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(Su Wen · Tiao Jing Lun)

The Yellow Emperor asked, saying: I have heard the acupuncture methods state: For excess, use draining; for deficiency, use tonifying. What is meant by excess? What is meant by deficiency? Qibo replied: There are five types of excess and five types of deficiency. Which aspect does Your Majesty wish to inquire about? The Yellow Emperor said: I wish to hear them all. Qibo said: There is Shen (Spirit/Mind) excess and Shen deficiency, Qi (Vital Energy) excess and Qi deficiency, Xue (Blood) excess and Xue deficiency, Xing (Form/Body) excess and Xing deficiency, Zhi (Will/Knowledge) excess and Zhi deficiency. These ten conditions all arise from an imbalance in the body's Qi. (Shen belongs to the Heart, Qi belongs to the Lungs, Xue belongs to the Liver, Xing belongs to the Spleen, and Zhi belongs to the Kidney. Each has its own deficiency and excess syndromes, hence their Qi states are unequal.) The Yellow Emperor said: Humans possess Jing (Essence), Qi, Jin (Fluids), and Ye (Thick Fluids); four limbs, nine orifices, five Zang organs, sixteen body parts, and three hundred and sixty-five acupoints. From these, a hundred diseases arise. The generation of all diseases involves both deficiency and excess. Now you say there are five types of excess and five types of deficiency. How do they arise? (The meanings of "Jing Qi" and "Jing Ye" are detailed in Chapter 25 of the Zang Xiang category. The four limbs refer to hands and feet; combined with the nine orifices and five Zang organs, they form sixteen body parts. The three hundred and sixty-five joints refer to the convergence points of meridians and collaterals. As stated in the Jiu Zhen Shi Er Yuan chapter: "At the intersections of joints, there are three hundred and sixty-five meetings." The so-called "joints" are places where Shen Qi travels and enters/exits, not merely skin, flesh, sinews, and bones. All these parts are bases for the generation of various diseases.) Qibo said: All these diseases originate from the five Zang organs. (Whether Yin, Yang, interior, or exterior, nothing is not governed by the five Zang organs.) The Heart stores Shen, the Lungs store Qi, the Liver stores Xue, the Spleen governs muscles/flesh, and the Kidneys store Zhi, thereby forming the physical body. (This precisely illustrates that form manifests externally while Shen resides internally; only these five aspects are involved.) Yi (Intent) communicates, connecting internally with Marrow, thereby forming the body shape and five Zang organs. (Yi refers generally to the Five Shen within the human body. Marrow represents the profound transformation of life. The Five Shen reside in the five Zang organs, with the Heart as the master. Thus, when Yi is harmonious and connects internally with Marrow to form the body and Zang organs, they function mutually.) The pathways of the five Zang organs all emerge from the Jing Sui (Meridian Tunnels) to circulate Xue and Qi. If Xue and Qi are disordered, a hundred diseases change and arise; therefore, one must guard the Jing Sui. (Sui means hidden paths. Meridians run deep within and are invisible, hence called Jing Sui. The five Zang organs are internal, while Jing Sui are external; the pulse channels connect to circulate Xue and Qi. If Xue and Qi are disordered, a hundred diseases arise. Thus, by guarding the Jing Sui, one can treat diseases of the five Zang organs.)

The Yellow Emperor asked: What about Shen excess and deficiency? Qibo said: Shen excess leads to incessant laughter; Shen deficiency leads to sorrow. (The Heart stores Shen, which is the essence of Fire. When Yang is victorious, Shen Qi is vigorous, leading to joy and laughter. When Yang declines, Yin attacks, leading to worry and sorrow. The Ben Shen chapter states: The Heart stores Pulse, and Pulse houses Shen. Heart Qi deficiency leads to sorrow, while excess leads to incessant laughter. The Xing Zhen chapter states: Those with much Yang tend to be joyful; those with much Yin tend to be angry. These are all consistent with this principle.) If Xue and Qi have not yet gathered unevenly, and the five Zang organs are stable, but pathogenic factors lodge in the form (body surface), causing chills and goosebumps without entering the meridians, this is called the slight disease of Shen. (This is an external pathogen invading the Heart meridian. Bing means gathering unevenly. When pathogens invade and linger, they may gather with Qi or Xue, worsening the condition. Here, since Xue and Qi have not gathered unevenly and the pathogen is not deep, the five Zang organs remain stable. Only chills and goosebumps appear, not reaching the meridians. This is a superficial slight pathogen on the surface of the pulses, constituting a slight disease of Shen, hence called Shen Wei.) The Yellow Emperor asked: How should tonification and drainage be performed? Qibo said: For Shen excess, drain the blood from the Xiao Luo (Small Collaterals). Do not puncture too deeply, and avoid injuring the Da Jing (Major Meridians), so that Shen Qi becomes balanced. (Xiao Luo refers to Sun Luo (Sun Collaterals). Chi means to discard. The Heart governs Xue vessels and stores Shen. Since Shen is originally formless, for Shen excess, one only needs to drain the blood from the Xiao Luo. Avoid deep bleeding or injuring the major meridians, and Shen will naturally balance.) For Shen deficiency, observe the Xu Luo (Deficient Collaterals), press to guide Qi, needle to facilitate flow, do not cause bleeding, and do not leak Qi. By unblocking the meridians, Shen Qi becomes balanced. (Pressing to guide Qi means directing Qi to the area. Needling to facilitate flow means tonifying deficiency to remove stagnation. Since the disease lies in Shen deficiency, bleeding and leaking Qi are inappropriate; the goal is merely to unblock the meridians.) The Yellow Emperor asked: How to needle slight pathogens? Qibo said: Massage without releasing, apply needles without pushing hard, transfer Qi to the deficient area, and Shen Qi will recover. (This treats external pathogens lodging in the Heart meridian, i.e., the aforementioned Shen Wei. Slight pathogens are on the surface of the Heart meridian, so massage should continue to dissipate external pathogens; applying needles without pushing hard avoids damaging the interior. This allows transferring Qi to the deficient area, expelling pathogens and restoring Shen.)

The Yellow Emperor said: Excellent. What about Qi excess and deficiency? Qibo said: Qi excess leads to panting, coughing, and rebellious Qi; Qi deficiency leads to clear breathing but shortness of breath. (This reflects the deficiency and excess of the Lung organ. The Ben Shen chapter states: Lung Qi deficiency causes nasal congestion, difficulty breathing, and shortness of breath; Lung Qi excess causes wheezing, chest fullness, and仰息 (breathing with raised chest). They are largely similar.) If Xue and Qi have not yet gathered unevenly, and the five Zang organs are stable, but the skin shows slight pathology, it is called Bai Qi Wei Xie (White Qi Slight Leakage). (This is a superficial pathogen of the Lung meridian. The meaning of Xue and Qi not gathering unevenly is as before. The Lungs govern the skin and belong to Metal. A slight pathogen invades, hence called White Qi Slight Leakage.) The Yellow Emperor asked: How should tonification and drainage be performed? Qibo said: For Qi excess, drain the Jing Sui, but do not injure the meridians, do not bleed, and do not leak Qi. For Qi deficiency, tonify the Jing Sui, and do not leak Qi. (The meaning of Jing Sui is as above. Draining the Jing Sui means observing the pulse of excess and draining the pathogenic Qi. Do not injure the major meridians, bleed, or leak healthy Qi; this is the method for needling Qi. If this applies to excess, how much more so for deficiency.) The Yellow Emperor asked: How to needle slight pathogens? Qibo said: Massage without releasing, withdraw the needle and look at the patient, saying: "I will insert it deeply." Upon encountering the person, there must be a change (fear/response); Jing Qi naturally submerges, pathogens scatter, having no place to rest, Qi leaks through the Cou Li (pores/skin texture), and True Qi achieves harmony. (This treats slight pathogens of the Lung meridian. Shi means arrival. Ge means change. First, perform massage to promote the flow of Qi in the skin. Then withdraw the needle, look at the patient, and say: "I will insert it deeply," intending to induce fear so that Spirit remains inward. "Shi ren bi ge" means that when the needle reaches the person, there must be a transformation of the previous statement, actually inserting shallowly. In this way, Jing Qi subsides internally, pathogens scatter and leak externally, allowing True Qi to find its proper place.)

The Yellow Emperor said: Excellent. What about Xue excess and deficiency? Qibo said: Xue excess leads to anger; Xue deficiency leads to fear. (This reflects the deficiency and excess of the Liver organ. The Ben Shen chapter states: The Liver stores Xue. Liver Qi deficiency leads to fear; Liver Qi excess leads to anger.) If Xue and Qi have not yet gathered unevenly, and the five Zang organs are stable, but the Sun Luo overflow externally, then there will be stagnant blood in the Major Meridians. (This is a superficial pathogen of the Liver meridian. The pathogen is not in the Zang but in the Meridians. Observe if the Sun Luo pulses overflow externally; if so, know that there is stagnant blood inside the Major Meridians.) The Yellow Emperor asked: How should tonification and drainage be performed? Qibo said: For Xue excess, drain the Sheng Jing (Full Meridians) and release blood. For Xue deficiency, observe the Xu Jing (Deficient Meridians), insert the needle into the pulse, retain it for a long time while observing. When the pulse becomes large, quickly withdraw the needle, ensuring no blood is lost. (For Xue excess, the Sheng Jing is full and overflowing, so drain and release blood. For Xue deficiency, observe the deficient meridians and insert the needle to tonify. However, the method for tonifying deficiency requires retaining the needle to await Qi, described as "waiting for the honored guest, unaware of the passing day." After retaining the needle for a long time, if the pulse becomes large, indicating Qi has arrived, quickly withdraw the needle. Losing blood would worsen deficiency, so ensure no blood is lost.) The Yellow Emperor asked: How to needle stagnant blood? Qibo said: Observe the Xue Luo (Blood Collaterals), prick to release blood, preventing evil blood from entering the meridians and causing disease. (This treats superficial pathogens of the Liver meridian. Evil blood is in the collaterals; removing it quickly prevents it from entering the meridians.)

The Yellow Emperor said: Excellent. What about Xing excess and deficiency? Qibo said: Xing excess leads to abdominal distension and difficult urination/defecation; Xing deficiency leads to paralysis of the four limbs. (This reflects the deficiency and excess of the Spleen organ. Jing refers to a water name; Sou refers to urination. Spleen dampness victory causes Qi stagnation, leading to abdominal distension and difficult urination/defecation. The Spleen governs the four limbs, so deficiency leads to limb paralysis. This aligns with the Ben Shen chapter. Jing sounds like Jing; Sou sounds like Sou.) If Xue and Qi have not yet gathered unevenly, and the five Zang organs are stable, but muscles twitch, it is called Wei Feng (Slight Wind). (This is a superficial pathogen of the Spleen meridian. The Spleen governs muscles. For slight pathogens not yet deep, there is only muscle twitching, like insects moving slightly. Spleen Earth fears Liver Wood/Wind; Wind moves, hence called Slight Wind. Ru sounds like Ruan, also pronounced Ru Yun.) The Yellow Emperor asked: How should tonification and drainage be performed? Qibo said: For Xing excess, drain the Yang Jing (Yang Meridians); for Xing deficiency, tonify the Yang Luo (Yang Collaterals). (The Jing points and Luo points taken are all from the Foot Yangming Stomach Meridian, because the Stomach is the Yang of the Spleen. Thus, excess is drained, draining Spleen Yang pathogens; deficiency is tonified, tonifying Spleen Yang Qi.) The Yellow Emperor asked: How to needle slight pathogens? Qibo said: Select the space between muscles (Fen Rou), do not injure the meridians, do not damage the collaterals. When Wei Qi recovers, pathogens dissipate. (This treats slight pathogens of the Spleen meridian. Pathogens are in the muscles, so one should only needle the Fen Rou space, allowing Wei Qi to recover, thus pathogens naturally dissipate. Suo means scatter.)

The Yellow Emperor said: Excellent. What about Zhi excess and deficiency? Qibo said: Zhi excess leads to abdominal distension and undigested stool diarrhea; Zhi deficiency leads to Jue (Cold extremities/reversal). (This reflects the deficiency and excess of the Kidney organ. The Kidneys store Zhi, which is the essence of Water. Water transforms into Cold. Thus, Kidney pathogen excess leads to Cold Qi in the abdomen, causing abdominal distension and undigested stool diarrhea. Kidney Qi deficiency leads to Yin deficiency and Yang hyperactivity, causing Jue reversal upward. The Ben Shen chapter states: The Kidneys store Jing, and Jing houses Zhi. Kidney Qi deficiency leads to Jue; Kidney Qi excess leads to distension. The Jie Jing Wei Lun chapter states: In Jue, Yang Qi gathers above, and Yin Qi gathers below. Yang gathering above means Fire shines alone; Yin gathering below means cold feet, and cold feet lead to distension.) If Xue and Qi have not yet gathered unevenly, and the five Zang organs are stable, but bone joints show movement. (This is a slight pathogen of the Kidney meridian. The Kidneys govern bones. When pathogens have not entered the Zang but press against the bones, there is a pulsating sensation in the bone joints.) The Yellow Emperor asked: How should tonification and drainage be performed? Qibo said: For Zhi excess, drain the blood of Ran Gu (Ranjin); for Zhi deficiency, tonify Fu Liu. (Ranjin should be Ran Gu, the Ying-Spring point of the Foot Shaoyin Kidney Meridian. Releasing its blood drains Kidney excess. Fu Liu is the Jing-River point of the Foot Shaoyin Kidney Meridian. Guiding Qi there tonifies Kidney deficiency.) The Yellow Emperor asked: How to needle when Xue and Qi have not yet gathered unevenly? Qibo said: Take points immediately at the location of the pathogen, do not injure the meridians. At the site of the pathogen, emptiness is achieved instantly. (This treats pathogens in the bone joints of the Kidney meridian. Ji qu zhi means taking points exactly where the pathogen resides. Thus, by not injuring the Jing points, pathogens naturally leave and instant emptiness is achieved.)