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Chapter 3 of 14
针灸甲乙经
The Yellow Emperor asked: In all methods of acupuncture, one must first take "Spirit" as the foundation. Blood, vessels, nutrient qi, defensive qi, essence, and spirit—these are all stored by the five zang organs. What are virtue, qi, life, essence, spirit, ethereal soul, corporeal soul, mind, intention, will, thought, wisdom, and deliberation? Please explain the principles behind these.
Qi Bo replied: What Heaven bestows upon me is "virtue"; what Earth bestows upon me is "qi." When virtue and qi flow and intermingle, "life" is generated. The primordial substance of life is called "essence" (🌿 the foundational substance of life). The vital activity produced by the union of two essences is called "spirit" (the master of life). The mental activity that follows the spirit is called "ethereal soul." The perceptual instinct that comes and goes together with essence is called "corporeal soul." The function that enables one to cognize external things is called "mind." What the mind recalls and remembers is called "intention." What intention persists in is called "will." Deliberating repeatedly according to will is called "thought." Long-term planning arising from thought is called "deliberation." Handling affairs well through deliberation is called "wisdom."
Therefore, to nourish life with wisdom, one must comply with the four seasons, adapt to cold and heat, harmonize joy and anger, find peace in one's dwelling, moderate yin and yang, and balance hardness and softness. In this way, pathogenic qi will not arise, and one can attain longevity and health.
Thus: Fear, wariness, and excessive rumination will injure the "spirit." When the spirit is injured, one becomes fearful and restless, with the spirit scattering and failing to be retained. Grief that stirs the interior will deplete essence and qi, causing one to lose vitality. Excessive joy causes spirit qi to dissipate and fail to be stored within. Worry causes qi to become blocked and fail to flow smoothly. Great anger causes the mind to become confused and unable to govern itself. Fear causes spirit qi to be agitated and unable to be restrained.
The Plain Questions states: Anger causes qi to ascend counterflow; in severe cases, vomiting of blood, as well as qi counterflow after eating—hence "qi rises." Joy causes qi to harmonize and the will to be fulfilled, with nutrient and defensive qi flowing freely—hence "qi slackens." Grief causes the heart system to contract, the lung lobes to rise, the upper and middle burners to become obstructed, nutrient and defensive qi to fail to spread, and heat to accumulate within the body—hence "qi dissipates." Fear causes spirit qi to retreat; retreat causes the upper burner to close; closure causes qi to return; return causes the lower burner to become distended—hence "qi fails to move." Heat causes the interstices to open, nutrient and defensive qi to flow freely, and profuse sweating. Fright causes the heart to have nothing to rely on, the spirit to have no place to return, and thought to have no place to settle—hence "qi becomes chaotic." Labor causes panting and sweating, with both interior and exterior depleted—hence "qi is exhausted." Rumination causes the mind to be tied to something, the spirit to come to rest, and qi to stagnate and fail to move—hence "qi becomes knotted."
The liver stores blood, and the ethereal soul resides within blood. The liver manifests in speech as qi and in fluid as tears. When liver qi is deficient, one is prone to fear; when liver qi is excess, one is prone to anger. The Plain Questions states: When a person lies down, blood returns to the liver. The liver receiving blood enables vision; the feet receiving blood enable walking; the palms receiving blood enable grasping; the fingers receiving blood enable clutching.
The heart stores the vessels, and the spirit resides within the vessels. The heart manifests in swallowing as qi and in fluid as sweat. When heart qi is deficient, one is prone to grief and worry; when heart qi is excess, one cannot stop laughing.
The spleen stores nutrient essence, and the intention resides within it. The spleen manifests in belching as qi and in fluid as drool. When spleen qi is deficient, the four limbs cannot move and the five zang organs become restless. When spleen qi is excess, there is abdominal distension and difficult urination and defecation.
The lungs store qi, and the corporeal soul resides within qi. The lungs manifest in coughing as qi and in fluid as nasal mucus. When lung qi is deficient, breathing becomes difficult with scant qi; when lung qi is excess, there is wheezing with sound, full distension of the chest, and breathing with the head raised.
The kidneys store essence, and qi resides within essence. The kidneys manifest in yawning as qi and in fluid as saliva. When kidney qi is deficient, the four limbs become cold; when kidney qi is excess, there is abdominal distension and restlessness of the five zang organs. One must carefully examine the patterns of illness in the five zang organs to understand the deficiency or excess of their qi and regulate them with caution.
When liver qi is grieved and stirred within, it injures the ethereal soul. When the ethereal soul is injured, one becomes manic and delirious, essence cannot be guarded within, causing contraction of the genitals and sinews, the ribs on both flanks unable to be raised, withered hair and dull complexion, and death occurs in autumn. The liver manifests in the sound of shouting, in pathological change as spasm, and in the will as anger; anger injures the liver. When essence qi converges in the liver, worry is generated. The liver and kidneys complement each other; the spleen and lungs complement each other. The spleen belongs to earth, and all four organs are nourished by it. Thus, fear originates from the liver and matures in the kidneys; love originates from the spleen and matures in the liver. The liver pairs with the gallbladder, and the gallbladder is the organ of refined essence. The kidneys store essence, so fear and anger share the same origin; when either is excessive, both organs are injured.
For the heart: fear and rumination injure the spirit. When the spirit is injured, one becomes fearful and unable to control oneself, with withered flesh, dry hair, and dull complexion; death occurs in winter. The heart manifests in the sound of laughter, in pathological change as worry, and in the will as joy; joy injures the heart. When essence qi converges in the heart, joy is generated. When the heart is deficient, there is grief; grief leads to worry. When the heart is excess, there is laughter; laughter leads to joy. The heart and lungs complement each other; the spleen and heart complement each other. Joy originates from the heart and matures in the lungs; rumination originates from the spleen and matures in the heart. When either is excessive, both organs are injured.
For the spleen: unresolved sorrow and worry injure the intention. When the intention is injured, one becomes vexed and confused, the four limbs cannot be lifted; with dry hair and dull complexion, death occurs in spring. The spleen manifests in the sound of singing, in pathological change as hiccough, and in the will as rumination; rumination injures the spleen. When essence qi converges in the spleen, sensations of hunger arise.
For the lungs: excessive joy injures the corporeal soul. When the corporeal soul is injured, one becomes manic; in mania, the consciousness cannot govern itself, the skin becomes parched; with dry hair and dull complexion, death occurs in summer. The lungs manifest in the sound of weeping, in pathological change as coughing, and in the will as worry; worry injures the lungs. When essence qi converges in the lungs, grief is generated.
For the kidneys: prolonged and intense anger injures the will. When the will is injured, one forgets one's previous words; the lower back and spine cannot bend or extend; with dry hair and dull complexion, death occurs in late summer. The kidneys manifest in the sound of groaning, in pathological change as shivering, and in the will as anger; anger injures the kidneys. When essence qi converges in the kidneys, fear is generated. Unresolved fear injures the essence; when essence is injured, there is aching weakness of the bones, cold extremities, and seminal emission or involuntary discharge.
Thus, the five zang organs primarily store essence and must not be injured. When injured, they lose their containing function and yin becomes deficient; yin deficiency leads to absence of qi; absence of qi leads to death. Therefore, those who use acupuncture must observe the patient's demeanor and understand the preservation or loss, gain or absence, of spirit, ethereal soul, and corporeal soul. If these five are already injured, acupuncture can no longer treat the condition.
The Yellow Emperor asked: The five zang organs each have five transformations. I wish to hear the principles behind them. Qi Bo replied: Humans have five zang organs; each has five transformations, and each transformation has five acupoints (transporting points). Thus, five times five makes twenty-five, corresponding to the five seasons.
The liver is a yang organ, its color is green, its season is spring, its days are jia and yi, its note is jue, and its flavor is sour. The heart is a yang organ, its color is red, its season is summer, its days are bing and ding, its note is zhi, and its flavor is bitter. The spleen is a yang organ, its color is yellow, its season is late summer, its days are wu and ji, its note is gong, and its flavor is sweet. The lungs are a yin organ, their color is white, their season is autumn, their days are geng and xin, their note is shang, and their flavor is pungent. The kidneys are a yin organ, their color is black, their season is winter, their days are ren and gui, their note is yu, and their flavor is salty. These are the five transformations.
The zang organs govern winter—in winter, needle the well point. The color governs spring—in spring, needle the brook point. The season governs summer—in summer, needle the stream point. The note governs late summer—in late summer, needle the channel point. The flavor governs autumn—in autumn, needle the sea point. These are the five transporting points corresponding to the five transformations. The source point does not independently correspond to the five seasons but is calculated together with the channel points; therefore, six times six makes thirty-six.
When disease is in the zang organs, select the well point. When disease manifests in color changes, select the brook point. When disease alternates between mild and severe, select the stream point. When disease manifests in sound changes, select the channel point. When the channels are full with blood stasis or disease arises from improper diet, select the sea point.
If one defies the qi of spring, then minor yang fails to generate, and liver qi undergoes internal transformation. If one defies the qi of summer, then major yang fails to grow, and heart qi becomes internally deficient. If one defies the qi of autumn, then major yin fails to harvest, and lung qi becomes scorched and full. If one defies the qi of winter, then minor yin fails to store, and kidney qi becomes sunken and turbid. The yin and yang of the four seasons are the root of all things. Hence, the sages nourish yang in spring and summer, and nourish yin in autumn and winter, thereby conforming to the root. To defy the root is to destroy the foundation of life. Yin and yang are the beginning and end of all things; compliance with them brings life, while defiance brings death. Hence, the sages do not treat a disease that has already begun but rather treat what has not yet begun. They discuss the mutual conquest of transmission among the five zang organs: for example, if heart disease transmits to the lungs, treatment should be administered preemptively before the lungs become diseased.
The lungs pair with the large intestine; the large intestine is the organ that transmits waste. The heart pairs with the small intestine; the small intestine is the organ that receives and transforms substances. The liver pairs with the gallbladder; the gallbladder is the organ of clear purity. The spleen pairs with the stomach; the stomach is the organ of the five grains. The kidneys pair with the bladder; the bladder is the organ of fluids. The minor yin channel belongs to the kidneys and connects upward to the lungs, thus governing both organs. The triple burner is the organ of the middle passage, the waterway through which channels issue; it belongs to the bladder and is the solitary organ. These are the pairings of the six fu organs.
The Plain Questions states: The brain, marrow, bones, vessels, gallbladder, and the uterus—these six are generated by earth qi, all stored in yin, modeled after the earth. Therefore, they only store but do not discharge and are called extraordinary fu organs. The stomach, large intestine, small intestine, triple burner, and bladder—these five are generated by heaven qi, and their qi models heaven. Therefore, they only discharge but do not store, receiving the turbid qi of the five zang organs; they are called transforming and transmitting organs that cannot retain substances for long but transmit and expel them. The anus also serves the five zang organs, and grain and water cannot be stored for long.
The five zang organs store essence qi without discharging, hence they can be full but not replete. The six fu organs transmit and transform substances without storing, hence they can be replete but not full. When food and water enter the mouth, the stomach is replete while the intestines are empty; when the food descends, the intestines are replete while the stomach is empty. Hence, "replete but not full; full but not replete."
Why is the qi at the radial pulse uniquely regarded as the master of the five zang organs? The stomach is the sea of food and water, the great origin of the six fu organs.
The liver and gallbladder form a pair; hence, foot reverting yin and foot minor yang are interior–exterior. The spleen and stomach form a pair; hence, foot major yin and foot yang brightness are interior–exterior. The kidneys and bladder form a pair; hence, foot minor yin and foot major yang are interior–exterior. The heart and small intestine form a pair; hence, hand minor yin and hand major yang are interior–exterior. The lungs and large intestine form a pair; hence, hand major yin and hand yang brightness are interior–exterior.
Among the five zang organs, the lungs serve as the canopy, with broad shoulders, sunken chest, and a throat that protrudes outward. The heart is the sovereign; the supraclavicular fossa is its pathway. The liver is the general, tasked with observing the exterior; the size of the eyes can indicate its strength. The spleen is the defender of the stomach, transmuting food and water; the condition of the lips and tongue can indicate good or ill fortune. The kidneys govern the exterior, tasked with distant listening; the quality of the ears can indicate their character.
Among the six fu organs, the stomach is the sea. A broad jaw, thick neck, and spacious chest allow the five grains to be accommodated. A long nasal passage indicates the condition of the large intestine; thick lips with a long philtrum indicate the small intestine; fullness below the eyes indicates the courage of gallbladder qi; protruding nostrils indicate leakage from the bladder; height of the central nasal ridge indicates restraint of the triple burner. These are the methods for observing the six fu organs. If the three divisions of the face are even and balanced, the zang organs are calm and sound.
The nose is the official of the lungs; the eyes are the officials of the liver; the lips are the official of the spleen; the tongue is the official of the heart; the ears are the officials of the kidneys. These five officials are used to observe the five zang organs. When the lungs are diseased, there is panting with flaring nostrils. When the liver is diseased, the eyes become green. When the spleen is diseased, the lips become yellow. When the heart is diseased, the tongue curls and the cheekbones redden. When the kidneys are diseased, the cheekbones and forehead become black.
Lung qi communicates with the nose; when the nose is harmonious, it can distinguish fragrances and stenches. Heart qi communicates with the tongue; when the tongue is harmonious, it can distinguish the five flavors. The heart belongs to fire, and the kidneys belong to water; water and fire assist each other. Heart qi communicates with the tongue; the tongue is not an opening, but its connection to the opening is through its attachment to the ear. Liver qi communicates with the eyes; when the eyes are harmonious, they can see the five colors. All vessels are attributed to the eyes. Spleen qi communicates with the mouth; when the mouth is harmonious, it can distinguish the flavors of the five grains. Kidney qi communicates with the ears; when the ears are harmonious, they can hear the five notes. The kidneys have their opening in the ears; kidney qi communicates upward to the ears and downward to the genitals and anus.
When the five zang organs are disharmonious, the nine orifices become blocked. When the six fu organs are disharmonious, qi and blood stagnate and form abscesses and swellings. When pathogenic qi is in the fu organs, the yang channels become disharmonious; disharmony of the yang channels causes qi to stagnate; qi stagnation causes yang qi to become hyperactive. When pathogenic qi is in the zang organs, the yin channels become disharmonious; disharmony of the yin channels causes blood to stagnate; blood stagnation causes yin qi to become hyperactive. When yin qi becomes too hyperactive, yang qi cannot circulate throughout—this is called "repulsion." When both yin and yang become hyperactive and cannot circulate mutually—this is called "blockage and repulsion." One with blockage and repulsion cannot live out a full natural lifespan and dies.
The Yellow Emperor asked: All human beings receive qi from Heaven and Earth. Some enjoy their full natural lifespan, while others inevitably become ill. Why is this? Qi Bo replied: The five zang organs inherently have differences of large and small, high and low, firm and fragile, upright and crooked. The six fu organs likewise have differences of large and small, long and short, thick and thin, knotted and straight, relaxed and tense. These twenty-five variations each differ from one another—some are beneficial, some harmful; some auspicious, some ominous.
When the heart is small, one is calm and secure; external pathogens cannot injure, but one is easily injured by worry. When the heart is large, worry cannot injure, but one is easily injured by pathogenic factors. When the heart is high, it presses upon the lungs, causing vexation, forgetfulness, and difficulty in resolution. When the heart is low, the organ is exposed externally, easily injured by cold, and easily frightened by words. When the heart is firm, the organ is tranquil and well-guarded. When the heart is fragile, one easily suffers from wasting-thirst and heat in the middle. When the heart is upright, one benefits from harmony and is difficult to injure. When the heart is crooked, one's conduct lacks consistency and one has nothing to guard.
When the lungs are small, one drinks little and is not prone to panting. When the lungs are large, one drinks much and is prone to chest impediment and counterflow of qi. When the lungs are high, there is qi rising with panting, coughing, and counterflow. When the lungs are low, they press upon the cardia, causing hypochondriac pain. When the lungs are firm, one is not prone to cough with counterflow of qi. When the lungs are fragile, one easily suffers from wasting-thirst and injury. When the lungs are upright, one benefits from harmony and is difficult to injure. When the lungs are crooked, there is unilateral pain in the chest and hypochondrium.
When the liver is small, one is calm and secure, without hypochondriac disease. When the liver is large, it presses upon the stomach and throat, easily causing disease in the diaphragm and pain in the hypochondrium. When the liver is high, it pushes against the cardia from above, causing tightness in the hypochondrium and "running piglet" syndrome. When the liver is low, it presses upon the stomach, leaving the hypochondrium vacant; vacuity exposes one to pathogenic influence. When the liver is firm, the organ is tranquil and difficult to injure. When the liver is fragile, one easily suffers from wasting-thirst and injury. When the liver is upright, one benefits from harmony and is difficult to injure. When the liver is crooked, there is unilateral pain beneath the ribs.
When the spleen is small, one is tranquil and difficult to be injured by pathogens. When the spleen is large, there is pain beneath the ribs and the inability to walk swiftly. When the spleen is high, it pulls on the lower ribs and causes pain. When the spleen is low, it presses down on the large intestine, and the organ being exposed is easily injured by pathogens. When the spleen is firm, the organ is tranquil and difficult to injure. When the spleen is fragile, one easily suffers from wasting-thirst and injury. When the spleen is upright, one benefits from harmony and is difficult to injure. When the spleen is crooked, there is infantile convulsion and a tendency toward distension.
When the kidneys are small, one is tranquil and difficult to injure. When the kidneys are large, one is prone to lower back pain, cannot bend or extend, and is easily injured by pathogens. When the kidneys are high, one is prone to lower back and spinal pain, and cannot bend or extend. When the kidneys are low, there is pain in the lower back and sacrum, inability to bend or extend, and proneness to "fox hernia." When the kidneys are firm, one is not prone to lower back pain. When the kidneys are fragile, one easily suffers from wasting-thirst and injury. When the kidneys are upright, one benefits from harmony and is difficult to injure. When the kidneys are crooked, one is prone to lower back and sacral pain. These twenty-five variations are the causes of human susceptibility to disease.
How does one know these variations? Through outwardly observable signs:
For red complexion (heart): if the skin texture is fine, the heart is small; if coarse, the heart is large. If the sternum has no protrusion, the heart is high; if the protrusion is small and short, the heart is low. If the protrusion is long, the heart is firm; if the protrusion is weak, small, and thin, the heart is fragile. If the protrusion descends straight without angling, the heart is upright; if the protrusion angles to one side, the heart is crooked.
For white complexion (lungs): if the skin texture is fine, the lungs are small; if coarse, the lungs are large. If the shoulders are broad, the chest sunken, and the throat elevated, the lungs are high; if the armpits converge and the ribs are spread, the lungs are low. If the shoulders and back are thick, the lungs are firm; if the shoulders and back are thin, the lungs are fragile. If the back and chest are thick, the lungs are upright; if the chest is slanted, the lungs are crooked.
For green complexion (liver): if the skin texture is fine, the liver is small; if coarse, the liver is large. If the chest is broad and the ribs are upturned, the liver is high; if the ribs are weak, the liver is low. If the chest and ribs are well-formed, the liver is firm; if the ribs are weak, the liver is fragile. If the chest and abdomen are well-proportioned, the liver is upright; if the ribs are tilted, the liver is crooked.
For yellow complexion (spleen): if the skin texture is fine, the spleen is small; if coarse, the spleen is large. If the lips curve upward, the spleen is high; if the lips sag, the spleen is low. If the lips are firm, the spleen is firm; if the lips are large but not firm, the spleen is fragile. If the lips are even above and below, the spleen is upright; if the lips are slanted, the spleen is crooked.
For black complexion (kidneys): if the skin texture is fine, the kidneys are small; if coarse, the kidneys are large. If the ears are high, the kidneys are high; if behind the ears is sunken, the kidneys are low. If the ears are firm, the kidneys are firm; if the ears are thin and not firm, the kidneys are fragile. If the shape of the ears is upright, the kidneys are upright; if the ears are slanted, the kidneys are crooked. Of these various changes, those who can maintain them are secure; those who diminish them become ill.
There are those who dwell in deep seclusion, spared from worry and fear, yet still inevitably fall ill. Why is this? Qi Bo said: The five zang and six fu organs are the dwellings of pathogenic qi. When the five zang organs are all small, one has fewer illnesses but more anxieties. When the five zang organs are all large, one carries himself slowly and is difficult to disturb with worry. When the five zang organs are all high, one is ambitious and remote. When they are all low, one is content to occupy an inferior position. When they are all firm, one does not become ill. When they are all fragile, one is never free of illness. When the five zang organs are all upright, one is harmonious, beneficial, and wins the hearts of others. When they are all crooked, one harbors wicked thoughts and is prone to thievery, cannot be trusted, and is fickle.
The corresponding signs of the six fu organs: The lungs pair with the large intestine, and the large intestine corresponds to the skin. The heart pairs with the small intestine, and the small intestine corresponds to the vessels. The liver pairs with the gallbladder, and the gallbladder corresponds to the sinews. The spleen pairs with the stomach, and the stomach corresponds to the flesh. The kidneys pair with the triple burner and bladder, and the triple burner and bladder correspond to the interstices and body hair.
The lungs correspond to the skin: when the skin is thick, the large intestine is thick; when the skin is thin, the large intestine is thin. When the skin is loose and the abdomen is large, the large intestine is relaxed and long; when the skin is tense, the large intestine is tight and short. When the skin is smooth, the large intestine is straight; when the skin and flesh do not separate clearly, the large intestine is knotted.
The heart corresponds to the vessels: when the skin is thick, the vessels are thick, and when the vessels are thick, the small intestine is thick. When the skin is thin, the vessels are thin, and when the vessels are thin, the small intestine is thin. When the skin is relaxed, the vessels are relaxed, and when the vessels are relaxed, the small intestine is large and long. When the skin is thin and the vessels are small, the small intestine is small and short. When the yang channels have many curves, the small intestine is knotted.
The spleen corresponds to the flesh: when the flesh is firm and large, the stomach is thick; when the flesh is thin, the stomach is thin. When the flesh is small and thin, the stomach is not firm. When the flesh is disproportionate to the body, the stomach sits low; a low stomach causes the lower orifice to be constrained and dysfunctional. When the flesh is not firm, the stomach is relaxed. When the skin and muscles are free of small granules, the stomach is tight. When there are many small granules, the stomach is knotted; a knotted stomach causes the upper orifice to be constrained and dysfunctional.
The liver corresponds to the sinews: when the nails are thick and yellow, the gallbladder is thick; when the nails are thin and red, the gallbladder is thin. When the nails are firm and green, the gallbladder is tight; when the nails are soft and red, the gallbladder is relaxed. When the nails are straight, white, and without striations, the gallbladder is straight; when the nails are sinister in color, black, and with many striations, the gallbladder is knotted.
The kidneys correspond to the bones: when the flesh is firm and the skin is thick, the triple burner and bladder are thick; when the flesh is coarse and the skin is thin, the triple burner and bladder are thin. When the interstices are loose, the triple burner and bladder are relaxed; when the skin is tight and lacks body hair, the triple burner and bladder are tight. When the body hair is fine and thick, the triple burner and bladder are straight; when the body hair is sparse, the triple burner and bladder are knotted.
By observing these external corresponding signs, one can know the internal pathological conditions of the zang and fu organs.
The five viscera have six bowels, and the six bowels have twelve source points. The twelve source points emerge from the four junctures (elbow and knee joints). The four junctures govern the five viscera; when the five viscera are diseased, one should select the twelve source points. The twelve source points are where the five viscera receive the essence qi of the three hundred and sixty-five joints. When the five viscera are diseased, it manifests at the twelve source points, and each source point corresponds to its respective viscus. By clearly knowing the source points and observing their reactions, one can know where the disease of the five viscera lies.
The lesser yin within yang is the lung, whose source emerges at Taiyuan (one on each side). The greater yang within yang is the heart, whose source emerges at Daling (one on each side). The lesser yang within yin is the liver, whose source emerges at Taichong (one on each side). The greater yin within yin is the kidney, whose source emerges at Taixi (one on each side). The utmost yin within yin is the spleen, whose source emerges at Taibai (one on each side). The source of the fat region emerges at Jiuwei (one). The source of the barren region emerges at Boyang (Qihai) (one). In total there are twelve source points, which treat diseases of the five viscera and six bowels.
For abdominal distension, select the three yang channels; for sunken stool (undigested food diarrhea), select the three yin channels. When the five viscera are diseased, it is like being pierced by a thorn, defiled by filth, bound by a knot, or shut behind a door. Though the thorn has been long, it can still be removed; though the filth has been long, it can still be washed away; though the knot has been long, it can still be untied; though the door has been long shut, it can still be opened. Some say that prolonged illness cannot be treated, but this is incorrect. Those skilled in acupuncture treat illness like pulling out a thorn, like washing away filth, like untying a knot, like breaking open a blockage; though the disease is prolonged, it can still be cured. Those who say it cannot be treated simply have not mastered the technique.
The Yellow Emperor asked: The twelve channels externally correspond to the twelve rivers and waters, and internally pertain to the five viscera and six bowels. The twelve rivers and waters receive water and flow; the five viscera house spirit, qi, soul, and essence and store them; the six bowels receive grain and move it, receive qi and raise it; the channels receive blood and transport it. How do these correspond for treatment? Can you explain the depth of needling and the number of moxa cones?
Qibo replied: The hardness or fragility of the viscera, the size of the bowels, the amount of grain, the length of the vessels, the clarity or turbidity of blood, the amount of qi — among the twelve channels, some have much blood and little qi, some little blood and much qi, some both much blood and qi, some both little blood and qi — all have fixed measures. In treatment with acupuncture and moxibustion, each is regulated according to its channel qi, and there are established rules. This is the principle of matching humans to heaven and earth and responding to yin and yang, which must be carefully examined.
Foot yangming externally corresponds to the sea, internally pertains to the stomach. Foot taiyang externally corresponds to the Qing River, internally pertains to the bladder, and drains the water passage. Foot shaoyang externally corresponds to the Wei River, internally pertains to the gallbladder. Foot taiyin externally corresponds to the Lake, internally pertains to the spleen. Foot jueyin externally corresponds to the Mian River, internally pertains to the liver. Foot shaoyin externally corresponds to the Ru River, internally pertains to the kidney. Hand yangming externally corresponds to the Yangtze River, internally pertains to the large intestine. Hand taiyang externally corresponds to the Huai River, internally pertains to the small intestine, from which the water passage emerges. Hand shaoyang externally corresponds to the Luo River, internally pertains to the Triple Burner. Hand taiyin externally corresponds to the Yellow River, internally pertains to the lung. Hand jueyin (pericardium) externally corresponds to the Zhang River, internally pertains to the pericardium. Hand shaoyin externally corresponds to the Ji River, internally pertains to the heart.
These twelve rivers and waters all have outer sources and inner endowments, with the outer and inner interconnected like a ring with no end. The human channels and vessels are likewise. Therefore heaven is yang and earth is yin; above the waist is heaven, below the waist is earth.
The depth of needling and moxibustion: Foot yangming is the sea of the five viscera and six bowels, with large vessels, much blood, abundant qi, and strong heat. If not needled deeply, it cannot be dispersed; if not retained, it cannot be drained. Foot yangming has much blood and qi; needle to a depth of six fen and retain for ten breaths. Foot shaoyang has little blood and qi; needle to a depth of four fen and retain for five breaths. Foot taiyang has much blood and qi; needle to a depth of five fen and retain for seven breaths. Foot taiyin has much blood and little qi; needle to a depth of three fen and retain for four breaths. Foot shaoyin has little blood and much qi; needle to a depth of two fen and retain for three breaths. Foot jueyin has much blood and little qi; needle to a depth of one fen and retain for one breath. The hand yin and yang channels receive qi from a near pathway, and the qi comes quickly; needling depth should not exceed two fen, and retention should not exceed one breath. Adjust according to fatness or thinness flexibly; this is called "following the constancy of heaven," and the same applies to moxibustion. Excessive moxibustion produces perverse fire, causing withered bones and rough vessels; excessive needling depletes qi.
(⚠️ This section involves specific needling depths, breath-count retention times, and moxibustion cone numbers, which are ancient acupuncture operational standards for academic research only; strict prohibition against self-application.)
The human body has four seas, and the twelve channels and waters all flow into the seas. There are the sea of marrow, the sea of blood, the sea of qi, and the sea of water and grain.
The stomach is the sea of water and grain; its upper point is at Qijie, and its lower point reaches Zusanli. The Chong vessel is the sea of the twelve channels (sea of blood); its upper point is at Dazhu, and below it emerges at Shangjuxu and Xiajuxu. Danzhong is the sea of qi; its upper point is above and below the Zhugu, and anteriorly at Renying. The brain is the sea of marrow; its upper point is at the crown of the head, and below at Fengfu.
When the four seas are in accord, life is sustained; when they are reversed, decline ensues. Knowing how to regulate them brings benefit; not knowing brings harm.
When the sea of qi is in excess, there is fullness in the chest, rapid and urgent breathing, and a red face; when deficient, qi is insufficient to speak. When the sea of blood is in excess, one often feels the body enlarged and oppressed, though unable to identify where the disease is; when deficient, one often feels the body shrunken and narrowed, also unable to identify where the disease is. When the sea of water and grain is in excess, there is abdominal fullness and distension; when deficient, one feels hungry but cannot eat. When the sea of marrow is in excess, one feels light, vigorous, and strong beyond normal limits; when deficient, there is dizziness, tinnitus, soreness and weakness of the legs, blurred vision, fatigue, and a tendency to lie down.
The method of treatment: carefully guard the points and regulate their deficiency or excess, not violating their prohibitions; those who follow will recover, those who reverse will surely fail.
The Yellow Emperor asked: What is the fifty cycles? Qibo replied: The twenty-eight constellations of heaven, each with thirty-six divisions, and the qi of the human body circulating one full circuit amounts to one thousand and eight divisions.
The human channels and vessels, upper and lower, left and right, anterior and posterior, total twenty-eight vessels, with a total body length of sixteen zhang and two chi, corresponding to the twenty-eight constellations. The clepsydra releases one hundred markings to divide day and night. With one exhalation, the pulse beats twice and qi moves three cun; with one inhalation, the pulse also beats twice and qi moves three cun; one exhalation and one inhalation form one settled breath, and qi moves six cun. In ten breaths, the pulse moves six chi, and the sun moves two divisions. In two hundred and seventy breaths, qi moves sixteen zhang and two chi, completing one full circuit of the body, and the clepsydra releases two markings. In five hundred and forty breaths, qi completes two circuits, and the clepsydra releases four markings. In two thousand seven hundred breaths, qi completes ten circuits, and the clepsydra releases twenty markings. In thirteen thousand five hundred breaths, qi completes fifty circuits of the body, the clepsydra releases one hundred markings, the sun moves through the twenty-eight constellations, and when the water is exhausted, the pulse completes its course.
The movement of defensive qi: In a year there are twelve months, and in a day there are twelve double-hours. Zi and Wu form the meridian, Mao and You form the parallel. Heaven completes one circuit of the twenty-eight constellations; from Fang to Bi is yang, from Mao to Xin is yin. Yang governs day, yin governs night. Defensive qi circulates fifty cycles through the body in one day and night, moving through yang twenty-five cycles during the day and through yin twenty-five cycles during the night, circulating through the five viscera.
At dawn, when yin qi is exhausted, yang qi emerges from the eyes. When the eyes open, qi moves through the head, descends along the neck, follows the foot taiyang channel down to the tip of the little toe. Its dispersing branches divide at the eyes, go down the hand taiyang channel to the outside of the little finger. Another dispersing branch separates at the outer canthus, descends the foot shaoyang channel, and pours into the space between the second and third toes. Ascending, it follows the hand shaoyang channel down to between the little fingers. Another branch ascends to the front of the ear, joins the jaw vessel, pours into the foot yangming channel, descends to the dorsum of the foot, and enters between the five toes. A dispersing branch goes from the ear down the hand yangming channel, enters between the thumb and index finger, enters the palm, reaches the sole of the foot, emerges at the medial malleolus, descends into the yin aspect, and rejoins the eyes, completing one cycle.
When the sun moves one mansion (station), the qi of the body travels one full circuit plus eight-tenths of another; when the sun moves two mansions, three circuits plus six-tenths; when three mansions, five circuits plus four-tenths; when four mansions, seven circuits plus two-tenths; when five mansions, nine circuits; when six mansions, ten circuits plus eight-tenths; when seven mansions, twelve circuits plus six-tenths; when fourteen mansions, twenty-five circuits with a remainder.
When yang is exhausted, it enters yin, and the yin aspect receives qi. When defensive qi enters yin, it flows from foot shaoyin into the kidney; from the kidney into the heart; from the heart into the lung; from the lung into the liver; from the liver into the spleen; and from the spleen back into the kidney, completing one cycle. During the night, when the sun moves one mansion, the qi of the body travels one cycle through the yin viscera plus eight-tenths of another, like yang completing twenty-five cycles before rejoining at the eyes. Differences in waking and sleeping times arise because of inexact divisions remaining.
Waiting for qi before needling: Take dawn as the standard, and the end of night as the beginning. In one day and one night, the clepsydra releases one hundred markings; twenty-five markings mark half a day. Carefully wait for where the qi is located and then needle; this is called "meeting the time." If the disease is in the yang aspect, one must first wait until qi arrives at the yang aspect and then needle; if the disease is in the yin aspect, one must first wait until qi arrives at the yin aspect and then needle. Carefully await the proper time, and the disease can be expected to resolve; missing the time and reversing the waiting will leave all hundred diseases unremoved.
(⚠️ This section contains the time-selective needling theory of "waiting for qi before needling," which is ancient academic thought and not practical operational guidance.)
The movement of nutritive qi has water and grain as its root. Grain enters the stomach; the essential qi is transmitted to the lung, flows and spreads internally, and disperses externally. The pure portion travels through the channel pathways, moving unceasingly, ending and beginning again — this is the pattern of heaven and earth.
The movement of qi starts from the hand taiyin lung channel, proceeds along the inner edge of the arm, pours into the hand yangming channel and ascends to the face. It pours into the foot yangming channel, descends to the dorsum of the foot, and pours into the space between the big toe and second toe. It joins the foot taiyin, ascends to the spleen, and from the spleen pours into the heart. It follows the hand shaoyin channel, emerges from the axilla, descends the arm, and pours into the tip of the little finger. It joins the hand taiyang channel, ascends, emerges at the inner shoulder, pours into the inner canthus, ascends to the crown, descends the nape, joins the foot taiyang channel, follows the spine down through the sacrum, and pours into the tip of the little toe. It follows the sole of the foot, pours into the foot shaoyin channel, ascends and pours into the kidney, and from the kidney pours into the heart, dispersing outward into the chest. It follows the pericardium channel, emerges from the axilla, descends the arm, enters between the two tendons, enters the palm, emerges from the tip of the middle finger, and returns to pour into the tip of the ring finger. It joins the hand shaoyang channel, ascends and pours into Danzhong, disperses through the Triple Burner, and from the Triple Burner pours into the gallbladder and emerges at the flanks. It pours into the foot shaoyang channel, descends to the dorsum of the foot, and again from the dorsum pours into the space between the big toe and second toe. It joins the foot jueyin channel, ascends to the liver, and from the liver ascends through the diaphragm, follows the throat into the nasal cavity, and stops at the "animal gate" (upper palate). A branch separates, ascends the forehead, follows the crown down the midline of the nape, follows the spine into the sacrum — this is the Du vessel. It connects to the genitals, ascends past the pubic hairline, enters the navel, ascends along the abdomen, enters the supraclavicular fossa, descends to pour into the lung, and again emerges from the taiyin.
This is the normal pathway of nutritive qi circulation.
The Yellow Emperor asked: From where does a person receive qi? How do yin and yang intersect? What is nutritive qi? What is defensive qi? Where does nutritive originate? Where does defensive converge? The old and the young differ in qi, and yin and yang occupy different positions — I would like to hear of their intersection.
Qibo replied: A person receives qi from water and grain. Grain enters the stomach; the essential qi is transmitted to the lung, and all five viscera and six bowels receive its qi. Among these, the clear is nutritive, and the turbid is defensive. Nutritive moves within the vessels, and defensive moves outside the vessels. Nutritive circulates unceasingly and holds a great meeting after fifty cycles. Yin and yang interconnect like a ring with no end. Defensive qi moves through yin twenty-five degrees and through yang twenty-five degrees, dividing into day and night. When qi reaches yang, one wakes; when it reaches yin, one sleeps.
At midday, yang is at its peak — this is called "double yang." At midnight, yin is at its peak — this is called "double yin." Taiyin governs the interior, and taiyang governs the exterior; each moves twenty-five degrees. When the sun sets and yang is exhausted, yin receives qi; at midnight, all people lie down — this is called "merged yin." At dawn, when yin is exhausted, yang receives qi. Thus is the cycle, following the same order as heaven and earth.
Why is it that the elderly have difficulty sleeping at night, while the young and strong rarely wake during the night? What qi causes this? In the strong, qi and blood are abundant, muscles are smooth and slippery, the qi pathways are open and unobstructed, and nutritive and defensive qi move without losing their regular order — therefore they are spirited during the day and sleep soundly at night. In the elderly, qi and blood decline, muscles wither and dry, the qi pathways become rough and blocked, the qi of the five viscera struggles with each other, nutritive qi diminishes while defensive qi stirs internally — therefore they lack spirit during the day and cannot sleep at night.
Nutritive qi emerges from the middle burner, and defensive qi emerges from the lower burner. The upper burner emerges from the stomach opening, ascends alongside the throat, passes through the diaphragm, and spreads through the chest; it proceeds to the axilla, follows the hand taiyin channel, and returns to pour into the hand yangming channel; it ascends to the tongue and descends to pour into the foot yangming channel. It constantly moves together with nutritive qi through yin and yang, each covering twenty-five degrees in one cycle, thus completing fifty cycles day and night that repeat endlessly, and holds its great meeting at the hand taiyin.
When a person eats hot food and drink that enters the stomach, before the qi has settled, sweat appears on the face, or on the back, or on half the body, and does not follow the pathways of defensive qi. Why is this? This is due to external attack by wind, which opens the interstices internally, causing the pores to steam and release, and defensive qi to scatter and flee, unable to follow its normal pathways. This qi is swift and lively, and escapes through any opening it encounters; thus it does not follow its regular route, and this is called "leaking discharge."
The middle burner also joins at the stomach opening, emerging after the upper burner. It receives qi, separates the dregs, steams the fluids, transforms the essential, and pours upward into the lung, where it transforms into blood, nourishing the body — nothing is more precious than this. Therefore it alone moves through the channels and passageways, and is called "nutritive."
Blood and qi are different in name but the same in kind. Nutritive and defensive are essential qi; blood is spirit qi. Therefore blood and qi differ in name but are the same in kind. Thus one who has lost blood has no sweat, and one who has lost sweat has no blood; a person cannot lose both simultaneously.
The lower burner separates from the ileum, pours into the bladder, and percolates through. Water and grain commonly remain together in the stomach; the dregs descend to the large intestine, forming the lower burner. Its percolating and separating juices follow the lower burner and seep into the bladder.
When a person drinks alcohol, the alcohol enters the stomach; before the grain is digested, urine is passed earlier. Why? Alcohol is the fluid of ripened grain; its qi is swift and slippery. Therefore it enters after the grain but emerges before the grain's fluids. Thus it is said: The upper burner acts like mist (💨diffusing and spreading), the middle burner acts like soaking (🌊decomposing water and grain), and the lower burner acts like a drainage ditch (🌊letting water flow downward).
The Yellow Emperor asked: How are the clear and turbid of human qi? Qibo replied: That which receives grain is turbid; that which receives qi is clear. The clear pours into yin; the turbid pours into yang. Within the turbid there is clear that ascends and emerges through the throat; within the clear there is turbid that descends and moves into the stomach. The clear moves upward, and the turbid moves downward. When clear and turbid interfere with each other, this is called "chaotic qi."
The clear ascends and pours into the lung; the turbid descends and flows into the stomach. The clear qi of the stomach ascends and emerges from the mouth; the turbid qi of the lung descends and pours into the channels, accumulating internally in the sea of qi. The hand taiyang alone receives the turbidity of yang, and the hand taiyin alone receives the clarity of yin. The clear ascends to the orifices; the turbid descends through the various channels. The foot taiyin alone receives the turbidity within yin.
The clear has slippery qi; the turbid has rough qi. Therefore needling yin channels should be deep with retention, and needling yang channels should be shallow with quick withdrawal. When clear and turbid interfere, regulate by the number method.
(⚠️ This section involves principles of needling depth and retention/quick withdrawal, which is ancient acupuncture theory and not operational guidance.)
A person has essence, qi, fluids, humor, blood, and vessels. When two spirits unite and form the body, that which precedes the body's existence is "essence." When the upper burner opens and disperses the flavors of the five grains, warming the skin, filling the body, and nourishing the hair, like mist and dew irrigating, this is "qi." When the interstices open and sweat is released, this is "fluid." When grain enters and qi fills, moistening and nourishing the bones, allowing joints to bend and extend, replenishing the brain and marrow, and keeping the skin moist, this is "humor." When the middle burner receives juice and transforms it to red, this is "blood." That which restrains nutritive qi so it does not scatter and leak is "vessels."
Judging excess and deficiency of the six qi: When essence is depleted, deafness occurs; when qi is depleted, the eyes lose clarity; when fluid is depleted, the interstices open and sweat pours forth profusely; when humor is depleted, there is bone bi (impediment), difficulty bending and extending, withered facial complexion, reduced brain and marrow, soreness and weakness, and tinnitus; when blood is depleted, the complexion becomes pale, withered, and without luster; when vessels are depleted, the vessels become hollow and empty. These are the signs for observing the six qi.
Water and grain enter the mouth and are transported to the intestines and stomach, and their fluids divide into five kinds. When the weather is cold and clothing is thin, they become urine and qi; when the weather is hot and clothing is thick, they become sweat; when sorrow and qi combine, they become tears; when the middle is hot and the stomach slackens, they become saliva; when pathogenic qi flows adversely and the qi is blocked and unable to move, it does not move and becomes water distension.
That which the upper burner emits qi to warm the muscles and fill the skin is "fluid"; that which remains and does not move is "humor." When the weather is hot and clothing is thick, the interstices open, and therefore sweat appears. When cold remains within the muscles, fluids and humors congeal and produce pain. When the weather is cold, the interstices close, qi becomes rough and cannot move, and water flows down to the bladder, becoming urine and qi.
Among the five viscera and six bowels, the heart is the master; the ear is the listener; the eye is the observer; the lung is the minister; the liver is the general; the spleen is the guard; and the kidney governs the exterior. Therefore the fluids and humors of all five viscera and six bowels ascend and seep into the eyes. When the heart is sad and qi combines, the heart system tightens; when tight, the lung lobes lift, fluids overflow upward, and therefore coughing with tearing occurs. When the middle is hot, the stomach digests grains, the intestines and stomach become distended and full, and therefore the stomach slackens; when slack, qi flows adversely, and therefore saliva emerges.
The five grains' fluids and humors combine to form a paste that seeps internally into the bone cavities, replenishes the brain and marrow, and flows downward to the inner thighs. When yin and yang are not in harmony, fluids overflow and flow downward to the genitals; marrow and fluids are both reduced, and if they descend excessively, deficiency results; with deficiency, there is low back pain and soreness. When the yin and yang qi pathways are blocked, the four seas are closed, the Triple Burner does not drain, fluids and humors do not transform, and water and grain converge in the intestines and stomach, remain in the lower burner, cannot seep into the bladder, and the lower burner distends, water overflows and becomes water distension. These are the orderly and reverse aspects of the five separations of fluids and humors.
The Yellow Emperor asked: When a strange pathogen is not within the channels, what is it? Qibo said: It is the blood collaterals (abnormality of superficial small vessels beneath the skin). When one faints after needling a blood collateral, it is because the vessel qi is excessive while the blood is deficient; needling depletes qi, and with qi depletion one collapses. When blood spurts out, it is because both blood and qi are abundant and yin qi is considerable, and the blood is slippery; needling it causes spouting. When the blood emerges black and turbid, it is because yang qi has accumulated and lingered without being drained. When the blood emerges clear and watery, it is because newly drunk water has seeped into the collaterals and has not yet mixed with the blood. When swelling appears after needle withdrawal, it is because yin qi accumulated in yang; when needled, the blood has not emerged but qi moves ahead. When the complexion becomes pale, it is because the qi of yin and yang have newly merged but are not yet harmonized; draining them causes both yin and yang to collapse. When vexation and oppression arise after needle withdrawal, it is because needling the collaterals has depleted the channels and yin qi has been lost. When much blood is lost without becoming deficient, it is because yin and yang combine into bi (impediment), and both yin and yang are in excess.
(⚠️ This section involves the practice and reaction analysis of blood-letting needling, which belongs to ancient needling theory and is strictly prohibited from imitation.)
When the needle becomes tight after insertion into the flesh, it is because heat follows the needle and causes heat; with heat, the blood adheres to the needle.
Leigong asked: Wind is the beginning of all diseases, and reversal (jue) arises from cold-dampness. How can one distinguish them? The Yellow Emperor replied: One should observe the glabella (Queding area). When the complexion is thin and moist, it is wind. When the complexion is vivid and turbid, it is bi (impediment). When the complexion is in the ground area (chin), it is reversal (jue). These are the general rules of each color indicating its respective disease.
Some people die suddenly without being ill, because great qi (pathogenic qi) enters the viscera and bowels. When illness slightly subsides and a color appears on the forehead as large as a thumb, even without illness, death will certainly occur. Observe the correspondence of each facial region to the viscera and bowels: The forehead is the head and face; above the glabella is the throat; the glabella is the lungs; below the eyes is the heart; the bridge of the nose is the liver; to the left of the bridge of the nose is the gallbladder; the tip of the nose is the spleen; the alae of the nose are the stomach; the center of the face below the cheekbones is the large intestine; the lateral cheeks are the kidneys; below the kidneys is the navel; above the tip of the nose is the small intestine; below the tip of the nose is the bladder and uterus. The cheekbones are the shoulders; behind the cheekbones are the arms; below the arms are the hands. The inner and upper region of the eyes is the chest and breasts; the lateral aspect of the cheeks is the back; along the jaw ascending is the thigh; the center is the knee; below the knee is the shin; below the shin is the foot.
Blue-black indicates pain; yellow-red indicates heat; white indicates cold. If the color is coarse and bright, the disease is superficial; if the color is deep and dull, the disease is deep. If the color moves upward, the disease is worsening; if the color moves downward like clouds dispersing, the disease is about to resolve. If external color penetrates internally, the disease is entering from the exterior to the interior; if internal color moves to the exterior, the disease is emerging from the interior to the exterior.
When disease arises from within, first treat the yin, then treat the yang; when disease arises from without, first treat the yang, then treat the yin. Use yang to harmonize yin, use yin to harmonize yang. Carefully examine the location, and every treatment will be appropriate. Being able to distinguish left and right is great mastery. The positions differ between men and women, which is why it is called yin and yang.
The normal and abnormal states of the five colors: Red should be like white silk wrapped around vermilion, not like ochre; white should be like the luster of white jade, not like white chalk; blue should be like the luster of verdant jade, not like indigo dye; yellow should be like yellow realgar wrapped in gauze, not like loess; black should be like the color of repeated lacquering, not like charcoal.
Blue like kingfisher feathers, black like bird feathers, red like a rooster's comb, yellow like a crab's belly, white like pig fat — seeing these five colors indicates vitality. Blue like grass dregs, black like coal ash, yellow like trifoliate orange fruit, red like putrid blood, white like withered bone — seeing these five colors indicates signs of death.
If the complexion is yellow with blue eyes, yellow with red eyes, yellow with white eyes, or yellow with black eyes, in all these cases death does not occur. If the face is blue with red eyes, face red with white eyes, face blue with black eyes, face black with white eyes, or face red with blue eyes — in all such cases, death occurs.
The Yellow Emperor asked: People are divided into yin and yang. What is meant by yin person and yang person? Shaoshi replied: Between heaven and earth, nothing departs from the five; humans also correspond to this, and it is not merely one yin and one yang. There are taiyin people, shaoyin people, taiyang people, shaoyang people, and yin-yang peaceful people. These five types differ in physical form, and in sinew, bone, qi and blood.
Taiyin people: Greedy and not benevolent, outwardly humble but internally deeply guarded, fond of advancing yet averse to withdrawing, with suppressed emotions not revealed, not attending to current affairs, and lagging behind others in action.
Shaoyin people: Somewhat greedy and possessing a disposition to harm others; when they see others suffer losses, they feel as if they have gained something; they delight in injuring others; when they see others honored, they instead become angry; they harbor jealousy and resentment without gratitude.
Taiyang people: Self-contented in their dwelling, fond of speaking of great matters, lacking ability yet speaking emptily, with ambitions issued toward all four directions, acting without regard for right and wrong, often self-righteous in their doings, and when things fail, they do not repent.
Shaoyang people: Meticulous in deliberation and fond of self-importance; when holding a minor office they display themselves ostentatiously; fond of external connections, not inclined to internal attachment.
Yin-yang peaceful people: Quiet in dwelling, without groundless fear, without groundless joy, in accord with external things, contending with no one, adapting with the times, noble yet yielding, lowly yet not flattering. This is the most ideal state.
Needling principles for the five types: Taiyin people have much yin and no yang; the yin blood is turbid, and the defensive qi is rough; only by rapid draining can the disease be shifted. Shaoyin people have much yin and little yang, a small stomach and large intestines, and the six bowels are not in harmony; one must carefully examine and regulate them, for their blood is easily lost and their qi is easily injured. Taiyang people have much yang and no yin; one must cautiously regulate them, and must not drain their yang while losing their yin; if the yang becomes severely depleted, they easily become manic. Shaoyang people have much yang and little yin; the channels are small and the collaterals are large; blood is in the interior and qi is in the exterior; they should be supplemented in yin and drained in yang. For yin-yang peaceful people, drain when excessive, supplement when deficient; when neither excessive nor deficient, treat along the channel.
(⚠️ This section concerns needling principles for the five constitutional types, representing ancient acupuncture pattern-discrimination theory, NOT operational instructions.)
Thereafter classified according to the five phases into twenty-five types of people: wood-phase people, fire-phase people, earth-phase people, metal-phase people, and water-phase people, each having five subtypes, combining to make twenty-five people. Each form has corresponding color, physical characteristics, temperamental tendencies, and corresponding relationships for the abundance or deficiency of qi and blood in the channels and collaterals.
When the form and color correspond, this is auspicious; when the form and color overcome each other, there are year taboos. The great taboo years for a person are often added by nine: seven, sixteen, twenty-five, thirty-four, forty-three, fifty-two, sixty-one years of age — these are all taboo ages for a person, and one cannot but remain tranquil regarding them.
The abundance and deficiency of qi and blood are observed and assessed through external indicators such as body hair, skin color, flesh, and muscle. Finally, the six types of qi-response phenomena in needling are discussed: spirit moves and qi moves first; qi and needle meet together; when the needle is withdrawn, qi moves alone; healing after several needlings; qi counterflow upon needle insertion; disease worsening after several needlings — mechanisms are explained separately for each.