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Ping An: This chapter, from the beginning to the end, is found in Volume 9, Chapter 60 "Yu Ban" (Jade Tablet) of *Ling Shu* (Spiritual Pivot). From "Huang Di said: When disease arises..." to the end, it is also found in Volume 11, Chapter 9 of *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion).

Huang Di said: I considered the small needle (Xiao Zhen, a minor acupuncture needle) to be a minute instrument. Yet Master, you align it with Heaven above, Earth below, and Humanity in between. I believe this exceeds the intent of the small needle. I wish to hear your explanation. (The subtle principle of the Nine Needles (Jiu Zhen, nine types of ancient acupuncture needles) aligns with the great Dao of the Three Powers (San Cai, Heaven, Earth, and Humanity). I fear it is too much. 'Wu' here refers to the Dao. Ping An: In *Ling Shu*, "Shao Zhen" is written as "Xiao Zhen", and there is an additional character "Yan" below.)

Qi Bo said: What is greater than the needle? What is greater than the needle are only the Five Weapons (Wu Bing, ancient weapons including bow, shu, spear, ge, and ji). The Five Weapons are instruments for death, not for life. Moreover, humanity serves as the stabilizer between Heaven and Earth; how can one fail to comprehend this? To treat humans, we rely solely on the needle. Compared to the Five Weapons, which is smaller? (Humanity, as the stabilizer between Heaven and Earth, holds supreme nobility. There are five weapons: first the Bow (Gong), second the Shu (a blunt weapon), third the Spear (Mao), fourth the Ge (dagger-axe), and fifth the Ji (halberd); these are tools of death. Although the Nine Needles are small, they are instruments of life. The Sage uses them to benefit the people; who would call this a trivial path? Thus, it is vast without outer limit, minute without inner boundary, fine enough to enter no space, and capable of granting long life—this is surely the Nine Needles. Ping An: "Fei Sheng Zhi Bei Ye" in *Ling Shu* is written as "Fei Sheng Zhi Ju". "Tian Di Zhi Zhen Sai Ye" in *Ling Shu* lacks the character "Sai". Note on Five Weapons: In *Zhou Li · Xia Guan*, the Officer of Weapons manages the Five Weapons. Zheng Sinong states: "The Five Weapons are Ge, Shu, Ji, Qiu Mao, and Yi Mao." Additionally, the infantry's five weapons include Bow and Arrow but lack Yi Mao. This differs slightly from the current text.)

Huang Di said: When disease arises, there may be unpredictable anger or joy, irregular diet, deficiency of Yin Qi (Vital Energy associated with cooling/moistening functions), excess of Yang Qi (Vital Energy associated with warming/activating functions), and stagnation of Ying Qi (Nutritive Qi circulating in the vessels). Consequently, Ju (deep abscesses) and Yong (superficial sores) develop. (There are four causes for the development of Yong. 'Ce' means measure. Unregulated anger and joy cause competitive Qi to gather, leading to Yong—this is the first cause. Irregular diet, indulgence without regard for cold or warmth, leads to Yong—this is the second cause. Deficiency of Yin Qi in the Zang organs and excess of Yang Qi in the Fu organs, with flourishing Yang Qi, leads to Yong—this is the third cause. Pathogenic factors lodging in the Blood, accumulating and failing to circulate, lead to Yong—this is the fourth cause. Yong and Ju are essentially the same; if Yong persists and destroys bone, it is called Ju. Ping An: In *Ling Shu* and *Jia Yi Jing*, "Bing Sheng Zhi Shi" is written as "Sheng Bing Zhi Shi".)

When Yin and Yang Qi do not flow freely, and two heats clash, pus is formed. Can the small needle extract it? (This section explains the origin of pus formation. Pathogenic factors lodge in the skin; disharmony between Cold and Warmth causes internal and external heats to strike each other, rotting flesh into pus. One might fear the small needle cannot extract it. Ping An: In *Ling Shu*, there is no "Qi" after "Bu Tong". In *Jia Yi Jing*, "Liang Re" is written as "Er Re".)

Qi Bo said: Even the Sage cannot resolve a condition that has already transformed [into pus], because pathogenic factors cannot remain stagnant. Therefore, when two armies face each other, banners visible, and white blades arrayed in the open field, this was not planned in a single day. To enable a person to obey orders and prohibit actions, ensuring soldiers suffer no blade-related disasters, is not a task accomplished in a day; it requires prolonged effort. (Ping An: In *Ling Shu*, "Xie" is written as "Zhi Xie"; "Xu Jiu Zhi Fang De Ye" is written as "Xu Yu Zhi De Ye". From "Sheng Ren Bu Neng Shi Hua Zhe" to "Xu Jiu Zhi Fang De Ye", this passage is absent in *Jia Yi Jing*.)

To allow the body to suffer from Ju/Yong diseases and the accumulation of pus and blood—is this not far from the Great Dao? The birth of Ju/Yong, the formation of pus and blood, does not fall from the sky nor emerge from the earth; it arises from the accumulation of the minute. Therefore, the Sage’s governance addresses conditions before they take shape, while fools encounter them only after they have fully formed. (‘Zhi’ is pronounced Changzhi fan, meaning a banner. The Sage cannot let the body transform into disease because the Sage governs before chaos arises, preventing pathogenic factors from lingering. Thus, likened to white blades arrayed in the field, planning takes time, soldiers face no disaster due to long-term training, and Ju/Yong do not arise. Harmonizing the interior takes many days; thus, suffering from Ju/Yong indicates being far from the Dao of Harmony. Accumulated stones form mountains, accumulated water forms rivers, accumulated crimes bring disaster, accumulated Qi forms abscesses. These do not come from heaven or earth but result from failing to eliminate fragility and minuteness. The Sage acts differently: governing the state before chaos arises, regulating the body before disease manifests, unlike fools who dig wells only when thirsty or forge weapons only when fighting. Ping An: *Jia Yi Jing* lacks the eight characters "Bu Cong Tian Xia Bu Cong Di Chu"; "Ji Wei" is written as "Ji Ju". "Gu Sheng Ren Zhi Zhi Zi Yu Wei You Xing Ye" in *Ling Shu* is written as "Gu Sheng Ren Zi Zhi Yu Wei You Xing Ye", and in *Jia Yi Jing* as "Zi Zhi Yu Wei Xing". Note on White Blades: Yuan edition writes "Ren" as "Ren". "Sheng Ren Bu Er": "Er" is a typo for "Yi". "Dou Fang Zhu Bing": "Fang" is written as "Er".)

Huang Di said: If the condition has taken shape but is not encountered, and pus has formed but is not seen, what should be done? ('Zao' means encounter. 'Zi' refers to the common people, whom the Emperor treats as children. Not encountering means that when the abscess has taken shape, the people cannot perceive it; when pus has formed, they cannot see it. What then should be done? Ping An: "Qi Yi You Xing Bu Zi Zao, Nong Yi Cheng Bu Zi Jian" in *Ling Shu* is written as "Qi Yi Xing Bu Yu Zao, Nong Yi Cheng Bu Yu Jian", and in *Jia Yi Jing* as "Qi Yi You Xing, Nong Yi Cheng".)

Qi Bo said: Once pus has formed, ten out of ten cases die, with only one surviving. (Yong arising at joints, back, or within the abdomen becomes incurable once pus forms, hence ten deaths to one survival. Ping An: "Yi" in *Ling Shu* and *Jia Yi Jing* is written as "Yi".) Therefore, the Sage establishes effective prescriptions to prevent the condition from reaching the stage of pus formation. (Thus, the Sage clearly establishes effective prescriptions to treat Yong when it is still minute, preventing it from forming pus. Ping An: "Bu Shi Yi Cheng" in *Ling Shu* is written as "Fu Shi Yi Cheng".) These are inscribed on bamboo slips and silk, enabling those with ability to follow them and transmit them to future generations without end, for the sake of those who do not encounter [early treatment]. (Inscribing on bamboo and silk is because the common people cannot perceive or recognize early-stage Ju/Yong. Ping An: "Zhong Zhi" in *Ling Shu* is written as "Zhong Er"; "Zi" is written as "Yu". From "Gu Sheng Ren Bu Shi" to "Zao Zi Ye", this passage is absent in *Jia Yi Jing*.)

Huang Di said: If pus and blood have already formed and then are encountered by the people, can they be treated with the small needle? (Yong arising at the back, joints, or within the abdomen: once pus and blood have formed and are recognized by the people, can the small needle cure it? Ping An: "Qi Yi You Nong Xue" in *Ling Shu* has "Yi" written as "Yi"; in *Jia Yi Jing* as "Yi Cheng". "Er Hou Zao Zi" in *Ling Shu* is written as "Er Hou Zao Hu"; *Jia Yi Jing* omits these four characters. "Ke Zao" in *Ling Shu* is written as "Bu Dao Zhi"; *Jia Yi Jing* omits "Zao".)

Qi Bo said: Using small methods to treat small conditions yields small results; using large methods to treat large conditions causes much harm. Therefore, for those with formed pus, only Bian Shi (stone lancets) and Pi Feng (lancet knives) should be used to drain it. (Treating small Yong with small needles is difficult to heal, hence "small results". Treating large pus with large needles causes extensive damage, hence "much harm". Thus, once pus forms, only Bian Shi is needed. Ping An: "Yi Da Zhi Da Duo Hai" in *Jia Yi Jing* is written as "Yi Da Zhi Da Zhe Qi Gong Da, Yi Xiao Zhi Da Zhe Duo Hai Da". "Yi Cheng Nong Zhe" in *Ling Shu* and *Jia Yi Jing* is written as "Yi Cheng Nong Xue Zhe". "Bian Shi" in *Ling Shu* and *Jia Yi Jing* is written as "Bian Shi". In *Ling Shu* and *Jia Yi Jing*, the character for lance is written as "Pi". Note on difficult healing: Yuan edition writes "Nan Yu".)

Huang Di said: If there is much harm, can preservation still be achieved? (Much harm refers to the injury caused by Bian Shi, which can even lead to death.)

Qi Bo said: It depends on whether the case is Ni (Rebellious/Ominous) or Shun (Smooth/Favorable). (Ni cases involve much harm leading to death; Shun cases allow pus drainage and survival.)

Huang Di said: I wish to hear about Ni and Shun. Qi Bo said: If the patient presents with white sclera showing blue/black discoloration and small palpebral fissures, this is the First Ni; vomiting after taking medicine is the Second Ni; abdominal pain with extreme thirst is the Third Ni; inability to move the shoulders and neck is the Fourth Ni; hoarseness and loss of complexion are the Fifth Ni. Apart from these, the case is Shun. (If the Five Injuries [symptoms] appear first, followed by drainage, it is Ni. If the Five Injuries are absent initially, and drainage occurs after pus formation, it is Shun. 'Si' is pronounced Xianqi fan, meaning broken voice. Ping An: "Bai Yan" in *Jia Yi Jing* is written as "Bai Jing". Ou in *Ling Shu* and *Jia Yi Jing* is written as "Ou"; there is an additional character "Wu" after "Chu Ci".)