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Chapter 65 of 78
黄帝内经·素问
Overall Paraphrase
The Yellow Emperor asked: Diseases have Biao (outward, later manifestations) and Ben (internal, earlier roots). Acupuncture has Ni (counter) and Cong (following). What does this mean?
Qi Bo answered: Generally speaking, the principles of acupuncture require first distinguishing the properties of Yin and Yang, ensuring that front and back correspond to each other, that counter-treatment and following-treatment are applied appropriately, and that Biao and Ben can be mutually transferred. Thus it is said: when the disease manifests at the Biao level, treat the Biao; when the root lies in the Ben, treat the Ben; when the root is in the Ben but treatment proceeds from the Biao, treat the Biao; when the manifestation is at the Biao but treatment proceeds from the Ben, treat the Ben. Therefore, some treatments succeed by addressing the Biao, others by addressing the Ben; some succeed through counter-treatment, others through following-treatment. Hence, one who understands Ni and Cong can act correctly without hesitation; one who understands Biao and Ben can succeed in every attempt; one who does not understand Biao and Ben is said to be acting blindly and recklessly.
The principles of Yin-Yang, Ni-Cong, and Biao-Ben appear small in scope yet are great in meaning. From one principle one can infer the harm of a hundred diseases. They seem few yet are many; they seem shallow yet are extensive, allowing one to know a hundred from one. From the shallow, one perceives the profound; from the near, one discerns the distant. Biao and Ben are easy to speak of, but not easy to achieve in practice. When treatment opposes the condition, it is called Ni (counter); when treatment aligns with the condition, it is called Cong (following). For disease that arises first and is followed by Jue Ni (rebellion of qi and coldness of the limbs), treat the Ben. For disease that arises after initial Jue Ni, treat the Ben. For cold that precedes other diseases, treat the Ben. For disease that arises first and is followed by cold, treat the Ben. For heat that precedes other diseases, treat the Ben. For heat that is followed by Zhong Man (epigastric and abdominal distention), treat the Biao. For disease that arises first and is followed by diarrhea, treat the Ben. For diarrhea that precedes other diseases, treat the Ben. These conditions must be regulated first, then other diseases can be treated. For disease that arises first and is followed by Zhong Man, treat the Biao (here the text again emphasizes that Zhong Man is an acute Biao condition). For Zhong Man that precedes heart vexation, treat the Ben. The human body has Ke Qi (external pathogenic qi) and Tong Qi (the body's inherent disordered qi). When urination and defecation are obstructed, first treat the Biao; when urination and defecation are free, treat the Ben. When disease arises with excess of pathogenic qi, first treat the Ben and then the Biao; when disease arises with deficiency of righteous qi, first treat the Biao and then the Ben. Carefully examine the severity and urgency of the disease, and weigh and regulate with intent: for mild and superficial conditions, Biao and Ben may be treated together; for severe and deep conditions, treat the Biao or the Ben alone. For disease that arises first with urinary and fecal obstruction followed by other diseases, treat the Ben.
The above discussion of "treatment" and "acupuncture" represents ancient theoretical discourse and is provided for scholarly study only, not as medication or treatment guidance.
Regarding disease transmission (the sequential progression of disease): Heart disease manifests first as heart pain; after one day, cough; after three days, hypochondriac distending pain; after five days, obstruction and closure, with bodily heaviness and pain; if not resolved after another three days, the ancients considered death possible. In winter, death occurs at midnight; in summer, at midday.
Lung disease manifests first as panting and cough; after three days, hypochondriac fullness and pain; after another day, bodily heaviness and pain; after five days, abdominal distention; if not resolved after ten days, the ancients considered death possible. In winter, death occurs at sunset; in summer, at sunrise.
Liver disease manifests first as dizziness, blurred vision, and hypochondriac distending fullness; after three days, bodily heaviness and pain; after five days, abdominal distention; after three days, lower abdominal, lumbar, spinal, and calf pain; if not resolved after another three days, the ancients considered death possible. In winter, death occurs at sunset; in summer, at breakfast time.
Spleen disease manifests first as bodily pain and heaviness; after one day, abdominal distention; after two days, lower abdominal, lumbar, and spinal pain with calf soreness; after three days, spasmodic pain in the muscles beside the back and urinary obstruction; if not resolved after ten days, the ancients considered death possible. In winter, death occurs at the period of Ren Ding (around 9-11 PM); in summer, at the evening meal time.
Kidney disease manifests first as lower abdominal, lumbar, and spinal pain with calf soreness; after three days, spasmodic back muscle pain and urinary obstruction; after three days, abdominal distention; after three days, bilateral hypochondriac distending pain; if not resolved after another three days, the ancients considered death possible. In winter, death occurs at dawn; in summer, at dusk.
Stomach disease manifests first as distention; after five days, lower abdominal, lumbar, and spinal pain with calf soreness; after three days, spasmodic back muscle pain and urinary obstruction; after five days, bodily heaviness; after six days, if not resolved, the ancients considered death possible. In winter, death occurs after midnight; in summer, in the afternoon.
Bladder disease manifests first as urinary obstruction; after five days, lower abdominal distention, lumbar, and spinal pain with calf soreness; after one day, abdominal distention; after one day, bodily pain; after two days, if not resolved, the ancients considered death possible. In winter, death occurs at the rooster's crow; in summer, at the period of Shen (3-5 PM).
When various diseases transmit according to this sequence, the ancients held that there are designated times of death and that acupuncture should not be applied lightly. If the transmission skips one organ and stops, or spreads to three or four organs, only then may acupuncture be applied.
Bu Gua's Note: This content is based on classical texts of traditional Chinese medicine and is provided solely for the study of traditional culture and classical scholarship. It does not constitute any medical diagnosis, medication recommendations, or treatment advice. Please consult a qualified healthcare provider if you feel unwell.