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Ping An (Editor's Note): This section, from "Xing Le Zhi Ku" to "Chu Qi E Xue", is found in *Su Wen* (Plain Questions), Volume 7, Chapter 24, "Blood and Qi Form and Will"; also in *Ling Shu* (Spiritual Pivot), Volume 12, Chapter 78, "Nine Needles Discussion"; also in *Jia Yi Jing* (Classified Classic of Acupuncture and Moxibustion), Volume 6, Chapter 2; and also in the Japanese *Ishinpō* (Medical Center Formula), Volume 1, "General Principles of Treating Diseases," Part 1. From "Yangming has abundant blood and qi" to the end, both *Su Wen* and *Ling Shu* appear in the aforementioned chapter. Additionally, from "Yangming has abundant blood and qi" to "Shaoyin has little blood and abundant qi", this text also appears in *Ling Shu*, Volume 10, Chapter 65, "Five Tones and Five Flavors".

When the body is at ease but the mind is distressed, diseases arise in the vessels (Mai, channels/vessels). Treatment involves moxibustion and acupuncture. (Body refers to physical form. Mind refers to the heart's will. The Heart governs the vessels; due to heart strain, pathogenic factors damage the vessels, which corresponds to the Heart. Thus, moxibustion and acupuncture are used to tonify or sedate vessel diseases.) When the body is laborious but the mind is joyful, diseases arise in the sinews (Jin, tendons/ligaments). Treatment involves warming compresses and Daoyin (guiding and pulling exercises). (Physical labor causes sinew strain; pathogenic factors damage the sinews, corresponding to the Liver. Sinew diseases require prompt treatment; thus, warming compresses and Daoyin are used to regulate sinew diseases. Medicinal cloths are applied for warming and traction to achieve harmony. Ping An: In *Su Wen*, the section on "Xing Ku Zhi Le" follows the section on "Xing Le Zhi Le".)

When both body and mind are at ease, diseases arise in the flesh (Rou, muscles). Treatment involves Bian stones (Bian shi, stone knives for surgical incision) and acupuncture. (When both form and spirit are idle, pathogenic factors lodge in the muscles, corresponding to the Spleen. This often results in carbuncles and swellings; thus, Bian needles and hot stone compresses are used to regulate it. *Shan Hai Jing* states: On Mount Gao, there is much jade, and stones can be made into Bian needles. These can be used to lacerate carbuncles and swellings. Ping An: In the note "often develops carbuncles and swellings", the character "zhong" (swelling) is erroneously printed as "pi" (spleen) in Yuan edition.)

When both body and mind are laborious, diseases arise in the throat obstruction (Yan He, throat blockage/dyspnea) or thirst. Treatment involves herbal medicine. (Both form and spirit suffer from laborious qi consumption; exogenous pathogens damage the qi, affecting the throat obstruction, corresponding to the Lung. "He" refers to the sound of lung wheezing. Some versions read "ke" (thirst). Therefore, decoctions, pills, and powders are used for treatment. Ping An: "Yan He" is written as "Yan Yi" in *Su Wen* and "Kun Jie" in *Jia Yi Jing*. "Medicine" is written as "Bai Yao" in *Su Wen*, "Gan Yao" in *Ling Shu* and *Jia Yi Jing*, while *Ishinpō* quoting *Tai Su* retains "Yao".)

Frequent fright and alarm cause obstruction of sinews and vessels; diseases manifest as numbness and insensitivity (Bu Ren). Treatment involves massage and medicinal wine (Lao Yao). This is called the "Five Forms" (Wu Xing, referring to the five types of physical conditions). (Fright relates to the Kidney; frequent bodily fear leads to pathogenic factors lodging in sinews and vessels, causing obstruction, corresponding to the Kidney. Pain arises between sinews, vessels, and skin, resulting in Bi syndrome and numbness. Thus, massage and Lao Li (medicinal wine) are used. "Five Forms" describes stating the appropriate treatments. Ping An: In *Su Wen*, "sinews and vessels" is "jingluo"; "Wu Xing" is followed by "Zhi Ye". *Ishinpō* lacks the four characters "Shi Wei Wu Xing".)

Therefore it is said: Puncture Yangming to release blood and qi. (Hand Yangming is the Large Intestine channel; Foot Yangming is the Stomach channel. These two channels connect up and down with strong qi. When these two channels are full, puncturing them releases both blood and qi. Ping An: "Gu Yue" (Therefore it is said) is absent in *Su Wen*; *Jia Yi Jing* reads "Gu Zhi Yue".) Puncture Taiyang to release blood and avoid releasing qi. (Hand Taiyang is the Small Intestine channel; Foot Taiyang is the Bladder channel. These two channels connect up and down with abundant fluids. When these two channels are full, puncturing them releases blood; if pathogenic factors lodge, evil qi is released. Puncture Shaoyang to release qi and avoid releasing blood. (Hand Shaoyang is the Sanjiao channel; Foot Shaoyang is the Gallbladder channel. These two channels connect up and down with abundant qi. When these two channels are full, puncturing them releases qi; if pathogenic factors lodge, evil blood is released.) Puncture Taiyin to release blood and qi. (Hand Taiyin is the Lung channel; Foot Taiyin is the Spleen channel. Although these two Taiyin channels are interior-exterior pairs with the two Yangming channels, their blood and qi are both abundant, so both blood and qi are released. Ping An: In *Su Wen*, "chu xue qi" is "chu qi e xue"; *Jia Yi Jing* agrees. *Su Wen* Xin Zheng Xiao says: "According to *Tai Su*: 'Puncture Yangming to release blood and qi, puncture Taiyin to release blood and qi.' Yang Shangshan says: 'Although Yangming and Taiyin are interior-exterior pairs, their blood and qi are both abundant, so both are released. If so, Taiyin and Yangming are equally abundant in blood and qi. Previously, Taiyin was described once as having abundant blood and little qi, and twice as having abundant qi and little blood, making it impossible to know definitively. Examining the intent of simultaneous blood and qi release in *Tai Su*, neither previous description is accurate; it should align with Yangming.'") Puncture Jueyin to release blood and avoid releasing qi. (Hand Jueyin is the Pericardium channel; Foot Jueyin is the Liver channel. They are interior-exterior pairs with the two Shaoyang channels. The two Shaoyang have abundant qi and little blood; yin and yang are opposite, so the two Yin channels have abundant blood and little qi. Therefore, when the two Jueyin channels are full, blood is released; if pathogenic factors lodge, evil qi is released.) Puncture Shaoyin to release qi and avoid releasing blood. (Hand Shaoyin is the Heart channel; Foot Shaoyin is the Kidney channel. They are interior-exterior pairs with the two Taiyang channels. Since the two Taiyang have abundant blood and little qi, and yin and yang are opposite, the two Yin channels have abundant qi and little blood. Therefore, when the two Shaoyin channels are full, qi is released; if pathogenic factors lodge, evil blood is released. Ping An: The sentence on puncturing Shaoyin precedes Jueyin in *Su Wen* and *Jia Yi Jing*. The note misses the character "yi" before "yin yang" in Yuan edition.)

Yangming has abundant blood and qi; Taiyang has abundant blood and little qi; Shaoyang has abundant qi and little blood; Taiyin has abundant blood and qi; Jueyin has abundant blood and little qi; Shaoyin has little blood and abundant qi. (This explains the differences in releasing blood and qi when puncturing the three Yin and three Yang channels. Ping An: "Taiyin has abundant blood and qi" is written as "Taiyin usually has abundant qi and little blood" in *Su Wen*, and "abundant blood and little qi" in *Ling Shu* and *Jia Yi Jing*. *Su Wen* Xin Zheng Xiao says: "According to *Jia Yi Jing · Twelve Waters Chapter*, the abundance of blood and qi in Taiyang and Taiyin differs from *Su Wen*. Also, in the chapter *Yin-Yang Twenty-Five Persons: Form, Nature, Blood, and Qi Differences*, it matches *Su Wen*. Perhaps Huangfu Mi preserved both due to doubt. Now examining *Jia Yi Jing · Yin-Yang Twenty-Five Persons: Form, Nature, Blood, and Qi Differences Chapter*, Taiyin is stated as 'usually abundant blood and little qi', still differing from *Su Wen*. Perhaps the Song ministers' version of *Jia Yi Jing* differed from the current version; preserving this for reference.) Foot Yangming and Taiyin are interior-exterior pairs; Shaoyang and Jueyin are interior-exterior pairs; Taiyang and Shaoyin are interior-exterior pairs; this constitutes the Yin-Yang of the feet. Hand Yangming and Taiyin are interior-exterior pairs; Shaoyang and Heart Master (Pericardium) are interior-exterior pairs; Taiyang and Shaoyin are interior-exterior pairs; this constitutes the Yin-Yang of the hands. (Now we know the locations of hand and foot Yin-Yang. Ping An: In *Su Wen*, the Taiyang-Shaoyin pair is above the Shaoyang pair, and the Yangming-Taiyin pair is below the Shaoyang pair. The eight characters "Jin Zhi Shou Zu" in the note were part of the text in *Su Wen*, where "suo zai" was written as "suo ku".)

In all disease treatment, one must first remove the blood, eliminate the source of suffering, observe what the patient desires, then sedate excess and tonify deficiency. (The general method of treating diseases: for pains caused by blood, puncture and remove the area where blood gathers. After removing the blood, observe the patient's emotional desires to determine deficiency and excess, then apply tonification and sedation methods. Ping An: *Su Wen* adds "nai" after "xue"; *Ling Shu* lacks this paragraph. In the note, "xue ju" (blood gathering), the character "ju" is erroneously printed as "ci" (puncture) in Yuan edition.)