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Huangdi asked: Food and drink enter the mouth, are transported to the stomach and intestines, and their fluids are differentiated into five types. When it is cold and clothing is thin, they become urine and qi; when it is hot and clothing is thick, they become sweat; when grieving, qi merges, and they become tears; when there is internal heat and the stomach is relaxed, they become saliva; when pathogenic factors reverse internally, qi becomes blocked and fails to circulate, leading to water distension. I do not know how this arises?

Qibo replied: Food and drink all enter through the mouth, their flavors divide into five categories, and are distributed to the respective seas of the zang-fu organs. The jinye (body fluids) each travel along their own pathways. Therefore, the qi emitted by the Shangjiao (Upper Jiao) that warms the muscles and fills the skin is called Jin (thin fluid); that which remains and does not circulate is called Ye (thick fluid). When it is hot and clothing is thick, the couli (pores and interstices) open, so sweat is produced. When cold lingers between the fenrou (muscle intervals), condensed foam causes pain. When it is cold, the couli close, qi flow becomes sluggish, water flows down to the bladder, and thus urine and gas are formed. Among the zang-fu organs, the Heart is the master, the ears are for hearing, the eyes are for observation, the Lungs are the prime minister, the Liver is the general, the Spleen is the guard, and the Kidneys govern the exterior. Thus, the jinye of the zang-fu organs all seep upward into the eyes. When the heart grieves, qi merges, causing the xinxin (heart connection/tissue) to contract; contraction lifts the lung leaves, lifting causes fluid to overflow upwards. Because the xinxin contracts and the lungs cannot remain lifted constantly, moving up and down intermittently, coughing and salivation occur. Internal heat causes rapid digestion of food in the stomach; rapid digestion causes worms to move up and down in the intestines, filling and expanding the gut, leading to gastric relaxation; relaxation causes qi to rebel upwards, resulting in spitting saliva. The jinye of the five grains combine to form a paste-like substance, which infiltrates inward into the bone cavities, nourishes the brain marrow, and flows downward into the inner thighs. If yin and yang are disharmonious, fluid overflows and flows downward into the yin regions; marrow and body fluids decrease and flow downward. Excessive downward flow leads to deficiency; deficiency causes pain and soreness in the lower back and spine. If the qi pathways of yin and yang are blocked, the Four Seas are closed, the Sanjiao (Triple Burner) fails to drain, and jinye fail to transform, water and grain mix in the stomach and intestines, separate at the ileum, stagnate in the Lower Jiao, and fail to permeate into the bladder, causing Lower Jiao distension. Overflowing water results in water distension. This describes the normal and abnormal patterns of the five differentiations of jinye.

Huangdi asked: I wish to hear about those odd pathogens that are not in the meridians. What is the cause? Qibo replied: They are in the blood collaterals. Huangdi asked: Why does pricking blood collaterals cause fainting? Why does blood shoot out? Why is blood dark and turbid? Why is blood clear and half liquid? Why is there swelling after needle removal? Why does the face turn pale blue regardless of whether bleeding is much or little? Why is there no change in facial color but feeling of vexation after needle removal? Why is there abundant bleeding without physical trembling? I wish to understand the reasons.

Qibo replied: In cases where pulse qi is excessive but blood is deficient, pricking causes qi depletion; qi depletion leads to fainting. In cases where both qi and blood are abundant and yin qi is predominant, the blood is slippery, and pricking causes it to shoot out. When yang qi accumulates and stays long without being discharged, the blood becomes dark and turbid, hence it cannot shoot. After new drinking, fluid渗 (seeps) into the collaterals but has not yet harmonized with blood, so when blood comes out, the juice separates. If one has not drunk recently but has water retention in the body, prolonged stagnation leads to swelling. When yin qi accumulates in the yang aspect, qi becomes obstructed in the collaterals; thus, upon pricking, qi moves before blood exits, causing swelling. When yin and yang qi have just met but not yet harmonized, applying draining methods causes both yin and yang to deplete, separating interior and exterior, leading to loss of complexion and a pale blue appearance. Pricking without color change but with vexation occurs because pricking collaterals empties the meridians; emptying meridians belonging to yin causes yin qi to deplete, leading to vexation. When yin and yang qi combine to form Bi syndrome (obstruction), this means evil qi overflows into the meridians externally and injects into the collaterals; thus, both yin and yang have excess. Even with abundant bleeding, deficiency cannot be achieved.

Huangdi asked: How should one examine them? Qibo said: Observe if the blood vessels are full, hard, transverse, and red, with positions varying up and down, small as needles, large as chopsticks. Pricking and draining them ensures safety; do not lose the correct count. Losing the count returns the condition to its original degree. Huangdi asked: Why does the needle feel stuck in the flesh? Qibo said: Heat adheres to the needle, creating heat; heat causes blood to adhere to the needle, making it feel hard.