Deal the entire deck of cards between players, except the last card, which you place face down in the center of the table.
Turn the center card (starting card) face up at the center of the table so that all players can see it.
Take turns, beginning with the player to the left of the dealer. This player puts down a card with a number higher than the face-up center card. If the player doesn't have a higher-numbered card, he can play a puffer-fish card, the equivalent of a "zero."
Continue the play clockwise until someone runs out of cards, keeping in mind that a color can never be repeated twice in a row. If a player does not have a higher number, a puffer fish, or a card of the same color, she must announce that she is skipping her turn. Play proceeds to the next player to the left.
Announce "Out" when all of the cards in a player's hand have been played. The first player to run out of cards is the winner.