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The Five Zang organs each have their associated Fu organs, and the six Fu organs possess twelve Yuan-source points. These twelve Yuan-source points originate from the "Four Passes" (Si Guan), which refer to the areas around the elbows and knees. The Four Passes govern diseases of the five Zang organs; when disease occurs in the five Zang organs, one should select these twelve Yuan-source points for treatment. The twelve Yuan-source points are where the five Zang organs receive the Qi and essence from the three hundred and sixty-five joints of the body. When disease arises in the five Zang organs, it manifests at the twelve Yuan-source points, and each point has its specific origin. By understanding the locations of the Yuan-source points and observing their responses, one can ascertain the pathology of the five Zang organs.

The Shaoyin organ within Yang is the Lung (Fei), whose Yuan-source point originates from Taiyuan (LU-9) bilaterally. The Taiyang organ within Yang is the Heart (Xin), whose Yuan-source point originates from Daling (PC-7) bilaterally. The Shaoyang organ within Yin is the Liver (Gan), whose Yuan-source point originates from Taichong (LR-3) bilaterally. The Taiyin organ within Yin is the Kidney (Shen), whose Yuan-source point originates from Taixi (KI-3) bilaterally. The Zhinyin organ within Yin is the Spleen (Pi), whose Yuan-source point originates from Taibai (SP-3) bilaterally. The Yuan-source point of the Gao (fat/marrow) originates from Jiwei (CV-15). The Yuan-source point of the Huang (diaphragm/epigastrium) originates from Boyang (CV-17). All twelve Yuan-source points govern diseases of the five Zang and six Fu organs. For distension, select points on the Yang meridians; for undigested food diarrhea (Suxie), select points on the Yin meridians (another version states that for stagnation, select Yin meridians).

Currently, disease in the five Zang organs is like having a thorn in the flesh, dirt on clothes, a knotted rope, or a blocked passage. Even if long-standing, a thorn can be pulled out; even if old, dirt can be washed away; even if tightly knotted, a knot can be untied; even if long blocked, an obstruction can be cleared. Some say that chronic diseases cannot be treated; this view is incorrect. A skilled practitioner treats disease as if pulling out a thorn, washing away dirt, untying knots, or clearing blockages; even if the disease is chronic, it can be cured. Those who claim it is incurable have simply not mastered the correct technique.

The Yellow Emperor asked: There are twelve meridians, which externally correspond to twelve rivers and internally belong to the five Zang and six Fu organs. The twelve rivers accept water and conduct it. The five Zang organs store Shen (Spirit), Qi, Hun (Ethereal Soul), and Po (Corporeal Soul). The six Fu organs receive grain and conduct it, receiving Qi and dispersing it. The meridians receive blood and nourish the body. How should these three aspects be integrated for treatment? What are the depths of needling and the number of moxa cones for moxibustion? Can you explain them?

Qibo replied: The hardness or fragility of the Zang organs, the size of the Fu organs, the quantity of grain, the length of the vessels, the clarity or turbidity of the blood, and the abundance or scarcity of Qi—all these factors, including whether the twelve meridians have abundant blood and little Qi, little blood and abundant Qi, abundant blood and Qi, or scarce blood and Qi—have fixed determinations. When treating with acupuncture and moxibustion, one must regulate the Qi of the meridians accordingly, adhering to these constant correspondences. This reflects how humans participate in Heaven and Earth and respond to Yin and Yang, and thus must be carefully examined.

Foot-Yangming corresponds externally to the Sea Water and internally belongs to the Stomach.
Foot-Taiyang corresponds externally to Clear Water and internally belongs to the Bladder, connecting through the water passages.
Foot-Shaoyang corresponds externally to the Wei River and internally belongs to the Gallbladder.
Foot-Taiyin corresponds externally to Lake Water and internally belongs to the Spleen.
Foot-Jueyin corresponds externally to the Mian River and internally belongs to the Liver.
Foot-Shaoyin corresponds externally to the Ru River and internally belongs to the Kidney.
Hand-Yangming corresponds externally to the Jiang River and internally belongs to the Large Intestine.
Hand-Taiyang corresponds externally to the Huai River and internally belongs to the Small Intestine, from which water passages emerge.
Hand-Shaoyang corresponds externally to the Luo River and internally belongs to the Sanjiao (Triple Burner).
Hand-Taiyin corresponds externally to the He River and internally belongs to the Lung.
Hand-Jueyin corresponds externally to the Zhang River and internally belongs to the Pericardium.
Hand-Shaoyin corresponds externally to the Ji River and internally belongs to the Heart.

All these twelve river waters corresponding to the five Zang and six Fu organs have external sources and internal endowments; they are internally and externally connected, like a circle without beginning or end. Human meridians are the same. Thus, Heaven is Yang and Earth is Yin; above the waist is Heaven, below the waist is Earth. Areas north of the sea are Yin; areas north of lakes are Yin within Yin; areas south of the Zhang River are Yang; areas from north of the He River to the Zhang River are Yang within Yin; areas from south of the Luo River to the Jiang River are Yang within Yang. This constitutes the Yin-Yang distribution of a region. This is why humans correspond to Heaven and Earth.

Question: How do the rivers correspond to the meridians regarding their distance, shallowness, depth, and the quantity of water and blood, which vary? How should needling be performed based on these combinations?
Answer: Foot-Yangming is the Sea of the five Zang and six Fu organs; its vessels are large, with abundant blood and Qi, and strong heat. Needling this meridian requires deep insertion to disperse pathogenic factors, and retention of the needle to drain excess.
Foot-Yangming has abundant blood and Qi; needle depth is 6 fen, retained for ten breaths.
Foot-Shaoyang has scarce blood and Qi; needle depth is 4 fen, retained for five breaths.
Foot-Taiyang has abundant blood and Qi; needle depth is 5 fen, retained for seven breaths.
Foot-Taiyin has abundant blood and scarce Qi; needle depth is 3 fen, retained for four breaths.
Foot-Shaoyin has scarce blood and abundant Qi; needle depth is 2 fen, retained for three breaths.
Foot-Jueyin has abundant blood and scarce Qi; needle depth is 1 fen, retained for one breath.

For the meridians of the hands (Yin and Yang), the pathways for receiving Qi are proximate, and the arrival of Qi is rapid. Needle depth should not exceed 2 fen, and retention should not exceed one breath. For variations in age, stature, size, and leanness or robustness, one must use mental estimation. This is called following the constant laws of Heaven; moxibustion follows the same principles. Exceeding these limits in moxibustion may lead to "evil fire," causing dry bones and stagnant pulses; exceeding them in needling may lead to Qi depletion.

Question: Can the size of meridians, quantity of blood, thickness of skin, firmness of muscles, and size of flesh serve as measurement standards?
Answer: Those suitable for standard measurement are those of medium build, neither emaciated nor lacking in blood and Qi. For individuals who deviate from this norm, such as those suffering from Xiao Ke (Wasting-Thirst) who are thin and have lost muscle mass, how can standard measurements apply? One must carefully palpate and press, observe the cold, heat, excess, and deficiency, and regulate accordingly. This is called establishing true methods based on appropriateness.