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Capítulo 5 de 81
黄帝内经·灵枢
Editorial Note: The original text contains numerous transcription and transmission errors. The following is a faithful paraphrase according to the standard version of Lingshu · Gen Jie, preserving the original terminology.
Complete Paraphrase
Qi Bo said: The qi of Heaven and Earth mutually respond; cold and warm seasons shift and pass. In the Way of Yin-Yang 🌗, which is deficient and which is excessive? The pattern of Yin is even, the pattern of Yang is odd. When disease arises in spring and summer, Yin qi is scant and Yang qi is abundant — when Yin and Yang are not harmonized, what should be supplemented and what should be drained? When disease arises in autumn and winter, Yang qi is scant and Yin qi is abundant; Yin qi prevails while Yang qi declines. Therefore stems and leaves wither, and dampness descends and returns below. As Yin and Yang shift with the seasons, what should be drained and what should be supplemented?
Abnormal pathogens that leave the channels and move chaotically are too numerous to count. If one does not understand the roots and knots (roots at the extremities of the four limbs, knots at the head, face, and trunk), the qi gates of the five zang and six fu will be damaged, the gate pivots will be destroyed, opening and closing will become disordered, and essential qi will leak out — Yin and Yang will be lost in great quantity, beyond recovery. The key of the nine needles lies in zhong-shi (beginning and end); if one can grasp zhong-shi, a single phrase suffices; if one does not understand zhong-shi, the Way of acupuncture is cut off.
The foot-taiyang channel is rooted at Zhiyin, knotting above at Mingmen — here Mingmen refers to the eyes. The foot-yangming channel is rooted at Lidui, knotting above at Sangda — Sangda is in the area of the clamped ears. The foot-shaoyang channel is rooted at Qiaoyin, knotting above at Chuanglong — Chuanglong is within the ear.
Among the Yang channels: Taiyang governs opening, Yangming governs closing, and Shaoyang governs pivoting.
The foot-taiyin channel is rooted at Yinbai, knotting at Taicang. The foot-shaoyin channel is rooted at Yongquan, knotting at Lianquan. The foot-jueyin channel is rooted at Dadun, knotting at Yuying, and connecting to Danzhong.
Among the Yin channels: Taiyin governs opening, Jueyin governs closing, and Shaoyin governs pivoting.
The foot-taiyang channel roots at Zhiyin, slips at Jinggu, infuses at Kunlun, and enters at Tianzhu and Feiyang. The foot-shaoyang channel roots at Qiaoyin, slips at Qiuxu, infuses at Yangfu, and enters at Tianrong and Guangming. The foot-yangming channel roots at Lidui, slips at Chongyang, infuses at Xialing (i.e., Zusanli), and enters at Renying and Fenglong.
The hand-taiyang channel roots at Shaoze, slips at Yanggu, infuses at Xiaohai, and enters at Tianchuang and Zhizheng. The hand-shaoyang channel roots at Guanchong, slips at Yangchi, infuses at Zhigou, and enters at Tianyou and Waiguan. The hand-yangming channel roots at Shangyang, slips at Hegu, infuses at Yangxi, and enters at Futu and Pianli.
These are the distributions of root, slip, infusion, and entry for the twelve channels. Whenever the collateral vessels are replete, the corresponding sites may be regulated accordingly.
The qi of the channels circulates fifty cycles in one day and one night to nourish the essential qi of the five zang. If this number is not met, it is called "wild life" (a state of life violating normalcy). The so-called fifty circulations mean that the five zang are all capable of receiving qi.
Palpating the pulse at the wrist, count the beats: if among fifty beats there is not a single intermittent pulse (regular periodic pause), it indicates that the five zang can all receive qi. If one intermittent pulse appears within forty beats, it indicates that one zang has lost its qi. One intermittent pulse within thirty beats: two zang have lost qi. One within twenty beats: three zang have lost qi. One within ten beats: four zang have lost qi. If an intermittent pulse appears before the count reaches ten beats, the five zang have all lost qi. In judging short-term prognosis, the key lies in "zhong-shi." The absence of an intermittent pulse within fifty beats is normal; based on this, one may understand the temporal patterns of the five zang qi. What is called poor short-term prognosis is when the pulse comes swiftly one moment and slowly the next.
The Yellow Emperor asked: People's bodies differ in forward and reversed conditions — such as the size of bones and joints, hardness and brittleness of muscles, thickness of skin, clarity and turbidity of blood, slipperiness and roughness of qi movement, length of vessels, amount of blood, and number of channels — these I already understand. However, these pertain to ordinary people and manual laborers. What of the noble lords and gentlemen of high rank who feed on rich meats — whose bodies are soft and fragile, whose muscles are weak, yet whose blood qi is fierce and slippery? When needling them, can speed and slowness, shallowness and depth, and the amount of needling be identical?
Qi Bo replied: How could those nourished on rich and refined foods be the same as those fed on coarse grains and vegetables? When qi is slippery, the needle should be withdrawn quickly; when qi is rough, the needle should be withdrawn slowly. When qi is fierce, the needle should be fine and insertion shallow; when qi is rough, the needle should be large and insertion deep. Deep insertion calls for retaining the needle; shallow insertion calls for quick withdrawal. From this we see, needling of ordinary laborers should be deep with retention, while needling of noble lords should be light, shallow, and gradual. This is all based on the differences in the fierce, slippery nature of their qi.
The Yellow Emperor asked: How does one judge the forward-reversed relationship between physical form/qi and pathological qi?
Qi Bo replied: When the body's righteous qi is insufficient but the pathological qi is excessive, the pathogen is dominant — one should urgently drain the pathogenic qi. When the body's righteous qi is excessive but the pathological qi is insufficient — one should urgently supplement the righteous qi. When the body's righteous qi is deficient and the pathological qi is also deficient, then both yin-yang qi are insufficient — acupuncture should not be used. If acupuncture is applied, the righteous qi will become even more depleted, yin and yang will both become exhausted, blood and qi will be spent, the five zang will be emptied, and the bone marrow of sinews and bones will dry up. The aged will thus perish, and even the strong will struggle to recover. When the body's righteous qi is excessive and the pathological qi is also excessive, this is a state of both yin and yang in excess — one should urgently drain the pathogenic factors, harmonizing deficiency and excess. Hence it is said: Excess is drained, deficiency is supplemented — this is the principle.
Therefore it is said: If one needles without understanding the distinctions of forward and reversed, true qi and pathogenic qi will struggle. Applying supplementation to an excess condition causes the yin-yang qi to scatter in all directions, filling and overflowing — the intestines and stomach become distended, the liver and lungs become internally distended within, and yin-yang become chaotically disordered. Applying drainage to a deficiency condition will cause the channels and vessels to become empty, blood and qi to wither, the intestines and stomach to lose strength, the skin to be thin and cling to the bone, and the hair and interstices to dry up — this is to hasten the arrival of death.
Therefore the key of needle usage lies in understanding how to harmonize yin and yang; when yin and yang are harmonized, the essential qi can shine forth, the body and qi become united, and the spirit can be stored within. Thus a superior practitioner can harmonize the qi, a mediocre practitioner will only disturb the pulse qi, and an inferior practitioner exhausts the essential qi and endangers life. Therefore the inferior practitioner must be taken seriously as a caution. One must carefully examine the changes of the five zang diseases, the correspondence of the five pulses, the deficiency and excess of the channels and collaterals, and the coarseness or smoothness of the skin; only then can treatment be applied.
Note: The above contents regarding acupuncture points and needling methods are translations of ancient theoretical insights for scholarly study only and do not constitute operational guidance for needling procedures.
This content is based on classical Chinese medicine texts and is provided solely for cultural, traditional study and reading. It does not constitute medical diagnosis, prescription, or treatment advice. Please seek timely medical assistance when required.