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All diseases worsen during the day and remain quiet at night; this indicates excess in Yang pathology, signifying a Qi disorder without Blood involvement. All diseases worsen at night and remain quiet during the day; (Text implies Yin/Blood pathology).

The treatise states: To observe the key principles of pathogenesis and apply the nature and function of medicinal flavors, one can then understand the root of the disease. Therefore, if treating a disease without seeking its root, one cannot eliminate the great fire hidden deep within.

The Yellow Emperor said: I wish to hear about the pathogenesis. Qibo replied: All wind diseases causing tremors and dizziness belong to the Liver. Minimizing worry and anger prevents wind from prevailing and causing movement. The Liver... [text fragment] ...the hypochondriac region, obstruction of the diaphragm and throat, difficulty in swallowing food and drink. In severe cases, tinnitus, vertigo, blindness, sudden stiff collapse, abdominal urgency and twisting pain, hypochondriac pain, vomiting, and diarrhea occur. In extreme cases, tremors, dizziness, and epilepsy manifest, with pain under both hypochondria radiating to the lower abdomen, inducing anger. In deficiency patterns, vision is blurred, and there is excessive fear, as if being pursued.

For all diseases of Liver Wood wind pathology, heat is the root, and wind is the branch. Fire does not burn by itself but flares up when encountering strong wind; the Liver is not inherently excessively hot but becomes so due to Lung Metal deficiency allowing Wood to overact. Wang Bing noted: Wind arises from Wood, and Dryness belongs to Metal transformation, thus Dryness can overcome Wind. If sudden stiff collapse occurs, treating conditions like Xiao-Dan (wasting-thirst), Pu-Ji (sudden fall), Pian-Ku (hemiplegia), and Wei-Jue (flaccidity and cold limbs) in wealthy individuals often addresses disorders caused by rich foods. When the Qi of the Five Viscera is peaceful, it manifests as Fu-He (nourishing harmony); if excessive, Fa-Sheng (growth); if deficient, Wei-He (slackening).

All pain, itching, and sores belong to the Heart. Stillness allows for divine clarity; heat excess causes swelling. The Heart is the root of life and the manifestation of Shen (Spirit). Its brilliance appears on the face, and it nourishes the vessels... [text fragment] ...rotation and houses, representing the disaster of Fire. Fire differs from Water; Water is wise, Fire is foolish. Fire's nature is violent and rapid. Pathologically, it presents as heat in the chest, dry throat, fullness in the right hypochondrium, skin pain, aversion to cold and fever, cough, spitting blood, bloody stools, epistaxis, sneezing, vomiting, changes in urine color. In severe cases, itchy sores, swelling, shoulder and back pain, pain in the supraclavicular fossa, painful ulcers with fever,惊惧 (fright/confusion), aversion to cold, trembling, delirium, sadness, forgetfulness, nasal bleeding, inappropriate laughter, sores, profuse bleeding, madness, red eyes, chest pain, hypochondriac distension and pain, pain between the chest and scapula, back pain. In deficiency, the chest and abdomen are distended, with pain radiating between the hypochondria and lower back. Treatment involves using Cold to overcome Heat. Wang Bing noted: For mild heat, use cool herbs to harmonize; for major heat, use cold herbs to remove it; for intense heat, use sweating methods. If sweating fails to resolve it, restrain it; if restraint fails, seek its belonging organ to decline it. It is also said: Strengthen the master of Water to control the sunlight. The Classic states: Qi varies in quantity, diseases vary in severity, treatments vary in urgency, and prescriptions vary in size. Thus, when Heat invades internally, treat with Salty-Cold, assist with Sweet-Bitter, astringe with Sour, and disperse with Bitter. The Heart desires softness; urgently eat Salty to soften it. Below the Ministerial Fire, Yin Essence supports it. Below the Wood Qi... therefore Fire's tyranny is great. Nothing dries things more than Fire. In summer, when Heat is extreme, things lose their scent and become moistened by Water, exuding fluids into trees and bodies. Extreme Heat leads to sweating, which is Fire extreme transforming into Water. Laypeople fail to distinguish this, mistaking non-truth for truth. If not treated at the peak, attacking the ruling Qi instead reveals ignorance of root and branch, following false images of concurrent transformation, worsening the disease and harming life. Thus, when this Zang is balanced, it shines brightly (Sheng-Ming); if excessive, it blazes (He-Xi); if deficient, it hides (Fu-Ming). Wang Bing noted: All beginnings arise from the Heart.

All dampness-induced swelling and fullness belong to the Spleen. Flavors perceive Qi transformation; Dampness excess causes loose stools. The Spleen is the official of granaries and the residence of Ying (Nutritive) Qi. It is called an vessel, capable of transforming... [text fragment] ...transformation by Wood, Earth excess is controlled by Wind. Spleen excess is treated with Dryness. Dampness is Water; Water excess causes swelling. If Water does not flow, flesh wastes away. If Dampness is above, induce vomiting with Sour herbs; if below... Thus, when Dampness prevails, balance with Bitter-Hot, assist with Sour-Acrid. Sweet-Acrid disperses through sweat. When Dampness invades internally, treat... Eat Bitter to dry it. Also: Below Earth Qi, Wood Qi... Upper half body, Dampness excess, Fire Qi stagnates... Fire circulates within, using Heat. Thus... Wind controls Earth. If Spleen Dampness obstructs Earth, Dryness... Accumulated fluid, bloating, fullness, swelling, Damp-Heat, dryness, wasting-thirst. Do not... prefer new and dislike old, always keep moist, do not let it dry out. Thus...

All Qi stagnation belongs to the Lung. Lung Qi is usually clear and smooth; Dryness excess causes dryness. The Lung is the root of Qi and the abode of Po (Corporeal Soul). Its brilliance appears in hair, and it nourishes... [text fragment] ...cough, abdominal borborygmi, watery diarrhea, counterflow cough, chest and hypochondriac fullness radiating to the lower abdomen, sudden severe pain preventing turning, dry throat, dusty complexion, bad complexion, lower back pain, hernia in men, lower abdominal pain in women, floating deficiency epistaxis, scaling of the sacrum, yin, thigh, and leg. In excess, wheezing, cough, counterflow Qi, shoulder and back pain. From sacrum to knee and leg. In deficiency, shortness of breath, inability to complete inhalation, deafness, dry throat. Treatment: Heat overcomes Dryness; Dryness arises from Metal; Heat transforms from Fire. Metal excess is controlled by Fire; Lung excess is controlled by Bitter. Also: Below Metal Qi, Fire Qi supports it. When Dryness invades internally, treat with Bitter-Warm, assist with Bitter-Acrid, purge with Bitter. If Lung Qi rebels upward, urgently eat Bitter to drain it. Wang Bing noted: To control Dryness excess, must use Bitter-Warm. Thus Metal governs Autumn and belongs to Yin, its Qi is cool. Extreme coolness brings clear weather, yet things appear dry like Fire. This is Metal extreme transforming into Fire. Thus blood and fluid depletion occurs. Dryness transformation, if extreme, causes irritability, heat, Qi stagnation, flaccidity, and weakness in hands and feet, unable to grasp. All sounds correspond to Metal Qi. Thus, when this Zang is balanced, it is just (Shen-Ping); if excessive, it hardens (Jian-Cheng); if deficient, it transforms (Cong-Ge).

All chills and fever belong to the Kidney. Water rests and nourishes, movement consumes; Cold excess causes hardness. The Kidney governs hibernation, the root of sealing and storing, the abode of Jing (Essence). Its brilliance appears in hair, and it nourishes bones. Its flavor is Salty, color Black. It is the official of strength and ingenuity, emerging from skill. It is Yin within Yin, connecting with Winter Qi. Its pulse is Stone-like. Wang Bing noted: There are two Kidneys, shaped like two beans joined, curving along the spinal ligaments, fatty outside, white inside, black surface, governing Essence storage. The Immortal Classic says: Heart is Ministerial Fire, Kidney is Ministerial Fire, indicating Kidney belongs to Fire, not Water. The Classic states: Dan-Zhong is the official of messenger, joy emerges from it. Dan-Zhong is between the breasts, orders come from the Kidney, meaning Fire resides in Water position, rising brings joy. Although there are two Fires, in Five Elements theory, they are both Heat. Left Kidney belongs to Water, storing Essence in men, binding Bao (Uterus) in women. Right Kidney belongs to Fire, circulating through San Jiao. The way of prosperity stems from this. Beside the seventh vertebral segment lies the "Small Heart," referring to Ming-Men (Gate of Life) Ministerial Fire. The Classic says its change is freezing, clear hail/snow. Pathologically, Cold invading heart pain, lower back and leg pain, joint stiffness, difficulty bending/extending, bitter cold reversal, abdominal fullness, night sweats. In excess, abdominal and shin swelling, wheezing/cough, heavy body, sweating, aversion to wind. In deficiency, chest pain, lower abdominal pain, cold extremities, unhappiness. Wang Bing noted: Lower abdomen refers to Large and Small Intestines. This is Left Kidney Water pain. If Right Kidney Ming-Men Ministerial Fire pathology: Shortness of breath, sores, scabies, abscesses, hypochondriac fullness, edema of chest/back/head/face/limbs, abdominal distension, vomiting/reversal, twitching, joint pain radiating downward, warm malaria, sudden abdominal pain, hemorrhage, seminal emission, red eyes, heart heat, confusion, sudden pain, oppression, retching, sores, fright/restlessness, sore throat, tinnitus, vomiting/diarrhea, sudden death, tumors, nodules, erysipelas—all due to Ministerial Fire excess. Treatment: Cold overcomes Heat, Heat overcomes Cold. If Heat invades internally, treat with Salty-Cold; Fire excess, balance with Salty-Cold. Below Ministerial Fire, Water Qi supports it. If Cold invades internally, treat with Sweet-Hot, assist with Sweet-Acrid. Cold excess, balance with Acrid-Hot. Also: Kidney dislikes dryness, urgently eat Acrid to moisten it. Kidney desires firmness, eat Bitter to firm it. Water is originally Cold; extreme Cold becomes Ice. Water carries things like Earth; Ice/Hail/Snow shows Water Cold extreme transforming into Earth controlling Water, called concurrent transformation. Extreme Cold disease manifests as Kidney fullness. Left Kidney deficiency, supplement with Water; Right Kidney deficiency, supplement with Fire. Thus, this Zang balances with stillness/submission (Jing-Shun); deficiency leads to dried stream (He-Liu); excess leads to overflowing water (Liu-Yan).

All Jue (reversal), constipation, and diarrhea belong to the Lower Jiao. Jue means Qi rebellion; Gu means restriction. Qi rebellion causes Liver/Kidney loss of control, leading to inability to restrict, with unregulated entry/exit.

All Wei (flaccidity), asthma, and vomiting belong to the Upper Jiao. Lung is the chief of Zang organs, covering the Heart like a canopy. Lung Heat scorches leaves causing Wei; this is Qi stagnation and obstruction. Asthma... Diarrhea... Vomiting... No... Meaning... Fire... Drink...

All inhibition, shivering, and loss of spiritual control belong to Fire. Inhibition, shivering, fright, confusion, loss of spiritual control, palpitations, and arrhythmia are all internal Heat production. Treatment should involve restraining...

All spasms and neck stiffness belong to Dampness. Cold and Damp share nature; Water and Fire coexist. Foot Taiyang Bladder Meridian belongs to Water, hence Dampness can injure it. Its... Middle... Detailed...

All rebellious rushing upward belong to Fire. Chong means attack; Fire Qi flares upward, so extreme Heat stagnates internally.

All distension and abdominal enlargement belong to Heat. Lung governs... Sheng-Ming...

All restlessness, mania, and transgression belong to Fire. Stomach excess makes limbs solid, enabling climbing high. Limbs are the root of all Yang meridians. The Classic states: Yang excess over Yin... Pulse flow... If Fire...

All sudden rigidity belong to Wind. Tyrannical and harmful. Strong and powerful, lacking flexibility. Caused by Jueyin Wind-Wood excess. Wang...

All diseases with sound, drumming like a drum, belong to Heat. Abdominal distension with drum-like sound upon percussion indicates extreme Heat. The Classic states... Heat excess... How to clarify... Cheng-Qi Tang...

All swelling, pain, sourness, fright, and terror belong to Fire. Swelling: Heat excess internally injures Qi causing stagnation. Pain/sourness: Fire excess controls Metal, not... Origin...

All twisting, convulsions, and turbid fluids belong to Heat. Heat dries and scorches sinews, causing twisting and pain responding to Wind, belonging to Liver. Severe cases spit... Unceasing... Heat Qi, added with purging, Dampness excess. If three pathogens mix, it becomes Huo-Luan (cholera). Thus Zhang Zhongjing said: Vomiting and diarrhea named Huo-Luan. Therefore... Liao... Xiang... Well...

All pathological fluids, clear and cold, belong to Cold. Fluid pathology is Cold. Thus water is pure and cold, undigested food/vomit/diarrhea. Yellow and... Sour. ...Undigested... Classic... Says...

All astringency, withering, dryness, hardness, and scaling belong to Dryness. Astringency/withering: Fluid Qi deficiency, Blood failing to nourish skin/flesh, Qi obstruction. Thus skin... Heat... Thus law says: Cold contracts; contraction causes dryness/astringency/scaling. Heat relaxes; relaxation nourishes/moistens. All belong to Dryness-Metal transformation. Wang Bing noted: Living things are slippery/smooth; dead things are dry/astringent. Treatment: Open pathways, nourish Yin, retreat Yang, use Cool herbs. Nutritive Blood flows, numbness/anesthesia, astringency/dryness/scaling all find their place. Carefully avoid Wu-Tou (Aconite) herbs. The Classic states: The operational numbers of Metal/Water/Fire/Wood/Earth, and the governing transformations of Cold/Summer Heat/Dryness/Dampness/Fire/Wind, reveal Heavenly Dao and allow adjustment of people's diseases. All diseases received return to the Way of Five Elements and Six Qi victory/defeat and abundance/decline.