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Huangdi asked Shaoyu, "The strength of sinews and bones, the firmness or fragility of muscles, the thickness of skin, and the density of interstices (Cou Li) vary among individuals. How do they differ in their tolerance for pain from acupuncture needles and stones, as well as moxibustion/fire therapy? The thickness and firmness of the stomach and intestines also vary; how does this affect their tolerance for medicinal drugs? I wish to hear your complete explanation."

Shaoyu replied, "Individuals with strong bones, flexible sinews, relaxed muscles, and thick skin can tolerate pain. They are also tolerant of the pain caused by acupuncture needles and stones, as well as the heat from fire therapy (Huo Jiu)."

Huangdi asked, "How can we identify those who can tolerate the heat of fire therapy?"

Shaoyu answered, "Those with a dark complexion and beautiful bone structure can tolerate fire therapy."

Huangdi asked, "How can we identify those who cannot tolerate the pain of acupuncture needles and stones?"

Shaoyu replied, "Those with firm muscles and thin skin cannot tolerate the pain of acupuncture needles and stones, nor can they tolerate the heat of fire therapy." (Note: The original text implies 'fire' refers to the heat of moxibustion/fire therapy).

This passage reiterates that the skin, flesh, sinews, and bones rely on the nourishment provided by the Shaoyin (Lesser Yin) and Yangming (Bright Yang) meridians. Shaoyin inherits the essence-qi of congenital origin, while Yangming transforms the refined essences of food and drink. Therefore, the strength of sinews and bones, the firmness of muscles, the thickness of skin, and the density of interstices are all determined by the qi of Shaoyin and Yangming. A dark complexion and beautiful bone structure indicate abundant blood and qi in Shaoyin. Relaxed muscles and thick skin indicate abundant blood and qi in Yangming. Mozi stated, "The Kidney is the water organ; thus, those with vigorous Shaoyin qi can tolerate the heat of fire therapy." Yangming inherits the qi of Autumn Metal; therefore, those with weak qi cannot tolerate acupuncture needles or fire therapy.

Huangdi asked, "When people contract diseases, some suffer simultaneous injury, some recover easily, and others recover with difficulty. What is the reason for this?"

Shaoyu replied, "When injured simultaneously, those with more heat in their bodies recover easily, while those with more cold recover with difficulty."

This section discusses the qi of Shaoyin separately. Shaoyin is the Ultimate Yin but serves as the source of generating qi. Thus, having more heat indicates vigorous generating qi in Shaoyin, while having more cold indicates deficient generating qi in Shaoyin. Human form and qi are generated from postnatal food and drink and originate from congenital Yin and Yang. When form and qi are vigorous, pathogenic factors dissipate; when they are deficient, pathogenic factors remain. Therefore, the ease or difficulty of recovery depends on the prosperity or decline of the generating qi in Shaoyin. Zhu stated, "The congenital essence-qi of Shaoyin relies on postnatal food and drink for nourishment. The combination of two fires gives rise to Yangming. Yangming inherits dry and hot qi. Having more heat indicates vigorous Shaoyin qi. Vigorous Shaoyin qi receives support from Yangming. This section discusses Shaoyin receiving qi from Yangming for nourishment; the next section discusses Yangming receiving qi from Shaoyin for transformation."

Huangdi asked, "How can we determine who can tolerate the toxicity of medicines?"

Shaoyu replied, "Those with thick stomach walls, dark complexions, large bones, and robust physiques can all tolerate drug toxicity. Conversely, those who are emaciated and have thin stomach walls cannot tolerate drug toxicity." (Note: 'Sheng' is pronounced with the level tone, meaning to bear or tolerate.)

This section further discusses the interaction between Shaoyin and Yangming. Yangming resides in the center, belonging to Earth, governing the reception of food and drink. It relies on the ascending qi of Shaoyin. The combination of Wu (Yang Earth) and Gui (Yin Water) transforms into the qi of Great Fire and Earth, thereby enabling the steaming and separating of refined essences from food and drink. Therefore, individuals with thick stomach walls, dark complexions, large bones, and robust physiques possess abundant qi and blood in both Shaoyin and Yangming, allowing them to tolerate drug toxicity. Ni stated, "The Middle and Lower Jiao mutually nourish each other, resulting in strong sinews and bones and abundant muscles." This commentary should be read in conjunction with the *Su Wen* chapter on "Jue Lun" (Treatise on Reversal).