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Huangdi asked Bogao: When pathogenic factors invade the human body, sometimes they cause the eyes to remain open and prevent sleep. What qi causes this?

This chapter discusses the movement of Wei Qi (Defensive Qi) inside and outside the body, and Zong Qi (Gathering Qi) inside and outside the meridians. The qi moving inside the vessels travels with Ying Qi (Nutritive Qi); the qi moving outside the vessels turns with Wei Qi. The internal and external aspects naturally move in mutual opposition and harmony. Xu Zhengong said: This chapter uses the metaphor of pathogenic factors invading to clarify the movement of Wei Qi and Zong Qi; hence the chapter is named "Evil Invading" (Xie Ke). However, the canonical text primarily discusses the movement of healthy qi.

Bogao replied: When grains enter the stomach, their dregs, fluids, and Zong Qi are divided into three pathways. Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart vessels, and governs respiration. Ying Qi secretes its fluids, injects them into the vessels, transforms them into blood, nourishes the four extremities, and internally irrigates the five zang and six fu organs, corresponding to the time intervals marked by water clocks. Wei Qi is its fierce, rapid, and slippery aspect; it moves first in the four extremities, between the muscle divisions and skin, without resting. During the day, it moves in the Yang aspects; at night, it moves in the Yin aspects. It frequently passes through the sectors of Foot-Shaoyin and moves among the five zang and six fu organs. Now, if Jue Qi (Rebellious Qi) invades the five zang and six fu organs, then Wei Qi alone guards the exterior, moving in Yang and unable to enter Yin. Moving in Yang makes Yang qi abundant; when Yang qi is abundant, the Yang Qiao vessel becomes excessive (or sunken/deficient in function relative to Yin, though Xu Zhengong suggests "sunken" might be an error for "excessive" based on the *Da Huo* chapter), preventing entry into Yin. Due to Yin deficiency, the eyes cannot close.

This section discusses how Zong Qi and Ying Qi move within the vessels, corresponding to respiration and water clock intervals, while Wei Qi moves outside the vessels, traveling in Yang during the day and Yin at night. The blood and qi in the skin and meridians move in alternating opposition and harmony. According to the *Wu Wei* chapter: The great qi that gathers and does not move accumulates in the chest, is called the Sea of Qi, emerges from the Lung, follows the throat, so exhalation sends it out and inhalation draws it in. This is Zong Qi following Lung qi to move in the skin; upon exhalation, the qi exits, and all 84,000 hair pores close; upon inhalation, the qi enters, and all 84,000 hair pores open. This chapter discusses Zong Qi penetrating the Heart vessels to govern respiration. The Heart vessels refer to the vessels of the Hand-Jueyin Pericardium. The Pericardium governs the vessels, moving from the Heart vessels into the sixteen meridians. In one breath cycle (one xi), the vessels move six cun. Over a day and night of 13,500 breath cycles, the vessels move 810 zhang, completing one full circuit of fifty Ying cycles. This shows that both Zong Qi and Ying Qi are half-nourished within the vessels and half-moving outside them. Wei Qi is fierce, rapid, and slippery, moving alone outside the vessels, in Yang during the day and Yin at night, governing the opening and closing of day and night. Moving in Yang causes the eyes to open and the body to rise; moving in Yin causes the eyes to close and the body to lie down. If Jue Qi invades the five zang and six fu organs, Wei Qi guards the exterior alone, moving in Yang and unable to enter Yin, thus causing insomnia. I note: The discussion of Wei Qi being unable to enter Yin leading to insomnia appears repeatedly, but each instance has its specific meaning; students should analyze them clearly. Xu Zhengong said: The *Da Huo* chapter states: "When Wei Qi cannot enter Yin, Yang qi becomes full; when Yang qi is full, the Yang Qiao vessel becomes excessive." The character "sunken" (xian) in this chapter is suspected to be an error.

Huangdi said: Excellent. How should it be treated? Bogao said: Tonify what is deficient, drain what is excessive, regulate deficiency and excess, unblock the pathways, and eliminate the pathogen. Administer one dose of Banxia Tang (Pinellia Decoction). Once Yin and Yang are unblocked, sleep will resume immediately. Huangdi said: Excellent. This is what is meant by clearing blockages, achieving thorough meridian circulation, and harmonizing Yin and Yang. I wish to hear the prescription. Bogao said: For the decoction, use eight sheng of flowing water from a distance of a thousand li, stir it ten thousand times, and take five sheng of the clear water for boiling. Cook it using reed fire. When the water boils, add one sheng of Shumi (Sorghum) and five he of processed Banxia (Pinellia Tuber). Simmer slowly until only one and a half sheng remains. Remove the dregs. Drink one small cup, three times a day, gradually increasing the dosage until the desired effect is achieved. Therefore, for newly onset diseases, sleep comes as soon as the cup is set down, and sweating indicates recovery; for chronic cases, three doses are sufficient. (Shumi sounds like 'shu', it is the glutinous variety of Ji/Sorghum).

This section discusses regulating the qi of Foot-Shaoyin and Foot-Yangming to facilitate the internal movement of Wei Qi. Generally, Wei Qi moving in Yin descends from the Hand and Foot Yangming meridians to the foot, intersects with Foot-Shaoyin, and from Foot-Shaoyin irrigates the five zang and six fu organs. Therefore, one must regulate the qi of these two meridians. Tonifying deficiency means tonifying deficient Wei Qi; draining excess means draining excessive Jue Qi; regulating deficiency and excess aims to balance internal and external conditions, unblock pathways, and remove rebellious pathogens. Banxia is white and round, sweet and pungent, belonging to the Yangming category. The Monthly Ordinances state that Pinellia grows in the fifth month, born from sensing a yin qi. The Stomach belongs to Wu Earth, and the Kidney stores Tian Gui (Heavenly Water/Essence). One dose of Banxia Tang initiates a yin qi, sending it upward to the Stomach; Wu and Gui combine to transform into Fire and Earth qi, thereby unblocking internal and external Yin and Yang, allowing immediate sleep. This is described as clearing blockages, achieving thorough meridian circulation, and harmonizing Yin and Yang. The Kidney is a Water organ and the source of generating qi; when qi moves, water disperses. The Stomach is a dry-heat organ governing Central Earth, desiring Yin-Yang harmonization but not the invasion of cold water. Hence, water from a thousand li away, known as Labor Water (Lao Shui), is used. Stirring it ten thousand times renders the water's nature powerless, preventing it from assisting cold water from rising. Eight is the completion number of Metal; Five is the generation number of Earth. Yangming governs Autumn Metal, and the Stomach occupies Central Earth; thus, using eight sheng and five sheng assists Yangming Stomach qi. Reeds are aquatic plants; cooking with reed fuel assists the vital qi within water. Grain is earth produce ripening in autumn; adding one sheng of Shumi assists Stomach qi. In ancient times, harmony in the abdomen and free urination were signs of efficacy. Sleeping immediately after drinking and sweating indicate that healthy qi is harmonized, rebellious qi has scattered, and Wei Qi can enter and exit freely. Xu Zhengong said: Jue Qi is the rebellious qi of the zang and fu. Qi originates from Foot-Shaoyin Kidney and is generated by Foot-Yangming Stomach. Therefore, regulating the qi of these two meridians resolves the rebellious qi. "Yin and Yang are already unblocked" and "Yin and Yang are harmonized" refer respectively to the Yin and Yang traveled by Wei Qi internally and externally, and the Yin and Yang of Shaoyin and Yangming, which interact harmoniously.

Huangdi asked Bogao: I wish to understand how human limbs and joints correspond to Heaven and Earth. Bogao answered: Heaven is round and Earth is square; the human head is round and feet are square to correspond. Heaven has the sun and moon; humans have two eyes. Earth has nine provinces; humans have nine orifices. Heaven has wind and rain; humans have joy and anger. Heaven has thunder and lightning; humans have voice and sound. Heaven has four seasons; humans have four limbs. Heaven has five tones; humans have five zang organs. Heaven has six laws (pitch pipes); humans have six fu organs. Heaven has winter and summer; humans feel cold and heat. Heaven has the Ten Heavenly Stems; humans have ten fingers. Earth has twelve earthly branches; humans have ten toes, the penis, and scrotum to correspond. Women lack these two segments, conforming to the human form. Heaven has Yin and Yang; humans have husband and wife. A year has 365 days; humans have 360 joints. Earth has high mountains; humans have shoulders and knees. Earth has deep valleys; humans have axillae and popliteal fossae. Earth has twelve rivers; humans have twelve main meridians. Earth has spring veins; humans have Wei Qi. Earth has grasses; humans have fine hairs. Heaven has day and night; humans have sleeping and waking. Heaven has constellations; humans have teeth. Earth has small hills; humans have minor nodes. Earth has rocks; humans have prominent bones. Earth has forests; humans have Mu Jin (gathered sinews). Earth has clustered towns; humans have flesh. A year has twelve months; humans have twelve joints. Earth has places where grass does not grow in four seasons; humans have infertility. These are ways in which humans correspond to Heaven and Earth.

This section discusses how the human body, limbs, zang-fu, and Yin-Yang correspond to the sun, moon, stars, mountains, rivers, trees, and grasses of Heaven and Earth, indicating that humans participate in the triad of Heaven, Earth, and Humanity. Wei Qi moves in Yang during the day and Yin at night, corresponding to the celestial sphere's rotation around the Earth, completing 365 degrees in a year. The sun, moon, and five planets follow the celestial orbit; wind, rain, thunder, and lightning execute according to heavenly weather; mountains, springs, and valleys are covered by heaven; trees and grasses grow sensing heavenly qi. Wei Qi moves in Yang during the day, ascending to the head, eyes, mouth, and teeth, descending to the calves, knees, and surrounding limbs, muscles, skin, and hair; at night, it moves in Yin, circulating internally through the five zang and six fu organs, steaming the Mu Jin, and filling the chest and abdomen. The human body and zang-fu correspond to the descent and ascent of the Six Qi and the entry and exit of the Five Movements. The movement of Wei Qi corresponds to the earth's rotation and penetration through the ground. Thus, it is said that just as there are spring waters on earth, there is Wei Qi in humans. This shows that Wei Qi not only moves inside and outside the body but also penetrates inside and outside the meridians. Xu Zhengong said: Earth has grasses, humans have fine hairs. Women's menstruation arriving on time reflects the leaching of blood from the skin and hair. Men with weak Chong and Ren vessels and undeveloped Zong Jin do not grow beards, analogous to grass not growing in four seasons, corresponding to male infertility. Qiu Rulin said: There was an ancient grass with thirty leaves on one stem; one leaf falls at sunset. If the moon is small, twenty-nine leaves fall, corresponding to women's timely menstruation.

Huangdi asked Qibo: I wish to learn the principles of holding the needle, the rationale of insertion, the meaning of yielding and withholding, how to open the skin and interstices, the bends and turns of the vessels, where they emerge, where they stop, where they move slowly, where they move quickly, and where they enter deeply. I wish to hear completely about the acupoints of the six fu organs on the body, briefly describing their separation points. How do separated vessels enter Yin and separate vessels enter Yang? Through what pathway do they travel? I wish to hear the methods fully. Qibo said: The questions posed by the Emperor encompass the entirety of needle therapy. Huangdi said: Please let me hear them completely.

This section asks about the principles of acupuncture while simultaneously inquiring about the movement of blood and qi inside and outside the skin and meridians, including points of entry, exit, arrival, cessation, and separation. Skin and interstices are the qi aspect outside the vessels. The bends and turns of the vessels, where they emerge and stop, refer to the arrival, cessation, entry, and exit of blood and qi moving inside and outside the meridians. The rationale of needle insertion involves how to achieve these arrivals, cessations, speeds, and slownesses. The acupoints of the six fu organs on the body are the roots and tips of the Hand and Foot Three-Yang meridians. Separation points refer to where meridians branch off and emerge at the Qi Street. Skin is Yang, vessels are Yin. "Separating to enter Yin" means blood and qi outside the vessels leave the skin to enter the vessels. "Separating to enter Yang" means blood and qi inside the vessels leave the vessels to enter the skin. Through what pathway do they travel? Qibo stated that the Emperor's question concerns the circulation of Yin-Yang and blood qi. Knowing the internal and external aspects of blood qi allows one to know how to use needles. Qiu Rulin said: This clarifies the operational entry and exit of blood qi through needle therapy. Acupuncture and blood qi circulation both accord with the Great Dao of Heaven and Earth.

Qibo said: The Hand-Taiyin Lung Meridian emerges from the tip of the thumb, curves inward, follows the edge of the white flesh to Taiyuan behind the proximal joint, stays to allow seepage, curves outward, ascends below the proximal joint, curves inward, and meets the Yin collaterals at Yuji. Multiple vessels converge here, making the qi slippery. It lies hidden under the olecranon, curves outward, emerges at Cun Kou and moves upward to the medial elbow, enters below the large tendon, curves inward, ascends to the axilla, curves inward, and goes to the Lung. This is the bending and turning of forward movement and reverse counting.

This section separately discusses Zong Qi outside the vessels, following the Hand-Taiyin meridian, moving forward but counted in reverse. Zong Qi moving outside the vessels emerges from Lung qi, hence its qi is slippery. It lies hidden under the olecranon, curves outward, emerges at Cun Kou and moves. Curving outward, it ascends below the proximal joint, staying to seep into the skin and hair. The Hand-Taiyin Lung Meridian emerges from the thumb tip, curves inward, follows the white flesh edge to Taiyuan behind the proximal joint, curves inward, and meets the Yin collaterals at Yuji. Multiple vessels converge, ascending to the medial elbow, entering below the large tendon, curving inward, ascending to the axilla, curving inward, and going to the Lung. This is the Lung meridian moving from the finger Jing point to the Lung. Zong Qi outside the vessels moves from the axilla above to Yuji. This is the bending and turning of forward movement and reverse counting.

The Hand-Jueyin Pericardium Meridian emerges from the tip of the middle finger, curves inward, follows the medial side of the middle finger, stays in the palm, lies hidden between two bones, curves outward, emerges between two tendons at the bone-muscle junction, its qi is slippery, ascends two cun, curves outward, moves between two tendons, ascends to the medial elbow, enters below the small tendon, stays at the meeting of two bones, ascends into the chest, and internally connects to the Heart and Lung.

This section separately discusses Zong Qi moving within the vessels, from the Pericardium meridian, nourishing the twelve meridians to correspond to respiration and water clocks. Its Zong Qi outside the vessels also bends and turns in the skin along the same meridian. Zong Qi emerging from the Lung and moving in the skin scatters outside the twelve meridians, each moving forward and backward along its own meridian. Thus, moving outside the Pericardium meridian, it curves outward between two tendons at the bone-muscle junction, its qi is slippery, ascends two cun of the arm, curves outward, and seeps into the skin and hair. The Hand-Jueyin Pericardium Meridian emerges from the middle finger tip, curves inward, follows the medial side, stays in the palm, lies hidden between two bones, moves between two tendons, ascends to the lateral elbow, enters below the small tendon, stays at the meeting of two bones, ascends into the chest, and internally connects to the Heart and Lung. This is also forward movement and reverse counting. Blood and qi outside the vessels are bounded by their respective meridians; thus, those inside the vessels bend within the vessels, and those outside bend outside along the meridian. The above two sections discuss Zong Qi accumulating in the chest, emerging from the Lung, moving in the skin regions of the twelve meridians to govern respiration and opening/closing, penetrating the Heart vessels, and nourishing the twelve meridians to correspond to respiration, demonstrating internal-external correspondence.

Huangdi said: Why does the Hand-Shaoyin Meridian alone have no Shu points? Qibo said: Shaoyin is the Heart meridian. The Heart is the great master of the five zang and six fu organs, the residence of the Spirit. Its organ is solid, and pathogens cannot invade it. If they invade, the Heart is damaged; if the Heart is damaged, the Spirit departs; if the Spirit departs, death occurs. Therefore, any pathogen affecting the Heart actually affects the Pericardium. The Pericardium is the meridian of the Heart Master. Thus, the Hand-Shaoyin Meridian alone has no Shu points.

This section explains the reason for Zong Qi penetrating the Heart vessels to govern respiration. Blood vessels are governed by the Heart. The Pericardium acts on behalf of the Heart's blood and qi. The Monarch is non-actionable, with the Spirit stored internally. The Pericardium, as the Minister, executes orders on behalf of the Monarch. The Spirit is stored internally, and the organ is solid, so pathogens cannot harm it. Damage to the Heart leads to death. Shaoyin is the Heart meridian. The Pericardium is the Heart Master's meridian. It has no Shu points because the Pericardium transmits blood and qi on its behalf.

Huangdi said: Does the Shaoyin Meridian, having no Shu points, never get sick? Qibo said: Its exterior meridian may be diseased while the interior organ remains healthy. Therefore, one only treats the meridian at the end of the sharp bone behind the wrist (Shenmen). The other vessel entrances, exits, bends, and turns, and their speeds, are all like the movement of the Hand-Shaoyin Pericardium meridian. Thus, the Ben Shu points are selected based on the deficiency or excess and speed of the qi. This is called draining according to the surge and tonifying according to decline. In this way, pathogens are eliminated, and true qi is fortified. This is called following the order of Heaven.

This section continues to explain why Shaoyin has no Shu points: the Spirit is stored internally and does not transmit blood and qi like other meridians, and the Shaoyin meridian circulates from exterior to interior. Therefore, when externally invaded by pathogens, one only selects Shenmen at the sharp bone behind the wrist, as the disease is in the exterior meridian but not the organ. The entrance, exit, bend, turn, speed, and slowness of the other twelve Hand and Foot meridians are all like the Hand-Shaoyin Pericardium meridian, meaning the twelve meridians are similar, and it is not that Shaoyin alone lacks Shu points. Selecting the Ben Shu points of Shaoyin is based on the deficiency or excess of healthy qi, not pathogens. If Heart qi is surging and excessive, drain it; if declining, tonify it. Since the Spirit is stored internally and the organ is solid, pathogens in the exterior meridian do not damage the interior. Thus, one only tonifies or drains the Shu points based on the strength or weakness of healthy qi. The *Ba Zheng Shen Ming Lun* states: Follow the order of Heaven, observe the times of fullness and emptiness, track the sunlight's position, stand upright, and wait. The Heart is the Supreme Yang within Yang and corresponds to the Sun. If declining, tonify it, waiting for the sun at its zenith; if surging, drain it, waiting for the sun to set.

Huangdi said: How should one hold the needle and decide whether to insert or withdraw? Qibo said: One must first clearly know the root and tip of the twelve meridians, the cold and heat of the skin, and the fullness, emptiness, slippery, and choppy nature of the pulse. A slippery and full pulse indicates the disease progresses daily; a deficient and thin pulse indicates a long-standing condition; a large and choppy pulse indicates Bi syndrome (painful obstruction). If Yin and Yang are identical (on both sides), the disease is difficult to treat; if the root and tip are still hot, the disease persists; if the heat has declined, the disease has gone.

Hold the Chi area (forearm inner surface) and examine the firmness or fragility, size, slippery or choppy texture, and cold, warm, dry, or damp nature of the flesh. Observe the five colors of the eyes to know the five zang organs and determine life and death. Examine the blood vessels and observe the colors to know cold, heat, and Bi syndrome.

This section discusses distinguishing pathogenic qi located inside or outside the skin and meridians, noting differences in entry, exit, fullness, and decline. Root and tip refer to the origins and endings of the twelve meridians, the flow and exchange of blood and qi. Cold and heat of the skin indicate pathogenic qi in the skin. Fullness, emptiness, slippery, and choppy pulses indicate pathogenic qi in the meridians. A slippery and full pulse means the disease advances daily within the meridians; a deficient and thin pulse means the disease lingers outside the vessels. Those outside are skin (Yang) and bones/muscles (Yin). A large and choppy pulse indicates cold-heat Bi syndrome. If Yin and Yang are identical on left and right, the disease is hard to treat, meaning superficial and deep layers (skin, bone, muscle) are all diseased. If the root and tip are still hot, the disease remains in the blood vessels; if the heat has declined, the pathogenic qi leaves with the blood and qi of the meridians via the Qi Street. The *Xie Qi Zang Fu Pian* states: Slippery pulse corresponds to slippery Chi skin; choppy pulse corresponds to choppy Chi skin. Thus, holding the Chi area and examining its firmness, size, slippery/choppy nature reveals the cold, warm, dry, or damp state of the skin and muscle divisions. The blood colors of the five zang manifest in the eyes; observing the five eye colors allows one to know the five zang and determine prognosis. Disease in the zang is half-dead, half-alive. Examining blood collaterals and skin/hair reveals the cold or heat of Bi syndrome. The *Pi Bu Lun* states: The twelve meridian networks are the skin regions. Blue color indicates pain; black indicates Bi; yellow-red indicates heat; white indicates cold; seeing all five colors indicates mixed cold and heat. This chapter discusses Ying, Wei, and Zong Qi, with Ying qi moving in and out of the meridians. Therefore, holding the needle and deciding insertion requires observing whether pathogenic qi is in the skin, meridians, or internal zang organs.

Huangdi said: Regarding holding the needle and deciding insertion, I do not yet understand its meaning. Qibo said: The principle of holding the needle requires seriousness, correctness, tranquility, and calmness. First know deficiency and excess, then apply speed and slowness. The left hand holds the bone; the right hand traces the meridian. Do not entangle the flesh. For draining, be serious and correct; for tonifying, close the skin. Use an auxiliary needle to guide the qi. Pathogens disperse, and true qi remains.

This section discusses nourishing true qi when needling blood vessels. True qi is received from Heaven, unmingled with grain qi, and fills the body. Yielding and withholding refer to following and opposing techniques. Not entangling the flesh means needling vessels without damaging muscle.

Huangdi said: How should one open the skin and interstices? Qibo said: Follow the muscle divisions. With the left hand, separate the skin. Gently and slowly insert the needle correctly. Ensure the Shen (Spirit) does not scatter, and the pathogen will be expelled.

This section discusses nourishing Shen qi when needling the skin. Shen qi is generated by the interaction of the two essences. The two Shens are the essence of Tian Yi (Heavenly Unity) and the postnatal essence of water and grain.

Huangdi asked Qibo: Humans have eight void areas (Ba Xu). How can they be used for diagnosis? Qibo answered: To diagnose the five zang organs. Huangdi said: How? Qibo said: The Lung...