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(To govern the world,) one uses weapons and armor to quell chaos, and rites and music to educate and govern a peaceful era; (to treat diseases,) one uses formulas such as Shi Li Mi Yu to cure human ailments. These are summaries of available treatments.

The Yellow Emperor said: When physicians treat diseases, the same disease is treated with different methods—including acupuncture, stone therapy, moxibustion, herbal medicine, Dao Yin (guiding and pulling), and An Qiao (pressing and kicking)—and all result in recovery. Why is this?

Qibo replied: This is caused by differences in geographical terrain. (Supplementary note: Refers to following the laws of heaven and earth's growth, flourishing, harvesting, and storage, as well as the trends of elevation, depression, dryness, and dampness.) Therefore, the Eastern region is where heaven and earth begin to generate things. It is a land of fish and salt, near the seashore and waters. The people there eat fish and prefer salty food. They are content with their location and enjoy their food. Eating fish tends to cause internal heat, while excessive salt consumption damages blood. (Supplementary note: Fish causing sores and internal heat are confirmed signs; salt causing thirst and damaging blood are manifest signs.) Thus, the people there have dark skin and loose tissue texture. Their diseases are mostly carbuncles and ulcers. (Supplementary note: Because blood is weak and heat is present, carbuncles and ulcers arise.) Treatment is suitable for Bian Shi (Stone Needle). (Needles made of stone.) Hence, Bian Shi therapy also originated from the East.

The Western region is an area rich in gold and jade, covered in sand and stones, where heaven and earth gather and constrain. (Supplementary note: "Gather and constrain" means drawing things inward to converge.) The people there live on hillsides where it is windy, and the soil and water are tough and strong. They do not wear silk but coarse woolen cloth, sleep on fine grass mats, and eat rich, fatty, and delicious foods. (Supplementary note: He refers to woolen cloth, Jian to fine grass, Hua to delicious foods like Su Luo.) Therefore, external pathogens cannot harm their physical bodies, and diseases arise internally. (Supplementary note: Tough soil and water, rich and fatty diet, closed pores, and abundant Qi and blood prevent external pathogens from harming them. "Internal" refers to excesses in emotions—joy, anger, worry, thought, fear—and dietary or sexual indulgences.) Treatment is suitable for Du Yao (Poisonous Drugs/Herbal Medicine). (Supplementary note: "Yao" refers to plants, insects, fish, birds, and beasts; because they can attack diseases, they are all called "poisonous".) Hence, Du Yao therapy also originated from the West.

The Northern region is where heaven and earth store and hide things. The terrain is high, people live on hills, wind and cold are biting, and ice is freezing. The people enjoy living in the wild and consume dairy products. This leads to Cold Organs and Fullness diseases. (For fullness in the middle jiao, purging from within is indicated; this is what is meant.) Treatment is suitable for Moxibustion. (Supplementary note: Due to freezing water and cold, diseases affect the cold organs; burning the skin with fire mugwort is called Moxibustion.) Hence, Moxibustion therapy also originated from the North.

The Southern region is where heaven and earth nurture and grow, and Yang Qi is abundant. The terrain is low, the soil and water are weak, and fog and dew accumulate. (Supplementary note: High groundwater makes the soil weak and causes fog and dew to gather.) The people there favor sour flavors and eat fish. (Supplementary note: refers to non-aromatic foods; another version says eating fish.) Thus, the people there have tight skin texture and reddish complexions. Their diseases are mostly spasms and Bi Syndrome (Obstruction). (Supplementary note: Sour flavor has a收敛 (astringent/converging) effect, making muscle texture dense. In places of abundant Yang, the complexion is red. Internal dampness and external heat cause spasms and Bi. I believe this is also due to the converging nature of sour flavor leading to disease.) Treatment is suitable for Jiu Zhen (Nine Needles). (Small needles.) Hence, Jiu Zhen therapy also originated from the South.

The Central region is flat and damp, where heaven and earth generate myriad things. (Supplementary note: Following the virtue of Earth, it generates many things.) The people there have diverse diets and do not engage in hard labor. (Supplementary note: Convergence from four directions and return of all things mean people eat diversely without toil.) Thus, their diseases are mostly Wei Syndrome (Flaccidity), Jue Syndrome (Reversal/Cold Extremities), and alternating cold and fever. (Supplementary note: Dampness is below, causing flaccidity. Qi rebellion and cold/fever. The Classics state: Dampness from the earth harms the skin, flesh, sinews, and vessels when contracted.) Treatment is suitable for Dao Yin (Guiding and Pulling) and An Qiao (Pressing and Kicking). (Dao Yin involves shaking sinews and bones and moving joints; An involves pressing skin and flesh; Qiao involves lifting hands and feet.) Hence, Dao Yin and An Qiao therapies also originated from the Center.

Therefore, the Sages combined these treatments, each applied according to its appropriateness. Thus, although treatment methods differ, all diseases recover because the physician understands the specific condition of the disease and grasps the general principles of treatment. (Discussion on Regional Suitability.) A skilled healer treats at the level of the hair and skin (stopping it at the initial stage); the next best treats at the level of muscles and skin (saving it after it has arisen); then treats at the level of sinews and vessels (attacking established disease); then treats at the level of the Six Fu Organs (treating severe disease); and finally treats at the level of the Five Zang Organs, where patients are half-dead and half-alive. (Supplementary note: Treating established disease yields only half recovery. Hua Shou notes: Not referring to the physician, but the patient's condition being incurable.)

When a disease first begins, it can be cured by acupuncture. (Supplementary note: When the meridians are subtle.) If the pathogenic factor is at its peak, wait for it to decline before treating. (Supplementary note: Treating at peak strength damages True Qi.) Therefore, for mild pathogens, use dispersing methods to expel them (Supplementary note: For light pathogens, disperse and remove them); for heavy pathogens, reduce them (Supplementary note: Reduce what is heavy); for declining pathogens, clarify their nature and attack them (Clarify the evil as the pathogen declines to attack it). For deficiency of form, warm with Qi-tonifying agents; for deficiency of essence, tonify with flavor-rich substances (Wen Cun refers to gentle warming; Qi Wei refers to the flavors of medicines and foods). For pathogens located high, induce vomiting to expel them; for those located low, guide them out through the lower orifices (Supplementary note: Expulsion and guidance). For fullness in the center, purge from within (Inside refers to the abdomen; Purge refers to dispersing accumulation). For pathogens causing exterior symptoms, soak the body to induce sweating; for pathogens in the skin, use diaphoresis (Both refer to sweating, but "soaking" is lighter than "releasing"). For fierce and rapid pathogens, press and restrain them (Rapid and fierce pathogens are restrained by pressing). For Excess conditions, disperse or purge them (Supplementary note: Yang Excess is dispersed, Yin Excess is purged, hence the following text). Examine Yin and Yang to distinguish soft and hard; treat Yin diseases by addressing Yang, and Yang diseases by addressing Yin (Drawing from Yin to Yang, from Yang to Yin, treating right from left, left from right, follow the same principle). Stabilize Blood and Qi, keeping them in their proper locations. For Blood Excess, lanced and drained (Break and drain); for Qi Deficiency, guide and lift it (Che reads as Dao; guiding allows Qi to flow smoothly, see *Yang Ying Xiang Da Lun*).

Qibo said: In ancient times, Tang Ye (Grain Decoctions) were prepared but not consumed. (Supplementary note: Prepared for backup but not used.) In middle antiquity, virtue declined slightly, and pathogens frequently arose; consuming Tang Ye ensured complete safety. (Supplementary note: Hearts were still close to the Dao, so consumption was safe.) In the current age, one must use Qi Du Yao (Potent Herbal Medicines) to attack internally, and Shi Zhen Ai Cao (Stone Needles and Moxa) to treat externally.

The Yellow Emperor asked: What causes medical treatment to fail when the form is ruined and blood is exhausted?

The answer is: Because Shen (Spirit/Mind) no longer responds.

What does it mean that Shen does not respond?

It means the Way of Acupuncture and Stone has failed. If Jing Shen (Spirit and Mind) does not advance and Zhi Yi (Will and Intent) is not regulated, the disease cannot be cured. (Commentary: Even if herbs ruin the form and moxa/needles exhaust the blood, if the physician's efficacy fails, it is likely because the patient's Shen Qi has declined. Although potent drugs and needles exist, they cannot be utilized or directed. Thus, "Shen does not respond." Medicine requires Zheng Qi (Upright Qi) to circulate; needles require Zheng Qi to drive them. Thus, "The Way of Needles and Stones": if Jing Shen advances and Zhi Yi is regulated, the disease can be cured; if Jing Shen scatters and Zhi Yi dissipates, even using needles and stones will not cure the disease.) Now, Essence is destroyed, Shen departs, and Ying Wei (Nutritive and Defensive Qi) cannot be recovered. Why? Because desires are endless and worries never cease, Jing Qi becomes lax and ruined, Ying Blood stagnates, and Wei Qi dissipates. Thus, Shen departs, and the disease does not heal. (Supplementary note: Jing Shen is the source of life; Ying Wei is the master of Qi. If Qi fails to support the source, and Shen does not reside internally, how can the disease heal? This shows Shen does not respond. See *Tang Ye Lao Li Lun*.)

Qibo said: In middle antiquity, when treating diseases, upon the arrival of pathogens, treatment began immediately. Tang Ye was taken for ten days to eliminate Ba Feng (Eight Winds) and Wu Bi (Five Obstructions). (Ba Feng refers to winds from eight directions: East is Infant Wind, affecting sinews and Liver; South is Great Weak Wind, affecting vessels and Heart; Southeast is Weak Wind, affecting muscles and Stomach; Southwest is Strategy Wind, affecting flesh and Spleen; West is Parting Wind, affecting skin and Lungs; Northwest is Folding Wind, affecting Hand Taiyang vessel and Small Intestine; North is Great Strong Wind, affecting bones and Kidneys; Northeast is Ominous Wind, affecting armpits/sides and Large Intestine. ○ Wu Bi refers to Bi Syndrome caused by mixing Wind, Cold, and Dampness: Bone Bi in Winter, Sinew Bi in Spring, Vessel Bi in Summer, Muscle Bi in Late Summer, Skin Bi in Autumn.) If not cured in ten days, use Cao Su (Grass Sprouts), Cao , and branches of roots and tops to assist. (Refers to medication. ○ Cao Su is decoction, is grass root, branch is stem. Herbs may use roots, shoots, branches, flowers, or fruits. If Tang Ye is insufficient, all parts are used together to aid absorption, hence "roots and tops assist.") When Ben Biao (Root and Branch) are aligned, the pathogen submits. (Disease is Root, Physician is Branch. If Root and Branch do not align, pathogen does not submit. This is called mismatched treatment. If aligned, treatment matches, and pathogen submits. New Correction states: Obtain Root and Branch, and pathogen scatters. Meaning: treating the root and branch of the disease causes pathogen to scatter. I agree with the correction.)

In late antiquity, treatment is different. Treatment does not follow the Four Seasons, ignores Sun and Moon cycles, and fails to examine Reversal and Compliance. (Supplementary note: Qi of Four Seasons resides in specific areas, e.g., Spring Qi in Meridians. Physicians should avoid pathogens based on location. Ignoring Sun/Moon means ignoring daily temperature/light changes and lunar phases, detailed in *Ba Zheng Shen Ming Lun*, included in *Ci Zhen Chao*. Examining Reversal/Compliance means judging if a disease is treatable. I consider Reversal/Compliance as following floating/sinking and opposing cold/heat/warmth/cold.) Only when disease forms are established do they use needles externally and Tang Ye internally. Crude physicians act recklessly, assuming attack is possible, so old diseases persist and new ones arise. (Supplementary note: Crude means rough; Reckless means failing to judge feasibility. See *Yi Jing Bian Qi Lun*.)

The Yellow Emperor asked: Combining human form with laws of Four Seasons and Five Elements, how is compliance achieved? How is reversal defined?

Qibo said: Five Elements are Metal, Wood, Water, Fire, Earth. They alternate in nobility and baseness (Supplementary note: Noble when timely, base when untimely). This determines life and death, success and failure, and the timing of remission and exacerbation of Five Zang Qi (Supplementary note: Remission is rest, exacerbation is prosperity), as well as the period of life and death.

Liver governs Spring, Foot Jueyin and Shaoyang dominate, days Jia and Yi. Liver suffers from Urgency (Excess Qi), urgently eat Sweet to缓和 (relax). Heart governs Summer, Hand Shaoyin and Taiyang dominate, days Bing and Ding. Heart suffers from Laxity (Heart Qi Deficiency), urgently eat Sour to收 (gather/astringe). Spleen governs Late Summer, Foot Taiyin and Yangming dominate, days Wu and Ji. Spleen suffers from Dampness, urgently eat Bitter to燥 (dry). Lung governs Autumn, Hand Taiyin and Yangming dominate, days Geng and Xin. Lung suffers from Qi Rebellion, urgently eat Bitter to泄 (drain/purge). Kidney governs Winter, Foot Shaoyin and Taiyang dominate, days Ren and Gui. Kidney suffers from Dryness, urgently eat Pungent to润 (moisten), open Cou Li (pores), produce Jin Ye (Body Fluids), and move Qi. (These nine characters are suspected to be original annotations.)

Disease in Liver: Cures in Summer, worsens in Autumn if not cured in Summer, persists in Winter if not fatal in Autumn, recovers in Spring. Avoid wind. Liver disease: Clear at dawn, severe at dusk, quiet at midnight. Liver desires dispersion, urgently eat Pungent to disperse, use Pungent to tonify, Sour to purge (Sour gathers, thus purges. Ideally Salty purges, but since Liver desires dispersion, using Sour gathering/Salty softening as tonification/purging is debated).

Disease in Heart: Cures in Late Summer, worsens in Winter if not cured in Late Summer, persists in Spring if not fatal in Winter, recovers in Summer. Avoid warm food and hot clothes. Heart disease: Clear at noon, severe at midnight, quiet at dawn. Heart desires softness, urgently eat Salty to soften (taking softness), use Salty to tonify, Sweet to purge (taking soothing effect).

Disease in Spleen: Cures in Autumn, worsens in Spring if not cured in Autumn, persists in Summer if not fatal in Spring, recovers in Late Summer. Avoid warm food, overeating, damp ground, and wet clothes (Warmth, dampness, and fullness all injure Spleen Qi). Spleen disease: Clear during day, severe at sunrise, quiet at dusk. Spleen desires relaxation, urgently eat Sweet to relax, use Bitter to purge (taking draining effect), Sweet to tonify.

Disease in Lung: Cures in Winter, worsens in Summer if not cured in Winter, persists in Late Summer if not fatal in Summer, recovers in Autumn. Avoid cold food and cold clothes. Lung disease: Clear at dusk, severe at noon, quiet at midnight. Lung desires contraction, urgently eat Sour to contract (Sour contracts, thus tonifies), Pungent to purge (Pungent disperses, thus purges).

Disease in Kidney: Cures in Spring, worsens in Late Summer (Supplementary note: Sixth month; Summer is mother of Earth, Earth grows in center, governed by Long, hence Late Summer), persists in Autumn if not fatal in Late Summer, recovers in Winter. Avoid (Supplementary note: Heat/Fever), hot food, and warm moxa clothing (Kidney dislikes dryness). Kidney disease: Clear at midnight, severe in Four Seasons (transition months), quiet at dusk. Kidney desires firmness, urgently eat Bitter to firm, use Bitter to tonify, Salty to purge (Salty softens).

When pathogens invade the body (Supplementary note: Pathogen refers to anything improper: Wind, Cold, Summer Heat, Dampness, hunger, fullness, labor, rest—not just ghosts or plagues), they interact via overcoming relationships (Commentary: e.g., Liver Wood disease is overcome by Lung Metal). Recovery occurs when reaching the element it generates (Supplementary note: Reaching what it produces); worsening occurs when reaching the element that overcomes it (Supplementary note: Reaching what overcomes it); persistence occurs when reaching the element that generates it (Supplementary note: Reaching what produces it); recovery/recurrence occurs when returning to its own prosperous position (Supplementary note: Returning to its own旺 place). One must first determine the pulses of the Five Zang (Supplementary note: Liver String-like, Heart Hook-like, Lung Floating, Kidney Deep, Spleir代-like. Classics: Know meridian pulses before disease pulses), then one can speak of remission/exacerbation times and life/death periods (See *Zang Qi Fa Shi Lun*).

Form comfortable, Mind bitter: Disease arises in vessels, treat with Moxibustion and Acupuncture (Supplementary note: Form is body, Mind is heart/mind. Form comfortable means little physical labor; Mind bitter means deep thinking. Deep thinking blocks Ying/Wei, causing Qi/Blood stagnation, hence disease in vessels. Tonifying deficiency and reducing excess is the way of Moxa/Acupuncture).

Form comfortable, Mind comfortable: Disease arises in flesh, treat with Needles and Stone (Supplementary note: Sinews/bones not labored, mind joyful, flesh texture tight, Qi channels full, Wei Qi stagnant, hence disease in flesh. Wei Qi leakage is drained by needles; abscesses broken by stone. Bian Shi is now replaced by needles).

Form bitter, Mind bitter: Disease arises in sinews, treat with Hot Compress and Dao Yin (Supplementary note: Form bitter means professional toil; overuse causes injury, hence disease in sinews. Hot Compress is medicinal heat; Dao Yin is guiding).

Form bitter, Mind bitter: Disease arises in throat/pharynx, treat with Hundred Medicines (Throat/pharynx, *Jia Yi Jing* reads "Exhaustion"; Hundred Medicines, reads "Sweet Medicines". Commentary: Internal and external labor consumes Blood and Qi; Blood injury and Qi depletion cause throat/pharynx dysfunction).

Frequent fright and fear: Meridians blocked, disease arises in numbness (Bu Ren), treat with Massage and Lao Yao (Alcohol Medicine) (Commentary: Fright injures Heart (Master of Vessels); Fear injures Kidney (Master of Blood). Heart/Kidney injury causes Blood/Vessel stagnation, meridian blockage, and numbness. Numbness means loss of sensation, leading to Bi. Massage opens blockages and guides Yin/Yang; Lao Yao is wine medicine, nourishing Zheng, dispelling evil, regulating Middle, and managing Qi/Form. See *Qi Xing Zhi Lun*).

The Yellow Emperor asked: What about diseases not arising from hair/skin but from exhaustion of Five Zang Yang Qi, with fluids filling the chest, Po (Corporeal Soul) dwelling alone, Gu Jing (Lonely Essence) inside, Qi exhausted outside, form emaciated unable to fit clothes, limbs urgent with internal movement? (Not from hair/skin means internal origin. Yin Qi internal excess, Yang Qi exhaustion, unable to enter abdomen, hence "Five Zang Yang Exhausted". Jin Ye is fluid, Chong is full, Guo is skin/body. Yin accumulates inside, Water Qi swells, attacks Lung, Lung Qi lonely. Inner is Lung Spirit, Kidney is Water Harm, Son does not save Mother, hence "Po dwells alone". Yin Essence damaged inside, Yang Qi wasted outside, San Jiao blocked, Water passages不通, water fills skin, body swollen, hence "Form cannot keep clothes with garments". All these cases show rapid pulse in limbs beating internally against Lung. Lung movement means rapid breathing/cough. Such cases indicate Water Qi blocking abdominal membrane, edema spreading on body surface. Si Ji refers to extremities, i.e., limbs.)

Qibo said: Balance using weighing scales, remove Wan Chen (Stagnant Accumulation), thereby slightly move Four Limbs, wear warm clothes (Slightly move means gently move limbs to gradually disseminate Yang Qi, thus warming. Or: Disperse exterior by moving limbs to gradually warm the surface). Mu Ci (Counter-point Pricking) at the site to restore form. Open Gui Men (Ghost Gate) (Gui Men refers to where Water Qi resides. Yang is Fire/God, Yin is Water/Ghost. Water Qi on exterior is a pestilence, hence Ghost Gate), Clean Jing Fu (Clean Mansion) (Supplementary note: Removing stagnant accumulation is cleaning impurities; either purging down or promoting urination removes stale accumulation, hence Cleaning Mansion. Clean opposes Stale). Jing (Essence) serves regularly, Wu Yang (Five Yangs) are distributed,疏涤 (purifying) Five Zang, thus Jing self-generates, Form self-prospers, Flesh and Bone protect each other, Ju Qi (Great Qi) becomes balanced. (Balancing weights means examining pulses: Floating/Shallow is Exterior, Deep is Interior. Interior is purged, Exterior is sweated, hence "Open Ghost Gate, Clean Mansion". Removing Wan Chen means removing long-standing water/stasis, like weeds unfit for the body. Moving Four Limbs gently allows Yang Qi to disseminate, hence "Wear Warm Clothes". When Main Meridians are thin, Collaterals overflow; when Collaterals overflow, Mu Ci adjusts them, restoring form without swelling, hence "Mu Ci at site to restore form". Opening Ghost Gate is opening Xuanku (Pores) to dispatch Qi. Wu Yang is Yang Qi of Five Zang. Cleaning Mansion is draining Bladder to remove Water. When pulses harmonize, Five Jing Qi serves regularly. Sweat is Kidney storage. Gradual distribution of Five Zang Yang clears external turbidity. Thus, Essence generates, Flesh prospers, Zang-Fu harmonize, Flesh/Bone Qi protects each other, Major Meridian Qi recovers. See *Jin Ye Lao Li Lun*.)

The Yellow Emperor said: In treating diseases, observe Form, Qi, Color, Luster, Pulse Prosperity/Decline, and Disease New/Old. Treat promptly. Form and Qi matching is called Treatable (Supplementary note: Qi strong/Form strong, Qi weak/Form weak is matching). Color and Luster floating is called Easily Cured (Supplementary note: Floating color/luster indicates harmonious Blood/Qi, hence easy cure). Pulse following Four Seasons is called Treatable (Supplementary note: e.g., Spring String-like). Pulse weak and slippery indicates Stomach Qi, named Easily Treated, take time appropriately (Supplementary note: Treat when appropriate time arrives for success. Follow seasonal Blood/Qi locations. I consider Spring Qi in Meridians etc. *Jia Yi Jing* reads "Treat without delay", both interpretations valid).

Form and Qi mismatching is called Difficult to Treat (Supplementary note: Strong Form/Weak Qi, Weak Form/Strong Qi are mismatches). Color dull and dry is called Difficult to Cure (Supplementary note: Dull means unclear and ugly, dry means lack of luster). Pulse solid and hard is called Increasingly Severe (Supplementary note: Solid/Hard pulse indicates Excess Pathogen, hence increasingly severe). Pulse reversing Four Seasons is Untreatable; must examine Four Difficulties (Previous four sentences constitute Four Difficulties), and clearly inform them.所谓逆四时者 (So-called Reversing Four Seasons): Spring gets Lung Pulse, Summer gets Kidney Pulse, Autumn gets Heart Pulse, Winter gets Spleen Pulse, all hanging/severe/deep/choppy, named Reversing Four Seasons (Supplementary note: Hanging/Severe means detached like a hanging object severed). No Zang Shape in Spring/Summer with Deep/Choppy Pulse (Supplementary note: Means no Zang pulse shape exists), nor Floating/Large Pulse in Autumn/Winter, named Reversing Four Seasons.

○ Wind is the chief of hundred diseases (Supplementary note: Precedes other diseases). Now Wind-Cold invading humans causes hair to stand straight, skin pores closing, generating heat (Supplementary note: Invading means lodging in form. Wind hits skin, Cold wins Cou Li, hence hair stands, Xuanku closes, heat generates). At this time, Sweating is indicated. Or Bi, Numbness, Swelling/Pain (Supplementary note: Disease arises thus. Heat in Blood/Qi causes Bi/Numbness; Cold injuring form causes Swelling/Pain). At this time, Tang Xi (Decoction Compress) and Fire Moxa/Acupuncture can remove it.

If untreated, disease enters Lung, named Lung Bi, causing cough and upward Qi (Supplementary note: Evil entering Yang causes madness, entering Yin causes Bi. Entering Lung is Bi. Lung change is cough, cough causes upward Qi). If untreated, Lung transmits to Liver, disease named Liver Bi, also named Jue, Hypochondriac Pain, Vomiting (Supplementary note: Lung Metal chops Wood, Qi enters Liver, hence transmitting to Liver. Liver governs Anger, Anger causes Qi rebellion, hence named Jue. Liver vessel from lower abdomen belongs to Liver, connects Gallbladder, spreads along hypochondrium, follows throat, hence pain and vomiting). At this time, Pressing or Ear Pricking is indicated.

If untreated, Liver transmits to Spleen, disease named Pi Feng (Spleen Wind), causing Dan (Jaundice), Abdominal Heat, Vexation, Yellow Urine (Supplementary note: Liver corresponds to Wind/Wood, overcomes Earth, Earth receives Wind, hence Spleen Wind. Spleen disease easily causes Jaundice. Spleen vessel enters abdomen, belongs to Spleen, connects Stomach, crosses diaphragm,注入 Heart, hence abdominal heat/vexation, yellow urine from excretion). At this time, Pressing, Medicines, and Baths are indicated.

If untreated, Spleen transmits to Kidney, disease named Shan Jia (Hernia/Mass), Lower Abdomen Oppressive Heat and Pain, White Discharge, also named Gu (Parasite/Distortion) (Supplementary note: Kidney vessel from inner thigh pierces spine, belongs to Kidney, connects Bladder, hence lower abdominal oppressive heat/pain, white urine. Oppressive heat binds internally, consumes fat/meat like worms eating, daily damage, hence named Gu. ○ Commentary: Yuan means oppression/stagnation. Disease not from own meridian but oppressed by others. Yuan also reads Ke (Guest), meaning lodging. Guest heat lodged in lower abdomen, lingering, transforms to white via Metal). At this time, Pressing and Medicines are indicated.

If untreated, Kidney transmits to Heart, sinews/vessels pull and spasm, disease named Chou (Convulsion/Twitching) (Supplementary note: Kidney Water insufficient, sinews dry/tense, hence pulling. Yin Qi internally weak, Yang Qi externally burning, sinews/vessels受热 jump/twitch, hence named Chou). At this time, Moxa and Medicines are indicated.

If untreated, after ten days, law dictates death (Arriving at Heart, Qi is extreme, thus death. If transmission continues, see below). Kidney transmits to Heart, Heart reverses and transmits back to Lung, causing Cold/Heat (Supplementary note: Lung injured twice, hence Cold/Heat). Law dictates death in three years (Three years should be three days. From Lung disease, transmitting through overcoming cycles to Kidney to Heart, law dictates ten [days?]).