凡刺之道。毕于终始。明知终始。五脏为纪。阴阳定矣。阴者主脏。阳者主腑。阳受气于四末。
阴受气于五脏。故泻者迎之。补者随之。知迎知随。气可令和。和气之方。必通阴阳。五脏为阴。
六腑为阳。传之后世。以血为盟。敬之者昌。慢之者亡。无道行私。必得夭殃。
此篇论人之脏腑阴阳。经脉气血。本于天地之所生。有始而有终也。五营运论曰。东方生风。
风生木。木生酸。酸生肝。南方生热。热生火。火生苦。苦生心。夫风寒暑湿燥热。天之六气也。
木火土金水。地之五行也。天食人以五气。地食人以五味。是天之六气。化生地之五行五味。五行
五味。以生人之五脏。五脏内合六腑。以应地之五行。外合六经。以应天之六气。故曰明知终始。
五脏为纪。谓人之五脏。本应五行之化也。请言终始。经脉为纪。平与不平。天道毕矣。谓人之
经脉。应天之六气也。末结曰太阳之脉。其终也戴眼反折。太阴终者。腹胀不得息。是人之阴阳
血气。始于地之五行。天之六气所生。而终于地之六经。天之六气也。故曰其生五。其数三。谓生
于五行。而终于三阴三阳之数也。阴者主脏。阳者主腑。脏腑阴阳之相合也。阳受气于四末。阳
受天气于外也。阴受气于五脏。阴受地气于内也。故泻者迎之。迎阴气之外出也。补者随之。追阳气
之内交也。故曰知迎知随。气可令和。和气之方。必通阴阳。
谨奉天道。请言终始。终始者。经脉为纪。持其脉口人迎。以知阴阳有余不足。平与不平。天
道毕矣。所谓平人者不病。不病者。脉口人迎应四时也。上下相应而俱往来也。六经之脉不结动也。
本末之。寒温之。相守司也。形肉血气。必相称也。是谓平人。少气者。脉口人迎俱少。而不称尺
寸也。如是者。则阴阳俱不足。补阳则阴竭。泻阴则阳脱。如是者。可将以甘药。不可饮以至剂。
如是者弗灸。不已者。因而泻之。则五脏气坏矣。
谨奉天道。请言终始者。谓阴阳经脉。应天之六气也。夫血脉本于五脏五行之所生。而外合于
阴阳之六气。有生始而有经终。故曰终始者。经脉为纪也。持其脉口人迎。以知阴阳有余不足。平
与不平。盖诊其脉以候其气也。应四时者。春夏之气。从左而右。秋冬之气。从右而左。是以春夏
人迎微大。秋冬气口微大。是谓平人。上下相应者。应天之六气。上下环转。往来不息。六经之脉。
随气流行。不结动也。本末者。有本标之出入。寒温者。应寒暑之往来。各相守司也。形肉血气。
谓脉外之血气与六经之脉。必相称也。脉口人迎。以候三阴三阳之气。是以少气者。脉口人迎俱少。
尺以候阴。寸以候阳。不称尺寸者。阴阳气虚。而又应于尺寸之脉也。甘药者。调胃之药。谓三阴
三阳之气。本于中焦胃腑所生。宜补其生气之原。道之流行。故不可饮以至剂。谓甘味太过。反留
中也。弗灸者。谓阴阳之气。不足于外。非经脉之陷下也。因而泻之。则五脏气坏者。六气化生
五行。五行上呈六气。五六相得而各有合也。
人迎一盛。病在足少阳。一盛而躁。病在手少阳。人迎二盛。病在足太阳。二盛而躁。病在手
太阳。人迎三盛。病在足阳明。三盛而躁。病在手阳明。人迎四盛。且大且数。名曰溢阳。溢阳为
外格。脉口一盛。病在足厥阴。厥阴一盛而躁。在手心主。脉口二盛。病在足少阴。二盛而躁。在手
少阴。脉口三盛。病在足太阴。三盛而躁。在手太阴。脉口四盛。且大且数者。名曰溢阴。溢阴为
内关。内关不通。死不治。人迎与太阴脉口。俱盛四部以上。命曰关格。关格者与之短期。
左为人迎。右为气口。以候三阴三阳之气。圣人南面而立。前曰广明。后曰太冲。左东而右西。
天道右旋。地道左迁。故以左候阳而右候阴也。躁者。阴中之动象。盖六气皆由阴而生。从地而出。
故只合足之六经。其有躁者在手。以合六脏六腑。十二经脉。盖十二经脉。以应三阴三阳之气。非
六气之分手与足也。外格者。谓阳盛于外。而无阴气之和。内关者阴盛于内。而无阳气之和。关格
者。阴关于内。阳格于外也。开之曰。脉口、太阴也。人迎、阳明也。盖脏气者。不能自至于手太
阴。必因于胃气。乃至于手太阴。是左右皆属太阴。而皆有阳明之胃气。以阳气从左而右。阴气从
右而左。故以左候三阳。右候三阴。非左主阳而右主阴也。阴中有阳。阳中有阴。是为平人。若左
独主阳。右独主阴。是为关阴格阳之死候矣。
人迎一盛。泻足少阳。而补足厥阴。二泻一补。日一取之。必切而验之。疏取之上。气和乃
止。人迎二盛。泻足太阳。补足少阴。二泻一补。二日一取之。必切而验之。疏取之上。气和乃止。
人迎三盛。泻足阳明。而补足太阴。二泻一补。日二取之。必切而验之。疏取之上。气和乃止。
脉口一盛。泻足厥阴。而补足少阳。二补一泻。日一取之。必切而
验之。疏而取上。气和乃止。脉口二盛。泻足少阴。而补足太阳。二补一泻。二日一取之。必切而
验之。疏取之上。气和乃止。脉口三盛。泻足太阴。而补足阳明。二补一泻。日二取之。必切而验
之。疏而取之上。气和乃止。所以日二取之者。阳明主胃。大富于谷气。故可日二取之也。人迎与
脉口俱盛三倍以上。命曰阴阳俱溢。如是者不开。则血脉闭塞。气无所行。流淫于中。五脏内伤。如
此者因而灸之。则变易而为他病矣。
补泻者。和调阴阳之气平也。阳二泻而阴一泻者。阳常有余而阴常不足也。阳补二而阴补一者。
阳可盛而阴不可盛也。故溢阳不曰死。溢阴者死不治矣。必切而验之者。切其人迎气口。以验三阴
三阳之气也。疏当作躁。谓一盛而躁。二盛而躁。当取手之阴阳也。阳明主胃。大富于谷气。故可
日二取之。盖三阴三阳之气。乃阳明水谷之所生也。人迎与脉口俱盛。命曰阴阳俱溢。盖阴盛于内。
则阳盛于外矣。阳盛于左。则阴盛于右矣。如是者。若不以针开之。则血脉闭塞。气无所行。流溢
于中。则内伤五脏矣。夫盛则泻之。虚则补之。陷下则灸之。此阴阳之气。偏盛不和。非陷下也。
故灸之则生他病矣。
凡刺之道。气调而止。补阴泻阳。音气益彰。耳目聪明。反此者气血不行。
此言三阴三阳之气。从五脏之所生。故曰明知终始。五脏为纪。凡刺之道。气调而止。谓阴阳
之气偏盛。刺之和调则止矣。然又当补阴泻阳。补阴者。补五脏之里阴。泻阳者。导六气之外出。
六节藏象论曰。五气入鼻。藏于心肺。上使五色修明。音声能彰。顺气篇曰。五者音也。音主长夏。
是补其脏阴。则心肺脾脏之气和。而音声益彰矣。肝开窍于目。肾开窍于耳。肝肾之气盛。则耳目
聪明矣。补其脏阴。导其气出。则三阴三阳之气和调。
而无偏盛之患矣。夫阴阳血气。本于胃腑五脏之所生。胃者。水谷血气之海也。海之所以行云气者
天下也。胃之所出气血者经隧也。经隧者。五脏六腑之大络也。故不补阴泻阳。则气血不行。
所谓气至而有效者。泻则益虚。虚者脉大如其故而不坚也。坚如其故者。适虽言故。病未去也。
补则益实。泻者脉大如其故而益坚也。夫如其故而不坚者。适虽言快。病未去也。故补则实。泻则
虚。痛虽不随针。病必衰去。必先通十二经脉之所生病。而后可得传于终始矣。故阴阳不相移。虚
实不相倾。取之其经。
此言补泻三阴三阳之气。必俟经脉和调。所谓终始者。经脉为纪也。泻者。泻其盛而益其虚也。
坚、实也。虚者。脉大如其故而不坚也。若坚如其故者。适虽言故已和调。而所生之病未去也。补
者。所以益实也。实者。脉大如其故而益坚也。夫如其故而不坚者。适虽言快。乃阴阳之气和而快。
然经脉之病未去也。盖始在三阴三阳之是动。渐及于经脉之所生。故所谓气至而有效者。针在三阴
三阳之气分。经脉虽不随针。而经脉之病必衰去。经气之相应也。故必先通十二经脉之所生病。而
后可传于终始矣。故阴阳不相移。虚实不相倾。言阴阳之气。无虚实之倾移。则当取之其经。所谓
不虚不实。以经取之。盖言阴阳之气。已无虚实。则脉应和调矣。脉不调者。所生病也。故当取之
其经。故曰脉大如其故者。谓阴阳之气。已如其故而无盛虚。坚不坚者。经脉所生之病。尚未平
也。开之曰。先为是动。后病所生。此因气以及经。
凡刺之属三。刺至谷气。邪僻妄合。阴阳易居。逆顺相反。沉浮异处。四时不得。稽留淫 。
须针而去。故一刺则阳邪出。再刺则阴邪出。三刺则谷气至。谷气至而止。所谓谷气至者。已补
而实。已泻而虚。故已知谷气至也。邪气
独去者。阴与阳未能调而病知愈也。故曰补则实。泻则虚。痛虽不随针。病必衰去矣。
此承上文而言去阴阳偏盛之邪。又当调其经脉也。谷气者。荣卫血气。生于水谷之精。谓经
脉之气也。阳邪阴邪者。阴阳偏盛之气也。盖因邪僻妄合于气分。使阴阳之气不和而易居也。逆顺
者。谓皮肤之气血。从臂肘而行于手腕之前。经脉之血气。从指井而行于手腕之后。病则逆顺相
反矣。浮沉异处者。阴阳之气。与经脉不相合也。四时不得者。不得其升降浮沉也。此因邪僻淫
于阴阳之气分。而致经脉之不调也。故一刺则阳邪出。再刺则阴邪出。而阴阳之气调矣。三刺则
谷气至。而经脉之血气和矣。故已补其三阳之虚。则阳脉实矣。已泻其三阴之实。则阴脉虚矣。已
补其三阴之虚。则阴脉实矣。已泻其三阳之实。则阳脉虚矣。故已知谷气至而脉已调矣。如气分之
邪独去。而阴与阳之经脉。虽未能调而病知愈也。故曰补则实。泻则虚。痛虽不随针。病必衰去矣。
按官针篇曰。先浅刺绝皮。以出阳邪。再刺则阴邪出者。少益深绝皮。致肌肉未入分肉间也。已入
分肉之间。则谷气出。盖在皮肤分腠之间。以致谷气。不在脉也。故曰痛虽不随针。谓针在皮肤
而痛应于脉。非针在脉而痛于脉也。开之曰。经脉之血气。水谷之所生也。病在三阴三阳之气。故
补之泻之。则阴阳之气和。而经脉未调也。谷气至而后经脉和调。故曰凡刺之属三。
阴盛而阳虚。先补其阳。后泻其阴而和之。阴虚而阳盛。先补其阴。后泻其阳而和之。
此复论调和经脉之阴阳。所谓盛则泻之。虚则补之者。调和三阴三阳之气也。不虚不实。以经
取之者。谓阴阳之气已调。无虚实之偏僻。而经所不调者。又当取之于经也。夫经脉之血气。本于
脏腑所生。故当先补其
正虚。而后泻其邪实。开之曰。前节论调气而经脉不调。上节论在皮肤以致谷气。此节论取之其经。
三脉动于足大趾之间。必审其实虚。虚而泻之。是谓重虚。重虚病益甚。凡刺此者。以指按之。
脉动而实且疾者。疾泻之。虚而徐者则补之。反此者病益甚。其动也。阳明在上。厥阴在中。少阴
在下。
此篇论三阴三阳之气。本于五脏五行之所生。而五脏之气。生于后天水谷之精。始于先天之
水火。盖水生木而火生土金也。以上数节。论三阴三阳之气。候于人迎气口。谓本于阳明水谷之
所生。从五脏之经隧。出于皮肤而见于尺寸。此复论五行之气。本于先天之肾藏。下出于胫气之街。
散于皮肤。复从下而上。本经动 篇曰。冲脉者。十二经之海也。与少阴之大络。起于肾。下出
于气街。循阴股内廉。斜入 中。循胫骨内廉。并少阴之经。下入内踝之后。入足下。其别者。
斜入踝。出属跗上。入大趾之间。注诸络以温足胫。是先天水火之气。下出于胫气之街。故阳气
起于足五趾之表。阴气起于足五趾之里。此水火阴阳之气。出气街而散于足五趾也。其别者。斜入
踝。出属跗上。入大趾之间。是先天之水火。化生五行之气。随冲脉与少阴之大络。注于足大趾之
间。而复上行。故少阴在下者。谓天一之水。地二之火。厥阴在中者。谓天三之木。阳明居中土。
而主秋金之气。阳明在上者。谓地四生金。天五生土也。此言五脏五行之气。生主中焦之阳明。始
于下焦之少阴。其上行者。出于阳明。而走尺肤。其下行者。出于少阴。而动于足大趾之间。
膺俞中膺。背俞中背肩膊。虚者取之上。重舌刺舌柱。以铍针也。手屈而不伸者。其病在筋。
伸而不屈者。其病在骨。在骨守骨。在筋守筋。
夫皮肉筋骨。五脏之外合。脉外之气分也。此承上文而言五行之气。从足上行。如有虚者取之。
取者。谓迎其气之外出也。胃俞在膺中。脾俞在膺旁。肺俞在背肩。心之窍在舌。肝之气在筋。肾
之气在骨。是五脏之气虚者。各随其所在而取之。玉师曰。此论脉外之气。故在心只言舌而不言脉。
本篇重在五行六气之生始出入。故篇名终始。而论刺则曰虚者取之。曰以铍针也。曰在骨守骨。在
筋守筋。读者味之。其义自得。张开之曰。上节曰少阴在下。阳明在上。谓数之始于一而终于五。
The principles of acupuncture are fully contained in the concept of "Zhong Shi" (Beginning and End). Once one clearly understands Zhong Shi, the Five Zang Organs serve as the guiding principle, and Yin and Yang are thereby determined. Yin primarily governs the Zang organs, while Yang primarily governs the Fu organs. Yang Qi receives its nourishment from the four extremities, whereas Yin Qi receives its nourishment from the Five Zang organs. Therefore, for the reducing method, one needles against the direction of the Qi flow (Ying); for the tonifying method, one needles with the direction of the Qi flow (Sui). By understanding Ying and Sui, the Qi can be harmonized. The method to harmonize the Qi must involve a thorough comprehension of Yin and Yang. The Five Zang organs belong to Yin, and the Six Fu organs belong to Yang. This knowledge is passed down to future generations, sworn by blood. Those who respect it will prosper; those who slight it will perish. Those who act unrighteously and selfishly will surely suffer premature misfortune.
This chapter discusses how human Zang-Fu Yin-Yang and the Qi and Blood of the meridians originate from Heaven and Earth, having both a beginning and an end. The *Wu Yun Da Lun* states: The East generates Wind; Wind generates Wood; Wood generates Sour flavor; Sour flavor generates the Liver. The South generates Heat; Heat generates Fire; Fire generates Bitter flavor; Bitter flavor generates the Heart. Cold, Wind, Summer-heat, Dampness, Dryness, and Heat are the Six Qi of Heaven. Wood, Fire, Earth, Metal, and Water are the Five Phases of Earth. Heaven nourishes humans with the Five Qi, and Earth nourishes humans with the Five Flavors. Thus, the Six Qi of Heaven transform into the Five Phases and Five Flavors of Earth, which in turn generate the Five Zang organs of humans. Internally, the Five Zang organs combine with the Six Fu organs to correspond to the Five Phases of Earth; externally, they combine with the Six Meridians to correspond to the Six Qi of Heaven. Hence, it is said that by clearly understanding Zhong Shi, the Five Zang organs serve as the guideline, meaning that human Five Zang organs fundamentally correspond to the transformations of the Five Phases. Let me speak of Zhong Shi. The meridians serve as the guideline. Whether the body is balanced or imbalanced, the Way of Heaven is complete. This refers to the fact that human meridians correspond to the Six Qi of Heaven. The conclusion states: When the Taiyang meridian ends, symptoms include upward staring eyes and opisthotonos; when the Taiyin meridian ends, symptoms include abdominal fullness and inability to breathe. This demonstrates that human Yin-Yang Qi and Blood begin with the generation by the Five Phases of Earth and the Six Qi of Heaven, and end with the Six Meridians of Earth and the Six Qi of Heaven. It is therefore said, "Its generation is five, its number is three," referring to generation from the Five Phases and ending with the numbers of Three Yin and Three Yang. Yin governs the Zang, and Yang governs the Fu, representing the mutual combination of Zang-Fu Yin-Yang. Yang receives Qi at the four extremities, receiving Heavenly Qi from the exterior; Yin receives Qi in the Five Zang organs, receiving Earthly Qi from the interior. Thus, the reducing method goes against the outward movement of Yin Qi, and the tonifying method follows the inward interaction of Yang Qi. Therefore, it is said that knowing Ying and Sui allows the Qi to be harmonized. The method to harmonize Qi must pass through Yin and Yang.
Respectfully following the Way of Heaven, let us discuss Zhong Shi. Zhong Shi refers to the meridians serving as the guideline. By holding the Maikou (Cunkou pulse) and Renying pulse, one can determine the excess or deficiency of Yin and Yang, and whether the state is balanced or imbalanced, thus completing the knowledge of the Way of Heaven. A so-called "Ping Ren" (normal/healthy person) does not suffer from disease. Such a person's Maikou and Renying pulses correspond to the Four Seasons, moving up and down in response to each other and flowing together. The pulses of the Six Meridians do not show knotting or restlessness. The root and branch, cold and warmth, guard and manage each other. The form, flesh, Qi, and Blood must be proportional. This is called a Ping Ren. A person with "Shao Qi" (deficient Qi) has both Maikou and Renying pulses that are weak and do not correspond to the standard measurements. In such cases, both Yin and Yang are deficient. Tonifying Yang would exhaust Yin, and reducing Yin would cause Yang to collapse. For such individuals, sweet herbs may be used for regulation, but potent/decocted strong medicines should not be drunk. Moxibustion should not be applied. If the condition persists and one proceeds to reduce, the Qi of the Five Zang organs will be damaged.
Respectfully following the Way of Heaven, let us discuss Zhong Shi, which means that Yin-Yang meridians correspond to the Six Qi of Heaven. Blood vessels originate from the generation of the Five Zang and Five Phases and externally combine with the Yin-Yang Six Qi. There is a beginning and an end to the meridians; hence, Zhong Shi is defined by the meridians as the guideline. By examining the Maikou and Renying pulses, one knows the excess or deficiency of Yin and Yang, and balance or imbalance. Generally, diagnosing the pulse is to observe the Qi. Corresponding to the Four Seasons means that the Qi of Spring and Summer moves from left to right, while the Qi of Autumn and Winter moves from right to left. Therefore, during Spring and Summer, the Renying pulse is slightly larger, and during Autumn and Winter, the Qikou pulse is slightly larger. This is called a Ping Ren. "Up and down responding" refers to corresponding to the Six Qi of Heaven, circulating continuously without cessation. The pulses of the Six Meridians follow the flow of Qi without knotting or restlessness. "Root and branch" refers to the entry and exit of Ben and Biao; "Cold and Warmth" refers to responding to the coming and going of Cold and Heat, each guarding its position. "Form, flesh, Qi, and Blood" refers to the Qi and Blood outside the vessels and the pulses of the Six Meridians, which must be proportional. Maikou and Renying are used to observe the Qi of Three Yin and Three Yang. Thus, in cases of Shao Qi, both Maikou and Renying are weak. The Chi position observes Yin, and the Cun position observes Yang. Not corresponding to the Cun-Chi standards indicates deficiency of Yin and Yang Qi, yet appearing in the Cun-Chi pulses. Sweet herbs regulate the Stomach because the Qi of Three Yin and Three Yang originates from the Middle Jiao Stomach organ. It is appropriate to tonify the source of generating Qi and the flow of the Dao. Therefore, one should not consume overly cloying sweet substances, as excessive sweetness leads to stagnation in the Middle Jiao. Moxibustion is contraindicated because the insufficiency of Yin and Yang Qi is external, not due to sinking of the meridians. Reducing in such cases would damage the Qi of the Five Zang organs, as the Six Qi generate the Five Phases, and the Five Phases present to the Six Qi, with Five and Six combining appropriately.
If the Renying pulse is one-fold stronger than the Cunkou, the disease is in the Foot Shaoyang meridian; if one-fold stronger and restless, it is in the Hand Shaoyang meridian. If two-fold stronger, the disease is in the Foot Taiyang meridian; if two-fold stronger and restless, it is in the Hand Taiyang meridian. If three-fold stronger, the disease is in the Foot Yangming meridian; if three-fold stronger and restless, it is in the Hand Yangming meridian. If four-fold stronger, large and rapid, it is named Yi Yang (Overflowing Yang), also known as Wai Ge (External Grid). If the Maikou pulse is one-fold stronger than the Renying, the disease is in the Foot Jueyin meridian; if one-fold stronger and restless, it is in the Hand Jueyin (Pericardium) meridian. If two-fold stronger, the disease is in the Foot Shaoyin meridian; if two-fold stronger and restless, it is in the Hand Shaoyin meridian. If three-fold stronger, the disease is in the Foot Taiyin meridian; if three-fold stronger and restless, it is in the Hand Taiyin meridian. If four-fold stronger, large and rapid, it is named Yi Yin (Overflowing Yin), also known as Nei Guan (Internal Closure). If Nei Guan is blocked, death is inevitable and untreatable. If both Renying and Taiyin Maikou are more than four-fold stronger, it is called Guan Ge (Grid and Closure). Patients with Guan Ge have a short life expectancy.
The left side is Renying, and the right side is Qikou, used to observe the Qi of Three Yin and Three Yang. The Sage faces south. The front is called Guang Ming, and the back is called Tai Chong. Left is East, Right is West. The Way of Heaven rotates clockwise, and the Way of Earth moves counter-clockwise. Therefore, the left observes Yang and the right observes Yin. Restlessness is a dynamic image within Yin. Generally, the Six Qi are born from Yin and emerge from the Earth, so they correspond only to the Foot Six Meridians. Where there is restlessness in the Hand meridians, it corresponds to the Six Zang and Six Fu organs and the Twelve Meridians. The Twelve Meridians correspond to the Qi of Three Yin and Three Yang, not merely divided between Hand and Foot by the Six Qi. Wai Ge means Yang is excessive on the exterior without Yin to harmonize it. Nei Guan means Yin is excessive on the interior without Yang to harmonize it. Guan Ge means Yin is closed inside and Yang is repelled outside. Explainers state: Maikou belongs to Taiyin, and Renying belongs to Yangming. Visceral Qi cannot reach the Hand Taiyin lung meridian on its own; it must rely on Stomach Qi to arrive. Thus, both left and right belong to Taiyin and possess Yangming Stomach Qi. Since Yang Qi moves from left to right and Yin Qi moves from right to left, the left observes Three Yang and the right observes Three Yin. This does not mean the left solely governs Yang and the right solely governs Yin. Yin contains Yang, and Yang contains Yin; this is a Ping Ren. If the left solely governs Yang and the right solely governs Yin, it is a fatal sign of Guan Yin Ge Yang.
If Renying is one-fold stronger, reduce the Foot Shaoyang and tonify the Foot Jueyin. Two reductions and one tonification, performed once daily. One must palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. If Renying is two-fold stronger, reduce the Foot Taiyang and tonify the Foot Shaoyin. Two reductions and one tonification, performed every two days. Palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. If Renying is three-fold stronger, reduce the Foot Yangming and tonify the Foot Taiyin. Two reductions and one tonification, performed twice daily. Palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. If Maikou is one-fold stronger, reduce the Foot Jueyin and tonify the Foot Shaoyang. Two tonifications and one reduction, performed once daily. Palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. If Maikou is two-fold stronger, reduce the Foot Shaoyin and tonify the Foot Taiyang. Two tonifications and one reduction, performed every two days. Palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. If Maikou is three-fold stronger, reduce the Foot Taiyin and tonify the Foot Yangming. Two tonifications and one reduction, performed twice daily. Palpate to verify, disperse Qi in the upper regions, and stop when the Qi harmonizes. The reason for twice-daily treatment is that Yangming governs the Stomach, which is rich in Grain Qi, allowing for frequent treatment. If both Renying and Maikou are more than three-fold stronger, it is called Yin Yang Ju Yi (Both Yin and Yang Overflowing). If such blockage is not opened, blood vessels become obstructed, Qi cannot flow, and it overflows internally, damaging the internal Zang organs. Applying moxibustion in such cases would lead to other diseases.
Tonification and reduction aim to balance Yin and Yang Qi. Two reductions of Yang and one tonification of Yin reflect that Yang is often in excess and Yin is often deficient. Two tonifications of Yang and one tonification of Yin reflect that Yang can be abundant but Yin should not be. Thus, Yi Yang is not termed fatal, but Yi Yin is deemed fatal and untreatable. Palpation is necessary to verify the Qi of Three Yin and Three Yang via Renying and Qikou. The character "Shu" (disperse) should be read as "Zao" (restless). Meaning that if one-fold or two-fold stronger with restlessness, one should treat the Hand Yin-Yang meridians. Yangming governs the Stomach and is rich in Grain Qi, hence twice-daily treatment is possible. The Qi of Three Yin and Three Yang is generated by Yangming Grain and Water. If Renying and Maikou are both strong, it is called Yin Yang Ju Yi. Yin excess inside leads to Yang excess outside; Yang excess on the left leads to Yin excess on the right. Without needle intervention to open the blockage, blood vessels close, Qi stagnates, and internal damage occurs. Excess requires reduction, deficiency requires tonification, and sinking requires moxibustion. Here, the Yin-Yang Qi is imbalanced due to excess, not sinking; thus, moxibustion would cause other diseases.
The principle of all acupuncture is to stop when the Qi is harmonized. Tonifying Yin and reducing Yang enhances voice and breath, making ears and eyes sharp. The opposite results in stagnant Qi and Blood.
This section explains that the Qi of Three Yin and Three Yang originates from the Five Zang organs. Hence, understanding Zhong Shi makes the Five Zang organs the guideline. Acupuncture stops when Qi is harmonized, meaning after treating Yin-Yang excess. However, one must tonify Yin and reduce Yang. Tonifying Yin involves tonifying the interior Yin of the Five Zang; reducing Yang involves guiding the exterior exit of the Six Qi. The *Liu Jie Zang Xiang Lun* states: Five Qi enter the nose, store in the Heart and Lung, brighten the complexion, and clarify the voice. The *Shun Qi Pian* states: Sounds correspond to Late Summer. Tonifying visceral Yin harmonizes the Qi of the Heart, Lung, and Spleen, enhancing voice. The Liver opens into the eyes, and the Kidney opens into the ears. Abundant Qi in the Liver and Kidney sharpens vision and hearing. Tonifying visceral Yin and guiding Qi out harmonizes Three Yin and Three Yang, preventing excess. Yin-Yang Qi and Blood originate from the Stomach and Five Zang. The Stomach is the Sea of Grain, Qi, and Blood. Just as the sea clouds the world, the Jing-Sui (Meridian Channels) are where Qi and Blood exit the Stomach. Jing-Sui are the great collaterals of the Five Zang and Six Fu organs. Without tonifying Yin and reducing Yang, Qi and Blood cannot flow.
Regarding "Qi arrival brings efficacy": After reduction, the patient becomes more deficient; the pulse may be large as before but not firm. If it remains firm, although the patient feels relief, the disease persists. After tonification, the patient becomes more solid; the pulse is large as before and becomes firmer. If it is large but not firm, although the patient feels comfort, the disease persists. Thus, tonification leads to solidity, reduction leads to emptiness. Pain may not vanish immediately with the needle, but the disease will certainly recede. One must first understand the diseases generated by the Twelve Meridians to apply Zhong Shi. Thus, Yin and Yang do not shift, deficiency and excess do not tilt, and treatment is taken from the meridians themselves.
This section discusses tonifying and reducing the Qi of Three Yin and Three Yang, waiting for meridian harmony. Zhong Shi uses meridians as the guideline. Reduction removes excess and benefits deficiency. "Jian" (firm) means solid. Deficiency is a pulse large as usual but not firm. If firm as usual, though the patient reports harmony, the disease remains. Tonification benefits solidity. Solidity is a pulse large as usual and firmer. If large but not firm, though the patient feels comfortable, the meridian disease remains. Disease starts in the Shi Dong (Moving) aspects of Three Yin and Three Yang and gradually affects the meridian-generated diseases. Qi arrival efficacy applies when needling the Qi aspect of Three Yin and Three Yang; even if the meridian doesn't change immediately, the disease recedes due to meridian Qi resonance. Thus, one must understand diseases of the Twelve Meridians first. If Yin-Yang do not shift and deficiency-excess do not tilt, treat the meridian. "No deficiency, no excess, take from the meridian" implies that when Yin-Yang Qi has no deficiency or excess, the pulse should harmonize. If the pulse is discordant, it is a disease of the meridian, so treat the meridian. "Pulse large as usual" means Yin-Yang Qi has returned to normal without excess or deficiency. Firmness or lack thereof indicates the meridian-generated disease is not yet resolved. Explainers say: First is Shi Dong, then the generated disease. This moves from Qi to Meridian.
There are three categories of acupuncture. Needling reaches Gu Qi (Grain Qi). Pathogenic deviations combine randomly, Yin and Yang exchange positions, reverse and forward oppose, floating and sinking differ, and Four Seasons are lost. Stagnant and wandering pathogens require needles to remove them. The first needle expels Yang pathogens; the second expels Yin pathogens; the third brings Gu Qi. Stop when Gu Qi arrives. Gu Qi arrival means the deficient has been tonified to solidity and the excess has been reduced to emptiness. If only pathogenic Qi leaves while Yin and Yang remain unharmonized, the disease still heals. Thus, tonification brings solidity, reduction brings emptiness. Pain may not cease with the needle, but the disease will recede.
This continues the previous text on removing Yin-Yang excess pathogens and regulating meridians. Gu Qi is Ying-Wei Qi and Blood, generated from Grain Essence, referring to Meridian Qi. Yang and Yin pathogens are imbalanced Qi. Pathogenic deviations combine with Qi, causing Yin-Yang disharmony. Reverse and Forward refer to Skin Qi flowing from arm/elbow to wrist front, and Meridian Qi flowing from finger wells to wrist back. Disease reverses this. Floating/Sinking differences mean Yin-Yang Qi does not match meridians. Loss of Four Seasons means loss of ascending/descending/floating/sinking dynamics. Pathogenic deviation in Yin-Yang Qi causes meridian disharmony. First needle expels Yang pathogens, second expels Yin pathogens, harmonizing Yin-Yang. Third needle brings Gu Qi, harmonizing Meridian Blood-Qi. Tonifying Three Yang deficiency makes Yang pulses solid; reducing Three Yin excess makes Yin pulses empty. Tonifying Three Yin deficiency makes Yin pulses solid; reducing Three Yang excess makes Yang pulses empty. Thus, Gu Qi arrival means pulse harmony. If only Qi-level pathogens leave, even if meridians are unharmonized, the disease heals. As stated, tonification brings solidity, reduction brings emptiness. Pain may not cease with the needle, but the disease will recede. The *Guan Zhen Pian* states: Superficial needling exits Yang pathogens; deeper needling exits Yin pathogens without reaching muscle fascia. Reaching muscle fascia brings Gu Qi. Gu Qi is reached in skin and fascia, not in vessels. Thus, pain responds to needling in skin affecting meridians, not needling in meridians causing pain. Explainers say: Meridian Blood-Qi comes from Grain. Disease in Three Yin/Yang Qi is treated by tonifying/reducing to harmonize Qi, but meridians remain unharmonized until Gu Qi arrives. Hence, three types of needling.
If Yin is excess and Yang is deficient, first tonify Yang, then reduce Yin to harmonize. If Yin is deficient and Yang is excess, first tonify Yin, then reduce Yang to harmonize.
This re-discusses harmonizing Yin-Yang in meridians. "Excess reduce, deficiency tonify" harmonizes Three Yin/Yang Qi. "No deficiency, no excess, take from the meridian" means when Yin-Yang Qi is harmonized without bias, but meridians remain unharmonized, treat the meridians. Meridian Blood-Qi originates from Zang-Fu, so first tonify righteous deficiency, then reduce pathogenic excess. Explainers say: Previous sections discussed harmonizing Qi with unharmonized meridians, and skin needling to bring Gu Qi. This section discusses taking from the meridians.
Three pulses move between the big toes. Examine their excess or deficiency. Reducing deficiency is called "Chong Xu" (Double Deficiency), worsening the disease. When needling these, press with fingers. If pulsating, solid, and rapid, reduce quickly. If weak and slow, tonify. Opposite actions worsen the disease. Their movements are: Yangming above, Jueyin middle, Shaoyin below.
This chapter discusses how Three Yin/Yang Qi originates from Five Zang/Five Phases, which are generated by post-natal Grain Essence and pre-natal Water/Fire. Water generates Wood, Fire generates Earth/Metal. Previous sections discussed observing Three Yin/Yang Qi via Renying/Qikou, originating from Yangming Grain, exiting skin via Zang meridians. This re-discusses Five Phase Qi originating from pre-natal Kidney, descending to Qi Street, dispersing in skin, rising again. The *Ben Jing Dong Shu* states: Chong Mai is the Sea of Twelve Meridians. Together with the great collateral of Shaoyin, it originates in the Kidney, descends to Qi Street, follows inner thigh, enters popliteal fossa, follows inner tibia, runs with Shaoyin, enters behind medial malleolus, enters sole. Its branch enters ankle, emerges on dorsum, enters between big toe, nourishes collaterals to warm legs. Pre-natal Water/Fire Qi descends to Qi Street. Yang Qi rises from dorsal toes; Yin Qi rises from plantar toes. This Water/Fire Yin-Yang Qi disperses from Qi Street to toes. Branches enter ankle, emerge on dorsum, enter between big toes. Pre-natal Water/Fire transforms into Five Phase Qi, flows with Chong Mai and Shaoyin collateral to big toe, then ascends. Shaoyin below represents Heavenly One Water and Earthly Two Fire. Jueyin middle represents Heavenly Three Wood. Yangming center Earth governs Autumn Metal Qi. Yangming above represents Earthly Four Metal and Heavenly Five Earth. This states Five Zang/Five Phase Qi generates Middle Jiao Yangming, starting from Lower Jiao Shaoyin. Ascending Qi exits Yangming to Chi Skin; descending Qi exits Shaoyin to big toe.
Back-Shu points correspond to Back and Shoulders; Chest-Shu points correspond to Chest. Treat deficiencies in the upper regions. For double tongue, needle the tongue pillar with a Bi Needle. Inability to flex but ability to extend indicates disease in Jin (Sinews); inability to extend but ability to flex indicates disease in Gu (Bones). Treat Bones by focusing on Bones, treat Sinews by focusing on Sinews.
Skin, flesh, sinews, and bones are external combinations of Five Zang, belonging to Qi outside vessels. This continues discussing Five Phase Qi rising from feet. For deficiencies, treat accordingly. "Treat" means welcoming Qi outward. Wei Shu is in chest, Pi Shu beside chest, Fei Shu on back/shoulder. Heart orifice is tongue, Liver Qi is sinews, Kidney Qi is bones. Deficient Zang Qi is treated according to location. Master Yu says: This discusses Qi outside vessels, so Heart mentions tongue but not pulse. This chapter focuses on generation/start/end/input/output of Five Phases/Six Qi, titled Zhong Shi. Needling instructions mention treating deficiencies, using Bi Needle, focusing on bone/sinew. Readers should ponder this. Zhang Kaizhi says: Previous section mentioned Shaoyin below, Yangming above, referring to numbers starting from one and ending at five.