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Ping An: This chapter appears in Volume 2, Chapter 5 "Gen Jie" (Roots and Knots) of the *Ling Shu* (Spiritual Pivot), and also in Volume 2, Chapter 5 of the *Jia Yi Jing* (Classic of Jia Yi).

Qi Bo said: Heaven and Earth interact with each other; cold and heat shift and succeed one another. In the way of Yin and Yang, which is less and which is more? (It is inferred that there were questions before and after; the principle here requires explanation, so Qi Bo does not wait for a question. The Qi of the Two Modes (Yin and Yang) interact harmoniously, hence it is called mutual interaction. When Yin is excessive, it transforms into Yang; when Yang is excessive, it transforms into Yin. Therefore, the Qi of Yin and Yang cannot be biased towards being more or less.) The Way of Yin is even, and the Way of Yang is odd. (Yang represents the Heavenly Way, its number is odd; Yin represents the Earthly Way, its number is even.) Diseases arising in Spring and Summer: Yin Qi is scarce and Yang Qi is abundant. If Yin and Yang are disharmonious, how should tonification and sedation be applied? (If a disease arises in Spring and Summer, where Yang Qi is abundant and Yin Qi is scarce, this constitutes Yin-Yang disharmony; how should tonification and sedation be applied?) Diseases arising in Autumn and Winter: Yang Qi is scarce and Yin Qi is abundant. When Yin Qi is excessive and Yang Qi declines, the stems and leaves wither and dry up, dampness flows downward and soaks the roots. As Yin and Yang shift and transform, how should tonification and sedation be applied? (If a disease arises in Autumn and Winter, where Yin Qi is abundant and Yang Qi is scarce, the decline of Yang Qi causes stems and leaves to wither, while the excess of Yin Qi causes body fluids to soak the roots. This is also a shift of Yin and Yang, with differences in abundance and scarcity; how should tonification and sedation be applied? Ping An: In the *Ling Shu* and *Jia Yi Jing*, "shi er xia HT" is written as "shi yu xia gui". Note that "HT" is synonymous with "jin" (soak/immersion).) Strange pathogens departing from the meridians are countless. (Wind, Cold, Summer-heat, Dampness, and hundreds of other bizarre pathogens invade the meridians causing disease; myriad things differ greatly, hence they are countless. "Li" means to pass through.) If one does not understand the Roots and Knots of the Zang-Fu organs, the joints will break, the pivots will fail, the opening and closing will lose control leading to the escape of Zheng Qi, Yin and Yang will suffer great loss, and recovery will be impossible. (Root refers to the origin; Knot refers to the connection. If humans do not understand that Roots and Knots are the essentials of the Zang-Fu, then when pathogens depart from the meridians, the joint gates of the Taiyang channel will break, the tendino-muscular pivots of the Shaoyang channel will fail, and the closing function of the Yangming channel will be disrupted, leading to the leakage of Stomach Qi and Taiyang Qi. Precisely because the Roots and Knots are unknown, the Gate, Pivot, and Closing cannot maintain their functions, causing Yin and Yang to lose their governance. Once the disease is established, treatment becomes ineffective.)

The essence of the Nine Needles lies in understanding the Beginning and End (Roots and Knots). Thus, knowing the Beginning and End allows one to summarize it in a single statement; not knowing them leads to the extinction of the Dao of acupuncture. (Beginning and End refer to Roots and Knots. Understanding the concept of Roots and Knots is but a single statement. Ping An: The *Ling Shu* has the character "Xuan" before "Yao". The *Ling Shu* reads "Gu Neng Zhi", while the *Jia Yi Jing* reads "Neng Zhi". The *Ling Shu* reads "Xian Jue", while the *Jia Yi Jing* reads "Jue Yi".)

The Foot-Taiyang Bladder Channel originates at Zhiyin (BL-66) and knots at Mingmen (the Eyes). (This Root-Knot of the Taiyang channel is the same as the Biao-Biao [Root-Branch], except that the Ben [Root] is five cun above Zhiyin, which differs. Ping An: The *Ling Shu* and *Jia Yi Jing* add "Mingmen zhe mu ye" [Mingmen means the eyes] after "Mingmen".) The Foot-Yangming Stomach Channel originates at Lidui (ST-45) and knots at Sangda (the upper palate). Sangda refers to the area grasping the ears. (This is consistent with the Biao-Biao and Zhong-Shi. Ping An: The *Jia Yi Jing* writes "Sangda" as "Hangsang".) The Foot-Shaoyang Gallbladder Channel originates at Qiaoyin (GB-44) and knots at Chuanglong (the ear). (Also consistent with the Biao-Biao. Ping An: The *Ling Shu* and *Jia Yi Jing* add "Chuanglong zhe er zhong ye" [Chuanglong means the center of the ear] after "Chuanglong"; the *Jia Yi Jing* is identical but omits the character "Zhong".)

Foot-Taiyang serves as the Gate (Guan), Foot-Yangming serves as the Closing (He), and Foot-Shaoyin serves as the Pivot (Shu). (The Three Yin and Three Yang channels form doors on the body, with Ying and Wei circulating within. There are three types of doors: First, the Gate door, compared to Taiyang; Second, the Door leaf, compared to Yangming; Third, the Door pivot, compared to Shaoyang. Ping An: In the *Ling Shu* and *Jia Yi Jing*, "Wei Guan" is written as "Wei Kai"; see the previous chapter "Yin Yang He" for explanation. The two missing characters in the note regarding the body are tentatively supplied as "Mai Yu" [meridians on].) If the Gate breaks, the flesh and joints deteriorate, and sudden diseases arise. Therefore, for sudden diseases, treat the Taiyang channel, assessing excess and deficiency. "Du" (sound: du) refers to internal deterioration in congenital cases, characterized by flaccid and weak muscles. (Taiyang governs bone Qi as the Gate; thus, if bone Qi breaks, the flesh and joints deteriorate internally. "Du" implies internal deterioration in congenital cases. Internal deterioration of flesh and joints leads to sudden disease. Recognizing sudden disease indicates a break in the Taiyang Gate, hence treating Taiyang. Ping An: The *Ling Shu* writes "Du", while the *Jia Yi Jing* writes "Kui Huan" [ulcerated and flaccid]. The *Ling Shu* writes "Pi Rou Wan", while the *Jia Yi Jing* writes "Pi Rou Huan". The Yuan edition omits the four characters "Rou Jie Nei Bai" [flesh and joints deteriorate internally] after "Gu Qi Zhe" [bone Qi breaks].) If the Closing breaks, Qi has no place to rest, and Wei diseases (flaccidity) arise. Therefore, for Wei diseases, treat the Yangming channel, assessing excess and deficiency. (Yangming governs flesh and Qi; thus, if flesh and Qi break, Zheng Qi cannot restrain itself, leading to body flaccidity and cold limbs. Flaccidity without contraction indicates a break in the Yangming Closing. Ping An: The *Jia Yi Jing* writes "Disease" instead of "Disease/Ji".) "Qi having no place to rest" means Zhen Qi (True Qi) stagnates and Xie Qi (Pathogenic Qi) occupies the space. (The ability to stop Qi from leaking and promote Qi nourishment is the essence of Zhen Qi. A break in the Yangming Closing causes Zhen Qi to stagnate and become ineffective, allowing Pathogenic Qi to occupy the space, leading to Wei disease. Ping An: Another version adds "Yong" [use] after "Yao" [essence] in the note.) If the Pivot breaks, the bones tremble and cannot stand firmly on the ground. Therefore, for trembling bones, treat the Shaoyang channel, assessing excess and deficiency. (Shaoyang governs tendons, which constrain the joints. If joint Qi is lax and unconstrained, bones tremble. Trembling bones indicate a break in the Shaoyang Pivot. Ping An: The *Jia Yi Jing* writes "Yao" [shake] for "Yao", and "Bu Neng An" [cannot be at peace] for "Bu An".) Trembling bones mean joints are lax and cannot retract. "Trembling bones" means shaking; one must investigate their root. (Joints are lax and shake. "Qiao" sounds like "He". Diagnose and investigate to find the source of the disease, then treat. Ping An: The *Jia Yi Jing* adds "Zhe" [particle] after "Bu Shou", and lacks the ten characters "Gu Yao Zhe" and "Suo Wei Gu Yao Zhe Yao Ye". The *Ling Shu* writes "Qiong" for "Qiao".)

The Foot-Taiyin Spleen Channel originates at Yinbai (SP-1) and knots at Taicang. (Yinbai is at the tip of the big toe. Taicang is at the Zhongwan point, differing from the Biao-Biao. Ping An: The *Jia Yi Jing* writes "Yinbai" as "Yin Bai", likely an error. The missing character before "Zhong Guan" in the note is written as "Wan" in the Yuan edition. According to the Zhongguan point, this book calls it "Zhong Guan", while the *Jia Yi Jing* calls it "Zhong Wan", which is the Taicang point, one cun below Shangwan, located between the xiphoid process and the umbilicus, being one of the fifteen points of the Ren Mai on the abdomen starting from Jiwei. It is tentatively supplemented as "Fu" [abdomen].) The Foot-Shaoyin Kidney Channel originates at Yongquan (KI-1) and knots at Lianquan (CV-23). (The Shaoyin channel first emerges at Yongquan as the Root, travels to two cun below the ankle as the Ben [Root], ascends to Lianquan above the larynx as the Knot, and reaches the base of the tongue and Kidney Shu as the Biao [Branch]; there are these differences. Ping An: The *Ling Shu* and *Jia Yi Jing* write "Huang" for "Yong". In the note, "Shang Zhi She Ben", the Yuan edition writes "Shang" as "Zhi" [stop].) The Foot-Jueyin Liver Channel originates at Dazhun (LR-1), knots at Yuying (CV-24), and ends at Danzhong (CV-17). (The Jueyin channel first emerges at Dazhun as the Root, travels five cun above Xingjian as the Ben, reaches Yuying and Danzhong as the Knot, and finally reaches the Liver Shu as the Biao; there are these differences. Ping An: The *Ling Shu* and *Jia Yi Jing* write "Luo" [connect] for "Zhong" [end]. The Jueyin section in the *Jia Yi Jing* appears before the Shaoyin section.)

Foot-Taiyin serves as the Gate, Foot-Jueyin serves as the Closing, and Foot-Shaoyin serves as the Pivot. (There are two types of doors: inner and outer. The Three Yin are inner doors, the Three Yang are outer doors. The Gate of the inner door refers to Taiyin; the Closing of the inner door refers to Jueyin; the Pivot of the inner door refers to Shaoyin. Ping An: In the *Ling Shu* and *Jia Yi Jing*, "Guan" is written as "Kai", same as below; see previous notes.) If the Gate breaks, the Granary (Spleen/Stomach) cannot transport, leading to diaphragmatic洞泄 (profuse diarrhea). Treat the Taiyin channel, assessing excess and deficiency, because a broken Gate causes illness due to Qi deficiency. (Taiyin governs water and grain to nourish the body and flesh. If Taiyin meridian Qi breaks, water and grain cannot move, hence "Granary has no transport". Due to lack of transport, Diaphragm Qi becomes weak, causing uncontrolled profuse diarrhea, leading to illness from Qi deficiency. Ping An: The *Ling Shu* and *Jia Yi Jing* write "Ge" for "Li", and repeat "Ge Dong" after "Dong".) If the Closing breaks, Qi relaxes and sadness is prevalent. For sadness, treat the Jueyin channel, assessing excess and deficiency. (Jueyin governs tendons; if Jueyin tendon Qi is lax, there is no restraint on sadness. Ping An: The *Ling Shu* writes "Jue" [cut off] for "Shi", and the *Jia Yi Jing* writes "Chi" [relax]. The *Jia Yi Jing* writes "Shan" [good/fond] for "Xi" [like].) If the Pivot breaks, pulse Qi becomes knotted and obstructed. For obstruction, treat the Shaoyin channel, assessing excess and deficiency; all knots should be treated. (Shaoyin governs bones; if bone Qi is damaged, Shaoyin pulse flow is blocked, leading to knotting and obstruction. "Knot" refers to Shaoyin collateral knotting. Ping An: The *Ling Shu* adds "Bu Zu" [deficiency] after "Jie Qu Zhi".)

The Foot-Taiyang channel originates at Zhiyin, flows to Jinggu (BL-64), pours into Kunlun (BL-60), and enters Tianzhu (BL-10) and Feiyang (BL-58). (Among the Shu points, discussing the Six Yang channels, following the sequence of Jing-Well, Ying-Spring, Shu-Stream, Yuan-Source, Jing-River, He-Sea corresponding to the Five Elements until reaching the body as the extreme. Here, the hand and foot Six Yang channels flow upward from Root to Entry, differing from the *Ben Shu* and *Ming Tang Liu Zhu*. Here, "Root" corresponds to "Chu" [exit/emerge] elsewhere; "Flow" corresponds to "Guo" [pass] elsewhere. Only the Hand-Taiyang "Flow" does not correspond to the "Guo" at Wanggu, but shifts to the "Xing" [travel] at Yanggu, suggesting a special case for this channel. Here, "Pour" corresponds to "Xing" [travel] elsewhere. Only the Foot-Yangming "Pour" does not correspond to the "Xing" at Jiexi, but shifts to the "He" [sea] at Xiaguan (Xiaoling), also indicating a special case. Here, "Entry" differs from elsewhere. All Six Yang channels take the finger/toe tips as Roots, ascending to connect with the divergent collaterals, called Entry. Entry has two locations: one enters the major collateral, the other ascends to the head entering various Tianzhu points. Only the Hand and Foot Yangming channels reach the neck, entering Renying and Futu anteriorly. The *Liu Zhu* considers "Chu" as Jing-Well; here, Root is Jing-Well, as Jing-Well is where water emerges, so Root equals Jing-Well. Tianzhu is in the depression lateral to the large tendons of the neck, the regular channel of Foot-Taiyang. Feiyang is seven cun above the lateral malleolus, the major collateral of Foot-Taiyang. Ping An: The *Ling Shu* writes "Liu" [flow] for "Liu", same below, not repeated. The Yuan edition leaves three spaces for "Cheng Ru Ru" [called entry entry].)

The Foot-Shaoyang channel originates at Qiaoyin, flows to Qiuxu (GB-40), pours into Yangfu (GB-38), and enters Tianrong (SI-17/GB-9 area context) and Guangming (GB-37). (Tianrong is behind the angle of the jaw below the ear, the regular channel of Foot-Shaoyang. Guangming is seven cun above the lateral malleolus, the major collateral of Foot-Shaoyang. Ping An: The *Jia Yi Jing* writes "Qiao Yang" for "Qiao Yin".)

The Foot-Yangming channel originates at Lidui, flows to Chongyang (ST-42), pours into Xiaoling (ST-36/Zusanli), and enters Renying (ST-9) and Fenglong (ST-40). (Renying is beside the larynx where the large vessel pulses under the hand, the regular channel of Foot-Yangming. Fenglong is eight cun above the lateral malleolus in the depression lateral to the tibia, the major collateral of Foot-Yangming.)

The Hand-Taiyang channel originates at Shaoze (SI-1), flows to Yanggu (SI-2), pours into Shaohai (SI-3), and enters Tianchuang (SI-16) and Zhizheng (SI-7). (Tianchuang is in the depression posterior to Futu below the angle of the jaw where pulsation is felt under the hand, the regular channel of Hand-Taiyang. Zhizheng is five cun posterior to the wrist, the major collateral of Hand-Taiyang. Ping An: The *Jia Yi Jing* writes "Gu Gu" for "Yang Gu".)

The Hand-Shaoyang channel originates at Guanchong (TE-1), flows to Yangchi (TE-4), pours into Zhigou (TE-6), and enters Tianyou (TE-15) and Waiguan (TE-5). (Tianyou is in the neck, above the supraclavicular fossa, posterior to Tianrong, anterior to Tianzhu, below Wanggu, above the hairline, the regular channel of Hand-Shaoyang. Waiguan is one cun inside three cun posterior to the wrist, the major collateral of Hand-Shaoyang.)

The Hand-Yangming channel originates at Shangyang (LI-1), flows at Hegu (LI-4), pours into Yangxi (LI-5), and enters Futu (LI-18) and Pianli (LI-6). (Futu is one cun below the angle of the jaw, posterior to Renying, the regular channel of Hand-Yangming. Pianli is three cun posterior to the wrist, the major collateral of Hand-Yangming.)

These are called the Roots of the Twelve Channels; those with abundant collaterals should all be treated. (Here, Root-Entry into channels involves only the Six Yang; comprehensively discussed, there are also the Six Yin channels, but this speaks generally. The so-called Roots are all three channels; following these Twelve Regular Channels, where side collaterals have abundant blood/Qi, one should measure and treat within the corresponding region. Ping An: The *Ling Shu* and *Jia Yi Jing* lack the character "Gen" [Root]. The *Jia Yi Jing* writes "Luo Sheng" for "Sheng Luo".)