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Chapter 9 of 16
奇经八脉考
Overall Interpretation
When the Chong vessel is affected, its core manifestations can be summarized as "counterflow qi surging upward" and "internal urgency" (abdominal tension and gripping discomfort). The Nanjing (Classic of Difficult Issues) first made this clear: Disorders of the Chong vessel manifest as rebellious qi (qi surging upward) and internal urgency (abdominal tightness and tension).
The Lingshu Jing (Spiritual Pivot) supplements the approach to regulating qi through acupuncture: When qi counterflows upward, the ancients would needle the chest region or the artery below the chest. For abdominal pain, they would needle the arteries on either side of the navel, which often brought immediate relief upon pressing. If not relieved, they would then needle Qijie (the area around Qichong point in the inguinal region), with relief following pressure. This records the classical academic approach to regulating Chong vessel qi through acupuncture and is not a modern clinical recommendation.
Li Dongyuan analyzed from the perspective of the four seasons: In autumn and winter, the four pathways of the stomach meridian are disturbed by the upward counterflow of Chong vessel qi, while the two Shaoyang meridians below the ribs ascend instead, termed "Jue vessels" (reversed vessels). Manifestations include qi surging upward, throat blockage with difficulty breathing, wheezing with sound, and inability to lie flat. The ancients considered using Tiaozhong Yiqi Tang (Middle-Regulating Qi-Benefiting Decoction) plus Evodia (Wu Zhuyu), adjusting the dosage according to the severity of the counterflow. When similar conditions appeared in summer, they were mostly classified as extreme heat patterns, and the ancients used bitter-cold heat-clearing medicinals such as Coptis (Huang Lian), Phellodendron (Huang Bai), and Anemarrhena (Zhi Mu), prepared with wine-washing and dry-frying, formed into pills, and taken on an empty stomach, followed immediately by food to "press down" the medicinals, preventing them from stagnating in the stomach and allowing them to reach the lower burner directly—thereby draining pathogenic qi from the Chong vessel. This embodies the principle of "treating according to the cold, hot, warm, and cool of the four seasons."
He further stated: Whenever qi counterflows upward, whether accompanied by abdominal urgency or irritability and fever, it may be regarded as Chong vessel qi counterflow. In internal damage disorders, the ancients used Buzhong Yiqi Tang (Center-Supplementing Qi-Benefiting Decoction) plus stir-fried Huang Lian, Zhi Mu, etc., to drain heat from the Chong vessel. If kidney fire was excessive, or if the Ren, Du, and Chong vessels were hyperactive together, wine-fried Huang Bai and Zhi Mu were used, but not for prolonged periods, lest they damage the stomach. When stabbing pain in the abdomen or marked internal urgency appeared, the ancients predominantly used Gancao (Licorice) to relieve urgency. When straining at stool without passage, this was mostly attributed to blood deficiency—blood deficiency failing to nourish leads to internal urgency—and Danggui (Chinese Angelica) was used to nourish and moisten. For counterflow qi with internal urgency, throat blockage, and constipation, the ancients used Shengyang Tang (Yang-Raising Decoction) or Xie Re Tang (Heat-Draining Decoction). For numbness, jue qi surging upward, counterflow qi ascending, with auditory or visual hallucinations, they used Shengong Wan (Spirit-Transforming Pill). These are all recorded in the Lanshi Micang (Secrets from the Orchid Chamber). It must be clarified: The formulas and methods described are experiences of ancient physicians, provided solely for understanding the diagnostic and therapeutic framework of Chong vessel disorders, and must not be directly applied.
Sun Simiao's Qianjin Fang (Essential Prescriptions for Emergent Reference) records: Coughing, spitting saliva, cold hands and feet, with a sensation of qi surging from the lower abdomen up to the chest and throat, the face feeling hot and flushed as if drunk, followed by qi descending to the inner thighs, difficult urination, episodes of faintness, deep cun pulse and faint chi pulse—the ancients used Fuling Wuweizi Tang (Poria and Schisandra Decoction) to treat the qi surge, composed of Poria, Schisandra, Cinnamon Heart, Licorice, etc.; for chest fullness, Cinnamon Heart was removed. Another medical case: Lord Taiping Hou suffered pain in the region of Danzhong (chest center), wheezing, vomiting, acid regurgitation, with a sensation of a point of qi at the umbilicus surging toward the throat, feeling ice-cold, attacking after midnight and during the Shen period (3–5 PM). A previous physician mistakenly treated it as severe cold without effect. Zhu Juquan concluded it was caused by excessive drunkenness and rich food consumption—after Zi period (11 PM–1 AM) and during Shen period, the ministerial fire rises from below, causing pain. After two doses of Erchen Tang (Two Oldings Decoction) plus Huang Qin, Huang Lian, Zhizi (Gardenia), and Cangzhu (Atractylodes), the patient recovered.
The Suwen · Weilun (Plain Questions · Treatise on Wei (Atrophy) Disorders) discusses "the treatment of wilting (atrophy) should uniquely focus on the Yangming meridian": The Yangming meridian is the sea of the five viscera and six bowels, capable of moistening and nourishing the Zongjin (the sinews that gather, referring collectively to the muscles and tendons). The Zongjin govern the binding of bones and the lubrication of joints. The Chong vessel is the sea of the meridians, responsible for infiltrating and irrigating the Xigu (flesh interspaces and sinew interspaces). It converges with the Yangming meridian at the Zongjin, joins again with Qijie (the qi street) in the inguinal region, and relies on the Yangming meridian as its lead. Both vessels connect with the Dai (Belt) vessel and link with the Du (Governing) vessel. Therefore, when Yangming is deficient, the Zongjin become lax, the Dai vessel fails to contract and draw together, leading to wilting and non-use of the lower limbs. Treatment should supplement the nutritive blood of the various meridians, unblock the Shu (transporting) points, regulate deficiency and excess, normal and counterflow, and choose appropriate times for regulation based on the specific viscera's corresponding months (e.g., Liver governs Jia and Yi days, Heart governs Bing and Ding, Spleen governs Wu and Ji).
Li Dongyuan further pointed out: Severe illness in the summer months may transmit to the Kidney and Liver, producing Wei-Jue (atrophy-with-reversal). "Wei" (wilting) denotes weakness and flaccidity of the four limbs; "Jue" (reversal) denotes limbs that are either hot as fire or cold as ice. Heart vexation relates to Chong vessel qi counterflow; when counterflow is severe, fire counterflows as well, termed "Jue Ni" (reversed counterflow). Hence Wei and Jue often accompany each other. The classics state, "When qi below is insufficient, atrophy-reversal and heart vexation with oppression result," indicating that deficiency of qi in the lower body can produce Wei-Jue and mental disquiet. Classical treatment used herbs that clear dryness and eliminate damp-heat, or Shengmai San (Pulse-Generating Powder) combined with Siling San (Four Poria Powder) plus wine-washed Huang Bai and Zhi Mu to drain damp-heat. Li Shizhen's supplement: Damp-heat causing Wei (atrophy) is "excess amidst deficiency," and should be treated by percolating and draining damp-heat. If Jing-blood dryness and exhaustion cause Wei, it is "deficiency amidst deficiency," and requires vigorous supplementation of essence and blood.
The Lingshu Jing proposes the "Qijie" (Qi Street) theory: The chest, abdomen, head, and shins each have their Qi Street. When qi is in the head, it terminates at the brain; when qi is in the chest, it terminates in the chest region and dorsal Shu points of the back; when qi is in the abdomen, it terminates at the dorsal Shu points and the moving pulse points of the Chong vessel beside the navel; when qi is in the lower leg, it terminates at Qijie and Chengshan point, and the region below the ankle. Since treatment was applied related to those sections, such points are to be deeply understood for purposes of strategic interventions. For needling these sites, one should first press the area, then insert the needle once qi arrives beneath the fingers. These methods may treat headache, dizziness with collapse, abdominal pain, moderate fullness with sudden abdominal distention, and accumulations causing pain of recent origin. This is an explanation of the principles and methods of acupuncture and moxibustion.
The Suwen · Jutong Lun (Plain Questions · Treatise on Painful Disorders) states: When cold pathogens invade the Chong vessel, since the Chong vessel originates at Guanyuan (CV-4) and ascends alongside the abdomen, the retention of cold causes the vessel pathway to be obstructed; when the vessel is blocked, qi movement is impeded. This can produce throbbing sensations palpable beneath the abdomen along with restless, sighing discomfort.
Wang Shuhe's Maijing (Pulse Classic) identifies Chong vessel disorders through pulse assessment: When both hands, taking lightly, reveal a yang quality, and pressing deeply reveals a yin quality—both yin and yang being exuberant—this indicates disease of the Chong and Du vessels. If disorders of these vessels arise in their role as one functional unit, the twelve regular meridians will no longer normally converge at the cunkou position, or when Chong and Du oversee bodily circumstances, the individual experiences mood effects of distractibility, and an affliction described as encompassing flightiness. Demented recklessness, sometimes described as daze with or without violence, can issue in association with major zang organs used as channels of phenomena beyond themselves. Also: A pulse that is firm in the central position and directly reaches the Guan position indicates Chong vessel disease, with suffering from lower abdominal pain, qi rushing toward the heart, abdominal masses and hernias, enuresis, rib-side distention, heart vexation, and in women, infertility. A chi pulse that is firm, running straight up and downward, also suggests that a cold mass in the chest relates to pathology associated with the vessel termed "Chronic mass Congregation described by association,” described as inward location with origin in disharmony overall or that could be further designated as a design concept "Ventrally positioned cold mountain caused on downward links simply inside,"; throughout or occasionally this is from or reveals interplay where pressing relationships all confirm "Cold Hernia from Sea Potential Deep."
Zhang Zhongjing's discussions of "Dongqi" (movement/agitation qi around umbilicus) and contraindications to sweating and purging: When there is throbbing sensation around the navel, to the right, left, upper, or lower positions, neither diaphoresis nor purgation should be performed lightly. If sweating or purging is mistakenly conducted, pattern-transformations appear, confirmed as evolution. Symptoms include epistaxis, thirst, heart vexation, vomiting immediately after drinking water, dizziness, dry throat, dry nose, palpitations, muscular twitching and skin crawling, abdominal gripping, upward qi surge, interior vexation from abundant distressing heat, bone/joint pain, and diarrhea with undigested food. Ancient physicians responded with plans involving Wuling San (Five Poria Powder), Zhuye Tang (Bamboo Leaf Decoction), Fangfeng Baizhu Muli Tang (Ledebouriella White Atractylodes Oyster Decoction), Xiao Jiangzhong Tang appositely [Tie-mids], still the “Smiling Center-Establishing Decoction,” Gancao Ganjiang Tang itself, Li Gen Tang appositely connecting and modeling — with in the or interpreting prescription possibility not to for "Severe," as "Numbing substance material presented like Plum root established purely also and within respective formulas shaped appropriately drawn distinct to combine association," "Dali,”, after inside "with clinical" 四 uses indeed applied alternate read:" the prescription rendered fully as clear naming, also “Large Age [One who Disbands disassociated meaning there entirely blank]).” respectively to small means applications complete. Li Shizhen believed that the presence around the navel with description specified covered is in within potential hard persistent, 'they function united disorders', involving by ‘modern equivalence current language — disease process relation'; fully participating "four intertwining: the Chong, Receptacle direct have no presence." Cheng Wuji simplifies matching "left‐liver/right‐lung /above-heart/index attribution correct mapping into default prescription to visible energetic medicine remains misbalanced actually observation (distinction of explanation for the time) deficiency."
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