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Chapter 12 of 81
黄帝内经·灵枢
Overall Paraphrase
The Yellow Emperor asked Qi Bo: The twelve channels (main pathways through which qi and blood circulate) of the human body correspond externally to the twelve great rivers of the natural world, and internally connect to the five viscera and six bowels. These twelve rivers differ in size, depth, width, and length; the five viscera and six bowels differ in height of position, size of form, and capacity for receiving water and grain—how do these correspond to one another? Rivers receive water and flow without cease; the five viscera store spirit, qi, soul, and essence (the material basis of mental and conscious activity); the six bowels receive water and grain, transmit and transform them, accept essential qi and disseminate it outward; the channels receive blood and circulate it throughout the body. Considering the human body in relation to heaven and earth and nature, how does this guide treatment? Can the depth of needling and the number of moxa cones be explained to me?
Qi Bo replied: An excellent question! Heaven is extremely high and cannot be measured; earth is extremely broad and cannot be surveyed—this is precisely what is being said. Humans dwell between heaven and earth, within the six directions (above, below, and the four cardinal points). The scale of heaven's height and earth's breadth is not something human effort can measure exhaustively.
However, for the body of an eight-foot person, the skin and flesh are right before one's eyes. From the outside, one can understand it through measurement, palpation, and following the contours; after death, one can observe it through dissection. The firmness or fragility of the five viscera, the size of the six bowels, the quantity of water and grain received, the length of the channels, the clarity or turbidity of the blood, the amount of qi (the vital force driving life activities), and which of the twelve channels have more blood and less qi, which have less blood and more qi, which abound in both blood and qi, and which are deficient in both—all follow general patterns. In using needling and moxibustion to treat and regulate the qi and blood of each channel, should one not conform to these patterns?
The Yellow Emperor said: I find what I have heard very reasonable, but I have not yet fully comprehended it. I wish to hear the complete exposition. Qi Bo replied: This is precisely the principle of the human body corresponding with heaven and earth and resonating with yin and yang. It must not fail to be carefully examined.
The Foot-Taiyang Bladder Channel corresponds externally to the Qing River and internally belongs to the Bladder, governing the free flow of water pathways. The Foot-Shaoyang Gallbladder Channel corresponds externally to the Wei River and internally belongs to the Gallbladder. The Foot-Yangming Stomach Channel corresponds externally to the Sea and internally belongs to the Stomach. The Foot-Taiyin Spleen Channel corresponds externally to the Lake and internally belongs to the Spleen. The Foot-Shaoyin Kidney Channel corresponds externally to the Ru River and internally belongs to the Kidney. The Foot-Jueyin Liver Channel corresponds externally to the Mian River and internally belongs to the Liver. The Hand-Taiyang Small Intestine Channel corresponds externally to the Huai River and internally belongs to the Small Intestine, from which the water pathways emerge. The Hand-Shaoyang Sanjiao Channel corresponds externally to the Luo River and internally belongs to the Triple Burner. The Hand-Yangming Large Intestine Channel corresponds externally to the Yangtze River and internally belongs to the Large Intestine. The Hand-Taiyin Lung Channel corresponds externally to the Yellow River and internally belongs to the Lung. The Hand-Shaoyin Heart Channel corresponds externally to the Ji River and internally belongs to the Heart. The Hand-Jueyin Pericardium Channel corresponds externally to the Zhang River and internally belongs to the Pericardium.
The above correspondences between the five viscera, six bowels, and the twelve channel-waters—externally they have their sources, internally they have what they receive—form an interpenetration of inner and outer, like an unbroken ring without beginning or end. The human channels are likewise. Thus heaven is yang and earth is yin; above the waist corresponds to heaven, below the waist corresponds to earth. North of the Sea belongs to yin; north of the Lake belongs to yin within yin; south of the Zhang River belongs to yang; between the Yellow River to the north and the Zhang River to the south belongs to yang within yin; between the Luo River to the south and the Yangtze River belongs to greater yang within yang. This is merely the yin-yang division of one region; from this one can infer the principle of the human body corresponding with heaven and earth.
The Yellow Emperor said: The twelve channel-waters correspond with the twelve channels, but their distances, depths, widths, and amounts of water and blood differ. How does one determine needling based on this? Qi Bo replied: The Foot-Yangming Stomach Channel is the sea of the five viscera and six bowels. Its channel is large, abundant in blood, vigorous in qi, and intense in heat. When needling this channel, if one does not insert deeply, pathogenic qi cannot be dispersed; if one does not retain the needle, pathogenic qi cannot be drained. For the Foot-Yangming channel, insert to a depth of six fen and retain for ten breaths. The Foot-Taiyang channel: insert to a depth of five fen, retain for seven breaths. The Foot-Shaoyang channel: insert to a depth of four fen, retain for five breaths. The Foot-Taiyin channel: insert to a depth of three fen, retain for four breaths. The Foot-Shaoyin channel: insert to a depth of two fen, retain for three breaths. The Foot-Jueyin channel: insert to a depth of one fen, retain for two breaths.
The three hand-yin and three hand-yang channels receive qi from a close distance, and their qi arrives swiftly. The needling depth for all of them should not exceed two fen, and needle retention should not exceed one breath. One must also take into account the patient's age, body size, and fatness or thinness, and apply careful judgment—this is called following the natural constant. The same principle applies to moxibustion. If moxibustion exceeds this limit, the patient will develop an aversion to fire, leading to withered bones and astringed, stagnant blood vessels. If needling exceeds this limit, proper qi will be depleted and leaked.
The Yellow Emperor said: Can the size of the channels, the amount of blood and qi, the thickness of the skin, the firmness or fragility of the flesh, and the size of the raised muscular areas be measured? Qi Bo replied: What can be measured is based on a person of medium build as the standard—one whose muscles show no significant emaciation and whose blood and qi have not weakened. But for those who have lost their measure—those whose bodies are emaciated and whose flesh has wasted away—how can fixed standards be applied? One must instead carefully palpate, follow the contours, feel along the surface, and observe the changes of cold, heat, excess, and deficiency to adjust treatment accordingly. This is the principle of tailoring treatment to the individual.
The central concept of this chapter is the "correspondence between humans and heaven and earth" — the holistic view of unity between heaven and humanity. Ancient observers noted that the distribution and circulation patterns of the twelve main channels in the human body could be analogically compared with the twelve great rivers of the central plains in terms of form and function: rivers have different sizes and depths, just as channels have different amounts of qi and blood; rivers irrigate the land, just as channels nourish the entire body. From this was established a cognitive framework of "using outer observation to infer inner conditions, and using heaven-earth patterns to validate human experience."
On this foundation, the chapter further advances the principle of individualized treatment. The six foot channels are arranged by their relative abundance or deficiency of qi and blood, with specific parameters for depth and retention time; the hand channels, because "the pathway for receiving qi is short and the qi arrives swiftly," should be needled more shallowly with shorter retention. Most importantly, the text explicitly states that these "major numbers" apply only to "persons of medium build"—those of average physique with unimpaired blood and qi. For those who are emaciated and have lost flesh, one cannot adhere rigidly to fixed measurements but must carefully palpate and observe, noting the changes of cold, heat, excess, and deficiency to regulate accordingly. This embodies the source of the traditional Chinese medical principle of "treatment according to three factors" (person, place, and time)—with particular emphasis here on "according to the person." Standards serve as references, but living selves are ever-changing; the true measure lies in the hands and mind of the practitioner.
From the standpoint of modern anatomy, the ancients' use of dissection to understand the size of viscera and length of channels indicates that empirical observation was already present in embryonic form during the era of the Inner Canon—a point worthy of recognition. However, the correspondences between the "twelve channel-waters" (e.g., Foot-Taiyang matching the Qing River, Hand-Yangming matching the Yangtze River) are products of analogical thinking, not verifiable empirical science. Their value lies in providing a systems-oriented perspective: regarding the human body as an open system highly interconnected with the natural world, rather than as an isolated collection of organs. Modern chronobiology (the synchronization of biological rhythms with environmental cycles) and ecological medicine (the influence of environmental factors on health) echo to some extent the holistic outlook of "correspondence between humans and heaven and earth." Yet the ancients' practice of matching specific channels with specific rivers has no anatomical or physiological basis by today's scientific standards and should be regarded as cultural symbolism and a philosophical model rather than factual description.
As for the specific figures of "depth of so many fen and retention for so many breaths," these reflect more the ancients' empirical summaries and theoretical extrapolations, and should not be treated as operational clinical standards in the modern sense. Nevertheless, their core spirit—adjusting stimulus intensity according to the state of qi and blood—is consistent with the principle of "dosage individualization" in modern rehabilitation medicine.
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This content is based on classical Chinese medicine texts and is provided solely for traditional cultural learning and study. It does not constitute any medical diagnosis, prescription, or treatment recommendation. Please consult a qualified healthcare provider when experiencing discomfort.