黄帝问于岐伯曰。余闻刺有五节奈何。岐伯曰。固有五节。一曰振埃。二曰发 。三曰去爪。四
曰撤衣。五曰解惑。
黄帝曰。夫子言五节。余未知其意。岐伯曰。振埃者。刺外。去阳病也。发 者。刺腑输。去腑
病也。去爪者。刺关节肢络也。撤衣者。尽刺诸阳之奇输也。解惑者。尽知调阴阳补泻有余不足相
倾移也。
此章论真气游行出入于肢节皮肤经脉之间。皆当调之和平。导其通利。真气者。所受于天。与谷
气并而充身者也。受于天者。先天所生之精气。谷气者。水谷所生之营卫宗气津液也。节之交三百六
十五会。神气之所游行出入。故曰刺节。有因真气不调。有为邪气所阻。故篇名刺节真邪。赵庭霞
曰。两精相搏谓之神。两精者。先天之精。后天水谷之精。是真气即是神气。分而论之。各有其名。
合而论之。总属中下二焦所生之血气也。
黄帝曰。刺节言振埃。夫子乃言刺外经。去阳病。余不知其所谓也。愿卒闻之。岐伯曰。振埃者。
阳气大逆。上满于胸中。愤 肩息。大气逆上。喘喝坐伏。病恶埃烟。KT 不得息。请言振埃。尚
疾于振埃。黄帝曰。取之何如。岐伯曰。取之天容。黄帝曰。其咳上气穷 胸痛者。取之奈何。岐
伯曰。取之廉泉。黄帝曰。取之有数乎。岐伯曰。取天容者。无过一里。取廉泉者。血变而止。帝曰
善哉。（ 充人切恶去声KT 音噎 音屈）
此阳气逆于内。而不能充行于形身也。阳气者。阳明水谷所生之气。大气宗气也。阳气大逆。故
愤肩息。大气逆上。故喘喝坐伏也。六元正纪论曰。阳明所至为埃烟。病恶埃烟。KT 不得息。阳
明之气病也。阳明者。土也。请言振发其阳明之气。疾如振发其尘埃也。天容。手太阳小肠之经。刺
之以通阳气之逆。 者。语塞也。其咳上气穷 胸痛者。所受于天之气上逆。不得合并而充身也。故
取任脉之廉泉。以通肾脏之逆气。一里者。如人行一里。其气已通。言其速也。血变者。通其血络也。
闵士先曰。手太阳心之腑也。通神气。故取手太阳之天容。
黄帝曰。刺节言发 。余不得其意。夫发 者。耳无所闻。目无所见。夫子乃言刺腑输。去腑病。
何输使然。愿闻其故。岐伯曰。妙乎哉问也。此刺之大约。针之极也。神明之类也。口说书卷。犹不
能及也。请言发 。耳尚疾于发 也。黄帝曰善。愿卒闻之。岐伯曰。刺此者。必于日中。刺其听宫。
中其眸子。声闻于耳。此其输也。黄帝曰善。何谓声闻于耳。岐伯曰。刺邪以手坚按其两鼻窍。而疾
偃其声。必应于针也。黄帝曰善。此所谓弗见为之而无目视。见而取之。神明相得者也。
此言神气之通于七窍也。 者耳无所闻。目无所见。上窍之不通也。听宫。手太阳之经。心之腑
输也。眸子耳中之珠。刺耳之听宫。尚疾于发目之 。是耳窍与目窍之相通也。以手坚按其两鼻窍。
而疾偃其声。必应其耳中之针。是耳窍与鼻窍口窍之相通也。而上之七窍不通。独取手太阳以通心神
之气。而七窍皆利。是神明之通于七窍也。心为阳中之太阳。故必于日中取之。
黄帝曰。刺节言去爪。夫子乃言刺关节肢络。愿卒闻之。岐伯曰。腰脊者。身之大关节也。肢胫
者。人之管以趋翔也。茎垂者。身中之机。阴精之候。津液之道也。故饮食不节。喜怒不时。津液内
溢。乃下留于睾。血道不通。日大不休。俯仰不便。趋翔不能。此病荣然有水。不上不下。铍石所取。形不可
匿。常不得蔽。故名曰去爪。帝曰善。
此言津液随神气而渗灌于诸节者也。津液生于中焦阳明。淖泽于骨。所以濡筋骨而利关节。腰脊
者。从大椎至尾 。乃身之大关节也。手足肢胫之骨节。人之管以趋翔。盖津液淖泽于肢胫。则筋骨
利而胫能步趋。肢能如翼之翔也。茎垂者。肾之前阴。乃宗筋之会。肾者胃之机关。主受藏津液。夫肾
脏所藏之津液。从宗脉而上濡于空窍。故曰茎垂者。身中之机。阴精之候。津液之道也。此言胃腑所生
之津液。随神气而淖注于骨节。肾脏所藏之津液。从宗脉而上濡于空窍。如饮食不节。喜怒不时。则津
液内溢。乃下流于睾囊。血道不通。日大不休。俯仰不便。趋翔不能。此病荣然有水。不上不下。当用
铍石取之。形谓前阴。爪者脉之余。谓形不可藏匿。常不得遮蔽。有若去其宗筋。故命曰去爪。
黄帝曰。刺节言撤衣。夫子乃言尽刺诸阳之奇输。未有常处也。愿卒闻之。岐伯曰。是阳气有余。而
阴气不足。阴气不足则内热。阳气有余则外热。内热相搏。热于怀炭。外畏绵帛。近不可近身。又不可近席。腠理
闭塞。则汗不出。舌焦唇槁。腊干嗌燥。饮食不让美恶。黄帝曰善。取之奈何。或之于其天府大杼
三。又刺中膂以去其热。补足手太阴以出其汗。热去汗稀。疾于撤衣。黄帝曰善。
此因津液不外濡于皮毛。以致阳热盛而不可近席。不上济于心脏。以致内热盛而热如怀炭。盖阳
气者。火热之气。阴气者。水阴之气也。故曰尽刺诸阳之奇输。奇输者。六腑之别络也。津液生于胃
腑水谷之精。大肠主津液。小肠主液。胆者。中精之府。膀胱者。州都之官。津液藏焉。是六腑之津
液。从大络而外濡于皮肤分肉者也。心为阳中之太阳。太阳膀胱为水府。水火上下相济者也。水液不
上滋于心。以致心火盛而热于怀炭。舌焦唇槁。腊干嗌燥。心不和。故饮食不知味也。或之于其者。
谓水谷之津液。皆藏于膀胱。水液随太阳之气。营运于肤表。或不必尽刺诸阳之奇输。取之于其天府
大杼三 。使膀胱所藏之津。外濡于皮毛。又恶太阳经之中膂。通津液上滋于心脏。以去其热。手太阴
乃金水之生源。而外主皮毛。足太阴主脾而外主肌肉。脾主为胃行其津液者也。故当补足手太阴以出其
汗。热去汗稀。疾于彻衣之去热也。
黄帝曰。刺节言解惑。夫子乃言尽知调阴阳补泻有余不足相倾移也。惑何以解之。岐伯曰。大风
在身。血脉偏虚。虚者不足。实者有余。轻重不得。倾侧宛伏。不知东西。不知南北。乍上乍下。乍反
乍复。颠倒无常。甚于迷惑。黄帝曰善。取之奈何。岐伯曰。泻其有余。补其不足。阴阳平复。用针若
此。疾于解惑。黄帝曰善。请藏之灵兰之室。不敢妄出也。
此言阴阳不调。致神志之迷惑也。夫火为阳。水为阴。水火者。阴阳之征兆也。火之精为神。
水之精为志。大风在身。则血脉偏虚。虚者不足。实者有余。主脉偏虚。则轻重倾侧矣。阴阳不调。
则神志迷惑矣。神志迷惑。是以不知东西。不知南北。而反复颠倒也。故当泻其有余。补其不足。阴
阳平复。疾于解惑。夫血者神气也。心脏所主。而发原于肾。是以风伤血脉。则阴阳不调。阴阳不调。
则神志昏而甚于迷惑也。此五节论神气不调。故曰刺节。节者。神气之所游行出入。神游最速。故曰
疾于撤衣。疾于解惑。闵士先曰。以上五节。虽有气神津液之分。然总不出于下焦之肾脏膀胱。中
焦之阳明胃腑。盖下焦乃所受于天之精。中焦乃后天之谷气。两者相搏而为神也。
黄帝曰。余闻刺有五邪。岐伯曰。病有持痈者。有容大者。有狭小者。有热者。有寒者。是谓五
邪。黄帝曰。刺五邪奈何。岐伯曰。凡刺五邪之方。不过五章。瘅热消灭。肿聚散亡。寒痹益温。小
者益阳。大者必去。请道其方。
此节言真气通会于皮肤肌腠之间。而有壅滞大小寒热之病。邪者。谓不得中正之和调也。章、法也。
谓阳盛于外而为瘅热者。使之消灭。气热而为壅肿者。使之散亡。寒者致其神气以和之。真气小者益
其阳。大者必使之归去。各有平调之法也。闵士先曰。始言刺节。中论真气。末言外邪。故曰刺节
真邪。所谓邪病者。谓不得中和之道而为病也。若以外邪之病论之。去经义远矣。
凡刺痈邪。无迎陇。易俗移性不得脓。脆道更行。去其乡。不安处所。乃散亡。诸阴阳过壅者。
取之其输泻之。
此气滞于皮肤肌腠之间。而为肿聚也。痈者。壅也。此因气壅而肿。非痈脓者。离合真邪论曰。
天暑地热。则神
水波涌而陇起。经之动脉。其至也。亦时陇起。盖言此气壅于皮肤分肉而为肿。无迎刺陇起之经脉
也。俗犹习俗。性者。心之所生也。谓心所生之神气。习聚于此。当移易其流行。非痈脓。故不得
脓。脆道。肌肉之理路也。聚气从脆道更行。去其所聚之乡。不使安其处。则聚气乃行散矣。诸阴阳
之脉。所过于壅处者。取其输而泻之。盖皮肤分肉之气。从经输络脉而出。恐聚气之流于脉络也。此
言合并充身之真气。亦营运环转之无端也。
凡刺大邪日以小。泄夺其有余。乃益虚。剽其通。针其邪。肌肉亲视之。毋有反其真。刺诸阳分肉间。
大者。谓真气容大于肌腠之间。故当使之日小。夫有饮于外。则不足于内。若泄夺其有余。乃益
虚其内矣。盖言日以小者。使之复反于内。非夺其外。泄也。故剽切其真气通会之处。针其有余之气。
以通于内。亲、近也。近视其肌肉致密而小。则外内和平矣。若毋有反其真者。再刺诸阳分肉间。盖
真气者。神气也。从关节而出于肌腠之外。故剽通其关节。其有未反者。再取之肌肉也。闵士先曰。
水谷所生之气。从大络而出于分肉。神气出入于关节之间。总属中焦之谷气而分走其道。赵庭霞曰。
谷气与下焦之精气相搏。而后谓之神。
朱卫公曰。毋有反其真。刺诸阳分肉间。是真气从节而出。可复从分肉理路而入。亦环转出入者也。
凡刺小邪日以大。补其不足。乃无害。视其所在迎之界。远近尽至。其不得外侵而行之。乃自费。
刺分肉间。小者通会于肌腠之气虚小。故当使日以渐大。即追而补之。乃无害。视其气至之所在。而迎
之于界。界者。节之交也。使上焦之神气。中焦之谷气。下焦之天真。远近尽至。则日以大矣。侵、
渐进也。费、用也。其不得外侵而
行之者。乃中焦之谷气自用。不与下焦之天真合并而充身。故当刺分肉间以通其谷气。闵士先曰。
追而济之曰补。盖追其正气之内归。小者当迎之使出。不当追之使入。曰补其不足乃无害者。言此处
追而补之。则彼处溢而自出矣。谓真气之环转出入者也。朱卫公曰。此节与上节交错环转。本篇
论气血之离合出入。圣人反复辩论。曲尽婆心。学人不可不深体之。
凡刺热邪越而苍。出游不归乃无病。为开辟门户。使邪得出。病乃已。
热邪者。阳气盛而留于肌腠之间。故为热也。苍苍者。天之正色也。越而苍者。使邪热发越。而
天真之气色见矣。出游不归。谓神气游行于外。而不返其真。此为开辟门户。使邪得出而后病乃已。
故虽出游不归乃无病。
此盖言真气外内出入。环转无息者也。
凡刺寒邪日以除。徐往徐来。致其神。长户已闭。气不分。虚实得调。其气存也。
寒气者。所得于天之水寒。神者。火之精也。水火相感。神志合精。是为和平。故刺寒邪者。日
以除其寒。徐往徐来。以致其神气。即闭其门户。使气不分。而寒热之虚实得调。其真气乃存矣。上节
论开辟门户以去邪。此论门户已闭乃存正。
黄帝曰。官针奈何。岐伯曰。刺痈者用铍针。刺大者用锋针。刺小者用圆利针。刺热者用 针。刺
寒者用毫针也。
此申明五者之病。皆在皮肤肌肉之气分。故所用之针。皆取痹于肌肉者也。
请言解论。与天地相应。与四时相副。人参天地。故可为解。下有渐洳。上生苇蒲。此所以知形
气之多少也。阴阳
者。寒暑也。热则滋雨而在上。根 少汁。人气在外。皮肤缓。腠理闭。血气减。汗大泄。皮淖泽。
寒则地冻水冰。人气在中。皮肤致。腠理闭。汗不出。血气强。肉坚涩。当是之时。善行水者。不能
往水。善穿地者。不能凿冻。善用针者。亦不能取四厥。血脉凝结。坚搏不往来者。亦未可即柔。故
行水者必待天温。冰释冻解。而水可行。地可穿也。人脉犹是也。治厥者必先熨。调和其经。掌与腋。
肘与脚。项与脊以调之。火气已通。血脉乃行。然后视其病脉。淖泽者刺而平之。坚紧者破而散之。
气下乃止。此所谓以解结者也。
此解论所受于天之气。从阴而生。自下而上。应天地之寒暑往来。随四时之生长收藏者也。渐洳。
濡滋之地也。苇蒲生于水中。其质柔弱。中抽坚茎。名曰蒲槌。内刚外柔。为坚心之坎水。以比人之
元阳。生于精水之中。故曰此所以知形气之多少也。谓充于形中之气。生于天一水中。知所秉之浓薄。
则知气有多少矣。人之阴阳出入。应天地之寒暑往来。热则滋雨在上。而万物之根 少汁。盖言精水
亦随气而上出者也。热则人气在外。腠理开而汗大泄。津气外泄。故在内之血气减少。此言人之血气。
本于下焦之精气也。地冻水冰。则天气收藏。而人气在中。皮肤致密。而汗不出。精气内藏。故血气
Huangdi asked Qibo: I have heard that there are five categories of acupuncture techniques. What are they? Qibo replied: Indeed, there are these five categories. The first is called "Zhen Ai" (Shaking off Dust), the second "Fa Meng" (Opening the Blind), the third "Qu Zhua" (Removing Claws), the fourth "Che Yi" (Taking Off Clothes), and the fifth "Jie Huo" (Resolving Confusion).
Huangdi said: Regarding the five categories mentioned by the Master, I do not yet understand their meaning. Qibo said: "Zhen Ai" involves needling the *Wai Jing* (Outer Meridians) to eliminate pathogenic factors in the Yang aspect. "Fa Meng" involves needling the *Shu* points of the Six Fu organs to eliminate diseases of the Six Fu organs. "Qu Zhua" involves needling the joints and collateral vessels of the limbs. "Che Yi" involves comprehensively needling the extraordinary *Shu* points of all Yang meridians. "Jie Huo" involves fully understanding and harmonizing Yin and Yang, using tonification for deficiency and sedation for excess to restore balance.
This chapter discusses the circulation and entry/exit of *Zhen Qi* (True Qi) among the limbs, joints, skin, and meridians, which should all be regulated to achieve harmony and promote smooth flow. *Zhen Qi* is formed by combining the clear Qi inhaled from nature with the Qi derived from food and drink to fill the body. That inhaled from nature refers to the essence generated congenitally (pre-heaven), while the Qi from food and drink refers to the *Ying Qi* (Nutritive Qi), *Wei Qi* (Defensive Qi), *Zong Qi* (Gathering Qi), and body fluids generated post-heaven. There are 365 junctions throughout the body where divine Qi circulates and enters/exits, hence the term "Ci Jie" (Needling the Joints/Junctions). Sometimes it is due to dysfunction of True Qi, and sometimes due to obstruction by pathogenic factors; thus the chapter is titled "Ci Jie Zhen Xie" (Needling the Junctions: True Qi and Pathogens). Zhao Tingxia stated: When two essences interact, Shen (Spirit) is produced. The two essences refer to pre-heaven essence and post-heaven food-and-drink essence. True Qi is essentially Divine Qi; when analyzed separately, they have different names, but collectively, they belong to the blood and Qi generated by the Middle and Lower Jiao.
Huangdi said: In the context of acupuncture techniques, "Zhen Ai" was mentioned, yet you spoke of needling the Outer Meridians to treat Yang diseases. I do not understand what this means. I wish to hear it explained in detail. Qibo said: "Zhen Ai" refers to severe rebellion of Yang Qi, filling the chest upwards, causing oppression, shoulder-lifting breathing, rebellion of the Great Qi, wheezing with sound, restlessness in sitting or lying down, aversion to smoke and dust, and throat obstruction preventing respiration. Let me explain "Zhen Ai"; its effect is faster than shaking off dust. Huangdi said: How should acupoints be selected? Qibo said: Select Tianrong (SI17). Huangdi said: If the patient has cough and rebellious Qi, extending to chest pain, how should one select points? Qibo said: Select Lianquan (CV23). Huangdi said: Is there a limit to the manipulation? Qibo said: For Tianrong, do not exceed one li (a measure of time/distance indicating quick action); for Lianquan, stop when the blood color changes (from dark to bright red). Huangdi said: Excellent. (Note: Chong ren qie, E qu sheng, KT yin ye, yin qu).
This occurs because Yang Qi rebels internally and cannot circulate to fill the body. Yang Qi is generated from the food and drink of the Yangming Stomach. The Great Qi is the Zong Qi. Severe rebellion of Yang Qi causes oppression and shoulder-lifting breathing; rebellion of the Great Qi upward causes wheezing and restlessness. The *Suwen: Liuyuan Zhengji Dalun* states: When Yangming governs, there is dust and smoke. Aversion to dust/smoke and throat obstruction indicate disease of the Yangming channel. Yangming belongs to Earth. Let me explain the revitalization of Yangming Qi; its speed is like shaking off dust. Tianrong belongs to the Hand-Taiyang Small Intestine Channel; needling it unblocks rebellious Yang Qi. "KT" refers to speech impediment or throat obstruction. Cough, rebellious Qi, and chest pain occur because the Qi received from heaven rebels upward and fails to combine to fill the body. Thus, we select Lianquan of the Ren Mai to unblock rebellious Qi of the Kidney. "One li" implies the speed at which Qi flows, like walking one li. "Blood change" refers to unblocking blood collaterals. Min Shixian stated: The Hand-Taiyang Small Intestine is the Fu organ of the Heart, connecting to Divine Qi; hence, Tianrong of the Hand-Taiyang is selected.
Huangdi said: Regarding "Fa Meng" in acupuncture techniques, I do not understand its meaning. "Fa Meng" implies deafness and blindness, yet you speak of needling Fu organ Shu points to treat Fu organ diseases. Which point achieves this? I wish to know the reason. Qibo said: What an insightful question! This is the general principle of needling, the ultimate method, belonging to the realm of spiritual transformation. Words and texts cannot fully express it. Let me explain "Fa Meng"; hearing recovers even faster than "Fa Meng". Huangdi said: Good, please explain in detail. Qibo said: To needle here, one must do so at noon, needle Tinggong (SI19), ensuring the sensation reaches the eyes, and the sound is heard in the ears; this is the characteristic of this Shu point. Huangdi said: Good, what does "sound heard in the ears" mean? Qibo said: When needling to expel pathogens, press firmly on both nostrils with your hand, then have the patient make a sound quickly; this sound must correspond to the needle sensation. Huangdi said: Good. This is described as acting without seeing form, not relying on visual inspection, but perceiving the pathology and selecting points accordingly, achieving harmony between spirit and needle.
This discusses the communication of Divine Qi through the seven orifices. "KT" refers to deafness and blindness, indicating blockage of the upper orifices. Tinggong belongs to the Hand-Taiyang channel, the Shu point of the Heart's Fu organ. The pupils are the essence within the eyes. Needling Tinggong in the ear has an effect faster than treating eye "KT", demonstrating the connection between the ear and eye orifices. Pressing the nostrils and making a sound corresponds to the needle sensation in the ear, demonstrating the connection between the ear, nose, and mouth orifices. For blockage of the upper seven orifices, selecting only the Hand-Taiyang channel to regulate Heart Spirit Qi allows all seven orifices to open, illustrating Divine Qi communicating through the seven orifices. The Heart is the Taiyang among Yang organs; therefore, needling is performed at noon.
Huangdi said: Regarding "Qu Zhua" in acupuncture techniques, you spoke of needling joint and limb collaterals. Please explain in detail. Qibo said: The waist and spine are the major joints of the body. The limbs and calves are the tools for human movement. The penis and scrotum are the mechanisms within the body, indicators of Yin essence, and pathways for body fluids. If dietary habits are irregular, and emotions like anger and joy are not regulated timely, body fluids will overflow internally and accumulate downward in the testicles. Blood channels become blocked, leading to progressive swelling without relief. Flexion and extension become difficult, and walking is impaired. This disease involves water-dampness retention, neither ascending nor descending, requiring treatment with a Pi Shi (scalpel/surgical knife). The deformity cannot be hidden and often requires exposure, hence the name "Qu Zhua" (Removing Claws). Huangdi said: Good.
This discusses body fluids permeating joints along with Divine Qi. Body fluids are generated in the Middle Jiao Yangming Stomach, moistening bones to nourish sinews and facilitate joint mobility. The waist and spine, from Dazhui (GV14) to the coccyx, are the major joints. The bone joints of the hands, feet, limbs, and calves are the tools for movement. Generally, when body fluids moisten the limbs and calves, sinews and bones become supple, allowing walking and flight-like movement of limbs. The penis and scrotum are the anterior yin of the Kidney, the convergence of the Zong Jin (Major Sinews). The Kidney is the gatekeeper of the Stomach, governing the storage of body fluids. Body fluids stored in the Kidneys ascend via the Zong Mai to nourish the orifices; thus, the penis and scrotum are the body's mechanism, indicators of Yin essence, and pathways for body fluids. This describes body fluids generated by the Stomach nourishing joints via Divine Qi, and body fluids stored in the Kidneys ascending to nourish orifices. Irregular diet and unregulated emotions cause fluid overflow into the scrotum, blocking blood channels, causing progressive swelling, difficulty in movement, and water retention. Treatment requires a Pi Shi. "Xing" refers to the external genitalia; "Zhua" refers to the remnant of pulse/Qi, implying the form cannot be concealed, resembling the removal of the Zong Jin, hence the name "Qu Zhua".
Huangdi said: Regarding "Che Yi" in acupuncture techniques, you spoke of comprehensively needling extraordinary Shu points of Yang meridians without fixed locations. Please explain in detail. Qibo said: This indicates excess Yang Qi and deficiency of Yin Qi. Deficiency of Yin leads to internal heat; excess Yang leads to external heat. Internal and external heat clash, feeling like holding charcoal, while the exterior fears cotton and silk; proximity to the body or mat is intolerable. Collapses are closed, so no sweat is produced; the tongue is scorched, lips withered, cheeks dry, and throat parched, losing the ability to distinguish flavors. Huangdi said: Good, how to select points? One may needle Tianfu (LU3) and Dazhu (BL11) three times each, and also needle Zhonglshu (BL45) to remove internal heat, and tonify the Hand-Taiyin Lung Channel to induce sweating. As heat dissipates and sweat decreases, the effect is faster than removing clothes. Huangdi said: Good.
This occurs because body fluids fail to moisten the skin and hair externally, leading to extreme Yang heat intolerance; failure to nourish the Heart internally leads to extreme internal heat, feeling like holding charcoal. Yang Qi is fire-heat Qi; Yin Qi is water-yin Qi. Hence, comprehensively needling extraordinary Shu points of Yang meridians. Extraordinary Shu refers to the divergent collaterals of the Six Fu organs. Body fluids originate from the essence of food and drink in the Stomach; the Large Intestine governs Jin (thin fluids), the Small Intestine governs Ye (thick fluids), the Gallbladder is the storehouse of essence, and the Bladder is the officer of the capital storing fluids. These Six Fu fluids moisten the skin and muscles via large collaterals. The Heart is Taiyang among Yang; the Bladder is the Water House; Water and Fire mutually nourish. If fluids fail to ascend to nourish the Heart, Heart Fire becomes excessive, causing scorched tongue, withered lips, dry cheeks/throat, and loss of taste due to Heart disharmony. "Or select from..." means that since food-and-drink fluids are stored in the Bladder and circulate on the surface via Taiyang Qi, one need not needle all extraordinary Shu points. Selecting Tianfu and Dazhu three times each moistens the skin with Bladder fluids. Avoiding Zhonglshu facilitates fluid ascent to the Heart to clear heat. The Hand-Taiyin Lung is the source of Metal and Water, governing the skin externally; the Foot-Taiyin Spleen governs muscles externally and transports fluids for the Stomach. Therefore, tonifying the Hand-Taiyin induces sweating. Heat dissipation and reduced sweating show efficacy faster than removing clothes to cool.
Huangdi said: Regarding "Jie Huo" in acupuncture techniques, you spoke of harmonizing Yin and Yang, tonifying deficiency, and sedating excess to resolve confusion. How is confusion resolved? Qibo said: When severe Wind pathogens reside in the body, blood vessels become unevenly deficient. The deficient side is insufficient, the excess side is abundant. Balance of weight is lost, leading to tilting, falling, and disorientation regarding directions. Movements are erratic, alternating up/down and reversal, more chaotic than confusion itself. Huangdi said: Good, how to select points? Qibo said: Sedate the excess, tonify the deficiency, restoring Yin-Yang balance. Using needles in this manner resolves confusion faster than waking from a dream. Huangdi said: Good. Store this in the Linglan Chamber; do not leak it lightly.
This discusses how Yin-Yang disharmony leads to mental confusion. Fire is Yang, Water is Yin; they are manifestations of Yin-Yang. The essence of Fire is Shen (Spirit); the essence of Water is Zhi (Will). Wind pathogens cause uneven vessel deficiency. Vessel deficiency leads to physical imbalance. Yin-Yang disharmony leads to mental confusion, causing disorientation and erratic behavior. Thus, sedate excess, tonify deficiency, restore balance, resolving confusion quickly. Blood is Shen Qi, governed by the Heart but originating in the Kidney. Wind damaging vessels causes Yin-Yang disharmony, leading to mental cloudiness worse than confusion. These five techniques address Shen Qi dysfunction, hence "Ci Jie". Jie refers to junctions where Shen Qi circulates. Shen Qi moves fastest, hence effects are faster than removing clothes or resolving confusion. Min Shixian stated: Although these five techniques involve Qi, Shen, and fluids, they ultimately relate to the Lower Jiao Kidney/Bladder and Middle Jiao Yangming Stomach. Lower Jiao holds heavenly essence; Middle Jiao holds post-heaven grain Qi. Their interaction produces Shen.
Huangdi said: I have heard of five types of pathogens in needling. Qibo said: Diseases include those presenting as abscesses (Yong), enlargement (Rong Da), constriction (Xiao Xiao), heat (Re), and cold (Han). These are the Five Evils. Huangdi said: How to needle the Five Evils? Qibo said: The methods for the Five Evils fall under five chapters. Eliminate intense heat, dissipate swellings, warm cold bi, tonify Yang for small deficiencies, and remove excess for enlargements. Please explain the methods.
This section discusses Zhen Qi circulating in the skin and muscle layers, encountering stagnation, size variations, and cold/heat pathogens. "Evil" refers to deviation from central harmony. "Chapter" refers to method. For Yang excess externally causing intense heat, eliminate it. For Qi heat causing swelling, dissipate it. For cold, use Shen Qi to harmonize. For small Qi deficiency, tonify Yang. For large excess, remove it. Each has a balancing method. Min Shixian stated: Beginning with needling junctions, discussing Zhen Qi, and ending with external pathogens justifies the title "Ci Jie Zhen Xie". Evil disease refers to pathology arising from lack of harmony. Discussing only external pathogens strays from the canonical meaning.
When needling Yong (abscess/stagnation) evils, do not needle against the rising surge. Change habits and shift nature; do not allow pus formation. Traverse fragile pathways, leave the site of accumulation, prevent stability, and the pathogen will dissipate. For any Yin-Yang channel passing through stagnation, select the Shu point and sedate.
This describes Qi stagnating in skin and muscles causing swelling. Yong means stagnation. This is swelling due to Qi stagnation, not suppuration. The *Lihé Zhenxie Lun* states: In summer heat, earth heat rises, causing spiritual waters to surge and vessels to bulge. Do not needle against the bulging vessel. "Custom" refers to habit; "Nature" refers to the mind's generation. The Shen Qi generated by the mind accumulates here; one must shift its flow. Since it is not suppuration, no pus forms. "Cui Dao" refers to muscle texture. Accumulated Qi moves along fragile textures, leaving the site, preventing stability, and dispersing. For channels passing through stagnation, select Shu points and sedate. Skin/muscle Qi exits via channel Shu and collaterals; this prevents accumulation from flowing into collaterals. This illustrates that combined Zhen Qi circulates endlessly.
When needling Da (large/excess) evils, reduce them daily. Sedate and drain the excess, thereby tonifying the interior. Pierce the通畅 (smooth) passages, needle the pathogen, observe the muscle proximity, and ensure it does not return to its true state. Needle between the Yang muscle compartments. "Da" refers to Zhen Qi expanding beyond muscle layers; thus, it must be reduced daily. External invasion causes internal deficiency. Draining excess reduces internal deficiency. "Reduce daily" means returning it internally, not draining external pathogen. Pierce the通畅 areas of Zhen Qi, needle excess Qi to connect internally. "Qin" means near. Observe muscles becoming dense and smaller, achieving internal-external peace. If it does not return to true state, needle Yang muscle compartments again. Zhen Qi is Shen Qi, exiting joints to muscles; pierce joints, and if not returned, needle muscles again. Min Shixian stated: Grain Qi exits large collaterals to muscles; Shen Qi enters/exits joints. Both belong to Middle Jiao grain Qi distributing via paths. Zhao Tingxia stated: Grain Qi interacts with Lower Jiao essence to form Shen.
Zhuweigong stated: Do not let it return to true state; needle Yang muscle compartments. Zhen Qi exits joints and re-enters via muscle textures, circulating continuously.
When needling Xiao (small/deficiency) evils, enlarge them daily. Tonify deficiency, causing no harm. Observe the location, meet it at the boundary, ensuring Qi from near and far arrives. Prevent external invasion and usage; needle between muscles. "Xiao" refers to deficient Qi in muscle layers; thus, enlarge it daily by chasing and tonifying. Observe Qi arrival and meet at the boundary. Boundary refers to joint junctions. Ensure Upper Jiao Shen Qi, Middle Jiao Grain Qi, and Lower Jiao Heavenly Essence arrive from near and far, enlarging daily. "Qin" means gradual advance. "Fei" means use. Failure to invade externally means Middle Jiao Grain Qi uses itself without combining with Lower Jiao Essence. Needle muscles to connect Grain Qi. Min Shixian stated: Chasing and assisting is tonification. Chase internal return of Zheng Qi. Small evils should be met to exit, not chased to enter. "Tonify deficiency causing no harm" means tonifying here causes overflow elsewhere, illustrating circular Qi movement. Zhuweigong stated: This section intersects with the previous one, discussing Qi-Blood separation/entry/exit. The Sage debates repeatedly with great care; students must deeply comprehend.
When needling Re (heat) evils, vent them to cyan (clear). Wandering out without returning brings no disease. Open the gates to let pathogens exit, and the disease ceases.
Heat evil is excess Yang Qi remaining in muscle layers. "Cang Cang" is the true color of heaven. "Vent to cyan" means venting heat so the true Qi color appears. "Wandering out without returning" means Shen Qi travels externally and does not return to truth. This opens gates for pathogens to exit, curing the disease. Thus, wandering out without returning results in health.
This illustrates the continuous internal-external circulation of Zhen Qi.
When needling Han (cold) evils, remove them daily. Move slowly in and out, guiding Shen. Close the long gates. Qi does not scatter. Deficiency and excess are balanced, preserving Qi.
Cold Qi is water-cold received from heaven. Shen is the essence of Fire. Water and Fire interact, Shen and Zhi combine, achieving peace. Needling cold evils removes cold daily. Slow movement guides Shen Qi. Closing gates prevents Qi scattering, balancing cold/heat deficiency/excess, preserving Zhen Qi. The previous section discussed opening gates to expel pathogens; this discusses closing gates to preserve righteousness.
Huangdi said: How are official needles used? Qibo said: Use Pi Needle for Yong (abscess), Feng Needle for Da (excess), Yuanli Needle for Xiao (deficiency), Chan Needle for Re (heat), and Hao Needle for Han (cold).
This clarifies that the five diseases affect Qi in skin and muscles; thus, needles targeting muscle bi are used.
Please discuss the Resolution Theory. It corresponds to Heaven and Earth, aligns with the Four Seasons. Man participates in Heaven and Earth, thus capable of resolution. Below are damp marshes; above grow reeds and cattails. This indicates the abundance or scarcity of Form and Qi. Yin and Yang are Cold and Heat. Heat brings rain overhead; roots lack juice. Human Qi is external; skin is relaxed, pores closed, blood/Qi reduced, heavy sweating, skin moist. Cold freezes earth and water; human Qi is internal; skin is dense, pores closed, no sweat, blood/Qi strong, muscles firm and rough. At such times, a skilled water-runner cannot move water; a skilled digger cannot break frozen ground. A skilled acupuncturist cannot treat Si Jue (Four Reversals). Blood vessels congeal, hard and unyielding, cannot be softened immediately. Thus, water-running waits for warmth, ice melting, for water to flow and ground to be dug. Human vessels are similar. Treating reversals requires moxibustion/warming first to harmonize channels. Palms and axillae, elbows and feet, neck and spine are regulated. Once fire Qi connects, blood vessels flow. Then observe pathological pulses: moist ones are needled to level; hard/tight ones are broken and dispersed. Stop when Qi descends. This is resolving knots.
This Resolution Theory explains Qi received from heaven, born from Yin, ascending from below, responding to celestial cold/heat cycles and seasonal growth/storage. "Jian Ru" refers to damp, moist land. Reeds/cattails grow in water, soft outside but tough inside (pith), symbolizing Kan Water (hard heart) compared to human Yuan Yang born in essence water. Thus, knowing the density of Qi in form reveals Qi abundance. Human Yin-Yang entry/exit responds to seasonal cold/heat. Heat brings rain, roots lack juice, indicating essence water ascends with Qi. Heat places human Qi external, pores open, heavy sweating, fluid loss, reducing internal blood/Qi. This shows blood/Qi originates from Lower Jiao essence. Freezing earth/water means weather stores, human Qi internal, dense skin, no sweat, essence stored, blood/Qi strong.