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The disease that occurs first is the root (Ben, 本), and the disease that occurs later is the branch (Biao, 标); it is essential to clarify the relationship between root and branch. However, the distinction between contrary (Ni, 逆) and compliant (Cong, 从) treatments must not be overlooked. Contrary treatments should be prioritized, while compliant treatments may follow. If one treats what can be treated later first, and delays treating what should be treated first, the error will be significant.

Yellow Emperor asked: Diseases have root and branch distinctions, and acupuncture has contrary and compliant methods. How is this so? Qibo replied: The method of acupuncture must distinguish Yin and Yang, ensure correspondence between front and back, apply contrary and compliant principles correctly, and shift focus between root and branch appropriately. Thus, it is said: if the pathology is at the branch, seek treatment at the branch; if at the root, seek treatment at the root; if at the root but seeking treatment at the branch; or if at the branch but seeking treatment at the root. Therefore, some cures are achieved by targeting the branch, some by targeting the root, some by using contrary methods, and some by using compliant methods. (Understanding the true nature of the disease and grasping the general principles of treatment allows for the flexible use of both contrary and compliant methods, ensuring accurate application.) Thus, knowing contrary and compliant means acting rightly without doubt; knowing root and branch ensures success in every attempt. (When the Dao is free from doubt and understanding is profound, there is no need to ask others, and actions will invariably be correct.) Ignorance of root and branch is called reckless action. (Shallow understanding and superficial knowledge lead to actions that often contradict reality, resulting in frequent errors.) The principles of Yin-Yang, contrary-compliant, and root-branch appear small but are great; knowing one aspect reveals the harm of a hundred diseases. (Reaching the ultimate level. Observing the specific examples seems small, but exploring their implications reveals greatness. Thus, knowing one thing allows understanding the harm of a hundred diseases.) Few in words but abundant in meaning, shallow in expression but broad in scope; one can know a hundred things from one principle. (...Note: Broadness does not exceed the shallow and few; therefore, it is crucial to grasp the essentials.) Improper treatment is contrary; proper treatment is compliant. If Qi reversal occurs after the initial disease, treat the root; if Qi reversal precedes the disease, treat the root. If cold symptoms appear before the disease, treat the root; if cold symptoms appear after the disease, treat the root. If heat symptoms appear before the disease, treat the root; if fullness in the middle Jiao (Zhongman, 中满, chest/abdominal distension) appears after heat, treat the branch. If diarrhea occurs after the initial disease, treat the root; if other diseases arise after diarrhea, treat the root, but first regulate the diarrhea before treating other conditions. If Zhongman appears after the initial disease, treat the branch; if irritability arises after Zhongman, treat the root. There are external pathogenic factors (Keqi, 客气) and internal matching factors (Tongqi, 同气). If urination and defecation are obstructed, treat the branch; if they are unobstructed, treat the root. (Note: Although diseases have root and branch distinctions, treatment should follow the urgency of the condition. The most critical and urgent situations are Zhongman and obstruction of urination/defecation. Regardless of whether they belong to root or branch, priority is given to immediate treatment.) When a disease manifests as excess (Yu, 有余), treat the root first and the branch later; when it manifests as deficiency (Bu Zu, 不足), treat the branch first and the root later. (Note: Excess diseases are easier to treat with fewer variations, allowing progression from root to branch. Deficiency diseases are harder to treat with more variations, requiring treatment from branch to root first. Why? Because the urgency of the condition differs.) Carefully observe the severity of the condition and adjust accordingly. For mild cases, treat both root and branch simultaneously (Bing Xing, 并行); for severe cases, treat only one aspect (Du Xing, 独行). (Jian refers to mild/slow, Shen refers to severe/urgent. Duo refers to many symptoms but easy to handle; Shao refers to few symptoms but difficult to handle. Adjusting by mind means assessing the sufficiency or deficiency of root and branch, not abandoning principles for arbitrary decisions. Note: Bing Xing and Du Xing refer to treatment methods for mild and severe conditions respectively. Mild conditions with slow progression and multiple symptoms can use combined sovereign and assistant herbs for regulation, hence "simultaneous treatment." Severe conditions with dangerous symptoms and urgent progression require concise and potent prescriptions, hence "single treatment." The commentary stating that simultaneous means shared pathogenic invasion and single means invasion of one meridian is incorrect.) If obstruction of urination/defecation precedes the disease, treat the root. (Note: Reiterating obstruction of urination/defecation emphasizes its urgency, necessitating early treatment.)

Regarding disease transmission: Heart disease begins with heart pain. (Note: The Heart is a Fire organ; excessive fire causes burning pain.) After one day, coughing occurs. (Heart Fire overacts on Lung Metal, transmitting to the Lung; the Lung's movement change manifests as cough.) After three days, flank support pain occurs. (Lung Metal overacts on Liver Wood, transmitting to the Liver; since the Liver meridian traverses the flanks, pain occurs here. After five days, obstruction and blockage occur, with body pain and heaviness. (Liver Wood overacts on Spleen Earth, transmitting to the Spleen. Note: The Spleen governs movement; injured by Wood, it cannot move properly, causing these symptoms.) If not resolved within three days, death ensues, occurring at midnight in winter or noon in summer. Transmission follows the cycle of overcoming, attacking only the weak. With four injuries to the Five Zang organs, longevity is impossible; thus, death occurs at Zi-Wu hours (midnight-noon). (Note: Xin Zheng Jiao states: "'According to Ling Shu Jing: 'Grand Qi enters the Zang, disease starts in the Heart, transmits to the Lung after one day, to the Liver after three days, to the Spleen after five days. If not resolved in three days, death occurs at midnight in winter or noon in summer.' According to Jia Yi Jing: 'Disease starts in the Heart with heart pain, transmits to the Lung causing cough after one day, to the Liver causing flank pain after three days, to the Spleen causing obstruction and body pain/heaviness after five days. If not resolved in three days, death occurs at midnight in winter or noon in summer.' Detailed examination shows Su Wen discusses disease, Ling Shu discusses Zang, and Jia Yi Jing combines both, mentioning both disease and Zang.") Lung disease presents with wheezing and coughing. (Note: The Lung governs respiration and Qi; disease leads to wheezing and coughing.) After three days, flank distension and pain occur (transmission to Liver). After one day, body heaviness and pain occur (transmission to Spleen). After five days, abdominal distension occurs. (Note: Transmission to Kidney; water accumulation fails to flow, causing distension. Commentary claiming transmission to Fu organs is incorrect.) If not resolved in ten days, death ensues, occurring at sunset in winter or sunrise in summer. Liver disease presents with dizziness and vertigo of head and eyes, flank distension and fullness. (Liver meridian connects internally to eyes and flanks, causing these symptoms.) After three days, body heaviness and pain occur. (Note: Transmission to Spleen causes heaviness/pain; Spleen governs muscles. Commentary claiming transmission to Lung is incorrect.) After five days, abdominal distension occurs (self-transmission to Fu organs). After three days, lower abdomen, waist, spine, and groin pain occur, with spasms. (Stomach transmits to Kidney; its meridian starts at the foot, runs through the popliteal fossa, emerges medial to the knee, ascends posterior-medial thigh, penetrates spine, belongs to Kidney, and links to Bladder, causing these symptoms.) If not resolved in three days, death ensues, occurring at sunset in winter. (Note: Jia Yi Jing says noon.) Or early meal time in summer (Mao Zheng, exactly 5 AM). Spleen disease presents with body pain and heaviness. (Spleen governs muscles.) After one day, abdominal distension occurs. (Note: Transmission to Stomach.) After two days, lower abdomen, waist, spine pain, and calf soreness occur. (Stomach transmits to Kidney.) After three days, paraspinal muscle pain and urinary retention occur. (Note: Kidney transmits to Bladder, causing retention. KT refers to paraspinal muscles. The Bladder meridian runs 1.5 cun lateral to the spine; pathogenic invasion causes pain. The KT mentioned in Ling Shu likely refers to this. KT sounds like 'Lu'.) If not resolved in ten days, death ensues, occurring at Ren Ding (around 9 PM) in winter or Yan Shi (25 ke after Yin hour, approx. 4:15 AM) in summer. Kidney disease presents with lower abdomen, waist, spine pain, and popliteal soreness. (Zhen Qi descends to Kidney, causing this.) After three days, paraspinal muscle pain and urinary retention occur, self-transmitting to Fu organs. Note: Xin Zheng Jiao states: "'Ling Shu Jing says transmission to KT and Bladder, which is self-transmission to Fu and reaching KT.'" After three days, abdominal distension occurs, Bladder transmits to Small Intestine. Note: Water transmits to Fire Fu organ; Qi stagnation causes distension. Jia Yi Jing reads "ascends to Heart, Heart distension." After three days, bilateral flank support pain occurs. (Fu transmits to Zang. Note: Xin Zheng Jiao states: "'Ling Shu Jing says: 'Transmits to Small Intestine after three days, ascends to Heart after three days.' Now saying bilateral flank pain implies Small Intestine Fu transmitting to Heart causing pain.'") If not resolved in three days, death ensues, occurring at Da Chen (daybreak) in winter or Yan Bu (towards dusk) in summer. (Da Chen is bright dawn. Yan Bu is approaching dusk.) Stomach disease presents with abdominal distension and fullness. (Its meridian traverses the abdomen. Note: Although the meridian traverses the abdomen, the Stomach is the Sea of Water and Grain; disease impairs digestion, causing distension and fullness.) After five days, lower abdomen, waist, spine pain, and popliteal soreness occur. (Stomach transmits to Kidney.) After three days, paraspinal muscle pain and urinary retention occur. (Self-transmission to Fu and reaching KT.) After five days, body heaviness occurs. (Bladder, a Water Fu organ, transmits to Spleen. Note: Xin Zheng Jiao states: "'Ling Shu Jing and Jia Yi Jing both say ascends to Heart after five days, implying Bladder transmits to Heart, causing heaviness due to overcoming. Wang Bing's note claiming transmission to Spleen is incorrect.' Strictly speaking, body heaviness belongs to Spleen disease, but transmission to Heart also causes heaviness; this must be known.") If not resolved in six days, death ensues, occurring after midnight in winter or Ri Die (8 ke after Wu hour, approx. 1-3 PM) in summer. Bladder disease presents with urinary retention. (Because it is the Fu organ of fluids.) After five days, lower abdominal distension, waist/spine pain, and popliteal soreness occur (self-returning to Zang). After one day, abdominal distension occurs. (Kidney re-transmits to Small Intestine.) After one day, body pain occurs. (Small Intestine transmits to Spleen. Note: Xin Zheng Jiao states: "'Ling Shu Jing says ascends to Heart after one day, implying Fu transmits to Zang. Jia Yi Jing reads transmits to Spleen, consistent with Wang Bing's note.'") If not resolved in two days, death ensues, occurring at Ji Ming (1-3 AM) in winter or Xia Bu (afternoon Shen hour, 3-5 PM) in summer. Various diseases transmit in this sequence; such cases have fixed death periods and are not suitable for acupuncture. (Note: Transmission via Five Elements overcoming represents the normal pattern. Death periods may or may not align; do not rigidly adhere to them.) If the transmission skips one Zang, or reaches three or four Zang organs, acupuncture may be performed. (Transmission to three Zang organs involves Qi that the current organ cannot overcome. Transmission to four Zang organs reaches the generating parent organs. Since they cannot harm each other, and generation implies no conflict between father and son, Qi flows smoothly, making acupuncture appropriate. Note: Wang Ben stops at "skipping one Zang," while Jia Yi Jing has no stop word, which is correct; this has been deleted.)