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Chapter 71 of 81
黄帝内经·灵枢
Huangdi asked Bo Gao: When evil qi invades the human body, sometimes it causes the eyes to remain open and prevents sound sleep—what qi is responsible for this? Bo Gao explained: After the five grains enter the stomach, they are divided into three pathways: dregs, fluids, and the Zong Qi (Pectoral Qi). The Zong Qi (the qi in the chest that drives respiration and the heart vessels) accumulates in the chest, rises upward through the throat, penetrates the heart vessels, and drives respiration. The Ying Qi (Nutritive Qi, the qi within the vessels that provides nourishment) is secreted from the fluids, enters the vessels and transforms into blood, nourishing the four limbs externally and the five viscera and six bowels internally, moving with the regularity of a clepsydra (water clock). The Wei Qi (Defensive Qi, the qi outside the vessels responsible for defense and warmth) is agile, slippery, and swift, first circulating among the four limbs, between the sinews and flesh, and beneath the skin without rest; during the day it moves in the yang portions, and at night it enters the yin portions, often entering the five viscera and six bowels from the interstices of the Foot-Shaoyin channel.
If rebellious (counter-flow) qi resides in the five viscera and six bowels, the Wei Qi can only float externally and move in the yang portions, unable to smoothly enter yin. When it moves in yang, yang qi becomes hyperactive, and the Yang Qiao Vessel becomes replete; when it cannot enter yin, the yin portion becomes deficient—therefore the eyes cannot close and insomnia results.
Huangdi asked how to treat this. Bo Gao said: Supplement what is deficient, drain what is excessive, regulate vacuity and repletion, clear the pathways, and expel evil qi, then combine this with the ancient Banxia Tang (Pinellia Decoction). The formulation principle is as follows: take eight sheng of flowing river water and wave it ten thousand times; take five sheng of the clear portion and boil it with reeds as fuel; after the water boils, add one sheng of shu mi (glutinous sorghum) and five he of processed pinellia; simmer slowly, reducing to one and a half sheng; remove the dregs, and drink one small cup each time, three times daily, gradually increasing the dose until effectiveness is achieved. Those with recent-onset illness can sleep after drinking it, and resolution occurs with sweating; those with chronic illness may find rest after three doses. ⚠️ This is a record from ancient texts, embodying the treatment principle of "unblocking yin and yang, harmonizing the stomach, and calming the spirit"—for scholarly study only, and must not be used as a self-prescribed remedy.
Huangdi further asked how the limbs and joints of the human body correspond to heaven and earth. Bo Gao answered using "image-taking and categorical analogy": Heaven is round and earth is square; the human head is round and the feet are square, corresponding to this. Heaven has sun and moon; humans have two eyes. Earth has nine provinces; humans have nine orifices. Heaven has wind and rain; humans have joy and anger. Heaven has thunder and lightning; humans have voice and sound. Heaven has four seasons; humans have four limbs. Heaven has five tones; humans have five viscera. Heaven has six pitch-pipes; humans have six bowels. Heaven has winter and summer; humans have cold and heat. Heaven has ten days (stems); humans have ten fingers. The earthly branches number twelve; humans have ten toes and reproductive organs—women are two segments fewer, yet they can gestate the human body. Heaven has yin and yang; humans have husband and wife. The year has 365 days; humans have 360 joints. Earth has high mountains; humans have shoulders and knees. Earth has deep valleys; humans have armpits and popliteal fossae. Earth has twelve rivers; humans have twelve main channels. Earth has spring veins (underground water channels); humans have Wei Qi. Earth has grasses; humans have body hair. Heaven has day and night; humans have sleeping and waking. Heaven has arrayed stars; humans have teeth. Earth has small hills; humans have small joints. Earth has rocks; humans have prominent bones. Earth has forests; humans have sinews and membranes. Earth has towns and cities; humans have well-developed muscles. The year has twelve months; humans have twelve large joints. Earth has places where no grass grows in four seasons; humans have those who cannot bear children. This is the manifestation of the correspondence between the human body and heaven and earth.
Huangdi asked about the application of needling, the principles of needle insertion, the zong and she techniques (retaining and releasing), opening the skin and unblocking the interstitial spaces (cou li), as well as the flexions and extensions of the channels, where they emerge and stop, their rapidity and slowness, and how the six bowels transport to the body, among other things. Qi Bo said: What Huangdi has asked already encompasses the essential principles of needling.
Qi Bo explained the pathway of the Hand-Taiyin Lung Channel: It emerges from the tip of the thumb, bends inward, travels along the white fleshy border to the Taiyuan point (LU-9) behind the knuckle where it pauses; it bends outward toward the area below the knuckle, bends inward to meet the yin network vessels at the thenar eminence (Yu Ji), where numerous vessels pour together; the channel qi is smooth and slippery, traveling concealed beneath the thenar eminence bone, bending outward to emerge at the Cunkou (radial pulse site) and ascending, reaching the inner aspect of the elbow, entering beneath the large sinew, bending inward and ascending along the arm yin surface, entering the axilla, bending inward toward the lung—this is the flexion-extension pathway measured along varying depths.
The Hand-Jueyin Pericardium Channel: It emerges from the tip of the middle finger, bends inward along the inner border of the middle finger ascending to pause in the palm, travels concealed between the two bones, bends outward to emerge between the two sinews at the junction of bone and flesh; its qi is smooth and slippery, ascending two cun, bending outward to travel between the two sinews, ascending to the inner aspect of the elbow, entering beneath the small sinew, pausing at the junction of the two bones, ascending into the chest, and internally connecting with the heart vessels.
Huangdi asked: Why does the Hand-Shaoyin Heart Channel alone have no shu points? Qi Bo said: Shaoyin is the heart channel. The heart is the great master of the five viscera and six bowels, the residence where the spirit is stored. The visceral qi is firm and solid, and evil qi cannot directly invade it; if it were invaded by evil, the heart would be injured; when the heart is injured, the spirit departs; when the spirit departs, death follows. Therefore, when evil qi attacks the heart, it always does so through the pericardium network—the pericardium is the channel of the heart's master. Hence, the Hand-Shaoyin channel alone has no shu points. However, the external portion of the Shaoyin channel may be diseased while the viscus itself is not, so the point at the tip of the prominent bone on the ulnar side of the wrist (the Shenmen area) is specifically used for regulation. The flexions, extensions, and rapid-slowness of the other channels are all similar. According to the vacuity or repletion and rapidity or slowness of qi, points are selected: when qi is replete, use draining; when qi is vacuous, use supplementing; thus evil qi is dispelled and true qi is strengthened—this follows the natural order.
The acupuncture techniques recorded in this section are therapeutic principles from ancient texts, intended for academic understanding only, and must not be performed by the reader.
Huangdi asked about holding the needle and the techniques of zong (retaining) and she (releasing). Qi Bo said: One must first understand the root and branch of the twelve channels, the cold and heat of the skin, and the exuberance, debilitation, smoothness, and roughness of the pulse. If the pulse is slippery and exuberant, the disease is progressing; if vacuous and thin, the disease is chronic; if large and rough, it indicates painful bi (obstruction); if the yin and yang pulse patterns are confused, the disease is difficult to treat. If the root and branch are still hot, the disease is still present; when the heat recedes, the disease departs. One must also examine the skin of the forearm (chi fu), observing the firmness or fragility, size, slipperiness or roughness, cold or heat, and dryness or dampness of the muscles; observing the five colors of the eyes to understand the five viscera and determine life or death; and examining the color of the blood vessels to know cold, heat, pain, and bi obstruction.
The way of holding the needle: One must be upright and tranquil, first know the vacuity or repletion, then proceed with the rapid or slow techniques. The left hand secures the bone while the right hand presses and locates the point along the channel—do not struggle with the muscles and flesh. For draining, maintain an upright posture; for supplementing, press and close the skin, assist and guide the needle qi, causing evil qi to disperse and drain, while true qi finds peaceful residence.
For spreading the skin and opening the interstices: Follow the interstices between the divided sinews and flesh; the left hand separates the skin, and the needle is inserted gently with the needle body slowly and uprightly maintained—ensuring the spirit qi is not scattered and evil qi is expelled.
The Eight Deficiencies (Ba Xu): The two elbows, two armpits, two hip joints (Biguan areas), and two popliteal fossae are eight joint regions that can reflect the condition of the five viscera. When the lung and heart have evil, the evil circulates and lodges in the two elbows; when the liver has evil, it lodges in the two armpits; when the spleen has evil, it lodges in the two hip regions; when the kidney has evil, it lodges in the two popliteal fossae. These regions are the chambers of the joints' mechanisms—places where true qi passes and blood network vessels travel. Evil qi and stagnant blood should not remain there; if they remain, they injure sinews and network vessels, causing flexion and extension disabilities—leading to contracture and spasms.
Wei Qi Departure from Yang and Entry into Yin in Relation to Sleep
This chapter posits the core mechanism of insomnia as "yang failing to enter yin." The Wei Qi moves in the yang portions during the day and enters the yin at night; if evil qi obstructs, the Wei Qi cannot enter yin, and the eyes cannot close—resulting in sleeplessness. This is one of the classic formulations of sleep theory in Chinese medicine.
Banxia Tang "Resolving Blockage and Obstruction"
Banxia Tang combines pinellia and glutinous sorghum. The ancients believed it unblocks yin and yang, harmonizes stomach qi, and transforms phlegm-dampness, embodying the logic that "when the stomach is harmonized, sleep is peaceful." The formula targets "obstruction and non-passage" rather than simple tranquilization—it belongs to the method of unblocking and dispersing.
Image-Taking Analogy and Correspondence Between Heaven and Humanity
This chapter extensively lists correspondences between the human body's structures and natural phenomena, reflecting the ancient holistic concept of "the human body as a miniature heaven-earth." Its purpose is to show that human beings do not exist in isolation but correspond to natural rhythms.
The Heart as the Monarch Organ—The Pericardium Receives Evil on Behalf
The Hand-Shaoyin Heart Channel has no shu points because the heart is where "the spirit is stored" and cannot be directly invaded. Evil qi attacks the heart through the pericardium, which deputizes on its behalf. This theory provides the rationale for locating point indications on the Pericardium Channel.
Needle Retaining and Releasing, and Vacuity-Repletion Supplementing and Draining
Before needling, one must co-examine the pulse and the signs—inspect the skin, pulse, forearm skin, and eye colors. In procedures, emphasis is placed on "being upright and proper, calm and tranquil," adjusting supplementing and draining so that evil departs and true qi remains secure.
The Eight Depots (Ba Xu) as Chamber of Mechanisms
The elbows, armpits, hips, and popliteal fossae are where joints flex and extend and blood and qi converge—easy sites for evil qi to lodge. Lodging will cause contraction and impeded movement. This provides a formative theory for "joint diseases related to the viscera."
Boxia's Reminder: This content is based on classical Chinese medical texts and is provided solely for traditional cultural study and reading. It does not constitute medical diagnosis, medication advice, or any form of treatment recommendations. Consult a qualified healthcare professional for any health concerns.