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(From *Ling Shu: Shou Yao Gang Rou Pian*)

Huangdi asked Shaoshi, "I have heard that human constitutions vary: some are rigid and some are flexible; some are weak and some are strong; some are short and some are tall; some are Yin and some are Yang. I wish to hear the principles behind this." Shaoshi replied, "Within Yin there is Yin, and within Yang there is Yang. If one carefully examines Yin and Yang, there will be a method for acupuncture. (Rigidity and flexibility, weakness and strength, shortness and tallness are all transformations of Yin and Yang. Although people know to speak of Yin and Yang, they do not know that there is Yin within Yin and Yang within Yang. Therefore, one must carefully examine Yin and Yang so that acupuncture techniques can be correctly applied.) Knowing where the disease originated allows for logical needling; carefully assessing the onset of the illness and aligning it with the times ensures internal harmony with the Zang-Fu organs and external harmony with the sinews, bones, tendons, and skin. (Knowing the origin means understanding whether the disease began in the Yin or Yang aspect, thus allowing for reasoned needling. Assessing the onset involves observing how Wind transforms via Wood, Heat via Fire, Dampness via Earth, Dryness via Metal, and Cold via Water, thereby corresponding to the seasons. From the internal Zang-Fu to the external sinews, bones, and skin, all follow this principle; integrating these aspects reveals the root of the disease.) Therefore, there is Yin and Yang internally, and also externally. Internally, the Five Zang organs are Yin and the Six Fu organs are Yang; externally, the sinews and bones are Yin and the skin is Yang. (Internal is Yin and external is Yang is the general rule. However, there is Yin and Yang within both. Thus, internally, the Zang organs are Yin because they reside in the interior; the Fu organs are Yang because they reside in the exterior. Externally, the deep sinews and bones are Yin, and the superficial skin is Yang. Hence, within Yin and Yang, there is further differentiation into Yin and Yang. Just as each of the Five Zang organs contains Blood and Qi, so do the Six Fu organs. In the Fu organs, Blood is Yin within Yang, while Qi is Yang within Yang; in the Zang organs, Qi is Yang within Yin, while Blood is Yin within Yin. The same applies to skin and bones. Thus, the *Tian Yuan Ji Da Lun* states: 'Heaven has Yin and Yang, and Earth also has Yin and Yang.' This is the meaning. From this, we see that the unity of Yin and Yang is present everywhere.) Therefore, it is said that when the disease is in the Yin of Yin, one should needle the Ying-Spring and Shu-Stream points of the Yin meridians; (Yin of Yin refers to Yin pathology located in the Yin division; one should needle the Ying-Spring and Shu-Stream points. Since the Qi at these points is relatively weak, they belong to the Yin category, such as Yuji (LU 10) as the Ying-Spring point and Taiyuan (LU 9) as the Shu-Stream point of the Hand-Taiyin Lung Meridian.) When the disease is in the Yang of Yang, one should needle the He-Sea points of the Yang meridians; (Yang of Yang refers to Yang pathology located in the Yang division; one should needle the He-Sea points. As the He-Sea points are where Qi enters, still within the Yang division, needling them prevents the pathogen from penetrating deeper, such as Quchi (LI 11) of the Hand-Yangming Large Intestine Meridian.) When the disease is in the Yang of Yin, one should needle the Jing-River points of the Yin meridians; (Yang of Yin refers to Yang pathology affecting the Yin; one should needle the Jing-River points of the Yin meridians. As the Jing-River points are where Qi flows strongly, representing Yang within Yin, such as Qu (LU 5) of the Hand-Taiyin Lung Meridian.) When the disease is in the Yin of Yang, one should needle the Luo-Connecting vessels. (Yin of Yang refers to Yin pathology affecting the Yang; one should needle the various Luo-Connecting vessels. Since these vessels are superficial and located in the Yang division, such as Pianli (LI 6) of the Hand-Yangming Large Intestine Meridian.) Therefore, it is said that disease in the Yang is called Feng (Wind); disease in the Yin is called Bi (Obstruction); disease involving both Yin and Yang is called Feng-Bi. (The Yang meridians receive Wind, hence disease in the Yang is called Feng. Pathogens entering the Yin cause obstruction, hence disease in the Yin is called Bi.) Manifestations that are visible/formidable but painless belong to the Yang category; (the disease is shallow and external.) Manifestations that are invisible/intangible but painful belong to the Yin category; (the disease is deep and internal.) Intangible yet painful conditions indicate that Yang is intact but Yin is injured; urgently treat the Yin and do not attack the Yang; tangible yet painless conditions indicate that Yin is intact but Yang is injured; urgently treat the Yang and do not attack the Yin. ('Intact' means solid/undamaged. Do not attack Yang when the disease is in Yin, nor attack Yin when the disease is in Yang; this applies to all treatments regarding exterior-interior and deficiency-excess.) If both Yin and Yang Qi are agitated, with symptoms appearing intermittently, accompanied by vexation and heart discomfort, this is called 'Yin prevailing over Yang,' known as neither exterior nor interior; the patient's condition will not last long. (Agitation of both Yin and Yang indicates disease in both exterior and interior. Intermittent symptoms indicate fluctuating irregularity. Vexation indicates severe Yin pathology surpassing Yang. Generally, treating disease requires seeking its root. If treating the exterior affects the interior, or treating the interior affects the exterior, it is because both Yin and Yang are injured. Thus, it is termed neither exterior nor interior, making treatment difficult, and the physical form will not endure long.)

Huangdi asked Boga, "I have heard of the sequence of Xing (Form), Qi (Energy), and Bing (Disease), and their correspondence between interior and exterior. What is it?" (Xing manifests externally, while Qi circulates internally. Disease damaging Xing and Qi occurs sequentially, each having specific correspondences.) Boga replied, "Wind and Cold damage Xing; Worry, Fear, Anger, and Resentment damage Qi. Damage to Qi affects the Zang organs, resulting in Zang disease; Cold damaging Xing corresponds to Xing manifestations; Wind damaging sinews and vessels results in vessel manifestations. This is the correspondence among Xing, Qi, exterior, and interior. (Wind and Cold invade from outside, thus damaging Xing. Emotional labor originates from inside, thus damaging Qi. Internal injury leads to disease in the Zang-Fu; external injury corresponds to the skin and hair. If Wind damages sinews and vessels, which lie between exterior and interior, it corresponds to the sinews and vessels. This distinguishes the relationships of Xing, Qi, and interior-exterior.)" Huangdi asked, "How should one needle?" Boga replied, "For a disease lasting nine days, three needleings suffice; for a disease lasting one month, ten needleings suffice. The number and duration depend on this reduction principle. (Generally, a three-day disease may require only one needle ing; thus, a nine-day disease requires three, and a one-month disease requires ten. For any disease, the frequency and duration should be calculated by reducing according to this principle; this is the major law of needling.) For chronic Bi syndrome that does not leave the body, observe the blood collaterals and drain all the stagnant blood. (Chronic Bi persisting in the body implies blocked circulation due to Yin pathogens in the blood vessels; therefore, one must observe the blood collaterals and completely evacuate the blood.)" Huangdi asked, "Regarding diseases of the exterior and interior, what is the difference in treatment difficulty?" (The previous text discussed difficulty based on duration; here, the question concerns difficulty based on location.) Boga replied, "If Xing is diseased first but has not entered the Zang organs, reduce the number of needleings by half compared to the standard; (Exterior disease without interior involvement is shallow, so the number of needleings should be halved; e.g., for a one-month disease, five needleings suffice.) If the Zang organs are diseased first and then manifest in the Xing, double the number of needleings. This is the correspondence of difficulty within a month. (Interior disease manifesting externally is deep, so the number of needleings should be doubled; e.g., shallow disease requires five needleings per month, while severe disease requires ten. Diseases have depth, hence treatment has varying degrees of difficulty.)"