，随其攸利，（病有中外，治有表里。在内者，以内治法和之，在外者，以外治法和之；其次大者，以平气法平之；盛甚不已，则夺其气令其衰也。假如小寒之气，温以和之，大寒之气，热以取之，甚寒之气，则下夺之，夺之不已，则逆折之，折之不尽，则求其属以衰之，小热之气，凉之和之；大热之气，寒以取之；甚热之气，则汗发之；发之不尽，则逆制之，制之不尽，则求其属以衰之，故曰∶汗之下之，寒热温凉，衰之以属，随其攸利。攸，所也。）谨道如法，万举万全，气血正平，长有天命。（守道以行，举无不中，故能驱役草石，召遣神灵，血气保平和之候，天真无耗竭之由。）
This refers to the positional relationships of the Zang and Fu organs. The Heart and Lung are located proximally (closer to the surface/exterior), while the Liver and Kidney are located distally (further from the surface/exterior); the Spleen and Stomach reside in the center. The Three Yang meridians (Taiyang, Yangming, Shaoyang) and the Gallbladder also have proximal and distal distinctions: the upper third of the body is considered proximal, and the lower two-thirds are considered distal. (If the physician's insight is profound and their adaptation appropriate, then when the prescription formula has an odd number of ingredients, the dosage ratio should be even; when the formula has an even number of ingredients, the dosage ratio should be odd. In this manner, for proximal conditions, use an even-numbered formula and administer it frequently; for distal conditions, use an odd-numbered formula and administer it sparingly. Hence it is said: small formulas have many ingredients, large formulas have few ingredients.) If the odd-numbered formula fails to cure, employ an even-numbered formula; this is called a "Chong Fang" (Repeated/Complex Formula). If the even-numbered formula also fails, employ a counter-assistance method (Fan Zuo) to achieve the cure; this is what is meant by cold, heat, warmth, and coolness following the nature of the disease. (In prescribing, it is better to use mild drugs than heavy ones, non-toxic drugs rather than toxic ones, and small dosages rather than large ones. Therefore, if the odd formula does not dispel the pathogen and the even formula leaves the disease present, reverse the approach by assisting with drugs that share the same qi as the disease to capture it. Heat opposes cold, and cold contradicts heat. Minor heat can be subdued by cold herbs; minor cold can be eliminated by heat herbs. However, extreme cold or heat will inevitably contend with drugs that contradict their nature and resist opposing qi. Just as different sounds do not resonate and different qi do not combine, physicians may hesitate to attack. If attacked, the pathogenic qi and medicinal qi will clash, leading to self-imposed closure and retention of cold or heat. Thus, the Sages act in reverse to align the qi, causing resonance and combination, allowing cold and heat to intermingle so that they eventually transform from opposition to unity, softening hardness and breaking rigidity. This discusses the principles of formulating prescriptions, which do not depart from odd and even numbers but must exhaustively master their systems.)
Jun (Emperor) herb: 1, Chen (Minister) herbs: 3, Zuo (Assistant) herbs: 9; this is the system of a Large Formula. For distal conditions with mixed odd/even ingredient counts, increase the dosage. Large formulas have few ingredients; few means doubling. The Liver and Kidney are distal; decoctions and powders should be taken frequently and in larger amounts.
Jun herb: 1, Chen herbs: 2; this is the system of a Small Formula. For proximal conditions with mixed odd/even ingredient counts, decrease the dosage. Small formulas have many ingredients; many means multiplying by nine. The Heart and Lung are proximal; decoctions and powders should be taken frequently but in smaller amounts.
Huan (Slow): Tonifying the Upper Jiao or treating upper body diseases requires slow-acting formulas. Slow action results in thin scent and flavor; treating the primary condition slowly addresses the Root (Ben).
Ji (Urgent): Tonifying the Lower Jiao or treating lower body diseases requires urgent/fast-acting formulas. Urgent action results in thick scent and flavor; treating secondary/exogenous conditions urgently addresses the Branch (Biao).
Qi (Odd): Jun 1, Chen 2 is an odd-numbered formula. Jun 2, Chen 3 is also an odd-numbered formula. Yang numbers are odd.
Ou (Even): Jun 2, Chen 4 is an even-numbered formula. Jun 2, Chen 6 is also an even-numbered formula. Yin numbers are even.
Fu (Return/Repeat): If the odd formula fails, use the even formula; this is called a Chong Fang (Complex Formula).
Therefore, the onset of hundred diseases arises from the Root (Ben), from the Branch (Biao), from both Root and Branch, from treating the Root alone, from treating the Branch alone, from treating the Middle Qi, from treating both Root and Branch, from contrary treatment (Ni Qu), and from following treatment (Cong Qu). (Counter-assistance is called Ni Qu [Contrary Treatment]. Using odd/even formulas is called Cong Qu [Following Treatment]. Treating cold disease with cold herbs and heat disease with heat herbs is called Ni Qu. Cong means following/compliance.)
Ni (Contrary) is actually Zheng Shun (Correct Compliance). If one follows, it is Ni (Contrary). (When severe cold repels yang, treating the apparent heat with heat; when severe heat repels yin, treating the apparent cold with cold—these are all termed "Ni" at the time. Although externally using contrary methods, internally it is compliant. This Ni is correct compliance. If cold repels yang but is treated with cold, or heat repels cold but is treated with heat, although externally compliant, the Middle Qi becomes obstructed. Thus, a formula that seems compliant is actually contrary.) Hence it is said: Knowing the Branch and Root, one uses them without peril; clearly understanding Contrary and Following, one walks the right path without doubt. Not knowing these is insufficient for diagnosis and sufficient to disrupt the Classics. Crude practitioners laugh, thinking they know, saying heat diseases are not yet resolved, then cold diseases arise; confusing similar qi with different forms, they misdiagnose and disrupt the meridians. (The application of the Six Qi, crude practitioners and skilled practitioners only grasp half. The transformation of Jueyin, crude practitioners think is cold, but it is actually warm; the transformation of Taiyang, crude practitioners think is heat, but it is actually cold. Comparing these mutually, their usage loses the Way, so their learning and application do not reach half the skill of a practitioner. The Root and Branch of each meridian differ in cold and heat; speech ought to investigate the Branch, discussing the Branch should seek the Root. Speaking of Qi without exhausting Root and Branch, discussing disease without distinguishing Yin and Yang, the mind is confused about the correct principle, and treatment further disrupts the meridians; such people are called crude practitioners.) The Way of Root and Branch is concise yet comprehensive, small yet great; one can speak of one and know ten, understanding the harm of disease. Speaking of Branch and Root is easy and non-damaging; observing Root and Branch allows Qi to be regulated, clearly understanding Overcoming and Repaying. This serves as a model for all people. (This states that each of the Six Qi has its own Root and Branch, and all hundred diseases should understand Root and Branch.)
I wish to hear about the Pathogenesis (Bing Ji). All wind syndromes involving tremors and dizziness belong to the Liver. (Wind nature is movement, Wood Qi is similar.) All cold syndromes involving contraction and pulling belong to the Kidney. (Contraction means gathering; pulling means urgency. Cold substances contract, Water Qi is similar.) All Qi stagnation and fullness belong to the Lung. (High autumn air is cool, dew and smoke gather; when coolness arrives, Qi becomes hot, and if severe, Qi is exhausted. Observing material phenomena, this belongs to the Lung. Man denotes fullness; Yu denotes rushing pressure. The function of Qi is similar to Metal Qi.) All damp syndromes involving swelling belong to the Spleen. (Thin earth implies shallow water, thick earth implies deep water, flat earth is dry, high earth is wet; the presence of dampness is similar to Earth Qi.) All heat syndromes involving stupor and convulsions belong to Fire. (Fire symbolizes brightness.) All pain, itching, and sores belong to the Heart. (When the Heart is quiet, disease is mild; when agitated, pain is severe. All beginnings arise from the Heart; pain, itching, and sores originate from the Heart.) All Jue (reversal) syndromes, constipation, and diarrhea belong to the Lower Jiao. (Lower refers to the Lower Jiao, Liver and Kidney. Guarding the lower is the Qi of the Kidney. The gate and key are the Qi of the Liver. Thus, all Jue, constipation, and diarrhea belong to the Lower Jiao. Jue involves reversed Qi strength. Gu means confinement. All upward reversing Qi, inability to control excretion, irregular entry and exit, and unstable dryness and moisture are due to the guardianship of the Lower Jiao.) All Wei (withering) syndromes, wheezing, and vomiting belong to the Upper Jiao. (Upper refers to the Upper Jiao, Heart and Lung Qi. Scorching heat is the Qi of the Heart; transforming heat is the Qi of the Lung. Heat stagnates in the upper, so disease affects the Upper Jiao. These are all internal pathogenesis of the Five Zang organs.) All muteness, shivering, and loss of spiritual control belong to Fire. (Internal production of heat.) All spasms and neck stiffness belong to Dampness. (Taiyang damaged by dampness.) All rebellious Qi rushing upward belong to Fire. (The nature and function of rising flame.) All distension and abdominal enlargement belong to Heat. (Heat stagnates internally, generating Lung distension.) All sudden dryness, mania, and deviation belong to Fire. (Heat is excessive in the Stomach and four extremities.) All sudden rigidity and straightening belong to Wind. (Yang is depressed internally, Yin moves externally.) All diseases with sounds, drum-like upon percussion, belong to Heat. (Refers to audible sounds.) All diseases involving swelling, pain, soreness, and fright belong to Fire. (Excess of various Qi.) All twisting and turning, with turbid fluids, belong to Heat. (Fan Li refers to tendon twisting; Shui Ye refers to urine.) All diseases involving clear and cold fluids belong to Cold. (Discharge from above and below, including vomiting and urination.) All vomiting of sour fluid, sudden diarrhea with tenesmus belong to Heat. (Suan refers to sour fluid and foam. These are pathogens of the Twelve Meridians, with pathogenesis entering from outside.)
Thus, the *Da Yao* says: Carefully observe the pathogenesis, assign each to its category; seek those that exist, seek those that do not; hold responsible those that are excess, hold responsible those that are deficiency. First determine the five overcomings, unblock the blood and Qi, make them smooth and reaching, until peace is achieved; this is called it. (Profound is the words of the Sages. Seeking existence/non-existence, holding responsibility for excess/deficiency: if severe cold is not warmed by heat therapy, there is no Fire; if heat returns after leaving, appearing by day and hiding by night, acting seasonally, there is no Fire, one should assist Fire. If severe heat is not cooled by cold therapy, there is no Water; if heat moves and stops suddenly, appearing and disappearing intermittently, there is no Water, one should assist Water. Internal rejection with vomiting and inability to eat indicates Fire. Vomiting and regurgitating food after eating indicates no Fire. If cold is not cooled, blame lack of Water; if heat is not warmed, blame lack of Fire. If warming lasts briefly, blame Heart deficiency; if cooling lasts briefly, blame Kidney insufficiency. Excess is drained, deficiency is tonified; empty is filled, full is emptied. Let upper and lower be unobstructed, blood and Qi flow smoothly, then cold and heat harmonize naturally, and Yin and Yang regulate. This discusses pathogenesis, listing nineteen points regarding the method of good treatment.)
I wish to discuss the formulation system. Jun 1, Chen 2 is a Small Formula; Jun 1, Chen 3, Zuo 5 is a Medium Formula; Jun 1, Chen 3, Zuo 9 is a Large Formula. Cold is treated with Heat, Heat is treated with Cold; minor cases are treated contrarily (Ni), severe cases are treated following (Cong). (Minor diseases are like human fire; encountering grass ignites it, encountering wood burns it; it can be subdued by wetness, extinguished by water. Thus, contrary to its nature, it is broken and attacked. Severe diseases are like dragon fire; encountering grass flames, encountering water burns; not knowing its nature, attacking with water/wetness only makes the flame reach the sky, stopping only when materials are exhausted. Those who know its nature follow the abnormal principle: chasing it with fire causes the burning to self-extinguish and the flame to be quenched. Ni (Contrary) means attacking heat with cold, and cold with heat. Cong (Following) means attacking with cold/heat that follows its nature. Hence the formula says: Contrary is Zheng Zhi (Orthodox Treatment), Following is Fan Zhi (Reverse Treatment); follow more or less, observing the situation.) Hardness is reduced, invaders are removed, exhaustion is warmed, knots are scattered, retention is attacked, dryness is moistened, urgency is eased, scattering is gathered, damage is benefited, idleness is moved, fright is calmed, upper is lowered, lower is raised, massaged, bathed, pressed, seized, opened, developed; adapting to the matter is the goal. (Measure the syndrome, adapt to the matter.) The Emperor asked: What are Ni and Cong? The Yellow Emperor replied: Ni is Zheng Zhi (Orthodox Treatment), Cong is Fan Zhi (Reverse Treatment); follow less or more, observing the situation. (Speaking of Ni is Orthodox Treatment. Speaking of Cong is Reverse Treatment. Contrary to pathogenic Qi for Orthodox Treatment means attacking heat with cold, cold with heat; although seemingly following pathogenic Qi, it is actually Reverse Treatment.) The Emperor asked: What is Fan Zhi? The Yellow Emperor replied: Heat used with Cold, Cold used with Heat, Obstruction treated with Obstruction, Flow treated with Flow; one must subdue the master cause and first address the origin. Initially they are the same, finally they are different; this can break accumulations, dissolve hardness, harmonize Qi, and ensure cure. (Heat used with Heat: hot substances taken cold; after swallowing, the cold nature disappears, and the hot nature emerges. Cold used with Heat: cold substances taken hot. Middle fullness with Lower deficiency: open the middle, tonify severely at the lower. Small doses cause congestion, large doses promote circulation; thus middle fullness removes itself, lower deficiency becomes solid; this is Obstruction treated with Obstruction. Also, severe internal heat binding with continuous diarrhea: heat should be treated with cold, but binding must be removed; using cold purgatives disperses binding and stops diarrhea; this is Flow treated with Flow. Administer cold with heat, cool and proceed; administer heat with cold, warm and proceed. Initially same, finally different; this is called it.) Contrary and Following, Contrary then Following, Following then Contrary; unblocking Qi to make it regulated is the Way. (Ni means contrary to pathogenic Qi for orthodox treatment. Cong means following pathogenic Qi for reverse treatment. Contrary to Qi for orthodox treatment makes it compliant; following disease for reverse capture makes it harmonized, hence Ni and Cong. Below, unblock Qi, let pathways open, then Qi responds to cold/heat and transforms.)
How are diseases internal and external? From internal to external, regulate the internal; from external to internal, treat the external. (Cut off each source.) From internal to external, flourishing externally, first regulate internal, then treat external; from external to internal, flourishing internally, first treat external, then regulate internal. (All mean removing the root first.) If internal and external do not affect each other, treat the main disease. (Internal and external not affecting each other means separate diseases. This discusses three methods for treating exterior-interior patients: having Root/Branch, having sequence, and having main focus.) Treat cold with heat, treat heat with cold; regions cannot abandon the plumb line and change their way. If there is a heat patient, cooled but still hot; if there is a cold patient, warmed but still cold; both exist, new diseases arise again, how to treat? (Meaning treatment fails to resolve disease, instead generating cold/heat due to drug properties, creating new diseases.) The Yellow Emperor replied: All cases where cooling increases heat should be taken from Yin; cases where warming increases cold should be taken from Yang; this is called seeking the affiliation. (Meaning benefiting the source of Fire to eliminate Yin shadows, strengthening the master of Water to control Yang sunlight, hence called seeking affiliation. Crude practitioners are biased and shallow, attacking cold with heat, treating heat with cold; before heat treatment ends, cold illness arises; as cold attack deepens, heat disease rises again. With heat rising, middle cold remains; with cold generating, external heat does not remove. Wanting to attack cold, both become hot and halt; wanting to treat heat, thinking of cold, one stops. Advancing and retreating in battle, danger reaches extremes. How could they know the source of Zang-Fu has masters of cold, heat, warmth, and coolness! Taking the Heart need not uniformly use heat; taking the Kidney need not uniformly use cold. But benefiting Heart Yang, cold also circulates; strengthening Kidney Yin, heat is also acceptable. Or treating heat with heat, cold with cold, ten thousand attempts ten thousand complete.) The Emperor asked: Taking cold but becoming hotter, taking heat but becoming colder, what is the reason? The Yellow Emperor replied: Treating the Wang Qi (Dominant Qi), therefore it reverses. (Objects have cold/heat, Qi nature has Yin/Yang. Touching Wang Qi strengthens its function. Liver Qi is mild/warm, Heart Qi is summer-hot, Lung Qi is cool/clear, Kidney Qi is cold/chilly, Spleen Qi combines them. Thus spring using clear to treat Liver reverses to warm; summer using cold to treat Heart reverses to hot; autumn using warm to treat Lung reverses to clear; winter using heat to treat Kidney reverses to cold. This is because supplementing Wang Qi is too excessive; supplementing Wang excessively causes excessive cold/heat Qi in the Zang.)
The Five Flavors enter the Stomach, each returning to its preference; thus Sour enters Liver first, Bitter enters Heart first, Sweet enters Spleen first, Pungent enters Lung first, Salty enters Kidney first. Long-term use increases Qi; this is the constant of material transformation. Increased Qi lasting long is the cause of premature death. (Entering Liver is Warm, entering Heart is Hot, entering Lung is Clear, entering Kidney is Cold, entering Spleen is Supreme Yin combining four Qi. All increase their flavor to benefit Qi, thus each follows the Qi function of its own Zang. Thus long-term Coptis and Sophora consumption reverses to heat; this is the category, others are similar. Only human intention is negligent and cannot carefully monitor. Hence long-term use increases Qi, constant of material transformation. Qi increasing endlessly, Zang Qi becomes biased excess, Zang has biased extinction, then there is sudden death; hence increased Qi lasting long is the cause of premature death. Therefore taking hundred medicines, lacking five flavors, borrowing four Qi, and taking long-term, although initially beneficial, long-term leads to sudden death. This is called it. Fasting from grains and taking medicine avoids sudden death; why? No grain flavor assistance. Returning to eating grains, one also dies prematurely.) Methods for regulating Qi must distinguish Yin and Yang, determine internal/external, each guard their territory; internal treated internally, external treated externally; minor cases regulated, next level balanced, excess cases captured, sweating or purging; cold, heat, warmth, coolness, decline by affiliation, following what is beneficial. (Disease has internal/external, treatment has exterior/interior. Internal treated with internal methods, external treated with external methods; next, large cases balanced with Qi-leveling methods; excess extremely unyielding, capture Qi to make it decline. Suppose small cold Qi, warm to harmonize; large cold Qi, heat to capture; severe cold Qi, purge downward. Purge unyielding, reverse to suppress; suppression incomplete, seek affiliation to decline. Small heat Qi, cool to harmonize; large heat Qi, cold to capture; severe heat Qi, sweat to release. Release unyielding, reverse to control; control incomplete, seek affiliation to decline. Hence: sweat/purge, cold/heat/warmth/coolness, decline by affiliation, following what is beneficial. You means 'what'.) Strictly follow the Way according to method, ten thousand attempts ten thousand complete, blood and Qi correctly peaceful, long possessing heavenly mandate. (Guarding the Way to act, every move hits the mark, thus able to command herbs and stones, summon spirits, blood and Qi maintain peaceful state, true nature not exhausted.)