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The origins of disease can be categorized into four types: First, lesions originate internally due to the movement of Qi; Second, lesions manifest externally due to the movement of Qi; Third, diseases arise internally independent of Qi movement; Fourth, diseases arise externally independent of Qi movement.

Those originating internally due to Qi movement refer to conditions such as Ji Ju (accumulations and masses), Xia (abdominal masses with shifting pain), Liu Qi (tumor-like Qi stagnation), Ying Qi (goiter or neck masses), He Jie (scrofula or subcutaneous nodules), and Lei Xian (leprosy and epilepsy).

Those manifesting externally refer to conditions such as Yong Zhong Chuang Yang (carbuncles, swellings, sores, and ulcers), Jia Jie Ju Zhi (scabs, scabies, carbuncles, and hemorrhoids), Diao Xuan Fu Zhong (dizziness and edema), Mu Chi Biao Zhen (red eyes and skin blisters/rashes), and Fu Zhong Tong Yang (visceral swelling, pain, and itching).

Those arising internally independent of Qi movement include causes such as Liu Yin (retained fluid/drink), dietary irregularities, hunger and satiety imbalances, physical exhaustion, Su Shi (retained food), Huo Luan (cholera-like vomiting and diarrhea), emotional factors like Bei Kong (sorrow and fear) and Xi Nu (joy and anger), Xiang Mu (obsessive longing), and You Jie (depressive stagnation).

Those arising externally independent of Qi movement include environmental and external pathogens such as Zhang Qi (miasma), Zei Mei (evil spirits/pestilence), Chong She (insect and snake bites), Gu Du (gu poison), Fei Shi (flying insects causing harm), Gui Ji (ghost strikes), Chong Bo (blunt trauma/crushing), Zhui Duo (falls), Feng Han (wind-cold), Shu Shi (summerheat-dampness), Zhuo She (cuts from blades and arrows), Ci Ge (punctures and lacerations), and Ta Pu (beatings with whips and sticks).

Regarding these four categories, some are cured by treating only the interior, while others require simultaneous treatment of both interior and exterior; some are cured by treating only the exterior, while others require combined treatment; some are cured by treating the interior first and then the exterior, while others are cured by treating the exterior first and then the interior; some require detoxification and attacking methods, while others require non-toxic herbs for regulation and guidance. In applying these methods, treatments may be heavy or light, slow or rapid, astringent or dispersing, moistening or drying, softening or hardening. Practitioners differ in their understanding and application, each relying on their own judgment, favoring certain approaches over others, which necessitates further inquiry.

The concept of "Wu Ku Liu Xin" (Five Bitters and Six Pungents) has never been adequately explained, likely because historians omitted it as uncertain. One day, Zhengjun Ma posed this question to Mr. Zhang. Initially, Mr. Zhang had no answer. After walking fifteen li, he suddenly gained insight and joyfully returned to explain it to Zhengjun Ma. He reasoned that "Wu Ku" (Five Bitters) refers to the Five Zang Organs being internal and Yin in nature, thus suitable for bitter substances, aligning with the principle that sour and bitter induce vomiting and purging, which are Yin actions. "Liu Xin" (Six Pungents) refers to the Six Fu Organs being external and Yang in nature, thus suitable for pungent substances, aligning with the principle that pungent and sweet substances disperse and ascend, which are Yang actions. This is the underlying logic. Zhengjun Ma greatly admired his profound insight, considering it to have uncovered the hidden mysteries not transmitted by ancients. Thus it is said: "He who knows the essence needs but one word to conclude; he who does not know the essence wanders endlessly."