Understanding Disease Progression and Treatment in Traditional Chinese Medicine

The Yellow Emperor said: “I have learned the knowledge of the Nine Needles from my teacher and have read some classic texts, which mention therapies such as guiding energy, massage, moxibustion, cupping, acupuncture, fire needling, and herbal treatments. When applying these methods, should I use only one treatment at a time, or can multiple treatments be used together?”

Qi Bo replied: “The various therapies mentioned in the classic texts are designed to address the different diseases of many people. They are not intended to be used all at once on a single patient.”

The Yellow Emperor said: “So it is about mastering a general principle and not forgetting it, which can resolve complex issues. I now understand the fundamentals of Yin and Yang, the theory of deficiency and excess, diseases caused by improper care, and various methods of treatment. I now wish to understand the changes that occur in diseases, as well as the principle behind how pathogenic factors lead to the depletion of vital energy, making recovery difficult. Can you explain this?”

Qi Bo replied: “This is a crucial issue. Understanding these medical principles is like being clear-headed in daylight; without understanding, it is like closing your eyes in the dark, unable to perceive anything. Therefore, it is not only important to accept and master these principles, but to apply them practically. Through focused attention and exploration, you can reach a state of full understanding. In the practical application, you will grasp the essence, achieving fluidity and mastery. These theories should be written down and passed down to future generations, not kept privately and taught only to one’s descendants.”

The Yellow Emperor asked: “What is the concept of ‘daylight clarity’?”

Qi Bo replied: “When you understand the principles of Yin and Yang, it is like solving a confusing problem or waking up from drunkenness to clarity.”

The Yellow Emperor asked: “What is ‘night blindness’?”

Qi Bo replied: “After pathogenic factors invade the body, they cause internal changes that are silent, shapeless, and invisible—just like closing your eyes in the dark, unable to see anything. These changes often occur unnoticed, leading to hair loss, sweat, or open pores. If the vital energy is greatly weakened and the pathogenic factors spread, they can travel through the blood vessels to the internal organs, causing abdominal pain and dysfunction of the organs. When the pathogenic influence becomes intense and the vital energy is depleted, it becomes very difficult to treat.”

The Yellow Emperor asked: “What happens when pathogenic factors invade the internal organs?”

Qi Bo replied: “When pathogenic factors first affect the heart, they will spread to the lungs within one day, to the liver in three days, and to the spleen in five days. If the condition does not improve within three more days, it will lead to death. In winter, death occurs at midnight; in summer, it occurs at noon. If the disease starts in the lungs, it will spread to the liver in three days, to the spleen in one day, to the stomach in five days, and if not treated within ten days, death will occur. In winter, death will occur at sunset; in summer, at sunrise. If the disease begins in the liver, it will spread to the spleen in three days, to the stomach in five days, to the kidneys in three days, and if not cured within three days, it will lead to death. In winter, death will occur at sunset; in summer, at breakfast time. If the disease starts in the spleen, it will spread to the stomach in one day, to the kidneys in two days, and to the spine and bladder in three days. If not cured within ten days, death will occur. In winter, death happens at night, just as people are falling asleep; in summer, at dinner time. If the disease begins in the stomach, it will spread to the liver in five days, to the spine and bladder in three days, and to the heart in five days. If not treated within two more days, death will occur. In winter, death happens at midnight; in summer, in the afternoon. If the disease starts in the kidneys, it will spread to the spine and bladder in three days, to the heart in three days, and to the small intestine in three days. If not treated in three more days, death will occur. In winter, death happens at dawn; in summer, at dusk. If the disease starts in the bladder, it will spread to the kidneys in five days, to the small intestine in one day, and to the heart in one day. If not treated in two more days, death will occur. In winter, death happens at dawn; in summer, in the afternoon. The above diseases follow a specific order of transmission based on mutual conflict among the organs, so there is a set time for death, and acupuncture should not be used. If the disease spreads irregularly, skipping organs or spreading to the second, third, or fourth organ, acupuncture can be used as treatment.”