Vertical- move the left and right front tubes up and down. Move by prying- slide a screwdriver under the front and lift- or by hammering down. Both lightly and very small amounts, of course. Look at a triangle to get a match of the upper and lower image. After adjustment, be prepared for it to shift overnight and need to be adjusted before sealing up.
Horizontal- the Medalist does not have an infinity stop. The focus scale is arbitrary. The thing that really matters is the agreement between the film plane and the rangefinder. All the rest is fluff. On back of the lens tube, upper right, are a smaller silver headed screw and a larger black headed screw. The silver screw is a lock- undo about 1/2-3/4 turn. With ground glass in the film plane, open lens and focus on something at a medium distance. 10-15 feet. Now adjust the black screw, which moves the rangefinder cam, in and out to get the film plane focus and rangefinder focus to match. Turn lock screw back in. The basic idea is that with the rangefinder and lens in agreement at one point, the cam and helical motion agreement across the range will be maintained. In practice this does work out.
Short version of full rangefinder set up- Get lines straight, split top/bottom set (sorry, that's about four paragraphs). Lens at full extension, set focus scale with 3-1/2 foot line under red IR mark on scale. Have camera 10 feet (10.0 at aperture scale or so) and set cam follower (skinny black arm on right prism mount) so rangefinder alignment and 10 foot mark agree (Kodak manual says use 15 feet for this but I have a small shop and consider accurate close focus more important). Now do rangefinder/lens alignment procedure above.