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Difficulty 62 states: The Jing-Well and Ying-Spring acupoints of the Zang organs are only five in number, whereas the Fu organs have six. What is the reason for this? The answer is: The Fu organs belong to Yang. The San Jiao (Triple Burner) Qi circulates through all the Yang meridians; therefore, an additional Yuan-Source point is established, named "Yuan" (Source). The reason why the Fu organs have six points is that they share one Qi with the San Jiao. To "share one Qi" means that the Qi also circulates through the Yang meridians, not that all organ Qi originates solely from the San Jiao.

Difficulty 63 states: The *Shi Bian* (Ten Transformations) mentions that the Ying-Spring and He-Sea points of the Five Zang and Six Fu organs all begin with the Jing-Well point. Why is this? The answer is: The Jing-Well point corresponds to the East and Spring, the time when all things begin to grow. All creatures that walk, breathe, fly, or crawl, as well as all living things that come into existence, are born in accordance with Spring. Therefore, the year begins with Spring, and the days begin with Jia (the first Heavenly Stem); thus, treatment begins with the Jing-Well point.

The *Ling Shu · Ben Shu* chapter states: The Jing-Well points of the Zang organs belong to Wood, while those of the Fu organs belong to Metal. Here it says the Jing-Well points of both Zang and Fu belong to Wood, which may indicate that Yue Ren (Bian Que) had a different source. Differences between the *Nan Jing* and the *Nei Jing* are noted after each difficulty for future verification.

Difficulty 64 states: The *Shi Bian* further states: Yin Jing-Well points belong to Wood, Yang Jing-Well points to Metal; Yin Ying-Spring points to Fire, Yang Ying-Spring points to Water; Yin Shu-Stream points to Earth, Yang Shu-Stream points to Wood; Yin Jing-River points to Metal, Yang Jing-River points to Fire; Yin He-Sea points to Water, Yang He-Sea points to Earth. The Yin and Yang attributes differ completely. What is the meaning? The answer is: This concerns the relationship of Gang (Firm/Yang) and Rou (Soft/Yin). The Yin Jing-Well point is Yi Wood, and the Yang Jing-Well point is Geng Metal. Geng (Yang Metal) is the Gang aspect of Yi (Yin Wood), and Yi is the Rou aspect of Geng. Since Yi belongs to Wood, it is said that the Yin Jing-Well point is Wood; since Geng belongs to Metal, it is said that the Yang Jing-Well point is Metal. The rest follow this pattern. The latter part discusses the principles of Yin-Yang pairing with great precision.

Difficulty 65 states: The classic says, "What emerges is the Jing-Well, what enters is the He-Sea." How does this method work? The answer is: What emerges is the Jing-Well. The Jing-Well corresponds to the East and Spring, the beginning of all growth, hence "what emerges is the Jing-Well." What enters is the He-Sea. The He-Sea corresponds to the North and Winter, when Yang Qi enters and stores, hence "what enters is the He-Sea."

Difficulty 66 states: The classic says the Yuan-Source point of the Lung emerges at Taiyuan (LU 9); the Yuan-Source point of the Heart emerges at Daling (PC 7); the Yuan-Source point of the Liver emerges at Taichong (LR 3); the Yuan-Source point of the Spleen emerges at Taibai (SP 3); the Yuan-Source point of the Kidney emerges at Taixi (KI 3); the Yuan-Source point of the Shaoyin emerges at Duigu (Shenmen, HT 7); the Yuan-Source point of the Gallbladder emerges at Qiuxu (GB 40); the Yuan-Source point of the Stomach emerges at Chongyang (ST 42); the Yuan-Source point of the San Jiao emerges at Yangchi (TE 4); the Yuan-Source point of the Bladder emerges at Jinggu (BL 64); the Yuan-Source point of the Large Intestine emerges at Hegu (LI 4); the Yuan-Source point of the Small Intestine emerges at Wangu (SI 4). Why do all twelve meridians use the Shu-Stream point as the Yuan-Source point? The answer is: The Shu-Stream points of the Five Zang organs are where the Qi of the San Jiao travels and where the True Qi stays and stops. Why is the Shu-Stream point where the San Jiao travels considered the Yuan-Source? The answer is: The moving Qi between the kidneys below the navel is the root of human life and the foundation of the twelve meridians, hence it is called "Yuan" (Source). The San Jiao is the special envoy of the Yuan Qi, primarily responsible for circulating the Qi of the Upper, Middle, and Lower Burners through the Five Zang and Six Fu organs. Yuan is the honorific title of the San Jiao; therefore, wherever the Qi stops, it is called Yuan. When any of the Five Zang or Six Fu organs are diseased, their Yuan points should be selected.

The *Ling Shu · Ben Shu* chapter states: The Heart point emerges at Zhongchong, which is the Jing-Well point belonging to Wood, etc. This treats the acupoints of the Hand-Jueyin Pericardium meridian as the exit and entry points of the Heart. Because the Heart is the master of the body and the residence of the Spirit, its organ is solid and cannot be invaded by pathogens; thus, pathogenic factors affecting the Heart actually affect the Pericardium. Therefore, Daling is taken as the Yuan-Source point of the Heart. However, the *Jia Yi Jing* states that Shaochong is the Jing-Well point of the Heart, treating the Heart meridian itself as having its own Jing, Ying, Shu, Jing, and He points. This description does not exist in either of the two meridians. Taking Duigu as the Yuan-Source point of Shaoyin might be based on the *Jia Yi Jing*.

Difficulty 67 states: The Mu-Acupuncture points of the Five Zang organs are all on the Yin side (anterior trunk), while the Shu-Back points are all on the Yang side (back). What does this mean? The answer is: Yin diseases manifest on the Yang side, and Yang diseases manifest on the Yin side. Therefore, the Mu points are located on the Yin side, and the Shu points on the Yang side.

Difficulty 68 states: The Five Zang and Six Fu organs all have Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points. What do they govern? The answer is: The classic states: what emerges is the Jing-Well, what flows is the Ying-Spring, what pours is the Shu-Stream, what moves is the Jing-River, and what enters is the He-Sea. The Jing-Well governs fullness in the heart region; the Ying-Spring governs fever; the Shu-Stream governs heaviness of the body and pain in the joints; the Jing-River governs coughing, wheezing, chills, and fever; the He-Sea governs rebellious Qi and diarrhea. These are the diseases governed by the Jing-Well, Ying-Spring, Shu-Stream, Jing-River, and He-Sea points of the Five Zang and Six Fu organs.

Difficulty 69 states: The classic states: tonify deficiency, sedate excess, and if neither deficient nor excess, treat according to the meridian. What does this mean? The answer is: Tonify the Mother in cases of deficiency, sedate the Child in cases of excess. One should tonify first, then sedate. "Neither deficient nor excess, treat according to the meridian" means the primary meridian is diseased itself without interference from external pathogens; thus, one should select points from that specific meridian directly, hence "treat according to the meridian."

The tonification and sedation methods in the *Nei Jing* vary: some take points from the same meridian, others from different meridians; some sedate first then tonify, others tonify first then sedate; some use one meridian, others three or four. The methods are not uniform. If one were to rigidly apply "tonify the Mother and sedate the Child" as a fixed rule, it would not necessarily be correct.

Difficulty 70 states: In spring and summer, puncture shallowly; in autumn and winter, puncture deeply. What is the reason? The answer is: In spring and summer, Yang Qi is above, and human Qi is also above, so one should puncture shallowly. In autumn and winter, Yin Qi is below, and human Qi is also below, so one should puncture deeply. What does "spring and summer each achieve one Yin, autumn and winter each achieve one Yang" mean? The answer is: Spring and summer are warm; to achieve one Yin, upon initial insertion, penetrate deeply to the level of the Liver and Kidney (deep layers), obtain Deqi, and hold/pull to draw in Yin Qi. Autumn and winter are cold; to achieve one Yang, upon initial insertion, place the needle superficially to the level of the Heart and Lungs (superficial layers), obtain Deqi, and push forward to bring out Yang Qi. This is called achieving one Yin in spring and summer, and one Yang in autumn and winter.

Difficulty 71 states: The classic states: when puncturing the Ying (Blood) aspect, do not injure the Wei (Defensive) aspect; when puncturing the Wei aspect, do not injure the Ying aspect. What does this mean? The answer is: To puncture the Yang aspect (Wei), insert the needle horizontally (obliquely); to puncture the Yin aspect (Ying), use the left hand to press and massage the Ying-Stream or Shu-Stream point being needled until the Qi disperses, then insert the needle. This is called puncturing Ying without injuring Wei, and puncturing Wei without injuring Ying.

Horizontal insertion refers to the Floating Needling method in the *Ling Shu · Guan Zhen* chapter. Pressing and massaging to disperse Qi refers to methods like palpating and rubbing described in the *Su Wen · Li He Zhen Xie Lun*. These serve as simple and appropriate methods for puncturing Yin and Yang.

Difficulty 72 states: The classic states: if one knows the Qi of Ying (meeting/opposing) and Sui (following), one can regulate it. The method of regulating Qi must lie in Yin and Yang. What does this mean? The answer is: "Ying and Sui" refers to knowing the circulation of Ying and Wei Qi and the flow of Qi and Blood in the meridians. By taking points against or with the direction of flow, it is called Ying and Sui. "The method of regulating Qi must lie in Yin and Yang" means understanding the interior/exterior and surface/depth relationships, and regulating according to Yin and Yang, hence "the method of regulating Qi must lie in Yin and Yang."

Difficulty 73 states: All Jing-Well points have thin muscle and little Qi, insufficient for treatment. How should they be punctured? The answer is: All Jing-Well points belong to Wood; Ying-Spring points belong to Fire. Fire is the Child of Wood. When one wishes to puncture the Jing-Well point, one should sedate using the Ying-Spring point. Thus, the classic states that tonification cannot be used as sedation, and sedation cannot be used as tonification. This is what is meant.

While Difficulty 69 distinguishes Mother and Child between different meridians, this difficulty uses the Mother-Child relationship within a single meridian. The meanings differ, but the logic is extremely refined.

Difficulty 74 states: The classic states: in Spring puncture Jing-Well, in Summer puncture Ying-Spring, in Late Summer puncture Shu-Stream, in Autumn puncture Jing-River, in Winter puncture He-Sea. What is the reason? The answer is: Puncturing Jing-Well in Spring because the pathogen is in the Liver; puncturing Ying-Spring in Summer because the pathogen is in the Heart; puncturing Shu-Stream in Late Summer because the pathogen is in the Spleen; puncturing Jing-River in Autumn because the pathogen is in the Lung; puncturing He-Sea in Winter because the pathogen is in the Kidney. Why are the Liver, Heart, Spleen, Lung, and Kidney associated with Spring, Summer, Autumn, and Winter? The answer is: When one of the Five Zang organs is diseased, there are usually five manifestations. For example, Liver disease: green complexion indicates Liver; fishy odor indicates Liver; preference for sour taste indicates Liver; desire to shout indicates Liver; desire to weep indicates Liver. The symptoms are numerous and cannot be fully listed. The four seasons have their numbers and are all associated with Spring, Summer, Autumn, and Winter. The subtlety of acupuncture lies in details as fine as autumn down.

Difficulty 75 states: The classic states: East is Excess, West is Deficiency; sedate South, tonify North. What does this mean? The answer is: Metal, Wood, Water, Fire, and Earth should balance each other. The East belongs to Wood, the West to Metal. If Wood becomes excessive, Metal should restrain it; if Fire becomes excessive, Water should restrain it; if Earth becomes excessive, Wood should restrain it; if Metal becomes excessive, Fire should restrain it; if Water becomes excessive, Earth should restrain it. The East corresponds to the Liver, indicating Liver Excess; the West corresponds to the Lung, indicating Lung Deficiency. Sedate the Southern Fire, tonify the Northern Water. The South belongs to Fire, which is the Child of Wood; the North belongs to Water, which is the Mother of Wood. Water overcomes Fire. The Child can make the Mother Excess, and the Mother can make the Child Deficient. Therefore, by sedating Fire and tonifying Water, the intention is to allow Metal to balance Wood. The classic says: "If you cannot treat the deficiency, what else is there to ask?" This is what is meant.

Difficulty 69 states: Deficiency is treated by tonifying the Mother, Excess by sedating the Child. Here, Excess is treated by sedating the Child and tonifying the Mother, while Deficiency is treated by tonifying the Child. The reason is unclear.

Difficulty 76 states: What are tonification and sedation? When tonifying, from where is Qi obtained? When sedating, where is Qi placed? The answer is: When tonifying, obtain Qi from the Wei (Defensive) layer; when sedating, place Qi in the Ying (Nutritive) layer. If Yang Qi is deficient and Yin Qi is excessive, one should first tonify Yang, then sedate Yin. If Yin Qi is deficient and Yang Qi is excessive, one should first tonify Yin, then sedate Yang. The free circulation of Ying and Wei Qi is the key.

Difficulty 77 states: The classic states: superior physicians treat disease before it arises (Zhi Wei Bing), while average physicians treat disease after it has arisen. What does this mean? The answer is: Treating disease before it arises means seeing Liver disease and knowing that the Liver will transmit to the Spleen; therefore, one first strengthens the Spleen Qi to prevent it from receiving the Liver pathogen. This is called treating disease before it arises. Average physicians see Liver disease, do not understand the transmission, and focus solely on treating the Liver; this is called treating disease after it has arisen.

The section on "Superior Physicians Treat Disease Before It Arises" in the first chapter of the *Jin Gui Yao Lue* aligns perfectly with this, yet it is not found in the *Ling Shu* or *Su Wen*. It is likely that Zhang Zhongjing cited Yue Ren's words, and Yue Ren himself had another source.

Difficulty 78 states: Acupuncture has tonification and sedation. What does this mean? The answer is: The method of tonification and sedation does not necessarily depend on respiration and needle withdrawal/insertion. A skilled acupuncturist relies on the left hand; an unskilled one relies on the right hand. At the time of needling, first use the left hand to press, massage, tap, and nail the Ying-Stream or Shu-Stream point. When the Qi arrives, resembling a pulsating artery, insert the needle along this sensation. Obtaining Deqi, pushing the needle inward is tonification; withdrawing and shaking the needle outward is sedation. If Deqi is not obtained, differentiate by gender (men: exterior/superficial manipulation; women: interior/deep manipulation). If Deqi is still not obtained, it indicates ten deaths and untreatable conditions.

Respiration-based insertion and withdrawal as tonification/sedation methods refer to the *Su Wen · Li He Zhen Xue Lun*. Yue Ren believed that tonification and sedation methods extend beyond this, hence elaborating on the reliance on the left versus right hand.

Difficulty 79 states: The classic states: Ying (opposing) and seizing it, how can it not become deficient? Sui (following) and assisting it, how can it not become excess? Deficiency and Excess seem like gaining and losing; Excess and Deficiency seem like existing and not existing. What does this mean? The answer is: Ying and seizing refers to sedating the Child point; Sui and assisting refers to tonifying the Mother point. For example, in Heart disease, sedating the Shu-Stream point of the Hand-Jueyin Pericardium is Ying and seizing; tonifying the Jing-Well point of the Hand-Jueyin Pericardium is Sui and assisting. Regarding Excess and Deficiency, it refers to the sensation of firmness vs. softness. A firm and solid Qi sensation indicates successful Deqi (gaining); a soft and weak sensation indicates failure (losing). Hence, "seeming to gain and seeming to lose."

The *Nei Jing* acupuncture methods observe respiration and needle direction for tonification and sedation, using the orientation of a single point as Ying and Sui. Here, points upstream in the same meridian are used for Ying (sedation), and points downstream for Sui (tonification), using adjacent points as Ying and Sui. The principle is similar, but the method differs.

Difficulty 80 states: The classic states: "See as entering, see as exiting." What does this mean? The answer is: "See as entering" means that when the left hand feels the Qi arriving, the needle is inserted. After insertion, when the Qi sensation dissipates, the needle is removed. This is called "see as entering" and "see as exiting."

In this section, the character "Ru" (as/if) is read as "Er" (and/then), making the meaning clear.

Difficulty 81 states: The classic states: Do not make Excess more Excess or Deficiency more Deficient; do not damage what is insufficient and add to what is already in excess. Does this refer to the Cun Kou pulse? Or does the disease itself have Excess and Deficiency? How should the tonification and sedation be applied? The answer is: This refers to the disease, not the Cun Kou pulse. It means the disease itself has Excess and Deficiency. For example, Liver Excess and Lung Deficiency: Liver is Wood, Lung is Metal. Metal and Wood should balance each other; one should know to use Metal to balance Wood. If the Lung is Excess and the Liver is slightly Deficient with shortness of breath, and the needle practitioner fails to tonify the Liver but instead reinforces the Lung Excess, this is called "making Excess more Excess and Deficiency more Deficient," damaging the insufficient and adding to the excessive. This is the harm caused by average physicians.