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The pathology of the Five Elements is fundamentally uniform, yet the Qi generated by them differs. For instance, Wood governs Wind transformation (Feng Hua), but diseases arising from it are not confined solely to the Liver; Fire governs Heat transformation (Re Hua), but diseases arising from it are not confined solely to the Heart. This is due to the differences in the governing principles of Si Tian (Sovereign Heaven) and Si Di (Sovereign Earth) over the annual cycles, causing diseases to vary accordingly. Furthermore, there are instances of deficiency in the year, emptiness in the month, or disharmony in the season, where a Dominant Qi (Sheng Qi) may overcome its counteracting element causing damage, or a Restoring Qi (Fu Qi) may retaliate but be controlled by its counteracting element.

According to the classics: If Heavenly Fire descends, Lung Qi ascends to follow, Metal Qi manifests, and grasses suffer; if Dryness Qi (Metal) descends, Liver Qi ascends to follow, Wood Qi manifests, and Earth suffers. Discussing from the perspective of normal overcoming relationships, when Fire arrives, Lung disease occurs; when Metal arrives, Liver disease occurs. However, now, if Heavenly Fire descends, Metal follows the Qi of Heaven to exert influence, so disease arises conversely in the Liver; if Heavenly Metal descends, Wood follows the Qi of Heaven to exert influence, so disease arises conversely in the Spleen. By analogy: When Jue Yin (Wind-Wood) governs Si Tian, Spleen Qi ascends to follow, and Water suffers; when Tai Yang (Cold-Water) governs Si Tian, Heart Qi ascends to follow, and Metal suffers; when Shao Yin (Ministerial-Fire) governs Si Tian, Lung Qi ascends to follow, and Wood suffers; when Tai Yin (Damp-Earth) governs Si Tian, Kidney Qi ascends to follow, and Fire suffers. All these can be deduced. This is the supreme nature of Heavenly degrees, unique among others. The Classics state that Heaven can control colors because it can overcome what defeats itself, preventing harm. Regarding Si Di (Sovereign Earth), it represents the upright Qi transformation, manifesting according to specific syndromes.

Regarding the differences in years governed by Yun (Five Movements), one must observe the Qi transformation of Si Tian. For example, in the Liu Jia (Six Jia) years, Yang Earth governs the movement, with distributions of Yin condensation and flowing abundance, which differs from the Liu Ji (Six Ji) years. However, Ji Si and Ji Hai years are similar to Liu Jia years. In Liu Geng (Six Geng) years, Liver diseases are common, but in Geng Yin and Geng Shen years, Metal cannot control the Liver; in Liu Wu (Six Wu) years, Lung diseases are common, but in Wu Chen and Wu Xu years, Fire cannot harm the Lung. Where Qi transformation reaches, it is like a balance scale; one can seek disease through Qi. Only the signs of Sheng (Dominance) and Fu (Restoration) differ, making them difficult to predict in advance; one must also seek syndromes based on the abundance or scarcity of Qi. Disease caused by Sheng Qi is mild, while disease caused by Fu Qi is severe. In Sheng, the element that does not overcome is subjected to being overcome; in Fu, it is like avenging an enemy. This is another point that must be known.

Taking Wood disease as an example, originating from the constraint of Lung Metal, it is merely like excessive Lung Qi invading the Liver, causing symptoms such as blurred vision, back itching, hearing loss, chest pain, and heaviness of the body. However, if Wood transformation is excessive, Liver Qi acts recklessly, severely injuring the Spleen, then Metal will come to rescue (restore), and the pathogenic factor will conversely injure the Liver, causing heaviness of the body, vexation and oppression, chest pain radiating to the back, fullness in both hypochondria, and pain radiating to the lower abdomen. Thus, the Classics say "corresponding above to the White Star (Tai Bai)," referring to the Restoration Qi of Metal. Although this is so, human Qi is akin to Heavenly and Earthly Qi; the Qi of the Five Zang Organs is the Qi of the Five Yun Movements, and the Qi of the Three Yin Meridians is the variation of the Six Qi. Considering the abundance or scarcity of Qi in one's own body, it need not be entirely determined by Heavenly and Earthly Qi transformations. In Ji Hai years, people often have Liver diseases but some have Lung diseases; in Zi Wu years, people often have Heart diseases but some have Kidney diseases. This is because each individual possesses their own Heavenly and Earthly Qi transformation laws. The methods of regulation and treatment are the same as those for the arrival of Five Yun and Six Qi.

Although the diseases are the same, the resulting pathologies, underlying causes, and reasons for illness vary. Some arise from excess in the primary organ, some from deficiency in the primary organ, and some from similarities in the pathways of the meridians. The Classics record that diseases generated by the Two Fires (Shao Yin and Tai Yang), although varying in severity, are essentially the same. (Tai Yang and Tai Yin) Water and Earth share a womb, Cold and Damp share transformations, and the diseases they generate are similar. The eyes converge many tendons, leading to diverse pathological changes; the Heart commands the Five Zang Organs, leading to strange diseases. Clear and turbid Qi originate from different sources, each having its mechanism; exterior and interior present different states, each having its response. Now, detailing these examples aims to clarify the secrets of treating diseases.