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In the chapter "Dividing One Day into Four Seasons" of *Ling Shu* (Spiritual Pivot), the Yellow Emperor asked: The onset of all diseases must originate from dryness and dampness, cold and heat, wind and rain, yin and yang imbalance, excessive emotions (joy and anger), improper diet, and unsuitable living environment. When pathogenic qi combines with healthy qi, a specific pathological form arises; when pathogens lodge in the zang-fu organs, disease names are established. Most diseases manifest as being lucid in the morning, peaceful during the day, aggravated in the evening, and severe at night. Why is this? Qibo replied: This corresponds to the pattern of seasonal qi. Spring generates, summer grows, autumn harvests, and winter stores. This is the normal cycle of qi, and the human body also responds to it. Dividing one day into four seasons, morning corresponds to spring, midday to summer, sunset to autumn, and midnight to winter. In the morning, healthy qi begins to generate, and pathogenic qi declines, so the patient feels better in the morning; at midday, healthy qi grows strong; when strong, it overcomes evil, so the patient feels peaceful; in the evening, healthy qi begins to decline, and pathogenic qi begins to arise, so symptoms worsen; at midnight, healthy qi enters the zang organs, and pathogenic qi dwells alone in the body, so symptoms are most severe.

All diseases arise either from external invasion by the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) or internal injury by the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). Pathogens interact with healthy qi to form disease manifestations, and the location where pathogens lodge determines the disease name. The reason why most cases show improvement in the morning and peace during the day, but worsening in the evening and severity at night, is that the twelve double-hours of a day correspond to the qi transformation of the twelve months of a year. When the body's yuan qi (Original Qi) is prosperous, evil is defeated and healthy qi prevails, resulting in mild and peaceful symptoms; when qi declines, evil prevails and healthy qi is defeated, leading to aggravated and severe symptoms.

The Yellow Emperor asked: What causes some cases to be contrary to this pattern? Qibo answered: This occurs when the condition does not follow the seasonal qi patterns, but is instead dominated by the independent pathology of the Zang organs. In such cases, symptoms become severe when the organ qi is overcome by the seasonal qi, and improve when the organ qi overcomes the seasonal qi. The Yellow Emperor asked: How should this be treated? Qibo answered: By following the timing of heaven, the prognosis of the disease can be predicted. Those who follow these principles are skilled physicians; those who go against them are crude practitioners.

This statement refers to conditions where symptoms are heavy in the morning and light at night, which contradicts the previous section. This happens because the patient does not conform to the general seasonal climate laws, and the five Zang organs independently dictate the disease nature. Generally, the flow of human yuan qi responds to seasonal climates, but exceptions occur when there is a pre-existing predisposition of deviation or rebellion in the organ qi. Therefore, when encountering times when the organ qi cannot withstand the seasonal qi (i.e., the seasonal qi overcomes the organ qi), the disease worsens. For example, if Liver Wood disease encounters Geng-Shen or Xin-You days (Metal overcomes Wood), the disease worsens. Conversely, when encountering times when the organ qi overcomes the seasonal qi, the disease improves. For instance, on Jia-Yin or Yi-Mao days (Wood qi is prosperous), the disease improves. Other cases can be deduced similarly. Therefore, treatment must follow the principles of seasonal qi transformation, adjusting through appropriate tonification and sedation methods. Whether the disease will heal or not can be predicted. Physicians who understand the principle of following seasonal timing are good doctors; those who violate it are crude workers.

In the chapter "Jade Machine and True Viscera Theory" of *Su Wen* (Basic Questions), the Yellow Emperor asked: Wind is the leader of all diseases. Now, when wind-cold invades humans, causing all hair to stand erect and skin pores to close, resulting in fever, at this time, sweating therapy should be used. If bi-syndrome (Obstruction Syndrome) occurs with numbness, pain, and swelling, at this time, hot compresses, moxibustion, and acupuncture should be used to remove the pathogen. If untreated, the disease enters the Lung, named Lung Bi (Lung Obstruction), causing cough and rebellious qi; if untreated, the Lung transmits to the Liver, named Liver Bi (Liver Obstruction) or Jue (Reversal), with symptoms of hypochondriac pain and vomiting food; at this time, massage or ear acupuncture may be used. If untreated, the Liver transmits to the Spleen, named Spleen Wind (Spleen Feng), causing jaundice, abdominal heat, vexation, and yellow urine; at this time, massage, herbs, or baths may be used. If untreated, the Spleen transmits to the Kidney, named Shan-Jia (Hernia and Mass), with lower abdominal burning pain and white discharge, also known as Gu (Gu Disease); at this time, massage or herbs may be used. If untreated, the Kidney transmits to the Heart, causing tendons and vessels to pull and spasm, named Chou (Convulsion); at this time, moxibustion or herbs may be used. If untreated, after ten days, death is expected according to the pattern. If Kidney evil transmits to the Heart, and the Heart reverses it back to the Lung, causing chills and fever, death is expected after three years. This is the sequence of disease transmission.

Wind is transformed from Yang Qi; its nature is active and dispersing. All pathogens harming humans must enter via Wind, hence Wind is called the leader of all diseases, and it is said to move swiftly and change frequently. If initial wind-cold damaging the skin and hair is not treated, it gradually deepens and transmits to the Lung, forming Lung Bi, causing cough and rebellious qi; transmitting to the Liver, it forms Liver Bi, causing hypochondriac pain and vomiting, because the Liver meridian runs along the hypochondrium and enters the Stomach, causing Stomach Qi to rebel and food to be vomited; transmitting to the Spleen, it forms Spleen Wind, causing jaundice, because the Spleen belongs to Wet Earth, and jaundice results from dampness stagnating and transforming into heat; pathogenic heat accumulates, causing abdominal heat and vexation, with yellow turbid stool excreted, as Heart and Spleen Qi connect, allowing pathogenic heat to exit via the Small Intestine; transmitting to the Kidney, it forms Shan-Jia, still connecting to the Liver, causing lower abdominal burning pain ("Yuan" means unbearable groaning), and white urinary discharge similar to strangury, due to the Kidney's failure to store essence; transmitting to the Heart, it causes tendons and vessels to pull and spasm into convulsions, because the Heart governs blood vessels. These pathogens transmit to the organs they overcome, termed Thief Evil, and circulate through all five Zang organs. If not urgently treated, and delayed for another ten days, death ensues. If Kidney evil transmits to the Heart, and Heart Qi is strong, reversing it to the Lung, where the Lung governs skin and hair, and the evil exits via Ying and Wei (Nutritive and Defensive Qi), causing chills and fever. However, this long-transmitted evil becomes knotted with Qi and Blood, like oil mixed into flour, unable to resolve. After dragging on for three years, Yuan Qi fails and exhaustion leads to death. This is the sequence of pathogenic transmission.