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(From *Ling Shu: Xie Ke Pian*)

Huangdi asked Qibo, saying: "I wish to hear about the principles of holding the needle, the rationale for inserting the needle, the meaning of 'zong she' (releasing or withholding treatment), and how to open the skin and interstices. Where are the sites where the meridians curve, enter, and exit? Where do they emerge? Where do they stop? Where do they move slowly? Where do they move quickly? Where do they enter internally? I also wish to hear completely about the acupoints of the six fu organs on the body. Please briefly explain the locations where the meridian branches separate and converge; when entering yin from yang, or separating from yin to enter yang, what path do they follow? I wish to hear the methods in detail."

Qibo replied, "The questions raised by Your Majesty cover the entirety of acupuncture principles."

Huangdi said, "I wish to hear them all." (Note: "Emerging, stopping, moving slowly, moving quickly, and entering" refer to the meanings of the Five Shu points. "Locations of separation and convergence" refers to the separation and convergence of meridian branches. Pronounced 'han'.)

Qibo said: "The meridian of Hand-Taiyin [Lung] emerges from the tip of the thumb, curves inward along the border of the white flesh, reaches Taiyuan (LU9) behind the first metacarpophalangeal joint, where it pauses and pulses, then curves outward upward below the joint, curves inward to meet with various yin collaterals at Yuji (LU10). Multiple vessels pour into this area, their qi is smooth and slippery, they lie hidden beneath the styloid process of the radius, curve outward to emerge at Cun Kou (Radial Artery pulse position) and travel through Jingqu (LU8), ascend to the medial edge of the elbow, enter below the large tendon, curve inward upward toward the axilla, enter the axilla, curve inward to travel to the Lung. This is a curved path that follows the forward direction but counts backward." (Note: The following two sections both describe the curvature of the Five Shu points. The tip of the thumb is Shaoshang (LU11), the Jing-Well point. Curving inward along the white flesh border to behind the joint is Taiyuan (LU9), the Shu-Stream point. In general, the boundary between yin and yang meridians in the human body is marked by the purple-white flesh border; purple on the outside belongs to the yang aspect, white on the inside belongs to the yin aspect, which is generally true. 'Dan' describes water rippling. The pulse moves at Taiyuan, hence 'pauses and pulses'. From here, curving outward upward below the joint, curving inward to meet yin collaterals at Yuji (LU10), the Ying-Spring point. All yin meridians converge here, hence multiple vessels pour in. Their qi is smooth and slippery, lying hidden beneath the post-carpal bone, curving outward to emerge at Cun Kou and traveling through Jingqu (LU8), the Jing-River point. Ascending to the medial edge of the elbow, entering below the large tendon, is Chize (LU5), the He-Sea point. Then from here, curving inward past the axilla, entering the axilla to travel to the Lung. However, the Lung meridian normally travels from the zang organ to the hand as forward movement; here it goes from the hand to the zang, hence it is described as 'forward movement counting backward' in terms of curvature.)

The meridian of Hand-Jueyin [Pericardium] emerges from the tip of the middle finger, curves inward along the medial side of the middle finger upward to stay in the palm, lies hidden between the two bones, curves outward to emerge between the two tendons at the junction of bone and flesh, its qi is smooth and slippery, ascends two cun outward to travel between the two tendons, ascends to the medial edge of the elbow, enters below the small tendon, stays at the meeting of the two bones (Quze PC3), ascends into the chest, and internally connects to the Heart meridian. (Note: The tip of the middle finger is Zhongchong (PC9), the Jing-Well point. Curving inward along the middle finger upward to the palm is Laogong (PC8), the Ying-Spring point. Lying hidden between the two bones, emerging outward between the two tendons at the bone-flesh junction is Daling (PC7), the Shu-Stream point. Its qi is smooth and slippery, ascending two cun outward to travel between the two tendons is Jianshi (PC5), the Jing-River point. Ascending to the medial edge of the elbow, entering below the small tendon, staying at the meeting of the two bones is Quze (PC3), the He-Sea point. From here ascending into the chest and internally connecting to the Heart meridian is the curved path of Hand-Jueyin, following forward movement but counting backward. Note: This chapter discusses the curvature of the twelve meridians, mentioning only Hand-Taiyin and Hand-Jueyin, likely to introduce the subsequent discussion on why Shaoyin has no Shu points. Therefore, it speaks only of the two meridians above the diaphragm. Detailed meanings of the curvature of other meridians are already provided in chapters such as 'Jing Mai' and 'Ben Shu', so there is no need for further detail here.)

Huangdi asked, "Why does the meridian of Hand-Shaoyin [Heart] alone have no Shu points?"

Qibo replied, "Shaoyin is the Heart meridian. The Heart is the great master of the five zang and six fu organs, the residence of the spirit. Its organ is solid, and pathogens cannot accommodate themselves within it. If they were to accommodate, the Heart would be damaged; if the Heart is damaged, the spirit departs, and if the spirit departs, death occurs. Therefore, any pathogens located in the Heart are actually located in the Pericardium (Bao Luo). The Pericardium is the meridian of the Heart Master. Thus, it alone has no Shu points." (Note: Hand-Shaoyin is the Heart meridian. Hand-Jueyin is the Pericardium meridian. Although the meridians are divided into two, the organ source is one. The Pericardium is external, serving as the guard for the Heart. The Heart is the great master of the five zang and six fu organs, the residence of the spirit. Its organ is solid, and pathogens cannot harm it; if harmed, death ensues. Therefore, any pathogens in the Heart are in the external Pericardium. Since the Heart is the Ruler and the Pericardium is governed by the Heart, it is called the Heart Master. When treating disease, treating the Shu points of the Pericardium is equivalent to treating the Heart. Hence, the Shaoyin meridian alone has no Shu points. Detailed meanings are found in the 'Ben Shu' chapter, see Meridian Category 16.)

Huangdi asked, "If Shaoyin alone has no Shu points, does it not get sick?"

Qibo replied, "Its exterior meridian may be diseased while the internal organ remains healthy. Therefore, one should exclusively select the acupoint at the end of the sharp bone behind the palm. The remaining pathways of entry, exit, curvature, and speed of flow are identical to those of the Hand-Shaoyin Heart Master meridian. Thus, the selection of Shu points for this meridian is based on the deficiency or excess and speed of its qi. This is called draining according to the surge of pathogenic factors and tonifying according to the decline of healthy qi. By doing so, pathogenic factors are eliminated, and genuine qi becomes solid. This is called following the order of Heaven." (Note: For all zang-fu and meridians, where there is a zang, there is a meridian. The zang resides internally, while the meridian travels externally. The Heart organ is solid and resides internally, so pathogens cannot accommodate within it, but the meridian cannot avoid disease. Therefore, when the Shaoyin meridian is diseased, one should select the acupoint at the end of the sharp bone behind the palm, which is Shenmen (HT7), the Shu-Stream point. The entry, exit, curvature, and speed of the remaining meridians are like those of the Hand-Shaoyin Heart Master meridian, meaning the Shu points of Shaoyin and Heart Master are similar in function. Thus, 'Ben Shu' refers to the Shu points of the original Shaoyin meridian, not implying they are all in the Pericardium as mentioned earlier. Therefore, if pathogens are in the Pericardium, treat the Shu points of Heart Master; if pathogens are in the Shaoyin meridian, treat the Shu points of the original meridian. Selecting based on deficiency and excess eliminates pathogenic qi and consolidates genuine qi, preserving the natural order bestowed upon the meridians. Note: The 'Ben Shu' chapter lists five Shu points for each of the five zang and six for each of the six fu, but none for Hand-Shaoyin. This chapter specifically raises this question to clarify that the Heart is the Great Master and cannot tolerate pathogens. Although it states there are no Shu points, this section mentions selecting the point at the sharp bone behind the palm and the similarity to Heart Master meridian flow. This shows that if the Heart organ is healthy, there are no Shu points for treating the organ; if the Shaoyin meridian is diseased, there are Shu points for treating the meridian. Thus, the *Jia Yi Jing* records the Shu points of Shaoyin: Shaochong as Jing-Well, Shaofu as Ying-Spring, Shenmen as Shu-Stream, Lingdao as Jing-River, and Shaohai as He-Sea, completing the set for the twelve meridians. This logic is based on this text.)

Huangdi asked, "How should one practice 'zong she' (withholding or using the needle)?" (Note: 'Zong' means to proceed slowly or relax; 'She' means not to use.)

Qibo replied, "One must first clearly understand the origin and termination of the twelve primary meridians, the cold and heat of the skin, and the fullness, emptiness, slipperiness, and roughness of the pulse." (Understanding these allows one to know whether the needle should be used or withheld.) "A pulse that is slippery and full indicates the disease is progressing daily; a pulse that is empty and thin indicates a chronic condition persisting over time; a pulse that is large and rough indicates Bi syndrome (painful obstruction)." (This refers to conditions where pathogenic qi is excessive or genuine qi is deficient, making rapid cure difficult; treatment should be gradual and slow.) "When yin and yang appear identical (both interior and exterior injured, blood and qi exhausted), the disease is difficult to treat; one should withhold the needle." "If the root (internal organs) still feels hot, the pathogen remains; treatment should be slow." "If the heat has subsided, the disease is also gone; the needle can be withheld." "Palpate the cubital region (Chi), observe the firmness, fragility, size, smoothness, roughness, cold, warmth, dryness, and dampness of the muscles. Simultaneously observe the five colors of the eyes to ascertain the state of the five zang organs and determine life and death. Observe the blood vessels and inspect the complexion to identify cold, heat, and Bi syndrome." (The meanings of palpating the Chi and observing the eyes are detailed in the Pulse and Color categories. Determinations of severity and mortality here constitute the principles of withholding or using the needle.)

Huangdi said, "Regarding the withholding or using of the needle, I have not yet grasped its full meaning." (Not only does the severity of the disease dictate withholding or using, but also the insertion, withdrawal, retention, and departure during needle handling involve 'zong she'. Having not understood the details, he asks again.)

Qibo replied, "The principle of holding the needle requires uprightness and steadiness, calmness and tranquility. One must first discern deficiency and excess before applying rapid or slow techniques. The left hand fixes the bone, the right hand guides the needle. Avoid contact with the muscle tissue. For draining, the needle must be inserted upright and straight; for tonifying, the skin pore must be closed after removal. Assist the needle to guide the qi, allowing pathogenic factors to disperse and genuine qi to reside." (The method of holding the needle should be prudent and cautious, proceeding with gentleness and composure to avoid error. Thus, one must be upright and steady, calm and tranquil. First knowing the deficiency or excess of the disease dictates the rapid or slow technique. The left hand holds, the right hand guides, ensuring precise insertion into the acupoint, avoiding the muscle mass. 'Guo' refers to wrapping or surrounding. For draining, insert upright and straight; for tonifying, close the skin upon needle withdrawal. Use the hand to assist the needle in guiding the qi, ensuring pathogenic factors disperse and genuine qi recovers and resides. Only then can the needle be removed. This is the principle of 'zong she' in needle handling.)

Huangdi asked, "How should one protect the skin and open the interstices?" (Note: 'Zhi' implies fear or aversion. How to proceed without fearing injury to the skin while opening the interstices?)

Qibo replied, "Follow the intervals between the muscle bundles. With the left hand, separate the skin. Insert the needle slightly and slowly, keeping it upright. Ensure the Shen (Spirit/Mind) remains undisturbed, allowing the pathogenic factors to depart." (When using the needle, one must follow the muscle fissures. The left hand separates the skin, and the right hand inserts the needle slightly and slowly with an upright motion. This ensures natural composure, correct insertion, preservation of Shen, expulsion of pathogens, and protection of the skin and interstices.)