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Huangdi asked: Diseases have the concepts of Biao (Branch/Symptom) and Ben (Root/Cause), and acupuncture treatment involves Ni (Counter/Reverse) and Cong (Following/Compliant) approaches. What is the rationale behind this? Qibo replied: In all acupuncture methods, one must distinguish between Yin and Yang, ensure that anterior and posterior points correspond to each other, apply the principles of Ni and Cong correctly, and flexibly shift the focus between Biao and Ben. Therefore, it is said that if the pathogen is at the Biao, treat the Biao; if the pathogen is at the Ben, treat the Ben; if the pathogen is at the Ben but treated via the Biao, or if the pathogen is at the Biao but treated via the Ben. Thus, in treatment, some are cured by addressing the Biao, some by addressing the Ben, some by using Ni methods, and some by using Cong methods. Therefore, those who understand Ni and Cong can practice Zheng (Correct/Standard) therapy without doubt; those who understand Biao and Ben will succeed in every attempt; those who do not understand Biao and Ben are called acting recklessly. The Dao of Yin-Yang, Ni-Cong, and Biao-Ben appears small yet is great; stating one principle allows one to know the harm of a hundred diseases; appearing few yet is many; appearing shallow yet is profound. One can know the deep through the shallow, and know the distant by observing the near. Discussing Biao and Ben is easy to understand but often neglected. Treatment contrary to principles is Ni; treatment conforming to principles is Cong. If illness occurs first and then Qi reversal follows, treat the Ben; if Qi reversal occurs first and then illness follows, treat the Ben; if cold exposure occurs first and then illness follows, treat the Ben; if illness occurs first and then cold symptoms follow, treat the Ben; if heat occurs first and then illness follows, treat the Ben; if heat occurs first and then Zhongman (chest and abdominal fullness/distension) follows, treat the Biao; if illness occurs first and then diarrhea follows, treat the Ben; if diarrhea occurs first and then other illnesses follow, treat the Ben, but one must first regulate the diarrhea before treating other illnesses; if illness occurs first and then Zhongman follows, treat the Biao; if Zhongman occurs first and then vexation of the heart follows, treat the Ben. The human body has Keqi (External Pathogenic Qi) and Tongqi (Internal Matching Qi). If urination and defecation are obstructed, treat the Biao; if they are unobstructed, treat the Ben. If the disease onset manifests as Excess (Yu), treat the Ben first and then the Biao. If the disease onset manifests as Deficiency (Bu Zu), treat the Biao first and then the Ben. Carefully observe the severity and remission of the condition and adjust accordingly: for mild conditions, treat both Biao and Ben simultaneously; for severe conditions, treat either Biao or Ben exclusively. If obstruction of urination and defecation occurs first and then illness follows, treat the Ben.

Regarding the transmission of diseases: Heart disease begins with chest pain; after one day, it transmits to the Lung causing cough; after three days, it transmits to the Liver causing distending pain in the hypochondrium; after five days, it transmits to the Kidney causing obstruction and blockage, body pain, and heaviness. If the disease persists for three more days without improvement, death ensues, occurring at midnight in winter and at noon in summer. Lung disease begins with wheezing and cough; after three days, it transmits to the Liver causing distending pain in the hypochondrium; after one day, it transmits to the Kidney causing body heaviness and pain; after five days, it transmits to the Spleen causing abdominal distension. If the disease persists for ten more days without improvement, death ensues, occurring at sunset in winter and at sunrise in summer. Liver disease begins with dizziness and blurred vision, and distending fullness in the hypochondrium; after three days, it transmits to the Spleen causing body heaviness and pain; after five days, it transmits to the Kidney causing abdominal distension; after three days, it transmits to the Heart causing lower back, spine, and abdominal pain, and shin soreness. If the disease persists for three more days without improvement, death ensues, occurring at sunset in winter and at breakfast time in summer. Spleen disease begins with body pain and heaviness; after one day, it transmits to the Kidney causing abdominal distension; after two days, it transmits to the Heart causing lower abdominal, lower back, spine, and shin pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention. If the disease persists for ten more days without improvement, death ensues, occurring at Rending (9-11 PM) in winter and at Yan Shi (late morning meal) in summer. Kidney disease begins with lower abdominal and lower back/spine pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention; after three days, it transmits to the Spleen causing abdominal distension; after three days, it transmits to the Heart causing distending pain in both hypochondria. If the disease persists for three more days without improvement, death ensues, occurring at Da Chen (early dawn) in winter and at Yan Bu (late afternoon) in summer. Stomach disease begins with abdominal distension; after five days, it transmits to the Kidney causing lower abdominal and lower back/spine pain; after three days, it transmits to the Liver causing back meridian pain and urinary retention; after five days, it transmits to the Heart causing body heaviness. If the disease persists for six more days without improvement, death ensues, occurring after midnight in winter and at a specific hour in summer. Bladder disease begins with urinary retention; after five days, it transmits to the Kidney causing lower abdominal distension and lower back/spine pain; after one day, it transmits to the Spleen causing abdominal distension; after one day, it transmits to the Heart causing body pain. If the disease persists for two more days without improvement, death ensues, occurring at Ji Ming (3-5 AM) in winter and at Xia Bu (late afternoon) in summer. When various diseases transmit sequentially in this manner, there is a fixed time for death, and acupuncture should not be performed. However, if the transmission skips one Zang organ, or stops after reaching three or four Zang organs, acupuncture may be applied.