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(From *Ling Shu: Evil Qi, Zang-Fu Organs, and Disease Manifestations Chapter*)

Huangdi asked: I have heard that the Qi of the Zang and Fu organs flows into and converges at the He-Sea points after passing through the Ying-Spring and Shu-Stream points. By what pathway do they enter? Upon entering, where do they connect and pass through? I wish to hear the explanation. (Each of the five Zang and six Fu organs has five Shu points; the point where the Qi enters is called the He-Sea point, i.e., the He-Sea point of each meridian. However, the three Yang meridians of the hand also have connections between upper and lower parts with communicating Qi and vessels, which are also referred to as "He." Thus, the question here concerns the entry pathway and connection.)

Qibo replied: These are the divergent branches of the Yang meridians that enter internally and belong to the Fu organs. (The following text discusses how the six Yang meridians internally belong to the Fu organs, thereby clarifying that the lower He-Sea points of the three hand-Yang meridians are located on the feet.)

Huangdi asked: Do the Ying-Spring, Shu-Stream, and He-Sea points have specific names respectively?

Qibo replied: The Ying-Spring and Shu-Stream points treat diseases of the exterior meridians, while the He-Sea points treat diseases of the interior Fu organs. (The Qi at the Ying-Spring points is superficial, so it can treat diseases of the exterior meridians. The Qi at the He-Sea points penetrates deeply, so it can treat diseases of the interior Fu organs.)

Huangdi asked: How should one treat diseases of the interior Fu organs?

Qibo said: Select the He-Sea points for treatment.

Huangdi asked: What are the names of these He-Sea points?

Qibo said: The lower He-Sea point of the Stomach is Zusanli (ST36). (The Stomach belongs to the Foot-Yangming Meridian. Zusanli is the point where the meridian Qi converges as the He-Sea point.) The lower He-Sea point of the Large Intestine is Shangjuxu (ST37). (The Large Intestine belongs to the Hand-Yangming Meridian. The He-Sea point of this meridian is Quchi (LI11), but its lower He-Sea point is located at Shangjuxu (ST37) on the Foot-Yangming Meridian.) The lower He-Sea point of the Small Intestine is Xiajuxu (ST39). (The Small Intestine belongs to the Hand-Taiyang Meridian. The He-Sea point of this meridian is Xiaohai (SI8), but its lower He-Sea point is located at Xiajuxu (ST39) on the Foot-Yangming Meridian.) The lower He-Sea point of the Sanjiao (Triple Burner) is Weiyang (BL39). (The Sanjiao belongs to the Hand-Shaoyang Meridian. The He-Sea point of this meridian is Tianjing (TE10), but its lower He-Sea point is located at Weiyang (BL39) on the Foot-Taiyang Meridian. Note: The Large Intestine, Small Intestine, and Sanjiao all belong to the three hand-Yang meridians. However, the large and small intestines are Fu organs of the Lower Jiao and are connected to the Stomach. Although their meridians are in the upper body, their Qi and vessels do not depart from the lower body, hence their lower He-Sea points are on the Foot-Yangming Meridian at Shangjuxu and Xiajuxu. The Sanjiao is the solitary Fu organ, governing all aspects of the three divisions and nine inspections. Therefore, the part of the meridian in the upper body belongs to the hand, and the part in the lower body resides on the foot. Among the twelve meridians, only the three hand-Yang meridians have lower He-Sea points. Thus, the *Ben Shu* chapter states: "The Large Intestine and Small Intestine both belong to the Stomach." The lower He-Sea point of the Sanjiao is located anterior to the little toe of the foot, posterior to the Shaoyang meridian, emerging from the lateral side of the leg, named Weiyang. This refers to the aforementioned situation. See detailed discussion in the Meridians Category, Section 16.) The lower He-Sea point of the Bladder is Weizhong (BL40). (The Bladder belongs to the Foot-Taiyang Meridian. Weizhong is the He-Sea point of this meridian.) The lower He-Sea point of the Gallbladder is Yanglingquan (GB34). (The Gallbladder belongs to the Foot-Shaoyang Meridian. Yanglingquan is the He-Sea point of this meridian.)

Huangdi asked: What is the method for locating these points?

Qibo replied: When locating Zusanli, flex the foot dorsum to find it; when locating the Juxu points (Shangjuxu and Xiajuxu), elevate the foot to find them; when locating Weiyang, flex and extend the leg to search for it; (Weiyang is six cun below Chengfu (BL81). "Searching by flexion and extension" means flexing the thigh to observe the crease at Chengfu and extending the leg to measure the distance to Weiyang.) When locating Weizhong, flex the knee to find it; when locating Yanglingquan, sit upright with knees aligned horizontally, and locate the point laterally corresponding to Weiyang. (Sitting upright with knees aligned means sitting properly with both knees at the same height. "Laterality of Weiyang" likely refers to the lateral aspect of Weizhong, which corresponds to the position of Yanglingquan. "Shu" is pronounced with the rising tone or departing tone.) For locating points on the exterior meridians, guide and stretch the meridian to follow its course. ("Yu" means to draw/guide. "Shen" means clear/explicit. To treat exterior meridian diseases, one uses Ying-Spring and Shu-Stream points, but one must clearly guide and define the path before treating accordingly. "Yu" is pronounced like "yu".)

Huangdi said: I wish to hear about the diseases of the six Fu organs.

Qibo replied: Facial heat indicates a disease of the Foot-Yangming Meridian; blood engorgement in the collaterals of the thenar eminence (fish area) indicates a disease of the Hand-Yangming Meridian; vertical or depressed pulses on the dorsum of both feet indicate a disease of the Foot-Yangming Meridian, which is the pulse pattern of the Stomach. (The Foot-Yangming Meridian runs over the face, hence facial heat. The Hand-Yangming Meridian runs over the surface of the hand's thenar eminence, hence collateral engorgement there. The foot dorsum is called "Fu"; the pulses on the dorsum refer to Chongyang (ST42). Vertical implies firmness and excess; depressed implies weakness and deficiency. Both are pathological signs of the Foot-Yangming Stomach Meridian. As stated later, Large Intestine diseases present similarly to Stomach diseases, so this Stomach pulse pattern likely includes the Hand-Yangming Meridian.) In cases of Large Intestine disease, there is severe pain in the intestines with gurgling sounds; if exposed to cold in winter, diarrhea occurs, with pain around the umbilicus, and an inability to stand for long periods. The presentation is similar to Stomach disease; treatment should target Shangjuxu (ST37). ("Yue" should be read as "month". The Large Intestine is subordinate to the Stomach, hence similar presentations. Shangjuxu is the lower He-Sea point of the Large Intestine, so it should be selected.)

In cases of Stomach disease, there is abdominal distension, pain in the epigastrium centered behind the heart, radiation to both hypochondriac regions, obstruction in the diaphragm and pharynx, and difficulty swallowing food. Treatment should target Zusanli (ST36). (Zusanli is the He-Sea point of the Yangming Meridian, so it is indicated for Stomach disease.)

In cases of Small Intestine disease, there is pain in the lower abdomen, pain radiating from the lower back and spine to the testicles, frequent urgency to defecate, heat in front of the ears, severe cold, isolated intense heat on the shoulder, heat between the little finger and the ring finger, or depressed pulses. These are the signs of Hand-Taiyang Meridian disease; treatment should target Xiajuxu (ST39). (The Qi transformation of the Small Intestine acts on the lower abdomen, connects posteriorly to the lumbar spine, and draws downward to the testicles, causing various pains and urinary/fecal retention with urgency, resembling hernia conditions. The areas in front of the ears, on the shoulder, and between the fingers are pathways of the Hand-Taiyang Meridian, hence these symptoms. Depressed pulses are a sign. Xiajuxu is the lower He-Sea point of the Small Intestine, so it should be selected.)

In cases of Sanjiao (Triple Burner) disease, there is abdominal fullness due to Qi stagnation, particularly hardness in the lower abdomen, inability to urinate, urgency, and if water overflows and stagnates, distension ensues. The signs manifest in the large collaterals outside the Foot-Taiyang Meridian, located between the Taiyang and Shaoyang meridians, and may also be seen in the pulse. Treatment should target Weiyang (BL39). (When diseased, the Sanjiao loses its function as the official of drainage, leading to poor water passage, resulting in abdominal hardness/fullness, urinary urgency, and distension from fluid retention. Weiyang is the lower He-Sea point of the Sanjiao, so it should be treated.)

In cases of Bladder disease, there is unilateral swelling and pain in the urinary region; pressing with the hand creates the urge to urinate but results in nothing coming out. There may be heat on the shoulder or depressed pulses, as well as heat or depressed pulses at the lateral aspect of the little toe and posterior to the tibial malleolus. Treatment should target Weizhong (BL40). (These are all diseases of the Bladder Fu organ. Weizhong is selected because it is the He-Sea point of the Foot-Taiyang Meridian.)

In cases of Gallbladder disease, there is frequent sighing, bitter taste in the mouth, vomiting of old bile, palpitations/uneasiness in the heart region, fear of being captured, a sensation of obstruction in the throat with frequent spitting. The pathology lies at the root and branch of the Foot-Shaoyang Meridian. One should also examine for depressed pulses and apply moxibustion. For cases with chills and fever, target Yanglingquan (GB34). ("Dandan" describes a state of unease. "Ai ran" describes a sound. Root and branch refer to the Fu organ as the root and the meridian as the branch. Depressed pulses indicate deficiency, suitable for moxibustion. Chills and fever indicate pathogenic factors, suitable for needling Yanglingquan, the He-Sea point of the Foot-Shaoyang Meridian.")

Huangdi asked: Is there a principle for needling?

Qibo replied: When needling these points, one must accurately penetrate the Qi-Acups (Qi points) and avoid striking the flesh joints. Penetrating the Qi-Acup allows the needle to flow smoothly like a channel; striking the flesh joint causes skin pain. (Where meridian Qi arrives is called the Qi-Acup. Where muscle fibers have boundaries is called the flesh joint. "Ran" means adhering. "Xiang" means path/channel. Hitting the Qi-Acup connects the needle to the vessel pathway, unblocking the meridians; missing it merely injures the flesh joint, causing pain. "Ran" is alternatively written as "You".) If tonification and sedation are reversed, the illness will worsen. Needling the sinews leads to flaccidity; the pathogenic evil cannot exit. Instead, it mixes with the true Qi, creating chaos and remaining inside, attaching internally. This results from imprecise needling, confusing the correct and incorrect approaches, which is the fault of the practitioner. (Reversing tonification and sedation inevitably exacerbates the disease. Missing the evil and hitting the sinew allows the evil to exploit the deficiency, mixing with true Qi and returning inward. All these errors stem from failing to carefully discern the correct and incorrect methods, constituting the practitioner's fault.)