先病为本，后病为标，标本固所当明。而逆从尤不可不辨，逆者宜先，从者可后。倘先其所可后，而后其
所宜先，则失之远矣。
黄帝问曰∶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，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。（得病之情，知治大体，则逆从皆可，施必中焉。）
故知逆与从，正行无问，知标本者，万举万当。（道不疑惑，识既深明，则无问于人，正行皆当。）不知标本，
是谓妄行。（识犹褊浅，道未高深，举且见违，故行多妄。）夫阴阳逆从标本之为道也，小而大，言一而知百
病之害。（着之至也。观其所举则小，寻其所利则大，以斯明着，故言一而知百病之害。）少而多，浅而博，
可以言一而知百也。（……按∶博多不外乎浅少，是故贵乎知要也。）治反为逆，治得为从。先病而后逆者治
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，先热而后生中满者治其标；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。人有客气，
有同气。小大不利治其标，小大利治其本。（按∶病虽有标本之分，而治当从缓急之势。势之急而危者，无过
中满、小大不利，二者而已。故不论其属标属本，而惟以先治为贵也。）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。（按∶有余之病，易治而无变，故可由本以及标；不
足之病，难治而多变，故当先标而后本。何者？以缓急之势不同也。）谨察间甚，以意调之，间者并行，甚者
独行。（间谓多也，甚谓少也。多谓多形证而轻易，少谓少形证而重难也。以意调之，谓审量标本不足有余，
非谓舍法而以意妄为也。按∶并行独行，谓间甚之治法也。间病势缓而证多，尚可参用君佐以调治，故云并行；
若病之甚者，证危而势急，非简要之药不能治，故云独行也。注以并为共受邪气，独为一经受邪，误矣。）
先小大不利而后生病者治其本。（按∶此再言小大不利，为病最急，则治之不可不早也。）
夫病传者，心病先心痛，（按∶心为火脏，火炽燔则痛也。）一日而咳，（心火胜金，传于肺也，肺在变
动为咳故尔。）三日胁支痛，（肺金胜木，传于肝也，以其脉循胁肋，故如是。五日闭塞不通，身痛体重，
肝木胜土，传于脾也。按∶脾主运动，为木所伤则不能运动，故如是。）三日不已死，冬夜半，夏日中。
以胜相伐，唯弱是从，五脏四伤，岂其能久，故死于子午之时也。（按∶新校正云∶“按灵枢经云∶‘大气入脏，
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。’甲乙经云∶‘病先
发于心，心痛，一日之肺而咳，三日之肝胁支痛，五日之脾闭塞不通，身痛体重，三日不已死，冬夜半，夏日
中。’详素问言其病，灵枢言其脏，甲乙经并素问灵枢之文，而病与脏兼举之。”）肺病喘咳，（按∶肺主息
主气，故病则喘咳。）三日而胁支满痛（肺传于肝。）一日身重体痛，（肝传于脾。）五日而胀，（按∶脾传
于肾，水壅不行，故胀。注言自传于腑，误矣。）十日不已死，冬日入，夏日出。肝病头目眩，胁支满，（肝
脉内连目胁，故如是。）三日体重身痛，（按∶肝传于脾，故体重身痛，脾主肌肉故也。注言传肺，又误矣。）
五日而胀，（自传于腑。）三日腰脊少腹痛，痉 ，（谓胃传于肾，以其脉起于足，循 内，出 内廉，上股
内后廉，贯脊属肾，络膀胱，故如是。）三日不已死，冬日入，（按∶甲乙经作日中。）夏早食。（卯正之
时也。）脾病身痛体重，（脾主肌肉故尔。）一日而胀，（按∶脾传胃也。）二日少腹腰脊痛，胫 ，（胃传于
肾。）三日背KT 筋痛，小便闭，（按∶肾传膀胱故便闭。KT ，脊肉也。脊开一寸五分为膀胱经脉，邪传入
故痛。灵枢经言之KT ，盖谓此也。KT 音吕。）十日不已死，冬人定，夏晏食。（人定谓申后二十五刻，晏
食谓寅后二十五刻。）肾病少腹腰脊痛， ，（脏真下于肾故如是。）三日背KT 筋痛，小便闭，自传于腑。
按∶新校正云∶“灵枢经云之KT 膀胱，是自传于腑及之KT 也。”三日腹胀，膀胱传于小肠。按∶水传火
腑，气壅不行故胀。甲乙作“上之心，心胀。”三日两胁支痛，（腑传于脏。按∶新校正云∶“按灵枢经云∶‘
三日之小肠，三日上之心。’今云两胁支痛，是小肠腑传心脏而发痛也。”）三日不已死，冬大晨，夏晏晡。
（大晨，大明时也。晏晡，向昏时也。）胃病胀满，（以其脉循腹故。按∶其脉虽循腹，然胃为水谷之海，胃
病则不能化水谷，故胀而满也。）五日少腹腰脊痛， ，（胃传
于肾。）三日背KT 筋痛，小便闭，（自传于腑，及之KT 也。）五日身体重，（膀胱水腑，传于脾也。按∶
新校正云∶“按灵枢经及甲乙经各云五日上之心，是膀胱传心，为相胜而身体重。今王氏言传脾者，误也。”
谨按身重本属脾病，传心亦令身重，不可不知也。）六日不已死，冬夜半后，夏日 。（日 ，谓午后八刻，
未正时也。）膀胱病小便闭，（以其为津液之腑故尔。）五日少腹胀，腰脊痛， （自归于脏。）一日腹胀，
（肾复传于小肠。）一日身体痛，（小肠传于脾。按∶新校正云∶“按灵枢经云一日上之心，是腑传于脏也。
甲乙经作之脾，与王注同。”）二日不已死，冬鸡鸣，夏下晡。（鸡鸣，谓丑正之分。下晡，谓日下于晡，申
后时也。）诸病以次是相传，如是者，皆有死期，不可刺。（按∶五行以胜相传，言其常也。若夫死期，有相
符者，有未必相符者，不可拘执。）间一脏，及至三四脏者，乃可刺也。（至三脏者，皆是其己不胜之气也。至
四脏者，皆至己所生之父母也。不胜则不能为害于彼，所生则父子无克伐之期，气顺以行，故刺之可矣。按∶
王本间一脏止，甲乙经无止字，是也，今删之。）
先发生的疾病为本，后发生的疾病为标，标本的关系固然需要明确。而治疗的逆法与顺法尤其不可不加以辨别，逆法应当优先使用，顺法可以随后使用。如果先处理那些可以后处理的病证，而后处理那些应当先处理的病证，那就差得太远了。
黄帝问道：疾病有标本之分，针刺治疗有逆从之法，这是为什么呢？岐伯回答说：凡是针刺的方法，必须辨别阴阳，前后呼应，逆从之法得以施行，标本的主次得以转换。所以说，有的病在标，就求治于标；有的病在本，就求治于本；有的病在本，却求治于标；有的病在标，却求治于本。所以治疗中，有的取标而获效，有的取本而获效，有的用逆法而获效，有的用顺法而获效。（掌握了疾病的真情，知晓治疗的大体原则，那么逆法和顺法都可以使用，施治必然中肯。）所以懂得逆与从，正行其道无需疑问；懂得标本，就能万举万当。（道理没有疑惑，认识既已深刻明了，就不必询问他人，正行皆能得当。）如果不了解标本，这就叫做妄行。（认识偏狭浅薄，道术不够高深，举动往往违背常理，所以行为多属妄为。）阴阳、逆从、标本这些道理，看似微小实则宏大，言及一事即可知晓百病的危害。（达到极致的境界。观察其所列举的则显得微小，探寻其利益所在则显得宏大，以此明白显赫，所以说言一而知百病的危害。）内容少而涵盖多，理论浅显而知识广博，可以说言一而知百。（……按：广博多不外乎浅显和少数，所以贵在掌握要领。）治疗不当即为逆，治疗得当即为从。先发病而后出现气机逆乱的，治疗其本；先气机逆乱而后发病的，治疗其本；先寒而后生病的，治疗其本；先病而后生寒的，治疗其本；先热而后生病的，治疗其本；先热而后出现中满（胸腹胀满）的，治疗其标；先病而后泄泻的，治疗其本；先泄泻而后产生其他疾病的，治疗其本，必须先调理好泄泻，然后才能治疗其他疾病；先病而后出现中满的，治疗其标；先中满而后出现烦心的，治疗其本。人有客气（外感邪气），有同气（内伤之气）。大小便不通利的，治疗其标；大小便通利的，治疗其本。（按：疾病虽有标本之分，但治疗应当根据病势的缓急来决定。病势危急严重的，无非是中满和大小便不利这两种情况。所以不论其属于标还是本，都以先治疗为贵。）疾病发作表现为有余（实证），先治其本，后治其标；疾病发作表现为不足（虚证），先治其标，后治其本。（按：有余的病，容易治疗且无变化，所以可以由本及标；不足的病，难治且多变，所以应当先标而后本。为什么呢？因为病势的缓急不同。）仔细察看病情的轻重，用心来调治，病情轻缓的标本兼治，病情危重的单治其一。（间指轻缓，甚指危重。多指症状多而轻易，少指症状少而重难。用心调治，是指审量标本的虚实多少，并非抛弃法则而凭主观臆断行事。按：并行和独行，是指针对轻缓和危重病情的治疗方法。病势缓而症状多的间病，还可以参用君药佐药来调治，所以叫并行；若是病情危重的，症状危险而病势紧急，非简要的药物不能治疗，所以叫独行。注解说并为共同受邪气，独为一经受邪，是错误的。）先大小便不利而后生病的，治疗其本。（按：这里再次强调大小便不利，因为病最急，所以治疗不可不早。）
关于疾病的传变：心病先发心痛，（按：心为火脏，火炽盛焚烧则痛。）一日后咳嗽，（心火克肺金，传于肺，肺在变动时表现为咳。）三日后胁肋支撑疼痛，（肺金克肝木，传于肝，因其经脉循行胁肋，所以如此。五日后闭塞不通，身体疼痛沉重，（肝木克脾土，传于脾。按：脾主运动，被木所伤则不能运动，所以如此。）三日不好就会死亡，冬季在夜半，夏季在中天（中午）。以相克之气相互攻伐，只向虚弱的一方传导，五脏受到四次伤害，怎么能长久，所以死于子午之时。（按：新校正说：“按《灵枢经》说：‘大气入脏，病先发于心，一日传肺，三日传肝，五日传脾，三日不好死亡，冬季夜半，夏季中天。’《甲乙经》说：‘病先发于心，心痛，一日传肺而咳，三日传肝胁肋支撑痛，五日传脾闭塞不通，身体疼痛沉重，三日不好死亡，冬季夜半，夏季中天。’详细考察，《素问》讲病，《灵枢》讲脏，《甲乙经》综合了《素问》和《灵枢》的文字，将病与脏并举。”）肺病喘咳，（按：肺主呼吸主气，所以生病则喘咳。）三日后胁肋胀满疼痛（肺传于肝。）一日后身体沉重疼痛，（肝传于脾。）五日后腹胀，（按：脾传于肾，水湿壅滞不行，所以腹胀。注解说自传于腑，是错误的。）十日后不好死亡，冬季日入（傍晚），夏季日出（清晨）。肝病头目眩晕，胁肋支撑胀满，（肝脉内连目和胁，所以如此。）三日后身体沉重疼痛，（按：肝传于脾，所以身体沉重疼痛，脾主肌肉的缘故。注解说传肺，又错了。）五日后腹胀，（自传于腑。）三日后腰脊少腹疼痛，痉挛抽搐，（谓胃传于肾，因其经脉起于足，循行腘内，出腘内廉，上股内后廉，贯脊属肾，络膀胱，所以如此。）三日不好死亡，冬季日入，（按：《甲乙经》作日中。）夏季早食（卯正之时，即早晨五点整）。脾病身体疼痛沉重，（脾主肌肉的缘故。）一日后腹胀，（按：脾传胃。）二日后少腹腰脊疼痛，小腿肚酸痛，（胃传于肾。）三日后背脊旁肌肉疼痛，小便闭，（按：肾传膀胱所以小便闭。KT，脊肉也。脊开一寸五分处为膀胱经脉，邪气传入所以痛。《灵枢经》所说的KT，大概就是指这个。KT音吕。）十日后不好死亡，冬季人定（晚上九点左右），夏季晏食（寅后二十五刻，即凌晨四点一刻左右）。肾病少腹腰脊疼痛，腘窝酸痛，（脏真下行于肾所以如此。）三日后背脊旁肌肉疼痛，小便闭，自传于腑。按：新校正说：“《灵枢经》说传于KT和膀胱，是自传于腑及至KT。”三日后腹胀，膀胱传于小肠。按：水传火腑，气机壅滞不行所以腹胀。《甲乙经》作“上之心，心胀。”三日后两胁肋支撑疼痛，（腑传于脏。按：新校正说：“按《灵枢经》说：‘三日传小肠，三日传心。’现在说两胁肋支撑痛，是小肠腑传心脏而发痛。”）三日不好死亡，冬季大晨（天亮时），夏季晏晡（黄昏时）。（大晨，大明时也。晏晡，向昏时也。）胃病胀满，（因其经脉循行腹部。按：其脉虽循腹，然胃为水谷之海，胃病则不能化水谷，所以胀而满也。）五日后少腹腰脊疼痛，腘窝酸痛，（胃传于肾。）三日后背脊旁肌肉疼痛，小便闭，（自传于腑，及至KT。）五日后身体沉重，（膀胱水腑，传于脾。按：新校正说：“按《灵枢经》及《甲乙经》各云五日上之心，是膀胱传心，因相克而身体重。现在王冰注解说传脾，是错误的。”谨按身体沉重本属脾病，传心也会令身体沉重，不可不知。）六日不好死亡，冬季夜半后，夏季日昳（日昳，谓午后八刻，未正之时，即下午一点到三点之间）。膀胱病小便闭，（因其为津液之腑的缘故。）五日后少腹胀，腰脊痛，腘窝酸痛（自归于脏。）一日后腹胀，（肾复传于小肠。）一日后身体疼痛，（小肠传于脾。按：新校正说：“按《灵枢经》云一日上之心，是腑传于脏。《甲乙经》作之脾，与王注相同。”）二日不好死亡，冬季鸡鸣（凌晨一点到三点），夏天下晡（日落申后时，即下午三点到五点）。各种疾病依此顺序相传，像这样，都有死期，不可针刺。（按：五行以相克顺序相传，说的是常态。至于死期，有的相符，有的未必相符，不可拘泥固执。）间隔一脏，以及传到三四脏的，才可以针刺。（传到三脏的，都是它自己不能克制的气。传到四脏的，都到了它所生的父母脏。不能克制就不能对彼方造成危害，所生则是父子关系没有克伐之期，气顺而行，所以针刺是可以的。按：王本中间隔一脏止，甲乙经无止字，是对的，现在删去。）
The disease that occurs first is the root (Ben, 本), and the disease that occurs later is the branch (Biao, 标); it is essential to clarify the relationship between root and branch. However, the distinction between contrary (Ni, 逆) and compliant (Cong, 从) treatments must not be overlooked. Contrary treatments should be prioritized, while compliant treatments may follow. If one treats what can be treated later first, and delays treating what should be treated first, the error will be significant.
Yellow Emperor asked: Diseases have root and branch distinctions, and acupuncture has contrary and compliant methods. How is this so? Qibo replied: The method of acupuncture must distinguish Yin and Yang, ensure correspondence between front and back, apply contrary and compliant principles correctly, and shift focus between root and branch appropriately. Thus, it is said: if the pathology is at the branch, seek treatment at the branch; if at the root, seek treatment at the root; if at the root but seeking treatment at the branch; or if at the branch but seeking treatment at the root. Therefore, some cures are achieved by targeting the branch, some by targeting the root, some by using contrary methods, and some by using compliant methods. (Understanding the true nature of the disease and grasping the general principles of treatment allows for the flexible use of both contrary and compliant methods, ensuring accurate application.) Thus, knowing contrary and compliant means acting rightly without doubt; knowing root and branch ensures success in every attempt. (When the Dao is free from doubt and understanding is profound, there is no need to ask others, and actions will invariably be correct.) Ignorance of root and branch is called reckless action. (Shallow understanding and superficial knowledge lead to actions that often contradict reality, resulting in frequent errors.) The principles of Yin-Yang, contrary-compliant, and root-branch appear small but are great; knowing one aspect reveals the harm of a hundred diseases. (Reaching the ultimate level. Observing the specific examples seems small, but exploring their implications reveals greatness. Thus, knowing one thing allows understanding the harm of a hundred diseases.) Few in words but abundant in meaning, shallow in expression but broad in scope; one can know a hundred things from one principle. (...Note: Broadness does not exceed the shallow and few; therefore, it is crucial to grasp the essentials.) Improper treatment is contrary; proper treatment is compliant. If Qi reversal occurs after the initial disease, treat the root; if Qi reversal precedes the disease, treat the root. If cold symptoms appear before the disease, treat the root; if cold symptoms appear after the disease, treat the root. If heat symptoms appear before the disease, treat the root; if fullness in the middle Jiao (Zhongman, 中满, chest/abdominal distension) appears after heat, treat the branch. If diarrhea occurs after the initial disease, treat the root; if other diseases arise after diarrhea, treat the root, but first regulate the diarrhea before treating other conditions. If Zhongman appears after the initial disease, treat the branch; if irritability arises after Zhongman, treat the root. There are external pathogenic factors (Keqi, 客气) and internal matching factors (Tongqi, 同气). If urination and defecation are obstructed, treat the branch; if they are unobstructed, treat the root. (Note: Although diseases have root and branch distinctions, treatment should follow the urgency of the condition. The most critical and urgent situations are Zhongman and obstruction of urination/defecation. Regardless of whether they belong to root or branch, priority is given to immediate treatment.) When a disease manifests as excess (Yu, 有余), treat the root first and the branch later; when it manifests as deficiency (Bu Zu, 不足), treat the branch first and the root later. (Note: Excess diseases are easier to treat with fewer variations, allowing progression from root to branch. Deficiency diseases are harder to treat with more variations, requiring treatment from branch to root first. Why? Because the urgency of the condition differs.) Carefully observe the severity of the condition and adjust accordingly. For mild cases, treat both root and branch simultaneously (Bing Xing, 并行); for severe cases, treat only one aspect (Du Xing, 独行). (Jian refers to mild/slow, Shen refers to severe/urgent. Duo refers to many symptoms but easy to handle; Shao refers to few symptoms but difficult to handle. Adjusting by mind means assessing the sufficiency or deficiency of root and branch, not abandoning principles for arbitrary decisions. Note: Bing Xing and Du Xing refer to treatment methods for mild and severe conditions respectively. Mild conditions with slow progression and multiple symptoms can use combined sovereign and assistant herbs for regulation, hence "simultaneous treatment." Severe conditions with dangerous symptoms and urgent progression require concise and potent prescriptions, hence "single treatment." The commentary stating that simultaneous means shared pathogenic invasion and single means invasion of one meridian is incorrect.) If obstruction of urination/defecation precedes the disease, treat the root. (Note: Reiterating obstruction of urination/defecation emphasizes its urgency, necessitating early treatment.)
Regarding disease transmission: Heart disease begins with heart pain. (Note: The Heart is a Fire organ; excessive fire causes burning pain.) After one day, coughing occurs. (Heart Fire overacts on Lung Metal, transmitting to the Lung; the Lung's movement change manifests as cough.) After three days, flank support pain occurs. (Lung Metal overacts on Liver Wood, transmitting to the Liver; since the Liver meridian traverses the flanks, pain occurs here. After five days, obstruction and blockage occur, with body pain and heaviness. (Liver Wood overacts on Spleen Earth, transmitting to the Spleen. Note: The Spleen governs movement; injured by Wood, it cannot move properly, causing these symptoms.) If not resolved within three days, death ensues, occurring at midnight in winter or noon in summer. Transmission follows the cycle of overcoming, attacking only the weak. With four injuries to the Five Zang organs, longevity is impossible; thus, death occurs at Zi-Wu hours (midnight-noon). (Note: Xin Zheng Jiao states: "'According to Ling Shu Jing: 'Grand Qi enters the Zang, 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 not resolved in three days, death occurs at midnight in winter or noon in summer.' According to Jia Yi Jing: 'Disease starts in the Heart with heart pain, transmits to the Lung causing cough after one day, to the Liver causing flank pain after three days, to the Spleen causing obstruction and body pain/heaviness after five days. If not resolved in three days, death occurs at midnight in winter or noon in summer.' Detailed examination shows Su Wen discusses disease, Ling Shu discusses Zang, and Jia Yi Jing combines both, mentioning both disease and Zang.") Lung disease presents with wheezing and coughing. (Note: The Lung governs respiration and Qi; disease leads to wheezing and coughing.) After three days, flank distension and pain occur (transmission to Liver). After one day, body heaviness and pain occur (transmission to Spleen). After five days, abdominal distension occurs. (Note: Transmission to Kidney; water accumulation fails to flow, causing distension. Commentary claiming transmission to Fu organs is incorrect.) If not resolved in ten days, death ensues, occurring at sunset in winter or sunrise in summer. Liver disease presents with dizziness and vertigo of head and eyes, flank distension and fullness. (Liver meridian connects internally to eyes and flanks, causing these symptoms.) After three days, body heaviness and pain occur. (Note: Transmission to Spleen causes heaviness/pain; Spleen governs muscles. Commentary claiming transmission to Lung is incorrect.) After five days, abdominal distension occurs (self-transmission to Fu organs). After three days, lower abdomen, waist, spine, and groin pain occur, with spasms. (Stomach transmits to Kidney; its meridian starts at the foot, runs through the popliteal fossa, emerges medial to the knee, ascends posterior-medial thigh, penetrates spine, belongs to Kidney, and links to Bladder, causing these symptoms.) If not resolved in three days, death ensues, occurring at sunset in winter. (Note: Jia Yi Jing says noon.) Or early meal time in summer (Mao Zheng, exactly 5 AM). Spleen disease presents with body pain and heaviness. (Spleen governs muscles.) After one day, abdominal distension occurs. (Note: Transmission to Stomach.) After two days, lower abdomen, waist, spine pain, and calf soreness occur. (Stomach transmits to Kidney.) After three days, paraspinal muscle pain and urinary retention occur. (Note: Kidney transmits to Bladder, causing retention. KT refers to paraspinal muscles. The Bladder meridian runs 1.5 cun lateral to the spine; pathogenic invasion causes pain. The KT mentioned in Ling Shu likely refers to this. KT sounds like 'Lu'.) If not resolved in ten days, death ensues, occurring at Ren Ding (around 9 PM) in winter or Yan Shi (25 ke after Yin hour, approx. 4:15 AM) in summer. Kidney disease presents with lower abdomen, waist, spine pain, and popliteal soreness. (Zhen Qi descends to Kidney, causing this.) After three days, paraspinal muscle pain and urinary retention occur, self-transmitting to Fu organs. Note: Xin Zheng Jiao states: "'Ling Shu Jing says transmission to KT and Bladder, which is self-transmission to Fu and reaching KT.'" After three days, abdominal distension occurs, Bladder transmits to Small Intestine. Note: Water transmits to Fire Fu organ; Qi stagnation causes distension. Jia Yi Jing reads "ascends to Heart, Heart distension." After three days, bilateral flank support pain occurs. (Fu transmits to Zang. Note: Xin Zheng Jiao states: "'Ling Shu Jing says: 'Transmits to Small Intestine after three days, ascends to Heart after three days.' Now saying bilateral flank pain implies Small Intestine Fu transmitting to Heart causing pain.'") If not resolved in three days, death ensues, occurring at Da Chen (daybreak) in winter or Yan Bu (towards dusk) in summer. (Da Chen is bright dawn. Yan Bu is approaching dusk.) Stomach disease presents with abdominal distension and fullness. (Its meridian traverses the abdomen. Note: Although the meridian traverses the abdomen, the Stomach is the Sea of Water and Grain; disease impairs digestion, causing distension and fullness.) After five days, lower abdomen, waist, spine pain, and popliteal soreness occur. (Stomach transmits to Kidney.) After three days, paraspinal muscle pain and urinary retention occur. (Self-transmission to Fu and reaching KT.) After five days, body heaviness occurs. (Bladder, a Water Fu organ, transmits to Spleen. Note: Xin Zheng Jiao states: "'Ling Shu Jing and Jia Yi Jing both say ascends to Heart after five days, implying Bladder transmits to Heart, causing heaviness due to overcoming. Wang Bing's note claiming transmission to Spleen is incorrect.' Strictly speaking, body heaviness belongs to Spleen disease, but transmission to Heart also causes heaviness; this must be known.") If not resolved in six days, death ensues, occurring after midnight in winter or Ri Die (8 ke after Wu hour, approx. 1-3 PM) in summer. Bladder disease presents with urinary retention. (Because it is the Fu organ of fluids.) After five days, lower abdominal distension, waist/spine pain, and popliteal soreness occur (self-returning to Zang). After one day, abdominal distension occurs. (Kidney re-transmits to Small Intestine.) After one day, body pain occurs. (Small Intestine transmits to Spleen. Note: Xin Zheng Jiao states: "'Ling Shu Jing says ascends to Heart after one day, implying Fu transmits to Zang. Jia Yi Jing reads transmits to Spleen, consistent with Wang Bing's note.'") If not resolved in two days, death ensues, occurring at Ji Ming (1-3 AM) in winter or Xia Bu (afternoon Shen hour, 3-5 PM) in summer. Various diseases transmit in this sequence; such cases have fixed death periods and are not suitable for acupuncture. (Note: Transmission via Five Elements overcoming represents the normal pattern. Death periods may or may not align; do not rigidly adhere to them.) If the transmission skips one Zang, or reaches three or four Zang organs, acupuncture may be performed. (Transmission to three Zang organs involves Qi that the current organ cannot overcome. Transmission to four Zang organs reaches the generating parent organs. Since they cannot harm each other, and generation implies no conflict between father and son, Qi flows smoothly, making acupuncture appropriate. Note: Wang Ben stops at "skipping one Zang," while Jia Yi Jing has no stop word, which is correct; this has been deleted.)