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Bone Cavity Treatise: The marrow cavities are located five fen behind the head, below the sharp bone at the edge of the skull (this is the Fengfu acupoint). One is below the Duanji, one is below the central compound bone in the lower neck, and one is above the spinal bone, above the Fengfu point. The cavity below the spinal bone is located in the empty space below the sacral bone. Several marrow cavities are on the face flanking the nose, or the bone cavity below the mouth corresponds to the two shoulders. The cavities of the bilateral arm bones are located in the Yang aspect of the upper arm. The cavity of the forearm bone is located in the Yang aspect of the arm, four cun away from the ankle, between the two bones. The cavity above the femur is located in the Yang aspect of the thigh, extending four cun above the knee. The bone cavity above the auxiliary bone of the knee. The bone cavity below the movement in the pubic hair at the root of the thigh. The bone cavity behind the sacrum is located behind the hip bone, four cun apart. Flat bones have converging permeation lines but no marrow pores; they easily transform into bone without cavities.

This discusses that if human body joints have gaps, then there are channels for marrow. If bones have no gaps, the body has no pores, how can it penetrate and gather subtle essence to nourish each other? When moxibustion is applied to joints, these cavities are mostly used.

At the beginning of the Ming Dynasty, the Medical Bureau was established, later changed to the Imperial Medical Supervisory Office, and then to the Imperial Medical Academy. Positions such as Director, Vice-Director, and Clerk were set up to specialize in diagnosing diseases and preparing medicines. In the 14th year of Hongwu, it was designated as a fifth-rank office, with additional positions of Director, Assistant Director, Medical Officer, and Imperial Physician created, starting to grant honorary titles based on civil service ranks. In the 22nd year, the Director was again changed to President, and Assistant Director to Vice-President. Its subordinate agencies included the Hui Min Medicine Bureau, and a Raw Medicine Warehouse was also set up within the academy, each with a Chief and Deputy Chief.

All studies in the academy are divided into thirteen departments. From Imperial Physicians downwards, medical officers and doctors each specialize in one department.
The President, Vice-President, and Imperial Physicians of the academy take turns on duty every day in two shifts at the Imperial Medicine Bureau within the inner court.
Medical officers are generally inherited through family lineage or appointed by recommendation from outside. Those proficient in medical arts are recommended by the academy to serve in the Imperial Medicine Bureau.
All medicines submitted as tribute from various regions and used by the imperial household are stored and managed in the inner court. At the beginning of the dynasty, medical officers prepared medicines in the internal bureau. Officials of the academy diagnose the imperial pulse, Imperial Physicians review and verify, and together with eunuchs, prepare medicines in the internal bureau. The medicine packets are sealed jointly, and a memorial is submitted detailing the properties of the herbs in the prescription and the methods for treating the symptoms. Medical officers and eunuchs sign their names before submission, records are kept in registers, and the medicine is sealed with the seal of the Secretariat. Once the memorial is complete, it is attached to the register, signed under the date, and kept by eunuchs for inspection. Cooking imperial medicines is supervised by academy officials and eunuchs. Every two doses are combined into one, cooked, and then divided into two vessels. One vessel is tasted first by the Imperial Physician, then the Vice-President, then the eunuch, and the other vessel is presented to the Emperor.
When princes' mansions request physicians to treat illnesses, the academy dispatches officials or medical officers upon imperial decree. If civil or military ministers and foreign chieftains fall ill, they are also dispatched upon decree. Whether the treatment is appropriate is reported back in memorials. If the army lacks physicians, requests are made by the Commander-in-Chief or Governor-General for allocation.
Children of medical families were traditionally selected to study medicine in the academy. This practice was restored in the 5th year of Hongzhi, with two or three teachers appointed. Examinations are held quarterly. Every three or five years, one senior official and two medical officers conduct exams. Those who master their specialty are admitted as medical officers, receiving rations and duties. Those who do not pass are allowed to study for another year and re-examined. Those who fail three times are dismissed. If many students succeed after five years, the teachers may be promoted upon recommendation.
During the Hongwu era, there were fixed quotas for medical officers and doctors, which varied thereafter. All prepared medicines in the academy. If medical officers and doctors were still dispatched to various places for medication use.
Dongzhi Room (36 medical officers), Anle Hall (3 medical officers, 36 medical officers), Directorate of Palace Attendants (2 medical officers), Study Hall (6 medical officers), Ganming Gate (3 medical officers), Laundry Bureau (2 medical officers), Tianshou Mountain (2 medical officers), Songling Lingtai (3 medical officers), Tuan Ying (1 medical officer, 12 medical officers), Five Camps Army (3 medical officers), Three Thousand Camps (4 medical officers), Embroidered Uniform Guard (3 medical officers), Shenji Camp (1 medical officer, 4 medical officers), Front Guard of Fu Army (3 medical officers), Hui Min Bureau (3 medical officers), Huitong Guesthouse (3 medical officers), Daci'en Temple (3 medical officers), Xuanfu (1 medical officer), Jingxing Pass (2 medical officers), Juyong Pass (1 medical officer), Longmen Qianhu Suo (1 medical officer), Wanquan Right Guard (1 medical officer), Huailai Guard (1 medical officer), Shanhaiguan (1 medical officer), Guangning Guard (2 medical officers), Siziyu (1 medical officer), Kaiyuan (1 medical officer), Yongning Guard (1 medical officer), Dushi (1 medical officer), Daomaguan (1 medical officer), Baiyangkou (1 medical officer).
Medical officers receive seven dou of grain per month, doctors receive four dou, and previously medical officers received two shi per month. In the Hongzhi era, this was reduced to seven dou like medical officers.
If princes' mansions lack good physicians, the academy recommends medical officers to the Ministry of Personnel for selection.
Since the Hongwu era, those selected for medical service in the academy were exempted from local corvée in their home counties. In the 2nd year of Hongzhi, those serving in the Imperial Medicine Bureau were exempted for two households, and those serving in the academy for one household.
Medical officers with physical disabilities or over seventy years old unable to serve are exempted.
Annual medicinal materials required nationwide are collected from producing areas. Since the Yongle era, the quota was 55,474 jin. Since the Chenghua era, the number has gradually increased to over 163,557 jin currently, including 64 centipedes and snakes, 21 pairs of Gekko gecko and Aconitum carmichaelii, and 20 worm-eaten papayas.
[Zhejiang Provincial Administration Commission] 31,851 jin 7 liang, 108 sheets of gold foil, 72 sheets of silver foil.
[Jiangxi Provincial Administration Commission] 7,556 jin 12 liang.
[Huguang Provincial Administration Commission] 4,849 jin 7 liang 7 qian 2 fen 6 li, 9 white-banded kraits, 10 black snakes.
[Fujian Provincial Administration Commission] 2,765 jin 1 liang 9 qian 1 fen.
[Sichuan Provincial Administration Commission] 16,420 jin 8 liang, 4 pairs of Aconitum carmichaelii.
[Guangdong Provincial Administration Commission] 9,929 jin 3 liang 4 qian, 17 pairs of Gekko gecko.
[Guangxi Provincial Administration Commission] 9,723 jin 10 liang.
[Shanxi Provincial Administration Commission] 8,955 jin 4 qian 5 fen.
[Shandong Provincial Administration Commission] 8,738 jin 6 liang.
[Henan Provincial Administration Commission] 8,649 jin 4 liang.
[Shaanxi Provincial Administration Commission] 11,744 jin 7 liang.
[Liaodong Military Commission] 800 jin.
[Yingtian Prefecture] 3,658 jin 8 liang.
[Zhenjiang Prefecture] 3,717 jin 6 liang 6 qian, 45 red-headed centipedes.
[Suzhou Prefecture] 18,079 jin 3 liang.
[Songjiang Prefecture] 1,440 jin.
[Huizhou Prefecture] 949 jin 8 liang.
[Ningguo Prefecture] 4,994 jin 10 liang 2 qian, 20 inferior worm-eaten papayas.
[Taiping Prefecture] 181 jin 7 liang 6 qian.
[Chizhou Prefecture] 613 jin.
[Fengyang Prefecture] 2,007 jin.
[Yangzhou Prefecture] 745 jin 3 liang 2 qian.
[Huaian Prefecture] 3,127 jin 8 liang.
[Luzhou Prefecture] 85 jin 12 liang 5 qian 9 fen.
[Anqing Prefecture] 458 jin.
[Guangde Prefecture] 630 jin.
[Chuzhou] 1,592 jin 11 liang 2 qian 5 fen.
[Xuzhou] 63 jin.
[Hezhou] 223 jin 14 liang.
[Yongping Prefecture] 215 jin.
[Qingzhou] 700 jin.
[Bao'an Prefecture] 700 jin.
[Daming Prefecture] 1,050 jin.
[Hejian Prefecture] 2,177 jin.
[Baoding Prefecture] 50 jin.
[Zhendin Prefecture] 765 jin.
All medicinal materials delivered from across the country are stored in the Raw Medicine Warehouse of the academy. Two Imperial Physicians and one Chief verify and accept them, with an official from the Ministry of Rites supervising. At the end of the year, two copies of the ledger are made according to regulations: one kept in the academy for reference, and one sent to the Ministry of Rites for inspection.
Medicinal materials such as Cinnabar and Deer Antler were previously subject to extra tributes by border garrison officials, causing harm along the way. In the 23rd year of Chenghua, an edict prohibited further submissions.
For equine diseases in the army, the academy provides medicinal preparations.
Medical officers recommended by prefectures and counties nationwide who are suitable for the rank of medical officer are sent by the Ministry of Rites to the academy for examination, assisted by an official from the relevant department. Those who pass are sent to the Ministry of Personnel for appointment; those who fail are returned to their hometowns as commoners, and the original guarantor officials are punished.
Paper and stationery required by the academy are to be contributed by passed medical officers from prefectures and counties. This practice was later discontinued, but in the 18th year of Chenghua, it was approved to resume the old regulation.