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Huangdi asked, "Qi rebellion causes obstruction in the Upper Jiao (Upper Diaphragm). The so-called Upper Jiao obstruction refers to the condition where food is ingested and immediately regurgitated; I am already aware of this. As for parasites causing Lower Jiao obstruction (Lower Diaphragm), where food is expelled only after a long time, I do not fully understand its mechanism and wish to hear it explained thoroughly."

Qibo replied, "If emotions such as joy and anger are not regulated, diet and drinking are not moderated, and exposure to cold and heat is not timely, then cold fluids will remain in the intestines. If they remain, the parasites become cold; if the parasites become cold, they accumulate and stay at the Xiaowan (lower opening of the stomach). Staying at the Xiaowan causes the stomach and intestines to become distended and full, preventing the Wei Qi (Stomach Qi) from circulating, allowing pathogenic factors to reside there. When a person eats, the parasites move upward to feed; when they move upward, the Xiaowan becomes empty. Emptiness of the Xiaowan allows pathogenic factors to prevail; when they prevail, accumulation remains, leading to the formation of an abscess. Once the abscess forms, the Xiaowan becomes constricted. If the abscess is inside the stomach wall, the pulse is deep and the pain is profound; if the abscess is outside the stomach wall, the swelling is external and the pain is superficial, with hot skin over the abscess. By pressing the abscess and observing the flow of Qi, one should first prick shallowly around it, then gradually deepen the insertion, repeating the pricking no more than three times. Observe whether the swelling is superficial or deep to determine the depth of needling. After needling, apply moxibustion or warming therapy to ensure heat penetrates inward. Daily application of internal heat will cause pathogenic factors to decline, allowing the large abscess to rupture. Simultaneously use Canjin (a specific acupuncture contraindication or auxiliary method) to remove internal pathogens. Maintain a state of tranquility and non-action to allow Qi to flow freely. Afterwards, administer sour and bitter herbs to facilitate digestion and downward movement of grain, resolving the Lower Jiao obstruction."

Huangdi asked, "What is the diagnostic approach for a patient suffering from a gastric abscess?"

Qibo said, "In diagnosing this condition, one must examine the Stomach pulse. The pulse should be Deep and Choppy (Xi), described as Fine (Xi) in the Suwen. A Deep and Choppy pulse indicates Qi rebellion. Qi rebellion causes the Renying point (carotid artery, reflecting Stomach Qi) to appear very full and rapid, indicating Heat. The Renying pulse reflects Stomach Qi; rebellion and fullness cause Heat to gather at the stomach opening without circulating, thus forming a gastric abscess. Fullness and excess in the Liver, Kidney, and Lung meridians lead to abscesses. Lung abscess presents with wheezing and fullness in both calves (legs); Liver abscess presents with fullness below both hypochondria, waking with fright during sleep, and inability to urinate; Kidney abscess presents with fullness from the feet to the lower abdomen, asymmetry in calf size, limping, and predisposition to hemiplegia or wasting."

Huangdi asked, "The intestines and stomach receive grain. The Upper Jiao releases Qi to warm the muscles, nourish the joints, and open the interstices. The Middle Jiao releases Qi like mist, pouring into the muscle valleys and penetrating the Sun collaterals (finest network vessels). Fluids are harmonized, transforming into red blood. Harmonized blood fills the Sun collaterals first, then enters the Luo collaterals. When Luo collaterals are full, it enters the Jing meridians. Yin and Yang expand and move with respiration, following regular pathways and principles, coordinating with Heaven, never ceasing. Palpating and regulating the pulse involves treating deficiency by removing excess: draining reduces excess, but improper technique may cause deficiency; retaining needle time regulates the sequence of Qi. Treating excess by tonifying deficiency: tonification adds to sufficiency. When Blood and Qi are regulated, Shen Spirit is maintained. I know the arrival and non-arrival of Blood and Qi, but I do not know the origin of carbuncles and ulcers, the timing of success and failure, the periods of life and death, which may be near or far. How can we estimate them?"

Qibo said, "The circulation of meridians does not cease, matching the degrees of Heaven and the records of Earth. Thus, if celestial bodies lose their order, eclipses occur; if earthly channels lose their discipline, waterways overflow, grass and fireflies fail to grow, and grains do not multiply. If communication lines are blocked, people cannot travel, and villages separate. Blood and Qi operate similarly. Let me explain the reason. Blood vessels, Ying (Nutrient) Qi, and Wei (Defensive) Qi circulate endlessly, corresponding above to celestial stars and below to earthly measures. When Cold Evil lodges in the meridians, Blood becomes viscous and stagnant. Stagnation prevents flow, causing Wei Qi to gather there and unable to return. Thus, swelling and abscesses form. Cold transforms into Heat; excessive Heat rots flesh, turning it into pus. If pus is not drained, tendons rot; if tendons rot, bones are injured; if bones are injured, marrow diminishes. If not located at bone openings for drainage, the tendons and bones become withered and empty. Withered tendons and bones lose their connection to muscles. Meridians decay and leak,薰 (smoking/burning) the Zang organs. Damage to the Zang organs leads to death."