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(The content in *Suwen: Treatise on the Transmission of Diseases according to Root and Branch* and *Lingshu: Chapter on Disease* that is identical to this chapter is not repeated.)

The principles of Yin and Yang, Reversal and Compliance, Root (Ben) and Branch (Biao) are seemingly small yet great; stating one allows knowing the harm of a hundred diseases. They are few yet contain much, shallow yet extensive; by understanding one, one can comprehend many. ("One" refers to the Root, "Hundred" refers to the Branches.) Through the shallow, one understands the deep; observing the near, one knows the far. Discussing Branch and Root seems easy, but truly grasping it is difficult. (These principles of Root, Branch, Reversal, Compliance, and Yin-Yang seem shallow and close to common sense. Although speaking of them is easy, in reality, few can attain them.) Treatment that is inappropriate constitutes Reversal (Ni); treatment that is appropriate constitutes Compliance (Cong). (This explains the meaning of Reversal and Compliance in treatment. "Appropriate" means harmonious, i.e., compliant.) If disease arises first and then Qi reversal occurs, treat the Root. If Qi reversal occurs first and then disease arises, treat the Root. If coldness arises first and then disease develops, treat the Root. If disease arises first and then coldness manifests, treat the Root. If heat arises first and then disease develops, treat the Root. (Some diseases cause Qi and Blood reversal due to illness; some reversals lead to secondary diseases; some illnesses arise from Cold or Heat; some Cold or Heat symptoms arise from illness. By treating the original Root that caused the condition, the subsequently arising Branch diseases can heal without specific treatment.) If heat arises first and then abdominal fullness develops, treat the Branch. If disease arises first and then diarrhea develops, treat the Root. If diarrhea arises first and then other diseases develop, treat the Root; one must regulate the diarrhea before treating other diseases. If disease arises first and then abdominal fullness develops, treat the Branch. If abdominal fullness arises first and then vexation of the heart develops, treat the Root. (For all diseases, the Root is treated first, except for abdominal fullness, where the Branch is treated first. This is because abdominal fullness involves pathogenic factors in the Stomach. The Stomach is the root of the Zang-Fu organs. When the Stomach is full, the Qi of medicine and food cannot circulate, and the Zang-Fu lose their nourishment. Thus, treating this first is also a way of treating the Root.) Humans have External Qi (Ke Qi) and Same Qi (Tong Qi). (External Qi refers to the circulating influencing Qi, which comes and goes irregularly, hence called External Qi. Same Qi refers to the dominant Qi of the four seasons, which remains consistent year after year, hence called Same Qi. If Qi is disharmonious, both External Qi and Same Qi can cause disease.) If urination and defecation are obstructed, treat the Branch. If urination and defecation are free, treat the Root. (Regardless of whether the disease is caused by External Qi or Same Qi, or if other diseases existed prior to the obstruction of urination and defecation, the Branch must be treated first. While other conditions are treated by addressing the Root, this exception addresses the Branch, because obstruction of the two excretions is a critical emergency. Although it is a Branch condition, it must be treated first; this is what is meant by "treating the Branch in emergencies." For all other diseases where urination and defecation are free, treating the Root is undoubtedly correct. My commentary: In this chapter regarding Root and Branch, nine-tenths involve treating the Root, while only abdominal fullness and obstruction of urination/defecation involve treating the Branch. These two cases are merely addressed first due to urgency. As stated in *Yinyang Yingxiang Dalun*: "In treating disease, one must seek the Root." Observing the word "must," even for abdominal fullness and obstruction of urination/defecation, there is a distinction between urgent and non-urgent situations determining the sequence. This reveals the profound principle of treating Root and Branch. Alas, contemporary physicians often fail to understand the principles of seeking Root and Branch, and distinguishing between slowness and urgency. Consequently, they treat the Branch nine times out of ten and the Root only two or three times out of ten. Moreover, they frequently cite "treat the Branch in emergencies, treat the Root in non-emergencies" without discerning what is truly slow or most urgent, leading to confusion and errors that harm patients. This stems from a failure to comprehend the true meaning of Root and Branch in this chapter.) When a disease manifests with Excess (Youyu), address the Root first and the Branch later; treat the Root first, then the Branch. When a disease manifests with Deficiency (Buzu), address the Branch first and the Root later; treat the Branch first, then the Root. (This discusses Root and Branch based on the strength of pathogenic Qi. If the manifesting Qi is Excess, it will likely overact upon other Zang-Fu or Qi, transmitting from Root to Branch; thus, the Root must be treated first. If the manifesting Qi is Deficient, it will likely be overacted upon by other Zang-Fu or Qi, transmitting from Branch to Root; thus, the Branch must be treated first. This is essentially treating the source of generation.) Carefully observe the severity and mildness of the condition to adjust treatment accordingly. For mild conditions, treat Root and Branch simultaneously (Bingxing); for severe conditions, treat singly (Duxing). ("Mild" refers to superficial/shallow disease; "Severe" refers to heavy/deep disease. Superficial disease can be treated comprehensively, hence "simultaneous treatment." Severe disease cannot tolerate complex/mixed interventions, hence "single treatment." Lack of precision in treatment is a major taboo; therefore, careful adjustment is required. Another interpretation: In mild cases, Pathogenic Qi and Healthy Qi interact and exchange, hence "simultaneous treatment." In severe cases, Pathogenic Qi dominates and runs rampant, hence "single treatment." This interpretation is also logically sound. "Jian" is pronounced with the departing tone.) If obstruction of urination and defecation arises first and then other diseases develop, treat the Root. (Obstruction of urination and defecation are both acute syndromes; thus, regardless of Root or Branch, they should be treated first. This sentence likely belongs after the preceding "obstruction of urination and defecation" clause and was misplaced due to bamboo slip error in ancient texts. My commentary: Treating the two excretions, treating urination is particularly difficult. Understanding that proper Qi transformation enables urination, one realizes that for dryness of blood in the Large Intestine, one should not use Mirabilite (Natrii Sulfas) or Rhubarb (Rhei Radix et Rhizoma) for purging, and for closure of Qi in the Bladder, one certainly should not use formulas like Wuling San.)