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Commentary states: When viewed as a whole, they are the same; when separated, they are different. The establishment of Fire and Water, and the gathering of all things, all possess similarities and differences; what is there to be surprised by? Fire produces smoke; when constrained, it is not bright; when the flame ignites, it becomes bright through the smoke. Water belongs to Kan (the trigram for water); when obstructed, it does not flow; when the obstruction in Kan is cleared, it flows. All things have their categories; when they exceed their boundaries, they differ from the norm. Humans have ranks of respect and humility; when they follow the Way, they differ from the masses.

Infants suffering from illness without progression of disease have been known since ancient times. It is said that conditions such as Gan accumulation (pediatric malnutrition syndrome), vomiting, and diarrhea, if they progress further, will transform into Wind-Startle (pediatric convulsions) and Phlegm-Heat. This is not strange; one can treat them according to their symptoms. If slight changes occur, one should examine the severity to manage them. However, contemporary physicians often neglect medical study and fail to grasp this fundamental principle. Their opinions on feasibility do not strive for perfection. They do not realize that disease onset has distinctions between similarity and difference: the commonality of the pathogen received is termed "Same," while the atypical manifestation is termed "Different." Among the aforementioned eight symptom patterns, transmission can occur. Unlearned practitioners do not understand the mechanism of transmission; upon onset, they simply claim it is a difference. In reality, it is caused by these differences. One must understand that the pathogen lies within the process of transmission. If, in haste, one recklessly administers pills and powders, cold and heat may conflict, deficiency and excess may destroy each other, exterior and interior may become blocked, and Yin and Yang may oppose each other. This disrupts the hundred vessels, disturbs the five Zang organs, obstructs the meridians, and impedes Ying and Wei (nutritive and defensive qi). Consequently, the original symptoms hide and transform into other diseases; the onset cannot be accurately named, and treatment fails to examine the underlying principles. Blindly attacking and purging without cause, yet miraculously preserving life, the damage sustained is then mistakenly regarded as bizarre. Within accumulation syndromes, many diseases present with differences (the so-called differences refer to improper treatment of accumulation syndromes leading to transmission, rather than mere surprise; it is the received pathogen that causes this). Gan Qi disease presents numerous external signs. Its manifestations often appear after the deterioration of accumulation diseases. Managing Gan Qi is similar. Investigating its source addresses its beginning; observing its symptoms allows for treating the disease. Therefore, if pills and powders are used improperly, chronic diseases will not linger long. Any strange diseases suffered by infants are likely due to a lack of clear observation. If neglected until adulthood, patients often suffer from lingering ailments.

Commentary states: Human life is rooted in Qi and Blood; longevity is found in peace and comfort. At age sixteen (2 x 8), a male's Defensive Qi (Wei Qi) becomes robust; at age fourteen (2 x 7), a female's Nutritive Blood (Ying Blood) begins to circulate fully. When Tian Gui (menstrual fluid/reproductive essence) arrives, Qi and Blood become vigorous. Although a father's reproductive age may not yet reach full maturity, he is still called a child; although his form is differentiated and name established, this description applies from childhood to old age. Current secular customs allow marriage at age fifteen for males and thirteen for females. While this does not conform to ancient rites, it aligns with human nature. Emotions stir within; if males break their Yang too early, their Essence and Qi are damaged; if females break their Yin too early, their meridians are injured. Even if pregnancy occurs, gestation and nurturing will inevitably be deficient. Children may be born with rickets, incomplete Bian Zheng (physiological growth phases in infants), or dwarfism. Or, if males reproduce beyond age sixty-four (8 x 8) and females beyond age forty-nine (7 x 7), the offspring are unlikely to be healthy. Alternatively, there may be Yin excess with Yang deficiency, or Yang excess with Yin deficiency. Females may take medicine for uterine cold, or males may take elixirs for impotence. Such practices regarding descendants are unworthy of discussion and are not orthodox theories. Ancient sages' writings evaluated management methods but rarely investigated their origins, showing limited foresight regarding premature death versus longevity and their associated harms. It is seen that adults suffer from Deficiency-Labor (Xu Lao) and die successively. People call this "Chuan Shi" (a contagious wasting disease, resembling tuberculosis), claiming it is caused by ghosts or parasites. I believe this is incorrect. "Chuan Shi" refers to the transmission of the "corpse" of flesh, bones, Qi, and Blood. It results from insufficient paternal Essence and deficient maternal Qi. How could there be an external corpse to transmit? Assertions of ghost-induced harm or parasite mischief ignore that the aforementioned meanings are contained within the symptoms. Although adults grow up, one should not view this merely as hereditary Labor-Wasting disease. Rather, constitutional endowment is like a flower needing soil protection or a tree whose prosperity or decline depends on its roots. As children, humans cannot know this themselves. Moreover, indulgence leads to sudden Qi deficiency and pulse collapse in females. Blaming fate or criticizing poor medication quality, they fail to blame their own insufficient root constitution, which is the true cause.