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Wind-bi and Yinluo, conditions that are severe and incurable, (When the disease is in the Yang meridians, it is called "Wind"; when in the Yin meridians, it is called "Bi"; when both Yin and Yang meridians are affected, it is called "Wind-Bi"; Yinluo refers to the progressive deepening of pathogenic factors over time. Luo sounds like Lu.) The patient feels cold in the feet as if walking on ice, and at times hot as if immersed in boiling water; there is aching and weakness in the thighs and calves (Yinluo), mental restlessness, headache, occasional vomiting, occasional hiccuping, dizziness, sweating has already occurred, and after a long time, visual blurring occurs. Emotions fluctuate between sorrow, joy, and fear; there is shortness of breath and dysphoria. Such a condition will lead to death within three years. (The coldness of walking on ice and the heat of entering boiling water affect the lower limbs (thighs and calves), the middle (abdomen and heart), and the upper (head and eyes), leaving no part unaffected; exteriorly there is sweating, interiorly there is shortness of breath and dysphoria, or sorrow, or erratic emotions. This is a sign of simultaneous disease in Yin and Yang. Although supportable for a time, death is inevitable within three years.) Methods such as Dao Yin (qigong exercises), Xing Qi (circulating qi), Qiao Mo (massage), Jiu Yun (moxibustion and warming), Ci (acupuncture), and drinking medicinal decoctions are common methods used by the general public, not all of which can be mastered or applied by a single individual. (This means treatment should be tailored to the individual's suitability; thus, everyone has their own applicable method.) Adhere to this principle without deviation, and the principles of all things can be comprehended. (If one grasps this fundamental principle, the myriad ways of treatment can be fully understood.) However, the key to Yin and Yang, the logic of Deficiency and Excess, and the errors of pathogenic migration belong to treatable categories; whereas diseases involving transformation, progressive transmission, and collapse of healthy Qi are incurable. (Pathogenic transmission does not necessarily imply immediate danger; however, if healthy Qi collapses completely, it becomes incurable.) This clarity is like waking up in the day, while confusion is like closing one's eyes at night. What is "waking up"? It is understanding Yin and Yang clearly, like resolving confusion or sobering from drunkenness. What is "closing eyes at night"? It is silence without sound, formless and indistinct; hair follicles and skin pores are damaged, healthy Qi is disrupted and overturned, pathogenic factors spread diffusely, blood vessels transmit stagnation, and major pathogenic Qi enters the Zang organs, causing abdominal pain and profuse diarrhea, leading to death rather than life. (Clarity like waking signifies enlightenment of the Dao; obscurity like sleeping signifies difficulty in examination. Major pathogenic Qi refers to strong evil pathogens. When pathogens invade humans, they are silent and invisible. Upon collapse, symptoms include damaged hair/follicles and disrupted healthy Qi, leading only to death.)

If major pathogenic Qi enters the Zang organs, and the disease originates in the Heart, after one day it transmits to the Lung, after three days to the Liver, and after five days to the Spleen; if it persists for another three days without improvement, death occurs. In winter, death occurs at midnight; in summer, at noon. (Disease originating in the Heart transmitting to the Lung represents Fire overcoming Metal; after three days, Metal overcomes Wood, so it transmits to the Liver; after five days, Wood overcomes Earth, so it transmits to the Spleen. If the pathogen remains after three more days and worsens, death ensues. Winter midnight is the peak of Water energy; summer noon is the peak of Fire energy. Heart Fire fears Water, hence death in winter at midnight; Yang pathogen reaches extreme excess, hence death in summer at noon. Generally, extreme deficiency leads to death, and extreme excess leads to death; bias in dominance leads to bias in extinction. This applies to all Five Elements. The following meanings follow this pattern.) If the disease originates in the Lung, after three days it transmits to the Liver, after one day to the Spleen, and after five days to the Stomach; if it persists for ten days without improvement, death occurs. In winter, death occurs at sunset; in summer, at sunrise. (Transmission from Lung to Liver, and Liver to Spleen, follows the cycle of overcoming. Transmission from Spleen to Stomach is between Interior and Exterior. Lung pathogen prospers at Shen and You hours, hence death in winter at sunset; Metal energy fails at Yin and Mao hours, hence death in summer at sunrise.) If the disease originates in the Liver, after three days it transmits to the Spleen, after five days to the Stomach, and after three days to the Kidney; if it persists for three days without improvement, death occurs. In winter, death occurs at sunset; in summer, at breakfast time. (This is Liver Wood transmitting to Spleen Earth, and Earth pathogen transmitting to Kidney Water. When Wood is injured, Metal dominance brings danger, hence fearing sunset in winter; when Liver disease occurs, Wood strength intensifies, hence fearing breakfast time in summer.) If the disease originates in the Spleen, after one day it transmits to the Stomach, after two days to the Kidney, and after three days to the Back Muscles and Bladder; if it persists for ten days without improvement, death occurs. In winter, death occurs at dusk (Ren Ding); in summer, at dinner time (Yan Shi). (This is Earth pathogen attacking Water, with mutual transmission between Interior and Exterior. Ren Ding is Hai hour; Spleen Earth disease in winter fears it because Cold Water insults Earth. Yan Shi is Si hour; Spleen disease in summer fears it because Wu and Ji hours dominate and combine with pathogens.) If the disease originates in the Stomach, after five days it transmits to the Kidney, after three days to the Back Muscles and Bladder, and after five days upward to the Heart; if it persists for two days without improvement, death occurs. In winter at midnight, in summer at Wei hour. (This is Earth pathogen transmitting to Water, and Water transmitting to Fire, thus from Bladder to Heart. Winter midnight after Chou hour, and summer Wei hour, are both times of Earth dominance; thus Stomach disease meets these times, Qi exhausts and fails. [Character], pronounced Die.) If the disease originates in the Kidney, after three days it transmits to the Back Muscles and Bladder, after three days upward to the Heart, and after three days to the Small Intestine; if it persists for three days without improvement, death occurs. In winter at early morning (Da Chen), in summer at late afternoon (Yan Bu). (This is Water disease attacking Fire, with mutual transmission between Interior and Exterior. Da Chen is Chen hour, the storehouse of Water; Yan Bu is Xu hour, where Earth controls Water. Thus, Kidney disease cannot exceed this timeframe.) If the disease originates in the Bladder, after five days it transmits to the Kidney, after one day to the Small Intestine, and after one day to the Heart; if it persists for two days without improvement, death occurs. In winter at cockcrow, in summer at late afternoon. (This is also mutual transmission between Water and Fire organs, from Exterior to Interior. Winter cockcrow is Chou hour, the extreme of Yin; summer late afternoon is Wei hour, feared by Water. Bladder is the Water Fu organ, so both extreme excess and extreme deficiency lead to death.) Various diseases transmitted sequentially in this manner all have fixed death periods and are untreatable. Those transmitting by skipping one Zang, or two, three, or four Zangs, may be treated.

Regarding disease transmission: Heart disease first presents with chest pain. (The following details the visible symptoms of transmission. Thus, Heart disease must first present with chest pain.) After one day, coughing occurs. (Heart disease transmits to Lung. As mentioned earlier, "transmitting to Lung after one day" implies this meaning; other Zangs follow this rule.) After three days, distending pain in the hypochondrium occurs. (Lung transmits back to Liver, hence distending pain in the hypochondrium, i.e., "transmitting to Liver after three days.") After five days, obstruction and blockage occur, with body pain and heaviness. (This is "transmitting to Spleen after five days." Spleen disease fails to transform and transport, causing obstruction.) If it persists for three days without improvement, death occurs. (After three more days without improvement, Spleen transmits to Kidney, injuring all five Zangs, hence death.) Death occurs in winter at midnight, in summer at noon. (These are Zi and Wu hours. Although explained above, Shaoyin Jun Fire governs Zi and Wu opposite transformations; Heart connects to its Qi, loss of control leads to death, which is another interpretation.) Lung disease presents with wheezing and coughing. (Lung governs respiration, hence disease manifests as wheezing and coughing.) After three days, distending fullness and pain in the hypochondrium occur. (Transmitting to Liver after three days.) After one day, body heaviness and pain occur. (Transmitting to Spleen after one day.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days, from Zang to Fu.) If it persists for ten days without improvement, death occurs. (After ten days without improvement, Stomach transmits to Kidney, and the numbers of generation and completion of Five Elements reach their limit, hence death.) Death occurs in winter at sunset, in summer at sunrise. (These are Mao and You hours, belonging to Dry Metal transformation. Lung governs Qi; loss of control leads to death.) Liver disease presents with dizziness of head and eyes, and distending fullness in the hypochondrium. (Liver opens into the eyes, and meridians distribute along the hypochondrium.) After three days, body heaviness and pain occur. (Transmitting to Spleen after three days.) After five days, abdominal distension occurs. (Transmitting to Stomach after five days.) After three days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after three days.) If it persists for three days without improvement, death occurs. (After three days without improvement, Kidney transmits back to Heart, hence death.) Death occurs in winter at sunset, in summer at breakfast time. (You and Mao hours, governed by Dry Metal, feared by Wood.) Spleen disease presents with body pain and heaviness. (Spleen governs muscles.) After one day, abdominal distension occurs. (Transmitting to Stomach after one day.) After two days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after two days.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) If it persists for ten days without improvement, death occurs. (After ten days without improvement, it transmits back to Heart, hence death.) Death occurs in winter at dusk, in summer at dinner time. (These are Si and Hai hours, governing Wind Wood transformation, feared by Spleen disease.) Kidney disease presents with pain in the lower abdomen, waist, and spine, and weakness in the shins. (Kidney governs the lower part; its meridians run through the lower abdomen, waist, spine, and bones.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) After three days, abdominal distension occurs. (Transmitting to Small Intestine after three days.) After three days, distending pain in both hypochondria occurs. (Transmitting upward to Heart after three days. The regular meridian of Hand Jueyin pericardium branches downward three cun below Yuan Ye, entering the chest, hence distending pain in both hypochondria.) If it persists for three days without improvement, death occurs. (Injuring Lung Metal again.) Death occurs in winter at early morning, in summer at late afternoon. (These are Chen and Xu hours, Earth governs the four seasons, feared by Water, hence governing Kidney disease.) Stomach disease presents with abdominal distension and fullness. (Stomach meridian distributes inside the abdomen.) After five days, pain in the lower abdomen, waist, and spine, and weakness in the shins occur. (Transmitting to Kidney after five days.) After three days, pain in the back and spinal muscles/tendons, and urinary retention occur. (Transmitting to Back Muscles and Bladder after three days.) After five days, body heaviness occurs. (Transmitting upward to Heart after five days; blood vessels are injured, causing body heaviness and pain. There may be a missing character "pain" after "heaviness".) If it persists for six days without improvement, death occurs. (Heart transmits back to Lung.) Death occurs in winter after midnight, in summer at Wei hour. (Chou and Wei govern Wet Earth transformation, Qi connects to Stomach; loss of control leads to death, naturally so.) Bladder disease presents with urinary retention. (Bladder is the Fu organ of fluids.) After five days, lower abdominal distension, pain in the waist and spine, and weakness in the shins occur. (Transmitting to Kidney after five days.) After one day, abdominal distension occurs. (Transmitting to Small Intestine after one day.) After one day, body pain occurs. (Transmitting to Heart after one day, from Fu to Zang. Heart governs blood vessels, hence body pain.) If it persists for two days without improvement, death occurs. (Heart disease unimproved will inevitably transmit to Metal Zang, hence death.) Death occurs in winter at cockcrow, in summer at late afternoon. (Chou and Wei hours, Earth controls Water, hence feared by Bladder disease.) Various diseases transmitted sequentially to death as described above all have death periods and are untreatable by acupuncture. (The aforementioned death periods vary in proximity, likely due to vital organs and Qi deficiency/excess. Cang Gong said: those who can eat die past the period, those who cannot eat die before the period. This is exactly what is meant. Since there is a death period, acupuncture is contraindicated.) Those transmitting by skipping one Zang or up to three or four Zangs may be treated with acupuncture. (Skipping three or four Zangs means transmission is not sequential; treatment leads to recovery, hence acupuncture can be used. "Treatable/Untreatable" here is synonymous with "Acupuncturable/Contraindicated" mentioned earlier.)

When the Qi of Hand Taiyin (Lung) ceases, the skin and hair become dry and brittle. Taiyin circulates Qi to warm the skin and hair; thus, without Qi nourishment, skin and hair become brittle. Without nourishment at the skin joints, fluids depart, nails wither, and hair breaks. Hair breaking indicates hair dies first; Bing day brings aggravation, Ding day brings death, as Fire overcomes Metal. (Hand Taiyin is Lung. Lung governs skin and hair; thus, Qi cessation causes fluid departure from skin joints, manifesting as withered nails and broken hair. Lung Metal fears Fire, hence critical on Bing/Ding days.) When the Qi of Hand Shaoyin (Heart) ceases, the vessels become obstructed. Obstruction prevents blood flow; lack of blood flow causes hair color to lose luster. Thus, the face turns black like lacquered charcoal, indicating blood dies first; Ren day brings aggravation, Gui day brings death, as Water overcomes Fire. (Hand Shaoyin is Heart. Heart governs blood vessels; thus, vessel cessation causes blood death first, manifesting as dull hair and black face. Heart Fire fears Water, hence critical on Ren/Gui days. Mao sounds like Mao, meaning hair.) When the Qi of Foot Taiyin (Spleen) ceases, the vessels fail to nourish muscles. Lips and tongue are the root of muscles; without vessel nourishment, muscles soften. Soft muscles cause tongue atrophy and fullness in the philtrum. Fullness in the philtrum causes lip eversion. Lip eversion indicates flesh dies first; Jia day brings aggravation, Yi day brings death, as Wood overcomes Earth. (Foot Taiyin is Spleen. Spleen governs muscles; thus, Qi cessation causes flesh death first, manifesting as full philtrum, atrophied tongue, and everted lips. Spleen Earth fears Wood, hence death on Jia/Yi days.) When the Qi of Foot Shaoyin (Kidney) ceases, bones become withered. Shaoyin is the Winter pulse, submerging to moisten bone marrow. Thus, without bone moisture, flesh cannot adhere. Lack of flesh-bone affinity causes flesh to soften and recede. Receding flesh makes teeth appear long and dirty, and hair loses luster. Hair losing luster indicates bone dies first; Wu day brings aggravation, Ji day brings death, as Earth overcomes Water. (Foot Shaoyin is Kidney. Kidney belongs to Water, hence Winter pulse. Kidney governs bones; thus, Qi cessation causes bone death first, manifesting as non-adherent flesh/bone, long/dirty teeth, and withered/lusterless hair due to essence failure. Kidney Water fears Earth, hence death on Wu/Ji days.) When the Qi of Foot Jueyin (Liver) ceases, tendons sever. Jueyin is Liver Wood; Liver is the convergence of tendons. Tendons gather at the genitalia and connect to the base of the tongue. Thus, without vessel nourishment, tendons contract. Contraction pulls the tongue and testicles, causing blue lips, curled tongue, and retracted testicles. This indicates tendons die first; Geng day brings aggravation, Xin day brings death, as Metal overcomes Wood. (Liver Qi cessation causes tendon death first, manifesting as blue lips, curled tongue, and retracted testicles/scrotum. Liver Wood fears Metal, hence death on Geng/Xin days.) When the Yin Qi of all five Zangs ceases, the eye system twists, causing vertigo. Vertigo indicates Spirit (Zhi) dies first. Spirit death leads to death in one and a half days. (Essence of all five Zangs ascends to the eyes; thus, Yin Qi cessation causes eye twisting/vertigo and Spirit death. Spirit resides in Kidney, the spirit of Yin. True Yin exhausted, death occurs within a day and a half. Now, patients with severe illness suddenly losing vision is precisely the sign of Yin Qi exhaustion.) When the Yang Qi of the six Fu organs ceases, Yin and Yang separate. Separation causes pores to open and sweat to leak out (Jue Han). Thus, prognostication in the morning indicates death in the evening, and vice versa. (Sweat is originally Yin essence, secured by Yang Qi. Yang Qi cessation causes Yin-Yang separation and open pores, leading to collapse sweat. Death occurs instantly.)

Diseases have short-term prognoses. Diseases in the three winter months that align with Yang will, if pulse signs of death appear in the first month of spring, result in death by the end of spring. (Three winter months are Yin abundance. Disease aligning with Yang refers to Yang syndrome/pulse. End of spring is early summer. At the time of Water dominance, disease aligning with Yang indicates insufficient seasonal Qi and excessive pathogenic Qi. By Meng Chun (first lunar month), Yang Qi arises, making Yang pathogen stronger and Yin Qi more depleted. If pulse shows death signs, by the transition from Spring to Summer, Yang excess and Yin deficiency reach extremes, leaving no escape.) Diseases in the three winter months where medical reasoning is exhausted (no hope of life) will die when grass turns green and willow leaves sprout. (Reasoning exhausted means observation of pulse/symptoms shows no vitality. Winter disease with this prognosis dies when grass turns green and willow leaves appear, marking the change of Yin/Yang Qi, hence "all perish." Sha reads Shaojie.) Spring diseases where Yin and Yang are both severed have a death period in Meng Chun. (Yin/Yang severed means no Yang in Yin, no Yin in Yang, no communication. Disease persisting from winter into spring with this state indicates exhaustion of generating Qi, with short-term death in Meng Chun.) Spring diseases are called "Yang Sha" (Yang Decline). (Spring Yang Qi rises, but disease is in Yang, hence "Yang Sha." Sha means decline.) Yin/Yang severed diseases have a death period when grass dries. (For Spring Yang Sha diseases with Yin/Yang blockage, death occurs in late autumn when grass dries, as Metal Qi dominates and kills Spring-originating disease.) Summer diseases reaching "Zhi Yin" (Extreme Yin) do not last more than ten days. (Spleen and Kidney are Zhi Yin. In Summer Yang abundance, extreme injury to Spleen/Kidney causes true Yin collapse. Heavenly stems change Qi, which cannot be endured, hence not exceeding ten days.) "Yin Yang Jiao" (Interaction) has a death period at Lian Shui. (Yin Yang Jiao: Yin pulse appearing in Yang means Yang Qi loses control; Yang pulse appearing in Yin means Yin Qi loses control. Though no critical symptoms, the pulse is inverted. Appearing in summer, it is critical at Lian Shui time in mid-autumn. Lian sounds like Lian, meaning clear.) Autumn diseases where Three Yang pulses rise simultaneously will resolve spontaneously. (Autumn Yang declines, Yin grows. Even if Three Yang pulses rise, Yang cannot overcome Yin, hence spontaneous resolution.) Diseases of Yin Yang interaction present as inability to sit while standing, or unable to stand while sitting. (Autumn Qi is gathering but not yet gathered. Yin Yang interaction disease injures Jing or Qi, causing movement impairment. Yang overcoming Yin causes inability to sit; Yin overcoming Yang causes inability to stand.) "San Yang Du Zhi" (Three Yang Alone Arriving) has a death period at Shi Shui (Stone Water). (San Yang Du Zhi is Two Yang arriving together, indicating Yang hyperactivity and Yin exhaustion. Yin exhaustion in winter has no life potential; lone Yang meeting water is extinguished, hence death at Stone Water time.) "San Yin Du Zhi" (Three Yin Alone Arriving) has a death period at Sheng Shui (Abundant Water). (San Yin Du Zhi is Yin without Yang. Sheng Shui is the rainy season of the first lunar month. Lone Yin cannot survive alone; thus, it cannot maintain existence during Yang abundance.)