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Symptoms manifest externally; by observing external symptoms, one verifies internal pathology. Only when the mind is free from doubt and the disease reveals no hidden aspects can treatment be discussed. If symptoms are unclear yet treatment is administered arbitrarily, few cases will avoid harming the patient. Therefore, the ancients established the Four Diagnostic Methods (Si Zhen): Inspection (Wang) to verify physical appearance and complexion; Auscultation and Olfaction (Wen) to verify voice and breath; Inquiry (Wen) to ascertain etiology through asking about daily life and diet; and Palpation (Qie) to determine the disease by feeling the pulse and respiration. Thus, with detailed internal and external examination yielding clear evidence, subsequent treatment becomes effortless and effective.

Therefore, a physician treating disease should be like Yu the Great controlling the waters: dredging channels, venting accumulation, opening blockages, and removing obstructions, following the nature of water without relying on personal ingenuity or forced interventions. The meridians (Jing Sui) in the human body follow constant rules; once balance is lost, Yin and Yang become disharmonious. Excess Yin leads to Yang pathology, and excess Yang leads to Yin pathology. This principle is clear and orderly. If a physician gathers evidence inaccurately, it inevitably results in moxibustion applied to Yang sites for Yin diseases, and to Yin sites for Yang diseases. Where excessive moxibustion is indicated but insufficient heat is applied, the fire power fails to eliminate the disease; where minimal moxibustion is indicated but excessive heat is applied, the fire power becomes too strong, aggravating the disease. Furthermore, there are acupoints contraindicated for moxibustion (Jin Jiu); applying them causes harm and requires utmost caution.

In the past, Cang Gong discussed the illness of King Wen of Qi, citing pulse theory: "At twenty, pulse qi should tend towards rapidity; at thirty, towards brisk walking; at forty, towards sitting calmly; at fifty, towards lying down; above sixty, qi should be greatly diminished." King Wen was under twenty, a time when pulse qi tends towards rapidity, yet his pulse was slow and unresponsive, violating the Heavenly Dao and the four seasons. Later, hearing that physicians used moxibustion, his condition worsened; this was an error in diagnosing the disease. Thus, at twenty, one is called having a "changeable constitution" (Yi Zhi), and according to protocol, Bian stone (Bian Shi) and moxibustion should not be used. Abusing these methods exhausts the qi.

He also treated a woman from the North Palace of Qi,司空 (Sikong). Upon palpating her pulse, he said: "The pathogenic qi of hernia resides in the Bladder, causing difficulty in urination and defecation, with red urine." Moxibustion was applied to the Foot-Jueyin Liver Meridian (Zu Jueyin Gan Mai) at one point on each side. Consequently, urinary incontinence ceased, and urination became clear. From this, we know that moxibustion has its appropriate and inappropriate applications. It depends on the practitioner's profound insight to determine life and death, correct chaos, and remain a good physician. However, this matter is indeed difficult to discuss. Heaven has four seasons with excess and deficient energies; Earth has differences in cold, heat, dryness, and moisture across directions; Humans vary in age (old, young, vigorous) and diet (rich vs. coarse food). There are also changes from wealth to poverty, status to obscurity, and unfulfilled desires. Pathogenesis arises subtly; treatments may differ for the same disease or converge for different diseases. Without innate sensitivity, how can one fully perceive the knotting of the Five Zang Organs? The *Nan Jing* states: "Knowing one method makes a Lower Physician; knowing two, a Middle Physician; knowing three, an Upper Physician. The Upper Physician cures nine out of ten; the Middle Physician, eight out of ten; the Lower Physician, six out of ten." Thus, can a physician completely cure a patient without clear pulse and symptom differentiation? No. Diseases manifest in myriad variations; each disease has a name. If the name is incorrect, speech is disordered; if speech is disordered, affairs fail. Those ancient masters who could see the lesion from afar did so for no other reason than their clarity in evidence and skill in treatment.