Library

*Suwen: Treatise on the Three Regions and Nine Observations*

The Yellow Emperor asked, "I have heard from you, Master, about the Nine Needles. Their content is numerous and profound, beyond counting. I wish to hear the essential principles so that I may entrust them to my descendants and transmit them to future generations. I will engrave them in my bones and hide them in my liver and lungs, accept them by drinking blood and making an oath, and dare not recklessly disclose them." (Note: "Shu" means to entrust; "Zhuo" means to record; "Shaxue" refers to drinking blood to make an oath; "Shu" is pronounced with the rising tone; "Sha" is pronounced as 'suo jia'.) May this principle accord with the Way of Heaven, having a definite beginning and end, corresponding above to the light of heaven, the stars, and the calendar cycles, and below to the four seasons and the Five Elements, with the alternation of nobility and baseness, winter yin and summer yang. How should man correspond to this? I wish to hear the method.

Qibo replied, "How excellent your question is! This is the supreme number of Heaven and Earth." (Although Heaven and Earth are vast, and all things are many, nothing can exist outside the realm of 'number'. The way of number is great, hence it is called the supreme number.)

The Yellow Emperor said, "I wish to hear the supreme number of Heaven and Earth. How does it combine with human form and qi-blood, enabling us to understand and decide matters of life and death? What should we do?"

Qibo said, "The supreme number of Heaven and Earth begins with One and ends with Nine." (Number begins with One and ends with Nine; this is the natural number of Heaven and Earth. For example, in the *Yijing*, there is the Supreme Ultimate (Taiji), which generates the Two Modes (Liangyi); the Two Modes generate the Four Images (Sixiang); the Four Images generate the Eight Trigrams (Bagua), while the Supreme Ultimate operates within them. This reflects the number Nine of Yang. Furthermore, regarding the positions of the Four Images, Old Yang is One, Young Yin is Two, Young Yang is Three, and Old Yin is Four; regarding the numbers of the Four Images, Old Yang is Nine, Young Yin is Eight, Young Yang is Seven, and Old Yin is Six. Connecting One, Two, Three, Four with Nine, Eight, Seven, Six, with Five occupying the center, also reflects the number Nine of Yang. Thus, speaking of Heaven regarding years, one year governs four seasons, and one season governs ninety days; this is the Nine of Heavenly Number. Speaking of Earth regarding positions, it is 'Nine wears the head, One treads the feet, Three is on the left, Seven on the right, Two and Four are shoulders, Six and Eight are feet, and Five is in the central palace'; this is the Nine of the Luoshu. Speaking of Man regarding affairs, the number of Huangzhong (Yellow Bell) starts at Nine. Nine times nine yields eighty-one fen, serving as the root of all matters; this is the Nine of Human Affairs. Beyond the number Nine is Ten, but Ten reverts to becoming One. Hence, it is said that the supreme number of Heaven and Earth begins with One and ends with Nine.) One is Heaven, Two is Earth, Three is Man. Multiplying by three, three times three equals nine, corresponding to the Nine Fields (Jiuye). (One is odd, thus corresponding to Heaven. Two is even, thus corresponding to Earth. Three is composite/participatory, thus corresponding to Man. Hence it is said: Heaven opens at Zi hour, Earth is created at Chou hour, and Man is born at Yin hour; this is what is called the Three Powers (Sancai). Multiplying the Three Powers by three corresponds to the Nine Fields. The Nine Fields refer to the meaning of the Nine Palaces of the Luoshu and the Nine Provinces of Yu's Tribute, detailed in diagrams such as the Nine Palaces and Star Fields.) Therefore, humans have Three Regions (Sanbu), each region having Three Observations (Jiu Hou), used to decide life and death, treat the hundred diseases, regulate deficiency and excess, and eliminate pathogenic evils. (Speaking of Heaven, Earth, and Man in terms of upper, middle, and lower, it is called the Three Powers. Speaking of the human body in terms of upper, middle, and lower, it is called the Three Regions. Dividing each of the Three Regions into three parts constitutes the Three Observations. Three multiplied by three is called the Three Regions and Nine Observations. The meridians and collaterals of the whole body enter and exit through here, so they can decide life and death, treat the hundred diseases, regulate deficiency and excess, and eliminate pathogenic evils. My commentary: The Three Regions and Nine Observations in this classic explicitly refer to the arteries in the upper, middle, and lower parts of the human body as described below. This was likely the diagnostic method of antiquity, where specific pulse sites in the Three Regions and Nine Observations were used to diagnose the qi of various organs and use acupuncture to eliminate pathogenic evils, rather than referring solely to the Cun Kou pulse. For instance, Zhang Zhongjing's pulse diagnosis method takes the Cun Kou at the upper part and the Fu Yang pulse at the lower part, which follows this intent. Looking at the *Nan Jing, Chapter 18*: "The Three Regions are Cun, Guan, Chi; the Nine Observations are Floating, Middle, Sinking." This divides the Three Regions and Nine Observations of diagnosis solely based on the Cun Kou pulse. Later practitioners of pulse diagnosis revered this. Although it is a convenient method for diagnosticians, it is not the original intent of Xuanyuan and Qibo. Students should investigate its meaning thoroughly.)

The Yellow Emperor asked, "What are the Three Regions?"

Qibo said, "There is the Lower Region, the Middle Region, and the Upper Region. Each region has three observations. These three observations consist of Heaven, Earth, and Man. One must point to them and guide [the student], only then can the truth be obtained." (Pointing and guiding means receiving instruction from a teacher to acquire true knowledge.)

The Upper Region Heaven is the artery at the two temples; (The artery beside the forehead, located near the Hanyan acupoint, where the qi of the Foot-Shaoyang Gallbladder Meridian flows.) The Upper Region Earth is the artery at the two cheeks; (The arteries on the cheeks, near the Dicang and Daying acupoints, where the qi of the Foot-Yangming Stomach Meridian flows.) The Upper Region Man is the artery in front of the ears. (The artery in front of the ear, near the Heliao acupoint, where the qi of the Hand-Shaoyang Sanjiao Meridian flows.)

The Middle Region Heaven is the Hand-Taiyin Lung Meridian; (The artery at the Cun Kou behind the palm, next to the Jingqu acupoint, where the qi of the Lung Meridian flows.) The Middle Region Earth is the Hand-Yangming Large Intestine Meridian; (The artery between the metacarpal bones of the thumb and index finger, next to the Hegu acupoint, where the qi of the Large Intestine Meridian flows.) The Middle Region Man is the Hand-Shaoyin Heart Meridian. (The artery below the sharp bone behind the palm, next to the Shenmen acupoint, where the qi of the Heart Meridian flows.)

The Lower Region Heaven is the Foot-Jueyin Liver Meridian; (The artery three cun below the Qichong acupoint, near the Wuli acupoint, where the qi of the Liver Meridian flows. It should be taken while lying down. For women, take the Taichong acupoint, located in the depression two cun posterior to the base of the big toe.) The Lower Region Earth is the Foot-Shaoyin Kidney Meridian; (The artery behind the medial malleolus next to the calcaneus, near the Taixi acupoint, where the qi of the Kidney Meridian flows.) The Lower Region Man is the Foot-Taiyin Spleen Meridian. (The artery above the fleshy part of the foot, passing over the tendons, directly below the Wuli acupoint near the Jimen acupoint. It can only be felt with deep pressure, where the qi of the Spleen Meridian flows. If observing Stomach Qi, one should take the Chongyang acupoint on the dorsum of the foot.)

Therefore, the Heaven of the Lower Region observes the Liver, (Foot-Jueyin Meridian, thus observing the Liver.) the Earth observes the Kidney, (Foot-Shaoyin Meridian, thus observing the Kidney.) and the Man observes the Qi of the Spleen and Stomach. (Foot-Taiyin Meridian. The Spleen and Stomach are connected by membranes, thus allowing observation of their Qi.)

The Yellow Emperor asked, "How are the observations of the Middle Region?"

Qibo said, "There is also Heaven, Earth, and Man. Heaven observes the Lungs, (Hand-Taiyin Meridian, thus observing the Lungs.) Earth observes the Qi of the Chest, (Hand-Yangming Large Intestine Meridian. The Large Intestine and Small Intestine both belong to the Stomach, and the stomach cavity connects to the chest, thus observing the Chest Qi.) and Man observes the Heart. (Hand-Shaoyin Meridian, thus observing the Heart.)

The Yellow Emperor asked, "What does the Upper Region observe?"

Qibo said, "There is also Heaven, Earth, and Man. Heaven observes the Qi of the Head and Horns (temples/forehead), (Arteries at the two temples, thus observing the head.) Earth observes the Qi of the Mouth and Teeth, (Arteries at the two cheeks, thus observing the mouth and teeth.) and Man observes the Qi of the Ears and Eyes. (Artery in front of the ear, thus observing the ears and eyes.)

The Three Regions each have Heaven, Earth, and Man. Three constitute Heaven, three constitute Earth, and three constitute Man. (The Upper, Middle, and Lower regions each have Heaven, Earth, and Man, forming the Three Regions and Nine Observations.) Three multiplied by three combines to form Nine. The Nine divide into the Nine Fields, and the Nine Fields correspond to the Nine Viscera. Thus, there are five Spirit Viscera (Shen Zang) and four Form Viscera (Xing Zang), combining to form nine viscera. (The meaning of Nine Fields is seen previously. The Nine Viscera refer to the Nine Observations mentioned above. The five Spirit Viscera are: Liver stores Hun, Heart stores Shen, Lungs store Po, Spleen stores Yi, Kidneys store Zhi. The four Form Viscera are: Head/Horns, Ears/Eyes, Mouth/Teeth, and Chest. Together they form nine viscera. This refers to the nine viscera of man, which correctly correspond to the nine fields of the earth, thereby conforming to the supreme number of Heaven and Earth.) When the qi of the five zang organs fails, the complexion must become wan (wan/severe pallor/dullness). Wan indicates certain death. (Complexion is the banner of Shen; viscera are the residence of Shen. When the complexion is wan, Shen has departed. When Shen departs, the viscera fail. Thus, death is certain. Wan refers to being withered, dark, lacking luster, and abnormal in color.)

The Yellow Emperor asked, "How should one observe?"

Qibo said, "One must first measure the fatness or thinness of the body to regulate the deficiency or excess of qi. Excess is treated by draining (Xie); deficiency is treated by tonifying (Bu)." (Observation refers to diagnosing the condition. Measurement refers to assessing deficiency and excess. Fatness or thinness of the body implies differences in needle depth, as described in the *Ni Shun Fei Shou Pian*. Deficiency or excess of disease implies differences in treatment methods of tonification and drainage, as described in the *Zhong Shi Pian*, *Jiu Zhen*, and *Zhen Jie* chapters. Although this speaks of acupuncture methods, those using herbs can infer similarly. My commentary: The acupuncture treatment methods of antiquity required examining the pulse and signs of the Three Regions and Nine Observations to regulate the prosperity and decline of the nine viscera. Modern people only know pressing acupoints to find disease, remaining ignorant of the principles of deficiency and excess in the various meridians. Rarely is divine or sage-like medical skill heard of today; this is likely due to losing the root. Xie is pronounced with the departing tone.)

One must first remove the blood stasis in the vessels before regulating, (Whenever there is blood stasis in the vessels causing obstruction, one must first puncture to remove the stagnation before regulating deficiency and excess.) regardless of the disease, aiming for balance. (For severe diseases, achieving results is not easy. Therefore, one need not ask about the speed of efficacy, but should aim for the balance of qi and blood. This corresponds to the content in the following twenty-five chapters of the same section and should be investigated mutually.)