Library

The location of the disease is not fixed; it may be on the left or on the right. Since it cannot be named as a single syndrome, treatment naturally cannot adhere to a fixed method. By overlooking the form of the disease and directly probing its root, pointing east while striking west—this is the unconventional tactic in warfare, which refers to Miao Ci (Mysterious Puncture).

The Yellow Emperor asked: I have heard of Miao Ci but do not yet understand its meaning. What is Miao Ci? Qi Bo replied: When pathogenic factors invade the body, they first lodge in the skin and hair. If they remain and do not depart, they enter the Sun vessels (fine collateral branches); if they remain and do not depart, they enter the Luo vessels (collaterals); if they remain and do not depart, they enter the Jing vessels (main meridians), internally connecting to the Five Zang organs and spreading to the stomach and intestines. When both Yin and Yang are affected, the Five Zang organs are injured. This is the sequence by which pathogens enter from the skin and reach the extreme of the Five Zang organs. In such cases, one should treat the Jing vessels. Now, if pathogens lodge in the skin and enter the Sun collaterals, remaining and not departing, causing blockage and obstruction so that they cannot enter the Jing vessels, they overflow into the Da Luo vessels (large collaterals) and produce strange diseases. (Disease in the blood collaterals is called Qi Xie [Strange Pathogen]. Note: The New Correction states: "Quan Qiyuan said: 'Da Luo refers to the fifteen collaterals.'") When pathogens lodge in the Da Luo vessels, they flow from left to right and from right to left, interacting with the meridians above and below, left and right, and distributing to the four extremities. Their qi has no fixed location and does not enter the acupoints of the meridians; this is called Miao Ci. (Four extremities refer to the four limbs.) The Emperor said: I wish to hear about Miao Ci. Why take the left to treat the right, and the right to treat the left? How is it done? How does it differ from Ju Ci (Giant Puncture)? Qi Bo said: When pathogens lodge in the Jing vessels, excess on the left causes disease on the right, and excess on the right causes disease on the left. There are also cases of shifting; if pain on the left persists while the pulse on the right becomes diseased first, in such cases, one must use Ju Ci, ensuring to penetrate the Jing vessel, not the Luo vessel. (The "first diseased" refers to the condition where the disease on one side has not ceased, while the other side begins to show signs of disease in succession. Note: "Must penetrate the Jing vessel" means must hit the site of the pathology.) Therefore, for Luo vessel diseases, the pain is distributed contrary to the Jing vessels, hence it is called Miao Ci. (Luo vessels refer to the branch collateral of the regular meridians, not the Zheng Bie [regular divergent collaterals], but also include the divergent collaterals such as Gongsun and Feiyang. Note: The New Correction states: "Wang Shuhe said it is not the Zheng Bie. In this chapter, when pathogens lodge in the Foot Taiyin Luo causing lower back pain, the commentary cites 'from the thigh merging with Yangming, ascending through the diaphragm, connecting to the throat, and piercing the tongue,' which is the regular meridian of Taiyin, also a combined regular vessel. How can it be called non-regular?" ) The Emperor said: I wish to know how to perform Miao Ci? How are points selected? Qi Bo said: When pathogens lodge in the Foot Shaoyin Luo, it causes sudden heart pain, acute distension, and fullness/supporting sensation in the chest and hypochondrium. (Because its Luo branch merges with the regular meridian, originating from the Kidney, ascending through the Liver and Diaphragm, and traveling to the Pericardium, thus when pathogens lodge there, these symptoms occur.) For those without accumulation, bleed at Ran Gu Qian (Anterior to Ran Gu), which is the Ran Gu point. It is located anterior to the medial malleolus, under the prominent bone, in the depression. It is the Ying-Spring point of the Foot Shaoyin. Insert three fen, retain the needle for three breaths, moxa three Zhu. Needling this point often produces bleeding, making the patient feel hungry and desire food immediately. If not cured, take the left to treat the right, and the right to treat the left. (Meaning: if pain is on the left, treat the right; if on the right, treat the left. Other cases follow this pattern. Note: The character "pain" in the commentary is less comprehensive than "disease".) For newly onset diseases, five days of treatment will suffice. (For chronic conditions with new exacerbations, treat for five days until resolved.) When pathogens lodge in the Hand Shaoyang Luo, it causes Bi syndrome of the throat, curled tongue, dry mouth, vexation, pain along the lateral aspect of the arm, and inability to raise the hand to the head. (Because its meridian circulates around the wrist, emerges on the lateral arm, ascends to the shoulder, enters the Clavicular fossa, distributes in the Chest center, and scatters to connect with the Pericardium. Its branch ascends from the Chest center out of the Clavicular fossa to the neck. Also, the Heart Master governs the tongue. Hence these symptoms.) Prick the nail corner of the ring finger (fourth finger) of the hand, distance from the tip like the width of a leek leaf, one prick on each side. (This refers to the Guan Chong point, the Jing-Well point of Shaoyang. Insert one fen, retain for three breaths, moxa three Zhu. Both sides are needled, hence "one each." Wei [wei] means sore/ulcer. Note: The New Correction states: "'Jia Yi Jing' says Guan Chong is at the end of the little finger's fourth finger; saying middle finger here is an error." Wei sounds like 'wei', meaning sore, referring to the sore formed by moxibustion or needling.) In robust individuals, relief is immediate; in the elderly, relief comes after a short while. Take left to treat right, right to treat left. Newly onset diseases resolve in a few days. When pathogens lodge in the Foot Jueyin Luo, it causes sudden Hernia and acute pain. (Because its Luo vessel leaves five cun above the medial malleolus and connects to Shaoyang. Its branch ascends along the shin to the testis and knots at the penis. Hence sudden Hernia and acute pain. Testis refers to the scrotal sac. Note: Testis sounds like 'gao'.) Prick the junction of the nail and flesh at the big toe of the foot, one prick on each side. (This refers to the Da Dun point, at the tip of the big toe, distance from the nail corner like the width of a leek leaf. It is the Jing-Well point of Jueyin. Insert three fen, retain for ten breaths, moxa three Zhu.) In men, relief is immediate; in women, after a short while. Take left to treat right, right to treat left. When pathogens lodge in the Foot Taiyang Luo, it causes pain in the head, neck, and shoulder. (Because its regular meridian originates from the brain, descends separately behind the neck. Its branch descends separately from the inner aspect. Also, its Luo vessel ascends from the foot, follows the back to the head. Hence head, neck, and shoulder pain. Note: The New Correction states: "'Jia Yi Jing' says: 'Its branch enters the brain from the vertex, returns and descends separately behind the neck.' Wang Shuhe said 'regular meridian' should read 'branch'.") Prick the junction of the nail and flesh at the little toe of the foot, one prick on each side, relief is immediate. (This refers to the Zhi Yin point, the Jing-Well point of Taiyang. Insert one fen, retain for five breaths, moxa three Zhu. Note: 'Jia Yi Jing' says: 'On the lateral side of the little toe, distance from the nail corner like the width of a leek leaf.') If not cured, prick three cun below the lateral malleolus, take left to treat right, right to treat left, relief after a meal time. (This refers to the Jin Men point, Foot Taiyang Xi-Cleft point. Below the lateral malleolus, insert three fen, moxa three Zhu.) When pathogens lodge in the Hand Yangming Luo, it causes fullness of Qi in the chest, panting, supporting sensation, and heat in the chest. (Because its meridian starts at the shoulder end, enters the Clavicular fossa, and connects to the Lung. Its branch ascends from the Clavicular fossa to the neck. Hence these symptoms.) Prick the nail corner of the index finger of the hand, distance from the tip like the width of a leek leaf, one prick on each side, take left to treat right, right to treat left, relief after a meal time. (This refers to the Shang Yang point, the Jing-Well point of Hand Yangming. Insert one fen, retain for one breath, moxa one Zhu. Note: 'Jia Yi Jing' says: 'Shang Yang is on the medial side of the index finger, distance from the nail corner like the width of a leek leaf.') When pathogens lodge between the arm and palm, flexion is impossible. Prick behind the ankle. (Note: The New Correction states: "Quan Qiyuan said: 'This is the ankle joint of the human hand.'") First press with the finger; when painful, then prick. Use the waxing and waning of the moon to determine the number of pricks: on the first day of the waxing moon, one prick; second day, two pricks; fifteenth day, fifteen pricks; sixteenth day, fourteen pricks. (Following the number of days. Before the half-moon is called waxing; after the half-moon is called waning, varying with fullness and emptiness.) When pathogens lodge in the Foot Yangqiao vessel, it causes eye pain starting from the inner canthus. (Because its vessel originates from the foot, ascends to the head, and belongs to the inner canthus, hence eye pain starts from the inner canthus. How to verify? The Eighty-One Difficulties states: "The Yangqiao vessel originates in the heel, follows the lateral malleolus, and ascends to Feng Chi." The Needle Classic states: "Yinqiao enters the nasal cavity, belongs to the inner canthus, and merges with Taiyang Yangqiao to ascend." Tracing this leads to the inner canthus.) Prick half a cun below the lateral malleolus, two pricks on each side. (This refers to the Shen Mai point, the origin of Yangqiao. Below the lateral malleolus, in the depression fitting the nail. Insert three fen, retain for six breaths, moxa three Zhu.) Prick left to treat right, right to treat left, relief after walking the distance of ten li. When a person suffers a fall, evil blood remains inside, causing abdominal fullness and distension, and inability to pass stool or urine. First drink purgative medicine. This injures the upper Jueyin vessel and the lower Shaoyin Luo. Prick below the medial malleolus, anterior to Ran Gu, bleed the blood vessels. (This is the Shaoyin Luo. Note: The New Correction states: "Checking 'bleed blood vessels,' the character 'vessel' is suspected to be 'Luo'.") Prick the arterial pulse on the dorsum of the foot. (This refers to the Chong Yang point, the Yuan-Source point of the Stomach. Insert three fen, retain for ten breaths, moxa three Zhu. Mainly treats abdominal enlargement and loss of appetite; taken here due to abdominal fullness.) If not cured, prick one on each side of the hair tuft (nail bed area), bleed to see blood, relief is immediate. Take left to treat right, right to treat left. (This refers to the Da Dun point, the Jing-Well point of Jueyin.) For those prone to sadness, fright, and unhappiness, prick according to the method above. (Also prick as described above.) When pathogens lodge in the Hand Yangming Luo, it causes deafness and intermittent inability to hear sounds. (Because its branch goes from the Clavicular fossa, up the neck, through the cheek. Another branch enters the ear and meets at the Zong vessels. Hence these symptoms.) Prick the nail corner of the index finger of the hand, distance from the tip like the width of a leek leaf, one prick on each side, hearing is restored immediately. (Same as the previous Shang Yang point.) If not cured, prick the junction of the nail and flesh at the middle finger, hearing is restored immediately. (This refers to the Zhong Chong point, the Jing-Well point of the Hand Jueyin. At the tip of the middle finger, distance from the nail like a leek leaf, in the depression. Insert one fen, retain for three breaths, moxa three Zhu. Ancient texts have missing bamboo slips, no Luo vessel can be found; perhaps it is pricking the junction of the nail and flesh at the little finger. Why say this? The following text says the Hand Shaoyin Luo meets in the ear. If it is the tip of the little finger, it is called Shao Chong, the Jing-Well point of Hand Shaoyin. Insert one fen, retain for one breath, moxa one Zhu. Note: The New Correction states: "Wang Shuhe said perhaps it is the Shao Chong point at the little finger's nail junction. According to 'Jia Yi Jing', the regular Hand Jueyin ascends along the throat, exits behind the ear, and meets Shaoyang below Wan Gu. In that case, why doubt Shao Chong instead of Zhong Chong?") For those who do not hear intermittently, do not prick. (Intermittent hearing loss indicates Luo Qi exhaustion, so do not prick.) For wind generation in the ear (tinnitus), prick in the same manner, left to treat right, right to treat left. (Note: Wind generation refers to self-sounding in the ear, like hearing wind. The needling method is the same as above.) For all Bi syndromes moving back and forth with no fixed location, located between the muscle intervals, prick when painful. Use the waxing and waning of the moon to determine the number of pricks. The practitioner should adjust the number of pricks according to the flourishing and declining state of Qi. Pricking beyond the daily number depletes Qi; pricking fewer than the daily number fails to drain Qi. Prick left to treat right, right to treat left. Stop when the disease is cured. If not cured, repeat the needling as prescribed. (The reason for using the moon's phases as the number is to follow the fluctuation of Qi. On the first day of the waxing moon, one prick; second day, two pricks, gradually increasing; fifteenth day, fifteen pricks; sixteenth day, fourteen pricks, gradually decreasing. Pricking in this way ensures neither excess nor deficiency.) When pathogens lodge in the Foot Yangming Meridian, it causes rhinitis, epistaxis, and coldness in the upper teeth. (Because its vessel originates at the nose, crosses the forehead, descends along the lateral nose, enters the upper teeth, emerges beside the mouth encircling the lips, crosses Chengjiang below, follows the jawline posteriorly descending to the lower border, emerges at Da Ying, follows Jiache, ascends anterior to the ear. Hence rhinitis, epistaxis, and coldness in the upper teeth. Furthermore, since its vessel crosses on the face, listing meridian diseases illustrates the category of Miao Chu. Hence the following text. Note: The New Correction states: "Quan Qiyuan's edition and 'Jia Yi Jing' read 'Yangming Luo' instead of 'Yangming Meridian'.") Prick the junction of the nail and flesh at the second toe (middle toe) of the foot, one prick on each side, take left to treat right, right to treat left. ('Middle' should be 'Big'; a transcription error. According to 'Ling Shu' and 'Kong Xue Tu Jing', there is no acupoint at the junction of the nail and flesh of the middle and second toes; it should be the big and second toes, which is Li Dui, the Jing-Well point of Yangming. Insert one fen, retain for one breath, moxa one Zhu.) When pathogens lodge in the Foot Shaoyang Luo, it causes hypochondriac pain with difficulty breathing, coughing, and sweating. (Because its branch originates from the outer canthus, descends to Da Ying, meets Hand Shaoyang at..., adds to Jiache, descends the neck, merges at the Clavicular fossa, enters the chest below, pierces the Diaphragm, and connects to the Liver and Gallbladder. Hence hypochondriac pain, coughing, and sweating.) Prick the junction of the nail and flesh at the second toe of the foot, one prick on each side. (This refers to the Xiao Yin point, the Jing-Well point of Shaoyang. Insert one fen, retain for one breath, moxa three Zhu. Note: Xiao Yin is at the tip of the second toe of the foot, distance from the nail corner like the width of a leek leaf.) Difficulty breathing resolves immediately; sweating stops immediately. For coughing, wear warm clothes and eat warm food; resolves in one day. Take left to treat right, right to treat left; disease resolves immediately. If not cured, repeat needling as prescribed. When pathogens lodge in the Foot Shaoyin Luo, it causes sore throat with inability to swallow food, spontaneous anger, and Qi rushing upward to Ben Shang. (Because its branch originates from the Lung, connects to the Heart, and pours into the chest. Also, its regular meridian originates from the Kidney, ascends through the Liver and Diaphragm, enters the Lung, follows the throat, and clamps the base of the tongue. Hence dry throat, pain preventing swallowing, spontaneous anger, and Qi rushing upward to Ben Shang. Ben refers to Qi rushing. Note: The New Correction states: "Wang Shuhe's interpretation of Ben Shang as Qi rushing is incorrect. Yang Xuancao said: 'Ben is the Diaphragm.' Thus Qi rushes to the Diaphragm. Since the text says Qi rushes, how can Ben mean Qi rushing?") Prick the central vessels of the sole of the foot, three pricks each, totaling six pricks, relief is immediate. Take left to treat right, right to treat left. (This refers to the Yong Quan point, the Jing-Well point of Shaoyin. In the depression of the sole of the foot. Insert three fen, retain for three breaths, moxa three Zhu.) For swelling in the throat, inability to swallow saliva, or inability to spit out saliva at times, bleed at Ran Gu Qian, relief is immediate. Take left to treat right, right to treat left. (This is also the Foot Shaoyin Luo. Because its Luo vessel runs alongside the large meridian following the throat, hence this needling. These twenty-nine characters were originally misplaced before the section on pathogens lodging in the Hand/Foot Shaoyin/Taiyin/Yangming Lues, now moved here. Note: The New Correction states: "Wang's commentary regarding the Luo vessel running with the large meridian along the throat is confused. 'Jia Yi Jing' says the Foot Shaoyin Luo ascends to the Pericardium. The Shaoyin Meridian follows the throat. Wang's commentary mixes Meridian and Luo; 'Jia Yi Jing' should be correct.") When pathogens lodge in the Foot Taiyin Luo, it causes lower back pain radiating to the lower abdomen, pulling towards the... , and inability to breathe while extending backwards. (The Foot Taiyin Luo merges with Yangming at the thigh, ascends through the sacrum, connects with Jueyin and Shaoyang below..., and follows the sacrum internally into the abdomen, connects to the throat, and pierces the tongue. Hence lower back pain radiates to the lower abdomen, pulling to the... . ... refers to the soft empty area of the costal margin. Receiving pathogenic factors causes Luo contraction and urgency, hence inability to extend backward and breathe. The 'Breathing' character is absent in the 'Lower Back Pain' chapter. Note: The New Correction states: "Wang's commentary says Foot Taiyin Luo; 'Jia Yi Jing' says Taiyin Regular Meridian, not Luo. Wang calling it Luo is unclear.") Prick the gap between the waist and sacrum, above the two gluteal muscles; this is Yao Shu. Use the waxing and waning of the moon to determine the number of pricks. Release the needle for immediate relief. Take left to treat right, right to treat left. (The gap between the waist and sacrum bones is called Jie. In the middle is Yao Shu. Insert two cun, retain for seven breaths. 'Zhong Gao Kong Xue Tu Jing' says: "Take left to treat right, right to treat left." The point is in the midline, so this is incorrect. Next, below the waist, flanking the sacrum, there are four bony voids on each side, all treating lower back pain. The lower... matches the meridian; these are where Foot Taiyin, Jueyin, and Shaoyang knot. Insert two cun, retain for ten breaths, moxa three Zhu. HT refers to the two ankle gluteal muscles. Yao Shu, Kun, and Shen should all be taken. Note: The New Correction states: "This item on pathogens lodging in Foot Taiyin Luo and its needling method appears in the 'Lower Back Pain' chapter, where the commentary is very detailed. Here, only the three characters 'Yao Shu' are added. Additionally, Quan Qiyuan's edition originally lacked these three characters. Wang Shuhe knew well that Yao Shu cannot be treated by taking left/right, so he commented, but did not know Quan Qiyuan's edition originally lacked them.") When pathogens lodge in the Foot Taiyang Luo, it causes spasms, stiffness of the back, and pain radiating to the hypochondrium. (Because its meridian descends separately from the medial malleolus, penetrates the gluteal muscles, and meets in the... Hence spasms, back stiffness, and pain radiating to the hypochondrium. Note: The New Correction states: "Quan Qiyuan's edition and 'Jia Yi Jing', after 'pain radiating to the hypochondrium', add 'internally radiating to the heart causing pain'.") Start needling from the nape, count the vertebrae flanking the spine, press firmly. Where pressing elicits pain upon touch, prick three locations beside it, relief is immediate. (Counting vertebrae from the nape means counting from Da Zhui to the second vertebra, one cun five fen on either side, following the spine laterally. Pressing reveals pain, indicating the site of pathogen lodging. Prick according to the depth of the tender spot. Since pathogens lodge beside the spinal bones, it says "prick beside it".) When pathogens lodge in the Foot Shaoyang Luo, it causes pain lingering in the pivot (Hua Tuo's term for hip joint), and inability to lift the thigh. (Because its meridian emerges from the Groin, circles the pubic region, and enters horizontally into the Hip Aperture. Hence pain lingers in the Hip Pivot, followed by resolution of pain but inability to lift the leg. Pivot refers to the Hip Pivot.) Prick the Pivot with a fine needle. If cold, retain the needle for a long time. Use the waxing and waning of the moon to determine the number of pricks. Relief is immediate. (...Posterior to the Hip Pivot is the Huan Tiao point. Because it is posterior to the Hip Pivot, it says "prick posterior to the Hip Pivot". Huan Tiao is where the Qi of the Foot Shaoyang meridian issues. Insert one cun, retain for twenty breaths, moxa three Zhu. The fine needle is the seventh needle. Note: The New Correction states: "'Jia Yi Jing' says Huan Tiao is in the Hip Pivot. 'Qi Xue Lun' says it is in the division of the two Hip Apertures. This text says 'prick the Pivot', and Wang Shuhe interprets it as posterior to the Hip Pivot, which is an error.") For deafness, prick Hand Yangming. If not cured, prick the communicating vessel emerging anterior to the ear. (The "anterior" Hand Yangming refers to the point at the index finger's nail corner, distance from the tip like a leek leaf, which is Shang Yang. According to 'Zhong Gao Kong Xue Tu Jing', in the Hand Yangming meridian, Shang Yang, He Gu, Yang Xi, and Pian Li all treat deafness. However, the text refers to the anterior Shang Yang, not He Gu etc. The communicating vessel anterior to the ear corresponds to the Ting Hui area of the Hand Yangming meridian. Insert four fen, moxa three Zhu.) For dental caries, prick Hand Yangming. If not cured, prick the vessel entering the teeth, relief is immediate. (According to 'Jia Yi' and 'Liu Zhu Tu Jing', in the Hand Yangming meridian, Shang Yang, Er Jian, San Jian, He Gu, Yang Xi, Pian Li, and Wen Liu all treat toothache. Hand Yangming passes through the cheek and enters the lower teeth; Foot Yangming follows the lateral nose and enters the upper teeth. Note: Qu sounds like 'qu', meaning decayed teeth.) When pathogens lodge between the Five Zang organs, the disease involves pain radiating along the vessels, coming and going intermittently. Observe the disease and apply Miao Ci to the nail corners of the hands and feet. (Prick their Jing-Well points on each side, take left to treat right, right to treat left.) Observe the vessels, bleed them. Prick every other day. If one prick does not cure, five pricks will cure. (If there are visible blood vessels, prick as described.) For Mu Chuan radiating to the upper teeth, with cold pain in the teeth and lips, observe the blood vessels on the dorsum of the hand and remove the blood. (If the disease transmits abnormally and radiates to the upper teeth with cold pain in teeth and lips, prick the Hand Back Yangming Luo.) One prick at the nail corner of the second toe of Foot Yangming, one prick each at the nail corner of the index finger of Hand Yangming, relief is immediate. Take left to treat right, right to treat left. (Refers to the second toe Li Dui point. For the index finger, it refers to Shang Yang, the Jing-Well point of Hand Yangming. The Needle Classic states: "For toothache not fearing cold drinks, take Foot Yangming; for toothache fearing cold drinks, take Hand Yangming." Note: The New Correction states: "Checking the earlier text 'pathogens lodge in Foot Yangming, prick the junction of the nail and flesh of the middle and second toes', the character 'second' is erroneously added. It should only say 'middle toe nail junction', which is correct.") When pathogens lodge in the Hand/Foot Shaoyin, Taiyin, and Foot Yangming Lues, these five Lues all meet in the ear and connect superiorly to the left corner of the head. (Hand Shaoyin True Heart vessel, Foot Shaoyin Kidney vessel, Hand Taiyin Lung vessel, Foot Taiyin Spleen vessel, Foot Yangming Stomach vessel. These five Lues meet in the ear and emerge to connect to the left frontal angle.) When all five Lues are exhausted, it causes movement of all body vessels while the form remains unconscious. The appearance resembles a corpse, or it is called Shi Jue (Corpse Fainting). (Describing sudden fainting resembling death, with body vessels still pulsating like normal people. However, when Yin Qi is excessive above, Lower Qi steams upward and Pathogenic Qi reverses. Reversed Pathogenic Qi causes Yang Qi to become chaotic. Chaotic Yang Qi causes the five Lues...)