Library

The sage established the measurements for acupuncture and moxibustion, ensuring they correspond to Heaven and Earth. Thus, Heaven has the constellations and 365 degrees (referring to the celestial degrees), and Earth has its main rivers (the Qing, Wei, Hai, Hu, Ru, Mian, Huai, Luo, Jiang, He, Ji, and Zhang rivers, corresponding to the twelve meridians of the human body). When the climate of Heaven and Earth is mild, the river waters remain calm; when it is cold and the earth freezes, the river waters congeal and flow sluggishly; when it is hot and the earth is warm, the river waters boil and overflow; when sudden storms arise, the river waters surge and rise in waves (indicating disharmony of Yin and Yang).

When pathogenic factors enter the vessels, cold causes blood to congeal and stagnate, while heat makes Qi fluid and moist (both resulting from changes in cold and heat). Deficient pathogens take the opportunity to invade, much like river water encountering wind. The pulsating arteries in the meridians also rise intermittently as their movement reaches a certain point. Moving within the vessels, they follow the course smoothly (Just as pathogens invade the meridians due to deficiency, similar to river water meeting wind—i.e., blood vessels responding to Qi—the meridians thus rise intermittently. This is because pathogens within the vessels move dynamically with the fluctuation of healthy Qi. "Xunxun" describes a state of compliance or following along.)

Upon palpating the Cun Kou pulse, it may appear large or small at times: a large pulse indicates the arrival of pathogenic factors, while a small pulse indicates peace (normalcy). Pathogens move within the vessels without a fixed location (Pathogens travel with the vessels and inevitably reach the Cun Kou; presence of pathogens causes swelling and enlargement, while absence results in calmness and smallness, manifesting according to their location, hence described as moving without a fixed place). Whether affecting Yin or Yang, there is no rigid standard; one must observe by following the pulse. Through the Three Regions and Nine Palpation sites, if pathogens are suddenly encountered, their pathway should be obstructed early (To "e" means to restrain).

For the reducing method: Insert the needle during inhalation, preventing Qi rebellion (During inhalation, Qi arrives; for excess conditions, reverse Qi is removed, so one avoids causing rebellion). Retain the needle quietly for a long time to prevent the spread of pathogens (While the previous Qi remains uneliminated and new Qi approaches, retain the needle quietly to wait for the opportune moment to reduce, preventing the re-spread of pathogens). Rotate the needle during inhalation, using the arrival of De Qi as the measure (While pathogens remain, wait for the patient's next inhalation, then rotate the needle, taking the sensation of De Qi as the standard). Withdraw the needle during exhalation, removing it completely upon the end of exhalation, allowing the major Qi (pathogenic Qi) to exit entirely; this is called reduction (To "yin" means to withdraw. Inhalation is entering Qi, exhalation is exiting Qi. After complete exhalation comes inhalation; after full inhalation, exhalation does not accompany it. This text discusses the reducing method where the needle is inserted during inhalation; the subsequent text discusses tonification where the needle is inserted after complete exhalation, implying that tonification precedes reduction in the reducing method).

For deficiency, apply tonification. First, palpate and stroke the area (Using the left hand first to palpate and stroke aims to locate the acupoint accurately). Press and disperse (Pressing the acupoint with fingers aims to disperse the Qi). Push and press (Rubbing and pressing the skin with fingers aims to facilitate smooth needle insertion). Tap until distended (Tapping the acupoint focuses intention, causing Qi to follow, making the vessels full and distended like anger). Scratching and inserting (As before, use the left thumb nail to scratch the exact acupoint before inserting the needle). Unblock and extract (After insertion, wait for Qi circulation before extracting the pathogenic factor). Draw outward from the gate to close the Shen (The "gate" refers to the acupoint gate; this is the method of withdrawing the needle after obtaining De Qi).

For the tonifying method: Insert the needle after complete exhalation, retain it quietly for a long time until De Qi arrives. Wait as if for a honored guest, unaware of the passing day (This means retaining the needle quietly until Qi arrives). Once Qi has arrived, protect it carefully (Adjust and care for it). Withdraw the needle during inhalation so that Qi does not escape, remaining in its place (Withdrawing during inhalation keeps Qi filled internally). Push and close the gate, allowing Shen and Qi to remain, keeping the major Qi contained; this is called tonification (Closing the gate secures Qi externally and retains Shen and Qi, hence termed tonification. The following details the tonifying method).