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Those receiving the Qi of grain and food are turbid; those receiving natural Qi are clear. Clear Qi enters Yin, while turbid Qi enters Yang. The clear portion of turbidity ascends to emerge from the pharynx, while the turbid portion of clarity descends. When clear and turbid interfere with each other, it is called chaotic Qi (Luan Qi). The Yellow Emperor asked: Yin is clear and Yang is turbid; within turbidity there is clarity, and within clarity there is turbidity. How can they be distinguished? Qibo replied: The general distinction of Qi is that clear Qi ascends to pour into the Lung (Fei), while turbid Qi flows downward into the Stomach (Wei). The clear Qi of the Stomach ascends to emerge from the mouth. The turbid Qi of the Lung descends to pour into the meridians and accumulates internally in the Sea of Qi (Dan Zhong / Qi Hai). The Yellow Emperor asked: All Yang meridians receive turbid Qi; which Yang meridian receives the heaviest turbidity? Qibo replied: The Hand-Taiyang Small Intestine Meridian alone receives the turbidity of Yang Qi, while the Hand-Taiyin Lung Meridian alone receives the clarity of Yin Qi. Its clear Qi flows upward to the orifices, and its turbid Qi descends through the various meridians. All Yin meridians receive clear Qi, but the Foot-Taiyin Spleen Meridian alone receives its turbidity. The Qi of clarity is slippery (Hua), while the Qi of turbidity is sluggish (Se). This is the normal state of Qi. Therefore, when needling Yin meridians, one should needle deeply and retain the needle; when needling Yang meridians, one should needle superficially and withdraw quickly. For cases where clear and turbid Qi interfere, regulation is achieved by adjusting the number of manipulations.

If disease originates in the Heart (Xin): after one day it transmits to the Lung (Fei), after three days to the Liver (Gan), after five days to the Spleen (Pi). If it persists for three more days without resolution, death occurs. Death occurs at midnight in winter and at noon in summer. If disease originates in the Lung (Fei): after three days it transmits to the Liver (Gan), after one day to the Spleen (Pi), after five days to the Stomach (Wei). If it persists for ten more days without resolution, death occurs. Death occurs at sunset in winter and at sunrise in summer. If disease originates in the Liver (Gan): after three days it transmits to the Spleen (Pi), after five days to the Stomach (Wei), after three days to the Kidney (Shen). If it persists for three more days without resolution, death occurs. Death occurs at sunset in winter and at breakfast time in summer. If disease originates in the Spleen (Pi): after one day it transmits to the Stomach (Wei), after two days to the Kidney (Shen), after three days to the spine (Lu) and Bladder (Pang Guang). If it persists for ten more days without resolution, death occurs. Death occurs at "Ren Ding" (early night) in winter and at dinner time in summer. If disease originates in the Stomach (Wei): after five days it transmits to the Kidney (Shen), after three days to the spine (Lu) and Bladder (Pang Guang), after five days it ascends to the Heart (Xin). If it persists for two more days without resolution, death occurs. Death occurs at midnight in winter and at dawn in summer. If disease originates in the Kidney (Shen): after three days it transmits to the spine (Lu) and Bladder (Pang Guang), after three days it ascends to the Heart (Xin), after three days to the Small Intestine (Xiao Chang). If it persists for three more days without resolution, death occurs. Death occurs at "Da Chen" (early morning) in winter and at early afternoon in summer. If disease originates in the Bladder (Pang Guang): after five days it transmits to the Kidney (Shen), after one day to the Small Intestine (Xiao Chang), after one day to the Heart (Xin). If it persists for two more days without resolution, death occurs. Death occurs at "Ji Ming" (cockcrow) in winter and at late afternoon in summer. Various diseases transmit sequentially in this manner, all having fixed periods of death, and acupuncture is contraindicated. However, if the transmission skips one Zang organ or involves three to four Zang organs, then acupuncture may be performed.