或曰。内经治病。汤液醪醴为甚少。所载服饵之法才一二。而灸者四五。其他则明针
法无虑十八九。厥后方药之说肆行。而针灸之法。仅而获存者。何也。
曰。内经上古书也。上古之人。其知道乎。劳不至倦。逸不至流。食不肥鲜。以戕其内
。衣不蕴热。以伤其外。起居有常。寒暑知避。恬 虚无。精神内守。病安从生。虽有贼风虚邪
。莫能深入。不过凑于皮肤。经滞气郁而已。以针行滞散郁。则病随已。何待于汤液醪醴耶
。当今之世。道德已衰。以酒为浆。以妄为常。纵欲以竭其精。多虑以散其真。不知持满。
不解御神。务快其心。逆于生乐。起居无节。寒暑不避。故病多从内生。外邪亦易中也。经
曰。针刺治其外。汤液治其内。病既属内。非藉汤液之荡涤。岂能济乎。此和、缓以后。方
药
不宜于今。汤液宜于今。而不宜于古也。
经曰。上古作汤液。为而弗服。中古之时。服之万全。当今之世。必齐毒药攻其中。针
灸治其外。虽形弊血尽而功不立。此之谓也。
或曰。针灸宜于古。而不宜于今。吾已闻命矣。然今之病。亦有针灸而愈者。何也。
经
其病立已。盖病之初起。邪之新客。当此之时。元气未伤。邪气尚浅。以针除之。甚得其宜。
学人察识于此。而于用针治病。亦可以知其大概矣。故曰。上工刺其未生者也。其次刺其未
盛者也。其次刺其已衰者也。下工刺其方袭者也。与其形之盛者也。与其病之与脉相逆者也
。故曰。方其盛也。勿敢毁伤。刺其已衰。事必大昌。
或曰。九针之所主。皆外伤欤。抑亦有内伤欤。
经曰。一曰 针。头大末锐。令无得深入。主病在皮肤无常者。二曰员针。筒身员末。
主无
。四曰锋针。筒其身。锋其末两三隅。主四时八风。客于经络为痼病者。令可以泄热出血而
发痼病也。五曰铍针。末如剑锋。主寒与热争。两气相搏。合为痈脓。可以取大脓也。六曰
员利针。令尖如 。且员且锐。微大其末。反小其身。主虚邪客于经络而为暴痹。令可深内
以取之也。七曰毫针。尖如蚊虻喙。长一寸六分。静以徐往。微以久留。主邪客经络。而为
寒热痛痹者也。八曰长针。锋利身薄。主深邪远痹。八风内舍于骨解腰脊骨腠间也。九曰大
针。大如梃尖。微员。主淫邪流溢于节解皮肤之间。以写机关之水也。九针长短大小各有所
施。不得其用。疾弗能移。病浅针深。内伤良肉。病深针浅。病气不写。病小针大。气写大
甚。病大针小。气不泄泄。机按。今之针士。决痈用锋针铍针。其他诸病。无分皮肤肌肉血
脉筋骨。皆用毫针。余者置而不用。甚有背于经旨矣。于此而知九针所主。多系外邪薄凑为
病。用针施泻。深中病情。使今之人而有是病。针亦在所必用。若夫病邪大甚。元气已伤。
决非针之所能济矣。假如痨瘵阴虚火动。法当滋阴降火。针能滋阴否乎。痿症肺热叶焦。
法当清金补水。针能补水否乎。经曰。阴阳形气俱不足。勿取以针。而调以甘药是也。知此
则病之可针不可针。亦可以类推矣。奈何世之专针科者。既不识脉。又不察形。但问何病。便
针何穴。以致误针成痼疾者有矣。间有获效。亦偶中耳。因而夸其针之神妙。宁不为识者笑
耶。
或曰。针灸当明经络。可晓以否。
曰。直行者。谓之经。经有十二。所以行血气。通阴阳。以荣于身者也。其始从中焦注
手太阴、阳明。阳明注足阳明、太阴。太阴注手少阴、太阳。太阳注足太阳、少阴。少阴注
手厥阴、少阳。少阳注足少阳、厥阴。厥阴复注手太阴也。（此则荣气之行也。然卫气昼但
行于阳。而不行于阴。夜但行于阴。而不行于阳。不与荣同道。不与息数同应。）
又曰。五脏之道。皆出于经隧。以行气血。气血不和。百病乃变化而生。是故守经隧焉
。（隧。潜道也。经脉行而不见。故谓之经隧。详见阳经外络内。阴经内络外条。）旁出者。谓
之络。（经之横支。交接别经者。）十二经有十二络。（如太阴属肺。络大肠。手阳明属大肠
。络肺之类。）兼阳跷络、阴跷络、脾之大络。为十五络也。皆从十二经之所始。转相灌溉
。朝于寸口、人迎也。又曰孙络。（小络也。经脉为里。支而横者为络。络之别者为孙络。
又曰。节之交三百六十五会者。络脉之渗灌诸节者也。节者。神气之所游行出入者也。非髀
肉筋骨也。）
问曰。荣卫之气。亦有别乎。
曰。荣者。水谷之精气也。和调于五脏。洒陈于六腑。乃能入于脉也。故循脉上下。贯
五脏。络六腑也。卫者。水谷之悍气也。其气剽疾滑利。不能入于脉也。故循皮肤之中。分
肉之间。熏于肓膜。散于胸腹。逆其气则病。从其气则愈。不与风寒湿气合也。（详见井荥
俞经合注）
或曰。经脉与络脉异乎。
曰。经脉十二者。伏行分肉之间。深而不见。其虚实也。以气口知之。诸脉之浮而常见
者。皆络脉也。诸络脉不能经大节之间。必行绝道而出入。复合于皮中。其会皆见于外。故诸刺
络脉者。必刺其结。上甚血者。虽无结。急取之。以写其邪而去其血。留之发为痹也。凡诊
络脉。色青则寒且痛。赤则有热。鱼际络青。胃中寒。鱼际络赤。胃中热。其暴黑者。留久
痹也。其有赤有黑有青者。寒热气也。青短者。少气也。凡刺寒热。皆多血络。必间日一取。
大血尽而止。乃调其血实。
或曰。经病络病。治有异乎。
经曰。邪之客于形也。必先舍于皮毛。留而不去。入舍于孙络。留而不去。入舍于络脉
。
。五脏乃伤。此邪之从皮毛而入。极于五脏之次也。如此。则治其经焉。（邪客于经。左盛
则右病。右盛则左病。亦有移易者。左痛未已。而右脉先病。如此者。必巨刺之。左刺右。
右刺左。必中其经。非络脉也。）今邪客于皮毛。入舍于孙络。留而不去。闭塞不通。不得
入于经。流溢于大络。（即前血络。外不得出。内不得入故也。）而生奇病也。（病在血络谓
奇邪）夫邪客大络者。左注右。右注左。上下左右。与经相干。而布于四末。其气无常处。
不入于经俞。故曰缪刺。（络病。其痛与经脉缪处也。亦宜左刺右。右刺左。虽与巨刺同。
此刺络而彼刺经也。）
或曰。十二经脉皆络三百六十五节。节有病。必被经脉。治之亦有法乎。
曰。五脏得六腑。相为表里。经络支节。各生虚实。其病所居。随而调之。病在脉。调
之血
骨。淬针药熨。病不知所痛。两跷为上。身形有痛。九候无病。则缪刺之。（缪刺者。刺络
脉。左痛刺右。右痛刺左。）痛在于左。而右脉先病者。巨刺之。（巨刺者。刺经脉也。左痛
刺右。右痛刺左。）必谨察其九候。针道毕矣。
或曰。经病亦有宜刺者乎。
经曰。肝病。实则两胁痛引少腹。善怒。虚则目KT KT 无所见。耳无所闻。善恐。如人将
捕之。取其经厥阴与少阳。（非其络病。故取其经。取厥阴治肝气。少阳调气逆。）气逆则头痛。
耳聋不聪。颊肿。取血者。（胁中气满。独异于常。乃气逆之诊。随其左右。有则刺之。）
心病。实则胸中痛。胁支满痛。膺背肩甲间痛。两臂内痛。虚则胸腹大。胁与腰相引痛。取
其经少阴、太阳。舌本下血。其变病。刺 中血。（或呕变也。 在掌后。去腕半寸。） 脾
病。实则身重善饥。肉痿。足不收。行善螈。脚下痛。虚则腹满。肠鸣飧泄。食不化。取其经。太
阴、阳明、少阴血。肺病。实则喘咳逆气。肩背痛。汗出。尻阴股膝髀 足皆痛。虚则少气
不能报息。耳聋嗌干。取其经。太阴、足太阳外。厥阴内血。（太阳外。厥阴内。则少阴也
。视少阴足脉。左右有血满异常者。刺之。） 肾病。实则腹大胫肿。喘咳身重。寝汗憎风。
虚则胸中痛。大小腹痛。清厥意不乐。取其经。少阴、太阳血。（注云。凡刺之道。虚补实
写。不虚不实。以经取之。是谓得道。经络有血。刺而去之。是谓守法。犹当揣形定气。先
去血脉。而后乃调有余不足也。）
或曰。六腑病形刺法何如。
经曰。大肠病者。肠中切痛而鸣。冬日重感于寒则泻。当脐痛。不能久立。与胃同候。
取巨虚上廉。 胃病者。腹胀。胃脘当心而痛。上支两胁。膈咽不通。食饮不下。取之三里。
小肠病者。小腹痛。腰脊控睾而痛。时窘之后。当耳前热。若寒甚。若独肩上热甚。及手小指次
指间热。若脉陷者。此其候也。取之巨虚下廉。 三焦病者。腹胀。小腹尤坚。不得小便。
窘急。溢则水留为胀。取之委阳。膀胱病者。小腹偏肿而痛。以手按之。即欲小便而不得。肩
上热。若脉陷。及胫踝后足小指外廉皆热。取之委中。 胆病者。善太息。口苦。呕宿汁。
心中澹澹。恐人将捕之。嗌仲介介然。数唾。在足少阳之本末。亦视其脉之陷下者。灸之。取
阳陵泉。（凡刺此者。必中气穴。无中肉节。中肉节。则皮肤痛。中筋。则筋缓。邪气不出
。补写反。则病益笃。）
或曰。精气津液血脉。亦有别乎。
经曰。两神相搏。合而成形。常先身生。是谓精。上焦开发。宣五谷味。熏肤。充身。
泽毛。若雾露之溉。是谓气。腠理发泄。汗出溱溱。是谓津。谷入气满。淖泽注于骨。骨属屈伸。泄
泽补
谓脉。精脱者。耳聋。气脱者。目不明。津脱者。腠理开。汗大泄。液脱者。骨属屈伸不利
。色夭。脑髓消。胫酸。耳数鸣。血脱者。色白。夭然不泽。其脉空虚。
或曰。病有在气分者。在血分者。不知针家亦分气与血否。
曰。气分血分之病。针家亦所当知。病在气分。游行不定。病在血分。沉着不移。以积
块言之。腹中或上或下。或有或无者。是气分也。或在两胁。或在心下。或在脐上下左右。一定
不移。以渐而长者。是血分也。以病风言之。或左足移于右足。或右手移于左手。移动不常
者。气分也。或常在左足。或偏在右手。着而不走者。血分也。凡病莫不皆然。须知在气分
者。上有病。下取之。下有病。上取之。在左取右。在右取左。在血分者。随其血之所在。
应病取之。苟或血病写气。气病写血。是谓诛伐无过。咎将谁归。
或曰。三阴三阳。气血多少之刺。可得闻乎。
曰。经曰手阳明大肠、足阳明胃经。多血多气。手少阳三焦、足少阳胆、手少阴心、足
少阴肾、手太阴肺、足太阴脾六经。少血多气。 手厥阴心包络、足厥阴肝、手太阳小肠、足太
阳膀胱四经。多血少气。故刺阳明。出血气。刺太阳、厥阴。出血恶气。刺少阳、太阴、少阴
。出气恶血。故曰。知脏腑血气之多少。而用补写是也。
或曰。形气病气。何以别之。
经曰。形气不足。病气有余。是邪胜也。急写之。形气有余。病气不足。急补之。形气
不足。病气不足。此阴阳俱不足也。不可刺之。刺之则重不足。老者绝灭。壮者不复矣。形气有余。
病气有余。此阴阳俱有余也。急写其邪。调其虚实。故曰。有余者写之。不足者补之。此
之谓也。（夫形气者。气谓口鼻中喘息也。形谓皮肉筋骨血脉也。形胜者。为有余。消瘦者
。为不足。其气者。审口鼻中气。劳役如故。为气有余也。若喘息气促气短。或不足以息者
。为不足。故曰。形气也。乃人之身形中气血也。当补当写。不在于此。只在病来潮作之时
。病气精神增添者。是病气有余。乃邪气胜也。急当写之。病来潮作之时。精神困穷。语言
无力及懒语者。为病气不足。乃真气不足也。急当补之。若病患形气不足。病来潮作之
时。病气亦不足。此阴阳俱不足也。禁用针。宜补之以甘药。不已。脐下气海穴取之。）
或曰。病有脏腑阴阳内外高下。何别何治。愿详言焉。
经曰。内有阴阳。外亦有阴阳。在内者。以五脏为阴。六腑为阳。在外者。筋骨为阴。
皮肤为阳。故曰。病在阴之阴者。刺阴之荥 。病在阳之阳者。刺阳之合。病在阳之阴者。刺阴
之经。病在阴之阳者。刺脉络。
又曰。病有形而不痛者。阳之类也。无形而痛者。阴之类也。无形而痛者。其阳完而阴
伤之也。急治其阴。无攻其阳。有形而不痛者。其阴完而阳伤之也。急治其阳。无攻其阴。阴阳
俱动。乍有形乍无形。加以烦心。命曰阴胜其阳。此谓不表不里。其形不久。
经曰。风寒伤形。忧恐忿怒伤气。气伤脏乃病。脏伤形乃应。风伤筋脉。筋脉乃应。此
形气外内之相应也。治此者。病九日。三刺而已。病一月。十刺而已。多少远近。以此衰之
。久痹不去身者。视其血络。尽出其血。帝曰。内外之病。难易之治何如。伯高曰。形先病
而未入脏者。刺之半其日。脏先病而形乃应者。刺之倍其日。
经曰。刺诸热者。如以手探汤。刺寒清者。如人不欲行。阴有阳疾者。取之下陵、三里
。正往无殆。气下乃止。不下复始也。疾高而内者。取之阴之陵泉。疾高而外者。取之阳之陵泉
A person asked: In the *Neijing* (Inner Canon), the treatment of diseases using decoctions and fermented medicinal wines is very rare. The methods of taking medicine recorded are only one or two, while moxibustion is four or five, and other acupuncture methods account for about eighteen or nineteen. Later, theories of herbal formulas became widespread, while acupuncture and moxibustion were barely preserved. Why is this?
The reply was: The *Neijing* is a book from ancient times. Did people in ancient times understand the Great Dao? They worked without becoming exhausted, rested without becoming indulgent, ate food that was not rich and fresh so as not to damage the interior, wore clothes that did not retain heat so as not to injure the exterior, had regular daily routines, knew how to avoid cold and heat, maintained a tranquil and empty mind, and guarded their spirit within. How could disease arise? Even if evil winds and pathogenic factors invaded, they could not penetrate deeply; they merely gathered at the skin surface, causing stagnation in the meridians and Qi depression. Using needles to unblock stagnation and disperse depression would cure the disease immediately. Why wait for decoctions and fermented medicinal wines?
In today's world, morality has declined. People treat wine as water, make abnormality a norm, indulge desires to exhaust their essence, worry excessively to scatter their true Qi, do not know how to maintain fullness, do not understand how to control their spirit, seek only mental pleasure, and go against the joy of life. Their routines are irregular, and they do not avoid cold and heat. Therefore, diseases mostly arise from within, and external pathogens easily invade. The Classics state: "Acupuncture treats external conditions; decoctions treat internal conditions." Since the disease belongs to the interior, how can it be cured without relying on the cleansing power of decoctions? This is why after Bian Que and Yi Huan, herbal formulas were unsuitable for ancient times but suitable for today, while decoctions were suitable for today but not for ancient times.
The Classics state: "In ancient times, decoctions were made but not consumed. In middle antiquity, consuming them ensured complete recovery. In today's world, one must use potent medicines to attack the interior and acupuncture/moxibustion to treat the exterior. Even if the form is exhausted and blood depleted, efficacy will not be established." This refers to the situation described above.
Another asked: I have heard that acupuncture and moxibustion are suitable for ancient times but not for today. However, there are patients today who are also cured by acupuncture and moxibustion. Why?
The reply was: It is because the disease has just begun, and the pathogen is newly arrived. At this time, the Yuan Qi (Original Qi) is not yet damaged, and the pathogenic factor is still shallow. Removing it with needles is very appropriate. Students who can observe this will understand the general principles of treating diseases with needles. Thus it is said: An excellent physician punctures before the disease arises; a secondary physician punctures when the disease is not yet vigorous; a tertiary physician punctures when the disease has already declined; an inferior physician punctures when the pathogen is attacking, when the body's righteousness is vigorous, or when the disease contradicts the pulse. Thus it is said: When the disease is vigorous, do not dare to harm the righteous Qi; puncturing when the disease has declined ensures great prosperity.
Another asked: Do the Nine Needles primarily treat external injuries, or do they also treat internal injuries?
The reply was: 1. Chan Needle (Needle with a large head and sharp tip): Prevents deep insertion; treats diseases located in the skin with no fixed shape. 2. Yuan Needle (Round Needle): Cylindrical body with a rounded tip; treats... [text missing in source]. 4. Feng Zhen (Sharp Needle): Cylindrical body with a three-edged tip; treats stubborn diseases caused by seasonal winds invading the meridians, allowing for heat release and bleeding to dispel stubborn pathology. 5. Pi Zhen (Sword Needle): Tip like a sword edge; treats conflict between cold and heat where two energies clash forming abscesses/pus, used to drain large amounts of pus. 6. Yuanli Needle (Round-Sharp Needle): Tip like a mosquito proboscis, round and sharp, slightly larger at the end, thinner in the body; treats sudden bi-syndrome caused by deficient pathogens invading meridians, allowing deep insertion. 7. Hao Zhen (Fine Needle): Tip like a mosquito proboscis, 1 cun 6 fen long; enters slowly upon qi arrival, retained lightly for a long time; treats cold-heat pain-bi caused by pathogens invading meridians. 8. Chang Zhen (Long Needle): Sharp and thin body; treats deep pathogens and distant bi-syndromes, where eight winds lodge between bones, waist, spine, and interstices. 9. Da Zhen (Large Needle): Thick like a club tip, slightly round; treats overflowing pathogenic factors between joints and skin, used to drain fluid from joints.
Each of the Nine Needles has specific applications. Misusing them fails to move the disease. If the disease is superficial but the needle is too deep, healthy flesh is injured internally; if the disease is deep but the needle is too shallow, pathogenic Qi is not expelled; if the disease is minor but the needle is too large, Qi is excessively drained; if the disease is major but the needle is too small, Qi is not adequately released. Commentary: Modern acupuncturists use Feng and Pi needles for abscesses, but for all other diseases, regardless of whether the pathology is in skin, muscle, blood vessels, sinews, or bone, they use only Hao Needles, discarding the rest. This greatly contradicts the Classic's intent. From this, we know the Nine Needles mainly address diseases caused by external pathogens pressing upon the body. Using needles to drain is highly accurate. If modern people had these diseases, needles would certainly be necessary. However, if the pathogen is severe and Yuan Qi is damaged, needles alone cannot save them. For example, in consumption (Lao Zhai) with Yin deficiency and fire hyperactivity, the method should be nourishing Yin and descending fire; can needles nourish Yin? In flaccidity syndrome (Wei Syndrome) with lung heat scorching leaves, the method should be clearing metal and tonifying water; can needles tonify water? The Classics state: "When Yin-Yang, Form, and Qi are all insufficient, do not use needles; instead, regulate with sweet herbs." Knowing this, one can infer which diseases are suitable for needling. Alas, modern specialists in acupuncture often fail to recognize pulses or observe the form, asking only "what disease" and then needling whatever point, leading to misdiagnosis and chronic illness from incorrect needling. Occasional successes are mere chance. To boast of the miracle of needles is indeed laughable to experts.
Another asked: Acupuncture and moxibustion require understanding the meridians. Can this be explained?
The reply was: Straight-running channels are called Jing-Meridians (Main Meridians). There are twelve, used to circulate Blood and Qi, connect Yin and Yang, and nourish the body. They start from the Middle Jiao, flowing into Hand Taiyin and Hand Yangming; Hand Yangming flows into Foot Yangming and Foot Taiyin; Foot Taiyin flows into Hand Shaoyin and Hand Taiyang; Hand Taiyang flows into Foot Taiyang and Foot Shaoyin; Foot Shaoyin flows into Hand Jueyin and Hand Shaoyang; Hand Shaoyang flows into Foot Shaoyang and Foot Jueyin; Foot Jueyin returns to flow into Hand Taiyin. (This is the circulation of Ying-Qi. However, Wei-Qi travels only through Yang channels during the day and Yin channels at night, not following Ying-Qi or breathing cycles.)
It is also said: The pathways of the Five Zang organs all emerge from the Jing-Tunnels (Meridian Tunnels) to circulate Blood and Qi. When Blood and Qi are disharmonious, hundred diseases arise. Therefore, guard the Jing-Tunnels. (Tunnel refers to hidden paths. Meridians travel invisibly, hence called Jing-Tunnels. See details on Yang meridians connecting externally and internally, Yin meridians connecting internally and externally.) Branching off are called Luo-Collaterals (Connecting Vessels). (Horizontal branches of meridians that connect to other meridians.) The twelve meridians have twelve Luo-Collaterals. (e.g., Taiyin belongs to Lung, connects to Large Intestine; Hand Yangming belongs to Large Intestine, connects to Lung, etc.) Plus Yang Qiao, Yin Qiao, and the Great Luo of the Spleen, totaling fifteen Luo-Collaterals. All originate from the twelve meridians, irrigating each other, converging at Cun Kou and Ren Ying. Also mentioned are Sun-Luo (Sun Collaterals). (Small collaterals. Meridians are the main lines; horizontal branches are Luo; branches of Luo are Sun-Luo.) Also: The intersections of joints, 365 Hui (Assemblies), are where collateral vessels seep and irrigate various joints. Joints are places where Shen-Qi (Spiritual Qi) travels and exits/enters, not referring to thigh muscles or bones.
Question: Is there a difference between Ying-Qi and Wei-Qi?
Answer: Ying (Nutrient Qi) is the refined essence of grain and water. It harmonizes with the Five Zang, spreads to the Six Fu, and then enters the vessels. Thus it follows the vessels up and down, penetrating the Five Zang and connecting the Six Fu. Wei (Defensive Qi) is the fierce Qi of grain and water. Its nature is rapid and slippery, unable to enter the vessels. Thus it travels among the skin and between muscles, steaming the Huang membranes, and spreading in the chest and abdomen. Reversing its flow causes disease; following its flow leads to recovery. It does not combine with wind, cold, dampness, or dryness. (See notes on Well, Ying, Shu, Jing, He points).
Another asked: Are Jing-Meridians and Luo-Collaterals different?
Answer: The twelve Jing-Meridians run deep between muscles, invisible to the eye. Their excess or deficiency is known via the Qi Kou pulse. All visible, floating vessels are Luo-Collaterals. Luo-Collaterals cannot pass through large joints; they must take alternate routes in and out, rejoining under the skin, with intersections visible externally. Therefore, when needling Luo-Collaterals, one must needle the knotted areas. If blood is abundant superiorly, even without knots, urgent extraction is needed to drain evil and remove blood; retention leads to Bi-syndrome. Generally, diagnosing Luo-Collaterals: Blue color indicates cold and pain; red indicates heat; blue at Yu Ji indicates stomach cold; red at Yu Ji indicates stomach heat; sudden black indicates long-standing Bi; mixed red, black, and blue indicates cold and heat; short blue indicates Qi deficiency. When treating cold and heat, many blood collaterals should be needled, taken every other day until blood is exhausted, then regulating blood excess.
Another asked: Is there a difference in treating Jing-Meridian diseases versus Luo-Collateral diseases?
Answer: The Classics state: Pathogens first lodge in the hair follicles/skin. If not expelled, they enter Sun-Luo. If not expelled, they enter Luo-Collaterals... [text missing] ...then the Five Zang are injured. This is the sequence of pathogens entering from skin to Zang. In such cases, treat the Jing-Meridian. (Pathogen in Jing: Left excess causes right symptoms, right excess causes left symptoms. If left pain persists while right pulse shows disease, use Ju Ci (Giant Puncture): needle right for left pain, left for right pain. Must hit the Jing, not the Luo.) Now, if pathogen lodges in skin/Sun-Luo, blocks flow, cannot enter Jing, but overflows into Da Luo (Large Collaterals/Blood Vessels - unable to exit externally or enter internally), strange diseases arise. (Disease in blood collaterals is called Qi Xie/Evil). Pathogens in Da Luo move left to right and right to left, interacting with Jing, distributing to extremities, with no fixed location, not entering Jing-Shu points. Hence called Miu Ci (Counter Puncture). (Luo disease pain is counter to Jing location. Also use left-for-right, right-for-left. Though similar to Ju Ci, this needles Luo while that needles Jing.)
Another asked: The twelve meridians connect to 365 joints. If a joint is diseased, the meridian is affected. Is there a treatment method?
Answer: Five Zang and Six Fu are exterior-interior pairs. Meridians and joints generate excess and deficiency. Treat according to the location. Disease in vessels: regulate Blood. Disease in sinews: regulate sinews. Disease in bone: regulate bone. Use cauterization/herbal hot compresses. If pain location is unknown, use the Two Qiao vessels. If body has pain but Nine Pulses show no disease, use Miu Ci (needle collateral, left for right pain, right for left pain). If pain is on the left but right pulse is diseased, use Ju Ci (needle Jing, left for right pain, right for left pain). Carefully examine the Nine Pulses; the way of needling is complete.
Another asked: Are there Jing-Meridian diseases suitable for needling?
Answer: The Classics state: Liver disease: Excess causes hypochondriac pain radiating to lower abdomen, irritability. Deficiency causes blurred vision, hearing loss, fearfulness as if being caught. Take the Jing of Jueyin and Shaoyang. (Not Luo disease, so take Jing. Jueyin treats Liver Qi; Shaoyang regulates rebellious Qi.) Rebellious Qi causes headache, deafness, swollen cheeks. Take blood points. (Fullness in hypochondrium differs from normal, indicating rebellious Qi. Needle whichever side shows excess.) Heart disease: Excess causes chest pain, flank/fullness pain, anterior back/shoulder blade pain, inner arm pain. Deficiency causes large chest/abdomen, pulling pain in flanks/waist. Take Jing of Shaoyin and Taiyang. Bleed tongue root. For variations, bleed Xi-Zhong (Xi point). (Or vomiting variation. Xi is behind palm, half cun from wrist.) Spleen disease: Excess causes heavy body, hunger, muscle atrophy, foot weakness, twitching, sole pain. Deficiency causes abdominal fullness, borborygmus, loose stools, undigested food. Take Jing of Taiyin, Yangming, Shaoyin blood. Lung disease: Excess causes wheezing, cough, rebellious Qi, shoulder/back pain, sweating, pain in buttocks/genitals/thighs/knees/calves/feet. Deficiency causes shortness of breath, inability to complete inhalation, deafness, dry throat. Take Jing of Taiyin, outside Taiyang, inside Jueyin blood. (Outside Taiyang, inside Jueyin implies Shaoyin. Observe Shaoyin foot pulse; if blood fullness is abnormal on either side, needle it.) Kidney disease: Excess causes abdominal swelling, leg edema, wheezing/cough, heavy body, night sweats, aversion to wind. Deficiency causes chest pain, lower abdominal pain, cold extremities, unhappiness. Take Jing of Shaoyin and Taiyang blood. (Note: The way of needling is tonify deficiency, drain excess. If neither, take from the Jing. This is the correct Way. If meridians have blood, needle to remove it; this is observing Law. One must assess form and determine Qi, first removing blood vessels, then regulating excess and deficiency.)
Another asked: What is the needling method for Six Fu organ diseases?
Answer: Large Intestine disease: Cutting pain in intestines with rumbling. Winter cold exacerbates diarrhea, umbilical pain, inability to stand long. Same prognosis as Stomach. Take Shang Lianxu (ST37). Stomach disease: Abdominal distension, epigastric pain opposite heart, radiating to flanks, blocked diaphragm/throat, inability to eat/drink. Take Zusanli (ST36). Small Intestine disease: Lower abdominal pain, lumbar/spinal pain radiating to testicles, urgency after defecation. Heat in front of ears, or extreme cold, or intense heat on shoulder, or heat between little finger and ring finger, or depressed pulse. These are signs. Take Xia Lianxu (SI36). Sanjiao disease: Abdominal distension, especially firm lower abdomen, inability to urinate, urgency. Overflow causes fluid retention and distension. Take Weiyang (BL39). Bladder disease: Asymmetric lower abdominal swelling and pain. Pressing induces urge to urinate but none comes. Heat on shoulder, depressed pulse, heat on posterior calf/ankle/little toe lateral side. Take Weizhong (BL40). Gallbladder disease: Frequent sighing, bitter taste, vomiting old bile, palpitations, fear as if being caught, feeling of obstruction in throat, frequent spitting. Located at origin/end of Foot Shaoyang. Also observe depressed pulses; apply moxa. Take Yanglingquan (GB34). (Commentary: When needling here, must hit Qi-Acups, not flesh nodes. Hitting flesh nodes causes skin pain; hitting sinews causes sinew laxity; failing to expel evil, reversing tonification/draining worsens disease.)
Another asked: Are Essence, Qi, Jin-Ye (Body Fluids), and Blood different?
Answer: The Classics state: Two spirits interact to form shape, existing before the body; this is Essence (Jing). Upper Jiao opens and develops, disseminates grain flavors, steams skin, fills body, moistens hair, like mist/dew irrigation; this is Qi. Pores open, sweat pours profusely; this is Jin (Thin Fluids). Grain enters, Qi fills, moist substance notes to bones, bones flex/extend, excretes moisture to supplement brain marrow, skin moistens; this is Ye (Thick Fluids). Middle Jiao receives Qi, extracts juice, changes to red; this is Blood. Essence depletion causes deafness. Qi depletion causes poor vision. Jin depletion causes open pores, profuse sweating. Ye depletion causes stiff joints, sallow complexion, brain marrow wasting, leg soreness, frequent tinnitus. Blood depletion causes white complexion, lackluster luster, empty pulses.
Another asked: Diseases exist in Qi Level and Blood Level. Do acupuncturists distinguish between Qi and Blood?
Answer: Acupuncturists must know Qi and Blood level diseases. Disease in Qi level moves freely; disease in Blood level is fixed and immovable. Regarding masses: Moving up/down, present/absent in abdomen is Qi level. Fixed in flanks, epigastrium, or around navel, growing gradually is Blood level. Regarding wind disease: Moving from left foot to right foot, or right hand to left hand, frequently changing is Qi level. Staying in left foot or right hand, fixed and not moving is Blood level. All diseases follow this. Know that for Qi level: upper disease, take lower; lower disease, take upper; left disease, take right; right disease, take left. For Blood level: follow the blood's location, treat according to disease. If draining Qi for Blood disease, or draining Blood for Qi disease, this is punishing the innocent; who bears the blame?
Another asked: May I hear about the needling differences regarding Qi and Blood abundance in the Three Yin and Three Yang?
Answer: The Classics state: Hand Yangming Large Intestine and Foot Yangming Stomach are abundant in both Blood and Qi. Hand Shaoyang Sanjiao, Foot Shaoyang Gallbladder, Hand Shaoyin Heart, Foot Shaoyin Kidney, Hand Taiyin Lung, Foot Taiyin Spleen (six meridians) are deficient in Blood, abundant in Qi. Hand Jueyin Pericardium, Foot Jueyin Liver, Hand Taiyang Small Intestine, Foot Taiyang Bladder (four meridians) are abundant in Blood, deficient in Qi. Therefore, needling Yangming drains both Blood and Qi; needling Taiyang/Jueyin drains Blood, avoids Qi; needling Shaoyang/Taiyin/Shaoyin drains Qi, avoids Blood. Thus: Knowing the abundance of Qi and Blood in Zang-Fu allows proper tonification and drainage.
Another asked: How to distinguish Form-Qi and Disease-Qi?
Answer: The Classics state: Insufficient Form-Qi, Excessive Disease-Qi indicates Evil Victory; urgently drain. Excessive Form-Qi, Insufficient Disease-Qi requires urgent tonification. Insufficient Form-Qi, Insufficient Disease-Qi indicates Yin-Yang deficiency; do not needle. Needling causes double deficiency; the elderly may die, the strong may not recover. Excessive Form-Qi, Excessive Disease-Qi indicates Yin-Yang excess; urgently drain evil, regulate excess/deficiency. Thus: Drain excess, tonify deficiency. (Form-Qi: Qi refers to nose/mouth breathing; Form refers to skin/flesh/bones/blood vessels. Robust form is excess; emaciated is deficiency. Qi: Assess breathing. Normal labor breathing is Qi excess. Panting, shortness of breath, or insufficient breath is Qi deficiency. Thus Form-Qi refers to Qi and Blood in the body. Tonification/Drainage depends not here, but on the disease flare-up. If spirit increases during flare-up, Disease-Qi is excess (Evil victory); urgently drain. If spirit is exhausted, speech weak/lazy during flare-up, Disease-Qi is deficiency (True Qi deficiency); urgently tonify. If patient has insufficient Form-Qi and insufficient Disease-Qi during flare-up, this is Yin-Yang deficiency; prohibit needling, use sweet herbs. If ineffective, needle Qihai (CV6) below navel.)
Another asked: Diseases involve Zang-Fu, Yin-Yang, Interior-Exterior, High-Low. How to distinguish and treat? Please explain in detail.
Answer: The Classics state: Interior has Yin-Yang; Exterior has Yin-Yang. Inside: Five Zang are Yin, Six Fu are Yang. Outside: Sinews/Bone are Yin, Skin is Yang. Thus: Disease in Yin-of-Yin (Zang), needle Ying-Spring of Yin. Disease in Yang-of-Yang (Skin), needle He-Sea of Yang. Disease in Yang-of-Yin (Sinews/Bone), needle Jing-River of Yin. Disease in Yin-of-Yang (Blood Vessels/Luo), needle collaterals.
Also: Disease with form but no pain is Yang type. Pain without form is Yin type. Pain without form means Yang is intact but Yin is injured; urgently treat Yin, do not attack Yang. Form without pain means Yin is intact but Yang is injured; urgently treat Yang, do not attack Yin. Both Yin-Yang move, sometimes form appears, sometimes disappears, plus vexation: named Yin overcoming Yang. This is neither exterior nor interior; life is short.
The Classics state: Wind-Cold damages Form; Worry/Fear/Anger damages Qi. Qi damage injures Zang causing disease; Zang damage affects Form causing response. Wind damages sinews/vessels; sinews/vessels respond. This is correspondence between Form-Qi and Interior-Exterior. Treating this: Disease 9 days, 3 needleings suffice; Disease 1 month, 10 needleings suffice. Adjust quantity/distance accordingly. Long-standing Bi not leaving body: observe blood collaterals, drain all blood. Emperor asked: Difficulty of treating Interior vs Exterior diseases? Bo Gao replied: Form diseased first, not entered Zang: needle half the days. Zang diseased first, Form responds: needle double the days.
The Classics state: Needling heat conditions: like hand probing hot water. Needling cold/chill conditions: like person unwilling to walk. Yin having Yang disease: take Xi-Ling (ST34) and Zu-Li (ST36). Go straight without fatigue; stop when Qi descends; if not, restart. Disease high and internal: take Yin-Lingquan (SP9). Disease high and external: take Yang-Lingquan (GB34).