Library

Huangdi asked: What qi causes tinnitus in humans? Qibo replied: The ears are the gathering place of the Zong Mai (Major Meridians). Therefore, when the Stomach is empty, the Zong Mai becomes deficient. Deficiency leads to sinking downward, and when the meridians experience exhaustion of Qi and Blood, tinnitus occurs. Treatment should involve tonifying the Kerenren acupoint (Shangguan, GB19), as well as the Shaoshang acupoint (LU11) located at the junction of the nail and flesh on the thumb.

The eyes and ears are the sensitive orifices for vision and hearing; thus, they are both gathering places of the Zong Mai and connect with the Heart. The Zong Mai refers to the meridians through which Zong Qi (Gathering Qi) circulates. Clear Yang Qi accumulates in the chest and is named Zong Qi, formed by the convergence and ascending movement of congenital Yuan Qi (Original Qi) and postnatal Gu Qi (Grain Qi). Therefore, when the Stomach is empty, its Qi sinks downward, causing the ascending meridian Qi to exhaust. The orifices lack clear and spiritual Qi; if Clear Qi does not ascend, Turbid Qi cannot descend. If Turbid Qi does not descend, Yang Qi becomes depressed and moves internally, resulting in tinnitus. The Classic further states: The great collateral of the Stomach is named Xuli (CV17), located below the left breast, where pulsation can be seen through clothing; this reflects the Zong Qi. Thus, the Qi of the Zong Mai originates from the Stomach; when the Stomach is deficient, the meridian Qi is exhausted. Kerenren belongs to the Gallbladder Meridian, while the acupoint on the thumb nail is Shaoshang (LU11) of the Lung Meridian. The Lung governs the Qi of the whole body, and the Gallbladder Meridian enters the ear. Tonifying these two meridians helps unblock Yang and assist Qi, enabling it to reach the upper regions.

Huangdi asked: What qi causes a person to bite their own tongue? Qibo replied: This is due to Jue Ni (Rebellious Qi) moving upward, with meridian Qi arriving at specific locations. When Shao Yin (Lesser Yin) Qi arrives, the tongue is bitten; when Shao Yang (Lesser Yang) Qi arrives, the cheek is bitten; when Yang Ming (Bright Yang) Qi arrives, the lips are bitten. Observe the primary affected meridian and apply the tonification method.

The Qi of the meridians ascends, descends, and circulates cyclically. If it becomes disordered and Jue Ni moves upward, the meridians at the site of Qi arrival become full and distended, interfering with the teeth, leading to unconscious biting. When Shao Yin meridian Qi reaches the tongue, the tongue is bitten; when Shao Yang meridian Qi reaches the cheek, the cheek is bitten; when Yang Ming meridian Qi reaches the lips, the lips are bitten. Excess in the upper part implies deficiency in the lower part; tonifying the lower part will calm the Qi.

In ancient times, people possessed profound virtue and strong constitution, free from internal injuries. Even if exposed to external pathogens, they remained on the muscle surface; thus, treatment favored acupuncture and Bian stone therapy, with little use of decoctions. In later generations, human Qi transformation gradually weakened, desires increased, and constitutions became frail, allowing pathogens to easily enter the interior. Consequently, acupuncture and Bian stone therapies were often unsuitable. Since the Han Dynasty, Zhang Zhongjing established theories and formulated prescriptions based on the principles of the *Neijing* (Classic of Internal Medicine), becoming the ancestor of Formula and Pulse studies. Specialized disciplines emerged, and those studying formulas and pulses neglected acupuncture techniques. Indeed, Yin-Yang, Qi, and Blood originate from the Zang-Fu organs, enter the meridians, and circulate throughout the body. Therefore, not only are decoctions necessary for internal injuries and deficiency syndromes, but they can also expel external pathogens from the interior to the exterior via the meridians. Hence, acupuncture has been rarely used in recent times, and few masters excel in it.

Although treatments are divided into specialties, the underlying principles remain unified. One must thoroughly understand the Dao of Yin-Yang, Five Elements, and Qi transformation; the depth and superficiality of Zang-Fu organs and meridians; the circulation patterns of Ying (Nutritive) and Wei (Defensive) Qi and Blood; as well as the strength of constitution, the nature of external pathogens (rigid or soft), seasonal climate (cold or hot), and geographical elevation. All these must be carefully examined and fully known. Only then, using Wang (Inspection), Wen (Auscultation and Olfaction), Wen (Inquiry), and Qie (Palpation) to differentiate syndromes and apply treatments, can errors be avoided. Thus, Formula and Pulse studies serve as the guideline for all disciplines. Acupuncture requires knowledge of acupoints and involves different tonification and sedation methods, making its techniques detailed. Regarding herbal formulas, one must understand drug properties and flavors, distinguishing between cold, hot, warm, cool; floating, sinking; ascending, descending; heavy, light; thick, thin. Drugs may enter Zang-Fu, travel through meridians, move in the Qi level, or move in the Blood level; they may gather or scatter, drain or attack, tonify or sedate. Success depends entirely on proper combination, following the roles of Jun (Sovereign), Chen (Minister), Zuo (Assistant), and Shi (Envoy), and the systems of odd/even and large/small formulas. Its principles and methods are more refined and miraculous than acupuncture. Once swallowed, drugs enter the interior; errors cannot be reversed, so the stakes are much higher than in other disciplines, making it no easy task. A gentleman aims to save the world; when successful, he benefits all under heaven, ideally serving as a minister; when unsuccessful, he cultivates his own virtue. One must know medicine, as knowing medicine allows one to benefit others. However, pretending to know what one does not know is worse than ignorance. Why? Ignorance of medicine only fails to protect oneself; pretending to know harms others initially and oneself finally, which is inevitable retribution. Although their original intent was to cure disease, lack of academic clarity and arbitrary self-will lead to unknowing killing, for which there is guilt. This is merely a mild rebuke! Over time, weakness accumulates into thickness; hence, choosing a profession requires caution. To minimize faults, one must devote oneself to studying the classics and principles. The Classic states: An expert physician cures nine out of ten cases; an inferior physician cures six out of ten. In today's world, curing six out of ten is sufficient to balance merits and faults, and I would call such a person an expert. True experts of antiquity are now unseen. Therefore, I have collected classical statements as guidelines for formula physicians. Those committed to Ren (Benevolence) should review them repeatedly and not neglect them. From now on, prescription formulation is paramount. However, diseases vary infinitely, and medicines must be applied according to the condition. If syndrome differentiation is unclear, what use is a formula? It brings no benefit but harm; having a formula is worse than having none. Thus, syndrome differentiation precedes treatment discussion and must be studied in the chapters on Four Diagnostic Methods and various diseases. To preserve oneself, one must know this; to do things well, one must sharpen one's tools!