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[Ping An]: This chapter appears in *Ling Shu* (Spiritual Pivot), Volume 3, Chapter 12 "Jing Shui" (Meridian Waters), and also in *Jia Yi Jing* (Classified Classic of the Academy), Volume 1, Chapter 7, with only slight differences in syntax.

Huang Di asked Qi Bo: The twelve meridians of the human body externally correspond to the twelve major rivers of the world, and internally belong to the Zang-Fu organs (Five Zang and Six Fu organs). [The world has eighty-one provinces; what is referred to here as "Zhong Guo" (Central State) is merely one province, named Chi Xian Shen Zhou (Red County Divine Land). Outside each province lies a ring of sea water; outside the sea water lies a great mountain range. Thus surrounded by three rings of sea and three rings of mountains, humans dwell within, called one province. Within each province are twelve major rivers, while minor hills and streams outside are countless. The human body is similar; there are twelve major meridians, and beyond them, major and minor collaterals are innumerable. Among the eighty-one provinces, we take only the terrain of this "Central State" to correspond to the internal affiliation of the twelve meridians with the Zang-Fu organs, because humans are born in this state and inherit its terrain and Qi.] These twelve meridian waters differ in size, depth, breadth, narrowness, distance, and proximity. Similarly, the height, size, and capacity for receiving grain of the Zang-Fu organs vary. How do they correspond? [This asks for the basis of taking the twelve meridians as models after the meridian waters.] Meridian waters receive their source and flow; [This asks for the basis of each Zang-Fu organ and meridian managing its own nourishment. The twelve meridian waters each receive water from their source and transport it to the sea, hence called "receiving water and flowing."] The Five Zang organs store Shen (Spirit), Qi (Energy), Hun (Ethereal Soul), Po (Corporeal Soul); [The Five Zang organs combine with the Qi of the Five Spirits: Heart combines with Shen, Liver with Hun, Lung with Po, Spleen with Ying (Nutritive Qi), Kidney with Jing (Essence). The Five Zang combine with the Five Spirits' Qi and store them. [Ping An]: Below the character "Zang", both *Ling Shu* and *Jia Yi Jing* have the character "Zhi" (of), same as Yuan's edition.] The Six Fu organs receive grain and circulate it, receive Qi and disperse it; [The Stomach receives the five grains and ripens them, transmitting to the Small Intestine, which holds them. The Small Intestine transmits to the Large Intestine, which conducts. The Large Intestine transmits to the Broad Intestine, which expels. The Stomach separates fluids downward, exiting via the Bladder's bladder-body, and discharging from the yin orifices. The Gallbladder is the organ of pure essence, containing Wood essence, storing but not excreting. This is how the Fu organs receive grain and circulate. The Five Fu organs share Qi with the San Jiao (Triple Burner), so the Six Fu organs receive Qi, and the San Jiao circulates it as the origin, hence called "dispersing". [Ping An]: In the note, "Cheng Shu" (ripened), the character "Shu" was mistakenly printed as "Re" (heat) in Yuan's edition. Also, the five characters "Bie Zhi Chu Pang Guang" (separate fluids exit Bladder) were originally missing/incomplete; carefully examining the remaining parts eaten by insects suggests these five characters. Yuan's edition reads "Pang Guang Pang Guang" (Bladder Bladder).] The meridians receive blood and nourish the body. [Ying Qi (Nutritive Qi) emerges from the Middle Jiao, passes the stomach opening, and exits after the Upper Jiao. This is called receiving Qi, separating dregs, secreting Jin Ye (Body Fluids), transforming Jin Ye into fine essences, injecting them into the Lung meridians, transforming into blood, flowing through the twelve meridians to nourish the living body. Thus, nothing is more precious for sustaining life than blood. Therefore, Ying Qi travels alone in the twelve meridians, guiding and nourishing the body, hence called Ying Qi. Ying Qi traveling in the meridians is like mist. Blood in the meridians is like water in a canal. Thus, the twelve meridians receive blood and nourish accordingly. [Ping An]: The character above "Jin Ye" in the note is incomplete due to insect damage; Yuan's edition makes it "Cheng" (become), but careful examination shows it is definitely not "Cheng"; leave a space.] If we integrate them for treatment, how should it be done? Can you tell me about the depth of acupuncture and the number of moxibustion cones? [Ying Qi emerges from the Middle Jiao... thus nothing is more precious for sustaining life than blood. Therefore, Ying Qi travels alone in the twelve meridians, guiding and nourishing the body, hence called Ying Qi. Ying Qi traveling in the meridians is like mist. Blood in the meridians is like water in a canal. Thus, the twelve meridians receive blood and nourish accordingly. [Ping An]: The character above "Jin Ye" in the note is incomplete due to insect damage; Yuan's edition makes it "Cheng" (become), but careful examination shows it is definitely not "Cheng"; leave a space.]

Qi Bo replied: Excellent question! Heaven is so high it cannot be measured, Earth is so vast it cannot be quantified; this is what is meant. Moreover, humans are born between Heaven and Earth, within the Six Directions. The height of Heaven and the breadth of Earth are beyond human measurement. As for an eight-chi tall person, skin and flesh are on the surface, which can be measured, palpated, and traced externally; after death, the body can be dissected to observe internally. [The greatness of Yin and Yang cannot be measured by human effort. For the eight-chi human body, while alive, one observes skin and flesh, palpates color and pulse; after death, one dissects the body parts to view the Zang-Fu organs. Unlike Heaven and Earth, this is knowable. [Ping An]: "Wai Ke Du Liang" (externally can be measured), Yuan's edition adds "Sheng" (life) below "Wai", which is incorrect; *Ling Shu* also lacks it. "Bu" (parts) is written as "Pou" (dissect) in *Ling Shu*.] The firmness and fragility of the Zang organs, the size of the Fu organs, the amount of grain, the length of the pulses, the clarity and turbidity of blood, the quantity of Qi, whether the twelve meridians have much blood and little Qi, little blood and much Qi, much blood and much Qi, or little blood and little Qi, all have fixed standard numbers. When treating with needles and moxa, adjusting their meridian Qi, do we strictly adhere to these constants? [Humans inherit Qi and form bodies, having seven different types. Using needles and moxa for regulation certainly has constant principles, unlike the immeasurable Heaven and Earth.]

Huang Di said: I heard it pleasantly, but did not understand it deeply in my heart. I wish to hear it completely. ["Kuai Yu Er" means superficial knowledge; "Jie Yu Xin" means deep understanding. [Ping An]: Below "Zu Wen" (hear completely), *Ling Shu* has the character "Zhi".]

Qi Bo replied: This is because humans participate in Heaven and Earth and correspond to Yin and Yang, and must be carefully observed. [Precisely because Heaven and Earth are immeasurable, yet humans participate in Heaven and Earth, they must not fail to observe.]

The Foot-Taiyang Meridian externally corresponds to Qing Shui (Clear Water) and internally belongs to the Bladder. [Qing Shui originates in Neihuang County, Wei Commandery, flows south through Qingquan County, and enters the Yellow River northeastward. [Ping An]: Below "Pang Guang" (Bladder), *Ling Shu* and *Jia Yi Jing* have the five characters "Er Tong Shui Dao Yan" (and unblocks the water pathways), placed later in this book.] The Foot-Shaoyang Meridian externally corresponds to Wei Shui (Wei River) and internally belongs to the Gallbladder. [Wei Shui originates from the Bird-Rat Shared Cave Mountain in Shouyang County, Longxi Commandery, flows northeast to Huayin to enter the Yellow River, passing four commanderies, traveling 1,870 li, it is the soaking water of Yongzhou.] The Foot-Yangming Meridian externally corresponds to Hai Shui (Sea Water) and internally belongs to the Stomach. [Hai (Sea) implies darkness/haziness, referring to its vastness, looking dark and unfathomable at the edges, hence called Sea. Hai refers to the Four Seas. The Foot-Yangming meridian has the most blood and Qi, corresponding to the Four Seas, the head of all waters.] The Foot-Taiyin Meridian externally corresponds to Hu Shui (Lake Water) and internally belongs to the Spleen. [Hu should be [Character], Tuoshui originates in Lucheng County, Dai Commandery, flows east through nine commanderies, traveling 1,340 li, becoming Bingzhou Chuan. Another interpretation says: Hu should be Gu, Gushui originates in Yuyang Commandery, flows southeast into the sea, traveling 750 li. Both waters can serve as correspondence. [Ping An]: [Character] is printed as "Yu" in Yuan's edition.] The Foot-Shaoyin Meridian externally corresponds to Ru Shui (Ru River) and internally belongs to the Kidney. [Ru Shui originates from Gaoling Mountain in Dingling County, Runan Commandery, flows southeast into the Huai River, passing four commanderies, traveling 1,340 li.] The Foot-Jueyin Meridian externally corresponds to Mian Shui (Mian River) and internally belongs to the Liver. [Mian, pronounced mian-shan fan. Mian Shui originates from Fan [Character] Mountain in Wu Commandery, flows east into the Yangtze River. [Ping An]: Mian is written as "Mian" (Mian River) in *Ling Shu* and *Jia Yi Jing*. Note: "Wu Commandery", the character "Wu" was originally copied as "Wu", Yuan's edition as "Nan Commandery". Checking *Shui Jing Zhu*, Mian Shui originates from Juliu County, Wudu Commandery, Wild Wolf Valley, so it should be "Wu".] The Hand-Taiyang Meridian externally corresponds to Huai Shui (Huai River) and internally belongs to the Small Intestine, and unblocks the water pathways. [Huai Shui originates from Tongbai Mountain in Pingwu County, Nanyang Commandery, flows southeast into the sea, passing four commanderies, traveling 3,240 li.] The Hand-Shaoyang Meridian externally corresponds to Ta Shui (Ta River) and internally belongs to the San Jiao (Triple Burner). [Ta, pronounced tang-he fan. Ta Shui originates in Pingyuan Commandery, flows northeast into the sea. Additionally, there is a Ta River in Henei, originating from Wangwu Mountain, flowing southeast into the Yellow River. Both waters can serve as correspondence.] The Hand-Yangming Meridian externally corresponds to Jiang Shui (Yangtze River) and internally belongs to the Large Intestine. [Jiang Shui originates in Shengqian County, Minshan Commandery, Shu, flows southeast into the sea, passing nine commanderies, traveling 7,660 li. [Ping An]: Note: "Shengqian" was originally copied as "Waiqian", should be "Sheng" according to *Shui Jing Zhu*.] The Hand-Taiyin Meridian externally corresponds to He Shui (Yellow River) and internally belongs to the Lung. [He Shui originates from the northeast corner of Kunlun Mountain, then潜行 (flows underground) to the Kingdom of Khotan at the edge of Cong Ling, reaches Jishi Mountain, flows northeast into the sea, passing sixteen commanderies, traveling 9,400 li.] The Hand-Taiyin Meridian externally corresponds to Ji Shui (Ji River) and internally belongs to the Heart. [Ji Shui originates in Heng County, Hedong, reaches Wangwu Mountain, flows northeast into the Yellow River.] The Hand-Zhongyin (Pericardium) Meridian externally corresponds to Zhang Shui (Zhang River) and internally belongs to the Pericardium. [Zhang Shui is Qing Zhang Shui (Clear Zhang River), originating northwest of Shao Mountain in Gu County, Shangdang, flowing east to merge with Zhuo Zhang (Turbid Zhang) and enter the sea. Another explanation is Zhuo Zhang, originating from Fajiu Mountain west of Changzi County, Shangdang, flowing east into the sea.]

All these Five Zang, Six Fu, and twelve meridian waters have external sources and internal endowments. They are internally and externally connected, like a circle without beginning or end. Human meridians are the same. [The twelve meridian waters, such as the Yang emerging from Min Mountain, the Yellow River from Kunlun, have external sources. Flowing into the sea represents internal endowment. After reaching the sea, water rises as the Heavenly River, flows out from the source again, and enters the sea, representing internal-external connection, like a circle without end. Human meridians are also so: Foot-Taiyin meridians start from the toes, representing external source. Ascending to connect Fu and belong to Zang, compared to entering the sea, represents internal endowment. Hand-Taiyin meridians go from chest to hand, transforming into Hand-Yangming meridians, starting from the hand, representing external source. Ascending to connect Zang and belong to Fu, represents internal endowment. Going up the head to become Foot-Yangming meridians, descending from head to foot, transforming back into Foot-Taiyin meridians, represents internal-external connection, like a circle without end. [Ping An]: "Wai Nei" (external-internal) is written as "Nei Wai" (internal-external) in *Ling Shu* and *Jia Yi Jing*.] Thus, Heaven is Yang, Earth is Yin; above the waist is Heaven, below the waist is Earth. [Above the human waist is Heaven/Yang; below the waist is Earth/Yin. Meridians ascend to Heaven and descend to Earth, moving with the meridian waters, hence they correspond.] Thus, north of Qing Shui is Yin; north of Hu Shui is Yin within Yin. [North of Qing Shui is already Yin; Hu is north of Qing, so it is Yin within Yin.] South of Zhang Shui is Yang; north of He Shui to Zhang Shui is Yang within Yin. [South of Zhang is Yang, North of He is Yin, so North of He to Zhang is Yang within Yin.] South of Ta Shui to Jiang Shui is Yang within Great Yang. [Ta resides in Yang land, so it is Yang within Great Yang. [Ping An]: "Tai Yang" (Great Yang), the character "Tai" is missing in *Jia Yi Jing*.] This is the Yin and Yang of this one province, therefore humans and Heaven and Earth participate together. [The principle of Yin and Yang is formless, infinitely large outside, infinitely small inside. But humans born in one province must imitate its form, hence using the Yin and Yang of one province to correspond to humans. [Ping An]: "Zhou" (province) is written as "Yu" (corner) in *Ling Shu*.]

Huang Di said: Regarding the correspondence of meridian waters to meridians, their distances, depths, and the amounts of water and blood differ. How should they be integrated for acupuncture? [Three questions: 1. Distance of meridian waters and meridians; 2. Depth; 3. Amount of water and blood. However, there are three differences in body meridians; please adjust accordingly.]

Qi Bo replied: The Foot-Yangming Meridian is the Sea of the Five Zang and Six Fu organs. [The Stomach receives water and grain, transforms them into blood and Qi, forming the Foot-Yangming meridian, which nourishes the Five Zang and Six Fu. The Five Zang and Six Fu receive and complete blood and Qi, likened to the Four Seas providing endless nourishment, hence called Sea.] Its pulse is large, blood is abundant, Qi is vigorous, and heat is strong. [Foot-Yangming gets its name "Sea" for four reasons: 1. Its pulse is thick/large; 2. Its blood is abundant; 3. Its Grain Qi is vigorous; 4. Its Yang Qi is hot. With these four meanings, it is compared to the Sea. [Ping An]: One character is missing below "Re" (heat) in the original; added based on *Ling Shu* and *Jia Yi Jing*.] To needle this, if not deep enough, the pathogen will not disperse; [Needling this pathway, for a medium-sized person, the Foot-Taiyang meridian needs to be needled 6 fen deep. It is considered deep. The meridian is deep under the skin, and blood/Qi is abundant, so 6 fen deep is required to disperse the Qi.] if not retained, the excess will not be drained. [Since blood and Qi are abundant, retention is needed to drain effectively. If heat gathers in the skin causing disease, drain it quickly, hence "heat is drained quickly".] Foot-Taiyang: depth 5 fen, retain 7 breaths. Foot-Shaoyang: depth 4 fen, retain 5 breaths. Foot-Yangming: depth 6 fen, retain 10 breaths. Foot-Taiyin: depth 3 fen, retain 4 breaths. Foot-Shaoyin: depth 2 fen, retain 3 breaths. Foot-Jueyin: depth 1 fen, retain 2 breaths. [Question: The Qi of the twelve meridians originates from different acupoints, and the 365 acupoints belong to their respective meridians. When needling the twelve Hand and Foot meridians here, are these the 365 acupoints originating from these meridians? Or are they the 30 Shu points of the Five Zang and 36 Shu points of the Six Fu on the limbs? Answer: The primary selection involves the 30 Shu points of the limbs and 36 Shu points of the Six Fu. Other interstitial acupoints, if stated to originate from a meridian, belong to that meridian. Thus, selecting its meridian means selecting its originating acupoint. Question: The needling depths for Hand and Foot Yin/Yang here differ greatly from those in the Ming Tang (Acupuncture and Moxibustion Classic). How are they determined? Answer: The depths here and in Ming Tang each give an example. Depending on the person and disease, there are many examples, cannot be generalized. Now, Foot-Taiyang meridian in skin/flesh is slightly deeper than 4 fen, so 5 fen is used as an example. If the meridian runs deeper or shallower, one should palpate and determine accordingly; others follow this. Retaining 7 breaths is an example based on the strength of Taiyang Qi. If the disease fluctuates, the duration can be adjusted; it is not fixed; others follow this. [Ping An]: The Foot-Yangming section in *Ling Shu* precedes Foot-Taiyang. In *Jia Yi Jing*, "Duo Xue Qi Ci" (needling for much blood and Qi) follows Yangming and Taiyang; "Shao Xue Qi Ci" (little blood and Qi) follows Shaoyang; "Duo Xue Shao Qi Ci" (much blood little Qi) follows Taiyin and Jueyin; "Shao Xue Duo Qi Ci" (little blood much Qi) follows Shaoyin.]

The Yin and Yang of the Hands have near pathways for receiving Qi, and their Qi arrives swiftly. Their depth should not exceed 2 fen, and retention should not exceed 1 breath. [Hand Yin six meridians go from hand to chest, belong to Zang and connect Fu, each 3 chi 5 cun long. Hand Yang six meridians go from hand to head, belong to Fu and connect Zang, each 5 chi long. Foot Yin six meridians go from foot to chest, belong to Zang and connect Fu, each 6 chi 5 cun long. Foot Yang six meridians go from foot to head, belong to Fu and connect Zang, each 8 chi long. These twelve Hand and Foot meridians circulate blood and Qi up and down. Since Foot meridians are long, the circulation path is distant; additionally, they are Yin Qi, so movement is slow. Since Hand meridians are short, the circulation path is near; additionally, they are Yang Qi, so movement is fast. Because the path is near and meridians are shallow, needling depth should not exceed 2 fen. Because Qi moves fast, retention should not exceed 1 breath. [Ping An]: "Qi Shen" (its depth) is written as "Qi Ci Shen" (its needling depth) in *Ling Shu* and *Jia Yi Jing*. Note: "Cong Shou Zhi Xiong" (from hand to chest), the character "Xiong" (chest) was originally missing, Yuan's edition made it "Wei" (stomach). Based on the note's "Cong Zu Zhi Xiong" (from foot to chest), it should be "Xiong".] For people of different ages, sizes, and body types (fat/thin), one must use mental discernment; this is called following the constant of Heaven. [Liao, pronounced li-tiao fan, means to select/take. Human life has five stages: newborn is infant; able to smile is child; over 6 years old is small; over 18 years old is young; over 20 years old is strong; over 50 years old is old. Now, under 30 is considered young; over 30 is long/old. In Huang Di's time, over 7 chi 5 cun was large; under 7 chi 5 cun was small. Today, one can mentally estimate human size. Tian (Heaven) means Principle/Li. Changes in age, size, and body type are variable and not constant; harmonizing with Heaven is subtle, this is the constant Way of Heaven. Sages use mental discernment to subtly harmonize with the principle, hence called "following the constant of Heaven". [Ping An]: "Liao" is written as "Liao" (estimate) in *Jia Yi Jing*. Note: "Wei Hai" (as child), the lower half of "Hai" was eaten by insects; examining the upper remainder suggests "Hai". Japan's *Ishinpō* Vol. 25 quoting *Tai Su Jing* says: Newborn is infant, able to smile is hai-er (child). I propose "Hai". Yuan's edition made it "Xiao" (small), and changed subsequent text "over 6 small" to "young", "over 18 young" to "strong", "over 20 strong" to "long", inconsistent with original copy. Also, two characters below "Zhuang" (strong) were missing; based on *Ling Shu · Wei Qi Shi Chang* "over 50 is old", I propose adding "Fifty".] Moxibustion follows the same rules. Moxibustion exceeding these limits results in "Evil Fire", causing bone dryness and pulse stiffness; needling exceeding these limits causes Qi depletion. [Moxibustion must also consider age, size, fat/thin, Qi strength/weakness, acupoint depth, seasonal temperature, and number of cones. One must not lose common sense in haste. If cone count is insufficient, severe diseases do not heal; if exceeding limits, fire toxin enters the body, bones wither, meridians suppurate, named Evil Fire disease. Fire has no good or bad; excessive fire causes more damage, hence named Evil Fire. [Ping An]: "Hui" is written as "Se" (stiff) in *Ling Shu* and *Jia Yi Jing*, Yuan's edition as "Kui" (ulcerate). Based on the note "meridians suppurate", it should be "Kui" (ulcerate), other editions also write "Kui".]

Huang Di asked: The size of meridians, amount of blood, thickness of skin, firmness of muscle, and size of the popliteal fossa (Gu), can these be measured? [Fu means skin. Gu means the fleshy mass around the knee. Listing ten different human forms, asking for methods of measurement to fit the mean. [Ping An]: *Ling Shu* writes "Shao Duo" as "Duo Shao", "Gu" as "Gu".]

Qi Bo replied: Those that can be measured are those of medium build, neither emaciated nor lacking in blood and Qi. For those who have lost their normal state, who are extremely emaciated and whose flesh has wasted away, how can one measure and needle them? One must carefully palpate, trace, press, and observe their cold/heat and excess/deficiency to regulate them; this is called true treatment based on appropriateness. [Medium build does not just mean 7 chi 5 cun, but also those whose fat/thin, cold/heat, excess/deficiency are balanced/appropriate. Ji, pronounced jie. A person of 7 chi 5 cun is defined as medium build. Men, pronounced men-tun fan, means to touch/palpate. [Ping An]: "Shi Du" (lost state), the character "Shi" is written as "Fu" (man/those) in *Ling Shu*.]