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[Ping An]: This chapter appears in *Ling Shu* (Spiritual Pivot), Volume 1, Chapter 4, "Disease Forms of Evil Qi and Zang-Fu Organs". From "the Qi of the Five Zang and Six Fu Organs" to here at the "Stomach Meridian", it is found in *Jia Yi Jing* (Systematic Classic of Acupuncture and Moxibustion), Volume 4, Part 2. From "the Large Intestine Fu organ" to "selecting Zusanli (ST36)", it is found in *Jia Yi Jing*, Volume 9, Chapter 7. From "diseases of the Small Intestine" to "selecting Shangjixu (ST37)", it is found in *Jia Yi Jing*, Volume 9, Chapter 8. From "diseases of the San Jiao (Triple Burner)" to "selecting Weiyang (BL39)", it is found in *Jia Yi Jing*, Volume 9, Chapter 9. From "diseases of the Gallbladder" to "Yanglingquan (GB34)", it is found in *Jia Yi Jing*, Volume 9, Chapter 5. From "when needling this, one must hit the Qi-Acumen" to the end, it is found in *Jia Yi Jing*, Volume 5, Part 1. Only from the "Large Intestine" downwards, although the meaning of the text in *Jia Yi Jing* is the same, the order of arrangement is slightly different.

Huang Di said: I have heard that for the Qi of the Five Zang and Six Fu organs, the Ying-Spring points, Shu-Stream points, and He-Sea points are where the Qi enters and gathers. Now, through what pathway do they enter? Where do they connect and pass after entering? I wish to hear the reason behind this. (This asks about the running path and destination of the Ying-Spring, Shu-Stream, and He-Sea points of the Zang-Fu meridians. Ping An: In *Jia Yi Jing*, "Shu" is written as "Yu". Currently, both *Ling Shu* and *Jia Yi Jing* write it as "Ling". In *Jia Yi Jing*, "Lian Guo" is written as "Cong Dao", lacking the seven characters "Yuan Wen Qi Gu" and the subsequent answer by Qi Bo.)

Qi Bo answered: These are the divergent branches of the Yang meridians that enter the interior and belong to the Fu organs. (What is stated here regarding "He" refers to selecting the points where the divergent branches of the Three Yang meridians belong to the Fu organs, called "He", and not selecting Yin meridian points. This is because Yang meridians internally belong to the Fu organs; when evil qi invades, it first reaches the Fu organs and then reaches the Zang organs.)

Huang Di asked: Do the Ying-Spring points and He-Sea points each have their own names?
Qi Bo answered: The Ying-Spring points treat diseases of the exterior meridians, while the He-Sea points treat diseases of the interior Fu organs. (The Ying-Spring and Shu-Stream points of the Five Zang and Six Fu organs have not yet reached the interior, so they only treat diseases of the exterior meridians. What is stated here regarding "He" refers only to selecting those belonging to the interior Fu organs from the Yang meridians to treat diseases of the interior Fu organs. Ping An: In *Jia Yi Jing*, there is a character "Zang" after the word "Wai".)

Huang Di asked: How are interior Fu organ diseases treated?
Qi Bo answered: By selecting the He-Sea points.
Huang Di asked: Do the He-Sea points each have specific names?
Qi Bo answered: The He-Sea point of the Stomach enters at Zusanli (ST36). (The Qi of the Stomach follows the Foot-Yangming Stomach Meridian and converges at Zusanli; therefore, when the Stomach has disease, Zusanli is selected to treat the Stomach Fu. Ping An: The character "Ru" is absent in *Ling Shu*.)
The He-Sea point of the Large Intestine enters at Shangjixu (ST37). (The Qi of the Large Intestine follows the Foot-Yangming Stomach Meridian and converges at Shangjixu; therefore, when the Large Intestine has disease, Shangjixu is treated.)
The He-Sea point of the Small Intestine enters at Xiajixu (ST39). (The Qi of the Small Intestine follows the Foot-Yangming Stomach Meridian and converges at Xiajixu; therefore, when the Small Intestine has disease, Xiajixu is treated.)
The He-Sea point of the San Jiao (Triple Burner) enters at Weiyang (BL39). (The Qi of the San Jiao follows the Foot-Taiyang Bladder Meridian and converges at Weiyang; therefore, when the San Jiao has disease, Weiyang is treated.)
The He-Sea point of the Bladder enters at Weizhong (BL40). (The Qi of the Bladder follows the Foot-Taiyang Bladder Meridian downward and converges at Weizhong; therefore, when the Bladder has disease, Weizhong is treated. Ping An: Both *Ling Shu* and *Jia Yi Jing* have the character "Yang" after "Zhong".)
The He-Sea point of the Gallbladder enters at Yanglingquan (GB34). (The Qi of the Gallbladder follows the Foot-Shaoyang Gallbladder Meridian downward and converges at Yanglingquan; therefore, when the Gallbladder has disease, Yanglingquan is treated.)

Huang Di asked: How should these points be accessed?
The answer was: When accessing Zusanli (ST36), lower the dorsum of the foot; when accessing Shangjixu (ST37) or Xiajixu (ST39), lift the foot; when accessing Weiyang (BL39), flex and extend the leg to search for it; when accessing Weizhong (BL40), flex the knee to access it; when accessing Yanglingquan (GB34), stand upright with the knee vertical, place your hand level with the knee, and go down to the Yang side of Weiyang to access it; when accessing points of the exterior meridians, draw and extend the limb to follow them. (Below describes the method of accessing the six He-Sea points to treat interior Fu diseases. Standing upright makes the knee vertical. Yu means to pull or draw. Ping An: In *Jia Yi Jing*, "Suo" is written as "Qu"; "Qu Er Qu Zhi" is written as "Qu Xi Er Qu Zhi". In *Ling Shu*, there is no "Li" before "Shu", and "Shen" is written as "Shen".)

Huang Di said: I wish to hear about the diseases of the Six Fu organs.
(The Six Fu organs and their six corresponding He-Sea points are used to treat interior Fu diseases, but the forms of Fu organ diseases are unknown.)
Qi Bo said: Heat in the face indicates a disease of the Foot-Yangming [Stomach] meridian. (Below discusses diseases of the Hand and Foot Yangming meridians. Heat in the face occurs because the Yangming meridian originates in the face; thus, heat in the face is a sign of Foot-Yangming disease.)
Blood visible in the collaterals of the thenar eminence (Yuji area) indicates a disease of the Hand-Yangming [Large Intestine] meridian. (The Hand-Yangming meridian runs behind the thenar eminence; thus, blood in the collaterals of the thenar eminence is a sign of Hand-Yangming disease.)
A pulse that is firm or depressed on the dorsum of the feet indicates a disease of the Foot-Yangming [Stomach] meridian; this is the Stomach meridian. (The Foot-Yangming meridian descends to the dorsum of the foot and enters between the big toe; thus, a tight or depressed pulse on the dorsum of the foot is a sign of Foot-Yangming disease. Ping An: In *Ling Shu*, "Jian Ruo" is written as "Shu".)

For diseases of the Large Intestine, there is cutting pain in the intestines accompanied by gurgling sounds (zhuozhuo); if exposed to cold again in winter, diarrhea occurs; there is pain around the navel, and the patient cannot stand for long periods. This presents with the same signs as Stomach diseases, and Shangjixu (ST37) should be selected. (Below describes the forms of Six Fu organ diseases and the locations of the points to be selected. Pain at the navel is due to the transverse colon, which is part of the Large Intestine, being located at the navel; thus, Large Intestine disease causes pain at the navel. "Presenting with the same signs as the Stomach" means that the Qi of the Large Intestine converges with the Foot-Yangming Stomach meridian at Shangjixu, hence the shared signs. Zhuo, pronounced tu jiao, refers to the sound of water in the intestines. Ping An: In *Ling Shu*, "Ze Xie" is written as "Ji Xie"; *Jia Yi Jing* lacks these two characters.)

For diseases of the Stomach, there is abdominal distension, pain in the epigastrium centered at the heart region, radiating upward to both hypochondria, obstruction in the diaphragm and pharynx, and difficulty swallowing food. Zusanli (ST36) should be selected. (Pain in the epigastrium centered at the heart region occurs because the main branch of the Foot-Yangming Stomach meridian ascends to the thigh, enters the abdomen, belongs to the Stomach and disperses to the Spleen, ascends to connect with the Heart, and follows the pharynx upward; its major collateral runs along the lateral aspect of the tibia, ascends to connect with the head. Thus, pain in the epigastrium and heart region radiates to the hypochondria, causing obstruction in the diaphragm and pharynx. Ping An: In *Ling Shu* and *Jia Yi Jing*, "Wei Guan" is written as "Wei Wan". In *Ling Shu*, "Shang Jiao" is written as "Shang Zhi"; in *Jia Yi Jing*, it is written differently. In *Ling Shu*, "Ge" is written as "Ge".)

For diseases of the Small Intestine, there is pain in the lower abdomen, pain radiating from the waist and spine to the buttocks, and frequent urgency to defecate. (The Small Intestine is located in the lower abdomen attached to the spine, looping on the left; thus, pain in the lower abdomen, waist, spine, and buttocks occurs, along with frequent urgency to defecate. Ping An: In *Ling Shu*, "Shao Fu" is written as "Xiao Fu". In *Ling Shu* and *Jia Yi Jing*, "Kong Kao" is written as "Kong Gao". Note: The character "Zuo" (left) in Yuan's edition was mistakenly printed as "Kong".)
Heat in front of the ear, severe cold, or excessive heat above the eyebrows alone. (The Small Intestine meridian belongs to the Hand-Taiyang, ascending to the outer canthus and entering the ear; thus, Small Intestine disease manifests as cold and heat in these areas. Ping An: In *Jia Yi Jing*, there is no "Dang" before "Er". In *Ling Shu* and *Jia Yi Jing*, "Mei" is written as "Jian".)
Heat between the little finger and the adjacent finger, or a depressed pulse, are signs of Hand-Taiyang [Small Intestine] disease; Xiajixu (ST39) should be selected. (These are sites where the Hand-Taiyang meridian exits; thus, heat here and a depressed pulse serve as signs. Ping An: In *Ling Shu*, the character "Bing" (disease) appears after "Tai Yang".)

For diseases of the San Jiao (Triple Burner), there is abdominal fullness of Qi, especially hardness in the lower abdomen, inability to urinate, and distress/urgency. (You means excessive. Ping An: In *Jia Yi Jing*, "Zhang" is added after "Fu"; "You Jian" is written as "You Shen Jian".)
If fluids overflow, edema results; if they remain, distension results. The signs appear in the large collateral outside the Foot-Taiyang [Bladder] meridian, located between the Taiyang and Shaoyang meridians, and are also visible in the pulse. Weiyang (BL39) should be selected. (Overflow of fluids in the Lower Jiao results in edema. Between the Taiyang and Shaoyang meridians lies the Lower He-Sea point of the San Jiao, Weiyang. Ping An: In *Ling Shu*, there is no "Wei" after "Shui Shang"; "Liu Ze" is written as "Liu Ji". In *Jia Yi Jing*, "Weiyang" is written as "Weizhong".)

For diseases of the Bladder, there is unilateral swelling and pain in the lower abdomen; pressing with the hand creates the urge to urinate but prevents it. (Unilateral swelling means the rest of the abdomen is not swollen; this is a Fu organ disease. Ping An: In *Ling Shu*, "Ze Yu" is written as "Ji Yu".)
Heat in the shoulder or a depressed pulse, as well as heat or a depressed pulse on the lateral side of the little toe and behind the ankle/tibia, indicate that Weizhong (BL40) should be selected. (The Foot-Taiyang Bladder meridian originates at the inner canthus, ascends to the forehead, descends to the neck, follows the tibia and ankle to the lateral side of the little toe; thus, Bladder disease manifests as heat and depressed pulses along the meridian's path. Ping An: In *Jia Yi Jing*, "Jian Shang" is written as "Mei Shang", with a note saying "Another version reads Jian." In *Ling Shu*, "Wai Ce" is written as "Wai Lian". In *Jia Yi Jing*, "Qu Zhi Wei Zhong Yang" is written as "Qu Weizhong".)

For diseases of the Gallbladder, there is frequent sighing. (Gallbladder disease leads to restless Hun spirit, hence the desire to sigh.)
Bitter taste in the mouth and vomiting of old bile. (Gallbladder heat overflows fluid essence, causing bitter taste and vomiting of stored bile. Ping An: In *Jia Yi Jing*, "Zhi" is written as "Shui".)
Palpitations and fear, as if someone were about to capture them. (Gallbladder disease causes heart palpitations and terror, hence the sensation of being hunted. Ping An: In *Jia Yi Jing*, "Shan" appears before "Kong". *Ling Shu* lacks "Ru".)
A sensation of obstruction in the throat with frequent spitting. The signs are located at the root and tip of the Foot-Shaoyang [Gallbladder] meridian. ( refers to obstruction; a sensation of something blocking the throat, pronounced ju xie fan. The root of the Foot-Shaoyang meridian is between Qiaoyin points, and the tip is at Chuanglong, representing the root and tip. Ping An: In *Jia Yi Jing*, "Shuo Tuo" is written as "Shu Ke Tuo". In *Ling Shu*, "Hou" is absent after "Tuo".)
Also observe if the pulse is depressed; apply moxibustion. If there are alternating chills and fever, select Yanglingquan (GB34). (Depressed pulses indicate cold, hence moxibustion is applied. For chills and fever, Yanglingquan is selected, which is a standard acupuncture and moxibustion treatment.)

Huang Di asked: Is there a principle for needling?
Qi Bo answered: When needling these points, one must accurately strike the Qi-Acumen (energy centers) and avoid striking the flesh joints. Striking the Qi-Acumen allows the needle to roam freely within the alleys (meridian channels); striking the flesh joints causes pain in the muscle and skin. (Below describes the method of inserting the needle. Striking the flesh without hitting the spaces between muscles, or striking the joints without hitting the bone acupoints, does not allow roaming in the alleys. Alley refers to streets, places of empty cavities. Ping An: In *Ling Shu*, "You" is written as "Ran", with a note saying "Another version reads You." In *Ling Shu* and *Jia Yi Jing*, "Ru Fu" is written as "Pi Fu".)
If tonification and sedation are reversed, the disease will worsen. (Sedating deficiency and tonifying excess is called reversal.)
Striking the tendon causes flaccidity. (Striking the tendon without targeting the painful spot injures the tendon, causing weakness and flaccidity.)
Evil qi will not exit; it will contend with the True Qi, causing chaos that cannot be removed, and instead lodge internally. If the use of the needle is not prudent, it turns order into disorder.
Huang Di said: Excellent. (If one strikes the flesh joints or tendons, missing the empty cavities, the evil qi will not exit, contending with the True Qi, causing chaos between righteous and evil qi, leading to internal disease, because the use of the needle was imprudent and contrary to principles. Ping An: In *Ling Shu*, "Yu Zhen Qi Xiang Bo" is written as "Yu Qi Zhen Xiang Bo"; in *Jia Yi Jing*, it is written as "Yu Zhen Xiang Bo". Note: Internal disease was mistakenly printed as internal pain in Yuan's edition.)