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Huangdi asked: The Taiyin and Yangming meridians are exterior and interior to each other, corresponding to the pulses of the spleen and stomach respectively. Why do they manifest different diseases? Qibo replied: The positions of Yin and Yang differ; their deficiency and excess alternate; their rebellion and compliance vary. Some pathogens originate from within, some from without. Because the pathways of invasion differ, the names of the diseases differ. Huangdi said: I wish to hear about these differences in detail. Qibo said: Yang corresponds to the Qi of Heaven and governs the exterior; Yin corresponds to the Qi of Earth and governs the interior. Therefore, the Path of Yang is solid (excess), and the Path of Yin is hollow (deficient). Thus, when attacked by treacherous winds and empty evils (external pathogenic factors), the Yang meridians receive them first; when injured by irregular diet and improper daily routine (internal causes), the Yin meridians receive them first. When received by Yang, it enters the Six Fu-organs; when received by Yin, it enters the Five Zang-organs. Entering the Six Fu-organs results in fever and inability to lie down at proper times, progressing upward to panting and calling out; entering the Five Zang-organs results in fullness and obstruction, progressing downward to undigested diarrhea (Sun-xie), and over time to intestinal dysentery (Chang-pi). Therefore, the throat governs the Qi of Heaven, and the pharynx governs the Qi of Earth. Consequently, the Yang meridians receive Wind pathogen, and the Yin meridians receive Dampness pathogen. The Yin Qi ascends from the feet to the head, then descends along the arms to the fingertips; the Yang Qi ascends from the hands to the head, then descends to the feet. Hence it is said that diseases of Yang ascend to the extreme before descending, and diseases of Yin descend to the extreme before ascending. Therefore, those injured by Wind suffer on the upper part first; those injured by Dampness suffer on the lower part first. Huangdi asked: Why does disease of the Spleen lead to immobility of the four limbs? Qibo said: The four limbs all derive Qi from the Stomach, but this Qi cannot reach the meridians directly; it must rely on the Spleen to be transmitted. Now, if the Spleen is diseased and cannot transport fluids and essences for the Stomach, the four limbs do not receive Water-Grain Qi. The Qi declines day by day, the vessel pathways become obstructed, and the sinews, bones, muscles, and flesh lack Qi to nourish them, hence they do not function. Huangdi asked: Why does the Spleen not govern a specific season? Qibo said: The Spleen belongs to Earth, governs the Center, and constantly nourishes the Four Zang-organs throughout the four seasons. It presides for eighteen days during each season's transition, and thus cannot exclusively govern one season. The Spleen organ constantly adheres to the essence of Stomach-Earth. Earth generates all things and models Heaven and Earth; its Qi extends from top to bottom, reaching the head and feet, so it cannot govern a specific time. Huangdi asked: The Spleen and Stomach are connected only by membranes, yet how can the Spleen transport fluids for the Stomach? Qibo said: The Foot-Taiyin is one of the Three Yin meridians. Its vessels penetrate the Stomach, belong to the Spleen, and connect to the throat. Therefore, the Taiyin transmits Qi to the Three Yin meridians. The Yangming is the exterior of the Yang meridians and the Sea of the Five Zang and Six Fu organs; it also transmits Qi to the Three Yang meridians. The Zang and Fu organs each receive Qi from the Yangming through their respective meridians. Thus, the Spleen helps the Stomach transport fluids. If the four limbs do not receive Water-Grain Qi, they decline increasingly day by day, the Yin vessel pathways become obstructed, and the sinews, bones, muscles, and flesh lack Qi to generate, hence they do not function.