R — Original Text (Reading)
In treating disease, the same illness is treated in different ways, yet all are cured—why is that? Qibo replied: It is due to the terrain. ...Therefore the sage combines treatments and each gets what is appropriate for it. Thus the treatments differ yet all illnesses are cured because one grasps the circumstances of the illness and understands the general principles of treatment.
— Huangdi Neijing · Suwen, Chapter 12, Discourse on Different Methods and Appropriate Directions
I — Methodological Framework (Interpretation)
The same problem takes on different appearances in different environments, so there is no single solution that fits all places. The Suwen uses the constitutional and treatment differences of the five directions (east, west, north, south, center) to explain this principle: People of the east are prone to abscesses and sores and should use stone needles; people of the west have strong constitutions and should use potent medicines; people of the north have cold viscera and should use moxibustion; people of the south suffer from contractures and impediments and should use fine needles; people of the center suffer from flaccidity and reversal and should use daoyin and massage—the same "treating disease," five places, five approaches.
The key is not to memorize five solutions, but to master the way of thinking of "adapting to place": first analyze the characteristics of the current environment (climate, diet, constitution, customs), then judge how these characteristics affect the solution, and finally choose an adapted solution or use multiple solutions in a "combined" way.
When your solution fails in a new environment, the problem is usually not the solution itself, but that you assumed a "standard environment"—yet real environments always have local particularities. "Combining treatments" further reminds us: when a single solution is insufficient, you can combine multiple solutions, letting each method play its appropriate part, without insisting on a single answer.
A1 — Applications in the Text (Past Application)
Case 1: Different treatments for the five directions
- Problem: For the same treatment of disease, why does the east use stone needles, the west use potent medicines, the north use moxibustion, the south use fine needles, and the center use daoyin and massage?
- Use of the methodology: The Suwen analyzes one by one the geography and climate of the five directions → dietary customs → constitutional characteristics → commonly occurring diseases, and then gives the corresponding optimal treatment. The eastern seaboard has much fish and salt; people tend to have internal heat and abscesses, so stone needles are appropriate to drain pus; the north is frozen and cold; people have cold viscera and fullness diseases, so moxibustion is appropriate to warm yang.
- Conclusion: The differences in treatment are not arbitrary but determined by the environment. "It is due to the terrain"—when the terrain differs, the solution must differ.
- Result: Each of the five treatments is most effective in its own region, but an expert who "combines treatments" can use them together, so that "each gets what is appropriate for it."
Case 2: Constitutional differences between the northwest and southeast and adjustment of treatment
- Problem: The same disease requires different treatments in the northwest and the southeast.
- Use of the methodology: The Wuchang Zheng Da Lun points out that "the qi of the northwest is dispersing and cold, while the qi of the southeast is contracting and warm; this is what is meant by treating the same disease differently." In the northwest, yin essence is offered upward, and people's constitutions tend toward excess, requiring dispersion of pathogenic factors; in the southeast, yang essence descends, and people's constitutions tend toward deficiency, requiring consolidation and holding fast.
- Conclusion: "Treating the same disease differently"—when the diagnosis is the same but the environment differs, the solution must be adjusted.
- Result: Patients treated according to place recover faster, while copying a solution yields poor results.
A2 — Trigger Scenarios (Future Trigger) ★
In what situations would a user need this skill?
- Solution migration failure: The user has a solution that was successfully validated in location A/scenario A/market A, but after migrating it to location B/scenario B, they find the effect is greatly diminished, and they need to diagnose the cause and adjust.
- Parallel deployment in multiple locations: The user needs to roll out the same project/product/policy simultaneously in multiple different regions or scenarios, and needs to design variants tailored to local conditions.
- Localization adaptation: The user's general solution needs to be adapted to a specific culture, climate, regulations, or user habits, and cannot be copied as is.
Language signals (activate when these appear in the user's words)
- "Why does it work here but not there?"
- "The solution fails as soon as it's moved somewhere else"
- "Can we just copy that solution over directly?"
- "Every region's situation is different"
- "Localization adaptation is needed"
- "A one-size-fits-all solution won't work"
Distinction from adjacent skills
- Difference from
cascade-prediction: tailoring to local conditions focuses on "adapting the same problem to different environments," while transmission-change prediction focuses on "how one problem cascades and spreads to other links." The former is the spatial dimension, the latter is the temporal dimension. - Difference from
zheng-xie-assessment: tailoring to local conditions is analyzing environmental characteristics to adjust the solution, while healthy-pathogen/excess-deficiency is assessing one's own capabilities vs. external pressure to decide whether to supplement or drain. The former focuses on environmental differences, the latter focuses on the balance of forces.
E — Executable steps (Execution)
When the skill is activated, the agent should execute the following steps:
-
Analyze the current environmental characteristics
- List the key characteristics of the target environment: geographic/climatic conditions, culture/customs, user characteristics, institutional/rule constraints.
- Compare with the assumed environment of the original solution, and mark the points of difference.
- Completion standard: produce an "environmental difference list" with at least 3 significant differences.
-
Compare against the solution-environment fit table
- Compare each key element of the original solution one by one with the target environment, and judge whether it is a match, a conflict, or missing.
- Pay special attention to: which elements will fail in the new environment? Which elements are instead more valuable? Which new elements need to be added?
- Completion standard: label each key element as "keep/adjust/replace/add."
- Stop condition: if all elements match with no conflicts, it means the environmental differences are not large, and you can skip to step 3 for simplified adjustment.
-
Adjust the solution or hybridize multiple solutions
- For elements marked "adjust" and "replace," design alternatives adapted to the new environment.
- If a single solution is insufficient to cover the situation, adopt "hybridization for treatment"—combine the essence of multiple solutions so that each means is appropriately applied.
- Completion standard: produce the localized final solution, and label the environmental reason corresponding to each adjustment.
B — Boundary (Boundary) ★
Do not use this skill in the following situations
- Purely logical problems where environmental factors are unimportant: such as mathematical calculations, code syntax, etc., where the answer is unrelated to region/scenario, and tailoring to local conditions is meaningless.
- Scenarios that already have precise quantitative models: if environmental variables have already been precisely captured by a mathematical model (such as the design of standard engineering parts), there is no need to replace it with qualitative analysis.
Failure modes the author warns about in the book
- Treating without understanding the terrain—Suwen explicitly states, "One must understand the way of heaven and the principles of geography, and how yin and yang alternate in dominance... only then can one know a person's physical constitution and qi." Applying a plan without analyzing the environment is "reckless action."
- Clinging to a single approach—"treating with a combination" is the highest state. If one stubbornly adheres to one treatment method and rejects others, one cannot "give each its proper place."
The author's blind spots / limitations of the era
- Suwen's regional classification (the five directions) is too coarse. Environmental differences in modern society are far more complex than east, west, south, and north—more dimensions need to be added (industry, organizational culture, technology stack, etc.).
- The ancient practice of "adapting to local conditions" relied mainly on accumulated experience. In modern times, data analysis can be used to achieve more precise environment-solution matching.
Easily confused neighboring methodologies
- "Analyze specific problems specifically"—adapting to local conditions is not a vague "it depends," but rather a structured analysis process from environmental characteristics to solution fit.
- "A/B testing"—A/B testing verifies after the fact which solution is better, while adapting to local conditions predicts before the fact which solution is more suitable based on environmental characteristics. The two are complementary.
Related skills (to be filled in stage 3)
- contrasts-with: seasonal-regimen — Four-season regimen is "adapting to the times" (adjusting the plan according to seasonal time), while adapting to local conditions is "adapting to local conditions" (adjusting the plan according to the geographical environment). Both are components of the "three adaptations" in Suwen, corresponding respectively to the two dimensions of time and space. When a user's plan fails when the seasons change, use four-season regimen; when it fails when the location changes, use adapting to local conditions.
Audit information
- Verification passed: V1 ✓ / V2 ✓ / V3 ✓
- Test pass rate: {{%}} (see test-prompts.json)
- Distillation time: 2026-04-18