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The human body becomes ill in the manner of a violent storm entering the *Couli* (interstices of skin and muscle), gradually deepening to become disease. Therefore, those skilled in treatment treat at the level of the hair and skin; next, they treat at the level of the flesh and muscles; next, at the level of the sinews and vessels; next, at the level of the Six Fu-organs; and lastly, at the level of the Five Zang-organs, at which point the condition is half-dead and half-alive. (Being "skilled" refers to an expert physician who is adept at knowing the signs of color, voice, form, and pulse, and profoundly understands the root and branch. Thus, treating the hair and skin can cure diseases of the Zang-organs, and treating the Zang-organs can eliminate diseases of the hair and skin. So, if the disease is in the hair and skin, treat the hair and skin; if in the Five Zang-organs, treat the Five Zang-organs. Whether treating shallow with shallow, deep with deep, shallow with deep, or deep with shallow, achieving a cure constitutes supreme wisdom and perfect success. Now, when pathogenic factors enter from the superficial hair and skin and reach the depth of the Five Zang-organs, if an expert physician encounters a case where five die and five survive, it is because both Yin and Yang meridians have been severely affected by pathogens.)

Therefore, pathogenic factors from Heaven (external climatic evils) that affect the body harm the Five Zang-organs; (This refers to the empty winds from the Eight Directions descending from above, causing deep damage, thus harming the Five Zang-organs.) Improper cold or warmth in food and water that affects the body harms the Six Fu-organs; (Between heaven and earth, the qi and flavor derived from food and water are utilized. The Six Fu-organs store food and water; if regulation is lost and harmony disrupted, the Six Fu-organs are harmed subsequently.) Dampness from Earth that affects the body harms the skin, flesh, sinews, and vessels. (The Kidney is the Water organ, governs the bones, and is deep; slight dampness cannot immediately cause injury. The other four organs govern the skin, flesh, sinews, and vessels, which are external; upon exposure, they are injured first, before reaching the Six Fu-organs.)

Therefore, when using acupuncture, one draws from Yin to guide Yang, and from Yang to guide Yin; (For example, if the Liver Meridian of Foot-Jueyin is excess and the Gallbladder Meridian of Foot-Shaoyang is deficient, one must drain Jueyin to tonify Shaoyang, which is drawing from Yin to guide Yang. If Shaoyang is excess and Jueyin deficient, one must drain Shaoyang to tonify Jueyin, which is drawing from Yang to guide Yin. Other cases follow this pattern.) One treats the left side using points on the right, and the right side using points on the left; (This refers to *Miu Ci* [mirrored puncture], puncturing the collateral vessels; and *Ju Ci* [major puncture], puncturing the main meridians.) One knows the patient's condition through one's own healthy state; (Meaning the physician, being healthy, can understand the patient's pathology.) One knows the interior through the exterior; (One may observe the exterior pulses of the Six Fu-organs to know the interior pulses of the Five Zang-organs; or observe the exterior manifestations of color and voice to know the interior conditions of the Zang-Fu organs.) One observes the principles of excess and deficiency, detects minor faults, and uses this method without peril. (If the pulse at Cun Kou beats more than fifty times before a intermittent beat, it is called "excess"; if fewer than fifty, it is called "deficiency." Detecting minor signs of Guan-Ge [obstruction] allows one to identify the fault. Saving people by detecting minor faults means treating potential diseases before they manifest, ensuring ten out of ten successes, thus avoiding danger.)

A skilled diagnostician palpates the pulse; (Being "skilled" means an expert physician is proficient in diagnosis. The essence of diagnosis lies in palpating the pulse.) First distinguishing Yin and Yang, examining clarity and turbidity, to know the pulse positions; (In palpating the pulse, one must first distinguish the Yin pulses of the Five Zang-organs and the Yang pulses of the Six Fu-organs, and also examine whether Ying-Qi is turbid and Wei-Qi is clear, noting the differences in the Cun, Guan, and Chi positions of both hands.) Observing respiration and listening to sounds to know the source of suffering; (One must observe the slowness, speed, roughness, and fineness of the patient's breathing, and listen to the sounds corresponding to the Five Elements, thereby knowing which part among the Five Zang-organs, Six Fu-organs, skin, flesh, sinews, vessels, or bone marrow is suffering. This is knowing illness through sound.) Observing the standards of balance and regularity to know the location of the disease; (The face displays the Qi colors of the Five Zang-organs, Six Fu-organs, and Five Elements; observing these reveals the diseased organ. This is knowing illness through inspection.) Palpating the Cun and Chi positions and observing floating, sinking, slippery, and choppy qualities to know the origin of the disease; (Choppy [Se] implies not slippery. From the Guan position to the Yuji area is nine fen for "Cun"; from Guan to Chize is one cun for "Chi"; together they total one cun and nine fen, known as "Cun-Chi." In general, palpating Cun Kou yields the Qi of the Five Zang-organs and Twelve Meridians to judge good or bad; palpating Chi also reveals good or bad. According to this classic, there is no independent "Guan" position. Guan is merely the boundary between Cun and Chi and has no independent territory. According to Bian Que, Cun Kou is Yang, occupying nine fen; Chi is Yin, occupying one cun; totaling one cun and nine fen, with no space for Guan. Hua Tuo stated that Cun, Chi, and Guan each occupy one cun, totaling three cuns. It is unknown what basis supports this. Wang Shuhe and Huangfu Mi offered different views, all including a Guan position; since these lack basis, they should not be used. However, Guan cannot be said to not exist; it is simply the division point between Cun and Chi. The Spleen pulse resides in the middle; when diseased, it may appear between Cun and Chi. The details are clarified in later chapters. The method of palpation is: first distinguish Yin/Yang and clear/turbid, identify positions, then inspect voice/color, determine suffering, and finally palpate Cun-Chi to observe seasonal pulses and identify the disease source.) By treating without error and diagnosing without failure...

Thus it is said: When a disease first begins, it can be cured by acupuncture; (Because of skilled diagnosis, when the disease just arises, small needles are used to regulate and remove it, without toxic drugs, as it is mild and easily dispersed.) When it is strong, one can wait for it to decline. (When disease is strong, direct treatment is inadvisable, like attacking a well-formed army; waiting for its decline makes removal easier, as in malaria.) Thus it is said: For light and dispersing pathogens, use dispersing methods; (Referring to wind-bi, due to their light and moving nature, use guidance and fine needles to disperse them.) For heavy and stagnant pathogens, use reducing methods; (Referring to damp-bi, due to their heaviness, use burning needles and moxibustion/pressing to gradually reduce them.) For declining pathogens, use clarifying and expelling methods; (Referring to mania, take advantage of their decline to clarify and expel them.) For deficiency of form, warm with Qi; (For those who are cold, thin, and short of breath, tonify their Yang Qi.) For deficiency of essence, supplement with flavor; (For deficiency of essence/fluids in the Five Zang-organs, use the five flavors of medicine and food to nourish.) For high locations, induce vomiting; (For wind-heat excess in the head and chest, induce vomiting to expel it.) For low locations, guide and drain; (For cold-damp excess in the waist and feet, guide drainage to exhaust it.) For fullness in the middle, drain internally; (For Qi distension in the intestines and stomach, drain from within.) For those with pathogens, use soaking; (" " denotes cold. Pathogens refer to cold-heat evil Qi in the intestines and stomach. Whether entering Zang-Fu or residing in the skin, needles and medicines are used to induce sweating and resolve. *Suwen* and *Jiayi Jing* read "Ze Xing" [soak the body]; Yuan edition reads "Qing"; here we follow the original manuscript " ".) For those on the skin, release through sweating; For fierce and rapid pathogens, press and puncture; (" " [fan zhao fan] means rapid. "Han" [hu dan fan] means fierce. To stop the rapid Qi from scattering, press with the hand to locate the point, then insert the needle.) For excess conditions, scatter and drain. (All excess conditions should be scattered and drained.) Examine Yin and Yang to distinguish soft and hard; treat Yin for Yang diseases, and Yang for Yin diseases. (Soft things belong to Yang; hard things belong to Yin. If Yin meridians are invaded and the disease flows into Yang meridians, Yin is the root and Yang is the branch. Treating the root means treating the Yin meridian, i.e., treating Yin for Yang disease. Similarly, treating Yang for Yin disease follows this logic. In the human body, if Yin meridians are excess, Yang must be deficient; if Yang is excess, Yin must be deficient. Therefore, for Yang deficiency diseases, draining Yin is appropriate; for Yin excess diseases, tonifying Yang is appropriate.) Determine the Blood and Qi, keeping each in its proper place; for Blood excess, lancedrain; for Qi deficiency, draw and guide. (Determine whether the disease is in Qi or Blood, respecting their distinct territories. For draining, use needles to remove excess Blood; for tonifying, use needles to guide Qi. After guiding Qi to tonify the skin, release the skin to close the pores, preventing Qi leakage. "Che" [si ye fan] means guide. *Jiayi Jing* reads "Qi excess" instead of "Qi deficiency." *Suwen* writes " " instead of "Che". Note: Yuan edition writes "Cong Pi" instead of "Zong Pi" [release skin].)