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Chapter 14 of 14
针灸甲乙经
This volume is the twelfth volume of The Systematic Classic of Acupuncture and Moxibustion (Zhen Jiu Jia Yi Jing), systematically discussing the pathomechanisms (internal mechanisms of disease onset and development) and needling methods (acupuncture point selection principles) for fourteen common symptoms caused by "abnormal pathogens traveling through the open orifices" (excessive yawning, hiccoughing, sobbing, shivering, belching, sneezing, flaccidity, weeping with nasal discharge, sighing, drooling, tinnitus, biting the tongue, forgetfulness, and excessive hunger), as well as various conditions including loss of voice, insomnia, eye disorders, ear disorders, oral and dental disorders, epistaxis, throat obstruction, goiter, gynecological disorders, and pediatric disorders.
Chapter 1 · Yawning, Hiccoughing, Sobbing, Shivering, Belching, Sneezing, Weeping with Nasal Discharge, Sighing, Drooling, Tinnitus, Biting the Tongue, Forgetfulness, and Excessive Hunger
The Yellow Emperor asked: Why do people yawn? Qi Bo replied: Defensive Qi (the protective qi that circulates on the body surface) moves through the yang aspects during the day and the yin aspects during the night. Night belongs to yin and governs quiet repose; yang governs ascent, while yin governs descent. When yin qi accumulates below and yang qi has not yet been fully expended, yin and yang pull against each other, and thus one yawns repeatedly. When yang qi is exhausted and yin qi prevails, one closes the eyes and sleeps; when yin qi is exhausted and yang qi prevails, one awakens. The kidneys govern yawning; in treatment, one should drain Foot Lesser Yin (kidney channel) and supplement Foot Greater Yang (bladder channel). Why do people hiccough? When grain enters the stomach, stomach qi is transported upward to the lungs. If pre-existing cold qi becomes intermingled with newly ingested grain qi in the stomach, the new and the old become disordered, correct and pathogenic qi contend, qi movement reverses upward, and emerging from the stomach above, this produces hiccoughing. The lungs govern hiccoughing; therefore, supplement Hand Greater Yin (lung channel) and drain Foot Greater Yin (spleen channel). One may also use a grass stalk to stimulate sneezing to stop it, or a sudden fright may also arrest it. Why do people sob? This occurs when yin qi prevails and yang qi is deficient, with yin qi moving rapidly and yang qi moving sluggishly. Yin prevails and yang is about to expire, hence sobbing occurs. Supplement Foot Greater Yang and drain Foot Lesser Yin. Why do people shiver with cold? When cold qi lodges in the skin, yin prevails and yang is deficient, hence shivering and chattering of the teeth; one should supplement all the yang channels. Why do people belch? When cold qi lodges in the stomach, reversal qi disperses upward from below and again emerges from the stomach, thus producing belching. Supplement Foot Greater Yin and Foot Greater Yang. Why do people sneeze? When yang qi is harmonized and unobstructed, it overflows into the heart and exits through the nose, thus producing sneezing. Supplement the Ying-Spring point of Foot Greater Yang and the origin of the brow (Cuanzhu, BL-2). Why do people experience flaccidity of the limbs? When stomach qi is not substantial, all the vessels become vacuous, the sinews and vessels slacken and lack strength, and after exerting force in the yin aspect of the body, qi cannot recover. One should supplement within the intermuscular spaces at the location affected. Why do people become sorrowful and weep with nasal discharge? The heart is the master of the five viscera and six bowels; the eyes are where the ancestral vessels converge and are the pathway of upward fluids; the mouth and nose are the portals of qi. When sorrow and anxiety arise, the heart is stirred; when the heart is stirred, the five viscera and six bowels all tremble; the ancestral vessels respond, the fluid pathways open, and tears and nasal discharge both flow out. Fluids are what nourish the refined essence and moisten the open orifices. When the fluid pathways open, tears flow; when weeping does not stop, fluids become exhausted; when fluids are exhausted, essence is not nourished, and the eyes cannot see — this is called "depletion of essence." Supplement Tiānzhù (BL-10), where the channel passes alongside the neck. Why do some people weep without tears, or with few tears and little nasal discharge? The heart possess the refined essence of the five viscera; the eyes are its orifices, and the complexion is its glory. When one has virtue, qi harmonizes in the eyes; when one has sorrow and anxiety, it manifests in the complexion. When sorrow arises, tears flow down — from whence does the water arise? The multitude of essences (the ancestor of water) is accumulated water; accumulated water pertains to absolute yin; absolute yin is the essence of the kidneys. Essence is able to retain water and wrap and support the fluids, hence water does not move. The essence of water is aspiration (zhi); the essence of fire is spirit (shen). When water and fire mutually stimulate, and spirit and aspiration are both sorrowful, then the water of the eyes is born. The proverb says "sorrow of the heart is also called sorrow of the aspiration"; aspiration and the essence of the heart together converge upon the eyes. Nasal discharge is the seepage of the brain; the brain pertains to yang (some say yin); marrow is the filling of the bones. Aspiration is the master of the bones; therefore, when water flows, nasal discharge follows it. Nasal discharge and tears are like brothers; when urgent, they both come forth. Why do some people weep without tears emerging, or with few tears and nasal discharge not following? When weeping does not produce tears, it is because the weeping is not born of sorrow; when one does not weep, it is because the spirit is not compassionate. When the spirit is not compassionate, the aspiration is not sorrowful; yin and yang hold each other in check — how could tears come forth alone? When aspiration is sorrowful, there is distress; distress then surges against yin; surging against yin causes the aspiration to leave the eyes; when spirit does not guard the essence, and spirit and essence leave the eyes, tears and nasal discharge both emerge. When there is reversal, yang qi converges above and yin qi converges below; when yang converges above, fire alone blazes; when yin converges below, the feet become cold and distended. One water cannot overcome five fires, hence the eyes become blind. When wind qi rushes at the eyes, yang qi remains within guarding the essence, and fire qi scorches the eyes; therefore, when seeing wind, tears flow down — just as a violent wind arises and can bring rain. Why do people sigh? When忧思 (worry and obsessive thinking) arise, the heart-system becomes constricted, and the airway is bound and obstructed; therefore, one sighs deeply to stretch it open. Supplement Hand Lesser Yin, Heart Governor (Pericardium), and Foot Lesser Yang, retaining the needles. Why do people drool? When food and drink enter the stomach and there is heat in the stomach, the worms (intestinal parasites) are stirred; when the worms are stirred, the stomach slackens; when the stomach slackens, the Liánquán (CV-23) opens, and hence drooling occurs. Supplement Foot Lesser Yin. Why do people experience tinnitus? The ear is where the ancestral vessels converge. When the stomach is vacuous and empty, the ancestral vessels become vacuous; when vacuous, they sink downward; when the flowing vessels are in some measure depleted, tinnitus results. Supplement Kèzhǔrén (ST-3, Shangguan) and the point where the nail of the thumb meets the flesh (Shàoshāng, LU-11). Why do people bite their own tongue? This is due to reversal qi rushing upward, with the vessel qi all arriving. When Lesser Yin qi arrives, one bites the tongue; when Lesser Yang qi arrives, one bites the cheek; when Greater Yang qi arrives, one bites the lip. Observe the channel governing the condition and supplement it. Why do people become forgetful? When upper qi is insufficient and lower qi is excessive, the intestines and stomach are replete while the heart and lungs are vacuous. When vacuous, the Constructive and Defensive qi remain below and cannot ascend at the proper time, hence forgetfulness. Why do people become easily hungry yet not wish to eat? When the essence qi converges upon the spleen, heat remains in the stomach; when the stomach is hot, it digests grain, hence easy hunger; when stomach qi reverses upward, the stomach duct becomes congested, hence lack of appetite. For forgetfulness and excessive hunger, first examine the viscera and bowels, remove minor irregularities, then regulate the qi — when excessive, drain; when vacuous, supplement. All fourteen of the above pathogens are caused by abnormal pathogens (irregular pathogenic qi) traveling through the open orifices. Wherever the pathogen resides, there is insufficiency. Therefore, when upper qi is insufficient, the brain is not full, the ears frequently ring, the head tilts, and the eyes are closed; when middle qi is insufficient, bowel and bladder function changes and the intestines rumble; when lower qi is insufficient, there is wilting and reversal with vexation in the heart.
Chapter 2 · Cold Qi Lodging in the Epiglottis Causing Loss of Voice and Inability to Speak
The Yellow Emperor asked: When a person suddenly becomes sorrowful or enraged and cannot produce sound, which qi is obstructed? Shào Shī said: The pharynx is the pathway of water and grain; the larynx is the passage through which qi ascends and descends; the epiglottis is the portal of sound; the lips and mouth are the fan of sound; the tongue is the mechanism of sound; the uvula is the gate of sound; the nasopharynx is where qi is distributed and released; the hyoid bone is directed by spirit qi and governs the movement of the tongue. When clear nasal discharge flows continuously, it is because the nasopharynx does not close and qi distribution has lost its office. When the epiglottis is small and thin, qi exits quickly, opening and closing are facile, and sound is easily produced; when the epiglottis is large and thick, opening and closing are difficult and qi exits slowly, hence speech becomes repetitive (stuttering). Sudden loss of voice is caused by cold qi lodging in the epiglottis; the epiglottis cannot move, cannot descend to the mechanism and fan, and the opening and closing of the mechanism and fan are impaired, hence there is no sound. The Foot Lesser Yin vessel ascends to tie to the root of the tongue, connects with the hyoid bone, and terminates at the epiglottis. Drain its blood vessels on both sides, and turbid qi will be removed. The vessel of the epiglottis ascends to connect with the Conception Vessel; additionally, needle Tiāntū (CV-22), and the epiglottis will again move. For sudden loss of voice with qi choking, needle Fútū (LI-18) and the root of the tongue to cause bleeding. For loss of voice with inability to speak, needle Nǎohù (GV-17). For sudden loss of voice with inability to speak, and sore throat, needle Fēngfǔ (GV-16). For a slack tongue with loss of voice, needle Yìmén (GV-15, Yamen). For sore throat with loss of voice, Tiāntū governs it. For frequent vomiting after eating with inability to speak, Tōnggǔ (BL-66) governs it. For loss of voice with inability to speak, Qīmén (LR-14) governs it. For sudden loss of voice with inability to speak, Zhīgōu (SJ-6) governs it. For loss of voice with inability to speak, Hégǔ (LI-4), Yǒngquán (KI-1), and Yángjiāo (GB-35) govern it.
Chapter 3 · Inability to Sleep, Inability to See, Excessive Sleeping, Restless Sleeping, Inability to Lie Supine, Flesh Atony, Various Sounds Accompanying Breathing, and Wheezing
The Yellow Emperor asked: When pathogenic qi lodges in the human body, why do some people not sleep? Bó Gāo said: After the five grains enter the stomach, they are divided into three pathways: dregs, fluids, and Ancestral Qi (the qi accumulated in the chest). Ancestral qi accumulates in the chest, exits through the throat, passes through the heart and lungs, and drives respiration. Constructive Qi (the nutritive qi that circulates within the vessels) secretes fluids, infuses into the vessels, and transforms into blood to nourish the four limbs and internally infuse the five viscera and six bowels. Defensive Qi circulates through the yang aspects when awake and through the yin aspects when asleep; when Defensive Qi enters the yin aspects, it commonly travels from the interstices of the Foot Lesser Yin aspect through the five viscera and six bowels. Now when pathogenic qi lodges in the five viscera, Defensive Qi circulates alone externally, moving through yang without being able to enter yin. When it moves through yang, yang qi prevails and the Yang Heel Vessel becomes full; when it cannot enter yin, yin qi becomes vacuous — hence the eyes cannot sleep. In treatment, one should supplement what is insufficient, drain what is excessive, and regulate the vacuity and repletion, thereby opening the passage and expelling the pathogen. Administer one dose of Banxia Decoction (Pinellia Decoction); when yin and yang are already unobstructed, sleep will immediately come. The formula: take eight shēng of water from a running stream, ladle it out ten thousand times, take five shēng of the clear portion, boil over a fire of reed stalks, add one shēng of glutinous sorghum and five gě of prepared Pinellia ternata, simmer slowly until one and a half shēng remains, remove the dregs, and drink one small cup, three times daily, gradually increasing until effective. In new cases, sleep follows immediately upon drinking the cup, sweating brings recovery; in chronic cases, three doses complete the cure. (Note: This formula is a record of ancient scholarship and is provided for study only; do not self-administer.) Why do people close the eyes and cannot see? When Defensive Qi circulates through yin but cannot enter yang, yin qi prevails and the Yin Heel Vessel becomes full, while yang qi becomes vacuous — hence the eyes close and cannot see. Why do people become drowsy and sleep excessively? When the intestines and stomach are large while the skin is rough (moist), the intermuscular spaces are not free-moving. When the intestines and stomach are large, Defensive Qi stays long in its circulation; when the skin is rough, movement is slow. Defensive Qi moves through yang by day and through yin by night; when yang qi is exhausted one sleeps, when yin qi is exhausted one awakens. When the intestines and stomach are large and Defensive Qi remains long in yin, its qi is not clear, and one desires sleep — hence excessive sleeping. When the intestines and stomach are small and the skin is slippery, Defensive Qi remains long in yang — hence little sleeping. Sudden excessive sleeping occurs when pathogenic qi lodges in the upper burner, which becomes closed and impassable; after eating, drinking broth causes Defensive Qi to remain long in yin without moving — hence sudden excessive sleepiness. In treatment, one should first examine the viscera and bowels, remove minor irregularities, then regulate qi — when excessive, drain; when vacuous, supplement. One must first know the toil and pleasure of the physical constitution, then select the points. When some people lie down but are restless, it is because a viscus has been injured and the emotions are biased — hence restless sleep. When one cannot lie supine, it is because the lungs are the cover of the viscera; when lung qi prevails, the vessels become large; when the vessels are large, one cannot lie supine. What is "flesh atony" (ròu kē)? When Constructive qi is vacuous, the flesh becomes numb with loss of sensation; when Defensive qi is vacuous, the limbs cannot move; when both are vacuous, there is numbness with inability to move; the flesh and body appear bound and punished, the person's body and intention lose coordination, and death occurs in thirty days. (Note: This is a record of ancient observation and should not be used for prognosis.) When one has reversal qi and cannot lie down while breathing with sound, or can lie down with silent breathing, or has normal daily activities but audible breathing, or wheezes when lying down, or cannot lie down, cannot walk, and wheezes, or cannot lie down and wheezes when recumbent — which viscus causes each respectively? Inability to lie down with audible breathing is reversal of the Greater Yang. The three foot yang channels should descend; now, reversing, they ascend, hence breathing with sound. The Greater Yang is the stomach vessel; the stomach is the sea of the six bowels, and its qi should also descend. When Greater Yang reverses and does not follow its proper pathway, one cannot lie down. The Lower Classic says "when the stomach is discordant, one cannot sleep peacefully" — this is the meaning. Normal daily activities with audible breathing is due to reversal of the lung collateral vessel failing to follow the channel up and down; it lodges in the channel without moving. Since collateral pathologies are mild, daily activities remain normal. Inability to lie down with wheezing upon recumbency is due to water qi lodging within. Water qi follows the fluids and lodges; the kidneys are the water viscus and govern fluids, and govern lying down and wheezing. For palpitations preventing sleep, water qi ascending and descending, and wandering qi of the five viscera, Sānyīnjiāo (SP-6) governs it. For inability to sleep, Fúxì (BL-38) governs it.
Chapter 4 · Eye Disorders Arising from Movement of the Foot Greater Yang, Foot Greater Yin (sic), and Hand Lesser Yang Vessels
The Yellow Emperor asked: I once climbed a high terrace and mid-way felt dizzy and confused. Closing my eyes and concentrating my spirit, calming my heart and settling my qi, I remained for a long time without resolution. I let down my hair and knelt at length, then bowed to look again — for a long time it did not cease, and then suddenly stopped on its own. What kind of qi causes this? Qi Bo said: The essential qi of the five viscera and six bowels ascends to pour into the eyes and become their refined essence. The nest of essence is the eye; the essence of the bones is the pupil; the essence of the sinews is the black of the eye; the essence of the blood is the network vessels; the essence of qi is the white of the eye; the essence of the flesh is the binding structure. Together they wrap, gather the essence of sinews, bones, blood, and qi, and, with the vessels, form the ocular system, which ascends to connect with the brain and emerges posteriorly in the nape of the neck. Therefore, when a pathogen strikes the head and eyes at a time when the body is vacuous, and its penetration is deep, it follows the ocular system into the brain. When it enters the brain, the brain spins; when the brain spins, it draws the ocular system taut; when the ocular system is taut, the eyes become dizzy and spin. When the pathogen strikes the essence itself, the essence can no longer hold together; when essence disperses, vision becomes distorted, and one sees two objects. The eyes are the essence of the five viscera and six bowels, the constant nourishing ground of Constructive, Defensive, Hun (ethereal soul), and Po (corporeal soul), and the locus where spirit qi is generated. When the spirit is fatigued, the Hun and Po disperse and the aspiration and intention become disordered. The pupil and the black of the eye correspond to yin; the white of the eye and red vessels correspond to yang; when yin and yang combine and transmit, there is clarity of vision. The eye is the envoy of the heart; the heart is the abode of the spirit. When the spirit divides and the essence is disordered, one suddenly sees extraordinary places; when the essence, qi, Hun, and Po are dispersed and cannot hold together, it is called "confusion" (huò). The Yellow Emperor asked: Why is it that whenever I go to the Eastern Garden I become confused, and when I leave I recover? Qi Bo said: When the heart has something it delights in and the spirit has something it recoils from, sudden mutual confusion causes essence and qi to become disordered. With erroneous vision, confusion results; when the spirit moves, confusion resolves. The mild form is called "dizziness" (mí); the severe form is called "confusion" (huò).
The lateral canthus of the eye is called the sharp canthus; at the medial corner near the nose, the upper is the outer canthus and the lower is the inner canthus. Redness of the eyes indicates disease in the heart, disease in the chest. In examining eye pain, red vessels coursing from above downward indicate Greater Yang disease; from below upward indicate Greater Yang (sic — Greater Yin/Yang) disease; from outward inward indicate Lesser Yang disease. When the gallbladder moves heat to the brain, it produces nasal sinus congestion (profuse turbid nasal discharge), which transmits into chronic nasal congestion, epistaxis, and dimming of vision — all caused by qi reversal. The Foot Greater Yang vessel has branches that flank the nose and enter the face; it is named Xuánlú (GB-5), connecting with the mouth opposite the root of the eye. For headache drawing the jaw, select this point. The Foot Greater Yang vessel has a branch that passes through the neck and enters the brain; it properly attaches to the root of the eye and is named the Eye System. For painful affliction of the head and eyes, select the point between the two sinews in the nape of the neck. The Yin and Yang Heel Vessels intersect at the sharp canthus; when yang qi is exhausted, one closes the eyes; when yin qi is exhausted, one sleeps. For red, painful eyes beginning from the inner canthus, select the Yin Heel Vessel.
Chapter 5 · Ear Disorders Arising from Movement of the Hand Greater Yang and Hand Lesser Yang Vessels
Sudden collapse with deafness and obstruction of the ear, with the ear blocked and impassable, is caused by internal qi suddenly surging upward. For ear conditions not arising from internal or external wind stroke, there is lingering stagnation and wasting. Head pain, tinnitus, and impairment of the nine orifices commonly arise from the intestines and stomach. In the "Fāméng" (rousing the dull) needling method: one must perform it during the day, needling Tīnggōng (SI-19) so that the needle sensation reaches the pupil and the sound is heard externally. After needling, press both nostrils firmly with the hands and have the patient rapidly lift the head; the sound will necessarily respond in the ear. For tinnitus, select the artery anterior to the ear. For ear pain that cannot be needled, the ear contains pus or impacted cerumen, and the ear hears nothing. For deafness, select the point on the little finger where the nail meets the flesh (Shàozé, SI-1); first needle the hand, then the foot. For tinnitus, select the point on the middle finger where the nail meets the flesh, selecting the left for the right and the right for the left. For deafness without pain, select Foot Lesser Yang; for deafness with pain, select Hand Greater Yang. For tinnitus, Bǎihuì (GV-20), Hànyàn (GB-4), Lúxī (GB-19), Tiānchuāng (SI-16), Dàlíng (PC-7), Piānlì (LI-6), Qiángǔ (SI-2), and Hòuxī (SI-3) all govern it. For ear pain, deafness, and tinnitus, Shàngguān (GB-3) governs it; it must not be needled deeply. For deafness with tinnitus, Xiàguān (ST-7), Yángxī (LI-5), Guānchōng (SJ-1), Yèmén (SJ-2), and Yánggǔ (SI-5) govern it. For deafness with tinnitus and headache drawing the jaw, Ěrmén (SJ-21) governs it. For heavy head and jaw pain drawing with clamorous noise in the ear, Héliao (SJ-22) governs it. For deafness like the sound of wind, Tīnghuì (GB-2) governs it. For deafness with filling sensation as if hearing nothing, clamorous as cicada song, Tīnggōng (SI-19) governs it. For deafness, Yìfēng (SJ-17), Huìzōng (SJ-7), and Xiàguān (ST-7) govern it. For deafness with hearing nothing, Tiānchuāng (SI-16) governs it. For deafness with clamorous sound hearing nothing, Tiānróng (SI-17) governs it. For tinnitus with loss of hearing, Jiānzhēn (SI-9) and Wángǔ (GB-12) govern it. For wind arising in the ear, tinnitus, and fluctuating deafness, Shāngyáng (LI-1) governs it. For deafness with obstruction, Hégǔ (LI-4) governs it. For deafness with pain in both temples, Zhōngzhǔ (SJ-3) governs it. For turbid, confused sound in the ear with hearing nothing, Wàiguān (SJ-5) governs it. For sudden qi deafness, Sìdú (SJ-9) governs it.
Chapter 6 · Oral and Dental Disorders Arising from Movement of the Hand and Foot Greater Yang Vessels
In examining dental caries pain, press along the area where the Greater Yang vessel passes; where there is pathological change, there will be heat alone: in the left, the left is hot; in the right, the right is hot; in the upper, the upper is hot; in the lower, the lower is hot. The arm Greater Yang has a branch entering the teeth; it is named Dàyíng (ST-5) (some say Héliao, LI-19). For caries of the lower teeth, select it; if there is aversion to cold, supplement; if there is no aversion to cold, drain. The Hand Greater Yang has a branch entering all the teeth; it is named Jiǎosūn (SJ-20). For caries of the upper teeth, select the nose and the area anterior to the nose. When the disease manifests with the pulse exuberant, drain; when vacuous, supplement. Alternatively, select outside the eyebrow, with exuberance drained and vacuity supplemented. For loose, painful teeth with no aversion to cold drinks, select Foot Greater Yang; with aversion to cold drinks, select Hand Greater Yang. For slack tongue, drooling, and vexation, select Foot Lesser Yin. For double tongue, pierce the lingual frenulum with a lance needle. For swollen upper dental caries, Mùchuāng (GB-16) governs it. For painful upper dental caries with aversion to wind and cold, Zhèngyíng (GB-17) governs it. For dental caries with tooth pain, Fúbái (GB-10) and Wángǔ (GB-12) govern it. For tooth pain, Quánliáo (SI-18) and Èrjiān (LI-2) govern it. For upper dental caries, Duìduān (GV-27) and Ěrmén (SJ-21) govern it. For bleeding between the teeth, painful falling of the tooth bed, and inability to open the mouth drawing to the nose, Yínjiāo (GV-28) governs it. For cheek swelling, tension of the mouth, and pain of the cheek bone preventing chewing, Jiáchē (ST-6) governs it. For painful upper dental caries with aversion to cold, Shàngguān (GB-3) governs it. For deviation of the mouth, frequent yawning, pain of the lower teeth, swollen cheek with aversion to cold, mouth not closing, tongue unable to speak, and inability to chew, Dàyíng (ST-5) governs it. For swollen lower dental caries, Xiàguān (ST-7) governs it. For teeth unable to chew and swollen gums, Jiāosūn (SJ-20) governs it. For deviation of the mouth, frequent yawning, and mouth not opening, Yìfēng (SJ-17) governs it. For sublingual swelling making speech difficult and protrusion of the tongue, Tōnggǔ (BL-66) governs it. For sublingual swelling causing difficulty in speech and protrusion of the tongue with drooling, Liánquán (CV-23) governs it. For deviation of the mouth, needle Tàiyuān (LU-9). For swelling and foul odor in the mouth, Láogōng (PC-8) governs it. For painful dental caries with aversion to cold drinks, Sānjiān (LI-3) governs it. For deviation of the mouth, Piānlì (LI-6) governs it. For oral and dental pain, Wēnliū (LI-7) governs it. For painful dental caries, Hégǔ (LI-4) governs it; another source says Shàohǎi (HT-3) governs it.
Chapter 7 · Blood Spillage Causing Epistaxis (Nasal Congestion and Polyps Appended)
Sudden obstruction with internal qi reversal, the liver and lungs striking against each other, and blood spilling forth from the nose and mouth: select Tiānfǔ (LU-3). This is one of the five great and five systemic depots of the stomach. For incessant epistaxis with profuse bleeding, select Foot Greater Yang; for copious epistaxis, select Hand Greater Yang; if not resolved, needle below the carpal bones; if not resolved, needle in the popliteal fossa to cause bleeding. For nasal congestion and epistaxis, Shàngxīng (GV-23) governs it. When a nasal fistula develops into leprosy-like affliction, Nǎokōng (GB-19) governs it. For nasal congestion with obstruction, stuffy blockage with qi blockage, deviation of the nose with copious nasal discharge, and nasal congestion with epistaxis and abscesses, Yíngxiāng (LI-20) governs it. For epistaxis with a hanging abscess and old flesh within, obstructed and impassable, and inability to distinguish fragrance and odor, Sùliáo (GV-25) governs it. For nasal blockage with mouth deviation and copious nasal discharge that cannot be stopped, Héliao (LI-19) governs it. For obstruction of nasal polyps, pain in the nasal tip and forehead, and erosive sores within the nose, Yínjiāo (GV-28) governs it. For nasal congestion with inability to breathe, inability to distinguish fragrance and odor, and incessant epistaxis, Shuǐgōu (GV-26, Renzhong) governs it. For incessant epistaxis, Chéngjiāng (CV-24) and Wěizhōng (BL-40) govern it. For nasal obstruction, Qiángǔ (SI-2) governs it. For epistaxis, Wàngǔ (GB-12) governs it.
Chapter 8 · Throat Impediment and Sore Throat Arising from Dynamic Pulses of the Hand and Foot Yangming and Shaoyang Channels Throat impediment with inability to speak: select the Foot Yangming channel; if able to speak, select the Hand Yangming channel. For throat impediment, Wangu (GB 12), Tianrong (SI 17), Qishe (ST 11), Tianding (LI 17), Chize (LU 5), Hegu (LI 4), Shangyang (LI 1), Yangxi (LI 5), Zhongzhu (SJ 3), Qiangu (SI 2), Shangqiu (SP 5), Rangu (KI 2), and Yangjiao (GB 35) all govern it. For throat impediment with throat swelling and inability to swallow water or gruel, Xuanji (CV 21) governs it. For throat impediment with inability to swallow food, Jiuwei (CV 15) governs it. For throat impediment with the throat feeling as if something is stuck, Sanjian (LI 3) governs it. For throat impediment with inability to speak, Wenliu (LI 7) and Quchi (LI 11) govern it. For throat impediment with qi counterflow, deviated mouth, and the throat feeling as if gripped, Xingjian (LR 2) governs it. For pain within the throat preventing ingestion of food, Yongquan (KI 1) governs it.
Chapter 9 · Goiter and Tumor Arising from Qi Stagnation For goiter (swelling in front of the neck), Tianchuang (SI 16) (some versions state Tianrong, SI 17) and Naohui (SJ 13) govern it. For goiter and tumor, Qishe (ST 11) governs it.
Chapter 10 · Miscellaneous Gynecological Diseases The Yellow Emperor asked: When a woman is nine months pregnant and loses her voice, what disease is this? Qi Bo said: This is due to blockage of qi in the uterine collateral vessels. The uterine collaterals are connected to the kidney, and the Shaoyin channel of the foot passes through the kidney and connects to the root of the tongue, therefore she cannot speak. Treatment is unnecessary; after natural delivery in the tenth month, she will recover on her own. The principle of treatment: one must not damage what is insufficient, nor augment what is excessive, lest one bring about harm. What is meant by "insufficient" refers to emaciation of the body, in which case stone needling (draining method) must not be used. What is meant by "must not augment what is excessive" refers to the presence of a fetal mass in the abdomen mistakenly treated with draining methods; if drained, then the essential qi will be expelled while the disease lingers alone within the abdomen, and hence it is said, "bringing about harm." How does one know a woman is with child and about to give birth? When the body has illness but no pathogenic pulse. When examining a woman, if the Hand Shaoyin (Heart) pulse moves markedly, this indicates pregnancy. When a nursing mother suffers heat disease, with a fine and sunken pulse, if the hands and feet are warm, the prognosis is good; if hands and feet are cold, the prognosis is poor (note: this is an empirical observation of the ancients and should not be used as a prognostic criterion today). When a nursing infant suffers wind stroke, fever, wheezing, thirst, elevation of the shoulders upon breathing, with a rapid and large pulse, if it moderates there is survival, if it remains rapid there is death (note: likewise an ancient observation). For menstrual discharge with red and white discharge in a nursing woman, Yaoshu (GV 2) governs it. For female infertility, vaginal prolapse, and incessant leukorrhea, Shangliao (BL 31) governs it. For female red and white leukorrhea with accumulation and distension beneath the heart, Ciliao (BL 32) governs it. For low back pain preventing bending and extending, first select Quepen (ST 12), then select the sacral coccyx. For women with incessant red discharge mixed with white, difficult urination, and scanty menstruation, Zhongliao (BL 33) governs it. For women with uncontrollable draining of dark moisture, red leukorrhea, itching and pain in the vagina, pulling sensation in the lower abdomen, and inability to bend or extend, Xialiao (BL 34) governs it. For borborygmus with diarrhea, Xialiao (BL 34) governs it. For residual ailments after childbirth, Huangmen (BL 51) governs it. For alternating chills and fever, shortness of breath, and restless lying, Yingchuang (ST 16) governs it. For breast abscess, chills and fever, and pain preventing palpation, Rugen (ST 18) governs it. For abdominal fullness, hernia accumulations, residual postpartum ailments, infertility, and vaginal itching, pierce Shimen (CV 5). For female infertility with blood stasis within preventing its descent, Guanyuan (CV 4) governs it. For women with red and white discharge followed by vaginal dryness and pain, aversion to sexual intercourse, hard lower abdomen, and urinary retention, Qugu (CV 2) governs it. For women with obstructed blood flow, Huiyin (CV 1) governs it. For women with malignant blood accumulation in the uterus causing counterflow, fullness, and pain, Shiguan (KI 18) governs it. For amenorrhea, running piglet qi (sensation of gas rushing upward), and pulling pain radiating to the lower back and spine extending upward and downward, Qixue (KI 13) governs it. For women with red leukorrhea, Dahe (KI 12) governs it. For women with pain within the uterus and menstruation not ceasing at its proper time, Tianshu (ST 25) governs it. For lower abdominal distension and fullness, pain pulling into the vagina, lumbar and spinal pain upon menstruation, uterine masses, and cold in the uterine orifice, Shuidao (ST 28) governs it. For women with cold in the vagina, Guilai (ST 29) governs it. For women with irregular menstruation or sudden cessation, abdominal distension and fullness, urinary retention, heat in the body, spasmodic pain within the abdomen, hernia with genital swelling, difficult lactation, fetal qi attacking the heart, and retained placenta — in all cases, at Qichong (ST 30), insert the needle three cun deep; when qi arrives, drain it. For women without children and with lower abdominal pain, Qichong (ST 30) governs it. For residual postpartum ailments, inability to eat or drink, fullness in chest and hypochondrium, dizziness, cold feet, gripping heart pain, frequent belching, smelling putrid-sour odors, and distension and bi obstruction with abdominal fullness, Qimen (LR 14) governs it. For women with hardness and pain in the lower abdomen and amenorrhea, Daimai (GB 26) governs it. For women with red and white discharge, tenesmus, and convulsions, Wushu (GB 27) governs it. For milk accumulation (galactocele), Taiyuan (LU 9) governs it. For infertility, Shangqiu (SP 5) governs it. For women with hernia-type accumulations which upon palpation feel hot as if boiling water is being poured onto the inner thigh down to the knee, with undigested food diarrhea, moxa and needle Ququan (LR 8). For women with pain inside the vagina and hardness, tension, and pain in the lower abdomen, Yinlingquan (SP 9) governs it. For women with vaginal bleeding or obstructed blood amenorrhea, and distension with rebellious qi, Xuehai (SP 10) governs it. For irregular menstruation, deterioration of the body after seeing blood, and cold in the genitals, Xingjian (LR 2) governs it. For breast abscess, Taichong (LR 3) and Fuliu (KI 7) govern it. For women with hernia and swelling of the lower abdomen, loose stools, urinary retention, enuresis, vaginal pain, dark facial complexion like dust, and pain beneath the eyes, Taichong (LR 3) governs it. For women with a large lower abdomen, difficult lactation, dry throat with craving for drink, Zhongfeng (LR 4) governs it. For women with vaginal bleeding, Taichong (LR 3) governs it. For women with hernia around the umbilicus, Zhongfeng (LR 4) governs it. For large hernia with infertility, Zhubin (KI 9) governs it. For women with hernia, swelling of the lower abdomen, and red and white leukorrhea varying in quantity, Ligou (LR 5) governs it. For women with hernia-type accumulations, lower abdominal swelling, painful vaginal prolapse, the menstrual flow descending, vaginal swelling or itching, seepage of greenish fluid, amenorrhea with infertility, and lack of appetite, Ququan (LR 8) governs it. For women with permanent sterility or who have never given birth, Yinlian (LR 11) governs it. For women without children, Yongquan (KI 1) governs it. For women with infertility, sudden vaginal prolapse, and leakage of menstrual blood, Rangu (KI 2) governs it. For women whose menstruation does not descend, Zhaohai (KI 6) governs it. For vaginal prolapse in women, Shuiquan (KI 5) governs it. For women with vaginal bleeding, abdominal distension and fullness preventing breathing, and yellow urine, Yingu (KI 10) governs it. For breast abscess with fever, Sanli (ST 36) governs it. For breast abscess with fright-induced bi disorder, heavy lower legs, feet unable to draw back, and heel pain, Juxu Xialian (ST 39) governs it. For irregular menstruation, deterioration of the body upon seeing blood, and breast swelling, Linqi (GB 41) governs it. For women with difficult labor and retained placenta, Kunlun (BL 60) governs it.
Chapter 11 · Miscellaneous Pediatric Diseases In infantile illness, when the hair all stand reversed upward, the prognosis is poor (note: this is an ancient empirical observation and should not be used for judgment today). In infants, the appearance of green vessels between the ears indicates abdominal pain. For large-stool with green material and undigested food diarrhea, if the pulse is large and the hands and feet are cold, it is difficult to cure; for undigested food diarrhea with a small pulse and warm hands and feet, recovery is easy (note: same principle). For fright epilepsy with five presentations of the pulse, needle the Hand and Foot Taiyin each with five punctures; puncture the Taiyang channel with five; puncture beside the Hand and Foot Shaoyin collaterals with one each; puncture Foot Yangming once; at five cun above the ankle, administer three needle insertions. For pediatric fright epilepsy, Benshen (GB 13), Qianding (GV 21), Xinhui (GV 22), and Tianzhu (BL 10) govern it. If there is upward deviation of the eyes (staring), Linqi (GB 41) governs it. For pediatric fright epilepsy complicated by convulsions, rigid spine, eyes turning upward and rolling, Jinsuo (GV 8) governs it. For pediatric fright epilepsy and convulsions with rigidity of the spine pulling mutually, Changqiang (GV 1) governs it. For pediatric headache from dietary disturbances, Yixi (BL 45) governs it. For the onset of pediatric epilepsy with eyes rolling upward, Cuanzhu (BL 2) governs it. For pediatric umbilical wind with eyes rolling upward, pierce Sizhukong (SJ 23). For pediatric epilepsy, vomiting and diarrhea, fright and loss of essence, and blurred vision, Chimai (SJ 18) and Changqiang (GV 1) govern it. For pediatric fright epilepsy with inability to breathe, Luxi (SJ 19) governs it. For pediatric fright epilepsy appearing as if seeing things, Lieque (LU 7) governs it, and additionally select the Yangming collateral. For pediatric foul breath from the mouth and fullness of the chest and hypochondrium, Laogong (PC 8) governs it. For pediatric cough with diarrhea and unwillingness to eat, Shangqiu (SP 5) governs it. For pediatric epilepsy with agitation of the hands and feet, blurred vision, clenched jaw, and yellow urine, Shangqiu (SP 5) governs it. For pediatric epilepsy with enuresis — in deficiency all types of epilepsy and mania arise; in excess there is urinary retention, heat in the lower abdomen, and excessive sleepiness — Dadun (LR 1) governs it. For pediatric umbilical wind with inability to open the mouth and susceptibility to fright, Rangu (KI 2) governs it. For pediatric abdominal fullness preventing eating and drinking, Xuanzhong (GB 39) governs it. For pediatric equine epilepsy, Pucan (BL 61) and Jinmen (BL 63) govern it. For wind from the head to the feet, convulsions, the mouth clenched tight and unable to open, sudden fullness in the abdomen upon each bowel movement that does not descend with pressure, sneezing, sadness, and wheezing, Kunlun (BL 60) governs it.
1. The Mutual Root Relationship of Yin-Yang and Sleeping and Waking At the beginning of this volume, using "yawning" and "inability to sleep" as entry points, the text systematically expounds the core model of TCM sleep theory: the circadian movement of defensive qi between the yin and yang. During the day, defensive qi travels through the yang twenty-five circuits; at night, it travels through the yin twenty-five circuits. When yang qi is exhausted, one lies down; when yin qi is exhausted one wakes. Insomnia (inability to sleep) was summarized as "defensive qi unable to enter the yin," while excessive sleepiness represented "defensive qi lingering in the yin for long." This model links the sleep-wake cycle directly to the pathways of qi movement, representing the most classic theoretical explanation of sleep from the Neijing onward.
2. Correspondence Between Orifices and Viscera The fourteen conditions of "abnormal qi attacking the empty orifices" each have clear visceral affiliation — the kidneys govern yawning, the lungs govern hiccup, the heart governs belching, the stomach governs snoring, and the will together with the heart govern weeping and nasal discharge, among others. This represents the TCM diagnostic logic that "what is within must manifest without": abnormalities of the orifices are not purely local problems but external projections of disordered visceral qi dynamics. Therefore, treatment does not target the local symptom itself but modulates virtuality and repletion in the corresponding viscera and channels.
3. Systematic Application of Supplementation and Draining Principles Nearly all conditions in the entire volume are governed by the core maxim: "when replete, drain; when vacuous, supplement." It is important to note, however, that many seemingly "replete" presentations (such as shuddering with cold, sighing, tinnitus) are ultimately attributed to deficiency. When pathogenic qi is able to lodge in the orifices, the root cause is insufficiency of local rightful qi — echoing the principle: "where pathogens accumulate, qi must be vacuous."
4. Early Exploration of Phonatory Anatomy The descriptions of the speech apparatus — epiglottis, lips and mouth, tongue, uvula, nasopharynx, and hyoid bone — in Chapter Two constitute a relatively systematic anatomical-functional understanding of vocal production in ancient China. Though distinct from modern anatomy, the functional stratification of the "door, fan, latch, trigger" of voice demonstrates how the ancients integrated anatomical observation with functional reasoning.
5. The Connection Between the Eyes and the Brain The description in Chapter Four that "the ocular system ascends and connects, in the interior, to the brain, and exits in the back at the nape" clearly posits a pathway linking the eyes and the brain through the "ocular system," with pathogens able to "follow the eye system to enter the brain." This is among the clearest records of the eye–brain pathway in traditional Chinese medical texts — far more complex than the stereotype that "Chinese medicine does not recognize the brain."
Areas of Correspondence:
Limitations of historial record / cautions:
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Educational perspective only — 古籍解读提供; Never decision guidelines.