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Capítulo 75 de 81
黄帝内经·灵枢
The following content involves ancient acupoints, needles, and techniques. It is all described as classical scholarly theory and is provided for study and research only, not as operational guidance.
The Yellow Emperor asked Qi Bo: I have heard that there are "Five Methods" in needling. What do they refer to? Qi Bo replied: Indeed, there are five: Zhen Ai (an ancient needling method, named for being as effective as shaking off dust), Fa Meng (named for restoring hearing and sight as if dispelling darkness), Qu Zhao (named for removing water pathogens like trimming excess nails), Che Yi (named for reducing heat as quickly as taking off clothes), and Jie Huo (named for restoring the mind as if resolving confusion). Zhen Ai needles the outer channels (the superficial, yang aspect of the channels) to dispel pathogens from the yang regions. Fa Meng needles the Fu-Shu points (the points where the six fu organs transport their qi) to treat fu organ disorders. Qu Zhao needles the joints and collateral vessels of the limbs. Che Yi needles the extraordinary transport points of all the yang channels. Jie Huo involves fully understanding the excess and deficiency of yin and yang, then supplementing deficiency and draining excess to correct the imbalance.
The Yellow Emperor asked for the specific meaning of Zhen Ai. Qi Bo said: When yang qi is severely chaotic and accumulates in the chest, there will be a sensation of fullness and oppression in the chest, gasping with raised shoulders, reversed qi flow, wheezing with sound, an inability to sit or lie still, an aversion to smoke and dust, and difficulty breathing upon smelling them. It is called "Zhen Ai" because the effect of needling is faster than shaking off dust. Treatment uses Tian Rong (SI 17). If there is cough with upward counterflow qi, shortness of breath with inability to stretch out, and chest pain, use Lian Quan (CV 23). When needling Tian Rong, the needle should be retained no longer than the time it takes to walk one li. When needling Lian Quan, observe until the color of the blood circulation changes.
The Yellow Emperor then asked about Fa Meng. Qi Bo said: Fa Meng addresses the condition of not hearing sounds and not seeing objects. This is an exquisite skill within needling, close to the realm of "spirit brilliance." It is difficult to fully transmit through oral explanation or written records. It must be done at midday. Needle Ting Gong (SI 19) to cause the needling sensation to reach the pupil, and for the ear to hear sound — this indicates the point has been reached. The so-called "hearing sound in the ear" refers to the technique where the practitioner presses firmly on both nostrils of the patient and quickly has the patient lower their head or hold their breath; the sound the patient makes will correspond with the needling sensation. This is a method that does not rely solely on visual observation but is completed through the mutual response of spirit and qi.
Regarding Qu Zhao, Qi Bo said: The lumbar spine and back are the major joints of the body; the four limbs and shins support the body's movement. Jing Chui (external genitalia and scrotum) is a crucial area of the body, an external sign of yin essence, and a passage for fluids. If diet is irregular and emotions are uncontrolled, fluids accumulate internally, descend and remain in the scrotal region, the blood passages become blocked, and there is progressive swelling, making bending and stretching difficult, walking difficult, with local dampness accumulation and blocked communication between upper and lower. The ancient method used instruments like the pi needle and bian stone to remove the water pathogen. Since the disease manifestation cannot be hidden, similar to cutting off a nail, it is called "Qu Zhao."
Regarding Che Yi, Qi Bo said: This treats an excess of yang qi and deficiency of yin qi. When yin qi is insufficient, there is internal heat; when yang qi is excessive, there is external heat. When internal and external heat combine, the body feels as hot as if holding charcoal, the person fears clothing touching the body and cannot approach a mat. The cou li (texture and gaps of the skin and muscles) are blocked, sweat does not come out, the tongue is dry, lips are parched, the throat is dry, and the person cannot distinguish the taste of food or drink. Treatment uses Tian Fu (LU 3) and Da Zhu (BL 11), needling each three times. Also needle Zhong Lǚ to remove heat, and supplement the foot and hand taiyang channels to promote sweating. When heat recedes and sweating diminishes, it is faster than removing clothes.
Regarding Jie Huo, Qi Bo said: When great wind harms the body, the blood vessels become deficient on one side. The deficient side is insufficient, and the excess side is overabundant. The limbs feel imbalanced in weight, the body leans and bends, and the person cannot distinguish east, west, south, or north. Symptoms fluctuate between upper and lower, and are inverted and irregular — more severe than ordinary confusion. The principle of treatment is to drain excess and supplement deficiency, restoring balance between yin and yang. When needling is done appropriately, it resolves faster than untying a knot.
The Yellow Emperor asked about the Five Evils. Qi Bo replied: The diseases are: chronic abscess (Chi Yong), greatness (Rong Da), smallness (Xia Xiao), heat, and cold — these five are the Five Evils. The principles for needling the Five Evils are no more than five: dispel heat evil, disperse swellings and abscesses, warm cold bi, supplement yang for small evils, and remove great evils.
Needle selection: For abscesses, use the Pi needle; for great evil, use the Feng needle; for small evil, use the Yuanli needle; for heat evil, use the Chan needle; for cold evil, use the Hao needle.
The theory of resolving knots corresponds with heaven and earth and harmonizes with the four seasons. In low, damp places, reeds and rushes grow on top. From this, the ancients could deduce the amount of water and soil qi. Humans, corresponding with heaven and earth, can likewise infer the abundance of form and qi from external signs. Yin and yang can manifest as cold and heat: When the weather is hot, dampness and water vapor rise above, and plants have less sap in their roots. Correspondingly, the qi in humans moves to the exterior, the skin relaxes, the cou li open, blood and qi relatively diminish, sweat is profuse, and the skin becomes moist. When the weather is cold, the earth freezes and water turns to ice, the qi of humans moves internally, the skin becomes dense, the cou li close, no sweat is produced, blood and qi are relatively replete, and the muscles are firm and rough. At such times, one skilled in navigating water cannot travel on ice, one skilled in digging cannot dig into frozen earth, and one skilled in needling cannot immediately treat cold extremities. When blood vessels are congealed and rough and circulation is impeded, it is impossible to soften them immediately.
Therefore, to move through water, one must wait for warm weather and the melting of ice; similarly, it is with the channels and vessels of the human body. To treat cold extremities, one must first use warming methods, such as hot fomentation, to harmonize the relevant channels and regions — such as the palms and armpits, elbows and feet, and nape of the neck and spine — wait for the warmth of the fire to penetrate, and then the blood vessels will move. Only then observe the location of the illness: If the vessel is smooth and moist, needle it to level it; if hard and tense, break and scatter it, allowing qi to descend, then stop. This is what is meant by "resolving knots."
The key to using needles is regulating qi. Qi accumulates in the stomach and transforms into nutritive and defensive qi (ying and wei; ying nourishes, wei warms and protects), each moving along its own pathway. Zong qi (the great qi of the chest, which drives respiration and blood movement) is retained in the sea of qi in the chest, flows down to the qi streets (qi jie), and ascends to the respiratory tract. Cold feet are due to zong qi being unable to descend; the blood within the vessels is congealed and stationary. Without using warming fire to regulate this, it will not be possible to needle. The one who uses needles must first examine the deficiency or excess of the channels and collaterals, press along their pathways, press and pluck them, and observe where the vessels respond to the hand; only then should points be selected and needled. When the six channels are harmonious, there is no disease, and even if disease is present, it will heal naturally. If a particular channel has excess above and deficiency below, and it cannot flow freely, there must be a transverse collateral added over the great channel causing it to be blocked. Locate this and drain it — this is called "resolving knots."
When there is cold above and heat below, first needle points of the taiyang channel of the neck and retain the needles for a long time. After needling, apply warming fomentation to the neck and scapulae to cause heat to descend and join with the heat below. This is called "pushing upward and guiding upward." When there is heat above and cold below, observe the deficient and sunken vessels in the channels and collaterals, select points, and stop when qi moves downward. This is called "drawing downward and guiding downward." When great heat pervades the whole body, with mania, delusions, auditory hallucinations, or rambling speech, observe the foot yangming channel and its great collaterals and select points. For deficiency, supplement; for blood excess, drain. Have the patient lie supine with the practitioner at the head, using the four fingers of both hands to press and hold the carotid artery. After pressing for a prolonged time, roll and push downward toward the supraclavicular fossa; repeat this sequence. Stop once the heat recedes. This is called "pushing and scattering." This is a description of ancient external methods and should not be attempted in modernity.
The Yellow Emperor asked: A single channel can produce dozens of diseases — pain, abscess, heat, cold, itching, bi syndrome, numbness, and myriad changes without end. What is the cause? Qi Bo answered: All are due to evil qi.
There is true qi (the fundamental qi endowed by heaven, combined with the essential qi of water and grain to nourish the entire body), upright qi (the vital wind of normal seasonal climate), and evil qi (the vacuous thief wind that causes disease). True qi is endowed from heaven and joins with the qi of water and grain to nourish the whole body. Upright qi is the wind of normal seasonal qì. It comes from one direction, neither in excess nor deficient. Evil qi is the vacuous secret wind that injures deeply and cannot dissipate on its own. The upright wind injures externally — this is shallow — and leaves after merging with true qi. Its coming is gentle. When upright qi matches true qi, the upright wind departs of itself; if one bodily qi is insufficient, the upright qi dwells residually. Therefore, when one wind arrives, it causes the corresponding contraction/spasm, called bi syndrome. When pestilential qi of great recklessness pervades in a transient manner, with fatal catastrophic catastrophes and brutal devastation, the entire body's massive qi will scatter, hence the transformation into diseases that vanish.
Vacuous evil targeting human bodies: Deep entrance is truly encompassed yet painful in a fixed location; evading to reside in a profound location. From the deep...
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...先有灑淅恶寒，毫毛竖起，腠理开。
By vacuous evil:
A chill first gives rise to trembling, hairs standing on end, pores open for the entry of evil deeper.
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【Vacuous evil injures in part shallow in the flesh; separate bone-rubbing becomes ...】
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—— Bu Gua — Content note. For classical heritage TCM reading only.