Cargando...
Capítulo 54 de 78
黄帝内经·素问
Overall Paraphrase
The Yellow Emperor asked: I wish to hear the explanation of the Nine Needles (nine types of acupuncture tools with different shapes and uses), and the principles of supplementation and drainage for deficiency and excess (deficiency of righteous qi and excess of pathogenic qi). Qibo replied:
1. Needle Sensations in Supplementation and Drainage for Deficiency and Excess 🩺
When needling deficiency conditions, supplementation should be used to strengthen them, and the sign is heat beneath the needle: because righteous qi becomes fully replenished, and when qi movement is vigorous, heat is generated🔥. When excess conditions are full, drainage should be used, and the sign is coolness beneath the needle: because stagnant excess qi is reduced, and when the overbearing tendency recedes, it turns cool. Here, "qi deficiency" refers to the reduction of pathogenic excess qi, not deficiency of righteous qi.
"Stagnant old blood should be removed" means to release accumulated morbid blood🩸. When pathogenic qi is excessive, use drainage: after withdrawing the needle, do not press closed the needle hole; for supplementation, withdraw the needle slowly and press the hole closed quickly; for drainage, withdraw the needle quickly and press the hole closed slowly. What is called deficiency and excess is essentially the amount of cold and warm qi.
"As if absent, as if present" refers to pathogenic qi being extremely subtle and difficult to detect. "Observe what comes after and what comes before" means understanding the order of development of the disease. When the physician performs supplementation or drainage, the rules must not be abandoned; "as if obtained, as if lost" refers to deviating from proper regulations. The essential points of deficiency and excess are most skillfully handled by the Nine Needles, because each of the nine needles suits particular locations and uses. The timing of supplementation and drainage must correspond with the opening and closing of channel qi (qi circulating in the meridians). The Nine Needles have different names and shapes to exhaust all situations requiring supplementation or drainage.
2. Waiting for Qi and Governing the Spirit in Needling Techniques 🧘
When needling excess conditions, wait for the excess to decline: retain the needle until yin qi (cold-cool qi) has fully arrived in abundance, then withdraw; when needling deficiency conditions, wait for righteous qi to become replenished: when yang qi (warm-heat qi) arrives in abundance and there is heat beneath the needle, then withdraw. "Channel qi has arrived, guard it carefully and do not lose it" means that once qi has arrived, do not casually change the technique.
The depth of needling depends on the physician's inner judgment of whether the disease lies internally or externally; the lesion may be near or far, but the principle of waiting for qi is the same — one must await qi arrival. "As if facing a deep abyss" reminds the physician to be cautious and never neglectful; "the hand as if gripping a tiger" means holding the needle with the same strength and focus as pressing down a tiger; "the spirit not distracted by myriad things" means calmly observing the patient without looking left and right; "the needle should not be inserted obliquely" means the posture of holding the needle must be upright; "must stabilize the spirit" means looking into the patient's eyes, calming their spirit, and making channel qi easier to move.
What is called Sanli is located three cun below the knee; "fuzhi" refers to lifting the knee where the fleshy region is easily visible; "juxu" is the depression beside the tibia when the foot is lifted; "xialian" is the depressed area of the muscle.
3. The Nine Needles and Correspondence between Heaven and Humanity 🌍
The Yellow Emperor said: I have heard that the Nine Needles correspond above to Heaven, Earth, the Four Seasons, and Yin-Yang. I wish to hear the principle, so it may be transmitted to later generations as a constant law. Qibo said: One is Heaven, two is Earth, three is Humanity, four is the Four Seasons, five is the Five Sounds, six is the Six Pitch-Pipes, seven is the Seven Stars, eight is the Eight Winds, nine is the Nine Fields — the human body has correspondences, and each of the Nine Needles has its appropriate application. Hence they are called the Nine Needles.
Human skin corresponds to Heaven, human flesh to Earth, human vessels to Humanity, human sinews to the Four Seasons, human voice to the Five Sounds, the combined qi of human yin-yang to the Six Pitch-Pipes, human teeth and face to the Seven Stars, the qi of human inhalation and exhalation to the Eight Winds, and the nine orifices and three hundred sixty-five networks to the Nine Fields. Therefore: Needle 1 treats the skin, Needle 2 treats the flesh, Needle 3 treats the vessels, Needle 4 treats the sinews, Needle 5 treats the bones, Needle 6 regulates yin-yang, Needle 7 benefits essence, Needle 8 removes wind, Needle 9 opens the nine orifices and removes pathogenic qi from the three hundred sixty-five joints. This is how each of the Nine Needles governs specific functions. Human intention corresponds to the Eight Winds, human qi corresponds to Heaven, human hair, teeth, ears, eyes, and five voices correspond to the Five Sounds and Six Pitch-Pipes, the yin-yang vessels and blood of humans correspond to Earth, the human liver corresponds to the number nine. The nine orifices total three hundred sixty-five.
Final Section Explanation: Regarding the final passage beginning "Human one observes movement and stillness, Heaven two observes the five colors…," successive generations of annotators and collators believe the text is disordered, with significant corruptions and omissions, making line-by-line interpretation unreliable. Its fragmentary meaning roughly concerns observing human movement and stillness, the five colors, the five sounds, the six pitch-pipes, and the four seasons' cold and warmth, dryness and dampness, to examine excess and deficiency and changes in joints and qi-blood. However, the exact expressions can no longer be trusted as authentic, and this book does not force an interpretation.
Deficiency and excess can be "perceived"
This chapter grounds abstract deficiency and excess in the cold and heat sensations beneath the needle. In supplementation, heat appears under the needle when qi arrives; in drainage, coolness appears under the needle when qi arrives. The ancients used the amount of cold and warmth as an indicator of the rise and fall of pathogenic versus righteous qi.
Supplementation and drainage are not only techniques but also timing and opening/closing
Slow withdrawal with quick pressing of the hole constitutes supplementation; quick withdrawal with slow pressing constitutes drainage. Supplementation and drainage must correspond with the opening and closing of channel qi, reflecting the temporal factor.
"Governing the spirit" is the core
"As if facing a deep abyss," "hand as if gripping a tiger," "eyes not glancing sideways," "stabilizing the patient's spirit" — these show that ancient acupuncture placed tremendous importance on the focused attention of both physician and patient. Acupuncture is not a mechanical operation but a unity of "regulating the spirit" and "awaiting qi."
The Nine Needles are layered instruments
The skin, flesh, vessels, sinews, bones, and other layers correspond to different needle types. The correspondence between Heaven and Humanity draws analogies between bodily structure and natural order, expressing holistic thinking and the concept of instrumental specialization.
Related Concepts
Further Reading
Bua Gua Reminder: This content is based on classical Chinese medicine texts and is provided solely for traditional cultural study and research. It does not constitute any medical diagnosis, medication, or treatment advice. If you feel unwell, please seek medical attention promptly.