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The *Tuning the Meridians* chapter of the *Huangdi Neijing* states: The generation of pathogenic factors arises either from the Yin aspect or from the Yang aspect. Those arising from the Yang aspect result from wind, rain, cold, and heat (external climatic pathogens), which are heavenly pathogenic factors affecting the body; those arising from the Yin aspect result from improper diet, irregular living habits, and emotional fluctuations (joy and anger), belonging to earthly cold and heat pathogens. Upon infection, they tend to damage the Six Fu organs, forming diseases of seven types of injury. Thus it is said...

How do wind and rain pathogens injure the human body? Qibo replied: Wind and rain pathogens first invade the skin, then transmit to the Sun vessels (the finest capillaries). When the Sun vessels are full, they transmit to the Luo vessels; when the Luo vessels are full, they transport to the Large Meridians. At this point, blood and Qi co-reside with the pathogen between the muscle intervals and interstices. The pulse becomes firm and large, hence termed "Excess Syndrome" (Shi Zheng). Excess syndrome is characterized by external hardness and fullness, and pain upon palpation. This reiterates the process of injury by the Eight Beneficial Pathogens (referring to external six climatic pathogens); such exogenous pathogens contract wind-cold from the exterior...

The Yellow Emperor asked: How do cold-damp pathogens injure the human body? Qibo replied: Cold-damp pathogens invading the person cause the skin to become loose and unable to retain tension, the muscles to become stiff and tight, Ying blood (nutritive blood) to flow sluggishly, and Wei Qi (defensive Qi) to dissipate. Therefore... This is the injury of Qi in the clear and empty region (referring to the lower part or Yin position), and the disease trajectory necessarily begins from the feet. Thus it is said: Earthly dampness, upon infection, tends to damage the skin, flesh, sinews, and vessels. All variations of diseases arise from... all due to...

The Yellow Emperor asked: How does Yin generate Excess? Qibo replied: If joy and anger are not regulated, it leads to the counterflow of Yin Qi upward. Upward counterflow results in deficiency below; deficiency below causes Yang Qi to move upward (note: the original text may contain an error; usually understood as Yang Qi following upward or lower deficiency leading to Yang hyperactivity). The so-called counterflow of Yin Qi upward is caused by extreme anger, not joy. Joy harmonizes and relaxes Qi; the character "joy" here might be a transcription error, as explained previously. Blood... due to anger...

The Yellow Emperor asked: How does Yin generate Deficiency? Qibo replied: Excessive joy causes Qi to sink downward; excessive grief causes Qi to dissipate, resulting in empty pulses. Additionally, consuming cold and raw foods causes cold Qi to fumigate and fill the interior...

Zhang Yuansu (Jiegu) analyzed: For Yin Deficiency, it refers to improper diet and living habits as well as emotional dysregulation. According to the *Suwen: Yin-Yang Yingxiang Daelun*, "Joy and anger injure Qi." Now it says that joyful Qi moves downward...

The Yellow Emperor stated: The classic states that Yang Deficiency leads to external cold, Yin Deficiency leads to internal heat, Yang Excess leads to external heat, and Yin Excess leads to internal cold. I have heard this, but I do not understand the underlying principles...

This section involves the Yellow Emperor asking about four syndromes: Yang diseases at the exterior and Yin diseases at the interior. Yang Deficiency leads to external cold, Yang Hyperactivity leads to external heat; this clarifies how exogenous pathogens damage the exterior and the excess of the Six Climatic Pathogens...

Qibo replied: Yang Qi receives its energy from the Upper Jiao to warm the skin and muscle intervals. Now, because cold is outside, the Upper Jiao is blocked, causing cold to remain exclusively on the exterior, thus...

Yin chills refer to cold shivering originating from the heart, not whole-body trembling. This also elucidates the principle that Yang Deficiency generates external cold; this is an Excess syndrome caused by wind-cold damaging the exterior.

How does Yin Deficiency generate internal heat? Qibo replied: Due to overexertion and fatigue, the form and Qi decline, grain Qi (digestive essence) is insufficient, leading to the failure of the Upper Jiao to disseminate and the Lower Wan (lower stomach outlet) to be obstructed, causing Stomach Qi to stagnate and transform into heat...

This again clarifies the manifestation of diseases where dampness enters from the lower body, resulting from the imbalance of cold and hot food and drink, thereby damaging the Six Fu organs. This indicates Middle Jiao insufficiency, where the Spleen and Stomach are primarily affected, stemming from dietary issues...

How does Yang Excess generate external heat? Qibo replied: When the Upper Jiao is not unobstructed, the skin becomes dense, the cilia pores close, and Wei Qi cannot vent out, thus...

This represents the transmission of exogenous cold transforming into heat, requiring purgative treatment. Hence the classic states: When humans are injured by cold pathogens, they develop heat diseases.

How does Yin Excess generate internal cold? Qibo replied: Jue Qi sinks and condenses, cold accumulates in the chest without dispersing. Without dispersal, warming Qi departs, leaving only cold, which causes blood to coagulate...

This again clarifies Spleen-Stomach insufficiency and physical overexertion, where Middle Jiao Ying Qi is diseased, eventually transmitting to Cold-Middle (Spleen-Stomach deficiency-cold). Treatment should solely focus on tonifying Yang and draining Yin.

The Yellow Emperor asked: When Yin and Yang merge, and Blood and Qi merge, and the disease form is established, how should acupuncture treat this? Qibo replied: To treat this condition, select the Jing-Tunnel meridians, draw blood from the Ying level...

This section elucidates Spleen-Stomach Ying Qi insufficiency; one should guide Yang from Yin and drain the blood collaterals and Jing-Tunnels. Ying governs blood and belongs to Yin; Wei governs Qi and belongs to Yang...

The Yellow Emperor asked: When Blood and Qi merge, the disease form is established, and Yin and Yang antagonize each other, what are the methods for tonification and sedation?

This reiterates the inquiry regarding the Eight Winds (exterior pathogens) and Shanghan exogenous pathogens, representing exterior Excess syndromes, which require sedation. For Blood-Qi merging, as well as Yin diseases from overexertion and Spleen-Stomach dampness...

Qibo replied: To sedate Excess, insert the needle when Qi is abundant. Insert the needle along with the Qi to open the gate, like opening a window. Withdraw the needle along with the Qi so that Essence and Qi are not damaged...

It speaks of opening acupoints to drain pathogenic factors. "Qie" means urgent/rapid. It refers to rapid needle withdrawal. Upon detailed examination of the meaning of "Qie," it does not mean rapid withdrawal, but rather palpating the acupoint pathway...

The Yellow Emperor asked: How is tonification for Deficiency performed? Qibo replied: Hold the needle without placing it randomly, to stabilize the patient's mind. Insert the needle during exhalation; as Qi exits, the needle enters. The space around the needle must be sealed tightly so that Essence cannot escape...

This describes the treatment method for Deficiency-type internal diseases affecting the Spleen and Stomach.

The Yellow Emperor said: Master, you stated there are ten types of Excess and Deficiency, all arising from the Five Zang organs and their five pulses. The Twelve Primary Meridians all generate their diseases (Note: *Jia Yi Jing* states: all generate hundred diseases... Excess... Blood... Regulate... Qi...)

Diseases in the sinews are regulated via the sinews (Liver governs sinews; treating sinew diseases focuses on Liver Blood). Diseases in the bones are regulated via the bones (Kidney governs bones; treating bone diseases focuses on Kidney; for Heat, prick quickly; for Cold, leave the needle in place). Use fire-needle劫刺 (rob/strike needling) on the lower areas and sites of spasm (For sinew diseases associated with the Spleen, use fire-needle rob-sticking on the meridians; for tendon spasms, apply moxibustion/warming, first ensuring Qi circulation). Diseases in the bones use quenched needles and medicinal warming (Kidney governs bones; for bone bi caused by severe cold, first apply medicinal warming then quenched needling; quenched needling is equivalent to fire-needling). If the site of pain is known, the Two Chong vessels (Yin and Yang Heel Vessels) are primary (Diseases of Yin/Yang Heel vessels manifest as epilepsy and convulsions with unknown discomfort; taking the Two Heel Vessels as primary means selecting mid-vessel points located below the lateral malleolus of the Foot Taiyang and Foot Taiyin meridians). If the body has pain but the Nine Pulse inspections cannot distinguish the pathology, use Miao-stickling (lateral needling). If the disease is on the left but the right pulse is abnormal, use Ju-stickling (deep needling against the meridian flow) (If vital Qi cannot pass through the Guan and Chi positions, deep needling is absolutely necessary). Carefully inspect the Nine Pulses, and the Dao of Needling is complete.

The *Tuning the Meridians* chapter states: The generation of pathogenic factors arises either from the Yin aspect or from the Yang aspect. Those arising from the Yang aspect result from wind, rain, cold, and heat; those arising from the Yin aspect result from... Prepared... Not fully detailed...

*Medical Discoveries* discusses the Chong, Du, and Ren meridians, citing the *Nan Jing, Chapter 28*: The Eight Extraordinary Vessels are not constrained by the Twelve Primary Meridians. Where do they start and where do they connect? The Du Mai (Governing Vessel) starts at the Shu point of the lower extremity (Changqiang, GV1), runs parallel within the spine, ascends to Fengfu (GV16), and enters to connect with the brain. The Ren Mai (Conception Vessel) starts below Zhongji (CV3), ascends above the pubic hair, and follows the abdomen...

The Du, Ren, and Chong meridians share a common source, starting between the two yins, and dividing into three vessels. The Ren Mai starts at Huiyin (CV1), roots at Qugu (CV2), enters the anterior yin, emerges into the abdominal interior, passes the umbilicus and ascends, attaching to the Foot Jueyin Liver Meridian, serving as the source of transformation and generation, penetrating all meridians without exception. The Chong Mai divides into two channels, starting at Huiyin, rooting at Qichong (ST30), entering the abdominal interior as two channels, ascending alongside the umbilicus, attaching to the Foot Yangming Stomach Meridian, scattering in the chest. One theory states it ascends to the brain and upper angle of the ear, descends to the medial malleolus, connects to the dorsum of the foot; if spasmodic like a drawn rope, moving up and down, it connects all meridians without omission because it originates from the Stomach Meridian; thus it is the Sea of the Twelve Meridians, serving as the master of transformation and ascent/descent. The Du Mai emerges from Huiyin, roots at Changqiang (GV1), ascends within the spine to the vertex, attaches to the Foot Taiyang Bladder Meridian. The Bladder is called the Head of Yang, also known as Ju Yang (Great Yang); Ying and Wei Qi are connected to it. The Du Meridian serves as an attachment...

The Chong and Du meridians root in the Lower Jiao. The Lower Jiao is the interior, the earth pathway, blood, and Yin aspect. From below the umbilicus to the Foot Shaoyin aspect, down to the bone marrow, it governs the movement of Yin twenty-five cycles... having fixed limits. The state of its pathogens... eyes and soul like... great abundance... the arrival of major trends... First sedate Chong and Du, to... like a drainage ditch. The classic states: In... like urine and feces passing smoothly, not... sweet and warm in the Yang aspect... assist Yin Qi, temporarily drain and ascend, stopping when Qi levels.

*Nan Jing, Chapter 36* states: Each Zang organ has one, why does the Kidney have two? The answer is: The two kidneys are not both Kidneys; the left is the Kidney, the right is the Mingmen (Gate of Life).

Li Dongyuan (Jiegu) stated: Whether male or female, the left is the Kidney and the right is the Mingmen. In men, storing essence occurs in the Qi Sea; in women, connecting to the uterus occurs in the Blood Sea. Governing... bone... strength... forming saliva... Qi Decoction...

*Nan Jing, Chapter 37* states: When pathogens are in the Six Fu organs, the Yang pulses are discordant. When Yang pulses are discordant, Qi stagnates. When Qi stagnates, Yang pulses become vigorous. When pathogens are in the Zang organs... Yin Qi is too abundant, preventing Yang Qi from nourishing, hence termed "Ge" (Obstruction). Yang Qi... unable to mutually nourish, hence termed "Guan Ge" (Lock and Obstruction). Guan Ge means failing to complete life... It is said: The movement of Qi is like flowing water that cannot stop. Thus Yin... Its cycle ends and restarts without overflowing. Human Qi internally warms the Zang...

Annotation explains: Pathogens in the Zang organs clarify the cold and hot nature of food and drink; upon infection, they damage the Six Fu organs. This is due to irregular diet and physical overexertion, thereby injuring the Six Fu organs... Yuan... Yin Excess generates... Heaven has eight... Clarify the Zang... Refers to... Also... Also. Six... Then disease... Change... Injury...