标本，阴阳先后之气也。先病为本，后病为标。人身正气调和，外感风热湿火燥寒之气，谓之客气，
则以外感客气为本，三阳三阴正气为标。若正气先病，因病而生风热湿火燥寒之气，谓之同
气，则以三阳三阴正气为本，所生同气为标。故治有从本者，有从标者，有先治其本而后治其标者，有先
治其标而后治其本者，间者并行，甚者独行，此标本之大法也。病传者，心病传肺，肺病传
肝，肝传脾，脾传肾，相克而传，皆有死期。若间一脏，则相生而传，病当自止，不止，而至三四脏者，
乃可刺，此病传之大法也。《灵枢》有《病本》篇论标本，《病传》论论病传，分而为二，此则合为一也。
黄帝问曰∶病有标本，刺有逆从奈何？
帝承上编四时刺逆从之意，谓欲知刺之逆从，必知病之标本，不知病之标本，犹未知刺之逆从，
故问病有标本，刺有逆从奈何？
岐伯对曰∶凡刺之方，必别阴阳，前后相应，逆从得施，标本相移。
别，音逼。应，平声。刺得其宜，标本始得，故凡刺之方，必别四时六气之阴阳，在表在里，
浅刺深刺，前后相应，何者为逆，何者为从，逆从得施，则因标治本，因本治标，而标本可以相移，
是刺得其宜。而标本始得也。
故曰∶有其在标而求之于标，有其在本而求之于本，有其在本
而求之于标，有其在标而求之于本，故治有取标而得者，有取本而
得者，有逆取而得者，有从取而得者，故知逆与从，正行无问，知
标本者，万举万当，不知标本，是谓妄行。
当，去声。《至真要大论》曰∶百病之起，有生于本者，有生于标者，有取本而得者，有取标而得
者，有逆取而得者，有从取而得者。故曰有其在标而求之于标，此病生于标，取标而得也。有其在
本而求之于本，此病生于本，取本而得也。二者乃从取之法也。有其在本而求之于标，有其在标而求之于
本，二者乃逆取之法也。故申明治有取标而得者，即在标而求之于标也。有取本而得者，即在
本而求之于本也。有逆取而得者，即在本求标在标求本也。有从取而得者，即在标求标，在本求本也。故知
逆取与从取之法，则正行而无可问。正行无问，可以万举万当，无有妄行，故又曰∶知标本
者，万举万当，不知标本，是谓妄行。
夫阴阳逆从标本之为道也，小而大，言一而知百病之害，少而多，浅而博，可以言
一而知百也，以浅而知深，察近而知远，言标与本，易而弗及，治反为逆，治得为从。
易，去声。此复举阴阳逆从标本，至大深远，而治之宜审也。上文论阴阳逆从标本，故曰夫阴阳逆从标
本之为道也，小而至大，言一标本逆从，而知百病之害，夫小而大者，乃少而能多，浅而能
博，故可以言一而知百病之害也，浅而博，是以浅而知深，少而多，是察近而知远，故言标与本，言易而知
之弗及，不知标本，治之相反，则为逆，识其标本，治之得宜始为从，此阴阳标本逆从，而为治之宜审也。
先病而后逆之，治其本；先逆而后病者，治其本∶先寒而后生
病者，治其本；先病而后生寒者，治其本∶先热而后生病者，治其本。
此下论标本先后之治，与《灵枢·病本》论辞意相同，凡病皆当治本，惟中满而大小不利当治其标，
更当察其间甚，为并行独行之治也。先病而后逆者，先病为本，后逆为标，当治其先病之本。先
逆而后病者，先逆为本，后病为标，当治其先逆之本。先寒而后生病者，先寒为本，后病为标，当治其先
寒之本。先病而后生寒者，先病为本，后寒为标，当治其先病之本。先热而后生病者，先热为
本，后病为标，当治其先热之本。凡此皆治本之法也。
先热而后生中满者治其标。
《病本》篇无此句。此承上文而言，先热后生中满，则不治先
热之本，而治中满之标。中满，则上下不交，人以中土为本。故治其标。
先病而后泄者治其本，先泄而后生他病者治其本，必且调之，
乃治其他病，先病而后生中满者治其标，先中满而后烦心者治其本。
先病而后泄者，治其先病之本。先泄而后生他病者，治其先泄之本，先泄则中土先虚，既治其本，必且
调之，乃治其他病，所以重其中土也。先病而后生中满者，则治中满之标，先中满而后烦心
者，则治中满之本，虽有标本，中满当先治也。
人有客气，有同气。
承上文而言，所谓先病先逆先寒先热先泄先中满者，人有客气，有同气也。客气者，风热湿火燥寒之气，侵
入人身而为病也。同气者，人身厥阴之气同于风，少阴之气同于热，太阴之气同于湿，少阳之气同于火，
阳明之气同于燥，太阳之气同于寒。病三阴三阳之正气，固有风热湿火燥寒之同气而为病也。
小大不利治其标，小大利治其本。
上文中满治标，更当审其小大二便，所以补上文未尽之意。后生中满，而治后病之标者，以中满，则小
大二便不利，故治其后病之标。若中满而小大利，亦当先治其本。所以申明中满治标，而补其未尽之意也。
病发而有余，本而标之，先治其本，后治其标。病发而不足，
标而本之，先治其标，后治其本。
有余者，邪气有余。不足者，正气不足。病发而邪气有余，则本而标之，申明本而标之者，先治其邪
气之本，后治其正气之标，此治有余之法也。病发而正气不足，则标而本之，申明标而本之者，
先治其正气之标，后治其邪气之本，此治不足之法也。《天元纪大论》云∶厥阴之上，风气主之；少阴之上，
热气主之；太阴之上，湿气主之，少阳之上，火气主之；阳明之上，燥气主之；太阳之
上，寒气主之。所谓本也。是以风热湿火燥寒淫气为本，人身三阳
三阴正气为标。
谨察间甚，以意调之，间者并行，甚者独行，先小大不利而后生病者治其本。
间，去声，下同，间，相兼也。甚，独盛也。治本治标，其中复有间甚，故当谨察间甚，以意调之，
如邪正之有余不足，叠胜而相间者，则并行其治。并行者，补泻兼施，寒热互用也。如但邪气有余，但正气
不足，而偏甚者，则独行其治。独行者，专补专泻专寒专热也。若先小大二便不利，后生标本之病者，无论间
甚，但治其本，以行其便，是察间甚之中，而小大不利，当先治也。此一节，论标本先后治法之不同。
夫病传者，心病先心痛，一日而咳，三日胁支痛，五日闭塞不
通，身痛体重，三日不已，死，冬夜半，夏日中。
此下皆论病传。其传也，相克而传，故病皆死，与《灵枢·病传》论大旨相同，辞稍异也。《病传》
论云∶病先发于心，一日而之肺，三日而之肝，五日而之脾，三日不已，死，冬夜半，夏日中，
夫病传者，心病先心痛，是病先发于心也，一日而咳，一日始传之肺也，三日胁支痛，又三日而传之肝也，
五日闭塞不通，身痛体重，又五日而传之脾也，心肺肝脾相传，则火刑金，金刑木、木刑
土。又三日而病不已，则死，冬夜半，水刑火也，夏日中，亢极自焚也。日月营运，一寒一暑，言冬可
以该秋，言夏可以该春。
肺病喘咳，三日而胁支满痛，一日身重体痛，五日而胀，十日不已，死，冬日入，夏日出。
《病传》论云∶病先发于肺，三日而之肝，一日而之脾，五日而之胃，十日不已死，冬日入，夏
日出。肺病喘咳，病先发于肺也。三日而胁支满痛，三日始传之肝也。一日身重体痛，又一日而传之脾
也。五日而胀，又五日而传之胃也。肺肝脾胃相传，则金刑木，木刑土，又十日而病不已，则死，冬
日入，气不内归也，夏日出，气不外达也。
肝病头目眩，胁支满，三日体重身痛，五日而胀，三日腰脊少
腹痛胫 ，三日不已，死，冬日入，夏早食。
病传论云，病先发于肝，三日而之脾，五日而之胃，三日而之肾，三日不已死，冬日入，夏早食。肝
病头目眩胁支满，病先发于肝也。三日体重身痛，三日始传之脾也。五日而胀，又五日而传之
胃也。三日腰脊少腹痛胫 ，又三日而传之肾也。肝脾胃肾相传，则木刑土，土刑水。又三日而病不已，
则死，冬日入，申酉属金，金克木也。夏早食，寅卯属木，不能生旺也。
脾病身痛体重，一日而胀，二日少腹腰脊痛胫 ，三日背KT 筋
痛，小便闭，十日不已，死，冬人定，夏晏食。
病传论云∶病先发于脾，一日而之胃，二日而之肾，三日而之膂膀胱，十日不已死，冬人定，夏晏食。
脾病身痛体重，病先发于脾也。一日而胀，一日始传之胃也。二日少腹腰脊痛胫 ，又二日
而传之肾也。三日皆KT 筋痛，小便闭，又三日而传之膀胱也。脾胃肾膀胱相传，则土刑其水，脏腑皆病。又
十日而病不已，则死，冬之人定在戌，夏之晏食亦在戌，皆土不生旺而死也。
肾病少腹腰脊痛， ，三日背KT 筋痛，小便闭，三日腹胀，
三日两胁支痛，三日不已，死，冬大晨，夏晏晡。
《病传》论云∶病先发于肾，三日而之膂膀胱，三日而上之心，三日而之小肠，三日不已死，冬大晨，
夏晏晡。肾病少腹腰脊痛 ，病先发于肾也。三日皆KT 筋痛，小便闭，三日始传之膀胱也。
三日腹胀，又三日传之胃，而不传之心也。《病传》论三日而上之心，三日而之小肠，乃传其所胜，水克火也。
此下三段，皆不传心与小肠，而传脾与胃，乃传所不胜，土克水也。我克克我，皆为逆传，
其义一也。三日两胁支痛，又三日而传之肝也。肾膀胱胃肝相传，则水受土刑，土受木刑。又三日而病不已，
则死。冬大晨，冬之大晨在辰。夏晏晡，夏之晏晡在戌，晡与 同，皆土制其水而死也。
胃病胀满，五日少腹腰脊痛 ，三日背KT 筋病，小便闭，五
日身体重，六日不已，死，冬夜半后，夏日 。
《病传》论胃病在脾病下，膀胱在肾病下，乃脏腑相连。此则先脏
后腑，故胃与膀胱，总列于后也。病传论云∶病先发于胃，五日而之肾，三日而之膂膀胱，五日而上之心，
二日不已死，冬夜半，夏日 。 ，HT 也。胃病胀满，病先发于胃也。五日少腹腰脊痛
，五日传之肾也。三日背KT 筋痛小便闭，又三日而传之膀胱也。五日身体重，又五日传之脾，而不传之
心也。胃肾膀胱与脾相传，皆土刑其水。又六日而病不已，则死，冬夜半后，其时在丑。夏日
映，其时在未。皆土不生旺而死也。病传论二日死，此则六日死，盖偶一为二，偶三为六，其理一也。病传
论夜半死，此则夜半后死，夫夜半之子，一阳初生，阳气不生，虽夜半不死，而夜半后亦死，理亦一也。
膀胱小便闭，五日少腹胀，腰脊痛， ，一日腹胀，一日身
体痛，二日不已，死，冬鸡鸣，夏下晡。
《病传》论云∶病先发于膀胱，五日而之肾，一日而之小肠，一日而之心，二日不已死，冬鸡鸣，夏下
晡。膀胱病小便闭，病先发于膀胱也。五日少腹胀腰脊痛 ，五日始传之肾也。一日腹胀，
一日身体痛，又一日传胃，又一日传脾，而不传小肠与心也。膀胱与肾、胃与脾相传，则腑脏皆病，水病土
刑。又二日而病不已，则死，冬之鸡鸣在丑，膀胱肾病，土克水也。夏之下晡在申，脾胃皆病，土不生金也。
诸病以次是相传，如是者，皆有死期，不可刺，间一脏止，及至三四脏者，乃可刺也。
《玉机真脏论》云∶五脏相通，移皆有次。次者，木火土金水相生而传。故诸病以次，是相传之正。
如是者，谓如上文之相克而传。则皆有死期，虽治无功，故不可刺。若间一脏相传，其病当止。如
肺欲传肝而肾间之，则金生水，水生木；肾欲传心而肝间之，则水生木，木生火；肝欲传脾而心间之，则
木生火，火生土；心欲传肺而脾间之，则火生土，土生金；脾欲传肾而肺间之，则土生金，金
生水。是以其病当止。若不止，及至三四脏者，是以次相传，乃可
刺也。此一节论病传相克之死期，必相生而传，始可刺治也。
"Mark" (Biao) and "Root" (Ben) refer to the sequence of Qi of Yin and Yang. The disease that occurs first is called the "Root", and the disease that occurs later is called the "Mark". If the body's righteous Qi is harmonious, and external pathogenic factors such as Wind, Heat, Dampness, Fire, Dryness, and Cold invade, these are called "Guest Qi" (Ke Qi). In this case, the external Guest Qi is the Root, and the Righteous Qi of the Three Yang and Three Yin meridians is the Mark. If the Righteous Qi becomes diseased first, generating internal pathogenic factors of Wind, Heat, Dampness, Fire, Dryness, and Cold due to the illness, these are called "Same Qi" (Tong Qi). In this case, the Righteous Qi of the Three Yang and Three Yin meridians is the Root, and the generated Same Qi is the Mark. Therefore, treatment may follow the Root, follow the Mark, treat the Root first then the Mark, or treat the Mark first then the Root. When the condition is mild, both Root and Mark are treated simultaneously (Bing Xing); when the condition is severe, only one aspect (either Root or Mark) is treated exclusively (Du Xing). This is the general principle of handling Root and Mark.
Regarding the transmission of disease: Heart disease transmits to the Lung, Lung disease to the Liver, Liver disease to the Spleen, and Spleen disease to the Kidney. This is transmission in the order of mutual restriction (Ke), which carries a fatal prognosis. If transmission skips one Zang organ, it follows the order of mutual generation (Sheng), and the disease should cease on its own. If it does not cease and progresses to the third or fourth organ, acupuncture may be applied. This is the general principle of disease transmission. The *Ling Shu* has a chapter titled "Disease Root" discussing Root and Mark, and a chapter titled "Disease Transmission" discussing transmission; they are divided into two chapters here, but combined into one in this text.
The Yellow Emperor asked: Diseases have distinctions of Root and Mark, and acupuncture has methods of contrary (Ni) and compliant (Cong) approaches. What is the rationale?
The Yellow Emperor, building upon the previous discussion on seasonal acupuncture contraindications, stated that to understand the contrary and compliant aspects of acupuncture, one must know the Root and Mark of the disease. Without knowing the Root and Mark, one cannot understand the acupuncture approach. Thus, he asked about the principles of Root/Mark in disease and Ni/Cong in acupuncture.
Qi Bo replied: In all acupuncture methods, one must distinguish Yin and Yang, ensure correspondence between prior and subsequent actions, apply Ni and Cong appropriately, and allow Root and Mark to shift relative to each other.
"Distinguish" (Bie) is pronounced 'bi'. "Correspond" (Ying) is pronounced with the level tone. Only when acupuncture is appropriate can Root and Mark be grasped. Therefore, in all acupuncture methods, one must distinguish the Yin and Yang of the four seasons and six Qi, determine whether the pathology is in the exterior or interior, and decide between shallow or deep needling. Actions must correspond sequentially. One must identify what is contrary and what is compliant. When Ni and Cong are applied correctly, one can treat the Root via the Mark, or the Mark via the Root, allowing Root and Mark to transform into one another. This constitutes appropriate acupuncture, truly mastering Root and Mark.
Thus it is said: If the pathology is at the Mark, seek treatment at the Mark; if at the Root, seek treatment at the Root; if at the Root, seek treatment at the Mark; if at the Mark, seek treatment at the Root. Therefore, some cures are achieved by targeting the Mark, some by targeting the Root, some by contrary treatment (Ni Qu), and some by compliant treatment (Cong Qu). Those who understand Ni and Cong act correctly without doubt; those who understand Root and Mark achieve success in every attempt; those who do not understand Root and Mark act recklessly.
"Dang" is pronounced with the departing tone. The *Zhi Zhen Yao Da Lun* states: The onset of hundred diseases arises from either the Root or the Mark; some are cured by targeting the Root, some by targeting the Mark, some by contrary treatment, and some by compliant treatment. Thus, "if at the Mark, seek treatment at the Mark" refers to disease arising from the Mark, cured by targeting the Mark. "If at the Root, seek treatment at the Root" refers to disease arising from the Root, cured by targeting the Root. These two are methods of compliant treatment (Cong Qu). "If at the Root, seek treatment at the Mark" and "if at the Mark, seek treatment at the Root" are methods of contrary treatment (Ni Qu). Hence, curing by targeting the Mark corresponds to seeking treatment at the Mark; curing by targeting the Root corresponds to seeking treatment at the Root. Curing by contrary treatment corresponds to treating the Mark while the Root is involved, or vice versa. Curing by compliant treatment corresponds to treating Mark with Mark, and Root with Root. Understanding Ni and Cong allows for correct action without question. Correct action ensures success in every attempt and prevents reckless behavior. Thus, it is said: Knowing Root and Mark leads to universal success; ignorance of them leads to reckless action.
The principle of Yin/Yang, Ni/Cong, and Root/Mark appears small yet is great; speaking of one reveals the harm of a hundred diseases; appearing few yet is many; appearing shallow yet is profound. Knowing one allows understanding of a hundred; using the shallow to understand the deep; observing the near to understand the far. Discussing Root and Mark seems easy but is hard to fully grasp. Treatment contrary to the nature is Ni; treatment appropriate to the nature is Cong.
Here, the principle of Yin/Yang, Ni/Cong, and Root/Mark is reiterated as profound and distant, requiring careful consideration in treatment. The preceding text discussed these principles, stating that this Dao is small yet great. Speaking of one instance of Root/Mark/Ni/Cong reveals the harm of a hundred diseases. Small yet great means few yet many, shallow yet broad. Thus, knowing one reveals the harm of a hundred diseases. Shallow yet broad allows understanding the deep; few yet many allows observing the near to understand the far. Discussing Root and Mark seems easy but is difficult to exhaust. Not knowing Root and Mark leads to contrary treatment (Ni); recognizing them leads to appropriate treatment (Cong). This explains why the treatment of Yin/Yang/Root/Mark/Ni/Cong requires caution.
If disease precedes rebellion (Ni), treat the Root; if rebellion precedes disease, treat the Root. If cold precedes disease, treat the Root; if disease precedes cold, treat the Root. If heat precedes disease, treat the Root.
The following discusses the treatment of Root and Mark based on sequence, consistent with the *Ling Shu · Bing Ben*. Generally, diseases should treat the Root, except for cases of abdominal fullness (Zhong Man) accompanied by difficulty in urination and defecation, where the Mark is treated. One must also observe the severity (Jian/Shen) to apply simultaneous or exclusive treatment. If disease precedes rebellion, disease is Root, rebellion is Mark; treat the initial disease (Root). If rebellion precedes disease, rebellion is Root, disease is Mark; treat the initial rebellion (Root). If cold precedes disease, cold is Root, disease is Mark; treat the initial cold (Root). If disease precedes cold, disease is Root, cold is Mark; treat the initial disease (Root). If heat precedes disease, heat is Root, disease is Mark; treat the initial heat (Root). All these are methods of treating the Root.
If heat precedes abdominal fullness (Zhong Man), treat the Mark.
This sentence is absent in *Bing Ben*. It continues the previous argument: if heat precedes Zhong Man, do not treat the Root of the heat, but the Mark of the Zhong Man. Zhong Man obstructs the interaction between upper and lower, and humans regard the Middle Jiao (Earth) as fundamental. Therefore, treat the Mark.
If disease precedes diarrhea, treat the Root; if diarrhea precedes other diseases, treat the Root of the diarrhea. One must first regulate it, then treat other diseases. If disease precedes Zhong Man, treat the Mark; if Zhong Man precedes vexation in the heart, treat the Root.
If disease precedes diarrhea, treat the Root of the initial disease. If diarrhea precedes other diseases, treat the Root of the diarrhea. Diarrhea first depletes the Middle Jiao (Earth). After treating the Root, one must regulate it before treating other diseases, emphasizing the importance of the Middle Jiao. If disease precedes Zhong Man, treat the Mark of Zhong Man. If Zhong Man precedes heart vexation, treat the Root of Zhong Man. Although there are Root and Mark distinctions, Zhong Man must be treated first.
Humans have Guest Qi (Ke Qi) and Same Qi (Tong Qi).
Continuing from above, the conditions of initial disease, rebellion, cold, heat, diarrhea, and Zhong Man arise because humans have Ke Qi and Tong Qi. Ke Qi refers to Wind, Heat, Dampness, Fire, Dryness, and Cold invading the body. Tong Qi refers to the correspondence between internal organs and elements: Jueyin corresponds to Wind, Shaoyin to Heat, Taiyin to Dampness, Shaoyang to Fire, Yangming to Dryness, and Taiyang to Cold. Disease in the Three Yin and Three Yang Righteous Qi naturally involves these corresponding pathogenic factors.
Difficulty in urination and defecation requires treating the Mark; normal urination and defecation require treating the Root.
The previous mention of treating Zhong Man as the Mark needs supplementation regarding urination and defecation. Treating the Mark of late-onset Zhong Man is because Zhong Man causes obstruction of urination and defecation. If Zhong Man occurs with normal urination and defecation, the Root should be treated first. This clarifies the exception for Zhong Man and supplements the previous points.
If disease onset involves excess (You Yu), treat the Root first, then the Mark. If disease onset involves deficiency (Bu Zu), treat the Mark first, then the Root.
Excess refers to pathogenic excess. Deficiency refers to righteous Qi deficiency. In disease with pathogenic excess, treat the Root (pathogen) first, then the Mark (righteous Qi). This is the method for treating excess. In disease with righteous deficiency, treat the Mark (righteous Qi) first, then the Root (pathogen). This is the method for treating deficiency. The *Tian Yuan Ji Da Lun* states: Above Jueyin, Wind rules; above Shaoyin, Heat rules; above Taiyin, Dampness rules; above Shaoyang, Fire rules; above Yangming, Dryness rules; above Taiyang, Cold rules. These are the "Root". Thus, the excessive Qi of Wind, Heat, Dampness, Fire, Dryness, and Cold is the Root, and the Righteous Qi of the Three Yang and Three Yin is the Mark.
Carefully observe the severity (Jian/Shen) and adjust accordingly. Mild conditions are treated simultaneously (Bing Xing); severe conditions are treated exclusively (Du Xing). If difficulty in urination/defecation precedes other symptoms, treat the Root.
"Jian" (mild/composite) is pronounced with the departing tone. "Shen" (severe/exclusive) refers to predominant intensity. Between treating Root and Mark, there are degrees of severity. Observe Jian and Shen to adjust treatment. If pathogenic and righteous excess/deficiency alternate and intermingle, treat both simultaneously (Bing Xing). Simultaneous treatment involves combining tonification and purging, or hot and cold therapies. If only pathogenic excess or only righteous deficiency exists predominantly, treat exclusively (Du Xing). Exclusive treatment focuses solely on tonification, purging, heating, or cooling. If difficulty in urination/defecation precedes Root/Mark symptoms, regardless of severity, treat the Root to unblock the bowels/bladder. This section highlights that within the observation of severity, obstruction of urination/defecation takes priority. This paragraph discusses the differences in sequential treatment of Root and Mark.
Regarding disease transmission: 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 Spleen causing obstruction, body pain, and heaviness. If not resolved after three more days, death ensues, occurring at midnight in winter or noon in summer.
The following discusses disease transmission. Transmission follows the cycle of mutual restriction (Ke), leading to death, consistent with the *Ling Shu · Bing Chuan*, though wording differs slightly. *Bing Chuan* states: Disease starts in the Heart, transmits to the Lung after one day, to the Liver after three days, to the Spleen after five days. If unresolved after three days, death occurs at midnight in winter or noon in summer. Heart disease starting with chest pain indicates onset in the Heart. Cough after one day indicates transmission to the Lung. Hypochondriac pain after three days indicates transmission to the Liver. Obstruction and body pain after five days indicate transmission to the Spleen. The transmission Heart-Lung-Liver-Spleen represents Fire punishing Metal, Metal punishing Wood, and Wood punishing Earth. Death after three more days occurs at midnight in winter (Water punishing Fire) or noon in summer (Extreme Yang self-immolation). The movement of sun and moon brings cold and heat; mentioning Winter encompasses Autumn, and Summer encompasses Spring.
Lung disease presents 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 Spleen causing body heaviness and pain. After five days, it transmits to the Stomach causing abdominal distension. If unresolved after ten days, death ensues, occurring at sunset in winter or sunrise in summer.
*Bing Chuan* states: Disease starts in the Lung, transmits to the Liver after three days, to the Spleen after one day, to the Stomach after five days. Unresolved after ten days, death occurs at sunset in winter or sunrise in summer. Wheezing/cough indicates onset in the Lung. Hypochondriac pain after three days indicates transmission to the Liver. Body heaviness/pain after one day indicates transmission to the Spleen. Abdominal distension after five days indicates transmission to the Stomach. Transmission Lung-Liver-Spleen-Stomach represents Metal punishing Wood, and Wood punishing Earth. Death after ten days occurs at sunset in winter (Qi fails to return inward) or sunrise in summer (Qi fails to reach outward).
Liver disease presents with dizziness of head and eyes, 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 Stomach causing abdominal distension. After three days, it transmits to the Kidney causing pain in the lower abdomen, waist, spine, and shins. If unresolved after three more days, death ensues, occurring at sunset in winter or breakfast time in summer.
*Bing Chuan* states: Disease starts in the Liver, transmits to the Spleen after three days, to the Stomach after five days, to the Kidney after three days. Unresolved after three days, death occurs at sunset in winter or breakfast time in summer. Dizziness and hypochondriac fullness indicate onset in the Liver. Body heaviness/pain after three days indicates transmission to the Spleen. Abdominal distension after five days indicates transmission to the Stomach. Lower back/shin pain after three days indicates transmission to the Kidney. Transmission Liver-Spleen-Stomach-Kidney represents Wood punishing Earth, and Earth punishing Water. Death after three more days occurs at sunset in winter (Shen/You belong to Metal, Metal overcomes Wood) or breakfast time in summer (Yin/Mao belong to Wood, unable to generate prosperity).
Spleen disease presents with body pain and heaviness. After one day, it transmits to the Stomach causing abdominal distension. After two days, it transmits to the Kidney causing lower abdominal, waist, spine, and shin pain. After three days, it transmits to the Bladder causing back muscle pain and urinary retention. If unresolved after ten days, death ensues, occurring at Ren Ding time in winter or Yan Shi time in summer.
*Bing Chuan* states: Disease starts in the Spleen, transmits to the Stomach after one day, to the Kidney after two days, to the Du Bladder after three days. Unresolved after ten days, death occurs at Ren Ding in winter or Yan Shi in summer. Body pain/heaviness indicates onset in the Spleen. Abdominal distension after one day indicates transmission to the Stomach. Lower back/shin pain after two days indicates transmission to the Kidney. Back muscle pain and urinary retention after three days indicate transmission to the Bladder. Transmission Spleen-Stomach-Kidney-Bladder represents Earth punishing Water, affecting all Zang-Fu. Death after ten days occurs at Ren Ding (Xu hour) in winter or Yan Shi (Xu hour) in summer, both times associated with Earth failing to generate prosperity.
Kidney disease presents with lower abdominal, waist, spine, and shin pain. After three days, it transmits to the Bladder causing back muscle pain and urinary retention. After three days, it transmits to the Stomach causing abdominal distension. After three days, it transmits to the Liver causing distending pain in the hypochondrium. If unresolved after three more days, death ensues, occurring at Da Chen time in winter or Yan Bu time in summer.
*Bing Chuan* states: Disease starts in the Kidney, transmits to the Du Bladder after three days, to the Heart after three days, to the Small Intestine after three days. Unresolved after three days, death occurs at Da Chen in winter or Yan Bu in summer. Shin/waist pain indicates onset in the Kidney. Back muscle pain and urinary retention after three days indicate transmission to the Bladder. Abdominal distension after three days indicates transmission to the Stomach, not the Heart. *Bing Chuan* mentions transmission to Heart/Small Intestine (Water overcoming Fire). The following sections describe transmission to Spleen/Stomach instead (Earth overcoming Water). Both overcoming and being overcome are contrary transmissions. Pain in the hypochondrium after three days indicates transmission to the Liver. Transmission Kidney-Bladder-Stomach-Liver represents Water punished by Earth, and Earth punished by Wood. Death after three more days occurs at Da Chen (Chen hour) in winter or Yan Bu (Xu hour) in summer, both times representing Earth controlling Water leading to death.
Stomach disease presents with abdominal distension. After five days, it transmits to the Kidney causing lower abdominal, waist, spine, and shin pain. After three days, it transmits to the Bladder causing back muscle pain and urinary retention. After five days, it transmits to the Spleen causing body heaviness. If unresolved after six days, death ensues, occurring after midnight in winter or Ying time in summer.
In *Bing Chuan*, Stomach follows Spleen, and Bladder follows Kidney, reflecting connected Zang-Fu pairs. Here, Zang precedes Fu, so Stomach and Bladder are listed last. *Bing Chuan* states: Disease starts in Stomach, transmits to Kidney after five days, to Du Bladder after three days, to Heart after five days. Unresolved after two days, death occurs at midnight in winter or Ying in summer. "Ying" is "Ying". Abdominal distension indicates onset in Stomach. Lower back/shin pain after five days indicates transmission to Kidney. Back muscle pain/urinary retention after three days indicates transmission to Bladder. Body heaviness after five days indicates transmission to Spleen, not Heart. Transmission Stomach-Kidney-Bladder-Spleen represents Earth punishing Water. Death after six days occurs after midnight (Chou hour) in winter or Ying (Wei hour) in summer, both times representing Earth failing to generate prosperity. *Bing Chuan* says death in two days; this text says six days. Even numbers become two, odd numbers become six; the principle is the same. *Bing Chuan* says death at midnight; this text says after midnight. Midnight (Zi hour) is when Yang Qi first generates. If Yang Qi does not generate, death occurs after midnight. The principle is the same.
Bladder disease presents with urinary retention. After five days, it transmits to the Kidney causing lower abdominal distension, waist/spine/shin pain. After one day, it transmits to the Stomach causing abdominal distension. After one day, it transmits to the Spleen causing body pain. If unresolved after two days, death ensues, occurring at Ji Ming time in winter or Xia Bu time in summer.
*Bing Chuan* states: Disease starts in Bladder, transmits to Kidney after five days, to Small Intestine after one day, to Heart after one day. Unresolved after two days, death occurs at Ji Ming in winter or Xia Bu in summer. Urinary retention indicates onset in Bladder. Lower abdominal/back/shin pain after five days indicates transmission to Kidney. Abdominal distension and body pain after one day each indicate transmission to Stomach and Spleen, not Small Intestine or Heart. Transmission Bladder-Kidney and Stomach-Spleen affects all Zang-Fu, Water disease punished by Earth. Death after two days occurs at Ji Ming (Chou hour) in winter (Bladder/Kidney disease, Earth overcomes Water) or Xia Bu (Shen hour) in summer (Spleen/Stomach disease, Earth fails to generate Metal).
When diseases transmit sequentially in this manner (mutual restriction), there is always a fatal period, and acupuncture is contraindicated. If transmission skips one organ (mutual generation), the disease will stop. If it progresses to the third or fourth organ (sequential generation), acupuncture may be applied.
The *Yu Ji Zhen Zang Lun* states: The Five Zang are interconnected, and changes follow a specific sequence. Sequence refers to the generation cycle of Wood, Fire, Earth, Metal, Water. Sequential generation is the normal transmission. The aforementioned restrictive transmission leads to death and is untreatable, hence acupuncture is contraindicated. If transmission skips one organ (e.g., Lung to Liver with Kidney intervening), it follows generation (Metal generates Water, Water generates Wood), and the disease stops. Similarly for other pairs (Kidney-Heart with Liver intervening; Liver-Spleen with Heart intervening; Heart-Lung with Spleen intervening; Spleen-Kidney with Lung intervening). Thus, the disease stops. If it does not stop and reaches the third or fourth organ via sequential generation, acupuncture is permissible. This section discusses the fatal prognosis of restrictive transmission and states that only generative transmission allows for curative acupuncture.