。经曰。病在上者。阳也。病在下者。阴也。痛者。阴也。以手按之不得者。阴也。深刺
之。痒者。阳也。浅刺之。病先起阴者。先治其阴。后治其阳。病先起阳者。先治其阳。后治
其阴。（病在上者。下取之。在下者。上取之。病在头者。取之足。在腰者。取之 。病生
于头者。头重。生于手者。臂重。生于足者。足重。治病者。先刺其病所从生者也。）
经曰。病始手臂者。先取手阳明、太阴而汗出。病始头首者。先取项太阳而汗出。病始
足胫者。先取足阳明而汗出。足太阴可汗出。足阳明可汗出。故取阴而汗出甚者。止之于阳。取
阳而汗出甚者。止之于阴。
或曰。经言病有虚邪。有实邪。有贼邪。有微邪。有正邪。何谓也。
经曰。从后来者。为虚邪。从前来者。为实邪。从所不胜来者。为贼邪。从所胜来者。
为微邪。自病者。为正邪。假令心病由中风得之。为虚邪。木在火后。生火为母也。饮食劳倦得
之。为实邪。土在火前。为子也。中湿得之。为贼邪。水克火也。伤寒得之。为微邪。火胜
金也。伤暑得之。为正邪。火自病也。
或曰。有正经自病。有五邪所伤。针治亦当别乎。
经曰。忧愁思虑。则伤心。形寒饮冷。则伤肺。恚怒气逆。上而不下。则伤肝。饮食劳
倦。则伤脾。久坐湿地。强力入水。则伤肾。此正经自病也。盖忧思喜怒。饮食动作之过。而致
然也。风喜伤肝。暑喜伤心。饮食劳倦喜伤脾。（劳倦亦自外至）寒喜伤肺。湿喜伤肾。此五
邪所伤也。盖邪由外至。所谓外伤也。凡阴阳脏腑。经络之气。虚实相等。正也。偏实偏虚
。失其正。则为邪矣。由偏实也。故内邪得而生。由偏虚也。故外邪得而入。机按。经言凡
病皆当辨别邪正内外虚实。然后施针补写。庶不致误。
或曰。经言虚者补之。实者写之。不虚不实。以经取之。何谓也。
经曰。虚者补其母。母能令子实也。实者写其子。子能令母虚也。假令肝病虚。则补厥阴
之合。曲泉。实则写厥阴之荥。行间。不虚不实。以经取之者。是正经自病。不中他邪。当自取
其经。如井主心下满之类。正经自病。所谓忧愁思虑则伤心。强力入水则伤肾之类是也。不虚
不实。是诸脏不相乘。故云自取其经（重解卷末）
或曰。经言无实实。无虚虚。损不足。益有余。何谓也。
经曰。此谓病有虚实也。假令肝木实。肺金虚。金木当更相平。当知金平木。假令肺实
而肝虚。微少气。用针不补其肝。而反重实其肺。所谓实其实。虚其虚。损不足。益有余也。
或曰。七情所伤之病。何以察识。亦可以刺否。
经曰。智者之养生也。必顺四时而适寒暑。和喜怒而安居处。节阴阳而调刚柔。如是则
邪僻不生。长生久视。故心怵惕思虑。则伤神。伤神则恐惧自失。脾忧愁而不解。则伤意。意伤
则乱。肝悲哀动中。则伤魂。魂伤则狂忘不精。肺喜乐无极。则伤魄。魄伤则狂。肾盛怒
而不止。则伤志。志伤则喜忘。恐惧而不解。则伤精。精伤则骨酸痿厥。是故五脏主藏精者
也。不可伤。伤则失守而阴虚。阴虚则无气。无气则死矣。故用针者。察观病患之态。以知
精神魂魄之存亡得失之意。五者以伤。针不可以治之也。
又曰。肝藏血。血舍魂。肝气虚则恐。实则怒。脾藏营。营舍意。脾气虚则四肢不用。
五脏不安。实则腹胀。泾溲不利。心藏脉。脉舍神。心气虚则悲。实则笑不休。肺藏气。气舍魄。肺气虚则鼻
塞不利。少气。实则喘喝。胸盈仰息。肾藏精。精舍志。肾气虚则厥。实则胀。五脏不安。
必审五脏之病形。以知其气之虚实而谨调之也。
又曰。肺心有邪。其气留于两肘。肝有邪
。其气留于两腋。脾有邪。其气留于两髀。肾有邪。其气留于两 。凡此八虚者。皆机关之
宝。真气之所过。血络之所游。邪气恶血固不得住留。住留则伤筋络骨节。机关不得屈伸。
故病挛也。
或曰。八正之候何如。
经曰。候此者。常以冬至之日。立于叶蛰之宫。其至也。天必应之以风雨者矣。风雨从
南方
为虚风。主伤人杀害。故圣人谨候虚风而避之。邪弗能害。）其以夜半至也。民皆卧而弗犯
。故其岁民少病。以昼至也。民皆懈惰而中之。故民多病。虚邪入客于骨而不发于外。至其
立春。阳气大发。腠理开。因立春之日。风从西方来者。民皆又中于虚风。此两邪相搏。经
气结代者矣。故诸逢其风而遇其雨者。命曰遇岁露焉。而岁之和而少贼风。则民少病而少
死。贼风邪气寒温不和。则民多病而死矣。
或曰。诸病逆顺。可得闻乎。
经曰。腹胀身热脉大。一逆也。腹鸣而满。四肢清泄脉大。二逆也。衄而不止脉大。三
逆也
日而死矣。腹大胀。四末清。脱形泄甚。一逆也。腹胀便血。脉大时绝。二逆也。咳溲血脱
形。脉
时而死矣。工不察此而刺之。是谓逆治。五夺者。形肉已夺。一也。大夺血之后。二也。大汗
出之后。三也。大泄之后。四也。新产及大血之后。五也。此皆不可写。热病脉静。汗已出
。脉盛躁。一逆也。病泄。脉洪大。二逆也。着痹不移。 肉破。身热。脉偏绝。三逆也。淫
而夺形。身热。色夭然白。及后下血 笃重。四逆也。寒热夺形。脉坚搏。五逆也。小儿病
。头毛皆逆上者。必死。
或曰。经言痹病有众痹。有周痹。何分别耶。
经曰。众痹者。此各在其处。更发更止。更居更起。以右应左。以左应右。非能周也。
刺此
左右。各当其所。痛从上下者。先刺其下以遏之。后刺其上以脱之。痛从下上者。先刺其上
以遏之。后刺其下以脱之。此内不在脏。而外未发于皮。独居分肉之间。真气不能周。故曰周
痹。
问曰。经言凡痹往来。行无常处者。在分肉间痛。刺之以月。死生为数。何也。
经曰。用针者。随气盛衰以为 数。针过其数。则曰脱气。不及日数。则气不写。左刺
右。
。二日二 。渐多之。十五日十五 。十六日十四 。渐少之。（如是刺之则无过数。无
不及矣。）
或曰。经言热病有五十九刺。可得闻欤。
经曰。热病三日。气口静。人迎躁者。取之诸阳。五十九刺。以写其热。而出其汗。实
其阴
是。头入发一寸旁三分各三。凡六 。更入发三寸。边五。凡十 。耳前后口下者各一。项
中一。凡六 。巅上一。囟会一。发际一。廉泉一。风池二。天柱二也。热病七日八日。脉
口动。喘而短（一作弦）者。急刺之。汗且自出。浅刺手大指间。热病汗且出。及脉顺可汗者
。取之鱼际、太渊、大都、太白。写之则热去。补之则汗出。汗出太甚。取之内踝上横脉以止
之。热病七八日。脉微小。病溲血。口中干。日半死。脉代者。一日死。热病已得汗。脉尚
躁。喘且复热者死。热病七八日。脉不躁。躁不散数。后三日中有汗。三日不汗。四日死。
热病脉尚盛
颇有寒者。热在髓。死不可治。又热病不可刺者有九。一曰。汗不出。大颧发赤。哕者死。
二曰。泄而腹满甚者死。三曰。目不明。热不已者死。四曰。老人婴儿。热而腹满者死。五
曰。汗不出。呕下血者死。六曰。舌本烂。热不已者死。七曰。咳而衄。汗不出。出不至足
者
或曰。刺热病亦有异乎。
或曰。寒热瘰 在颈腋者。何气使然。
经曰。此皆鼠 寒热之毒瓦斯。留于脉而不去也。鼠 之本。皆在于藏。其末上出于颈腋
之间。
其寒热。审按其道以予之。徐往徐来以去之。其小如麦者。一刺知。三刺已。若反其目视之
。其中有赤脉。上下贯瞳子。见一脉。一岁死。见一脉半。一岁半死。见二脉。二岁死。见
二脉半。二岁半死。见三脉。三岁死。见赤脉不下贯瞳子。可治也。
或曰。痈疽何以治之。
经曰。痈疽之生。脓血之成。积微之所生也。故圣人自治于未有形也。愚者遭其已成者
。脓
已成脓血者。其惟砭石铍锋之所取也。所谓多害者。观逆顺也。其白眼青。黑眼小。一逆。
内药而呕。二逆。腹痛渴甚。三逆。肩项不便。四逆。音嘶色脱。五逆。除此五者。顺矣。
或曰。水肿之病。宜刺乎。
经曰。经脉满则络脉溢。络脉溢则缪刺之。以调其络脉。使复其形而不肿。缪刺者。不
分隧
。脉微弱者。今亦往往而缪刺之。祸不旋踵。盖不审经言。脉络满溢。宜缪刺之理也。
或曰。人有肥瘦白黑小长。刺法同乎否乎。
经曰。年质壮大者。血气充盈。肤革坚固。因加以邪。刺此者。深而留之。婴儿者。其
肉脆
色
少。肉廉廉然。薄唇轻言。血清气滑。易脱于气。易损于血。刺此者。浅而疾之。壮士真骨
者。坚肉缓节。监监然。此人重则气涩血浊。刺此者。深而留之。多益其数。劲则气滑血清
。刺此者。浅而疾之。常人者。视其黑白。各为调之。其端正敦浓者。血气调和。刺此者。
无失常数也。
或曰。匹夫大人。刺法同乎。
经曰。气滑则出疾。气涩则出迟。气悍则针小而入浅。气浊则针大而入深。深则欲留。
浅则
。春气在毛。夏气在皮肤。秋气在分肉。冬气在筋骨。凡刺病者。各以其时为齐。故刺肥人
以秋冬之齐。刺瘦人以春夏之齐。
经曰。营之生病也。寒热少气。血上下行。卫之生病也。气痛时来时去。怫气贲响。风
寒客
者内热。刺布衣者以火淬之。刺大人以药熨之。以熨寒痹所刺之处。令热入至于病所。起步
内无见风。每刺必熨。如此病已。所谓内热也。
或曰。三虚三实者。何谓也。
经曰。三虚者。乘年之衰。逢月之虚。失时之和。因为贼风所伤。是谓三虚。故论不知
三
或曰。人身有四海。何也。
经曰。胃者水谷之海。其输上在气街。下至三里。冲脉者。为十二经之海。其输上在于
大杼
海。其输上在于其盖。下在风府。气海有余者。气满胸中。 息面赤。不足。则气少不足以
言。血海有余。则常想其身大。怫然不知其所病。不足。常想其身小。狭然不知其所病。水
谷之海有余。则腹满。不足。则饥不受谷食。髓海有余。则轻劲多力。自过其度。不足。则
脑转耳鸣。胫酸眩冒。目无所见。懈怠安卧。治此者。审守其输。而调其虚实。无犯其害。顺
者得复。逆者必败。
或曰。诸家言某穴主某病。其说亦可从乎。
曰。治病无定穴也。邪客于人。与正周流上下。或在气分。或在血分。无有定止。故喻
用针
守某穴主某病之说。执中无权。按谱施治。譬之狂潦泛溢。欲塞下流而获安者。亦偶然耳。
夫病变无穷。灸刺之法亦无穷。或在上。下取之。或在下。上取之。或正取之。或直取之。
审经与络。分血与气。病随经所在。穴随经而取。庶得随机应变之理。岂可执以某穴主某病
哉。或曰。此固然矣。但学人望洋无下手处。曰。譬犹匠者。教人以规矩。取方圆也。规矩
之法在师。方圆之法则在子弟。夫圣人之于针。非经络孔穴。无以教后学。后学非经络孔
穴
守神。粗守关。上守机。机之动。不离其空中。此之谓也。
或曰。八穴治病。多有效者。何如。
曰。人身正经十二。奇经有八。大络十五。小络三百余。皆所以行气血也。圣人取穴。
三百
不知。孔穴不可不认。不知经络。无以知血气往来。不知孔穴。无以知邪气所在。知而用
。用而的。病乃可安。今之用八穴者。络穴六。经穴二。余络余经。置而不用。速求巧捷。
遂悖圣经。又有六十六穴。拘于日时开阖。用之犹未周备。而况拘于八穴者乎。盖八穴病在
气分。则有可劫之功。若在血分。徒损元气。病何由安。正是血病而泻气也。邪在血分。则
直求病之所在。而取之可也。今人泥而不用。良可笑耶。
或曰。膻中、鸠尾、中庭。人亦有针之者。宁无禁乎。
曰。心为一身之主。至贵不可犯。膻中、鸠尾、巨阙。心之宫城也。心主虚怯。不能主
事。
狂者有之。用针之士。多于膻中、鸠尾、中庭针之。亦犹伊芳尹之于太甲。周公之于孺子。事
有差误。则将倾覆社稷。荼毒生灵。其害有不可胜言者矣。夫针三穴亦然。犯真心。死不可
救。必须自揣己才。果有如伊芳周之能。可以扶危持颠。方能保心于无危也。
或曰。针三阴交。主何病也。
曰。足之三阴。从足走腹。太阴脾经循内踝上直行。厥阴循内踝前交入太阴之后。少阴
肾经
非危疾急证。与三阴俱有干者。不可轻刺。脾肾气常不足。肝虽有余。亦是宿血之藏。误刺
则脱人元气。不可不慎。
或曰。伤寒刺期门穴者。何如。
曰。十二经始于手太阴之云门。以次而传。终于足厥阴之期门。期门者。肝之募也。伤
寒过经
胁下肥气。凡是木郁诸疾。莫不刺之。以其肝主病也。经云。穴直乳下两肋端。又曰。在不
容旁一寸五分。古人说得甚明。今人不解用也。
或曰。刺胸腹者。必避五脏。何谓也。
经曰。中心。一日死。中肝。五日死。中脾。十日死。中肾。六日死。中肺。三日死。
The Classic states: Diseases located in the upper part of the body belong to Yang; diseases located in the lower part belong to Yin. Pain belongs to Yin; pain that cannot be localized by palpation also belongs to Yin, and requires deep needling. Itching belongs to Yang, and requires shallow needling. If a disease originates from the Yin aspect first, treat the Yin first, then the Yang; if it originates from the Yang aspect first, treat the Yang first, then the Yin. (For diseases in the upper part, take points from the lower part; for diseases in the lower part, take points from the upper part. For diseases in the head, take points on the feet; for diseases in the waist, take points on the back. Diseases originating in the head cause heaviness in the head; those originating in the hands cause heaviness in the arms; those originating in the feet cause heaviness in the feet. In treating diseases, first needle the site where the disease originated.)
The Classic states: For diseases starting in the arm, first needle the Hand-Yangming Large Intestine channel and the Hand-Taiyin Lung channel to induce sweating. For diseases starting in the head, first needle the Foot-Taiyang Bladder channel at the neck to induce sweating. For diseases starting in the lower leg, first needle the Foot-Yangming Stomach channel to induce sweating. The Foot-Taiyin Spleen channel and Foot-Yangming Stomach channel can also induce sweating. Therefore, if taking Yin channel points causes excessive sweating, stop it by taking Yang channel points; if taking Yang channel points causes excessive sweating, stop it by taking Yin channel points.
Someone asked: The Classic mentions five types of pathogenic factors: Xu-Xie (Deficiency Evil), Shi-Xie (Excess Evil), Zei-Xie (Thief Evil), Wei-Xie (Minor Evil), and Zheng-Xie (Correct Evil). What do these mean?
The Classic states: Pathogenic factors coming from the Mother organ are called Xu-Xie (Deficiency Evil); those coming from the Child organ are called Shi-Xie (Excess Evil); those coming from the organ that overcomes me are called Zei-Xie (Thief Evil); those coming from the organ that I overcome are called Wei-Xie (Minor Evil); and diseases arising from the organ itself are called Zheng-Xie (Correct Evil). For example, heart disease caused by wind-stroke (Liver Wood generates Heart Fire) is Xu-Xie, because Wood follows Fire, and Wood generating Fire represents the Mother-Child relationship. Disease caused by diet and fatigue (Spleen Earth generates Heart Fire) is Shi-Xie, because Earth precedes Fire, representing the Mother-Child relationship. Disease caused by dampness invasion (Kidney Water overcomes Heart Fire) is Zei-Xie, because Water overcomes Fire. Disease caused by cold injury (Lung Metal is overcome by Fire) is Wei-Xie, because Fire overcomes Metal. Disease caused by summerheat (Heart Fire self-disease) is Zheng-Xie, because Fire is self-diseased.
Someone asked: There are cases of self-disease of the regular channels and injuries from the Five Evils. Should acupuncture treatment distinguish between them?
The Classic states: Worry and overthinking damage the Heart; exposure to cold and consumption of cold drinks damage the Lungs; anger with counterflow Qi rising and not descending damages the Liver; improper diet and overfatigue damage the Spleen; sitting long in damp places or forcing entry into water damages the Kidneys. These are self-diseases of the regular channels. This is generally due to excesses in emotions, diet, and activity. Wind easily damages the Liver; Summerheat easily damages the Heart; diet and fatigue easily damage the Spleen (though fatigue seems internal, it is triggered externally); Cold easily damages the Lungs; Dampness easily damages the Kidneys. These are injuries from the Five Evils. Generally, pathogens come from outside, which is external injury. When Yin-Yang, Zang-Fu, and Meridian Qi are balanced in deficiency and excess, it is normal; deviation towards excess or deficiency, losing normalcy, becomes evil. Due to deviation towards excess, internal evils arise; due to deviation towards deficiency, external evils enter. Wang Ji's commentary: The Classic states that all diseases should be distinguished regarding the nature, origin (internal/external), and deficiency/excess of the pathogen before applying tonification or sedation needling, to avoid errors.
Someone asked: The Classic says "Tonify deficiency, sedate excess, and for neither deficient nor excess, take from the channel." What does this mean?
The Classic states: For deficiency, tonify its Mother channel, as the Mother can make the Child full. For excess, sedate its Child channel, as the Child can make the Mother empty. For example, in Liver deficiency, tonify the He-Sea point Ququan of the Jueyin Liver channel; in excess, sedate the Ying-Spring point Xingjian of the Jueyin Liver channel. "Neither deficient nor excess, take from the channel" refers to self-disease of the regular channel without transmission from other organs' pathogens. One should directly take points from the affected channel, such as Jing-Well points governing chest fullness. Self-disease of the regular channel refers to conditions like worry damaging the Heart or forceful water entry damaging the Kidneys. "Neither deficient nor excess" means there is no mutual overcoming among the Zang organs, hence "take from its own channel" (a re-explanation of the end of the volume).
Someone asked: The Classic says "Do not tonify excess, do not sedate deficiency, do not harm what is insufficient, and do not add to what is already excessive." What does this mean?
The Classic states: This refers to the deficiency and excess of diseases. For example, if Liver Wood is in excess and Lung Metal is deficient, Metal and Wood should balance each other. One should know to use Metal to level Wood. If Lung is in excess and Liver is deficient, presenting with shortness of breath, and the practitioner fails to tonify the Liver but instead further sedates the Lung, this is called "making excess more excess, making deficiency more deficient, harming the insufficient, and adding to the excessive."
Someone asked: How can diseases damaged by the Seven Emotions be identified? Can they be treated with acupuncture?
The Classic states: Wise people nourish life by following the four seasons to adapt to cold and heat, harmonizing joy and anger to live peacefully, regulating Yin and Yang to adjust hardness and softness. By doing so, deviant diseases will not arise, ensuring longevity. Thus, fear and overthinking damage Shen (Spirit); damaging Shen leads to fear and loss of self-control. Unresolved sorrow damages Yi (Intellect); damaging Yi leads to mental confusion. Sadness moving within damages Hun (Ethereal Soul); damaging Hun leads to madness, forgetfulness, and lack of clarity. Unrestrained joy damages Po (Corporeal Soul); damaging Po leads to madness. Uncontrolled rage damages Zhi (Willpower); damaging Zhi leads to forgetfulness. Unresolved fear damages Jing (Essence); damaging Jing leads to soreness and weakness of the bones and cold extremities. Therefore, the Five Zang organs store Jing and must not be damaged. Damage leads to loss of control and Yin deficiency; Yin deficiency leads to lack of Qi; lack of Qi leads to death. Thus, acupuncturists must observe the patient's state to know the survival or loss of Spirit, Ethereal Soul, Corporeal Soul, etc. If these five are damaged, acupuncture cannot cure them.
It is also said: The Liver stores Blood, and Blood houses Hun. Liver Qi deficiency causes fear; Liver Qi excess causes anger. The Spleen stores Ying (Nutritive) Qi, and Ying Qi houses Yi. Spleen Qi deficiency causes inability to use the limbs and disharmony of the Five Zang; Spleen Qi excess causes abdominal distension and difficult urination and defecation. The Heart stores Mai (Vessels), and Vessels house Shen. Heart Qi deficiency causes sadness; Heart Qi excess causes incessant laughter. The Lungs store Qi, and Qi houses Po. Lung Qi deficiency causes nasal congestion and difficulty breathing, shortness of breath; Lung Qi excess causes wheezing, chest fullness, and仰息 (breathing with raised chest). The Kidneys store Jing, and Jing houses Zhi. Kidney Qi deficiency causes cold extremities; Kidney Qi excess causes abdominal distension and disharmony of the Five Zang. One must carefully examine the manifestations of Zang diseases to know the deficiency or excess of their Qi and regulate them cautiously.
It is also said: When the Lungs and Heart have pathogens, their Qi remains in the two elbows; when the Liver has pathogens, their Qi remains in the two axillae; when the Spleen has pathogens, their Qi remains in the two thighs (Pi); when the Kidneys have pathogens, their Qi remains in the two popliteal fossae (Guo). These eight voids (Ba Xu) are treasures of the joints, passages of True Qi, and routes of blood collaterals. Pathogens and bad blood should not stay here; if they stay, they damage sinews, collaterals, and bone joints, causing joint stiffness and spasms.
Someone asked: What are the observations for the Eight Normals (key solar terms)?
The Classic states: To observe these, one usually stands in the Ye Zhe Palace (North Kan position) on the day of Winter Solstice. When the Qi arrives, Heaven responds with wind and rain. If wind and rain come from the South, it is called Xu Feng (Empty Wind), which harms and kills. Thus, sages carefully observe and avoid Empty Wind so pathogens cannot harm. (If it arrives at midnight, people are sleeping and not exposed, so few get sick that year. If it arrives during the day, people are lax and exposed, so many get sick.) Empty evil enters and lodges in the bones without manifesting externally. When Spring Equinox arrives, Yang Qi expands greatly, pores open, and if wind comes from the West on that day, people are again struck by Empty Wind. These two evils collide, knotting the Meridian Qi. Those who encounter this wind and rain are called encountering Year Dew. If the year is harmonious with few Thief Winds, people have few diseases and deaths; if Thief Wind and pathogens clash with cold and warmth, people suffer many diseases and deaths.
Someone asked: Can you explain the reverse and favorable signs of various diseases?
The Classic states: Abdominal distension, fever, and large pulse is one reverse sign. Bowel sounds, abdominal fullness, cold extremities, diarrhea, and large pulse is the second reverse sign. Unstopping epistaxis and large pulse is the third reverse sign (death may occur on the same day). Abdominal distension, cold extremities, emaciation, and severe diarrhea is one reverse sign. Abdominal distension with bloody stool, large pulse with intermittent beats is the second reverse sign. Coughing and hematuria with emaciation and specific pulse changes indicate death (may occur on the same day). A physician who needles without observing these is practicing reverse treatment.
The "Five Deprivations" are: 1. Emaciation of flesh and muscle; 2. After massive blood loss; 3. After profuse sweating; 4. After severe diarrhea; 5. After childbirth or massive bleeding. None of these should be sedated.
In heat diseases, if the pulse is quiet but becomes rapid and restless after sweating, it is one reverse sign. In diarrhea, if the pulse is洪大 (Surging-Large), it is the second reverse sign. In fixed Bi syndrome with immobility, muscle wasting, fever, and absent pulse on one side, it is the third reverse sign. In淫邪 (Licentious/Excessive pathology) with emaciation, fever, pale waxy complexion, followed by bloody stool and severe condition, it is the fourth reverse sign. In alternating cold and heat with emaciation and firm, gripping pulse, it is the fifth reverse sign. In children, if illness causes hair to stand on end, death is certain.
Someone asked: The Classic mentions Zhong Bi (Multifocal Bi) and Zhou Bi (Circulating Bi). What is the difference?
The Classic states: Zhong Bi occurs in various locations, alternating in onset and cessation, shifting positions, left corresponding to right, right to left, not circulating throughout the body. To needle this, take points on both sides corresponding to the pain. If pain travels from top to bottom, needle the lower part first to block it, then the upper part to release it. If pain travels from bottom to top, needle the upper part first to block it, then the lower part to release it. Zhou Bi is internal, not in the Zang, and external, not yet in the skin, residing alone between muscle layers, where True Qi cannot circulate fully, hence called Zhou Bi.
Question: The Classic says Bi syndrome moves without fixed location, causing pain between muscle layers, and needling frequency is based on the moon's phases. Why?
The Classic states: The acupuncturist adjusts the number of needles according to the rise and fall of Qi. Needling beyond the limit causes Qi depletion; falling short fails to expel Qi. Needle left-right, right-left. Day 1: two times; Day 2: two times; gradually increase. Day 15: fifteen times; Day 16: fourteen times; gradually decrease. (This ensures no excess or deficit.)
Someone asked: The Classic mentions fifty-nine points for heat diseases. Can you list them?
The Classic states: On the third day of heat disease, if the Cun Kou pulse is quiet and Ren Ying pulse is restless, take points from all Yang channels using the fifty-nine needling method to sedate heat and induce sweat, thereby filling Yin. The points are: Six points one cun inside the hairline, three on each side; ten points three cun inside the hairline, five on each side; one point each in front of and behind the ears, below the mouth, and in the middle of the neck (six total); one point on the vertex, one at Xinhui, one at the hairline, one at Lianquan, two at Fengchi, and two at Tianzhu. On days seven or eight, if the pulse port moves, with panting and shortness of breath (or string-like pulse), needle urgently to induce spontaneous sweat; shallowly needle the space between the big toe (Shangyang). For heat disease about to sweat or with favorable pulses for sweating, take Yuji, Taiyuan, Dadu, and Taibai. Sedating clears heat; tonifying induces sweat. If sweat is excessive, take the transverse vessel above the medial malleolus to stop it. On days seven or eight, if the pulse is minute, with hematuria and dry mouth, death occurs in half a day; if the pulse is intermittent (Dai), death occurs in one day. If heat disease has sweated but pulse remains restless with panting and recurrent fever, death ensues. If on days seven or eight the pulse is not restless, but restless and rapid without dispersing, sweat within three days indicates survival; no sweat by day four indicates death. If heat disease pulse remains full with significant chills, heat is in the marrow, death is incurable. There are nine contraindications for needling heat diseases: 1. No sweat, red cheeks, hiccups (death); 2. Diarrhea with severe abdominal fullness (death); 3. Blindness with unrelenting heat (death); 4. Elderly or infants with fever and abdominal fullness (death); 5. No sweat, vomiting, and bloody stool (death); 6. Ulcerated tongue base with unrelenting heat (death); 7. Coughing with epistaxis, no sweat, or sweat not reaching feet... (text cuts off).
Someone asked: Is needling for heat diseases different?
Someone asked: What causes cold-heat Luoli (scrofula) in the neck and axilla?
The Classic states: These are toxins from mouse Luoli cold-heat, lingering in the vessels. The root lies in the Zang, emerging at the neck and axilla. Treat by carefully following the meridians, entering slowly and withdrawing slowly. Small ones like wheat grains heal after one insertion, cured after three. If looking into the eyes reveals red vessels piercing the pupil, one vessel predicts death in one year; one and a half vessels, one and a half years; two vessels, two years; two and a half vessels, two and a half years; three vessels, three years. If red vessels do not pierce the pupil, it is treatable.
Someone asked: How to treat Yong Ju (carbuncles and ulcers)?
The Classic states: Carbuncles and ulcers arise from accumulation of the minute. Sages treat before form appears; fools suffer after formation. Once pus and blood form, only stone lancets and scalpels can treat. Observing reverse and favorable signs is crucial. Reverse signs: blue whites of eyes with small black pupils (one); vomiting after taking medicine (two); severe abdominal pain and thirst (three); stiff shoulder and neck (four); hoarse voice and loss of complexion (five). Beyond these, it is favorable.
Someone asked: Is acupuncture suitable for edema?
The Classic states: When Jing vessels are full, Luo vessels overflow; when Luo vessels overflow, use Miao Ci (lateral needling) to regulate Luo vessels and restore shape without swelling. Miao Ci does not distinguish meridians. Now, even with weak pulses, Miao Ci is often used, bringing immediate disaster. This is due to ignoring the Classic's principle that full and overflowing Luo vessels require Miao Ci.
Someone asked: Do fat, thin, white, dark, tall, and short people require the same needling methods?
The Classic states: Robust adults with full Qi and blood and tough skin, when attacked by pathogens, require deep needling with retention. Infants with fragile flesh, ruddy color, thin lips, light speech, clear and slippery Qi and blood, prone to Qi depletion and blood damage, require shallow and quick needling. Strong men with solid bones and muscles: if heavy, Qi is stagnant and blood turbid, requiring deep needling with retention and increased frequency; if agile, Qi is slippery and blood clear, requiring shallow and quick needling. Ordinary people: adjust according to skin color. Those upright and thick have harmonious Qi and blood; needle without deviating from standard rules.
Someone asked: Do commoners and nobles require the same needling methods?
The Classic states: Slippery Qi requires quick withdrawal; stagnant Qi requires slow withdrawal. Fierce Qi requires small needles and shallow insertion; turbid Qi requires large needles and deep insertion. Deep needling retains; shallow needling withdraws quickly. Spring Qi is in the hairs; Summer Qi in the skin; Autumn Qi in the muscle layers; Winter Qi in the sinews and bones. Needling must follow seasonal standards. Needle robust people with winter/autumn standards; thin people with spring/summer standards.
The Classic states: Ying disease presents with cold-heat, shortness of breath, and abnormal blood flow. Wei disease presents with migrating pain, turbulent Qi sounds, and internal heat from wind-cold. Needling commoners uses fire cautery; needling nobles uses herbal warming. Apply warming to the needled site of cold Bi to drive heat to the disease site. Avoid wind after needling. Warm every time needled until cured. This treats internal heat.
Someone asked: What are the Three Deficiencies and Three Excesses?
The Classic states: Three Deficiencies refer to being in a year of declining fortune, meeting a deficient moon phase, and losing seasonal harmony, thus injured by thief wind. This is called Three Deficiencies. (Text implies ignorance of Three Deficiencies leads to error.)
Someone asked: What are the Four Seas of the human body?
The Classic states: The Stomach is the Sea of Water and Grain, with Shu points at Qichuang and Zusanli. The Chong Mai is the Sea of Twelve Channels, with Shu points at Dazhu and Xiangu. The Danzhong is the Sea of Qi, with Shu points at the upper and lower vertebral column and Renying. The Brain is the Sea of Marrow, with Shu points at Baihui and Fengfu. Excess Qi Sea causes chest fullness, panting, and red face; deficiency causes shortness of breath. Excess Blood Sea makes one feel large and depressed; deficiency makes one feel small and constrained. Excess Water/Grain Sea causes abdominal fullness; deficiency causes hunger without desire to eat. Excess Marrow Sea causes lightness and strength beyond normal; deficiency causes dizziness, tinnitus, sore legs, blindness, lethargy, and desire to lie down. Treat by examining Shu points and regulating deficiency/excess without violating taboos. Following this restores health; opposing it leads to failure.
Someone asked: Various schools say specific points treat specific diseases. Is this acceptable?
Answer: There are no fixed points for curing diseases. Pathogens move with Zheng Qi, residing in Qi or Blood levels without fixed location. Clinging to "Point X treats Disease Y" is rigid and ineffective, like trying to stop a flood by blocking the downstream. Diseases change infinitely; needling methods must also be infinite. Take upper points for lower diseases, lower for upper, direct or indirect. Examine Jing and Luo, distinguish Blood and Qi, follow the meridian for the disease and the point. This allows flexibility. How can one cling to specific point-disease pairs? Some say learners don't know where to start. Answer: Like a carpenter teaching rules for squares and circles. The teacher holds the rules; the student produces the shapes. Sages use meridians and points to teach; students must learn them to understand Qi/Blood flow and pathogen location. Knowledge must be applied accurately. Coarse practitioners guard joints; superior practitioners guard the timing/movement of Qi. This is the essence.
Someone asked: Eight points often work well for diseases. What about this?
Answer: The body has twelve Regular Channels, eight Extraordinary Channels, fifteen Major Collaterals, and hundreds of minor collaterals, all moving Qi and Blood. Sages selected 360 points... (text implies complexity). Not knowing meridians prevents understanding Qi/Blood flow; not knowing points prevents locating pathogens. Knowledge must be applied correctly. Using only eight points (six Luo, two Jing) ignores others, seeking shortcuts against the Classics. Even restricting to 66 points based on time openings is incomplete, let alone eight points. Eight points work for Qi-level diseases but damage Yuan Qi in Blood-level diseases. This is sedating Qi for Blood disease. For pathogens in Blood, find the site and needle directly. Modern rigidity is laughable.
Someone asked: Are there contraindications for needling Tanzhong, Jiutui, and Zhongting?
Answer: The Heart is the master, precious and inviolable. Tanzhong, Jiutui, and Jueque are the palace walls of the Heart. If the Heart Master is weak, patients may become manic. Practitioners often needle these points, akin to ministers serving a young king; errors could topple the state. Needling these three risks touching the True Heart, leading to incurable death. One must assess skill; only those with abilities like Yi Yin or Duke of Zhou can safely support the critical and protect the Heart.
Someone asked: What diseases does Sanyinjiao treat?
Answer: The Foot Triple Yin channels ascend from foot to abdomen. The Taiyin Spleen channel goes straight up the medial malleolus; the Jueyin Liver channel crosses anterior to it and enters posterior to Taiyin; the Shaoyin Kidney channel... (text cuts off). Unless it is a critical emergency involving all three Yin channels, do not lightly needle. Spleen and Kidney Qi are often deficient; Liver stores old blood. Mistaken needling depletes Yuan Qi. Be cautious.
Someone asked: What about needling Qimen for Shanghan (Cold Damage)?
Answer: The twelve channels start at Yunmen of Hand-Taiyin and end at Qimen of Foot-Jueyin. Qimen is the Mu point of the Liver. In advanced Shanghan, with hypochondriac masses or Wood stagnation diseases, needle this point as the Liver governs the pathology. The Classic states the point is under the nipple at the rib end, or 1.5 cun lateral to Burong. Ancients explained this clearly; moderns fail to apply it.
Someone asked: Needling the chest and abdomen requires avoiding the Five Zang. What does this mean?
The Classic states: Piercing the Heart causes death in one day; piercing the Liver in five days; piercing the Spleen in ten days; piercing the Kidney in six days; piercing the Lung in three days.