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I. Reiteration of the Law Regarding Failure to Understand the Root and Branch in Treatment (One Law, Elaborating Two Articles from *Neijing*)

All diseases have a root (*ben*) and a branch (*biao*), and there are also cases that appear to be the branch but are actually the root, or appear to be the root but are actually the branch. If one fails to clearly distinguish between Yin and Yang, reversal and compliance, mistaking the branch for the root, the root for the branch, the apparent branch as the branch, and the apparent root as the root, thereby confusing standard principles and applying acupuncture and herbs in a reversed manner, this is the fault of the physician.
In treating disease, one must seek the root.
All matters and changes originate from Yin and Yang. The pathogenesis, properties of medicines, pulse diagnosis, and treatment principles are most closely related to this. Therefore, whoever treats disease must necessarily seek its root, whether it originates from Yin or from Yang. Knowing the source of the disease and directly targeting it constitutes good treatment. If one does not know how to seek the root, one will be as lost as facing an ocean, with no way to proceed. Nowadays, people fail to understand the sages' emphasis on the root; those treating the branch account for seven or eight out of ten, while those treating the root account for only two or three. Moreover, they often cite "treat the branch in acute cases, treat the root in chronic cases," yet upon examining their rationale for acute and chronic, they reverse and misidentify them, harming patients with every move, due to a failure to study thoroughly with enlightened masters. Thus, whenever disease leads to Qi rebellion, rebellion leads to transformation, cold/heat generates disease, or disease generates cold/heat, if one treats the original source from which these arose, subsequent diseases will heal spontaneously without further treatment. Therefore, obtaining a Yin pulse but presenting Yang symptoms indicates a root of Yin and branch of Yang. Obtaining a Yang pulse but presenting Yin symptoms indicates a root of Yang and branch of Yin. If one treats the branch instead of the root, death will ensue. How can a physician not know to seek the root?
Knowing the branch and root ensures safe application; clearly understanding reversal and compliance allows for precise action; ignorance of these renders one unfit to discuss diagnosis and liable to disrupt the classics. Thus, *Da Yao* states: "The mediocre practitioner chuckles, thinking it easy to know. Saying heat has not ceased, yet cold disease begins again; same Qi but different forms, confusing diagnosis and disrupting meridians—this is what is meant."
Walking the middle path without doubt requires true insight. Mediocre practitioners arrogantly claim the Dao is easily known; thus, seeing Yang manifestations of the branch, they immediately treat with fire methods. False heat remains unresolved, while true cold arises again. Although the Qi of Yin and Yang may seem similar, the manifested forms are vastly different. Ignorant of this, mediocre practitioners inevitably become confused.
The onset of hundred diseases mostly stems from the root. The functions of the Six Qi vary, originating sometimes from the branch, sometimes from the Middle Qi. Taiyang Cold Water has Cold as root and Heat as branch; Shaoyin Ministerial Fire has Heat as root and Cold as branch. Their treatment may follow the root or the branch, depending on an assessment of cold and heat. Shaoyang Ministerial Fire transforms into Fire as the root; Taiyin Damp Earth transforms into Dampness as the root. Their treatment follows only the root of Fire and Dampness, not the branch of Shaoyang or Taiyin. Yangming Dry Metal transforms into Dryness as the root, with Yangming as the branch; Jueyin Wind Wood transforms into Wind as the root, with Jueyin as the branch. Their treatment does not follow the root or branch but rather the Middle, which refers to the Interconnected Qi. Generally, Yangming and Taiyin are exterior-interior pairs, their Qi interacting reversely in the middle; thus, Dry Metal is treated via the Middle Qi of Damp Earth. Jueyin and Shaoyang are exterior-interior pairs, their Qi communicating in the middle; thus, Wind Wood is treated via the Ministerial Fire's Middle Qi. This is because the root and branch Qi of these two meridians do not align, so treatment is determined by the Interconnected Qi. As for Taiyang and Shaoyin, which also serve as each other's Interconnected Qi, their cold or heat nature and root/branch distinction are very clear, so there is no need to seek resolution in the Middle Qi. For all other diseases, treatment targets the root; only in cases of fullness in the epigastrium (*Zhongman*) and obstruction of urination and defecation is the branch treated. Fullness in the epigastrium implies stomach fullness; when the stomach is full, the Qi of medicine and food cannot circulate, causing all Zang-Fu organs to lose their nourishment, leaving no time to treat the root. Treating the branch first becomes the fundamental approach. Obstruction of urination and defecation is a critical symptom, more urgent than any other acute condition, so it is treated first. Apart from this, there are no other instances of treating the branch. Regarding the root and branch of pathological Qi: if a disease manifests with excess, it will inevitably affect other Zang organs or Qi; treating the root first prevents invasion into other Zang organs or Qi, which is optimal. If a disease manifests with deficiency, it will inevitably be affected by other Zang organs or Qi; treating the branch first prevents involvement of the root Zang or Qi, which is optimal. Furthermore, the disease is the root, and the physician is the branch. If the physician does not assess the depth of the disease, and the disease does not select the competence of the physician, this is also a mismatch of root and branch. Since the concept of root and branch is complex and difficult to clarify, this outlines the general principles.

II. Reiteration of the Law Regarding Failure to Align with the Four Seasons (One Law, Elaborating Five Articles from *Neijing*)

Treating disease contrary to the Qi of growth, development, transformation, storage, and conservation of the Four Seasons is called violating Heaven's will, which is inauspicious and constitutes the physician's fault.
Treatment not based on the Four Seasons.
Not basing treatment on the Four Seasons means failing to know that the Qi of each season has its own origin, thereby violating these Qis. Spring generation is based on Winter storage; Summer growth is based on Spring generation; Late Summer transformation is based on Summer growth; Autumn harvest is based on Late Summer transformation; Winter storage is based on Autumn harvest. If Winter Qi does not store, it cannot support Spring generation; if Spring Qi does not generate, it cannot support Summer growth. Failing to understand Heavenly timing means failing to know the Way of storing and nurturing life, making remediation impossible.
Violating Spring Qi causes Shaoyang to fail to generate, leading to internal alteration of Liver Qi. In summer, a cold transformation may occur.
Yang Qi fails to stimulate and emerge, becoming internally stagnant in the Liver, causing Liver Qi to become chaotic and injured. Liver injury leads to Heart Fire losing its source; thus, during Summer, Fire is insufficient, and Cold Water insults it, transforming heat into cold.
Violating Summer Qi causes Taiyang to fail to grow, leading to emptiness in Heart Qi. In autumn, malaria may develop.
Yang Qi fails to flow smoothly and flourish externally, pressing inward on the Heart, dissipating internal warmth, resulting in an empty sensation in the heart. Heart deficiency and internal emptiness lead to various Yang diseases. Heart injury allows Summer-heat to invade; by autumn, Metal Qi converges, trapping Summer-heat internally. Yin desires to enter but Yang rejects it, causing cold; Fire desires to exit but Yin binds it, causing heat. Metal and Fire contend, resulting in alternating chills and fever, i.e., malaria.
Violating Autumn Qi causes Taiyin to fail to receive, leading to scorched and distended Lung Qi. In winter, undigested stool diarrhea (*Sunxie*) may occur.
Lung heat scorches the leaves, causing distension. Lung injury causes Kidney Water to lose its source; thus, during Winter, Kidney deficiency leads to *Sunxie*. *Sunxie* refers to cold diarrhea where water and grain are not separated.
Violating Winter Qi causes Shaoyin to fail to store, leading to Kidney Qi sinking alone. In spring, flaccidity and cold extremities (*Wei Jue*) may occur.
Shaoyin governs storage. If Shaoyin Qi does not hide and sink, but Kidney Qi sinks alone, there is authority without balance, like a cold stove without smoke, leading to diseases such as leakage and deep cold. Kidney injury causes Liver Wood to lose its source. Since the Liver governs sinews, during Spring, sinew diseases manifest as flaccidity. Yang values deep storage; thus, failure to store in Winter leads to Yang deficiency and cold extremities. This demonstrates that the generative command of Spring and Summer cannot be violated by the conserving Qi of Autumn and Winter, and vice versa. Can physicians violate the principle of nourishing Yang in Spring/Summer and Yin in Autumn/Winter?

III. Reiteration of the Law Regarding Failure to Assess Geographic Suitability (One Law, Elaborating Six Articles from *Neijing*)

Treating disease without observing the differing winds, diets, and dwellings of the Five Directions, and applying uniform treatment, results in ineffective medication, which is the physician's error.
Failing to emulate the patterns of Heaven and the principles of Earth brings disaster.
Heavenly timing was discussed above; the cold, warmth, dryness, dampness, rigidity, and softness of Earth differ among the Five Directions. Humans fall ill accordingly. Thus, *Neijing* names the chapter *Yi Fa Fang Yi Lun* (Treatise on Different Methods for Different Regions), showing that sages adapted their methods to the winds of the Five Directions to benefit the people.
People in the East eat fish and prefer salty flavors. Fish causes heat accumulation in the center; salt damages blood. Consequently, their skin is dark and texture loose, and their diseases are carbuncles and ulcers. Treatment is suitable with bi-shi (stone needles), which therefore originated in the East.
Fish induces sores; salt induces thirst. Blood weakness and heat predispose to carbuncles and ulcers.
People in the West live on hills and experience much wind. The soil and water are rigid and strong. They wear coarse mats instead of clothes, eat refined foods, and are fat. External pathogens cannot harm their bodies; their diseases arise internally. Treatment is suitable with toxic drugs (*Du Yao*), which therefore originated in the West.
Rigid soil and water, combined with fatty diets, close the pores and fortify Qi and Blood, preventing external pathogens from causing harm. Diseases arise from excessive emotions (anger, joy, worry, sorrow, fear) and excesses in diet and sexual activity.
The North is high in elevation. Living on hills, exposed to cold wind and ice, people enjoy living outdoors and consuming dairy. Cold in the Zang organs causes fullness diseases. Treatment is suitable with moxibustion, which therefore originated in the North.
Cold water and ice cause diseases arising from Zang cold.
The South is low in elevation. The soil and water are weak, and fog/dew accumulates. People prefer sour flavors and fermented foods, resulting in dense skin texture and red complexion. Their diseases are spasms and bi-syndrome. Treatment is suitable with fine needles (Nine Needles), which therefore originated in the South.
Fermented foods are not fragrant; sour flavor is astringent, leading to dense muscle texture. In places of abundant Yang, the complexion is red. Internal damp-heat causes sinew spasms and vessel bi.
The Center is flat and damp. People eat varied diets and do not labor heavily. Their diseases are often flaccidity, cold extremities, and alternating chills/fever. Treatment is suitable with Daoyin (guiding and pulling) and Anqiao (pressing and kneading), which therefore originated in the Center.
East is sea-level; South is low; West and North are high; Center is flat and damp. Different Earth Qi produces different diseases.
Sages combine all methods for treatment, each finding its appropriateness. Thus, although treatments differ, diseases are cured because the condition is understood and the general principles of treatment are known.
Adapting to the Five Directions ensures appropriateness; only sages can fully comprehend these natures.
Spring Qi moves west; Summer Qi moves north; Autumn Qi moves east; Winter Qi moves south. Thus, Spring Qi starts below, Autumn Qi starts above, Summer Qi starts in the middle, Winter Qi starts at the surface/bia. Spring Qi starts on the left, Autumn Qi starts on the right, Winter Qi starts behind, Summer Qi starts in front. These are the constants of normal seasonal transformation. Therefore, in the highest places, Winter Qi prevails; in the lowest places, Spring Qi prevails. One must carefully observe this.
Earth has heights and depths; Qi has warmth and coolness. High places are cold; low places are hot. Loss of cold/coolness causes distension; loss of warmth/heat causes sores. Purging resolves distension; sweating resolves sores. This is the normal opening and closing of pores, differing only in degree. Qi in the Northwest disperses and contracts; Qi in the Southeast gathers and warms. This is called "same disease, different treatments." Thus, for cold and cool Qi, use cold/cool treatments and water baths; for warm and hot Qi, use warm/hot treatments and strengthen internal retention, aligning with the Qi to achieve balance. For false conditions, reverse this. High areas are governed by Yin Qi; low areas by Yang Qi. Residents of high areas live long; residents of low areas die young.

IV. Reiteration of the Law Regarding Failure to Assess Reversal and Compliance (One Law, Elaborating Two Articles from *Neijing*)

In treating disease, some cases require opposing the trend (Direct Treatment), while others require following the trend (Contrary Treatment). Failing to compare and contrast, responding randomly, is the physician's fault.
Failure to assess reversal and compliance.
Failure to assess whether the disease is treatable or not.
Reversing compliance leads to acting against the norm.
"Reversal" (Ni) means treating heat with cold and cold with heat, opposing the disease. "Compliance" (Cong) means treating cold with cold and heat with heat, following the disease. Compliance is Contrary Treatment. Reversal is Direct Treatment, which is easy to distinguish. Compliance is Contrary Treatment, which is hardest to distinguish. Cold includes True Cold and False Cold; Heat includes True Heat and False Heat. True cold/heat is cured by Direct Treatment. False cold/heat cured by Direct Treatment leads to death. False cold presents as external cold but internal heat, with rapid and forceful pulse, or deep and beating pulse, or aversion to clothing despite cold body, or hot constipation, or irritability/fullness with desire to drink, or foul intestinal discharge. This is clearly extreme heat masquerading as cold, i.e., Yang excess repelling Yin. False heat presents as external heat but internal cold, with faint and weak pulse, or rapid but empty pulse, or floating and large without root, or wiry and hollow/intermittent pulse. Despite intense heat, spirit is quiet; despite delirious speech, voice is weak; or false mania stops when restrained; or mosquito-bite-like spots are pale red and fine; or preferring cold water but drinking little; or red tongue coating but refusing to remove blankets; or frequent urination; or unconstipated stool. This is clearly extreme cold masquerading as heat, i.e., Yin excess repelling Yang. For false cold, clear internal heat; once cleared, floating Yin retreats. For false heat, warm true Yang; once warmed, deficient fire returns to its source. This is the case for Contrary Treatment. When standard formulas (Seven Formulas) fail, use counter-agent addition. E.g., treating cold with heat but encountering cold rejection; add cold to allow entry. Treating heat with cold but encountering heat rejection; add heat to allow entry. Also, taking cold medicine hot uses heat to facilitate cold; taking hot medicine cold uses cold to facilitate heat. These are methods of counter-agent variation, facilitating the trend, making treatment easier, representing minor Contrary Treatment.

V. Reiteration of the Law Regarding Failure to Differentiate Opposing Pulse and Symptoms (One Law, Elaborating Nine Articles from *Neijing*)

Treating disease without differentiating opposing pulses and symptoms, acting ignorantly, is the physician's fault. Unless unavoidable, one must inform the patient clearly and strive for the difficult outcome, in which case nothing is impossible.
Qi deficiency with body heat is called "opposing."
Yang Qi deficiency should not present with body heat, yet it does. Body heat should present with vigorous pulse, yet it is weak. Disease Qi and symptoms do not match, hence "opposing." How can one treat recklessly when opposing?
High food intake but low Qi is called "opposing."
Food enters the Stomach, aiding Stomach Qi, spreading through collaterals, and should be abundant. Now, high intake but low Qi indicates Stomach Qi fails to distribute.
No food intake but high Qi is called "opposing."
Stomach Qi scatters externally, merging with the pulse.
Vigorous pulse with low blood volume is called "opposing." Low pulse with high blood volume is called "opposing."
Meridians transport Qi, collaterals receive Blood. Meridian Qi enters collaterals, collaterals receive Meridian Qi. If signs do not match, it is abnormal.
High food intake but low blood results from blood loss, with dampness settling below.
Blood loss causes blood deficiency; blood deficiency causes Qi excess. Excess Qi stagnates internally, forcing fluids into the Lower Jiao, hence "dampness settles below."
Low food intake but high Qi indicates pathogen in Stomach and Lung.
Stomach Qi is insufficient; Lung Qi flows down into the Stomach, so pathogen is in Stomach. However, Lung Qi entering Stomach means Lung Qi loses self-guarding. Without self-guarding, pathogen follows. Hence, pathogen in Stomach and Lung.
Small pulse with high blood volume indicates heat in beverages.
Fluid retention in Spleen/Stomach causes Spleen Qi overflow; overflow causes internal heat.
Large pulse with low blood volume indicates Wind Qi in Lung, preventing fluid intake.
Excessive Wind Qi prevents fluids from entering vessels.
Full form, small pulse, shortness of breath indicating danger. Thin form, large pulse, excessive Qi in chest indicating death.
Considering this article, the previous four are critical conditions. Small pulse with short Qi is dangerous; large pulse with excessive Qi is fatal. This aligns with the deduction of damaged and excessive pulses.

VI. Reiteration of the Law Regarding Failure to Observe Four Ease/Four Difficulty Signs (One Law, Elaborating Two Articles from *Neijing*)

Combining observation of color, palpation of pulse, and examination of symptoms makes prognosis as clear as looking at one's palm. Mediocre physicians fail to distinguish ease and difficulty, even claiming ease where none exists, which is the physician's fault.
In treating disease, observe form, Qi, color, luster, pulse vigor/withered state, and disease novelty/chronicity, ensuring treatment is timely. If form and Qi correspond, it is treatable; if color/luster is bright and floating, it is easily curable; if pulse conforms to Four Seasons, it is treatable; if pulse is weak and slippery, indicating Stomach Qi, it is easily treated.
Qi abundance matching form abundance, Qi deficiency matching form deficiency, indicates correspondence, hence treatable. Bright color/luster indicates harmonious Blood and Qi, hence easily curable. Spring wiry, Summer hook, Autumn floating, Winter sunken pulses conform to seasons, hence treatable. Weak and slippery pulse indicates moderate Stomach Qi, neither excessive nor deficient, hence easily treated.
Form and Qi mismatch indicates difficult treatment; dull, dry, lusterless color indicates difficult cure; solid and hard pulse indicates worsening; pulse reversing Four Seasons indicates untreatable. Must examine the four difficulties and inform clearly.
Mismatch of form and Qi, dull/dry color, solid/hard pulse lacking Stomach Qi, and pulse reversing Four Seasons are difficulties for skilled physicians, requiring clear communication. Mediocre physicians consider these easy and fail to examine them.

VII. Reiteration of the Law Regarding Failure to Assess Novelty vs. Chronicity (One Law, Elaborating Six Articles from *Neijing*)

Treating disease without distinguishing new disease/excess pathogen from chronic disease/deficient righteous Qi, leading to disorder in urgency and sequence, resulting in reinforcing excess and depleting deficiency, is the physician's fault.
Small pulse with unchanged complexion indicates new disease.
Qi is depleted but Spirit remains strong.
Unchanged pulse with changed complexion indicates chronic disease.
Spirit persists, but pathogen overwhelms righteous Qi.
Changed pulse and changed five colors indicate chronic disease.
Both Spirit and Qi are depleted.
Unchanged pulse and unchanged five colors indicate new disease.
Both Spirit and Qi are strong. New diseases require urgent treatment; chronic diseases require slow regulation.
If Zang organs are exhausted, complexion will be dull; dullness indicates death.
Color is the flag of Spirit; Zang organs are the residence of Spirit. When Spirit departs, Zang organs fail; when Zang organs fail, color appears dull and evil.
Thus, prolonged disease undergoes transmission and transformation; if Upper and Lower do not connect, even a good physician cannot act.
For deep and prolonged diseases, transformations transmit; if Upper and Lower Qi do not communicate, even excellent methods are useless.

VIII. Reiteration of the Law Regarding Failure to Prioritize Annual Qi (One Law, Elaborating Four Articles from *Neijing*)

Treating disease without understanding the prosperity/decline of Annual Qi and the deficiency/excess of Human Qi, thereby releasing pathogens to attack righteousness and reinforcing excess/depleting deficiency, is the physician's fault.
Not knowing the annual addition, Qi prosperity/decline, and origins of deficiency/excess disqualifies one from being a practitioner.
Ignorance of Annual Movement prosperity/decline leads to ignorance of Human Qi deficiency/excess. Missing timing and reversing signs, failing to distinguish Five Treatments, allows internal pathogens to arise, which the practitioner cannot control.
Not knowing the arrival/non-arrival of Qi, missing timing and reversing signs, leads to indistinguishable Five Movements' prosperity/decline. If internal pathogens arise and affect humans, even practitioners cannot prevent it, due to ignorance of temporal Qi.
Not combining with Four Seasons and Five Elements, adding mutual overcoming, releasing pathogens to attack righteousness, cuts off long life.
Ignorance of pathogen/righteous Qi deficiency/excess leads to reckless attacks, depriving true Yuan Qi, killing people secretly. Thus, it is strictly forbidden.
First prioritize Annual Qi; do not violate Heavenly Harmony. Do not reinforce excess or deplete deficiency, causing premature death. Do not introduce pathogens or lose righteousness, cutting off long life.
*Neijing* earnestly warns; learners must seek teachers to clarify. Each year has Six Qi, governing policies of facing south or north. First know the location of these Six Qi; human pulses respond at Cun and Chi positions.
Wherever Taiyin is, pulse is sunken; wherever Shaoyin is, pulse is hook; wherever Jueyin is, pulse is wiry; wherever Taiyang is, pulse is large and long; wherever Yangming is, pulse is short and choppy; wherever Shaoyang is, pulse is large and floating. These six pulses constitute Heavenly Harmony; those who do not recognize them call them disease pulses. Attacking cold to induce heat, pulse remains unchanged while heat disease arises. Restricting heat to induce cold, pulse remains same while cold disease arises. Seeking comfort, how is this possible? Premature death usually stems from here: not assessing deficiency/excess, using only attacks, reinforcing excess/depleting deficiency, introducing pathogens, losing righteousness, causing premature death and cutting off long life.
In years of Northern Administration, if Shaoyin is in the Fountain (Lower Jiao), Cun Kou pulse does not respond; if Jueyin is in the Fountain, Right does not respond; if Taiyin is in the Fountain, Left does not respond. In years of Southern Administration, if Shaoyin is in the Sky (Upper Jiao), Cun Kou pulse does not respond; if Jueyin is in the Sky, Right does not respond; if Taiyin is in the Sky, Left does not respond. For all non-responsive cases, reversing the diagnosis yields response. In years of Northern Administration, if Three Yin are below, Cun does not respond; Three Yin