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Huangdi asked, "When physicians treat diseases, the same disease is treated with different methods, yet all are cured. Why is this?" Qibo replied, "It is caused by the differences in geographical terrain."

Therefore, in the Eastern regions, where heaven and earth begin to generate life, producing fish and salt near the seashores and waters, the people eat fish and prefer salty flavors. They are content with their dwellings and delight in their food. However, eating fish tends to cause heat to accumulate internally, while excessive salt consumption damages the blood. Consequently, the people of these areas typically have dark skin and loose skin texture. Their diseases are mostly carbuncles and ulcers (suppurative sores), which are best treated with Bian stones (stone tools used for lancing or draining). Thus, Bian stone therapy originated from the East.

In the Western regions, rich in metals, jade, sand, and rocks, where heaven and earth gather and condense energy, the people live on hills and face strong winds. The water and soil are hard and strong. The people wear coarse cloth and grass mats instead of silk, and their diet is refined and rich, leading to obesity. Therefore, external pathogenic factors find it difficult to damage their physical bodies, and diseases arise internally. These are best treated with 'Du Yao' (medicines with strong therapeutic properties/potency). Thus, medicinal treatment originated from the West.

In the Northern regions, where heaven and earth store and conceal energy, the terrain is high and hilly, and the climate is cold with biting wind and ice. The people enjoy living in the open countryside and consume dairy products. Due to internal coldness, they suffer from fullness and distension diseases. These are best treated with moxibustion. Thus, moxibustion originated from the North.

In the Southern regions, where heaven and earth nurture and grow, and yang energy is abundant, the terrain is low, and the water and soil are weak. It is an area where fog and dew gather. The people prefer sour flavors and fermented foods. Consequently, the people have tight skin textures and reddish complexions. Their diseases are mainly spasms and bi-syndrome (painful obstruction syndromes involving joints and muscles). These are best treated with fine needles (the nine needles). Thus, needle therapy originated from the South.

In the Central regions, the terrain is flat and damp, and heaven and earth produce a vast variety of things. The people have mixed diets and do not engage in heavy labor. Therefore, their diseases are often atrophy syndromes (limb weakness), jue syndromes (cold extremities), and alternating chills and fever. These are best treated with Daoyin Anqiao (guiding and pulling exercises combined with massage and manipulation). Thus, Daoyin Anqiao therapy originated from the Center.

Therefore, the sages combine various treatments, applying each according to its suitability. Although the treatments differ, the diseases are all cured because the physician understands the true nature of the disease and grasps the general principles of treatment.

Huangdi asked, "I have heard that in ancient times, treating diseases only required shifting spirit and changing qi (altering mental state and regulating qi flow), which could be achieved through Zhuyou (a form of psychological therapy involving incantations explaining the cause of illness). Today, however, diseases are treated internally with medicines and externally with needles and stones; some are cured, others are not. Why is this?" Qibo replied, "In ancient times, people lived among beasts, moving about to avoid cold and dwelling in shaded places to avoid heat. Internally, they had no burdens of longing or attachment; externally, they had no strain from official duties. This was an era of tranquility and emptiness, where pathogenic factors could not penetrate deeply. Therefore, medicines were not needed for internal treatment, nor needles and stones for external treatment; shifting spirit and using Zhuyou were sufficient.

The world today is different. Worries and anxieties burden the interior, and physical hardship damages the exterior. People fail to follow the changes of the four seasons and go against the appropriate rhythms of cold and heat. Treacherous winds strike frequently, and empty evils invade morning and night, penetrating inward to the five zang organs and bone marrow, and outwardly damaging the orifices and skin. Hence, minor illnesses become severe, and major illnesses lead to death; therefore, Zhuyou alone cannot cure them."

Huangdi said, "Excellent. I wish to examine patients, observe signs of life and death, resolve doubts, and grasp the essentials clearly as if illuminated by the sun and moon. May I hear how?" Qibo replied, "Observing complexion and palpating pulses are highly valued by Heaven and transmitted by ancient masters. In ancient times, Huangdi dispatched Jiu Daiji to organize the study of complexion and pulses, connecting them to spiritual insights, integrating them with the Five Elements (Metal, Wood, Water, Fire, Earth), the Four Seasons, Eight Winds, and Six Directions, adhering to constant principles while observing their dynamic changes to understand their subtleties and essentials. To grasp the essentials, one must focus on complexion and pulses. Complexion corresponds to the Sun, and pulses correspond to the Moon. By constantly seeking their essence, one grasps the key. Changes in complexion should correspond to the pulses of the four seasons. This is what Heaven values, aligning with spiritual wisdom, thereby avoiding death and promoting life. Following this path leads to longevity, and such rulers are called Sage Kings.

In middle antiquity, when disease arrived, it was treated immediately. Decoctions were administered for ten days to eliminate diseases caused by the Eight Winds and Five Bi syndromes. If there was no improvement after ten days, branches of herbs (stems and roots) were used, supporting both root and branch. Once root and branch were addressed, the pathogenic factor was subdued.

In later antiquity, treatment was different. Treatment did not follow the four seasons, ignored the cycles of the sun and moon, and failed to assess compliance or deviation. Only after the disease form had fully developed did they attempt to treat the exterior with fine needles and the interior with decoctions. Incompetent physicians acted hastily, believing aggressive attack was necessary. Consequently, the original disease persisted, and new diseases arose.

Huangdi said, "I wish to hear the essential principles." Qibo replied, "The ultimate principle of treatment is not to neglect complexion and pulses. Using them without confusion is the great rule of treatment. Reversing compliance and deviation, or failing to distinguish root and branch, leads to the loss of spirit and even the fall of the state. Abandoning the old and embracing the new allows one to become a True Person (Zhenren)."

Huangdi said, "I have heard the essentials from you, Master. You stated that treatment does not depart from complexion and pulses; this is what I know." Qibo said, "The pinnacle of treatment lies in 'One' (Unity/Singularity)." Huangdi asked, "What is meant by 'One'?" Qibo replied, "'One' means obtaining the cause through inquiry (specifically, understanding the patient's specific condition)." Huangdi asked, "How is this done?" Qibo replied, "Close the doors and windows, focus entirely on the patient, ask many questions about their situation, and follow their intent to elicit the truth. Those who retain their Shen (Spirit) will prosper; those who lose their Shen will perish." Huangdi said, "Excellent."