#### Step 1: Thermal Quality - Assess the primary thermal character of the presenting pattern. Hot, cold, mixed, or neutral? #### Step 2: Fluid Quality - Assess wet/dry character. Are fluids in excess, deficient, blocked, or scattered? #### Step 3: Disruption Mode - How is the pathological process moving? Is it accumulating, eroding, stuck, or dispersing? #### Step 4: Temperature Substate - Where on the 11-point thermal scale is the pattern? Which specific substate? #### Step 5: Spirit Hub - Which hub is primarily affected? Upper (cognitive/mental), middle (cardiac/respiratory), lower (somatic/eliminative)? #### Step 6: Situation Number - Cross quality × mode to identify the primary therapeutic situation. Note any secondary situations. #### Step 7: Formulation - Select attractor/stabilizer/buffer/vector herbs specific to the identified situation(s). Consider compound formulation if needed. ### Movement Between Situations Therapeutic situations are not static diagnoses — they are snapshots of a moving system. Understanding the typical progressions and transitions between situations allows the practitioner to anticipate where the organism is headed and to intervene at the trajectory level rather than only the current-state level. **Common transitions:** - Febrile Excess (1) Heat Erosion (5) if unaddressed. - Cold Stagnation (10) Cold Erosion (6) if chronic. - Damp Accumulation (3) Wet Collapse (7) if prolonged. - Hot Stagnation (9) Heat Dissipation (13) if the containment fails. Understanding these trajectories is essential for formulation that works with the system's momentum rather than against it.