Library

(From *Suwen: Treatise on the Laws of the Viscera*)

When the Liver is diseased, there is pain in the hypochondriac regions radiating to the lower abdomen, causing irritability; (This is due to Excess pathogenic factors in the Liver. The Liver meridian distributes over the hypochondrium and reaches the lower abdomen; when pathogens are excess, pain occurs in the hypochondrium radiating to the Shaoyang region. The emotion of the Liver is Anger; thus, when Liver Qi is strong, one becomes easily angered.) If Deficient, vision becomes blurred (*Kuang Kuang*), hearing is impaired, and there is excessive fear, as if being pursued by someone. (The eyes are the orifices of the Liver. The Liver meridian ascends to the pharynx, connecting to the eye system. The Liver and Gallbladder are exterior-interior pairs; the Gallbladder meridian enters the ear from behind. Thus, when Qi is deficient, vision and hearing are lost. Liver deficiency leads to Gallbladder deficiency, resulting in timidity and fear. *Kuang* sounds like "Huang".) Treatment should involve selecting points from the Foot Jueyin (Liver) and Foot Shaoyang (Gallbladder) meridians; (Selecting these meridians indicates the pathology is not in the collaterals. Selecting Jueyin treats the Liver, and Shaoyang treats the Gallbladder. This follows the discussion on Excess and Deficiency above: Deficiency requires tonification, Excess requires sedation. The following examples follow this pattern.) If Qi rebels upward, headache, deafness, poor hearing, and facial swelling occur; bloodletting should be performed. (Qi rebelling upward causes upper excess, leading to headache, deafness, and facial swelling. The Liver meridian meets the Du vessel at the vertex and descends to the interior of the cheek; the Gallbladder meridian enters the ear and descends to the Jiache point. To treat this, select areas where the meridian blood is abundant; according to the left or right, if there is stasis, puncture to sedate.)

When the Heart is diseased, there is pain in the chest, distension and fullness in the hypochondrium, pain below the ribs, pain between the sternum, back, and scapula, and pain in the inner aspect of both arms; (This is Excess pathogenic factors in the Heart meridian. The Hand Shaoyin Heart meridian originates from the heart system, goes up to the lungs, and emerges from the axilla; the Hand Jueyin Pericardium meridian has a branch that runs through the chest and out to the hypochondrium, reaching the axilla, then along the medial arm into the elbow, and down the forearm between two tendons. Additionally, the Heart and Small Intestine are exterior-interior pairs; the Small Intestine meridian surrounds the scapula and crosses the shoulders. Hence these symptoms.) If Deficient, the chest and abdomen become distended, and there is pulling pain between the hypochondrium and the waist. (The chest, abdomen, waist, and hypochondrium are all areas reached by the Hand Shaoyin and Hand Jueyin meridians. Heart deficiency leads to Yang deficiency and stagnation of rebellious Qi, causing chest and abdominal distension. The Heart governs blood vessels; blood deficiency fails to nourish the sinews and vessels, causing pulling pain between the waist and hypochondrium.) Treatment should involve selecting points from the Hand Shaoyin and Hand Taiyang meridians, and bleeding under the tongue; (Hand Shaoyin and Hand Taiyang correspond to the Heart and Small Intestine meridians; select according to Excess or Deficiency. The Heart opens into the tongue, so bleeding under the tongue sedates Excess.) For variant diseases, prick the Weizhong (BL40) area for bloodletting; (Variant disease refers to conditions belonging to Shaoyin but presenting differently than described above. Weizhong is the He-Sea point of the Foot Taiyang Bladder meridian and the Xi-Cleft point of the Hand Shaoyin Heart meridian; releasing blood allows pathogens to be expelled. *Xi* is synonymous with "gap".)

When the Spleen is diseased, the body feels heavy, muscles become flaccid and weak, the feet cannot support weight, walking may involve spasms, and there is pain in the soles of the feet; (This is Excess pathogenic factors in the Spleen meridian. The Spleen belongs to Earth and governs muscles. When Earth pathogens dominate with dampness, the body feels heavy and muscles become flaccid. Flaccidity implies bi-syndrome weakness and numbness. The Spleen governs the four limbs, hence foot weakness and spasms. Spasms refer to twitching of hands and feet. The Spleen meridian originates at the big toe, passes above the malleolus, causing sole pain. *Wei* sounds like "Wei" or "Rui". *Yuan* sounds like "Chi", "Xi", or "Ji".) If Deficient, there is abdominal fullness, borborygmus, undigested stool diarrhea, and food stagnation. (The Foot Taiyin Spleen meridian connects to the Spleen and links to the Stomach. Spleen deficiency loses its transportive function, disrupting Middle Qi, causing these ailments. *Sun* sounds like "Sun".) Treatment should involve selecting points from the Foot Taiyin and Foot Yangming meridians, and bleeding from the Foot Shaoyin meridian. (The Spleen and Stomach are exterior-interior pairs, so select Foot Taiyin and Yangming. Shaoyin is the Kidney meridian. The Spleen governs Dampness, the Kidney governs Water; Water can assist Dampness to injure the Spleen, so bleeding from Shaoyin drains Cold-Excess. As in the *Juebing* chapter treating Spleen Heart-pain, Ren Gu (KI2) and Taixi (KI3) of the Kidney meridian are selected, following similar logic. See Acupuncture Category 64 for details.)

When the Lungs are diseased, there is wheezing, coughing, rebellious Qi, shoulder and back pain, and sweating; (This is Excess pathogenic factors in the Lung meridian. The Lungs store Qi and govern respiration; their movement manifests as coughing. Disease causes wheezing, coughing, and rebellious Qi. The back is the mansion of the chest, and the shoulder is close to it, hence shoulder-back pain. The Lungs govern skin and hair; disease causes porous pores and leakage, hence sweating.) Pain extends to the sacrum, yin region, thighs, knees, thighs, calves, and feet; (These symptoms belong to the Foot Shaoyin meridian. The Shaoyin meridian originates from the sole, follows the medial malleolus into the heel, ascends along the medial calf, exits the posterior medial malleolus, ascends the posterior medial thigh, penetrates the spine, connects to the Kidneys, and links to the Bladder. Now Lung disease involves the Kidneys because Qi sinks to the lower part, and the Mother disease affects the Child; hence the text also selects Foot Shaoyin to treat it. *Kao* pronunciation is "Kai Gao Qie". *Bi* pronunciation is "Bing Mi Qie", also "Bi". *Shuan* pronunciation is "Zhuan". *Shuan* pronunciation is "Hang", also "Xing Jing Qie".) If Deficient, there is shortness of breath, inability to complete inhalations, deafness, and dry throat. ("Bao" means repeat/complete. Inability to complete inhalations means short breathing difficult to sustain. The Luo vessel of the Hand Taiyin Lung meridian converges in the ear, so Qi deficiency causes deafness; its meridian circulates the throat, causing dry throat. *Yi* sounds like "Yi".) Treatment should involve selecting the Hand Taiyin Lung meridian, and bleeding from the lateral aspect of the Foot Taiyang Bladder meridian and the medial aspect of the Foot Jueyin Liver meridian. (Taiyin is the primary meridian of the Lungs, so puncture according to Excess or Deficiency. Also select the lateral aspect of Foot Taiyang, where "lateral" refers to anterior. Medial aspect of Foot Jueyin, where "medial" refers to posterior. Specifically, the medial side of the calf directly above the posterior medial malleolus, which is the location of the Foot Shaoyin meridian. Observe the pulses of both feet; wherever the Shaoyin portion shows blood fullness differing from normal, remove it by bleeding to sedate Excess.)

When the Kidneys are diseased, there is abdominal distension, leg edema, wheezing and coughing, body heaviness, night sweats, and aversion to wind; (This is Excess pathogenic factors in the Kidney meridian. The Foot Shaoyin Kidney meridian ascends along the medial calf, runs alongside the umbilicus, and enters the Lungs. Yin pathogens invade upward, causing abdominal distension, leg edema, and wheezing/coughing. The Kidneys govern bones; bone disease causes body heaviness. The Kidneys govern the five fluids; in the Heart, it is sweat. Kidney pathogens harass the Heart, weakening Heart Qi internally, leading to night sweats. As stated in *Mai Yao Jing Wei Lun*: Excess Yin leads to profuse sweating and cold body. This is what is meant. Profuse sweating implies exterior deficiency; exterior deficiency implies Yang decline, hence aversion to wind. *Zeng* sounds like "Zeng".) If Deficient, there is pain in the chest, pain in the greater and lesser abdomen, cold extremities with reversal, and lack of joy. (The Foot Shaoyin meridian emerges from the Lungs, links to the Heart, and pours into the chest. Kidney deficiency leads to non-interaction between Heart and Kidney, causing chest pain. Pain in the greater and lesser abdomen corresponds to the Kidney meridian ascending from below to Yu Fu (CV14). The Kidneys store Essence; Essence transforms into Qi. Essence deficiency leads to Qi deficiency, causing coldness and reversal. The Spirit of the Kidney is Will (Zhi); only when Will is insufficient does one feel unhappy.) Treatment should involve selecting bleeding points from the Foot Shaoyin Kidney and Foot Taiyang Bladder meridians. (Foot Shaoyin and Foot Taiyang are exterior-interior pairs. Generally, acupuncture follows tonifying Deficiency and sedating Excess. However, if there is blood stasis in the meridians, one must first remove the blood vessels, then balance the excess and deficiency. *San Bu Jiu Hou Lun* states: First measure the body's fat/thinness to regulate Qi excess/deficiency, sedate Excess, tonify Deficiency, but must first remove blood stasis before regulating. This is what is meant.)