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*Ling Shu: Dong Shu Chapter* (Full Text)

Huang Di asked: Among the twelve meridians, why do the pulses of the Hand-Taiyin Lung Meridian, the Foot-Shaoyin Kidney Meridian, and the Foot-Yangming Stomach Meridian beat continuously without stopping? (There are twelve meridians in total connecting the hands and feet. However, only the Hand-Taiyin, Foot-Shaoyin, and Foot-Yangming meridians possess distinct arterial pulsations. The specific points of these pulsations are the Taiyuan point on the Hand-Taiyin meridian, the Taixi point on the Foot-Shaoyin meridian, and the Renying point above and Chongyang point below on the Foot-Yangming meridian; the pulsations at these sites are particularly pronounced.)

Qi Bo replied: This clearly reflects the characteristics of the Stomach pulse. The Stomach is the sea of the five zang organs and six fu organs. Its clear qi ascends and pours into the Lungs. The Lung qi travels along the Hand-Taiyin meridian. This travel occurs with the rhythm of respiration. Therefore, with each exhalation, the pulse moves twice; with each inhalation, the pulse also moves twice. Since respiration never ceases, the pulse beats without stopping. (To say "this clarifies the Stomach pulse" means that the pulsations of these three meridians are all due to Stomach Qi. As the sea of the five zang and six fu organs, where its abundant Qi reaches, the pulsation is uniquely strong. The reason the Hand-Taiyin meridian pulses is that after the Stomach receives food and drink, it sends clear Qi up to the Lungs. The Lung Qi then travels via the Hand-Taiyin meridian. Its movement follows the cycle of breath. Breath movement causes pulse movement. Thus, as long as breathing continues, the pulse at the Cun Kou site beats incessantly.)

Huang Di further asked: When the Qi passes through the Cun Kou, from where does the vigorous forward momentum corresponding to ten breaths originate? To where does the recessive backward retreat corresponding to eight breaths subside? Through what pathway does it return? I do not understand its ultimate limit. (Cun Kou refers to the pulse of the Hand-Taiyin Lung Meridian. Up and down refer to the advancing and retreating trends. Eighteen metaphorically represents the forms of prosperity and decline. Yan means "where" or "how". Xi refers to growth or advancement. "Shang shi yan xi" implies that when the pulse advances, its Qi is prosperous; where does this Qi come from to grow? "Xia ba yan fu" implies that when the pulse retreats, its Qi declines; where does it go to subside? The pathway of this going and returning seems indeed difficult to fathom completely.)

Qi Bo replied: When Qi leaves the Zang organs, it erupts suddenly like an arrow shot from a crossbow, or like water cascading down a cliff. As it rises to the Yu Ji area, it begins to weaken. The remaining weak Qi disperses and ascends retrogradely, so its movement becomes subtle. (When internal Qi originates from the Zang organs and extends externally to the meridians, its sudden eruption resembles an arrow shot from a bow or water falling from a height, describing an unstoppable, sharp, and vigorous force. However, the tip of a powerful arrow eventually loses strength, and the end of a rapid current slows down. Thus, as Qi moves from Cun Kou upward to Yu Ji, it transitions from prosperity to decline. The remaining Qi ascends retrogradely in a state of dispersion, making its movement appear slight. This explains why the prosperity and decline of Qi are unequal.)

Huang Di asked: Why does the Foot-Yangming Stomach Meridian also pulse? (This is the meridian of the Stomach.)

Qi Bo replied: Stomach Qi ascends to pour into the Lungs. Among this, the fierce and swift Wei Qi (Defensive Qi) rushes upward to the head. It follows the throat, ascends through the orifices, follows the optic system to enter and connect with the brain, emerges from the cheekbone area, descends to the Keyuzhuren point, follows the Yache point to merge with the Foot-Yangming primary meridian, and then descends together to the Renying point. This is how Stomach Qi branches off to travel via the Foot-Yangming meridian. (Stomach Qi ascends to the Lungs, while its fierce Qi rushes to the head, following the throat upwards, entering the brain via the optic system, emerging from [the cheekbone], descending to meet the Keyuzhuren point of the Foot-Shaoyang Gallbladder Meridian, and the Yache point, thereby merging with the primary Foot-Yangming Stomach Meridian and descending to the pulsating Renying point. This represents the internal activation of Stomach Qi manifesting externally as the pulsation of the Yangming meridian. Note: Yache is also known as Quya, likely referring to the Jiache point. The definition of a certain character as "yellowish face due to hunger" does not align with the canonical intent. Based on this chapter, such as the Miscellaneous Diseases section stating "[Pain at this location], puncture the pulsating artery at the foot-Yangming curve until bleeding appears, and it stops immediately," and the Manic Disorder section treating mania by selecting two [locations] on the head, these refer to locations on the head and face. This section describes emerging from the brain, descending past Keyuzhuren; thus, this location should be below the brain, before the temple, and above Keyuzhuren, specifically on the superior aspect of the temporal bone, between the two Taiyang points. This character is pronounced 'Kan' or 'Hai Gan'.) Therefore, the pulsations of Yin and Yang, upper and lower, are consistent. Consequently, if a Yang disease presents with a small Yang pulse, it is a contrary sign; if a Yin disease presents with a large Yin pulse, it is a contrary sign. If both Yin and Yang pulses are either both still or both agitated, appearing uniform like a taut rope, this indicates disease. (The term "Yin and Yang, upper and lower" collectively refers to the Hand-Taiyin mentioned above. Since Stomach Qi ascends to the Lungs, they share a common origin. Although the Stomach belongs to Yangming with its pulse emerging at Renying, and the Lung belongs to Taiyin with its pulse emerging at Cun Kou, their Qi is inherently connected, so their pulsations respond identically. However, Renying belongs to the Fu organ and is Yang; in Yang diseases, the Yang pulse should be large, so a small one is contrary. Cun Kou belongs to the Zang organ and is Yin; in Yin diseases, the Yin pulse should be fine, so a large one is contrary. Thus, the *Si Shi Qi* chapter states: "Qi Kou observes Yin, Renying observes Yang." Therefore, Yin and Yang have distinct pulse characteristics. If Yin and Yang are indistinguishable, being either both still or both agitated uniformly like a straightened rope, the Yin and Yang Qi must be biased toward one side, leading to pathology. Detailed meanings of Renying and Qi Kou regarding Yin and Yang can be found in the Zang Xiang Category, Part 11.)

Huang Di asked: Why does the Foot-Shaoyin Kidney Meridian also pulse? (This is the meridian of the Kidney.)

Qi Bo replied: The Chong Mai (Penetrating Vessel) is the sea of the twelve meridians. It originates from the lower part of the Kidney along with the large collateral of the Foot-Shaoyin meridian, emerges from the Qichong point, runs along the medial aspect of the thigh, obliquely enters the popliteal fossa, follows the medial aspect of the tibia, runs parallel to the Foot-Shaoyin meridian, descends behind the medial malleolus, and enters the sole of the foot; its branch obliquely enters the ankle, emerges on the dorsum of the foot, enters between the big toe, and pours into the various collaterals to warm the legs and calves. This is the normal pulsation of this vessel. (The Foot-Shaoyin meridian pulses because it runs parallel to the Chong Mai. The Chong Mai is also the sea of the twelve meridians, originating with the Foot-Shaoyin collateral from below the Kidney, emerging from the Qichong point of the Foot-Yangming Stomach Meridian, running through the thigh, popliteal fossa, and medial malleolus to enter the foot; its branch emerges on the dorsum of the foot, pouring into the collaterals to warm the calves. This is why the Taichong and other vessels pulse continuously. This section is largely identical to the *Ni Shun Fei Shou* chapter; see the Acupuncture Category, Part 20 for details.)

Huang Di asked: The circulation of Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) penetrates up and down, forming a circle without beginning or end. Now, if suddenly exposed to pathogenic factors or severe cold, causing the limbs to become flaccid and weak, the pathways of Yin and Yang in the pulse, and the intersections where Qi transfers, become disordered. How does the Qi return to its cycle? (The circulation of Ying and Wei Qi follows Yin-Yang rhythms. If pathogenic factors occupy these pathways, their operation will be disrupted, preventing continuous circulation. Hence, the cause is questioned.)

Qi Bo replied: The four extremities are the meeting places of Yin and Yang meridians; these are the major collaterals of Qi. The Si Jie (Four Streets/Airways) are the direct pathways of Qi. Therefore, when the major collaterals are blocked, the direct pathways remain open. When the extremities recover from stagnation, Qi recombines, transferring mutually like a circle.

Huang Di said: Excellent. This is what is meant by "like a circle without end, unknown in its chronology, ending and restarting again." This is precisely what is referred to. (The four extremities refer to the four limbs. All twelve meridians terminate and originate at the limbs, hence they are called the meeting of Yin and Yang and the major collaterals of Qi. However, although the major collaterals meet at the limbs, there are direct pathways for Qi circulation called the Four Streets, as mentioned in the previous chapter regarding Airway Qi. Pathogens usually attack the major collaterals first. Thus, when collaterals are blocked, the direct pathways remain patent. Once the pathogens dissipate and the extremities relax, blockage in one area leads to patency in another, allowing Qi to combine, return, and transfer without loss. This is why it is described as a circle without end, whose chronology cannot be grasped.)