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The five zang organs of humans naturally correspond to the four seasons. Therefore, if one's conduct does not accord with the seasonal timing, illness will occur; if treatment does not accord with the seasonal timing, it will be contrary to medical principles. Thus, it is crucial to follow the patterns of heaven and time.

Huangdi asked: "How should one combine human physiology with the laws of the four seasons and the Five Phases for treatment? How does one follow (the laws) correctly, and how does one go against them? I wish to hear about the meaning behind these gains and losses." Qibo replied: "The Five Phases are Metal, Wood, Water, Fire, and Earth. Their alternating dominance and subordination allow us to know life and death, to determine success and failure in treatment, and to establish the qi of the five zang organs, the times of remission and exacerbation, and the periods of life and death." (Note: The phase ruling the season is noble; the non-ruling phase is humble. Following the season leads to remission and recovery; opposing it leads to exacerbation and death.) Huangdi said: "I wish to hear this in detail." Qibo said: "The Liver governs Spring, and the Foot Jueyin (Liver) and Foot Shaoyang (Gallbladder) meridians are primarily responsible. (Jueyin is the Liver meridian, Shaoyang is the Gallbladder meridian; since Liver and Gallbladder are interior-exterior paired, their treatment principles are the same.) The corresponding days are Jia and Yi. (Jia and Yi belong to East Wood.) When the Liver suffers from tension/spasm, consume sweet flavors to relax it. (Sweet flavor has a mild and relaxing nature. Note: Quan Yuanqi stated, 'Liver suffering from tension means there is excess liver qi.') This is because the Liver is like a general, rich in qi and prone to anger, housing Ministerial Fire. Its symptoms and pulse indicate that upon illness, tension is inevitable, which is the norm. The method for treating the Liver is first to drain and then to tonify, which is correct.

The Heart governs Summer, and the Hand Shaoyin (Heart) and Hand Taiyang (Small Intestine) meridians are primarily responsible. (Shaoyin is the Heart meridian, Taiyang is the Small Intestine meridian; since Heart and Small Intestine are interior-exterior paired, their treatment principles are the same.) The corresponding days are Bing and Ding. (Bing and Ding belong to Fire, South Fire.) When the Heart suffers from flaccidity/looseness, consume sour flavors to astringe it. (Sour flavor has an astringent nature. Note: Quan Yuanqi stated, 'Heart suffering from looseness indicates Heart Qi deficiency.') This is because the Heart generates blood and serves as the master of the body, prone to activity and worry, making its blood easily depleted; upon illness, flaccidity and weakness appear, which is the norm. However, looseness leads to dispersion, so to tonify the Heart, one must use sour flavors to astringe.

The Spleen governs Late Summer, and the Foot Taiyin (Spleen) and Foot Yangming (Stomach) meridians are primarily responsible. (Taiyin is the Spleen meridian, Yangming is the Stomach meridian; since Spleen and Stomach are interior-exterior paired, their treatment principles are the same.) The corresponding days are Wu and Ji. (Wu and Ji belong to Earth, Central Earth.) When the Spleen suffers from dampness, consume bitter flavors to dry it. (Bitter flavor has a firm and drying nature. Note: The Spleen belongs to Earth; when Earth is deficient, it cannot control Water, leading to excessive Dampness. Excessive Dampness leads to loose stools, which further weakens the Spleen; thus, Spleen diseases often suffer from Dampness. The method to treat Dampness is to dry it with Bitter. Since Bitter enters the Heart to tonify Fire, and Fire generates Earth, the Earth becomes dry with the aid of Fire, and the Spleen removes Dampness with Bitter.)

The Lung governs Autumn, and the Hand Taiyin (Lung) and Hand Yangming (Large Intestine) meridians are primarily responsible. (Taiyin is the Lung meridian, Yangming is the Large Intestine meridian.) The corresponding days are Geng and Xin. (Geng and Xin belong to Metal, West Metal.) When the Lung suffers from rebellious Qi ascending, consume bitter flavors to drain/descend it. (Bitter flavor has a dispersing and draining nature. Note: Quan Yuanqi stated, 'This is also due to excess Qi.') This is because the Lung governs all Qi; normally, Qi flows smoothly downward, but upon illness, Qi rebels upward. The cause of rebellion is often rooted in Fire; utilizing bitter-cold herbs to drain heat turns rebellion into smooth flow.

The Kidney governs Winter, and the Foot Shaoyin (Kidney) and Foot Taiyang (Bladder) meridians are primarily responsible. (Shaoyin is the Kidney meridian, Taiyang is the Bladder meridian.) The corresponding days are Ren and Gui. (Ren and Gui belong to Water, North Water.) When the Kidney suffers from dryness, consume pungent flavors to moisten it, opening the interstices, promoting fluid distribution, and unblocking Qi. (Pungent flavor has a moistening nature. Note: Water is consumed daily and depleted daily, so the Kidney suffers from dryness. Dryness causes fluid depletion, closure of interstices, and blockage of upper and lower Qi. To open and unblock, Pungent is essential. Pungent travels to the Lung, which is the Mother of the Kidney; the descending command is controlled by the Lung. If the Mother benefits, it naturally nourishes the Child, thus opening interstices, distributing fluids, unblocking Qi, and moistening dryness.)

In Liver diseases, recovery occurs in Summer (the Son controls the Ghost/Pathogen). If not recovered in Summer, exacerbation occurs in Autumn (the Son rests, and the Ghost reigns again). If not fatal in Autumn, stability is maintained in Winter (the Ghost rests, and the Mother nourishes, so Qi holds in the home of Parents). Recovery begins in Spring (returning to its own position). Wind exposure is prohibited. (Wind Qi connects with the Liver, so avoid exposure. Note: This illustrates the example of seasonal generation and restriction.) In Liver diseases, recovery occurs on Bing-Ding days; if not recovered, exacerbation occurs on Geng-Xin days; if not fatal, stability is maintained on Ren-Gui days, and recovery begins on Jia-Yi days. (Note: This illustrates the example of daily elemental cycles.) In Liver diseases, clarity occurs at dawn (Wood reigns), exacerbation occurs in the late afternoon (Metal reigns), and quietness occurs at midnight (Water reigns). (Note: This illustrates the example of hourly elemental cycles. The generation and restriction of the Five Phases are immutable rules. Although the text for each Zang seems similar, there are actually three distinct layers: seasons, days, and hours. Otherwise, stating recovery in Summer and then again on Bing-Ding days would be redundant. Wang Bing’s and Quan Yuanqi’s original notes were confused; this has been corrected. The same applies to the other four Zangs.) The Liver desires dispersion; consume pungent flavors to disperse it. Use Pungent to tonify, and Sour to drain. (Note: This illustrates the tonification and drainage of a single Zang. Why does the Liver desire dispersion? The Liver belongs to Wood; Wood has a generating nature, liking freedom and hating stagnation. Thus, Liver stagnation causes disease. The Classic says: 'When Wood is stagnant, vent it.' To disperse Liver stagnation, nothing is better than Pungent. Since Pungent disperses stagnation, dispersing is tonifying. However, Sour flavors enter the Liver. Treating the Liver with Sour should theoretically be tonification, yet here it is called drainage. Why? When treating a Zang disease, if one does not use a flavor that harmonizes with the organ as a guide, the medicine will be rejected. Thus, to treat Liver disease, one must use Sour flavors as guides. Although Sour is astringent, it also has a draining function.)

In Heart diseases, recovery occurs in Late Summer. If not recovered, exacerbation occurs in Winter. If not fatal, stability is maintained in Spring, and recovery begins in Summer. Warm food and hot clothing are prohibited. (Heat causes Heart agitation, so these are forbidden.) In Heart diseases, recovery occurs on Wu-Ji days; if not recovered, exacerbation occurs on Ren-Gui days; if not fatal, stability is maintained on Jia-Yi days, and recovery begins on Bing-Ding days. In Heart diseases, clarity occurs at noon (Fire reigns), exacerbation occurs at midnight (Water reigns), and quietness occurs at dawn (Wood reigns). The Heart desires softness/flaccidity; consume salty flavors to soften it. Use Salty to tonify, and Sweet to drain. (Note: The Heart is a Yang Zang, governing Blood and Fire, acting through Yang. Excess Yang leads to hyperactivity, causing the Heart to desire softness. Salty is best at softening; Salty belongs to Water. Using Water to control Fire extinguishes Fire and calms the Heart, so softening is tonifying. 'Rou' (soft) implies gentleness; the Heart Fire is prone to hyperactivity and needs gentleness. To curb its rebellious upward momentum and drain it downwards, Sweet is suitable, as Sweet is mild and good at draining heat.)

In Spleen diseases, recovery occurs in Autumn. If not recovered, exacerbation occurs in Spring. If not fatal, stability is maintained in Summer, and recovery begins in Late Summer. Warm food, overeating, damp ground, and wet clothes are prohibited. (Warmth, dampness, and fullness all damage Spleen Qi, so they are forbidden.) In Spleen diseases, recovery occurs on Geng-Xin days; if not recovered, exacerbation occurs on Jia-Yi days; if not fatal, stability is maintained on Bing-Ding days, and recovery begins on Wu-Ji days. In Spleen diseases, clarity occurs during the day, exacerbation occurs at sunrise, and quietness occurs in the late afternoon. (Earth reigning brings clarity; Wood restricting causes exacerbation; Metal supporting brings quietness, reflecting the resting/reigning meanings. Note: 'Bu' refers to mid-afternoon.) The Spleen desires relaxation; consume Sweet flavors to relax it. Use Bitter to drain, and Sweet to tonify. (Note: The Spleen is connected to the Stomach, so the Stomach likes relaxation, and the Spleen also desires it. No flavor is more relaxing than Sweet. Relaxing the Spleen with Sweet returns it to its preference, tonifying it. If Sweet tonification is excessive, Bitter should be used to drain. Bitter is the opposite of Sweet; too much Sweet creates Heat, requiring Bitter-Cold to drain. Note: The Spleen naturally likes Sweet and dislikes Bitter; its drainage and tonification represent the true nature of the Spleen. The desires of the other four Zangs are not what they naturally like, but rather describe pathological states. Reading carefully clarifies this.)

In Lung diseases, recovery occurs in Winter. If not recovered, exacerbation occurs in Summer. If not fatal, stability is maintained in Late Summer, and recovery begins in Autumn. Cold food and cold clothing are prohibited. (The Lung dislikes Cold Qi. The *Ling Shu* states: 'Cold form and cold drinks injure the Lung.' Drinks injure the Lung, so food certainly does. The Lung dislikes not only Cold but also Heat.) In Lung diseases, recovery occurs on Ren-Gui days; if not recovered, exacerbation occurs on Bing-Ding days; if not fatal, stability is maintained on Wu-Ji days, and recovery begins on Geng-Xin days. In Lung diseases, clarity occurs in the late afternoon, exacerbation occurs at noon, and quietness occurs at midnight. (Metal reigning brings clarity; Water reigning brings quietness; Fire reigning causes exacerbation.) The Lung desires astringency; consume Sour flavors to astringe it. Use Sour to tonify, and Pungent to drain. (Sour astringes, hence tonification; Pungent disperses, hence drainage. Note: Pungent is specialized in dispersal, so its draining nature is inherent. Unlike the drainage of Liver and Kidney, which requires Sour or Salty as guides, Pungent drains by its very nature.)

In Kidney diseases, recovery occurs in Spring. If not recovered, exacerbation occurs in Late Summer. If not fatal, stability is maintained in Autumn, and recovery begins in Winter. Avoid charred foods, hot foods, and warm roasted clothing. (The Kidney nature dislikes dryness, so these are forbidden.) In Kidney diseases, recovery occurs on Jia-Yi days; if not recovered, exacerbation occurs on Wu-Ji days; if not fatal, stability is maintained on Geng-Xin days, and recovery begins on Ren-Gui days. In Kidney diseases, clarity occurs at midnight, exacerbation occurs during the four seasons (last 18 days of each), and quietness occurs in the late afternoon. (Water reigning brings clarity; Earth reigning causes exacerbation; Metal reigning brings quietness.) The Kidney desires firmness; consume Bitter flavors to firm it. Use Bitter to tonify, and Salty to drain. (Note: Why does the Kidney desire firmness? The Kidney belongs to Water. There is only one Water, which cannot overcome the Five Fires. Thus, Water deficiency leads to Kidney Qi flaccidity, so Kidney diseases desire firmness. Firming the Kidney with Bitter means the Kidney also considers Bitter as tonification. The meaning of Salty drainage is the same as for the Liver.)

When pathogenic Qi invades the body, it acts according to mutual overcoming (Pathogens include wind, cold, summer-heat, dampness, hunger, fullness, labor, and rest, not just ghosts or plagues). Recovery occurs when reaching the phase it generates (the phase generated by the diseased organ). Exacerbation occurs when reaching the phase that overcomes it (the phase that overcomes the diseased organ). Stability is maintained when reaching the phase that generates it (the phase generating the diseased organ). Recovery begins when reaching its own ruling position (its own dominant phase). (Note: This summarizes the periods of remission, exacerbation, life, and death for the five Zangs.) One must first determine the pulses of the five Zangs before discussing the times of remission/exacerbation and life/death. (Note: 'Jian' means slightly better; 'Shen' means severe. Remission leads to life, severity leads to death. 'Jian' sounds like 'Xian'.)

In Liver diseases, pain under both hypochondria radiates to the lower abdomen, causing irritability. The Liver Jueyin meridian rises from the foot, wraps around the genitalia, reaches the lower abdomen, pierces the diaphragm, and spreads along the hypochondria, causing pain under the hypochondria radiating to the lower abdomen. Excess Liver Qi causes anger (*Ling Shu*: "Excess Liver Qi causes anger"). Deficiency causes blurred vision and deafness, fearfulness, feeling as if being hunted. (The Liver Jueyin meridian runs from the hypochondria, up the throat, into the nasal cavity, connecting to the eye system. The Gallbladder Shaoyang meridian branch goes from behind the ear into the ear, out the front, to the outer canthus. Hence these symptoms. Fear implies unsettled Hun. Note: 'KT' sounds like 'Huang'.) Treat by selecting the Jueyin and Shaoyang meridians. (Meridians, not collaterals, are selected.) Rebellious Qi causes headache, deafness, poor hearing, and cheek swelling. (Liver Jueyin rises from the eye system to the forehead, meeting the Du vessel at the vertex, causing headache. Gallbladder Shaoyang branches exit the ear and pass through the cheekbone. Liver Jueyin branches descend from the eye system to the inner cheek. Hence deafness, poor hearing, and cheek swelling. Thus, the Shaoyang is included above.) Select vessels for bleeding. (Fullness of blood in vessels differs from normal, indicating rebellious Qi. Prick where blood accumulates on either side. Note: The following five paragraphs discuss different deficiency/excess patterns of the five Zangs, treated by meridian. Liver excess causes anger due to strong Qi; deficiency causes fear due to weak Qi. Feeling hunted describes extreme fear. Liver is Zang, Gallbladder is Fu; treating both is necessary because treating the Zang alone may fail, while treating both cures. The note claiming Jueyin treats Liver Qi and Shaoyang treats rebellious Qi is erroneous. Rebellious Qi here refers to Ministerial Fire in the Liver rising, causing upper symptoms. Deafness is total loss of hearing; poor hearing is hearing but unclear. Bleeding refers to acupuncture/pricking. If 'selecting meridians' was mentioned earlier, it includes herbal and acupuncture treatments.)

In Heart diseases, pain in the chest, distension/fullness in the hypochondria, pain under the hypochondria, pain in the precordium, back, and scapula, and pain in the inner arms. (Heart Shaoyin branch runs from the chest out to the hypochondria. Hand Jueyin Pericardium meridian starts in the chest, branch runs from chest to hypochondria, down axilla, along arm between Taiyin and Shaoyin, into elbow, down forearm between tendons. Heart Shaoyin main line goes from Heart connection up Lung, out axilla, down posterior arm, to wrist bone. Small Intestine Taiyang meridian goes from arm, around scapula, crosses shoulders. Hence these symptoms.) Deficiency causes large chest/abdomen,牵引 (pulling) pain between hypochondria and waist. (Pericardium Jueyin goes from chest to Pericardium, down diaphragm, connecting Sanjiao. Branch runs chest to hypochondria. Heart Shaoyin goes from Heart connection down diaphragm to Small Intestine. Hence these symptoms.) Select Shaoyin, Taiyang meridians, and blood under the tongue. (Shaoyin runs up throat beside Heart connection. Hence select base of tongue and meridian blood.) For altered conditions, prick Xi-Cleft point blood. (Note: Altered condition means different from initial onset; note's 'vomiting alteration' is wrong. Hand Shaoyin Xi-Cleft is in palm pulse, half cun from wrist, behind little finger.)

In Spleen diseases, heavy body, frequent hunger, muscle flaccidity, inability to hold/walk with feet, spasms, and sole pain. (Spleen resembles Earth and governs flesh, hence heavy body and flaccid muscles. Flaccidity means weakness. Spleen Taiyin starts at big toe, runs medial leg, up medial malleolus, up thigh. Kidney Shaoyin starts at little toe, crosses sole, up thigh, exits medial thigh. Hence inability to walk, spasms, sole pain. Note: Wang's text says 'good muscle', *Jia Yi Jing* says 'frequent hunger'; follow *Jia Yi Jing*.) Deficiency causes abdominal fullness, borborygmus, undigested stool diarrhea. (Spleen Taiyin enters abdomen, connects Spleen, links Stomach. Hence symptoms. *Ling Shu*: "Deficient Middle Qi causes abdominal fullness and borborygmus.") Select Taiyin, Yangming, and Shaoyin blood. (Shaoyin is Kidney meridian. Selected due to spasms and sole pain previously mentioned. Note: Note attributes spasms/sole pain to Kidney, hence including Shaoyin is correct. But inability to walk is also Kidney-related, why omitted? Also, Spleen disease with phlegm-damp heaviness or Fire excess hunger is clearly Excess. Symptoms like flaccidity, walking difficulty, and pain seem Deficient, but are caused by Fire consuming flesh, Damp-Turbidity sinking, or Fire-drying tendons causing spasms. These appear Deficient but are Excess. Why involve Kidney? Earth excess attacks Water, so Spleen disease transmits to Kidney.)

In Lung diseases, wheezing, coughing, rebellious Qi, shoulder/back pain, sweating, and pain in sacrum, genitals, thighs, knees, hips, popliteal fossa, calves, and feet. (Lung stores Qi and governs breathing; changes manifest as cough. Hence wheezing/cough. Lung nourishes skin/hair; excess pathogen causes Heart fluid to leak as sweat. Kidney Shaoyin runs up thigh, spine, connects Kidney/Bladder. Lung disease affects Kidney meridian, causing pain in sacrum to feet, hence selecting Shaoyin below. Note: Shoulder/back pain is due to rebellious Qi from wheezing/cough.) Deficiency causes shortness of breath, inability to complete inhalation, deafness, and dry throat. (Qi deficiency prevents full inhalation. Lung Taiyin collateral meets ear, causing deafness. Kidney Shaoyin goes from Kidney through Liver/Diaphragm to Lung, up throat. Lung deficiency fails to moisten throat via Kidney Qi, causing dryness.) Select Taiyin, lateral Taiyang, and medial Jueyin blood. (Refers to medial ankle posterior straight up, which is Shaoyin. Note: Why involve Kidney in Lung disease? Lung is Mother, Kidney is Child; Mother disease affects Child.)

In Kidney diseases, abdominal swelling, calf edema, wheezing/cough, heavy body, night sweats, and aversion to wind. (Kidney Shaoyin starts at foot, goes up thigh, through pubic bone, along abdomen to Lung. Hence abdominal/calf swelling and wheezing. Kidney disease affects bones, causing heaviness. Kidney pathogen attacks Lung, weakening Heart Qi; Heart fluid becomes sweat. Edema and sweating condense Yin pores, while Yang scorches Upper Jiao, causing internal heat/external cold, hence aversion to wind.) Deficiency causes chest pain, lower abdominal pain, cold extremities, and unhappiness. (Kidney Shaoyin connects Heart, entering chest. Kidney deficiency leaves Heart unchecked; Heart Qi steams Lung, causing chest pain. Taiyang meridian goes down to feet. Kidney deficiency prevents Taiyang Qi from reaching feet, causing cold feet and rebellious Qi. 'Qing' is cold Qi, 'Jue' is rebellious Qi; cold/rebellious Qi causes abdominal pain. Insufficient Zhi causes restless Shen, hence unhappiness.) Select Shaoyin and Taiyang blood.

Liver color is Green;适宜 (suitable) to eat Sweet. Rice, beef, dates, okra are Sweet. (Liver likes tension, so Sweet provides relaxation.) Heart color is Red;适宜 to eat Sour. Mung beans, dog meat, plums, leeks are Sour. (Heart likes looseness, so Sour provides astringency.) Lung color is White;适宜 to eat Bitter. Wheat, mutton, apricots, wild onions are Bitter. (Lung is prone to rebellious Qi, so Bitter provides drainage.) Spleen color is Yellow;适宜 to eat Salty. Soybeans, pork, chestnuts, soybean leaves are Salty. (These适宜 flavors regulate mechanisms. Kidney is the gate of Stomach; Spleen/Stomach are paired. Salty softens the gate, allowing Stomach Qi to move, which allows Spleen transformation. Thus, Spleen's适宜 flavor differs.) Kidney color is Black;适宜 to eat Pungent. Millet, chicken, peaches, green onions are Pungent. (Kidney likes dryness, so Pungent provides moisture.) These five,