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(Full text of *Suwen: Shi Congrong Lun* [Plain Questions: Discourse on Demonstrating the Method of Cong Rong])

The Yellow Emperor sat in repose and summoned Lei Gong, asking him: "You have studied arts and recited medical texts. If you can browse diverse studies, apply the method of 'Bi Lei' (comparative classification), and integrate principles to explain your strengths to me regarding the five zang organs and six fu organs, including the gallbladder, stomach, large and small intestines, spleen, bladder, brain marrow, nasal discharge, saliva, crying and sorrow, and the pathways of water metabolism—all these are what sustain human life—any negligence in treatment constitutes an error. ([Bi Lei] refers to comparing different symptoms to categorize them for assessing the condition; details are in Chapter 18 of 'Lun Zhi Lei'. Meanings of five zang and six fu organs are detailed in Chapter 23 of 'Zang Xiang Lei'. 'Water' refers to the five fluids, i.e., the fourteen aspects from the gallbladder to nasal discharge and saliva, representing blood and qi upon which life depends. If these are not understood, actions will inevitably be erroneous. Thus, treating beyond the disease's extent is called 'Guo' (excess), treating below the disease's need is called 'Shi' (deficiency), and failing to achieve balance is considered a treatment error.) You must clarify this to achieve perfection; even if you cannot know everything, you will avoid resentment from the world. (Failure to achieve perfection implies errors, leading to others' resentment.)"

Lei Gong replied: "I request to recite the upper and lower volumes of the *Mai Jing* (Pulse Classic). Although numerous, my ability to distinguish differences and apply comparative classification has not yet reached perfection, so how can I sufficiently clarify these matters?" (The ancient *Mai Jing* here refers to the meanings found in treatises such as *Mai Yao Jing Wei* and *Ping Ren Qi Xiang*.)

The Emperor said: "Try again to thoroughly understand the abnormalities of the five zang organs, the disharmony of the six fu organs, the failures of needle and stone therapies, the suitability of herbal medicines, and the flavors and effects of decoctions. State their conditions fully and answer my questions. If there is anything unknown, please ask." ('Bie Shi Tong' means reviewing what is already known. For what remains unclear, one should inquire about the unknown.)

Lei Gong said: "Liver deficiency, kidney deficiency, and spleen deficiency all cause heavy body and mental distress. Should one administer toxic drugs, acupuncture, moxibustion, bian stones, or decoctions? Some recover, some do not. I wish to hear the explanation." (The liver governs sinews; sinew pathology leads to inability to contract and hold. The kidney governs bones; bone pathology makes movement difficult. The spleen governs the four limbs; limb pathology causes fatigue and weakness, hence the heaviness. However, since these three zang organs are yin, yin deficiency leads to yang hyperactivity, causing irritability and fullness.)

The Emperor said: "How old are you to ask such superficial questions? I asked about profound mysteries (Yao Ming), yet you answered with general chapters. Why?" (This means the answer did not address the question, resembling the asker's own confusion. 'Yao Ming' refers to profound and subtle principles. As stated in *Ba Zheng Shen Ming Lun*: 'Observing the unseen' refers to the fact that changes in form, qi, ying, and wei are not visible externally, but only skilled physicians know them. By combining seasonal variations, lunar phases, and climatic shifts, they adjust treatments and often perceive changes before they manifest externally, thus 'observing the unseen.' This was what the Emperor asked, but Lei Gong's answer was wrong, hence the rebuke. 'Yao' sounds like 'Yao'.)

Spleen pulse weak and floating resembles lung pulse; kidney pulse small and floating resembles spleen pulse; liver pulse rapid, deep, and scattered resembles kidney pulse. These are areas where physicians often get confused. However, by applying the method of 'Cong Rong' (calm and comprehensive analysis), one can discern them." (Spleen pulse is naturally soft; when diseased and weak-floating, it resembles lung. Kidney pulse is naturally slightly deep; when diseased and small-floating, it resembles spleen. Liver pulse is naturally slightly wiry; when diseased, rapid, deep, and scattered, it resembles kidney. Pulses may be similar; failure to distinguish leads to error, confusing one for another, due to physician ignorance. If one understands the principles of *Cong Rong Pian* and applies comparative classification, the subtleties of profound medicine can be grasped. Note: Wang Bing commented: Floating and slow is spleen; floating and short is lung; small, floating, and slippery is heart; rapid, tight, and scattered is liver; pounding, deep, and slippery is kidney. This details the characteristics of five zang pulses to clarify this section. Diagnosis involves observing organ qi via location or pulse morphology; mastering the principle reveals infinite subtleties. Learners should integrate this.) As for the three organs (liver wood, spleen earth, kidney water) coexisting, this is known even to children; why ask?" (Spleen corresponds to earth, liver to wood, kidney to water. All three reside below the diaphragm with similar qi and pulses, hence 'coexisting'.)

Lei Gong said: "Here is a patient with headache, tendon cramping, heavy bones, timidity and shortness of breath, hiccups and belching, abdominal fullness, frequent fright, and insomnia. Which organ is affected? The pulse is floating and wiry, and firm like stone upon pressure. I do not understand. I re-ask about the comparative classification of the three organs to understand it." (This section discusses differential diagnosis of kidney disease. Floating pulse resembles lung; wiry pulse resembles liver; stone-firm pulse resembles kidney. Hard to distinguish precisely, hence the re-question on comparative classification. 'Yue' (hiccups) is pronounced jué or huì. 'Yi' (belching) is pronounced yī or ài.)

The Emperor said: "This is what is meant by 'Cong Rong'." (Quoting classic terminology, see below.) "For the elderly, seek pathology in the fu organs; for the young, in the meridians; for the prime-aged, in the zang organs." (This summarizes the method of distinguishing differences and classifying. Elderly people often have rich diets; fu organs receive food, so examine fu organs for excess. Young people often neglect wind-cold and fatigue; pathogens affect meridians, so examine meridians for injury. Prime-aged people often indulge in sexual activity; zang organs store essence, so examine zang organs for deficiency/excess.)

What you described ignores the stagnation of heat from the eight winds causing consumption of the five zang organs, and the transmission of pathogens." (The Emperor states Lei Gong's inquiry focused only on symptoms, ignoring causes such as eight-wind heat stagnation, zang consumption, and pathogen transmission sequences. 'Yun' is synonymous with 'Yu' (stagnation). 'Shuo' is pronounced shuò.)

A floating and wiry pulse indicates kidney insufficiency." (Kidney pulse should be deep; floating indicates yin deficiency. Water generates wood; wiry indicates qi leakage, hence kidney insufficiency.)

A deep and stone-like pulse indicates kidney qi internal stagnation." (Deep and stone-like means deeply hard. Yin without yang prevents kidney qi from reaching out, causing internal stagnation.)

Timidity and shortness of breath indicate blocked water pathways and depletion of form and qi." (Essence forms the body and transforms into qi. Blocked water pathways lead to depletion of form and qi, causing timidity and shortness of breath.)

Cough and irritability indicate rebellious kidney qi." (Empty water-zang steals mother qi upward, causing cough and irritability, indicating rebellious kidney qi.)

One person's qi pathology lies in one zang. To say three zang organs are involved violates medical principles." (All these refer to one person's qi pathology located solely in the kidney. For example, headache is due to water deficiency and fire flaring; tendon cramping is due to kidney water failing to nourish sinews; heavy bones relate to kidney governing bones; hiccups/belching involve kidney meridian passing through liver/diaphragm with rebellious yin qi; abdominal fullness is water evil insulting spleen earth; fright relates to kidney storing zhi (will); insomnia is due to yin deficiency preventing eye closure. The root is kidney, yet claiming three zang organs are involved contradicts principles.)

Lei Gong said: "Here is a patient with flaccid limbs, coughing, hematochezia. I diagnosed lung injury. The pulse was floating, large, and tight. I dared not treat. A crude practitioner used bian stones, resulting in bleeding, after which the patient recovered and felt lighter. What is this?" (This section discusses differential diagnosis of spleen disease. 'Bian' is pronounced biān.)

The Emperor said: "Your capabilities are extensive, but your diagnosis of this case is wrong. It is like a wild goose flying toward the sky; though it aims high, its limits are unfathomable." (Meaning: I know your skills are many, but diagnosing this as lung injury is incorrect. Like a goose flying high, its trajectory is as unpredictable as the vast sky.)

The sage treats disease by following laws, applying comparative classification, and navigating the unseen, tracing from top to bottom, without rigid adherence to fixed rules." (Following laws means adhering to ancient standards. Applying comparative classification means analyzing phenomena. Navigating the unseen means mastering change amidst uncertainty. One can trace upwards or downwards. Laws should not be abandoned nor rigidly applied; one should not be bound by appearances. This is the highest treatment of sages.)

A floating, large, and deficient pulse indicates spleen qi external severance, departing from stomach qi to return to Yangming." (The queried pulse/symptoms indicate spleen/stomach disease. Spleen is yin, interior to stomach; stomach is yang, exterior to spleen. Floating, large, deficient pulse suggests exterior excess and interior deficiency, meaning spleen qi is severed externally from stomach. Spleen qi departs to Yangming, causing this pulse. According to *Xue Qi Xing Zhi Pian*, Yangming has abundant qi and blood; puncturing Yangming releases qi and blood. Thus, the crude practitioner's use of bian stones likely drained Yangming excess.)

Two fires cannot overcome three waters, hence the chaotic and irregular pulse." ('Two fires' refer to heart and lung, above the diaphragm. 'Three waters' refer to liver, spleen, and kidney, below the diaphragm. This represents five zang imagery where yin exceeds yang, hence two fires cannot overcome three waters. Spleen is yin earth, relying on fire generation. Now spleen qi departs from stomach, severing Yangming externally, causing chaotic pulse due to lack of stomach qi in spleen.)

Flaccid limbs indicate spleen essence failing to circulate." (Spleen governs four limbs.)

Coughing indicates water qi merging with Yangming." (Spleen pathology fails to control water, causing water evil to overflow and invade stomach fu, obstructing airways, leading to cough. All zang/fu organs can cause cough.)

Hematochezia indicates urgent pulse and blood lacking proper pathways." (Meridians transport qi and blood to nourish yin/yang. Urgent pulse results from qi chaos; qi chaos leads to blood chaos, causing bleeding into stool, losing normal circulation. Blood failing to stay central relates primarily to lung.)

To consider this lung injury is madness. Failure to apply comparative classification shows unclear understanding." ('Kuang' means madness/error. Failing to apply comparative classification leads to misdiagnosing cough as lung injury due to unclear knowledge. Integrating pulse and symptoms would reveal spleen pathology, not lung, through analogy.)

Regarding 'lung injury,' it is actually spleen qi failing to maintain, stomach qi failing to clear, meridian qi failing to function, true zang pulse breaking, collateral meridians severing, and five zang leakage, manifesting as epistaxis or hematemesis. These two are dissimilar." (This clarifies lung injury signs. Lung metal injury steals mother qi, causing spleen failure. Grain enters stomach and transmits to lung; lung disease prevents grain qi transport, causing stomach turbidity. Lung regulates ying/wei and connects yin/yang; lung injury disrupts ying/wei, causing meridian dysfunction. 'True zang' refers to lung. Lung damage disrupts governance, causing meridian deviation and loss of zang stability, leading to leakage. Thus, either epistaxis or hematemesis occurs. Pathology in spleen vs. lung is fundamentally different, hence dissimilar. Note: Five zang (heart, lung, liver, spleen, kidney) are yin. This chapter focuses on three yin diseases, omitting heart and liver. Heart is monarch, inviolable; liver is general, strong wood. Hence, only spleen/kidney/liver pulses and earth/water/wood interactions are discussed initially. Excluding these, kidney stores essence, lung stores qi, spleen processes grain. Water disease affects lung; metal disease affects spleen (stealing mother qi); earth disease ruins other organs (losing transformation source). Three yin deficiencies center on these three zang. Injury to all three is rarely survivable. The Sage emphasizes this; learners must investigate deeply.)

This is like heaven having no shape and earth having no pattern, or white and black being far apart." (Heaven has images, earth has positions. Ignorance makes heaven seem shapeless and earth patternless. This illustrates that injuries to the three zang present distinct symptoms that are hard to distinguish, just as white and black are vastly different.)

This is my fault; because you know this, I did not tell you." ('Shi' means this. Meaning: Lei Gong's error stems from my failure to instruct him earlier.)

Clearly citing comparative classification and the Cong Rong method is called 'Zhen Jing' (Classic of Diagnosis), which is the supreme Dao." (This chapter clearly cites symptoms and uses comparative classification to align with Cong Rong methods, hence named 'Zhen Jing', representing the supreme Dao.)