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Chapter 4 of 16
奇经八脉考
Yue Ren (Bian Que) said: The Yang Dimensional Vessel (Yangwei Mai, one of the Eight Extraordinary Meridians, primarily maintaining the yang meridians) and the Yin Dimensional Vessel (Yinwei Mai, maintaining the yin meridians) are like a net that enwraps and connects the entire body. Their qi becomes full and accumulates, but unlike the twelve regular meridians, they do not circulate and irrigate the other meridians. Yangwei arises where all yang meridians converge; Yinwei arises where all yin meridians intersect. Yangwei governs the maintenance of the yang aspect, while Yinwei governs the yin aspect. If yin and yang cannot maintain each other, a person will feel restless and lose purpose, be in a daze, and the body will feel loose and slow, unable to control itself. He also said: When Yangwei is diseased, the person suffers from aversion to cold and fever. When Yinwei is diseased, the person suffers from chest and heart pain. The original annotation says "rongrong" (溶溶) describes a state of slowness and weakness.
Zhang Jiegu believed: Defensive qi (yang qi that travels on the body surface and serves protective functions) is yang and governs the exterior. When Yangwei is invaded by pathogens, the disease locus is on the exterior, hence the suffering from chills and fever. Nutritive qi (yin qi that travels within the vessels and serves nourishing functions) is yin and governs the interior. When Yinwei is invaded by pathogens, the disease locus is in the interior, hence the suffering from heart pain. When yin and yang maintain each other, nutritive and defensive qi are harmonious. When nutritive and defensive qi are not in harmony, a person will lose their spirit and the body cannot control itself.
He cited Zhang Zhongjing's statement: When a patient constantly sweats spontaneously, it is because defensive qi is not harmonizing with nutritive qi. The ancients believed Guizhi Decoction (a classical formula) could be used to harmonize them. He further said: If the patient becomes restless and unrelieved after taking Guizhi Decoction, one may first needle Fengchi (GB-20) and Fengfu (GV-16), then administer Guizhi Decoction. Fengchi and Fengfu are meeting points of the Yangwei. If after taking Guizhi Decoction the patient still has spontaneous sweating, fever, and aversion to cold, with a pulse that is floating at the cun position and weak at the chi position yet counter-disturbed, this indicates the disease is in Yangwei, so these two points are needled first. Zhang Zhongjing also said: When there is no other disease in the zang-fu organs, and the patient regularly has fever and spontaneous sweating that does not resolve, this is disharmony of defensive qi; the ancients believed Guizhi Decoction is the treatment.
Zhang Jiegu further said: When Yinwei is diseased, the suffering is heart pain, and the treatment principle lies at the convergence points of the three yin meridians. For Taiyin syndrome, the ancients used Lizhong Decoction; for Shaoyin syndrome, Sini Decoction; for Jueyin syndrome, Danggui Sini Decoction and Wuzhuyu Decoction. These are all classical formulas from ancient texts, presented here solely for theoretical discussion.
Li Shizhen held that the Yangwei vessel maintains connection with the three yang meridians of the hand and foot, among which the Foot-Taiyang and Foot-Shaoyang are always mutually attached. Chills and fever occur only in these two meridians, hence Yangwei disease also involves chills and fever. Defensive qi travels through the yang aspect during the day and the yin aspect at night. When yin is deficient, there is internal heat; when yang is deficient, there is external cold. When pathogens are in the channel and conflict with yin internally, there is aversion to cold; when conflict with yang externally, there is fever. When chills and fever are on the exterior with Taiyang syndrome signs, the ancients believed Guizhi is used for sweating cases and Mahuang for non-sweating cases. When chills and fever are in the semi-exterior-semi-interior level with Shaoyang signs, modified Xiaochaihu Decoction should be used. If nutritive and defensive qi are weak, the spirit timid and debilitated with chills and fever, the ancients used Huangqi Jianzhong Decoction, Bawu Decoction and similar formulas. Li Shizhen believed Zhang Jiegu's restriction of the Guizhi pattern merely to Yangwei was incomplete.
As for Yinwei disease manifesting as heart pain, Zhang Jiegu merely used warming medicinals for the three yin channels. This is appropriate when cold is attacking the three yin channels. However, heart pain due to heat reversal in the three yin channels seems to have been neglected. Although the Yinwei vessel intersects the three yin meridians as it runs, it ultimately returns with the Ren vessel. Therefore, heart pain is often caused by qi of the Shaoyin, Jueyin, and Ren vessels surging upward. Sudden pain rarely has heat signs; chronic pain rarely has cold signs. Pain that slightly relieves upon pressure is deficient; pain that aggravates upon pressure is excess. For cold-type pain involving Shaoyin and the Ren vessel, the ancients used Sini Decoction; involving Jueyin, Danggui Sini Decoction; involving Taiyin, Lizhong Decoction. For heat-type pain involving Shaoyin and the Ren vessel, use Jinling Powder or Yanhusuo Powder; involving Jueyin, Shixiao Powder; involving Taiyin, Chengqi Decoction. If there is internal injury to nutritive blood involving the Ren, Chong, and hand Jueyin [vessels], decoctions such as Siwu Decoction, Yangying Decoction, Miaoxiang Powder, etc. are appropriate, selecting based on the disease. Li Shizhen said that distinguishing yin-yang deficiency-excess in this manner would likely produce no errors.
⚠️ The formulas and acupuncture methods above are ancient treatment approaches recorded in classical texts; they are for scholarly study only and must not be used as modern medication or acupuncture guidance.
Wang Shuhe's Mai Jing (Pulse Classic) states: When the cun pulse slants from the Shaoyin region toward the Taiyang region, it indicates the Yangwei vessel. When the pulse is abnormally active, the person suffers from muscle numbness with itching, skin pain, loss of sensation in the lower body, sweating with chills; also suffers from falling, making goat-cry-like sounds, spasmodic twitching of the hands and feet, and in severe cases loss of voice with inability to speak. The ancients recommended needling Ke Zhuren point (ST-7, located in the depression anterior to the condyle of the mandible, at the upper margin of the zygomatic arch, a meeting point of Hand and Foot Shaoyang and Yangming).
It further states: When the cun pulse slants from the Shaoyang region toward the Jueyin region, it indicates the Yinwei vessel. When the pulse is abnormally active, the person suffers from epilepsy, falling stiff, and goat-cry-like sounds; also suffers from falling stiff with loss of voice, muscle numbness with itching, regular spontaneous sweating, aversion to wind, and a sensation of the body being chilled (xixi in appearance). The ancients recommended needling Yangbai (GB-14) and Jinmen (BL-63) (see section above), with Pucan (BL-61) to be referenced under the Yang Qiao Vessel section.
Li Shizhen commented: Wang Shuhe attributed epilepsy to the yin and yang dimensional vessels. Ling Shu attributed epilepsy to the yin and yang qiao vessels. The phrasing differs between the two but their principles align. Yangwei ascends from the lateral malleolus, runs along the yang aspect to the shoulder and elbow, passes the ear and forehead, and ultimately travels among the gatherings of yang in the external aspect where defensive qi operates. Yinwei ascends from the medial malleolus, runs along the yin aspect up the flank to the throat, traveling among the intersections of yin in the internal aspect where nutritive qi operates. Yangqiao arises in the heel, ascends along the lateral malleolus outside the thigh to the flank, ribs, and shoulder blade, traveling the left and right of the body, ending at the inner canthus. Foot Qiao arises in the heel, ascends the medial malleolus along the inner thigh to the throat, joins the Ren vessel, and ends at the inner canthus. When pathogens attack the Yinwei or Yinqiao, Manic-Depressive (dian) disorder manifests; when they attack the Yangwei or Yangqiao, Epileptic (xian) seizures manifest, Fen Epilepsy belongs to yang and is active, governed by the yang vessels; Dian belongs to yin and is static, governed by the yin vessels. In general, the points of these four vessels should be needled, differentiating yin and yang [patterns].
Wang Shuhe stated: When the pulse is examined as floating in the Yangwei, the person suddenly develops dizziness upon rising. When yang is exuberant and excess, there is chest and shoulder difficulty with breathing, and a sensation of sudden chills like being splashed. When the Yinwei pulse is examined as deep, large, and excess, the person suffers from chest pain, hypochondriac distension, and heart pain. A pulse appearing like a string of beads manifests in males as excess fullness in both hypochondria and lumbar pain; in females as genital pain with abscess-like formations.
Su Wen · Yaotong Lun (Plain Questions · Treatise on Lumbar Pain) states: When a disease of the Yangwei causes lumbar pain, the superior, distressed area | As a pre-Qin text detail.
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