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In the Eighteenth Difficulty, Qin Yueren stated: "The Hand Taiyin Lung and Hand Yangming Large Intestine belong to Metal; the Foot Shaoyin Kidney and Foot Taiyang Bladder belong to Water. Metal generates Water. The nature of water is to flow downward and cannot ascend, therefore it is located in the lower part. The Foot Jueyin Liver and Foot Shaoyang Gallbladder belong to Wood. Wood generates the Fire of the Hand Taiyang Small Intestine and Hand Shaoyin Heart. The nature of fire is to flare upward and cannot descend, therefore it is located in the upper part. The Hand Jueyin Pericardium and Hand Shaoyang Sanjiao (Triple Burner) belong to Fire. Fire generates the Earth of the Foot Taiyin Spleen and Foot Yangming Stomach. Earth governs the Central Palace, therefore it is located in the middle part."

Hua Borun annotated: The Hand Taiyin Lung and Hand Yangming Large Intestine belong to Metal, which generates from below the Water of the Foot Taiyang Bladder and Foot Shaoyin Kidney. Since the nature of water flows downward, it resides in the lower part; the Foot Shaoyin Kidney and Foot Taiyang Bladder belong to Water, which generates the Wood of the Foot Jueyin Liver and Foot Shaoyang Gallbladder. Wood generates the Fire of the Hand Shaoyin Heart, Hand Taiyang Small Intestine, and Hand Jueyin Pericardium. Since the nature of fire flares upward, this constitutes the upper part; Fire generates the Earth of the Foot Taiyin Spleen and Foot Yangming Stomach, which resides in the middle part, and Earth subsequently generates Lung Metal. This represents the mutual generation and nourishment between mother and child within the Five Elements (Wu Xing).

Observing the diagram listed in the Eighteenth Difficulty, it places the Fire of the Hand Jueyin Pericardium and the Fire of the Hand Shaoyang Sanjiao at the right Chi pulse position in the lower part. The diagram contradicts its own annotation. Later generations unanimously revered this view without further verification. Moreover, the classic text only mentions the Hand Taiyin and Hand Yangming, and the Foot Taiyang and Foot Shaoyin, dividing them into upper and lower parts, expressing the idea that the Lung is high and the Kidney is low, with mother and child gazing upon each other. According to the *Mai Jing* (Pulse Classic), the Heart and Lung are combined in the Upper Jiao (Upper Burner), the Spleen, Stomach, Liver, and Gallbladder are combined in the Middle Jiao (Middle Burner), and the Kidney and Bladder are combined in the Lower Jiao (Lower Burner). The two Chi pulses separately diagnose the two Kidneys, with no mention of the Hand Jueyin or Hand Shaoyang. The diagnostic methods in the *Qian Jin Fang* (Essential Prescriptions Worth a Thousand Gold) are identical to those in the *Mai Jing*. However, the *Ling Lan Mi Dian Lun* (Treatise on the Secret Canon of Spiritual Orchids) states: "The Danzhong (Chest Center) is the official of the messenger, from whom joy and pleasure arise." Wang Bing (Qi Xuanzi) annotated: "The Danzhong is located between the two breasts in the chest. It serves as the medium for the Ruler Heart to disseminate orders, distributing Qi and balancing Yin and Yang. When Qi is harmonious and will is content, joy arises naturally." The *Mai Yao Jing Wei Lun* (Treatise on the Essentials and Subtleties of Pulse Diagnosis) holds that the exterior aspect of the left Cun pulse corresponds to the Heart, while internally it diagnoses the Danzhong. The Danzhong is one of the Twelve Zang Organs. Because it is formless, it resides in the chest alongside the Heart and Lung, hence its diagnosis is attached here.

It is likely that the diagram in the *Ben Yi* (Original Meaning) was not Hua Borun's true intent, as it contains self-contradictions. This must be due to later generations adhering rigidly to the saying in the *Mai Jue* (Pulse Rhymes): "Right Lung, Large Intestine, Spleen, Stomach, Mingmen," and forcing the diagram to fit. Because Earth resides in the middle part, they placed Fire in the lower part to generate Middle Earth. They failed to consider: what does the Fire of the Hand Taiyang Small Intestine and Hand Shaoyin Heart generate thereafter? The wise can discern this themselves.

According to He Yiyang's *Yi Xue Tong Zong* (Comprehensive Source of Medical Learning): The *Tu Zhu Nan Jing* (Diagram and Annotation of the Classic of Difficult Issues) was plagiarized by Zhang Shixian of Siming from the old chapters of Ji Tianxi, Yuan Kunlong, and Yu Shu. He took fragments and broken texts, superficially added his own opinions, deceived people by claiming it as a new composition, and had it printed by the Transport Commission of Weiyang. There are many errors in meaning. Therefore, the diagrams and annotations in the *Nan Jing Ben Yi* were actually compiled by Zhang Shixian, with later additions and compilations by others. It is clear that this was not the work of Master Hua.