Lingshu: Five Prohibitions, Chapter 61

A Vernacular Translation and Interpretation of "Lingshu · Five Prohibitions, Chapter 61"

Some characters in the original text of this chapter contain transcription/recording errors (e.g., "Geng 176 Toyota" should be "Geng-Xin Day"). The following translation and interpretation are based on the standard edition of Lingshu with textual corrections.

Overall Paraphrase

The Yellow Emperor asked Qi Bo: I have heard that acupuncture has Five Prohibitions. What are the Five Prohibitions? Qi Bo replied: They refer to refraining from needling under circumstances where needling is not permitted. The Yellow Emperor asked: I have heard that acupuncture has Five Exhaustions. Qi Bo replied: For righteous qi that must not be further damaged, purging methods must not be used. The Yellow Emperor asked: I have heard that acupuncture has Five Excesses. Qi Bo replied: Both supplementation and purging must not exceed their proper limits. The Yellow Emperor asked: I have heard that acupuncture has Five Reversals. Qi Bo replied: When the condition of the disease contradicts the pulse, it is called the Five Reversals. The Yellow Emperor asked: I have heard that acupuncture has Nine Appropriatenesses. Qi Bo replied: Thoroughly comprehending the theory of the nine needles is called the Nine Appropriatenesses.

The Yellow Emperor further asked: What are the Five Prohibitions? Qi Bo said: On Jia and Yi days, when the qi is self-multiplied at that time, do not needle the head, nor use the "Fa Meng" (Dispelling Obscurity) needling method within the ears; on Bing and Ding days of self-multiplication, do not use the "Zhen Ai" (Shaking off Dust) needling method on the shoulders, throat, or Lianquan point; on Wu and Ji days of self-multiplication during the four seasonal Earth periods, do not needle the abdomen, nor use the "Qu Zhua" (Removing Claws) method to drain water; on Geng and Xin days of self-multiplication, do not needle the thigh, knee, or other joint regions; on Ren and Gui days of self-multiplication, do not needle the lower legs. These are the Five Prohibitions.

The Yellow Emperor asked: What are the Five Exhaustions? Qi Bo replied: The body and muscles having already become emaciated and wasted is the first Exhaustion; after major hemorrhage, that is the second Exhaustion; after profuse sweating, that is the third Exhaustion; after severe diarrhea, that is the fourth Exhaustion; after recent childbirth or major blood loss, that is the fifth Exhaustion. In these five conditions, purging methods must not be used.

The Yellow Emperor asked: What are the Five Reversals? Qi Bo replied: In febrile disease, if the pulse is conversely calm, or after sweating the pulse becomes abnormally large and agitated, this is the first Reversal; in diarrhea disease, if the pulse is conversely bounding and large, this is the second Reversal; in bi syndrome (painful obstruction) that is fixed and unmoving, with broken-down flesh, body heat, and pulse qi that is partially exhausted, this is the third Reversal; when pathogenic evil has spread for a long time, the body has declined, there is body heat, the complexion is withered white, and subsequently clotted blood is discharged in heavy amounts, this is the fourth Reversal; when cold-heat disease consumes the body, and the pulse conversely is hard and striking against the fingers, this is the fifth Reversal.

🧠 Deep Understanding

Core Principles 💡

• Time-Based Needling Prohibitions: The ancients paired the Heavenly Stem days, the four seasons, and body regions, believing that qi and blood flourish and decline according to temporal patterns. When a particular region is "self-multiplied" at its governing time, needling that region should be avoided to prevent disturbing qi and blood. This embodies the principle of "adapting to the times" and a cautious approach to needling practice.
• Purging Prohibited in Deficiency: The Five Exhaustions (five states of severe deficiency of qi, blood, and body fluids where purging must not be applied) all represent severe depletion of righteous qi. Using purging methods in these states creates "deficiency upon deficiency"—making the already deficient even more depleted—which is a major therapeutic taboo.
• Pulse and Manifestations Considered Together; Contradiction Indicates Reversal: under normal conditions, the pulse and clinical manifestations should correspond to each other. All Five Reversals represent contradiction between the disease and the pulse, indicating that righteous qi cannot overcome the pathogen or that pathogenic qi is extremely rampant, with a poor prognosis. This emphasizes that diagnosis and treatment must be based on holistic judgment.
• Supplementation and Purging Have Limits; Understanding Needles and Using Them Well: The Five Excesses speaks of "measure," and the Nine Appropriatenesses speaks of "understanding principles." Both point toward the fact that needling must not be applied indiscriminately or excessively.

Modern Perspectives 🌟

• The "Heavenly Stem–body region" correspondence in time-based prohibitions belongs to ancient numerological deduction and should not be mechanically applied in modern times. However, the underlying idea that "qi and blood have rhythms, and treatment should be timed appropriately" bears vague resonance with modern research on biological rhythms and is worth understanding culturally.
• The concept of the Five Exhaustions aligns well with modern safety principles: in states of massive blood loss, profuse sweating, severe diarrhea, or post-childbirth, the priority should be fluid replacement, nourishment, and stabilizing vital signs—rather than performing further injurious "attacking and purging" procedures.
• The Five Reversals emphasize that "inconsistency between the disease condition and the pulse" is a danger signal, similar to the modern clinical need for heightened vigilance when vital signs or laboratory indicators do not parallel the patient's condition. However, specific pulse findings cannot replace modern diagnostic testing.

Wellness Insights ⚡

• After profuse sweating, severe diarrhea, major hemorrhage, childbirth, or chronic disease with emaciation, the focus should be on quiet recuperation and recovery—avoid forced exercise, sauna-induced perspiration, overexertion, and blindly pursuing "detoxification" or "purging fire" measures that further damage righteous qi.
• In daily life, pay attention to regular rhythms: keep a regular schedule for rest and activity, eat with moderation, and give the body stable windows for recovery.
• Learn the traditional holistic view of "pulse-manifestation mutual reference": rather than focusing on a single indicator, comprehensively sense the overall state of the body. However, if the body continues to feel unwell, seek medical attention promptly.

📚 Related Knowledge

• Associated Concepts: Five Prohibitions (time-and-position-based needling restrictions), Five Exhaustions (purging prohibited in deficiency), Five Excesses (excessive supplementation or purging), Five Reversals (contradiction between pulse and manifestation), Nine Appropriatenesses (appropriateness of the nine needles); the nine needles; adapting to the times; the warning against deficiency upon deficiency; pulse-manifestation mutual reference.
• Further Reading: Lingshu · Nine Needles and Twelve Sources (Jiu Zhen Shi Er Yuan), Lingshu · Beginning and End (Zhong Shi), Lingshu · Official Needling (Guan Zhen), Lingshu · Discourse on the Nine Needles (Jiu Zhen Lun), Suwen · Discourse on Needling Prohibitions (Ci Jin Lun).

This content is based on classical Chinese medicine texts and is provided solely for the study and cultural understanding of traditional knowledge. It does not constitute any medical diagnosis, medication recommendation, or treatment advice. If you feel unwell, please seek medical attention promptly.