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Chapter 15 of 16
奇经八脉考
Qin Yueren (Bian Que) said: When the Dai Vessel is affected, the presenting symptoms are abdominal distension and a lax, powerless lower back, as if one were sitting in water. "Rongrong" (溶溶) describes a slow, relaxed, and slack quality.
The Mingtang (Acupuncture Classic) records: The two acupoints on the Dai Vessel (the Dai mai points) are indicated for a slack and relaxed sensation in the lower back and abdomen, as if the belly were a sac filled with water; in women, for lower abdominal pain, tenesmus (urgent need to defecate with a bearing-down sensation in the anus), cramping of the limbs, irregular menstruation, and reddish or whitish vaginal discharge. Needling may be performed to a depth of six fen, and moxibustion with seven cones is prescribed.
Zhang Jiegu said: Disorders of the Dai Vessel are governed by the Taiyin channel (Spleen channel). Moxibustion at Zhangmen acupoint (a Liver channel point and Front-Mu point of the Spleen) on both sides is appropriate, with three cones on each side.
The Suwen (Plain Questions) states: When pathogenic qi invades the collateral of the Taiyin channel, it causes lumbar pain that radiates to the lower abdomen and to the soft hollow area beneath the floating ribs (the soft-costal region at the lowest margin of the ribcage), impairing normal respiration. "Miao" (眇) refers to the soft, hollow region below the floating ribs.
Zhang Zhongjing said: After recovery from a serious illness, if water qi (edema) appears below the waist, treat it primarily with Muli Zexie San (Oyster and Alisma Powder); if there is no improvement, apply moxibustion to the Zhangmen point.
Wang Shuhe said: When the Dai Vessel is affected, pain encircles the navel and radiates through the lower back and spine, extending to the inner thighs (yingu).
Wang Haicang said: For pediatric epilepsy with hernia (hernial swelling), moxibustion at the Zhangmen point with three cones may bring about a cure. This is because the Dai Vessel courses through the region governed by the Jueyin channel (Liver channel), while being regulated by the Taiyin channel. He also said: In women's menstrual disorders and metrorrhagia (flooding bleeding), when the condition has progressed over time to the point of exhaustion and depletion, astringent and tonifying methods are appropriate; for blood closure (amenorrhea) of prolonged duration resulting in exhaustion, supplementing should be combined with breaking blood stasis. Breaking blood has three methods: first, use Siwu Tang (Four Substances Decoction) with added safflower, blended with Astragalus and Cinnamon Bark; second, use Siwu Tang with added safflower, blended with Pangolin Scales, Peach Kernel, and Cinnamon Bark, decocted with boy's urine and wine; third, use Siwu Tang with added safflower, blended with Zhang Yuansu's (Elder Yi's) Moyao San (Myrrh Powder).
Zhang Zihe said: Of the twelve regular channels and the eight extraordinary vessels, seven all circulate continuously upward and downward. Only the Dai Vessel arises from the lateral lower abdomen, below the floating ribs, encircles the body once, and passes through the waist like a girdle. The Chong Vessel (which regulates qi and blood of the twelve channels) and the Ren Vessel (which governs the yin channels of the body) course along the abdomen and flanks, running beside the navel, and flow down to Qichong (the qi street, located at the inguinal region), where they connect to the Dai Vessel and further to the Du Vessel (which governs the yang channels of the body). The Chong, Ren, and Du vessels all originate from the same source but take different pathways — one source branching into three — and all connect to the Dai Vessel. Because the various channels travel up and down, leaving residual heat lodged within the region of the Dai Vessel, the accumulated guest heat stagnates and suppresses, causing white secretions to overflow and drip down with urine, unabating — this is what is called vaginal discharge (white leukorrhea). The Neijing (Inner Canon) says: When one's thoughts are unceasing, desires cannot be fulfilled, intentions wander licentiously abroad, or sexual intercourse is excessive, this may give rise to sinew痿 (flaccidity) and white overflow (spontaneous emission of whitish secretions resembling semen, which in men passes with urine and in women drips ceaselessly).
All these conditions should be treated from the perspective of damp-heat, following methods similar to those used for dysentery. In red and white dysentery, pathogenic heat is transmitted to the large intestine; in red and white vaginal discharge, pathogenic heat is transmitted to the small intestine. Later physicians have all regarded red as indicating heat and white as indicating cold — this error has persisted for a thousand years and represents a misjudgment on the part of medical practitioners.
He further said: The Zisheng Jing (Classic of Nourishing Life) records a woman suffering from red and white vaginal discharge. Someone applied moxibustion to her Qihai point without effect. The next day, moxibustion was applied to her Dai mai point, and a ghost whispered in her ear: "Yesterday's moxibustion was also fine, it just didn't reach me; today it has reached me, so I am leaving. You may offer a wine and food sacrifice to me." Her family followed the ghost's words and made the offering, whereupon she recovered. I initially found this matter strange, then was reminded of the story of the two ghosts of Duke Jing of Jin in his gaohuang (from the Zuozhuan, where Duke Jing of Jin, critically ill, dreamed of two ghosts dwelling between his heart and diaphragm). That was a case of extreme deficiency from exhaustion, in which only then could ghosts take advantage to dwell there. This woman likewise, through excessive mental strain and depletion, allowed a ghost to dwell in her body. Once moxibustion reached the correct point, the ghost could not but depart. From then on, whenever any patient with this condition came to me, pressing this point would invariably elicit a sore, painful response; sending them home to apply moxibustion at this point invariably brought a cure. This point is located one cun and eight fen below the floating ribs on both sides of the costal region. If one also applies moxibustion to the Baihui point (at the vertex of the head), the result is even better. The Neijing says: When disease is in the upper part, select points from the lower part; when disease is in the lower part, select points from the upper part. It also says: For disease above, treat below; for disease below, treat above — this is precisely the principle involved.
Liu Zonghou said: Vaginal discharge disorders mostly arise from yin deficiency and yang exhaustion, where nutritive qi (the essential qi circulating within the vessels) fails to ascend, the channels become congealed and sluggish, the Chong qi descends, and essential qi accumulates and stagnates in the extraordinary meridian territories of the lower burner, brewing into disease. Its naming as a disorder of the Dai Vessel corresponds to its morphological presentation. White discharge belongs to the qi aspect and red discharge belongs to the blood aspect. These disorders often result from intoxication, excessive eating, sexual fatigue, or consumption of desiccating, heating substances; some also arise from damp-phlegm flowing and pooling in the lower burner, from kidney-yin deficiency with dampness flourishing, from fright and fear causing the Liver wood to overpower the Spleen earth with turbid fluids flowing downward, or from unceasing longing producing sinew flaccidity — what is called "disease of the two yang arising from the heart and spleen." Other causes include damp-heat from the remaining channels twisting and stagnating below the lower abdomen, or deficiency-cold of the lower origin (the primordial yang of the kidneys) with dampness macerating the uterus. Treatment methods vary: some use purging, some use emesis; some combine dispersal with tonification, tonification with promoting diuresis, desiccation with upbearing, moistening with warming nourishment; or warming and tonifying, or astringing — these various approaches reflect the principle of adaptable treatment based on the pathological mechanism.
Chao Yuanfang's Zhubing Yuanhou (Treatise on the Origins and Manifestations of Various Diseases) states: In kidney-attachment disorder (a condition of cold-damp clinging to the kidney channel), the lower back is painfully cold like ice, the body feels heavy, and the waist feels as though loaded with five thousand coins (describing a heavy, sagging sensation). The patient is not thirsty, urination remains free and easy, and the condition arises after sweating from exertion while the inside of clothing becomes damp and cold; over time it transforms into edema. The Qianjin Fang (Important Formulas Worth a Thousand Gold) uses Shenzhu Tang (Kidney-Attachment Decoction), the Sanyin Fang uses Shenshi Tang (Dampness-Draining Decoction), and Li Dongyuan uses Duhuo Tang (Angelica pubescens Decoction) to treat it.
The core academic value of this chapter lies in its systematic collection of understandings regarding Dai Vessel disorders from physicians of various dynasties before the Jin-Yuan period, presented in three progressive layers:
First, the location of the Dai Vessel and its pathomechanism. Zhang Zihe clearly outlined the unique position of the Dai Vessel from the perspective of channel pathways — it is the only channel among the eight extraordinary vessels that runs transversely in a circular manner, "encircling the body once, passing through the waist like a girdle." The Chong, Ren, and Du vessels share "one source branching into three" but all connect to the Dai Vessel, meaning the Dai Vessel undertakes a transverse binding and restraining function within the extraordinary vessel system. When the Dai Vessel is diseased, the core manifestation is "loss of restraint" — the lower back and abdomen become slack and powerless, as if sitting in water, like a sac filled with water. Qin Yueren's phrase "the loins feeling relaxed as if sitting in water," the Mingtang's "the loins and abdomen slack and water-bag-like," and Wang Shuhe's "pain encircling the navel radiating to the lower back and spine" all describe this core pathological picture.
Second, the multi-level attribution of the disease location. Zhang Jiegu explicitly states that the "Taiyin governs it," while Wang Haicang adds, "the Dai Vessel courses through the Jueyin region, yet it is the Taiyin that governs it." This reflects the dialectical thinking in TCM regarding Dai Vessel disorders: the Dai Vessel itself is not directly paired with a zang-fu organ, but the regions it traverses bear the closest relationship with the Liver (Jueyin) and Spleen (Taiyin) channels. Moxibustion at the Zhangmen point (a Liver channel point and Front-Mu point of the Spleen) is precisely the clinical application of this concept.
Third, the etiological evolution from "damp-heat" to "multiple causes." Zhang Zihe forcefully advocated that vaginal discharge conditions "should all be treated from the perspective of damp-heat" and criticized the millennium-old error of regarding "red as heat, white as cold." Liu Zonghou further expanded the scope, proposing multiple etiologies including yin deficiency with yang exhaustion, damp-phlegm flowing downward, fright causing wood to overpower earth, longing damaging the heart and spleen, and deficiency-cold of the lower origin, pointing out the diagnostic feature that "white belongs to the qi aspect and red belongs to the blood aspect," as well as the "living method" of treatment: "either purge or cause vomiting, or combine dispersal with tonification, tonification with diuresis, desiccation with upbearing, moisturizing with warming nourishment." This evolution from a single cause to multiple differential diagnoses marks an important milestone in the maturation of TCM theories on vaginal discharge disorders.
From a modern medical perspective, this chapter contains aspects that resonate with current understanding, as well as clear historical limitations.
Aspects that can be corroborated: Abnormal vaginal discharge (such as increased leukorrhea or reddish-white discharge) in modern gynecology indeed often correlates with reproductive tract infections (such as vaginitis, cervicitis, or pelvic inflammatory disease). The pathological products of the inflammatory response bear a phenomenological overlap with the TCM concepts of "damp-heat pouring downward" and "accumulated heat causing suppression." Zhang Zihe's analogy of "treating it like dysentery," while its specific attribution of "small intestine" and "large intestine" does not fully correspond to anatomical reality, nonetheless shows internal consistency in its conceptual framework of "pathogen — inflammation — abnormal secretion," parallel to the logic that "heat transmitted to the intestines causes dysentery, and heat transmitted to the lower burner causes discharge." Additionally, Chao Yuanfang's description of kidney-attachment disorder — lower back cold and painful as ice, body heavy as if carrying five thousand coins, contracted from damp-cold inside clothing after sweating from exertion — closely matches the clinical presentation of chronic lumbar muscle strain or lumbar fasciitis induced by cold-damp environments in modern medicine, and the triggering factor of "damp and cold inside the clothing" has a certain scientific basis.
Aspects requiring cautious interpretation: Zhang Zihe's citation of the "ghost attachment" medical case from the Zisheng Jing represents a cultural narrative within classical medical texts, reflecting the spiritual belief framework through which society at the time interpreted disease, and lacks scientific basis. However, Zhang Zihe's own reflection on "ghost attachment" deserves attention — he attributed the "ghost's dwelling" to "exhaustion from mental strain and deficiency," and believed that once moxibustion reached the correct point "the ghost could not but depart." In effect, he was recognizing a relationship between the patient's constitutional deficiency and the alleviation of symptoms, merely expressed within the linguistic constraints of his era. His observation that "pressing this point invariably elicits a sore, painful response" shows phenomenological similarity to the modern concept of myofascial trigger points and may appropriately be regarded as historical experiential data.
The following general lifestyle recommendations can be drawn from this chapter (not intended for any specific disease):
Related Concepts:
Further Reading:
This content is based on classic TCM texts and is provided solely for the study and appreciation of traditional culture. It does not constitute any form of medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.