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The skin encompasses the whole body and commands the zang-fu organs; thus it is called a "region" (Bu), indicating that it is the master of its domain. The function of the skin is to internally enclose the zang-fu organs and externally control the opening and closing of pores, with hair follicles attached to it; therefore, it serves as the gateway for various pathogenic factors to enter and exit. However, although pathogens enter via the skin, the skin does not bear responsibility for causing this entry. Although the chapter is divided into three sections, it consistently conveys only one main idea.

Yellow Emperor asked: I have heard that the skin has specific regions, meridians have their pathways, tendons have connections, and bones have measurements; the diseases they generate differ. I wish to understand how to distinguish their regions, their locations in the left/right, upper/lower, yin/yang, and the beginning and end of diseases. Qibo replied: To understand the skin regions, one should take the meridians as the guiding principle; this applies to all meridians. [Commentary: Skin is the shell of the body, encompassing all meridians. Regions refer to areas such as the spine belonging to the Du Meridian, or the abdomen traversed by the Ren and Chong Meridians.] The yang aspect of the Yangming Meridian is named Haifei. The same method applies above and below [Hand-Yangming and Foot-Yangming]. Observe the superficial collaterals visible within these regions; they are all collaterals of the Yangming Meridian. [Above refers to Hand-Yangming Large Intestine, below to Foot-Yangming Stomach. Commentary: *Ling Shu* states, "What is visible in the vessels are all collaterals." Since main vessels run deep within the flesh and are invisible, what can be seen are likely the superficial collaterals.] If the color is predominantly blue/green, there is pain; if black, bi-syndrome; if yellow/red, heat; if white, cold; if all five colors appear, there is alternating cold and heat. [Commentary: Wherever the regions of the Stomach and Large Intestine meridians extend, if such colors appear, one knows whether there is pain or cold/heat, allowing for treatment. This represents the superficial manifestation of collaterals; knowing this for Yangming allows inference for other meridians.] When collaterals are full of pathogenic factors, they invade and lodge in the main meridians. [Commentary: Collaterals lie beneath the skin. Pathogens enter from skin to collaterals; if not resolved, they move from collaterals to meridians.] Yang governs the exterior, Yin governs the interior. [Yang refers to yang collaterals, Yin to yin collaterals; this is a general statement. This applies to all meridians seen on the hands, feet, and body.] The yang aspect of the Shaoyang Meridian is named Shuchi. The same method applies above and below. [Commentary: Above, Hand-Shaoyang Sanjiao; Below, Foot-Shaoyang Gallbladder. Observe the superficial collaterals visible within these regions; they are all collaterals of the Shaoyang Meridian. When collaterals are full, they invade and lodge in the main meridians. Thus, those in the yang aspect govern inward retention, while those in the yin aspect govern outward excretion to seep into the interior; this applies to all meridians. Commentary: Yang indeed governs the exterior, but its qi constantly protects and secures the body, preventing leakage, directing inward to the Dantian. Yin indeed governs the interior, but its blood constantly nourishes the zang-fu, preventing stagnation, directing outward to the nine orifices. Exterior and interior mutually support each other, so that qi and blood naturally seep into the twelve main meridians. What is meant by governing inward/outward is essentially governing exterior/interior. This is the subtle principle of the harmonization of heaven and earth; why did the commentary omit this?] The yang aspect of the Taiyang Meridian is named Guanshu. The same method applies above and below. [Commentary: Above, Hand-Taiyang Small Intestine; Below, Foot-Taiyang Bladder.] Observe the superficial collaterals visible within these regions; they are all collaterals of the Taiyang Meridian. When collaterals are full, they invade and lodge in the main meridians. The yin aspect of the Shaoyin Meridian is named Shuru. [Commentary: *Jia Yi Jing* writes "Shuzhu".] The same method applies above and below. [Commentary: Above, Hand-Shaoyin Heart; Below, Foot-Shaoyin Kidney.] Observe the superficial collaterals visible within these regions; they are all collaterals of the Shaoyin Meridian. When collaterals are full, they invade and lodge in the main meridians. When entering the meridians, [pathogens] flow from the yang regions into the meridians; when exiting, they flow from the interior yin into the bones. [Commentary: The previous mention of internal exit refers to the subtlety of yin-yang mutual rooting; this mention of entry and exit refers to the sequence of pathogenic advance and retreat. Yang regions refer to collaterals and skin/hair; pathogens enter from yang to yin; thus, upon exit, they naturally return from yin to yang. The character "bone" here is suspected to be an error.] The yin aspect of the Heart Master (Pericardium) is named Haijian. The same method applies above and below. [Commentary: Above, Hand-Jueyin Pericardium; Below, Foot-Jueyin Liver.] Observe the superficial collaterals visible within these regions; they are all collaterals of the Heart Master. When collaterals are full, they invade and lodge in the main meridians. The yin aspect of the Taiyin Meridian is named Guanzhe. The same method applies above and below. Observe the superficial collaterals visible within these regions; they are all collaterals of the Taiyin Meridian. When collaterals are full, they invade and lodge in the main meridians. ["Region" refers to the area distributed by the respective meridian's collaterals; "superficial" means appearing on the surface. Commentary: The names of the twelve meridians are difficult to understand; forced interpretations in commentaries, and fabricated meanings by Wang Yuwei, are meaningless. It is best to retain them briefly. Concepts like yin/yang, interior/exterior, exit/entry are the essential meanings and cannot be ignored. These twelve meridian-collateral systems are the regions of the skin. Arranging yin and yang positions, the region is governed by the skin, hence called the region of the skin. Commentary: The above separately lists the order of the twelve meridians; the following summarizes the sequence of pathogens entering from outside to inside."]

Therefore, the origin of all diseases begins first in the skin and hair. When pathogens attack, the interstices (Cou Li) open; once open, pathogens enter and lodge in the collaterals. If they remain without departing, they transmit to the meridians; if they remain without departing, they transmit to the fu organs and accumulate in the intestines and stomach. [Lin means accumulation.] When pathogens initially enter the skin, chills arise, hair stands erect, and interstices open. [Suran refers to aversion to cold. Qi means erection of hair. Cou Li refers to skin pores and tissue textures.] When entering the collaterals, the collateral vessels become full and the color changes. [Full means distended; change means alteration from normal.] When lodging in the meridians, they encounter deficiency, causing sinking/depression. [Meridian deficiency allows pathogen entry, hence "encountering deficiency". Pulse deficiency and qi scarcity cause sinking.] If remaining between sinews and bones, excessive cold causes sinew spasm and bone pain; excessive heat causes sinew flaccidity and bone wasting, muscle emaciation and rupture, hair standing straight and deteriorating. [Spasm means tightness. Flaccidity means relaxation. Wasting means emaciation. *Zhen Jing* says, "Cold causes sinew tension, heat causes sinew relaxation; cold excess causes pain, heat excess causes qi depletion." Muscle is the marker of hair; thus, muscle wasting leads to rupture, and hair stands straight and deteriorates.]

The Yellow Emperor said: You spoke of the twelve regions of the skin; what diseases do they produce? Qibo said: The skin is the region of the vessels. [Commentary: Region implies command. Skin envelops the body, and vessels govern it, hence "region of the vessels."] When pathogens lodge in the skin, interstices open; once open, pathogens enter and lodge in the collaterals. When collaterals are full, they inject into the meridians; when meridians are full, they enter and reside in the zang-fu organs. Therefore, although the skin has regions, it does not directly generate serious illness. [Vessels run within the skin, having specific parts. When vessels receive pathogenic factors, disease arises accordingly; it is not generated by the qi of the skin itself. Commentary: "Regions do not participate" is ambiguous here. *Jia Yi Jing* reads "not healed"; Yuan Qi's version says "disharmony with meridians causes serious illness," both incorrect. Generally, pathogenic invasion enters via the skin to reach zang-fu. But unless the vital qi within is already deficient, how would interstices open for pathogens to enter? Although pathogens enter via the skin's regions, ultimately it is unrelated to the skin itself. The Emperor's question about what diseases the twelve skin regions produce implies suspicion that skin itself generates disease. Qibo replies that skin merely encompasses the body and serves as a gateway for pathogen entry/exit. Pathogen entry stops only at the most deficient points; external entry is summoned by the interior. What does the skin have to do with it? Carefully savoring the dialogue reveals the meaning. "Yu" is pronounced with the departing tone.]