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Difficulty 68 states: The five Zang organs and six Fu organs each have Jing-River, Ying-Spring, Shu-Stream, Jing-River (Jing), and He-Sea points. What are their respective indications?

The answer is: The classic texts state that where the Qi emerges is the Jing-River point; where it flows is the Ying-Spring point; where it pours in is the Shu-Stream point; where it travels is the Jing-River (Jing) point; and where it enters and gathers is the He-Sea point. The Jing-River point indicates fullness below the heart; the Ying-Spring point indicates fever of the body; the Shu-Stream point indicates heaviness of the body and pain in the joints; the Jing-River (Jing) point indicates cough, asthma, cold, and heat; the He-Sea point indicates rebellious Qi and diarrhea. These are the diseases indicated by the Jing-River, Ying-Spring, Shu-Stream, Jing-River (Jing), and He-Sea points of the five Zang and six Fu organs.

"Indicates" means "treats." This text comes from the *Ling Shu: Chapter on Nine Needles and Twelve Origins*. The Jing-River point is like the source of spring water emerging from a valley. The Ying-Spring point is like small streams that are not yet flowing freely. The Shu-Stream point is where Qi is transported and poured in. The Jing-River (Jing) point is the path through which Qi passes after the Shu-Stream point. The He-Sea point is where the water flows and converges. The Jing-River point treats fullness below the heart because the Jing-River point corresponds to Wood, and Wood corresponds to the Liver, which governs fullness, heaviness, and joint pain. The Ying-Spring point corresponds to Fire, and Fire corresponds to the Heart, which governs body fever. The Shu-Stream point corresponds to Earth, and Earth corresponds to the Spleen, which governs bodily heaviness. The Jing-River (Jing) point treats cough and cold/heat because the Jing-River point corresponds to Metal, and Metal corresponds to the Lung, which governs cold and heat. The He-Sea point treats rebellious Qi and diarrhea because the He-Sea point corresponds to Water, and Water corresponds to the Kidney, which governs diarrhea. This discussion covers only one aspect of diseases arising from the five Zang organs. It does not separately discuss the six Fu organs because listing the five Zang organs is sufficient to encompass the six Fu organs. However, the methods for differentiating diseases and selecting acupoints in the *Huang Di Nei Jing* are actually not limited to this; one cannot stick rigidly to this single theory without flexibility.

Commentary: This section (referring to Difficulty 7) discusses acupoints. However, regarding the distance of one Cun between certain acupoints, should it be measured with the Zhou chi, Qin chi, Han chi, or modern chi? Opinions vary widely, and no consensus has been reached, all due to a lack of understanding of the concept of "Tong Shen Cun" (body-proportional measurement). Some believe that using the middle segment of the patient's middle finger as one Cun constitutes exclusive transmission of the art. They fail to realize that in thin individuals, whose fingers are long but bodies small, the horizontal Cun across the back and abdomen would appear too wide. In obese individuals, whose fingers are short but bodies tall, the horizontal Cun across the back and abdomen would appear too narrow. For those with long bodies and long fingers but small heads, the Cun across the head would seem too long. For those with short bodies and short fingers but large heads, the Cun across the head would seem too short. Given such discrepancies caused by differences in fatness, leanness, length, and shortness, how can accuracy be achieved? The so-called "Tong Shen Cun" must be determined based on the patient's own body proportions. Examining the method, it should primarily rely on the measurements in the *Ling Shu: Chapter on Bone Measurements*, measuring the patient's body dimensions and scaling them accordingly, thereby eliminating errors due to length and weight. For example, the *Bone Measurements* chapter states that the distance from shoulder to elbow is one chi seven cun. If the patient's shoulder-to-elbow distance measures one chi three cun six fen, applying an eight-fold reduction ratio, the stated "one Cun" between specific acupoints would actually equal only eight fen. The rest can be inferred similarly. This flexible application of Tong Shen Cun is a crucial matter in acupuncture and moxibustion and must be understood.

Appendix: *Ling Shu: Chapter on Bone Measurements*
Yellow Emperor asked Bo Gao: The Pulse Measurement chapter discusses the lengths of the meridians; how are they established? Bo Gao replied: First measure the size, width, and length of the bone joints, and then the length of the meridians can be determined. Yellow Emperor said: I wish to hear the standard measurements for ordinary people. For a person seven chi five cun tall, what are the sizes and lengths of their bone joints? Bo Gao replied: The circumference of the large bones of the head is two chi six cun; the chest circumference is four chi five cun; the waist circumference is four chi two cun; the area covered by hair, from the crown to the nape, is one chi two cun. (*Jia Yi Jing* adds "one" before "chi"). From below the hairline to the chin is one chi. This is the average proportion for adult men. (*Jia Yi Jing* reads "adult men" instead of "gentlemen"). From the Adam's apple to the center of the Quepen (ST12) is four cun. From Quepen to the [chest pit/axilla] is nine cun; exceeding this indicates a large lung, falling short indicates a small lung. From the [chest pit/axilla] to Tianshu (ST25) is eight cun; exceeding this indicates a large stomach, falling short indicates a small stomach. From Tianshu to the Henggu (pubic symphysis) is six and a half cun; exceeding this indicates a wide and long transverse colon, falling short indicates a narrow and short one. The Henggu is six and a half cun wide. From the upper border of the Henggu to the upper border of the inner condyle is one chi eight cun. From the upper border of the inner condyle to its lower border is three and a half cun. From the lower border of the inner condyle to the medial malleolus is one chi three cun. From the medial malleolus to the ground is three cun. From the knee to the dorsum pedis connection is one chi six cun. From the dorsum pedis connection to the ground is three cun. Therefore, if the bone circumference is large, it is excessive; if small, it is deficient. From the corner of the shoulder to the pillar bone (first thoracic vertebra spinous process) is one chi. The part hidden in the armpit during walking is four cun. From the armpit to the costal margin is one chi two cun. From the costal margin to the hip pivot (greater trochanter) is six cun. From the hip pivot to the middle of the knee is one chi nine cun. From the knee to the lateral malleolus is one chi six cun. From the lateral malleolus to the Jinggu (BL64) is three cun. From Jinggu to the ground is one cun. The width behind the ear at the Wanggu point is nine cun. The width in front of the ear at the Ermen point is one chi three cun. The distance between the two cheekbones is seven cun. The width between the two breasts is nine and a half cun. (*Jia Yi Jing* reads eight cun). The width between the two thighs is six and a half cun. The foot is one chi two cun long and four and a half cun wide. From shoulder to elbow is one chi seven cun; from elbow to wrist is one chi two and a half cun. From the wrist to the proximal phalanx of the middle finger is four cun. From the proximal phalanx to the tip is four and a half cun. From the neck hairline to the dorsal spine is two and a half cun. From the spinal column to the twenty-one coccygeal vertebrae is three chi. The upper segments are one and one-fourteenth cun long, with the remainder at the bottom; thus, the upper seven segments up to the spinal column total nine and seven-ninety-eighths cun. These are the bone measurements of ordinary people, used to establish the lengths of the meridians. Therefore, when observing the meridians in the body, those that appear floating and firm, bright and large, indicate abundant blood; those that are fine and deep indicate abundant Qi.

This concludes Volume Five, Difficulties 62 to 68, discussing acupoints.